For Some Planetary Pilgrims, "Fighting Cancer" is not an Appropriate Metaphor

Some time ago, I wrote about my understanding of spiritual care of persons who have been affected by cancer, either personally or as family members (June 25, 2011). One of my points had been that we often overuse the term "fighting cancer", or "staying positive". This overuse could create a perception that if the patient does not get better it must be because they did not fight hard enough, or because they "lost the battle".

Today's Globe and Mail, August 22, 2011 has published a relevant article, in reference to the death of Jack Layton, Leader of the New Democratic Party and the Leader of the Opposition in the Canadian Parliament.

I have found this article particularly meaningful and useful. It is certainly time to explore our understanding of cancer, and of persons who have cancer. Though many cancer patients see themselves as fighters in a battle, it may well be time for us to consider other metaphors. A look at way that Jack lived the last six months of his life, and a reading of his Lettter to Canadians, demonstrates that, really, he did not "lose" anything. In fact, Jack died of Cancer, and we have lost a great Canadian example, but his spirit soared as he encouraged us to choose love over anger, hope over fear, and optimism over despair,

In the spirit of respect for Jack's example, and in appreciation to the Globe and Mail, I would like to share the article in its entirety:

Jack Layton didn’t lose a fight: He died of cancer
CARLY WEEKS
From Tuesday's Globe and Mail , Published Monday, Aug. 22, 2011 4:56PM EDT
Last updated Tuesday, Aug. 23, 2011 8:20AM EDT

Did Jack Layton die from cancer because he didn’t fight the disease hard enough? Of course not.
Why, then, did so many headlines and social media messages spreading news of his passing Monday morning at age 61 announce that he had lost a battle with cancer?

Even Prime Minister Stephen Harper, in his statement about the opposition leader’s death, noted that Mr. Layton “gave his fight against cancer everything he had,” and that he “never backed down from any fight.”

It’s a common cliché, one many of us use when talking about a disease that is often feared and rarely understood.
But to those touched directly by cancer, equating the illness with a war against the enemy, fighting an adversary, or suffering in order to survive can diminish understanding of the challenges and complexities faced by patients and their families.

“The idea that he was waging a battle which he lost demeans him,” said Robert Buckman, a medical oncologist at Princess Margaret Hospital in Toronto. “I absolutely feel that he did not lose to an adversary.”

Many oncologists and cancer patients have been pushing in recent years for a change in the well-meant, but often misguided words and phrases that have become ingrained in the cancer lexicon.

The outpouring of emotion over Mr. Layton’s death provides an opportunity to ask whether it’s time to move beyond the militaristic metaphors and clichés.

A significant problem is that most of the common words and phrases we use to describe the experiences of people who have been diagnosed with cancer imply that personal will and self-control play a large part in determining who will live or die.

To say Mr. Layton lost his fight implies he had a say over his fate.

“He didn’t choose any of that any more than I could have chosen the colour of my eyes: It’s that arbitrary,” Dr. Buckman said. “It’s a much more mature and helpful comment to say this man, faced with a rotten hand of cards, as it were, really gave meaning to his life and to what he did in his life.”

London-based writer Mike Marqusee, who has discussed his experiences with multiple myeloma in several pieces in The Guardian, says cancer has little to do with battle. “The [emphasis] on cancer patients’ ‘bravery’ and ‘courage’ implies that if you can’t ‘conquer’ your cancer, there’s something wrong with you, some weakness or flaw,” Mr. Marqusee wrote in 2009. “If your cancer progresses rapidly, is it your fault? Does it reflect some failure of willpower?”

Similarly, saying someone who is now cancer-free is a “survivor” conveys that he or she is somehow better than the people who didn’t make it, said Peter Ellis, staff medical oncologist at the Juravinski Cancer Centre in Hamilton, Ont.

“It does set up a battle with a winner and a loser, and I think that some people certainly think that there would be better ways of talking about this,” said Dr. Ellis, who is also an associate professor in the department of oncology at McMaster University.

Instead of fixating on the idea of a cancer battle, Dr. Ellis and a growing number of experts in the field say, it is more important to focus on learning to live with cancer.

For those undergoing treatment, this can be much more empowering than the idea they can somehow control the ultimate outcome if they fight hard enough.

It is the attitude that gets Barb Rowe-Bennett through each day. The 64-year-old Toronto resident, who has had cancer off and on for nearly 20 years, is in the last stages of palliative care after her breast cancer metastasized, or spread, to her bones and lungs.The medication she is taking keeps her comfortable and enables her to leave the house, spend time with family and enjoy each day as it comes.

Ms. Rowe-Bennett doesn’t see herself as a “survivor” even though she has managed to outlast the cancer thus far; nor does she feel she has been cursed by bad luck because the disease is still with her.

“I just feel that cancer is an interference in your life, and you have a choice of making it good or bad,” she said. “You can bring yourself down, and it can be the worst of the worst, or you can say ‘I can carry on, I will deal with [it] on a daily basis.’ ”

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Thanks for reading the article. This is not to say that having cancer is not a devastating struggle; it is! But it is also something over which we do not have so much control. Winning and losing, in this context, can be quite irrelevant.  Much more important to explore how we can soar, rise above it, and value the example of life well lived. Listen to Jack's last words to us: "My friends, love is better than anger. Hope is better than fear. Optimism is better than despair. So let us be loving, hopeful and optimistic. And we’ll change the world."
  
On my part, I continue my pilgrimage. And we will see you around, exploring the use of language, sometimes fighting and struggling, but above all living this pilgrimage of ours, until we get to Santiago.