This article asks a question that I’ve been wondering about for a long time: is it insensitive or inappropriate to speak of someone “losing their battle” with cancer?
I’ve seen many people die of cancer and I have never walked away from one without thinking that the person was heroic in their courage and endurance. Terminal cancer is a demanding and agonizing process, no matter how good the pain management and how strong and loving the support system around the person (I hesitate to say “patient,” as that reduces the person to the disease, which seems equally unfair, adding insult to injury). Â It is a process that requires extraordinary valor. Some people valiantly fight the disease with denial or by insisting on curative measures until they draw almost their last breath (sometimes it is doctors who impose this, which makes me furious, when hospice could bring such a measure of physical and spiritual comfort and peace), some people valiantly face death and prepare for it with serene equanimity – everyone does the best they can with the damned thing once they reach that terminal stage.
I’m sure my own early experience losing my father colors my thinking on this. I remember cringing when I read my father’s obituary headline, “Carl Weinstein, Police Official, Succumbs at 50.” It was so wrong a term to use in relation to my vibrant father who would never have succumbed to anything, even heart failure! I much preferred the headline that read “New Canaan Commissioner Dead at 50” and a third, which read, “Carl Weinstein: Founder and President of Eastman Cable Rep Dies.” To the point. He died. He didn’t “succumb” or “lose a battle.”
I am generally not in favor of any metaphors that indicate that we are ever at war with our own bodies. This extends even to ostensibly benign expressions like, “I hate my thighs!” I believe that it is very likely useful to do visualizations where one imagines healthy cells rushing in and overcoming cancer cells, but I have not experienced having cancer cells (that I know of) and don’t know how I would feel about battle metaphors if I did have cancer. Maybe they help. I feel like those of us who haven’t endured the ravages of a wasting illness don’t get to make that call.
What do you think? I am especially hoping to hear from those of you who have lived with cancer or loved those who have. I think it’s important for pastors to get input on this.
I’m not a pastor, nor have I had cancer, but as a lay person I find it jarring when people who die are described as “winning the battle” or “losing the battle”. If life or illness must be described as a battle, I would just say, “his battle is over”. [I appreciate that. It reminds me of a May Sarton poem I often read at funerals that speaks of someone “laying down their fiery burden.” – PB]
I work as a customer service rep in an Oncology Pharmacy. So everyday I am speaking to patients and their families to help them obtain their medications. Every one I have spoke to has their own unique language and experience. The man who cried the entire call and apologized because his bain turmor was so close to the emotion center that he had no control of his emotions. He spoke of how he was doing something especially for his family, that he disliked, but for them – cause it was what they wanted. (he went on a cruise for them.) He knew he didn’t have much time. Yet another man said he didn’t need any more meds – he only had a few days left. He was completely calm. I left that call in tears. Some are fighting a battle-round 3.. Some are taking their medicine as if it were just a necessary vitamin. Ohers are in fear for their life… quite literally. In my 3 yrs of experience, I have found no set way or response from those with cancer or their families. I listen to them and use their language for their experience.
My dad was also afflicted with cancer for the last months of his earthly life, which ended at the age of 63. I think we can get so caught up in the semantics of a loved one’s passing that we lose sight of the fact that those people suffer a great deal of pain and anguish, not knowing just how or when their journey on earth will end. I have referred to his death as “losing the battle,” because that’s what ultimately happened. However, I think it’s important to realize that, for a Christian, it’s more of a “graduation” to Heaven. However you refer to it, it’s still a painful thing to watch, knowing that the treatments known to man are, at best, only touching the surface, with no promise that the cancer will not reappear in some other part of the person’s body. I think it’s much more important to make sure that the person is at peace with God, knowing that the end will bring only a greater peace and joy for eternity.
Your post brings up questions for me in the way I talk about my own illness. I often speak of treating my mental illness as “fighting for my life.” I do feel it is that way, yet your post makes me wonder if I would be ok if I died from my illness and someone said I “lost the battle.” I’m not sure. I do know that the image of my life being worth fighting for helps me. With suicide so possible, I do feel like I need to fight to stay alive, but if I lost the battle, what does that imply? I wasn’t strong enough? Didn’t care enough? And cancer is a different illness so I can’t speak to how the battle imagery helps or not in that situation but I see why you bring it up and ask us to look at these phrases we use so often. Thanks!
I am an Anglican priest, and widowed, single father of two. My wife died with cancer almost 3 1/2 years ago, a mere 16 months after her initial diagnosis. The first summer of chemo gave good results, at first. But by winter it was clear the cancer was back and chemo was again scheduled for the spring . . . but this time the cancer had metastasized throughout her body and repeatedly delayed and complicated chemo treatments. It became a summer of growing despair, anxiety, increasing amounts of pain medication. I watched my vital, active energetic 46 year old wife actually waste away. Until the last 2 weeks though, even after sitting in bed for weeks, barely eating, whenever she met with the Oncologist, or Cancer Centre Staff, she would perk up, and be on, joking and convincing them she was going to pull through again. . . I was with her when she died and it was quite awful.
To address the question of the metaphor of the Battle with Cancer.
I don’t know. Like all metaphors, it might work sometimes, for some people. In many ways I felt like I was in the corner of a boxing ring, as my wife grew increasingly weary and took longer and longer breaks from the fight, and it became obvious that she (we?) were not going to come through this one. She had told me about 4 months earlier “You do know this will not end well?” And yet only 2 months later she rallied, in spirits, briefly, determined “to beat this thing”.
I have more problem with the statement “She fought bravely.” She did, sometimes. But the disease broke her down and wasted her with such devastating cruelty, that it seemed there was no will to resist, to push through anymore.
And I suppose that might be where the final decision was made, resist or let go. I don’t know.
Both her mother and one of her sisters predeceased her, with similar cancers. In don’t recall my wife ever referring to them as having lost their battle, or even fighting a battle.
When she did die, I made a point of saying that. She died with cancer. She is dead. Perhaps she did just give up. Maybe she was overpowered.
Thanks for posing the question. I will continue to turn this over.
An afterthought about being at war with our bodies. I think the image of the battle with cancer was, for us, more like arming the body to battle the invading cancerous cells, recognizing that there would be casualties on both sides; the hope being that the chemo or radiation would kill most of the cancerous cells, and only some of the healthy cells.
I had breast cancer about nine years ago, and I thought about this “battle” metaphor a fair amount then. Interesting you should bring it up. For me, the metaphor has become a tired cliche. It’s the go-to phrase in so many obituaries. I don’t mean to judge those who use it. I’m just saying, for me, it sounds like a cliche, and so it annoys me a bit.
It also annoys me because it’s not the only, or necessarily for everyone the best, stance to take when facing cancer treatment. In my case, “battle” just wasn’t a helpful image, and it didn’t ring true to me. It’s not that I chose to have anything against the image; it just didn’t register. I appreciate the specific criticisms discussed in the article you link to, implying that one may have control over their outcome if they’re “tough enough,” and may not have been tough enough if they “lose.” I thought about those things some, too, but mostly, the “battle” image simply bored me or just didn’t engage me enough to even care that much about those implications for myself.
My response to my diagnosis felt a lot quieter and more reflective than “battle.” Honestly (once I got over the initial shock and fear), “submission” is a more accurate term for my response, and I can imagine that many people will find that disappointing, falling short of their expectations about how “strong” and, well, warrior-like they want to imagine cancer patients as being.
My instinct was to trust my doctors and nurses, and submit. Far from seeing myself as some kind of soldier fighting cancer, I saw myself laying my body down, submitting to those working to heal me, in some fear of course but also in deep gratitude for their skill and commitment to their calling. (Yes, I educated myself about my options, made informed choices, and wasn’t wallowing in denial, but “submit” still feels more accurate to me than “battle.”) Sure, I can see how this doesn’t fit the “P.C.” (for lack of a better term) pattern of rhetoric and attitude we hear in the standard cancer-fighting stories, but, well, see what I care! Ha.
Now, granted, although I had surgery, chemo, and radiation, and suffered some of the common debilitations associated therewith, my struggle through treatment was a lot easier than that of many others. So maybe I eschew the “battle” metaphor because I didn’t have to put up as difficult a fight as others. I can see how it really looks like a battle for some folks, and maybe when you’re mired in it to that severe level for months or years on end, “battle” is the only metaphor that makes sense. Everyone’s mileage varies.
I remember talking with a good friend about the “courageous battles” in the obits and wondering aloud: would it really be so bad to say instead something like, “After a long journey through treatment, remission, and re-occurrence, she submitted gracefully to cancer”? Is the only good death one in which you go out fighting to the end?
I never call myself a “survivor,” either. It’s just too rah-rah for me.
Forgive me for being so long-winded, but thanks for the opportunity to share.
My beloved partner Joan died of ovarian cancer after 17 months of treatment and six weeks of hospice. It was an amazing journey. The night she died, as we washed and anointed her body, I was very aware that the cancer had not “won” – it was as dead as the body she left behind. Joan’s many gifts – among which steadfastness, passion, humor, and song were counted – were in all of us, and in people she never even knew she’d touched.
I take care to avoid the battle language, as well as the congratulatory “survivor” stuff. When exactly is a cancer patient a survivor? Finishing chemo? radiation? Successive rounds of treatment? After you are “cancer free”? For how many years? If you “beat” one cancer but then develop a whole different kind and this time you are not invincible – do you forfeit your survivor status?
Thanks for asking.
This is a little tangential to your question, but I hope that people who are interested in this issue will read the relatively new book “The Emperor of All Maladies.” Written by a doctor, it’s a “biography” of cancer, giving the history of cancer diagnosis and treatment through the ages, interspersed with a few stories of his own patients in the present day.
I’ve been cringing reading some of the early treatments, even those of not so long ago, like more and more radical mastectomies, higher and higher doses of radiation, ever more toxic agents of chemotherapy. It’s a wonder anyone survived the treatment, no less the disease. (And few did.)
Just a little book review here… sorry for the hijack.
I have not had cancer and I don’t know what metaphors I’ll choose for the end of my life until I get there. Maybe I will gracefully depart, or maybe I’ll go fighting, kicking and screaming, or maybe it’ll be something different. I hope I’ll have chosen (been able to choose) the end that is right for me and the people I’m leaving, and I hope that I won’t be judged harshly no matter what it’s like.
It was a hot topic up here when Jack Layton died.
http://www.theglobeandmail.com/life/health-and-fitness/health/conditions/jack-layton-didnt-lose-a-fight-he-died-of-cancer/article4250996/
[Bailey, that was the article that the first sentence of this post links to. That’s the inspiration for this column! – PB]
PB, your description of the obit headlines for your dad rings true to my experience when my mother died ten years ago (I was 20). I was determined to describe her according to the reality: that she was dead, not passed on, not passed away, not finally resting; not gone away but gone forever. I think that now, with a few more years on me, I would probably care somewhat less how other people described the situation, but I think I would still use the same language myself. Dead people are dead. Dead, dead, dead. Otherwise, what good Easter morning?
Thank you for posting this article. I appreciate it on several levels. Jack Layton was a ray of hope on the otherwise discouraging Canadian political scene – he spoke justice for people, care of the environment and concern for the wider world. And lived bravely with his cancer.
As a pastor, I’m convinced of the need not to use euphemisms in the face of death. And as a two-time cancer survivor (which is a term I do feel comfortable using), I’ve had plenty of opportunity to reflect on the language of battling cancer, which is language I deeply distrust. Cancer is something I have lived with, through diagnosis, treatment and then remission (so far; I also live with the awareness that my body seems susceptible to cancers, and that remissions may not be for ever). My cancers have been fought by medical expertise – surgery, drugs, radiation – not by me; my body has been the place where the therapies did their work.
I want to address a different word you used: courage. Now, I don’t have cancer.
I do have quite a few serious, chronic illnesses. I hate it when people tell me I’m courageous when they find out. I’m also transsexual. I really hate it when people tell me I’m courageous when they find out about that. With the latter, it feels very Othering. People can slap on that label and don’t have to deal with the more complicated issues. They can feel good about seeing me as some kind of hero instead of seeing me and validating me as a person. They often don’t even bother to learn the details of my situation so they can judge for themselves (or, better yet, ask for MY opinion) if courage was involved. In my case, it is inaccurate. I transitioned out of necessity/desperation, because death was the only other option, and it wasn’t an act of bravery. The label is very ironic. No one tells me I’m so courageous because I have extreme anxiety, but that’s the only illness/symptom that demands courage. Facing my fears is difficult and each time I do, it’s act of bravery. My other illnesses aren’t like that. For example, living with chronic pain isn’t something that needs courage. It’s difficult, but there’s no element of conscious choice, of being afraid and doing things anyway.
I know many people with the same illnesses/situations that I do feel the same way about the “courageous” label. I don’t know enough people with cancer to know what they think about the word when applied to them. My mom has cancer, but we’ve never had that conversation. Maybe it is different. Maybe people with cancer welcome that word. I don’t know. However, I would say that it’s a good idea to find out whether or not they like it before using it.
This very issue was probably first formally addressed in 1978 by Susan Sontag (who had had cancer) in her book “Illness as Metaphor.”
http://litmed.med.nyu.edu/Annotation?action=view&annid=782
She later also wrote a similar book about AIDS:
http://litmed.med.nyu.edu/Annotation?action=view&annid=783
Although family history suggests that I am much more likely to develop cardio/cerebrovascular disease than cancer, if I ever receive an oncology diagnosis, I will not refer to my treatment (should I choose to undergo it, depending on type and stage) as a “battle,” but perhaps as a “challenge.” I certainly won’t go to “Look Good, Feel Better” classes, which I consider misogynist. If anyone laments the loss of my hair, I’ll remind them that I personally regret the loss of my appetite. . .and may need to begin mentally and spiritually preparing for the loss of my life. [Thank you for reminding me of Sontag’s work. – PB]
I was diagnosed with ovarian cancer. It will be five years Easter 2013. I do not like the words: battle, courage, survivor. I fought to get diagnosed. It was a difficult journey. Chemo was difficult. But all I did was go one day at a time.
What bothers me is the impression it leaves if you “lose” the battle or don’t survive. It seems to me it puts much more responsibility on the person with cancer than is realistic.[This has always been my impression and concern. – PB] I got so tired of people telling me I had to have a good attitude. I’d always respond that there are loads of studies that show attitude doesn’t matter. Cancer is random. Recovery is random. It’s not a battle; it’s a disease.
Does someone battle heart disease or diabetes? Does someone survive those diseases?
It is important to be careful with language. [Thanks for writing and for sharing your story. Blessings. – PB]