A mesothelioma diagnosis brings with it intense emotions and difficult clinical jargon.
While it’s vital for patients and doctors to discuss treatment strategies in the clearest terms possible, it’s only natural for cancer survivors to draw on more poetic language when reaching out for emotional support.
“Cancer patients use metaphors to help describe their cancer experience and increase others’ understanding of their life experiences,” licensed mental health counselor Dana Nolan told Asbestos.com.
Nolan runs The Mesothelioma Center’s monthly support group, and she has seen firsthand how survivors use familiar images and concepts to make sense of cancer treatment and explain their feelings to others.
Ever since the 1970s, when President Nixon declared the “War on Cancer,” military terms have provided many of the most common metaphors for cancer treatment. In recent years, however, many institutions have officially discouraged aggressive metaphors in favor of softer language that refers to cancer treatment as a journey.
“Some survivors and caregivers do connect with the ‘battle’ or ‘war’ metaphor, but others reject that description, as they don’t want to be at war with something within themselves,” Nolan said. “Some people talk about their cancer experiences as a rollercoaster, with lots of ups and downs, or as running a marathon.”
Cancer survivors adopt a variety of metaphors from all areas of life, and whether a metaphor is empowering or disempowering depends very much on the context in which it is used.
Many medical metaphors are inspired by military terms. Patients undergoing treatment for mesothelioma are said to be “battling cancer,” and they may speak of cancer cells as an “enemy invasion” in their bodies.
“The battle metaphor helps some people feel stronger, like a warrior, which gives them hope,” Nolan explained. “But some people do not like that metaphor at all, as they don’t feel like a warrior — nor do they want to. So metaphors like that shouldn’t be universally prescribed to all cancer survivors.”
The overall “War on Cancer” metaphor is an effective device for bringing communities together and raising funds for research, because it positions cancer as a common enemy people can unite against.
However, this metaphor also casts mesothelioma patients as soldiers in a war they did not sign up for. It can imply that if they lose their “cancer battle,” it may be because they did not “fight hard enough.”
This is a profoundly unfair judgement in light of how resistant mesothelioma is to conventional treatment.
Many cancer survivors find less morbid ways to talk about their conflict with cancer. Drawing from everyday life, one can think of eliminating cancer cells as a tiring but necessary task like weeding a garden or de-icing a sidewalk.
Rather than a violent battle, some patients think of treatment as playing a game of chess against the cancer, which requires strategy, patience and a level head.
The journey metaphor for cancer treatment became popular because it fits into the broad philosophy of “life as a journey.”
By framing cancer treatment this way, patients are less likely to feel anxious about living up to the expectations of people who want them to “beat the cancer,” and they are less likely to feel guilt or shame if their bodies do not respond well to treatment.
The journey metaphor also makes it clear cancer treatment is a long and uncertain process, not a war that can be won in a single decisive battle.
However, journey metaphors are not necessarily more empowering or comforting than battle metaphors, as a recent study of communication in an online cancer survivors’ forum revealed.
Mesothelioma patients may feel as though they’ve been forced onto an arduous path filled with obstacles, or they may feel like unwilling passengers with no control over their destination.
The metaphor of a rollercoaster ride aptly conveys how patients can be taken from high hopes to depths of depression and back again with each new scan and test result.
One type of journey metaphor that gives patients more authority is marathon running. A marathon is long and difficult, but it is also a testament to the runner’s determination and love for life.
Much of the public debate around the language of cancer treatment focuses on contrasting battle metaphors and journey metaphors, but ultimately each mesothelioma patient has the freedom to use whatever words bring them the greatest peace of mind.
Patients who face multiple relapses and remissions may think of treatment as a dance, in which sometimes they lead and sometimes their cancer leads.
Recognizing cancer begins in their own bodies, some patients think of treatment as re-establishing a musical harmony by getting all their cells to sing in tune again.
Many patients find strength in humor by personifying their cancer with a silly nickname or even thinking of it as a troublesome roommate they must adjust to. This is fitting because there is currently no cure for mesothelioma, which means no matter how long medical technology can extend survival, patients will likely have to live with some level of cancer care for the rest of their lives.
Indeed, this is the reality for most forms of cancer and many types of chronic diseases.
For this reason, many patients choose to emphasize how they can continue living their lives after their diagnosis — going beyond surviving to thriving. What this means is for each individual to decide, and there are as many perspectives on survivorship as there are mesothelioma survivors.
“I don’t think there is a ‘better’ or healthier way to describe cancer,” Nolan confirmed. “I don’t recommend a particular metaphor or suggest how someone should experience or communicate their feelings or perspective about cancer. Mesothelioma is a very individual experience, and I believe the usefulness of metaphors is to further understanding of the cancer experience between the cancer survivor and those who care about them.”