War metaphors in cancer

Lore & Background

The use of war and battle metaphors in medicine has been documented back to the 1600s. Over the 20th century, politicians have 'declared war' on cancer, diabetes, AIDS, and obesity. Military metaphors are not an exclusively Western phenomenon; battle terms are also used in traditional Chinese medicine. Contrarily, in sub-Saharan Africa, diseases are seen as a part of life that should be accepted, not fought.

War metaphors are commonly used by scientists, physicians, patients, and the general public. A 2010 study found that greater use of metaphors by physicians was associated with better understanding by patients. The phrase is often used when someone dies, and may appear in obituaries. For example, a statement from Victoria Wood's publicist in April 2016 said that Wood had 'passed away, after a short but brave battle with cancer'. In December 2016, journalist A. A. Gill was described by Sky News as having died after a 'short fight with cancer'.

Research in 2014 led by Elena Semino, a professor of linguistics at Lancaster University, alongside palliative care specialists, based on 1.5 million words of discussion, led Semino to say, 'We have enough evidence to suggest that battle metaphors are sufficiently negative for enough people that they shouldn't be imposed on anyone'. The study stated that doctors should avoid battle/fight metaphors unless patients themselves chose to use them, and obituaries should avoid them, especially the idea of 'losing' such a battle/fight.

Reader's Guide

The significance of war metaphors in cancer lies in their widespread use and the debate over their appropriateness. While they can help physicians explain cancer in a way understood by patients, critics argue they imply that cancer can be defeated if one fights hard enough, leading to feelings of guilt or failure when patients die. A 2014 study by Elena Semino and colleagues found that battle metaphors are sufficiently negative for many people that they should not be imposed on anyone. A 2003 study indicated that patients using war-related terminology to describe their breast cancer had higher rates of depression and poorer quality of life. The alternative metaphor 'journey with cancer' has been proposed as gentler. The legacy of this debate includes recommendations that doctors avoid battle metaphors unless patients choose them, and that obituaries avoid the idea of 'losing' a battle. The controversy extends to advertising campaigns, such as one by Sick Kids Hospital in Canada that depicted children as warriors, which was criticized for not portraying the true experience of serious disease.

Did You Know?

• The use of war and battle metaphors in medicine has been documented back to the 1600s.
• A 2010 study found that greater use of metaphors by physicians was associated with better understanding by patients.
• A 2003 study found that patients using war-related terminology to describe their breast cancer had higher rates of depression and poorer quality of life.
• The term 'journey with cancer' has been proposed to replace war metaphors.