THE PROBLEM WITH CANCER...

My work as a clinical ethicist in some of Houston's largest cancer hospitals has unveiled the shadow side of using war language to characterize patients' cancer narratives. War rhetoric in cancer care may not always be the most effective strategy for comprehending illness.
  1. ...is the way we talk about it.
  2. A new theme in healthcare is definitely emerging: how to better discuss death.
    Atul Gawande's novel 'Being Mortal' is a great start for those who want to learn about gently and compassionately discussing the end of life.
  3. But in order to facilitate and advance this difficult conversation, we must first change the very words we use to describe it.
  4. The language we use to discuss cancer is rooted in a propagandist history promoting the belief that this is a conflict we will win- that declaring war on cancer is the only way to confront it.
  5. Consequently, victory became defined only by “defeating cancer,” or finding a cure.
  6. While this metaphor may serve to motivate some people, we should not accept it uncritically as the only and right way to make sense of this disease.
  7. We should recognize how the war metaphor delimits the ways its hosts can talk about cancer, potentially silencing those for whom a combat mode is inappropriate or ineffective.
  8. Battle imagery can be a powerful, tangible way for some patients to understand cancer.
  9. It can ascribe to them the strength of warriors, the relentless spirit of soldiers, the bravery to fight.
  10. But it can also marginalize people who draw strength from other places.
  11. It can silence the voices of those who wish to peacefully seek comfort, rather than cure.
  12. While the war description of cancer has resulted in unprecedented attention and fundraising for cancer care, research, and survivorship, a balance should be reached between these successful efforts and language.
  13. A recommended but not often used script is to first ask patients: What do you understand about your illness and what do you want to know? Who among your friends and family can provide support? What are your goals in life — both short- and long-term?
  14. And while it creates a sense of camaraderie, we should avoid phrases such as “we will fight this” or "I know you can win."
  15. As physicians grow to embrace a more holistic view of cancer treatment, the public discourse surrounding death and disease must also evolve.
  16. Online tools such as “Let’s Have Dinner and Talk About Death” (http://deathoverdinner.org/get-started) are a step in the right direction. Ending the “war on cancer” is another.
  17. Difficult conversations are, by nature, difficult. But it can be liberating and empowering and BEAUTIFUL to open our hearts, ears, and minds to the many ways that people experience illness.
    Even if that isn't donning armor, battling cancer, and not resting until crowned the victor.
  18. At the end of the day, patients are people. Some people identify with the soldier archetype. For others, this imagery holds no water.
  19. The beauty of life and death is that varying opinions are okay. Difference is what makes us strong. Difference is what makes us beautiful.