The ubiquitous use of war metaphors in cancer may do more harm than good, according to research into the psychological impact the phrases have on people’s views of the disease.
Framing cancer in military terms made treatment seem more difficult and left people feeling more fatalistic about the illness, believing there was little they could do to reduce their risk, researchers found.
And while the language is intended to motivate people and make them more vigilant at spotting symptoms and getting them examined, the study found no evidence this was the case.
“Our work suggests battle metaphors could have a negative impact on how people think about cancer and those thoughts could undermine people’s intentions to engage in healthy behaviours,” said David Hauser, a psychologist at Queen’s University in Ontario, Canada.
Having cancer is not a fight or a battle
Hauser and Norbert Schwarz, a professor of psychology at the University of Southern California, studied the impact of war metaphors in cancer care after noticing how common the language had become. For example, instead of simply having cancer, patients were invaded by enemy cells that were fought with the latest ammunition in the oncologist’s armoury, in a battle many brave heroes lost.
“People use these metaphors thinking they have a beneficial impact, or at least no negative impact, but nobody has actually studied it,” Hauser told the Guardian.
In four separate experiments involving nearly 1,000 generally healthy volunteers, the researchers looked at how people’s opinions varied on reading passages about cancer patients that included battle metaphors, journey metaphors, or no metaphors at all. The battle metaphors included words such as “fight”, “attack” and invaded”.
Military metaphors may not be benign, the study found. After reading accounts of cancer patients sprinkled with war metaphors, people rated cancer treatment as more difficult than those who read the same passages with journey metaphors, or no metaphors at all. In an article to appear in Health Communication, the researchers warn that highlighting the difficulty of cancer treatment could generate fear that made people put symptoms out of their mind, with potentially harmful consequences.
Battle metaphors also made people more fatalistic. On reading passages peppered with war phrases, people agreed more with statements such as, “If someone is meant to get cancer, they will get it no matter what they do.” This could hit health drives to reduce people’s risk of the disease.
Finally, rather than encouraging people to get to a doctor faster if they had suspicious symptoms, the military phrases were found to have no beneficial effect.
Hauser said war metaphors were so ingrained in cancer language that it would be difficult to do away with them. But he called on cancer charities, those in the media, and others to be more aware that the language may not be helpful. He said more research was needed to see whether the metaphors were valued by cancer patients in particular.
Mandy Mahoney, a mother of two and an outreach support worker in London who has incurable metastatic breast cancer, said: “I think cancer-speak can be quite negatively loaded: the brave, fighter, warrior and survivor standard descriptors put an awful lot of pressure on the newly diagnosed.
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“You feel like you’re letting people down if you can’t manage permanent positivity or you have an emotionally wobbly day. It’s not constructive or helpful when you’re focusing on getting through the day-to-day living of a cancer diagnosis and treatment schedule. I prefer clear, factual language, so I describe myself as “living” with incurable cancer. I’m not brave or inspirational, I’m just trying to live the life I have left well.”
Margaret McCartney, a Glasgow-based GP, writer and broadcaster, said the use of military metaphors by charities was problematic. “There have been frequent uses of “war” or “fighting” when fundraising or in their literature, despite many people with cancer saying that it deeply upsets them.
“People who die from cancer have not died because they didn’t try hard enough. This research should give pause for thought to organisations who continue to use war terminology. The language we choose has profound consequences.”
Karen Roberts, the chief nursing officer at Macmillan Cancer Support, said: “There’s no such thing as a ‘typical’ person with cancer, so people have different preferences when it comes to discussing it. Talking about ‘battling’ cancer helps some people remain upbeat, but others find the effort of keeping up a brave face exhausting and are unable to open up as a result.”
Martin Ledwick, Cancer Research UK’s head information nurse, said: “There are no right or wrong words for people talking about their own personal experience and some people do see their cancer experience as a fight or a battle. But for others, we know that ‘fighting talk’ can be unhelpful and make them feel guilty or inadequate if they feel unable to ‘fight’, or if their cancer comes back in spite of treatment.
“This study adds more evidence to highlight the importance of being sensitive when we are communicating about cancer.”
This content was originally published here.