"Martial language propagates the dangerous myth that death is the result of a personal failure to fight hard enough."

I know we've discussed this ad nauseum, but McCain's military background seems to have inspired more use of this destructive metaphor.

/www.nbcnews.com/think/opinion/john-mccain-did-not-lose-his-battle-glioblastoma-because-cancer-ncna904486

Why is it we say he lost his battle with cancer? But we don't usually say he lost his battle with heart disease or dementia or diabetes. etc.

I have never identified with the Battle and Warrior metaphors. It just doesn’t resonate. You hit the nail on the head with the failure connotations that may go with death by cancer. Cancer is still such a terrifying thought for most people, perhaps somewhere in the psych it gives comfort to believe it could be “slain” should they develop it. Well, that’s my Freudian conclusion. lol

For an interesting discussion of cancer as metaphor (not only war, but also roller coaster and others) by a panel of oncologists, see theoncologist.alphamedpress.org/content/9/6/708.full.

War metaphors for the fight against deadly disease of all sorts, not only cancer, are age old. On YouTube you can view a newsreel from 1961 titled "War on Polio!": /www.youtube.com/watch?v=W88DcouLijY. Here in Micronesia, where genetics and poor diet contribute to unusually high rates of diabetes, I often hear talk of a "war on diabetes." The campaign to fluoridate water has often used the metaphor "war on cavities."

The war metaphor suggests that there's something each of us could do to prevent getting the disease. The upside is it prods people to make healthful changes in diet, exercise, etc. The downside is it shames those who contract the disease.

What makes the war metaphor especially destructive with respect to cancer is the sense that it is a disease where your own body "attacks" itself. Why can't I stop myself from killing myself? Why did my prostate go turncoat? Also, metastasis invites the invasion metaphor: what are my prostate cells doing in my rib cage? Why can't I tell them to just stop it? It's instinctive to feel that since the enemy is, in some sense, oneself, one should be able to fight it off. Or to feel "betrayed" by one's own body. I think a lot of the psychological appeal of immunotherapy is that it would allow us to heal ourselves.

Don't agree guys.
When I was Dxed I thought of it as a war.
Starting with determining the correct strategy for winning and then determining the correct tactics for implementing that strategy. In determining a strategy you first have to know your enemy, and I did hundreds of hours researching trying to understand what prostate cancer was and they type I had. Next you have to know your own strengths and weaknesses to implement a strategy that is suited to you. Lastly you have to implement that strategy, that includes getting ready for treatment, strengthening your body, getting in shape. Then you have to pick the best tacticians in order to win. This means researching the best docs in your treatment field. Using the best trained and natural talent increases your chances of winning. This also means investing in the best weapons, (I flew to Holland for the best scan available).
War is a pretty good analogy as everything you have to do in winning a war is the same thing you have to do in tacking this disease. I've been in a real war and also both I and my wife have had cancer, so I have experienced both first hand. Fighting hard is an extremely small part in waging a successful war, good planning and execution win wars.

Its really all about the species need for Glory...to make that...which is not...is...and to that ..which is...not...elementary Smedley!!Whot??

No conclusions to offer, but perhaps an observation or two.

After thinking about TA's premise about the unsuitability of military terminology for describing the relationship of patient to cancer, it occurred to me that there is also at times a curious relationship between a field of activity and the language used to describe it.

That applies very much to the military. In its field manuals and training documents, and I know this from experience, the whole style of writing is what one might call "pseudoscientific." For example, in the phraseology of the typical training manual,

we don't "kill" the enemy, we "neutralize" him.
we don't bomb a target, we do a "surgical strike" on it.
Indeed, the term "enemy" is ubiquitous in the manuals, never "those other people, those soldiers over there"
and, it's "elimination of threat" rather than "killing those trying to kill us"

I could give other examples.

When I first noticed this linguistic tendency after going on active duty, my initial assumption was that the wording was an attempt to minimize any emotional reactions on the part of the readers (soldiers) to words like "kill." And that's probably part of it. But I think something else that's going on here is that the military attempts to achieve the appearance of a scientific-like objectivity in its activities, in particular to cast the conduct of war in words that present it as being objective, predictable and controllable, almost like a laboratory experiment. After all, they do call it "military science," don't they? Evidentally this appeals to some leaders and others who want the perception of the objective, predictable and the controllable in the military things they do, whether this is a scientifically valid approach or not.

But then some medical writers seems to feel the need to go in the opposite direction. They borrow words and images from the military, setting aside to a degree the genuinely scientific milieu in which they normally operate and write, in order to inject a more emotional element into the discussion. Evidently they feel this approach offers an emotionally understandable picture of the situation, and one more satisfying to many patients.

The military terminology of "winning" or "losing" may be poor from the scientific viewpoint, but emotionally understandable and perhaps more "receivable" from many a patient's perspective.

Interesting that military writers on the one hand, and medical writers on the other, might be employing directly opposite strategies to achieve their ends.

I didn't opt to fight.
I just did as I was told.
I wasn't a warrior.
I spent a lot of time hiding behind things and running away.

don't label me a fighter or brave or anything.

“Tragically, some patients continue to opt for futile treatments and balk at end-of-life care (palliative or hospice care) because of an enduring fear that they'll disappoint family or be perceived as weak. Consistent with this, a study found that aggressive rhetoric and an expectation to “fight” leaves little space for patients to express their fear, shock, or sadness about their diagnosis.”

This is worded kinda funny....funny as in...”l’ll word this in a way so as to make my point appear more true than it may be”.

I’m unconvinced that the dying (or sick’s) feelings of “letting others down” is necessarily a result of peer pressure. It may very well be. (Who can argue with a study?). But it leaves out the possibility of the sick and dying’s feelings of guilt as being attributed to seeing loved ones hurt just as a result of their condition. Rightly or wrongly...feelings of regret and guilt can enter when we see others in pain due to our situation...even though our situation is unavoidable by us. I see this as possibly an inherently human trait...as opposed to something created by words or false analogies.

Humans are flawed creatures. It’s what makes us human. But being human isn’t ALL bad either. Not to get too philosophical....but it may very well be that in our flaws we may also find some of our strengths...

I *do* think it’s a good topic.

Post Edited (island time) : 9/1/2018 5:07:25 AM (GMT-6)

As for me, I have won some battles with prostate cancer but fear I am losing the war.
Woody

TA - Thanks once again for beginning such a great discussion.
Denis, I could not agree more with everything you’ve said. My life journey thus far has been SO BLESSED. PC has helped me realize that more clearly than ever before. Rather than being angry, ready to WAGE WAR, I’m doing the same with diet and exercise. Each time at the gym I see others in MUCH worse condition—but they are an inspiration: if THEY can do it, what do I have to complain about??
As for the war scenario, I’ve recently consulted with my OncDoc lieutenants that disagreed on my next steps. So I’ve gone with the lieutenant who recommends and offensive strike, and next week will begin Zytiga, even though Lupron Casodex is still working well after Taxotere. I know there’s a lot I can control, but ultimately there’s things the Man above will decide. That’s fine. I’ll continue to enjoy the journey as best I can. That’s made much easier by you guys posting in this forum. THANKS.

"We are strong
No one can tell us we're wrong
Searching our hearts for so long
Both of us knowing
Love is a battlefield
When I'm losing control
Will you…"

Most of you guys who find fault with war metaphors better not watch football this weekend.

I think Jerry really nails it: We all get to choose our metaphors-especially as patients. I don't need someone to tell me how to describe what is going on with me. If the metaphor works, then use it. If it doesn't, then don't.

That being said, to (as in this case) have outsiders who know nothing about what was going on inside Mr. McCain prattle on with the military metaphors seems a bit much--and says a lot more about their lack of creative writing skills as anything else.

Is there anyone left who can truly turn a great phrase? And do it so subtly that you don't realize just how great it was until it's past?

An old soldier (sorry, I know he was really a sailor) has graced us with this presence. Let him rest now.

PDA-

I checked the obits (well, some of them). Legacy.com allows one to search the obits that people have had. I just checked those whose last name began with "A," who died in the last month, and used the term "battle" (eliminating place names or non-metaphorical uses). There were 136 such uses. Here's how it broke down:

Cancer - 73%
Unspecified illness - 11%
Alzheimer's/Dementia - 4%
Parkinson's - 3%
Lung ailments - 2%
Heart ailments - 1%
Addiction - 1%
All other (diabetes, lupus, liver transplant, pancreatitis, MS, Crohn's) - 4%

Modifiers for the word "battle" were most often valiant, courageous, fierce, and brave. Often, the word "lost" is used with it (which is the problem with the metaphor). The battles are often described as "long," although some were "short."

I have no doubt that the war metaphor was used often in the time of tuberculosis, polio, Spanish Flu, cholera, and plague when each of those were prevalent.

This, in spite of the fact that heart disease is the #1 cause of death in the US (23%), followed closely by all cancers. So why is the battle metaphor not used for heart disease? Congestive heart failure, especially, is often a long drawn-out affair - it would seem to be amenable to the war metaphor, yet it is almost never used -- why?