In Defense of Cancer as a “Battle”

It seems incredibly natural to speak of fighting cancer as a battle. Deceased patients, then, have “lost” their battles. The cancer won, by killing them.

The pushback against cancer “battle” language has become common too. John McCain, Aretha Franklin, Roger Ebert, and so on. As cancer becoming seemingly increasingly ubiquitous, so too are people describing it as a battle — and other people not liking that.

Earlier this year, my father was diagnosed with glioblastoma multiforme, a highly malignant and incurable type of brain tumor with median survival time of around a year (and a 5-year survival rate of just 5% or so). You might think that, of all cancer patients and families, those afflicted with the biggies — glioblastoma, pancreatic cancer, metastatic anything — would distance themselves from the “battle” language.

Yet, every place where I read about brain cancer online is chock full of ordinary people who can’t stop referring to cancer as a “battle,” and their loved ones as “warriors.”What gives?

So I started thinking about it. Well, there is a good reason why cancer seems more battle-language-apt than other diseases. When the would-be enemy is something like heart disease, you might lament having a bum heart, but that bum heart is clearly one’s own. When an elderly person dies gradually of old age with no specific proximal cause, there’s nothing even quasi-exogenous to finger as a culprit. The cause is everything and nothing. The cause is daring to exist corporeally.

It’s quite easy to refuse to identify with a mass, a tumor, a clump of runaway cells. The cancer is not integral to your functioning body. It’s a specific thing that you’d prefer to jettison. That cancer isn’t me, it’s endangering me, a creepy lurking enemy within. Just cut it out! Radiate it all to hell! Cancer is readily categorized as a discrete, invading force.

Plus, I don’t understand the objection that “cancer as a battle” unduly saddles patients with full responsibility (or culpability) for their outcomes. When a fighter wins a battle, there’s no presumption that it’s completely due to their actions and individual force of will.

Instead, it’s widely recognized that success in battle (in sports, in life writ large) usually requires plenty of help, and good old luck luck. Everyone knows some fights aren’t fair. Cancer patients, like soldiers or members of teams, can contribute to their cause, but they do not hold total responsibility for either wins or losses.

More importantly, the language of battle has a rich, under-explored upside. Just plain “winning” is not the highest virtue of a warrior, in fact it’s not really a virtue at all. Virtues are states of character, fusions of attitude and behavior that one carries through life. Cancer warriors are called by circumstance to cultivate not only courage but equanimity, proper gratitude, proper hope.

Character development is hard regardless of the circumstances, and it may not always be obvious what the goal is or whether one’s reached it. Still, understanding cancer patients as warriors provides a metaphorical backdrop for understanding the moral tasks at hand.

I’m not the word police, and I haven’t had cancer. As far as I can tell, there’s certainly no value in pressing battle language on unwilling cancer patients. Some patients may prefer a “journey” metaphor, or something else entirely. If your loved one is afflicted with cancer, you might want to discuss with her how she’d like her condition and possible death described by you to others.

When people say something over and over again, it might just mean something. Losing a cancer battle at the end of one’s life doesn’t make that person a loser in general. If people thought it did, then why would they write it time and time again in their loved one’s obituaries? Instead, they’re speaking about a single episode of that person’s life, the one that happened to come at (and precipitate) the end.

That we mortals will all eventually “lose” our fight against entropy doesn’t make living — especially through specific medical hardship — not a battle. But the fact of universal loss does remind us to order our values and expectations accordingly.

As philosopher Scott Samuelson puts it in his incredible new book Seven Ways of Looking at Pointless Suffering, humans must somehow find a way to maintain a “fix-it” attitude towards changeable suffering while simultaneously adopting a “face-it” attitude towards all the rest. This is no small task, especially when the thing you’d like to fix (but might have to face) is growing inside your own body.

The dual fix-it/face-it mentality is what I see when people speak about their brain cancer “warriors” declining treatment, going into hospice, and meeting imminent death.
Even those warriors embroiled in unfair fights can fight honorably. This includes exercising courage, achieving some measure of emotional continence, maintaining a hope that’s grounded (not delusional), and reordering some priorities towards the end of life.

Warriors even die in battle — of course they do. As we teach our children, winning is nice but it isn’t everything. Character counts, right up to the end.