Politics & Media
Jul 21, 2017, 09:30AM

John McCain Isn't “Fighting” Cancer

Martial metaphors make it sound like people are responsible for their own illnesses.

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"John McCain is an American hero & one of the bravest fighters I've ever known," Barack Obama tweeted after McCain was diagnosed with brain cancer earlier this week. "Cancer doesn't know what it's up against. Give it hell, John."

Obama's tweet is typical in tone and content to many expressions of support for McCain. Well-wishers often referenced his military service in Vietnam, directly or obliquely, praised his courage, and said he’d fight hard against cancer. McCain, everyone seems to agree, is battling a dangerous enemy, who’ll be defeated by the Senator's great valor and strength of character.

Obama and others are trying to express their admiration for McCain by framing cancer as a war. Still, while their intentions are understandable, the metaphor is misleading. Cancer isn't a battle, and personal qualities like strength, bravery, or honor can do little to halt the disease's progress.

McCain’s brain cancer is called glioblastoma. It’s extremely aggressive. The prognosis for anyone with the disease is bad; most people live only 16 to 18 months after diagnosis. For men over 60, the outlook is even worse.

My father-in-law lived for a little over a year after his diagnosis. He lost function and quality of life rapidly though; for the last few months he was mostly unable to communicate or care for himself. There wasn't much fighting involved in his decline. His doctors gave him chemo, which made him ill, and then he got sicker. The likelihood is that McCain will be dead or incapacitated by this time next year. If he’s lucky, he may beat the odds. But whether he does is largely up to the cancer, his body, and his doctors. It won't be because he's braver, or more willing to fight, than my wife's dad. "As I often talk about in the brain tumor community," Adam P. Newman told me on Twitter "such discourse [of cancer as a battle] also ridiculously implies that those who die are just 'not tough enough.'"

Of course, Obama doesn't mean to say that my father-in-law died because he was insufficiently brave, or didn't fight hard enough. But using martial language to describe cancer does have an effect on how cancer patients are viewed, and on how they view themselves. In Bright-Sided, Barbara Ehrenreich, who contracted breast cancer, writes about the oppressive cult of positivity around the illness. "The words 'patient' and 'victim,' with their aura of self-pity and passivity, have been ruled un-P.C." Ehrenreich says. "Instead, we get verbs: those who are in the midst of their treatments are described as 'battling' or 'fighting'… language suggestive of Katharine Hepburn with her face to the wind." Ehrenreich reported that in some cases, people who have a breast cancer relapse have been expelled from their support groups, since they are no longer "survivors."

Framing cancer as an opportunity for individual effort and bravery is part of the larger American tendency to blame sick people for being ill, or for not trying hard enough to recover. Republican politicians, flailing about trying to justify throwing millions of people off health insurance, often circle around to the idea that people who lack care or are sick have done something wrong. Rep. Warren Davidson of Ohio told a crowd that a man who lacked healthcare should get a better job, suggesting that the man's lack of healthcare was his own fault. Politicians justifying Medicaid cuts claim that people who would be thrown off the rolls don't really need the benefits—they're just shirking. Virtuous people fight off illness without burdening taxpayers. The lazy, the depressed, and the uncourageous aren't really sick. And if by chance they are, they probably deserve it.

It's extremely fortunate that McCain has excellent, government-provided health care. The fact that he does will improve his chances of surviving glioblastoma far more than his bravery or willingness to fight. And if McCain gets very sick very quickly, that's not a sign that he didn't fight hard enough.

Human beings—all human beings who live long enough—eventually get sick and die. That's a hard to face. Language about battles can give people a sense that they are still in control of their own fate, and are not victims. But we shouldn't let the language of empowerment lead us to believe that sick people are actually able to will themselves to health, or that they are responsible for their own sickness. Instead, we need a health care system that helps everybody who needs care—no matter how brave or deserving politicians happen to think they are. 

  • Couldn't agree more, Noah. I loathe this language around disease, cancer specifically. People feel powerless because it's this titanic and lethal and scary thing that's inside of them and therefore invisible (at least at first). "Brave fight"... just abhorrent language.

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  • When my late wife was first diagnosed with cancer, I was amazed at the number of imbeciles who felt that addiction is a disease who also adhered to the ridiculous notion that cancer is a failure of will. It's the other way around. That said, there is an abundance of evidence that highly refined cannabis oil cures cancer.

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  • John McCain richly deserves it, that much is for sure.

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  • There is no way whatsoever that such language implies that those who succumb are not brave enough. Who could possibly believe people who express such a sentiment actually feel this way? This is beyond ridiculous.

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  • Hey Beck. I quote two people who had cancer who say that the metaphor caused them pain. I've spoken to numerous other people who say the article resonated for them as well. One woman says her mother asked why she was not getting well if she was fighting so hard; that frame made her feel like a failure.//Alan, just about nobody deserves brain cancer.//Nicky, thanks.

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  • Oh, so you quote selected people who say such a thing? Well that settles the matter. Give me a break.

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  • Two people told you something so people must now reframe how they encourage people to deal with a life threatening disease. Just listen to yourself.

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  • It is not about fighting the disease itself. It is about fighting to live well with the disease. Some days that means researching and finding the best treatments. Some days it means fighting the symptoms of cancer and / or treatment to do the things that are important to you. Some days it means taking time to grieve or worry and doing self-care so you can fight another day. It's about not giving up on living and having a high quality of life whether cancer is cured or not. When my mom died of cancer, I didn't think of it as her losing a battle, and I certainly didn't think it was her fault. I knew how hard she fought and what she went through wanting to be alive. She was proud to consider herself a cancer fighter. And she did win because she lived as long as she could, and she was a person who gave so much to others, especially me, and made me the person I am today. That's what being a fighter means.

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  • So much for trying to have a respectful conversation with Beck, I guess. No real surprise there.// Freewheelin', I've definitely talked to some people who find the fighting metaphor helpful, or innocuous. I'm not against people using it across the board; I think its ubiquity does really plug into ways of thinking about disease which make life harder for many (not least many cancer patients themselves.)

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  • Don't make me laugh talking about a respectful conversation, please. You're the last one who should ever say such a thing..

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