Is It Time To Retire ‘Fighting Words’ When We Talk About Breast Cancer?
This well-meaning provider had just diagnosed me with extensive Ductal Carcinoma In Situ (DCIS), or Stage Zero Cancer. Some doctors consider DCIS the earliest stage of cancer, but others believe it a precursor. The abnormal cells are "in situ," meaning they are contained within the lining of the milk ducts and have not become invasive.
There are different approaches to treating DCIS, from lumpectomies to mastectomies, depending on its extensiveness throughout the breast. Sometimes DCIS just sits there; other times, it becomes invasive, and occasionally, the cancer goes away. Based on this information, I opted for active surveillance (also known as watch and wait). Things seemed stable for three and a half years, but ultimately, cancer spread to my lymph nodes, which necessitated a double mastectomy, chemotherapy, and radiation treatment.
I am not at war with my body, and I reject that battleground language. I love my body and am working with it lovingly.
I had been private about my original diagnosis, but as a longtime yoga and meditation teacher who helps students manage crises, I needed to be open. The night before my surgery, I shared a post on social media. I wrote about the years I'd spent monitoring cancer and explained that a double mastectomy was now my best option. Then I told everyone how to support me: "I request that people not make comments about my being a warrior, a survivor, or about kicking cancer's ass," I wrote. "I am NOT at war with my body, and I reject that battleground language. I love my body and am working with it lovingly."
When I scrolled through the comments, I noticed confusion amidst the support. It's not lost on me that we used to describe people with cancer as victims. The linguistic shift toward warrior and fighter acknowledges that people diagnosed with cancer have agency and aren't doomed. The body as a battlefield metaphor is a vast improvement in that it enlisted people as active participants in their health journey. Cancer became something you could fight.
As you might imagine, I had a tough time finding medical staff and loved ones who understood how I felt about the language surrounding cancer, so I dove into literature on the subject. In Susan Sontag's 1978 essay, "Illness as Metaphor," she writes that "the controlling metaphors in descriptions of cancer are, in fact, not from economics, but from the language of warfare: every physician and every attentive patient is familiar with, if perhaps inured to, this military terminology." Sontag goes on to list multiple examples, such as the body being "under attack" and "colonized" by cancer, and the body's "defenses" usually failing to "obliterate" a tumor.
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I recognize that the terms I object to—warrior, fighter, and even survivor—are words that many people with cancer find empowering. I understand why: being cut open, infused with toxic chemicals, and burned feels like war. It's a journey filled with struggle and the perpetual question, "will I make it through?" Battle terms convey the gut-wrenching arduousness of our experience. Many of us want our loved ones to understand what we go through because it is tough, and we need your compassion. I support whatever helps empower people during treatment. Anything that makes us feel stronger is the right choice. Use it. Say it. Hashtag it. Do what you need to get yourself through it.
Still, I object to the implied violence that defines our bodies as battlegrounds and asserts that we are at war with ourselves as we try to heal. I understand why battleground language is useful, but I am proposing that there may be another way of framing breast cancer that empowers us more.
A 2015 study published in Current Oncology Reports examined the role of stress in patients with cancer. They found that unmanaged stress can lead to worse clinical outcomes and advocate for mind-body techniques such as meditation, tai-chi, and yoga. Stress is detrimental to healing, and—while the research doesn't address this specifically—I suspect that imagining oneself in a perpetual state of war during cancer treatment might make stress worse.
Additionally, language structures the way we think and talk about ourselves and the world around us. A 2013 study published in Psychological Science found that the words we use to describe events and memories can influence our mood. In the study, participants who used the past imperfect tense to describe past negative experiences were more likely to feel unhappy than those who used the past perfect tense. Saying, "I was crying" impacted their mood more negatively than saying "I cried." While this isn't a perfect analogy, it hints at my hunch: how we speak about cancer can inform your relationship to it.
I do not wish to be labeled by my illness or to make cancer the axis around which my life revolves.
A package labeled Survivorship marked the end of my treatment—upon receiving it, I recoiled. The packet contained a summary of my diagnosis and nine months of treatment. I had reminders to schedule appointments with my many doctors and suggestions for nutritionists, social workers, and support groups.
After I flipped through the packet, I thought about my reaction: What is the opposite of a survivor? A dead person. The survivor designation categorizes us as the not-dead. At a moment that is supposed to be a new beginning, the label chains me to the diagnosis indefinitely. I do not wish to be labeled by my illness or to make cancer the axis around which my life revolves. I do not exist in relation to cancer, and my having gone through cancer does not mean that my life must now be referenced in relation to this event. Being forever defined by a disease diminishes my complexity and humanity.
Survivor is particularly fraught because it allows people to believe that our lives revolve around the diagnosis while also granting them comfort—survivor means that the healing is complete. In medicine, things need to be concise since communication needs to happen quickly and efficiently. But cancer upends our lives, and these neat terms and designations can be upsetting. Cancer is inconvenient, and the language should be anything but tidy.
Shortly after my surgery—before I received my faithful packet—I'd stopped looking at my body altogether. I turned my back to the bathroom mirror while bathing and getting dressed. So, I began a practice: I gazed at myself in the mirror and placed my hands on my scars. I'd look and tell my body: "I love you."
Initially, seeing my new body was excruciating, but by asserting that I loved my body, I slowly began to detach from my old idea of how I looked. I could put down the armor that everyone told me treatment required and embrace the softness that healing needs. In The Cancer Journals, Audre Lourde writes of her mastectomy: "Any amputation is a physical and psychic reality that must be integrated into a new sense of self." After a few weeks of gazing and crying, I began to feel tenderness toward my new body. Tender language was vital to my healing process. We can't keep fighting forever.
Ultimately, the words we use help structure our experience. How do we wish to get through cancer treatment? How do we want to live our lives after cancer? Language matters. And I think it's time we spoke to our bodies with more love.
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