What REALLY is cancer?

Several weeks ago I came across an article by Daniel Menakar about the metaphors we use to describe cancer and its treatment. Many have argued that the typical military metaphors we use in regard to "fighting" cancer are not particularly helpful.

They say that putting the experience into martial terms means that those who die are by definition, at least figuratively, losers. Not just of their lives — as if their lives weren’t enough — but of personal wars. That they gave up. Dr. Andrew Weil says that “it’s not the best way” to think of cancer. Cancer patients writing online and bloggers have also deplored this linguistic habit. “Does it mean that if I croak it’s my fault?” one asks.

Menakar goes on to say that he, as a cancer patient, agrees with this but only partially. He finds it more "calming, less victimizing" to take a "rational" approach to cancer in which it is a problem to be solved, rather than a foe to be vanquished. But when the rubber meets the road and action must be taken--surgery, chemotherapy, coping with pain, etc.--it is the military metaphors that can give strength, courage and fortitude. So, he calls for a dual discursive approach to cancer: in private and when necessary we should draw on whatever metaphors give us strength, but in public we should attempt only "rational, problem-solving" language in relation to this disease.

About 3 or 4 days after SB's diagnosis and surgery, TW and I began to pick ourselves up and we did so through military metaphors. We would look at each other, with tears in our eyes, and say things like, "We are ready for battle," "We are ready to fight," and we would refer to our doctors as the army or assassins. I remember that as soon as we started talking like this my fear and helplessness began to decrease. They never went away but they became something that had a context. I was afraid, not of a mutation and growth of an anaplastic pilocyitc astrocytoma, but of going to battle with this enemy. Using the precise medical terms for SB's condition was utterly frightening because it was so foreign, so complex, so unknowable. But using the military metaphors changed our perspective without losing any of the objectivity of the situation. It was still a partially-resected tumor, the behavior of which was/is unpredictable. But it was now an enemy that we must do everything in our power to fight.

Menakar, however, suggests that this use of military metaphors is "irrational" and removed from how things "really are." We understand this distinction in our daily lives, in our work lives, and, for me, in academia. We say, "Things aren't black and white. There are shades of grey," or "Things are much more complex than that." In academia, binary thinking is derided. Male/female, pure/impure, sacred/profane: these are cultural constructions (i.e., irrational ideas) that mask a much more complex reality (i.e., the way things really are).

It's funny, though, how our attempts to get at what is "really going on" lead us right back into the world of metaphor. For Menakar, the "rational," reality-based way of seeing cancer is as a problem or puzzle to solve. Is this what cancer really is? He later recognizes the problem: "Try as we may, we cannot scour the language of metaphor. Cancer itself is a personification." The word is derived from the Greek karkinos, for crab. This is what tumors looked like with their vascular tendrils spreading from the central node.

The point of thinking more deeply about how we speak of cancer is not to try to get at what cancer really is, or what is really happening to us when we have cancer. These questions are technical and belong to the realm of technicians. In the real world, the world in which we live and die, and fall in love, we need ways to speak of cancer that help us act in the face of terrible uncertainty. This is what metaphors--and particularly binary metaphors like war with radically opposed units--can do for us. When we know who we are and who the enemy is, we can act without thinking and without fear.

The concerns Menakar relays from others--that military metaphors set up those who die from cancer as "losers," "defeated," "vanquished"--are valid, but show that these critics have not fully lived and felt this military metaphor. Because soldiers who die in battle, and who die fighting like hell, are those we honor and call heroes.