War metaphors are often used to describe a person's experience with cancer. Those who have died are said to have lost their "battle with cancer", while the living are described as "fighting cancer".
While the use of metaphors can help physicians explain cancer in a way that is understood by patients, it has been argued that words such as battle and fight are inappropriate, as they suggest that cancer can be defeated if one just fights hard enough. [1] [2] [3]
The use of war and battle metaphors in medicine has been documented back to the 1600s. [4] Over the 20th century, politicians have "declared war" on cancer, diabetes, AIDS, and obesity. [4]
Military metaphors are not a Western phenomenon. Battle terms are also used in traditional Chinese medicine. Contrarily, in sub-Saharan Africa, diseases are seen as a part of life that should be accepted, not fought. [4]
War metaphors are commonly used by scientists, physicians, patients, and the general public. [5]
A 2010 study found that greater use of metaphors by physicians was associated with better understanding by patients. [6]
The phrase is often used when someone dies, and may appear in obituaries. For example, a statement from Victoria Wood's publicist in April 2016 said that Wood had "passed away, after a short but brave battle with cancer". [7] [8] In December 2016, journalist A. A. Gill was described by Sky News as having died after a "short fight with cancer". [9]
Research in 2014 led by Elena Semino, a professor of linguistics at Lancaster University, alongside palliative care specialists, based on 1.5 million words of discussion, led Semino to say, "We have enough evidence to suggest that battle metaphors are sufficiently negative for enough people that they shouldn't be imposed on anyone". The study stated that doctors should avoid battle/fight metaphors unless patients themselves chose to use them, and obituaries should avoid them, especially the idea of "losing" such a battle/fight. By comparison, another common metaphor, comparing cancer to a "journey" was "less likely to lead to feelings of guilt or failure". [10] In a study conducted in 2003 stated that patients using war-related terminology to describe their breast cancer had higher rates of depression and "poorer quality of life". [11]
In a 2014 article in The Guardian titled "Having cancer is not a fight or a battle", physician Kate Granger, who was diagnosed with desmoplastic small-round-cell tumor (a type of sarcoma), explains how the use of military language, whilst perhaps aiming to instil a sense of positivity, can have the opposite effect. [12]
The use of war metaphors can have negative effects for patients. Patients perceive treatment to be more difficult when it is described to them using violent metaphors. [6] These metaphors can also lead to feelings of disempowerment, guilt, and fatalism. [6] One study found that the use of war metaphors in cancer public health decreased engagement in cancer prevention behaviors. [13] Another common criticism of this use of metaphor is that when patients die, the implication is that they did not fight enough, and if they fought harder, they would have been victorious. [14] [6] The term "journey with cancer" has been proposed to replace the war metaphors due to both help with the visualization of the disease and more gentleness for patients. [15]
Sick Kids Hospital in Canada spent $2 million on an advertising campaign depicting children as warriors clad in armor with weapons. This attracted controversy and was decried by some as not portraying the true experience of children with serious diseases. [6] [16] [17] [14] A charity has been named Cyclists Fighting Cancer [18] and foods have been described as "cancer-fighting". [19] Following the death of Robin Gibb, cancer survivor Jenni Murray criticized the media for using 'pugilistic terminology' arguing 'RIP Robin Gibb with an acknowledgement that he drew the short straw of a difficult disease'. [20]
The concept of a "battle with..." is used in similar phrases such as a "battle with depression". [21]
HIV researchers also commonly use battle metaphors.[ citation needed ] Some commentators have also criticized the use of war terms and militarization of the HIV/AIDS pandemic. [22]
The use of war metaphors spread during the COVID-19 epidemic, in which healthcare workers were described as "brave heroes", and those affected by coronavirus as "victims". [6]
A disease is a particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical conditions that are associated with specific signs and symptoms. A disease may be caused by external factors such as pathogens or by internal dysfunctions. For example, internal dysfunctions of the immune system can produce a variety of different diseases, including various forms of immunodeficiency, hypersensitivity, allergies, and autoimmune disorders.
Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.
Orthomolecular medicine is a form of alternative medicine that claims to maintain human health through nutritional supplementation. It is rejected by evidence-based medicine. The concept builds on the idea of an optimal nutritional environment in the body and suggests that diseases reflect deficiencies in this environment. Treatment for disease, according to this view, involves attempts to correct "imbalances or deficiencies based on individual biochemistry" by use of substances such as vitamins, minerals, amino acids, trace elements and fatty acids. The notions behind orthomolecular medicine are not supported by sound medical evidence, and the therapy is not effective for chronic disease prevention; even the validity of calling the orthomolecular approach a form of medicine has been questioned since the 1970s.
Illness as Metaphor is a 1978 work of critical theory by Susan Sontag, in which she challenged the victim-blaming in the language that is often used to describe diseases and the people affected by them.
Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood, in order to replicate inside a patient and produce additional normal blood cells. HSCT may be autologous, syngeneic, or allogeneic.
Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that affect the patient's immune system. Examples of these extrinsic factors include HIV infection and environmental factors, such as nutrition. Immunocompromisation may also be due to genetic diseases/flaws such as SCID.
AIDS-related lymphoma describes lymphomas occurring in patients with acquired immunodeficiency syndrome (AIDS).
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.
Prognosis is a medical term for predicting the likelihood or expected development of a disease, including whether the signs and symptoms will improve or worsen or remain stable over time; expectations of quality of life, such as the ability to carry out daily activities; the potential for complications and associated health issues; and the likelihood of survival. A prognosis is made on the basis of the normal course of the diagnosed disease, the individual's physical and mental condition, the available treatments, and additional factors. A complete prognosis includes the expected duration, function, and description of the course of the disease, such as progressive decline, intermittent crisis, or sudden, unpredictable crisis.
Tropical medicine is an interdisciplinary branch of medicine that deals with health issues that occur uniquely, are more widespread, or are more difficult to control in tropical and subtropical regions.
This is a timeline of HIV/AIDS, including but not limited to cases before 1980.
The Association of American Physicians and Surgeons (AAPS) is a politically conservative non-profit association that promotes conspiracy theories and medical misinformation, such as HIV/AIDS denialism, the abortion–breast cancer hypothesis, and vaccine and autism connections, through its official publication, the Journal of American Physicians and Surgeons. The association was founded in 1943 to oppose a government attempt to nationalize health care. The group has included notable members, including American Republican politicians Ron Paul, Rand Paul and Tom Price.
Survival rate is a part of survival analysis. It is the proportion of people in a study or treatment group still alive at a given period of time after diagnosis. It is a method of describing prognosis in certain disease conditions, and can be used for the assessment of standards of therapy. The survival period is usually reckoned from date of diagnosis or start of treatment. Survival rates are based on the population as a whole and cannot be applied directly to an individual. There are various types of survival rates. They often serve as endpoints of clinical trials and should not be confused with mortality rates, a population metric.
Henry Judah Heimlich was an American thoracic surgeon and medical researcher. He is widely credited for the discovery of the Heimlich maneuver, a technique of abdominal thrusts for stopping choking, first described in 1974. He also invented the Micro Trach portable oxygen system for ambulatory patients and the Heimlich Chest Drain Valve, or "flutter valve", which drains blood and air out of the chest cavity.
Siltuximab (INN), sold under the brand name Sylvant, is used for the treatment of people with multicentric Castleman's disease. It is a chimeric monoclonal antibody that binds to interleukin-6. It is an interleukin-6 (IL-6) antagonist.
Timothy Ray Brown was an American considered to be the first person cured of HIV/AIDS. Brown was called "The Berlin Patient" at the 2008 Conference on Retroviruses and Opportunistic Infections, where his cure was first announced, in order to preserve his anonymity. He chose to come forward in 2010. "I didn't want to be the only person cured," he said. "I wanted to do what I could to make [a cure] possible. My first step was releasing my name and image to the public."
The stages of HIV infection are acute infection, latency, and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, swollen lymph nodes, inflammation of the throat, rash, muscle pain, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts, various opportunistic infections, cancers, and other conditions.
The Berlin patient is an anonymous person from Berlin, Germany, who was described in 1998 as exhibiting prolonged "post-treatment control" of HIV viral load after HIV treatments were interrupted.
Big Pharma conspiracy theories are conspiracy theories that claim that pharmaceutical companies as a whole, especially big corporations, act in dangerously secretive and sinister ways that harm patients. This includes concealing effective treatments, perhaps even to the point of intentionally causing and/or worsening a wide range of diseases, in the pursuit of higher profits and/or other nefarious goals. The general public supposedly lives in a state of ignorance, according to such claims.
Tatiana Michelle Prowell is an American medical oncologist specializing in breast cancer. She is an Associate Professor of Oncology at Johns Hopkins School of Medicine and Breast Cancer Scientific Liaison at the U.S. Food & Drug Administration.
