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CANCER: The Battle Over Words

Communication is a cornerstone of our profession, but what does that have to do with cancer. Let's set the stage. The human burden of cancer looms large and if trends continue, it will soon be the #1 cause of death in the U.S. - surpassing heart disease. With that being said, odds are you or someone you love has been impacted by this dreadful diagnosis. EMS service calls for cancer patients are trending upward too, as more folks want to be treated from the comforts of home. When we hear the word cancer, many times it stops us in our tracks and finding the right words can be extremely difficult. To that end, you’ve likely heard battle language assigned to this disease. Words, such as “battle, fight, beat, win, survivor” – even more military style metaphors probably sound familiar. It all dates back to Nixon's "war on cancer" campaigns 50+ years ago.

Data, however, suggest we may have to choose our words more wisely. Battle language can help and empower many (the patient + the family) – but sometimes this language can actually do more harm than good with others….. you see in war; you have winners and losers. Some argue It is unfair and actually insensitive to divide the sick into winners and losers. Words and perspective matter - they also have implications!!!

The Journal of Psychosocial Oncology published some data to investigate specifically why the word “survivor” upsets some patients. Here is what they found (the word dismissed + reminded):

· Dismissed the fear of recurrence

· Dismissed the unique experience of each patient

· Dismissed the ongoing struggle after cancer

· Dismissed the fact that not everyone survives

· Reminded patients of a traumatic time in their life

· Reminded patients of the risk of death from cancer

Source: [Tedx Talk by Dr. Katie Deming on June 22, 2022]

Let me further explain: Cancer is not a foreign invader. Cancer can’t be stomped out by pure will. Cancer is cancer – no metaphors, no euphemisms. Cancer is your own cells going rouge. Cancer is a disease of cellular biology in which some cells stop obeying the good instructions they’ve been given. The cells replicate unchecked and seek out any opportunity they can – even spilling over and metastasizing into other body systems, different from its origin. These cells essentially forget how to die, and they just keep proliferating. The reality is that for some advanced staged patients - it may be impossible to fully recover.

As EMS professionals, whether it's cancer or another realm of medicine, we are obligated to follow a certain code of ethics. Public trust, patient rapport, respect, and effective communication are foundational elements of our industry. Every encounter matters. Please continue to be great communicators who advocate for patients. Words in a dictionary may seem powerless, but when strung together - they are powerful and can impact others (good or bad). The people we treat and care for are listening to what we say. Choose your words wisely.

This blog post is dedicated to my mother Tami (1962-2022), who died from metastatic lung cancer on September 13, 2022. My mom died after LIVING with cancer for a period of time, but she didn’t LOSE anything. Her body was more than a battleground - May she rest in peace!

January 23, 2023

Author: Joshua Ishmael, MBA, MLS(ASCP)CM, NRP

Pass with PASS, LLC.

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Very well stated Josh. I’m sorry for your loss. I am living with cancer currently as are many in the Fire/EMS service. Much debate centers around cause…many variables involved. Prostate Cancer can be removed surgically, treated with radiation, chemo, cryotherap…etc but never Truly goes away. The mindset of the patient …who may never become sick or symptomatic…is greatly affected in regards to what tomorrow brings. Does every “ache and pain signify a RETURN?? No….but the mental strain and toll it can take on the patient and loved ones cannot be measured. Personally…I also dislike the term “survivor”…I have not beaten Cancer…I’ve only stopped it from killing me at this time And stage. Early detection and appropriate treatment has given me…

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