Cancer is not a ‘Battle’

A cancer specialist friend – she has been an oncology consultant for some years now – said to me irritably: “I do wish to heaven that people would stop referring to cancer as a ‘battle’.  As in ‘so-and-so has lost her battle against cancer’. It is so unfair on cancer patients. It makes them feel they are failing, if they are ‘losing the battle’. And they are not. Because it’s not ‘a battle’.”

Yet this phrase continues to be invoked when a personality dies from cancer. Recently, it was “Paul Newman loses his battle against cancer”. Previously, the wonderful Ronnie Drew of The Dubliners was said to have “lost the battle” against his cancer, as had his wife, “lost” a similar battle a year before.

But cancer is not a “battle” in which you win if you fight fearlessly, and you lose if you go about it the wrong way, are a poor strategist, misdirect your troops, or cannot match the enemy in firepower. My oncologist friend is right: to talk about “winning” or “losing” the battle against cancer is deeply unjust to cancer patients, implies they should be blamed if they fail, and is turning a branch of medical science into sentimental metaphor.

Paul Newman was a great movie star whom we all adored, but he died of lung cancer because less than ten per cent of patients survive lung cancer. He was 83. Any death is a loss, but you have to die of something, and 83 is not a bad innings. Maybe cigarettes contributed to his illness, but maybe he was also genetically disposed to contracting cancer of the lung. If cigarettes were a contributory cause, is dying at the age of 83 a punishment? If so, it is a well-delayed punishment, being over the average age of male deaths for Americans, and well over the Biblical three score and ten: he certainly did not pass away prematurely.

Cancer is not one illness but a variety of diseases which strike at various and diverse parts of the human anatomy, male and female. It seems more prevalent today simply because people have stopped dying from other causes: the affliction of tuberculosis, or consumption, which swept away entire families in Ireland – and elsewhere – no longer occurs. Women, thank heavens, now seldom die in childbirth, and European men rarely die in battle: so we survive to be vulnerable to cancers instead.

Some cancers are related to lifestyle: women who breastfeed are less likely to get cancer of the breast: women who are not promiscuous (or who are virgins) are less likely to get cancer of the cervix. Thus nuns never get cervical cancer, but are vulnerable to breast cancer. But people also get cancer because their genes dispose them to it, or just because they are unlucky. A respectably married woman who has never had any other sexual partners than her husband can also contract cervical cancer – because her husband happens to be a carrier.

And it is sadly the case that some people have the misfortune to be treated by an incompetent doctor who does not act in time, or diagnose properly. But that needs a medical correction, not a phrase about “losing battles”.

We have all known people among our family and friends who have survived cancer: I went to a little drinks party recently where I observed that nine out of ten people in the room had had a brush with cancer. I have friends who have had breast cancer, bowel cancer, throat cancer and prostate cancer. I have known men to survive for over thirty years with prostate cancer – the late Lord Deedes, formerly editor of the Daily Telegraph and sometime Member of Parliament; Bill Deedes discovered he had prostate cancer in his early sixties, did  nothing about it, and he survived until well into his nineties. (Some prostate cancer should be treated, but some, as I understand it, is as well left undisturbed and remains on a plateau.)

But other beloved family members have died from cancer. My brother died at 54 from kidney cancer which metastisised into the bone: my sister from a cervical tumour which metastisised into the womb. Did they “lose the battle”, in the sense of not fighting hard enough, or effectively enough against the disease? Not at all. They were unlucky: the tumour was too aggressive to be treated effectively and spread too quickly. It wasn’t anything they did. It was a biological process, and it is no dishonour to the cancer patient if they should die.

Equally nefarious as the phrase “losing the battle” is the notion that cancer can be overcome by “positive thinking”, or drinking carrot juice, or imaging, or colour therapy. I have known people who did all that, to no avail. Who, after all, was healthier than Linda McCartney, Sir Paul’s first wife? She was an evangelising vegetarian, went in for every possible alternative therapy to “defeat” her breast cancer. But the tumour was too aggressive, and, alas, she died. No: she didn’t “lose the battle” against cancer – she died.