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Fight the good fight

Posted on September 23, 2015 at 12:00 AM

What is it about cancer? Hardly a week goes by without a newspaper headline telling us that some celebrity has ‘lost their brave fight’ against it. We are encouraged to raise money to finance ‘the war against cancer’ helping researchers ‘battling’ to find cures. It seems almost impossible to use the word ‘cancer’ without linking it to a military metaphor, but when did this all start and is it appropriate?

Most sources credit US president Richard Nixon with firing the first shot in ‘the war on cancer’ when he introduced the National Cancer Act of 1971. But he never used this expression in his State of the Union address or any related speeches and the words are not included in the act itself, which boosted cancer research in the USA by $100 million with the stated aim ‘to conquer this dread disease’. It appears that the war metaphor was conjured up by contemporary journalists - and it has stuck. Cowboy actor John Wayne stated his intention to beat the ‘big C’ when diagnosed with lung cancer in 1964. He survived removal of one lung and four ribs, but ultimately succumbed to stomach cancer in 1979. His posthumous web site still encourages us to; ‘saddle up and help bring courage, strength and grit to the fight against cancer’. Many cancer victims feel duty bound to declare their intention to fight their disease. This is all very odd, because cancer is one of the few diseases where an individual can do very little to affect the final outcome. If your aim is to live longer, fighting is not required; submission is best. Better to yield to the surgeon’s knife, submit to the oncologist’s venom and expose yourself to the radiotherapist’s rays. Once diagnosed with cancer, your chances of survival are not improved by lifestyle modification or a positive mental attitude.

Also the one thing that cancer consistently does is debilitate its victims, who usually don’t feel at all like fighting. While receiving treatment for oesophageal cancer, Christopher Hitchens says in his book ‘Mortality’ “… you feel swamped with passivity and impotence: dissolving in powerlessness like a sugar lump in water.” And for those overwhelmed by this torpor, the failure to fight leads to frustration and depression in sufferers and relatives alike.

Recently the British Heart Foundation launched its own military campaign: ‘Fight for Every Heartbeat’. It seems that these days every charity needs a war cry to successfully raise funds. “We're fighting cardiovascular disease through world class research”, they claim. Conjuring up a vision of laboratory workers clad in battle fatigues and armed guards protecting their secrets. Yet nothing could be further from the reality of medical research whether it is investigating a cure for cancer, heart disease or any other ailment. The systematic testing of new treatments, the rejection of failed therapies and the cautious introduction of new ideas could hardly be described as a war. And I have yet to meet a medical researcher who feels that they have enlisted in an army.

Unlike cancer sufferers, you seldom hear people with heart disease speak of fighting their illness. But strangely this is a disease worth fighting. If you stop smoking, lose weight, take more exercise, eat a healthy diet, overcome your distaste about taking regular medication and you can significantly prolong your life expectancy. This is just one example of many illnesses where a change in lifestyle and mental attitude can result in a positive outcome both in terms of preventing disease progression and improving quality of life. Sadly, cancer is not one of them.

That’s not to say that you cannot achieve great things following a diagnosis of incurable cancer. Take Kate Granger for example. Based on her own pitiful experiences she has launched a highly successful Twitter campaign (#hellomynameis) to encourage health care workers to introduce themselves by name when they first meet their patients. I was amazed when she told me this hardly ever happened when she was treated as a patient in the hospital where she also works as a doctor. Her campaign “…to encourage and remind healthcare staff about the importance of introductions in the delivery of care” has swept across the country and been adopted enthusiastically by most hospitals in the South West including my own in Exeter. She goes on to say; “I firmly believe it is not just about knowing someone's name, but it runs much deeper. It is about making a human connection, beginning a therapeutic relationship and building trust. In my mind it is the first rung on the ladder to providing compassionate care” But Kate is not really fighting her cancer, just making the best of what life is left to her. And isn’t that what we all should do, cancer or not?

Western Morning News 23rd September 2105

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