My dad passed away from prostate cancer when I was 18. His diagnosis wasn’t optimistic, but I tried to be. I vividly remember waiting in line at a Souplantation not long after he’d shared the news and telling him, “Dad, it’s OK, you’re so strong, you can beat this.”
My dad ― a primary care physician ― took it in stride, nodding good-naturedly at me and my little sister. But he knew it was unbeatable at that point.
Thirteen years after his death, I’m still regretting that moment.
I berate myself over those words because they quietly imply that cancer is a win-lose battle and that you’ve somehow “lost” if the disease overtakes you.
The idea that you can “beat” something as insidious as cancer perpetuates the myth that the patient is wholly responsible for their recovery, not a human caught up in an endless cycle of surgeries, chemotherapy, radiation and relapses. And if they don’t beat it? That’s failure.
But as a daughter, this totally cliched language made perfect sense: Even today, my dad lingers in my mind like a real-life Superman, a man who competed in bodybuilding contests in Southern California (at a time when Asian-American participants were few and far between), published a popular bodybuilding magazine, then went on to help patients fight ailments as a general practitioner.
In my magical-thinking stupor after his diagnosis, a fighter is what I wanted my father to be most. And what else are you supposed to say when a loved one is going through something as harrowing as a cancer diagnosis?
“Let’s fight this, you can beat this” is a common refrain among family and friends of cancer patients, said BJ Miller, a hospice and palliative care specialist who treats hospitalized patients with terminal or life-altering illness at the University of California, San Francisco Medical Center.
“I think we fall back on these statements for a few reasons, mostly habit,” he told HuffPost. “Sometimes, people aren’t really thinking when they say it. These tend to be moments of gesture more than dialogue.”
Plus, as Miller noted, culturally, we like to distance ourselves from death. Conflating sickness or suffering or death with weakness while casting ourselves as hero-warriors who can best it feels empowering in the moment.
“It helps to feel tough when you’re feeling weak,” Miller said. “We demonize cancer so we can mobilize the fight.”
We’re only human, though. Eventually, we all grow old and “lose” our respective fights, even if it’s not cancer our bodies succumb to.
“That’s something we all collectively have to come to terms with,” Miller said. “I think we’re starting to realize that we need a different construct than ‘beat cancer’ lest we make ourselves or others out to be losers for doing what we all have to do.”
“The knee-jerk reaction is to fight this demon ― to eliminate it. The problem is, in the quest for this, we sometimes forget the individual who is the unfortunate victim of cancer. In trying to get rid of the pest, many a time we end up hurting the host.”
– Nagashree Seetharamu, an oncologist at Northwell Health Cancer Institute and a breast cancer survivor
And the fact remains: Cancer is a veritable attack on a person; cancer cells grow and divide, grow and divide, ad nauseam, forming tumors that wreak havoc on the immune system. Your body is literally at war with itself.
The combat imagery we employ in conversation is fitting in that respect. When we tell a loved one they can “beat cancer,” we’re telling them not only that they’re strong, but that we’ll stand by them in the trenches. Unfortunately, sometimes that can lead to unintended mental health effects, especially if the patient has already made their peace with an advanced diagnosis.
Nagashree Seetharamu, an oncologist at Northwell Health Cancer Institute, understands our angry, outsized response to cancer. Even as advances are being made in research and as survival rates increase, cancer is a scary diagnosis. (She knows this firsthand; a few years back, she was diagnosed with early-stage breast cancer.)
“The knee-jerk reaction is to fight this demon ― to eliminate it,” she said. “The problem is, in the quest for this, we sometimes forget the individual who is the unfortunate victim of cancer. In trying to get rid of the pest, many a time we end up hurting the host.”
However the journey ends, our focus needs to be with the person: The winner should always be the patient.
“For me, ‘beating cancer’ means not letting cancer dictate how I ― or my patients ― live or die,” Seetharamu said. “That involves following through procedures and treatments to control or cure cancer when there are reasonable chances of doing so.”
It’s worth noting that there are obvious upsides to using optimistic language when discussing the disease. Research shows that a positive outlook in the face of cancer treatment may have an effect on the outcome.
There’s a middle ground between a rosy, “let’s beat this” perspective and total doom and gloom ― one I wish I’d been able to bridge when I first learned of my father’s diagnosis.
For starters, mentioning his prior strength in the face of hardship probably would have been heartening for him. That’s generally a safe approach, according to Kelsey Crowe, a cancer survivor and the author of There Is No Good Card for This: What To Say and Do When Life Is Scary, Awful, and Unfair to People You Love.
“If the person is hopeful, then instead of ‘you can beat this,’ you can say, ‘I have seen you weather many tough things before, and this one is the toughest,’” Crowe said. “If someone is more accepting that they may not beat the disease, you can say you admire someone for making peace with this phase of their life, and focus on cultivating a peaceful ending.”
In the end, there’s no playbook for this kind of thing. To the best of your ability, you just have to read the room and consider the person. Whatever you say, make sure it’s serving them, Miller said.
“I think there’s room enough for this more brutish approach ― the ‘you can beat this’ example ― but generally, we just need room for a wider spectrum of responses,” he said.
“You can also say something simple: ‘I’m so glad you told me. Whatever happens, and whatever decisions you make, I’m with you.’”
“Living With” is a guide to navigating conditions that affect your mind and body. Each month, HuffPost Life will tackle very real issues people live with by offering different stories, advice and chances to connect with others who understand what it’s like. In March, we’re covering cancer. Got an experience you’d like to share? Email firstname.lastname@example.org.