Clear Margins

Fighting talk

07 March 2022

On my way to a routine check-up.

Language is important. Word choices affect how we perceive and respond to what we encounter in the world around us. Many articles have already been written about how toxic terms like survivor and battle are when we talk about cancer and patients, outlining the detrimental effect this can have.

In this post I’d like to delve a little into why these terms are problematic beyond just a practical indicator of their effects, and look at how inaccurate it is to characterise experiences with health in this way.

It’s personal

Cancer is highly personal and idiosyncratic, but people often try to project their own chosen storyline onto you, the patient. A subject for another post, but so many conversations boil down to the other person essentially seeking your confirmation of how they want to frame what’s happening to you–and language is a key component.

The specifics of cancers, stages, and patient backgrounds have a massive impact on the reality of treatment and experience. Most of us still freak out a little when we hear the c-word, but in many cases a cancer diagnosis is nowhere near as scary or impactful as diseases we’ve normalised being around, like heart disease, which kills more of us. Our horror at “the big C” compromises the opportunity to engage with this ambiguity, and patients are burdened with ill-fitting descriptors. If that seems trivial it really isn’t, it all adds to the isolating effect of having the illness.

It’s judgemental

On a basic level the problem I have with a term like “survivor” is that it’s a value judgement. It frames being alive after cancer as an achievement, the unspoken implication being that those who are no longer around have “lost” their battle. The same applies to similar language around mental health and self-harm.

These judgements represent a ludicrously over-simplified version of events that ignores the complexity involved. Why on earth would we want to assert judgement people in these circumstances anyway ffs, is it the comforting delusion that survival is something you can simply choose? Cancer is caused by cell changes – it’s ambivalent – it isn’t a monster.

Like terms such as “imposter syndrome,” using a word like “survivor” is a way of encouraging people to internalise conditions that are not under their control–including inequality, which has an enormous impact on health outcomes across the board.

It ignores the role of privilege

Let’s delve a little deeper into the parameters. I’ve been given a diagnosis of early stage cervical cancer. Where I live, people with a diagnosis at the same stage have an over 90% five year survival rate (this doesn’t mean they think you’re only going to live for five years, they just stop checking after that time, and it’s less likely to be considered a factor in your eventual death whenever that occurs).

But I live in a country with a public national health service which provides a screening program designed to detect the exact type of cancer I have.

I come from a poor background, but aside from a rough childhood I’ve been fortunate enough to enjoy good health throughout my life. I’m fit, I eat well, and I don’t smoke–all things also associated with poverty, and all things that affect your likely outcome from a cancer diagnosis.

It unsettles me when I’m answering questions during treatment planning about these “lifestyle” factors–that they’re even written into the process / paperwork underlines how poverty is basically regarded as an accepted cause of poorer health outcomes and shorter lives.

It ignores history

Back on the subject of judgement, the cancer I have is caused by HPV, which is an STD. However, unlike people suffering from other STDs, I haven’t experienced any judgement or prejudice–because it’s an infection many heterosexuals get.

The development of medical care for HIV and AIDS is now benefiting other advances in treatments including for covid, and yet only came about through many years of committed activism among community members when the medical establishment didn’t want to know. What could “survivor” possibly imply in this context that isn’t incredibly ignorant of the realities?

Maybe I’ll survive, but don’t call me a survivor, because it’s an insult to people who didn’t / don’t enjoy the kind of care and privilege I do.

P.S. Shoutout to Macmillan for their commitment to inclusive language: