The Battle Against Cancer Metaphors: A Case for People-First Language

“Please stop calling me brave.”

I wrote that in a Facebook post in the fall of 2019, after I’d been diagnosed with late-stage colorectal cancer. I didn’t mean it as an admonishment. Friends and family from across the globe had reached out, sent gifts, and generally showered me with more love and support than I ever expected. But some people called me brave, others reminded me that I’m a fighter, a survivor. I saw this echoed by members of online and in-person support groups I’d joined. Even my dentist told me that she was a cancer survivor and, soon, I would be, too! We were Cancer Warriors and we would win this battle!

The truth is this kind of language makes me very uncomfortable.

For some people, underscoring their strength and resilience helps them in the dark moments, when it feels like the treatment is worse than the disease. Focusing on all that we have to live for—to fight for—can make it easier to endure the myriad indignities of testing, prodding, and poking that are inherent in cancer care. But for some of us, framing the disease experience using violent fight language leaves little room for nuance and raises more questions. Are people who have hit five years with no evidence of disease somehow better warriors than those who don’t? If my treatment doesn’t work, does that mean I’m weak or didn’t fight hard enough? If I die, am I less worthy of being remembered as a strong person, a role model, or a good friend?

Cancer is a complex set of diseases, and different people living with it have different preferences for how to describe themselves. I prefer people-first language that emphasizes me over my disease. Phrases like person with cancer versus cancer warrior highlight humanity over condition and hold space for the person involved to be more than one thing. It also allows the person to have multiple feelings about their cancer as things change over time. A year and a half after my initial diagnosis, my feelings have only become more nuanced and complicated; saying I’m “fighting” cancer reduces my experience to the days I have treatment or the drugs I take, rather than encompassing the whole of my emotions, struggles, and accomplishments.

As marketers in the health space, this presents an interesting challenge: How do we reach our target audience without inadvertently alienating a segment of it by using language some appreciate but others don’t? We do what we always strive to do: We listen. It’s important to remember that knowing your audience is one thing; listening to your audience is another. Do we hear people with cancer using these metaphors when they talk with one another? Do oncologists and clinicians use these metaphors? Or do we mainly hear them used in the mainstream media or among the general public? It is our responsibility as communicators to actively listen and take our cues from the audiences we are wanting to inform, educate, and empower.

I find myself in the role of both health communicator and target audience. It’s a surreal place to be sometimes, but it also offers me an opportunity—an opportunity to inform the way we communicate with people with cancer, by improving the way we listen. People-first communication requires intentionality and action. As health communicators it’s time we listen to understand and then incorporate what we hear. In the simplest terms, there are three steps to incorporating a people-first approach:

• Listen to the patient audience—actively and with the intent to understand;
• Value their experiences and their perspectives—as they are shared, not necessarily as you assume them to be; and
• Reflect those learnings in your messaging and outreach.

I value being heard as a person with cancer. And I value the opportunity to bring that experience to my work as a health communicator by both incorporating and promoting messages that put people first.

Allyson Harkey
Digital Content Strategist