On cancer “survivors”

Not to belittle for a moment anybody who’s had cancer and successfully gone through treatment, but the seeming overuse of the term “survivor” has always bothered me.  The other day I was watching a college basketball game and the announcers mentioned all the men they knew that were prostate cancer “survivors.”  Now, as I’ve written about many times, whether you have treatment or not, the substantial majority of men with a prostate cancer diagnosis would not die of the disease even if they received no treatment.  Now, how exactly do you survive something that wouldn’t have killed you anyway?  I was looking for another article on Slate– which I’ll save for a future post– and I came across this excellent piece on the trouble with “survivor” from a couple years back.  It’s by an oncologist who is a breast cancer “survivor.”

The National Cancer Institute defines a “cancer survivor” as someone who’s had a malignant tumor and remains alive. This holds whether you’re thriving after a single intervention, like surgical excision of a small tumor, or struggling for years with metastatic illness. The American Cancer Societyreports that nearly 12 million Americans are living today after a cancer diagnosis; each of us is a “survivor.”…

I can’t help but wrestle with the expression. The Latin roots—super and vīvere—support a straightforward meaning: that a person has outlived another. As an oncologist, I’m not convinced of this label’s accuracy, at least as it applies to a woman living after breast cancer; this, like some lymphomas and other tumors, can recur years, even decades after treatment ends. What’s more, I worry the “survivor” lingo might cause harm: Just as the term can support or reflect upon a patient’s courage and tenacity, it might alienate or wound someone who knows she can’t alter the course of her disease…

At a deeper level, what’s wrong is that the expression connotes strength or heroism. Today, survivor feeds into the concept of cancer as some sort of contest of harsh ordeals. Best sellers like Dr. David Servan-Schreiber’s Anticancer: A New Way of Life push the impression that survival implies you’ve done something right. The fault’s in the converse: If you don’t lick your tumor, you’ve failed. Maybe you chose the wrong treatment plan, ate the wrong foods, exercised too little or too much, or weren’t sufficiently optimistic. But cancer is not a mystic life challenge or game. It’s a disease, or really a set of complex diseases, that’s common, feared, and widely misunderstood…

Only a cynic would dismiss all the tangible, big-money support for research and the information and practical assistance offered by the survivor community’s enthusiasm. But the true heroes in this—those deserving of pink ribbons and medals, if they’re to be given—are those who struggle longest and hardest, who will never truly be “survivors” in the commonly accepted sense of the word.

It’s not the same for people like me, who move on with their lives after a discrete, albeit sometimes harrowing episode of illness. I’m an oncologist; I know I’ve done nothing in particular to deserve these eight years since my diagnosis. I lucked out, nothing more. And sure, I’m uncertain about my future. But who isn’t?

Good stuff.  I think on some level these issues bothered me (in addition to what I raised above) without me really realizing what it is about the term that’s always rubbed me wrong.  And for those who have survived an ordeal with cancer– good for you, most definitely.  I just think there are some real downsides to the term and that, in some case, it paints a false picture as well.

About Steve Greene
Professor of Political Science at NC State http://faculty.chass.ncsu.edu/shgreene

3 Responses to On cancer “survivors”

  1. Mike says:

    Yes, one would certainly not want to belittle anyone’s fight with cancer. (eyeroll) I’m sure it will make me a terrible person, but I find it annoying. When I hear about a man or woman who is mauled by a grizzly bear, their face and back hang in tatters and leaving a bloody trail as they walk out of the wilderness for five miles so they can flag down a car, I think “Now that’s a survivor”.

    But a person who followed the recommended oncologists treatment?

    The word survivor has become like the word miracle. Everyone’s a survivor, and everything is a miracle. A child gets sick, then gets well, it’s a miracle. Never mind modern medicine, antibiotics, the very latest treatment for the disease that someone has been working on for ten years, no, they had a miracle. Someone survives a tsunami that kills a quarter of a million people and they say it’s a miracle directed at them. Another finds out that a car drove into the bus shelter they were standing in ten minutes ago. Also a miracle.

    Me? I’ve survived influenza and food poisoning. And a half dozen misadventures and several car crashes. Just like billions of other people. I don’t think it’s worthy of a parade. Like most other males, I sometimes wonder how I made it past my teenage years at all.
    Perhaps we should start labeling everyone who leaves the hospital alive as survivors.
    I’m a heart transplant survivor.
    I survived influenza.
    I survived a cat bite and nearly lost my arm.
    I didn’t get MRSA in the ER, I’m a survivor.

    Put them on a plaque next to the people who survived a Nazi death camp for four years.

    Or maybe I’m just annoyed that the women breast cancer survivors dragon boat race trainers take over all the decent protected water kayaking places every summer and nearly killed me twice by ignoring the boating laws.

    Or maybe I’m just cranky this morning. (ha, this morning, he says)

    • Steve Greene says:

      Nice rant! Heart transplant?! Maybe not quite grizzly, but that merits “survivor” more than most things.

      • Mike says:

        It’s important to get a rant out every now and then somewhat anonymously on a blog to keep myself from going off in a supermarket and running amuck with a shopping cart and a gallon size bottle of dish washing soap in the vegetables section.

        And I’m glad you liked it. 🙂

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