Battle, fight, win — you hear these words describe cancer all the time, but medical experts are now re-thinking how we characterize the disease because of the emotional ramifications.
"It has the potential to be detrimental to patients, to their overall sense of well-being," said Dr. Elie Isenberg-Grzeda, a psycho-social oncologist at Sunnybrook Health Sciences Centre in Toronto.
"[Cancer] is sort of the antithesis of what we envision when we think of a fighter, or a warrior, or bravery."
But when people who have been diagnosed with cancer already feel unwell, he says receiving these messages that you should feel differently or the complete opposite adds "insult to injury."
Action verb framing
Why do we use this language in the first place?
Isenberg-Grzeda said he once had a patient describe cancer as feeling like an "assault on his body."
'What maintaining a positive attitude can do is help everyone feel like everything is quote okay.' - Dr. Elie Isenberg-Grzeda
"It makes perfect sense to me if someone is feeling assaulted that what they would do is assault back or retaliate back in some way," he said on Metro Morning Thursday.
"When we think about fighting, and doing, and going, and curing — all those sort of forward thinking kind of action verbs, those military or battle metaphors — what it doesn't leave a whole lot of time for is a lot of reflection for some of those other issues and questions."
The idea that battles have winners or losers — either defeating cancer or dying from it — gives people either a renewed sense of control over their treatment, or in other cases, when people can't change the outcome, a sense of defeat, according to Isenberg-Grzenda.
"In terms of what that does to someone's self-worth, particularly if those are their final days or months, that can be really devastating especially when we keep being told that people should have a positive attitude," he explained.
'Order restored to the world'
On the other end, Isenberg-Grzenda says there are benefits to remaining positive, particularly for family members and friends.
"It can make everybody in a family sort of feel like things are the way they should be, there is somehow order restored to the world, when what they previously found out is their loved one has a diagnosis of cancer," he said.
"What maintaining a positive attitude can do is help everyone feel like everything is quote okay."
'Sadness, anxiety, worry, fear'
A balance needs to be struck, he added.
"In reality, I almost never meet somebody who on the surface might appear to have a positive attitude, who when you scratch the surface a little bit doesn't have a lot of sadness, anxiety, worry, fear underneath it all," said Isenberg-Grzenda.
"The issue is the more of a positive attitude we're seeing, the less of the other stuff, that underlying stuff, those negative emotions."
'Sometimes there isn't anything to say'
How should people re-frame this when there is a pressure to find the right words?
"Sometimes we don't have to say anything and sometimes there isn't anything to say," he said.
"Sometimes just being present and a supportive ear for somebody who is going through this, allowing them the space to actually feel sad and express their sadness and vulnerability ... what you're doing is really freeing up the space for them to express what's really going on inside them."