Losing “Losing the Battle With Cancer” | Oncology | JAMA Oncology | JAMA Network
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April 2015

Losing “Losing the Battle With Cancer”

Author Affiliations
  • 1Department of Surgical Oncology and Department of Molecular and Cellular Oncology, University of Texas MD Anderson Cancer Center, Houston
  • 2Deputy Editor, JAMA Oncology
  • 3Knight Cancer Institute, Portland, Oregon
  • 4SWOG Group Chair’s Office, Oregon Health and Science University, Portland
  • 5Fight Colorectal Cancer, Alexandria, Virginia
JAMA Oncol. 2015;1(1):13-14. doi:10.1001/jamaoncol.2014.188

Patients with cancer lose many things of importance. As soon as they hear the words “you have cancer,” they lose control over their lives, as medical appointments immediately begin to shape their daily schedules. They may lose the ability to participate in activities that bring them joy, as a result of chronic treatment adverse effects such as neuropathy, bowel issues, or lymphedema. Too many lose their lives. We also commonly hear the statement that a patient has lost “his or her battle” with cancer. As physicians who treat oncology patients, and as advocates, we believe that this quote is unsuitable and even demeaning to the patient, his or her family, and friends.

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    2 Comments for this article
    The Battle Against Unsuitable Medical Language
    (1) David B. Sykes, (2) Darren N. Nichols | (1) Massachusetts General Hospital Cancer Center (2) University of Alberta
    It was with great pleasure that we read Drs. Ellis, Blanke, and Roach’s recent Viewpoint “Losing ‘Losing the Battle with Cancer’” 1. The authors entreat us to avoid this “unsuitable and even demeaning” colloquialism. We agree with them; language matters. In our own recent manuscript, we speak to the importance of updating our medical lexicon, and in particular to discontinuing the use of the word ‘fail’ with colleagues and patients 2,3. No patient fails chemotherapy, rather it is the chemotherapy and our lack of perfectly targeted therapies that fail the patient. The true physician, the true healer, masters this aspect of patient care, empowering the dying patient and preparing for death with the recognition that a cancer death is so often the bad luck of a particular mutation and not the result of the patient’s unwillingness to continue the battle with cancer. Perhaps our linguistic duty is to replace the battle metaphor with language that honors those who move through suffering and face the end of life’s journey with equanimity and grace. When we conflate beating cancer (a noxious disease) with beating death (a natural step in life’s journey) we are doing our patients and our system a grave disservice. Language matters. The authors are correct: the right language can save health care resource, avoid futile treatment, and help our patients in the journey towards a dignified death.References1. Ellis LM, Blanke CD, Roach N. Losing “Losing the Battle With Cancer”. JAMA Oncology. 2015;1(1):13-14.2. Sykes, DB, Nichols, DN. There Is No Denying It, Our Medical Language Needs an Update. Journal of Graduate Medical Education. 2015;7(1):137-138. 3. Parles, K, Chabner, B. ‘‘The patient failed chemotherapy’’… an expunged phrase. Oncologist. 2004;9(6):719; author reply 719.
    Re: Losing “Losing the Battle With Cancer”
    Carol Halberstadt, B.A. and graduate study | Person and patient living with cancer(s); Published in JAMA Poetry and Medicine; Newton, Massachusetts
    Yes, the language is pervasive, and it is deeply demeaning and insulting. There is no “war,” there is no “battle,” and there is no “losing” (or “winning”). There is illness and there is healing and there are short- and long-term side effects, and there is surviving and “survivorship”; there is suffering and pain, and there is life to be lived as well as it can be—and no one can predict or define exactly what that is, or what will be, because each patient, each person is unique and different, and at the end there is death, and before that there are all the other experiences that for me, as a poet, I’ve written about in the poems I‘ve been honored to have published since 2015 to 2019 in the Poetry and Medicine section in JAMA, among many others.

    Yet, despite your article almost 4 years ago, and the comment (below) that eloquently affirms that the “battle” language should be removed, it still appears regularly in the way people living (or dying) with cancers are described. There is no "courageous battle,” which is “lost” (or, if luck prevails, “won.”)

    I’m glad to see JAMA Oncology reissue this article.