Cancer and Metaphors: reflecting on how we talk about cancer

Choon Key Chekar

Originally posted on February 15, 2016 on the University of Leeds Centre for Health, Technologies and Social Practice blog.


In a recent public lecture in Lancaster, Professor Elena Semino (Head of Linguistics & English Language at Lancaster University) shared some fascinating findings from her work on cancer and metaphors. Drawing on corpus analysis of data from interviews and from a public online forum on cancer patients, Professor Semino explored how people with cancer use metaphors. In order to critically reflect on the culture where war metaphors dominate, Professor Semino has worked with health professionals and cancer charities to examine the impact of metaphors in health communication. This research is from a larger ESRC funded Metaphors in end-of-life care project.

In her talk, Professor Semino discussed two distinctive ways in which cancer was ‘talked about’ by patients and health professionals. One was the comparison/contrast between metaphors related to journey and warfares and the other topic was uses of humour in talking about cancer experiences. Although some patients and NHS prefer journey metaphors (cancer as a ’hard road’ and the process of diagnosis and treatment as a journey that one goes through) to warfare metaphors (such as fighting/beating cancer, a battle with cancer), Professor Semino argues that each metaphor might have different benefits for patients. Even though there has been strong criticism that ‘war’ metaphors can be harmful, metaphors are useful for patients and family members as a way of framing their experiences. For some patients in particular, depending on the stage of their cancer, war metaphors can be empowering and give them a sense of identity and purpose (e.g. ‘not giving up’, ‘being a fighter’). And from cancer charities’ point of view, war metaphors undeniably work better than, for example, journey metaphors in terms of fundraising.

As a way of disseminating her research findings, Professor Semino has been working on a ‘metaphor menu’ that could give people with cancer more sensitive and appropriate languages to describe their experiences. Examples include cancer as ‘a fairground ride’ that is scary but will end eventually or cancer as an ‘unwelcome lodger’ who turns up at your house to live with you (without your permission) but will leave eventually and might come back later. She found that the online patient forum was also a platform for a number of patients to find and use humour (in spite of their hardship) to frame their experiences and to then be able to share these experiences with fellow patients.

Since this public event was well attended by health professionals and patients, carers, friends and family members of cancer patients, questions that arose following the talk were equally fascinating and moving. One audience member pointed out that not a single week passes without seeing the expression of ‘losing a battle with cancer’ in national papers. He asked “How can we change this culture?”. In response, Professor Semino suggested the following phrase – ‘S/he lived as well as and as long as s/he could’!

Professor Semino’s talk gives us the opportunity to think about the impact of portrayals of cancer in the media and everyday conversations as well as in the medical setting. We have come a long way from being unable to talk about the ‘C’ word to having a successful TV series devoted to a cancer patient. Yet we have still got a fair way to go in helping cancer patients go through their treatment without the burden of being stigmatised or being criticised for not winning the ‘battle’ with cancer.