What Does It Mean to Think About Cancer as a Battle?

People often describe cancer as a “a battle” or “a war” or “a fight.”

But does that help? For sure, that metaphor can be motivating. But it can also be tricky, says my twin sister Lucy Kalanithi, M.D., on her podcast, Gravity.

“A battle is all-consuming,” she says. “Battle means only resistance, without much room for integration, or acceptance. And, in battle, there are…losers.”

When Lucy’s husband, Paul, died of cancer six years ago, she was startled to see a regional newspaper’s headline: “Paul Kalanithi, Who Penned Essays on Dying, Succumbs to Cancer.” ‘No, he didn’t,’ she thought. “He died, but he didn’t succumb.”

The battle metaphor can also be hard for patients to handle. “I don’t love it,” agreed Shekinah Elmore, a radiation oncologist who was interviewed on Lucy’s podcast. Shekinah has had multiple types of cancer, including breast and lung. Laughing, she says, “I told my husband, ‘If anyone writes about me, when I die, that I lost my battle with cancer, I will haunt them. I will come back and I will haunt them.’”

So, if we don’t describe cancer as a battle, how else can we think about it?

For guidance, Shekinah turned to the work of poet Audre Lorde, who’d suffered from liver cancer. Lorde said that “we should expand the definition of winning so that we can’t lose.” Her version of winning went like this: “I want to live the rest of my life, however long or short, with as much sweetness as I can decently manage, loving all the people I love, and doing as much as I can of the work I still have to do. I am going to write fire until it comes out my ears, my eyes, my nose holes — everywhere. Until it’s every breath I breathe. I’m going to go out like a f*cking meteor!”

After her own cancer diagnosis, Shekinah chose to continue with med school, get married, have a child and sign a 30-year mortgage on a house. “Just because I know that the ground may fall out from under my feet at any moment doesn’t mean I can’t continue to move forward to long-term dreams,” she says. “And none of that will be wasted. There’s a pressure to achieve these milestones when, really, any amount of time that I have parenting or living in that house is just so beautiful… Every good thing that I’ve done will be a part of someone’s life. And what a beautiful way to live your life… I decided that I’ve already made it, I’ve already won.”

In your life, have you used the battle metaphor? Have you found it helpful or complicated? Sending the biggest hug to anyone who needs one today. Here’s the full episode, if you’d like to listen, and you can find all eight Gravity episodes here. (Here’s a moving episode where Lucy and her daughter revisit Paul’s words.) Thank you so much, Lucy and Shekinah. xo

P.S. “Nine life lessons I learned after my cancer diagnosis.”

(Photo by McKinsey Jordan/Stocksy.)