‘War’ on cancer needs to end – The Journal News

Jay Bishoff| Special to the USA TODAY Network

My fourth year of medical school coincided with the first Gulf War, when I served as a United States Air Force surgeon during Operation Iraqi Freedom.

I was on rotation in France, where police arrived at the hospital to deport the wife of an Iraqi diplomat. Shed just had part of her colon removed.

When my professor refused to discharge her, the police drew their guns. One of Frances finest surgeons, my professor stood between the police and his patient. The police finally relented and left. (They eventually deported the diplomats wife when she recovered, as they had done with all Iraqi diplomats at the time.)

My professors words to me that day stayed with me: Patient care trumps politics every time.

Having seen the effects of combat firsthand, I know that patients including the wife of the diplomat, and the U.S. and coalition soldiers, Iraqi nationals and insurgents I eventually treated during Operation Iraqi Freedom come to us to live.

Thats why the vocabulary of war doesnt apply to patient care, especially cancer. That is important to remember as we marked Veterans Day this month.

Through that dark lens, weve been fighting, eradicating, wiping out and battling for 50 years. In the world of cancer treatment, this aggressive terminology is an unfortunate norm.

Some date the association between illness and war back to the 16th century. But in the 1970s, President Richard M. Nixon took up this approach with enthusiasm. In what was almost an extension of Nixons foreign policy, he declared war on drugs, and then on cancer with the National Cancer Act of 1971.

The legislation prioritized much-needed cancer research, then the countrys second leading cause of death. And the Vietnam Conflict-era conquest terminology surrounding cancer stuck.

Ultimately, though, these battles, wars and conflicts are little help to patients. Its a hard-won lesson I learned through indelible personal experiences, like the one with the wife of the Iraqi diplomat.

More than aggressive pressure, unnecessary urgency and unnerving comparisons, patients often need thoughtful expertise and unhurried communication.

Combative terminology, on the other hand, suggests patients may not be fighting their cancer hard enough. It positions them as winners and losers. Imagine applying that approach when a child has cancer. Its a black-and-white perspective in a medically grey situation.

British epidemiologist Michael Colman has a strong reaction to politicians use of war-like metaphors. Drop the lazy, simplistic jargon and the distorted priorities of war, he says, and focus on prevention to make long-term progress against cancer.

Colman has a point. Battle-focused language is, in my experience, almost laughable. It politically oversimplifies a complex disease especially considering that cancer remains our countrys second-leading cause of death since Nixon started war on it.

Canadian breast cancer survivors in a 2003 study who associated their illness with words like, "enemy," "loss," or "punishment" felt the impact of that terminology. They reported significantly higher levels of depression and anxiety and poorer quality of life than women who indicated a more positive meaning.

Journalist Katy Waldman wrote of a toxicity of the war metaphor, citing studies in which patients who view cancer as an adversary have reportedmore guilt, higher levels of depression and anxiety, andelevated pain.

Cancer is a journey, she says, with embarkations, milestones, resting points, and destinations deep into our symbolic understanding of a life. Some cancer patients cant be cured; they face a war with no clear end. Its a reasonable and powerful depiction.

The vocabulary of war ultimately diminishes and politicizes the suffering of cancer patients. It reduces a complicated condition to a clich. Having seen war up close, I want to calmly inform my patients with the knowledge theyll need to face cancer--to encourage them to build and strengthen themselves for an experience that focuses not on destruction, but on life.

Jay T. Bishoff, M.D., is the director of urology for Northwell Health's Central Region. Northwells Cancer Institute includes locations throughout Long Island, Manhattan and Westchester County.

Continued here:

'War' on cancer needs to end - The Journal News