Today is National Cancer Survivor’s Day. I guess “national” refers to the US, but what the hey. I’m one of these people too.

I’ve been inspired to write by Marie at Journeying Beyond Breast Cancer, a really super blog. (Reminds me that I need to start a blog roll and I’ve been really sloppy about linking my blog. Ooops!

Today’s post, about Reframing Cancer Survivorship inspired me to think again about the framing of cancer.

Almost exactly a year ago, I wrote a couple of posts about the war metaphors, and I’m going to borrow heavily from myself. So the transitions might be a fuzzy and incomplete.

For background, Susan Sontag’s Illness as Metaphor and the first few chapters of of Lakoff and Johnson’s Metaphors We Live By (the stuff about characterization of metaphors) are great references – a bit esoteric, propeller head stuff, but still, worth the read.

I have a problem with the whole War on Cancer/Race for the Cure/Cancer Survivor thing. Military frames play a big part in medicine – we fight disease, we win or lose wars against this, that and the other thing, and we survive. So the assumption is that you can win or lose against cancer (and other diseases). Winning is a cure, and losing is death or maybe recurrence. But also, as Sontag points out, cancer is evil, wicked. The enemy. Those of us with cancer have this evil in our bodies. It must be exorcised, excised, poisoned, removed, stopped. And treatments do this – chemotherapy aims to cease cell division and thus growth. Radiation targets, blasts, shoots. You’ll hear lots of people talk about the “slash, poison and burn” method of cancer treatment, pretty much the state of things.

The problem is in our bodies. Does that mean there is something intrinsically bad about us that has caused this evil to invade our bodies. Invasion, takeover, etc, etc. I don’t like the idea of assessing blame when the cause is so poorly understood. While some of us may have a propensity for cancer, I believe that its development is still probabilistic.

I want to help my body heal. I don’t want to kill parts of my body, and I don’t want this conflict within. I continue to search for the words that I am comfortable with, but I still can’t find them – war and battle images are too strong.

As it happens, war and disease seem to mirror each other In the 21st century – even in the late 20th, we began to experience conflicts without a clear-cut enemy. Think Vietnam as one of the first. Maybe even earlier wars had this – I am not a student of military history.

After the cold war, we lost our bad guys – no more communists. Who are the guys in the black hats? It’s no longer clear. Just as cancer becomes a chronic disease that is treated multiple times, war becomes a series of engagements, interactions. Blasting the enemy off the face of the earth becomes less effective, so often because the good guys are blasted away too. And this is a metaphor of chemotherapy. Especially with the older anthracyclines and the other stuff like cytoxan (alkalyzing agents? ), “good cells” such as white and red blood cells, mucosal linings in the digestive system and mouth, and hair are killed off during cell division. Chemotherapy as yet does not differentiate well between cancer and non cancer cells – it seeks out, finds and stops cell division no matter the sort of cell. It is rather like shooting fish in a barrel.

I still don’t like the idea of war in my body. Fighting is so ingrained into the language of disease. Sometimes I try to treat, manage, deal with it, rather than fight. I am happy to be “strong”. Now, however I view strength as listening to my body, and taking care of it – getting enough rest, eating well, and making sure I call my doctor when I don’t feel well. Not letting myself suffer needlessly. I am giving my body all the resources and strength it needs to manage the disease. It sounds so awkward. Fight is more active, quick, clear. But cancer is anything but clear. And I refuse to be called a victim.

So then I had the idea of incorporating the phrase “Make Love, Not War”.

With your body, anyway. And hopefully with someone you love, but that’s a different blog!

Sometime near the middle of my chemo, I started to look forward to my treatments, rather than fear them, or be bothered by them.

I told my oncologist this and he said that so many patients look at just the toxic elements of chemotherapy. And yes, it is a bunch of poison being loaded into your body. But this is how we treat the disease. We don’t know quite enough to single out individual cancer cells and kill them off. Not yet. Maybe someday, as medicine, like everything else, evolves. I remember Dr. McCoy on Star Trek talking about the brutality of 20th century medicine. He’d probably say the same about medicine in the early 21st. Remember how he’d just take that little metal thing and it would buzz, diagnose and treat? You didn’t remove a speck of clothing, either, or mess your hair.It probably rearranged the cells and made them happy again. We cringe when we think about the brutality of 19th century medicine – no handwashing, little anesthetic, no idea of sterile procedure. Medicine has certainly progressed since then. Although people still need to wash their hands. And if you live in the US you have to fight with your insurance to cover your treatments, it sounds a lot like a war. Haven’t had to deal with that in Switzerland yet. Yes, I know I digress. It’s part of my creativity. ;-p.

As I thought about this more, I was thinking of how this perspective (and I’m sure I’m not the first to think about it in this way) differs from a cancer as war perspective. When we think of cancer as war, and fighting, we are at war with our body. The treatments are violent, cells are killed. But I like to think of this as loving myself enough to care for myself, and to do what I need to to separate myself from my cancer, or potential cancer. And it’s still killing cells, but it’s more like separating out the potentially harmful cells and getting rid of them. Like trash removal. Or maybe organization where you get rid of what you don’t need. There’s nothing wrong with tossing stuff out. Maybe it’s not necessary to have a metaphor or an image, just think of it as loving yourself enough to take care of things. Although metaphors simplify the thought process – so there is a need to consider how we frame treatment processes and think about developing new metaphors – and maybe someone has already. I’ve not been trolling the literature these days.

For now, though it’s enough to say that loving yourself is better than fighting a war inside your body.