Have you ever noticed that cancer is the only disease we talk about in terms of war?
"He battled cancer so bravely, but after a long struggle he lost his fight."
We engage in a unique war with cancer - no one 'battles stroke', or 'fights heart disease'. Why do we talk about cancer in this way? And how does it affect the way we think about and deal with cancer?
Cancer looms large in the imagination. The dreaded C-word is universally feared. Warfare terminology may help to evoke support and to give us an important sense of control in the face of an enemy.
The terminology continues: we call people 'survivors' when their cancer is in remission. In the narrative we have created, survivors are strong, powerful 'heroes', and by implication people who die from cancer weren't courageous enough, didn't give it their all. Somehow it's their fault.
The battle it seems, is to be lost or won. When cancer wins - becomes terminal - you're a loser; 'defeated'.
In a study published last year called 'Good' deaths and 'bad' deaths, researchers found that war metaphors can lead to feelings of guilt and failure in patients who die of cancer, even though they have little control managing it.
Study author, Professor Elena Semino, of Lancaster University said: "Blame is being put on the patient, and there's almost a sense that, if you are dying, you must have given up and not have fought hard enough."
This can pile a lot of pressure on people with cancer, particularly to be 'brave' - when many say that really they don't have a choice. Does our determination to fight cancer prevent us from accepting it when we need to? Maybe the war rhetoric stops us from imagining that living with cancer, like we might do with motor neurone disease or multiple sclerosis, can be a valid option.
There is no right course of action - everyone is different. For some people, the right personal choice may be to call quits on further treatment, like chemotherapy, and choose palliation instead. It has nothing to do with being brave enough to continue, or strong enough to face treatment.
And what about the rest of us who are healthy - how does the war metaphor affect us?
Another study published last year, The war on prevention, found that using words like 'hostile' and 'fight' means people are less likely to engage in important limiting behaviours to prevent cancer, like reducing smoking and cutting back on red meat.
"When you frame cancer as an enemy, that forces people to think about active engagement and attack behaviours as a way to effectively deal with cancer," said David Hauser, who led the study. "That dampens how much people think about much they should limit and restrain themselves."
Just like the 'war on terror' and the 'war on drugs', the 'war on cancer' is an oversimplification of a complex issue for which there is not one solution.
For some people the battle narrative is a powerful one which helps them to cope. However, I do worry it indicates an exaggerated sense of control which may not be helpful if it feeds into the online market of people taking things into their own hands with bogus miracle 'cures' (which I've blogged about previously).
Many people prefer to talk about a 'journey with cancer' that is free from expectations.
"I tend to prefer terms such as 'living with cancer' and 'recovering from cancer treatment'," Vicky told the charity Breast Cancer Care. Susan said: "I simply say I have had treatment for breast cancer. The treatment is now finished. I really don't want to be labelled by an illness."
It's a small change in terminology, but an important one. Since most of us will be affected by cancer in some way throughout our lives, it is essential that we start to rethink how we talk about it.
This article originally featured on the author's blog, The Mehta Analysis.