Sunday, August 21, 2011

Young Adults with Cancer: Why 'War' Analogies Work But 'Warrior' Analogies Do Not

Many, many people don't like war analogies when it comes to cancer,  especially those of us who've been afflicted by it. We often hear that a comrade has lost or won his or her battle with cancer. Or about society declaring war on cancer. Or about someone fighting bravely against the disease.

Sure, this language of war is cliche, giving us a picture of the brave warrior fighting to the death against cancer. And those killed in the line of fire are our warrior-heroes, while the victors are extolled much like the soldiers of old news reels -- with hero-istic glory.

Yet, when it comes to those afflicted with cancer young, like it or not, war analogies do work.

I'm not talking about the romanticized cliche of the battle-mongering warrior, but about real war.

Real. War.

Not. Reel. War.

As someone who was diagnosed with breast cancer young, here are just some of the ways I have found having cancer being like fighting a war. As in war, people with cancer can die young, in their prime of life -- often leaving behind children, spouses/significant others, and parents.

I've seen a few friends cut down young before my very eyes. Their children attended their mommies' funerals.

As in war, cancer is unpredictable and random, an unseen enemy killing young friends and leaving others to survive in the wake of survivor's guilt and PTSD. Like war, cancer is a confusing hodge-podge of harrowing events, physical and emotional anguish, with the ever-looming possibility of death.

I first realized this cancer = war analogy when reading Tim O'Brien's novel The Things They Carried, a haunting piece about the Vietnam War that seems to be part memoir. O'Brien is a Vietnam War veteran.

My book club decided on this book, and I was excited to be reading it. And, as expected, it did not disappoint, for it is outstanding. Unexpectedly, however, the book caused me to cry a lot. I couldn't understand why it resonated with me on such a deep level. How could I relate to these young soldiers -- some who lived and some who died -- all of whom shared the physical and psychological upheaval that war causes? I cried because of what these soldiers went through -- an unromanticized experience of war.

But I also sobbed because the book caused me to have flashbacks about my friends who died young, leaving behind children and spouses and parents. The book reminded me how fragile life is, especially when one is in a war zone. The novel made me realize how difficult it has been for me to decipher what happened to me and acknowledge PTSD and survivor's guilt as just one part of the cancer experience. Like the war depicted in O'Brien's masterpiece, cancer is also ugly.

There's my favorite chapter, "Speaking of Courage," where a Vietnam veteran survivor drives continuously around a lake, trying to sort out the trauma he experienced and wondering how he could find the right language to tell his loved ones what he had been through. 

I've been there, done that. Though in my case, it didn't involve driving around a lake.

And the chapter "How to Tell a True War Story" has true words about war, hauntingly related to the actual warlike experience of fighting cancer young:

"A true war story is never moral. It does not instruct, nor encourage virtue, nor suggest models of proper human behavior. ... If a story seems moral, do not believe it. If at the end of a war story you feel uplifted, or if you feel that some small bit of rectitude has been salvaged from the larger waste, then you have been made the victim of a very old and terrible lie. ... you can tell a true war story by its absolute and uncompromising allegiance to obscenity and evil."

This passage is a far cry from various cancer-related organizations' uplifting "cancer warrior" images, another "terrible lie."

And one more quote from the book's first chapter "The Things They Carried": "Now and then ... there were times of panic, when [the soldiers] squealed or wanted to squeal but couldn't, when they twitched and made moaning sounds and covered their heads and said Dear Jesus and flopped around on the earth and fired their weapons blindly and cringed and sobbed and begged for the noise to stop and went wild and made stupid promises to themselves and to God and to their mothers and fathers, hoping not to die."

Even though I have not been a soldier of the Vietnam War, I could relate to this fear as a young cancer patient. All we can do is cover our heads and hope that cancer doesn't kill us. All we can do is beg the world that we don't die.

That's what true war is.

Going through cancer young is about facing untimely death.

It is about watching young friends get killed right before our eyes.

It is about leaving spouses and children behind.

For those cancer "survivors," it is about PTSD and/or other psychological burdens.

It is about the shrapnel of cancer treatments, which leaves us physically diminished.

Fighting cancer -- especially fighting cancer young -- is not about being a warrior, though. The warrior is a myth. Our society loves warrior mythology because our culture feeds on victorious war stories.

Fighting cancer is a true war story: about ugliness, trauma, fear, and all the hardships that war brings about.

I'm writing a book titled Calling the Shots: Coaching Your Way Through the Medical System. Please feel free to subscribe to this blog by clicking the orange subscribe button. I am a professional writer and have published numerous academic and magazine articles, as well as an essay on my breast cancer experience in the anthology Voices of Breast Cancer by LaChance Publishing. I can be contacted at and


  1. Beth,
    We need to hear more of your voice. Your story and what you and your friends have gone through gives all of us pause for thought. I can't imagine being diagnosed with cancer so young. It was bad enough at 50.


  2. "The Things They Carried" was brilliant. Few stories have stayed with me to the degree that O'Brien's work did.

    An apt and powerful analogy.

    Thanks for this post, Beth. From what I've seen women have various degrees of sensitivity and vulnerabilities as far as PTSD is concerned. Age is a factor, for sure, but I believe that there are other factors as well.

    I hope that at some point accurate assessments will help doctors & staff more readily identify and assist survivors w/PTSD before it becomes a nightmare too many have experienced. I look forward to hearing more about your work on this.


  3. Brenda,

    Thank you for your supportive comment, and I'm grateful for it. Yes, it's really hard to be diagnosed young, but at the same time, it's really hard to be diagnosed at any age.

    Thank you for reading my posting!

  4. Jody,

    I totally agree that the "The Things They Carried" is brilliant. I've read it several times.

    PTSD among cancer survivors is pretty common, I think. What really stinks is that war veterans get support (financially speaking) for treatment for this disorder, but those who survive cancer do not.

  5. So very well said, Beth. I've often said we need a stress de-briefing, but get none. (As an EMT in my past, we would have de-briefings after a serious and traumatic call.) With cancer, we are just told to go on and live life now. You can't really just pick up where you left off.

    I was diagnosed with invasive ductal carcinoma when I was 36. My last chances of motherhood, gone. Your post is spot on.

  6. This post is amazing...I love your writing. The young cancer war analogy is so true, but you really brought it home to me by comparing it to the book The Things They Carried. I think PTSD is interesting as I never thought of it with cancer until recently. But little else besides war and an illness that can take your life is so traumatic. It seems my patients have the hardest time after treatment as the rest of the world sees them as "cured" and they go on about their lives, never realizing a person with cancer is never the same and never forgets.

  7. Is there an assessment for PTSD in post cancer patients? Obviously, you all will not be coming in and saying "Hey by the way, I have PTSD, can you help?" What can we do as providers to ask the right questions and provide the right resources?

  8. Chrysalis,

    Thank you for your kind comment and for reading my posting. You are right about a stress de-briefing being so necessary for breast cancer patients. We are, indeed, told to just carry on with life as if nothing happened. Cancer stays with our psyches forever.

  9. Heather,

    Isn't it amazing how people with cancer who are deemed "cured" by society have trouble getting on with life? I mean, I've learned to cope and appreciate life to its fullest, but I resent it when people tell me that I need to "get over it."

    I don't know if there is an assessment for PTSD in post-cancer patients. I know there have been studies, but the public at large doesn't seem to think of PTSD except for war veterans. In fact, EMDR, a treatment for PTSD, is covered if you are a war veteran, but not a cancer veteran.

    Interesting how that plays out, huh?

  10. Chrysalis,

    Oh, by the way, chemo killed my fertility as well. I have since adopted a child. Have you considered that route?

  11. Thank you for your comments back to me, Beth. I hadn't realized you had responded to my comment. I just looked back here after reading your latest post. Your walk and descriptions are similar to my own. I made some different choices, but I see a lot of myself in your writings.

    I have, for years, told people how much I identified with the veterans. We are very similar to them, if not just like them.

    Wading through the battlefield, I watched many of my friends die. I've lost 8 in total, to various cancers. One, the 4yr old of a dear friend of mine. (He and I were undergoing treatments at the same time.) I lost my friend 3 yrs. after that,to the same type of cancer as mine. They didn't make it, I did. I came home (i.e., through treatments) with both physical and non-physical scars. It is unavoidable under those kinds of conditions and circumstances. Only another survivor can really know.

    We are so very much like our veterans that have endured the horrors of losing those they connected with, while fearing for their own lives under the circumstances they've found themselves in. You wrote a great post, Beth.

    The good news from all of that... is we can survive! We can make it through, and go on to touch the lives of others in positive ways. We can give hope that they can get through this battle, and they can find blessings on the other side of it. You are proof of that every single day. You were meant to be the mother of that beautiful little girl. Blessings come.

  12. Chrysalis,

    I'm sorry I didn't respond sooner to your comment.

    Thank you for your kind words regarding my posting.

    Losing eight friends to cancer is horrific. We are just like veterans from war. War seems to be glorified a lot in the media, but it, like cancer, is truly horrible.

    I'm so glad you survived! And I'm so glad you have shared your story with me.