“If the cancer treatments don’t help, how am I going to deal with it?”

The sheer emotion in this patient inquiry could fill an empty room. It is the distress of an irreconcilable paradox in care – a medical stalemate in a battle, without victory. The perception is that the only way left is to “give up and let cancer win”.

The conceptualization of treatment as violent conquest has given rise to an uneasy stalemate in cancer care. Medicine must stop sending patients to war.

The language of combat creates a dangerous false narrative, unwittingly labeling those diagnosed as combatants. Although the intention may be to empower an individual through their treatment journey, patients are inadvertently predisposed to feelings of failure, hopelessness, abandonment, or hopelessness.

A particular concern is when cancer is a life-limiting diagnosis. How can the treatment of a non-curative disease be framed as a fight when, from the outset, these patients are doomed to “lose”?

The misplacement of personal responsibility in a disease trajectory that is largely blind is both isolating and unfair. While legitimate emotions of fear or the trials of illness deserve validation, the deafening cries of “fighting” can overwhelm, trivialize, or silence them.

Our patients deserve better.

The language of cancer care communication significantly shapes the lived experience of treatment. As the practice of medicine evolves toward a person-centered model with a mission to cure individuals, not diseases, clinicians must try to incorporate each person’s unique values ​​and preferences into their treatment plans.

Person-centred care requires a person-centred language, or “language of life”. Communication using this approach focuses on improving a patient’s lived experience in the context of an illness that seeks to limit it in duration, quality, or both.

The language of life encompasses the concept of individuality in patient care. He advocates exploring a patient’s goals beyond the oversimplified goal of survival. The language of life expands the boundaries of prognostic discussions to incorporate both lifespan and quality of life.

In my conversations with patients, the focus of our communication is their life, not their cancer. We review treatment plans that seek to medicalize their lives in a way that supports their person-centered goals and avoids perilous paths that could harm them. We add value-based goals to treatment plans by making family, friends and travel a priority. Maintaining or restoring quality, functional independence and dignity are also fairly common themes.

We discuss how pain control can lead to better days and explore the balance between patient and person, particularly as one role increasingly tries to limit the other. We review the potential rewards or unacceptable trade-offs of cancer drug therapies or major surgeries that may be difficult to bear or, failing that, too dangerous to pursue.

These are stimulating discussions that may not get any easier, but it is at this delicate intersection of communication that the language of life identifies a patient’s needs and clinicians are suitably equipped to help them face the future.

Listening to stories of lives lived before a cancer diagnosis reminds me that clinicians must ultimately help patients continue the experience of life after a cancer diagnosis. This is all the more important when the cancer is not curable. Helping patients live life to the fullest with the disease is a collaborative feat, a convergence between the very clinical and the deeply personal. Doctors know a lot about the disease, while our patients know their lives. I always encourage patients to become active participants in their care rather than passive recipients.

Conversations about clinical care are often guided by laboratory tests and imaging, but context is easily lost in a sea of ​​medical investigation. The end result is that we can focus on the worrying question of whether cancer progresses despite treatment, but inadvertently miss the opportunity to determine whether “life” progresses despite cancer.

The treatment journey can be fraught with emotional, physical, spiritual and social stressors, with burdens of both illness and proposed therapies. Each of them threatens the experience of life in its own way. Our patients need all the support they can get. They must be heard and we must listen to them.

Now is not the time to send them to war.