Are we fighting cancer or the treatment? - Rethinking cancer language: a mini-series, Part 3

Perhaps what people are really fighting is not the cancer itself, but the toxicity of the treatments meant to cure it.

When I wrote about the language of war in Part 2 of my Rethinking Cancer Language mini-series, I explored how metaphors of 'battle' and 'survivorship' can subtly undermine healing.

Then I read Kevin Donaghy's Stories of Cancer and Hope. Thirty-nine stories. Almost all of them spoke of 'beating cancer' or 'fighting to the end'. And almost all involved chemotherapy, radiotherapy, or immunotherapy.

It left me wondering: were people really fighting cancer — or were they enduring the treatment?

The hidden reality of recurrence

The popular narrative is simple: you have surgery, maybe chemo or radiotherapy, you 'beat cancer', and then you move on. But biologically, it is far more complex.

Residual disease, tiny clusters of cancer cells that survive treatment, is common. Cancer stem cells (CSCs) in particular are remarkably resistant to currently available therapies. These are not like ordinary tumour cells. They function more like the roots of a weed: even if the visible growth is cut back, the roots remain and can regenerate when conditions allow.

This resistance means that chemo and radiation may shrink tumours but fail to eliminate CSCs, which are closely linked with relapse and poor outcomes.

Patients are often shocked when cancer returns, not because it is rare, but because the public story never prepared them for the reality that cancer is a chronic condition. The highest risk of recurrence is often in the first one to three years after treatment, yet the dominant narrative still suggests a neat ending.

When treatment feels like the real test

It is easy to see why people describe themselves as warriors. Chemotherapy, radiotherapy and often immunotherapy, too, are brutal treatments that take a massive toll on the body and mind. They destroy rapidly dividing cells indiscriminately, damaging healthy systems along with tumours. Side effects are brutal: fatigue, nausea, neuropathy, infertility, and organ damage. Some people never fully recover.

I was recently at a lecture on ovarian cancer where the OBGYN surgeon said plainly: 'chemotherapy can kill you and immunotherapy can kill you.' He was not exaggerating. These treatments are so toxic that in terminal cases, when the body is already exhausted, they are sometimes withheld because the treatment itself would be lethal. This is not something most patients ever hear expressed so directly.

The truth is more complicated than saying these treatments 'save lives'. For some, they may hold disease at bay, for others, they buy time, and for many, they create new layers of suffering. What is consistent is that they are profoundly toxic, hence the name cytotoxic treatment. To endure them requires enormous resilience, and it is often this ordeal, rather than cancer itself, that I believe patients describe when they speak of 'fighting'.

The problem of overtreatment

This is where oncologist Bryan Oronsky’s critique is so important. In his paper The War on Cancer: A Military Perspective he argued that the militaristic metaphor has done more than shape how we talk. It has shaped how we treat.

He describes how oncologists, researchers, and pharmaceutical companies all adopted the language of war: weapons, arsenals, silver bullets, therapeutic targets. Patients were recast as soldiers. The imperative was clear: hit hard, hit fast, aim for maximum tolerated dose (MTD).

But this strategy has backfired. Just as overuse of antibiotics breeds resistant bacteria, aggressive high-dose treatments select for resistant cancer cells, often CSCs, that survive and later drive relapse. In other words, the war-like approach may be fuelling the very resistance it hopes to eliminate.

Oronsky suggested reframing treatment in less retaliatory terms and adopting strategies of containment, managing cancer as a chronic condition like diabetes or hypertension, rather than escalating in an all-out attempt at eradication that can do more harm than good.

What the metaphors hide

Here lies the deeper danger. When we focus only on annihilating tumours, we miss the bigger picture. Cancer does not arise in isolation. It grows in an environment, a body whose chemistry, immune system, and stress load have been thrown out of balance.

Cutting out a tumour or blasting it with radiation may remove the weed, but if the soil remains fertile for weeds, they will return. And the soil is not just physical. Emotional trauma, chronic stress, and toxic environments all influence the chemistry in which disease takes root.

Inflammation is central to this. Most cancers develop in an inflammatory state. Cytotoxic treatments, while sometimes necessary, further compromise the immune system. Unless the underlying conditions are addressed, stress, trauma, nutrition, and lifestyle, the system remains vulnerable. Whether or not a person has chemo, if they never work on restoring balance in their bodies, the odds of long-term health are stacked against them.

Why transparent conversations matter

This is why informed discussions with oncologists are so critical. Patients often do not understand the difference between absolute and relative risk and benefit. A treatment that sounds like it cuts risk in half may reduce the likelihood of recurrence from four in a hundred to two in a hundred. That is still meaningful, but it is very different to the way it is often presented.

Without a clear understanding, many people agree to toxic treatments without grasping what they are truly gaining, what they are sacrificing, and what else they could be doing to support their health.

A real plan must go further than surgery and drugs. It should include strategies to restore immune function, reduce inflammation, and shift the conditions in which cancer grew in the first place. That means honest discussions about exercise, diet, sleep, alcohol, smoking, stress, relationships, and emotional wellbeing. Encouragingly, many charities are now promoting mindfulness, meditation, movement, and lifestyle change as integral parts of care. These are not 'extras', they are essential.

Towards a new conversation

The truth is that people are not failing if cancer recurs, nor are they weak if treatment is unbearable. They are navigating a system that too often equates toxicity with efficacy, and that tells simple stories about a disease that is anything but simple.

Perhaps the question is not whether we are fighting cancer or the treatment. Perhaps the better question is how we create the right conditions for health to flourish. That means addressing body chemistry, immune resilience, emotional patterns, and the wider environment of our lives, alongside appropriate medical care.

This is why the conversation about cancer needs to change. We need a new language, one that moves beyond war, beyond survivorship, beyond simplistic victory or defeat. We need words that honour complexity, acknowledge vulnerability, and open the door to healing as restoration and transformation.

Because cancer is not simply an enemy to be conquered. It is a message to be heard, a reality to be faced honestly, and an invitation to change the way we live and heal.

This brings us to a fundamental question: if cancer is a message to be heard rather than an enemy to defeat, what is it actually trying to tell us?

In Part 4 of the mini-series, we'll explore what it means to see cancer as a messenger and why the answer might transform how we approach healing.