Cancer emotions: upbeat, stoic or just scared?

Years ago, a friend and co-worker of mine with ovarian cancer lost all of her blonde hair during treatment. She donned a red wig and declared, “I’m going to do cancer as a redhead!” Her upbeat nature made it easier on the rest of us to accept her illness, so it was that much more shocking the day I walked into the newsroom to see a pink wreath on her desk.

Staying well through art.Senator Kennedy has appeared upbeat after a cancer diagnosis. (Neil Hamburg/Reuters)

I was reminded of my friend when I read the article “When Thumbs Up Is No Comfort” by my colleague Jan Hoffman, who writes about our cultural expectations of cancer patients to be upbeat, stoic and ready for battle. But often the reality is that people with cancer are scared, sad and depressed — and rightly so.

“That optimism reassures anxious relatives, the public and doctors, regardless of whether it accurately reflects the patient’s emotional state,” Jan writes. But she asks whether the game face maintained by high-profile cancer patients, such as Senator Edward M. Kennedy, really inspires others or simply reinforces unrealistic expectations that everyone should approach cancer with stoicism and courage. She writes:

Dr. Gary M. Reisfield, a palliative care specialist at the University of Florida, Jacksonville, believes that the language used by cancer patients and their supporters can galvanize or constrain them. Over the last 40 years, war has become the most common metaphor, with patients girding themselves against the enemy, doctors as generals, medicines as weapons. When the news broke about Senator Kennedy, he was ubiquitously described as a fighter. While the metaphor may be apt for some, said Dr. Reisfield, who has written about cancer metaphors, it may be a poor choice for others.

“Metaphors don’t just describe reality, they create reality,” he said. “You think you have to fight this war, and people expect you to fight.” But many patients must balance arduous, often ineffective therapy with quality-of-life issues. The war metaphor, he said, places them in retreat, or as losing a battle, when, in fact, they may have made peace with their decisions.

What do you think? Is upbeat and positive the best way to cope with cancer? Or does unvarnished optimism deny us the opportunity to confront our real fears? Read the full story here, and then share your thoughts below.