Commentary by Arthur L. Caplan, PhD
Cancer Doesn’t Care If You’re a Fighter
It is very common when learning that someone has been newly diagnosed with a life-threatening cancer that well-meaning family and friends weigh in with encouragement to fight. It is also unfortunate.
Cancer could not care less whether you are a fighter or not. What evidence there is does not show that adopting a fighting stance helps in terms of survival. I have seen many fighters die of cancer, and some who chose not to be seen as fighters live longer than others who did.
And there is an implication that if you are not a fighter, then you must be a coward or worse. This suggests that the only option available to anyone who is courageous is to choose to fight—to utilize every surgery, complementary medicine, chemotherapy, and experimental option. This is unfortunate as well, because it takes courage to decide not to battle fatal cancers, but rather to enjoy a better quality of life in the time that remains.
The latest example of this “you must be a fighter” ethic is John McCain.
The senator from Arizona just found out he has a glioblastoma, a very nasty form of brain cancer. Upon announcing his diagnosis, McCain was greeted by a chorus of friends and admirers urging him to fight and calling on him to be courageous in taking on the cancer. This is advice McCain does not need.
People Mean Well, But It’s the Wrong Tactic
Here is a sample from Twitter. Barack Obama said, “John McCain is an American hero, and one of the bravest fighters I’ve ever known. Cancer doesn’t know what it’s up against. Give it hell, John.” Joe Biden: “He is strong, and he will beat this.”
Gabrielle Giffords: “You’re tough! You can beat this. Fight, fight, fight!” Mike Pence: “Cancer picked on the wrong guy. John McCain is a fighter, and he’ll win this fight too.” A bunch of editorials in many newspapers across the nation echoed similar thoughts.
This is advice McCain does not need.
The odds of beating this cancer are long. Whether he does or doesn’t has nothing to do with his character or courage. That is not, despite some incredibly disrespectful comments President Trump made about him in the run-up to the presidential election, up for dispute.
McCain is a military hero. The genuine article. The former Navy pilot spent five and a half years in a notorious North Vietnamese prison known as the “Hanoi Hilton,” where he spent 2 years in solitary confinement and was brutally tortured despite being severely injured when he bailed out of his plane. Concerned about his fellow prisoners, he would not accept an early release.
Whatever cancer does to John McCain and however he chooses to treat it or not, he is a brave man who is certainly a fighter. As with anyone, he will find his own best path to dealing with a grim diagnosis. Whatever that is, he will remain a hero and a fighter.
Caplan is the Drs. William F and Virginia Connolly Mitty Professor and founding head of the Division of Bioethics at New York University Langone Medical Center in New York City. This commentary was originally published on Medscape, WebMD’s site for health care professionals. Read more commentaries from Caplan here.