Bladder Cancer and a “Great Attitude”

How many times have you heard someone say “you’ll beat cancer because you have a great attitude?”

On its face, this sounds upbeat, hopeful, and encouraging. What could be wrong with giving someone hope and complimenting their attitude?

Here’s the thing: it presumes that attitude is enough to get someone through cancer. What does it mean if the person doesn’t respond well to treatment? What does it say about their attitude if they die?

By correlating a great attitude with survival and recovery, the logic follows that someone who doesn’t recover or survive must not have had a great-enough attitude.

When a great attitude isn't enough

I never thought about this or realized this until my first husband, Ahmad, was very sick with Stage IV bladder cancer. He did have a great attitude. He did everything doctors told him to do. And more. He ate well, he rested, he followed up on every possible treatment option.

And he was upbeat most of the time, even in the toughest of our days. And yet, he did not ultimately survive. It wasn't for lack of trying and it wasn’t for lack of great attitude.

The cancer progressed

The standard-of-care platinum-based chemo did not impact his cancer one bit. In fact, it progressed during the treatment. Immunotherapy drugs were not yet widely available at that time.

And so, during that challenging time, I came to understand the trouble with telling someone their attitude will get them through cancer or that they just have to fight hard enough. More and more, these common refrains have been questioned in the press and by patients and caregivers. I think this is a positive thing.

What can you say instead?

People often ask, “well, what should I say to cancer patient or caregiver?” I can think of a lot of things but they mostly boil down to this: “I am thinking of you and am here for you in whatever way might be helpful to you.”

Talking about a patient’s attitude is, to my mind, in the same category as telling them “everything happens for a reason.” Kate Bowler, diagnosed with Stage IV colon cancer in her 30s, wrote an excellent book called “Everything Happens for a Reason: And Other Lies I’ve Loved.”

In it, she tells an anecdote about when some well-meaning person knocked on their door to deliver food. This person said of Kate’s cancer (to Kate’s husband), “everything happens for a reason.” Kate’s husband asked the person, “And what is the reason? What is the reason my wife is dying of cancer?” The shocked person did not know how to respond.

These clichés just don’t help

That person was, no doubt, well-intentioned but also oblivious to the impact such cliché sentiments, especially to a patient who may not survive long-term. These clichés just don’t help. And, in fact, they often hurt.

Whether you have been on the giving end of such clichés (I certainly had been before I experienced cancer firsthand) or the receiving end, we can all do a small something to change the conversation. If you’ve said things like these in the past, reconsider your words before they leave your mouth.

Challenge these statements

If you are on the receiving end of clichés, consider the following: If you have the emotional stamina and if the person saying it is someone you care about, you can gently challenge the statement. And gently point out how it feels to hear as a cancer patient or caregiver. People usually mean well but they just don’t know what to say or do. We can all help each other in this regard.