Brooke: Ever since the war on cancer was launched in the 70s, the battle has raged.

Anchor: Fighting battles on and off the field. A young girl’s courageous battle with cancer as her NFL-player dad gets a big honor here in Washington….We love that story.

Brooke: But when we asked listeners to share cancer-related words that make them cringe, it turns out the war metaphor neither serves the patient, nor even describes the reality of contending with cancer in the designated battlefield of one’s own body. As many listeners told us, including Mike Burns of Middletown New Jersey.

Mike Burns: If my family writes in my obituary that I died after a hard fought battle against cancer, I will come back from the dead to haunt them until the end of time. I hate all the cancer terminology having to do with fighting and battles and survivors and wars. I have multiple myeloma, which is incurable. It will kill me, if I don't get hit by a bus first. Does the fact that I will not win the so-called battle against cancer make me or others like me any less worthy? I don't think so.

Brooke: That metaphor is not only unsettling, according to David Hauser, it’s also unhealthy. He’s a PhD candidate at the University of Michigan Ann Arbor and author of the study, “The War on Prevention: Bellicose Cancer Metaphors Hurt Some Prevention Intentions.”

David Hauser: There’s books about foods that fight cancer, it appears in the slogans of cancer research organizations, it’s actually the number one conceptual metaphor that's employed in popular press science journalism about cancer.

Brooke: Isn't framing cancer as an enemy generally regarded as the right approach.

David Hauser: So some of the rationale for framing cancer as an enemy is, frame it as a battle and everybody will sign up to enlist. It'll motivate them to actually engage in these beneficial behaviors in order to offset the disease.

Brooke: But you started questioning that conventional wisdom after hearing a talk about prostate cancer.

David Hauser: Yeah so what got me into this research was - a possible effective treatment for prostate cancer involves what they call "watchful waiting." You treat the disease as a chronic illness, keep an eye on it and make sure it doesn't get any worse. And that struck a chord with me because a lot of research is basically "me-search." So I was attending this talk and I was utterly dumbfounded by this idea because to me it just didn't make any sense.

Brooke: Why not?

David Hauser: If cancer is an enemy that needs to be fought and destroyed, then it just didn't make any sense for a treatment to just leave it there and keep an eye on it. It needs to be completely wiped out and removed. I was basically thinking of cancer as if it was an enemy that needed to be fought. I realized that I was using a metaphor.

Brooke: And so you set out to determine whether using war language to describe cancer was having an impact on the way people actually confronted the disease.

David Hauser: Right. As if exposure to this metaphor actually effects the way that people think about the disease and actually effects how they think about prevention options for the disease. So in one of our studies, what we did was, we simply asked participants to list the cancer prevention behaviors that they would be willing to engage in. However we randomly assigned participants to either see enemy metaphors for cancer or not. So for the enemy metaphors group, we asked them what things would you do to fight against developing cancer in your lifetime. However for the control group we just asked them, what things would you do to reduce your risk of developing cancer. And what we found was this group who was exposed to the enemy metaphors for cancer actually listed fewer of these prevention behaviors involving limitation. So things like limiting your red meat intake or cutting processed foods from your diet. And what we took from that was that just simple exposure to enemy metaphors for cancer actually limits the extent to which these behaviors naturally come to mind and occur to people.

Brooke: What's the theory there?

David Hauser: When you metaphorically frame something, it forces you to think about that concept in terms of another, easier to understand concept. So whenever we metaphorically frame cancer as an enemy, then that causes people to bring attributes of how to deal with enemies onto their ideas about how to deal with cancer. And a major part of dealing with enemies involves active engagement and attacking at all costs. In contrast to that, it de-emphasizes self-limitation and behavioral restraint. What we were finding in a couple of studies was that simple exposure to these enemy metaphors for cancer were actually dampening people's thoughts of limitation and restraint because that's just not how you fight enemies.

Brooke: Now you also gave them a description of cancer, one of which read, "cancer is a broad group of diseases characterized by the hostile growth and invasive spread of abnormal cells" and the second group had the words "hostile" and "invasive" cut out. Then you presented the enemy language again. One group got, "this disease involves an imbalance of abnormal cellular growth in the large intestine." This other got "this disease involves an enemy uprising of of abnormal cellular growth in the large intestine."

David Hauser: And then finally we also had the neutral group where words relating to imbalance or enemies were simply removed and they just got simple messages like "the disease involves abnormal cellular growth in the body." All three groups got the essentially the same exact message. It was about a paragraph or two, giving risk statistics about colorectal cancer which is what we focused on for this one. And what we found was, compared to both of the other two groups, when people see these war metaphors, it hurts the extent to which they want to engage in these prevention behaviors.

Brooke: Thank you so much for doing this.

Hauser: Oh yeah no problem.

Brooke: David Hauser is a PhD candidate in social psychology at the University of Michigan Ann Arbor. He’s author of the study, “The War on Prevention: Bellicose Cancer Metaphors Hurt Some Prevention Intentions.”