Words matter: Restoring respect and dignity when referring to individuals with cancer

Patients often come to oncology clinics surrounded by family, friends, clergy, and others to provide emotional support, translate medical rhetoric, and take notes from the visits. Our patients themselves are mothers and fathers, sisters and brothers, friends, and, in some particularly trying scenarios, sons and daughters. They are real people who are facing the biggest challenge of their lives: their survival. Our patients remind us every day of the frailty of all our lives. All too often, we dehumanize our patients when providing care and also in our professional communications. We label our patients with cancer as “cancer patients. ” We do this during rounds, in presentations, in publications, and in the press. This connotation seems to emphasize the disease over the patients themselves. Oncologists and members of the cancer care delivery team are faced with numerous unprecedented challenges, including caring for an increasing number of patients; learning the usage and side effects of increasing numbers of new drugs; taking the time to understand the biology underlying new pathways, drugs, and biomarkers; and learning new approaches and technologies with which to select and refine therapy. The increasing complexity of providing the best care for patients can lead to physician/care provider burnout. Provider stress and burnout does not just affect the provider, but negatively impacts our patients as well. When the health care team is overwhelmed, it may be too easy to forget that it is a privilege to care for patients, and that we must maintain our empathy and sympathy for our patients and their families at all times. This balancing act can be challenging, and so it is imperative to hit the “reset” button from time to time and remember that our patients are human beings deserving of our respect, concern, and empathy throughout the entire course of their care, including the palliative phase (if and when this occurs). What does it mean to be a person with cancer? The old adage about understanding others and developing empathy, “. walk a mile in their shoes,” is fitting. How many cancer care providers are themselves patients with a lifethreatening or life-altering disease? It feels very different to be a patient with cancer or a serious illness one day and a cancer care provider the next. As providers, we know that building a trusting relationship with our patients is paramount to providing the best care, both physically and psychologically. Taking the time to do so shows that we recognize our patients’ fears, challenges, emotions, and anxiety, and that we see and respect them as people first and patients second. “Cancer patient” is a catchall term, a dehumanizing label, a category within a population described in percentages. Percentages are fractions of the whole. Indirectly, the term “cancer patient” can suggest the person is less than whole. Alternatively, using the term “patient with cancer” reinforces the individuality of each person who happens to have cancer. Each patient has his or her own story, challenges, treatment susceptibilities, and, of course, their own genetic fingerprint. To recognize this is to return to the patient their personhood. The best way to reinforce this, including teaching the next generation of care providers, is to make a concerted effort to always use the term “patients with XX cancer” in all our professional discourse. It is a small change in semantics that makes a big difference in respect for our patients. This principle extends beyond patients with cancer; it is an important humanizing effort for all providers toward all patients.