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Malignant Metaphor: Confronting Cancer Myths, a Memoir
“In addition to her clear medical explanations, Mitchell’s compassionate attitude will bring comfort to those readers and their loved ones facing a cancer diagnosis.” — Publishers Weekly
Award-winning science writer Alanna Mitchell confronts cancer myths in this powerful and personal book, as she recounts her family’s experiences with the disease. When her beloved brother-in-law John is diagnosed with malignant melanoma, Mitchell throws herself into the latest clinical research, providing us with a clear description of what scientists know of cancer and its treatments. When John enters the world of alternative treatments, Mitchell does, too, looking for the science in untested waters. She comes face to face with the misconceptions we share about cancer, which are rooted in blame and anxiety, and opens the door to new ways of looking at our most-feared illness.
Beautifully written, at once deeply personal and rigorous, Malignant Metaphor is a compassionate and persuasive book that has the power to change the conversation about cancer.
Award-winning science writer Alanna Mitchell confronts cancer myths in this powerful and personal book, as she recounts her family’s experiences with the disease. When her beloved brother-in-law John is diagnosed with malignant melanoma, Mitchell throws herself into the latest clinical research, providing us with a clear description of what scientists know of cancer and its treatments. When John enters the world of alternative treatments, Mitchell does, too, looking for the science in untested waters. She comes face to face with the misconceptions we share about cancer, which are rooted in blame and anxiety, and opens the door to new ways of looking at our most-feared illness.
Beautifully written, at once deeply personal and rigorous, Malignant Metaphor is a compassionate and persuasive book that has the power to change the conversation about cancer.
- GenresNonfictionCanadaScience
208 pages, Paperback
First published September 1, 2015
2 people are currently reading
346 people want to read
About the author
Alanna Mitchell
10 books15 followersAlanna Mitchell is an award-winning journalist and author who writes about science and social trends. She is a global thinker who specializes in investigative reporting. Her most recent full-length book, Sea Sick: The Global Ocean in Crisis, is an international bestseller that won the prestigious Grantham Prize for Excellence in Reporting on the Environment. Her one-woman play based on that book was nominated for a Dora Award and she toured across Canada. She lives in Toronto, Ontario.
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Displaying 1 - 15 of 15 reviews
July 7, 2015
A Canadian science journalist counters three misleading adjectives often applied to cancer: inevitable, preventable, and deserved. Like Susan Sontag does in AIDS and Its Metaphors, Mitchell examines the metaphorical trappings of cancer and tries to get back to the facts: in most cases we don’t know what causes cancer, and whether you get it is a simple question of luck.
She personalizes her quest for knowledge through two family experiences. First her brother-in-law, having already survived prostate cancer, was diagnosed with untreatable stage III melanoma. He was a take-charge patient and immediately turned to alternative therapies like injection of pure vitamin C (very promising, it seems) and mistletoe extract. Later Mitchell’s daughter had a thyroid cancer scare. In both cases, though, things turned out better than expected – proof that cancer is not the death sentence it often appears to be.
This is a short, readable layman’s summary of some current thinking about cancer. I recommend reading it in tandem with, or as a follow-up to, one of the books below.
Related reading:
• The Emperor of All Maladies by Siddhartha Mukherjee
• The Cancer Chronicles by George Johnson
• On Immunity: An Inoculation by Eula Biss
She personalizes her quest for knowledge through two family experiences. First her brother-in-law, having already survived prostate cancer, was diagnosed with untreatable stage III melanoma. He was a take-charge patient and immediately turned to alternative therapies like injection of pure vitamin C (very promising, it seems) and mistletoe extract. Later Mitchell’s daughter had a thyroid cancer scare. In both cases, though, things turned out better than expected – proof that cancer is not the death sentence it often appears to be.
This is a short, readable layman’s summary of some current thinking about cancer. I recommend reading it in tandem with, or as a follow-up to, one of the books below.
Related reading:
• The Emperor of All Maladies by Siddhartha Mukherjee
• The Cancer Chronicles by George Johnson
• On Immunity: An Inoculation by Eula Biss
October 22, 2018
A good book for people who don't have much knowledge about biology or cancer. I didn't finish the book because it was too basic of information for me. I did however recommend it to others which would benefit from this and needed to learn that: not all cancers have the same prognosis, it's not appropriate to equate curable cancers to non curable cancers (i.e. colon cancer localized to metastatic melanoma), to emphasize that "this holistic medicine cured a friend of a friend", etc.
May 29, 2017
more of an emotional journey through the trials of cancer. which is beautiful and poetic. but i was looking for more of a scientific standpoint on the whole cancer thing. and have not gone through this journey yet myself. and hopefully will not!
November 28, 2018
Too basic for anyone with medical background, but excellent for those without. I will definitely recommend this book to some family members who don't fully understand my mom's cancer, and keep telling us that some random hollistic drug worked on a friend of a friend...
May 23, 2017
it was well written, it just didn't really help the way that I had thought it would.
August 17, 2017
Read our review at https://bookthreat.com/2017/08/15/med...
June 26, 2019
An interesting examination of metaphors of illness and health. If creative nonfiction is a spectrum, this work falls more toward journalism than memoir.
July 7, 2024
An interesting look at our society’s view of cancer - with personal experiences among family members as well.
November 10, 2015
I have cancer, and I loved Malignant Metaphor. I loved Mitchell’s objectivity and honesty. I love those who can plow through reams of science and pull it together in a way that pokes holes in some of the unproductive myths we assume to be absolute truth. And I especially love it when that research yields a perspective that is in the end calming and encouraging rather than alarming.
I loved that she respectfully discusses our fear of cancer. She reminds us that it is our nature to construct a narrative when we’re afraid. “Random is not emotionally satisfying,” she writes. So we look for causes, cures, and metaphors that comfort us. We construct myths, both helpful and otherwise.
In a short history of fear, Mitchell outlines some of the major terror-inducing illnesses of our past. The Black Death. Leprosy. The Spanish Flu. Tuberculosis. TB, responsible for a quarter of all European deaths in the 19th century, was seen as evidence of moral weakness, of lack of ambition, of being an overly sensitive romantic. How’s that for an unhelpful myth?
And now, cancer. If you get cancer, you’ve got faulty genes. Or have had a bad lifestyle. Or have the wrong attitude, or the wrong personality.
The genetic link, it turns out, is a small one, responsible for perhaps two or three percent of cancer cases, she says. And with some obvious exceptions, lifestyle correlation has been inflated also, and doesn’t hold up to scrutiny. In addition, the idea that we can prevent cancer yields feelings of shame and guilt when we fail. Did I eat too much meat? Too much sugar? Did I sleep too little, exercise too little, work too much, drink too much? Not likely significant factors, says Mitchell. Did I allow myself to feel too much stress and anxiety? Suppress too much emotion? Allow too much negative thought? Again, no. The findings of a meta-analysis on personally types found no higher risk in those characterized by the suppression of emotion, pessimism, depression, and timidity.
The commonly used war metaphor falls shorts too, in Mitchell’s eyes. War is violent, implies a death toll, and is guilt-inducing. If I lose the war, was I weak? A poor fighter? Guilty of choosing the wrong course of action? “I think the brutality of the cancer metaphor saps our society of some of its productive vigor,” she writes. “Guilt and blame and fear are paralytic emotions, a black hole for energy.”
It may be a counterproductive and malignant metaphor, but we’ve come by it honestly enough. The battle with cancer clearly can be a matter of life and death, and the origins of chemotherapy itself lie in the use of chemical weapons—the original team of cancer drug researchers at Sloan-Kettering literally originated in the US government’s Chemical Warfare Service after World War II.
And though treatments and management of side effects have improved with time, and researchers now often look to the plant world for treatments, it can still feel very much like a war. Taxol, the drug which comes from the bark of the yew tree and which saved my life five years ago, nearly took it earlier this year. It is a potent therapy, and wears the label of weapon well.
As much as all this is true, I too am looking for a better metaphor. Some of us live with cancer for many years, much as others live with diabetes or high cholesterol or other chronic disease. I sometimes view it as more of a boxing match, one in which I occasionally get beat up, but also patched up again, and in which a defeat doesn’t need to spell death.
As to looking for fault, I’ve quit. The reality is that with a few exceptions, cancer is random. We have a long history of making up stories in the face of fear and poorly understood phenomena, stories that comfort and calm us, and that may or may not carry an element of truth. And the reality is that it has always been easier to hold victims responsible than to take responsibility as a society, which in this case would demand research on larger environmental causes that call into question an entire system of production and manufacturing.
Mitchell is a science writer, and it shows. She confirms my own inclination to take fund-raising messages with a generous shake of salt. Cancer is not, she says, when you adjust numbers for age and population growth, more prevalent than ever. And though it can still be deadly, survival rates for most cancers have increased.
Cancer is not happy news, no, but there is reason for optimism. We have a long history of facing challenges like this productively, and every reason to embrace life and health enthusiastically even in the face of current cancer realities.
I loved that she respectfully discusses our fear of cancer. She reminds us that it is our nature to construct a narrative when we’re afraid. “Random is not emotionally satisfying,” she writes. So we look for causes, cures, and metaphors that comfort us. We construct myths, both helpful and otherwise.
In a short history of fear, Mitchell outlines some of the major terror-inducing illnesses of our past. The Black Death. Leprosy. The Spanish Flu. Tuberculosis. TB, responsible for a quarter of all European deaths in the 19th century, was seen as evidence of moral weakness, of lack of ambition, of being an overly sensitive romantic. How’s that for an unhelpful myth?
And now, cancer. If you get cancer, you’ve got faulty genes. Or have had a bad lifestyle. Or have the wrong attitude, or the wrong personality.
The genetic link, it turns out, is a small one, responsible for perhaps two or three percent of cancer cases, she says. And with some obvious exceptions, lifestyle correlation has been inflated also, and doesn’t hold up to scrutiny. In addition, the idea that we can prevent cancer yields feelings of shame and guilt when we fail. Did I eat too much meat? Too much sugar? Did I sleep too little, exercise too little, work too much, drink too much? Not likely significant factors, says Mitchell. Did I allow myself to feel too much stress and anxiety? Suppress too much emotion? Allow too much negative thought? Again, no. The findings of a meta-analysis on personally types found no higher risk in those characterized by the suppression of emotion, pessimism, depression, and timidity.
The commonly used war metaphor falls shorts too, in Mitchell’s eyes. War is violent, implies a death toll, and is guilt-inducing. If I lose the war, was I weak? A poor fighter? Guilty of choosing the wrong course of action? “I think the brutality of the cancer metaphor saps our society of some of its productive vigor,” she writes. “Guilt and blame and fear are paralytic emotions, a black hole for energy.”
It may be a counterproductive and malignant metaphor, but we’ve come by it honestly enough. The battle with cancer clearly can be a matter of life and death, and the origins of chemotherapy itself lie in the use of chemical weapons—the original team of cancer drug researchers at Sloan-Kettering literally originated in the US government’s Chemical Warfare Service after World War II.
And though treatments and management of side effects have improved with time, and researchers now often look to the plant world for treatments, it can still feel very much like a war. Taxol, the drug which comes from the bark of the yew tree and which saved my life five years ago, nearly took it earlier this year. It is a potent therapy, and wears the label of weapon well.
As much as all this is true, I too am looking for a better metaphor. Some of us live with cancer for many years, much as others live with diabetes or high cholesterol or other chronic disease. I sometimes view it as more of a boxing match, one in which I occasionally get beat up, but also patched up again, and in which a defeat doesn’t need to spell death.
As to looking for fault, I’ve quit. The reality is that with a few exceptions, cancer is random. We have a long history of making up stories in the face of fear and poorly understood phenomena, stories that comfort and calm us, and that may or may not carry an element of truth. And the reality is that it has always been easier to hold victims responsible than to take responsibility as a society, which in this case would demand research on larger environmental causes that call into question an entire system of production and manufacturing.
Mitchell is a science writer, and it shows. She confirms my own inclination to take fund-raising messages with a generous shake of salt. Cancer is not, she says, when you adjust numbers for age and population growth, more prevalent than ever. And though it can still be deadly, survival rates for most cancers have increased.
Cancer is not happy news, no, but there is reason for optimism. We have a long history of facing challenges like this productively, and every reason to embrace life and health enthusiastically even in the face of current cancer realities.
May 17, 2015
This is an engaging memoir of a woman reflecting on and researching the cancer of those she loves. It is primarily about her relationship with her brother-in-law, who gets a melanoma diagnosis, but is not at a stage that traditional medicine can do anything for. So he looks at alternative medicine, and she, the science writer, submerges herself in research to try to make sense of things. She has a very good balance of the personal patient's feelings and the scientific research. And on the whole, this book is part of a growing body of literature that tells its readers that reality is not a simple thing, that science does not offer us certainty, and that we have a responsibility to learn as much as possible, do the best we can, and above all, treat each other with kindness rather than judgement.
I was somewhat unaware of some of the central problem, as Mitchell sees it, that when a cancer diagnosis is obtained, that we do a lot of blaming. I know I have a tendency to do that when a pack-a-day smoker gets lung cancer, or maybe, just maybe, someone who roasts their skin to a deep tan purposefully gets skin cancer, but I was shocked by some of the things shared by cancer patients that people had told them. That some personality flaw led to cancer. Or that it is lifestyle -- didn't eat enough organic broccoli. That much was troubling to me. Mitchell also shared some very helpful data, painting a picture of cancer's presence in our society, as a disease mostly of the aged, less common in younger patients than it used to be and certainly less deadly. She also made the strong point that only 30% of cancers are considered preventable at all (most of that is smoking), so 70% of them aren't due to any preventable cause. They're no one's fault. We can stop looking for someone to blame.
I found her analysis and description of all the alternative medicine advice that came her way (via her brother-in-law) enlightening. I've heard it said that being pregnant often carries the dubious benefit of having strangers walk up to you and give you advice for all kinds of things. Evidently having cancer is the same kind of thing, except you have the option of keeping the diagnosis a secret. But man, everybody seems to have an opinion on what you should do. How her brother-in-law and his family (including the author) handled this storm of advice and uncertainty was very interesting, and there's some really good science built into it.
There's a lot we still don't know about how our bodies work, and especially how they respond to cancer and its treatments. Mitchell raises more questions than she answers, which is inevitable and responsible on her part. She also spends some time grappling with uncertainty. I love her honesty when she admits that she was far more comfortable with that uncertainty when it was others, and then her brother-in-law who was diagnosed than she was when her daughter was diagnosed with cancer. All of a sudden all her cerebral probabilities and comfort with randomness and lack of answers were out the window. It's a beautiful piece of personal writing and a testament that dealing with uncertainty is and always will be hard for us humans.
I highly recommend this book because it's one of those that would make the world a better place if we all understood what's in here. That's saying a lot. It's part of a bigger picture that I hope we as a species will grow into... the recognition of complexity and randomness, and the deep reflection that is required to sort out what we can do and should do from other possibilities. The fact that we live in a world of probabilities but not certainties applies to everything from quantum mechanical interactions between particles (and, incidentally, the kinds of processes that may turn a cell cancerous) to our career paths. I commend Mitchell for an honest attempt to wrestle with this reality. Or, as she would no doubt prefer, to dance with this reality.
I got a free copy of this book from Net Galley.
I was somewhat unaware of some of the central problem, as Mitchell sees it, that when a cancer diagnosis is obtained, that we do a lot of blaming. I know I have a tendency to do that when a pack-a-day smoker gets lung cancer, or maybe, just maybe, someone who roasts their skin to a deep tan purposefully gets skin cancer, but I was shocked by some of the things shared by cancer patients that people had told them. That some personality flaw led to cancer. Or that it is lifestyle -- didn't eat enough organic broccoli. That much was troubling to me. Mitchell also shared some very helpful data, painting a picture of cancer's presence in our society, as a disease mostly of the aged, less common in younger patients than it used to be and certainly less deadly. She also made the strong point that only 30% of cancers are considered preventable at all (most of that is smoking), so 70% of them aren't due to any preventable cause. They're no one's fault. We can stop looking for someone to blame.
I found her analysis and description of all the alternative medicine advice that came her way (via her brother-in-law) enlightening. I've heard it said that being pregnant often carries the dubious benefit of having strangers walk up to you and give you advice for all kinds of things. Evidently having cancer is the same kind of thing, except you have the option of keeping the diagnosis a secret. But man, everybody seems to have an opinion on what you should do. How her brother-in-law and his family (including the author) handled this storm of advice and uncertainty was very interesting, and there's some really good science built into it.
There's a lot we still don't know about how our bodies work, and especially how they respond to cancer and its treatments. Mitchell raises more questions than she answers, which is inevitable and responsible on her part. She also spends some time grappling with uncertainty. I love her honesty when she admits that she was far more comfortable with that uncertainty when it was others, and then her brother-in-law who was diagnosed than she was when her daughter was diagnosed with cancer. All of a sudden all her cerebral probabilities and comfort with randomness and lack of answers were out the window. It's a beautiful piece of personal writing and a testament that dealing with uncertainty is and always will be hard for us humans.
I highly recommend this book because it's one of those that would make the world a better place if we all understood what's in here. That's saying a lot. It's part of a bigger picture that I hope we as a species will grow into... the recognition of complexity and randomness, and the deep reflection that is required to sort out what we can do and should do from other possibilities. The fact that we live in a world of probabilities but not certainties applies to everything from quantum mechanical interactions between particles (and, incidentally, the kinds of processes that may turn a cell cancerous) to our career paths. I commend Mitchell for an honest attempt to wrestle with this reality. Or, as she would no doubt prefer, to dance with this reality.
I got a free copy of this book from Net Galley.
May 26, 2015
I received a free copy from net galley in exchange for an honest review:
This book had good information and statistics of the actual face of cancer in this country and Canada. When you hear that 1/3 of the population will get cancer at some time, nobody mentions that that is so because we are living so much longer and no longer become prey of infectious disease. I always tell my students that our bodies are like old cars - something has to finally give out.
The book also refers a lot to Muckerjee's "Emperor of All Maladies" which is the most comprehensive look at cancer and cancer treatment.
The vitamin C study was fascinating and it makes me wonder, if they can trace melanoma cells in your blood, why can't somebody just come up with a simple blood test for any kid of cancer cells?
This book had good information and statistics of the actual face of cancer in this country and Canada. When you hear that 1/3 of the population will get cancer at some time, nobody mentions that that is so because we are living so much longer and no longer become prey of infectious disease. I always tell my students that our bodies are like old cars - something has to finally give out.
The book also refers a lot to Muckerjee's "Emperor of All Maladies" which is the most comprehensive look at cancer and cancer treatment.
The vitamin C study was fascinating and it makes me wonder, if they can trace melanoma cells in your blood, why can't somebody just come up with a simple blood test for any kid of cancer cells?
December 6, 2015
Great book that demystifies some of our beliefs and fears about Cancer.
The author mixes personal experiences plus historic and informative anecdotes plus scientific and statistical evidence. This is a great combination and that's why the book is interesting, eye-opening and easy to read.
The author does a pretty good job as a detective to enlighten us with all the intricate stuff about this pernicious disease and she simplifies the existing research and knowledge so we can understand it while we enjoy the reading.
She talks about several ways to approach the disease and some other ways we shouldn't do it, for both the patient and spectators.
The author mixes personal experiences plus historic and informative anecdotes plus scientific and statistical evidence. This is a great combination and that's why the book is interesting, eye-opening and easy to read.
The author does a pretty good job as a detective to enlighten us with all the intricate stuff about this pernicious disease and she simplifies the existing research and knowledge so we can understand it while we enjoy the reading.
She talks about several ways to approach the disease and some other ways we shouldn't do it, for both the patient and spectators.
November 12, 2016
I like the idea of challenging the current metaphors around cancer and I enjoyed the book but found it a little thin and too reliant on other books (I was left wondering if I should instead read Emperor of All Maladies since she references it so frequently? )
I wish she'd done more to challenge the alternate treatments. It felt like she was on the edge of calling bullshit but just couldn't because she was too close to the story.
I wish she'd done more to challenge the alternate treatments. It felt like she was on the edge of calling bullshit but just couldn't because she was too close to the story.
January 21, 2016
This was a fast and interesting read. Don't let the title scare you off, in fact if you fear cancer, like most of us do, than you should read this. Mitchell does a fine job at changing our perspective on this disease and suggesting we change the prevailing metaphors that cause us to fear it above all other diseases.
January 18, 2017
Mitchell makes a good point about the metaphors used in relationship with cancer. The book follows the cancer journeys of her brother-in-law and her daughter. Her pretense is that society
views cancer as "inevitable, preventable and deserved" a trifecta that should read "common, random and unlucky."
views cancer as "inevitable, preventable and deserved" a trifecta that should read "common, random and unlucky."
Displaying 1 - 15 of 15 reviews