The shame of cancer?

December 31, 2008 2:11 PM

Why was cancer once considered a shameful disease?

Ignorance about how cancer is "caught"? Or were all lingering, wasting, potentially disfiguring diseases equally shameful?

posted by Quietgal to Society & Culture (36 answers total)

I don't know that cancer was considered shameful. Where did you hear that?
posted by Chocolate Pickle at 2:18 PM on December 31, 2008

What is your information source? What is making you say that?

I remember that cancer was not discussed in the 1950's except in whispers and doctors did not generally tell patients that they would probably die. Instead doctors gave patients false hope or a false diagnosis.
posted by andreap at 2:19 PM on December 31, 2008

I'm an oncologist, and I've never heard of it referred to as a "shameful disease" until this question. The main person associated with this phrase, at least per Google, is a talk show host named Lisa Durden.

I'm much more familiar with cancer being referred to as "the dread disease" (see James Patterson's book by that title, an excellent examination of the cultural meaning of cancer).
posted by scblackman at 2:22 PM on December 31, 2008

Modern Americans tend to link health with virtue and illness with sin or failure. I do think there is an element of shame associated with cancer, particularly those with associated lifestyle factors, such as lung, skin, or colon cancer. Whether they say it or not, on hearing that someone has cancer, I think many people wonder "I wonder what they did to get that?"
posted by ottereroticist at 2:30 PM on December 31, 2008 [3 favorites]

This may be a bit tangential since it's about the present and about one particular kind of cancer, but here's an excellent recent article on the way lung cancer is treated as shameful while other cancers aren't.
posted by Jaltcoh at 2:35 PM on December 31, 2008

Response by poster: If you've read Rebecca you'll know what I'm talking about. (Don't want to spoil it any more than that.) I've seen this attitude occasionally, usually in pre-1950 sources, generally much older than that. It just seems odd that a disease that sometimes strikes seemingly out of the blue, without requiring any failure of "virtue", should have been a source of shame. (Especially given all the tragic Victorian heroines confined to their beds with tuberculosis, another lingering wasting disease.)
posted by Quietgal at 2:38 PM on December 31, 2008

I've never heard of it as "shameful", but I do know in the past that it wasn't spoken of much.

However, this could be crossing wires with more specific cancers, such as breast cancer or testicular cancer, which are generally more... embarrassing? or shameful? or something like that.

The way I heard it told was that Nancy Reagan "opened the doors" to breast cancer being more... accepted.

I would guess that Lance Armstrong did the same for men.
posted by phrakture at 2:39 PM on December 31, 2008

You may want to read Susan Sontag's work, Illness as Metaphor and AIDS and Its Metaphors.

Sontag argued that cultures attach meaning to illnesses, and instill guilt and shame in cancer sufferers by intimating they may have caused their disease by repressing their passions. Sontag also addresses societal stigmas associated with tuberculosis and AIDS.
posted by terranova at 2:47 PM on December 31, 2008 [2 favorites]

Before AIDS, cancer was the disease you did not speak of.

Susan Sontag wrote a book in 1988 on this subject: "AIDS and Its Metaphors"
posted by flif at 2:53 PM on December 31, 2008

If you are mistaken about cancer formerly being considered shameful, Quietgal, you are at least in very good company. From Susan Sontag's Illness as Metaphor, first published in 1978:

Given the romantic values in use for judging character and disease, some glamour attaches to having a disease thought to come from being too full of passion. But there is mostly shame attached to a disease thought to stem from the repression of emotion — an opprobrium echoed in the views propagated by Groddeck and Reich, and the many writers influenced by them. The view of cancer as a disease of the failure of expressiveness condemns the cancer patient; it evinces pity but also conveys contempt. ...
posted by jamjam at 2:54 PM on December 31, 2008

I've always understood cancer to be shameful in the way that terrible, personal tragedy is supposed to be private. Not shameful in the "it's your fault you caught it" way like a venereal disease. Just a terrible, private, emotionally painful matter that a more private and polite society meant you did not discuss in public.
posted by Nelson at 3:00 PM on December 31, 2008 [1 favorite]

If you've read Rebecca you'll know what I'm talking about.

That's a work of fiction. Authors often employ artistic license for the story. I also agree its doubtful that cancer ever had the stigma of, say, AIDS.
posted by damn dirty ape at 3:06 PM on December 31, 2008

Well I can say, and some Dutch MeFites can give more information I'm sure, that in Holland (actually I'm pretty sure that this is specific to the city of The Hague) a common epithet is to use the Dutch word for cancer as a swear word, as in the epithet "kanker hoer" (cancerous whore). It is used by some (older, I'm pretty sure) people as an all purpose swear word. As most swear words are based on some kind of taboo (be it sex, defecation or religion) that at least to me points to the fact that at some point cancer was considered a shameful disease.
posted by ob at 3:11 PM on December 31, 2008

I worked as a produce buyer at a food co-op for a while, and there was a large community of cancer patients and survivors (as well as many people who simply felt really nervous about getting cancer someday) in the membership. Many of them believed that they could cure cancer/keep cancer in remission/prevent cancer through a variety of "healthy" lifestyle and diet choices, and there was a tacit corollary that people who got cancer—or who failed to "beat" it—were somehow responsible by dint of their lifestyle (the standard American diet, usually, but I even recall unexpressed anger cited as a causative factor).
posted by pullayup at 3:13 PM on December 31, 2008

Not shameful per se, but the "C word" was deemed unspeakable as recently as the 70s when it was censored from a Monty Python sketch.
posted by Lentrohamsanin at 3:14 PM on December 31, 2008

It's not exclusively about cancer, but you might be interested in AIDS and Its Metaphors and Illness as Metaphor.
posted by pullayup at 3:17 PM on December 31, 2008

I found this article discussing cancer education efforts in the first half of the 20th century to be helpful. I think cancer used to have a stigma because it was often incurable, the causes unknown, required painful surgery, and involved long-term debilitation and possible disfigurement. Medical attitudes towards people with terminal illnesses were considerably less enlightened than they are today.
posted by KirkJobSluder at 3:33 PM on December 31, 2008

It just seems odd that a disease that sometimes strikes seemingly out of the blue, without requiring any failure of "virtue", should have been a source of shame.

This isn't specific to cancer. Perhaps I've misconstrued what you're getting at, but since biblical times there has been a strain of thought arguing that most any serious malady (cancer, blindness, disfigurement, etc.) is a punishment for the sufferer's--or the sufferer's ancestors', viz. "sins of the father"--moral shortcomings. Whether that applies to mid-20th Century perceptions...it's possible.
posted by kittyprecious at 4:01 PM on December 31, 2008

When my father-in-law developed cancer, the family refused to use the same bed linens. When he died, they threw his bed out. They thought cancer was contagious. They didn't quit loving him, but they weren't comfortable being around him. I don't think they were unique.
posted by clarkstonian at 5:11 PM on December 31, 2008

Like ottereroticist's comment listed above, I've heard of illnesses as a sin and AIDs does provide a perfect example of that (there's a lot of fundamentalists who say that AIDs is punishment for sinful behaviour).

Also, if we go back to the time of Decartes there are is a mind/body dichotomy (Cartesian Split). Bodily functions were considered to be less than those of the mind. I haven't heard it linked to cancer, but I could see how a link could be drawn. If one was closer to the body, they were considered to be inferior to those who had more connections to the mind. If someone had cancer, they'd be seen as closer to the body.
posted by DorothySmith at 5:12 PM on December 31, 2008

I wonder if we have a natural aversion to sickness, especially mysterious and misunderstood diseases. Only until have we've empathized with the illness in the form of a narrative, made for TV movie, or whatever, does it become culturally acceptable, losing its taboo and the shame associated with it. Good responses here about AIDS and material from the fifties, I know nothing on the sociology of disease, but 'tis a fascinating topic.
posted by ageispolis at 5:42 PM on December 31, 2008

I'm not sure that cancer was considered 'shameful' but I know that when my grandmother was diagnosed with lung cancer in the mid '70s, it was considered a death sentence. The response of my mother and grandfather was not so much 'shame' as a difficulty talking about a disease that would surely kill my grandmother (and it did). It was the extremely lethal nature of the disease that I think made people not want to talk about it. The lethal nature of many cancers hasn't changed but there surely has been a lot of progress in willingness to discuss cancer, as well as death and end of life issues.
posted by bluesky43 at 6:20 PM on December 31, 2008 [2 favorites]

I've never heard of or considered cancer to be shameful. Though it is often a very personal and private matter for people that outsiders might mistake as shame.

I avoid talking about it generally, but that's superstition.
posted by gjc at 7:13 PM on December 31, 2008

If you've read Rebecca you'll know what I'm talking about.

I have read Rebecca, and I disagree that it depicted having cancer as shameful. The term "dread disease" comes from people's fear of it, not from shame. The only thing that's really changed is a greater openness about cancer of the sexual or reproductive organs,
posted by orange swan at 7:16 PM on December 31, 2008 [1 favorite]

What clarkstonian said. Same thing happened in a branch of my extended family. My parents, who'd never been to college, couldn't understand how the college-educated son could have thought that he'd "catch" cancer from his father.
posted by apartment dweller at 7:58 PM on December 31, 2008

Response by poster: A fascinating range of answers - thanks, hive mind. I sort of thought the explanation would be something along the lines of Nelson's suggestion, in that originally the attitude was "It's unkind to discuss others' suffering", which gradually distorted into "Well, if nobody ever talks about it, there must be something shameful hiding here". It never occurred to me to consider the "disease = punishment for sin" angle for something like cancer which, unlike syphilis for example, doesn't require any "naughtiness" on the part of the patient.

In a way I'm glad that others can corroborate my impression that cancer was, and in some places still is, considered shameful. It makes no sense, and I haven't encountered this attitude in real life since I was a little girl listening to elderly relatives and neighbors, but it definitely went beyond dread (understandable) into shame (wha ...?). Google didn't turn up any good references, so I cited Rebecca since it's probably familiar to many here even if not the strongest example, but I know I've seen the attitude in other Victorian and Edwardian literature. Which I can't remember, of course, except for a "wha ...?" that stuck in my head all these years.

So how come consumption (TB) was OK to write about? That's another ugly frightening disease, but apparently not shameful for some reason. Any sociologists care to weigh in on this?
posted by Quietgal at 8:06 PM on December 31, 2008

I think the reason people were uncomfortable talking about it is that it was a death sentence, and so they avoided the topic because it was depressing. I believe that this was the main reason doctors might not disclose the illness to patients. I had a relative with terminal cancer decades ago, and their doctor I believe made an initial read on whether my relative wanted to know the truth, or whether they wanted to think only about fighting it and surviving.

I don't think cancer was (or is) considered shameful, however it was almost universally fatal. Cancer medicine have come far, and now it's much more likely to be treatable than it was even in the 1980s.
posted by zippy at 8:43 PM on December 31, 2008

"In the mid-70s, my Japanese mother hid her cancer diagnosis from her friends (also transplanted Japanese), she made it clear she felt she and our family would be stigmatized. "

In Japan there is a stigma to being a person exposed to the atomic bombs at Nagasaki or Hiroshima. Even being descended from such a person carries a certain stigma.

Perhaps your mother was worried your family would be stigmatized, since cancer is connected with exposure to the atomic bomb blasts?
posted by Modus Pwnens at 8:46 PM on December 31, 2008 [1 favorite]

"how come consumption (TB) was OK to write about?"

Because in the early stages you are still kind of ok, just weak, pink-cheeked but pale, and prone to fainting, ie the standard for Victorian womanhood only more so. And when you get very sick, you aren't actually disfigured, emitting pus from your infected wounds, or screaming in pain, or going mad.

(Note I'm thinking consumption (pulmonary) TB here, other kinds have hideous and unromantic symptoms).
posted by i_am_joe's_spleen at 11:15 PM on December 31, 2008

(Note also this is my personal opinion, not backed by scholarly research).
posted by i_am_joe's_spleen at 11:50 PM on December 31, 2008

I haven't heard of it being shameful, either. However, I can imagine that, in some cases, religion has made it, like other sicknesses, taboo. You know, the old "you're sick, because of your sin" chestnut. If there was any shame involved with cancer, I imagine some of it could come out of that sort of thinking. It could lead to thoughts of, "What has this person done so wrong that God would allow him to become/make him so sick?"
posted by metalheart at 2:02 AM on January 1, 2009

Well I can say, and some Dutch MeFites can give more information I'm sure, that in Holland (actually I'm pretty sure that this is specific to the city of The Hague) a common epithet is to use the Dutch word for cancer as a swear word, as in the epithet "kanker hoer" (cancerous whore). It is used by some (older, I'm pretty sure) people as an all purpose swear word. As most swear words are based on some kind of taboo (be it sex, defecation or religion) that at least to me points to the fact that at some point cancer was considered a shameful disease.

This isn't unique to cancer though, other diseases are also used this way in Dutch. (TB, for instance)
posted by atrazine at 3:03 AM on January 1, 2009

So how come consumption (TB) was OK to write about? That's another ugly frightening disease, but apparently not shameful for some reason. Any sociologists care to weigh in on this?

Check out the beginning of Susan Sontag's Illness as a Methaphor and AIDS and its Metaphors. The first 22 pages of it are available on Google Books, but in those first pages she compares TB and cancer and the differing culture attitudes towards them.

I think a big part of it is that TB was romanticized in the 19th century, according to wikipeida: Many people believed TB produced feelings of euphoria referred to as "Spes phthisica" or "hope of the consumptive". It was believed that TB sufferers who were artists had bursts of creativity as the disease progressed. It was also believed that TB sufferers acquired a final burst of energy just before they died which made women more beautiful and men more creative." Looking at the list of TB victims, I think I would have come to the same conclusion.
posted by radiomayonnaise at 7:19 AM on January 1, 2009

a common epithet is to use the Dutch word for cancer as a swear word,

For which see more here. Whole lot of curious in this, almost worthy of its own question.

Quietgal is right, though, if the old folks I know are anything to go by. I was a little surprised that others are were surprised. Interesting to know the ages of the surprised folk.
posted by IndigoJones at 7:30 AM on January 1, 2009

Response by poster: Again, thanks everyone for an even-more-interesting-than-expected discussion. The stigma attached to cancer in the US is definitely age-related; the people I heard it from when I was little would have been in their heyday around 1900 - 1930. Nowadays the prevailing attitude toward disease is pretty matter-of-fact, clinical and dispassionate (with a few unfortunate exceptions). It's jarring to encounter the strange mixture of superstition, religion and fatalism that held sway before WWII (or thereabouts). Not all that surprising - medicine had frustratingly few tools back then - but still jarring to the 21st Century reader.

Dutch curses and romanticizing TB are also pretty fascinating. Maybe there's a FPP in here somewhere ...
posted by Quietgal at 12:33 PM on January 1, 2009

Possible confusion with chancre, a stage of syphiis?
posted by bad grammar at 6:23 PM on January 1, 2009