There are two common media representations of ‘ordinary’ women who have breast cancer, the brave dead heroes, and the valiant survivors.

Recently my local paper carried a story about the ‘heartache of watching a friend die’. It was a familiar simple tale of the ‘bravest and most courageous woman’ the writer knew. Her friend had just died of breast cancer. We learned a little about Jackie who was bubbly and positive, a real laugh on a girls’ night out. The author was sure therefore that when her friend discovered the lump it couldn’t be anything serious. It turned out of course to be breast cancer, and the article is devoted to Jackie’s determined fight. Her bravery during chemotherapy is illustrated by a description of her riding away in a limousine for her birthday treat to watch her favourite footballer at the local stadium.

After treatment Jackie was ‘just fine’ so what a shock when the cancer returned. Again her friend was sure she’d be OK because Jackie was so positive and bad things are not supposed to happen to positive people but the cancer ‘got aggressive’ and killed her. Jackie was so brave she never once complained, or mentioned the pain, let alone talked about dying. She laughed till the end, had her family dancing round her death bed and died clutching tickets for the next football match.

In Jackie’s story there are all the elements of what Seale calls the ‘contemporary dying hero’ who defends and protects others, has an increased appreciation of life which others take for granted, and endures the physical and emotional parts of their illness while protecting and concealing their pain from others. Jackie was ‘full of life’ and had a sense of humour, was unselfish, caring, thoughtful. It is seemingly inevitable that in the genre of cancer death stories, we do not hear accounts of frightened or selfish or humourless or bad tempered people. Each dead hero is glamorised, sanitised and canonised.

A few weeks later and a video appeared on the internet from Sky News devoted to the remarkable story of a woman who has been living with secondary breast cancer for 34 years. The story was crammed full with myths and metaphors about how the lucky survivor was able to seal her own fate as one of the living...she just 'got on with it', she never complained, she played golf, she went to a spiritual healer who told her she was going to beat this. Being a competitive soul who 'likes to win' 'her attitude saved her'. Just like poor Jackie who didn’t make it, this woman is also praised for keeping the full horrors of her illness private and secret from those she loves.

I know some women with breast cancer who hail this as an inspirational example and, if it is true, it is certainly unusual, but in fact the story only highlights one extreme end of the statistical curve. If on average women with secondary breast cancer live 2 to 3 and a half years past diagnosis then a very few of them will live well beyond that, just as some live much shorter periods.

Valiant survivor stories convey some disturbing messages. They seem to imply that those unfortunate enough to die didn't fight quite hard enough. Perhaps they complained too much or had the wrong attitude.

Whether as dead hero or valiant survivor the popular media demands certain moral characteristics of those who have cancer, with cheeriness and ‘positivity’ particularly applauded. By implication a positive attitude allows brave cancer patients to accomplish feats while ill which those with lesser moral fibre cannot achieve. Bizarrely though, the examples cited are usually not extraordinary at all. Most people undergoing chemotherapy for breast cancer are able to carry on normal lives for at least part of their treatment cycles. There is nothing particularly brave, unusual or newsworthy in being able to celebrate a birthday, watch a football match or play golf.

In both these stories, while the outcomes are so very different, the acclaimed characteristics of these cancer heroes are similar. In neither account is there space for information about the diversity of breast cancer, nor credible explanation about why Jackie died so quickly or Rachel lived so long. Cancer is portrayed as a mysterious disease, ultimately beyond the control of rational treatment, contained only by the moral fibre and unique attitude of the unfortunate victim. When the hero dies it is in spite of her laudable attitude, while if she lives it is because of it.

Perhaps it sounds ungracious to criticise. Jackie’s friend no doubt feels better for seeing herself in the local rag, and Rachel, after years of difficult treatments, may well believe she has something of hope to offer others more recently diagnosed. However, ultimately these representations only serve to distort uncomfortable facts about breast cancer. They create burdensome expectations in others with cancer who can feel silenced if they express any negative feelings. They also create a category of ‘other’ for the worried well. If cancer patients are turned into special superhuman heroes then healthy people can distance themselves, and avoid thinking about what living with a life threatening condition might actually be like. In reality cancer is not a disease reserved for the specially brave, chirpy and positive. It does not discriminate. One in three in the UK will get cancer at some time. Survival rates for breast cancer may be slowly improving because of better diagnosis and new treatments, but survival has nothing to do with attitude.

Cancer is no longer spoken of in the hushed tones of the 1950s but the transformation of sad victims into brave dead heroes and valiant survivors only creates a new kind of secrecy about a poorly understood disease.

Clive Seale (1998) Constructing Death. The Sociology of Dying and Bereavement. CUP.

JaneRA 09/08