(Originally published on 20th November 2019 on the blog of the European Association for Palliative Care: https://eapcnet.wordpress.com/2019/11/20/a-metaphor-menu-for-people-living-with-cancer/)

Researchers at Lancaster University have produced a ‘Metaphor Menu for People with Cancer’ – a resource for meaning-making and communication that is freely available for anyone to read and use. Elena Semino (Lancaster University), Sheila Payne (Lancaster University) and Zsófia Demjén (University College London) explain.

“She lost her brave fight.” If anyone mutters those words after my death, wherever I am, I will curse them. This is how Kate Granger – a British doctor in her thirties – opened a 2014 newspaper article about her experience of living with incurable cancer, of which she died two years later. Many others have similarly rejected ‘Violence’ metaphors for cancer, and the UK’s National Health Service uses ‘cancer journey’ instead of any reference to fights or battles.

This raises some questions, however: What metaphors are actually used to talk about cancer? And are some metaphors better than others, especially for patients?

A project we carried out at Lancaster University aimed to answer these questions. We found evidence of the potentially harmful effects of Violence metaphors, for example when someone whose cancer has spread says: I feel such a failure for not winning this battle. However, we also found that no metaphor is inherently good or bad for everyone. Different people find different metaphors helpful as ways of coping with and communicating about different aspects of the complex experience of having cancer.

These findings created a challenge for us when people asked us to propose a set of guidelines based on our research. On the one hand, we knew that we could not produce a list of do’s and don’t’s that would work for everyone. On the other hand, we also could not just say that things were too varied and complex for us to come up with any suggestions for helpful and sensitive communication about cancer. This led us to create the ‘Metaphor Menu for People Living with Cancer’.

The Metaphor Menu consists of a series of quotes from people with cancer that involve a wide range of different metaphors, drawing from music, nature, fairground rides, and so on, as well as journeys and fights. The idea is that, as when selecting food in a restaurant, different people will prefer different metaphors, but hopefully everyone will find something that is right for them at a particular point in time. Metaphors are resources for communication and meaning-making. The more we have available, the better, especially when going through hardship.

We officially launched the Metaphor Menu on 7^thand 8^thNovember 2019, in Lancaster and London. It is now freely available on our project website for anyone to read and use. We do not intend it as an end point, however, but as a tool to stimulate new creative ways of talking about cancer, both for patients and health professionals.

If you are interested, feel free to use it, including by translating it into other languages. We would be very grateful to hear from you if you have any feedback, if you would like to suggest new metaphors, or if you use the Menu in any way, whether in a personal or professional capacity. You can contact us via the feedback form on the Metaphor Menu webpage or by emailing Elena Semino: e.semino@lancaster.ac.uk.

Reference

Semino, E., Demjén, Z., Demmen, J., Koller, V., Payne, S., Hardie, H. and Rayson, P. (2017) The online use of ‘Violence’ and ‘Journey’ metaphors by cancer patients, as compared with health professionals: a mixed methods study, BMJ Supportive and Palliative Care, 7, 1, 60-66.