Is laughter the greatest medicine for cancer patients?


December 6, 2017


Lancaster University


Spontaneous humor is used and appreciated
by people with cancer and can be a helpful way of dealing with distressing,
taboo or embarrassing circumstances, research shows.


Analysis led by Lancaster
University researchers suggests that spontaneous humour is used and appreciated
by people with cancer and can be a helpful way of dealing with distressing,
taboo or embarrassing circumstances.


People can use humorous
metaphors (figures of speech) to empower themselves by undermining the illness,
mocking it and distancing themselves from it.

In ‘Metaphor, Cancer and
the End of Life’, Elena Semino, Andrew Hardie, Sheila Payne and Paul Rayson,
from Lancaster University, and Zsófia Demjén from University College London,
present the methodology, findings and implications of a large-scale
corpus-based study of the metaphors used to talk about cancer and the end of
life (including care at the end of life) in the UK.

“We studied an
online forum for people with cancer and found that some contributors regularly
joke about what is happening to them,” says Professor Elena Semino, who
led the research team.

“For example, the
cancer is referred to as ‘Mr C’, a colostomy bag as ‘Baggy’ and an oncologist
as ‘the Wizard of Onc’.”

Co-author Dr Zsófia
Demjén adds: “Making fun of cancer helps some people on the online forum
cope with serious, threatening and unpredictable circumstances, and to bond
with one another.”

The whole study presents
what is the largest-scale study to date of metaphor in the experience of cancer
and (care at) the end of life.

It focuses on metaphor as
a central linguistic and cognitive tool frequently used to talk and think about
sensitive and subjective experiences, such as illness, emotions, death, and
dying. It can both help and hinder communication and well-being, depending on
how it is used.

The study examines
particularly the metaphorical language used by members of three different
groups in healthcare:

· People diagnosed with
advanced cancer

· Unpaid family carers
looking after someone who has cancer

· Healthcare

The team adopted corpus
linguistics — a branch of linguistics that uses computer-aided methods to
study a variety of linguistic phenomena in large digital collections of texts
known as ‘corpora’ (singular, ‘corpus’), to examine the metaphors used by the three
groups to talk about cancer and the end of life.

The team built a
1.5-million-word corpus consisting of interviews with and online forum posts by
people from each of the three groups.

They then used a
combination of qualitative analysis and corpus linguistic methods to present a
range of findings that have implications for: metaphor theory and analysis;
corpus linguistic and computational approaches to metaphor; and training and
practice in cancer care and hospice, palliative and end-of-life care.

The study shows the
metaphors most commonly used by members of the three participant groups, and
points out both differences and similarities across the groups.

It reveals the possible
effects and functions of different patterns of metaphor use, such as, to engender
a sense of community amongst cancer patients communicating in a peer-to-peer
online forum.

It argues that there are
no inherently ‘good’ or ‘bad’ metaphors in communication about illness, but
that different uses of metaphor may be more or less (dis)empowering, depending
on how they are used at different points in time and how they reflect and
reinforce different emotions, self-perceptions and degrees of agency and control.

The study has
implications for how healthcare professionals can engage with the metaphors
used by patients and family carers in clinical contexts, and generally for how
to employ metaphors sensitively and effectively in healthcare communications.

Professor Elena Semino:
“By exploring systematically the metaphors used by patients, family carers
and healthcare professionals in the context of cancer and the end of life, we
hope to increase healthcare professionals’ awareness of their own and others’
uses of language, so that they can adopt more sensitive and effective
communication strategies with patients and their families.

Top ten metaphors
revealed in the study

Animals: Used primarily
by patients and carers writing online. Both groups describe cancer negatively
as a ‘beast’. Animal metaphors are also used by both patients and carers to
describe themselves in self-deprecatory terms, usually because of attitudes or
behaviours that are part of the experience of illness. Several patients use
‘chicken’ metaphorically to suggest that they perceive themselves as the
opposite of the conventional notion of the ‘brave’ cancer patient, and are like
a scared animal in car headlights.

Sports and Games: Both
patients and healthcare professionals used the opposition between a ‘sprint’
and a ‘marathon’ metaphorically to suggest that, like a marathon, cancer
requires sustained effort, determination and resilience over a long period of
time. A doctor writing online suggests the ‘marathon vs. sprint’ metaphor is a
good way to prepare someone to care for a person with a terminal illness. There
are references to ‘winners’ and ‘gold medallists’.

Religion and the
Supernatural: Metaphors drawing from religion and the supernatural are more
frequent in online forum contributions by patients than by the two other
participant groups. Both patients and carers online describe distressing
situations as being in ‘hell’ and situations of uncertainty and lack of
activity (e.g. waiting for appointments or results) as being in ‘limbo’. Others
talk about the ‘green eyed monster’ and tumours as ‘dragons’.

Restraint: Both patients
and carers talk about the consequences of cancer in their lives in terms of
being physically restrained in a particular location. This applies particularly
to the inability to leave their homes so the house becomes a ‘trap’ or they are
‘trapped’ in a nightmare

Openness: The members of
all three groups use Openness metaphors to describe the ability and willingness
to talk honestly and explicitly about emotions, a cancer diagnosis, and/or the
imminence of death

Obstacles: The member of
all three groups talk — quite conventionally — about different kinds of
difficulties as ‘obstacles’ and ‘hurdles’.

Wholeness: Metaphors to
do with wholeness, and particularly loss of wholeness, are primarily used by
patients and carers writing online to talk about the consequences of illness or
bereavement for their own mental states, self-perceptions and sense of

Machines: These include a
number of highly conventional metaphorical expressions for people’s mental
lives, such as ‘coping mechanism’ or ‘switching off’ from worries. ‘Roller
coaster’ and ‘treadmill’ are common.

Violence and Journey: The
project team previously identified that Violence and Journey metaphors were the
most commonly used in the data. While there is evidence that violence metaphors
can be harmful for patients, the study showed that both violence and journey
metaphors can be empowering or disempowering, depending on how they are used.



by Lancaster
. Note: Content may be edited for style and length.

University. “Is laughter the greatest medicine for cancer patients?.”
ScienceDaily. ScienceDaily, 6 December 2017.