Cancer on Screen as “Cancertainment”

A previous blog post in this series discussed the role of metaphor in cancer and how the way we talk about cancer affects our attitudes and beliefs about it. For example, in her influential essay, Illness as Metaphor, Susan Sontag noted the way we describe being treated for cancer as “battling" the disease.¹ According to her, this creates a culture of shame for those who succumb to the illness. But the flip side to her argument is the notion that using the cancer-as-a-battle metaphor or other metaphors help us make sense of it. Portrayals of the cancer experience on film and on television have been subject to the same scrutiny.

Portrayals of various forms of illness on our screens are inevitable and, by extension, sickness and death make for important topics. The way they are portrayed, in particular, reflects our societal views and also has a role in influencing them.^2,3 Numerous depictions of the AIDS epidemic in the United States powerfully reflected changing attitudes toward the afflicted and the wider cultural implications of this on the marginalized groups associated with it.⁴ Similarly, the stigma about mental health is frequently explored in film.⁵ More specific societal changes, such as lessening acceptance of tobacco use, are reflected in the decreasing number of tobacco use portrayals over the past few decades.⁶ Traditionally, cancer portrayals on film lean towards the melodramatic and tragic. As a result, our collective fear of cancer and the death sentence seemingly attached to the diagnosis are reinforced whether we realize it or not.

In recent years, programs such as Netflix’s sitcom Alexa & Katie and Showtime’s The Big C have taken a humorous stance on the cancer experience. Constructing a comedy-drama about cancer was an unheard-of concept just a couple of decades ago when melodrama dominated Hollywood’s portrayals of cancer. Breaking Bad’s Walter White isn’t consumed by his cancer diagnosis; it transforms him into a celebrated anti-hero far into his survivorship. Other recent works, such as The Fault in Our Stars and 50/50, tackle the cancer experience with dramedy aimed at young adults. The Fault in Our Stars, in particular, has tried to tackle the angst and awkwardness of teenagers with relatable storylines about being a cancer patient (“What’s your story?” “I was diagnosed when I was thirteen…” “No, no, no – your real story.”), but in a more realistic way than the insurmountable heaviness of Love Story decades earlier. A Walk to Remember, released in 2002 and based on the popular Nicholas Sparks romantic drama novel of the same name, represents the changing narrative between the two aforementioned films. Adam Sandler’s brash and self-absorbed character in Funny People isn’t completely transformed into a saint after being diagnosed with acute myeloid leukemia but maintains certain flaws throughout his treatment and into his survivorship. These newer iterations of the cancer experience story portray it as a significant and life-changing part of the character’s identity – but by not their entire identity.

The changing tone of cancer portrayals seems to be in step with changing societal beliefs about what it means to be diagnosed with and to live with cancer, but that doesn’t mean there isn’t room for improvement. According to a recent analysis of cancer films, they have a tendency to portray the rarer and more severe forms of cancer, and don’t accurately depict the diversity of the cancer experience in terms of severity, the toll on quality of life, likelihood of survival, and the long-term effects for survivors.⁷ In fact, the complexities of survivorship are rarely depicted, if ever, including navigating long-term observation for recurrence or impact on fertility, as examples. Given the growing number of cancer survivors, more accurately portraying the average experience of cancer could provide a great benefit to those experiencing cancer in real life. Although the influence of watching cancer portrayals on screen has not been thoroughly studied, the possibility of the therapeutic effect is not that far-fetched. Bibliotherapy, or the use of narratives in the form of books as a therapeutic technique, has been studied and found to be effective in treating symptoms of mental disorders such as depression.⁸ Although to our knowledge no such form of therapy has been studied or proposed for film, it would be an interesting line of future inquiry.

So, should cancer patients, survivors, or caregivers be watching the dramatized versions of the experience on screen? Will it benefit anyone psychologically? If it helps individuals process their experiences, or if it will help loved ones or caregivers understand some of what the patient or survivor is going through, then, by all means, they should bust out the popcorn. But it’s important to take it with a grain (or sprinkle) of salt. Survival rates for many types of cancer are improving, and different people experience it in different ways. Above all, it’s important for patients to remember that a cancer diagnosis doesn’t define them, which is an idea often perpetuated by Hollywood and the film industry in general. Real people are not plot points meant to move storylines along.