Abstract
Euphemisms may be used to reduce the threat associated with the word "cancer." Cancer may be particularly threatening in Indian culture due to the myths surrounding its cause and prognosis. This study explored the prevalence of euphemism use by Indian patients and the relationship among euphemism use and illness cognitions, affect, health behaviour, and spontaneous self-affirmation (a behaviour associated with dealing with threat). In total, 350 cancer patients in India were recruited to take part in a study exploring patients' experiences of, and thoughts about, having an illness. They responded to a questionnaire measuring illness perceptions, coping strategies, anxiety, depression, health behaviours, and spontaneous self-affirmation. Patients were asked what words they used to describe their illness; euphemism users were those who used a euphemism (ie, non-medical term) as a first word. About 51% of patients used a euphemism as a first word. Those with less education, unskilled employment, a lower income, and more children were more likely to be euphemism users. Euphemism users reported (a) weaker illness perceptions (less personal control, greater reporting of symptoms, and less understanding of their condition), (b) less use of 3 of 14 coping strategies, (c) less likelihood of spontaneously self-affirming, and (d) fewer healthy eating days. Euphemism use in patients was not related to distress but was related to negative illness perceptions and use of fewer coping strategies, suggesting that we need further study about the extent to which euphemisms signal issues in psychological adaptation to cancer diagnosis.
Highlights
Euphemisms for cancer may be used to reduce the threat associated with the word “cancer.”[1] Cancer may be threatening in India due to the myths surrounding its cause
This study will explore the prevalence of euphemism use by Indian cancer patients and the relationship between euphemism use and illness cognitions, affect, health behaviour and spontaneous
This study suggests that Indian cancer patients' use of euphemisms for cancer is common with 51% choosing to use a euphemism as the first word to describe their illness and 69% of the sample using at least one euphemism
Summary
Euphemisms for cancer may be used to reduce the threat associated with the word “cancer.”[1] Cancer may be threatening in India due to the myths surrounding its cause. Cancer patients in India suffer discrimination due to cancer stigma including in their own families; 87% reported discrimination such as isolation,[5] asked to use separate clothes, food or utensils,[5] or in-laws disowning them.[10] Until recently, a significant number of families in India did not disclose a diagnosis of cancer to the family member affected.[11,12] there has been a recent shift in medical communication with more patients wanting to become involved in their medical decision making, but patients and families still finding communicating about cancer difficult owing to a lack of skills in this area and the stigma associated with it.[13] Euphemism use may present a way of openly talking about the illness without causing offence by eliminating the taboo of the word “cancer.”[14] it could be beneficial to the patient as it could reduce stigma and discrimination associated with cancer and allow communication; there may be negative effects
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