Sunday, 24 November 2024

Cancer care in Africa: translations of key words convey fear and need to change

Language can give people the power to take an active part in their own healthcare, or it can create barriers.

Effective communication raises awareness about diseases and is key to delivering good care to patients.

Yet in many African settings, this aspect of care is often overlooked.

Take cancer, for example. Understanding how cancer is discussed in various languages and cultural contexts is crucial. Better communication about the disease can reduce fear and stigma, improve patient outcomes and promote more informed decision-making.

The cancer burden in Africa is rising at a faster rate than anywhere else in the world. In a region where around 2,000 languages are spoken, the way cancer is communicated is important.

I am an epidemiologist and global health researcher who recently coauthored a paper about the way cancer terminology is expressed in African languages.

The findings suggest that translations of key terms, including “cancer”, “malignant”, “chronic” and “radiotherapy”, commonly conveyed elements of fear and tragedy. And that the words used may contribute to fear, health disparities and barriers to care, and pose communication difficulties for health professionals.

The results reinforce the need for culturally sensitive cancer terminology. This would improve cancer awareness and communication.

For cancer patients, the words used to describe their diagnosis and treatment can affect how they perceive their condition, their willingness to seek treatment, and their interaction with healthcare providers.

A study on cancer terminology

Our study investigated translations of cancer-related terms from various African languages and explored their cultural significance. We surveyed 107 healthcare professionals, community health workers and researchers from 32 African countries, representing 44 languages.

Participants were asked to provide translations of 16 common medical terms in their local languages and explain what those terms meant. These were terms like “cancer”, “radiotherapy”, “metastasis” and “survival”.

Results revealed a diversity of terminology and translations. Many local terms contained linguistic references that reflected cultural and social contexts.

Fear and stigma

The findings uncovered a striking pattern: many cancer-related terms carried deeply negative connotations. Often they were associated with fear, tragedy and incurability. Some translations even had malevolent spiritual meanings.

The term “cancer” is often associated with weightiness. It creates a feeling of being overwhelming, unbeatable and frequently final.

Terms like “malignant” and “chronic” carry similar weight, frequently coming with ideas of hopelessness and fatality.

What if the treatment meant to save your life sounded as terrifying as the disease itself?

One example in our study was the translation of “radiotherapy”. In several languages, the term was associated with burning – being scorched by fire, heat or electricity.

Such associations can make treatments seem more frightening than they are. They might deter patients from seeking the care they need.

Rich expressions to draw from

One fascinating example of how language shapes the understanding of cancer comes from a Ugandan participant. Their translation of “metastasis” (meaning “spread”) in Luganda was ekiziba kyasindika obwana bwayo ahare. This means “the mother mass has sent seedlings into another site”.

This vivid metaphor, deeply rooted in the local idioms and proverbs, likens the spread of cancer to the dispersal of seedlings from a central plant.

It shows how African languages can convey complex medical concepts through culturally resonant expressions.

In other instances cancer was referred to as the “wound with which we will be buried” (translated from Wolof), “forest disease” (translated from Djerma) and “parasitic plant” (translated from Shona).

These expressions extend beyond literal translation, providing valuable insights into how cultures think of cancer as a powerful and pervasive force in the natural world.

What next?

The study highlights the importance of cultural sensitivity in cancer communication.

When the language used to describe cancer and its treatments instils fear or perpetuates stigma, it becomes harder for healthcare workers to provide effective care.

Patients may delay seeking treatment, struggle to understand their condition, or feel hopeless about their prognosis.

Efforts to overcome stigmatising language during the early years of the HIV epidemic in Africa can serve as a blueprint for improving cancer communication.

Initiatives like the Stop TB Partnership’s Tuberculosis Language Guide offer lessons on using non-stigmatising terminology, which could be adapted to oncology.

Programmes such as the American Cancer Society’s patient education initiatives and the International Atomic Energy Agency’s Rays of Hope radiotherapy programme highlight the potential for positive language alternatives and effective translations in African cancer care.

The language used to communicate about cancer also matters because it can make a difference to health disparities.

Linguists, healthcare professionals and cultural leaders should work together to create new terminologies or adapt existing ones to be more neutral or positive.

Such efforts could pave the way for more compassionate, effective and culturally aligned healthcare communication across the continent.The Conversation

Hannah Simba, Associate Research Scientist, African Population and Health Research Center

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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