Reading Between the Lines
By Gail Short
When UAB English professor Cynthia Ryan, Ph.D., learned she had breast cancer as a 29-year-old doctoral student in 1993, it seemed like the whole country knew about it. The diagnosis came just as breast cancer started to enter the national consciousness in newspapers, on television, and especially in women’s magazines.
In 1992, the magazine Self launched its Pink Ribbon campaign to promote awareness of the disease. Other magazines soon joined the movement, publishing upbeat, inspiring stories under headlines such as “Saving Your Breasts: New Treatments, New Hope” and “Survivors Who Beat the Odds.”
These messages of hope were irresistible, Ryan remembers. “Every time I saw an article that encouraged breast cancer patients to drink green tea, for example, I figured that I needed to read it,” she says. But the relentlessly positive tone struck by the magazines began to ring false as Ryan’s battle with breast cancer continued and she dealt with hair loss, sickness, and other harsh realities of the disease. “The stories were all what sociologist Arthur Frank calls ‘restitution narratives,’ a standard plot emphasizing survival and return to a ‘normal’ state of health,” Ryan says. “Unfortunately, this plot doesn’t describe what many survivors experience.”
Variations on a Theme
This disconnect between published stories and lived experiences led Ryan to study the ways in which disease is discussed in the public realm—and in particular how consumer magazines depict breast cancer. Her work has appeared in the Journal of the American Medical Association and other prestigious publications. In 2008, following a second bout with breast cancer, Ryan was named a contributing writer to the American Association for Cancer Research publication Collaborations—Results.
Cynthia Ryan discusses the often-confusing media coverage of new mammography guidelines in this video
Most stories about breast cancer in popular women’s magazines feature only those women who have “beaten” breast cancer rather than those who are undergoing treatment or have an uncertain prognosis, Ryan says. And few articles show the range of emotions and responses that patients experience after diagnosis. As a result, Ryan says, patients can form unrealistic expectations for their treatments and outcomes. “A woman may, for example, compare her breast lump with one described by a woman in a magazine and assume that she should not have to undergo chemotherapy because the person in the magazine with a similar sized lump did not. Cancer is far more complicated than that.
Another issue, says Ryan, is that many women’s magazines focus solely on happy endings in which cancer is credited with giving survivors a new lease on life. “Many magazines feature women who present with a stage 1 or stage 2 breast cancer”—that is, malignancies caught at earlier stages, Ryan says. “The illness is portrayed as just a bump in the road. But not everyone completely bounces back to normal, and the implication is that those who don’t aren’t embracing the experience in the ‘right’ way.”
Happily Ever After?
Ryan explains that she is “not opposed to stories that offer positive endings and hope. Sometimes, these messages are what a survivor needs to get through the next treatment.” Her concern is that the predominance of these “uplifting plots” distorts reality. “Not all women experience restitution, and the diversity of their experiences should be acknowledged.”
Ryan says that by necessity, media sources simplify information about breast cancer, but the selection of information to present might be based on problematic criteria. “For instance, the decision to cover the positive effects of a treatment without sufficiently addressing its limitations skews what readers need to know to be sufficiently informed about their health.”
Representations of breast cancer in popular magazines can be improved by incorporating diverse experiences with the disease and a clearer indication of the significance—and remaining gaps—of the research and advice presented, Ryan says. “Such changes would retain the service element of such articles while more accurately depicting the complexity of facing breast cancer.”