Cancer treatment has evolved over the past 20 years, but has the way it is depicted in television and movies also changed?
The past 20 years have brought great advancements to cancer treatments, and people are living longer, healthier lives. But what has been depicted on the big screen does not always represent that. However, there has been some improvement compared with 20 years ago, according to some experts.
In honor of CURE®’s 20th anniversary, we dove deeper into the past two decades of cancer representation in television and movie culture, how it can be beneficial — and harmful — and where it will hopefully be going in the next 20 years.
Kate Folb said that there have been great strides to accurately depict cancer journeys. Folb is the director of Hollywood, Health & Society at the University of Southern California Annenberg Norman Lear Center in Los Angeles, where she partners with TV script writers to provide accurate information about medical storylines.
“It’s very important to have, first and foremost, accurate depictions ... making sure that shows are not spreading misinformation that could lead to harm,” she said in an interview with CURE®. “And then beyond that they could offer information that may be beneficial to an audience member.”
John Sencio agrees, calling the advancement of simply including people with cancer and stories around cancer on the big screen “monumental” and “rapid.” Sencio is a two-time cancer survivor who has been in the TV/movie industry for some time as a producer and host on MTV, NBC, HGTV and more.
But Colleen McBride, a professor in behavioral sciences and health education at the Rollins School of Public Health at Winship Cancer Institute at Emory University in Atlanta, tends to disagree. While there may be benefits to depicting a cancer diagnosis in TV or movies, she said more needs to be done to accurately depict what it’s like to live with cancer and not just the tragedy of dying young from cancer.
“A Walk to Remember,” a 2002 film based on the 1999 novel of the same name by Nicholas Sparks, tells a story of young love and tragedy inspired by the cancer journey of Sparks’ sister. The movie grossed $47.5 million.
The 2012 film “Now Is Good” portrays a young girl with terminal acute lymphoblastic leukemia who sets off to finish her bucket list with the help of her love interest.
This movie grossed $2.3 million.
And in 2014, another teen love-tragedy story brought many to tears. “The Fault in Our Stars” follows two chronically ill teenagers who meet at a support group and fall in love. In the end, one dies from their cancer. The movie grossed $307.2 million.
All these movies and many more share the theme McBride mentioned: young love and tragedy.
“Cancer is (often) an old person’s disease,” McBride said. “And right now, for many people, it’s a chronic disease, so they take medications and are able to live for a long time after diagnosis — which I don’t think is dramatically as interesting (a storyline). (It’s) much more interesting if it’s a young person struck down — our greatest fear, basically.”
And although this idea of tragic, unfair death does sell — as shown by the box office receipts — McBride said it can raise unnecessary worry and fatalism about cancer.
“I think it can certainly do harm,” she said, “in the sense of giving people with cancer a very fatalistic view of it, and also may discourage individuals from wanting to find out they have cancer because (they think), ‘What difference does it make if I’m going to die anyways?’”
Folb said that 20 years ago, “if you got a cancer diagnosis on a TV show it was doom and gloom and by the end of the episode that person was usually dead.” But, she stressed, cancer representation in TV and movies can be beneficial.
In some shows Folb has worked on, cancer is not a character’s defining characteristic. She mentioned the 2014 TV series “Chasing Life,” which followed a woman with a leukemia diagnosis through different journeys of life, including love, family and friends. Folb noted that the difference between this and shows or movies from 20 years ago is that this show didn’t depict cancer as a tragedy and instead showed someone with cancer who had a life outside of the disease.
“There were all kind of things going on in her life besides cancer. And we did go on her journey, but she was a three-dimensional person,” she said. “Cancer was only one facet of who she was.
“That benefits people who are living with cancer and it also helps change attitudes of the general public about what it’s like to live with cancer and that it doesn’t have to define your entire life.”
Another benefit of cancer representation in TV or movies, Folb said, is to spread awareness about the disease.
In 2013, one of the main characters on the “90210” reboot found out she had the BRCA breast cancer gene after her mother and aunt died from the disease. Folb noted that this was one of the first popular TV shows to have a storyline about the breast cancer gene.
After that episode aired, Hollywood, Health & Society conducted two complementary studies of adult women to evaluate how the public perceived the storyline. Results of both studies demonstrated that exposure to the episode increased knowledge on the BRCA gene and mastectomies.
“We see significant knowledge gains,” Folb explained. “People learn things they didn’t know, about treatment, about the disease, and their attitudes also shift. The more that audiences see people like themselves living with cancer, just living their lives, the more their attitudes can change about the disease.”
But one of the studies also showed that there was an increased fear regarding the consequences of the BRCA gene, a theme McBride previously discussed.
But McBride agrees with Folb that it may be beneficial and even motivational, if done correctly.
“Someone can look at living with cancer and see it as a positive outcome,” McBride explained.
“And so they may be more willing to seek out informa- tion, to take preventive actions to reduce a risk of cancer,” she said. “So it really can go both ways. But a fuller representation of how cancer really happens is what is needed.”
Sencio noted the 2007 film “The Bucket List,” which depicts two men who are dying from lung cancer and go off to fulfill a wish list before they die. In the end, one of the men dies from his disease.
“I do believe cancer representation in TV and movies can be very beneficial, especially if it provides insight and inspiration,” Sencio said. “And I think it really depends on the patient because everyone is different. I’ve been through this chaos twice ... and I know how meaningful it can be (to see something) authentic.”
Another good thing, Sencio added, is the sheer volume of representation over the past 20 years.
“I think the representation has grown at a staggering rate,” he said. “I think there is a lot more out there than when I was a kid in the ’80s. ... It’s been monumental, rapid ... and hopefully it becomes even more honest and accurate.”
Folb agrees, saying there are now more “well-rounded characters,” such as the main character in the 2014 TV series “Chasing Life,” and that there are more accurate depictions of a cancer journey, not just diagnosis and death.
She mentioned a 2017 two-part episode in the TV series “Grey’s Anatomy” in which the mother of a main character receives a diagnosis of inflammatory breast cancer after discovering a rash on her breast. The plot follows more than just her diagnosis and death, focusing instead on her journey with clinical trials, going to different institutions for different treatments and the reaction of a caregiving family member — things patients with cancer experience during the journey in the real world.
“We saw a little bit more of her journey and not desperation from her,” Folb said. “The desperation actually came from her daughter, who was desperate to save her mother. I think we’re seeing a lot more nuance.”
But that character still died in the end — which is why McBride says not much has changed in 20 years.
She compared the 1971 film “Brian’s Song” with the movie “The Fault in Our Stars,” and said that despite the more than 40 years between them, the ending is the same: young, tragic death caused by cancer.
“I’m a movie buff. I watch lots and lots of movies. And I don’t think it’s changed much,” she said.
McBride noted that she hopes that in the next 20 years there is a focus on cancer survivorship in film and TV to show that patients have a life after their diagnosis. It can be a part of their character, but not the only part.
“I think that could certainly give a more positive view that brings to light how many cancer survivors there are,” she said.
McBride added that the narrative must be flipped from dying to living, which could help normalize for patients and the general public that cancer is survivable. It could also be a teachable moment to portray a cancer survivor who is now living a full and healthier life compared with before their cancer diagnosis, she said.
“It doesn’t mean that even if you get cancer, your life isn’t going to be diminished. Your life could get even better post cancer,” she explained. “But these movies and TV shows are there to make money and attract. And I think that there’s a lot of work to get us beyond the fact that we’re still in the ‘Big C’ being one of the biggest worries and people still believing it’s a death sentence.
“I just wonder to what extent this would be a priority for these profitable movies,” McBride said. “How do you make cancer an interesting topic?”
Folb said she is proud to be part of the change underway to have cancer represented more often and more accurately on TV. As treatments and therapies have advanced over the past 20 years, so has the outlook for cancer.
She recalled that just hearing the word “cancer” 20 years ago was scary, and while it is still scary, more treat- ments and therapies are available. And as treatments advance and survival rates continue to rise, so should the representation of cancer in TV and movies.
“The more advances we make in treatment, mitigation and prevention, the more we’ll be able to depict cancer more like diabetes or HIV, or something that is a more chronic situation and not an immediate, terrible death sentence,” Folb explained.
“And I can see it going in that direction. And I can only imagine in 20 years, with more advances, that it will become an even less scary topic,” she said.
Sencio explained that he hopes to be a part of that change and bring a more authentic story of cancer to the small and big screens. Since his diagnosis, he has been working on “Thryvor,” a documentary about his journey, which will show viewers a real, raw depiction of what he went through with cancer.
“I’d imagine that cancer representation in TV and movies over the next 20 years will likely be much more common. Of course, with an increase in sheer volume, there will be an increase in misinformation — my doctors are already dealing with this — and it can be dangerous,” he said. “One safeguard is to collaborate with medical professionals ... then these stories can be an extraordinarily valuable resource. That’s my belief. The goal is survival. Cancer patients (and families) need healthy skepticism as this takes shape over the next 20 years. I look to the future of cancer representation in TV/movies with cautious optimism.”
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