The UroOnc Minute: The Role of Language in Cancer Care, With Jessica Rett, PhD

In this episode of The UroOnc Minute, host Adam B. Weiner, MD, is joined by Jessica Rett, PhD, a professor of linguistics at the University of California, Los Angeles (UCLA), to discuss how language can influence communication between urologists and patients with cancer. Drawing on their collaborative work, involving an upcoming essay in The Journal of Urology titled “Language as a Powerful ‘Influencer’ in Prostate Cancer,”¹ Rett explores how seemingly familiar medical terms, diagnostic language, and common metaphors can shape patients' understanding of their diagnoses and treatment options.

The conversation begins with the distinction between the words “cancer” and “carcinoma.” Although the terms have the same literal meaning, Rett explains that research she conducted with her students found that members of the general population perceive cancer as more frightening than carcinoma. Patients may associate a cancer diagnosis with a greater likelihood of death and a need for more aggressive intervention, highlighting how the emotional context of a word can extend beyond its clinical definition. Rett emphasizes that the word cancer can become a “conversation ender,” prompting patients to focus on their fears rather than asking what the diagnosis means for them individually.

Weiner and Rett also discuss the unintended confusion created by common medical terminology, including phrases such as “positive biopsy,” “positive margin,” and “negative scan.” Although these terms have precise meanings in clinical practice, patients may interpret them according to their everyday understanding of positive and negative. Rett suggests that physicians consider focusing on outcomes rather than test results, using concrete language to explain what has been found and what it means for the patient's health. The discussion also highlights the importance of moving beyond terminology in pathology and radiology reports when communicating findings to patients.

Another focus is the use of metaphors, particularly the language of “fighting” and “battling” cancer. Although these expressions are often intended to validate and encourage patients, Rett notes that research suggests they may inadvertently make treatment seem more difficult, reinforce fatalistic thinking, or contribute to the perception that all cancers carry the same implications. Weiner and Rett also explore why there is no universally appropriate terminology for discussing cancer, as the connotations of words can evolve over time and vary depending on patients' experiences and perspectives.

To close, Rett encourages urologists to make a habit of centering conversations on patients' individual goals and concerns rather than focusing exclusively on diagnostic labels. Helping patients understand what is happening in their bodies, what they can expect, and what options are available may create more productive conversations and support informed decision-making. As Weiner and Rett discuss, thoughtful language is not simply a matter of word choice; it is an important part of delivering patient-centered cancer care.

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REFERENCE

1. Weiner AB, Rett J, Eggener SE. Language as a Powerful “Influencer” in Prostate Cancer. J Urol. 2026:101097JU0000000000005330. doi:10.1097/JU.0000000000005330