From Surviving to Metaviving: A New Rhetorical Formation in Metastatic Breast Cancer Patient Discourse

This dissertation explores how language has evolved as metastatic breast cancer (MBC) has shifted from an imminent death sentence to a potentially chronic disease. War rhetoric, of which the survivor trope is a part, has been the primary mechanism by which healthcare defines the cancer experience. Using Celeste Condit's framework of rhetorical formations, I question if a new rhetoric of breast cancer is indeed emerging as new developments in medicine allow women with terminal disease to live longer. My data reveals that this new rhetorical formation, of which metavivor rhetoric is the anchor point, contains its own key metaphors and rhetorical appeals. In metavivor rhetoric, the focus becomes living with cancer, in which simply existing through a sense of homeostasis develops as the central part of the rhetoric. In this homeostasis as the key part of metavivor rhetoric, a cure is not the focus, as it is in survivor rhetoric. I explore how this emerging rhetoric supersedes the war rhetoric that is deeply entrenched in medical discourse--especially breast cancer--for decades, and how metavivor rhetoric builds upon and repudiates the war rhetoric. Through my qualitative rhetorical analysis of a popular breast cancer message board for patients with metastatic disease, I coded 589 posts to see how women use language to discuss living with MBC, and Condit's concept of rhetorical formations allows me to argue more specifically for the changes I see in patient discourse. My analysis revealed that women living with MBC argue against war/survivor rhetoric and prefer metavivor rhetoric and its ancillary terms, allowing them to transition to an acceptance of their own mortality. I conclude that a new rhetorical formation has taken shape within MBC patient discourse, with implications for women's mortality as they live with a chronic disease, and as I look to the future of this research, my goal is to promote rhetorical changes that will help to enfranchise women with MBC into the broader breast cancer discourse in the United States.