Why We Need to Stop Saying 'At Least It’s Not…'


When I was first diagnosed with rheumatoid arthritis (RA), quite a few people said to me, “At least it’s not cancer.” At the time I understood what people were getting at. After all, I just had painful joints, right? People with cancer have to undergo exhausting treatments and could die. That was much worse than rheumatoid arthritis, right?

Two weeks ago, I was diagnosed with cancer. I’ve done one surgery and have one more to go tomorrow. This time tomorrow I should be cancer-free. That was the grand total of my cancer treatment — two surgeries for a curative outcome. 

Three years ago, I was diagnosed with rheumatoid arthritis. Two years ago, I had major surgery on my left foot because of the RA. Eighteen months ago, I underwent chemotherapy to treat the RA after developing serious complications. A few months ago, I suffered potentially life-threatening complications due to the RA. I lost an unborn baby due to autoimmunity. My life expectancy is reduced. I have chronic pain and physical limitations. The RA is progressive and degenerative. There is no cure.

When I was diagnosed with cancer, no one said “at least it’s not rheumatoid arthritis.” I believe it is probably safe to say no one diagnosed with cancer has ever been told that. 

While I appreciate the fact that my cancer was detected early and is treatable, my situation highlights how diagnoses aren’t black and white. My RA is far more impactful than my cancer and will continue to be long after I am free of cancer. Telling me “at least it’s not cancer” demonstrates how much we stereotype illnesses. Worse, it shows how we place them in a superficial hierarchy. Saying to someone “at least it’s not …” is always going to be invalidating, and in a situation like mine, outright incorrect.

The truth is illness is not a competition. No one diagnosis is ever truly “worse” than another because they all have different levels of severity and impacts. Perhaps we should acknowledge the challenges a person faces when they’re diagnosed with or managing a health condition instead of using phrases like “at least it’s not …” 

Let’s remove the unhelpful comparisons and instead focus on providing support.

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