I was watching the TV show Fargo, which takes place in rural Minnesota. Most of the locals on the show speak with a recognizable midwestern accent, and there are some regionalisms that are common. The one that I noticed most was how when some of the characters were talking about another person they knew, they said he has the cancer. Most of the English-speaking world does not put an article before the names of most diseases — we would say he has cancer.

I believe that many of the early settlers in this part of America were from Scandinavia, and it heavily influenced the dialect and accent. Is this phrasing quirk related to this heritage?

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    You can have the measles, the flu, the mumps. Why not the cancer? May 10, 2014 at 19:41
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    Article usage is idiosyncratic, and I'm sure you're right in suggesting historic influences when it comes to diseases. Generally, I'd say, 'the' is optional with flu and plague, and virtually mandatory with 'the Black Death' and 'the French disease' (but not 'German measles'). May 10, 2014 at 19:43
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    There IS a TV show. It just started several weeks ago. It's based on the movie. See the Wikipedia article I linked to.
    – Barmar
    May 10, 2014 at 20:39
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    This question appears to be off-topic because it is about a supposedly "dialectal" usage in a TV series which is itself based on a movie. The Coen brothers, who are involved in both, are imho notorious for blurring the boundaries between actual/historical linguistic forms, and invented forms which merely suit their artistic purposes. It's a very rare usage May 10, 2014 at 21:31
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    This question appears to be off-topic because it is about a supposedly "dialectal" usage in a TV series, not actual English. May 10, 2014 at 21:57

3 Answers 3


To answer the question. They normally don't.

I live in the Midwest. I have had several friends and relatives over the past 10 years have cancer. I have never heard of "the cancer" from anyone, including friends and hospital staff.

I don't doubt your reference. What I doubt is your connection to Fargo and the dialect of the show and the Midwest. On the show they speak much more with a Canadian/local accent. It is something that you would hardly find in Illinois, Indiana, Missouri, Iowa, Arkansas, Nebraska, Kansas...

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    Be warned that some of those states you’ve named would not be recognized as “midwestern” by someone from Duluth or Green Bay.
    – tchrist
    May 10, 2014 at 23:05
  • @tchrist - I understand that the term means slightly different things to different people. I could have added Ohio, Kentucky, Tennessee, possibly Oklahoma. Maybe I could have left a state or two off. I don't think anyone from the midwest would consider Fargo the midwest (even if it is labeled so on some map). Certainly there are different dialects and for sure there is heavy Canadian influence, eh. May 11, 2014 at 2:54
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    @RyeɃreḁd The US Census Bureau considers the Midwest to be Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota and Wisconsin. I've never before heard anyone suggest that any of Arkansas, Kentucky, Tennessee and Oklahoma are in the Midwest. May 11, 2014 at 5:12
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    Different parts of the Midwest speak dramatically different dialects. There's no reason to expect somebody in Indiana to say "the cancer" just because several people in Minnesota say it. But Minnesota is still generally considered part of the Midwest. May 11, 2014 at 5:31
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    @DavidRicherby - we are talking about dialects not census bureau reports. I was listing the states with the Midwest dialects. As I mentioned those states (ones you listed) are borderline - because you will get both Midwest and Southern dialects. The other states you mentioned, the Dakotas, Minnesota, Michigan, Wisconsin... they tend to have different accents/dialects (Michigan probably different from the rest - more East coast) so I would not include them in a question. I am sure there are quite a few opinions on this, this is just mine. May 11, 2014 at 14:30

Cancer is not the only disease to which a definite article has been attached. The malady caused by the bacterium Yersinia pestis is often referred to as the plague, and one of its other descriptors, the Black Death, is another example.

My sense is that one of the reasons for attaching a definite article to the name of a disease may be that it reflects the notion people have of it as a mysterious and fated phenomenon ("the big C"); an irresistible and usually fatal affliction against which people are powerless, either because it is their destiny to succumb to it and/or because there is no known or guaranteed antidote or remedy.

However, that's only an unsubstantiated hypothesis, and it doesn't explain why not every much-feared and hard-to-cure or -prevent disease has acquired the definite article.

The likelihood of a Scandinavian origin for the use of the definite article when referring to cancer is not very plausible, for a couple of different reasons:

1) Among the main Scandinavian languages, only in Swedish is the usual word for cancer 'cancer':

  • Danish (DA): kræft, with cancer being a parallel but less-often-used term
  • Norwegian (NO): kreft
  • Swedish (SV): cancer

2) In most Scandinavian languages, the definite form of a noun is indicated by the addition of a suffix (typically -en or -et; e.g. the Danish word for liver [the organ] is 'lever', and the liver is 'leveren'). But when someone is described as suffering from cancer -- or indeed any disease -- this form is not the one used.

For example, He has liver cancer would be rendered as follows (the literal translation in all cases is "He has cancer in the liver"):

DA: Han har kræft/cancer i leveren

NO: Han har kreft i levern

SV: Han har cancer i levern

The bald description He is suffering from cancer follows the same pattern (in all cases it translates literally as "He suffers of cancer"):

DA: Han lider af kræft/cancer

NO: Han lider av kreft

SV: Han lider av cancer

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    "Cancer is not the only disease to which a definite article has been attached." This misses the point of the question. Cancer doesn't usually have the definite article and the question is asking why a particular speaker does use the article when referring to "the cancer" May 11, 2014 at 5:06
  • @David Richerby - The OP's second paragraph makes it obvious that he believes the use of the definite article with cancer is not restricted to a single speaker, but is widespread in the Minnesota region. I don't know whether the OP's impression is accurate or not; if you had read my response carefully, you'd have noticed that I didn't make any assumption either way about the accuracy of the OP's perception, but that I did reference a couple of examples where the definite article is attached to a disease. Your comment misses the point of my answer.
    – Erik Kowal
    May 11, 2014 at 5:17

If it is real, it's just a common over-generalisation error rather than an L1 interference. It seems that people assume that since you can get the flu, the plague etc. that one can "get" *the cancer. It's not just midwestern North Americans that I've heard this from, and whether or not people are parroting this usage just for humor's sake is another question.

The difference in usage lies in the fact that you contract the plague and influenza as they are communicable diseases. Cancer is not. It is caused by cancerous cells in the body, whereas the others are transmitted to the victim from another host via a virus or other pathogen. You contract the flu (referring to the Influenza Virus specifically, distinguishing it from many other viruses), but you develop cancer. You would only use the definite article if you were referring to specific cancerous cells - "the cancer cells in my liver..."

  • You can "have the shakes", which are not communicable. And you used to be able to "have the rheumatism", again not communicable. See Ngram. Furthermore, for many diseases which are communicable, you don't use the definite article. May 11, 2014 at 4:25
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    Umm, not exactly. You also contract Chicken Pox, Herpes, strep throat, encephalopathies, meningitis, bronchitis, pneumonia, HIV and almost innumerable other illnesses which have no article preceding them. There is no rule, rhyme, nor reason to it. May 11, 2014 at 4:40
  • @petershor Firstly, the formal usage of "the shakes" refers not a disease you contract, but a condition that you develop; Delirium tremens. Note that saying "*the Delirium tremens" is obviously incorrect. The definite article in "the shakes" is attached to the verb "shake" and creates a noun-phrase, "The Shakes". May 11, 2014 at 4:42
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    @Tea.Geek.nz - that's nonsense. We don't use an article for things inside or contracted or from something else. "conditions caused by or inside something else" is pure nonsense. May 11, 2014 at 4:52
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    You state that cancers are never caused by infection. This is incorrect. For instance, it has been shown that cancer of the cervix (plus several other cancers of the genital region) is often the result of infection with certain strains of the human papilloma virus (see en.wikipedia.org/wiki/Hpv ). For information about cancers caused by other infective agents, see en.wikipedia.org/wiki/Infectious_causes_of_cancer . I'm afraid this undermines the linguistic point you were making in your answer.
    – Erik Kowal
    May 11, 2014 at 5:31

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