What to say to someone diagnosed with cancer

When a dear friend is diagnosed with cancer what on earth do you say?

Common reactions are tears, fear, anger and a terrible sense of injustice. It is so  unfair that this should happen to a lovely soul who has never hurt anyone.

Even when you have been through it yourself, it could be so crass and insensitive to say ‘I know what you’re going through’. Because you don’t. Cancer diagnosis is a sledgehammer that slams into your life and appears to destroy every plan, hope, dream and sense of security that you may have had before. And any little insecurities or doubts you may have had, as we all do, are torn wide open, and the pain can be very, very raw. And everyone’s experiences are of course so different and unique.

But just how do you get across your concern without sounding patronising, and what’s the best way to offer your support?

Rosanne Kalick, of New York, reveals one gaffe-prone friend tried to make light of her double mastectomy by announcing: “Well, at least you’ll be symmetrical.” I had a ‘friend’ who said to me about my operation, ‘well you’re always trying to lose weight’ . yes really.

For Kalick, who had already endured multiple myeloma, a blood cancer several years prior to developing breast cancer, the comment and other anecdotes from friends spurred her on to write the book Cancer Etiquette: What to Say, What to Do When Someone You Love Has Cancer.

As part of her research, she collated stories from other survivors and practical strategies for friends, colleagues and loved ones to adopt.

Often, she says, the shock, memories of family members who had cancer and the individual’s fear of getting cancer cause people to speak before they’ve thought of the consequences of their words.

Examples include one young woman diagnosed with breast cancer who received a sympathy card from her mother and a casual acquaintance who asked someone who had a colostomy whether the bags were paper or plastic. In another example, one woman turned to another at lunch and told her not to touch the glass of another guest because “. . . she has cancer.”

Much of cancer etiquette, she says, revolves around the level of intimacy between the person diagnosed with cancer and the person trying to comfort him or her. A co-worker, for example, may not appreciate a joke about the extended holiday they’ll get during chemotherapy. But a spouse might.

“If you did not speak about an individual’s sex life, breast size, or baldness before the diagnosis what makes you think it is appropriate to ask those questions now?” writes Kalick. “Just because your uncle has had prostate surgery doesn’t give you permission to ask about impotence now.”

It is not uncommon for people to try and reassure their friends by saying that they will be fine, but this could be seen as ignoring cancer reality. Kalick suggests saying “I hope everything will be all right,” or “You’re in good hands, you’re getting the best treatment”.

If you’re going to ask someone with cancer “How are you?” be prepared for the answer. It may be better to say “how are you today?” so a person can speak honestly of how they feel at the moment.

Nor should subjects stay entirely on cancer. If you valued your friend’s advice about business, you can still ask for it.

“The fact that she’s having treatment doesn’t mean she is any less intelligent than she was before,” says Kalick. “There may be times when the drugs will give her a sense of ‘chemobrain’. Obviously, if she seems disoriented or excessively fatigued, postpone the question.

When in doubt about what to say, don’t say it. Think before you speak.”

A common phrase is to say: “If you need me, I’m here”. But I agree with what Kalick says, be specific. Should you bring round dinner on Tuesday or Thursday? Do they want their library books taking back or can you take the dog for a walk on Friday? Patients undergoing treatment may feel their life is out of control. So asking questions and giving people a choice can allow them to feel as if they are taking control.

Gifts can also keep a connection going with the person and say you are thinking about them. For example, moisturisers are good for skins which are drier as a result of chemotherapy.

But ultimately, making the occasional gaffe is going to happen, says Kalick. Cancer is a complex, frightening disease and in the long run it’s not the gaffes that matter, but the connections between people.

“There are no magic words,” she writes. “The magic is that friends and family are generally there for us.”

There are no guaranteed outcomes for any of us. But all that really matters if that your friend knows how much you love them, so tell them, and show them.

Other tips:

  • · Stay positive and speak often about upcoming events. Keeping them thinking about their former, more normal life keeps the stress level down while they are undergoing treatments and recuperating.
  • · Keep them focused on the future. Talk about events that will be taking place in the coming months or even a year from now. When they can visualise the future it seems more likely that they will be a part of it.
  • · don’t assume that they will be too tired or too sick to participate in a social gathering. Always invite them and let them have the option of canceling, even at the last minute, if necessary.
  • · just let them talk about whatever is on their mind. Being a friend means listening to what the other person wants or needs to talk about, without interrupting or being judgmental.
  • · As quickly as possible, get them back to their regular routine. If they can return to work and resume their typical daily activities, at least part of the time, they will be on their way to recovery.

    Kris Carr, one of my favourite writers has some great advice on her website

The one thing I can offer people who are recently diagnosed with a devastating illness is the unspoken knowledge that I get it. I get the pain, the anger and the unfairness of it all. Even so, because every situation is so unique I won’t compare our experiences or even talk about it unless she asks. Especially in the beginning. At that point, the only thing I really want to say is that I’m in her corner.



Cancer Etiquette: What to Say, What to Do When Someone You Know or Love Has Cancer by Roseanne Kalick.



About gabbymottershead

Inflammatory Breast Cancer survivor and advocate, Breast Cacner UK ambassador, party animal, proud grandmother, mother to two wonderful sons, wife to Paul, loving life in Manchester, the best place on earth. Love my family, live music, my house rabbit and general shenanigans.
This entry was posted in breast cancer, cancer, chemotherapy, inflammatory breast cancer, Kris carr. Bookmark the permalink.

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