Nothing can make you tongue-tied faster than hearing from a friend or loved one that they’ve been diagnosed with cancer.
And to ease our own discomfort, we sometimes say things that may do more harm than good.
Here’s what I mean. . .
Cancer patients hear dozens of clueless comments tumble from the mouths of friends, colleagues, strangers, and even loved ones.
Since cancer is so common today, cancer etiquette is a skill set everyone can use – but most of us have never learned. You can count me among the awkward ones. I feel like I never know the right thing to say.
Studies show that cancer patients who receive strong emotional support from loved ones experience better treatment outcomes. So don’t sabotage those you care about with avoidable blunders.
Besides being present, here are three other overarching principles to get you started:
- Realize that each person’s pain is unique. Don’t super-impose another person’s struggle on them… like your sister who had cancer or another friend who went through a trying time.
- THIS ONE IS REALLY IMPORTANT: Refrain from giving advice about symptoms or treatments unless the cancer patient asks for it. This is a tall order for those of us who believe in natural medicine. It’s frustrating to see people we love fail to take advantage of what’s available.
- Never imply that their suffering is part of God’s master plan. Or – worse yet — that it’s a direct result of their own choices, as in “their own mistakes.” It might be true – and believe me, the patient will be thinking about things she should have done differently, without any prompting from you. Don’t heap burning coals on her head.
Difficult things in life can’t always be explained. Cancer is very complex with multiple factors at play. And I can tell you from personal experience, a lot of people get cancer even though they’ve done everything right.
It really can happen to anyone
On July 1, 2019, The Atlantic ran a story about Kate Bowler – a young mom who had a great life, everything firing on all cylinders…
Until the fateful day when a physician’s assistant called her with news no one is ever prepared to hear.
The severe stomach pain Bowler had sought treatment for was actually stage 4 colon cancer – and she’d be lucky to make it through the next year.
Bowler was only 35… living her dream with a husband, a young son, and a job she absolutely loved.
She used to believe that bad things don’t happen to good people… and suffering always has a purpose.
With her cancer diagnosis, all of that went out the window. It’s normal to hope and expect that the best in life is yet to come. But how does it feel to think your best days might actually be behind you? And actually, there aren’t many days left?
Now that it’s been four years since her diagnosis, she gets scans every six months, continues treatments, and tries to savor every day.
She’s also speaking out about how you can best support those who are suffering.1
Start with this
Bowler says she had friends who simply disappeared after hearing her because they couldn’t emotionally handle her overwhelming problems.
The ones who stuck around often said things that made her feel sad, hurt, or angry…
Again and again she heard people say, “Everything happens for a reason.”
Even if, like many, you believe that’s true, keep it to yourself. It’s not helpful to someone who’s struggling to make sense of their suffering.
Bowler’s new memoir and podcast stemmed from her own awkward conversations – and from a deep-seated desire to help others navigate life’s darkest hours in ways that are supportive and beneficial.
Her memoir, Everything Happens for a Reason (And Other Lies I’ve Loved), is a frank, heartbreaking, and humorous account of learning to live without knowing what the future holds. Her podcast builds on the same themes.
What NOT to say
Some people make a habit of opening their mouth and inserting their foot. Some things are best left unsaid…
Here are some examples of what NOT to say:
- “You brought this on yourself.” Cancer patients are already pointing fingers. Don’t add to it. The last thing they need is more blame and shame. Stop lecturing, and listen instead. Besides, cancer is a complicated disease, and you’ll never know all the factors that played into it, so don’t pretend to. Almost nobody gets cancer because of just one cause, even smoking.
- “I knew someone who had that type of cancer. They died.” Cancer survivor Fred Hutch says he heard this so many times after his diagnosis that it almost became a joke. No soldier at war wants to hear about casualties. Or other bad news. Put yourself in their shoes and ask, “Would I want to hear that?”
- “What are your odds of survival?” Many cancer patients report being baffled when casual friends or even near-strangers ask about their prognosis. While this may be an appropriate question coming from a close loved one, it’s not for others to ask. The patient will tell you if he or she wants you to know AND feels up to talking about it. We’d all like to know, of course, so we can be supportive – and out of the less worthy motive of human curiosity. But especially if you’re just a friend or acquaintance, don’t ask.
- “Best of luck on your journey!” Cancer patient Diane Mapes says hearing this made her want to pull her hair out, even though she was bald from chemo. She had the urge to tell these perky people, “Hey, I’m not going on a cruise to Acapulco.” The expression is pretty silly when you think about it. Your friend with cancer had better be really New-Agey before you wish that one on him.
- Cancer is full of surprises, and one of them is finding out who’s really got your back. Long-term friendships often dry up and blow away. Sure, cancer is scary. It’s hard to know what to say. But responding with silence creates a whole new level of pain.
- “I know exactly how you feel.” No, you don’t. Even if you’ve battled cancer in the past, your experiences and perceptions may be different. Sharing your story (or your friend’s or relative’s) takes the focus away from the person standing in right of front of you who needs help. It makes the whole thing about you.. Instead, ask them what they’re feeling… and then listen.
- “You look great.” This may be well intentioned, but it’s hardly ever helpful. The patient may feel awful regardless of what they look like. And if in fact they don’t look good, the compliment is phony and patronizing. And whatever you do, don’t say, “You’ve really lost weight” in an attempt to make them feel good. By and large, cancer patients don’t want to lose weight, they want to keep it on.
- “God never gives you more than you can handle.” This comment is never as comforting as people hope it will be, so avoid it. I happen to think it’s true. . . but it’s between the patient and God to work it out.
One more thing…
Always assume your friend hears everything you say in their presence, even if he or she seems to be sleeping, dozing, or dazed. So don’t talk as if they’re not there when they’re right in front of you.
Conversations that encourage
When spoken from the heart, a simple “I’m so sorry” is perfectly fine when you first learn about their diagnosis.
Also nice to hear:
- “I love you.”
- “I’m here for you.”
- “I hate this %!@ disease and I’m bringing chocolate over right now.” (I just hope it’s dark chocolate with no sugar. . .)
Here are some more suggestions…
- Discuss their favorite topics – things like sports, travel, pets, or spirituality. Hope and anticipation are powerful healers.
- Ask them directly, “What’s the best way I can support you right now?”
- Continue to ask for their advice or opinion on personal issues. This keeps the two of you engaged with one another and makes your friend or relative feel like an important part of your life.
- Just hang out. Talk about “normal” stuff. It reestablishes some sense of normalcy and helps the patient engage in life beyond the treatment room.
- Include the patient when you’re talking with others in the room.
- Be willing to talk about cancer and even dying – but only if they bring it up.
- Say “I’m here for you if you want to talk, but I respect that it could be a difficult time. Either way, I’m here for you.”
- Realize that cancer leaves a long-term mark on people. Keep the conversation going, even when things seem like they’re “back to normal.” For them, it’ll never be the same old normal again.
Visiting dos and don’ts
Cancer can be isolating. Visits help patients feel like they did before cancer became the central focus of their life.
Be willing to simply hang out, especially if they’re tired. Take a book, crossword puzzle, or needlework, and keep them company while they doze or watch TV. Silence is fine, there’s no need to fill every moment with conversation.
Share music they enjoy. Watch a favorite movie or TV show together.
Offer to bring a snack or treat to share with them.
Read about topics your friend loves, then tell them what you learned.
Take a short walk with them if they’re up for it.
Give them hugs (and/or other physical displays of support and affection). Physical touch is crucial to emotional support.
Beyond talk… how to show love
Although it’s hard to know the right things to say, you may feel even more awkward trying to figure out how to actually help your friend or family member who has cancer.
Skip sweeping generalities along the lines of, “If there’s ever anything I can do to help, let me know.”
That puts the onus on the patient to think of something, and many (most) people won’t ask for help.
Instead, try suggesting one or more of the following action items. If the project is too big or long-term for you to tackle solo, organize a team to help.
- Make lunch or dinner one day a week. Ask about dietary restrictions – and what the patient feels like (or doesn’t feel like) eating.
- Clean their home periodically. Or pool resources with others and hire a cleaning service for them.
- Tend their lawn or garden.
- Babysit or pet-sit.
- Drive their children to sports practice or music lessons.
- Run errands, return or pick up library books and movies, go to the post office, take the dog to the groomer or vet, or buy groceries.
- Pick up supplements or meds.
- Pick up friends or family members from the airport or hotel they’re staying at.
- Take them to doctor appointments. Or travel with them to out-of-town treatments.
Small gifts (and notes) can lift spirits in a big way
Imagine how boring your friend’s days must be, more or less isolated from mainstream life. A laugh, a smile, or a small gift could lift their spirits tremendously.
Send brief notes or texts or have short phone conversations with them on a regular basis. Include silly graphics, cartoons, and other humorous tidbits.
If you give gifts, be sure to insist that thank you notes are not needed.
Here are some gift ideas, complements of the American Cancer Society.
- Silly socks
- Fun (or funny!) hats or scarves
- Silk pillowcases
- Bright linens
- Pajamas or robes
- Special soaps or lotions (non-toxic)
- Stamped postcards
- Favorite foods/snacks
- Massage devices or services
- Pictures of friends
- CDs or downloads of soothing music
- Funny movies
- Journals or notebooks
- Audio books
My only editorial comment on this list is that you want to take into account the friend’s gender and their taste in music, movies, etc. Silly hats and socks would not be to my taste. . .
What if they want to talk about death?
Death is probably the one and only topic that’s scarier than cancer, making it understandably uncomfortable. Here are some tips from the American Cancer Society on dealing with this sensitive subject…
Late-stage cancer patients may feel lonely even when they’re with people. They may pull away and withdraw. Don’t take it personally. Stay in the background, be there for them.
Listen to their concerns. They may be anxious about what will happen to their loved ones once they’re gone. They may express regret.
They may ask, “Why is this happening to me?” – a hard question, because there’s no good answer. The only honest response is “I don’t know.”
Hold their hand. Let them cry and express sadness or regrets. Share their pain.
It can be helpful to have a hospice professional present during late and terminal stages of cancer. They’re experts at answering questions that often arise at the end of a person’s life. But be aware that the drugs they administer can impede healing and hasten death.
There’s no getting around the difficulties and challenges of this disease, so encouraging your suffering friend or loved one is important. Incorporate this advice to ensure you do it well and don’t sabotage your efforts. And know that you made a positive difference in their life by how you supported them.