Iris peer mentor Bethany was diagnosed with a very rare and aggressive cancer at 30 years old. When she started losing her hair, she recalls one friend nervously saying, “At least now you don’t have to fix it before you go out!”
At the time, Bethany was able to gracefully exit the conversation, reminding herself that the hurtful way people often reacted to her treatment was because they simply didn’t know any better.
Talking about cancer is a difficult topic of conversation for many people. At best, interactions with friends and family become more empathetic. At worst, awkward or offensive.
Some people will try to make jokes out of their own discomfort. Others will try to sidestep the topic altogether. Unfortunately, this can hurt more than saying nothing at all.
Things To Say
You can also give them the choice of whether to talk about cancer or not by asking loved ones directly.
You can say something like, “I’m not sure how to support you best, but I want you to know that I can listen, or we can talk about something else.”
This is an authentic acknowledgment that you don’t know quite how to approach the topic and feels much more authentic than simply saying “How’s it going?” or not saying anything at all.
Asking open-ended questions shows that you genuinely want to help and hear how someone is doing. These can be things like:
- What would be most helpful today?
- What’s one wish or want that would make your life easier today?
- What are some topics that are off-limits today?
- What’s one thing you wish I would ask you or something you wish you could share?
Actions Can Speak Louder Than Words
If you’d like to offer to do something concrete for someone with cancer, give them choices. A helpful example would be: “I can drop off a meal, take your dog for a walk, do the laundry, or drive you to the doctor…now or anytime in the future. You choose.”
This lets people coping with cancer feel more in control at a time when life may feel unpredictable.
Another meaningful thing you can do is provide an unexpected surprise. Drop off a blanket or pick out a pair of extra soft socks. A handwritten note can bring a spark of enjoyment and can be re-read on days when a person may need extra love and support.
Things Not to Say
A general rule of thumb is to avoid starting any sentence with the words “at least.” During her treatment, which required a hysterectomy, Bethany recalls someone saying, “At least you’ll lose a few pounds from the surgery!” These kinds of comments can add to feelings of isolation or loss when a person needs support the most.
Forced cheeriness may not be helpful to someone in active treatment as it implies an optimism that the person with cancer may not actually share at that time. This includes avoiding catchphrases such as “You’ve got this” or “You’ll beat this!”
Even with the best of intentions, saying sorry can also prove to be tricky. “If someone says I’m sorry to me, my first thought is always ‘Sorry for what?’” says Bethany. Instead, try to show that you’re genuinely interested in hearing anything they feel like talking about.
Relationships May Change
Be aware that communication around cancer can impact relationships. Some friendships will grow stronger while others might fade away. “My husband and I ended up losing some friendships, while other people who we were not that close grew into the best of friends,” recalls Bethany.
This isn’t unusual. Often people with cancer discover that friends are good at different things. One person can give rides to doctor appointments while another can talk about the emotional aspects of treatment. The vulnerability of having cancer can unexpectedly deepen some relationships, and that can be a beautiful surprise.
Top 5 Do’s and Don’ts
- Do ask open-ended questions such as “What would be helpful to talk about?” or “What is on your mind?”
- Do volunteer a list of concrete things you can help with (such as buying groceries or driving them to an appointment). Let them decide what is most helpful.
- Do stay in touch. Sending an email or text which ends with “you don’t need to answer” lets people know that you are thinking of them while taking pressure off them to respond.
- Don’t use catchphrases like “You’ve got this!” or “You’ll beat this!” No one knows what the future holds and that might not be what the person needs to hear.
- Don’t tell them a story about someone you knew who had the same type of cancer and died from it.
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Reviewed by the Iris Clinical Editorial Board
This article meets Iris standards for medical accuracy. It has been fact-checked by the Iris Clinical Editorial Board, our team of oncology experts who ensure that the content is evidence based and up to date. The Iris Clinical Editorial Board includes board-certified oncologists and pharmacists, psychologists, advanced practice providers, licensed clinical social workers, oncology-certified nurses, and dietitians.