[2022-01-26] How to talk to someone who has cancer
For Bell Let's Talk Day, I'm sharing suggestions on how to speak with someone who has cancer. I was inspired by a post by Nicky Newman (@nicknacklou on Instagram), who has incurable stage 4 breast cancer. She recently published a post How to Support a Newly Diagnosed Cancer Hooman. I liked her advice and that of her readers, so I've repackaged it here, along with my own reflections.
Let's start with the basics. Having cancer sucks: it's scary, painful and time-consuming. It can affect not just physical health but mental health as well. How you respond to someone who has cancer can have a positive or negative effect on their mental health. Here are some do's and don'ts.
- Acknowledge that being diagnosed with cancer sucks. You don't have to get angry (I'm not a fan of the "f*ck cancer" mantra) or to act like it's the end of the world (for many cancers, it isn't). You can simply say, "I'm so sorry to hear that you are going through this."
- Don’t downplay the situation. Nicky writes: "saying things like 'you’ll beat this' or 'you never know, they are making new drugs all the time'" isn't helpful. As someone facing an incurable cancer, she would know. Though not all types of cancer are incurable, most newly diagnosed cancer patients are terrified. Saying "you'll beat this" can feel, to the patient, like you are dismissing the very real fear that they are experiencing. Saying "this must be very hard for you" gives the person an opportunity to share their feelings honestly.
- Avoid any sentence that starts with "at least." This is another form of downplaying the truly awful situation the person is in. The newly diagnosed cancer patient needs to be supported in processing the negative feelings they are experiencing, not encouraged to find the silver lining in the circumstances long before they're ready to do so.
- Don't predict the future. Cancer brings with it a lot of uncertainty, and the level of uncertainty varies with the type of cancer. Saying, "Don't worry" can sound like you think the patient is silly for experiencing a very common emotion with cancer, namely, worry. Leave the prognosis to the professionals. One commenter on Nicky's post wrote: "once you’ve been diagnosed it never leaves you, even after active treatment has finished every headache is a potential brain tumour, every ache is potentially bone cancer, every cough… lung cancer, the anxiety never leaves us, people don’t understand the mental health aspect of cancer unless they’ve experienced it first hand, and that’s fine, but we’re not being hypochondriacs, we’re not being drama queens and we keep a hell of a lot to ourselves because we don’t want to keep 'going on about it.'"
- Reassure them that you're not going anywhere. Though I didn't personally experience this, I have read that people facing a life-threatening illness can feel abandoned, almost as though their friends and family members think the disease is contagious. Saying "I'm here for you whenever you need me and in whatever way I can help" can go a long way to reassuring the person they are still loved and cared for.
- Just listen. Don't feel compelled to offer advice or to help the person get out of the legitimate funk they're in. And don't try to relate to the newly diagnosed person by mentioning that your aunt died of cancer.
- Don't offer advice on cancer prevention or treatment unless you are a healthcare professional specializing in the type of cancer the person has. One person recommended all these foods I should be eating to prevent cancer, which sounded a bit like victim blaming considering that I already had cancer. Other people recommended alternative therapies, which made me feel compelled to read the information when I knew that I was going to stick with what my oncologist advised.
- Be patient. Not everyone who is diagnosed with cancer is ready to talk right away. And some may wish to remain private in dealing with the disease. Regardless, let them know that you care and are available to talk should they wish to. Also, recognize that it may take them time to get back to you on questions regarding their results or prognosis because they're taking time to process the information themselves.
- Be proactive. Nicky recommends that you help without having to be asked. Patients can feel like a burden, so your being proactive can eliminate the need for them to ask for help. In response to Nicky's post, one person commented: "The people who just turned up with food and cooked meals without needing to be asked were my biggest heroes." How can you help? Drop off food. Send a card. Commit to checking in with the person every week (and follow through). Return their garbage and recycle bins to their garage. Send them a special pillow to help during their recovery.
- Send a care package. The night before I started chemotherapy for ovarian cancer, my sister dropped off a chemo care package that she, her daughter and my mother had put together. For my physical health, it contained Biotene mouthwash and Life Savers to address dryness in the mouth, a super soft toothbrush to deal with gum sensitivity, fragrance-free and hypoallergenic body wash and cream to counter skin dryness, lip balm to prevent dry lips, Gravol and ginger snacks to deal with nausea, and Epsom salts for a relaxing bath. For my mental health, it contained rubber duckies as well as words representing me—wife, mother, daughter, sister, aunt—and my loved ones.
- Treat them the same way. Yes, they're going through cancer, but they're still a friend, a sister, a daughter, a colleague. They're interested in more than just cancer. If you have good news to share, by all means, share it. Positive stories can be a respite from the negative situation. And if you're facing a hardship yourself, don't feel that you need to keep it from them. Just continue to treat them the way you did before they were diagnosed. One commenter on Nicky's post wrote: "People didn't want to tell me tough stuff going on with them because they thought I was already dealing with so much, but that just made me feel disconnected from my friends."
- Don't be afraid to joke. In response to Nicky's post, one reader recounted that she had a friend who lived across the country who would send her a card each week to open and read at each treatment—"never sentimental and always just funny." Another friend would send her an email the night before her chemotherapy with a "funny story from back in the day." One of my favourite humorous comments was "Go Neuts Go!" which someone shared on social media when my low neutrophils threatened to postpone my chemotherapy treatment.
- Stick with them for the long haul. Some cancer patients, like Nicky, will be facing cancer for years to come. Nicky advises: "don’t forget the diagnosis in the years that go by." She says that cancer patients may look like they're OK and act like they're OK, but may be dealing with both physical and mental side effects.
A simple approach to anyone who is feeling down—whether they've been diagnosed with cancer or another life-threatening illness, they've lost a loved one, or they're feeling depressed—is to validate how they're feeling. Saying "that really sucks" or "I'm sorry to hear what you're going through" gives the person permission to feel what they feel and communicates that it's OK for them to be sad, worried and scared. And if you really don't know what to say, try this: "I’m not sure what to say, but I want you to know that I care."
