When a friend or loved one has cancer, you may find yourself at a loss for words, afraid of saying the wrong thing and unsure how to offer your support.
While everyone is unique, therapists and social workers offer advice to patients and loved ones based on what their patients tell them is most helpful—and most hurtful—when navigating the relationships and social interactions after their diagnosis and through the various stages of their disease.
Even if you do feel uncomfortable and uncertain about what to say, it’s important to still reach out, advises Nicole Peeke, LCSW, ACHP-SW, a counselor and social worker at City of Hope® Cancer Center Duarte. She says communicating openly and even acknowledging your discomfort may be helpful. Asking sincere questions and really listening to the answers also are key.
“You might say, ‘If I’m being pushy or asking too many questions or you don’t want to talk about things, tell me.’ Let the patient guide you through that,” Peeke says.
Sadly, some friends or acquaintances in a cancer patient’s life may disappear because they don’t know what to say or do, experts say. Others, however, may unexpectedly show up to help.
“Oftentimes you’ll find people who have some experience with cancer, either personally or through a friend or family member, really show up out of nowhere,” says Lynne Thomas, MSW, a counselor at City of Hope Duarte. “They’re like this angel who walks through part of this with you and when things get a little bit better they may recede and those other people who disappeared may come forward because they have the capacity or maybe they dealt with some of their fear or it’s just not a crisis situation anymore. Know these relationships will ebb and flow.”
In this article, we’ll offer tips on communicating compassionately with cancer patients. Topics include:
- How to talk to cancer patients
- How to tell friends and loved ones you have cancer
- What to say to a cancer patient
- What to say to cancer patients at the end of life
If you’ve been diagnosed with cancer and would like to get a second opinion on your treatment options, call us or chat online with a member of our team.
How to talk to cancer patients
To support a friend or loved one with cancer it’s important to be present and listen to what the person may be experiencing and may need. Practicing genuine and humble curiosity is also important, taking your lead from the cancer patient, who may or may not want to talk about it.
“It’s ok to say, ‘I’m really afraid of saying something that’s going to offend you in some way,’” advises Thomas. “Just put it out there. Admit ‘I’ve never gone through this; I’m not going to assume to know what you’re experiencing. I might ask questions. I might be curious. Please forgive me if I’m insensitive. I don’t mean to be. I want to be supportive.’ ”
Understand, too, that cancer patients’ communication preferences and needs will likely change, so stay flexible. Today they may just want to sit quietly and watch a movie or go for a walk and not talk about cancer. Another day they may want to share what they are feeling and may welcome your active listening and questions.
How to tell friends and loved ones you have cancer
Sometimes the cancer patient can set the tone for relationships from the time of diagnosis, by thoughtfully and intentionally deciding how to share the news with friends and family.
If you are a cancer patient, assess your own feelings upon receiving a cancer diagnosis before you decide with whom and how to share the news. Talking to those closest to you may help you process the information and think about how to tell a broader circle of people in your life.
Other ideas include:
- Make a list of those you want to tell in person—perhaps close friends and family.
- For those who are not as close, consider asking another friend or family member to share your news.
- Think about how much you want to tell people and what aspects you may not want to share.
- Anticipate as much as possible what specific help you may need—a ride to appointments, a walking buddy, meals or childcare, for instance. When people ask what they can do to help, tell them.
- As you begin to widen the circle of people who know about your cancer diagnosis, make note of those comments or words that may annoy you or trigger feelings of anger or sadness. Once you identify them, plan for how to respond in the future. For instance, maybe you simply say, “I’m tired of talking about cancer. Let’s talk about something else.”
- If you don’t want to talk to people about your diagnosis, designate a family member or friend to be your spokesperson.
- Give yourself permission to take care of your own emotions when necessary and not worry or feel like you have to take care of others’ feelings about your diagnosis.
What to say to a cancer patient
One rule of thumb for friends and family members, according to Thomas, is to avoid hollow reassurance.
“These global reassurances that people offer—‘You’re going to beat this cancer. Stay strong. You got this.’ People mean well, of course, and want to be encouraging and helpful. But I find that reassurances that are based in reality, something that you can actually do or control is the best kind of reassurance,” she says. “For instance, ‘I’m here and I want to be helpful to you. I want to help you get through this. I’m available to support you.’ This is something a friend can say. A partner might say, ‘We’re going to get through this together.’ ”
Other tips include those listed below.
Follow the patient’s lead. Let the patient decide how much and when he or she wants to talk.
Focus on your friend or loved one, not you. “The one thing I’ve heard people say that is never really helpful is: ‘I know how you feel,’ Peeke says. “Maybe say, ‘I’ve been through this myself.’ Or, ‘I’ve been on a similar path so if there is anything I could ever share with you let me know.’ Just try to be very thoughtful and intentional and careful in your language in how you’re communicating concerns or your curiosity about someone’s experience with cancer.”
Avoid clichés, like "hero" and "battle" and trigger words. “Some people are really sensitive to the word ‘journey.’ Or ‘opportunity’—cancer is an ‘opportunity.’ That can be another triggering word,” says Thomas. “But, if the person with cancer is using those words, then it’s OK. Really pay attention to what they’re saying when they’re talking about this experience.”
Don't minimize their experience. Try not to say, "Don't worry, you'll be fine." You don't know that. Instead say, "I'm really sorry" or "I hope it will be okay." And don't refer to his or her cancer as "the good cancer." These statements downplay what he or she is going through. By being nonjudgemental, the door to communication stays open so the cancer patient may talk honestly about his or her fears and concerns.
Don't be intrusive. Don't ask questions about cancer patients’ numbers or tumor markers. If they want to talk about their blood results, they will. Give them the freedom to offer this information or not. Also, don’t ask personal questions that you wouldn't have asked before, especially when it comes to subjects like sex and religion.
Don't preach to them. Don't try to tell the person with cancer what to think, feel or how to act. You don't know what the patient is going through, so don't act like you do. Don't suggest alternative forms of treatment, a healthier lifestyle, etc. And don't tell a person with cancer to "stay positive," it will only cause frustration and guilt.
If they look good, compliment them. Positive comments are always nice but avoid negative remarks like ‘You look pale’ or ‘You’re so thin.’ People with cancer likely know it already and may be self-conscious or embarrassed by their appearance.
Respect their privacy. Don’t share information about the patient or his or her condition without first getting permission.
Accept that there will be good and bad days. Emotions will fluctuate and it’s unrealistic to expect constant positivity. Some days the patient may want to share negative feelings like anger or grieve what he or she has lost due to cancer. Other times, people may want to forget about their disease and remember happier times. It’s OK to share a laugh over a funny story if the moment is right. Again, let the patient lead and roll with it as much as you can.
Show them you care. Don’t just ask how you can help—act. Maybe deliver their favorite food or a special treat or a basket of books or a plant that you know will cheer them.
What to say to cancer patients at the end of life
How you communicate with a cancer patient may evolve depending on what they are experiencing—right after diagnosis, during treatment, in survivorship, if the cancer recurs or at the end of life.
The National Cancer Institute offers a comprehensive guide on to how to speak to friends, loved ones and children of all ages about advanced cancer including tips on how to initiate a family meeting.
“No matter where they are at in it—whether they’re in survivorship or not—they’ve been changed,” Thomas says. “It’s going to be different for everybody, so be curious about that. Ask ‘How are things different for you since you had this diagnosis?’ It may be really easy to answer or really difficult. Maybe no one has ever asked them that question before.”
For those close to the cancer patient, it can be difficult to talk about the end of life. Likely the cancer patient is having some of the same thoughts and fears. Sharing feelings about the uncertain future can be helpful for both the cancer patient and those close to them.
“I think, my lesson that I learn every day from this work is we’re healthy until we’re not,” Thomas says. “Health is not guaranteed for any amount of time. Being able to celebrate what we have right now—that we know we have this moment because we don’t know what the next moments are. I think anyone who’s gone through any type of serious illness has greater appreciation of that.”
In conversations at any time during a patient’s cancer journey, Peeke says to “express gratitude and love. Think about how to start to really show and express love and gratitude for people close to me.”
End-of-life decisions may be particularly challenging, so approach them with sensitivity toward the cancer patient’s perspective. Try to understand and cope with your own emotions without burdening your loved one.
If the patient asks for your opinion on their treatment or end-of-life decisions, be honest, but try not to answer questions you really don’t know the answers to, experts say. For that information, consider putting the patient in touch with his or her health care team which can assist with what the person may need.
No matter how uncomfortable it may be, try to stay present for the patient with comments like: “I’m not sure what to say, but know I do care.” Or “If you want to talk, I’m here.” Again, try to listen and tune into the patient’s needs and follow his or her lead.
“There’s no right or wrong way to do cancer,” Thomas says. “I think the best kind of coping mechanism is to simplify, keep planning, stay flexible and be specific in how you communicate.”
If you’ve been diagnosed with cancer and would like to get a second opinion on your treatment options, call us or chat online with a member of our team.
