Cancer etiquette

No longer a silent disease

It can be difficult to know what to say to someone with cancer. Unless you’ve been there yourself, you can’t possibly understand how it feels.

Many people say inappropriate things without realizing it. We often do the best we can, but our efforts still fall short. How do we find the right words to talk to someone with cancer?

Years ago, people spoke in whispers about cancer. Today, despite its prevalence, advances in treatment and increasing survival rates, many people still don’t know how to handle the news.

At some point, someone you know will likely get cancer. When it happens, you should be prepared to communicate appropriately about the disease.

Many cancer survivors share similar stories of awkward encounters and upsetting comments made by well-meaning individuals. Their collective observations help us define “cancer etiquette,” or rules of conduct for communicating with the cancer community. Since each person experiences cancer differently, one approach does not necessarily work for everyone. This information serves as a starting point for talking to someone with cancer. There is no single right way. Just keep trying.

Tips for talking to someone with cancer

Don't ignore them. Some people disappear when someone they know gets cancer. The worst thing you can do is avoid the person because you don’t know how to handle it. Cancer can be lonely and isolating as it is. Tell them, "I'm here for you," or "I love you, and we'll get through this together." It's even okay to say, "I don't know what to say," or send a note that says, "I'm thinking of you." Just stay connected.

Think before you speak. Your words and actions can be powerful. One comment can instantly undo someone's positive mood. Don't be overly grave and mournful. Avoid clichés, like "hero" and "battle." If the person gets worse, does it mean they didn't fight hard enough? Try to imagine if you were in your friend’s shoes. What you would want someone to say to you?

Follow their lead. Let the person with cancer set the tone about what he or she wants to talk about. It doesn't always have to be about cancer. Chances are your friend wants to feel as normal as possible. Tell him or her about something funny that happened. Allow your friend to talk about cancer if he or she wants. And save the pity eyes and voice.

Keep it about your friend, not you. Don't lose your focus. Avoid talking about your headache, backache, etc. This isn't about you. And as bad as you feel, he or she feels worse and may not be interested in hearing about how hard this has been on your life. Don't put him or her in the position of having to comfort you. Only ask questions if you truly want to hear the response.

Just listen. Sometimes just being there to listen—really listen— is the best thing you can do. Let the person with cancer talk without interrupting. You don't always have to have all the answers, just a sympathetic ear. He or she may not want to talk at all, and would rather sit quietly. It's okay to sit in silence.

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. Leave the door to communication open so they can talk about fears and concerns.

Don't be intrusive. Don't ask those with cancer questions about their 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 they're going through, so don't act like you do. Instead of saying "I know how you feel," try saying "I care about you and want to help." Don't suggest alternative forms of treatment, a healthier lifestyle, etc. And don't tell them to "stay positive," it will only cause frustration and guilt.

Refrain from physical assessments. Refrain from comments about how those with cancer look, particularly if it's negative. They don't need their weight loss or hair loss pointed out to them. And if they just started treatment, don't ask them about potential side effects. If you say anything at all, tell them they look stronger or more beautiful, but mean what you say.

Avoid comparisons. Everyone does cancer his or her own way. Don't bring up the private medical problems of other people you know. And don't talk about your friend with cancer who is running marathons or never missed a day of work. Avoid talking about the odds or making assumptions about prognosis. Just allow your friend to be who they are.

Show them you care. Show those with cancer that they’re still needed and loved. Give them a hug. Surprise them with a smoothie, books, magazines or music. Offer to help, such as cooking, laundry, babysitting or running errands. Be specific by asking, “What day can I bring you dinner?” And, offer to help only if you intend to follow through with it and won’t expect something in return.

Share encouraging stories. Offer encouragement through success stories of long-term cancer survivors. Avoid saying, “They had the same thing as you.” No two cancers are the same. And never tell stories with unhappy endings. If you know someone with the same type of cancer, offer to connect the two of them.

NOTE: This information is not intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to making decisions about your treatment.