What to say

What to Say (and Not Say) to a Cancer Patient

You want to say the right thing to your loved one, friend or colleague who’s recovering from cancer. But you’re not sure what’s best—and the last thing you want to do is say something wrong.

“Most importantly, be sincere and willing to listen,” says clinical psychologist Errol J. Philip, PhD, a researcher at the Laboratory for Psycho-oncology Research at the University of Notre Dame. “Don’t place undue importance on being positive.”

Your job is to show you care, not to lessen your friend’s worry or bring unbridled optimism to the table. Doing that can actually have the opposite effect because it implies his or her fears are ungrounded, which is unlikely.

It’s OK if you don’t know exactly what to say to someone with cancer. We’ll help you find the right words.

DO ask about our emotional health.

Don’t say: “How are you?”

Some people feel OK with this question, but for others, it’s hard because it’s very broad and they see endless ways to answer it.

Try: “How are your spirits?”

This is more specific, and it opens the door to sharing emotional burdens. “While others may want to find out what’s going on with our diagnosis or treatments, we patients often need to talk about our feelings. Asking “How are your spirits?”  gives us permission to go there in a non-socially awkward way,” explains Mend founder Lisa Lefebvre. “I’m not going to dump on you out of the blue at a social gathering. But if you give me a window to open up, I might gratefully accept.”

DON’T comment on appearance.

Don’t say: “You look pale.”
Don’t say: “You’ve lost a lot of weight.”
Don’t say: “Your poor hair!”
Don’t say: “Wow, did they remove your breasts?”

Don’t talk about how your friend or loved one looks. He or she already knows. “I lost 26 pounds,” says Sharon Seibel, who underwent treatment for pancreatic cancer. “For me, trying to gain weight was a struggle.” Comments made Seibel feel worse. There’s no way to frame cancer-related bodily changes in a positive way. Optimism can be infuriating. Even if you see a positive in a change, the reason for that change was devastating. Instead, try a simple, upbeat statement that doesn’t focus on appearance.

Try: “It’s so great to see you.”

DO speak from the heart—but DON’T project your personal anxieties.

Don’t say: “I’ve been so worried about you.”
Don’t say: “I haven’t been sleeping since I found out about your news.”
Don’t say: “Your diagnosis made me think I need to get checked out.”

It’s OK if you’re having a hard time dealing with your loved one’s cancer. But don’t succumb to the all-about-me syndrome. Try to be present and supportive of the person directly in front of you instead.

Try: “I’m not sure what to say, but I want you to know I care.”
Try: “I love you and I’m sorry you are going through this.”
Try: “I’m here for you. If you need to talk, cry, drink wine or eat a gallon of ice cream, just call—I’ll have the glasses and spoons ready.”

DON’T say, “Think positive.”

Don’t say: “It could be worse.”
Don’t say: “Just think positive thoughts.”
Don’t say: “God doesn’t give you more than you can handle.”
Don’t say: “Look on the bright side.”
Don’t say: “At least you’re lucky because X,Y or Z.”
Don’t say: “At least you’ve got the good cancer.”
Don’t say: “At least you’re single and don’t have kids to worry about.”

You may think optimism helps your friend feel better, but it often does the opposite. It discredits his or her feelings and implies positive thinking will somehow cure cancer. “I believe in the power of positive thinking,” explains Dana Dinerman, who underwent treatment for breast cancer. “But I also believe in the power of being able to vent to a friend.”

Try: “I hope things are going better.”
Try: “I know cancer hasn’t been easy. If you’d like to talk about some of the harder parts of this, I’m here for you.”
Try: “Don’t feel you need to look on the bright side. It’s ok to be sad about what’s been happening.”
Try: “That sucks.”

“I cannot tell you how unbelievably healing this is,” says Lefebvre, who was grateful for one particular friend who invariably responded with, “That sucks!” when she told her what was happening. It felt so good to hear those words, Lefebvre says, that she became the first person she’d call—every time.

DON’T talk about your aunt, friend, etc. who had cancer.

Don’t say: “My friend Jim just finished treatments. If you met him, you’d never know! He looks so healthy.”
Don’t say: “My aunt had the same cancer. She died, but I’m sure you can beat this.”

Making comparisons is the wrong way to go when deciding what to say to someone with cancer. Bringing up negative outcomes is extremely unsettling. And empty reassurance isn’t helpful. No two cancers or experiences are the same. It’s best not to compare stories.

Try: “What has been the hardest part of your journey? Can we figure out together how I can support you with this?”

DO be sensitive about cancer mortality specifics.

Don’t say: “Are you worried about dying?”
Don’t say: “What stage is your cancer?”
Don’t say: “What is your prognosis?”

Don’t ask for details about potential outcomes. Your friend may not want to share these deeply personal details and it may force him or her to relive upsetting information. If your friend wants to share concerns about the future with you, he or she will—on his or her own terms.

“People ask me all the time what stage it is, but I don’t know that they really understand the implications of what it means,” explains Sharon Seibel, who was diagnosed with pancreatic cancer six years ago. You may not realize it, but it’s like asking how likely she or he is to survive.

Seibel says it may be OK to ask what type of cancer a friend or colleague has, but not always. “People are struggling and constantly swimming upstream—they shouldn’t have to explain everything,” she says.

Try: “I’ve seen you handle some tough stuff in the past. Let’s go through this one together.”

DON’T give unsolicited advice.

Don’t say: “You should go see Dr. So-And-So.”
Don’t say: “I’ve read that the best hospital to be treated at is XYZ.”
Don’t say: “You should make healthier meals for yourself.”

“Unsolicited advice is seldom valuable,” says Mache Seibel, MD, a Harvard Medical School faculty member. Unless you’re his or her doctor, don’t tell your friend what to do. It may feel like you’re putting the blame on him or her, questioning his or her choices or doubting his or her medical team.

“I know it’s hard, especially if you really do feel like you have a great product for someone,” adds Tara Geraghty, who wrote Making Cancer Fun and whose 12-year-old daughter was diagnosed with stage IV cancer when she was three. “But trust me—everyone and their mother is offering us a miracle cure.”

Try: “If you ever want help with research or if you’d like someone to go with you when to doctors’ appointments, I can definitely do that for you.”

DO be sensitive to using ‘war against cancer’ clichés.

Don’t say: “You’re such a fighter.”
Don’t say: “You’re a warrior.”
Don’t say: “You’re so brave.”

Watch your friend’s language carefully. Not every cancer patient identifies with ‘warrior’ terminology. They may not feel like they are in a fight. Or they may feel weak. For some, saying they’re strong can make them feel worse. For others, it may be the support they need.

Try: “I’ll fight with you by your side” for those who want a fellow solider.
Try: “You don’t have to be strong for me. We can talk about what’s ever on your mind” for those who are orienting to their journey in other ways.

DON’T use your belief system to comment on their situation.

Don’t say: “God doesn’t give us more than we can handle.”
Don’t say: “Miracles do happen.”
Don’t say: “Everything happens for a reason.”

Not everyone is religious or spiritual. Your friend or colleague may have a different belief system than you. It’s best not to impose your approach on her or him. But you can offer up your spiritual support.

Try: “I’m thinking of you often and you are in my prayers.”

DO empathize without assuming you know what he or she is going through.

Don’t say: “I know how you feel.”
Don’t say: “You’re so much stronger than me!”
Don’t say: “I could never go through what you’re going through.”
Don’t say: “I can’t imagine being you right now.”

Be compassionate, but don’t assume you know what it’s like to be recovering from treatment. You’re not in your friend’s shoes—and that’s OK. Don’t make assumptions. Simply be empathic and open.

Try: “I know I can’t really understand what you’re feeling right now, but if you need to talk, I’m here to listen.”

One caveat: If you’re one cancer patient talking to another, something like, “I found chemo to be really hard. I know it’s not easy,” may be helpful.

DON’T profess to be able to predict the future.

Don’t say: “It’ll all work out.”
Don’t say: “Don’t worry, you’ll be fine.”
Don’t say: “I know you will get through this.”

Nobody knows what the future brings, so it’s best not to pretend you do.  Sometimes things work out, sometimes they don’t. Saying they will can make your friend feel like a failure if she or he worries about this–or if things don’t work out.

Try: “Limbo and uncertainty are hard. I’m sorry life has been so unpredictable.”

DON’T assume the end of treatment is the end of your friend or loved one’s struggles.

Don’t say: “Congratulations on getting through all that.”
Don’t say: “Now you can get on with your life again.”
Don’t say: “I’ll bet you want to start dating again now that your hair has grown back in.”

Finishing treatment isn’t the same as accomplishing something. It’s not something people in recovery can simply put behind them. “It’s never really over for us because of endless doctors’ appointments and fear of recurrence,” explains Sonja L. Faulkner, PhD, who underwent treatment for cancer and wrote The Best Friend’s Guide to Breast Cancer: What to Do if Your Bosom Buddy or Loved One is Diagnosed.

Cancer changes us permanently—for better or worse. No one ever gets their old life back. Their bodies might not be quite the same as before. Learning to accept permanent loss of body parts or functions takes time. Symptoms like anxiety, insomnia and pain and linger for months or years. After treatments end, people assume a patient is back to normal. They are not. They still need you.

Try: “I know you finished XYZ, but I’m still here for you.”
Try: “You’ve been through a lot. Putting life back together isn’t always easy. I’d like to help you if it feels overwhelming at times.”

Be the person they want to call

It can be hard to know what to say to someone with cancer. Let this guideline give you the confidence to be there for your loved one the best way you can. For further reading on this topic check out Kelsey Crowe’s Book There is No Good Card For This.

Kara Mayer Robinson has a Master’s degree in journalism from Columbia University. She is a freelance journalist for The New York Times, The Wall Street Journal, WebMD and Women’s Health & Fitness.
Lisa Lefebvre is the Founder of Mend After Cancer. She has experience recovering from 8 cancer-related surgeries, chemotherapy treatments, radiation protocols and hormone suppression therapy.

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