Yes, I have done a lot of bitching and ranting on this subject. I have often told people that in support groups, the two biggest topics are hair, and the dumb things people say. We rant about this for a while, and then we go back to hair. What I have tried to do here is offer some practical suggestions for how people can talk to their friends who are going through something that fortunately, they may not have experienced firsthand, and hopefully never will. I also want to provide some structure and framework around why words can hurt, and how to turn good intentions into actual support.
Try to remember that rational thought can be almost impossible for someone going through cancer treatment. Sometimes all you can do is get through the day you’re in. Tomorrow, next week, next month, will have to take care of itself. We don’t have time to think much about how we’re feeling or doing. We’re just trying to get through each thing, and then the next one, and try to save some strength for whatever is thrown at us next.
A final quick thought: I’m aware an Internet search will turn up five to ten pieces on this same subject. I skimmed them briefly, but these suggestions are entirely my own, based on my own experiences. And I didn’t see anything that paired up the Don’ts and Do’s the way I did. My words, as always, are my own.
So here are my suggestions about what NOT to say, and what you can say instead.
1. Have you made a plan?
See above. Planning requires rational thought, which is in short supply immediately after a diagnosis. Your care team is already asking you to make some tough decisions, and you don’t have answers to even half the questions people keep asking.
Better: “I’m here for you.” At the beginning, especially, that may be all your friend can process.
An aside: I once ranted at Dr. Phil and his guest doctor for a good fifteen minutes after they told us to make a plan. At that point, I felt even Dr. Phil had let me down.
2. My (mother, friend, cousin, etc.) did (whatever) and she was fine.
No one cares. No rational thought going on, remember? During cancer treatment it’s all me me me. And this is maybe the one time in a woman’s life she should be free to be thinking of herself and no one else. Of course, that’s impossible, because most of us have families. But we don’t need to be hearing about anyone else and what they did or didn’t do. Everyone goes down this road at a different speed, with a different road map, and no one has the right to point you in any direction other than the one you choose.
Better: “I’m here for you. Whatever you need to do to get through this is fine.”
3. Do you think you got cancer because (you’re overweight, you don’t eat right, you’re under stress, etc.)
Good God. How often do we as women need to hear that everything is our fault? If only we’d done this or that, or if we looked this or that, or made better choices, than maybe we would never get cancer? Come on. You know better. There’s literature all over the place on how we should reduce our risks by being perfect. You know what? No one knows. You got cancer because you got cancer. Period.
Better: “It sucks. But I’m here for you.”
4. Are you keeping up with your exercise?
This one really hits home for me because I didn’t. And I developed a very bad blood clot that could have ended my life had it been left untreated. I had made a conscious decision to skip working out until I felt better. I went through chemotherapy at the height of the pandemic, with all gyms closed, and I live downtown in an urban area. Walking would have meant shuffling around on my husband’s arm in plain sight of at least 100 people, masked or unmasked, with my head wrap on, looking like a concentration camp survivor. I have worked out five days a week for 40 years, and I was pretty sure I could get back to normal very quickly once treatment was over. And I was right…mostly. My cardio fitness came back almost overnight, although strength training took longer. I don’t regret my decision. Most of my care team has told me that my inertia had nothing to do with the blood clot. But part of me will always wonder.
Better: “Would you like to take a walk (swim, run, whatever) sometime? Pick a day.”
5. I’ve read that …. (almost anything here is not a good idea)
Again, we are already being bombarded with literature about cancer. Most of it is not very helpful. Surviving cancer treatment is an endless round of individual choices, most of which we don’t feel strong enough to make. So please don’t recommend any reading. If we feel up to reading, we’d rather read something that has NOTHING to do with cancer.
Better: “I just read a great new book, if you’re up to reading. If not, I can just tell you about it!”
6. If I were you, I’d… (again, nothing works here)
At this point, I think this is self-explanatory. You’re not me, and you have no idea what I’m thinking or feeling. How could you, when I’m not sure myself?
Better: “Do you feel like talking? If not now, I can take a rain check.”
7. Have you gotten a second opinion?
This in itself is not a bad question. It depends on when you’re asking, although the sad truth is there probably is no good time to ask it. In the beginning you’re overwhelmed. Later on, you’re probably already in treatment, and second guessing yourself is futile. For sure, if your friend asks your opinion, and you do have someone you’d like to recommend, go ahead. Just don’t push it.
8. Everything happens for a reason.
I REALLY hate this one. Really? There’s a reason I’m supposed to get cancer? How is this at all comforting? When I hear this one, I just hear someone trying to reassure him or herself that there really is a plan for everything. I’m not sure how cancer fits into any plan, at any time. I don’t wish to mock people who have a genuine faith that this is true, but it’s not what someone going through cancer needs to hear.
Better: “I don’t understand why this had to happen to you, but I’m here.”
9. You need to keep a positive mental attitude.
NEWS FLASH: Mental attitudes don’t treat or cure cancer. CANCER TREATMENT treats and kills cancer. Isn’t this just another way to blame the patient for the disease? Refer back to Number 2.
Now I am the last person to say that mental attitude is unimportant. I discussed this with a member of my support group, and she told me not to dis her positive mental attitude. She was battling stage 4 metastatic breast cancer, so I would never have presumed to tell her anything. For sure, anything you can do to stay positive helps. But some days it’s just too much work. And it never helps to hear this from someone else.
Better: “Let’s do something fun together. Whenever you feel up to it.”
10. But you’re OK now, right?
I saved this one for last, for several reasons. Because this is what you hear a lot when treatment has finished. Everyone who never had time to listen in the first place now wants to be reassured that you’re fine, just fine. It’s like asking a sexual abuse survivor if they’re “over it.” I’ve heard that plenty of times too.
The sad truth is, you’re not ok. You’re not over it. The real work of surviving the emotional trauma of cancer can’t begin while you’re still in treatment. You’re too busy trying to get through each day, with all the unpleasant surprises that keep coming up. Processing your emotional trauma has to wait.
For me, I didn’t even begin until at least three months after I finished treatment. Then I had 5-6 sessions with a therapist who specialized in working with cancer patients and decided that was enough. The truth is, that for least a year, I didn’t WANT to talk or think about cancer. There was a reason I waited until the one-year anniversary of my diagnosis to begin writing about it.
I still don’t like to write about it. And I don’t talk about it much either, except with the inner circle of friends in my life who’ve proven that they’re capable of unselfish listening. But I’m writing about it today, and will continue to do so, because there are things to be said, and not enough people are saying them.
Please take my suggestions to heart. One of every eight women you know will be diagnosed with breast cancer at some point in her life. I actually think that number is too low, because it seems that not a day goes by that I don’t hear about another case. And many times, the woman is younger than I am, and her cancer is much worse.
Don’t tell me how strong I am. No one is strong enough to get through cancer treatment alone. And don’t tell me to keep fighting. Military metaphors don’t help. I didn’t win any battles. I just got through it.
The most important thing is to keep talking. No one heals in silence. I hope this helps.