Say what? 8 things you shouldn't - or should - say to a cancer patient

A patient and oncologist offer their tips during Breast Cancer Awareness Month
woman breast cancer survivor
Speak from the heart when you're talking to someone with cancer, but be mindful of what you say. Getty Images

When it comes to clueless cancer comments, patients have heard them all, tumbling out of the mouths of colleagues, strangers and even loved ones like Montezuma’s verbal revenge. Some are universally annoying; others, more individually perturbing.

"Best of luck on your journey!” used to make me want to pull my hair out, even though I was already bald from chemo. I have breast cancer, I wanted to tell the perky people who tossed this at me like bon voyage confetti. I’m not going on a cruise to Acapulco.

Wondering what you should or shouldn’t say to a cancer patient? Read on for a few basic tips.

What are your odds? Questions like this from a loved one are to be expected. But when they come from a virtual stranger -- or a date, which is what happened to me – that’s just plain wrong. “There’s a very narrow group of people you’re closest to who deserve to have some idea about this so they can help support you,” says Dr. Julie Gralow, a clinical researcher at Fred Hutchinson Cancer Research Center and an oncologist at Seattle Cancer Care Alliance. “But for the average friend or more peripheral person, it’s up to the cancer patient to divulge what they want.” Gralow suggests letting the patient lead the conversation, i.e., if you have sensitive questions, keep them to yourself. “The patient will let you know if they want to share,” she says.

You brought this on yourself. Cancer patients do a lot of internal finger pointing as it is. Was it the weight gain? The stress? That mean thing I said to Toni Anderson back in fourth grade? The last thing we need is additional blame and shame from self-righteous souls who think they’ve cracked the code on our cancer. I’ve had people tell me I “gave myself cancer” because of one thing or another. Gralow, too, has heard similar memes from her patients. “People will make comments like ‘You should have exercised more’ or ‘You should have breast fed,’” she says. “Shoulding” all over cancer patients is never helpful, says Gralow, especially after the fact. Forget the lectures and try listening instead.   

I know someone with your type of cancer. They died. I’ve had so many people blurt this out after hearing about my diagnosis that it’s almost become a joke. Sure, I get that they may be mourning a loved one and/or trying to demonstrate some commonality. But no soldier at war wants to hear about the casualties. Or about how painful and debilitating everything got before the bitter end (seriously, people, process those details with your non-cancer friends). “When the first thing someone says is ‘My mother died of breast cancer,’ that’s just bad,” says Gralow. “But people don’t always think. Cancer is scary and we’ve got to respect that.” Instead of immediately blurting out bad news, Gralow suggests thinking about what it’s like being in the cancer patients’ shoes. Would you want to hear that?   

Forget what your doctor says, you should try X, Y or Z.  Juicing and jogging. Meditation and yoga. Coffee enemas and shots of Vitamin K. Sometimes it seems like everybody knows better than the professionals who’ve actually studied your scans and blood work and pathology reports and -- hello! -- cancer itself. But second guessing doctors is practically a national pastime. “I’ll see a patient and recommend a course of treatment and then some very well-meaning person will say, ‘My sister had breast cancer, too, and she got this [treatment]. Ask your doctor about it,’” says Gralow. The bottom line: cancer is complicated and foisting supplements and/or unsolicited advice onto patients undergoing treatment just increases their burden. “A lot of my patients say ‘I don’t want to take this, but I’m getting pressured,’” says Gralow. Her advice? Respect the patient – and their choices.

Nothing. Cancer is full of surprises and discovering who’s really got your back is one of them. I’ve had casual acquaintances come through like gangbusters. And long-term friendships dry up and blow away like so many dead leaves. Yes, cancer is scary and yes, it’s hard to know what to say. But when a loved one responds to “I have cancer” with silence, that conjures up a special kind of pain. Overwhelmed by a friend or family members’ diagnosis? Don’t focus on the cancer; focus instead on the person you love and what you can do for them. As Gralow suggests, try to remember “it’s about them; it’s not about you.”
Still flummoxed about what you should do or say to a loved one with cancer? A few additional thoughts:

Speak from the heart. A simple “I’m so sorry” is a perfectly fine thing to say in response to a new diagnosis (ditto for hugs). Also, nice to hear: I love you; I’m there for you; I hate this #%&@ disease and I’m bringing chocolate over right now.

Help with specific tasks. I’ll often turn down generic offers of help (it’s hard feeling weak) but when people offer something specific, I’ll relent. Instead of throwing out a catch-all, like “Let me know if I can do anything!” come up with some targeted tasks. Offer to pick their kids up from school. Or drop off dinner every Tuesday and Saturday for the next few weeks. Tell them you’d like to join them for their next chemo session. Or chip in with a few buddies to pay for weekly housecleaning.

Remember, even cancer patients get cancered out. Nobody wants to talk about one single aspect of their life 24/7 -- not even new moms. Either way, don’t forget to check in with your loved one about other aspects of their life – their work, their relationships, their addiction to “Downton Abbey,” etc. Just because someone is diagnosed with cancer doesn’t mean she stops being the person she was before.  


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