How do you know what to say to someone who has cancer?
We want to start by saying that there is no right or wrong way to speak to a person with cancer and it is OK if you don’t know what to say. This is your colleague / friend / loved one / family member who is ill, they may be scared or worried or they may be taking their diagnosis in their stride. The most important thing at this stage is to listen. However, carefully choosing what you say can also help you show your support.
Is there a right time to talk to someone with cancer?
Each person responds to their cancer diagnosis in their own way. Some people just go about their daily business and ignore cancer and some want to tell everyone every detail of their diagnosis and cancer treatment. Most people are somewhere in between. Sometimes, the person’s need to talk changes from day to day and may depend on where they are in their treatment or cancer journey. So we would suggest that if they start the conversation, let them take the conversation where they choose. If they don’t start a conversation about their cancer it is OK to ask if they want to speak about it and let them know that you want to support them. This is a respectful way to find out what they need.
Let your friend know it’s okay if they don’t want to talk.
Someone with cancer might not always want to think about or discuss their health or treatment. It may just be the wrong time or it may be always. Sometimes talking about their cancer or treatment makes them identify a “cancer patient” and this can strip away their self-identity. If they don’t want to say anything about their illness or treatments, talking about other things or having a joke (where appropriate) are often welcome distractions and another way to show support.
When someone is diagnosed with cancer they can go through a whole range of emotions. At times uncertainty or fears of treatment and the unknown can make cancer patients feel angry, depressed, or anxious. Fears of their future health and hope for their future may be at the top of their mind. This is a normal part of the cancer journey. It may be at these times that the person needs their friends and family members close for support. Some may need extra help from a support group to learn to deal with the changes cancer has brought into their life. These groups can sometimes also provide hope. Whether they will want to speak to you, or anyone, about their cancer or treatment, will vary from person to person. What is important is that you try to hear and understand how they are feeling, don’t make many suggestions and try to understand how their life has changed and their health may never be quite the same.
3 basic tips for what NOT to do when talking to a cancer patient
There is no doubt that it is sometimes hard to know what things to say to a person diagnosed with cancer and words like ‘stay positive’ or ‘be brave’ are not always appropriate.
We have three basic rules for what not to do when trying to show support.
1. Give advice
It is always hard to give good advice when you are not in the person’s shoes. When listening to someone’s problems, the natural reaction can be to attempt to offer a solution. Despite this inclination, in most circumstances, the best and safer option is to ask questions, or simply listen when they need to say something.
2. Discuss alternatives
Usually, by the time you hear that someone has cancer, they have already been overwhelmed with different cancer treatments or outcome scenarios. New or alternative treatments, or cancer-curing diets, are usually not what a person with cancer wants to hear at this stage. You may mean well, but it is not required to offer suggestions for other options, unless the person has specifically asked you for some, or revealed that they are actively looking for alternatives.
3. Speak about other people’s cancer
It is so easy to be reminded of other people’s cancer when faced with a friend or loved one who has a cancer diagnosis. People often try to relate the experiences of others to those they already understand, in order to show understanding, or for another well-intentioned reason. However, it is actually not a good idea to speak about these in most cases, as they are unlikely to be exactly relevant, and might even be depressing for the person you are talking to.
Unless you have uplifting stories that directly relate to the person you are talking to, it is best to stay away from the topic of other people’s cancer.
For example, if the person is concerned about taking a certain cancer treatment and you know someone who has had a (reasonably) positive experience with that treatment and is still OK, then that can be a nice thing to tell them. If appropriate you can even introduce the two people so they can learn from the experiences. It is obviously not OK to say that you know of an acquaintance with a similar cancer who died ….
Help to get you talking
Here are six tip to help you start talking
- If you are not sure what to say or even whether they want to talk about it, let them take the lead. If they want to speak they will and you should be a good listener. Some people want to speak about everything, some people don’t want to talk about it at all.
- There is no right or wrong way for a cancer patient to behave.
- It’s ok to ask if they want to talk about it, you just need to respect their answer. In fact, it may be best to ask, unless they start the conversation first and then let them take the conversation where they choose.
- Silence is sometimes better than noise. It helps people think and they may have a lot going on in their minds. If there is silence it’s Ok to wait until something is said, if you have nothing to say.
- Talking about cancer or treatments or side effects or indeed about anything too much, just because you think you should, can be annoying. It can suggest that you are not paying attention to the person’s needs and is not helpful.
- Smiling, and warm looks can get past the barriers of the illness to the person you know and love. If you don’t know them that well, silence, listening, and showing understanding may be the best way to show support. Warm touches for comfort may or may not be welcome and you need to think if you would do this to the person anyway if they were upset about something else.
Our responses to situations are shaped by all of our experiences from our past, which is what leads to such a variety of ways that people manage and cope with stressful life events. So it is not surprising that each person responds to their cancer diagnosis in their own way. Some may want to talk in detail. Others may not want to talk about it at all. Sometimes, the person’s need to talk changes from day-to-day. If they start the conversation, let them take the conversation where they choose. If they haven’t started the conversation ask if they would like to talk about it. This is a respectful way to find out what they need.
Let your friend know it’s okay if he or she doesn’t reply or want to talk.
Please remember that people with cancer don’t always want to think or talk about the disease. This makes them feel like their only identity is “cancer patient.” Laughing and talking about other things are often welcome distractions.
Things to remember when talking to cancer patients
- Don’t judge how they feel or act.
- Don’t make light of their feelings.
- Maintain eye contact to let your friend or loved ones know you are really present and listening carefully.
- Put your own feelings and fears aside.
- If you believe that someone’s health and lifestyle choices contributed to their illness, or that “God’s will” caused them to be ill, dont tell them this, there is no benefit in this.
- Don’t express overly pessimistic opinions. They almost definitely won’t appreciate it.
- Don’t be afraid to say something to your friend. It is better to say, “I don’t know what to say” than to not be there for them at all.
- Be OK with silence. Speaking because you’re nervous can be irritating and silence can help your friend to focus their thoughts. They may have a lot going on in their minds.
- Don’t try to find a positive view. Avoid “It could be worse,” or, “At least it isn’t…” For someone with this disease, you are probably describing their worst-case scenario (which they dont want to be reminded of).
- Avoid saying things that minimize what someone is going through such as “Everything will be fine“, “Cheer up” or “Don’t worry,”
Be yourself and try not to worry about whether you are doing things right. Let words and actions come from your heart, and remember that this is the same person.
Remember: you don’t need to know what to say and there are no right words
It’s sometimes not easy to know what to say to people with cancer. But it is important you don’t avoid them or the subject. This can make things very difficult for you in the long run.
You could say things like the following to get the conversation going:
- This must be very hard for you to go through.
- I am here if you want to chat.
- I want to help in any way I can.
- Are you having visitors?
- Is there anyone you would like me to contact for you?
- What advice can I give our friends about visiting you?
Try to hear and understand how they are feeling.
- Don’t make light, judge, or try to change the way they feel or act.
- Maintain eye contact. This gives your friend the sense that you are really present and listening carefully.
- Do not say, “I know how you feel.” it could make the person with cancer upset because you really don’t know how they feel.
Put your own feelings and fears aside.
- Don’t be afraid to talk with your friend. It is better to say, “I don’t know what to say” than to stop calling or visiting because it makes you feel bad.
- If you’re feeling tearful, let them know, but be brief. You may have to stay away until you can be there for your friend, without your friend having to comfort you.
Be OK with silence
- Try to be OK with silence. It may help your friend to focus their thoughts. Someone talking because they are nervous can be irritating.
- Sometimes silence is better than noise and can be comforting. It can help people think and they may have a lot going on in their minds.
- If there is silence its Ok to wait until something is said, if you have nothing to say.
Using humor can be an important way of coping
Humour can provide hope, support and encouragement. It can help relieve stress and let the person take a break from the more serious nature of the situation. But you don’t want to joke unless you know the person with cancer can handle it and appreciate the humor. You might want to steer away from jokes or stories about cancer unless you know the person well enough to gauge their response. Let the person with cancer take the lead; it’s healthy if they find something funny about a side effect, like hair loss or increased appetite, and you could certainly join them in a good laugh, but it’s best to let them initiate this.
Suggestions of helpful and unhelpful phrases
Positive language to help show your care and support
Here are some supportive phrases you might want to use:
- If/when you feel like talking, I’m here to listen.
- What are you thinking of doing, and how can I help?
- I care about you.
- I’m thinking of you.
- I hope it will be okay.
- I’m sorry this has happened to you.
Phrases that are unhelpful
Sometimes you might say something that you don’t even realize is offensive or insensitive. Here are some examples of what not to say:
- I know how you feel.
- I know what you should do.
- You will be ok
- You are brave/strong
- Keep fighting
- Don’t worry.
- How long do you have?
- Everything happens for a reason.
- What doesn’t kill you makes you stronger.
- This is God’s plan.
Comments like these minimize and dismiss your friend’s pain. Even though you may find they don’t respond when you say these unhelpful phrases (or change the subject or give a polite response), it’s best not to use them, as you don’t know what they are thinking/feeling inside.
It is also a good idea to stay away from comments about how their personal appearance has changed, especially if it’s negative. Any comments about weight, hair loss or surgery are most likely to be unhelpful unless they are sympathetic.
So for example ‘bald is beautiful is a bad comment because you don’t know how they are feeling about their hair. Saying ‘at least you get to have a free boob job!’ to someone having a mastectomy is insensitive and ignores the fact that the operation is not their choice and that their health is at risk. Another commonly used comment which is often used when someone has this disease is that the person does not look ill, or that they look great. Although meant well this might lead your friend to feel that you are not acknowledging their health issues, fear, and/or anxiety caused by your friend’s illness. Their world may be collapsing, it is irrelevant how they look.
How do you cheer up friends with cancer?
Although we do get asked this question, it’s not something we can answer easily. Cheering someone up when they are going through a terrible life experience is not always appropriate.
While it’s good to be encouraging to a cancer patient, it’s also important not to show false optimism or tell your friend with cancer to be brave or positive. Doing this can make them feel like you are not acknowledging very real fears, concerns, or feelings. It can also make them feel guilty for the very normal feelings that they are experiencing.
It might be more helpful to
- listen to their concerns
- let them know that you hear what they are saying
- tell them that you are a friend who will support them in their worst times as well as the good times
Tips on what to say when you want to offer to help
If you want to offer practical help to a friend, family members or loved ones with cancer, the words you use here are important too,
Many people say things like:
“I am here if you need someone”
“let me know if you need anything”
“I am here to support you”
Whilst these might be meant as sincere offers of help it would be easier for your friend to take you up on an offer of support if you were to make concrete suggestions of help. These simple phrases can go a long way in helping support a colleague, friend or your loved ones with cancer.
Positive ways to ask if you can help
Let me help you with…
This is one of the most helpful things you can say to patients. Instead of asking someone for advice on how you can help them, tell them specifically what you’re able to help with. Other things you might say that are more direct ways you can offer help are:
What day works for a visit?
What food can I make for you?
Can I take you to your appointment next week?
Let me know what shopping I can do for you
Examples can are things like
- driving them to their cancer treatment
- helping look after their friends and family
- offering to help with specific household chores
- visiting them in hospital (check that they want to see people first)
- thinking about what might make their life feel abit more normal and try to implement that, if they are up for it. Maybe a night in with friends or family watching TV, or a walk somewhere nice?
Practical ways to help people with cancer are discussed further here
What to say when you can’t visit your friend in person
When you cant get to visit a friend or family member who has been diagnosed with cancer, it doesn’t mean you can’t support them and stay connected. In fact, there are many ways you could still be helpful and show your support that would be appreciated when a visit is impossible.
Many people communicate with friends in many different ways and people with cancer are no different. If you do not see your friend regularly, a phone call, text message, or video call will show that you care. But you need to make sure your friend knows it is okay if they don’t reply to you.
An important thing to say here is to make sure you do make contact, whether by call, text or letter. You would be surprised how many people actually lose touch with their friends and family when they get their cancer diagnosis. This can affect friendships for many years.
A simple phone call, just to say that you heard about what is going on and feel sorry that you can’t be there to support them, can help someone with cancer feel less isolated. You could make regular phone calls or texts to check in on your friend and make sure they are ok, depending on what sort of relationship you have. If you make a specific time for a check-in call, let your friend know when you will be calling. Also, let your friend know that it is okay not to answer the phone.
You don’t have to talk about their cancer diagnosis or treatment and would need to gauge how much they wanted to say about what is going on. Just the simple act of getting in touch can make a huge difference to the life they are currently living.
What do you write in a card to a person with cancer?
The same rules above apply when writing to someone who has been diagnosed with cancer. You need to remember that this person with cancer is still the same friend, family member or loved one, They are just going through a very challenging time in their life, their world is changing and they may feel lonely and scared. A letter would not just be the place to comment on the fact that you are sorry to hear about what they are going through and to offer support through whatever means you can. It can also be an opportunity to take their thoughts away from their diagnosis. Perhaps you could relay some stories about what you have been up to, or suggest that you might visit your friend in the future.
There are also cancer empathy cards that have appropriate wordings on them which you can send to your friend to show support and free digital cancer support cards designed to be received immediately or in a scheduled manner, perhaps to coincide with the start or end of a treatment.
When cancer treatment is over
You still need to be sensitive in your language after treatment is over and your friend with cancer has got the ‘all clear’ from their doctor. After cancer treatment, your friend will now be trying to find their “new normal” and to navigate the next phase of life.
- The fear of cancer returning is possibly at the forefront of their thinking.
- Their bodies may have changed considerably.
- Drugs may still be in their systems for a few months to come.
Friends and family are an important part of this stage in their new life and encouragement and hope are needed at this stage of the journey.
Respect your friend’s privacy
A person with cancer is not obliged to tell everyone about their diagnosis.
Talking to other people about your friends’ cancer
If someone tells you that they have cancer their news is private, you should not tell anyone else unless they have given you permission. Let the person who has been diagnosed tell others. In some cases, patients might find it hard to tell their colleagues, friends, and family. They may ask you to spread the news or to tell certain people in which case it is OK, but you need to make sure that you can talk about them before you do.
If someone else asks you about it, you can say something like, “It’s for me to share this, but I’m sure they will appreciate your concern. I’ll let them know you asked about them.”
If someone else tells you about a person’s cancer you should ask the person who told you if it’s public information. If it’s not, you probably shouldn’t say anything to the person with cancer until you know they are ready.
Be yourself and try not to worry about whether you are doing things right. Let words and actions come from your heart, and remember that someone with cancer is the same person that was your friend / colleague / family member / loved one before the cancer diagnosis.
Dr Cohen started her working life as a research scientist and lecturer with over 100 peer-reviewed scientific publications.
She followed a classical scientific career until she left mainstream science in 2000 (which coincided with the birth of her first daughter) to establish the Life Science Communications company, Euroscicon Ltd.
Euroscicon Ltd was her first company (which she sold in 2016).
In 2013 Dr Cohen was diagnosed with Cancer and set up Cancer Care Parcel which provides appropriate gifts for people with cancer.
Dr Cohen is the lead scientific advisor at Optimised Healthcare. A medical profiling company which provides advanced disease prediction, prevention and wellness optimization services.
She also works with and establishes businesses and charities which benefit local, national and international communities.