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Published on August 13, 2015

Let’s talk about your cancer. Or notLet’s talk about your cancer. Or not

A few days after my cancerous left breast was removed, one of my favorite neighbors stopped by to check on me.

I was tired, mutilated and terrified of the soon-to-come chemotherapy and radiation. I was wearing a smock-style garment supposed to fashionably conceal the tubes coming out of my chest that were slowly draining into two small plastic bulbs in hidden pockets.

I was not wearing makeup.  Or probably shoes.  And I can only imagine my hair. Not exactly a picture of feminine glamor.

“Wow,” my neighbor said as he gave me a tentative hug. “Bilateral?”

Wow, indeed.

It’s hard to know what to say when someone has cancer (or substitute any other dire diagnosis here). As a neighbor or work colleague or even a close friend, we might not be privy to the intimate play-by-play or aware of every defeat and victory.

And to top it off, without even knowing it, the patient has taken on a mantle of entitlement and self-absorption that, while certainly earned, is sometimes formidable. Hence, the Internet eye rolling about stupid things people say to cancer patients.

A friend’s serious diagnosis is terrifying on so many levels. The fear of saying the wrong thing. The irritants of caretaking or extra work. The distress of seeing someone physically altered by illness. The despair of possible loss. The worry over who will comfort us.

And worse there’s that horrible moment of hearing the diagnosis for the first time, of feeling as if there’s something important that has to be said right now.

There’s not. Breathe. Wait three seconds. Gather your thoughts.

That’s the advice of Jeff Gaudet, the social worker who runs Cape Cod Healthcare’s cancer support groups. Gaudet speaks from experience: His wife died of breast cancer when his two children were young.

“Just be able to be honest and say, ‘I’m not sure what I can do to help but I care about you and tell me what I can do,’” he says.

And take heart.  I’ve been on both sides of this coin: the entitled and fearful patient and the bumbling, blurting friend. Acting out of love or concern for someone is rarely wrong. But based on advice from Gaudet and my fellow patients and caretakers, it’s good to keep these five things in mind:

  1. Ask, don’t tell. Asking is tricky. For some people it’s cathartic to talk about traumatic illness in every detail; for others, talking is traumatic in itself. And to make it even harder to negotiate, that can change day to day.

Start by asking a universal question: “I’m glad to see you; how’s your day going?” That leaves an opening but doesn’t create pressure to talk about the details of chemotherapy (which you really don’t want to hear).

Please, please resist the temptation to be what Gaudet calls a “rock turner” – meaning that you will leave no stone unturned to find or suggest a cure for your pal, even if your mania comes from love.

That means no advice on treatment unless you are asked. No unsolicited tales of how peach pits cured your sister or how bananas helped your nausea, or, worse, how this exact same kind of cancer killed your grandmother. (And, yes, people do say that.)

Unless asked, absolutely no details of your own experience with what might be painful treatments.

And beware commenting on anyone’s appearance. “Lovely new frock” is probably safe. “You’re rockin’ the bald look” might not be.

  1. Listen, listen, listen. Every mother has a childbirth story and every cancer patient has a diagnosis tale. Even if you’ve heard it six times, be willing to listen a seventh. Think of it as post-traumatic stress disorder.

I was so grateful for people who just listened without judgment or advice, who never mocked or discounted my fears. They just heard me out and offered to hold my hand.

And a warning: The need for a listener might continue long after treatment is over or resurface right before a doctor’s appointment or anniversary. Try to be there for the long haul.

  1. Never add to the load, lighten it. Blame is for knuckleheads. It’s easy to be angry if a friend is a chain-smoking, overweight, heavy drinker whose behavior may have contributed to whatever is going on. But I’m pretty sure a medical professional has already pointed that out – so take that off the to-do list.

Maybe when things are better there’s a way to encourage a change in lifestyle or plan a walk.

One friend was told that her cancer was the result of leaving her husband, but I’m pretty sure divorce is not on the FDA’s carcinogens list.

And one of my personal pet peeves: “God never gives you anything you can’t handle.” That’s just not true. People get overwhelmed all the time.  How about instead, “Give me something you can’t handle.”

Which brings us to lightening the load. There are all kinds of things to do for an ailing friend and not everything has to be a grand gesture. A card, a call, a trip to the grocery, a hug. All good.

  1. Pray. I stopped by the post office one day, a cap covering my very bald head and the woman behind the counter, whom I barely knew, asked what was wrong.

“Breast cancer,” I said.

“I’m sorry,” she said. “I just wanted you to know I’m praying for you every day.”

I’m not sure I believe in the literal power of prayer, but I believe in the power of people saying a prayer for you – keeping you in mind, being empathetic, holding out hope – and expressing it.  If prayer makes you queasy, telling someone “I’m holding you in my heart” works fine.

I used to imagine those Verizon ads with the huge network of people behind that one lonely guy. There’s power in that image.

  1. Be brave. Here’s what a traumatic diagnosis feels like: Imagine you are standing in the subway station about to catch the train and instead of the familiar MBTA, a Japanese bullet train roars into the station.

Within seconds, you crowd into a car in which no one speaks your language, headed to an unknown destination. Yet you must negotiate how to get off at the right station. And, oh yeah, if you don’t, you die.

Someone with cancer is on that train, barely holding on to their own sanity and courage. Do not share other people’s worries, or your own concerns or fears.  Make it about the patient. And be brave enough to simply offer the comfort of presence, perhaps in silence.  My sister-in-law shared this quote from Henri Nouwen, a 20th century Catholic theologian. It’s my new mantra:

“The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing… not healing, not curing … that is a friend who cares.”

10 good things you can do

We asked some veterans of traumatic illness – both patients and caretakers – for some good things people had done for them. A few ideas:

  1. Create an “angels list” of people to call for a grocery run, yard work, dog walk or oil change.
  2. Offer to organize and track all those offers in No. 1. Online tools like MealTrain and Google calendar make it easy.
  3. Cook, but ask first. Chemotherapy and drugs play havoc with appetite and cravings.
  4. Think normal but shorter: a walk, a cup of coffee, a movie, ice cream. One friend was grateful for a boat ride.
  5. Help with thank-you notes or Christmas cards.
  6. A yard/closet/kitchen clean up.
  7. Make a CD of music.
  8. Phone, email, text. Just keep in touch.
  9. Ask friends to contribute to a box of notes, hats, scarves.
  10. And a note to medical professionals: Patients and their families are often grateful for any sign of humanity – a hand to hold, a hug, an extra moment to listen. I was alone when I first got my diagnosis and the radiologist just sat and hugged and listened to me sob. I loved her for it.

Contact the American Cancer Society for additional resources in your area.