You hear from a friend that someone you both know and love has just been diagnosed with cancer. Or maybe you've gotten news about a beloved relative through the family grapevine. Along with the shock and fear you no doubt feel, you may well be wondering: What should I say to them? What words could possibly help?
A good place to start is to put yourself in their shoes. “Picture yourself in that situation, and think about the feelings you’d have if you’d just been diagnosed," says Thea Gallagher, Psy.D., clinical assistant professor in the Department of Psychiatry at NYU Langone Health, and a mental health and anxiety specialist who has been working with patients with physical health conditions for 14 years. "You might feel in shock, or overwhelmed, or scared. You might immediately take on a fighting attitude, or feel frustrated or angry, like life’s not fair. Or all of those things! You might be scared for the people around you, your loved ones. People who are diagnosed with cancer feel a barrage of emotions, most of them difficult ones.”
What to say to someone who has been diagnosed with cancer:
An important thing to ask yourself before you reach out to someone: Do you need a moment to process it first? If the topic is especially triggering or uncomfortable for you, there’s a chance you might say something that would make the person feel worse, by transferring your discomfort over to them. Give yourself a little time to process your emotions if needed. But remember — saying something, even awkwardly, can be so much better than saying nothing at all.
Here, from Dr. Gallagher and other cancer experts, are things to remember when talking to someone who has cancer.
Listen — and acknowledge it if you don’t know quite what to say.
“This is such a powerful thing,” says Dr. Gallagher. “Don’t feel like you have to fill the air. Less is more. Sometimes when a moment feels awkward, we’ll reach for a platitude, like “it’ll all be okay”—but resist the urge, even though you may think you’re being helpful.” It can be powerful to simply say, “I’m so sorry to hear the news—I don’t know really what to say in this moment, but I’m here to listen.” Dr. Gallagher adds, “It’s also important not to avoid the person, or to avoid or change the topic if they bring it up. Follow their lead. Don’t dictate the pace of the conversation. Let them do it.”
Don’t invalidate their feelings.
Remember: Whatever the person is going through is normal, whether that’s grief, anger, depression, fear, being remote and withdrawn or denial. They have the right to any and all emotions they’re feeling, and it’s not your job (or anyone’s job) to change that.
If you tell them to “stay positive” or that “it’ll all turn out okay,” this may sound upbeat to you, but phrases like this can discount and invalidate how the person may actually be feeling. “You might think that saying something like this is giving them hope in that moment — but you could actually be putting pressure on them to react a certain way, like they’re not allowed to feel the way they’re feeling,” says Dr. Gallagher. “Don’t assume you know how they feel. Meet them where they’re at.”
It’s possible that they’ll face their treatment in an upbeat, “I’ll win this battle” mode. The American Cancer Society points out that this doesn’t mean they’re in denial—particularly if they’re getting the medical help they need. They may simply have decided to take a positive outlook, and you can certainly follow their lead.
Be careful to avoid being judgmental.
As Cancer.net notes, getting cancer is never someone’s fault. In fact, the organization points out, research has proven that most cancer is caused by random mutations, or changes, in our genes. So it's key to avoid stigmatizing the person, says the American Cancer Society, which basically means blaming them for bringing the illness on themselves. (Like, “If only you had quit smoking years earlier than you did.” Or “I wonder if the weight you gained when you had your kids had something to do with this….” Or “Were you getting regular mammograms?”). Stigmatizing someone can have an incredibly negative impact on their psyche and how they approach their illness — so if you have those thoughts or feelings, keep ‘em to yourself. "Suspend your questions, especially in the beginning," says Dr. Gallagher.
If the person says something like “If only I’d quit smoking 10 years earlier” or “If only I’d gotten breast screening years ago,” then, Dr. Gallagher says, “Slow down, and think before you speak. They might be looking for answers to an unknown situation, or trying to make sense of it or assign blame. In this situation, it’s good to do reflective listening. ‘This sounds so scary — what can I do to help in this moment?’ A lot of time, cancer is a senseless situation.”
Remember: It's not about you.
Even if you’ve had cancer, don’t say that you know just how they feel. Not everyone who has cancer reacts the same way, of course. Similarly, it’s best to avoid telling them details about a friend or family who had the same type of cancer, because their experiences may be different (and it’s making it more about you, rather than them). “This invalidates the person's unique experience," says Dr. Gallagher. "Be curious about their experience. They just got hit by a Mack truck of news — it’s overwhelming. Try not to bring your own experiences into it, especially in the beginning.”
Offer specific support.
A vague offer like “Let me know if I can do something” or “Tell me what I can do to help” can sometimes put burden on the person’s already overwhelmed brain to come up with a task for you to do — even though your offer clearly comes from a place of wanting to help. Instead, or in addition, try offering something specific. Some ideas:
- “I’m taking my kids to the library—can I pick yours up on the way and take them too?”
- “Is there a certain kind of food I can bring you?”
- “I drive by the pharmacy every day — I’m happy to pick up any prescriptions or other things you need, anytime.”
- “I’m on my way to the supermarket — can I stop by first and grab your shopping list?”
- “I’m happy to drive you to your next doctor appointment. It’ll give us a chance to catch up.”
- “Want me to walk the dog?”
“Don’t pretend you know what they need,” adds Dr. Gallagher. “Try asking a simple question like, ‘Is there anything I can do for you today?’ Ask this on a regular basis. Many people find it hard to request help, so keep asking.”
Let them know they don’t need to respond.
If you send a note, flowers or even a simple text, tell them that they don’t need to get back to you — that you just wanted to let them know that you’re thinking of them. That way, if they’re feeling overwhelmed by expressions of support, it'll be clear to them that you don’t expect them to do anything in return.
Care for yourself as well.
According to the National Cancer Institute, the family and friends of cancer patients go through their own range of emotions — so realize that what you're feeling is normal as well. You may feel a similar variety of emotions—anger, guilt, helplessness, grief, fear and more. It’s important not to burden the other person with what's coming up for you, but make sure to practice self-care and let yourself feel what you’re feeling.
Keep showing up.
Right after someone is diagnosed, there’s a flurry of support and response from friends…and then it may drop off. So stay in touch: Send texts and/or notes, light and brief, to let them know you’re thinking about them. Drop off some flowers just because you saw some at the store, or a book for their kids from the library. And keep offering the sort of specific help mentioned above: The need may be there for quite some time, and your help will be appreciated. “It’s the most powerful thing you can do, because it’s a long haul,” says Dr. Gallagher.
Especially if it’s a close friend, try to treat them the same way you did before they had cancer — in other words, not with kid gloves, but certainly with a big dose of compassion. “There’s not a one-size-fits-all way to respond when someone you know is diagnosed with cancer,” says Dr. Gallagher. “You may mess up along the way and say the wrong thing, but keep showing up. Stay longer than you think you might need to, because it can be a long journey. Stick around. That’s the most important thing.”