What to say and do when someone has cancer

It can be very difficult to know what to say and what to do when someone you know is diagnosed with cancer, yet the type and quality of support that is offered can make an enormous difference in the person’s life as they navigate their treatment and, hopefully, their recovery.

Cancer can make for difficult conversations, and sometimes these are challenging to gauge. Some people find talking about their diagnosis and treatment uncomfortable, others welcome a chance to discuss it. At times, family, friends and colleagues of someone with cancer may also experience difficulty in speaking about it or knowing what to say. They may struggle to accept the news, feel distressed, and then find themselves saying things which are not comforting or supportive.

It can be very difficult to understand how someone diagnosed with cancer really feels, what they think and what support they really need.

What is known is that social support offered by others can improve patients’ psychological adjustment and some researchers suggest it can even enhance their survival.

Having spent time interviewing breast cancer survivors for a research project, it is very clear that having a network of supportive people around is vital. The project, a collaboration between researchers at the University of Derby and Imperial College London, recruited women via a Breast Cancer Care UK web forum.

We interviewed a sample of younger women who had opted not to have breast reconstruction following a mastectomy to find out how their treatment choices had affected their relationships with partners, friends and family members – something which has never been explored in a study before.

The women explained that, although the level of support they encountered was mostly positive, sometimes it was well-meaning but negatively received and, on occasions, it was emotionally distressing to them. The study’s findings offer ways that we can better support people living with cancer.

The different types of support people can offer

1. Emotional support (empathy, validation and assurance)

Women who were given messages such as “I’ll love you whatever”, regardless of whether they elected to seek reconstructive surgery or not, and who heard that their decisions would be fully supported by their partners and friends, told us they felt the most supported.

In some cases, however, friends and acquaintances made unhelpful comments about how they might make different decisions if it were them facing a mastectomy. Other comments such as “oh, you’re back to normal” when returning to work after cancer treatment were considered to diminish the enormity of the psychological and physical ordeal the patient had been through.

What can I do?

Offering cancer-patients a listening ear, a shoulder to cry on and supporting them in making decisions that are right for them are roles that close friends and family can play. Seeing people as being more than their appearance can also be helpful. Hair loss and in, some cases, loss of breast(s), can alter how people look and feel about themselves. Focusing on who they are rather than what they look like can really help.

Don’t

• Make assumptions about choices people living with cancer will make. Their life has turned upside down and they are adjusting to a new reality. Allow them to talk things through with you if they (and you) are ready
• Don’t talk about what you would do if you were in their shoes. You’re not
• Get so emotional that the person with cancer ends up having to support you!
   

2. Informational support (giving advice and information)

This is the role of health care practitioners and patients are often overwhelmed with information and may have to make decisions about their treatment based on this, sometimes within a short time-scale.

What can I do?

Offer to go with them to a medical appointment to take notes for them so this can help them to remember all the information that was discussed.

Try to support them as they make sense of the information in their own way.

Don’t

• Don’t google the cancer they have and offer them information unless they ask you to. Some people don’t want to know their odds, the statistics and the recurrence rate.
• If in doubt, don’t give informational advice, try supporting them in other ways.
   

3. Instrumental support (functional assistance with daily tasks)

Friends and acquaintances often come into their own by supporting in everyday tasks such as helping cancer patients with child care. The women in our study appreciated that having their children have more of a sense of normality during times of treatment helped them feel supported and more able to look after their own needs.

What can I do?

Offer to help with everyday tasks such as child care, going shopping, taking them to the hospital, cleaning their house, walking the dog or making a meal for their family. As they may have medical appointments, be fatigued by treatment, or recovering from surgery, or not interested in food due to chemotherapy, all these can help people living with cancer.

Don’t

• Assume people want or need this. Always ask if they would appreciate this type of support.

The study, ‘Do you mean I’m not whole?’ – Exploring the role of support in women’s experiences of mastectomy without reconstruction, was conducted by Dr Fiona Holland and Dr Jane Montague (University of Derby Psychology Department) and Dr Stephanie Archer (Imperial College London – a former Derby PhD student).