October 11, 2005

What to Say to Someone With Cancer


Have you ever been at a loss for words when a friend, colleague or a loved one has been given a diagnosis of cancer? LINDSAY JENNINGS finds out about cancer etiquette

A COLLEAGUE at work has recently discovered she has breast cancer. Do you dodge behind the photocopier every time you see her walking your way, desperately avoiding a conversation over her recent diagnosis? Or, do you rush up to her, gushing with sympathy before plucking out insensitive references to every person you have ever known who has had cancer and survived?

How to react when someone you know or love has cancer can be a bewildering experience for everyone involved. Insensitive comments, awkward pauses and ridiculous gaffes can come pouring out as soon as the 'C' word is mentioned.

But just how do you get across your concern without sounding patronising, and what's the best way to offer your support?

Rosanne Kalick, of New York, reveals one gaffe-prone friend tried to make light of her double mastectomy by announcing: "Well, at least you'll be symmetrical."

For Kalick, who had already endured multiple myeloma, a blood cancer several years prior to developing breast cancer, the comment and other anecdotes from friends spurred her on to write the book Cancer Etiquette: What to Say, What to Do When Someone You Love Has Cancer.

As part of her research, she collated stories from other survivors and practical strategies for friends, colleagues and loved ones to adopt.

Often, she says, the shock, memories of family members who had cancer and the individual's fear of getting cancer cause people to speak before they've thought of the consequences of their words.

Examples include one young woman diagnosed with breast cancer who received a sympathy card from her mother and a casual acquaintance who asked someone who had a colostomy whether the bags were paper or plastic. In another example, one woman turned to another at lunch and told her not to touch the glass of another guest because ". . . she has cancer."

Much of cancer etiquette, she says, revolves around the level of intimacy between the person diagnosed with cancer and the person trying to comfort him or her. A co-worker, for example, may not appreciate a joke about the extended holiday they'll get during chemotherapy. But a spouse might.

"If you did not speak about an individual's sex life, breast size, or baldness before the diagnosis what makes you think it is appropriate to ask those questions now?" writes Kalick. "Just because your uncle has had prostate surgery doesn't give you permission to ask about impotence now."

It is not uncommon for people to try and reassure their friends by saying that they will be fine, but this could be seen as ignoring cancer reality. Kalick suggests saying "I hope everything will be all right, " or "You're in good hands, you're getting the best treatment".

If you're going to ask someone with cancer "How are you?" be prepared for the answer. It may be better to say "how are you today?" so a person can speak honestly of how they feel at the moment.

Nor should subjects stay entirely on cancer. If you valued your friend's advice about business, you can still ask for it.

"The fact that she's having treatment doesn't mean she is any less intelligent than she was before, " says Kalick. "There may be times when the drugs will give her a sense of 'chemobrain'. Obviously, if she seems disoriented or excessively fatigued, postpone the question.

When in doubt about what to say, don't say it. Think before you speak."

A common phrase is to say: "If you need me, I'm here". But Kalick says to be specific. Should you bring round dinner on Tuesday or Thursday? Do they want their library books taking back or can you take the kids to the park on Friday? Patients undergoing treatment may feel their life is out of control. So asking questions and giving people a choice can allow them to feel as if they are taking control.

Gifts can also keep a connection going with the person and say you are thinking about them. For example, moisturisers are good for skins which are drier as a result of chemotherapy.

But ultimately, making the occasional gaffe is going to happen, says Kalick. Cancer is a complex, frightening disease and in the long run it's not the gaffes that matter, but the connections between people.

"There are no magic words, " she writes. "The magic is that friends and family are generally there for us."

Cancer Etiquette: What to Say, What to Do When Someone You Know or Love Has Cancer by Roseanne Kalick.

(Lion Books, 10.03 from www. am azon. co. uk)