By Greta Greer, MSW, LCSW

Nearly 12 million people living in the United States today were diagnosed with cancer at some point in their lives; some are undergoing active treatment and others are living cancer free. Most of us know at least one person with cancer, but how confident are you in your ability to communicate well with someone who has recently been diagnosed or is in treatment for cancer?

Feeling insecure about how to communicate well with a family member, friend, neighbor, or co-worker who is facing cancer is quite common. If I only had a nickel for every time I've heard "I don't know what to say!"  And it's especially confusing if you heard about the diagnosis "through the grapevine."

Communication is challenging even in the best of circumstances. So when cancer enters the picture, lots of deep emotions and concerns take it to a new level. It raises the stakes in terms of how it can affect your relationship. Saying or doing the "wrong" thing takes on added significance to your partner, family member, or friend when they have cancer. What you don't say or do is equally important.

Read on for some suggestions for talking to a friend or loved one who has cancer. In a future post, I'll get into some of the specific communication challenges you may face if you're that person's caregiver.

A few "do's"

First of all, if the person with cancer hasn't told you about it personally, find out if the information is confidential. If you aren't supposed to know about it, it's probably best not to say anything to the person. And you shouldn't tell anyone else about the cancer to respect their privacy.

But if the person isn't keeping their cancer under wraps, DO let them know you've learned about their diagnosis and have been thinking of them. If you sincerely wish to help, let them know that, too. Offer suggestions for specific things you are able to do such as prepare a meal, take them to appointments, pick up the kids, babysit, mow the lawn, etc. Also give some dates you are free to assist. Sending cards, flowers, or small gifts are also ways to show support.

When talking to someone who's just been diagnosed with cancer, it's best to keep communication simple. Just let the person know you care about them and how important he or she is in your life.

• Offer your support.
• Be a good listener.
• Watch for cues that can let you know they want to talk about their cancer. If they don't want to talk, respect it. (But continue to watch for and follow cues.)
• Do the same things together you used to before the cancer diagnosis if you can. Most people want to be treated the same as always, but check with them about how they feel and don't press to do anything they don't feel up to doing.
• Try to be OK with silence. Sometimes the person just needs a little time to focus her thoughts. Constantly talking because you are nervous can be irritating. A period of silence can allow someone the chance to express more thoughts and feelings.
• Touching, smiling, and warm looks are important ways to communicate also. Remember to use them.
• Try to maintain eye contact to demonstrate you are fully present and listening carefully.

And some "don'ts"

Cancer survivors I've worked with over the years say "You really find out who your friends are when you get cancer." Most common offenses? 

• Not calling.
• Not expressing concern and offering support.
• Not staying in touch (aka not "staying the course").
• Failing to make attempts to maintain the relationship as it was before cancer.
• Dismissing fears and concerns. ("Don't talk like that! You're going to be just fine. Now pick yourself up and go have lunch.")

Many people undergoing cancer treatment don't appreciate being told they don't look sick. They also don't care to hear about your Aunt Jane who died from cancer and Uncle John who survived with disabling side effects. On the other hand, platitudes or statements that might seem dismissive about the seriousness of the cancer can be equally insensitive.

Some other "don'ts":

• Don't try to control the conversation. Let the person with cancer take the lead. If he wants to talk, be a good listener. Listen to what is said and pay attention to how it is said. Sometimes what is not said is also important.
• Try to avoid giving advice. She probably just wants you to ask questions or listen.
• Don't say, "I know how you feel." It can anger a person because you have not been in her shoes, and you really don't know how she feels.
• People with cancer don't always want to think or talk about their disease. It can make them feel like their only identity is as "cancer patient." Laughing and talking about other things are often welcome distractions.
• Don't be overprotective. Encourage normal activities whenever possible.
• If your loved one asks your opinion about his illness, treatment or treatment outlook, be open and honest but don't try to answer questions you don't know the answer to. Your honesty will be sensed and appreciated.

Your best bet is to be yourself and try not to worry about whether you are doing everything perfectly. Let your words and your actions come from your heart. If you want more information about how to talk to someone who has cancer, call the American Cancer Society at 1-800-227-2345 or check out cancer.org.

And check back or subscribe to the RSS feed for my next blog to get some communication tips specifically for caregivers.


Greer is director of survivor programs for the American Cancer Society.