What to Say to Someone With Cancer

Memoirs, books, and blogs by cancer patients and survivors abound, often including horror stories of insensitive comments that were meant well, but came out the wrong way: “Other people have it worse!” “All you have to do is cut out sugar!” “I looooooove that wig on you!” 

From the fertile ground of awkward comments has sprung many online guides for what not to say.  Unfortunately, many are well-intentioned but awkward – or worse, sarcastic and downright mean.

To put this right, let’s condense all the well-meant but inept comments into one pretend person: we’ll call her Bumbling Buddy.  She’s fundamentally kind, but often misses the mark.  We’ll take a sympathetic look at what’s behind our Bumbling Buddy’s awkward phrasing and gently steer her into non-mortifying territory:

Bumbling statement #1: “Everything will be fine!  You can beat this thing!”

Bumbling Buddy wants to think positively.  She wants to be hopeful and inspiring, which is understandable.  But she paints too rosy a picture.  Her friend with cancer might not be fine and knows it.  A statement like this is meant to be reassuring but minimizes the gravity of the situation.  It also might make the friend less likely disclose bad news to Buddy for fear she’ll gloss over the very real, and likely very awful, experience.  Instead, try this:  “I’m here for you as you fight this.”

Bumbling statement #2: “Just think positively.  Visualize yourself getting better and you will.”

Getting better is not entirely under the cancer patient’s control.  If it were a matter of mindset, no one would ever die of cancer. 

The intention behind this is good; Bumbling Buddy wants to do something, not just stand idly by.  She wants to offer helpful, hopeful advice.  However, getting better is not entirely under the cancer patient’s control.  If it were a matter of mindset, no one would ever die of cancer.  It also places the responsibility on the patient, as if they can control the cancer simply by being positive or having the right fighting spirit. 

If the cancer spreads or their health worsens, they might feel like they failed or didn’t think positively enough.  If Buddy wants to offer support, she could try listening instead.  Listening is an action.  It may not feel like you’re doing anything, but it’s a rare and valuable skill.  Your loved one is probably inundated by anxious chatter; a listening ear is better than any lame advice.

Bumbling statement #3: “Let me know if I can do anything to help.”

I’ve been Buddy here.  I’ve made this mistake; I’ve murmured this statement, often because I want to be helpful, but also because I’m worried about being intrusive or offering something my friend doesn’t need.  I’ve since realized that the statement’s very openness makes it vague, and it places the burden on the patient to be a taskmaster. 

The urge to pitch in is laudable, though, and shouldn’t be squelched. In addition to offering to help, try following it up with some specifics.  “I’d love to do something to help out.  Since summer’s coming up, may I be in charge of mowing your lawn while you’re in treatment?”  or “May I come over sometime soon?  I’ll bring the whole last season of Family Guy and your favorite cannoli.”  Even something small counts, like “May I water the plant in your cubicle while you’re on leave?”

Bumbling statement #4: “You don’t look sick.” Or “You look so much better!  Last time I saw you, you looked awful!”

Some individuals are reassured to hear they look “normal” and don’t have the big C stamped on their forehead.  Most are sensitive about what surgery, chemo, radiation, or cancer itself has done to their appearance.  Bumbling Buddy means to compliment her friend, but instead the statements are, respectively, invalidating and insulting.  Either way, the friend probably feels like she’s in a fishbowl under scrutiny.  Steer clear of evaluation of appearance.  Instead, try: “It’s so nice to see you!”

Bumbling statement #5:  “Lung cancer?  Isn’t that one of the really bad ones?  Yeah, my aunt died of that.  And my husband’s mother had it and she had this really awful doctor—let me tell you…”   

Bumbling Buddy is looking for a way to connect.  Under most circumstances, telling horror stories is a great way to connect.  Mutual outrage about ridiculous situations is usually a great way to build common ground: “My niece stood in line for 7 hours at American Girl, too!”  “My car got towed from that Target parking lot, too!” 

But in the case of cancer, telling horror stories takes away hope and instills fear.  Plus, it makes it about you, not about them.  Instead, try: “Lung cancer? I’m thinking of you and your family. I’m sending you good vibes for your surgery and chemotherapy.”

Bumbling statement #6: “I know exactly how you feel.”

This statement tries to be empathetic—always a good goal.  Bumbling Buddy’s friend with cancer probably feels awful, and Buddy’s trying to show she’s on her friend’s side—again, good.  But this statement presumes too much, plus it sets up an expert-novice dynamic, something to be reserved for the patient and her doctor.  Instead, try: “If you’d like to talk about it, I’d love to hear how you are feeling.”

Bumbling statement #7: (nothing)

This is a tempting one.  Cancer can be unspeakable.  Bumbling Buddy might rationalize that her friend would be upset if she brought it up, or that her friend is probably overwhelmed right now and wouldn’t want to talk.  However, I’ve heard many patients say that cancer was the litmus test for who their friends are—sometimes acquaintances beat the door down to help while old friends drift away.  I’ll admit to making this mistake myself.  I learned the hard way that couples don’t count as a unit.  Even if your partner says something, you should, too, even if you just blurt out “I’m so sorry.”

All in all, don’t try to memorize the “right” thing to say.  Indeed, if this list makes you anxious about saying the wrong thing, throw it out and go see your loved one.  If you are present and genuine, you can’t go wrong.   If you bawl like a baby, spend most of the visit examining your shoes, or fear a crushing awkward silence, it’s okay.  If there is any time when it’s okay to be sad, uncertain, and awkward, this is it.  So simply try.  Do your best.  Your loved one doesn’t need a witty, well-crafted turn of phrase; he or she just needs you.  So pick up the kids, make a casserole, drive her to chemo, or simply watch all the old Arrested Development episodes with her. Be you, all the same.