What to Say. What Not to Say.


It’s a cancer cliche.

Some people just don’t know what to say.

You’ll hear it used to explain the silence or absence of people that avoid you once they’ve found out you have cancer. I’ve written before about cultivating a attitude of tolerance and forgiveness towards these people.  There are lots of reasons why some people can’t cope or choose to distance themselves.

For those that really don’t know what to say, or worry about saying the wrong thing, here’s my quick guide.

First prize for saying the right thing goes to my friend, Don McKenzie:

“What is it with tits. Here I’ve been admiring them all these years and now they keep trying to kill people I care about!”

I love this response. He made me laugh and told me he cared about me.

My husband’s response really requires a similar sense of humour:

“Oh that’d be right. I get the flu and you get cancer. You’re so competitive!”

Now, to me, this made me laugh so hard I almost hurt myself, but some people would find this type of comment to be in extremely poor taste.

There’s a proximity rule when it comes to humour. The closer you are to someone the more likely you are to know what they find funny. If someone other than a very close friend or relative tells you they have cancer then going for laughs can backfire. Go with one of the simple, all purpose responses:

“I’m so sorry to hear that.”

“Oh shit! That’s terrible news.”

The next most common response is an offer of help. “Please let me know if there’s anything I can do…” The trick here is to make sure that you are actually in a position to help if you’re asked. Don’t just say it. It’s awkward and frustrating if people offer to help and then disappear, or provide excuses for being unavailable. Better than extending a general offer of assistance is to commit to something specific:

“I’m going to cook you up some meals to keep in the freezer for when things get tough. What do you like to eat?”

“I know you’re not going to have much time for the garden. I’m going to call around once a week/fortnight/month to do some basic maintenance for you. Let me know what day of the week is best for you.”

“I’m a trained massage therapist and I’m going to call in once a week to give you a foot massage.”

“How do you feel about someone else doing your laundry? Would it be okay if I come over once a week and wash/sort/iron for you?”

“Give me a call anytime you’re feeling sad or just need to talk. I promise to listen.”

When I was first diagnosed my head was a maelstrom. Questions like “How can I help?” were met with blank stares and desire to blurt out, “Can you cure cancer?” People that found something specific to do were our greatest gift. Even small things like bringing in the mail on the way to visit, washing up cups and saucers after morning tea, emptying the dishwasher or pulling a couple of weeds all made a difference. Small things accumulate and the gesture is as valuable as the practical support.

When it comes to what not to say there’s been some absolute clangers.

First prize goes to Don Chandler, a long time family acquaintance that I ran into while I was out shopping. It was just after my hair had fallen out.

“I thought cancer made you thin.”

For the record, Don, it’s common for people to gain weight during chemotherapy. It’s also bad manners at any time to comment on someone’s weight and even more so when they’re fighting a potentially terminal illness.

As a general rule, comments about personal appearance should be limited to saying positive things. I was okay with “You look good without hair,” but a lot of cancer patients I’ve met would prefer that there’s no comment at all about being bald. From our perspective, it’s easy to forget how strange we look and it’s unpleasant to be reminded. The same goes for people that say “You look well,” particularly when it’s expressed with surprise. Fighting cancer can include looking puffy, bald, strange, rash-afflicted, pigmented, tired, gaunt and miserable.

Here’s my simple rule for comments on personal appearance; if you’ve just called around and caught me hanging out at home then it’s probably best to avoid observations about my appearance. I own a mirror. I know I look strange. If, on the other hand, I’ve spend time putting on makeup and a hat or a wig and dressed nicely to go out then please tell me I look great. It will give me confidence and help me to feel less self conscious.

First prize for compliments on physical appearance goes to Vicki Johnston. She hadn’t seen me for some months and we met at a club where a friend was singing. I’d gone to a lot of effort to look nice and it was the first time I’d worn my wig out in public.  She said:

“Wow, your hair’s come back in nicely.”

Brilliant. She really did look surprised when I told her it was a wig. For the record, telling someone that their wig looks good is telling them that you’ve noticed they’re wearing a wig, which is really the last thing you want to hear when you’re wearing a wig!

Questions can be as problematic as statements. Some people are happy to answer questions about their cancer and their treatment and some people aren’t. You’ll never put a foot wrong if you open with:

“How do you feel about talking about your cancer? Is it okay if I ask you about it?”

And the best, all purpose questions is:

“How are you feeling today?”

Prizes for really awful questions include;

“What did you do to get cancer?”

“Do you smoke?”

“Do you have unresolved anger in your life?”

Yes, I have actually been asked these. There’s already a great deal that’s been written about not blaming cancer patients for their disease. I have mixed feelings. On the one hand I don’t think it’s productive or useful to blame people for their illness while on the other hand I do think that each of us need to use any illness as an opportunity to review the way we live and to make healthy changes.

If you feel the need to blame people for their illness then keep it to yourself. Consider the possibility that your attitude might be a reflection of your desire to feel like you are in control of whether or not you get cancer.  Keep in mind that plenty of people get cancer without having ever exposed their bodies to known carcinogens. Some cancers have a strong genetic link. Remember that all of us have cancer cells circulating our bodies all of the time and it’s the ability of those cells to recruit their own blood supply that determines whether or not any of us get tumours. You have cancer cells too.

It’s also worth remembering that most people live a less than ideal life when it comes to preventing and avoiding illness. If you’re exercising at least three times a week, eating a perfectly healthy diet, meditating, engaged in joyful, rewarding activities for most of your day and a model of mental and physical well being then you get to feel smugly superior (but if you’re that evolved you probably don’t). Otherwise, please keep in mind that the difference between you judging me and me judging you is probably just a matter of luck and timing.

If you have cancer, be gentle with other people. Remember that most people do not wake up in the morning wondering how they can cause offence today. The more prickly you are the less friends you’ll see. Sometimes people are going to say the wrong thing. Consider the whole person and the history of the friendship rather than focusing on a few words in a stressful situation. 

If you cause offence to someone with cancer, just apologise. I’d rather my friends visit and risk putting their feet in their mouths than stay away for fear of doing so. We’re human. We make mistakes. Please know that most people don’t have a script in their head that you need to guess at. Cancer can be very isolating. If we look odd we might be avoiding social contact. If we’re having chemotherapy we might be avoiding infection. At any stage of treatment we might just be too tired to head out into the world. As long as you check first before visiting and know how to avoid outstaying your welcome you’ll be fine. (Hint; open with “How are you feeling today? How long would you like me to visit?).

I’ve particularly enjoyed trips away from home with someone else driving. I’ve been taken walking and to the movies. I’ve had a couple of trips to unpopular shopping centres (less crowds) and some great meals at out-of-the-way cafes. It’s been great to just get out of the house for while.

I’m most grateful to the friends that have hung in there for the long haul. When you’re first diagnosed there’s a flurry of cards and flowers but a lot of people then go back to their own lives. I’ve been very fortunate to have friends that keep me in their minds and their hearts. Last weekend we had two close friends turn up with fresh fish, salad, a smoker and chocolate for dessert. They made us all dinner, shared their endlessly entertaining company and then cleaned up afterwards.  They never worry about saying the right thing.

Perhaps the most important thing to say to someone with cancer is this;

“I love you.”

Assuming, of course, that you love them.

Cancer reminds us that life is finite, unpredictable and precious. People we love can die suddenly, or become very ill and die slowly. Most people I know that have lost a friend to cancer say that they are glad they got the chance to tell that person how important they were to them. Cancer opens the door to this kind of honesty. It’s one of cancer’s gifts.

So if someone you love is diagnosed with cancer, tell them that you love them. Tell them why they are important to you and what kind of impact they have had on your life. We are staring down the barrel of our own mortality and knowing that we have touched the lives of others is perhaps our greatest joy.


11 thoughts on “What to Say. What Not to Say.

  1. Hey! Thanks again for these wonderful posts. I find them so informative, at times very very funny, and all in all a really good read.
    Thank you
    🙂 ❤ xox

  2. Words cannot express my gratitude for your blog. I was diagnosed with Breast Cancer on the 2nd January this year. Happy New Year *SLAP!*. A mutual friend pointed me to your blog. It has been a most amazing and human source of information for me. Whilst I know that our journeys may differ it has given me an insight, a window into someone’s heart that has experienced similar. I know I’ll get through this. Thank you for helping me.

    • Oh Amanda, thank you so much for your beautiful message! I started the blog as a way to help me stay focused on my own recovery with the hope that it might also be of some benefit to other people going through similar things. I had a rough week this week, with someone I hardly know taking offence at something I wrote (of course I meant no offence) and sending me a very rude message. I nearly stopped writing! Getting your message has reminded me that the occasional ‘troll’ is just part of the landscape. It’s so great to know that my writing has helped you. Best wishes for your recovery. You are in my thoughts. X

  3. Hi.

    My name is Michael . I am Amanda’s husband . I also wanted to say a big thank you for your blog.

    As Amanda states It has been a source of valuable information for us. I love your spirit & your writing style. You are so open, honest & frank with the way you explain situations & express yourself. It really strikes a cord with me & I completely love reading your posts.

    Please don’t stop writing because of one comment as the information you provide is invaluable .

    Amanda is going in for surgery tomorrow & because of your posts we feel we are heading into this thing well prepared.

    A big thank you from the bottom of our hearts & I wish you all the best with your journey.


    • Thank you so much for your comment, Michael. Best wishes to both of you for a great outcome tomorrow. My doctor said a really great thing back at the start of all this; “We’re very good at treating breast cancer.” She was speaking the truth. I find out my pathology results tomorrow, probably around the same time Amanda is having her surgery. I hope it’s going to be a wonderful day for both of us. She will be in my thoughts. X

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