10 Things Not to Say to Someone with Breast Cancer… and One Thing You Should.

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I get it, people just don’t know what to say to someone who has been diagnosed with breast cancer. Many of the things you will hear, though well-meaning, are simply not helpful. Here is a list of ten things not to say, followed by the one thing we would like to hear from you.

1.  You’ll beat this

Really? How do you know that? Every day women die from breast cancer, and I may be one of those women. You certainly can’t tell me for sure that I won’t be.

2.  Treatment is so much better these days

While treatment has certainly improved, we still haven’t found a cure for cancer nor have we a guarantee that newer treatments will work for us. Cancer is still a fickle beast.

3. You caught it early

A variation on this theme is the “if you are going to get cancer, breast cancer is the best kind to get” trope. Again, early detection does not mean you will survive breast cancer. In spite of what you may think, not all women survive breast cancer with early detection. And no, there is no “best” cancer to get.

4. You’re so brave

I know this is meant to be encouraging, but it is also quite patronising. It is often followed by “I couldn’t do it”. None of us are prepared for cancer, we do what we have to do to keep going. We don’t feel brave – we are scared and we break down often. Your expectation that we must be brave all the time keeps us from letting you see the person who cries alone in the shower. By promoting stoicism in the face of cancer, you create unfair expectations and deprive us of an outlet for our darker fears.

5. My aunt had the same cancer and she survived

No two cancers are alike. While I am glad to hear your aunt got better, cancer is a complicated disease and chances are high her cancer is not the same as mine.

6. What’s your prognosis?

Never, ever ask anyone this question. It is highly personal, intrusive and insensitive. Enough said.

7. Have you tried (insert latest dietary nonsense). I hear it can cure cancer.

There is no shortage of dietary advice which urge cancer patients to drink only fruit and vegetable juice, avoid meat or dairy products or take large doses of supplements. However there is no evidence that these work, and many are downright harmful.

8. Did you know that stress causes cancer? Were you stressed before you were diagnosed?

This is a common belief. You may even wonder if it might true. To date no scientific studies have found that stress increases the risk of cancer. One study has even found that high stress levels can actually reduce the risk of breast cancer, by lowering oestrogen levels. And even in the event that stress and cancer are linked, the effects would be very small compared to other factors such as lifestyle, age or family history (Source: Cancer Research UK)

9. You don’t look sick

This sounds almost accusatory! As if to be a card-carrying cancer “sufferer” you must look the part. On the flip side of this, there are those comments you receive when you loose your hair – a confirmation you are in fact really sick. This can prompt statements such as “it’s only hair,” “it will grow back”, “you have a nice shaped-head”.

10. You must stay positive

I’ve saved the best for last. Ok, I admit that I caved in at the beginning to friends and family pressure to be positive because it reassured the people around me.  While I accept that for some people maintaining a positive attitude is a valid coping mechanism, for myself and many others, being expected to always show our sunny side is a denial of our pain, anger, grief and suffering.

So what should you say to someone with cancer?

Sometimes, there are no right words, sometimes the best you can do is listen, without judgement, without offering any (well-meaning but often clichéd) advice. Many people believe that in order to make someone feel better, they need to fix the problem or offer some solution, when all the person may want is to be listened to.  Rachel Naomi Remen says it better than I ever could:

The most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention…. A loving silence often has far more power to heal and to connect than the most well-intentioned words.

So perhaps the best thing you can say is to say nothing, but instead practice the art of deeply listening to what we want to say to you. Having listened in this way, you could then ask the following question, “what one thing can I do for you?” or “what do you need from me right now?” Knowing we have been heard and understood, we will feel freer to ask you for what we truly need in this moment.

Since writing this post, Elizabeth McKenzie has written a thoughtful post on this topic which has made me re-think the wisdom of proscribing do’s and don’ts when it comes to what to say.  You can read it here: Beyond Dos and Don’ts