What to Do, and Not Do, When Your Friend Has Cancer

As a psycho-oncologist, a 17-year breast cancer survivor, and a seven-year metastatic breast cancer survivor, I tend to serve as cancer central for friends whose loved ones suddenly get diagnosed with the disease. They usually ask, "What should I say?"

What is really happening inside them is that, whether consciously or unconsciously, they're feeling a mixture of pain and fear on behalf of their friend or family member, along with anxieties about themselves: If my friend can get this, so can I. This also leads to guilt: How can I be thinking of myself at a time like this? This anxiety and guilt either tie their tongues in knots or does the opposite, they lead to a reflexive barrage of ill-chosen words that might have been better left unsaid.

The best way to counteract the barrage is first to understand that it's part of a natural process. Don't let it get in the way of learning how to be a good friend in this trying time. In the meantime, here are a few Dos and Don'ts for guidance:

Do:

• Be wary of Dos and Don'ts lists. My Dos can be someone else’s Don'ts.

• Recognize that sometimes, you’ll do a don’t, no matter how hard you try. It’s how we’re built. I’ve said some doozies myself.

• Try to be yourself. You’re our friend because we like each other, not because you can magically fix our problems. You help us just by being you. And we understand—except when we’re at our crankiest—that our cancer is anxiety-provoking for you too. You can care about us and simultaneously fear being us.

• Forget about the cancer sometimes. Maybe even a lot of the time. Maybe even—depending on your friend’s personality and situation—most of the time. It’s only one unfortunate aspect of a life that’s otherwise filled with all sorts of interests, talents, and hobbies worth talking about. And banal irritations to kvetch about. Yes, you get to kvetch sometimes too. In its own bizarre way, it reminds us that we’re still in the mix.

• Listen: Get an idea of what might be most helpful to your friend in the current moment. When in doubt, you can always ask.
• Listen: If we cry, your words aren’t likely to be as powerful or as helpful as your ability to simply bear witness to our tears.
• Listen.

Don't:

• Criticize your friend’s headwear, unsolicited; and, no, it doesn’t help to keep offering to contact your neighbor the retired hat lady. (Yes, this recently happened to me)

• Start a conversation by lowering your voice and asking: How are you?

• Ask if it runs in our family. Most of the time, you’re just comparing your own risk factors to ours. FYI: 85 percent of the time, it won’t run in your family.

• Suggest some farcockteh new treatment or doctor you heard about from your cousin Schmendrick the Yale medical student. I promise we know more than either of you about the subject and are capable of finding our own doctors. Unless we ask for your advice, in which case, fire away.
• Get mad at yourself for getting it wrong. We all do. Mortality is a difficult business.