ADVICE

What to say

(and not say)

to someone who has cancer

By Kara Mayer Robinson, MA, LMHC

You want to say the right thing to your friend, family member or colleague who has cancer. But you’re not sure what’s best—and the last thing you want to do is say something wrong.

It’s OK if you don’t know what to say. We’ll help you find the right words.

 

DO ask about our emotional health.

Don’t say: “How are you?”

Some people are OK with this question, but for others it’s hard because it’s so broad and they see endless ways to answer it.

Try: “How are your spirits?”

This is more specific and it opens the door to sharing how they really feel. Your friend or family member may want to talk about their feelings and simply need an opportunity to open up.

DON’T comment on appearance.

Don’t say: “You look pale.”

Don’t say: “You’ve lost a lot of weight.”

Don’t say: “Your poor hair!”

Don’t say: “Wow, did they remove your breasts?”

Don’t talk about how your friend or loved one looks. They already know. “I lost 26 pounds,” says one cancer survivor. “For me, trying to gain weight was a struggle.” Others explain that comments often make them feel worse. “There’s no way to frame cancer-related bodily changes in a positive way,” says one survivor. “Optimism can be infuriating,” says another. Instead, try a simple, upbeat statement that doesn’t focus on appearance.

Try: “It’s so great to see you.”

 

DO speak from the heart—but DON’T project your personal anxieties onto them.

Don’t say: “I’ve been so worried about you.”

Don’t say: “I haven’t been sleeping since I found out about your news”

Don’t say:  “Your diagnosis made me think I need to get checked out.”

It’s OK if you’re having a hard time dealing with your friend or loved one’s cancer. But don’t fall into the all-about-me syndrome. Try to be present and supportive of the person directly in front of you.

Try: “I’m not sure what to say, but I want you to know I care.”

Try: “I love you and I’m sorry you are going through this.”

Try: “I’m here for you. If you need to talk, cry, drink wine or eat a gallon of ice cream, just call—I’ll have the glasses and spoons ready.”

 

DON’T tell them to think positive.

Don’t say: “It could be worse.”

Don’t say: “Just think positive thoughts.”

Don’t say: “God doesn’t give you more than you can handle.”

Don’t say: “At least you’re lucky because X,Y or Z.”

Don’t say: “At least you’ve got the good cancer.”

Don’t say: ”At least you're single and don't have kids to worry about."

Don’t downplay what your friend or loved one is going through. The fact is, cancer stinks. There’s no such thing as good cancer. Good news is rare. If your friend doesn’t have children, it doesn't mean they don’t have close family or friends to worry about.

You may think this helps your friend feel better, but it often does the opposite. It invalidates their feelings and implies positive thinking will somehow cure cancer. “I believe in the power of positive thinking,” explains one survivor. “But I also believe in the power of being able to vent to a friend.”

Try: “I hope things are going better.”

Try: “I know cancer hasn’t been easy.  If you’d like to talk about some of the harder parts of this, I’m here for you.”

Try: “Don’t feel you need to look on the bright side.  It’s ok to be sad about what’s been happening.”

DON’T talk about your aunt, friend, etc. who had cancer.

Don’t say: “My friend Jim just finished treatments. If you met him, you’d never know! He looks so healthy.”

Don’t say: “My aunt had the same cancer. She died, but I’m sure you can beat this.”

Comparisons can be annoying. Bringing up negative outcomes can be unsettling. And empty reassurance aren’t helpful. No two cancers or experiences are the same. It’s best not to compare stories. 

Try: “What has been the hardest part of your journey? Can we figure out together how I can support you?”

 

DO be sensitive about statistics and outcomes.

Don’t say: “Are you worried about dying?”

Don’t say: “What stage is your cancer?”

Don’t say: “What is your prognosis?”

Don’t ask for details about potential outcomes. Your friend may not want to share these deeply personal details and it may force them to relive upsetting information. If your friend wants to share concerns about their future with you, they will—on their own terms.

“People ask me all the time what stage it is, but I don’t know that they really understand the implications of what it means,” explains one woman being treated for breast cancer. You may not realize it, but it’s like asking how likely they are to survive.

One expert says it may be OK to ask what type of cancer a friend or colleague has, but not always. “People are struggling and constantly swimming upstream—they shouldn’t have to explain everything,” she says.

Try: “I’ve seen you handle some tough stuff in the past.  Let’s go through this one together.”

 

DON’T give unsolicited advice.

Don’t say: “You should go see Dr. So-And-So.”

Don’t say: “I’ve read that the best hospital to be treated at is XYZ.”

Don’t say: “You should make make healthier meals for yourself.”

“Unsolicited advice is seldom valuable,” says one professor of oncology. Unless you’re their doctor, don’t tell your friend what to do. It may feel like you’re putting the blame on them, questioning their choices or doubting their medical team. 

“I know it’s hard, especially if you really do feel like you have a great product for someone,” adds Tara Geraghty, who wrote Making Cancer Fun and whose 12-year-old daughter was diagnosed with stage IV cancer when she was three. “But trust me—everyone and their mother is offering us a miracle cure.”

Try: “If you ever want help with research or going to doctors with you, I can definitely do that for you.”

DO be sensitive to using ‘war against cancer’ clichés.

Don’t say: “You’re such a fighter.”

Don’t say: “You’re a warrior.”

Don’t say: “You’re so brave.”

Watch your friend’s language carefully. Not everyone identifies with ‘warrior’ terminology. They may not feel like they are in a fight. Or they may feel weak. For some, saying they’re strong can make them feel worse. For others, it may be the support they need.

Try: “I’ll fight with you by your side” for those who want a fellow solider.

Try: “You don’t have to be strong for me. We can talk about what’s ever on your mind” for those who are approaching their journey in other ways.

DON’T use your belief system to comment on their situation.

Don’t say: “God doesn’t give us more than we can handle.”

Don’t say: “Miracles do happen.”

Don’t say: “Everything happens for a reason.”

Not everyone is religious or spiritual. Your friend, family member or colleague may have a different belief system than you. It’s best not to impose your approach on them. But you can offer up your spiritual support.

Try: “I’m thinking of you often.”

 

DON’T make it about you. 

Don’t say: “You’re so much stronger than me!”

Don’t say: “I could never go through what you’re going through.”

Don’t say: “I can’t imagine being you right now.”

You’re not in your friend’s shoes—and that’s OK. Rather than shifting the focus onto you, acknowledge that you don’t know what it’s like.

Try: “I know I can’t really understand what you’re feeling right now, but if you need to talk, I’m here to listen.”

One caveat: If you’re one cancer patient talking to another, something like, “I found chemo to be really hard. I know it’s not easy,” may be helpful.

DON’T profess to be able to predict the future.

Don’t say: “It’ll all work out.”

Don’t say: “Don’t worry, you’ll be fine.”

Don’t say: “I know you will get through this.”

Nobody knows what the future brings, so it’s best not to pretend you do.  Sometimes things work out, sometimes they don’t. Saying they will can make someone feel like a failure if they worry about this – or if things don’t.

Try: “Limbo and uncertainty are hard. I’m sorry life has been so unpredictable.”

 

DON’T assume the end of treatment is the end of their struggles.

Don’t say: “Congratulations on getting through all that.”

Don’t say: “Now you can get on with your life again.”

Don’t say: “I’ll be you want to start dating again now that your hair has grown back in.”

Finishing treatment isn’t the same as accomplishing something. It’s not something people in recovery can simply put behind them. “It’s never really over for us because of endless doctors’ appointments and fear of recurrence,” explains Sonja L. Faulkner, PhD, who underwent treatment for cancer and wrote The Best Friend's Guide to Breast Cancer: What to Do if Your Bosom Buddy or Loved One is Diagnosed.

Plus no one ever gets their old life (and sometimes body) back. Cancer changes people, permanently – for better or worse. Learning to accept permanent losses of body parts or functions takes time. Symptoms like anxiety, insomnia, and pain and linger for months or years. After treatments end, people may assume someone is back to normal, when they’re not, and they still need you.

Try: “I know you finished XYZ, but I’m still here for you.”

Try: “You’ve been through a lot. Putting life back together isn’t always easy. I’d like to help you if it feels overwhelming at times.” 

 

Want more advice? Here’s what to do (and not do) for someone with cancer.

 

 

BONUS TIP

Let’s talk about it (or not).

There’s no obligation to talk about the cancer when you see someone. Read the room. Is your friend enjoying talking about other things? Join them!

You can talk about other things too.

  • Bring up topics you normally talk about.

  • Talk about something funny that happened.

  • Use humor—if they seem to be in the mood for it.