by Suzan St Maur
Cancer is a word that strikes fear into the heart of anyone diagnosed with it. These days, however, it certainly does not have to be a death sentence; more and more cancer patients are surviving either to full-term life expectancies or for many good years they wouldn’t otherwise have had, even as little as a decade ago.
I’m a 2 x cancer survivor (so far) and am still very much alive and kicking, and have every intention or remaining so until I’m well into my dotage. Thankfully, increasing numbers of my friends and co-cancer patients are looking towards a similar future.
However, when we find out a friend or relative has cancer and we want to drop them a line to show how much we care and support them, it’s essential to realize that it’s a very sensitive time, and you need to recognize the following key points to help you write.
Before you write: consider key points in their cancer journey
Often when I’m talking to newer cancer patients about their impending cancer journey I share that awful moment when the reality hits them. In my own case, it was when I was sat in the specialist’s office and caught sight of a badge on the nurse’s uniform, which said “oncology nurse.” I went to pieces.
It was the first time the reality had hit me square between the eyes; an iconic moment. This – or something similar – is common to many cancer patients. Whenever the reality hits you, in those early stages before you have had the time to absorb and come to terms with your diagnosis, you are very vulnerable.
And one of the worst parts about that is your sense of isolation. Although your friends and family are desperately worried about you, you know they can’t possibly know how it feels to be in your shoes (see below).
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Of course there are other points in someone’s cancer journey when you may also feel the need to share some kind words with them; most notably when they…
- Have surgery to remove a solid tumor/tumors
- Begin chemotherapy (this may happen before or after surgery)
- Begin radiotherapy
- Begin longer-term immunotherapy (e.g. for breast cancer)
- Complete treatment (often a difficult time because a return to “normal life” can be hard)
- Have a recurrence
- Receive a terminal diagnosis
So what do you write that may help?
To begin with, don’t be reluctant to write the person a note or email. Many cancer patients find that some of their friends and even relatives back off when they announce a cancer diagnosis – some people don’t know what to say so choose not to say anything. Unless you, as a cancer patient, go into strong denial (see below), realizing that some of your friends or family have become distant is the last thing you need. Cancer is a very lonely journey and most of us need as much support and companionship as we can get.
Writing tip: write a short note saying you’ve heard the news and you’re thinking of them, and ask them to get in touch with you when they have a moment to spare.
Find out at what stage the person is in his or her cancer journey. The way you write to someone who has just been diagnosed at an early, primary stage, is quite different from how you should write to someone who has metastatic cancer, and different again from someone who is definitely terminal. Use your common sense to determine the best ways to tackle this.
Writing tip: adjust what you write accordingly. If they are at an early stage ask them about upcoming treatment and plans; at later stages it’s better to avoid talking about the future and keep your topics very much in the present.
Never say you understand how they must feel, because unless you have had cancer yourself, you don’t. Having been a carer for someone with cancer, or being related to someone with cancer, doesn’t matter; you still don’t know how it feels, personally. So, say how you sympathize with what they must be going through, and hope they have the support they need not only from medical staff and family, but from other cancer patients going through similar treatment at the same time. That is a crucial help that many cancer patients only find out about later on in the journey; encourage them to join support groups as soon as possible. Those can be critically important for their recovery.
Writing tip: if you know someone else who has had a similar cancer, ask the person if he or she would like you to put them in touch. A personal introduction sometimes is more welcome than launching into an unknown support group.
Find out, by asking close family or friends if you need to, how much the cancer patient wants to know about their condition. Some people want to know every last detail of their disease, their treatment, their medication and so-on. Others don’t want to know anything – they just take the view of “get rid of it and don’t bother me with the details.” Others may not even want to talk about their cancer at all – a dangerous form of denial because it often leads to an explosion of reality later, but it’s something you must respect and just carry on your friendship as if nothing was wrong. And then, there are others who are somewhere between those extremes. Knowing how this particular person feels here will help you to write and relate appropriately.
Writing tip: even if you don’t know how much the person wants to know about his or her disease, don’t wait to find out. Keep in touch by email, ideally, just as you would if nothing was wrong. They may not answer you, but they will appreciate your being there for them and eventually will let you know how much, if at all, they want to talk about their cancer.
Don’t offer advice. Nearly everyone diagnosed with cancer gets inundated, very quickly, with a barrage of advice not only from the medics and charities involved, but also from everyone who happens to hear about their illness and has some alternative treatment or snake oil to sell. Some of these offers are potentially helpful, of course. But when you’re dealing with a cancer diagnosis and/or imminent treatment, the last thing you need is someone telling you what their great-aunt Martha had done to cure her bowel cancer. Yes, even if it worked. Never forget that everyone’s cancer journey is unique, and hearing how someone else with a similar disease was cured is not helpful, even though you might think it should be encouraging. Leave the advice to the medics.
Writing tip: if the person has a sense of humor, make gentle jokes about “snake oil salesmen” and other unwanted advice. Sometimes this way you will find out if the person does actually want some specific advice, and if so what; you can then make inquiries on their behalf.
Offer practical help if you know you can deliver it. Particularly if the cancer patient lives on his/her own, has dependent family, or otherwise is going to find it hard to cope, the knowledge that you’re willing to share in looking after kids/dogs, gardening, cooking or anything else of practical nature will be very welcome … especially when they’re going through chemo or radiotherapy which can make them feel very tired. Depending on where they live, too, they may be dependent on public transport to get them to and from chemo, radiotherapy or other treatment. Public transport and even hospital transport is tiring and often means you spend a whole day shunting around for, e.g., 10 minutes’ worth of time in the radiotherapy “tanning booth.” So if you have a car and some spare time, they will almost certainly welcome an offer of lifts there and back.
Writing tip: if you’re emailing the person, don’t make it look like you’re putting yourself out to help them, even if you are! He or she won’t want you to go to any trouble, so make it look casual and easy. E.G. “I’m doing some baking tomorrow – shall I put in a couple of extra apple pies for you guys?” … not “would you like me to bake you some apple pies tomorrow?”
Above all else, don’t treat them like invalids. Write to them about other things, too. Keep them involved in your mutual social/business life. If you’re a colleague, keep them up to speed with office gossip; even though they may be going through treatment they may still be able to work, if only part-time, and if not, they will probably come back to work once treatment is finished. If you’re social friends, let them know what’s going on in your circles. And involve them physically in social activities if they feel well enough – don’t assume they’re out of the picture until treatment ends. They may turn up to a social event in a wig or a scarf, but they’ll enjoy forgetting about their cancer for a few hours.
Writing tip: if they aren’t well enough to go out – but they enjoy keeping up with office or social gossip etc. – consider writing an amusing journal of day-to-day happenings and either email it to them, write it in a series of letters, or set up a blog for them.
And what else? I could go on at length but I think I have covered the main points here. If you have any questions about how to deal with cancer – as a patient, carer, relative or friend – I strongly recommend that you check out the UK charity, Macmillan. It offers extensive, well-written information on all aspects of living with cancer.
Remember this above all else: “you may have cancer, but you also have a life.” And increasingly, thank God, people who have cancer have many years of good quality life ahead of them. Some may be around for several years even with metastatic disease, and many will go on to die of other causes at the end of a normal life expectancy. Cancer is no longer quite the killer it was, but for many people it’s still as chilling and terrifying. What you write to family and friends struck by cancer can help them see it as less of a murderous condition, and ultimately more and more survivable as time and technology move on. Good luck!
Useful further reading to help you when writing to a cancer patient:
Macmillan – for all issues relating to every type of cancer, in the UK and beyond
NHS choices – UK based, reliable source of information about cancer and other health issues
Mayo Clinic – US based, reliable source of information about cancer and other health issues
BreastCancer.org – a US based site that provides a huge amount of extremely useful information on this type of cancer
This article was first published on How To Write Better.