What Is Okay to Say to a Cancer Patient?

Announce that you have cancer and it will likely be met with an outpouring of uncensored comments, a flood of words that had not been thought through, or it will be met with silence. There are people who strike a balance, who are able to parse the sensitivity inherent with the issue and comment accordingly, but most of us are not practiced in this. A significant number of the people a cancer patient encounters will fall into the silent category, not because of a lack of caring, but simply because knowing the "right" thing to say is anything but obvious.

So what is okay to talk about?

That is a question, as a stage IV lung cancer patient, that I have been asked to address quite often. My basic response is, know your audience. Not every patient is sensitive to the same issues, and navigating that may be the most difficult element of determining what is safe material for a discussion. (And this can apply with regard to patient to patient conversations, too. Few people have a sense of humor as dark as mine, and knowing where another patient's boundaries lie is tough to ascertain.)

I have known a lot of people to take the safe road of simply avoiding any topics related to cancer. Eventually, this runs the risk of coming across like they either do not care or simply have no clue. But often it is a well-meaning attempt to engage without sticking a foot in anyone's mouth. Then, of course, there are the people who always lead with the latest cancer news. Again, a well-meaning attempt to connect and thoughtfully engage, but not always welcome or effective. One thing that might make sense to avoid when opening an initial dialogue is the "I know someone who died of that" response. It comes up a lot, actually, and while it might be part of a relevant experience, it probably should not be the opening line.

Craving normal conversation

As a cancer patient, there is one thing that I often crave: normal conversation. Cancer can be a part of it, but if that is all we ever talk about it gets old fast. And if people are busy tip-toeing around my sensitivities, the conversation just becomes awkward. However, it is understandable that people have questions for the cancer patient, some of which might be sensitive for one reason or another. But if we do not talk about them, those questions might become giant white elephants, lingering about unaddressed but impossible to ignore.

Cancer is not a taboo. Treating it like one does not help patients. The more we talk about all the issues cancer patients face, the better it is for all of us. Certainly, we can all take a moment to consider who we are speaking to and behave with tact. And if you are not sure whether a topic will be appropriate or well-received, just ask, honestly and openly. I cannot express how much easier it is to open up about a topic when approached this way. Believe it or not, many patients actually want to talk about cancer-related issues but hold back because they are just as concerned about the sensitivity of their audience. Communication is a two-way street and there are often similar roadblocks on both sides of the line.

Ways to start the conversation

To help with this, here are a few starting topics that are okay to address:

• What is your diagnosis?
• How do you feel?
• What are your treatment options?
• How do you feel about those?
• Are you interested in hearing about other treatment options or news I have read about?

Beyond that, just ask. Talk to the patient so that you can understand his or her concerns, and although there may be very limited options for helping, just being there and conversing with the patient like a normal person is often the best gift you can offer.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.