Cancer: seven things not to say to someone who has it

2014-08-01 00:00

WHEN a close friend was diagnosed with cancer recently, a woman she considered a friend told her: “You must have done something very bad in a past life.” My friend laughed it off — and my fury on her behalf — saying that the woman who made the comment “meant well”.

Perhaps she did; perhaps she even believed what she was saying — that in some distorted, karmic view of reincarnation, cancer in this life is “visited” upon people as payment for sins committed in a “past life”.

She should have kept her mouth shut. What she said wasn’t helpful, it was probably hurtful deep down. It didn’t hasten my friend’s death little more than 18 months later, it wouldn’t have done anything to ease her path to the “next life”. The reality is, even the cleverest people say the stupidest things when faced with someone who is dying from cancer or any other life-threatening disease. I once read of a doctor who blurted out to a cancer patient: “Oh Jesus, you are so unlucky!” She found his comment “rather endearing”, although “probably not in the training manual” — a generous response.

It’s not true that sticks and stones will break your bones, but words will never hurt you. Words have power for good or for bad. Once said, words can never be unsaid. Words hang around in the ether and take on a life of their own. As the African proverb says: “Quarrels end, but words once spoken never die.”

That reminds me of a quote from Heartbroken, a New York Times bestseller by Lisa Unger, in which she writes of a character: “She wanted to take those words back. But they were out, shattering in the air all around them, slicing them both.”

It’s not always easy to know when something you say will be hurtful. Much like beauty, a helpful comment is in the eye of the beholder — or in this case the ear of the behearer. (Behearer isn’t a real word, but it sounds like it should be.)

The fact is, words in conversations around death and dying, just as in life and living, are not one size fits all. What one person facing cancer finds helpful, another may find hurtful.

The experts who can give best guidance are the ones at cancer’s coal face, who are living with the dread disease, or in a worst case scenario, dying from it.

I’ve compiled a list of seven things not to say to people with cancer. It’s not exhaustive, and it is drawn from those who have had to bear thoughtless comments, among them South African financial guru Bryan Hirsch, who was diagnosed with cancer in 1987, and Deborah Orr, one of Britain’s leading social and political commentators, who writes a weekly column for the Guardian.

Hirsch now counsels cancer patients and their families on how best to live with the disease. Orr was diagnosed with breast cancer in 2010 and writes extensively about the disease, including a column in the Guardian on what and what not to say to patients.

Here are some of the things not to say:

• “Cancer is a spiritual journey” — Orr says she knows her “journey” was meant to be “spiritual”, not least because kind people kept calling and asking her: “How are your spirits?” She felt bound to inform them that far as she could imagine, her spirits had breast cancer too “in an up-n-lite way”.

• “I’m so sorry you’ve got cancer” — you’re not half as sorry as the person who has it.

• “Be positive” —  doctors and psychologists act as if it’s in their job description to counsel people with cancer to be positive. There’s no research to prove it has any effect on clinical outcomes. It infuriates most cancer patients, and makes them “want to throw things, particularly when accompanied by a lecture on the power of positive thinking”.

• “If anyone can beat this, you can”, variations on the theme: “You’re so brave”, “fight, the good fight”, etc. — these are about the most inane things to say. One cancer patient says: “Character or fight has nothing to do with it. Your chances of surviving cancer are based on a whole range of factors. Personality is not one of them.” Orr found this comment particularly annoying. “It’s not comforting to be told you have to go into battle with your disease, like some kind of medieval knight on a romantic quest. Submitting to medical science in the hope of cure is just that: submission.”

• “You don’t look sick” — Hirsch looked his healthiest when he was first diagnosed with testicular cancer, so when he was desperately ill. He looked deathly ill on chemo, when he was getting better. Orr recommends taking the cue from the patient, before commenting on appearance.

• “Try yoga, detox, green food, red food, juice fast, snake oil” — you’re not an expert and even muesli-munching vegetarians get cancer. Respect the sick person’s choices.

• “What are your odds?” — unless you are very close to the patient, this is absolutely none of your business. Doctors are not gods. One oncologist told me he never tells patients how long they’ve got unless they ask. And when they do, he gives them an estimate based on his experience and research, but tells them he’s happy to say he has often been wrong, and many of his patients have lived long beyond the expectations of science.

That brings us round to what you should say. It’s not rocket psychological and communication science. The key is more listening than talking, treating cancer patients normally, and talking about ordinary things. Cancer patients don’t like to talk about their disease all the time. Offer targeted help, such as: “Give me your list and I’ll do your shopping today,” and “Can I walk the dog?”, rather than: “I really want to help.”

— Biznews.

• was founded and is edited by Alec Hogg. He can be contacted on Twitter (@alechogg and

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