When Someone You Know Has Cancer

Finding out that someone you know has cancer can be difficult. You may have many questions about cancer itself and about how you should talk to and act around this person. If you’re very close to the person with cancer, this can be a frightening and stressful time for you, too.

If the person with cancer is a co-worker, you might also wonder how your work situation will be affected by their diagnosis and treatment. Supervisors may wonder what they can do to best help the person while still getting the work done. Communication and flexibility are the keys to success.

What to expect when someone you know has cancer

Possible physical changes

There are some common physical changes shared by many people with cancer. The cancer itself causes some of these changes and others are the result of side effects of cancer treatment. Keep in mind that each cancer journey is different. The person with cancer may or may not have any of the following:

Hair loss, including eyebrows and eyelashes

Weight loss or weight gain

Appetite loss or increase

Changes in how things taste or smell

Extreme tiredness called fatigue (more information follows)

Pale skin and lips, or changes in skin color

Disfigurement (for example, the loss of a limb or a breast after cancer surgery)

Nausea and vomiting

Problems with sleep

Poor concentration (sometimes called chemo brain)

For many people with cancer, the hardest side effect to deal with is fatigue. People report that fatigue can be overwhelming, and they are surprised at how tired they can feel long after treatment ends. It can take a long time to heal after surgery, and people can feel tired for months after an operation. Chemotherapy can involve many weeks of strong medicines that worsen fatigue as the body heals. People getting radiation treatment also report extreme fatigue. Someone with cancer may also experience stress and emotional concerns, which add to exhaustion. Fatigue can go on for many months after treatment is over.

Possible emotional changes

Each person reacts in their own way to cancer and its treatment. It’s normal to feel sad and grieve over the changes that a cancer diagnosis brings. The person’s emotions and mood can change from day to day, even from hour to hour. This is normal. A person with cancer may go through any or all of the following emotions and thoughts:

Uncertainty

Anger

A sense of lack of control

Sadness

Fear

Frustration

Guilt

Mood swings

Much stronger and more intense feelings

A sense of being disconnected or isolated from others

Loneliness

Resentment

Grief

Over time, the person may discover some changes that are good:

A greater sense of resilience or strength

Peace, or a feeling of being at ease

A clearer idea of their priorities in life

More appreciation for their quality of life and the people they care about

Cancer can be very unpredictable. Someone with cancer can feel good one day and terrible the next. Expect that they will have good days and bad days. Learning to live with uncertainty is part of learning to live with cancer, both for the patient and for the people around them.

There may be times when the uncertainty and fear cause the person with cancer to seem angry, depressed, or withdrawn. This is normal and is a part of the process of grieving what was lost to the cancer (things like health, energy, time). Over time, most people are able to adjust to the new reality in their lives and go forward. Some may need extra help from a support group or a mental health professional to learn to deal with the changes cancer has brought into their lives. For more on this, please see Anxiety, Fear, and Depression.

How does someone cope with cancer?

People develop all kinds of coping styles during their lives. Some people are quite private, while others are more open and talk about their feelings. These coping styles help people manage difficult personal situations, although some styles work better than others.

Some people use humor and find it to be a relief from the serious nature of the illness. But some may become withdrawn and isolated from family and friends. A cancer diagnosis creates a lot of change. People often try to maintain as much control as they can in order to feel more secure. Some people become very angry or sad. They might be grieving the loss of their own healthy self-image, or the loss of control over their own lives.

Some people find it helps to simply be hopeful and do what they can to maintain that hope. Hope means different things to different people. And people can hope for many things while facing cancer.

You might assume that someone who is positive and optimistic must be denying the fact that they have cancer. If the person with cancer seems upbeat and unaffected by having cancer, don’t assume they’re in denial. Making the most of every day may simply be their way of coping. As long as they are getting medical care, they’re probably not in denial, and their way of coping with cancer should be respected. For more information, please see Coping With Cancer in Everyday Life.

How important is working to a person with cancer?

Facing cancer often brings with it an increased sense of the importance of work in a person’s life. Working can boost self-worth and help the person focus on what they’re able to do rather than on their illness. Work can be a safe haven away from the medical world and can help a person balance the feeling of being out of control.

Work is also a source of stability because it has a routine and is familiar. And work provides contact with other people. Cancer can be isolating, and being around people can be a great comfort. It may be very important for your co-worker to be at work as much as possible and be as productive as possible. Financial and insurance issues may also affect the decision to work during treatment.

How can cancer affect a person’s financial situation?

Cancer can cause money problems. The person may lose pay by being absent from work during and just after treatment. The worker’s pay may drop if shorter hours are worked while getting treatment or not feeling well. Employees may also need to pay more of their insurance premium if they work fewer hours or take time off for treatment. In some cases, health coverage may be stopped or decreased if they go to a part-time schedule. A lot depends on your workplace policies. It’s important for someone with cancer to understand in advance how schedule changes will affect their insurance, salary, and other benefits.

Frequent medical visits can also be a financial drain because of prescription costs and insurance co-pays (the part of treatment that insurance doesn’t pay). Co-pays can reach burdensome amounts. There are also parking fees, gasoline, and the costs of other services and equipment not covered by insurance. The costs add up very quickly.

Talking with someone who has cancer

You’re not alone if you don’t know what to say to someone who has cancer. You might not know the person very well, or you may have a close relationship. It can be harder in the workplace because relationships with co-workers are so varied. You might not know the person very well, or you may have worked together for many years and be close friends.

The most important thing you can do is mention the situation in some way that feels comfortable for you. You can show interest and concern, you can express encouragement, and/or you can offer support. Sometimes the simplest expressions of concern are the most meaningful. And sometimes just listening is the most helpful thing you can do.

Respond from your heart! Here are some ideas:

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

“I’m sorry to hear that you are going through this.”

“How are you doing?”

“If you would like to talk about it, I’m here.”

“Please let me know how I can help.”

“I’ll keep you in my thoughts.”

While it’s good to be encouraging, it’s also important not to show false optimism or tell the person with cancer to always stay positive. Doing these things might seem to discount their very real fears, concerns, or sad feelings. It’s also tempting to say that you know how the person feels. But while you may know this is a trying time, no one can know exactly how any person with cancer feels.

Using humor can be an important way of coping. It can also be another approach to support and encouragement. Let the person with cancer take the lead; it’s healthy if they find something funny about a side effect, like hair loss or increased appetite, and you can certainly join them in a good laugh. This can be a great way to relieve stress and take a break from the more serious nature of the situation. But you never want to joke unless you know the person with cancer can handle it and appreciate the humor.

If they look good, let them know! Avoid making comments when their appearance isn’t as good, such as “You’re looking pale,” or “You’ve lost weight.” It’s very likely that they’re acutely aware of it, and they may feel embarrassed if people comment on it.

It’s usually best not to share stories about family members or friends who have had cancer. Everyone is different, and these stories may not be helpful. Instead, it’s OK to let them know that you are familiar with cancer because you’ve been through it with someone else. Then they can pick up the conversation from there.

Respecting the privacy of someone who has cancer

If someone tells you that they have cancer, you should never tell anyone else unless they have given you permission. Let them be the one to tell others. If someone else asks you about it, you can say something like, “It’s not up to me to discuss this, but I’m sure Ann will appreciate your concern. I’ll let her know you asked about her.”

It might feel awkward if you hear “through the grapevine” that someone has cancer. You could ask the person who told you if it’s public information. If it’s not, you probably shouldn’t say anything to the person with cancer. But if it is public information, don’t ignore it. You might say, in a caring way, “I heard what’s happening, and I’m sorry.”

You may feel angry or hurt if someone who’s close to you didn’t share the news of a cancer diagnosis with you right away. No matter how close you are, it may take time for the person to adjust to the diagnosis and be ready to tell others. Don’t take it personally. Focus on how you can support that person now that you know. For more about this, please see Understanding Your Diagnosis.

How do I get over feeling uncomfortable around someone who has cancer?

Feeling sorry for them, or feeling guilty for being healthy yourself, are normal responses. But by turning those feelings into offerings of support you make the feelings useful. Asking how you can help can take away some of the awkwardness. Cancer is a scary disease. It can create a great deal of uneasiness for people who don’t have experience dealing with it. Don’t be ashamed of your own fears or discomfort. Be honest with the person about how you feel. You might find that talking about it is easier than you think.

Cancer often reminds us of our own mortality If you are close in age to the person with cancer or if you are very fond of them, you may find that this experience creates anxiety for you. You might notice feelings somewhat like those of the person who has cancer: disbelief, sadness, uncertainty, anger, sleeplessness, and fears about your own health. If this is the case, you may want to get support for yourself from a mental health professional or a local support group. If your company has an Employee Assistance Program (EAP), you can contact a counselor that way. You can also use other sources of counseling, such as your health insurance or religious support services.

Basic do’s and don’ts when someone you know has cancer

Do:

Take your cues from the person with cancer. Some people are very private while others will openly talk about their illness. Respect the person’s need to share or their need for privacy.

Let them know you care.

Respect their decisions about how their cancer will be treated, even if you disagree.

Include the person in usual work projects, plans, and social events. Let them be the one to tell you if the commitment is too much to manage.

Check before doing something for your co-worker with cancer, no matter how helpful you think you are being. Keep them up-to-date with what’s happening at work.

Listen without always feeling that you have to respond. Sometimes a caring listener is what the person needs the most.

Expect the person with cancer to have good days and bad days, emotionally and physically.

Keep your relationship as normal and balanced as possible. While greater patience and compassion are called for during times like these, your friend should continue to respect your feelings, as you respect their feelings.

Offer to help in concrete, specific ways.

Don’t:

Offer advice they don’t ask for, or be judgmental.

Feel you must put up with serious displays of temper or mood swings. You shouldn’t accept disruptive or abusive behavior just because someone is ill.

Assume your co-worker no longer can do the job. They need to feel like a valuable contributing member of the company or department.

Take things too personally. It’s normal for the person with cancer to be quieter than usual, to need time alone, and to be angry at times.

Be afraid to talk about the illness.

Always feel you have to talk about cancer. The person with cancer may enjoy conversations that don’t involve the illness.

Be afraid to hug or touch your friend if that was a part of your friendship before the illness.

Be patronizing. (Try not to use a “How sick are you today?” tone when asking how the person is doing.)

Tell the person with cancer, “I can imagine how you must feel,” because you really can’t.

Go around someone with cancer if you are sick, or have a fever or any other signs of infection.

Offering support to someone with cancer

It’s human nature to distance yourself from someone when they become ill. Cancer can force us to look at our own fears about illness, weakness, or death. This may make us reluctant to interact with someone facing cancer. But isolation can be a problem for people with cancer. Make an extra effort to reach out. Communication and flexibility are the keys to success.

Remember that the person you know with cancer may find it hard to ask for help or may be worried about seeming weak or vulnerable. Telling a person, “You’re so brave,” or “You’re so strong,” can put pressure on them to act strong when they may not feel up to it. Families can put subtle pressure on people with cancer by expecting or needing them to be strong all the time. In that case, you might play an important role for a friend who has cancer. They may know you well and trust you enough to confide in you. This kind of relationship can be a great gift for a person facing cancer.

If they need medical equipment or money for treatment, you can look into getting something donated or organize a raffle to help raise money. Or you can simply take up a collection to buy something that might not be covered by insurance.

The person with cancer may look to you for advice regarding financial worries, work issues, or other concerns. Be honest. Help if you can, but if you feel uncomfortable, say so. There are many places a person can get help and support, and you might suggest seeking the advice of a professional who is best suited to give that kind of guidance.

Keep in mind, too, that those close to the person with cancer will also need help and support. A family member who is responsible for the care of the person with cancer can become isolated and stressed. If you know that person, you may want to check in to see how they are doing, too. They might also be able to share ideas about how you can best help the person with cancer.

Continue to treat your friend as normally as possible. Don’t feel that you always have to talk about cancer. Include them in activities and social events. If they aren’t up to doing something, let them be the one to decide to say no. Keep inviting them unless they tell you otherwise. Ask what would be most helpful. Offer to help in specific ways, rather than saying, “Call me if I can help.” Here are some ideas:

Send or prepare a meal. Arrange a schedule of meal delivery.

Offer to help with child care. Arrange a schedule of day care pick-ups.

Offer a ride to and from treatment appointments.

Help run errands.

Offer to take their phone calls if they are tired and need to rest.

Coordinate visits by groups, or coordinate sending cards, flowers, or gifts.

Honor them by making contributions to related charities, organizing blood drives, or making special efforts in their name.

Welcome them back to work with something on their desk to show people missed them. Invite them to out lunch

Offer to do some research on their unanswered questions about cancer, or refer them to the American Cancer Society at 1-800-227-2345.

If the person agrees, plan a party when treatment is finished or on anniversary dates. Always check with them first before making party plans, including showing them the list of those to be invited.

What if the person’s cancer comes back?

In some cases, the cancer will come back (recur) and treatment will begin again. The person with cancer may or may not react in the same way they did the first time. Again, communication is key. Many people are quite upset when they learn the cancer is back. They may feel they don’t have the emotional or physical reserves to fight again. Others seem to accept a recurrence more easily. They may have expected it, or are simply ready, for whatever reasons, to fight again. By equipping yourself with the knowledge of how best to talk to the person with cancer, you can be most helpful to them.