At the stroke of midnight, 01 January, 2014, US Census Bureau statistics tell us that the population of the USA was 317,297,938. The American Cancer Society tells us that in the year 2014, 16 million out of those 317 million people will be diagnosed with cancer.

Half of all men will get cancer during their lifetimes

One-third of all women will get cancer

Three-quarters of all cancers strike after age 55

Fourteen million people are living with cancer; as survivors or current fighters

1500 people die from cancer every day

600,000 lives are lost every year

My brother Michael lost his life his life in 2012 to oral squamous cell carcinoma. Me, I’m one of the fourteen million survivors.

The numbers are clear. At some point in your life, you will want to visit a friend or loved one with cancer. It is scary as Hell. What to say? What to do? How do I help? We want to help, but we don’t know how. What are the rules for a visit with a cancer warrior?

My Seven Rules for Calling on the Cancer Warrior.

1) Make absolutely, positively, 100% certain you are healthy.

Whether from the chemo, the stress of the illness, or their cancer itself, many cancer patients have compromised immune systems. A little bug or a sniffle that might put you a bit under the weather could have serious repercussions for the health of a cancer patient. Even without your bug raising serious problems, a cancer patient already feels lousy enough. Keep your sniffle-ly nose to yourself. If your kid stayed home sick yesterday because of some norovirus, stay home.

i) Wear clean clothes. Your favorite sweater, the one a little kid goobered on yesterday in the queue at McDonald’s whilst you weren’t looking, might still harbor some Klebsiella or H. Influenzae.

ii) Wash in. Wash out. When you enter the house, wash your hands properly with soap and running water for 30 seconds-that’s singing Happy Birthday through twice. Or use hand sanitizer. Wash them again on your way out. It’s a good practice.

2) Make contact in advance.

My brother and I were as close as brothers can be. Yet, when he was deep in his cancer fight, I never dropped by. One, it’s just rude. Two, you never know what kind of day your friend is having. Michael really liked to make those contacts via text message. To a cancer patient, a ringing phone, when your pain and discomfort have just settled down enough so you can nap, is a huge and unwanted intrusion. Send a text. You might not get an answer. Don’t drop by ‘just to see if everything is all right.’ Most likely, your friend is getting some sleep.

Cancer, and cancer treatment, are exhausting beyond words. How exhausting? Picture yourself as you lie on the couch with your face turned towards the seat cushions. You hear something interesting on the TV. Now, try and imagine that you lack the energy to turn your head towards the TV to see what is on. Yep. That bad. Sometimes worse.

3) Time limit your visit.

When you text to see if there is a good time to visit, give a limit.

“Michael, is there a good time today or tomorrow for me to stop by for a twenty minute visit?”

When those twenty minutes are up, get up and go. If your friend wants you to stay longer, s/he’ll let you know.

Even when we have cancer, when someone visits our home, we feel as if we are the host. Just to burn the mental energy required to be “the host” is a huge drain on very limited psychological resources.

4) Contact the caregiver about gifts.

Before you bring anything with you, contact the patient’s caregiver. Radiation and chemotherapy play havoc with the senses. What to you is a lovely scented bouquet of flowers might kick off three hours of retching and vomiting for your friend. In addition, many people become highly sensitive to pollen during treatment. A plant might be nice. But ask.

We like to feed our friends and family when times are tough. Ask if there is anything special you could bring, and anything specific you should avoid. Just because your friend liked your lasagna two months ago, the smell of the tomatoes and basil might send her reaching for the waste bucket.

When Michael was ill, I brought him DVDs. He was a huge baseball and Detroit Tigers fan, so I brought him highlight DVDs from the Tigers amazing 1968 season. We were little kids then, just starting to fall in love with sports and our heroes. I also brought him Rocky and Bullwinkle videos. Mindlessly funny stuff. Norman Cousins, in his great book, Anatomy of an Illness, wrote at length how the Marx Brothers, Laurel and Hardy, and the other great comedians of his youth helped him heal during his bouts with ankylosing spondylitis.

“I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep,” he reported. “When the pain-killing effect of the laughter wore off, we would switch on the motion picture projector again and not infrequently, it would lead to another pain-free interval.”

5) Avoid forced optimism.

Don’t be a cheerleader.

“You’re going to be fine. I just know it.”

“Bullshit,” says the patient. “I might freakin’ die. That’s why they’re bolting my head to that goddam table and irradiating my skull. That’s why my body is slowly being carved to pieces. That’s why I get bags of ugly yellow chemicals pumped into my body. You don’t know shit about my illness. I’m laying here, feeling like if I blink 2% too hard, my eyeball is going to fall out of my face, and if I swallow without thinking on it first, I’m going to be curled up in a ball in the bathroom for the next two hours heaving my guts out, while I try not to have shit come pouring out my asshole, and you’re sitting there telling me ‘You’re going to be fine. I just know it?’ ”

“What the fuck do you know? Get the fuck out of here. Jesus, you fuckingidiot!”

Don’t play pity poker. Don’t tell a story about your cousin who’s a cancer survivor. Fact is, in the midst of my cancer, I don’t care. I’ve got my own problems right here, thankyouverymuch. When I was struggling with my melanoma, I found inspiration in an older friend who was fighting a much worse case of esophageal cancer. As cancer fighters and survivors, we’re good at finding our own inspiration. Hang out with me, that’s all I ask.

6) Physical contact. Ask first.

Cancer hurts. Sometimes, the pain cannot be imagined. Sometimes, a hug can be agony. Sometimes, you need a hug, a bit of human warmth and contact to remind you that you’re not alone. So ask before you hug. Pro-tip: Use your friend’s hug as your guide. As I was leaving my brother’s house, I’d always ask Michael if we could hug. When he said yes, I’d let him move towards me, and as firmly as he hugged me, I’d hug back, but just a bit softer. If you opt for a hand-squeeze, be just as gentle. Hard to believe, but some cancers cause such deep-seated bone pain that even a too-firm yet loving squeeze of the hand is agony.

What Should You Do?

7) Be there now.

Ram Dass titled his seminal 1971 work Be Here Now. When you are with a cancer fighter, be there. Turn off your damn phone. Your twitter feed can wait. If your friend wants to talk; Talk. With. Them. Listen, really listen, to what they’re saying. They’re talking with their eyes, and body language, as well as their words. Pay some fucking attention. They want to watch a little TV with you, then watch some TV. If they want to lie back for a few minutes and take six or eight deep breaths, why don’t you join them? Lower your shoulders from up around your ears, relax a moment, and join them in several deep quiet breaths.

You do realize, don’t you, that you too, are stressed? You do realize that your angst fills the room? It is hard to watch someone suffer, someone in fear, someone in pain. Let your heart fill with compassion, not pity, and join with them in your heart for a few moments. Don’t share your heartache. Let go of your pain and watch them relax along with you.

In the Torah, Jews are commanded to perform acts of lovingkindness. Buddha says “He who attends on the sick attends on me.” In the Christian Bible, Jesus commands his followers to care for the infirm. The atheist cares for the sick because there is no greater service to humanity than to care for the sick.

Be gentle. Be kind. Be compassionate. Be there now.