Meet people where they are is an incredibly powerful rule to live by. When people we love are in tough places, it’s sometimes too uncomfortable to meet them where they are. We may try to solve their problems for them. We may struggle with discomfort over the situation, or tell ourselves “they need space” – when we’re really protecting ourselves. Most people feel this way. But surface-level conversations only widen the gap between the person who desperately wants to be understood and the well-meaning friend who doesn’t want to make a misstep.

Sometimes being worried about saying the wrong thing keeps us from saying anything – even to the people we’re closest to. Things can get built-up in our own minds, and awkward as we fumble to find the words. Our own anxiety can stop us from having meaningful, healing conversations. When someone you know is diagnosed with cancer, it seems like nothing you say is going to sound right.

“I’m sorry” may sound like you’re pitying them or are predicting a negative outcome.

“You’ve got this!” may sound like you’re not giving the situation the appropriate weight.

“I’ll pray for you” may sound super generic, even if you mean it.

Letting someone know you care deeply without worrying them, prying, being negative, insensitive, coming off too saccharine, or glazing over something they may want to talk about because it makes you uncomfortable is basically threading the needle. But don’t panic! Everyone struggles with how to approach difficult topics and cancer is a big one – especially if you haven’t been there yourself.

Go there

Meet them where they are, even if you’re scared that it will be hard or emotional. Of course, appropriate timing is everything! I asked a few cancer survivors and those in active treatment for guidance on how they recommend talking to someone about their cancer. Here are some of their tips:

Don’t compare or “at least” - Fight the urge to immediately jump in and say you know so-and-so who had this exact cancer and everything turned out great. Statements like “at least they caught it early” or “at least it’s not stage 4 like Uncle Bob” are not helpful. Of course catching cancer early is ideal, and yes there is a spectrum of cancers from highly-treatable to terminal, but getting the diagnosis is a tough moment in their lives, regardless of the cancer, stage or prognosis. Give the situation the appropriate weight and realize your loved one needs time to process this life-changing news. Here's what a survivor had to say:

There is plenty of time during treatment to be grateful and reflect on your blessings, but it just made me feel worse when I was told by well-meaning people that this was going to be no big deal right after my diagnosis. I felt like it minimized what I was going through.

Ask specific questions to quell your anxiety (and theirs) – some of the best advice from survivors is how to break the ice and let the patient know you’re genuinely interested. Saying “thinking of you!” and stopping there is a one-way conversation. Asking specific questions can keep the conversation on the rails while also giving the patient the opportunity to share and process their complex feelings. Remember that asking tough questions is really hard for most people; most are too afraid of their own anxieties and feelings to “go there.” This means that your loved one may not be being asked how they feel or for details of their treatment very often. Allow space for them to do so when they’re ready.

Remember that this is a long process. Their feelings and mental state will change, then change again. The goal of talking is not to solve problems, it’s to let them be seen and heard. Give them the mic and use some guide rails to help you get the conversation going without the unsafe, open-ended “how are you?”

Ask specific questions!

How is treatment going?

Even if they say “it sucks and I hate it” – ask them: It sounds really hard. What is chemo / radiation like? How many sessions do you have? Find questions to make them the expert and about specific when they’re drifting into negative territory. Let them remind themselves of how far they’ve come. If they start talking, go a bit deeper – they may be craving an outlet. Ask:

‍What’s on your mind right now?

‍You can get them to talk and share without specifically identifying or labeling scary emotions out loud like “fear,” “loneliness,” “anger,” or “despair.”

Get specific so they don’t have to do more thinking. Other specific questions include:

How are the kids doing?

Do you feel pressure to be upbeat and positive for everyone?

How do you feel about your medical team?

Are you nervous about this appointment?

What’s the biggest surprise after your diagnosis?

Can I gather some recommendations and tips for you?

And the big one – Can I help by_______? (driving you, dropping off groceries tomorrow, taking the kids, introducing you in an email to a survivor, etc).

‍Think supportive, not overly positive

What I found interesting in conversations with survivors about this topic is how they made a clear delineation between “supportive” and “positive.” That’s not to say that being positive isn’t important – it is! But processing a cancer diagnosis and treatment is a long game. The patient needs to find their own, genuine version of positivity. Positivity cannot be spoon-fed by outsiders – they have to want it and see it and feel it themselves. This is where toxic positivity and too much rah-rah before they’re ready can backfire and make the patient feel alone. A lot of the loneliness cancer patients feel is from not being heard and not feeling “safe” enough to share their real thoughts and feelings with those around them. It’s hard to relate as-is with cancer, but if everyone is telling you to be positive and brushes over the hardships, the patient may feel like a downer, or that their honest feelings are not “welcome” to the crowd that wants to keep things light.

So – think supportive! The best way to do this is to take action. Bring groceries, organize a Meal Train, and offer in-person support by driving to or even attending medical appointments (when appropriate). A survivor shared this:

My husband did not handle my cancer diagnosis well, but one thing that was really helpful was him attending my appointments – especially my first ones. This allows the caregiver to see exactly what the patient will be dealing with, what to expect, and makes the patient feel supported.

Be the finder of helpful information! Reading the Do Cancer articles can help you as a caregiver find things to make chemo more tolerable, heal tender skin from radiation, build a healthy meal plan, or buy the world’s most comfortable socks. Love lives in small acts – show them how much you care by trying to understand and support their entire journey.

If they’re constantly upbeat, push them when you need to – Timing is everything here, and you have to have a very close relationship, but if they’re well into their treatment and they completely dismiss that anything is wrong or difficult, keep an eye on them. People who brush their cancer experience under the rug are in denial, or harboring trauma and animosities that will come out later. Gently remind them that you are here for them for anything that comes down the pike.

This time may feel like you’re walking on eggshells, but just break it down and simplify. You want your loved one to feel seen and heard, right? Give them gentle opportunities to share without being intrusive. You’ll eventually find the delicate balance, but until then – ask specific questions to help guide you to that right space for them. We will all suffer at some point in our lives and remembering the people who looked you in the eye during the hard times and listened will always have a special place in your heart and are key to your mental and emotional recovery. Be that person for them!

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