The person with cancer often feels they need to "put on a face" when they're in public and act as if they are fine so that others feel more comfortable.
©Simon Kneebone / Glossary of Awkward
Understanding the emotions of talking about cancer
Initiating a conversation with someone who has cancer is challenging. For the person with cancer, it’s a balancing act of managing emotions and not wanting to be pitied or feel they are suddenly expected to come up with answers to questions, many of which they don’t want to be asked or are reluctant to discuss. For you, the onlooker, it’s a balance between wanting to acknowledge that something is going on and not being seen to be intrusive or insensitive. To help you deal with this, it’s helpful to know why we often react as we do, to understand the emotions of talking about cancer. If you have some understanding of your reaction then it’s easier to work out how to manage the situation.
Why do we react the way we do?
Our brain is the most important organ we have when it comes to navigating the world. It helps us determine what we say, how we behave and how we make sense of what’s going on around us. Everything we observe is filtered through our brain, often in a millisecond, and we assess this information continually to form a response. Sometimes however the ability to make sense of what’s going on gets hijacked – like when we are surprised.
The element of surprise has the ability to leave us without an immediate idea of what to say and how to react. It can result in the very part of the brain which we use to reason, make decisions, plan and problem-solve becoming quite ineffective and shutting down to the extent that we say and do things which we later recognize to be inappropriate, insensitive, even hurtful. Why is this important to know? Because often when we see someone or something we aren’t prepared for, in our surprise, we react and say something without thinking. And this can have a really detrimental effect on the person being spoken to, especially if they are unwell or feeling vulnerable.
What’s it like for the person with cancer?
For the person with cancer, the diagnosis and subsequent treatment has meant a roller-coaster of emotions and thoughts. It is an intense time with little let-up and a sense of just putting one foot in front of the other. During this time, people have to continue with their lives and don’t have the option of avoiding everyday chores. They attend appointments, shop, still fill the car with fuel, drop off/pick up children, do the house-keeping and sometimes even continue to go to work, whether they feel well or not.
It can also be a confusing and disappointing time as some people who they thought would be there to support them have backed off, but others who they hardly know have stepped up to help. It’s a time of mixed emotions and uncertainty, made even more difficult on days when they feel physically unwell.
This is when it can become difficult to contemplate going outside the house (e.g. to the supermarket) because of who they might bump into – they don’t want to have people ask questions, offer sympathy or be awkward around them. The person with cancer often feels they need to “put on a face” when they’re in public and act as if they are fine so that others feel more comfortable.
For you, the onlooker
You now know what the brain does when you are surprised, and how the person who has cancer might be feeling when you see them in public. You can use this information to help you decide what to do when you see them. The main fear for people with cancer is that they will be bailed up and ambushed with 100 questions or that people will make insensitive remarks, offer endless suggestions or meaningless platitudes. If you are mindful not to do this when you have a conversation with them and remember that they are still a person, not just someone with a medical condition, there is a good chance you can have a meaningful conversation and let them know you care.
There are some useful tips to ensure you have these conversations:
To begin with, when you first hear that someone has cancer, it’s a good idea to make sure to check with the person who tells you as to whether it’s public information or only known by a few people (and you may have inadvertently been told). This gives you an idea to which it is a private matter, perhaps only for family and close friends.
Remember that you may be surprised to see them out and about for the first time in a while, so slow down and take time to step back and think about what you say.
If you’re not sure what to say, make a statement that is positive – “It’s good to see you”, a short statement which is neutral and low-key.
Keep the conversation neutral by saying that you heard they hadn’t been well, and were sorry to hear that. There’s a balance here between acting as if nothing has changed (so you risk the person with cancer feeling invisible) and being intrusive. You can say: “I just wanted you to know I’ve been thinking about you.” Then take their lead as to whether you ask questions or not. Making statements, rather than asking questions, gives you time both to assess the situation as well as to decide whether what you have said is enough.
Take your cues as to how much to say/not say from the person – if they follow up your question with more information and appear to want to talk, just listen, without interrupting. If it’s clear they don’t want to talk, or they move the conversation away from themselves, then take their lead and follow it. Don’t impose yourself on them with a lot of questions or fast talking because you might be uncomfortable.
If you want to offer to help, be proactive and make a direct and specific offer. Being specific when you offer help is useful for several reasons – it gives the person something concrete to think about and isn’t vague and intangible. So, start with something like: “I’d like to help and am not sure what would be most useful” is a good start. Then suggest something specific: “I know you have a dog and I’m always available for dog walking – I can come and pick your dog up each night around 5pm if that suits/ I’m free most days so would be happy to pick you up for appointments any day. Just ring me the day before/ I shop here on Wednesdays and Sundays so I could ring next time I’m here and see if you need anything and drop it round”. Being proactive, without being pushy, is a balancing act which can be done well if you remain sensitive to the cues you are getting from the other person. If they seem interested in your offer, suggest a specific day and time. You can also remind them that even if they don’t take up your offer now, if they change their mind down the track, your offer still stands.
Don’t be put off if the person seems dismissive of your offer – you may be someone they don’t know very well and they aren’t sure of whether you are just being polite or really mean what you say. Very often people are surprised by who steps forward to help as much as they are disappointed and hurt by those who keep their distance. Many people also find it difficult to accept help as they feel they are being a nuisance or think they should be able to do it all themselves. You have “sowed a seed” about your availability and willingness to help, and the person can go away and think about it.
It’s also helpful to remember that going through cancer treatment and the recovery process can be a lonely experience.
People get used to others who either try to make awkward conversation or, sometimes, even go out of their way to avoid them because they don’t know what to say. It’s a real bonus to meet someone who can just quietly listen, without interruption, and not ask a myriad of questions.
Remember that people are also very happy to talk about everyday things, to hear about what’s going on in your life and to have a laugh. It’s a relief from the constant focus on cancer and it keeps them up to date with what’s happening.If you don’t see the person face-to-face, remember that a card expressing that you are thinking of them and wish them well is usually well received. Even a text message – remembering to say “No need to reply” at the end – is also a way of offering support without the person feeling the obligation to respond.
Anyone who is unwell appreciates being treated as a normal person. Focus on what they are telling you and take your cues from them as to how much to ask. At times like this, a kind word or gesture and patient listening go a long way.