Grandmother with her dauther sitting on a couch. They are hugging
What (not) to Say to Someone with Breast Cancer
Elizabeth Lombardo, PhD
Dr. Elizabeth Lombardo is a Licensed Practicing Psychologist with a Ph.D. in Psychology and a Master's degree in Physical Therapy, and the authority on how to crush your inner critic so that you can live a life of purpose, fulfillment and True Success™. She’s America’s most trusted celebrity psychologist with over 100 national media interviews. She writes for Combined Insurance in an effort to help educate readers, but her medical opinions and advice are for entertainment purposes only and should not be considered a substitute for visiting your doctor.
This year over 290,000 women will be diagnosed with breast cancer in the U.S. and Canada. With such high numbers, it is likely you will know at least one person who receives this diagnosis or is in treatment. Being a positive source of support can help your loved one get through one of the most difficult times of their lives.
When I was getting my degree in psychology, I worked for four years in psycho-oncology which is a field where psychologists specialize in helping people facing cancer (both patients and their families). During that time, I discovered a lot about what is supportive, and what is not supportive, when interacting with someone who is facing a cancer diagnosis.
As often happens when I am working with clients, I also learned how to be a better source of support for those going through the challenge of cancer. I realized that, while well intentioned, some comments I had made may not have been the most helpful.
If you have a friend, colleague, or family member who has been diagnosed with breast cancer, I am certain you want to be a positive figure in their life. And yet, sometimes, good intentions can be received in a less than stellar way.
For that reason, and because it is breast cancer awareness month, I am sharing some helpful statements that will let your loved one hear how much you care, as well as what statements to avoid (and why).
DO NOT SAY “You need to fight hard.”
This insinuates that they have total control over the disease. They do not. Yes, they may choose to seek various treatments and these may seem like a battle to them. However, the notion that they need to fight hard also suggests that any decline in their health is caused by their weakness or not trying hard enough. What’s more, some may choose not to seek treatment or conventional treatment which is their prerogative.
INSTEAD, SAY “This must be a hard thing to go through.”
These simple words offer empathy and acknowledge that they may be struggling. You are not telling them what you think they should do, but rather providing an open heart of compassion.
DO NOT SAY "Let me know if you need anything."
This is vague and can feel empty to some (many, in my experience). While you certainly do not want to force anything on them, take a step back and ask yourself, “What might this person need?” Often, when someone is experiencing high levels of stress they are not even sure what they need.
INSTEAD offer a specific way you can help.
Organize a meal train. Let them know, “I am dropping off dinner tomorrow and it tastes great even if you freeze it”. Offer to come walk the dog, take their children out for a fun afternoon, clean their house (or hire someone else to). Consider things that they have to do above and beyond the cancer treatments and suggest a specific action you can take to help. A friend who was dealing with a breast cancer relapse had three children, one of whom was my daughter’s age. Knowing the other children’s activities, I helped set up rides to and from after school activities for all three kiddos so she could focus on her health. And another idea: surprise her with a funny or thoughtful card or care package.
DO NOT SAY “I know how you feel. My mother/sister/friend had breast cancer, too.”
Everyone experiences cancer differently. Their experience can change day by day- even hour by hour. Even if you yourself have dealt with cancer, you could not possibly know exactly what she is going through.
INSTEAD SAY “Wow, I can only imagine how challenging this may be for you.”
Here, you are not assuming it is awful, but are putting it out there as an option. This also can open the door for them to share more what they are dealing with: physically, emotionally, mentally, and spiritually.
DO NOT ASK “What stage is it?”
Avoid asking too many specific questions about the disease. They may not want to talk about it. For many, this is very personal and not something they want to share with everyone. At the same time, be open to listening what they want to share with you. Sometimes an open ear can be more welcome than asking questions.
INSTEAD offer to take her to her appointments.
Chemotherapy, radiation, follow-up visits with a surgeon or oncologist can be taxing, physically and emotionally. Not to mention, quite lonely. Offering to drive, as a source of instrumental and emotional support, can feel like a warm hug. And if she declines, accept the response. Let her know you are there, and she can always change her mind.
DO NOT avoid her or act differently.
Yes, she may be dealing with cancer. At the same time, that is part of her life, not her entire life. Most likely, she will want opportunities to talk about something non cancer related, to do “normal” and fun things. So, try to continue to interact with her in a way consistent with how you used to interact before the cancer diagnosis, if not even a bit more. Send her a text to let her know you are thinking of her or a meme that made you think of her that has nothing to do with cancer.
INSTEAD spend time with her.
SHE may decline, but knowing that you are thinking of her and have not put her in the “cancer only” discussion will be meaningful. Continue to reach out, especially during the Covid-19 pandemic when people with cancer and other serious conditions are more isolated than ever. Understand that it just might not be the right time for her. And don’t take it personally if she does not want to do something with you.
DO NOT tell her “You don’t look sick.”
How someone looks on the outside can be completely independent of how she feels on the inside. This type of comment can negate the struggles she might be having.
INSTEAD ask her how she is feeling today.
This allows a brief, not committal response, such as “fine.” It also opens the door for her to share more about any struggles she might be experiencing.
DO NOT offer platitudes such as “You will be fine” or “Everything happens for a reason.”
Such statements are often attempts to make the other person (and you) feel better, but they can be taken in a less than optimal way. For example, how do you know everything will be fine? Over 42,000 women die each year in the U.S. from breast cancer. And saying that everything happens for a reason can be interpreted at “you deserve this.” No one deserves cancer.
INSTEAD SAY “I am wishing you the best possible outcome.”
Be a source of positivity and love for her, without being overly and/or unrealistically optimistic. This can be a scary time for your loved one and letting them know you are not sugar coating what they are going through can be a welcome source of compassion.
DO NOT SAY “You need to stay positive.”
Dealing with cancer can be an emotional roller coaster. Telling someone how they should feel is counter-productive. They certainly have the right to be angry, scared, sad, frustrated, and/or irritable…
INSTEAD let her know you are there to listen.
Sometimes a non-judgmental, non-“fixing” ear can be just the gift a person needs. Sure, they may want to be positive, but realistically it is not always possible. Being a source with whom they feel comfortable venting, crying and sharing their fears can be a huge gift.
DO NOT say nothing at all.
This is likely a major event that your loved one is experiencing. Avoiding interacting with them because you don’t know what to say. On one level, your silence may be because you don’t want to say the wrong thing, but on a deeper level it is more about you not wanting to mess up. I have had many clients tell me that when friends avoid them, it feels like a slap in the face.
INSTEAD SAY “I don’t know what to say.”
Let them know that you don’t want to say the wrong thing. You might ask, “do you want to talk about it or talk about something else?” That way, you can get a better sense of what needs you can help them with at that time.
DO NOT say “If I was in your situation than I would….”
While likely coming from a loving place, offering treatment ideas (“Have you tried eating a vegan diet?”) or sharing your beliefs (“I would never get chemo - that is toxic for your body”) can feel like an insult. First, this is not about you, it is about her. Second, you have no idea what you would do in her situation. Even if you had cancer, your situation and circumstances are not the exact same as anyone else’s.
INSTEAD tell her she made a good decision.
Your loved one has spent time and energy figuring out her plan of action. Be a source of support for her. Unless she directly asks for your input, affirm and support her decisions.
DO NOT SAY “Aren’t you glad that is over?!”
Just because the active treatment may be complete, it does not mean that the stress goes away. In fact, I have worked with several women whose worry and stress increased after the cancer treatment. Why? Because, while their healthcare professionals were actively treating and evaluating the “progress” of the cancer during treatment, once that was over, no one was regularly assessing the recovery. The fear of relapse can be very strong and real for many.
INSTEAD let her know you are happy for them that the difficult treatments are over and acknowledge that “moving on can be hard.”
While you don’t want to assume how she is feeling, try offering up the possibility that post treatment may still be stressful. This will open a door to potentially share her fears or, at least, help normalize her distress.
Try these approaches to help your loved one better cope with cancer. It will help them- and you- feel better.