Etiquette has everything to do with situation, context, timing, individuals, circumstances, and cancer etiquette is the same. Many of us respond to the awkwardness of talking about cancer the same way we do to the awkwardness of eating lobster in public. We don’t do it.
I suppose if we take Hippocrates as our guide--first, do no harm--then being silent is better than saying, “Cancer is such a gift, don’t you think?” Someone actually said that to me right after I was diagnosed. Stopped me cold. However, it’s important to note that it was a person with cancer who said this to me. Fellow travelers can be the worst.
There are no rules, only suggestions and tips. In the end, I advise you to do the obvious. Ask the person you’re talking to what would make them feel most comfortable. And then do it.
Don’t ignore the elephant in the room. You should acknowledge that something has happened and is happening. You can start with saying, “I’m so sorry about your diagnosis. How are you?” If you really want to know and listen, invite the person to meet for coffee. However, you don’t have to be a confidant. It’s enough to take notice and say that you care.
Don’t offer treatment advice. It’s unlikely that you know something about the diagnosis that your friend or her doctors don’t already know. Even if you do, it’s pretty unlikely that the person with cancer wants to hear advice from you.
Do offer to make contacts. I will be forever grateful that when my next door neighbor found out that I have cancer, she talked with me about her own cancer research at the University of Chicago. “Let me get you in contact with Dr. Steinberg” was a sentence that changed my life. She has been such an incredible resource, giving me names and contact information for a dozen people. I haven’t connected with every person, but I know there’s a community out there.
Do give information about resources. The Cancer Support Center is the main reason that I’m a functioning and happy person with cancer. Believe me, I’ll tell people about the Center just like someone told me about the Center. You’d be amazed (or maybe not) at how little doctors know or share about these kinds of resources.
Don’t tell graphic or tragic war stories. Just after diagnosis, the last thing I wanted to hear about was how Larry’s sister’s mother-in-law died because a technician gave her the wrong dose of chemo. Heaven help me, the adrenaline throwing through my body was at toxic levels without anyone else’s horror stories.
Don’t minimize the diagnosis. Do not say, “Oh, bladder cancer’s no big deal. My dad has had that for 20 years and is doing fine.” Remember that I’m not your dad and that any cancer is a big deal. Skin cancer and bladder cancer and other “minor” cancers kill people every day. They cause suffering. They cause organ removal and disfigurement and fear and shame.
Do offer to help if you’d like to help. The best kind of help to offer is specific help. One of my colleagues at work said, “I know you’re new to the area and don’t know many people. I’d be glad to drive you to treatments or doctor’s appointments. I love to drive.” My next door neighbor said the same thing. They both meant it, and I know I can count on them if I need a ride. Let a person know what you’re good at or happy to do: will you run errands, pick up kids from school, buy groceries, wash clothes, babysit? Tell them, and then be ready to act. On the other hand, don’t say, “Let me know if I can help” instead of “I’m thinking about you” if you really don’t want to help.
Do check in even if the person seems healthy. Cancer doesn’t always show. We don’t all lose our hair, even if we’re having chemo. After treatment, our energy returns and we may actually be healthier than ever. I know I am. But cancer is still a shawl around my life. The worry, the fear, some side effects are still there. It means a lot to me when people still check in.
Do send a card. I can not tell you how marvelous it is to get a card, in person or in the mail. You don’t have to write much at all, and you don’t have to be eloquent. “I’m thinking about you” is enough. “I’m so sorry to hear about this” is always welcome. It means the world to have it in writing. I’ve read and re-read the generous cards and letters from friends.
Don’t ask for a health history. No one deserves cancer. It may seem to you like the four-pack-a-day smoker deserves to have lung cancer, but you’re wrong. You’re world view is screwy and hateful. If I’m overweight, a heavy drinker, a junk food eater, a sedentary couch potato, I still don’t deserve cancer. No one needs your help tracking down the cause, either. Thanks, but no thanks. Believe me when I tell you that the guilt and shame of having cancer after a lifetime of high risk behaviors are enough punishment. And, just to clarify, do not ask, “Are you a smoker?” It’s impossible to hear that without assuming bad intentions on your part.
Bottom line: when in doubt, ask. If you’d like to hug someone but you’re afraid you’ll hurt them, ask if it’s ok to hug them. If you’re open to hearing details, tell the person that if they ever want to talk about the nitty-gritty, you’re there. If you love to cook, ask them if they need food and if there’s anything they can’t eat.
People with cancer want what everyone wants, respect, concern, and care.
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Filed under: Advice