People's reactions to my diagnosis of breast cancer in 2003 (followed by an unrelated diagnosis of colon cancer in 2004) stuck in my mind more than I might have expected, considering my state of numbed shock at the time. There were some who looked embarrassed and uncomfortable, shuffling away as fast as decency permitted; others who flung their arms around me in a parody of grief; and those - mainly family and close friends - whose quiet presence was my rock and salvation throughout the months that followed.
Cancer used to be something that wasn't really talked about. In my parents' generation, the word was mouthed silently or whispered in hushed tones, as if to speak its name aloud might attract the disease's attention to the one uttering it. Nowadays, it's right out in the open with the latest advertising campaign from Cancer Research UK declaring open war in the form of the battle cry: "Cancer, we're coming to get you!"
I'm not sure whether today's proliferation of information on cancer comes from a heightened awareness of the disease and a change in social attitudes towards discussing it, or whether there really is more of it about these days. Either way, we all know someone who has been affected by cancer one way or another.
It's hard to know what to say to someone who has undergone a traumatic, life-changing event such as a cancer diagnosis. People are terrified of saying the wrong thing. Although nothing you say to a person with cancer can make it any worse for them, behaving authentically towards them can make a positive difference. There's no doubt that genuine human contact can be immensely fortifying in times of crisis.
One of my close friends, who didn't know what to say, simply said that she didn't know what to say. And that was fine. She was there for me throughout the whole ordeal and that was what mattered.
So, here are my general "dos and don'ts" for approaching someone diagnosed with cancer:
1. DO go and see them in person (unless you live on the other side of the world) instead of sending a message or talking on the phone. Hand-holding can be very comforting, if done spontaneously and without awkwardness, and is one of the many things that can't be done virtually.
2. DO offer practical help, such as looking after children, cooking meals, driving them to appointments, doing their shopping, weeding their garden, or even just putting the wheelie bin out for them every week. There are so many little things that you don't think of straight away but which can make such a difference; we had a neighbour who walked our dog for us, which was an immense help.
3. DO act authentically. Hug if you're a huggy person, but don't do it if you're not just because you feel it might be expected; your innate resistance will come across.
4. DO offer to walk with them. An odd one, this, but my sister walked for miles every day with me in the first weeks and months and it never failed to make me feel better.
5. DO listen without giving advice, unless asked for it. My husband - and again, my sister (I recommend that anyone diagnosed with cancer should obtain a sister, either their own or someone else's) - would listen to me endlessly talking over the same ground, repeating myself, pouncing on and second-guessing every word that fell from a doctor's lips, wailing "what if" and "if only", and railing about the unfairness of it all.
6. DON'T mouth platitudes or say anything you don't mean. Saying nothing at all is preferable. You might feel awkward just being there in silence, but it isn't about you. Some people dislike terms such as "fighting" or, even worse somehow, "battling" cancer. I personally loathe that expression, and I've read recently that people with cancer tend to do better by focusing on healing rather than the battle imagery.
6. DON'T tell them that they're "so brave" or that you couldn't possibly cope as well as them if it happened to you. Being brave is about having a choice whether or not to do something you're afraid of. Cancer patients don't have that choice. When you have cancer, some people like to put you in a different category to them - a category reserved for those brave, strong beings who can cope with cancer - as if it only happens to people who can deal with it. Basically, they feel the need to distance themselves from the knowledge that it could just as easily happen to them.
7. DON'T say you know how they feel because your parent/friend/dog had cancer. Unless you've had it yourself - and even then, it's a different experience for everyone - you don't.
3. DON'T - and this is the big one - tell them to stay positive. A person with cancer really doesn't need to feel like it's their own fault for not managing to be positive enough if they have a poor outcome. Sometimes they will feel the very opposite of positive, often at 3am when everyone else is asleep and the shadows are full of nightmares and they feel more alone and terrified than they've ever felt in their lives. Don't put that kind of pressure on them.
These guidelines are, of course, sweeping generalisations based purely on my personal experience and the feelings of a few people I've talked to. They may be way off the mark for others, so please be guided by your instincts and personal knowledge of your loved one. If you can take a moment to try to put aside your own feelings and reach out to them, you won't go far wrong.