What Should I Say To Someone With Cancer?

( I find this article really worth sharing to anyone who can relate. It is extracted, with the photo, from the May/June 2009 issue of Salubris, an NCCS bi-monthly publication.)

Written by Gilbert Fan

Manager: Department of Psychosocial Oncology

NCCS (National Cancer Centre Singapore)

It is never easy to talk to someone about cancer. The question often asked is: “Should we talk about their condition openly?” Well, there is no straightforward answer to this.

If we focused on the person who has cancer and not on the affliction itself, we should be able to strike a sensible, meaningful and appropriate conversation. You need to understand the person you are talking to. This is important, as what suits you may not be so to others.

However, it does help if you can strike a good balance between showing concern and obtaining information. Show concern in a way that would bring across the message that you care, while you gather enough information to know how to be of help. So it is about how to be appropriate and helpful.

LET’S EXPLORE THE FOLLOWING CONVERSATION:

EXAMPLE 1:  “I’m sorry to hear this. I’m really concerned about how you are doing right now. Do you mind talking with me about it?”

It gives the impression that you care and what matters to you is his/her coping with the illness.

VERSUS

EXAMPLE 2:  “I heard about it, what stage is your cancer? What kind of treatment did the doctor suggest to you?”

It gives the impression that you want an update. Your preoccupation is the cancer and not the person who has the cancer.

Many patients and their close kin would have decided who they wish to tell. Be mindful that it can be difficult to break the news to loved ones. As a result, sometimes they may be the last to know.

To those whom the patient has decided to tell, they can be very open and can talk in detail about the diagnosis, treatment and even prognosis. However, for others they may only discover about the illness through a third party. In this situation, we need to be sensitive to the privacy of the patient, and be mindful of the patient’s preferences in handling his/her private affairs.

Patients are afraid of being labeled “terminally-ill”, “incurable”, and “not doing as well as someone else we know”. There is this added pressure to live up to other’s expectations of them. It is the same as a parent who is afraid of being asked: “How did your child do in the PSLE examination?” This is especially so when the child does not meet societal expectation. In that way, parents are afraid of their child being compared with his peers, to be judged, and to be written-off as being “not good enough”.

The second most commonly asked question is: “How would a patient respond to the cancer diagnosis?”

Well, there is no one single standard reaction or response. Most responses reflect on individual disposition and personality. It is usually being influenced by an element of surprise as well. By this I am referring to one’s exposure to shock or crisis, familiarity with cancer such as family history, and one’s inability to maintain a healthy lifestyle.

There is a saying that preaches about how “the truth hurts”. Whether a person is prepared for cancer or not, the truth still hurts. No one is spared from the feelings of self-grievance, self-pity or even disorientation that comes with the realization of the truth. For some, their hurt may turn into disappointment or even anger towards themselves or worse, others close to them. Their reaction may appear baseless and meaningless and yet there is little that they can do to control it. They may even feel they are losing control of their lives. Some react silently as they cry within whilst others do it openly.

We often talk about having a purpose in life. In the case of cancer patients, they need to find a purpose to live. A familiar reaction is the fear of losing the fight to cancer. Cancer can disrupt one’s plans, self-confidence and even beliefs. Patients need to make sense of their illness. There is a need for them to understand the situation. If they do not, they may not know how to continue living their lives. Perhaps a lesson can be learnt from a rare few; for them having a purpose to live can be quite automatic. They can be self-driven, rational and they just move on. They accept that there is still life after cancer!