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Words People Say

By Jaroslava Salman, MD

“Whatever words we utter should be chosen with care, for people will hear them and be influenced by them for good or ill.” - Buddha

“Words can sometimes, in moments of grace, attain the quality of deeds.” - Eli Wiesel

Few life experiences inspire unsolicited advice from people the way that cancer does. Many of my patients tell me about other people’s reactions to their cancer. These reactions are often driven by people’s natural discomfort with illness, or dying, and the need to reassure the patient with cancer (but mainly themselves) that “everything will be OK”. Our culture nurtures the myth of limitless youth, health and individual self-efficacy. This myth only perpetuates the denial of reality that we all age, we all get sick and die, and that we are in fact inextricably dependent on others. For most patients with cancer this reality assumes a stark and often painful presence. At that point they wonder why suddenly people around them have such a strong urge to dispense advice on lifestyle, diet, treatments and other related topics.

There is no question that having a cancer diagnosis carries a stigma that many find uncomfortable to face. It reminds all of us of our vulnerability but not everyone is able to face that with maturity and strength. If you are someone dealing with cancer, you may find that some of those around you want to withdraw and not see you, or talk to you. Others would like to find faults in you or your lifestyle that would “explain” why you got sick. Some prefer to offer “solutions” and “fixes”. This is part of human nature, we have a hard time accepting life’s uncertainty and unpredictability. It makes us anxious and creates a need to find quick explanations or ways to prevent “bad things from happening”.

Recently, one of my patients told me about a family party she attended. She was approached by a family acquaintance asking her bluntly about her cancer diagnosis and treatment, including whether her “breasts had to be cut off”. Needless to say, my patient was shocked and although she felt “violated and traumatized” by such questioning, she was not sure how to respond in the moment.

The list of unhelpful and, let’s be honest, annoying things people say (often in good faith) to those dealing with cancer is endless. Perhaps you have heard some of these yourself:

“You have to be strong!”

“You just need to stay positive!”

“You don’t even look sick!”

“Have you tried ‘xyz’ treatment…?”

“You need to eat more of ‘xyz’!”

“You know, my friend had the same thing and…”

“This is a new journey for you!”

“God doesn’t ask you to carry any more than you can handle.”

And the list can go on! I bet you too have heard a handful of unhelpful comments that have been offered to you. Maybe well-meant, but hopelessly unhelpful. How can one respond in such situations in a way that is firm but respectful, allowing one to stand up for themselves? You may find it useful to think about possible responses ahead of time – to prepare yourself, rather than trying to scramble for the right words when confronted with a surprisingly unpleasant comment or inquiry.

It is important to keep in mind that you are under no obligation to explain your health/illness to anyone, like an acquaintance at a family gathering for instance. My patient could have said: “I’m sorry, but I consider my health a personal matter and I don’t want to talk about it right now.”

For many people it feels like a new territory when they have to figure out how much they want to disclose to relative strangers (e.g. colleagues at work) and how detailed they want to be with friends and family. You have the right to decide who you want to share your health information with. No one needs to know more than you are willing to share. For friends and family who are close to you, it often works best when you are direct about what you do, or do not, want from them. If they keep asking you questions you don’t feel comfortable answering, you may say: “I know you mean well but I really would prefer to talk about something else right now.” or “Just being with you helps me. The fact that you are thinking of me is enough for me.” Be specific in expressing your needs. Most people want to be helpful but are unsure what to say or do. It is often a relief for them when you offer guidance by making a specific request – whatever it may be. You may want to teach people close to you to say: “I want to be helpful to you. What can I do to be helpful?”

Unfortunately, none of us can control what other people will do or say. As if it wasn’t challenging enough, cancer often forces people to “grow a thicker skin”. However, no matter where you are, you can always take a slow, deep breath and remind yourself: “I am grounded and strong, like a mountain” and let the unhelpful words of others just roll down that imaginary mountain like little pebbles that cannot hurt you. You know what your situation means to you, and you can find the strength to overcome it in a way that works best for you.

To learn more about Dr. Jaroslava and her work, follow this link: https://www.cityofhope.org/people/salman-jaroslava