Dear Christine: My Friend Has Cancer. What Should I Say?

Dear Christine,

One of my best friends was just diagnosed with a very aggressive cancer. She has two little kids, a loving husband, and a full-time job. I’m not sure what to do or say or how I can help—my instinct is to jump in and start problem solving. Does she have the best doctor? Can she really afford to take time off of work? I know she knows that this could be terminal. She is only 47 years old.

I know your close friend recently went through something similar. Please just tell me what to do.

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—Scared and Sad

Dear Scared and Sad,

My friend, Susie Rinehart, would find it kind of funny that you are asking me what to do when a friend has a potentially terminal illness. Why? Because I initially handled her diagnosis so bizarrely.

Susie and I have been friends for more than 20 years. Before she found out that she had a big brainstem tumor, we’d been talking on the phone a lot about her desire to write a book. I don’t think it’s an exaggeration to say that in the months before her diagnosis, we’d clocked a dozen or more hours gabbing like middle schoolers in the 1980s (that is to say, endlessly on the phone, she in Colorado and I in California). I was trying to help her work out the particulars of her novel. Or of her fictionalized memoir. Or maybe it was meant to be a series of letters to her daughter. Or self-help book for young women in their 20s.

Suffice it to say, we didn’t know what form the book was going to take. But we did know that Susie had an important book in her.

When she found out that she had a tumor wrapped around her brainstem—one that might not be operable and could possibly maim or kill her in as little as three months—she called me. When I didn’t pick up, she left me a message explaining that they’d finally figured out why she’d been having such severe headaches for the past couple of years: It was a massive, tentacled tumor. They were interviewing surgeons. A mutual friend, himself a neurosurgeon, was helping Susie find the best of the best. It was a long road ahead.

I was not as stunned or worried as you’d think I’d be upon learning that one of my dearest friends had a serious illness. In addition to talking about the book, we’d also been talking about her headaches a lot. Two mysteries had been solved!

So instead of thinking through how one might appropriately respond to such news, I immediately called her back and left a long message:

Wow. I’m so sorry to hear that you have a tumor in your neck, but I’m so happy they’ve figured out what’s been causing your headaches! That’s so great. And I’m glad you are taking the time to find the best surgeon ever. Please let me know if there is anything I can do to help. And, also, not to be Pollyannaish about the ordeal that is surely ahead, but SUSIE! THIS IS YOUR BOOK!! You are going to write a memoir about this experience!!

My husband, Mark, overheard me leave that message back to her. After I told Mark what was going on, he said something like: “She just told you that she has brain cancer, and you told her ‘Congratulations! This is going to make for a great book!’ Call her back right now. Maybe you can stop her from listening to that message.”

In my next message, I said little more than, “I am such a dumbass.”

Coincidentally, a few months later, I was having lunch with a new friend, Kelsey Crowe, who was just launching her very helpful and very funny book, There is No Good Card for This: What to Say and Do When Life is Scary, Awful, and Unfair to People You Love.

Kelsey confirmed that I had not responded at all appropriately to Susie’s diagnosis. She gave me a few pointers for the next time something awful happens to someone I love. So here are few things I’ve learned from both Susie and Kelsey: 

1. Say something

While Kelsey admitted that what I chose to say to Susie was about the worst she’d ever heard, she was clear that saying something is always better than saying nothing. (But you might need to apologize for being a dumbass, if you are like me.)

A lot of people don’t know what to say when something awful befalls a friend or colleague, and so they don’t say anything at all. It’s terrible for people who are going through something difficult when they feel like people are avoiding them. Here are some things Kelsey suggests:

• “I am sorry you are going through this.”
• “I can’t imagine what you are going through. What’s that like for you?”
• “I want you to know I am here for you if there is anything I can do.”
• “You don’t look sick; how are you actually doing?”
• “How are you feeling today?”
• “I have seen you manage really tough things in the past and I know that you can get through this.”

2. Offer support

Your friend’s diagnosis is an opportunity for you to reach out in whatever way you can. It’s an opportunity to connect, to offer love, and to show compassion. Your relationship will naturally deepen when you offer support, especially if you don’t expect anything in return.

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Doing something, even something small, is better than avoiding the situation or the person, which will only make them feel more alone. Delivering a casserole might seem a little retro, but keeping the kids fed and the family trains running is hard if you’re not feeling well (and nothing says I love you like lasagna).

If you don’t cook or can’t reliably deliver things like meals, don’t feel compelled to sign up for that type of support. Maybe send an inspirational poem if that’s more your thing. Or perhaps you can easily drive the carpool for your friend, or be there to hold her hand during chemotherapy or treatments. Consider doing the thing that will bring you personally the most joy, or create the most connection.

3. Hold space for the scary, awful, unfairness of it all

Your friend’s life may have just fallen apart. There’s probably zero chance that she’s not thinking about the fact that she might die, leaving her young children without a mother. Those are some really hard thoughts to be alone with all the time.

So even though our first impulse is often to cheer someone up, or to offer platitudes like, “God never gives us something we can’t handle,” or to find a silver lining, sometimes optimism can make a sick person feel more alone and afraid. We can be hopeful that treatments will work and that everything will be okay in the end—and at the same time we can acknowledge the scary, awful, unfair outcomes that are also a possibility. Specifically, we can hold a place for them to say the unimaginable:

• “I might die.”
• “My children might grow up without a mother.”
• “Everything has fallen apart.”

Because Susie encouraged me to do this with another friend who had been diagnosed with possibly-fatal cancer, I started by telling him that I was there for him if he wanted to talk about all the dark things that were going through his head. I said, “I don’t believe you are going to jinx yourself if we talk about what you are most afraid of. Sometimes it can help to speak out loud about the worst-case scenarios.” Those conversations were brief—like a door we barely opened and barely peeked through—but they were among the most moving and heartfelt conversations I’ve ever had in my life, with anyone.

Your friend is lucky to have you, Scared and Sad. Not because you’re ready to jump in and start problem solving (please don’t do that), but because you can see how scary this situation is for her. You can see that her whole life has just been dumped upside down—that she’s lost a lot already, and she is likely sad about it, too. Your friend is not alone in her fear or her grief, thank goodness.

Fortunately, Susie forgave me for my initial response, because that’s the kind of friend she is. And, also, she did write a book about her experience. It’s called Fierce Joy, and I hope you’ll read it.

Warmly,
Christine