How to Talk to a Cancer Patient

Oh, this one made me laugh today. The link below from McSweeney's is serious business but if you have spent time here in CancerLand you will be nodding as you read and you'll be laughing too.

The title of the article is: "How to Talk to a Cancer Patient Without Being a Complete Twit".

Yep, I've been on both side of this one. I've been the recipient and the twit.

This is a good link to share with friends, family and coworkers. Many future twits out there and we can save them that life.

Here's the link:

https://www.mcsweeneys.net/articles/how-to-talk-to-a-cancer-patient-without-being-a-complete-twit

When Do You Tell Family and Friends About the Diagnosis?

In Today's Dear Abby advice column--in many US newspapers --the question and opinions--about whether to tell or not tell about a serious or terminal diagnosis. The column is in response to an earlier one where a man did not want to tell.

Abby shares her readers thoughts--yes to tell because it may lead to many loving interactions and maybe some reconciliation, or no, don't tell--keep your privacy and yes, we know people do say the most thoughtless things.

All valuable and valid points. Here's a link to the column:

http://www.arkansasonline.com/news/2018/apr/05/dear-abby-man-s-decision-to-keep-cancer/?f=features

But here's what is not considered: the impact on the caregiver in either scenario.

If the patient does want to tell then that impacts the caregiver, and if the patient does not want to tell

that impacts the caregiver too. Does the caregiver have any "rights" or consideration? That can also go both ways:

Telling can mean more support for the caregiver but it can also mean intrusion and expectations from others that increase the "work load." and not telling may allow the couple more intimacy and privacy but also limit the desired support for the caregiver.

The roles are not equal. The caregiver needs people to talk to. If it isn't from a support group or family--what will be the source of support.

This may be one of the trickiest things for a couple to negotiate in a cancer diagnosis...whose illness is it and who needs what kind of support from whom.

And also a question about workplace issues: if the choice is to keep the secret or privacy of the patient can the caregiver tell at work? how do they access FMLA or time-off to care for the patient.

All this to say it's not one sided or a simple issue, and it carries its own tensions at a time when fear and tension are flowing freely.

There is No Good Card for This

You have been there--on the giving end or the receiving end…

It's either "What should I say..?"

OR

"I can't believe they said that!"

Kelsey Crowe wrote a book to capture those moments and to help the rest of us not put foot in mouth…
no platitudes, alternatives to lasagna, and ways to be supportive with out reaching for bizarre mixed metaphors and saccharine sayings.

Here's the link t the interview on NPR last week. When you hear this you'll want her book, and you'll want to start making your own honest greeting cards.

Take a listen:
http://www.npr.org/2017/02/13/514164179/there-is-no-good-card-for-this-what-to-say-when-condolences-isnt-enough

The book is called: There's No Good Card for This.

But I Was Only Trying to Be Helpful

Oh, you know this feeling: You were only trying to be helpful, or to be kind, or to brighten her day. But it turns out that you were unkind, insensitive or even hurtful. How does that happen?

When talking to someone who has cancer, or the caregiver of someone with cancer, it’s not always easy to say the right thing. They have cancer but you can all too easily have foot-in-mouth disease.

The short answer to this dilemma is: Listen more. Talk less. Or, ask before you talk. That one translates as, “May I ask about how you are doing?” or “May I ask about your treatment?” or even, “Do you want to talk about your health—or would you rather hear the gossip from work?”

There is no perfect advice nor a perfect thing to say when you hear that someone has

cancer. If you have met one person with cancer, you met one person with cancer. Some folks will want to talk and talk about details and medical info. Some folks want to talk only to their doc, or partner, or support group. And no, you don’t get to nominate yourself to be part of the support group: it’s by invitation only.

But I know, I know, I know how deeply tempting it is, especially if you have cancer or you are a caregiver. And you often do have great advice and perspective. You just don’t get to slosh it all over someone with out asking permission. I stumble into this all the time. I mean, here I am blogging about couples and cancer: I read the research, I interview experts, I know some stuff-- so I’m always tempted. But I try to keep it here on the blog—mostly.

Also be careful with optimism. It’s great that your personality tips that way but saying, “Everything’s going to be great” may not be true, and now your friend knows they can’t confide in you or they know that, as Jack Nicolson said in the movie A Few Good Men, “You can’t handle the truth.”

Let the person with cancer lead the conversation. Offer news and updates on your life and the things that your common field of interest suggests. Take your lead on their language about cancer as well: If they are battling cancer or in a war with cancer you can use military lingo, but if they are not using militaristic metaphors, lay off—even if that is what you got you through your chemo. 

All of this requires powerful listening skills, and caring. So have a little talk with yourself before you talk to your friend. 

How Not to Say the Wrong Thing

Maybe you saw this fabulous article making the rounds on Facebook. OR maybe someone sent you the link or handed you the clipping. (In that later case read it twice because maybe there is a hidden message there for you.)

But I'm posting it here because it is simply smart and funny and true.

In CancerLand we know how it is to be on the receiving end of, "Dear God, did she really just say that?" kind of comments. But we also want to be careful that we are not the deliverer of such things either. And, given the stress and distortion of cancer, it's possible that out of love or pain or fear, we might say the screwiest things.

This fabulous article by Susan Silk and Barry Goldman  reminds friends and loved ones how to, as the title says, not say the wrong thing. But it goes to a place none have gone before--it adds this diagram to help you

determine whether you should say that thing you want to say to this person. Or maybe you can say it to some other person instead, or maybe just shut up and write in your journal or have a good cry.

The bottom line is: "Comfort IN. Dump OUT."

Here's the link to the article:
http://articles.latimes.com/2013/apr/07/opinion/la-oe-0407-silk-ring-theory-20130407

Take the time to click and read,  and do share this one like crazy.

Talking to a Sick Friend

We have been there. You have been the sick friend or you are the caregiver and you witness these conversations. A friend knows that you have cancer and what do they say now? They want to say something helpful, comforting or maybe distracting? But instead what comes out is painful, awkward or downright senseless.

And yes, it’s true even though we have been on the receiving end doesn’t mean we have not delivered our own misplaced advice, perspective or strange comments. In fact those of us in Cancer Land might be at greater risk of saying something untoward because we have some information or some advice.

But be mindful of this axiom: “A closed mouth gathers no feet.”

And then get this new book: “How to Be a Friend to a Friend Who’s Sick.” Its brand new and by Letty Cottin Pogrebin. Yes, you recognize that name. She was co-founder, with Gloria Steinem, of Ms. Magazine. So yes, this is a smart book and it’s not just etiquette—it’s also social perspective.

While warning off clichés and self-referential comments (My cancer, my wife’s cancer…) Pogrebin also explains how not to infantilize the patient, and how to talk with someone who has a terminal diagnosis. (Yes, of course you are visiting them—this is your good friend.)

“How to Be a Friend to a Friend Who’s Sick” is getting great reviews so you can find it easily at your local independent bookstore or at the library.

Who Has it Harder...

There’s a subtle competition in CancerLand. It happens with both patients and caregivers. It’s called “Who has it Harder?” and it goes like this:

What kind of cancer does he have? Colon cancer? What stage? Stage 3. Oh, that’s too bad. My brother had stage three, and he had a total bowel reconstruction. Oh wow. He had a resection, colostomy for six months, then another surgery. Yeah. It’s hard isn’t it? He didn’t miss a day of work. Oh, he missed a year. I had to take six months off. Quit my job. Retired early. And I had my own scare. Breast cancer two years ago. Me too. Mastectomy? No, lumpectomy but a year of chemo. No chemo but lymphedema forever. Yeah. I can’t do anything anymore. He has….

Maybe it’s because our worlds shrink so much? Maybe the chemo works on our lives just as it does on the tumors?

How do we fight that? How do we not engage in “Who has it harder? Maybe it’s CancerLand small talk? I feel so small I have to make cancer bigger? Or maybe it feels so bad and we feel like no one else understands so we keep the focus on the only thing we now feel expert about.

How to step out of the game? Get a life? Surrender to win?