When someone has cancer, keep other people’s cancer stories for when they ask

Someone you know has told you they have cancer. You want to say something, and one thing that can come out first is a story: the person you knew who had the same cancer, and how it went.

Many people who shared advice about this suggest leaving that story out when someone has only just told you, because it moves the conversation off the person in front of you and can come across as insensitive or morbid. The cancer charities say the same. Macmillan Cancer Support, in the UK, says: “It may not be helpful to tell the person about other people’s stories. Cancer is different for everyone.” The American Cancer Society, in the US, says: “It’s usually best not to share stories about family members or friends who have had cancer. Everyone is different, and these stories may not be helpful.” Cancer Research UK’s list of things to try not to do includes: “Compare their situation to somebody else you know, each person’s experience with cancer is unique.” One person adds that comparing a diagnosis to a different loss, such as a pet or a grandparent, also felt dismissive.

When someone tells you they have cancer, say you are sorry and that you are there, and keep stories about other people’s cancer for when they ask.

This page is for a friend, relative or colleague of the person with cancer. It does not cover caring for someone at home day to day, someone who is dying, or what to say after a death; the end of this page says where to look.

What to say instead

The American Cancer Society says to try to make your response “honest and heartfelt,” and offers plain words: “I’m not sure what to say, but I want you to know I care. I’m here for you.” “I’m sorry to hear that you are going through this.” “If you would like to talk about it, I’m here.” Macmillan says that if you find it hard to talk, “it is okay to say, ‘I don’t know what to say’,” and that being honest about your feelings “will help build trust between you.” If you have been close to cancer yourself, the American Cancer Society suggests this in place of the story: let them know you are familiar with cancer because you have been through it with someone else, “then they can pick up the conversation from there.”

Some people suggest, if you have nothing specific to offer, saying plainly that it is awful and asking how they are handling it, and then talking about ordinary things rather than the medical details again. The American Cancer Society says to ask whether they want advice or just support, and says your friend may not want to talk but may not like being alone either. Macmillan says to let them know it is okay to tell you they want to be alone, and, if you cannot visit, to call, text or send a card and say they do not have to reply. On humour, the American Cancer Society says to let the person with cancer take the lead, and Cancer Research UK says not to use it unless they have. The American Cancer Society also says: “don’t share their news unless they have given you permission.”

Lines to leave out

Cancer charities, and some people who have had cancer, name these lines. Said kindly, each can still land badly.

• “I know how you feel.” The American Cancer Society says not to say “I can imagine how you must feel,” “because you really can’t.” Cancer Research UK lists saying you know how they feel among the things to try not to do.
• “Be strong,” “be positive,” “fight it.” Cancer Research UK says these put pressure on the person to behave a certain way. The American Cancer Society says not to tell them how strong they are, because they may feel they have to act strong even when they are sad or exhausted.
• Battle language. Some people say that calling cancer a fight or a battle implies that someone who dies did not fight hard enough. The American Cancer Society says to ask your loved one how they feel about battle language before you use it, because for some people it is motivating and for others hurtful, especially when the cancer is advanced or cannot be cured: “Their disease didn’t progress because they fought any less.”
• “It will be fine.” Macmillan says to try not to say that everything will be fine, and that it is better to let people speak honestly about their feelings. For parents of a child with cancer, the American Cancer Society says of “It’s going to be OK”: “Unfortunately, no one knows what the outcome will be.” Some people say the same. One person, writing about someone who later died, says that hoping out loud was a kindness and not something to punish yourself over.
• Comments on how they look. The American Cancer Society says: “If they look good, let them know! Avoid making comments when their appearance isn’t as good, such as ‘You’re looking pale,’ or ‘You’ve lost weight.’” One person says praising weight loss can be painful for someone with a history of an eating disorder, and another that a remark about weight gain from steroids, or about hair loss, can hurt even when meant as a compliment. One person says “it will grow back” can brush aside the distress of someone who feels they are losing part of who they are. There is a page here called Don’t compliment the shrinking.
• Advice they did not ask for. The American Cancer Society says not to offer medical advice or your opinions on diet, vitamins and herbal therapies unless asked, and not to remind them of past behaviours that might be related to the illness, such as drinking or smoking, because some people feel guilty about those things. Some people say a person in treatment has probably already researched their options and may feel judged. The National Cancer Institute says a person with cancer who wants to use complementary or alternative medicine should talk with their own doctor or nurse first.
• Religious messages and pity. For parents of a child with cancer, the American Cancer Society says to avoid religious messages unless you are confident you understand the family’s beliefs. One person says that for someone who is religious, prayer can comfort more than secular words, so follow the person’s own sources of peace. One person lists “Is it serious?” and “You have so much to live for” as tone-deaf, and another names pity and a condescending tone among the hardest things to hear.

Before you visit or bring food

Cancer treatment can weaken the immune system, so a visitor’s cold or stomach bug is a larger matter than it would be if their immune system were not weakened. Macmillan lists “Do not visit if you are not feeling well” for a hospital visit and for a visit at home, and the American Cancer Society says not to be around someone with cancer if you are sick or have a fever or other signs of infection. The National Cancer Institute says people having treatment should stay away from people who are sick or have a cold, and that the people around them should wash their hands well. Macmillan says the risk is highest about 7 to 14 days after chemotherapy, and the American Cancer Society puts the lowest point of the white blood cell count at about 7 to 12 days after chemo starts; both say it varies, so the person’s own team can say when it applies to them. Call or text before you come. The American Cancer Society suggests short, regular visits over long ones far apart.

If you live with the person or spend a lot of time with them, the American Cancer Society says that “Household contacts, including children and teens, are a major source of exposure to infections,” and that it is important for family members, caregivers and other close contacts to be vaccinated. It says to talk to the person’s health care team before you or anyone close to you has any vaccine, because most can be given but there are exceptions.

If you cook, the American Cancer Society says: “If your friend is getting treatment, ask what they feel like eating.” One person says tastes change in treatment, so check before sending a favourite food, and another suggests keeping to what the family normally eats so there is no guilt about waste. The American Cancer Society’s food-safety page has a list for when a person’s white blood cell count is low. It says to avoid, among other things: raw or lightly cooked fish, shellfish and sushi; raw or soft-cooked eggs and foods made with raw eggs; unpasteurized milk, cheese and juice; soft, mold-ripened and blue-veined cheeses; raw vegetable sprouts; raw nuts and fresh nut butters; and foods from deli counters, buffets and bulk bins. It lists vacuum-sealed nuts and shelf-stable nut butters as fine. For anyone cooking, the same page says to cook meat until it is no longer pink and the juices run clear, that a food thermometer is the only sure check, and not to leave egg dishes or cream- and mayonnaise-based foods out of the fridge for more than an hour. In the UK, Macmillan says some foods can carry harmful bacteria, especially shellfish, poultry and eggs, and that people who have had an autologous stem cell transplant or are having high doses of chemotherapy may get specific advice from their nurse. Ask the person or the family what their team has told them. One person adds that hospital units often do not allow flowers, so ask before sending any.

Offers that carry a day on them

An open offer such as let me know if you need anything leaves the work with the person who has the least energy. There is a page here called Offer one thing, with a day on it about why. The American Cancer Society, writing about the parents of a child with cancer, says to be proactive and specific and to tell them exactly how you plan to help, for example, “I can let the dog out while you’re at the doctor tomorrow.” Some people suggest the same, because a person in treatment has little energy left to work out what they need and may not want to impose.

The charities’ lists of jobs overlap: dinner or freezer meals, an hour of cleaning, laundry, lawn or garden work, groceries, school pick-ups, pet care, and rides to appointments and waiting while they have treatment. If you go to an appointment, Macmillan suggests asking beforehand how involved they want you to be, and offering to write things down. The American Cancer Society says that running an errand for the caregiver is as helpful as running one for your friend.

Two limits come from the same pages. The American Cancer Society says to plan projects in advance and start them only after talking with your friend or the caregiver, and for parents it says not to be too insistent or ask too often. One person says sending strangers into the home, such as a cleaning crew the family did not ask for, can add stress, and another describes cleaning as a health matter when a person’s blood counts are low. Ask first either way. Cancer Research UK says to make sure you can commit to any offer you make.

If you are thinking of raising money, the American Cancer Society says to check with your friend first, because “Sometimes, raising money or crowdfunding can affect their benefits.” For advice on benefits, in the US LawHelp.org points to legal help by state, and 211 can point to local services. In the UK, Citizens Advice gives advice on benefits: England 0800 144 8848, Wales 0800 702 2020, Scotland 0800 028 1456, and in Northern Ireland, Advice NI 0800 915 4604.

When treatment ends

It can look as if the hard part is over. The American Cancer Society says it is common for phone calls, doctor visits and support to fade away when treatment ends, and that many people are not well prepared for the move out of treatment: money strain, long-term and late side effects and fear that the cancer will return can feel overwhelming and lonely. One person says the hardest period can begin once treatment stops and the check-ups thin out, leaving fear of a return and no clear next steps.

The American Cancer Society lists “Aren’t you so happy to be cancer-free/done with treatment?” among the phrases to try replacing, because the person may feel guilty or ashamed for not being happier or more grateful. Its suggestion: “It’s so great to see you done with treatment. I want you to know I’m still here for you, for as long as you need it.” One person suggests, instead of telling a survivor they are lucky to be alive, saying that you are glad they are in your life. The American Cancer Society says to end a call or note with “I’ll be in touch again soon,” and to follow through. If low mood or worry continues, it says it may be time to seek professional support, and that you can offer to help them find a counsellor or therapist who works with people with cancer.

If a child has cancer

The American Cancer Society page on supporting the parents of a child with cancer says to offer the other children in the family homework help, rides or activities, and to keep checking in with the parents after treatment ends. A paediatric oncologist quoted there says: “The most important thing is not to pull back.” Some people say brothers and sisters of a sick child are easily overlooked when the parents are stretched, and one person says taking them for a day or overnight helps the parents more than a short babysitting offer. The visiting and vaccination lines above matter here too; ask the parents what the child’s team has said about visitors.

Who this page is not for

If you are the person with cancer, this page is about the people around you, and the cancer charities named here have pages for you. If you live with the person and help care for them every day, the National Cancer Institute’s booklet When Someone You Love Is Being Treated for Cancer is about looking after yourself as a caregiver. In the US, Family Caregiver Alliance (1-800-445-8106) supports people who care for an adult family member, and in the UK Carers UK (0808 808 7777, Monday to Friday, 9am to 6pm) does. If the person is dying, Macmillan and the American Cancer Society each have a section for friends and family, and there is a guide here called Someone died for the days after a death.

The American Cancer Society also says that “A cancer diagnosis does not make abusive or unsafe behavior acceptable,” and that it is okay to set limits or seek support if a friendship is hurting you. If someone close to you is hurting, threatening or controlling you, the National Domestic Violence Hotline in the US is 1-800-799-7233, and in the UK the National Domestic Abuse Helpline is 0808 2000 247 (Scotland 0800 027 1234, Wales 0808 80 10 800, and for adults in Northern Ireland 0808 802 1414); in danger now, call 911 in the US or 999 in the UK. If you are finding this heavy yourself, it says you do not need to be ashamed of your own fears, and that you may want support from a mental health professional or a local support group.

If you want to talk to someone about cancer or about supporting someone, the American Cancer Society helpline in the US is 1-800-227-2345, which its site says is open 24 hours a day, 7 days a week. In the UK, Macmillan’s page says: “Call us free on 0808 808 0000,” 8am to 8pm, 7 days a week, and Cancer Research UK’s page lists freephone 0808 800 4040, 9 to 5 Monday to Friday. If this has you thinking about ending your life, call or text 988 in the US, or call Samaritans on 116 123 in the UK, at any hour; if you are in danger now, call 911 in the US or 999 in the UK, or elsewhere, your local emergency number.