What not to say to people with cancer

You might be surprised to learn that some of the well-meaning words said to people with cancer are the things they want least to hear.

Why do so many people say the wrong things? Those who don't have cancer might not have the insights to offer the right words. Some speak before thinking. Others stumble due to anxiety.

"Some people feel uncomfortable talking to those with cancer because the disease taps into their own fears and misconceptions," says Walter Baile, M.D., professor in the Department of Behavioral Science and director of I*CARE, a program at MD Anderson to improve communications among cancer patients, their families and their providers. "As a result, they respond on an emotional level rather than considering what could be helpful to the other person."

The best advice on this topic comes directly from those who have, or have had, cancer.

Take it personally

As you probably suspect, there isn't a universally acceptable set of phrases and actions. Statements that one person found encouraging, didn't resonate with another. Actions viewed as supportive to one, weren't as welcomed by the next.

Therefore, one of the first tips is to recognize someone's individuality. Take into account what you know about that person and tailor your interactions accordingly. Is he or she an open book and more likely to welcome inquiries, or someone who's more private about his or her personal life?

"We all bring our personalities into cancer," says Sharon Parker, an eight-year cancer survivor who also is a caregiver for someone with cancer and an employee who interacts with patients as senior administrative assistant in Place ... of Wellness. "So, think about that person's personality and factor it into deciding the best way to interact with him or her after a diagnosis."

If the person is a stranger, you still might be able to personalize your words. "I'm from Louisiana, so when I see someone wearing something reflecting my home state, I try to connect with them by telling them I'm a Baton Rouge boy," says Bill Baun, manager, Wellness Program, who is a three-year prostate cancer survivor.

Can't find a connection? General friendliness usually is well received. But, are knee-jerk pleasantries such as"Have a nice day" viewed as insensitive, since our patients are facinga serious disease that requires some not-so-pleasant treatments?" As a patient, phrases like that don't bother me," says Martin Raber, M.D., clinical professor in the Department of Gastrointestinal Medical Oncology, who was diagnosed with cancer in 1995. "But I also say 'Good luck' or 'I hope things go well for you today' to patients in casual encounters."

The downside of upbeat

When cancer is part of the discussion, many people hope to encourage by making positive statements. Ironically, these can backfire and produce the opposite reaction.

The American Cancer Society offers these insights: While it's good to be encouraging, it's also important not to show false optimism (such as, "I know you'll be all right"), or to tell the person to always have a positive attitude. Doing so might cause the person to feel you are discounting his or her fears, concerns or sad feelings.

Attempts to point out cancer's "silver lining" should be avoided.

While telling someone that he or she is brave or strong might seem like a compliment, it may actually make that person feel pressure to display these noble traits when they don't feel up to it. Statements of realistic empathy, such as "I'm sorry you're going through this," might be a better approach.

A gesture's worth a thousand words

If you feel tongue-tied when talking to someone with cancer, perhaps it's best to say nothing. "Eye contact, a compassionate smile or a reassuring hand squeeze are sometimes all the communication necessary," says Parker, who also emphasizes the importance of courtesy and small acts of kindness.

Another gesture that can be music to patients' ears is a genuine offer of help. "Instead of making a general statement, like 'Is there anything I can do for you?,' suggest a few essential activities that you can take off their plate," says Baile and several others. "Offer specific suggestions, such as going with them to an upcoming appointment, picking up some groceries or watching their children."

And continue offering periodically, as help declined at one point might be greatly appreciated later.

Avoid avoidance

Cancer can make a person feel isolated, and losing connections with people can add stress, according to Baile.

Make an extra effort to reach out. "It meant the world to me to know that people were concerned about me while I was in treatment and after," Parker says.

"We can do our best, but it's always possible that what we do or say will rub someone the wrong way. Just remember, if you do or say something 'wrong,' don't take it personally."

A longer version of this story originally appeared in Messenger, MD Anderson's bimonthly employee magazine.