What not to say to someone with cancer

When a friend, co-worker or family member is diagnosed with cancer, you may find yourself grasping to find the right words to provide comfort and support. While well-intentioned, some of the common responses we tend to have in these circumstances can actually be hurtful or dismissive.

To help navigate these difficult conversations, we asked experts to share what not to say when someone tells you they have cancer. A psychiatrist who works with cancer patients and their family members, as well as licensed counselors — one of whom is also a breast cancer survivor herself — all share with us some better responses to help frame these interactions.


“You Need To Stay Positive”

When someone has cancer and they’re told they need to “stay positive,” it becomes another stressor for them, explains psychiatrist Alan Hsu, M.D. from the Moores Cancer Center at UC San Diego Health. “For someone with cancer, this can sometimes be perceived as a signal that you need them to be doing well and that they now need to be careful not to make you feel worried about them,” Hsu says.

Feeling sad, anxious, demoralized and overwhelmed after a cancer diagnosis or progression of disease are all common experiences, and certainly we want to help people with cancer deal with distress, Hsu says. “However, these are emotions that cannot just be forced away by telling someone to keep a positive attitude.”

Often, this advice is accompanied by a warning to the effect of “if you can’t stay positive, your disease will spread faster,” Hsu has noticed. Not only is the person with cancer afraid that their disease will progress, now they are being told that if it happens, it will be their fault.

The pressure of positive thinking is sometimes so strong, Hsu has heard it described as the “tyranny of positive thinking.”

What to say instead: Ask how the person is coping, suggests Hsu, without immediately offering advice or suggestions. “Listen, and ask them what you can do to help,” he says. “If you are concerned the person is so depressed that they are suicidal or not taking care of their basic needs, then certainly get them medical attention as soon as possible. But in most cases they just need you to be available.”

Let them know that you are someone they can be genuine with, Hsu suggests, and that they don’t need to put on a happy face when they are around you. Most of the time, the person is not looking for their friends and family to problem-solve for them.


“God Never Gives You More Than You Can Handle”

Avoid responses that invalidate their emotions, says Julie Barthels, a licensed clinical social worker with a private practice in Rockford, Illinois. These responses can come in various forms, including phrases such as, “God never gives you more than you can handle,” or, “You’re strong,  you’ll get through this.”

What to do instead: The first response should be one of empathy, Barthels says. You can say something like, “I’m so sorry you are going through this.” Barthels, who herself has gone through a cancer diagnosis and is the author of the book “I’d Rather Love Life Than Hate Cancer,” says the people who were most supportive to her were those who let her experience whatever thoughts or feelings she had during the moment.


“I Know Someone Who Died Of Cancer”

Don’t tell cancer stories, Barthels says. When she was diagnosed with an aggressive form of breast cancer, someone told her, “I know someone who had that. They fought it for two years and then died.”

“That deflated my sense of hope for days,” Barthels says.

Even stories with positive outcomes move the the attention away from the person who is coming to terms with the diagnosis, she explains.

What to do instead: After offering empathy, Barthels suggests lending support, even by simply asking, “How can I support you?”

“Even if you are a cancer survivor, it’s important not to assume what the newly diagnosed cancer patient needs,” she says. “Every individual is different in how they deal with cancer.”


“You’re Going To Be Fine”

Saying everything will be OK is not a reassurance you can give, and it can also discount their feelings, explains Ashley Smith, a Tennessee-based licensed clinical social worker. This may also cut the conversation short, and prevent your friend or family member from sharing with you their fears and worries.

“You may need them to be fine,” Smith says. “But they need you to know they may not be fine.”

What to say instead: Saying, “I’m sorry you’re going through this, and I’m here for you” allows them to know they are not alone, Smith says.