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Dr. Nikhil Joshi Headshot

10 Things Not to Say to Someone With Cancer (and What to Say Instead)

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First off, you're an awesome person. You're reading this because someone you know is touched by cancer and you want to know how to avoid hackneyed phrases and suggestions which tick them off. As a person who recently finished treatment for cancer (Hodgkins Lymphoma) and a physician, I'm happy to take you through a brief tour of 10 things not to say:

10) How are you feeling?

How do you think they feel? They have cancer! How would you feel?! Next!

9) Have you tried praying?

Really? Now is the time you want to proclaim your faith? I write this as a person who believes in God: keep your personal beliefs to yourself. Not the time for missionary work.

8) Have you tried yoga/natural health products/getting rid of your cellphone to cure yourself?

Maybe it's just me as a physician, but they're probably on chemotherapy. Whatever your particular gripes are with the pharmaceutical companies (and you do have a point) chemotherapy has been trialed on tens of thousands, maybe hundreds of thousands of patients. The effects have been studied in depth. I received four rounds of ABVD chemotherapy because I believe in science and unlike yoga/kale/being gluten-free, it actually has been proven to cure my type of cancer.

7) Are you going to lose your hair?

Yes, most of us lose our hair. But thanks to Breaking Bad, Walter White cancer chic is in. Rock it with pride.

6) Have you heard from (insert ex-lover or ex-friend here)?

Is this the best time to remind someone that the love they probably cultivated for years or the friends they once were close to didn't reach out to them? No. No it isn't.

5) How are your parents/kids doing?

The whole family is so excited I have cancer! Said no one, ever. But, seriously what are they going to tell you other than everyone is doing the best they can?

4) We should go out for dinner/clubbing/take a trip!

Hmm, restaurants and clubs are usually no-nos. Think infection control: where can I take this person where there are a small number of people, none of them children, and for a short time that breaks up the monotony of their house/bed rest?

3) Think positive/read The Secret

Is thinking positive and cultivating a happy and balanced outlook important to people with cancer? Absolutely. Is telling someone else to think positive even the slightest bit helpful? Not at all. And don't get me started on The Secret.

2) You can beat this. You're strong.

People don't die of cancer because they've "lost the fight." That's an incredibly simplistic way of looking at it. People die of cancer because their tumor burden is simply too high and sometimes chemotherapy is ineffective depending on the type of cancer. This has nothing to do with their will to live, or their personal character, or how much suffering they've experienced.

1) You'll be fine.

Are you this person's physician? Are you just saying this because you want them to be fine but really know that no one knows how this is all going to play out? I hope so. I hope you face up to the reality that I did: that no one knows or has control over what happens in the course of any serious illness. Pretending everything is going to be fine is ridiculous and yes, condescending.

Hey! Now that this list is over, thanks for reading it. If you've said one of these phrases before, don't sweat it; you're at least one of the people who is trying to care about someone, so that makes you pretty great. What else can we ask for beyond someone trying to reach out to us? I'm the last person to actually give people a hard time over awkward but well-meaning phrases.

In the end, the most important thing to say to a person with cancer is anything at all. Because the isolation from cancer is sometimes the worst part of the disease. But here are my tips on a few good places to start:

5 Things You Should Say

5) Did you see the game last night?

One of my best friends called me a day before a round of chemotherapy to talk about football. I remember because we were talking about the Cowboys and I happen to like Tony Romo and was defending him as he played his heart out against the Broncos. But what I really appreciated about my friends' phone call was that it did not have anything to do with cancer. It was about normal guy stuff. Normal. It's almost enough to feel like winning the lottery to a cancer patient. Therefore you don't actually have to ask about football -- just ask about something normal. In fact, open up every conversation with something normal. If cancer gets talked about, great, if not, that's great too. Let the patient decide if they want to talk about it.

4) Remember that time when we... ?

Most patients like to recall the better times in their lives. Lots of people do. Sometimes the hardest part of having cancer is remembering that you are more than the patient version of yourself. That there is a person behind the diagnosis who once laughed and loved.

3) Did you hear about so-and-so?

This can only work if you actually know people in common. Letting someone know about the outside world which seems too far away for most of us can be both hilarious and soothing. Talking about someone else's problems was a relief from my own.

2) Netflix

Netflix. I lived on Netflix through my chemotherapy. I will always be grateful to the service for recently uploading all seven seasons of The West Wing. As a Canadian, I kept hoping Martin Sheen would consider coming here and becoming our next prime minister. But I digress. The bottom line is recommend movies or shows to watch that might have a humorous bent.

And the #1 thing to tell someone with cancer is...

1) You look great!

Cancer is a strange bedfellow. Somehow you go from being a normal person with normal desires to becoming this fragile human specimen sometimes on the cusp of life and death. And to be honest, after chemo, the last thing on your mind is being desirable. But as you recover, it never fails to crawl back into your mind. I never realized how important intimacy and human contact were until I couldn't have them freely anymore. Until my friends, family and romantic interests were afraid to touch me. To you this might seem trivial, but to me it was devastating.

So when I was going out to dinner before my last round of chemotherapy on a date and she told me I looked great and kissed me goodnight I realized not all compliments or kisses are equal. I truly appreciated it.

Dr. Nikhil Joshi is a physician, writer, speaker and author of The End of Suffering. Visit his website:

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