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Suleika Jaouad

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10 Things Not To Say To A Cancer Patient

Posted: 01/20/2012 8:42 am

When I was diagnosed with leukemia last May, I couldn't imagine what lay ahead for me. The last eight months may have well been eight years. It's been a blur of blood tests and bone marrow biopsies, fevers and infections. Any cancer patient can tell you that the disease turns you into an ersatz medical student, whether you like it or not. But navigating the social dynamics of living with cancer -- communicating with family and friends about my diagnosis, symptoms, fears and hopes -- was a challenge I did not expect.

The oncology world is overdue for an etiquette guide. As a commenter noted on my blog, unless you're Seth Rogen in 50/50, there's no script for what to say to someone with a life-threatening illness. But if you can avoid saying these 10 things, you're off to a good start:

1. Don't ask, "Is there anything I can do?" unless you mean it. If you do, then just do something! When you're sick, asking for help is tiring -- and it can make you feel guilty or pathetic.

2. Don't ignore someone with cancer because you don't know what to say. Say something authentic and from the heart (just not anything on this list!). The old joke about voting applies: do it early and often.

3. Avoid questions about mortality. "What are your chances?" and "How long do you have?" are major no-nos.

4. Don't talk about your friend/cousin/uncle who died of the same cancer.

5. Don't use nicknames that refer to the person's disease. They can come off as offensive, even if they're meant as a joke. These are a few names that I've actually been called: fuzz head, baldy, Suleikemia (really?!).

6. Don't say to someone who's just lost all of her hair, "You look like [insert: an alien, avatar, Pinky or The Brain, Gollum]." This is not the time for the Beat-poet game of "first thought, best thought."

7. Don't put undue pressure on a patient to change doctors or therapies. You may mean well (and you may be right), but be aware that how you offer input can be as important as what you're offering. What worked for you may not apply to someone else.

8. Don't just repeat phrases like "everything will be OK" if the patient is feeling scared or upset. Instead, just be a good listener.

9. Don't tell someone, "Wow, that sucks" upon hearing of their illness. Yes, we know it sucks. Reminders are not necessary.

10. If you say or do something awkward, rude or out of line, don't pretend that it never happened. Apologize, and ask for a redo! It's OK to make mistakes. Cancer patients are used to these kinds of blunders. We'll understand. Just don't play the ostrich in the sand.

If you've made any of these "mistakes," welcome to the club. I created this list from my own experience, not to inspire guilt or cast blame, but to unite us all in the realization that to talk about cancer is first to fail -- then, to "fail better" the next time.

Stay tuned for a future post, "10 Things You Can Do for a Friend With Cancer"

For more by Suleika Jaouad, click here.

For more on cancer, click here.

Suleika Jaouad writes a blog about her experience with cancer at Secrets of Cancerhood. You can follow her on Twitter at @suleikajaouad. Email questions and comments to her at secretsofcancerhood@gmail.com and/or make a comment below!

 

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When I was diagnosed with leukemia last May, I couldn't imagine what lay ahead for me. The last eight months may have well been eight years. It's been a blur of blood tests and bone marrow biopsies, f...
When I was diagnosed with leukemia last May, I couldn't imagine what lay ahead for me. The last eight months may have well been eight years. It's been a blur of blood tests and bone marrow biopsies, f...
 
 
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03:56 PM on 01/23/2012
If I am ever told i have cancer, I'll tell the doc goodbye, I've seen my father, who just turned 70 go through chemo (colon cancer, which traveled to his lungs, and cancer on his kidney), and basically when chemo couldn't do anymore they basically ran him out the door, and last time he went for a checkup last time basically said "You're still here?" and now my aunt is suffering through chemo with breast cancer, and she is a retired oncologist, the dark irony. So basically I probably won't say the wrong thing to a patient but the doc's going to get an earful.
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mrsL
marriage & motherhood with mirth and grace
10:20 AM on 01/23/2012
Those are all good rules for someone who is grieving a loss too.

Overall I think people mean well, but we stumble over our tongues in an effort to be comforting and helpful.

Perhaps the #1 thing to keep in mind if you are sick or have suffered a loss is to keep remembering that overall, people do indeed mean well even if it doesn't come out well.
10:16 AM on 01/23/2012
This really struck home, especially "but you look okay." Not all symptoms are visible. Here's what I love from friends: notice what I'm struggling with, what's not being attended to, and just pitch in if you can. That might be helping with the dishes after we have a meal, or sweeping the kitchen floor when you visit. It might be a phone call saying "Hey, I'm going to the pharmacy, do you need anything?" The day-to-day stuff can be overwhelming, and great friends lighten the load.
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69dogrudebark
GOP.....Guardians of Privilege
04:39 AM on 01/23/2012
Though I did not have cancer....I have a number of serious conditions that required multiple surgeries...

I would like to add to the above list....

Many people would say to me....wow...you lost a lot of weight....good for you....I would respond by saying that my liver was having problems and I was having a lot of side effects from surgery....then most of the time the response was.....Well you don't look sick....at first I would not say anything back and just smile and say thanks....but later....I would reply....do you have a cup of blood in the toilet bowl after every use? Is that looking sick? What does sick look like?....then I realized I was just being bitter because of their ignorance....so...I went back to the thanks...but added....I will remember that when I am having my symptoms control my life....
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mrsL
marriage & motherhood with mirth and grace
10:22 AM on 01/23/2012
Good for you for just saying "Thanks." I think people are trying to be positive for you and for themselves. If you said anything else they would probably just avoid you so that they wouldn't say anything stupid again. It's a narrow line to walk.
10:20 AM on 01/22/2012
Seems some people are losing sight of what the author is "suggesting". This is her private experience and what may or may not have helped her. My hubby is battling cancer off & on for 9 years. You wouldn't believe some of the things people have said or done or not done. All this is is some suggestions and maybe something to think about for someone. Your real friends and family are just there for you no matter what & don't even have to say anything. People you never knew cared, sometimes just come & are angels. People you thought cared & were your friends, often run off scared. Maybe just think about what you say to someone who has cancer or their loved ones before you say or do anything. Or just give them a hug.
02:51 AM on 01/22/2012
Things I detested. 1. the term survivor. 2. all those signs in people's yards, and in businesses for Relay for Life. To me it means, seeds planted for fear. Same with pink ribbons. There has to be better ways than the constant cancer cancer cancer cancer repeated reminders constantly in our faces. I am a have it, get it detected, get rid of it early, monitor it but for the most part forget it sort of individual. Some people thrive on constant reminders, I am not that sort of person. I think those constant reminders profit organizations and businesses but not the person afflicted.
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Bluesky555
Sometimes, ya just gotta SAY it...
08:14 PM on 01/21/2012
Whatever you do, DON'T say "Well at least you lost a lot of weight!"

Someone said that to my mother after she went through 6 months of excruciating chemo treatments (and beat her cancer).
Here's a clue; Being fat is not worse than cancer!! As a matter of fact, that 50 'extra pounds' my mother was carrying on her saved her life! All her doctors agree.
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french queen13
my beloved is mine and I am his
01:05 AM on 01/22/2012
Very good point! My BiL was a little overweight when he went through radiation and chemo, and I'd bet it helped. Though having come through it all, he's now pleased to be able to wear jeans he hasn't fitted into for a decade or two!
03:48 PM on 01/21/2012
I have another one to add: "Oh, you poor thing. See this? It's the world's smallest violin, playing the world's saddest song, just for you."
01:08 PM on 01/21/2012
May I add another? DON'T say Obamacare! Recently, my mother in law's friend had to wait two weeks for permission to insert a Stint ( I don't know if that is the correct spelling or not ) into her heart. The doctor explained to her that he had to get permission from the "Death Panel" and assure them that with the procedure she would live over 1 year. The friend questioned the doctor's statement and found out it was true. That regulation kicked in late December. The media doesn't tell you this. This applies to anyone over 70 years of age or older, yet. Scary stuff.
03:11 PM on 01/21/2012
I believe the correct spelling is "stent." I don't know anything about this particular case, of course, but it would have to be that, in the opinion of the doctor, the patient would be likely to live another year after having the surgery. No doctor can guarantee how long any patient will survive or whether they will even get through the surgery particularly when the patient is 70 or over. That is not exactly "scary," in my opinion, as many people die natural deaths even before age 70. We are not, after all, designed to live forever. In my opinion the more expensive procedures should be limited to patients 60 or below who have as reasonable life expectancy.
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sentimentiques
independent and ornery but purrfectly lovable
04:19 PM on 01/21/2012
It's easy to say that expensive procedures should be limited to patients 60 or below when there's nothing personal involved. If it's you or someone you love, someone in your family, can you really be so cavalier as to say that it's too bad, but it is what it is, time to go.

My husband is 69, he's on dialysis for kidney failure for the last two years. Because of dialysis, his resistance has been lowered, so that free-floating cancer cells in his body (which we all have, by the way) reared their ugly heads, and now after an excision, he has to undergo electron radiation until the end of February. So since he's over 60, are the doctors supposed to just pull the plug, say sorry, but the procedures are too expensive. He's a viable, productive human being who is of immense value to all who know him.

How can any death panel decide who is deserving of lifesaving procedures? How have we come to the point that someone, such as you, can decide that patients over 60 should just step aside and not waste medical procedures?
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shyhon
Truth, Justice and the American Way
06:51 PM on 01/21/2012
Let me tell you something csmomo.
I am over 60. I am physically fit and strong. I have been known to work 6-7 hours in my yard, mowing, blowing, and tree trimming with my chain saw. One day I moved 600 pounds of ceramic tiles from my porch to my garage. Oh, I should mention I carried each 50 box myself. I am easily able to bench press a great deal of weight.
Two years ago as a result of a car accident when I was rear ended, I had to have both my hips replaced. By your reckoning, I would have lived in pain for the rest of my life.
Oh, and I should mention, I am a woman. My brothers (in their 70's) are much stronger than I, and one still works daily repairing/remodeling RV's.
Get a reality check. People are living longer and healthier lives.
My husband’s father lived to 100. His brothers are strong, healthy and still travel. They are in their mid-late 80's.
Whatever age you are I know this; there is more of us than of people of your mentality and we will fight for the right to stay strong, and have healthy and productive lives to the end. You can count on it!
06:22 PM on 01/21/2012
Either you, your mother-in-law, her friend, the Doctor or all of you are liars.

If anything you said was even remotely true about Obamacare, it would be on Fox Spews 24/7.
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mrsL
marriage & motherhood with mirth and grace
10:28 AM on 01/23/2012
This was on Mark Levine's radio show. Close enough.

http://www.therightscoop.com/shock-brain-surgeon-confirms-obamacare-rations-care-has-death-panels/
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zoebliss
11:14 AM on 01/21/2012
im sorry but we arent barometers for your feelings. if we ask if theres something we can do is because we care. i'd rather be real than walk on eggshells. i get it, you are angry that you have cancer & are mad at the world. but be brave & suck it up. everybody dies. you arent some famous philantrophist or mother teresa so nobody should be walking on eggshells around you. and even if you were, you dont have the right to punish people on how they care for you.
11:36 AM on 01/21/2012
I thought I had heard or read it all, but telling a cancer patient to "be brave and suck it up. everyone dies" takes the cake.
01:09 PM on 01/21/2012
I agree with you.
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littleraerae
10:49 AM on 01/21/2012
I'm shocked that there even needs to be a list like this. Aren't these all obvious? Do people have absolutely no sense of sensitivity?
01:20 PM on 01/21/2012
Speaking as someone who has spent a large portion of this past year in active cancer treatment, no, not obvious. Several of these have been said to me.
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MJinCanada
Safe from zombies until my 2nd cup of coffee
08:15 PM on 01/21/2012
See the comments of Zoebliss and Markiscard just a few minutes after yours.
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Rex Devious
If you don't vote, don't bitch
02:50 AM on 01/21/2012
The problem with asking, "Is there anything I can do for you?" is that the person doesn't know if there is. Can you have my floors cleaned for me? Can you get me an extension on my taxes? How are you at curing Lymphoma?

The thing to do instead, is think of something you'd genuinely *enjoy* doing for them, have it ready, and then ask if it would be alright. For example, maybe you have a large collection of DVD's, and pride yourself on picking out films for friends you think they'd be surprisingly pleased with. Then ask, "Say, I have a couple of movies that I thought you'd love. Would it be OK if I brought them around and said hello?"

It doesn't matter if it's something to pass the time or significantly help with recovery, the key should always be something that is the result of the person being in your thoughts *anyway*, not really any different than they would be if they weren't sick. If the only reason you're thinking of them is because of that, let them know your pulling for them and leave it at that.

Which brings me to, "How are you doing?".

The answer to that is depressing to give, so don't ask unless you want to actually know. Otherwise, go with "How are you holding up?" or "I hope you're doing OK through all this".

Acting only on the care you *actually* have will mean the most.
schatsie
Wall Street is Worse than Vegas
09:36 AM on 01/21/2012
Having someone in your thoughts just doesn't do it.... I agree with you about offering something you think that they would appreciate. BUT if that is not what they want, it is easy to follow up with them opening up to you with what THEY WOULD appreciate....and if you ignore that, well that says a lot about you and your 'care', doesn't it.... And if you continually ignore what they say that they want, then you need to consider what kind of relationship you actually have....
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Rex Devious
If you don't vote, don't bitch
02:12 PM on 01/21/2012
If you just spend some time with them and listen, you will likely discover something you can (and will) do that will be greatly appreciated.

This is all about making it easier for someone, distracted by their disease and everything that comes with it, to ask for whatever help they'd want and you'd be happy to give.
01:11 PM on 01/21/2012
Giving a list like this generally inhibits a person from saying anything to a person who is experiencing a fatal illness. My father when he was dying had so many people say "I don't know what to say." He would've liked any comment besides that one.
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Rex Devious
If you don't vote, don't bitch
02:17 PM on 01/21/2012
I agree, it makes it look near impossible. That's why I tried to think of a few alternative suggestions too.

But keep in mind, these are suggestion of one person - they might not apply to everyone in that situation.

Is there anything people said to you father that you'd like to suggest to others?
10:35 PM on 01/20/2012
Fine to say you are rooting for them but stay away from commenting on their short hair. The hair thing can be real tricky.
schatsie
Wall Street is Worse than Vegas
09:39 AM on 01/21/2012
You are really spot on.....I can tell you I was overwhelmed with the lists of side effects....But the one thing I did not expect was that my scalp was BURNED....that it hurt so badly......Just like I was not prepared for the nerve pain after my mastectomy or what the surgery itself did to my lymph system....
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MJinCanada
Safe from zombies until my 2nd cup of coffee
08:38 PM on 01/21/2012
Even though I was prepared by reading, I found there were some shockers too. I knew my hair would fall out, and cut it short in preparation, but I didn't know it would happen almost all at once. My son walked into the kitchen as I was brushing handfuls of hair from my head into the garbage bin. He was so stunned all he could say was "that's more than I needed to see before breakfast" as if I'd been dancing around with toaster in the nude.

The lymph thing was what I was most scared of, oddly, even though there are a lot worse things than wearing a compression sleeve.
09:36 PM on 01/20/2012
.this.seems.so.obvious.
driller7530
Just a RETIRED Oilfield Cowboy
08:46 PM on 01/20/2012
Kudo's .
Even our Caretakers/spouses have hit on some of these.
nothing to be done except get over it and , get better.
and if you know a survivor , join us on the Cancer walk in march, the more the merrier.