October 29 2009, 10:48 AM

You’d think having breast cancer would give me some idea of how to react or what to say when I hear that someone I know has cancer, but it doesn’t seem to work like that.  I’m still sometimes just as mute and aghast as the next guy. But — at the risk of paralyzing you further when you are next faced with talking to someone with cancer — I can help with what not to say. Here are some pointers:

1.  “Don’t worry, you’ll be fine.” Please, make an effort. Use your imagination. And above all, don’t be dismissive of the person’s legitimate right to feel totally freaked out. Cancer is serious business. It’s Darth Vader, the Bogeyman and weird Haitian voodoo hexes all rolled into one. Let’s respect the fear, but nurture the hope. Try telling the person that you’re sending her prayers/energy/good mojo/whatever. Plagiarize — grab a quote from someone she’s inspired by (Winston Churchill’s “Keep buggering on” works for me.) Or, if you can pull it off, make her laugh, like my friend Ben did when he said: “I can’t believe it picked you… I feel sorry for the cancer.”

2. “My cousin had cancer and she never missed a day of work, even when she was having chemo.” Well, la-tee-da! I hate her already. This is called Lance Armstrong-ing. We are not all going to win the Tour de France 150 times during our cancer treatment. I do understand the intention to show by example what is possible; that a person can beat her cancer and it need not even slow her down, rah rah sis boom bah. But go gently, brave cheerleader, if you’re going this route. Avoid Lance Armstrong-ing.

3. “You should try a macrobiotic diet/seeing my guru/eating all your meals while standing on your head/etc.” There are many things outside of conventional medicine that can have amazing results. If you want to suggest something that might involve a big change for a person with cancer, remember that she might be trying just about everything she can manage already. You can inadvertently set her up to feel like she’s not really “fighting” if she doesn’t take your advice and meditate with a Shaman in Goa. If you passionately believe in a certain remedy, try an open-ended approach: “If you’re not really into talking about this let me know, but I heard of something I wanted to share with you, and you can feel free to take it or leave it.”

4. “You have to beat this for your daughter/son/kids.” Oh really? Because I wasn’t already lying awake at night in a cold sweat, just praying I’m going to see my child’s 10th birthday/bar mitzvah/wedding. But thanks for pointing it out, and adding that extra layer of self-blame if my next test results aren’t so hot… I know that this sort of statement is intended to get the person to draw on her inner parental love-power and pull through for the sake of her kids, and yep, that ferocious love is a pretty potent force. Nobody, sick or healthy, wants to imagine not being there as their children grow up. Sadly, you can do everything in your power to beat cancer and still not win – but is that because you didn’t love your kids enough?

5.  “I read a study that said __________.” Please see recent blog posts on the dangers of interpreting statistics and studies. If you read something that is interesting or that you think is important, tread very carefully when bringing it up with someone who has cancer.  Even if you’re a doctor, your information – or misinformation – can have a huge psychological impact, and not always for the better.

6. “Think of cancer as a gift/lesson/opportunity.” Let me ask you this, oh spewer of bunk, which kind of gift would you prefer: a bracelet/flowers/spa treatment… OR a disease that robs you of your health, job, hair, vitality, fertility and possibly your life? Need some time to think it over? Let me tell you what I would choose: not to have cancer ever again anymore for the rest of my life. That is a gift. However… there was a woman I knew and admired and loved like a second mom, and she used to refer to her cancer as “a gift wrapped in barbed wire.” This acknowledged that the experience of cancer did bring many positive things (inner strength, deep connections with other people, perspective on life – whatever) but that it was painful and hurtful and excruciating to get to those things. So in Mary Sue’s honour, I will allow this: if you really, really insist on suggesting that cancer is a gift, please emphasize that its one that comes wrapped in barbed wire and rolled around in a lot of crap, resembling a giant, spiky and foul-smelling truffle.

7. “Should you be having that glass of wine / cheeseburger / Marlboro Light / triple sundae with chocolate sauce / tequila body shot?” (Gosh, that does sound like a good time, doesn’t it??) OK, we all know that there are things that aren’t good for us; things that studies show are linked to different cancers; things that we should avoid.  Personally, when I indulge in these sorts of things from time to time I do so because I want to feel normal. Because they make me happy. Because I’ve had a bad day, dammit. Whatever the reason, I probably already know I shouldn’t be indulging, and I probably don’t need you to call me on it. My standard line is always, “You just worry about yourself, I’ve already got cancer.”

8. “Stay positive, it’s all in the attitude.” Before you say this, consider: Have you ever tried staying positive when all your hair falls out and you’re afraid of dying? Actually, this statement is not necessarily a no-no, but it’s a really tough call, because while keeping a positive attitude is important, it’s not necessarily going to affect your longevity. Apparently it’s authenticity that counts – feeling what you’re feeling when you feel it. Nobody can be positive all the time, so why should someone with cancer be able to constantly maintain a chipper outlook? Instead of telling someone her health depends on her positive attitude, just try doing what you can to make her life easier when she’s feeling like crap.

9. “We didn’t invite you because we thought you wouldn’t be up to it.” Don’t. Ever. Do. This. Always invite the person with cancer even if you know she’s bed-ridden. Make sure she knows that there’s no pressure to attend, but that you wanted her to know she’s included anyway. Keep inviting her to everything you would if she weren’t sick – the block party, the girls’ lunch, the political rally, the tarts-and-vicars soirée – everything. Let it be her choice if she can make it or not. You’ll be making her feel that she’s still part of the world; still herself. And besides, you never know when she might actually be up for one of these events.

10. “So-and-so said that getting your kind of cancer at your age is the worst because it means your chances of survival are terrible, and I was like, Oh this is so upsetting, why are you telling me this??” Why indeed, would anyone ever tell anyone that? Why would someone then recount it to the person with said “terrible chances of survival?” Yet someone really did say this to me once, without even realizing what she was saying. And I love her still, in spite of it.

I guess I wanted to end with that one to make the point that you can’t really say the wrong thing if your heart is in the right place. I mean, you can obviously (and quite spectacularly!) but it’s not the end of the world. And it shouldn’t be the end of a friendship. Love is clumsy sometimes. There’s no perfect thing to say, because everyone is different, and everyone’s cancer is different. Maybe the best approach is “I love you and I hate that you have to go through this, but I’m here for you.”

And then don’t forget to actually be there.