What to say

With the help of a registered psychotherapist, Clare, and our experienced breast cancer nurse, Janice, we’ve compiled the following wise words to put in your toolkit.

A diagnosis of breast cancer is deeply upsetting and shocking – not just for the patient, but also for family, friends and workmates. The person with the diagnosis may be contending with all sorts of feelings, such as fear, anxiety, anger and guilt. They may feel very raw and exposed and, therefore, more sensitive to comments than they usually would be.

Most of us would expect the person with the diagnosis to feel upset and frightened but may not expect anger or guilt, and yet these are very common feelings for patients to have.

Often we feel unequipped to deal with such bad news. Unwittingly, we might make it worse by saying the wrong thing. Sometimes, we say nothing at all, which can be just as hurtful.

Just to complicate matters it is important to think about how we communicate – such as our tone of voice. It is important not to underestimate the importance of non-verbal communication, for example, meeting somebody’s eye, or the impact of giving their hand a squeeze.

To help you find the right words, here are some frequently-repeated comments and a suggestion of what to say instead (and why):

• You'll be fine!
  
  This is well meaning but prevents patients from being able to express their fears. Instead say: I'm so sorry to hear that. What a shock for you. I know that there have been a lot of improvements in breast cancer treatments. (Try to stay away from the word ‘progress’ because it is used in such a confusing way in cancer services – disease ‘progressing,’ for example.)
  

• Stay positive.
  
  This puts unfair pressure on people. Instead say: I'm sure you'll have your ups and downs. Do call me if you're having a down day and we can do something together.

• I'd never do chemo/take Tamoxifen. They're so toxic....
  
  It’s important to respect the patient's choice regarding treatment and try not to impose your own beliefs. It is impossible for us to know what we really would do in that situation ourselves unless we have been in that position. Instead say: These treatments have been tried and tested, and really help people. They’re much less toxic than the cancer itself, and the medicines for stopping side effects are much better than they used to be.

• My friend/aunt/cousin died of breast cancer.
  
  

  Instead say: So many women live long lives after breast cancer these days thanks to improved treatments. We have to remember that, because it isn’t like it might have been 20 or 30 years ago.

• If you rub turmeric on your breast/eat asparagus/live on raw, organic veges and juices, you can cure this.
  
  None of these have any scientific merit so don't advise people about things you’ve read on the internet.

• What caused it? Maybe it's because you drank out of plastic bottles/carried your phone near your breast/had too much stress in your life...
  
  Don't blame the patient! Instead just agree that it’s unfortunately very common these days and little is known about the cause.

• Ask them to take both of your breasts off.
  
  Don't give uninformed advice. Instead, encourage the patient to talk to her surgeon about the best plan.

• Don't have a partial mastectomy. Have a full mastectomy to make sure.
  
  Outcomes from mastectomy vs. partial mastectomy are essentially the same. Instead say: Fortunately it's often possible to deal with breast cancer without removing your whole breast. I am sure that the surgeons will know what is best in your situation.

• Well, at least you can get a free boob job.
  
  Really?! Don't even go there.

• If you need any help, let me know.
  
  

  Again, this is well-intentioned, but often people won’t ask for help even when they really need it. Try being more specific with your offer, e.g. How about I bring dinner on Monday or pick the kids up after school on Thursday?

  
  

If you have said any of these things to a loved one, you are not alone. Who amongst us has never made a comment that they then regret? If you think you might have inadvertently caused offence or hurt, say sorry!

Finally, a patient has offered this advice to other patients:

If you’re on the receiving end of an unhelpful comment, understand that people are shocked and want to find a reason. Remember, we are fighting the disease, not people.

Many thanks to BCFNZ breast care nurse Janice Wood, and registered psychotherapist Clare Greensmith, who has counselled many breast cancer patients and their families.

Breast cancer has hidden ramifications; often all we see is 'glamorous' women but often, after all the treatment has finished, most people still feel very vulnerable - the effects of treatment last for a long time!

Instead of texting, pick up the phone.