Finding out you have cancer can be overwhelming for you as well as friends and family. People often don’t know what to say. They may feel sad and uncomfortable and might be afraid of upsetting you. They might be frightened about the possibility of losing you. Sometimes people find it easier to say nothing because they’re afraid of saying the wrong thing. Some people find it easy to talk, while others may become overly careful or act too cheerful.

Overview

Patient: “I had been given the all-clear when a DCIS was discovered. I was shocked and disappointed. I am independent and lone parent to a girl”.

No time for cancer. Life was too busy. It was a bolt from the blue. A provider for her daughter and doing up their house with no other support.

Patients most likely will have many different emotions as they learn more about their diagnosis and begin to learn about treatment options. It’s normal to wonder, “Why me?” or to feel sad, angry, or afraid. Physical and chemical changes from the treatment or the cancer itself can also affect your emotions. The first step is to admit to yourself how you feel. It’s OK to let yourself feel the way you do.

Patient: “accepting my diagnosis and being proactive was hard”

“I wanted to remain focused, get it over with and return to work”

“I am very independent” “I’m very capable and financially independent” “I’m fiercely independent”

Deciding who to tell

Only the patient can decide when to tell their friends and family they have cancer. People are very sobered by the news that someone has cancer. Most people need and want to talk to someone when they find themselves in this kind of situation. It may be even more important for single people without supportive family members nearby to let close friends know what’s happening. People who live alone often have a few extra needs compared to those who live with others.

Sometimes, telling those closest to the patient helps the patient take in the reality of what’s happening. Some people find that by talking, they begin to solve problems and think about other issues as their family and friends ask questions.

A patient might want to explain what kind of cancer they have, which treatments they might need, and their outlook (or prognosis).

It can be helpful to start by making a list of people that the patient wants to talk to in person. Then they can make another list of friends that they socialise with less often and have another friend or family member contact them with the news.

Disclosing to employer

• Ana “I’m very distressed. I was diagnosed with breast cancer yesterday afternoon, so I am trying to understand what that means”
• Jenny “I am so sorry to hear that. I had hoped you’d be given the all clear. Do you know what treatment you will need”?
• Ana “I think it is a small lump that will need to be removed and hopefully it won’t have spread. I’ll know more after the MRI scan next Monday.
• “Let me know what we can do to help or support you. It must be a stressful time for you”

The patient was in shock when she disclosed to her employer but the employer was understanding.

A week later...

Consultant acted quickly. Planned treatment – mastectomy and reconstruction in one operation. Really felt listened to, but the lump was bigger than they originally thought and it was quite an aggressive tumour.

Oncologist

Oncologist: “the tumour was bigger than I thought and it is aggressive. We have caught it early and I am confident we can treat it completely. I will want you to have six cycles of chemotherapy and then four fractions of radiotherapy. This is the ‘best and braces’ approach”.

Ana “I’m so foruntate it’s caught early, but it was nearly missed. I just want to get it started and done as quickly as possible. I’m ready to fight”

Later that week...

Work update

• Ana “it’s not as simple as I thought. I will need a mastectomy and chemotherapy”
• Jenny “Right, OK. Do you want to talk about time off and what we need to do?”
• Ana “Yes please. They said recovery time of three months, but that seems long”. I’d love to be back at work before then”
• Jenny “take your time. Your job will be here when you’re ready. I’ll talk with HR and sort out your sick pay allowance and comfirm that in writing”

Patient felt supported so far, but was still in a fog about that was going on. Work had been understanding but because she was a lone parent of a young girl, she felt on her own.

Two weeks later...

Director and HR said that they would pay her for two months to cover the time she would be off work – 8-12 weeks

Had felt 2 months pay would cover her 8—12 week recovery period.

It could be helpful to start by making a list of people that you want to talk to in person. Then you can make another list of friends that you socialize with less often and have another friend or family member contact them with the news.

Advice

Try different things until you find what works for you. When you keep other people involved and informed about your illness, it helps ease your burden. Friends and family can share their strength and concern with you and with each other, which can be helpful for everyone involved

Ana joined a support group for breast cancer survivors shortly after her diagnosis. It helped her process her feelings and feel connected and not alone.

“I could not do this without my support group. They’re going through this with me and we understand each other in ways that no one else can. My family tries to understand how I feel, but my support group friends know how I feel – they’re fighting cancer, too.”

Cancer is very personal and each patient needs to be comfortable with how much they share with people who just want to know what’s happening. They may have to think about ways to tell people that they don’t want to talk about their personal business. In many cases, “Thank you for asking, but I’d rather not talk about it right now” is enough to make people understand, but sometimes the patient may have to be more direct. “I’d prefer not to go into details” or “I don’t want to get into my private health issues” may be needed.