Your own head is spinning with a breast cancer diagnosis and you have doctors to see, procedures to endure, and decisions to make about your treatment. You may have worries about how you’ll manage your family, your career, and all the responsibilities of your life. You need to find ways to tell your family, your loved ones, possibly children, and close friends. The last thing you need is to have to respond to awkward questions and comments!
Once you tell people about a breast cancer diagnosis, they will have questions — well-intentioned questions, worried questions, thoughtful questions, and sometimes awkward and ridiculous questions and comments. How do you handle this when you’re overwhelmed yourself? It’s not easy, but I can suggest a few strategies that can help.
There are resources available to help you talk to family and friends and ways to answer their questions. You can be selective about telling friends and coworkers if you think carefully about how you share the news. Many women find it helpful to have a “cancer-free zone,” whether it’s work, a book club, or anyplace else they choose not to talk about cancer. If someone notices and asks, you can acknowledge their concern, but also let them know that you prefer not to talk about it in this setting. You are entitled to request privacy, and let anyone who asks know that you are focusing on your work, or the book club, or whatever it may be, and that you enjoy the distraction.
But breast cancer should not be a secret, and telling friends can lead to welcome emotional and practical support. People may ask STUPID questions and make AWFUL comments, but most people are well intentioned. They may be shocked, worried, and even frightened of the very word “cancer,” but they usually do not mean to be hurtful. It can help to be prepared for these situations and think in advance about how you wish to respond. Thinking it through and being prepared can help you answer in your own chosen way even when you are tired, upset, worried, or feeling OK but upset by the question or angry about a comment.
Friends can be a wonderful source of support and comfort. So answering their questions thoughtfully is worth the effort to maintain your close connection. Everything can feel emotionally supercharged when you get a cancer diagnosis and it is a challenge to respond in a friendly way. If you are too upset to respond pleasantly or calmly, it could be best to simply say, “I would rather not talk about it right now.” You can be prepared for these moments by having a topic ready to shift into — like your pets, or good recipes, or even the local weather forecast.
Treatment questions are common. People may make suggestions, offer non-expert advice, relate stories of other people they know who had breast cancer, and ask about your treatment. You do not have to answer! A simple “I will run that past my doctors” is a great answer, even if the idea is so silly you will never run it past your doctors. Pointed questions about sensitive things, such as, “Will you lose your hair?” or, “Will you will lose your breast or have reconstruction?” can be answered with a straightforward, “I prefer not to talk about that now.” You can tell friends that you have a really good medical team to talk to about cancer, and you want to talk about other things with friends.
Work-related questions can be particularly difficult. If somebody asks whether you will keep working, or how you will juggle work with treatment, try not to feel put on the spot. You have probably talked to your treatment team and have some idea of what you will be doing, but you also want to be protective of your professional life. It is good to think this part through before you discuss it with anyone at work, especially management and HR. Be cautious talking with coworkers who may inadvertently say something or be overheard. Remember anything you say to a coworker may be repeated to management. Speak to your healthcare team about a possible Family Medical Leave, short-term disability, or other accommodations that you may need.
Not only are there questions about a cancer diagnosis — there are also flat-out comments. Comments like, “God never gives you more than you can handle” are common, along with statements about how “strong” you are when you are feeling overwhelmed. Who wouldn’t feel angry about hearing these opinions at this time? Have you seen how politicians often don’t answer a question, but say something else instead? It’s a good strategy for these remarks. You can thank them for their concern, or ignore the comment and change the topic. If someone is persistent, you can tell them you don’t want to talk about it.
If you have a close friend you want to talk with, do that privately away from acquaintances. With close friends, you can answer questions, share what you wish to, and tell them what you need at this difficult time. Without such close friends, you may want to join a support group, in person or online, to talk about your feelings and medical and practical questions with people sensitive to this experience. It can be an emotional roller coaster, and having good emotional support will help to make it easier to handle awkward questions or comments.
Frequently people ask, “How can I help?” This is a kind question, but too vague to be helpful. Think of what sort of help you will need. Then you can respond with well-prepared answers: cooked dinners, carpool help, sweeping up autumn leaves, dog walking, and babysitting when you have doctor visits or treatment. Maybe rides to treatment or company from a very close friend during a doctor visit. Sometimes a friend can organize this for you so you don’t get three of the same meals on one night. Maybe you’ll want company for a movie night — or anything you wish. There are websites such as www.carecalendar.org that let friends sign on for things they can do to help. Delegate so you can use your energy for the things you really value, such as being with your children or your work. You can also say you’ll get back to them and “Thanks for the offer.” So don’t shrug this question off. Have an answer, or figure one out and get back to them.
Reassuring comments are very common, because people get anxious talking about cancer. The problem is the other person is the one who is trying to feel better. Breast cancer creates many uncertainties, and comment such as, “You’ll be fine” or, “It’s good they caught it early” may not feel good at all when you are justifiably frightened and upset. I like the idea of checking in with yourself and deciding whether you want to respond angrily by correcting the person and explaining you might not be fine, or that it is never good to have cancer. Or do you feel up to being patient and talking about your real feelings? It can depend a lot on who is commenting and how centered you’re feeling at the time. Think of the “PAUSE” button on your remote control, and imagine that you can press “PAUSE” in these encounters and not answer right away. “I will think about that” is a great and neutral answer that lets you take your time to decide how and when you will talk about it.
Positive spin comments about how great you look or how you were always so health conscious, or the “boob” job your insurance will now pay for, are annoying at best. Maybe you want to ignore these. The “boob” question possibly comes from a “boob” wanting a breast lift they cannot afford. When a thoughtless comment triggers you it can help to remember that you do not have to respond at all. Press “PAUSE,” change the subject, say you are not up to discussing it — whatever works well for you is fine. It is not your job to educate others. When you are facing major surgery for a life-threatening illness, real support will come from those who try to understand your actual feelings and give you the time and space you need to choose what you wish to share and discuss.
I am always shocked when someone shares a frightening story of cancer that has spread or someone who has died of breast cancer. You do not need these anecdotes! As a patient, you know about these possibilities already. You can choose what you will do, whether saying nothing, asking why they are telling you this, or walking away. But you probably will not be choosing your emotional response. After an incident like this, it is important to take care of yourself. Remind yourself of what you know about your individual prognosis. Reach out to a loved one, friend, local or online support group, or your medical team for help or information. Get some real information and support during this difficult time.
Coping with comments and questions, whether kind, awkward, or upsetting, is hard. People react to cancer news in different ways and may be wonderfully supportive or terribly upsetting. Think carefully about who you will choose to share with to limit unwanted conversations, while knowing your news may spread sooner or further than you wish.
In conclusion, preparing yourself with strategies that work for you can make it easier to navigate the questions and comments you will surely hear. Friends and family have different relationships with you, different feelings and experiences around cancer, and their own anxiety and worry about your diagnosis. If you are prepared for how you wish to respond — or not — it will be easier to cope with the inevitable questions and comments while also keeping the support and caring attention from the people in your life.