How to talk to someone with cancer

There are many ways of communicating, such as kissing, touching, laughing and frowning. However, talking is the most efficient and most specific way of communicating. Other methods of communication are still important, but for them to be of use, you usually have to talk first. 

Sometimes, people talk because they want to get something off their chest, especially if things have gone wrong. This can help to release some stress. You can provide relief to your loved one by allowing them to talk and listening to what they have to say. This can help your loved one even if you don’t have all the answers.

The idea of ‘good listening’ has been proven to be helpful. As part of a study in the US, a group of people were taught simple listening techniques. Volunteer patients then came to see them and talk about their problems. The listeners were not allowed to do or say anything, except nod and say ‘I see’ or ‘tell me more’. At the end of the hour, almost all of the patients said they had got very good help and support. 

It may seem like it's best to pretend that everything is fine and carry on as normal. But studies by psychologists have shown that not talking about a fear can make it feel bigger. 

People who have nobody to talk to are more likely to be anxious and depressed. Research has also shown that when people are seriously ill, one of their biggest problems is that other people don’t talk to them. 

One of the reasons that people bottle up their feelings about having cancer is shame. Many people are ashamed of some of their feelings, particularly their fears and anxieties. They are afraid of something but feel that they are not ‘supposed’ to be, so they become ashamed of themselves. 

One of the best way to help your loved one is to listen to their fears and stay close when you’ve heard them. By not backing away, you show that you accept and understand them. This will help to reduce your loved one's fear and shame.

• Get comfortable. Try to look relaxed even if you don’t feel it. Try to signal the fact that you are there to spend some time with them. For example, take your coat off or make a cup of tea. 
• Keep your eyes on the same level as the person you’re talking to, which almost always means sitting down. As a general rule, if your loved one is in hospital and chairs are unavailable or too low, sitting on their hospital bed is better than standing. 
• Try to keep the atmosphere as private as possible. Don’t try to talk in a corridor or on a staircase. That may seem obvious, but often conversations go wrong because of these simple things.
• Generally, there should be a comfortable amount of space between you and the person you are talking to. Try to make sure there are no desks or bedside tables between you. You could say something like: ‘It’s not very easy to talk across this table. Can I move it aside for a moment?’
• Keep looking at the person while they are talking and while you talk. Eye contact tells the other person that the conversation is just between the 2 of you. If there are moments when you find it hard to keep eye contact, try to stay close and hold the person’s hand or give a reassuring touch if you can.

Even if you are prepared for a major conversation with your loved one, try not to be offended if they do not want that at this moment. They might simply not be in the mood to talk to you that day. It’s also possible that they may want to talk about ordinary things, such as television programmes or sports events. Go with the flow and meet them where they are.

You may still help them by being there and listening while they talk about everyday matters, or perhaps don’t talk at all. 

If you’re not sure what they want, you can always say ‘Do you feel like talking?’ And remember, some people naturally talk less than others.

When your loved one is talking, it's important to actively listen. This means you must be really listening to what they are saying and thinking about that. You should not be thinking about what you’re going to say next or rehearsing your reply.

Try not to interrupt – don't talk while they are talking. Wait for them to stop speaking before you start.

Good listening doesn’t mean just sitting there while another person talks. You can actually help the person who is ill talk about what’s on their mind by encouraging them. Simple things work very well. Try nodding or saying things like ‘Yes’, ‘I see’ or ‘What happened next?’ 

You can also show that you’re hearing, and listening, by repeating back to the talker what you’ve heard. This is partly to check that you’ve got it right and partly to show that you’re listening and trying to understand. You can say things like ‘So you mean that...’ or ‘If I’ve got that right, you feel...’

If someone stops talking, it usually means that they are thinking about something painful or sensitive. Wait with them for a moment and then ask them what they were thinking about. You can hold their hand or touch them if you feel it is appropriate. Don’t rush it, even if the silence seems to last for a long time. Try to be comfortable with silence as it is a natural part of the communication process.

Sometimes you may think ‘I don’t know what to say’. This may be because there isn’t anything to say. Don't be afraid to say nothing and just stay close.

Sometimes, non-verbal communication, such as the way a person holds their body, how they move or whether they maintain eye contact, tells you much more about them than you expect. 

You’re allowed to say things like ‘I find this difficult to talk about’ or ‘I’m not very good at talking about...’ or even ‘I don’t know what to say’. 

An acknowledgement of feelings that are obvious to both of you (even if those feelings are yours), can dramatically improve the atmosphere. 

If you are confident you understand what your loved one means, you can say so. Responses such as ‘You sound very low’ or ‘I imagine that must have made you very angry’ tell them that you have picked up on the emotions they have been talking about or showing. 

If you’re not sure what they mean, then ask: ‘What do you think of it?’ or ‘How do you feel now?’. Or something like: ‘Help me understand what you mean a bit more’ can be useful.

If your loved one wants to talk about how bad they feel, let them. It may be distressing for you to hear some of the things they are saying, but if you can manage it, stay with them while they talk. 

If you think you can’t handle the conversation at that moment, then you should say so. Offer to try to discuss it again later. Try saying: ‘This is making me feel very uncomfortable at the moment – can we come back to it later?’

Do not change the subject without acknowledging that your loved one has raised it.

Ideally, you should not give advice unless it’s asked for. If it is asked for, try not to give advice early in the conversation because it stops dialogue. 

Use phrases like: ‘Have you thought about trying...’ or ‘A friend of mine once tried...’ 

This can be better than saying ‘If I were you, I’d...’, which makes your friend think (or even say) ‘but you’re not me'. That really is a conversation stopper.

Humour can be an important part of coping with major threats and fears. It can allow us to get rid of intense feelings and to get things in perspective.

Laughter can help people to cope with their situation. If your loved one wants to use humour, try to go along with it. It may really help them. This does not mean that you should try and cheer them up with a supply of jokes. Respond sensitively to their humour, rather than trying to change their mood.

When we are in good health, the threat of serious illness seems far away. Very few of us think about it before it happens. When it happens to us, we may feel shocked, confused, angry or even bitter.

A state of uncertainty may be even harder to deal with than bad news. Not knowing what to prepare for can be really difficult. You can help your friend a lot by simply acknowledging how unpleasant this state of uncertainty can be.

Tests and treatments for cancer can often involve many different professionals, each with their own expertise. Your loved one may feel unskilled or even foolish in this situation. They may also feel like they have no control. Remind your loved one that the various professionals are trying to make an accurate assessment of their cancer so that they can come up with the best treatment plan.

Your loved one may frequently experience physical problems. At various stages in their treatment, they may experience things like pain, nausea and extreme fatigue. It is really important to allow them to talk about any symptoms or side-effects that are bothering them.

Allow your loved one to acknowledge any outward signs of cancer or cancer treatment, such as hair loss. For example, you could help them to choose a wig or head scarf.

Most serious diseases, particularly cancer, seem to put up an invisible barrier between the person who is ill and the rest of society. Spending time with them and encouraging mutual friends to do the same is a good way to reduce that barrier.

Many people who have been successfully treated worry that their cancer will come back and that they might die if it does. 

You can’t get rid of this fear for your loved one, but it's important not to dismiss it. This could cause them more distress. Allow them to talk about it. By listening, you can reduce the impact and the pain of that threat.