It affects relatives, friends or neighbors: Many know people with a cancer diagnosis. And then the question arises: Do I avoid the topic, do I address it - and if so, how best? An expert from the German Cancer Society knows how to deal with this sensitive topic.
"So, how's the chemo going?" Very few people speak so casually to cancer patients in their environment. Even before the first sentence, the thought carousel is often spinning: Am I even allowed to speak to my neighbor or colleague about the illness? Is a "how are you?" not too banal? Or rather remain silent - the person is already busy enough with their diagnosis, right?
In an interview, Prof. Anja Mehnert-Theuerkauf from the German Cancer Society reveals how to find the right words when dealing with cancer patients - and how to deal with it when tears flow during the conversation.
Why are many people unsure when it comes to talking to cancer patients?
Anja Mehnert-Theuerkauf: The fear of hurting someone or stepping too close to them plays a major role. One may fear making the person emotionally unstable or even crying. In other words, in a situation that you might not be able to deal with yourself. And: Many of us are simply not practiced in such conversations. The fact that someone close to you has been diagnosed with cancer is often new.
How do you weigh up whether to bring up the topic of cancer when you meet someone with a known diagnosis?
If it is about a person from the wider social environment, for example a colleague at work, you can pay attention to what the person is signaling. You can often tell from this whether he or she wants to talk about it. If someone doesn't say anything about the disease, it can be a sign that he or she really doesn't want to talk about it.
But if someone drops: "I was in the hospital," then you can pick it up in conversation and see how the person reacts. For example by saying: "Yes, I heard about it, but I wasn't sure if I should ask you about it".
And if there is a cancer diagnosis in the family?
Especially when there is cancer in the family, it is always better to talk about cancer. But not at any time of the day or night, so not necessarily before going to bed when everyone is tired and worn out from the day.
Talking about the topic can be difficult at first, but in the medium term it relieves both those affected and their relatives and friends. And of course there are often urgent matters that need to be discussed: the living will, who will take on certain tasks, whether medication is taken regularly.
Are there situations that are better or worse suited to addressing the topic of cancer?
If you don't know the person concerned very well, you should pay attention to whether there are people in the room who could overhear. If so, it's best to leave the conversation about cancer alone or wait until you're not disturbed. This can happen at work, for example. You may get the other person into trouble because he or she is then forced to say something on the subject - without wanting to.
My observation is that it is easier to talk while walking. Because: You don't have to look at yourself all the time, you can endure breaks better and then you can do something nice - like stopping for a coffee. This is simply more pleasant for such a conversation than sitting across from each other and holding on to the table.
How do you deal with the uncertainty of hitting the right note?
Such conversations are sometimes a bit bumpy. But that doesn't matter. I think attitude is important. That you signal that you want to be there for the person.
One way can always be honesty, saying, "I'm not sure you want to talk about your cancer, but I still want to ask how you're doing." Open questions such as "How are you today?" are also advisable. or "What do you need right now?"
From your experience in working with patients: what do they want?
It is often not easy for those affected either. I remember a patient with breast cancer. She told her friends, "Guys, it's getting on my nerves that you keep asking me how I'm doing. Please don't ask me that anymore."
The friends - tidy as they were - stuck to it. But that bothered the patient. This example shows that those affected do not always know exactly what they need or want. It's a process that takes time.
What words or what behavior can hurt those affected?
For example, if you say to a co-worker, "How are you? Can I help you?", you should mean it. If you pretend or offer something that isn't there in the end, it's even more hurtful for those affected.
And phrases like "Cheer up" or "It'll be fine" are often not well received by those affected - no matter how well they are meant. Because these sentences can signal in the undertone "Just leave me alone with that". This appeasement often causes the conversation about cancer to die down.
Another mistake is coming too quickly with advice. Many sufferers report that it's just annoying when the whole world suddenly sees itself as an expert on their disease. It is important in such conversations to listen. Most will say something when they need something.
And what do I do if my counterpart cries during the conversation?
You don't have to do anything but be present. Crying is part of the psychological processing, for example of anger. You can hand a handkerchief or bring a glass of water. But you don't even have to do that.
Because crying is a good thing, as is anger. Both help the person concerned to process the situation. After crying, you often feel a little better afterwards. Emotions are normal in such a situation - an illness is a crisis, which can also be a crisis.
About the person: Prof. Anja Mehnert-Theuerkauf is a psychological psychotherapist. She heads the Department of Medical Psychology and Medical Sociology at the University Medical Center Leipzig. She is also a board member of the German Cancer Society (DKG).
(This article was first published on Wednesday, July 06, 2022.)
