The Silent Treatment: how to talk about cancer 

From cancer to suicide, uncomfortable silences work to isolate, making one feel as though their experience is too much for others. Language tends to fail in the face of life’s most difficult moments. If you’re not sure what to say to a loved one, that’s okay!

In conversations after the discovery of my mum’s brain metastasis, I became viscerally aware of the imposing silences that would grow during conversations around cancer. Cancer is by no means a rare diagnosis (one in two people will be diagnosed with cancer in their lifetime), yet despite this, we still don’t know what to say. In the months after my mum’s terminal diagnosis, I didn’t speak of cancer — not because I didn’t want to, but because too often the other party didn’t know how to respond.

In the Cancer Journals, Audre Lorde critiques the silences which accompanied her cancer diagnosis, and argues for conversation, stating, “imposed silence about any area of our lives is a tool for separation and powerlessness.” Cancer is a diagnosis that inherently involves a loss of power and choice. All roads after a terminal diagnosis lead to death, and conversation is one way to enable people to regain the power lost by this inevitable outcome. Great conversations around cancer give people strength, removing the sense of isolation, and replacing it with tears, laughter, and connection.

We need to get better at speaking about cancer. So, let me be your friendly guide on how to speak about the unspeakable.

Tiptoeing is awkward

If you have found out someone has cancer, their loved ones will also be aware of this. When sharing your good wishes, it is always best to openly acknowledge that you know. A simple “I’m thinking about your family, and sending you love” will always go further (and be less weird) than becoming way nicer to someone without saying anything. Be direct and honest, nothing you will say can be worse than hearing about a cancer diagnosis. Know that even if the other person does not respond to your text, or nods away your well-wishes, they appreciate it and likely will think about it long after the interaction ends.  

Don’t only speak about this! Follow their lead!

It is boring when the only thing people speak about is cancer. Life is full of so much more than treatment plans and MRI scans. After diagnosis, follow the person’s lead in how often you speak about cancer and acknowledge that sometimes it will be the only thing that the person wants to discuss, and other times it will never be mentioned. Don’t force it.

Context matters!

Grief has no hierarchy, but in the immediate whirlwind post-diagnosis, it is best to keep your own relationship with cancer to yourself and focus on the person right in front of you.

I remember every middle-aged person who would tell me about their elderly parents being diagnosed and how I would judge them harshly. A parent dying when they are 85, have achieved many of their goals, met their children, and have seen them become  fully established adults? Gosh, it must be tough!

With distance, I sympathise with others’ experiences and enjoy conversations where people reflect on their experience with cancer. This has only come through the passing of time. Your experience is rarely relevant immediately after diagnosis, and even in the years after, it is best to reflect on differing contexts before you bring up how your life has been shaped by cancer when someone is sharing how theirs has been.

Shut up about positivity

Nobody wants to hear about how you can think your way out of the abnormal genetic multiplication of cells. Really happy, lovely people die of cancer. Really awful, grumpy people survive it. A positive outlook does not cure cancer – that is wishful thinking. Preaching positivity places the burden of survival onto the person who has cancer, and if that diagnosis is terminal, people blame their oncoming death on themselves.

In your conversations, let people grieve and experience the full range of emotions that a diagnosis brings. Be quiet if you are only going to spurt out pseudoscientific, Belle Gibson advice – everyone would prefer the uncomfortable silence over that shit.

You know this person

At the end of the day, you know the person you are speaking with. Diagnosis doesn’t change that. If you find out that someone has been diagnosed, speak to them the way you always have, — about the mundane, about the exciting, about what’s funny. Trust your gut. Being present and sitting with someone through all the ups and downs goes further than you may realise.

This article speaks specifically of cancer, but tough conversations where the silence grows long, and becomes something that all parties are uncomfortably aware of, happens with many a tough topic. From cancer to suicide, uncomfortable silences work to isolate, making one feel as though their experience is too much for others. Language tends to fail in the face of life’s most difficult moments. If you’re not sure what to say to a loved one, that’s okay! Acknowledge this, and swing by their house with a frozen dinner – I can guarantee that will drown out an awful lot of those uncomfortable silences.

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