listening is often enough when having difficult conversations about cancer: 'people want to feel heard and validated'
8 minute read
for people who have just been diagnosed with cancer, there is no hard and fast rule regarding a good time or place to share. it’s all about looking inward at your needs, wants, and comfort level.
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this article was produced by the healthing editorial team with the support of a grant from wellspring cancer support. while wellspring cancer support made the production of this article possible, they did not have any editorial influence or control over the content, including review prior to publication.
getting a cancer diagnosis can be a surreal and devastating experience. everyone is aware that the potentially fatal disease exists, but until you sit across from a doctor and hear those three words—you have cancer—it’s next to impossible to imagine how that feels.
that initial blow will be the first difficult conversation a person has to have when diagnosed with cancer, regardless of the type or prognosis. sharing the news with other people in their lives, such as family, friends, co-workers, or even acquaintances, is the next challenge faced by people living with cancer, and knowing how to navigate these situations isn’t an inherent skill.
claire edmonds, a registered psychotherapist who specializes in oncology, has had many of these conversations, both with her patients and with her loved ones when she herself was diagnosed with cancer twice. she believes that the most challenging aspects of these conversations revolve around feelings, fear, and helplessness.
“we avoid these conversations by keeping things light or using empty reassurances,” she said. “typical would be, ‘gee, you look great. everything’s going to be fine,’ or, ‘don’t worry about that.’ and the very toxic one that i think we all have difficulty with is, ‘you just got to think positive.’ that’s a crushing thing to say to people. it’s a crushing thing to hear. and all these responses are pretty much designed to shut down the conversation.”
when a person divulges that they have cancer and someone responds in these ways, it can leave them feeling “very alone and isolated” and as if people don’t truly care about what they’re going through.
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“cancer becomes quite a lonely experience,” said edmonds, later continuing, “telling someone to be positive is asking them to shut down that experience and play act.”
susy borges, the associate director of wellspring cancer support, a canada-wide network of charities geared toward supporting those going through cancer journeys, finds that being vulnerable with others can be a hard thing to do, especially when going through cancer.
“(patients) kind of go into protective mode and may not want to authentically share some of their own fears and anxieties with people,” she said. “so, it’s hard to share with others how they’re feeling as they’re in the midst of some of the cancer-related stress that happens with a diagnosis, too.”
from both sides—patient and loved one—the conversations surrounding cancer can become ingenuine, especially if people don’t know how to broach the topic with one another in a meaningful way.
sharing your cancer diagnosis
for people who have just been diagnosed, there is no hard and fast rule regarding a good time or place to share that news. it’s all about looking inward at your needs, wants, and comfort level.
it’s essential to choose a time and place when you feel you can be completely authentic in your experience to avoid the surface-level interactions that will leave you feeling more alone than you had before you shared.
sometimes, that means sitting with the diagnosis on your own while seeking out programs or resources, such as those available through wellspring, or making a phone call to the person you love and asking them to meet you right after you leave your doctor’s appointment. it’s all incredibly personal.
as for where the conversation should take place, borges suggests “choosing a time where there isn’t a distraction” and doing it where you already feel most comfortable. by ensuring you’re in a stress-free environment and focusing solely on the conversation, you can be your authentic self.
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lean in when receiving the news
when it’s time to sit down and hear about your loved one’s cancer diagnosis, active listening is the best route to take to give them the space and the time to share what they’re going through free of judgment, advice, or input that they may not need at that moment.
oftentimes, these types of conversations make people want to escape so they don’t have to deal with the heaviness of it all. but when it comes to making a person living with cancer feel seen, heard, and supported, the opposite should be done. edmonds suggests leaning into the conversation, starting with active listening.
“it’s intentional, it’s effortful, focused, and what we try to do is quell all the busyness inside our heads, and we just stay with the other person, even if what they’re saying is difficult to hear,” she said.
edmonds notes that regurgitating what someone says back to them in “a small, bite-sized piece” can be beneficial because it shows that you’re truly listening. if someone says that their chemotherapy has been challenging to cope with, you might respond by repeating back to them, ‘oh, you’ve started your chemotherapy’ to show that you’ve heard what they said and are attentive and interested in their experience.
borges also notes that listening is one of the most important aspects because, often enough, having someone listen is the only thing a person who has cancer really needs.
“validating someone’s experience with cancer and acknowledging some of their cancer-related stressors … is probably the most helpful in that situation. people want to feel heard and validated when they’re sharing their thoughts and feelings around cancer,” she said.
when it’s time to stop listening, you can explore what they’ve told you with gentle curiosity by asking questions that pull focus to the fact that you were hearing every word they said and are interested in figuring out how they’re being supported so that you can assist where you can.
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questions about their medical support team, what’s next for them in treatment, and whether they have any support systems set up are good ways to open up the conversation further without making it feel interrogational.
“you’re not probing. you’re not being ferociously curious,” said edmonds. “you’re just gently letting the person know that you’re following them and you want to know more.”
this is also the time when certain judgements can slip through the cracks, which are less than validating during a difficult cancer conversation. you must try to keep certain opinions to yourself, as they can sometimes feel like an attack on how someone is navigating their cancer diagnosis.
telling people they should be doing one thing when they’re already doing another is an entirely avoidable conversation piece that can cause more harm than good. edmonds recalls that during her own cancer journey, someone suggested that she make her way south of the border for a second opinion—a piece of unwarranted advice that made her feel worse.
“i looked at her and said, ‘i am so overwhelmed with what i’m dealing with. you gotta be kidding me. that’s not available to me. i don’t have the bandwidth or the energy,” she said. “i felt she was judging that i didn’t do enough to help myself, and i was doing everything i could.”
instead, you can offer information without telling them what they should or shouldn’t be doing, allowing them to receive it and decide on their own if it’s right for them instead of feeling attacked. suggesting resources and support groups you know of are great ways to provide advice without the undertone of judgment.
the “shoulds” aren’t typically coming from a negative place but stem from a need to fix things for people you love, even if that thing is cancer.
“we may want to go in and sort of fix things, but listening to somebody else changes their experience,” said edmonds. “it’s very powerful when someone says, ‘let me listen and hear and acknowledge and witness.’ the other person who’s speaking goes, ‘oh, i can put it down for a little while.’”
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borges notes that saying or doing the right things isn’t always easy, but it’s not about that. it’s about listening to hear as opposed to listening to respond, and when it’s time to validate, that’s all you need to do.
“listening isn’t about answering the right way or finding the exact words. it’s about the human experience and just listening and validating,” she said. “we want them to realize that the person is still the same person, and giving them that space to share freely is the most practical thing they can do.”
offering a different kind of support
some people may be unable to offer the sit-and-listen approach, and that’s okay. everyone will react to the news differently, but it’s essential to acknowledge that if you can’t provide a place for your loved one to verbally unload, other sources of support can be equally helpful.
“there’s emotional support we’re talking about, but there’s practical support too,” said edmonds. “people in the world who are doers are really valuable, so if you’re a doer, do practical things.”
to practically support a person living with cancer, borges suggests finding out what they may struggle with during their journey and stepping up in a way that addresses those issues. some ideas include helping them with their groceries and making them dinner when they don’t feel up to the task, or taking walks with them throughout the week so they can retain a sense of normalcy in their lives.
“be mindful that a cancer diagnosis doesn’t define the person as who they are. at the end of the day, they are still the same person, and we’ve heard a lot from cancer patients that they really want to be treated as the same person,” said borges.
according to edmonds, “these acts of kindness are ways in which we increase kindness in the world,” noting that it can significantly improve someone’s experience when coping with cancer.
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you can provide these practical supports by making yourself available to your loved one with cancer, letting them know that you’re there for them when they need you. but also remember that for some people, reaching out isn’t easy to do.
edmonds suggests taking a proactive approach and instead of asking if they need anything, anticipate and plan accordingly.
“knock on the door when you’re going grocery shopping and say, ‘hey, i’m just stepping out to the grocery store. do you need anything? what can i pick up for you?’” she said. “don’t ask permission … just do it.”
after the conversation
once you have gotten through the conversation, it’s important to practice self-care to give yourself time to process and decompress. cancer conversations are challenging for all those involved and can take a heavy emotional toll on patients.
borges suggests taking a walk, having a cup of tea, or doing something restorative afterward. this allows you to feel what you need to feel while also caring for yourself.
she also suggests reaching out for support when needed.
“just take a moment to centre after a difficult conversation, and to seek support and not be afraid of connecting with other people,” she said. “realize that you’re not alone and there’s a whole community that’s here, ready and willing to offer support to you.”
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