Well-meaning but clueless person: “Let me know if you need anything.”
Snarky me: “Really?  Thanks!  Empty your purse and let’s see what you have in there. Wait, is that purse Prada? I need that; I have medical bills to pay and want to look good paying them. Oh, that’s a pretty wedding ring, lots of diamonds, can I have that too?”

What you should say is absolutely nothing. This is a time to do, not talk. Pick up the phone and order a day  of housecleaning service. Send over a fruit basket. Knock on the door and drop off a casserole.  Come over and scrub the tub.  Pick up the kids from school during chemo week.   Bring a DVD of a funny movie and some chocolate.  Stay with her in the hospital, so she will get good nursing care.  Do something, don’t just talk about it.  And, when you stop by to help, don’t be shocked if the house is a mess.  No judging –  the person has cancer and maybe can’t move her arms, and housecleaning is far from important.  Just help, and don’t ask permission first.

You don’t really think we are going to pick up the phone and ask you for help – do you? Would you? If you don’t want to do anything (and there is nothing wrong with that) then here is the right thing to say:  “I’m sorry you have cancer.”  No meaningless additions needed.

CP:  “You are so brave.”
SM: “Wow, how did you know about the child I rescued from the burning building last night? It wasn’t even in the papers!  Oh, are you referring to the time I went to war and fought for my country and got in the firefight and dragged my injured friend to safety? Or, do you mean the time I single-handedly stopped a bank robber from shooting that elderly lady?

No? You are referring to me showing up on time for doctor’s appointments?”

It’s nice to be called brave, but we cancer patients all know we aren’t. Brave is a word best reserved for people who deliberately put themselves in harm’s way.  Trust me, if I could get out of this, I would.  I’d run so fast I’d leave old people and children behind.  And puppies. All the puppies.  The truth is, I have no choice but to put one foot in front of the other and do what my doctors say.

What you should say:  “I’m sorry you have cancer.”  If you must add another phrase, you can say, “You are handling this difficulty with grace.”

Then order housekeeping service, because I am guessing what is going on in that bathroom isn’t that graceful.

CP:  “I know exactly how you feel.”
SM:  “Oh fantastic, let’s talk about the best way to relieve chemo-induced constipation without bringing on diarrhea! What’s your tip?”

Here’s the right thing to say:  “Tell me how you feel?”  And, then listen.  I’ll probably say I’m fine.  Because, I am.  But, someday I might not be.  And, if I want to tell you that my butt is plugged like a 2-year-old tube of super glue, then try to listen without telling me about the time you had the same experience.

CP:  “Oh, my Aunt Sally died of that.”
SM:  “Oh cool, was it a long, painful death?  Tell me all about it!”

What you should say:  “I’m sorry you have cancer.”    If you think I’m going to relate to you because you had relative who died of my disease, you are thinking incorrectly.  I’m well-aware this disease is fatal but maybe I’m in a good mood – don’t bring me down.

CP:  “You never know, you could get hit by a bus.”
SM:  “Our school has canceled busing, thanks to budget cuts, so the very real risk of a bus crashing through the front window into my office has been eliminated.  Whew.

Here is a fact:  40,000 women a year die of metastatic breast cancer.  I’m not quite up on how many people die by getting hit by a bus each year, but I’m guessing it’s more  in the 40 range.  (You might have to include trains in that too.)  Which do you think is more likely for me?

What should you say? “I’m sorry you have cancer.”

CB:  “At least you get perky new boobs.”
SM:  “Honey, you have clearly never seen reconstructed breasts.  Trust me, nobody is giving me any beads during Mardi Gras.”

Try, “I’m so sorry you are going through this.”

CB:  “You can beat this!  There are great treatments now.”
SM:  “Which one do you think will keep me in remission longer?  Navelbine and Herceptin?  Should I switch to Xyloda and Tykerb?   Should I ask for stereotactic body radiation or radiofrequency ablation?  What do you think about portal vein embolization?”

There are great treatments now. Some which keep cancers at bay for years.  None of which – to date – cures a woman with metastatic breast cancer. And, I’m guessing you have no clue what is out there for metastatic breast cancer patients. How about saying, “I hope you find a treatment that is easy, and I’m sorry you have to go through this.”

CB  “Just keep a positive attitude.”
SM: “Don’t worry, I’m so busy concentrating on controlling the rivers of diarrhea without needing a diaper, my blood levels being so low I can get infected if my dog sneezes, and vacuuming up the peeling skin on my hands and feet that I’m too busy to think negatively.”

It’s awful to tell somebody to think positively.  Do you think all those cancer patients who are now dead thought negatively?  It’s not a good thing to put the burden of our disease on us.

CP:  “Don’t worry, everything will be okay.”
SM:  “Oh, great! Did you read that in the tea leaves?  Was it in my horoscope?  Do you have a crystal ball?  Can I see?”

What you should say is … say it with me … “I’m sorry you got cancer.”  Don’t deny our reality.  It’s very likely that – for those of us with metastatic disease – everything will not be okay.  We hope it will.  We want it to be, and we are going to do everything in our power to live as long as we can.  But you have no idea what will happen.

CP: “Hey, look what happened to Lance Armstrong.”
SM:  “I know, I only wish I’d gotten cancer of the balls!”

The truth is, while not taking away from Lance’s story, his type of cancer has a high cure rate even at a later stage.  At the last stage of testicular cancer, Stage III,  there is a 50 percent to 80 percent five-year survival rate.  At Stage IV breast cancer, there is a 16% to 20% five-year survival rate.  So, yeah, look at Lance.  So what?

CP:  “So, how ARE you?” (Grave voice, sad face)
SM: “Fine thanks, and you?”

I’m still the same person, please talk about me behind my back like you are supposed to. When in front of me, put on your unconcerned face.

CP:  “Everything is going to be fine.”
SM:  “Why yes, everything will be fine. After I die, the world will still turn on its axis, people will get born, people will grow old. Flowers will bloom, rainbows will sparkle. I won’t be there to see any of it, but sure, it’ll be fine.

At least, until a moon-sized asteroid crashes into the earth and kills you all.”

Here’s the truth.  You can say any of those things to me, and I won’t mind.  You know why?  I lived 50 years without having cancer, and I probably said them all to somebody who did have cancer at some point too.  Nobody really knows what to do or say, and that’s part of being human.

The thing is, We With Cancer are just the same as we always were.  We aren’t braver; we are just sick.  We have the same hopes and dreams.  So, just treat us normally, as you would want to be treated.  Please, ask how we are doing and then take your cue from our response.

The one thing you should never do is put the onus of our illness back on us.  We didn’t cause it by negative thinking, by eating a hotdog when we were 12, by sitting in the sun, or by not exercising.  It just happens.  I am positive in spirit, but that won’t cure my cancer. Neither will being negative kill me.  It’s not my fault. Never deny our reality, whether you agree with it or not.

When all else fails, what do you say to a person who has cancer?

“I’m sorry.”

Ann Silberman is a breast cancer patient who blogs at But Doctor… I Hate Pink.