Friendships and Cancer

Cancer reminds us how much we need our friends. One thing that has been especially difficult during the coronavirus pandemic is the enforced isolation. Several of my patients who are living with recurrent cancer lament the absence of the neighborly and friendly support that helped them through their first cancer experience. We probably don't think much about all the ways that we depend upon one another until they aren't possible. It's the old saying: You don't know what you've got until you lose it.

Some things don't change. We continue to care about our friends, and they about us. A cancer diagnosis, or another life crisis, inevitably brings some surprises. When I talk with someone who is newly diagnosed, I often suggest that they make a list of people on whom they can depend and those whom they expect will not be so helpful. Then I tell them to put that list away for a year and to be prepared to have been wrong. Inevitably, there will be movement between the two lists, and there will also be new people who become very dear through this experience. Those new people may be neighbors or colleagues whom we barely know, people whom we meet at the Cancer Center or a support group, or someone who is a random encounter.

The dependable friends and the new ones are treasures in the world. It is the others, those who vanish, who hurt us. It is especially painful when they are seemingly close and old friends or even relatives. I no longer am surprised by the stories, but it is pretty shocking to learn of a college roommate or childhood friend or a sibling who maybe calls once and then disappears. Of course, we understand that this behavior may be due to their own personal issues, but that does not make it any easier. Many tears have been shed about lost relationships.

Sadly, I don't have suggestions about how to prevent these experiences; I don't think that is possible. I do have some thoughts about what to do later. During active cancer treatment, you just don't have the physical or emotional energy to focus on these hurts. Try to put them aside until a later time when you can think a bit more clearly about your response. During the weeks of treatment, you need to focus on yourself, and ruminating about other peoples' behaviors won't help. If necessary, remember Scarlett O'Hara’s strategy in Gone with the Wind to think about it tomorrow.

The first question is: Is this relationship worth trying to save? It may not be. We know that, through a long life, friends come and go. Some are convenient friends when we live next door or work together or have children in the same class. As time passes, those situations change, and those people often fade away painlessly. But what about the others? The people whom you believed would be with you always deserve more thought. Think long and carefully because you likely will be the one who has to reach out and you will be inviting the possibility of another hurt.

If you decide to make a phone call or write a note (and a real in-the-mail note carries much more significance than an email), keep it simple. Lead with something like: I have missed you. Your friend knows perfectly well that she/he has disappeared during a very tough time. If you feel that the connection is valuable and you want to try to save it, you will need to understand what happened, and you will need to find an authentic way to forgive. You likely will hear some bumbling explanation about I didn't know what to say or so much time passed that I was embarrassed to call you. Just listen. And, when you are ready, tell your friend how you felt.

Whether or not you are able to repair some of these damaged connections, remember to also hold tightly to the friends who were with you. Cancer reminds us what is most important in life, and the answer is always The People.