How to support a friend through cancer

It is painful and difficult when a friend has cancer. In addition to your worries about them, it is impossible not to worry about your own health. Depending on your personal history and experiences with cancer, you may be more or less frightened by your friend's diagnosis. It is important to try to separate your worries about yourself from your friendship with them. As the saying goes, This is not about you. Whether you live nearby or at a distance, you may feel that you don't know how best to help or even, sometimes, what to say. You want to support and love your friend, but you may not know how, and your friend may seem unreceptive, easily irritated, and generally not themselves.

When a friend has cancer, the usual rules and responsibilities of a close relationship are changed. This is not a 50/50 or even a 70/30 connection. Instead, for the duration of your friend's treatment, you need to carry at least 90% of the friendship. This means that your needs come a distant second, and you need to always remember that the details and problems in your life likely seem unimportant to someone who is struggling through chemotherapy. Just to make it even harder, there will be times when your friend wants only to hear about your job or relationships and is desperate to have a normal conversation. This is to say: you sometimes can't win. Be ready to be flexible and listen carefully to your friend's cues. There will be times when they want only to speak about cancer, and other times when they do not want to hear the word.

Here are some specific suggestions:

• Do not ask for details about their pathology report or staging. Wait for them to bring it up.
• Do not ask about the prognosis or, after treatment, how the doctors know if the chemotherapy and/or radiation worked. (They don't; only the safe passage of time will answer this question.)
• Do not remind them that anyone could be hit by a bus or that we are all going to die someday. This is neither reassuring nor helpful.
• Do not tell them about others who "sailed through" chemotherapy or, alternately, suffered each day of the treatment. Respect their individual experience.
• Send cards, emails, texts, and call often. The message is that you are thinking about them, and that they do not have to return the call.
• If you are nearby, call when you are heading out to do errands. Ask if you can pick something up or mail a package.
• Offer to drop off a meal or do a carpool run or care for their children. Think of other tasks that you can do for them: planting bulbs in the fall, weeding in the summer, shoveling walks in the winter. Do not leave it at: "Call me if you need something." Instead, offer to do something specific. And then offer again later.
• If you can afford it, occasionally send a small care package. This can be bubble bath or a couple of cotton scarves or trashy novels or another small treat.
• If you live far away, ask if they would like a visit or if, later, they might like to come visit you. Don't assume that you know the best time to get together or when they most need company and support. Ask.