15 Worst Things You Can Say to Someone Battling Breast Cancer
Think before you speak
While they may be your first thought when it comes to breast cancer symptoms, lumps aren't the only sign that something may be wrong.
"My sister/mother/friend had breast cancer."
"Everyone's got a cancer story," says Dennis Citrin, MD, PhD, author of Knowledge is Power: What Every Woman Should Know About Breast Cancer. While hearing your friend's diagnosis may seem like a good time to share the hardships of others, you have to realize all breast cancer patients aren't alike. "There can be subtle differences between the types of breast cancer that one person's experience may have no relevance for another," Dr. Citrin says. Every individual breast cancer patient will have her own unique struggles to face, so avoid relating the negatives, or even positives, of someone else's condition.
"Are you going to lose your hair?"
Most women view hair as a link to femininity, and the idea you might lose it can be very hard to bear. Even for a patient who's already thinning up top, best not to make a comment related to hair at all. "We all want to be told we look good," says Melanie Young, breast cancer survivor and author of Getting Things Off My Chest: A Survivor's Guide to Staying Fearless and Fabulous in the Face of Breast Cancer. If you notice your friend is looking particularly nice one day, make it a point to let her know. Another good bet: invite her to test out some new makeup with you and turn it into a fun day of pampering.
"Will you lose your breasts?"
Having a mastectomy is not necessary in many cases, so don't assume it's the norm for every breast cancer patient. "The new paradigm of treatment isn't focused on immediately sending patients to the surgeon," Dr. Citrin says. Most doctors will biopsy the tumor before determining the best course of action. Emerging research indicates that 10-year survival rates are equal among bilateral mastectomy and lumpectomy with radiation patients, so you may begin hearing of fewer women having both breasts removed. Bottom line: She may not yet know whether or not she needs a mastectomy, so safer not to bring it up. On the flip side, you shouldn't try to make a mastectomy out to be positive either. "I had people tell me, 'I wish my boob job was covered by insurance,'" Young says. "But do you wish you had cancer?"
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"Do you think hormone therapy or weight gain caused it?"
Like any type of cancer, there are many breast cancer risk factors that have been discovered from looking at patterns across large populations of women. But no one can say for sure what causes any individual's specific case. Sometimes DNA is damaged and cancer gets a start for no reason at all. "A lot of people feel anxiety when someone they know is diagnosed with breast cancer, so they try to explain it away," says Marisa Weiss, MD, a breast cancer survivor and director of breast radiation oncology at Lankenau Medical Center near Philadelphia and founder of Breastcancer.org. Try to avoid a "what if" line of questioning.
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"Are you sure you want to try that treatment?"
When breast cancer patients are first diagnosed, some family members feel like they need to take control of the situation, Moadel says. That includes trying to make decisions when it comes to how they should take their medications or what treatments might be best. This is one area where the breast cancer patient really needs to call the shots. "Cancer doesn't mean she'll want to stop doing the things most meaningful for her," Dr. Weiss says. No matter what treatment lies ahead for your loved one, keep in mind she ultimately know the best path for herself.
"You don't look sick."
Other people might try to downplay a loved one's condition, Moadel says. Making things out to be fine, however, isn't as uplifting as you'd think. Whether you're dealing with early stage or relapsed/recurrent breast cancer, it's still a scary thing. "Treating their illness like a minor ailment doesn't touch on how they're truly feeling," Moadel says. A person could be battling it for years to come, so you can't just push those fears aside. When a loved one is open to discussing their illness, don't be afraid to share the sadness with them and offer support when needed.
Saying nothing at all
After a breast cancer diagnosis, it's not uncommon for some people to completely avoid the topic or stop visiting all together, Moadel says. Hearing the words can be so shocking you might not know what to say at first. Start by asking what you can do to help. "The best supporters are the ones who can listen and respond to what the patient needs," Moadel says. Just showing you can be there to help a loved one cope is what matters most.
"Everything will be OK."
Being reassured is confusing because a lot of cancer patients still have a year of treatment in front of them," Dr. Weiss says. And each stage of breast cancer comes with different forms of treatment. For example, a stage I patient may have the lump removed and some radiation while stage III might require chemotherapy or surgery, according to the American Cancer Society. Not many breast cancer patients want to be told what to do either, so avoid statements like "Be positive" that come off as commands. "It's easy for you to say. You don't have to worry about feeling ill all day or the bills," Young says. Not every patient's journey will be smooth, so it's important to show you accept your loved one's condition and the treatment she's about to face.
"It must run in your family."
Though some breast cancer is tied to genetics, it's not always clear-cut. According to the National Cancer Institute, mutations in the BRCA1 and BRCA2 account for about 5 to 10% of all breast cancers. So calling out someone's condition as a "family thing" is insensitive and may not be accurate. It also gives your friend more cause to worry about the other members of her family tree. "When they are told they have breast cancer, women immediately think about their own daughters," Moadel says.
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"What stage are you?"
If you're a close friend or family member, wanting to know the stage of a patient's breast cancer is understandable. When you haven't known someone as long, like a co-worker or neighbor, it's best not to ask. With this phrase, you have to consider the underlying meaning behind the question. "What the patient really hears is, 'How close are you to death?'" Moadel says. It depends on the person, but not all people with breast cancer will want to talk about how far their condition has progressed. In that case, focus on the present and ask how their day is going instead.
"That's terrible news."
When you first hear someone has breast cancer, there's no denying it can be jarring. Your knee-jerk reaction might be to start talking about how awful it is. Thing is, statements like that make the news all about you, not the patient. "To have someone speak to you as if you're a goner and going to suffer is the worst," Moadel says. Even something as simple as "Oh my God" can crush a patient's spirit. Instead say "I'm sorry" and let the person know you'll be there for support. "Sometimes saying less in that first disclosure is best as long as you stay present," Moadel says.
"Wasn't your treatment supposed to work?"
When a person's cancer goes into remission, that doesn't mean she's cured. In fact, about 20% of breast cancer survivors who've undergone at least 5 years of treatment to prevent recurrence do end up relapsing within 10 years. There have been many breakthroughs with treatment for breast cancer, but it's difficult for doctors to guarantee one method will completely get rid of cancer. "With oncology there's no degree of certainty," Dr. Citrin says. "Part of a breast cancer patient's fear is tied to not knowing what the future holds." Instead of questioning where things went wrong, trust that your loved one's medical team knows the best plan to tackle the next stage of treatment.
"Just let me know what you need."
Breast cancer patients already have so much to think about. This comment puts more stress on them to find some way you can help. "I didn't know what I'd need until I was in the middle of it," Young says. Though it's perfectly fine to say she can count on you for help, keep the lines of communication open as time passes, Young says. Even better: take initiative. Next time you're at the grocery store, call her up and ask if there's anything you can get for her.
"Why haven't I heard from you?"
Managing treatment and figuring out how to pay medical bills can be overwhelming. It doesn't help when a patient gets bombarded for an update on her situation. "You just don't want to say the same thing over and over and spend time answering emails," Young says. After a loved one's been diagnosed, understand she may need time to get a handle on her life now that breast cancer is in the picture. After a few months, plan a time to treat her to coffee or dinner so you two can catch up.
"It could be a worse cancer."
Breast cancer may not progress as fast as, say, pancreatic cancer, but that doesn't mean it's any less serious. "I once had someone tell me, 'Your breasts are ornaments. It could be something internal,'" Young says. Breast cancer is still life-threatening, and at the end of the day, no cancer is worse than another. Say something like "I'm glad they caught it" or "You're in my prayers" instead.