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Let’s Be Honest …

The New Etiquette for Cancer Survivors
and Their Friends

by Letty Cottin Pogrebin

Inspiration image

(Photo by Mike Lovett)

In essence, you should be able to make these three simple, forthright statements to a loved one who has cancer:
Tell me what’s helpful and what’s not.
Tell me whether you want to be alone or want company.
Tell me what to bring and when to leave.

However, I know that the above sentences are easier for me to write than for the average person to speak, and it’s going to take a paradigm shift to make people feel comfortable saying them. Traditional illness etiquette leaves little room for such exchanges. Lacking the sense of permission to speak openly or the talent for mind reading, cancer sur­vivors and their friends often continue to spout bromides, fly on instruments, and sometimes miss the runway.

Nevertheless, giving your friend with cancer permission to tell you the truth about what they want and what they’re feeling doesn’t mean they have to tell you absolutely everything. When friends of mine asked how I was doing during breast cancer, I used to answer in detail – until I started noticing how often their eyes glazed over. (This usually happened at first mention of a sentinel node or estrogen receptor.) If we were talking on the phone, I’d hear the audio equivalent of a glazed eye – the soft click of computer keys or the whoosh of running water, a sure sign that they were multitasking. I took no offense. They didn’t mean to be rude. Medical terms are daunting, and minds wander.

Giving your friend with cancer permission to tell you the truth about what they want and what they’re feeling doesn’t mean they have to tell you absolutely everything.

Eventually, I realized that I didn’t have to report every detail. I wasn’t under oath. Besides, most people aren’t interested in our blood count or oncotype. Yes, they care about us, and yes, they hope we’re on the mend, but what they really want to know is pretty straightforward: Are we feeling better or worse? Are we hurt­ing? What can they do to help? Above all, they want clues to indicate how we wish to be treated.

We cancer survivors should provide that information not in coded messages but in just so many words. We should tell you whether we want visitors and, if so, when to come and how long to stay. We should admit if we’re exhausted or we don’t feel like talking. We should be clear about whether we want you to make us dinner and hang around while we eat or just deliver a covered dish. And if you’re going to bring us a pres­ent anyway, we may as well mention the book we’ve been eager to read, the edibles we most crave (and are permitted to consume), or the kind of flowers that make us happy.

I’m absolutely convinced that in illness, as in every other aspect of our lives, honesty is the best policy. It’s high time for the tyranny of politesse to give way to the frankness of truth telling. Were candor to become the prevailing modus operandi, people with cancer could be direct and honest without coming off as arrogant or demanding, and their friends would no longer flounder around trying to strike the right chord. Frankness may feel weird at first, but once both sides sign onto it, you and your friends will have one less thing to worry about.

♦ ♦ ♦ ♦ ♦

Letty Cottin Pogrebin is an author, activist, journalist, national lecturer, and breast can­cer survivor. This article is adapted from her book How to Be a Friend to a Friend Who’s Sick (published by PublicAffairs, a division of the Perseus Books Group). Learn more about Letty at

This article was published in Coping® with Cancer magazine, November/December 2014.