Things Not to Say to Someone With Lung Cancer

Comments That Can Be Hurtful to Someone with Lung Cancer

young girl covering her mouth as if she's said something she shouldn't have
What should you NOT say to someone with lung cancer?.

"Kind words, kind looks, kind acts and warm handshakes, these are means of grace when men in trouble are fighting their unseen battles." - John Hall

Over the years, we've had far too many people with lung cancer share their hurt over insensitive comments made by friends and loved ones. Not only have some of these remarks been hurtful, but they've felt devastating, coming at a time when people need as much love and support as possible. Most of the time, these comments are made with good intentions; people aren’t trying to be hurtful and cause pain. On the contrary, many of these comments are attempts to connect and share an understanding.

What seems hurtful to someone with cancer might not make sense to you. Many people living with cancer have shared that it's not the actual words spoken which hurt so much, but rather what they read into the words. For example, if your cancer is in remission or NED (no evidence of disease), out of kindness and concern you may hear people say, "How do you really know your cancer is gone?" Rather than feeling the love and concern that is intended, a comment like this can create anxiety about recurrence and even a sense of loneliness as you realize that you're alone with your own body in your journey with cancer.

As you read through this list, don’t chastise yourself if you’ve inadvertently made some of these comments to friends with cancer. We’ve all stuck our feet in our mouths at times, and your friend with cancer most likely made (and still makes) comments that can be hurtful to others with cancer. People with cancer are forgiving, but being mindful of the words we use may help someone with cancer feel perhaps a tad less alone in their journey.

It's frustrating to hear about "the wrong things to say" without also having a solution. So along with the comments below, we will suggest some alternative things you can sAY. Keep in mind that often it’s not just our words alone that people "hear," but our body language; body language is thought to account for 50 to 70 percent of communication. If you want to send a clear message to your friend that you’ll be there and want to help, make sure your body conveys those words as well.

1. Don’t Say: "How Long Did You Smoke?"

It seems almost universal that for those living with lung cancer, one of the first words a person says upon hearing of their diagnosis is "How long did you smoke." For some people with lung cancer, these words don’t hurt, or they mask their hurt with a comment such as one lung cancer survivor made: "Thank you for telling me that I deserve to have lung cancer." But for many people, these questions are terribly painful, as they feel they are being blamed for causing their disease. In addition to hurting emotionally, the stigma of lung cancer has actually led some people who have lung cancer to receive inadequate care, as they feel unworthy of proper treatment. People don’t usually ask about smoking to be hurtful. Instead, it's often a way of reassuring themselves that they're "safe." For example, if someone with lung cancer has smoked, or smoked for a longer period of time, that makes the other person's own chances of developing the disease lower. 

There are many lifestyle choices we make that can raise our risk of developing cancer, but for some reason, lung cancer is often singled out. The first words from our mouths upon learning a friend has breast cancer aren't ordinarily "how long did you breastfeed each of your children?" We don’t ask people with colon cancer how long they’ve been sedentary. Out of all of the comments listed in this article, if there is one to avoid, avoid asking about smoking. Keep in mind that 20 percent of women who develop lung cancer have never touched a cigarette. But even if someone has chain-smoked her entire life, she still deserves our love and care, our support, and the best medical care possible. As a last note, we've heard people argue that this question is important; that asking people with lung cancer about their smoking helps to educate others about the dangers of smoking. We will reply here that there are many resources for learning about the dangers of smoking, without doing so at the expense of hurting your friend.

Instead say: "I’m so sorry you have to face this disease."​

2. Don’t Say: "Call Me if You Need Anything"

This might look like a typing error. After all, why wouldn’t you ask your friend with cancer to call if she needs something? The reason this is not a writing error is that most of the time, that call just won’t happen. When we ask someone to call, we put the burden of calling on that person, and living with cancer is often burden enough.

In writing this, we aren't saying that you shouldn't offer help. Please do! But when you can, ask what you can do in a specific fashion, one that relieves your friend of the burden of needing to think. When I was going through chemotherapy for breast cancer, people would often ask how they could help me, but it was hard to think about what type of help I needed. Even decisions such as "would you like me to bring lasagna or pizza" were sometimes difficult, as I was overwhelmed by all of the decisions that I had to make concerning treatment. What helped the most were specific offers of help. One dear friend asked if she could come over on a Saturday and plant flowers (something that only required the brain power of a yes or no answer.) She then showed up, along with several other friends and trunk loads of flowers, and proceeded to fill all of my flower beds.

Sometimes just doing something without asking can be the greatest gift. I had friends that didn’t ask what I wanted but would show up with trays of frozen meals and supplies from the grocery store (and would take them straight to the fridge and freezer and unload them.). One friend brought over a pile of books saying they were the best books he had read that year (and made it clear that I wasn’t obligated to read them either).

Instead, say: "Can I come over next Wednesday and wash windows?" or "Can I drive you to your next treatment?" or "May I bring dinner next Tuesday?" or just show up with meals.

3. Don’t Say: "My Neighbor’s 2nd Cousin’s Ex-Husband Had Lung Cancer and He _______ "

It happens all the time. Upon hearing of a friend’s diagnosis, we offer stories about others we’ve known with a similar condition. But instead of these comments doing what they intend to do — create a connection — they often do just the opposite; leave our friend feeling even more alone.

Sharing stories about people who died, or horror stories about treatment, are the last things someone living with lung cancer needs to hear. But any comparisons can miss their mark and end up being hurtful. For example, when I was diagnosed, a friend commented to me that her daughter had "the same thing you have," and never missed a day of work. I’m sure her intent was to lessen my fears about treatment, but instead, it left me feeling like I would be judged if I needed to take time off — like I somehow "failed." Conversely, another friend pointed out how wonderful it was that her sister was not only able to quit her job after she was diagnosed, but that her husband began doing all of the cooking and laundry as well. Not helpful.

On rare occasions, sharing a story may be helpful. I have a friend with a rare cancer with a poor prognosis. She found comfort in hearing about another friend of mine who was living and thriving 15 years after the same diagnosis. But think carefully before sharing any stories. The focus should be on your friend, not on other people in your life who have faced cancer.

Instead say: "How are you holding up?" And listen.

4. Don’t Say: "I Know How You Feel"

"Really? You know what it’s like to have my body, with my particular type of cancer, with my specific symptoms, living with my children, in my home, with my financial concerns?" I realize that most people who say "I know how you feel" are trying hard to be supportive and make their friend feel less alone, but in reality, this can leave your friend feeling even more lonely and isolated.

Unless you’re living with lung cancer — and even if you are — you can’t understand what it’s like to be your friend. Everybody’s journey is different. It can be very tempting to say something like this if you’ve had cancer yourself. In some ways, having cancer gains you admission to a secret society of survivors, but comparisons among cancer survivors can be even more painful. For example, someone living with stage 4 lung cancer doesn’t want to hear someone with a stage 2 breast cancer say "I understand how you feel." Because they can’t.

Instead, say: "How are you feeling?" And be prepared to listen.

5. Don’t Say: "You Need To Have a Positive Attitude"

Keeping a positive attitude with cancer isn’t a bad thing; studies even suggest that having a positive attitude may help the immune system and reduce stress hormones in our bodies. But just as there is a time to be positive, there are times when you need to have a good cry.  

Telling people who are coping with cancer that they need to stay positive invalidates their feelings. This, in turn, can cause them to shut down and hold their feelings inside. Telling someone with cancer that they are "so strong" can have the same effect. If you want to support your friend with cancer, let him be in a place where he can be weak and express his fears.

Instead say: "I’m sure you feel down at times. If you need a shoulder to cry on, I’ll be here for you."

6. Don’t Say: "You Need to ___ " (Take Your Choice)

Some suggestions people make can be good. Some are neutral, and some could even be dangerous. I had one friend "advise me" that I should skip surgery and chemotherapy and instead just drink carrot juice every 2 hours. Of course, I chose to disregard her recommendation, but the bottom line is that giving advice is probably not how your friend with cancer needs you to support her.

If you're about to say something that begins with "you need to___" think again. Your friend has likely done a lot of research and is already overwhelmed with the options available. Likewise, sharing "conspiracy theories," or making comments about chemotherapy being a ploy for doctors to make money at the expense of cancer patients, doesn't do much to support someone recently diagnosed with cancer.

Instead say: "It sounds like you’ve chosen a good medical team. If you need, I’ll be happy to help you research your options."

7. Don’t Say: "Everything is Going to Be Alright"

Really? How can you be so sure?

Telling your friend that you're sure she'll be fine is likely not only untrue  but minimizes your friend's fears about treatment and the future.

Instead, say: "I’m going to be there for you." And be prepared to listen to her fears.

8. Don't Say: "God Can Use This"

Or the variation, "Everything happens for a reason." When someone first said this to me, my cynical response (that I kept to myself) was, "Right. He could have used me just as well without cancer."

I happen to have a strong faith, but I don’t believe God plans for some of us to have cancer so that we can help others. Likewise, I don’t believe that God gives people cancer because there is sin in their lives, or that if you "have enough faith," He will miraculously cure you. Many of us know of someone who had a very strong faith and beliefs, yet succumbed to cancer anyway. Likewise, miracles sometimes happen to those who have no faith at all.

Instead, say: "May I pray for you?" And if your friend says yes, make sure you do.

9. Don't Say "Don’t You Wish You Had Breast Cancer With All the Pink Stuff Instead of Lung Cancer?"

Yes, this is a true comment once spoken to someone with lung cancer. There is an imbalance in the amount of support (and funding) for lung cancer relative to breast cancer, but isn’t that obvious enough (and painful enough) without commenting about it?

Another "don’t say" came as a comment in a blog I wrote: "Lung Cancer Survivors Need to Stand up and Make a Difference Like Breast Cancer Survivors Did." Yes, breast cancer survivors have done a wonderful job of raising awareness. But to walk or run for lung cancer awareness you need to have lungs, and you need to live. The overall 5-year survival rate for breast cancer is around 90 percent. For lung cancer it's just a little over 17 percent.

Instead, say: "I’m ready and willing to join in to help the cause as a lung cancer advocate."

10. Don't Say: Nothing

Silence can be the hardest thing for someone with cancer. One of the greatest fears of people with cancer is being alone — facing treatment alone, facing pain alone, dying alone, or facing survivorship alone. I understand that I shared a number of things not to say to someone with lung cancer, but when it comes down to it, it’s better to say something than to say nothing at all. People with cancer are usually forgiving of the occasional less-than-tactful remark. It is astronomically more painful to feel abandoned.

Instead, say: "I don’t know what to say."

Final Thoughts and General Tips

Since silence is perhaps the worst thing you can "say" to someone with lung cancer, I don’t want people leaving this article paranoid that they’ll accidentally say the wrong thing. People living with cancer understand that their friends can find it difficult to know what to say. Instead of memorizing specific comments not to say, a few generalities might help.

  • Talk less and listen more.
  • Ask open-ended questions, and let your friend direct the conversation.
  • Instead of feeling a need to fix things or do something, what your friend needs most is simply for you to be there.
  • Avoid giving advice.
  • Avoid criticism.
  • Avoid the extremes—both belittling and catastrophizing the gravity of cancer can be hurtful to someone with cancer.

And remember: bad things do happen to good people. But sometimes, those bad things are a bit more tolerable when you have friends who make the effort to avoid saying things that can be hurtful, and replace those comments with supportive words instead.

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