How to tell your family and friends about your diagnosis

When I found out I had cancer — and that I needed surgery, and eventually chemotherapy and radiotherapy — my first thought wasn’t ‘am I going to make it?’, it was ‘how am I going to tell my mum?’

It’s a question that the 145,000 Australians diagnosed with cancer each year have to figure out for themselves — how do I tell my friends and family that I’m really, really sick?

I had tonsil cancer and because of modern science and the type of tumour I had, there was never a chance my lump was going to be fatal. Inconvenient, painful, and challenging to the very essence of my reserves and resilience? Yes. But fatal, no.

Still, the reactions to my cancer news ranged from stunned silence and disbelief to tears and admonishment for ‘joking about such a thing’ — I’m a comedian, so people constantly think I’m trying new jokes on them. It’s awful news to hear about a loved one, and as the one with the actual disease, you often end up being the comforter of those who are ostensibly there to support you.

I tried a range of news-breaking techniques that spanned from the bluntly brutal (“I have cancer”) and the syrupy euphemistic (“I have an illness that will make me sick for a while”) to the dispassionately scientific (“it’s a t2 tonsillar tumour to be removed by robotic surgery and radio/chemo mop-ups”).

Truth is, the approach didn’t make much difference. It came down to the personality of the person hearing the news. We got there in the end, finding a way to communicate in a way that was both comfortable for me as well as addressing the concerns and personalities of my support network.

A great deal of my trademark dark humour was on display, because it was my coping mechanism. Wisely, most people realised it probably wasn’t the best time to have the ‘you can’t joke about cancer debate’ with me — because, hey, you gotta be you.

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Try this before you speak

When it comes to breaking the news, palliative-care specialist Dr Judith Lacey has this advice: “First of all, you need to understand what the diagnosis means and have an understanding of what you do know, what you don’t know and what your questions are.”

In other words, arm yourself with the facts about your specific illness, what the treatment entails, what the side effects may be and how your doctors foresee it panning out. This is the starting point from which you can address the scope of what lies next for you and your loved ones. You may even want to have a couple of Q&A sessions with your medical team before letting your extended support network know what’s happening.

“This way you’re encouraging people, particularly family or close friends, to be participants in the journey with you,” says Dr Lacey.

“Make sure everybody’s together at the same time and say: ‘I haven’t been feeling well and this is the reason why.’ Also give them some reassurance that you’re being well supported by a dedicated medical team.”

She also recommends taking people — especially those involved in caring for you — to consultations. This is a particularly smart move as it allows them to ask all the questions they may have of the doctor and feel included.

If the disease is terminal, Dr Lacey says it’s important this fact is acknowledged and that death doesn’t become a taboo topic. You don’t want to leave things unsaid and emotions unacknowledged, so take the opportunities to say how you feel before it’s too late.

Show your support

Once you get over the shock, here’s how to help a loved one who’s just been diagnosed with cancer…

Ask if they need space or company

There were days when I just wanted to be left alone. But I didn’t dare say it out loud for fear of hurting others. “Not everybody wants lots of company,” says Dr Lacey. “Acknowledge that people need their space and their rest.” Where company can be highly valuable is at appointments and treatments. “Whether it’s just to keep them company or to help them remember what’s being said, people often get anxious around scan days, and support is often appreciated. It’s about learning when it’s really important to be around and when it’s not.”

Offer food, not just mantras

The Facebook affirmations were lovely, but what really helped me was the people coming over to help with the laundry or bringing a frozen meal. The practical help was sometimes exactly what was needed. For example, one of the side effects of chemo and radiotherapy is fatigue that builds like a tsunami. So while your friend may be able to drive to treatment, they’ll probably need a lift home afterwards. Offering to drive them to their sessions is a thoughtful way to offer your support.

Look for ways to pamper them

Gifts may sound like an obvious way to cheer someone up, but you can also get creative with them to make your loved one feel extra special. For me, while the flowers and PJs were lovely, what I really loved was the massage voucher – it reminded me that my body was not just an instrument of pain. “Some people may not be able to afford this on top of their medical bills,” says Dr Lacey, “so look for opportunities to pamper them. But be sure to check if that’s something they’ll actually like, so you’re not imposing it on them. Another great gift is that of time and space to go off on a holiday or pamper weekend. Perhaps offer to look after their kids for a weekend while they head off somewhere with their partner.”

Get educated

Find out what they’re going through so you’re better placed to offer emotional and practical support. Research their specific illness online, offer to attend doctor’s appointments with them and, perhaps most importantly, listen to them. Really pay attention when they talk about how they’re feeling and listen out for clues as to what they may be needing or wanting in terms of support.