Breast cancer: Etiquette
October 15th, 2010
08:48 AM ET

Breast cancer: Etiquette

This week Amanda Enayati will share the milestones of a life-altering journey that began the day she learned she had late-stage breast cancer more than three years ago.

Today let’s discuss cancer etiquette. I would call it serious illness etiquette but I thought I would specialize since cancer is what I know and, who knows, maybe the rules are different from disease to disease. (And yes, every one of the following has happened to me at some point.)

Finding out someone has cancer is awful. It is a cruel disease, which will strike one out of every two Americans. Hearing the bad news is shocking and devastating but it’s probably more shocking and devastating for the cancer victim than it is for you.

So pull yourself together.

You can be authentic, show a little emotion, maybe even shed a tear but for the love of God don’t make it about you and certainly don’t put the cancer patient in the position of having to console you as you sob, beat your chest and yell “Why? Why, God?’ up at the heavens.

Rein yourself in for a minute or two, and let the sick person set the tone. Maybe she wants you to hold her hand and cry with her. Maybe she just wants you to sit and listen. Or maybe she wants you to list the 101 reasons she will survive. Her call. Not yours.

If you don’t know what to say, don’t worry. Any variation of “I’m really sorry,” “I love you,” “My prayers/thoughts are with you” is perfectly okay.

If you find out someone has cancer from someone else, do not call her, burst into tears and sob: “Why do all the good ones have to die?” Yes, it’s true that all the good ones have to die. But all the bad ones have to die too. We all die sometime. Besides, it’s probably not okay to pronounce a living person, who is sitting there on the other end of the phone line, dead from something that they are more than likely hoping to beat (even if they don’t admit it).

Which leads me to my next point, and that is that the cancer patient may or may not die from that particular cancer. There are lots of folks who survive cancer—both early and late-stage—and never have a recurrence, even when the doctors anticipated a high probability that they would. I have read accounts of people who were given weeks and days to live—people who are still living decades later. Recovery is a function of many things and one of them is grace, something that none of us can ever begin to predict or quantify.

Next rule: Don’t look up the odds. Don’t point out the odds. Don’t confirm the cancer patient’s worst nightmares.

What’s that? You’re just being “realistic?” Well, shove the realism up your unmentionable bits and keep it there.

Don’t give anyone struggling with cancer a moniker that contains the word ‘cancer’ in it. Someone I love kept calling me Cancer Girl, like I was a superhero or something. Even in the throes of dealing with it, I didn’t want to hear the word cancer, much less have it associated with me as a nickname, and so I wanted to punch him in the nethers each and every single time he uttered the words. (But I didn’t. I didn’t say a word. I am now, though. Don’t do it.)

Say you’re an acquaintance of someone who’s dealing with cancer, make sure that every time you run into her, your face doesn’t crumple into a look of sorrow, your eyebrows knit together over a pair of puppy-dog eyes as you whine: “How are youuuuu?” in a soap opera voice. She probably was fine until the moment she laid eyes on you and now you’ve ruined the rest of her day with your faux pity.

On the other hand, when the patient is going through treatment, don’t ever tell her she looks bald, skinny, bloated, ashy, gray, red, sickly, even if it’s true. Lie if you need to. Tell her that she’s glowing, beautiful, vibrant, alive. (All of these rules apply to both men and women, by the way.)

One day when I was in the middle of chemo, my daughter’s nursery school teacher said to me: “Aren’t you supposed to be looking worse during chemo? How do you get more beautiful every day?” I swear I wanted to leave my husband right then and there, and marry this woman. I will adore her for life, not because of some compliment that more than likely wasn’t true, but because of her generosity of spirit and the gift of hope that she gave me through a few simple words uttered with pure intentions.

Listen. This is particularly important. When the person is in remission, say, one or two years out from treatment, hell, even six months out from treatment, don’t keep bringing up cancer every time you see them. Say you happen to run into the person in a social situation where everyone’s talking about the weather or politics or those crazy celebrities and their nutty antics, please please please don’t say anything like:

Your skin looks SO great, not like all the other times I’ve seen you when you looked so sick and kind of yellow, you know? Maybe even almost green. Like you weren’t doing so well. But now your skin looks like a healthy person’s skin. Even your hair. Hey, how often do you go to the oncologist? When is your next appointment? How are you feeeeeling?”

Because I promise you the person, no matter how polite she’s being, isn’t taking it well. If she wanted to bring it up, she would have. Because, with a few exceptions we can discuss at some point, she has either already moved on or is trying to move on. She’s hoping to forget the horrors she endured. She doesn’t want to relive it. She certainly doesn’t want to be reminded of it in a social situation. And so more than likely, she wants to take your smug little face and do violent things to it. Even if her face is a perfectly arranged mask of social civility.

Any questions?

Amanda Enayati’s work has appeared in Salon, the Washington Post, Detroit News, and "Let Me Tell You Where I’ve Been: New Writing by Women of the Iranian Diaspora" (University of Arkansas Press). You can follow her on Twitter @AmandaEnayati or her daily blog, practicalmagicforbeginners.com.

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.