I had a chance to talk with Stan Goldberg, author and professor emeritus from San Francisco State University, about his new book, Loving, Supporting, and Caring for the Cancer Patient. I recently reviewed his book on this site, and consider it an important resource for family members and friends wanting to support and honor a loved one with cancer. Dr. Goldberg’s perceptive observations and advice come from quantifiable research, from his own experience with prostrate cancer, and from the wisdom of his clients and patients as a hospice volunteer.
What is the most supportive way to help a close friend or family member who receives a cancer diagnosis?
Start with what your friend or family member needs. It’s different for everyone, but there are certain things we all have in common. Most know that their journey’s course will be uncertain, probably challenging, and likely to involve pain. Unless your loved one has been on a cancer journey before, she doesn’t know what to expect — other than that it won’t be a smooth ride. Tell her in words and show her in actions that you’re going to stay the course with her, and you won’t bail out when things get difficult.
It’s better when you can be specific. “Just tell me what you need, and I’ll be there for you,” may be sincere, but unless you’re specific, cancer patients can view it as just being polite. Saying something like, “I know you can’t lift grocery bags, so tell me what time tomorrow you want me to shop with you,” will feel more genuine than making a general offer.
Conversely, what should someone not do or say when their loved says, “I have cancer?”
We all wish for the best and often become too optimistic about outcomes. My clients and I have often heard phrases such as, “Don’t worry, you’ll overcome this.” We know our friends and relatives are being compassionate, but statements like these can sound empty. This doesn’t mean you should be pessimistic, but it’s better to walk the line between hope and reality.
In your book, you write about your own battle with cancer. What did you feel was the hardest transition to make after your diagnosis?
I still have two transition problems thirteen years after my diagnosis. The first involves adjusting to losses that changed my identity, including my inability to participate in the outdoor activities that had defined my life. The second is constantly wrestling with what’s important, given the possibility that cancer will end my life on its own schedule.
Many people don’t understand that for most people, a diagnosis of cancer is the beginning of a new life that may be difficult and is rarely stable. We start viewing things differently — from misinterpreting a casual comment as unsympathetic to believing that the loss of a cherished activity makes life worthless.
How should people close to the cancer patient approach those hard conversations about treatment options — or if it becomes apparent — a treatment’s failure?
The first consideration is timing: When should the difficult issue be discussed? In my ten years of hospice work, I never brought up the topic of death with my patients. Yet everyone at some time wanted to talk about it once they were ready. So it’s an issue of readiness. Knowing the personality and needs of your loved one, you may be able to tell when he’s ready for difficult conversations. If you’re unsure, start with a probing question — “Should we think about alternatives for the backpacking trip we planned?” — then you can use his response as a guide.
The second consideration is what treatment protocol to follow. Trying to think rationally about a frightening topic doesn’t necessarily help make the best rational decisions. If you anticipate that your loved one will be required to make a difficult choice — and there will be many on a cancer journey — you need to prepare her well in advance. For example, if you believe the advancing cancer will affect her lifestyle, begin talking about the potential changes and planning well in advance.
What advice do you have to help others with cancer cope with their new reality?
For thirteen years I’ve lived with my cancer as if it’s an unwanted guest in my body that will probably be with me until I die. I’ve never thought of it as a battle to survive. Instead I looked at what I could still do, what needed to be modified, and what I needed to let go. Every day I cope and adjust to fluctuating physical and psychological conditions.
It isn’t about giving up, or viewing life fatalistically, or pretending my body functions as it did before cancer. It’s about trying to nimbly walk through life understanding what’s possible and what isn’t. I’ve found peace and happiness through making adaptations.
To learn more, visit Stan Goldberg Writer.