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Women's Health Blog

Grit & Grace: True Friends & Hard Truths- Communicating after a Cancer Diagnosis

Friendships ebb and flow no matter what age you are or circumstance you’re in—that is just reality. My co-worker and I were discussing all the “best” friends that we’ve had throughout the seasons of our lives. Rarely have the friendships “ended,” rather our lives shifted and distance and time got the better of us. It takes effort and communication (with any relationship), but I think all too often, we take for granted the ease of friendship. So when things are no longer as easy and natural, space creeps in, and friendships fade away after a while. But hopefully you always have those few that step right back in where you left off.

 Friendship in the face of tragedy or life-altering circumstances take on a bit of a different shape. A flock of support rushes at you when news first breaks of cancer and usually all the way through treatment. But when the dust settles, and life “goes back to normal and you’re supposed to be fine,” that space creeps in, again. Maybe you feel like you’ve been forgotten or that people don’t care, but I think it goes back to the communication. Many people tread lightly—they don’t want to be negative or remind you of something hurtful, so often the communication has to be driven by the survivor. How on earth do you even start that conversation?

I have a patient that I have known for many years. I met Vivian shortly after she was diagnosed with breast cancer, and I have followed her and we’ve grown close over the years. I was taken aback at how positive she was when she was first diagnosed. She would come in for treatment and lift everyone else’s spirits. And the support she had was amazing—fundraisers, meal deliveries, childcare, housecleaning, and just the all-around positive presence of friends.  Shortly after she finished treatment, Vivian started to seem very down. I would talk to her once a week or so just to check in, and every week she sounded worse. But she promised me she was fine. A few months after treatment, I just felt like she was so sad, so I asked our counselor to reach out to her just to touch base. It turned out she was not fine—she felt alone and like all the support she had just disappeared. She was worried she would come across to others as attention seeking and dramatic, so she just stayed to herself. It was affecting her day to day life in a very negative way. After working with our counselor and coming up with a few strategies, Vivian was able to reach out to her friends and feel comfortable letting them know what she needed. Here are a few things she learned:

  1. Be directIf you’re nervous about coming across as over-dramatic, it is best to be direct about how you’re feeling--either in person, through a direct message on Facebook, or a note. “I’ve been having a much harder time than I anticipated, and I need someone to talk to or hang out with.
     
  2. Make a planAfter you’ve let them know you need to talk, set aside a specific time and place to talk. Invite them to dinner, have them over for a drink or coffee. Make them feel valued, but find someplace that you are comfortable and set the tone and expectation for the conversation. Let them know if you’re just looking for someone to check in with you on a regular basis or if you want to have a specific conversation. Should they wait for you to initiate when you need to, or should they take the lead when they notice a need.  It will relieve some of the uncertainty with how your friends should approach you in the future.
     
  3. Avoid being defensivePerhaps you feel purposefully left out or forgotten, but most of the time that is not the case. They may have assumed you were fine and didn’t want to bring up something negative. Think about how you would approach things if the roles were reversed. Your friends love you and would never want you to feel forgotten.

  1. Talk with other survivorsThey already understand and you’d be surprised how easy it can be to chat with someone in a Facebook group, even if it just prepares you to talk the people close to you.

It’s important that those you love and see in your everyday life know how you’re feeling and what you need. Know that ebb and flow of friendship allows you to take space but true friends stick around—they just might need a little guidance from you.  Brené Brown says that “authenticity is a collection of choices that we have to make every day. It’s about the choice to show up and be real. The choice to be honest. The choice to let our true selves be seen.” It’s not always easy to be that honest, but you’re worth it, and I can guarantee your friends think so too.

*Patient name has been changed for privacy purposes.

Amanda Gross

Amanda Aris

Amanda Aris is the Cancer Care Coordinator at Beebe Healthcare’s Tunnell Cancer Center. As part of the psychosocial services team at TCC, she navigates patients through the specialty pharmacy process of obtaining oral chemotherapies, coordinates all referrals to outside institutions, and works closely with the cancer survivorship programs and events. Although she has earned a Bachelor of Arts degree in English Literature and Secondary Education, she previously worked with cancer clinical trials as a Certified Clinical Research Professional in Philadelphia. Amanda is Baltimore born and an avid