What do you say?

What do you say to someone diagnosed with cancer?

I've hesitated about writing this blog. Of course, everyone reacts and deals with their diagnosis differently so there can be no rights and wrongs – after all, one man's compliment is another woman's smack in the teeth.

But in my own experience, and in listening to other people who have cancer, there are some common statements issued in good faith by caring souls who believe them to be soothing and consoling, which prove to be the opposite. And as it's frequently said that people don't know what to say when they find out their friend, relative or colleague has cancer, I thought I'd pick out a few classic comments where I suggest you proceed with caution.

Please don’t have nightmares. Much more than the clangers, we talk about the wonderful love and support which gets us through the tricky times. And I can honestly say that nobody has said anything that's made me cross or any more upset than I currently was – apart from the person who insisted on telling me a statistic about prognosis she'd read, but even that was said in good faith.

Compassion, whatever the wording, should never be criticised.

Besides, I'm sure I'm guilty of some of these myself…

We could all be run over by a bus.

Yes, we could, and I appreciate the sentiment. But crossing the road is a risk we take; having cancer is somewhat forced upon us and when we have it, the reality of a premature end is so much more blatant than the potential to find ourselves under the wheels of a bus. I would also say that if we were particularly worried about being run over by a bus, we could take precautions to prevent this unfortunate incident such as never crossing a road. I, and everyone I know who's been touched by cancer, would like to be told the one thing we must do to prevent cancer coming back. And we'd all do it. Unlike not crossing a road, this hasn't been discovered yet.

My friend's brother's sister's cousin had breast cancer twice and is fine.

I understand this one entirely. We all love a success story. Surely when someone has cancer, they also want to hear success stories, right?

Sort of.

But it's a certain kind of success story. Having cancer is about having your mortality thrust in front of your face; however aware you were of it before, it's just so much more immediate now. On diagnosis, I'd suggest there are two questions that people need answered – hopefully in the affirmative: Can I be cured? and, Can I stop it coming back? With cancer, one of the hardest things to believe is that if you're lucky enough to survive the first time, that your body won't get it wrong the next time. When those rogue cancer cells called, your body was found wanting. What logic says your defences will perform better next time? Much logic, actually. There's plenty of research and a wealth of stats to show that your body won't get caught out again and drugs such as Tamoxifen and Herceptin also help your body change its attitude. But whatever the scientists tell us, it takes time to trust your body again after cancer. If you have breast cancer and have had one breast removed, it's really hard to rationalise that you're not going to get cancer in the other one. And next time it might be harder to detect. It might have spread further. It might be more difficult to cure. And even if all the answers were positive, who would relish the idea of another round of treatments?

So, I suggest proceeding with caution in the choice of success stories. Those where people have survived multiple incidences of cancer are another resounding endorsement that recurrence happens. And that isn't something that somebody who's currently dealing with their first bout, wants to think about.

I've just read an article that if you snort three pieces of seaweed (freshly picked that morning from anywhere along the beach between Seahouses and Alnwick on the north coast) on the hour, every hour, they said it could reduce the risk of cancer.

I'm all for well-researched information which has scientific backing. Trust me, I'm as keen as anyone to discover a food source which will give me that piece of mind. But one person's chance hearing can be another person's 24 hours of research and if you magnify that up by all the good folk who've heard a rumour, all of a sudden you're wading through a confusion of unsubstantiated research where much better for your health might have been to relax and read a book. The most helpful suggestions are from those who hear something, carry out the research and only pass on the findings when they've done the work for you. Some people have done this for me and I really appreciate it.

We’re all going to die anyway.

Yes, we are. However, most of us hope that if we do our best to treat our body with respect, we'll live beyond retirement. It isn't something I take for granted but it is a hope. So yes, we will all die one day but when you've just been diagnosed with cancer at 45, your biggest fear is that the day could be forty years earlier than it might have been.

What's the prognosis?

No. Just no. Nobody has asked me this but I was staggered to hear that it was quite a common question and generally from relative strangers. Eeek! I don't think you need me to point out that if somebody hasn't discussed their prognosis, they probably don't want to talk about it. It isn't something you'd forget to mention.

Re chemo aches and groans: at least it means it's working.

It doesn't mean it's working; it doesn't mean anything significant and the inaccuracy of this upsets some people.

Re pending chemo: does it make it easier now you know what to expect?

I think this might be acute paranoia on my part but it feels like the awfulness of chemo is belittled with this question. It's as if, had you'd been stronger or braver rather than fearful for previous doses, the experience wouldn't have been as bad. In truth, knowing what's coming is more likely to make it worse.

You look great.

- when you don't and /or you feel terrible. This offends some people but not me, you can tell me as many times as you like ;)