Telling people about your cancer is difficult, and you will be prepared to expect that. What can be unexpectedly exhausting is dealing with people’s reactions to the news. It is natural to be concerned about how your close family and friends will be affected, and we all dread passing on bad news and the reactions we know will result. Different people react in different ways, and although you are the person who needs most support at this time, there will also be a period when you have to field a variety of responses to your news.
We were initially unprepared for people’s reactions too -everyone wanted to jump in the car and come to visit, to support and help us, and just to be close. But when people ask on the phone, it’s hard to make your brain work at all, let alone figure out whether or not you want visitors. In time, we could anticipate people’s reactions – ‘Can I do anything?’ and ‘Can I come and see you?’ – and had thought out in advance our own reactions: ‘Could you just keep in touch by phone?’ ‘Could you phone tomorrow and perhaps visit then?’; ‘Could you collect a prescription while we’re at the hospital?’; ‘Could you pass on the news to X?’ It took time to reach the stage where we were thinking clearly and could be specific, but gradually we got there.
Your close family and friends are likely to react at first with shock and disbelief. Comments like, ‘You seemed so well last time we saw you’ or ‘But you always seemed so strong and healthy’ express how difficult serious illness is to accept. Although people are aware that many cancers are completely undiscriminating in whom they affect, they still find it hard to believe that someone close to them could be affected – cancer always happens to someone else. A common knee-jerk reaction is to deny your cancer: ‘That can’t be right’ or ‘I can’t believe it’. You should be prepared for anger too, once the initial shock has passed – those close to you will feel rage that this should happen to you. This anger may feel as if it is directed at you personally, and can be difficult to cope with. You can do nothing to make your cancer disappear (which is what we would all like, of course), and other people’s anger can feel very unkind and unjustified, as if they are accusing you of choosing to have cancer. Such outbursts can be very painful, but many people do need to express their anger as a form of emotional release.
In some ways more difficult are those who are completely unable to cope with the fact of your cancer, and who react as though nothing has happened. You are trying to convey a very serious piece of news, and it can be both disconcerting and upsetting if the sole reaction is, ‘Sorry to hear that, mate. I suppose you won’t be coming to the pub on Friday?’ Many men do find illness and the emotions it generates very hard to talk about, and therefore feel it is better to say nothing at all. This does not mean that the emotional reaction is any less powerful, but rather that the vocabulary and the confidence to express those emotions are suppressed. Reactions such as, ‘Nothing I say will get rid of the cancer, so why bother’ or ‘I wouldn’t know what to say – I leave that to my wife’ can seem uncaring but this is rarely the reality. It is more likely that your friend or relative simply has no idea what to say and is so embarrassed at the prospect of any emotional reaction that they try to continue as normal and treat you as if your cancer doesn’t exist.
People can also be uncertain about how to talk to you or mistakenly feel that you have enough to cope with and that it is better not to ‘bother’ you at all. This doesn’t mean that they don’t care or are not interested in what is happening, but rather that they don’t want to add to your problems: ‘He’s got enough on his plate without me visiting/phoning’ or ‘I’d call, but I just don’t know what to say’. What feels to you like a withdrawal of support or friendship is often no more than confusion about how to behave. It can be useful to make it clear to friends and family that you would welcome their phone calls or visits, but that they should not be offended if sometimes you are not feeling strong enough or simply in the right mood to chat or see people. They will understand, and will probably welcome any such guidance you can give them.
Although you are still the same person, it can be difficult to accept that some people will treat you in a different way after hearing of your cancer. Being considered a cancer patient first and ‘Neil’ second can be intensely frustrating, especially if you are making efforts to retain as much control over your situation as you can. People may treat you as though you are no longer capable of your usual activities and try to take control of tasks or situations which you are perfectly able to manage yourself. They will have the very best intentions, but may need to be reminded that while you appreciate their concern, it would be better if they waited until you really need their help.
Being treated as a different person can manifest itself in more subtle ways. Most of us have a perception of ourselves which is associated with strength in some form, be it
as a breadwinner;
in relation to our family;
as someone who always copes;
as the person who always sorts out practical problems at home;
in a purely physical sense;
and this perception is often shared by those around you. In the same way that physical illness can undermine your own sense of strength, so others may see you in a new light. People may feel that they should no longer rely on you for your ‘strong’ qualities, not so much because they no longer exist but because you have something more important to concentrate on – your health and treatment. This can also be reflected in how they talk to you, and can be frustrating because you still need to be involved in the day-to-day problems and irritations of people’s lives. People might think, ‘We won’t bother to tell him about that, we’ll just sort it out ourselves.’
As a man, it can be confusing and distressing to realize that the expectations connected with your ‘strong’ qualities which were previously placed on you – both by yourself and others – have changed. On the one hand, people want to look after and ‘mother’ you, to take control on your behalf and ensure that you are not worried or bothered by the trivia of everyday life. On the other hand, you may also find that those close to you, in an effort to prevent you from becoming withdrawn, urge you to ‘pull yourself together’ or not to ‘let it get you down’. The very fact that people are reacting differently to you points to a change in their expectations which you may find difficult to deal with at first.
Although men are increasingly encouraged not to bottle up their emotions, there may still exist an unvoiced expectation that you will find the strength and reserves to cope simply because you are a man. This can feel deeply unfair because you just can’t win! You are urged to talk, to open up, to discuss your feelings but you may sense a slight discomfort in those around you that you need to, especially if this is uncharacteristic behaviour for you. If you keep your feelings to yourself, loved ones become concerned that you are trying to be too strong for them. Perhaps the best course is simply to trust to instinct and to talk to those you trust and feel comfortable with.
In the very early stages, you may not have the emotional energy to take as much interest in the trivia of everyday life as usual. Later, however, it can be very important to feel that you are not being sidelined because you are no longer capable of any useful input into other people’s problems. To be told after the event that ‘We didn’t think you’d be interested/didn’t want to upset you/thought you had enough to worry about’ can be very isolating. Although you need extra support, you don’t want to be constantly handled with kid gloves. It will take some time for you, together with your family and friends, to reach a good balance, but in the meantime you can assure them that staying in touch with the everyday details of other people’s lives is more helpful than troublesome for you.
Although I became very unwell very quickly, I still needed to feel involved in – and preferably in control over – the practical changes which we needed to make to our lives, and to a large extent, we managed this with the support of family and friends. What became extremely frustrating was to hear some people, with the best of intentions, asking Helen about my cancer and how I was rather than asking me – the classic scenario of talking about ‘the patient’ as if he isn’t there. These people were presumably trying to save me the effort and potential distress of going through my story yet again. Of course, there were times when I didn’t feel like talking, but on the whole, it feels better to be given the option! Similarly, while there were occasions when other people’s news felt pretty irrelevant, it was infinitely preferable to being excluded from all ‘normal’ conversation.
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