Too many of us know someone with cancer. In the midst of her treatment for breast cancer Alice Smellie reveals EXACTLY what you should say to your loved one – and the topics to definitely avoid

The moment is one that stays with you for ever. When a doctor gives you a cancer diagnosis, you take a sudden step sideways from happy reality to a dark parallel universe — a place I’d already entered in 2019 when my husband died suddenly.

Five months ago I was forced back there. One thing kept my head above water: the kindness of other women. I’d have been lost without it. Leah and I have been friends for 20 years. We met through work and, although we live a couple of hours apart, have always stayed in touch.

Three years ago, she was diagnosed with breast cancer, and I remember admiring her relentless cheeriness throughout what was clearly a horrendous time.

Then came my diagnosis with the same disease in September last year. Breast cancer affects around one in seven women, and throughout those first few weeks of increasing shock and anger, Leah was patiently there, answering every question, whether sent at midnight or 5am, and providing reassurance and comfort.

At first, it had all seemed quite doable. My first ever routine mammogram in a mobile unit in Frome, Somerset, led to a call back, then a biopsy and then a diagnosis of DCIS, ductal carcinoma in situ, or stage zero cancer, for which a lumpectomy and radiotherapy were recommended. Not great. But not a disaster. ‘It’s a blip — it’s not going to change your life,’ was the upbeat assessment from a nurse.

Loyal support: Alice Smellie (left) and Leah Hardy

Loyal support: Alice Smellie (left) and Leah Hardy

But, post-surgery, I received a phone call to say they’d found a minute bit of invasive cancer, too, and I was referred to an oncologist.

The tumour was tiny, but what’s called triple negative, which is a more aggressive form of the disease. My consultant recommended chemotherapy and then radiotherapy. 

To say I fell apart is an understatement. My family is brilliant, but mostly live hundreds of miles away. They and my friends received many weepy phone calls, and Leah most of all. I phoned or texted her at least once a day for weeks.

When treatment plans were constantly changing and evolving (for the worse), and the future, for at least the next few months, felt so uncertain, good friends were a constant presence. It’s the sole pleasurable and welcome side-effect of a cancer diagnosis.

It’s also true, however, that others did sometimes put their foot in it. Everything that was said came from a place of kindness, but it made me realise there is definitely a right and wrong way to approach other people’s illness.

Given how many of us are touched by cancer, I decided to write down what helped me and what did not.

So, here are my top tips for those supporting friends after a diagnosis. This is also an extended, loving and public thank you letter to the women who were there for me.

What to say 

I found a breezy ‘I’m so sorry, that’s rubbish,’ pretty much covered it. Then the conversation could move on quickly or, if I felt like giving more detail, I could do.

I was baffled and irritated by a work call with someone I barely know who wanted every single detail, and found myself giving curt, increasingly cross answers. It felt inappropriate and I didn’t want her to know intimate details.

‘Shall we put a fun date in the diary for when treatment is finished?’ is a good line, so long as you recognise plans can fall by the wayside if treatment changes.

The thought of a future containing spa days and nights out was very appealing, and now that I’ve finished chemo, even a trip to the cinema is exciting.

Joke about things. Perhaps this is specific to me — not everyone wants their cancer insulted — but a dear group of work colleagues made me laugh even when I was in the depths of despair.

‘Moaning about cancer again? It’s not as bad as being on a tight deadline,’ they might text. Cancer doesn’t make you a different person; sarcasm still made me laugh.

Everyone’s experience of cancer and chemo is totally unique, so don’t assume anything. Someone asked whether I was vomiting — these days there are amazing anti-nausea drugs so this is unlikely.

Also, it really wasn’t something I wanted to discuss. Leah sailed through chemo with thinning hair and a touch of brain fog. I seemed to have every side-effect possible, including a sunburn-like rash, aching joints, organ pain, dry eyes, dry mouth, sore mouth . . . If I wanted people to know about it, I would volunteer it.

What not to say

Some days no one was able to say the right thing. I had a powerful weekly steroid comedown that plunged me into utter despair. Anyone calling me on those days either got short shrift or I ignored the call — for their sake. No #warriorsurvivor in my house.

My family — why is it that we are rudest to our closest loved ones? — learned not to contact me on Monday or Tuesday. Good friends — clearly this is why I love them — didn’t ever get it wrong.

I especially didn’t want to hear stories about other women who had had breast cancer and died. This happened only once, and halfway through I could see that the teller had realised her gaffe and tailed off, but too late.

Alice says: 'Don’t ask for every single detail about the treatment — and don’t you dare tell me that everything happens for a reason'

Alice says: ‘Don’t ask for every single detail about the treatment — and don’t you dare tell me that everything happens for a reason’

Neither did I want to hear that, ‘everything happens for a reason’. I can see no positives whatsoever in my diagnosis and never will do. I also think it implies you need to become a better person, and I don’t need cancer to tell me that!

Don’t pull a sympathetic face and tell people ‘it’ll grow back’ when you see how much hair they’ve lost. Even though I used the cold cap that’s supposed to stop it happening (a torture in itself, in my opinion), I nonetheless lost great clumps, and it’s impossible to describe the distress it caused.

What I wanted was for people to ignore it, which meant the best thing to say was: ‘Your hair has hardly been affected’, in spite of blatant evidence to the contrary.

I loathed the entire process of chemo with all my heart, but especially resented the impact on my looks. By the end, I was round-faced from steroids, my hair was sparse and my body looked as though it had been fashioned from dough.

Perhaps I’m especially vain, but I felt that the whole process had already taken so much from me — I was missing out on my children, my social life, my work and couldn’t exercise or taste food — that this last insult to my self-image was almost too much to bear.

Neither was it especially helpful to hear ‘you were lucky it was caught early’ from those who dared to look on the bright side. Although I’ve perked up a bit, ‘lucky’ would be not having breast cancer.

A friend who’d had bowel cancer said that she struggled with, ‘Are you going to be all right?’

‘They might as well ask if I’m going to die,’ she grumbled, and another said that even, ‘How are you feeling?’ was triggering. I didn’t mind that, but often the answer was: ‘Horrendous.’

Don’t be offended

It’s a myth that illness makes us more tolerant. During chemo — when I was plagued by headaches, general anxiety, depression and sleeplessness for four nights a week — my mood ranged from grumpy to raging anger.

Don’t be offended by a growled response to any question or by a failure to reply altogether. It’s not you.

I didn’t want anyone to sit with me while I was having chemo except for Leah on the first occasion.

For me, the process felt incredibly personal and made me feel vulnerable, and much as I loved company the rest of the time, I didn’t want friends who hadn’t had cancer themselves to have the image of me in a cold cap and woozy from the IV antihistamines (actually, I quite enjoyed that bit).

Things to do

As a single parent to three children aged 19, 17 and 15 — two of whom are still at school — I was grateful for every bit of support offered.

One of the kindest things my friends did was to form a WhatsApp group (which I wasn’t on) and organise food deliveries every week.

I was asked for preferences, but frankly was just incredibly thankful for all of the lovely dishes — from chicken stew to vegan chilli to fish pie — that appeared by magic for me and the kids.

I craved vegetables and healthy protein such as fish and pulses, which is quite a departure from my usual toast and KitKat-heavy diet. On many occasions I didn’t have the energy even to think about meals, never mind cook.

A complication led to me spending three nights in hospital, during which time I was bombarded with kind messages and calls that I simply didn’t have the energy to respond to. One friend provided updates to anyone concerned when I didn’t have the strength to text.

Offer to stay over (if necessary): I was terrified of chemo and the side-effects (rightly so as it turned out — the first drugs affected my heart in an unusual but unpleasant side-effect), and having another grown-up around for a couple of nights gave me peace of mind if I felt unwell.

Offer to drive: it’s impossible to express my gratitude sufficiently to the mother who gave two of my kids a lift to school most days, or to those who drove me to and from various hospitals.

I live in the middle of the countryside in Somerset, but had my operation and first round of chemo at a London hospital, which is a good two-and-a-half hours away.

Get in touch if you’ve had cancer or if you’ve got friends who are going through treatment, too. I found it incredibly helpful to speak to those who’d had similar experiences, especially if they were a few years down the line. For once, reading books and clinical studies completely failed me — statistics and facts were simply too stark.

As well as the comforting expertise of Leah, I was put in touch with three friends of friends who had had triple-negative breast cancer. Hearing from sensible and intelligent women that the treatment was foul, but not unbearable, was incredibly helpful and comforting. 

One in particular was going through exactly the same chemo and we have since become good friends. A chemo buddy with whom you can laugh about the horrors (and swear copiously) is indispensable. Offer them up — you’re doing us both a favour.

Get hold of godparents. As my children are all in their late teens, the need for godparents is diminishing, but suddenly they came into their own — contacting the kids, taking them out and generally letting them know they had a large support network. 

My 15-year-old daughter’s godmother even took her to look around a new school sixth form as I was a week post-surgery on the open day. Parents of their friends have been equally generous.

Things to give

Very subjective, this one. I always got up and got dressed, as I didn’t want to exacerbate the feeling of ‘being ill’, but was frequently ready for bed by early evening.

One dear friend sent a beautiful dressing gown from One Hundred Stars and a group of colleagues sent a winter one with a hood from The White Company, both of which I have worn near-threadbare.

My love of Quality Street is well known, and I received a fair few bags through the post (all of which I ate). It’s worth finding out favourite foods!

Medics kept suggesting that I give up sugar, but as I was unable to taste anything but sugar and salt for a few weeks, and also had the raging hunger of steroids, I’m afraid this wasn’t possible.

Someone came over with a takeaway lunch from a local Michelin-starred restaurant, which was hugely appreciated.

Most of all, give the gift of company. The various complications I endured and the fact that I was immunocompromised meant that I was paranoid about colds and Covid, which could have landed me back in hospital.

Those who did a Covid test before visiting me for coffee made me feel briefly normal. I can’t imagine I was much fun, but they certainly were.

Leah says:

I always say that my doctors may have saved my life, but, like Alice, my friends saved my sanity. That’s one reason why I was so pleased to support her.

I joined the breast cancer club in August 2021 and was instantly plunged into a hell of existential terror and panic.

They call cancer a journey. I felt as though I was on the Titanic and it had just hit the iceberg. But whenever I was drowning, my friends, including Alice, were a life-raft, buoying me up with support, jokes, gossip and kindness.

In fact, I discovered many breast cancer survivors feel a desire — an obligation even — to help women who are newly diagnosed or still in the thick of treatment.

Supporting Alice helped make my own experience — previously a random hammer blow from fate — feel as though it had meaning and purpose. I was there in person for her first chemo session, and for phone calls whenever she needed to talk.

I remember once pacing for so long while we were chatting that I hit my 10k step count on my Fitbit — a double win!

I was able to tell Alice that her feelings, including steroid-induced rage, frustration with life being on hold, grief, and even the horror of losing a lot of her hair, were all completely normal, and the fact that I was speaking from experience made my reassurances more convincing. 

Our doctors may be brilliant, but they can’t really understand what it feels like to be a patient, and empathy is vital at this time.

While most women with breast cancer are cured, the disease can randomly recur, sometimes decades later. I live with the nagging hum of fear that my cancer might be silently spreading through my body, and yes, Alice’s diagnosis sometimes brought that worry bubbling to the surface.

But in the years since my diagnosis, I’ve become adept at keeping my fears at bay. When they creep in, I consciously push them away. In fact, most of the time, I never think about cancer at all. My hair has grown back just as thick as before; I’m working; my two young adult children are fine; I’m back to full fitness and I’m off to Paris at the weekend.

I hope that I have not only been a source of information and a shoulder to cry on for Alice, but that I can give my friend a glimmer of hope of a happy, normal life after cancer. Other women gave me hope in my darkest days and it has been an honour to take their kindness and pay it forward.

Want to send a gift… here are my favourites

Flowers through the letterbox are brilliant; sometimes I was physically unable to answer the door, and didn’t feel like it the rest of the time. From £15.20,

Treatment Bags is a non-profit charity dedicated to supporting cancer patients. The bags are brimming with carefully chosen gifts (wrapped by volunteers) to help alleviate side-effects and cheer mood, such as soft scarves, herbal tea, sleep spray, chocolate and lip balm. I loved mine. The suggested donation is £50,

Green & Black’s chocolate — normally a fan of less-sophisticated confectionery, I found myself turning to this. Chocolate Lovers Medium Gift Box, £15,

Bramley Geranium, Lavender and Sweet Orange Bubble Bath, £18.50, I spent an inordinate amount of time in the bath. Skin can be sensitive during treatment, and I found this product pleasant to use.

Treatment Bags is a non-profit charity dedicated to supporting cancer patients. The bags are brimming with carefully chosen gifts (wrapped by volunteers) to help alleviate side-effects and cheer mood, such as soft scarves, herbal tea, sleep spray, chocolate and lip balm

Treatment Bags is a non-profit charity dedicated to supporting cancer patients. The bags are brimming with carefully chosen gifts (wrapped by volunteers) to help alleviate side-effects and cheer mood, such as soft scarves, herbal tea, sleep spray, chocolate and lip balm

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