About this ebook

This ebook is about talking with someone who has cancer. It is for anyone who wants to support someone with cancer, including carers, family members and friends.

The ebook explains how to talk to and support someone who has cancer. We hope it helps you deal with some of the questions or feelings you may have.

This ebook does not have information for people who have cancer. We have other booklets and ebooks about talking about cancer that could help:

- Talking about cancer (for people who have cancer)

- Talking to children and teenagers when an adult has cancer.

See the end of the ebook for information about ordering these booklets and ebooks.

How to use this ebook

The ebook is split into sections to help you find what you need. You do not have to read it from start to finish.

It is fine to skip parts of the ebook. You can always come back to them when you feel ready.

Quotes

In this ebook, we have included quotes from people with cancer and their friends and family. These are from people who have chosen to share their story with us. To share your story, visit macmillan.org.uk/shareyourstory

For more information

If you have more questions or would like to talk to someone, call the Macmillan Support Line free on 0808 808 00 00, 7 days a week, 8am to 8pm, or visit macmillan.org.uk

If you would prefer to speak to us in another language, interpreters are available.

If you are deaf or hard of hearing, you can contact our support line using the Next Generation Text Service (NGT) by dialling 18001 0808 808 00 00.

We have some information in different languages and formats, including audio, eBooks, easy read, Braille, large print and translations. To order these, visit macmillan.org.uk/otherformats or call 0808 808 00 00.

The benefits of talking

Why talking is important

When someone close to you has cancer, talking to them about it might feel upsetting or uncomfortable. It might take some time for you both to cope with the news. There is no right or wrong way to cope.

But there are lots of ways talking can help. It can release stress and help you and the person with cancer feel better. Finding the words to describe events and feelings can help make sense of them.

Talking can help you and the person with cancer get the support you need. And being listened to and heard can help reassure them that they are not going through hard times alone.

Having strong emotional support can help someone adjust better to the changes cancer can bring. Having someone to talk to can help to prevent or reduce feelings of anxiety or depression. Support from family and friends can make a real difference.

You may feel you do not know what to say. Or you may worry you will say the wrong thing. Try to be open and sensitive to their feelings and respect their wishes. Often the most important things are just listening to the person and keeping in touch. Remember, they are the same person they have always been.

You might be worried about upsetting them. But talking about fear or distress does not usually make it worse. Often, talking can help.

Talking to children about cancer

Your child might need extra support to talk about cancer. This is especially true if the person with cancer is someone their age.

It can help to explain to them about cancer and its effects. Do not feel you need to talk about it in too much detail. Listen to them when they want to talk about it. Let them know you are there to answer any questions about what is happening.

Remind them the person with cancer is still the same person they were before. Encourage them to keep in touch. If the person with cancer is their friend, talk about how they can support their friend while they are feeling unwell.

CLIC Sargent has some helpful tools to help you support your child with talking about cancer. Visit clicsargent.org.uk.

‘I don’t have any of the answers and I don’t think I’ve ever given Sarah an answer. I’ve just said, “What I’m hearing is this….”’ Jane

Listening

Being a good listener

Most of us feel helpless when we are faced with cancer. But you can often help someone just by listening to them and letting them talk. Sometimes a caring listener is what the person needs the most.

Listening carefully is a skill you can learn. It helps you be more supportive and understand better what your relative or friend needs. You can listen without feeling you need to have answers.

Finding out if the person wants to talk

You do not need to rush into talking about the illness. Sometimes it is enough just to listen and let the person with cancer talk when they are ready. Let them know that if they want to talk about the cancer, you are ready to listen.

Your relative or friend may just want to talk about ordinary things. This could be things like TV programmes, sports events or what has been happening in your life. There is something very reassuring about day-to-day small talk. Sometimes people just want to enjoy a normal conversation. This can help them feel that cancer has not taken over every part of their life.

Follow their lead

You may be able to sense whether your relative or friend wants to talk. Listen to them carefully. If they tell you something about the cancer, ask them if they want to talk about it more. But let them decide if and when they want to have that conversation. If you are not sure, you can always ask ‘Do you feel like talking?’

If your relative or friend does want to talk about cancer, you could have a conversation about:

- what topics are okay to talk about

- how they will let you know if they do not want to talk about something

- what support you can offer that they will find helpful.

If they do not want to talk about cancer or their feelings, try not to take this personally. It does not mean you have done anything wrong. There are times when people choose not to talk about cancer. This may be because they do not feel it will be helpful for them. Or they may want a break from thinking about it. You can still help by listening and paying attention when they do choose to talk.

‘What I did was listen to how she felt, and eventually the illness became part of normal conversation.’ Georgia

How to listen

When your relative or friend is talking, it is important to give them your full attention. Here are some simple tips to follow.

Get the setting right

Somewhere comfortable and private is best. Here are some things you can do to help:

- Switch off your mobile phone and other distractions, like the TV.

- Let them know you have time to sit and talk with them.

- Keep your eyes at the same level as them. Try sitting down next to the person or at an angle to them, rather than directly opposite them. This can help the setting feel less intense.

- Sit close, but not too close. Sitting about 2 to 3 feet (60 to 90cm) away allows them some personal space. But you will still be close enough to be able to talk intimately.

- Sit quietly. This will help you look calm, even though you may not feel relaxed.

Show you are listening

Try to look at the person as you are listening, to show them they have your full attention. It is also good to nod occasionally and encourage them to talk with comments such as ‘Hmmm’, ‘Uh-huh’ or ‘Yes’.

Check you have understood

Misunderstandings can happen if you assume you know how the other person feels. Asking questions and giving feedback will help you check you have understood what they have said. It also shows you are listening and trying to understand.

Questions you could ask include:

- ‘Do you mean that…?’

- ‘What did that feel like?’

- ‘How do you feel now?’

It is also good to check what you have heard is right:

- ‘What I’m hearing is…’

- ‘It sounds like you are saying…’

Keep an open mind

Try to avoid talking while the other person is talking. Wait for them to stop speaking before you start. Do not get caught up with thinking about what you are going to say next. Listening is not the same as waiting to talk.

If they tell you about their fears or worries, it is important to let them be sad or upset. It may be distressing for you to hear some of the things they say. But it can really help them if you can just listen while they talk.

We have more information about coping with difficult emotions such as sadness or anger later in the ebook.

Respond with respect and understanding

It is good to be open and honest about your feelings. Here are some things to think about:

- Make time for both your feelings and your relative or friend’s feelings.

- Give your opinion respectfully, but remember your relative or friend may have a different opinion.

- Treat them the way you think they would want to be treated.

Breaks in the conversation

If someone stops talking, it might mean they are thinking about something painful or sensitive. Wait with them for a little while and then ask them if they want to talk about it. Do not rush. It is okay to wait until they feel ready to talk again.

Sometimes just being there and touching their hand or putting an arm around their shoulder can help more than words. If they pull their hand away or look uncomfortable, you will know this is a signal to give them space. But a touch may be just what is needed to help them talk. It shows you care and want to support them.

Respond to humour

If your relative or friend wants to use humour to help them cope, it is good to respond to this. But do not be the one to bring humour into the conversation, in case they do not find this helpful.

Main points to remember

- Check you understand what the person is saying – if you are unsure what they mean or how they feel, just ask.

- Remember, each person’s experience of cancer is different. Everyone copes in different ways and the way they cope may change over time. Respect the person’s feelings and wishes. Do not judge or offer advice they have not asked for. If you must offer advice, pause to think about how helpful it will be.

- Respond to humour, if the person uses it.

- Be open to hearing what the person has to say. Show you are listening by nodding and making eye contact.

- Allow the person to be sad or upset. Acknowledge how hard their situation must be.

- Make sure you look after yourself as well as the person with cancer. Get support for yourself if you need to.

What to avoid saying

We know lots of people worry about saying the wrong thing. Understanding what may be unhelpful, and why, may make you feel more confident.

Over the next few pages, we have listed some examples of things people with cancer tell us they do not find helpful to hear. We have also suggested some alternatives.

If you have said one or more of these things, do not be hard on yourself. No one gets it right all the time. The most important thing is you are trying to reach out and help. Do not let your anxiety about making a mistake make you afraid to offer support. Your relative or friend will appreciate that you are trying to help.

‘I know you will be fine.’

It is very common for people with cancer to have fears and worries. But it can be hard to hear someone you care about talking about these things. You might want to make them feel better by telling them everything will be okay. But often this does not help.

Saying things like ‘That is a good cancer to have’ or ‘At least you do not need to have chemotherapy’ is not usually helpful. The person with cancer may feel you do not understand the seriousness of what they are coping with.

What to say instead

Rather than dismissing what someone is facing, listen to them and let them speak freely about their feelings.

‘You are so strong.’

People often say this, because they admire how the person with cancer is coping. But it is not always helpful. The person may feel under pressure to be brave or strong all the time. They may then feel they can not admit to feeling sad or depressed. Or they might find it harder to ask for help when they are not coping so well.

What to say instead

You could tell them you understand they may have good days and bad days. Ask what support you can offer on those days.

‘You need to think positively.’

It is not usually helpful to tell your relative or friend to think positively. No one can feel positive all the time. It is normal for people to feel scared, angry, upset, sad or depressed at times, especially when dealing with cancer.

There is no evidence that positive thinking can make treatments more effective or stop cancer coming back. If you suggest it can, they may think they were not positive enough and it is their fault if treatment does not go well.

What to say instead

Ask them how they are feeling and be ready to hear what they say, even if it is not all positive. Being able to express and accept feelings is the first step in coping with them.

‘My aunt had cancer.’

When someone talks about their cancer experience, avoid telling them about someone else’s, unless they ask about it. Avoid sharing details you read on the internet or elsewhere, too. Each person’s experience is different.

Treat your relative or friend as an individual. Try to focus on them rather than comparing them with anyone else.

What to say instead

You could encourage them to tell you more about the cancer and listen to what they say. That way, they will know you are interested in hearing about their experience.

‘You look really tired.’

Think before making comments about someone’s appearance. Some people find changes to how their body looks or works some of the hardest parts of having treatment. If someone looks tired or has lost weight, they probably know this already. Being told does not help them feel any better.

What to say instead

It is generally best not to comment if someone is not looking well. Let your relative or friend mention their appearance if they want to talk about it.

If your relative or friend looks well, you may want to tell them this. You could say something like, ‘You look well, but how are you really feeling?’ This makes it clear you really want to know how they are and are not just assuming everything is fine.

‘You should try this diet I read about online.’

Think carefully before giving advice, especially about someone’s treatment. You should also avoid sharing details from the internet or elsewhere unless you know it is a reliable source.

You may have your own ideas about what would help your relative or friend. But it is worth stopping and asking yourself if your idea will really be helpful. You may want to tell them something you think may help them feel better. But sometimes people with cancer are overwhelmed with suggestions.

If you do make a suggestion, be ready to let it go if they do not seem interested. Remember your relative or friend may not always accept your advice or help. If they reject your suggestion, do not take it personally. Their preferences may be different from yours. It could also be one way they can stay in control of their life, when other parts of it feel out of control.

It is up to your relative or friend to make their own decisions about their treatment. Be ready to support their decision, even if it is not the same one you think you would make.

What to say instead

If you want to give advice but are not sure about it, you could say something like, ‘I wondered about this, but I do not want to suggest it if it is not the sort of thing you want’.

‘If you need anything, just give me a call.’

This is a kind offer to make, but it is a bit vague. It is better to make specific offers of help.

What to say instead

You could offer to collect the children from school, or drive your relative or friend to the hospital. Making a specific offer means they do not have to try to work out what you can help with. It also shows you really want to help and are not just being polite.

We have more information about offering practical support later in the ebook.

‘The best thing was when the phone rang, and my neighbour said, “Have you got any ironing? Get it together and I’ll come over in 10 minutes”. An hour later, a basket of clean, freshly ironed laundry was delivered back.’ Curtis

‘It is great that it is all over.’

Your relative or friend’s treatment may have finished, but they will still need support.

When treatment finishes, do not assume your relative or friend can just move on or feel happy about this. The end of treatment can often be a surprisingly hard time. It may be when people start realising what they have been through emotionally. They may be worried about the cancer coming back and miss the reassurance of regular contact with their cancer team. And they are often still coping with treatment side effects or adjusting to any permanent body changes.

What to do instead

Let your relative or friend know you are still available to listen to them when they want to talk.

Keeping in touch

Different ways of keeping in touch

There are many ways to keep in touch and to let your relative or friend know they are important to you. These can include:

- visiting them

- sending notes, cards, texts, messages and emails

- calling them

- talking to them on social media sites like Facebook and Twitter.

You can ask your relative or friend what they prefer.

During and after cancer treatment, people may have good days and bad days. There may be times when your relative or friend’s energy levels are low. If they are having treatment or are likely to be tired, try to keep phone calls and letters short. It is also good to call before you visit to ask if they are feeling well enough to see you.

Remember to be understanding if your relative or friend:

- does not always feel able to see you

- has to change plans at the last minute.

Keep inviting them

Remember to keep inviting your relative or friend to take part in plans, just like you did before they had cancer. Even if they do not feel well enough to come, it is always nice to be asked. Let them decide if they can come.

Letters, notes and cards

Handwritten notes can be special keepsakes for your relative or friend. Many people worry about what to write. But it does not have to be something deeply meaningful. If it is the first time you have written to them since their diagnosis, acknowledge what has happened. Remember to let them know you care.

If you are struggling to find words, you could write something like:

- ‘I am not sure what to say, but I want you to know I care.’

- ‘I am sorry to hear you are going through this.’

- ‘How are you doing?’

- ‘If you would like to talk about it, I am here.’

- ‘I will keep you in my thoughts.’

If your relative or friend has internet access, you may wish to send them an electronic card (eCard). An eCard is a digital greeting card or postcard that you can make and send online to someone’s email address. We have a range of free eCards available on our website. Visit ecards.macmillan.org.uk

Gifts

These do not have to be expensive. It really is the thought that counts. Look for small, practical things your relative or friend may need or enjoy. Think about what might make their day a little better. Fun things that may make them laugh or smile are good too.

Examples of gifts you could buy include:

- magazines, DVDs, books or audiobooks

- soft bed socks

- favourite foods or snacks

- a special pillow or a heating pad

- a handheld fan

- photos of family members or friends.

Calling and messaging

Phone calls

Phone calls are a great way to stay in touch. Here are some tips:

- Call at times that work best for your relative or friend.

- Remember they might be tired, so do not make the call too long.

- End the call by saying you will be in touch soon and make a reminder for yourself about when to call again.

You could also think about using video-chat apps like FaceTime and Skype. These let you see and talk to each other easily. Check with the person before you do this. They may prefer for you not to see them if they are feeling unwell.

Text messages

Many people keep in touch with text messages. They are a quick way of letting people know you are thinking of them. You could also use other messaging services, such as Facebook Messenger and WhatsApp.

When you message the person, let them know they do not need to reply straight away. You could say something like, ‘I want you to know I am thinking of you, but do not feel you have to reply’. This way, you are not putting pressure on them to respond.

Think about sending a message when you know the person is likely to be alone. For example, they might be less likely to have visitors late at night. Sending a message is a reminder that they have support.

Social media

Social media sites such as Facebook, Twitter and Instagram are popular ways of sharing thoughts, feelings and events. You can share things with many people at one time. They can be a good way of keeping in touch, especially if the person you are supporting feels tired or unwell.

If you want to talk with your relative or friend about cancer on social media, think about using private messaging. They may not want to talk about this in public.

Visits

It is very common for people with cancer to feel lonely and isolated. Try to spend time with your relative or friend. Being able to see them and hear their voice can often give you a better idea of how they are feeling. If they want to have a deep conversation about their feelings, this may be easier in person.

‘Have friends and family round for visits, but have someone else do the catering. Ensure there is a curfew for visitors, so they are not worn out.’ Amy

Offering to help

Offering to help

One of the most common problems when trying to help someone with cancer is knowing where to start. If you want to help, but do not know what to do first, this section has some tips and advice.

It is important to first find out if your relative or friend wants your help, and what kind of help they need. When you know they do want your help, you can offer to help with one of the things they need. It is always good to try to be specific. Rather than saying, ‘Let me know if there is anything I can do,’ you could ask:

- ‘Shall I do the shopping?’

- ‘Would you like me to pick up the children from school?’

- ‘Would you like me to take you to your next appointment?’

You can also say you will keep in touch to see if there are other things you can help with.

Some people find it hard to accept support, even if they need it. This means your relative or friend may say no to your offer. Try not to take this personally. They might not be ready to accept help yet, or they might want to remain independent. You could offer again later if they ever need any support.

Do not pester your relative or friend into accepting your help. Some people are happy to do things on their own.

Decide what you can do and want to do

Start by thinking about what you are good at. You probably have many skills that will help you support your relative or friend.

Here are some suggestions of things you could do to help:

- Cook for them. Make meals for them and any family members living with them. Taking them pre-cooked, frozen meals may be useful.

- Help around the house with cleaning, or in the garden.

- Take the children out for the day, to give the person some rest or time with their partner.

- Babysit, so their partner can visit them in hospital.

- When they come out of hospital, have groceries, such as bread and milk, or flowers waiting for them at home. Something as small as this could make a big difference to them.

- Offer to take them and their family to and from hospital.

Start with the small things

Start small and offer to do one or two practical things your relative or friend has mentioned. That way, they will not feel embarrassed or overwhelmed by the attention. It is important to only offer to do what you can manage. Do not aim to do too much. You may need to think about and understand what your relative or friend needs or likes.

If you have offered to cook meals, remember that people with cancer may have a small appetite. Or they may find things taste different because of treatment. If they do not eat what you have made, it is not an insult to your cooking. It is simply an effect of their illness. You could try asking them if there is any particular food that they enjoy right now. Putting small portions on a smaller plate may also help.

We have a booklet with lots of recipe suggestions for people affected by cancer, which you might find helpful.

Spend time together

It can help to spend regular time with your relative or friend. Think about the time you can realistically spend with them and try to be reliable. Remember that even short, regular visits will be something they can look forward to.

Go to appointments

People with cancer are often encouraged to take someone with them when they see the doctor or nurse. They often feel anxious about seeing the doctor and may forget questions they wanted to ask. If they ask you to be there with them, you could offer to help them prepare for the appointment.

You may find the following suggestions useful:

- Offer to write down the questions they want to ask.

- During the appointment, avoid speaking on behalf of your relative or friend, unless they ask you to. This may mean they forget what they wanted to say.

- Listen carefully to the information and answers the doctor gives. It may help to take notes or ask the doctor if you can record the conversation. This way, your relative or friend will not miss anything the doctor says.

- Ask if there is any written information available. This can help you and your relative or friend understand more about their cancer type and its treatment.

Helping during and after appointments

Your relative or friend may find it hard to take in information, especially if they are given bad news. Sometimes the shock of this makes a person unable to talk or think clearly for a short time. If you have their permission, this could be a good time to ask the questions you know they wanted to ask. You can also make sure you write down a contact number for the clinical nurse specialist (CNS) or consultant. This is good to have if your relative or friend needs to ask more questions. Or they may want to talk about what they have been told again another time.

You can remind your relative or friend afterwards of what the doctor said. They may find it helps if you listen to them as they think about any choices they need to make. You may also want to read through any written information you have been given. Remember to check with your relative or friend first if they want to know this information.

You can also call our support line on 0808 808 00 00 to talk about any treatment choices and to ask for more information.

You may also feel upset by the news given to your family member or friend. Supporting someone when you feel upset can be hard. So it is important to get support for yourself.

Involve other people

Like everyone else, you have your limits. There is always something more that could be done, but it is impossible to do everything. This is why it is useful to involve other people where possible, if your relative or friend agrees to this. For example, you could set up a rota to cook meals or to drive them to hospital appointments.

You may be able to find people with skills you do not have. For example, someone else may be able to do jobs such as gardening or housework. We have more ideas on ways to help your relative or friend in our booklet and ebook Looking after someone with cancer. See the end of the ebook for ways to order this.

What your relative or friend may be facing

Uncertainty

Most of us like to know what is going to happen to us. It helps us feel secure about our future. Having this feeling of certainty is a basic human need. We all like to feel in control. But people with cancer often feel this has been taken away from them. Their future may feel uncertain and they may not know what is going to happen to them. They may even talk about feeling out of control, because they are going through an unpleasant situation.

You can help your relative or friend by simply recognising how difficult it must be to face this uncertainty. You could also help them by looking at some of the things they can still control. These may be small things, such as when to go for a walk, what to eat or what to watch on TV. Or it may be a big decision, such as whether to have chemotherapy or to ask for a second opinion about treatment.

The fear of death

Although many people with cancer can be cured, your relative or friend may have a fear of dying. This fear could be about many different aspects of dying. It may always be there in the background, even if they never talk about it.

Even when people are cured, they often still worry the cancer may come back. This fear may fade over time. But it is important to give your relative or friend a chance to talk about it. By simply listening, you can support them.

Physical effects of cancer

Tiredness (fatigue)

Tiredness (fatigue) is very common in people with cancer, especially during treatment. It can be constant or it may vary, depending on what treatment someone is having. Tiredness can mean someone feels low in mood or more irritable than usual. It can also affect their concentration and memory.

Eating problems

Cancer treatment can sometimes cause people to:

- feel or be sick

- have a change in appetite

- have changes to their sense of taste making some foods taste unpleasant or all foods taste the same.

Changes in appearance

Cancer treatment can cause changes in appearance. These may be temporary or permanent.

Possible changes include:

- hair loss

- gaining weight or losing weight

- scars from surgery

- skin changes such as rashes, dry skin, spots or redness.

Changes in our appearance can make us feel vulnerable and self-conscious. Your relative or friend may worry about how other people may react, or how the changes may affect their relationships.

Most people need time to get used to body changes. Support from family and friends can help. Remember they are the same person you have always known. If they want to, let them talk to you about their feelings.

We have more information about coping with changes in appearance in our booklet and ebook Body image and cancer.

Changes to their role

During cancer treatment, many people stop doing the things they used to enjoy or do well. They may have stopped working, or stopped doing activities that involved contact with other people. These activities can reassure us that we are competent, needed, talented or funny. They remind us that other people value our skills, knowledge and humour.

Doing these activities can also give us a sense of self-worth. This is also known as self-esteem. Having positive self-esteem is about having confidence and respect for yourself. Not being able to do these activities can affect a person’s self-worth and how they think about themselves.

Remember your relative or friend is still the same person inside, even if they have had to cope with losses and changes. Their skills and qualities are still there, even if they do not have the chance to use them as much right now.

It might be helpful to think together about what they still want to do and can do, even if it is something small. Whatever they decide, it is important to support them.

Loneliness and isolation

Some people can feel isolated from their family, friends and workmates. If family and friends feel awkward about what to say, they may not visit or get in touch. You can help by keeping in regular contact and being a good listener. You can encourage other people to do the same.

Depending on others

Many people find it hard to think of themselves as someone who has cancer. They worry that because they need other people more than normal, they are being weak. But we all depend on each other throughout life, even if we like to think of ourselves as independent.

Difficult emotions

It is natural for people with cancer to have a mix of emotions. These can include sadness, fear and anger. These emotions can also come and go at different times.

Remember you may also be coping with your own strong emotions. It is important that you have other people you can talk to and get support from. This will help you. It will also help you support your relative or friend. There is more information about where to find support from others later in the ebook.

If your relative or friend is distressed

It can be upsetting to see someone we care about crying. But crying is a natural response to distress and it can be a helpful release. Some people do not want to cry. They may feel that if they start, they will not be able to stop. This is not true, as feelings can come and go.

Responding to distress

If your relative or friend cries, reassure them that it is okay to cry. This will let them know you are not put off by their tears. Touching, holding hands or giving them a hug may help too.

You might want to try to stay strong for them, but it is okay if you need to cry too. Being honest about your feelings will help build trust between you. It will also make it easier for the other person to be honest about their feelings.

If you are upset, you can tell your relative or friend you do not mind feeling that way. This lets them know they can open up, rather than try to protect you by keeping their feelings from you.

It is good to be honest about your feelings, but try to keep focused on your relative or friend’s feelings. This does not mean you do not need support. It is really important that you also have people you can talk to about how you are feeling.

If your relative or friend is angry

There may be times when your relative or friend’s frustration or anger with the situation is directed at you. They may be irritable or critical of your attempts to help. They might be angry about the cancer, but this can be hard to put into words. So they may take out their feelings on the people closest to them. This can be hard to take, especially when you are doing your best and are also coping with your own feelings.

We have a video about Ron and his wife Linda. They talk about how their relationship changed after Ron was diagnosed with cancer. You can watch it online at macmillan.org.uk/information-and-support

Responding to anger

Be ready to let go of minor arguments and be forgiving, understanding and supportive.

If your relative or friend is irritable or critical, try not to take it personally. Remember anger and irritability are common reactions to being diagnosed with cancer. If you feel upset or angry, give yourself time to calm down before you respond.

After a disagreement, find a time when you are both calm to talk about what happened and how you both feel. Instead of saying, ‘You always criticise me’ or, ‘You make me feel sad’, try to say something like, ‘I felt upset when we disagreed today. Can we work this out together?’

In most disagreements, both people have some responsibility. Listen to what your relative or friend tells you. Ask yourself, ‘Do they have a point?’ and, ‘Could I do anything differently?’ Talk about what both of you could change to make things work better.

Try to resolve the disagreement and forgive each other at the end of your talk. A hug or a kind word can help resolve the disagreement and make you feel closer. But this does not mean you should put up with an abusive relationship. If your relative or friend is being consistently verbally or physically abusive, ask your GP or someone else you trust for help.

Here are some tips on coping with anger:

- Try not to take it personally. Remind yourself they may be upset because of the cancer, rather than with you.

- Find a time when you are both calm to talk about it.

- Look for solutions you can both agree on.

- Get support for yourself from someone outside of the relationship.

If your relative or friend is in denial

If your relative or friend has been told they have cancer, this can be hard for them to accept. This is called denial, and it is a normal reaction. There are different ways a person may experience denial. They may accept some parts of their situation and not others.

If the person with cancer is in denial, it can be very hard to talk to them. There are certain things they may not talk about.

It may be upsetting for you, but denial is a strong coping tool and needs to be respected. It is important to listen to what they say. Some people will eventually accept their situation, but some choose to stay in denial. If that happens, try to accept it.

Counselling

Usually, people with cancer and those close to them adjust and find ways to cope with anger or anxiety. But sometimes people need outside help to deal with the strong emotions they have.

You or your relative or friend may be struggling with anger, anxiety or depression. It may be hard to share this with family or friends. A GP, cancer doctor or specialist nurse may suggest professional support. Seeing a trained counsellor or psychologist can give you or your relative or friend a chance to talk to someone outside the situation. They can also help explore feelings and find ways of coping.

We have a video about counselling that you might find helpful. Visit macmillan.org.uk/information-and-support

Looking after yourself

Looking after yourself

Supporting a person with cancer can be very rewarding and can bring you closer together. But it can also be demanding and sometimes upsetting. It is important to make sure you look after yourself and have the support you need. We have more information about coping when someone close to you has cancer and looking after someone with cancer in our booklets and ebooks Looking after someone with cancer and Cancer and relationships: support for partners, families and friends (see the end of the ebook).

Supporting yourself

If you are tired, it is important to rest. This may seem obvious, but many people carry on, even though they are tired. They then feel exhausted later. It is also important to get enough sleep.

Give yourself time to regularly do things you enjoy. This will help you feel rested and relaxed. Try to include things that:

- involve keeping in touch with other people, such as having lunch with a friend

- give you a sense of accomplishment, such as exercising or finishing a project

- make you feel good or relaxed, such as watching a funny film.

Help from others

Many people find they benefit from having other people’s support. This is nothing to be ashamed of. You should not feel you have failed if you need some support to deal with your own emotions. Sometimes talking to another family member or friend can be enough. Or you may find it helpful to talk with your relative or friend’s specialist nurse. They can tell you if there are any local support organisations or counselling services that can help you.

If your employer has an Employee Assistance Program (EAP), you can contact a counsellor that way. You can also contact our cancer support specialists on 0808 808 00 00. Organisations such as Samaritans, the British Association for Counselling and Psychotherapy or the UK Council for Psychotherapy can also give you more information and support.

If you have access to the internet, you may also want to join an online support group or chat room. Our Online Community is a website where you can chat to other people, blog about your experiences, make friends and join support groups. You can share your own thoughts and feelings and get support too. Visit community.macmillan.org.uk

Supporting someone with cancer may be something new to you. Every person is unique and there is no one way to get it right. It is important to remember that it is your care and compassion that your relative or friend will value most.

If you give unpaid support to a family member, partner, friend or neighbour who could not manage without this help, you may be a carer. We have more information for carers.

Further information

About our information

We provide expert, up-to-date information about cancer. And all our information is free for everyone.

Order what you need

You may want to order some leaflets or booklets, or download more ebooks like this one. Visit be.macmillan.org.uk or call us on 0808 808 00 00.

We have booklets on different cancer types, treatments and side effects. We also have information about work, financial issues, diet, life after cancer and information for carers, family and friends.

All of our information is also available online at macmillan.org.uk/information-and-support There you’ll also find videos featuring real-life stories from people affected by cancer, and information from health and social care professionals.

Other formats

We also provide information in different languages and formats, including:

- audiobooks

- Braille

- British Sign Language

- Easy Read booklets

- large print

- translations.

Find out more at macmillan.org.uk/otherformats If you’d like us to produce information in a different format for you, email us at cancerinformationteam@macmillan.org.uk or call us on 0808 808 00 00.

Help us improve our information

We know that the people who use our information are the real experts. That’s why we always involve them in our work. If you’ve been affected by cancer, you can help us improve our information.

We give you the chance to comment on a variety of information including booklets, leaflets and fact sheets.

If you’d like to hear more about becoming a reviewer, email reviewing@macmillan.org.uk You can get involved from home whenever you like, and we don’t ask for any special skills – just an interest in our cancer information.

Other ways we can help you

At Macmillan, we know how a cancer diagnosis can affect everything, and we’re here to support you. No one should face cancer alone.

Talk to us

If you or someone you know is affected by cancer, talking about how you feel and sharing your concerns can really help.

Macmillan Support Line

Our free, confidential phone line is open Monday–Friday, 9am–8pm. Our cancer support specialists can:

- help with any medical questions you have about your cancer or treatment

- help you access benefits and give you financial advice

- be there to listen if you need someone to talk to

- tell you about services that can help you in your area.

Call us on 0808 808 00 00 or email us via our website, macmillan.org.uk/talktous

Information centres

Our information and support centres are based in hospitals, libraries and mobile centres. There, you can speak with someone face to face.

Visit one to get the information you need, or if you’d like a private chat, most centres have a room where you can speak with someone alone and in confidence.

Find your nearest centre at macmillan.org.uk/informationcentres or call us on 0808 808 00 00.

Talk to others

No one knows more about the impact cancer can have on your life than those who have been through it themselves. That’s why we help to bring people together in their communities and online.

Support groups

Whether you are someone living with cancer or a carer, we can help you find support in your local area, so you can speak face to face with people who understand. Find out about support groups in your area by calling us or by visiting macmillan.org.uk/selfhelpandsupport

Online community

Thousands of people use our online community to make friends, blog about their experiences and join groups to meet other people going through the same things. You can access it any time of day or night. Share your experiences, ask questions, or just read through people’s posts at community.macmillan.org.uk

The Macmillan healthcare team

Our nurses, doctors and other health and social care professionals give expert care and support to individuals and their families. Call us or ask your GP, consultant, district nurse or hospital ward sister if there are any Macmillan professionals near you.

Help with money worries

Having cancer can bring extra costs such as hospital parking, travel fares and higher heating bills. If you’ve been affected in this way, we can help.

Financial guidance

Our financial guidance team can give you advice on mortgages, pensions, insurance, borrowing and savings.

Help accessing benefits

Our benefits advisers can offer advice and information on benefits, tax credits, grants and loans. They can help you work out what financial help you could be entitled to. They can also help you complete your forms and apply for benefits.

Macmillan Grants

Macmillan offers one-off payments to people with cancer. A grant can be for anything from heating bills or extra clothing to a much-needed break.

Call us on 0808 808 00 00 to speak to a financial guide or benefits adviser, or to find out more about Macmillan Grants. We can also tell you about benefits advisers in your area.

Visit macmillan.org.uk/financialsupport to find out more about how we can help you with your finances.

Help with work and cancer

Whether you’re an employee, a carer, an employer or are self-employed, we can provide support and information to help you manage cancer at work. Visit macmillan.org.uk/work

Macmillan Organiser

This includes a records book to write down information such as appointments, medications and contact details. Visit be.macmillan.org.uk or call us on 0808 808 00 00. You can also download the app on IOS or Android.

Other useful organisations

There are lots of other organisations that can give you information or support.

Counselling, bereavement and emotional support

Association for Family Therapy & Systemic Practice (AFT)

Tel 01925 444414

www.aft.org.uk

Promotes effective family therapy, systemic services and high standards of professional training and practice. Search for a family therapist on the website.

Barnardo’s

Tel 020 8550 8822

www.barnados.org.uk

Produces resources that are specially designed to help children face family bereavement or separation, including booklets, a board game and memory books.

British Association for Counselling and Psychotherapy (BACP)

Tel 01455 883 300

Email bacp@bacp.co.uk

www.bacp.co.uk

Promotes awareness of counselling and signposts people to appropriate services throughout the UK. You can search for a qualified counsellor on the website.

Childhood Bereavement Network

Tel 020 7843 6309

Email cbn@ncb.org.uk

www.childhoodbereavementnetwork.org.uk

A national, multi-professional group of organisations and individuals working with bereaved children and young people. Has an online directory you can search for local services.

Cruse Bereavement Care

Tel 0808 808 1677

www.cruse.org.uk

Provides bereavement counselling, information and support to anyone who has been bereaved, including children and young people. Has a network of branches across the UK. Also runs the Hope Again website for young people, which includes information and forums where visitors can share their experiences. Visit hopeagain.org.uk

Hope Support Services

Tel 01989 566317

Email help@hopesupportservices.org.uk

www.hopesupportservices.org.uk

Supports 11 to 25-year-olds when a family member is diagnosed with a life-threatening illness.

Relate

Email relate.enquiries@relate.org.uk

www.relate.org.uk

Offers advice, relationship counselling, sex therapy, workshops, mediation, consultations and more.

Relationships Scotland

Infoline 0345 119 2020 (Mon to Fri, 9.30am to 4.30pm)

Email enquiries@relationships-scotland.org.uk

www.relationships-scotland.org.uk

Provides relationship counselling, mediation and family support across Scotland.

Samaritans

Helpline 116 123 (24 hours a day, 365 days a year)

Email jo@samaritans.org

www.samaritans.org

Samaritans branches are located across England, Ireland, Scotland and Wales. Provides confidential, non-judgemental emotional support for people experiencing feelings of distress or despair, including those that could lead to suicide.

UK Council for Psychotherapy

Tel 020 7014 9955

Email info@ukcp.org.uk

www.psychotherapy.org.uk

Holds the national register of psychotherapists, psychotherapeutic counsellors and listening practitioners.

Winston’s Wish

Tel 08088 020 021

Email info@winstonswish.org.uk

www.winstonswish.org.uk

Helps bereaved children and young people rebuild their lives after a family death. Offers practical support and guidance to families, professionals and anyone concerned about a grieving child.

Youth Access

Tel 020 8772 9900 (Mon to Fri, 9.30am to 1pm and 2pm to 5pm)

Email admin@youthaccess.org.uk

www.youthaccess.org.uk

National membership organisation for young people’s information, advice, counselling and support services (YIACS). Find your local Youth Access service via the website.

Support for carers

Carers Trust

Tel 0300 772 9600 (Mon to Fri, 9am to 5pm)

Email info@carers.org

www.carers.org

Provides support, information, advice and services for people caring at home for a family member or friend. You can find details for UK offices and search for local support on the website.

Carers UK

Helpline (England, Scotland, Wales) 0808 808 7777 (Mon to Wed, 10am to 4pm)

Helpline (Northern Ireland) 028 9043 9843

Email advice@carersuk.org

www.carersuk.org

Offers information and support to carers across the UK. Has an online forum and can put people in contact with support groups for carers in their area.

LGBT-specific support

LGBT Foundation

Tel 0345 330 3030 (Mon to Fri, 10am to 10pm, and Sat, 10am to 6pm)

Email helpline@lgbt.foundation

www.lgbt.foundation

Provides a range of services to the LGBT community, including a helpline, email advice and counselling. The website has information on various topics including sexual health, relationships, mental health, community groups and events.

General cancer support organisations

Cancer Black Care

Tel 020 8961 4151

Email info@cancerblackcare.org.uk

www.cancerblackcare.org.uk

Offers UK-wide information and support for people with cancer, as well as their friends, carers and families, with a focus on those from BME communities.

Cancer Focus Northern Ireland

Helpline 0800 783 3339 (Mon to Fri, 9am to 1pm)

Email nurseline@cancerfocusni.org

www.cancerfocusni.org

Offers a variety of services to people affected by cancer in Northern Ireland, including a free helpline, counselling and links to local support groups.

Cancer Research UK

Helpline 0808 800 4040 (Mon to Fri, 9am to 5pm)

www.cancerresearchuk.org

A UK-wide organisation that has patient information on all types of cancer. Also has a clinical trials database.

Cancer Support Scotland

Tel 0800 652 4531 (Mon to Fri, 9am to 5pm)

Email info@cancersupportscotland.org

www.cancersupportscotland.org

Runs cancer support groups throughout Scotland. Also offers free complementary therapies and counselling to anyone affected by cancer.

Macmillan Cancer Voices

www.macmillan.org.uk/cancervoices

A UK-wide network that enables people who have or have had cancer, and those close to them such as family and carers, to speak out about their experience of cancer.

Maggie’s Centres

Tel 0300 123 1801

Email enquiries@maggiescentres.org

www.maggiescentres.org

Has a network of centres in various locations throughout the UK. Provides free information about cancer and financial benefits. Also offers emotional and social support to people with cancer, their family, and friends.

Penny Brohn UK

Helpline 0303 3000 118 (Mon to Fri, 9.30am to 5pm)

Email helpline@pennybrohn.org.uk

www.pennybrohn.org.uk

Offers a combination of physical, emotional and spiritual support across the UK,using complementary therapies and self-help techniques.

Riprap

www.riprap.org.uk

Developed especially for teenagers in the UK who have a parent with cancer. Has an online forum where teenagers going through similar experiences can talk to each other for support.

Tenovus

Helpline 0808 808 1010 (Daily, 8am to 8pm)

Email info@tenovuscancercare.org.uk

www.tenovuscancercare.org.uk

Aims to help everyone in the UK get equal access to cancer treatment and support. Funds research and provides support such as mobile cancer support units, a free helpline, benefits advice and an online ‘Ask the nurse’ service.

General health information

Health and Social Care in Northern Ireland

www.hscni.net

Provides information about health and social care services in Northern Ireland.

Healthtalk

Email info@healthtalk.org

www.healthtalk.org

Has information about cancer, and videos and audio clips of people’s experiences. Also provides advice on topics such as making decisions about health and treatment.

NHS.UK

www.nhs.uk

The UK’s biggest health information website. Has service information for England.

NHS Direct Wales

www.nhsdirect.wales.nhs.uk

NHS health information site for Wales.

NHS Inform

Helpline 0800 22 44 88 (Daily, 8am to 10pm)

www.nhsinform.scot

NHS health information site for Scotland.

Patient UK

www.patient.info

Provides people in the UK with information about health and disease. Includes evidence-based information leaflets on a wide variety of medical and health topics. Also reviews and links to many health- and illness-related websites.

Financial or legal advice and information

Benefit Enquiry Line Northern Ireland

Helpline 0800 220 674 (Mon, Tue, Wed and Fri, 9am to 5pm, Thu, 10am to 5pm)

Textphone 028 9031 1092

www.nidirect.gov.uk/money-tax-and-benefits

Provides information and advice about disability benefits and carers’ benefits in Northern Ireland.

Citizens Advice

Provides advice on a variety of issues including financial, legal, housing and employment issues. Use their online webchat or find details for your local office in the phone book or by contacting:

England

Helpline 03444 111 444

www.citizensadvice.org.uk

Wales

Helpline 03444 77 2020

www.citizensadvice.org.uk/wales

Scotland

Helpline 0808 800 9060

www.citizensadvice.org.uk/scotland

Northern Ireland

Helpline 0800 028 1181

www.citizensadvice.co.uk

Civil Legal Advice

Helpline 0345 345 4345 (Mon to Fri, 9am to 8pm, Sat, 9am to 12.30pm)

Minicom 0345 609 6677

www.gov.uk/civil-legal-advice

Has a list of legal advice centres in England and Wales and solicitors that take legal aid cases. Offers a free translation service if English isn’t your first language.

Department for Work and Pensions (DWP)

Personal Independence Payment (PIP)

Helpline 0345 850 3322

Textphone 0345 601 6677 (Mon to Fri, 8am to 6pm)

Carer’s Allowance Unit

Tel 0800 731 0297

Textphone 0800 731 0317 (Mon to Fri, 8am to 6pm)

www.gov.uk/browse/benefits

Manages state benefits in England, Scotland and Wales. You can apply for benefits and find information online or through its helplines.

GOV.UK

www.gov.uk

Has information about social security benefits and public services in England, Scotland and Wales.

Money Advice Scotland

Tel 0141 572 0237

Email info@moneyadvicescotland.org.uk

www.moneyadvicescotland.org.uk

Use the website to find qualified financial advisers in Scotland.

National Debtline (England, Wales and Scotland)

Tel 0808 808 4000 (Mon to Fri, 9am to 8pm, Sat, 9.30am to 1pm)

www.nationaldebtline.org

A national helpline for people with debt problems. The service is free, confidential and independent. Has an online chat service with an expert debt advisor.

NiDirect

www.nidirect.gov.uk

Has information about benefits and public services in Northern Ireland.

Personal Finance Society – ‘Find an Adviser’ service

www.thepfs.org/yourmoney/find-an-adviser

Use the website to find qualified financial advisers in your area of the UK.

The Money Advice Service

Helpline

0800 138 7777 (English)

0800 138 0555 (Welsh)

(Mon to Fri, 8am to 8pm, Sat, 9am to 1pm)

Typetalk 18001 0300 500 5000

Email enquiries@moneyadviceservice.org.uk

www.moneyadviceservice.org.uk

Runs a free financial health check service and gives advice about all types of financial matters across the UK. Has an online chat service for instant money advice.

Unbiased.co.uk

Helpline 0800 023 6868

Email contact@unbiased.co.uk

www.unbiased.co.uk

You can search the website for qualified advisers in the UK who can give expert advice about finances, mortgages, accounting or legal issues.

Disclaimer, thanks and sources

Disclaimer

We make every effort to ensure that the information we provide is accurate and up to date but it should not be relied upon as a substitute for specialist professional advice tailored to your situation. So far as is permitted by law, Macmillan does not accept liability in relation to the use of any information contained in this publication, or third party information or websites included or referred to in it.

Thanks

This ebook has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been approved by Professor Tim Iveson, Consultant Medical Oncologist and Macmillan Chief Medical Editor.

With thanks to: Diana Borthwick, Clinical Nurse Specialist; Jamie Cargill, Lead Nurse, Teenage and Young Adult Cancer; Shirley Crofts, Clinical Nurse Specialist and Clinical Psychologist; Liz Egan, Macmillan Working Through Cancer Programme Lead; Dr Joy Hall PhD, Psychosexual and Relationship Therapist; Elaine Heywood, Macmillan Counsellor; Darren McKinley, Teenage and Young Adults Project Manager, Teenage Cancer Trust; Helen Moorey, Clinical Nurse Specialist; Michelle Pengelly, Supportive Care Lead Nurse; and Dr Louise Robinson, Consultant Clinical Psychologist.

Thanks also to the people affected by cancer who reviewed this edition, and those who shared their stories.

We welcome feedback on our information. If you have any, please contact cancerinformationteam@macmillan.org.uk

Sources

We have used a number of sources in this publication. If you would like further information about the sources we use, please contact us at bookletfeedback@macmillan.org.uk

Can you do something to help?

We hope this ebook has been useful to you. It’s just one of our many publications that are available free to anyone affected by cancer. They’re produced by our cancer information specialists who, along with our nurses, benefits advisers, campaigners and volunteers, are part of the Macmillan team. When people are facing the toughest fight of their lives, we’re there to support them every step of the way.

We want to make sure no olne has to go through cancer alone, so we need more people to help us. When the time is right for you, here are some ways in which you can become a part of our team.

Share your cancer experience

Support people living with cancer by telling your story, online, in the media or face to face.

Campaign for change

We need your help to make sure everyone gets the right support. Take an action, big or small, for better cancer care.

Help someone in your community

A lift to an appointment. Help with the shopping. Or just a cup of tea and a chat. Could you lend a hand?

Raise money

Whatever you like doing you can raise money to help. Take part in one of our events or create your own.

Give money

Big or small, every penny helps.

Call us to find out more 0300 1000 200

macmillan.org.uk/getinvolved