Communicating with people living with cancer requires a thoughtful approach. It is sometimes hard to know what to say... or what not to say.

The Luxembourg Cancer Foundation estimates that around 18,000 Luxembourgish citizens live with cancer. There are roughly 3400 patients diagnosed every year. As one of the country's most prevalent diseases, it is probable that most of us know someone who has had or is going through cancer.

Communication issues

Many cancer patients report that their loved ones do not always know what to say or how to act around them following a cancer diagnosis. Some of us might experience uncertainty over whether to confront the topic of cancer or avoid it completely. Others might feel confident in asking about treatment or pain levels but less sure about how to address big emotions.

When asking questions, think about what you are expecting or hoping to hear. Are you giving your loved one an opening to describe their physical ailments? To express their worries or their fears? Whatever the reason, you need to be sure that you have the time and the emotional capacity to listen to the answer.

Learning to listen

Many of us have an innate urge to problem solve. When presented with an issue, it can be uncomfortable to let a problem sit. The likelihood is that you feel more useful offering up helpful comments to loved ones who are suffering. But sometimes, people living with cancer just want to be heard and accepted.

We all want to help our loved ones, and we hate to see them in pain. Often the following questions come from a place of love and genuine concern. But after speaking to some cancer patients, here are some tips you might find useful when communicating with anyone you know who is living with cancer.

Avoid: How are you?

Before asking "how are you?", ask yourself: Why am I asking this? Who am I asking it for?

This seemingly innocuous question has the power to bring on a bout of existential dread at the best of times. But for someone living with cancer, this question can be loaded. So try not to ask this unless you really mean it and have time to listen to the answer properly.

Practical questions that might be slightly easier for your loved one might be "how did you sleep? How is your pain today? Have you managed to eat something?" – all of which warrant a straightforward answer to open the conversation.

Avoid: You look great!

Try not to make assessments about their physical appearance. They already know their hair is falling out, or they have lost weight, or they are swollen from chemotherapy. If anything, give praise such as telling them they look strong or that they are still beautiful to you.

Avoid: I know someone who had this

Making comparisons between cancer patients or survivors is not helpful. Allow your loved one to deal with their cancer in their own way. They don't need you to lecture them about diet, medicine or exercise that worked for someone else.

Avoid: You'll be fine. It will be OK!

How do you know everything will be fine? Unless you are a qualified oncologist, it is likely that this kind of statement is unsupported by any medical evidence. Saying things like, "I am really sorry. I hope it will be OK" shows empathy and optimism instead.

Avoid: You can fight this! Don't give up!

Instructing a loved one to muster up the strength to fight or stay positive can backfire, leading to feelings of guilt and frustration. They might have days when they feel overwhelmed by sadness or hopelessness. They might be exhausted. Just make sure they know you care about them and do what you can to show your love: surround them with beautiful things; help them get out for some fresh air; give them a hug.

Avoid: Let me know if I can do anything

We use this phrase a lot! But it is very vague and open-ended. Often friends will not ask for your help because they do not want to be a burden to you. Instead, make statements and concrete plans. "I will bring you dinner later. I can take your kids to football practice. I'll be round tomorrow morning to tidy up." Helping with practical things and running errands is likely to provide a huge amount of relief.

Just make it clear that you are not expecting anything in return. Try to be aware of your loved one's social energy. Popping round to help with the laundry is great but make a swift exit if you notice they are not in the mood for company.

Helping from afar

Expats who can't offer help in the way of time or physical presence can find ways to help from afar. Sending a handwritten card shows you care. Flowers might cheer someone up, but paying for a cleaner, sending vouchers or organising food delivery services can also be very helpful and alleviate the mental load. Sending website links or suggestions for local support groups and services could also be a way of showing you care.

Text messaging

Avoid bombarding your loved one with questions. Rather, let them know you are thinking of them without putting any pressure on them. Send them photos, funny memes or suggestions for books or films. Write a message to say, "I'm just thinking of you – but no need to reply", which avoids the responsibility of an immediate response. Or let them know it's OK to reply with an emoji instead of a long-winded message.

Don't know what to say?

Be honest and tell them you are not sure what to say. It is better to be open and admit that you are unsure of how you can help, than not saying anything at all and disappearing from their radar. Even a little message to a friend such as "I'm thinking of you" or "I'm here for you" can brighten someone's day and remind them that they are not alone.

Allow silence to do the talking

When you are in the presence of your loved one, you don't necessarily need to say anything. Sometimes listening is more important than talking. Let them tell you how they feel. Let them rant, shout, have a cry. Let them sit in silence. You don't always need words to show someone you are there for them.

Taking the time to understand the needs of your loved ones will ensure you communicate with openness and empathy, enabling you to offer them the support that is right for them. You can find more information, advice, and support on the following websites: