5 Easy Ways to Have a Challenging Conversation About Cancer.

5 Easy Ways to Have a Challenging Conversation About Cancer.


Jeff Goodes

4 days ago at 2:41 PM

Every one of us knows the awkward moment of silence that precedes a serious conversation about any challenging topic, and often particularly about cancer. Here are five easy ways to open up these often difficult conversations in a way that is compassionate and empathetic.

Dr. Kathryn Mannix opens her new book with the sentence, "I can't find the right words." It captures that awkward moment before you start a challenging conversation, yet feel overwhelmed at the task.

Mannix is an expert in finding the right words in those moments. In her new book Listen: How to Find the Words for Tender Conversations, the UK author draws on her decades of experience as a palliative care physician, psychotherapist and trainer to create a guide to what she calls "tender conversations."

Mannix likes the word tender because tenderness implies empathy: a sense of recognizing the vulnerability in both yourself and the person you are speaking with. Tender means not abandoning the other person to their suffering; it means acknowledging and validating their suffering.

"It's about being intentionally, fully present," she states.  Mannix compares a tender conversation to examining a patient whose belly is swollen with pain caused by an inflamed appendix. With both situations, you must proceed with care and presence, and with a promise to stop immediately if the patient requests it. This approach acknowledges the presence of pain and the need for sensitivity.

As a palliative care doctor, Mannix has talked to countless families about the death of a loved one. She realized that the techniques that she's learned are "not just about end of life conversations, but about all those conversations that we feel a bit daunted about."

Here are five tips she offers to anyone who is faced with leading a challenging conversation.

1. Start with a cup of tea

Mannix tries to begin all tender conversations by inviting the other person to the conversation. Sitting down and offering a warm beverage is a way of doing this. It puts your humanity front and center. This is a particularly important gesture when there is a power imbalance, she says. It's a way of breaking out of a professional role: "It is a signal that we are now becoming people with each other." She says offering a cup of coffee or tea is a way of saying, "I'm here with you."

2. A conversation should be like a dance

Mannix compares these tender conversations to two people dancing. One person leads, but never forces. There is a constant rebalancing and give and take. Asking questions can be a way of opening up someone to a possibility. In this way, the leader's role flips. They become the listener and can guide the conversation to where it needs to go.

3. Be curious, open-minded and humble

Instead of dispensing advice, she advises to ask open-ended questions, such as: Do you have any information about this situation? Have you ever dealt with a problem like that in the past? If a friend had a problem like this, what would you advise them to do? What worries you the most about the situation? Help name someone's worst fear and give them space to hold it, she says.

4. Never use the phrase, "At least…"

A big mistake is trying to fix the other person's problems or offer false reassurances: "If you feel 'at least' coming out of your mouth, it doesn't matter what else you're going to say. It's the wrong thing to say," Mannix said. Helping them to look on the bright side is a well-intentioned, but hopeless and potentially hurtful strategy, she said. Avoid phrases like, 'At least your wife has a job' or 'at least you're young enough to get pregnant again,' she said.

"The bright side is not where they are, and it doesn't really matter whether that's a pregnancy loss, whether it's a redundancy," said Mannix. "The right thing to say is probably nothing, except, 'I'm really sorry. This must be so painful for you. I haven't got any words that are going to make this any better, but I'm prepared to just sit here and be with you.'"

5. Use the power of silence

Mannix believes that one of the most powerful tools for a tender conversation is silence. "It's just to shut up, get out of the way verbally and allow the person to feel those sorrowful or angry feelings and just be present." The feeling of wanting to fill the silence is well-intentioned, but it can be misguided. "It's incredible how much people want to help," said Mannix, but oftentimes, the most valuable gift at a moment of crisis is silent companionship.

Mannix pointed out that all her strategies are rooted in empathy. Her advice reminds us to take our armor off and just be with the person in pain.

"When we're trying to talk to our teenagers and they don't want our advice, it's because we're telling, not asking." she said. "It's because we're imposing, not inviting. So this isn't just about medical conversations. This is how we deal with each other when the stakes are high and how that works in conversations right across life."


Last activity by William Carson

Lucy Gidion

So much good advice here, I loved the part about not using "at least". How many times did someone say this to me and makes me cringe every time. At least you have the good cancer, at least you're not dead, at least your husband is working, etc etc. It's so minimizing to people's experience!

Justin Perdania

When my mom got sick I can't tell you how many people just fell off the face of the planet. No more calls, no more visits, nothing. I think they didn't know what to do for the most part - and frankly still don't - but wish that more people would read this about how to handle conversations the proper way.

Aditi Raya

Amen to this! Wish I'd share this with a few choice people who decided to be incredibly insensitive when discussing my new diagnosis with me.

Clare James

When I was first diagnosed with cancer, a vast majority of my conversations were very awkward, I wish I had this type of advice then.

William Carson

My good friend was just diagnosed with cancer, I will definitely keep this in mind.


What is OneVillage?

Navigate cancer with the help of the OneVillage community. Whether you're a patient looking to learn from the experiences of others, a supporter searching for the best 'last chemo' gift, or a survivor seeking medically approved content, OneVillage is the place for you. Find relatable content, care planning tools, and community groups with advice from people who understand.

Want to learn more about how it works?

Contact Us

Sign-up to personalize your cancer journey – free, always.