Most people have good intentions when Pink October rolls around. They truly want to do something to help cure breast cancer — a disease that is estimated to cause 40,000 deaths in the United States in 2017, and 522,000 deaths worldwide. However, what most people don’t know is that buying pink ribbons or reposting Facebook games doesn’t really help anybody.

The truth is, thanks to efforts made over the last 40 years, pretty much every American above the age of 6 is likely already aware of breast cancer. And unfortunately, early detection and awareness is not the cure-all we once thought it was back when the pink ribbon was invented.

Many women will be diagnosed with an early stage of breast cancer, get treated, and then still go on to have a metastatic relapse, and that’s what kills people. Which is why — now that we are all, in fact, aware — we need to start focusing our efforts on helping people who have advanced breast cancer. Not just buying pink T-shirts and reminding women to get checked.

Still, that doesn’t mean that there aren’t actionable things you can do during breast cancer awareness month. In fact, there are plenty of ways you can help people living with breast cancer (as well as help those working on a cure). Here are just a few ideas:

When picking a charity, make sure its focus is on patient support, not awareness. Patient support comes in many forms: makeup classes, gas cards, wigs, exercise classes, letters, and even full payment of treatment. All of these things can help through a trying time, both emotionally and physically.

Charities such as Chemo Angels and the American Cancer Society focus on patient support.

Research is a critical need. Globally, metastatic breast cancer receives much less funding than early-stage breast cancer, even though it is the only form of breast cancer that you can actually die of. Most of the charitable money goes to basic research that has little clinical application. So when you’re looking for charities to donate to, it’s important to find ones that are trying to get an actual a cure to patients and not just giving lip service to the idea of “awareness.”

StandUp2Cancer and The Breast Cancer Research Foundation are two excellent charities that are doing just that.

“Let me know if I can do anything for you.” Most of us with cancer hear that phrase often … and then never see that person again. The longer we are on treatment, the more we need help. We need our dogs walked, we need our kids to be driven somewhere, we need our bathrooms cleaned.

So if you know somebody who has cancer, don’t ask how you can help. Tell them how you plan to. Don’t put the burden of asking for help on the cancer patient.

Did you know you can make a difference in a cancer patient’s life without even ever speaking to them? In every town, there are community oncologists who will accept donations of blankets, hats, or scarves. Due to privacy issues, you may not be able to actually talk to them, but you can talk to the staff at the front desk and ask if they are willing to accept items.

There are many patients getting chemo who have nobody to drive them. You can leave flyers offering to do so, or post on community bulletin boards that you’re willing to help. You could also call a social worker to find out where the need is greatest.

Even writing cards and leaving them at chemo centers or hospital wards for cancer patients on holidays can be meaningful for somebody going through the most frightening time of their life.

Over the past decade, the NIH has cut funding for cancer research, and that could drop even further due to proposed NIH budget cuts. Changes in healthcare law have created confusion, and it is becoming harder for people with cancer to get medications, whether it be chemo or supportive medications. Necessary pain medications are now withheld (even from terminal patients) because doctors are afraid of “overprescribing.” Some anti-nausea meds are too expensive and insurance companies won’t allow them. For many people, this can mean pain near the end of their lives. We need that to change.

Remember that when you speak to a cancer patient, they don’t necessarily feel like warriors or survivors; they don’t always want (or need) to have a positive attitude. And nothing they did, from eating sugar to consuming processed foods, caused their cancer.

When somebody trusts you enough to tell you they have cancer, don’t respond by telling them they’re a warrior, or insinuate that they did something wrong. Just tell them that you are sorry this happened to them, and that you are here to listen. It’s important that you speak to them as the friends, colleagues, or loved ones they’ve always been. Cancer can be isolating, but you can be that reassuring figure who reminds them that they don’t always have to pretend to be brave.

Pink October has become almost a national holiday, with pink promotions everywhere. However, the money donated by companies often doesn’t go where it’s needed most: to metastatic cancer patients. We incurable cancer patients are your mothers, your sisters, and your grandmothers, and we need your support.

Ann Silberman is living with stage 4 breast cancer and is the author of Breast Cancer? But Doctor … I Hate Pink!, which was named one of our best metastatic breast cancer blogs. Connect with her on Facebook or Tweet her @ButDocIHatePink.