Q: I was diagnosed with breast cancer last week. The days since then have been a blur of scans, tests, meetings with doctors and surgeons, and sitting in waiting rooms. I’m holding up OK with the help of my partner and family, but I’m getting really anxious about how to explain this to everyone else.

I have social plans I probably need to cancel and commitments I won’t be able to keep up while I’m on chemo. That’s not even to mention all the workdays I’ll have to miss. What do I say? What if they freak out? I feel so lost.

It’s so profoundly and achingly unfair that, even as you come to terms with what this news means to you, you’re already having to think about how to explain it to others and deal with their reactions.

I wish I could wave a magic wand and everyone in your life who needs to know would know, and you could move on and focus on surviving this. (Of course, if I had a magic wand, I’d just take away the cancer instead. Duh, Miri.)

When I was diagnosed, telling people was probably one of the worst parts, even when they reacted ideally. Generally we don’t see our own faces when our world falls apart. But in sharing my diagnosis with people who cared about me, I had to watch them react as I made their world fall apart. At least that’s what it felt like to me.

You’re right, of course: You can’t put this off forever. Here are some ways to take care of yourself as you share this worst of news.

1. Designate a point person

Most people who have any sense of boundaries try not to share anyone’s medical details with others. (It’s a good rule of thumb.) But when you’ve been handed a diagnosis like this, sometimes that’s exactly what you want people to do.

Think about your partner and some of your close friends who you’ve already told. Which of them do you trust to share the news compassionately, and which of them have a large enough social network? Tell them what to share and whom to share it with. You don’t have to do this on your own.

2. Figure out who needs to know or who you want to know

The subject of disclosing a cancer diagnosis at work is its own thing, and I’ll direct you to these excellent resources to learn more about that. Besides that, though, the point of telling people you have cancer is for your benefit, not theirs. If it wouldn’t benefit you to have someone know, you’re not obligated to tell them. It’s your personal medical stuff, after all.

It’s also OK to tell people that you’re going through some medical treatment without going into the specifics. Will they be curious? Probably. Will they wish you had told them the details? Maybe. That’s not really your problem though.

Ask yourself, “Will my life be easier or better if [person] knows?” If the answer is no, you can put this off until you have more capacity to deal with it.

3. Make a script

As you mentioned, the early days of cancer treatment involve a lot of waiting. This can be its own circle of hell. Sometimes having a specific task to do while you’re in the waiting room can make it a bit more bearable.

For you, one such task could be thinking of a script to use when you share your diagnosis with someone. You can even create separate scripts for social acquaintances, colleagues, and so on.

Grab one of those tacky hospital notepads or use the Notes app on your phone. Literally write out what you might say. Here are some suggestions to get you started:

  • “I need to share with you that I was recently diagnosed with cancer. I’ll be starting chemo next week. It’s hard for me to talk about this right now, so if you have questions, please ask [point person].”
  • “I found out last week that I have breast cancer. Thankfully it’s treatable, but as you might imagine, I’m kinda freaking out. If you’d like to help, please join my Lotsa Helping Hands site.”
  • “As you might recall, I mentioned that I was having tests done. I’ve now learned that I have breast cancer. If you’d like to know more details, just ask. I’ll let you know if I’m not comfortable sharing something.”

4. Consider letting social media do most of the work for you

As I discussed in the previous column, social media can be a great tool to reduce the number of times you have to repeat painful things.

When I got diagnosed, I wrote (literally): “Looks like I was on the wrong timeline after all. I have cancer. Jesus Christ I’m 26 goddamn years old and I actually literally have literal cancer.”

I then added a whole paragraph about how I don’t want people to message me about this unless we’re offline friends. Elegant? No. Effective? Very. An appropriate use of the word “literally”? Extremely.

This isn’t a solution for everybody and depends very much on your comfort level and preferences around privacy. But it’s basically the nuclear option of cancer disclosure and it’s there if you want or need it.

5. Keep looking forward

This may sound like weird advice, and I wouldn’t blame you for thinking, “What the fuck, I’m about to start cancer treatment????

However, I wouldn’t be the first survivor to say that the period of time between diagnosis and the start of treatment is absolutely the worst, especially if you don’t know what stage it is yet.

Humans hate uncertainty. We find it so painful that in lab experiments, we consistently prefer actual pain to the vague possibility of pain.

Most people react to a cancer diagnosis with helpless flailing and thoughts like “OK I’M JUST GOING TO DIE THEN,” so when staging is complete and treatment starts, it can almost be a relief. A concrete thing to focus on, to get through.

You’re in the worst of the worst right now. Having to deal with telling other people about it is just shitty icing on a shit cake.

When it starts to feel like too much, remember that soon you’ll be in treatment, the treatment will be working, and if it’s not working? Your oncologist will try other treatments.

While it’s painful right now, you — and everyone in your support system — will settle into things soon. Just take it one day at a time. You got this.

Yours in tenacity,

Miri


Miri Mogilevsky is a writer, teacher, and practicing therapist in Columbus, Ohio. They hold a BA in psychology from Northwestern University and a master’s in social work from Columbia University. They were diagnosed with stage 2a breast cancer in October 2017 and completed treatment in spring 2018. Miri owns about 25 different wigs from their chemo days and enjoys deploying them strategically. Besides cancer, they also write about mental health, queer identity, safer sex and consent, and gardening.