Hester Hill Schnipper Photo courtesy of Beth Israel Deaconess Medical Center

WHEN YOU HAVE CANCER, engaging in conversations can sometimes feel like opening a wound that’s still healing. There are the expected difficult moments of breaking the news of your diagnosis to family, friends or people at work, but casual discussions can also be challenging as your health status becomes a conversation topic.

Unfortunately, the chances are good someone will say something insensitive about your cancer or probe a little too deeply into details about your prognosis. No matter how powerless this might make you feel in the moment, the good news is you are always in control of how you respond and what you say. As a rule, you can share or not share personal information as you choose.

The following tips can help you formulate your responses as you decide what treatment details you’d like to share with others.

1) Consider what you might say to different people based on your relationship with them. You may share more information with close friends, for example, but decide you want to keep certain details private from colleagues.

2) If someone you don’t know asks about your headscarf or something else that declares your cancer, it’s probably an attempt at empathy. However, that doesn’t mean you need to engage. You can simply tell the person you’d rather not talk about it.

3) The simplest exchanges to manage, although perhaps the most upsetting, are when someone says something clearly offensive. These comments might include, “That’s a really bad kind of cancer,” or, “My neighbor had the same kind of cancer and died in six months.” When this happens, try being silent for a moment to let what was said sink in for both of you. You might also ask the person why they would say that to you. Or you could just find a way to disengage and walk away.

4) If you don’t want to answer questions about certain aspects of your treatment, you can always respond briefly and pivot to another subject—such as the weather or what’s on sale in the produce department. Friends who know you will pick up on these clues. Friends who push might need a more direct response.

5) Sometimes you may want to say more about how you are doing, but the setting isn’t conducive to a discussion. In these cases, you might ask to talk at another time or set a lunch date.

6) If you are unsure about divulging personal information, stop talking. You can always say more later, but you can’t take back what you have already said.

7) You may find your desire to talk about your cancer changes from day to day. It’s OK to say you’re just not in the mood to talk about cancer on any given day.

8) Think about how you’d like to respond to unwanted suggestions for alternative treatments or diets. You could say, “Thanks, but I try to do only what my doctor recommends.”

9) If you are concerned about fielding multiple questions from members of a particular group, such as work colleagues or people in your book club, consider asking one friend to pass along whatever you have disclosed and ask that person to relay your wishes to the group concerning any future discussions about your health.

Hester Hill Schnipper, a licensed independent clinical social worker, is a breast cancer survivor who served as the manager of oncology social work at Beth Israel Deaconess Medical Center in Boston.