Hester Hill Schnipper Photo courtesy of Beth Israel Deaconess Medical Center

SOMETIMES IT’S HARD to square people’s good intentions with their insensitive comments. These verbal assaults come in many forms. The ominous: “My cousin had the very same cancer, and she died.” The invasive: “What is your prognosis?” Or the backhanded compliment: “I think your wig looks much better than your hair ever did.”

In the uncertain world of cancer, you can depend on one thing: Someone will say something that will be difficult to handle. Here are some ways to respond to insensitive comments.

1) Remember that you owe the other person nothing in this moment. Your obligation is to take care of yourself. Handling a verbal assault with thoughtful force will enable you to put it aside and save you many sleepless nights stewing.

2) The best all-purpose response is to wait—even a full minute—and then to ask in a puzzled but calm way: “Why did you just say that to me?” This neatly puts the burden back on the other person, who almost certainly will begin to squirm and apologize.

3) Plan a few responses, ranging from tactful to rude, and choose the one that fits the situation. You might say, “I know you care about me, but I would prefer not to talk about this.” Or you could more forcefully draw a line and say, “How dare you ask me that?” Living with cancer is not an etiquette contest; you are allowed to say whatever helps you most.

4) Consider ending a relationship over egregious statements, including those from your doctors and health care professionals, who deserve the same type of rebuttal as anyone else.

5) Keep an electronic or a paper list of outrageous comments. Having an actual place to file away insults gets them off your shoulders.

6) Respond later by sending an email or a note if you are still upset. This is likely to induce guilt in the recipient—while providing you an opportunity to express your feelings.

7) If you participate in an online or in-person support group, consider spending a few minutes at each meeting sharing the insensitive remarks. This gives you another outlet for unloading these negativities, and other participants may have some ideas for deflecting future hurtful comments.

8) Feel free to offer your doctor as an excuse for rejecting unsolicited treatment advice. For example, “My doctor has told me not to consider any special diets or supplements at this time.”

Of course, even well-meaning friends make mistakes. However, when you are going through cancer, your most important obligation is to yourself. If you can respond with honesty, people may well apologize. You can decide whether the hurt is too deep to ignore or whether you can move on with the relationship intact.

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.