Build rings of care: Supporting someone with cancer

When someone you care about has cancer, you may feel compelled to do things like find answers for them or take over all the household chores.

Oftentimes, though, the best thing you can do is simply slow down and listen.

“The inclination of anyone who loves somebody going through cancer is to say, ‘Let’s do this and look up this,’ and give lots of advice,” says Yarrow McConnell, MD, breast and surgical oncologist with the MultiCare Cancer Institute. “It’s all given in love, but often isn’t the right approach. Instead, we should be listening and asking, ‘What do you need or how can I help?’ as opposed to just deciding how you want to help.”

From diagnosis and treatment, to remission and even everyday life decades later, the physical, mental, psychological and spiritual implications will be different for each person and family, Dr. McConnell explains.

Open conversations and having a little grace, she says, will be key to supporting patients and those around them.

Care should flow inward

To illustrate how to focus your care, Dr. McConnell refers to the Ring Theory.

At the center is the person facing cancer. The first ring around them includes immediate family, such as a spouse, parents, close friends or however they define family, she explains. The next ring holds extended family and friends.

From there, the rings extend to other people in the patient’s life, such as co-workers, classmates or acquaintances. The outermost ring contains the health care team. The cancer patient and their loved ones can look to those outer rings, including the care team, for support and guidance.

“At all times, the love, care and listening has to flow in,” Dr. McConnell says. “The closest family flows in to the patient, while they can look outward to extended family and friends for what they need.”

Keep kids involved

While children may not be able to understand everything about the cancer journey of someone in their life, they do still have feelings that should be addressed, Dr. McConnell explains.

The key is to remember that although children process information differently, they can still handle the news when delivered in a way that works for them.

Honesty — within limits, such as avoiding complex words or possible scary outcomes — will be important to maintaining the consistency they need while also setting realistic expectations for how their days will look.

Be sure to also look out for new emotional or behavioral changes that can signal how they’re processing this life change.

People in the outer rings can focus their care inward by asking if someone in the first ring needs help or support while supporting the person at the center, she explains. For example, a co-worker of the patient’s spouse could pick up their morning coffee or cover them while they take important calls.

Most important, everyone must trust the person at the center and what they say their needs are.

Ask … and keep asking

Rather than assuming what someone does or doesn’t want to talk about or what help they need, Dr. McConnell emphasizes the importance of asking and continuing to do so.

Everyone’s needs change over time; that’s no different for someone going through cancer. Expressing those changing needs can be even harder when a person is used to being the one to care for others, or they’ve previously told you no.

“Some people have difficulty asking for help … the patient may feel like they told you no or what they needed at one point, and things have changed,” Dr. McConnell explains. “And now they need something different, and they have to say that.”

The best thing you can do is keep that line of conversation open, she adds. For example, if you’ve been bringing meals each weekend, check in after a month to see if they still want that. Or if something they used to do eagerly, such as a morning walk together, is now being met with resistance, ask if they want to switch things up.

And rather than worrying that you’re calling too much or too little, or pushing too much to talk, don’t be afraid to ask, Dr. McConnell says. Let them know you are happy to meet them where they are, whether that’s a daily text or a weekly call.

“Sometimes it takes some self-reflection. Are you doing something to truly care for the person, or do you want to do these things because you want to feel like you’ve done something?” Dr. McConnell asks. “Maybe you should be looking to the next ring out because it’s something you need. If you were truly doing it for the person at the center, you wouldn’t need to push them.”

If the person at the center says no, that’s OK, she adds.

Remission doesn’t mean the end

As important as it is to support someone during diagnosis and treatment, the challenges don’t stop with remission.

“We all think of cancer patients as going through treatment, chemo, surgery and radiation as being the time that they need our help and support the most,” explains Dr. McConnell. “But the time that comes after treatment when they are recovering and getting back to a new normal can be just as hard.”

Many people are trying to reconcile what happened — how they’ve changed both mentally and physically and how that’s going to impact them going forward, Dr. McConnell adds. That will be just as true for the people in the inner circles if treatment does not go as planned.

“Similar to grieving over a loss, it takes time to fully understand what you experienced. … It’s a long-term process,” she says. “It can be days, months and years after treatment where it’s still front and center for them.”

The anniversary of the cancer patient’s diagnosis should be an important touchpoint for those around them, Dr. McConnell adds. Put that date in your calendar so you don’t forget to reach out.

“Happy or sad, it’s important that we express our love for somebody,” she says.