bad news

After Cancer

Your friend might have more doctors’ appointments, tests, surgeries, and treatments than you ever thought possible. Here's how to be a help.

My friend is better — what happens now?

Congratulations!!!!! Your friend is better, as in they now have No Evidence of Disease (NED), so they’re in the clear. YAY!

• Navigating the post­cancer life

Now your friend can get back to living a regular life. It’s time to strike a delicate balance between acknowledging and respecting the insane trials and tribulations your friend went through, and acting like they are just a normal person. It could be that your friend might not want anyone else to know ever again. Or your friend might want to bond with other people who have had similar experiences, and be very public about what she went through. There are support groups that your friend can join, and you can always start your own, even if it’s just an informal weekly pizza night. It’s totally up to them to decide, and it’s your job as a good friend to honor that choice.

There are ways to give back and support individuals who might be going through a similar experience as your friend. Whether it’s through sharing stories online, participating in walks and fundraisers, or simply letting people know you and your friend are there if anyone wants to talk, we think the world is a little bit better when people offer to help each other out.

If your friend might want absolutely nothing to do with anything that has the word cancer anywhere near it ever again — that’s cool! Having cancer is just one of many things that can happen in a person’s life, and they don’t have to identify with the ‘survivor’ label at all. There’s still stigma around cancer, and your friend might want to keep things private and just enjoy being alive.

• Can your friend have kids?

Here’s one of the strange things about a friend who gets cancer when they are young: none of you may be thinking about babies anytime soon, but the doctors will bring it up. Some treatments and surgeries might make your friend infertile.There’s ways to freeze eggs and sperm, just in case, and some insurance policies cover the cost of those services. You can help your friend look into options if they are curious. There’s also lots of babies out there who need good homes, so adoption is always possible too. Regardless, be open to being a sounding board for your friend to discuss these options and her fears about them.

• What if it comes back?

Your friend will have regular follow­ups. First, the follow­ups might be every month, then maybe year or decade if nothing else pops up. These follow­ups are nerve­wracking, so as always, be good company. It’s scary to know that cancer can reappear in other parts of your friend’s body, and sadly, sometimes it does come back. If you have to go through it all again, it’s going to suck twice as much, so be prepared for the worst, but always hope for the best.

I’m not sure, but my friend might be dying.

Fuck. We’re so sorry, we were there. Not everyone makes it. It doesn't mean your friend didn’t fight hard enough, or that her doctors did anything wrong, or that karma’s a bitch or some other bullshit. This is a bit brutal, but sometimes, cancer kills people, and we know it sucks. It sucks so much.

• Okay. What now?

Cancer is an unpredictable motherfucker. It might make your friend steadily weaker over weeks, months, or years. Or things could be fine until one day your friend takes a sudden turn for the worse. Something totally unexpected can happen, like a really bad reaction to a drug, or complications from a risky surgery. The doctors might be able to let your friend know that they only have a little time left, or they might be completely caught off guard. It’s possible that the doctors might tell you what’s up, but not mention it to your friend if they don’t ask directly.

Anyway, brace yourself. Be prepared for an emergency. Keep your phone close and the battery charged, save the main doctor’s phone number so you can call if anything drastic happens, especially after surgery or during an intense phase of treatment or recovery. Know where her meds are, know which emergency room her doctors recommend, and call for help if needed. If you need to take a trip to the ER, call for backup. Go with your friend and have someone else follow with a bag of clothes, a toothbrush, and whatever else your friend might need. Backup can coordinate with the outside world while you take your friend in to deal with doctors, paperwork and anything else that lies ahead. This is where all those notes you saved in Evernote are really really handy, because the ER doctors probably won’t know your friend’s medical history, current meds, allergies and all of that other crucial info.

If there’s no emergency but just a long decline, be there. Keep your friend company, read out loud, play music, make sure they’re comfortable, and most of all, follow her lead. If she wants quiet time, just sit with her. If she wants to laugh and be distracted, collect a stack of jokes and funny stories before every visit. It’s going to be really hard to see your friend change, physically and emotionally. Stay strong, make sure you have a good network to support you, and do whatever you can to keep showing up.

But yeah, sometimes you might not feel like showing up. If you know your friend is in bad shape and it’s not getting better, it can be really painful to face them. Revisiting that creepy hospital
every time sucks. Remember to give yourself breaks, go out with other friends, and do your best to not let your feelings show to your friend. Most of all, keep your promises to her. If you say you’re going to visit, visit. Don’t make excuses. While it’s hard for you, it’s worse for your friend. Maybe this is a good time to play “it could be worse” and practice being selfless. It can also be a good time to work on legacy projects, or talk about how your friend would like you to remember them if they don’t make it.

You can't control whether or not your friend survives, but you can control how you're there for her, and that makes things a little better.

• My friend just died — what do I do?

If you’re there with your friend when it’s all over, call the people closest to her. Don’t text. Making these calls is a completely surreal experience —​you yourself will be in shock, and yet immediately you’ll need to demonstrate empathy and sensitivity for the people who are just hearing the news. Don’t post anything on the internet. Hearing people’s voices is a million times better than reading things.

If you receive a phone call with the news, take a few minutes to freak out. Maybe you didn’t know how serious it was, or that anything was wrong at all. We’re sorry. If you can, collect yourself, and start a phone chain. Call the people who cared about your friend the most, and delegate — ask them to tell a few other people so that one person isn’t burdened with making all the calls. Most of all, be there for each other. Now is a time for hugs, sleepovers and lots and lots and lots of tears.

Give yourself time to grieve, and consider taking some time off of work if you need it. Carry tissues in your purse, and consider clueing your boss in when you return to work (spreading the news via email can be way less awkward than in­office convos this time). Take care of yourself —​it's a weird shift, but let yourself be the one others take care for during this time. Definitely go see that great therapist you found earlier. The stages of grief are nonlinear and the waves can sneak up on you and knock you down when you're least expecting it, but eventually the space between the waves draws out, we promise.

• Why are people reacting so differently than me?

There’s an irreversible finality to death that just hurts like nothing else. Everyone’s going to react differently. Some friends might be in shock, especially if her death was sudden or if they didn’t know how sick she was. Some people might want to talk a lot, others might want to reflect quietly. The internet will go bananas when everyone finds out through Facebook or an email from the office. There will be an outpouring of messages and pictures from people who knew your friend at different stages of life. People will want to send flowers. People will want to give to a relevant charity. You will want to cry. That’s okay.

Let everyone do their thing and talk about it the way that feels okay for them. Everyone is going to grieve in their own way...some are going to share cheesy poems. Others are going to write long, public letters. Co­workers will come out and confess secret crushes. It’s going to be very strange. You may want to spend lots of time alone and others may want to talk about your friend and death and life in great depths. Remember that balancing your needs with what you’re able to give to others in this confusing time may be stressful. Be sure to understand your needs, and make time for them. You will find friends who are coping in a similar way, they may not be your closest friends, but you’ll find a comfort with them.

Your friend might be the first person you are close to who dies, and that’s actually kind of great, when you think about it. Cherish the fact that most of your other friends are alive and well.

• Will I have to clean out my friend’s stuff?

If your friend’s family isn’t around or doesn’t want to be involved, taking on this mammoth task may be in your future. Take a day with a few close friends to pack up their things, sort out which items should be kept and which donated, recycled or tossed. If your friend had any meds leftover, talk to her doctors and see if they can be given back to help other patients.

Even if you have your friend’s phone or computer password, leave all that alone. Hang on to the devices for a little bit in case someone needs to retrieve vital work or insurance information, and then agree on a date, maybe a year from now, to wipe everything and donate or recycle the machines. Respecting your friend’s privacy is so important, especially after she’s gone.

Letting go of things makes it feel really final and it can feel like there will be nothing left of your friend. You’ll come to realize that’s not true, but for some people experiencing grief, cleaning out friend’s belongings can be one of the hardest parts of the process.

What about a funeral? Memorial? Party?

Everyone will have different expectations. If your friend’s family is religious, it might dictate certain details about the memorial. But if you’re in charge, do something your friend would have liked. It’s okay to talk to your friend about this while they are alive.

• How do we plan a memorial?

We think you should do something pretty fast, with just enough time for out of town friends and family to get there. You can do a bunch of different things, to celebrate your friend’s life with all of her different circles of friends. A big gathering might be the most fitting way to start — collaborate with your friend’s other closest friends and family to invite everyone and anyone who would want to be there. Now’s definitely not the time to get petty and worry about who broke up with whom.

Pick a pleasant place where you can gather with your friends to talk, share and reminisce. It could be in someone’s house, in a park, at your friend’s favorite bar, wherever you’d like to spend a few hours remembering what you loved about your friend. You can put up pictures, bring notebooks for people to fill with stories about your friend, and generally create a lovely gathering that your friend would have approved of. There could be food, even though you might not be hungry, and there could be drinks, even though now’s maybe not the time to get drunk. Or maybe it might be? Life is strange. Do what feels right and raise a glass to your friend if that feels like a proper send-off.

• Figuring out what to say at a funeral

Say something meaningful. Keep it short. Keep tissues on hand. Share stories. If it helps, write things down and keep your notes on hand —​it’s hard to keep your train of thought when you’re looking at a crowd of teary friends. Here are some tips:

  • You could take the time to reflect on some of the ways your friend’s best traits shone through her actions and words, by sharing a few things about her that others might not have known.
  • Don’t brag or be possessive, even if she was your best friend, significant other, or sister or brother. Remember that this person meant something to everyone in the room.
  • Your friend was human, and you can share imperfect stories too, because even though your friend was extraordinary, losing the ordinary, mundane and boring things you did together is one the saddest things you’ll all have to deal with.
  • If your friend wanted to be remembered in a specific way, or asked for people to honor her by contributing to a cause that was close to their heart, or by living out values and ideas that were important to them, now is a great time to share those wishes.

• Handling all that internet business

There’s a few things going on here ­ first up, a crazy deluge of people posting about your friend’s death. At best, you’ll know some of the people posting and feel fondness for a time remembered together. At worst, you’ll feel overwhelmed and judge other people for posting weird things that you either find disingenuine or self­serving. Keep in mind, you’re having a bad day. It’s very convenient for you to displace your feelings of sadness by angrily judging the inspirational quotes and old photos posted by random people who you’ve never met but somehow knew your friend. Don’t waste the energy. We live in a world where, for many, social media is an acceptable arena to display your innermost feelings, grief included. You do what you want, and try not to be too bothered by other people’s posts.

Then there’s the handling of your friend’s social media accounts. This is whack. It’s possible to turn your friend’s facebook page into a memorial page, and if you have passwords and account logins, you can edit or delete profiles, albums, and other digital remnants. But you’ll miss a few, and your friend’s name will pop up somewhere on the internet ­ LinkedIn endorsements, tags on Instagram, with a little grey bubble on gchat, and/or listed as a top friend on snapchat, among others. It’s weird.

Tell me more: Digital Footprint

So, what now?

After the rush of people and hugs and emotions, slowly, things will get back to ‘normal’, whatever that means. You owe it to your friend to keep on living.

• A note on grief

Everyone grieves in different ways. Some of your friends might be very public about their feelings and emotions. Others might fall back on Hallmark cards, inspirational quotes, and flowers, because that’s what makes sense to them. If you find other people’s grief cheesy or offensive, keep those thoughts to yourself. This is another time where a professional therapist and a strong circle of friends and family is going to be really helpful (you can complain to them about whatever dumb thing your friend’s roommate’s sister said). Splurge on the good kind of tissues (with the moisturizer).

You might not feel good for a few weeks. You might not feel good for six months or even a couple of years. You’ll always remember your friend’s death –​​an experience like this takes a toll on people. Take the time you need to acknowledge and understand the gale­force storms of emotions you’re dealing with, and know that time will heal most things, if not all.

But it will pop up in strange ways and make you sad; sometimes both grateful and sad. Sometimes you'll visit a new place and wish your friend could be there with you to enjoy it. Sometimes angry. It’s not going to be easy. You’ll come across little reminders of your friend everywhere. Maybe you’ll find her hair on the shirt of yours she borrowed. Maybe she’s somehow still logged in to chat. Maybe you’ll meet someone with the same name. Give yourself a moment to let those memories wash over you, then take a deep breath and release them, acknowledging that there were good times. It’s okay, there will always be a little bit of sadness.

As time goes by, it might help to read how others have faced the same adversities. Novels and movies might resonate differently now, and your whole worldview will probably shift a little, or a lot. That’s not a bad thing. We won’t offer any platitudes about how overcoming adversity and mowing the lawn builds character, and we can’t tell you how to feel. But we feel that thinking about life in a meaningful way includes reckoning with death.

• What should I do for myself?

Remember all of those tips about staying healthy and strong so you can support your friend? The part about eating healthy, not drinking too much, getting a lot of sleep, etc? Well all that’s still important in the long run, but for now, just do whatever you need to make it through the day, and then the week, and then the month. In the first few days, if you need to run, cry, go to work, get a massage, get laid to feel better, fine. But this is a short hall pass — you have to starting talking, grappling, and eventually, accepting what happened.

It might be overwhelming to be around people all the time — if so, remember to reserve a lot of alone time. On the other hand, if spending time with people is the thing you want, then surround yourself with friends and family . A strong drink will help for a minute, but alcohol can make you even more depressed over time — now’s not the time to pick up a debilitating drinking habit. If you smoked before, that might help ease the stress and sadness, even though we can’t think of a better way to honor a friend that died from cancer than by quitting smoking.

There’s a lot​ of resources​ about understanding the stages of grief. Spoiler alert: they are real.

• How can I keep my friend’s memory alive?

The world belongs to the living. Allow yourself to honor your friend in whatever way feels right. You could write some stuff on the internet to help other people, like we’re doing with this website. You could start something in their name —​a charity, a garden, a new cookie recipe, a new dance move. You could plant a tree, adopt a puppy, or go on an adventure. You could donate to cancer research in their honor. You can find a way to keep in touch with your friend’s family. You can celebrate her birthday annually in a way that honors her with friends. You could launch fundraisers and find creative ways to help others going through the same thing.

But above all else, you can live more mindfully. Be more thankful. And appreciate life for what it is.


Disclaimer

We’re not doctors, psychologists, or counselors. We’re not life-coaches, or your parents, or experts on cancer. We’re not here to tell you what to do, we’re just sharing what we went through, and what we think was helpful for Crystal and for us while dealing with cancer. Our hope is that what you read here helps you in some way, but remember to think for yourself and use your own judgment! And always, if you’re experiencing a medical emergency, don’t google it or rely on what we've said here, call 911.