Health

How to help your loved one

A guide for supporting your mother, daughter, wife, sister or friend with breast cancer

If someone close to you has breast cancer, you probably wonder what you can do to support her. If you have the disease yourself, family and friends will be asking how they can help. Bernie Schlauch and Pat Brown, breast cancer survivors and peer counselors at Wellspring, a network of centres in Ontario that provide emotional and psychological support to individuals and families living with cancer, know what it’s like to experience breast cancer from both sides. Here’s their best advice on what you can do to support your friend:

During diagnosis

What your loved one with breast cancer might be feeling:

· She is likely terrified, sad, depressed, angry or dazed. “She may feel like it’s all a nightmare and she’ll wake up and it will all be over,” says Schlauch.
· Your friend may not be able to tell you what she needs or she may deny she requires anything, says Brown. “One of my friends finally had to tell me that I was being selfish because I wouldn’t let anyone offer any help.”

How you can help:

· When your sister tells you about her diagnosis, you’ll probably be in shock. What do you say? Tell her you’re sorry. That’s all she needs to hear.
· Let her sit in silence, if that’s what she needs. Don’t try to fill the air with chatter.
· Just listen. “You can’t take it away and you can’t make her feel better,” says Schlauch. She just needs someone to be there who is not afraid of her emotions and needs.
· If you have difficulty with emotions or hospitals, then let your loved one know. She has so much on her mind that she shouldn’t have to worry about how you feel. You can offer other ways to help instead. See below.
· Refrain from platitudes such as, “There’s nothing to worry about” or “You’ll get better soon.” It’s a long journey from diagnosis to treatment and beyond, and you cannot predict what will happen, says Schlauch.
· Ask if she wants help researching her diagnosis before you inundate her with reams of pamphlets and Web site addresses. “Some women don’t want to know,” says Schlauch.
· Learn the jargon. It would be helpful to know the medical terminology when she refers to terms you’ve never heard of.
· Research support groups in the community. “There’s nothing better for her than talking to someone who’s been through breast cancer,” says Schlauch.
· Offer to go to appointments with her only if you feel comfortable doing so, says Brown. Specialists can sometimes be difficult to understand and she’ll need someone there to take notes or ask the doctor to explain things in plain language if she becomes overwhelmed by all the information.
During treatment

Depending on her kind and stage of breast cancer, she may undergo surgery, which may be combined with chemotherapy, radiation or hormone therapy.

Lumpectomy and mastectomy, often combined with axillary node dissection or sentinel node biopsy, are the surgical options your friend may face. Each carries its own risks and conditions.

What she might be feeling:
Fear of the surgery would be her top concern. Then, after surgery, she may feel grief over her loss mixed with relief that it is over. Her chest may feel bare and cold, says Schlauch, who underwent a mastectomy.

How you can help:

· Talk to her. Ask about her fears and grief about the loss, says Schlauch. “It’s like a death in the family. Be respectful and don’t make light of it, especially if she is a small-breasted woman,” she adds.
· Be her chauffeur. The surgery may have weakened her arm, which might hamper her ability to move the steering wheel. Take her to appointments, offer to grocery shop or drive the kids to their hockey or ballet lessons.
· Do stretch exercises with her to keep scar tissue from hampering her range of movement. She should discuss with her physician when to begin and what kind of exercises are appropriate to stay flexible.
· Book a massage appointment for her only after she’s asked her doctor if it’s OK. Book a registered massage therapist who has experience with cancer patients and let her know what your friend has been through.
· Encourage her to take yoga, tai chi or stretch classes after consulting her physician. Gentle movements will help her body return to normal faster.
Chemotherapy

Chemotherapy is the administration of drugs—in pills and intravenously—that attack cancer cells as well as healthy cells in the body. Sessions every three weeks in hospital can continue for up to six months.

What she may be feeling:
The side effects of chemotherapy-from nausea to hair loss—are real and frightening. “Usually a woman will feel overwhelmed with fear, which is often worse than the treatment itself,” says Schlauch.

How you can help:
Offer to attend the chemo sessions with her, but only if you feel comfortable in hospital settings. Bring a light lunch and a sense of humour along. The treatment itself may last no longer than an hour, but you might have to wait in hospital all day.

· Deliver meals for her family. She may be in no mood to cook anything after a day of chemo.
· Bring her exotic beverages. The ability to taste anything after chemo can vary, so something with a zesty flavour may just hit the spot, says Schlauch. Try lemon zinger or raspberry herbal teas or guava or mango juices (frozen kinds are less acidic and better for the sore mouth that may be a side effect of chemo).
· Ask about her food cravings. She may want to eat pad Thai or eggs Benedict instead of her usual meals. Because nausea comes and goes, says Schlauch, it’s best not to bring over her favourite dish—she may associate it with the unpleasant side-effects.
· Accompany her on regular walks . The drugs used in chemotherapy take a while to be cleared from the body, says Schlauch. Exercise, approved by her doctor, will help her body rid itself of the toxins faster.
· Help her shop for a hat or wig before her chemo begins. Look for a rimless hat that is soft on the inside so as not to aggravate her tender skin, suggests Schlauch. Be honest about her choice of wig to help her look her best. Remind her that hair loss is temporary and hair will begin to grow back when treatments end.
· Buy her some luxurious, scent-free vitamin E skin lotion. Chemo can make the skin very dry.
· Take her out for a special lunch. Once she is feeling up to it, suggest you two go to her favourite restaurant. It will help her feel normal again.
· Arrange small gatherings. Everyone will want to be supportive and visit, but her white blood cell count may be low after chemo, putting her at high risk for infection. Suggest that only two or three healthy friends come over at a time.
Radiation

Treatments for radiation include daily sessions, five days a week for three to six weeks, which can be daunting.

What she may be feeling:
During radiation, a high-energy beam of photons is released through a linear accelerator which creates breaks in the cancer cells. There are two main potential side-effects: fatigue and irritated skin, such as a burn or rash.

How you can help:
Keep her company. Pat Brown suggests you accompany her to appointments, but only if you feel comfortable in a hospital setting. It usually takes about two hours (the treatment itself is only 10 minutes long). She’ll appreciate chatting with you during the waits.

· Do odd jobs. One of Brown’s friends offered to do her gardening, and she says it was a lot of fun watching her friend rake leaves while she sat on the porch, sipping lemonade and chatting with her.
· Walk her dog. When you’re fatigued from radiation, doing daily chores such as taking care of a pet can interfere with much-needed rest time.
· Take the kids out. Offer to take them to a movie or a park for the afternoon so she can nap.
· Pay for a maid. Brown was very appreciative of friends who booked a service to clean her house instead of ordering expensive flowers.

Want to support your friend even more? Check out these breast cancer support groups and fundraising organizations.

Help her without hurting yourself

Don’t burn out while supporting your friend with breast cancer. Keep these tips in mind:

· Know your limits. It’s OK to say no to her requests if it means you’d be sacrificing something you need or want to do. Suggest she ask her family or other friends to pitch in.
· Be honest. If you hate hospitals, say so. If you aren’t able to handle emotions, kindly tell your friend that you love her but you’re better at cooking meals than offering a shoulder to cry on.
· Talk to your family or other friends. You’ll need to share your feelings, such as fear and anger, so you don’t become overwhelmed.
· The Canadian Cancer Society has volunteers who can help family and friends deal with their concerns. Click on your province to find a counsellor near you.