Being honest about your feelings will help develop trust between you, and it’ll make it easier for the other person to be honest about their own feelings. It may be helpful to say things like,

• 'I find this difficult to talk about...'
• 'I'm not very good at talking about...'
• ‘I don’t know what to say.'

You may worry that saying things like this will cause your loved one or friend further distress. However, in practice it tends to have the opposite effect, and the person you're talking to may be relieved that someone understands. It’s quite possible that the person you’re talking to feels the same as you. Even if you share the same feelings, remember not to stay focused on your own feelings. Make sure that you bring your attention back to your relative or friend.

Misunderstandings can happen if you assume that you know how the other person feels. Asking questions and giving feedback will help you check you’ve understood what they have said. It also shows that you are listening and trying to understand.

Questions you could ask include:

• ‘Do you mean that…?’
• ‘What did that feel like?’
• ‘How do you feel now?’

It is also good to check what you’ve heard is right:

• ‘What I’m hearing is…’
• ‘It sounds like you’re saying…’

If your relative or friend wants to talk about how awful they feel, it’s important to let them. It may be distressing for you to hear some of the things they say. However, it can really help them if you’re able to stay with them and just listen while they talk. If you find it uncomfortable and too difficult to cope with just then, you could suggest a short break for a cup of tea or you could take a quick look around the room while you compose yourself. This will help move your attention away from what is distressing you.

If after a short break you still find that the conversation is too hard for you, you could say so and offer to discuss it later. Say something simple, such as, ’I’m feeling a bit emotional and it’s hard for me to talk about this now – could we talk about it later?‘

Don’t simply change the subject without acknowledging the fact that what your relative or friend is talking about is very important. When your relative or friend brings up the subject of their cancer, don’t immediately start talking about someone else you know who has, or has had, cancer. You may mean well, but remember that each person’s experience of cancer will be different, so talking about someone else’s experience may not be helpful. Treat your relative or friend as an individual and focus on them rather than comparing them with others who have cancer.

You may want to give advice to your relative or friend. You may want to tell them something that may help them feel better. But it’s probably more helpful to simply listen for as long as they wish to talk and then ask if there’s anything you can do to help them. You may be surprised at their answer, as they may come up with something unexpected.

You may have your own ideas, but it’s worth pausing and asking yourself if your idea will really be helpful. If you’re not sure, you could suggest something like, ‘I wondered about …, but I don’t want to suggest this if it’s not the sort of thing you want.’

Remember that your relative or friend may not accept your advice. If they reject your suggestion, don’t take it personally; their preferences may differ from yours. It could also be one way that they can stay in charge of their life when other parts of it feel out of control.

If your relative or friend wants to use humour to help them cope, it’s good to respond to this. But don’t be the one to introduce humour into the conversation in case they don’t find this helpful.

It’s quite natural for people to feel frightened, upset and sad when they've been diagnosed with cancer or are having treatment. Some people think that being positive can help cure cancer or make the treatment more successful. They may worry that feeling sad and having negative thoughts or emotions may make the treatment less successful, make the cancer grow faster or make it more likely to come back.

Although the development of cancer may be influenced by our thoughts, feelings and attitudes, research studies haven’t shown any convincing evidence that positive thinking can make treatments more effective or stop the cancer from coming back. It's also important to remember that cancer is influenced by many other things, such as our environment, smoking habits, diet and genetic make-up. No one can feel positive all the time - it’s all right to have times when you feel negative. If you believe that your relative or friend needs to be positive to get rid of the cancer and the cancer comes back, they may think that it’s their fault because they weren't positive enough. If a cancer does come back or can’t be cured, it’s often beyond their control. Cancer is a complicated illness, and even with modern treatments, not all cancers can be cured.

It can be upsetting to see someone we care about crying. But crying is a natural response to distress and it can be a helpful release.

Some people don’t want to cry because they feel that once they start, they won’t stop. This is not true, as feelings can come and go.

Responding to distress

If your relative or friend cries, reassure them that it’s okay to cry. This will let them know that you’re not put off by their tears. Touching, holding hands or giving them a hug may help too.

You might want to try to ‘stay strong’ for them, but it’s okay if you need to cry too. Being honest about your feelings will help develop trust between you. It will also make it easier for the other person to be honest about their feelings.

If you are upset, you can tell your relative or friend you are okay with feeling that way. This lets them know they can open up to you, rather than try to protect you by keeping their feelings from you.

Although it’s good to be honest about your feelings, try to keep focused on the feelings of your relative or friend. This doesn’t mean you don’t need support. It’s really important that you also have people you can talk to about how you are feeling.

Most of the time people with cancer, and those close to them, adjust and finds ways to cope with feelings of anger or anxiety. But sometimes people need outside help to deal with the strong emotions they have.

If you or your relative or friend is struggling with anger, anxiety or depression, it may be hard to share this with family or friends.

A GP, cancer doctor or specialist nurse may suggest professional support. Seeing a trained counsellor or psychologist can give you or your relative or friend an opportunity to talk to someone who is outside the situation. They can also help explore feelings and find ways of coping.

We have a video about counselling that you can watch.

People who are very ill may start to question their beliefs about life and its meaning. This may happen whether a person has a particular religious faith, is agnostic or is atheistic.

It’s important to distinguish between religion and spirituality. Religion concerns a particular faith, such as Catholicism or Buddhism. Spirituality has a wider meaning and applies to everyone. Spirituality means different things to different people, but some people may think of it as anything that relates to the ’inner soul and being’. A person may describe a piece of music, watching a beautiful sunset, a book that means a lot to them or being in love as something that has spiritual significance for them.

When people are seriously ill, they may feel emptiness, despair or hopelessness. Listening to and being with your relative or friend can really help support them at this difficult time. You don’t need to share a particular belief system to support them in this way. If your loved one has concerns about their religion or spirituality, they may wish to speak with a hospital chaplain or other spiritual leader.