When Tambre Thompson, 47, a flute instructor from Concord, California, learned she had breast cancer last May, her siblings immediately stepped in to help out. But she was also very touched by the level of support she received from her friends. "They took me to my doctor appointments, did my dishes, brought food by," she says. "But mostly, they gave me the feeling that I wasn't going to just completely sink."
Odds are that someone you know will be diagnosed with breast cancer: nearly one in eight women will develop the disease. But the encouraging news is that doctors are getting better at catching breast cancer early and treating it more effectively. There are more than 2.9 million breast cancer survivors in the United States today. And, like Tambre, many of them will come to rely on their friends and loved ones for help. Here's what you can do for someone who may find herself in one of the more common situations.
Be a good listener. "Being told you may have cancer is an overwhelming frenzy into the unknown, and uncertainty can breed fear," explains Niki Barr, Ph.D., a psychotherapist practicing in Dallas and the author of Emotional Wellness: The Other Half of Treating Cancer. "It's an emotional shock for everyone involved."
While you might be having your own freak-out in response to her news, one of the most important things you can do at this point is to keep calm, feel things out, and take your cue from your friend. "Some people want a lot of advice and help from the get-go," Barr says. "Others are simply looking for a sounding board."
Volunteer to be her secretary. "It's very difficult to process information when you are overcome with emotion," says Joanne Buzaglo, Ph.D., vice president of research and training for the Cancer Support Community, a nonprofit organization that provides social and emotional support to patients and their loved ones. If your friend is meeting with her doctor before the biopsy, offer to go along and take notes. Or volunteer to do some digging online for information. "Often people don't want to do the research for themselves because they're afraid of what they may learn," Buzaglo says. Also, when it's not your own health at stake, it can be easier to learn about the disease and treatment options and explain it to your friend in a way she can process.
A few good sites to check out: the National Cancer Institute, the American Cancer Society, the Centers for Disease Control and Prevention, the Breast Cancer Research Foundation, and the Cancer Support Community.
Educate yourself. As you gather information, read up so you can understand the situation, too. Take note that an abnormal mammogram is far from a diagnosis. Research shows that anywhere from 20 to 60 percent of positive mammogram results in the United States and Europe can be false positives. In all likelihood, the doctor will order another round of screenings, including an ultrasound (which uses sound waves to create an image of breast tissue) or an MRI (which uses magnets, radio waves, and a computer to create a highly detailed image of the breast). The radiologist might be able to do a biopsy at the same time as an MRI or sonogram by using a special needle, or a surgical biopsy might be required.
Help her through the waiting period. The four- to seven-day wait for a biopsy result can feel agonizingly long. "It's times like this that friends and family have a large impact," says Lidia Schapira, M.D., a breast cancer oncologist at Massachusetts General Hospital in Boston. Distractions can help—take her to the movies or lunch—but don't be afraid to validate her feelings. "The best thing you can do is tell her that you're standing by to listen and help in any way possible, no matter the results," Schapira says.
Mobilize her network. The support she needs depends largely on her personality, but also on her treatment plan. Patients who undergo a lumpectomy (surgery to remove the cancerous tissue) followed by radiation and hormonal therapy might experience some fatigue and pain, but the illness tends to be more manageable, Schapira says.
Those who need chemotherapy and/or more radical surgery such as a mastectomy often have a much bigger disruption to their lives. In any case, as word of her diagnosis spreads, she'll probably be inundated with questions and concern, all of which can be overwhelming, says Julie Silver, M.D., a cancer rehabilitation specialist at Harvard Medical School and editor of What Helped Get Me Through: Cancer Survivors Share Wisdom and Hope. Assign someone from the pool of loved ones to fill people in about her condition, and designate another person to take charge of organizing specific things your sister-in-law might need, like rides to doctor appointments.
Websites including caringbridge.org, carepages.com, and mylifeline.org allow you to set up an online support network where friends and family can get updates, volunteer to bring meals, or help out with other daily needs, like picking the kids up from soccer practice or doing a grocery store run. "It's a great way to keep people informed so the patient doesn't have to answer the same questions again and again, or get 12 tuna casseroles at once," says Letty Cottin Pogrebin, author of How to Be a Friend to a Friend Who's Sick.
Donate to her cause. When Jenny H.'s best friend, Caney, learned she had breast cancer, her college friends who didn't live nearby asked what they could do. They quickly started a fund to contribute to Caney's care, helping to pay for everything from a new wig and pretty scarves to magazine subscriptions and restaurant gift cards. "Having a fund meant that all of her friends could reach out and make an impact," Jenny says.
Offer to be her workout partner. Exercise can be tremendously helpful during treatment: Research shows that moderate activity can help reduce fatigue and anxiety, and boost immunity and self-esteem. Other research has shown that women who were physically active after being diagnosed with breast cancer had nearly half the risk of dying from the disease. Schedule a morning or afternoon walk (and if you notice your friend flagging, tell her you're the one who's tired and needs a rest).
Also help her de-stress by practicing a simple breathing technique together: Imagine following a triangle with your breath. Take a slow inhale along your left side, a slow exhale along your right side, and then pause briefly, counting to four, along the bottom.
Make a chemo kit. Chemotherapy can take an incredible toll, both physically and emotionally. A few simple items—what therapist Barr calls "an emotional toolbox"— can help relieve some of the stress and let your friend know that she's not alone. Items can include a journal to keep track of medications or questions for the doctor, a book with inspirational quotes, or just something she can hold, like a smooth stone. "It can be anything soothing and meditative," Barr says.
Tambre was comforted by a quilt made by a friend and would spend hours gazing at a collage purchased by another friend for strength and inspiration. "These personal items really made a big difference in keeping my spirits up," she recalls. Jenny would leave a bag of post-treatment goodies at her friend's house to give her something to look forward to. "One basket included DVDs and popcorn for the kids to have movie night with Mom," she says. "Another time we left lip gloss and a gift certificate to buy comfy clothes. We just wanted her to know that we were thinking about her."
Be her wingwoman. At some point, your friend might need to talk to others who are in similar circumstances. Cancer support groups can help, but they can also be intimidating. Offer to accompany her so she's not walking in alone, then give her the space to forge new bonds. "Talking to people who identify with what I'm going through is a much different level of communication, which I really couldn't have with my friends," Tambre says.
Stay connected. There's nothing like hearing good news, but after the initial relief, your friend still needs you to keep checking in. "When you're going through treatment, you have a concrete plan of action, and you have a medical support team in place to keep you on track," Buzaglo says. "But when that's over, people often become flooded with uncertainty and fear." Schedule a weekly check-in—a phone call, lunch, dinner—so she knows that you're still thinking about her.
And remember that being told you're "cancer-free" can be a complicated issue. "Sometimes we are imprecise about telling women when they are really considered 'cured,'" Schapira explains. The medical team might tell your friend she's cancer-free when they find no more evidence of the disease. "But you can be at a higher risk for a recurrence for up to 25 years, depending on the type of breast cancer," Schapira says. "So uncertainty can exist for quite a while."
Don't avoid the taboo. Your friend might never want to discuss her cancer again, or she might want to talk constantly about her worries. Either way, it's probably never far from her thoughts. Even if she's been told she's cancer-free, your friend might be taking medication like tamoxifen or a similar drug to help prevent a relapse. If she brings it up, don't be afraid to discuss her concerns, and reassure her she's doing everything she possibly can to stay healthy.
Be patient. "Most people are eager to return to regular life and enjoy the miracle of the ordinary and focus on movies, politics, sports, food, or gossip," Pogrebin says. "The sooner you can resume the things that defined your friendship pre-illness, the better. But at the same time, be sympathetic to occasional backsliding, when a friend may feel tired or depressed."
Accept her for who she is now. "Cancer is a life-changing event, and things almost never go back to normal," Schapira says. "It can take months or even years for a person to recover, and even then they might not be the same—physically or emotionally."
That was the case for Chandra Collins, 50, a holistic practitioner from Concord, California, who learned that she had breast cancer last year. "I'm trying to be more appreciative of what's around me, and for some of my friends, I'm not the same person I was before," she says. "But the ones who understand me best are always there. And at the end of the day, that's what good friends are all about."
Offering support to a close friend is a natural first response, but you might feel awkward reaching out to someone you don't know quite as well—such as a coworker whose wife is battling breast cancer. Some ideas and guidelines on how to help: