How to Treat a Family Member With Cancer: A Daily Guide for Families

How should you treat a family member with cancer, and what should or shouldn't you say at home? Read about age differences and practical tips for families.

When someone close to you is diagnosed with cancer, the atmosphere at home changes overnight. People start whispering in the kitchen, taking phone calls on the balcony and glancing at one another as if to ask, "Did you say something?" Being afraid of hurting the person you love while not knowing whether you are doing the right thing is one of the most common struggles families face. There is no single, ready-made answer to how to treat a family member with cancer, because every patient, every family and every illness journey is different. Still, there are some basic attitudes that help the person feel less alone and more respected. In this article I look at how you can build closeness at home and in everyday life, from the first weeks after the diagnosis through the treatment period.

What Does a Cancer Diagnosis Make the Family Feel?

Talking about how to approach the patient without talking about the feelings of their relatives would leave something out. Whatever you are feeling inevitably shows up in how you behave.

In the first days after a diagnosis, most families experience a kind of shock. The sense of reality becomes blurred; people carry on with their tasks on autopilot while their mind keeps returning to the same question. Then comes fear: fear of loss, fear of not being enough, fear of making the wrong decision. Some family members manage this fear through constant activity; they research, phone, book appointments and never stop. Others freeze, find it hard to go to the patient's side and avoid bringing up the subject.

Anger is also a common feeling. It can be directed at the hospital, the waiting times, the symptoms noticed too late, even at the patient themselves: "Why didn't you go to the doctor sooner?" This anger is often helplessness turned outwards. Recognising your feelings is the first step towards carrying them without unloading them onto the patient. I have written in detail about how the burden of long-term care can build up in the article on caregiver burnout.

How to Treat a Family Member With Cancer: Basic Principles

Do not see them as nothing more than their illness

A person diagnosed with cancer is still the same mother, the same father, spouse, sibling or friend. They still want to know how their football team got on, want to talk about the neighbour's wedding, want to see their grandchild's school report. If every conversation comes back to test results, blood counts and the treatment plan, the person is reduced to a "case". There is no need to avoid talking about the illness; but room also needs to be made for the rest of life.

Leave control to them as far as possible

A serious illness shakes a person's sense of control over their life. Other people start to decide about their body, their schedule, their work, even what they eat. That is why it matters to leave even small decisions to the patient: who visits today, who goes with them to the hospital, what is for dinner, who is told about the illness. The attitude of "we know what is best for you", however well meant, can leave the person feeling passive and worthless.

Value listening more than talking

Relatives often focus on finding the right sentence. Yet what the patient usually needs most is to be listened to without being interrupted, corrected or immediately consoled. Saying "Don't be scared, nothing is going to happen" to someone who says "I'm afraid" closes the feeling down. Saying "What are you afraid of? Would you like to tell me?" keeps the door open.

Go at their pace

Some patients want to talk about the diagnosis in detail straight away; others do not raise the subject for weeks. Both are ways of coping. Forcing someone to discuss information they are not ready for, or silencing them when they do want to talk, both increase their sense of loneliness.

Respond naturally to changes in their body

During treatment, changes such as weight loss or gain, hair loss, a pale complexion or surgical scars may appear. The family's reaction to these changes also affects how the patient will look in the mirror. Staring at their face the moment you walk in, saying in surprise "You've lost so much weight!", or, the opposite, averting your eyes as though nothing has happened can make the person uncomfortable. Meeting the changes without exaggerating them, but without ignoring them, is more reassuring. For example, it matters that the patient decides for themselves whether to wear a headscarf, a hat or a wig, and that the family respects that decision. If they want to share something about their appearance, listen; if they do not, do not push them to bring it up.

What Should and Shouldn't You Say to Someone With Cancer?

The sentences below are fictional examples; the aim is not to memorise phrases but to see the difference in attitude.

Sentences it may be wise to avoid:

• "My aunt had it too, she suffered terribly." (Other people's stories, especially negative ones, increase anxiety.)
• "Keep your spirits up and the rest will follow." (Linking the course of the illness to the patient's mood creates guilt on the days they feel low.)
• "Why did you do this, if only you'd given up smoking…" (Blaming someone for the past helps no one.)
• "You don't look ill at all." (Sometimes taken as a compliment, sometimes it leaves the person feeling that what they are going through is not seen.)
• "Try this herbal juice, someone's husband got better with it." (Non-medical suggestions put the patient and the family under pressure to make decisions.)

Sentences you could try saying:

• "I don't know what you're feeling, but I'm here for you."
• "Would you like to talk about the illness today, or shall we talk about other things?"
• "I could come with you to Thursday's check-up, would you like that?"
• "It makes complete sense that you're angry."
• "Tell me when you're tired, I'll look after the visitors."

Sometimes saying nothing is also an answer. Holding their hand, sitting quietly in the same room or watching a series together creates closeness where words fall short.

Different Approaches Depending on the Patient's Age

If the patient is a child

Children make sense of illness differently from adults. A preschool child may experience illness as a punishment and think, "Did I get ill because I was naughty?" It is important to tell them clearly that it is nobody's fault. Play is the main language through which children express their feelings; playing hospital, giving a doll an injection or drawing pictures are natural parts of this process. Keeping routines as far as possible, and not letting all the rules disappear, also gives a child a sense of security.

If the patient is a teenager

In adolescence, identity, peers and physical appearance come to the fore. For a young person, losing their hair or falling behind their classmates can be as hard as the diagnosis itself. It is important to give a teenage patient a say in decisions, to make room for them to talk to the doctor themselves and to support their connection with their friends. Overprotection clashes with the young person's need for autonomy and can increase anger.

If the patient is an adult

For an adult who works, raises children and contributes to the household income, cancer means their roles being shaken. Questions such as "Who will look after my children?", "Will I lose my job?" and "Am I becoming a burden on my spouse?" are often heard. Rather than taking everything away from this person, allowing them to keep the responsibilities they can manage helps them feel useful.

If the patient is older

In older patients, dignity and autonomy are very sensitive. The family may tend to gather and make decisions in the patient's absence, or to speak to the doctor on their behalf. Yet an elderly mother or father also has the right to receive information about their own illness and to take part in treatment decisions. If they have difficulty hearing or understanding, speaking slowly and clearly and giving them time for their questions is far more respectful than leaving them out of the conversation.

How to Treat a Family Member With Cancer at Home: Practical Tips

In Turkey, news of cancer often spreads quickly to the extended family, the neighbours and people from the same hometown. The phone never stops ringing, visitors arrive one after another and everyone walks through the door with a suggestion. This attention comes from love, but it can wear the patient out. The suggestions below can make life at home more manageable for both the patient and the family.

• Choose a "communication person". Having one person pass on news to relatives saves the patient from giving the same explanation over and over.
• Plan visits around the patient's energy. Tiredness can increase in the days after treatment. Deciding visiting times and lengths by asking the patient, and being able to say politely "They're resting today, I'll pass on your regards", can be your job.
• Don't insist about food. During treatment, appetite and sense of taste can change. Insisting on "just one more bite" turns the table into a source of tension. Share your concerns about nutrition with the treatment team.
• Get medical information from the doctor. Information heard online, on social media or from people around you often does not fit that person's situation. Consult the doctor in charge of treatment for all questions and decisions about it; going to appointments with a list of questions makes things easier.
• Share out responsibilities. Dividing tasks such as accompanying the patient to hospital, the pharmacy, the bills and the children's school among family members prevents one person from burning out.
• Don't forget the children at home. The patient's children or grandchildren always notice that something has changed at home. Hiding everything from them often leads their imagination to produce scenarios more frightening than the truth. Giving short, honest explanations suited to their age and keeping their school, play and sleep routines supports their sense of security.
• Allow laughter. Laughing at home is not disrespectful. For many patients, humour is one of the ways of holding on to normality.

Crowded family gatherings such as Bayram (religious holiday) visits, weddings or funerals may also need to be planned separately during this period. During phases of treatment when immunity is weakened, it is necessary to ask the doctor whether it is appropriate to be in a crowd, and to find out whether the patient wants to attend. Sometimes a short video call can be less tiring and more meaningful than a crowded visit.

Whether information should be hidden from the patient is also one of the issues families find hardest. I have looked at the effects of the "let them not know, so they won't be upset" approach on the patient in the article on hiding a diagnosis from the patient.

Treating someone with cancer well does not mean protecting them from everything; it means being able to carry their fear, their anger and their hope together.

When Should You Seek Professional Support?

Sometimes the question of how to treat a family member with cancer becomes heavier than the family can answer alone. Sadness, anxiety, anger and sleep problems are expected reactions after a diagnosis. However, some situations suggest that it may be helpful for the patient or family members to get support from a mental health professional:

• The patient has not enjoyed anything for weeks and has withdrawn completely
• Marked reluctance towards treatment, refusing appointments, or the thought "What difference does it make?" taking hold
• Intense anxiety or panic attacks clearly affecting daily life
• Conflicts in the family increasing, or communication breaking down completely
• The caregiver being unable to sleep, crying constantly or feeling they have collapsed
• Marked changes in the behaviour of the children at home

If the patient or a family member has thoughts of ending their life or says they want to die, do not carry this alone. In an emergency, call 112 (emergency services) or go to the nearest emergency department. If depressive symptoms are pronounced, an assessment by a psychiatrist may be important; you can talk openly about this with the treatment team.

How Are the Patient and Family Supported in Therapy?

Psychological support does not replace the medical treatment of cancer, but it can help carry the emotional weight of living with the illness. Some hospitals have psycho-oncology or psychosocial support units; you can ask your treatment team about this option.

Within cognitive behavioural therapy (CBT), topics often worked on with patients include tolerating uncertainty, working with catastrophic scenarios, building a daily routine suited to the treatment period and continuing activities that give meaning. With relatives, guilt, anger, a sense of inadequacy and setting boundaries are the main themes. Sometimes things that cannot be spoken about between the patient and their spouse or adult children can be addressed safely in joint sessions.

For children, play-based approaches can help us understand how the illness and the hospital experience have settled into the child's world. For adults, individual therapy can be a space where both the patient and the caregiver can make room for their own feelings. For people who find it hard to leave home because of treatment, sessions can also be held online.

Frequently Asked Questions

Is it all right to cry in front of a person with cancer?

Showing your feelings now and then can let the patient feel how much they matter to you and also gives them permission to cry. However, if it turns into a situation where the patient constantly has to comfort you, it helps to find another space in which to share your intense feelings.

What should I do if the patient doesn't want to talk about their illness at all?

This preference can also be a way of coping. A short sentence that leaves the door open ("We can talk whenever you want") is often enough. If treatment decisions or a medical emergency are involved, it is important to discuss this with the doctor, with the patient taking part.

How can I cope with relatives constantly bringing suggestions?

You can use a calm sentence that thanks them and closes the topic: "Thank you for caring, we make treatment decisions together with our doctor." Limiting how much the patient is exposed to these conversations is also a task family members can take on.

The patient keeps getting angry with me, should I take it personally?

During a serious illness, anger is often directed at the person who is trusted most. This does not mean they do not love you. Even so, you have every right to express your limits calmly and to look for support for your own exhaustion.

• #cancer and family
• #family caregiver
• #supporting a patient
• #patient psychology

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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