Have you ever heard the expression the “elephant in a room”? If you are a friend of a preteen or teen with cancer, you likely have seen an example of this “elephant” in your own friendship. In many friendships, kids feel uncomfortable talking about cancer, leaving the taboo subject as a big, undeniable “elephant in the room”.

Chemo. Clinic. Ports. Surgery. Radiation. Hospitals. Chances are, if you have a friend with cancer, you have heard many of these words before. Whether your friend’s diagnosis is recent or happened before you met, these words probably swirl chaotically around in your mind. They often make you wonder, “What does this mean?” and “Will my friend be OK?” You are scared for your friend and unsure of how to help them make it through this difficult time.

After interviewing current and past cancer patients, caregivers, friends of cancer patients and professionals dealing with childhood cancer, I found that they all have many of the same ideas about what is most helpful to a preteen or teen while they are going through treatment. Although there are ways to make your friend with cancer feel better while they are going through treatment, every friend is certainly unique.
Dances, parties, graduations, and proms are all significant events in a teenager’s life. They are social gatherings where you can mingle with your peers, make new friends, and strengthen the friendships you already have. However, when a preteen or teen has cancer, they tend to miss out on these important events because of medications, doctor’s appointments, sickly treatments, and other things that focus on making them better again. As a friend, it can be challenging to try and figure out how to handle such situations.

If you are the friend of a preteen or teen with cancer, it is important to remember to try and keep him or her included in social things at school. Joslyn, who is a childhood leukemia survivor, is a research study assistant in the Department of Psychiatry and Behavioral Sciences at the Memorial Sloan Kettering Cancer Center. When she was sixteen, Joslyn’s best friend was diagnosed with a rare and aggressive type of cancer. When her friend was forced to miss out on senior prom because of her cancer, Joslyn and her friends still tried to include her. Before heading out for prom, the entourage stopped by their friend’s house to take pictures and to say hi. Like Joslyn and her friends, try to keep your friend included in social things at school. This is just one of the many simple things that will make your friend feel more included and make it easier for them to deal with everything they are going through. Additionally, the biggest thing you can do is to try and maintain a sense of normalcy in your friendship. You must continue to treat your friend like you would if they didn’t have cancer. For example, instead of asking them “How are you feeling today,” ask them “Hey, how are you” like you would ask your other friends. As Lexie, a fourteen-year-old brain tumor survivor, says, “Treat (your friend) like a normal kid….I mean yeah, I might not be able to do everything, I might get tired faster…than other kids. But that doesn’t mean that I want to be treated differently in any way.”

Furthermore, as Dana Allen, a school social worker, says, you have to remember to continue to be a real, true friend. Keep communication open between you and your friend, and make sure to always be there for them through thick and thin. For instance, if your friend was being teased because they had lost their hair, be a good friend and stick up for them. “If you want to be a good friend to someone who has cancer, I would just stand up for them and show them compassion,” says Caroline, a twelve-year-old cancer patient.

On the other hand, just because you must remember to treat your friend normally does not mean you can forget that they are living with cancer, a sickening disease. They might not be able to do everything you can. Many kids who have or had cancer are affected physically. Some of the preteens and teenagers I interviewed who have been affected physically by their cancer include: Caroline, who cannot run around as fast as her peers, and can only see with half of her right eye; Lexie, who although she has been off of treatment for five years, still doesn’t have much peripheral vision; Grace, an eleven-year-old whose brain tumor, although it was not cancerous, has impacted her vision, breathing, talking and walking; and my best friend, Hailey, a fourteen-year-old who is still going through treatment, and is partially paralyzed down her right side. Your friend may feel tired sometimes, and might have to focus on things you don’t even have to think about, like walking up the stairs or getting to and from class without getting run over in the treacherous school hallways. But this does not mean that they are different from anyone else. Your friend still wants to be treated normally, even if they might have a few limitations on what they can and cannot do. You can help by taking the initiative to get together with your friend, helping them out with anything they might have trouble doing, exercising patience, and understanding that sometimes they might just want to sit and do something relaxing if they are not at their best.

Do you remember the phrase the “elephant in the room”? Sometimes, cancer can become this elephant between you and your friend with cancer. Often times, cancer is not discussed between a cancer patient and their friend. Maybe you are scared of talking about your friend’s cancer, or maybe you fear that they might not want to talk about their sickness. Sometimes this might be true, and your friend might want to focus on other things when they are not in clinic or at the hospital. However, the only way to be sure of what your friend is comfortable with is to ask. Lisa Scherber, Director of Patient and Family Programs at the Jimmy Fund Clinic at the Dana Farber Cancer Institute in Boston, says she thinks it would be best for a friend to approach this issue by saying, “Hey, listen, I’m not sure how to handle this with you, what’s the best way?” She says that being straightforward and simply asking your friend what they would like is the best way to handle this “elephant in the room,” especially since everyone is different.

As a supportive friend, you may have had the idea of going into clinic with your friend during his or her treatment. But before you go, it is helpful to be prepared. Prior to going, try to learn as much about what you are going to see as you possibly can. Talk to your parents or another adult who supports you, and discuss the things you might see. Moreover, you can ask your friend what their day is like. Understand that you are going to see many things you are not used to. I remember the first time I went to clinic with my best friend, Hailey, and how astonishing it was to see all of the medications, machines, and other sick kids. It was heartbreaking and emotional, but also an experience I will never forget. Plus, remember to not show too much shock at what you might see while you are there. As Lisa Scherber says, “As a friend, you have to sort of understand you’re going to see a lot of stuff here that you’re not used to seeing, but your friend is, so you can’t really put the big shock in, because it’s going make your friend feel kind of funny.”

Another way to help support your friend can be to raise money in his or her name. Whether the proceeds go to your friend and their family, to the hospital or clinic they go to for treatment, or to any other organization relating to cancer research and treatment, doing so will show your support and consideration for your friend. Joslyn and her friends organized a car wash and other fundraisers that went to her friend’s mom to help pay bills. Caroline’s friends raised money by setting up lemonade stands and making and selling jewelry. My friend Hailey and I decided to make and sell jewelry as well. We sold our jewelry around town at different functions and gave our proceeds to the Jimmy Fund Clinic, where she goes for treatment.

Overall, you must find a balance of treating your friend normally, but not forgetting that they do have cancer, and that it does affect their life and yours. They will most likely find comfort in meeting new friends who understand exactly what they are going through at support groups and camps, such as Camp Sunshine (a popular camp in Maine for kids with life-threatening illnesses and their families). However, as supportive as you can be, you must accept that you will probably never know exactly what your friend is going through.

As a friend of a kid with cancer, I know how difficult it can be to see your friend seem lonely at times. Often times I wish that others would at least try to be Hailey’s friend. I have asked many of my own friends before about why they might be afraid to approach Hailey. Through their responses, I have concluded that many of my peers might be “afraid” of Hailey’s cancer, or simply stay away from her just because she is different. It has been hard for me to try to understand this because when I met Hailey in third grade, her cancer did not mean anything to me. Cindy, whose daughter had a brain tumor, says, “But I think for…a regular person, who sees someone who’s different than who they are, I think it’s kind of hard to make new friends.” Lisa Scherber says that she has seen examples of friends who have just given up on their friendship, because they were either afraid of doing something wrong, or simply found it easier to run away, and not have to deal with their friend’s cancer. Although you cannot control other people’s actions, you can continue to be supportive of your friend and all they are going through.

As a friend of someone with cancer, I know that it can be frustrating when others don’t seem to understand that you are also going through your own emotions. Joslyn says, “You have your own emotions around your friend, or around your friend being treated, and sometimes people forget that. Sometimes (it’s) just a matter of, I think, slowing down, and looking at all the things that are underneath, and all of the people’s feelings and just realizing that this is really difficult, but…you just have to keep going.”