Breaking Bad News

For the most part, there is no “right” or “wrong” way to break bad news about mesothelioma to others. But it is helpful to think through whom you want to tell, and how you want to tell them, before you start sharing the news beyond your spouse or other closest family member.

The people you tell about your mesothelioma will have many of the same questions that you do. So of course it’s important for you to become as well informed as possible about the facts of your mesothelioma and how you plan to approach treatment. It is very helpful if a spouse or other close family member can assist you in this process, attending medical visits, asking questions along with you, and taking notes about what your physicians and other mesothelioma care providers say. This will not only help with your own treatment and life planning, but will help you be ready to answer questions that are likely to arise when you begin to share the news with others. This second person can also be present when you tell others about your mesothelioma, to help provide additional information as needed.

The bad news that you are sharing will startle people—sometimes into saying things they wouldn’t say under normal circumstances. Some people will jump far ahead to the worst- or best-case outcomes, no matter how unrealistic. Others will become extremely emotional, perhaps even angry. Don’t be surprised by a wide range of reactions.

Who Needs to Know?

Because mesothelioma can have such a broad impact on the lives of mesothelioma patients and their families, a variety of people may need to know the latest about your illness. But not everyone will need to know the same level of detail. For instance, siblings, adult children and your dearest friends may want to help you as much as possible and to follow developments in your treatment closely—and so are likely to want the most information about mesothelioma and exactly how you are affected.

People you don’t know as well—some neighbors or coworkers, and acquaintances such as those at your place of worship—may require only minimal information (if any) and very basic responses when they ask, “How are you doing?” Keep in mind, however, that these people are often part a mesothelioma patient’s extended support network and could be very helpful with tasks like cooking, errands, transportation and more. The trick is to balance how much of your personal medical situation you wish to share with how much people will need to know in order to help you, or to adapt their own plans because of the illness. What you choose to share about your mesothelioma is up to you, but remember that most people care enough to ask for at least a few details.

Strategies for Telling

People who are learning about a serious situation such as breaking the bad news for mesothelioma, usually prefer to learn this in person or at least by a phone call. This allows them to hear and interpret your tone of voice when you discuss the situation, as well as to immediately ask questions that help them better understand the facts. Here are some ideas for how to prepare to tell others about your mesothelioma:

Make a list. It can be helpful to start a list of the people who need to know about your mesothelioma, their phone numbers, and what facts they need to know (since the level of information that’ needed will vary from one person to the next). It might also be helpful to note, for each person, how you expect your asbestos cancer or its treatment to affect that person.

Seek advice. Clergy members, mesothelioma cancer center counselors and nurses, and your friends and family members all can help you figure out who to tell about your cancer, and what to tell them. Don’t hesitate to call on professional or personal experts. Clergy members, for instance, can help you gain and share spiritual perspective, while a family member might be able to tell you how best to approach their children or whose circumstances make it unlikely that they will receive the news gracefully or be able to help you.

Be prepared to provide information. People closest to you will want to understand your mesothelioma in the greatest detail. Most people know very little about mesothelioma—so it may be helpful to share with them any printed material your doctor gave to you, or Internet links of reliable sites that discuss the disease and its implications. That way you can keep your explanation of the disease medically simple, and also focus on specifics that relate to your cancer case.

Expect questions. Besides basic medical questions, people will ask about how you specifically are affected, what your prognosis is, what treatments you face, and more. Decide how much you want to tell them, and whether you plan to set up some system to keep them informed.

Anticipate others’ needs. People you tell about mesothelioma diagnosis will also want to know, “How will this affect me?” Will they be asked to help with chores or medical visits? What will happen if you become severely disabled? How will scheduling and plans you’ve made together, such as for vacations, be impacted? Will you need help paying for such treatment? Try to think through the answers to such questions before they arise.

Keep in Mind

Everyone will respond differently. You might encounter a range of emotional reactions, from quiet calm to emotional outbursts. Be ready for anything. Also, some people—even those who aren’t very close to you—will require lots of information to understand what’ going on, while others will require less. Some people might need time to process the implications of the situation; others will know right away. It may be helpful to think of each person with whom you have to share this news, and anticipate how the person will react—and then how you will respond. Visualizing the conversation might also help you work through any emotional reactions you’re likely to have but which you’d rather not share with that person.

People want to help. Before you share bad news with others, consider compiling a list of things you expect to need help with. Perhaps it’ someone to take over your monthly bill paying or grocery shopping, providing transportation to doctor’ appointments, stocking your freezer with foods you can eat, or filling in as baby-sitter for the grandkids when you can’t. Don’t hesitate to ask. On the other hand, some people will never offer much in the way of help, or will offer it and never deliver it. Plan accordingly. And for those who really can’t provide any help or support, or only offer help that you don’t really need, you can always ask them to keep you and your family in their thoughts or prayers.

You can’t predict the future. And neither can your doctors. It’ important to tell people that when navigating asbestos cancers, both hope and realism are important tools.

Others will find out about your diagnosis. So decide ahead of time how you want to handle questions or comments from people you didn’t share the news with directly. (For instance, you could thank them for their concern and tell them it’ exhausting to share all the details with everyone but that so-and-so can keep them up-to-date on your situation).

Following Up

No matter whom you share bad news with, be sure to plan on follow-up conversations. That way, you can address other issues and concerns that have arisen after you and the other person have processed the information further. You can also provide updates on your treatment and other issues that have developed since your initial conversation.

Also, people you see regularly (such as at work, or at weekly or monthly meetings) will continue to ask, “How are you?” Providing them with a brief but honest answer—such as “I have surgery next week and am worried but optimistic”—is appropriate.