How to Say Goodbye to Someone With Metastatic Breast Cancer

Patient Expert
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Someone close to you has advanced breast cancer. Maybe it’s a family member, perhaps a good friend, or someone who doesn’t fit the parameters of “good friend” but with whom you’ve become close through cancer treatment. The time has come when it’s apparent that all the good medical care in the world hasn’t taken away this person’s illness and, barring a miracle (medical or spiritual), they’re going to die. How do you deal — what do you say?


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Gauge their stage

First of all, carefully determine how the person is feeling. The worst thing you can do going in is to misinterpret the situation. Does your friend believe she’s dying? Has she accepted that fact, or is she pinning hopes on a clinical trial, a stronger round of chemo? Are family members or other friends trying to move her toward a decision to continue treatment — or to end it? If it’s not immediately apparent, a gentle question like “What does your future look like?” may give you your answer.


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Acceptance — then what?

If she’s accepted it, is this person bitter? Angry? At peace? All three (and more), depending on when you talk to her? At this point, listening is your best tool. If you let her talk, helping with simple prompts (e.g., “Tell me more about that”), you’ll eventually understand where your loved one is at in the journey — denial, anger, acceptance. And you can then identify how to connect in a positive way. Words can’t change the fact of death; but they can certainly soften the passage.


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Being angry is OK

If your friend or family member is angry, encourage her venting; she may have a tendency to shout and swear, while at the same time apologizing to you for her raw emotions or even “bad behavior.” Tell her you’re not upset by her anger, that you want to hear it. “Bring it on! Say every rotten, nasty thing you’re feeling!” Anger vented is anger dissipated.


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Hugs help

If your friend or family member is sad and tearful, you may both be comfortable not saying anything. While you’re sitting, give her a hug. Putting your arms around someone, drawing them into the warmth and comforting darkness of your body, can bring them back to their childhood, when Mom could fix anything with a hug. Touch truly is healing, and there’s no more genuine touch than a heartfelt, loving hug.


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Go ahead and cry

Crying is another form of venting; it’s not as violent as anger, but it’s just as powerful. Crying with someone – yes, you can cry, too – puts the sadness on the table. Have you heard the expression, “Worry shared is worry halved?” Crying with someone seems to accomplish the same thing, turning grief from a knot in the belly into a full-body experience, one that’s a gentle ache, rather than a fierce pain.


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Ask and listen

If your friend or family member is at peace with her death, you may want to gently ask her about what she thinks will happen after she’s gone: not to her body, but to her spirit. Does she believe that death is simply the absence of life, that it’s the final words in the novel: a literal “The End”? Honor that belief. Ask her to describe to you the good things she’s done in her life, the loving ways she’ll be remembered; the mark she’s made in the world, no matter how small.


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Does she believe in an afterlife?

Is this person religious? Ask her if she’d like you to pray with her; find out how she feels about heaven. Is she spiritual? Perhaps she’d like to describe her vision of the afterlife, which she can’t quite picture… If you sit quietly and listen, maybe prompt with some leading questions — “And what happens then? What does it feel like?” — you may be able to help her form a clearer picture in her mind, a place she can go to when the end comes closer.


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This all sounds good, but…

When you actually find yourself face to face (or on the phone, or even on e-mail) with a dying friend or family member, you may find yourself totally at a loss. Your voice won’t work, your fingers won’t move on the keyboard. This is absolutely natural. Death is terrifying to most of us; we usually hesitate even to say the word, preferring “pass away” or “going to a better place.” Understand this will happen to you — and be ready with a plan.


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Take the first step

If you’re face to face with your dying friend or family member, start with a hug. Look her in the eye. Then (and this applies to any situation, not just face-to-face), say something positive. Don’t say “I’m sorry;” that’s not only entirely self-evident, but also introduces sorrow to the situation. Or, “What can I do for you?” The answer may well be a dead-end “nothing.” Instead say, “I’m here for you. Say anything you want to me, or we can just sit together quietly. I’m bearing witness.”


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Laughter and love

If the situation seems right, tell a silly joke. Or maybe you share a funny family memory; recall it. Laughter ALWAYS helps. And most important, if you can, say “I love you.” As John Lennon sang so long ago, love is the answer — to so many of life’s situations. Even to death, the most powerful, difficult one of all.