In our ‘post-Christian’ world, it can take a life-threatening illness like cancer to compel many people to consider their own mortality. 

Cancer is just one of many serious and potentially life-threatening illnesses. So what’s special about cancer? Many people who have a brush with death of another kind talk about finding good in the midst of profound struggle. Yet there is something profoundly unsettling about the idea of cancer cells ‘invading the body’, of your body being at war with itself.

Sally Collings


"This is a time when, more than ever, you need to listen. Just listen. Don’t rush to offer solutions: a recurring theme for the people I interviewed forPositive was their passionate dislike for people saying ‘I know how you feel’."

The word ‘cancer’ is synonymous with death in most people’s minds, so a cancer diagnosis immediately forces you to face up to your own impermanence. 

Cancer reflects an essential characteristic of what it is to be human: we can be struck down by illness or injury. We are perishable, and one day our bodies will give out. Death seems to come as an enormous shock to us dwellers in the Western world, even though there is nothing more inevitable.

Dr Bruce Rumbold, a health sociologist and acting director of the palliative care unit at La Trobe University, says: "In a culture like ours, we live at arm’s length from the unpredictability and the horrors some people live with in Africa or the Middle East. Most of us can expect to live to an advanced age and we have somehow taken it as granted or as if it is our right. Increasingly, we are starting to hear stories of people who are quite offended when a loved one dies because their idea of medicine is that medicine should be able to save them. In other words, we haven’t really caught on to the idea that we all have to die."

For people without a spiritual or philosophical framework to live by, that concept may unveil a black chasm of terror. Yet after a cancer diagnosis many people reflect deeply and change their priorities, learning to live for today and hold on to what is most precious. They might throw in their job and start a new business; other people might take time to write about their experiences; some might make peace with their mother or their once-best friend. 

Writing in the New York Times, Abraham Verghese, a doctor, said of the HIV patients he had worked with: "Those patients whom I think of as having negotiated the illness most successfully were those who managed to use the illness to find meaning in their lives...They did not give up hope, but, instead, the nature of their hope changed; they wished for simpler things like a good night’s sleep or the strength to make a trip to a theme park with their children. In some cases, they seemed to live life more fully than the rest of us."

Does that mean it’s a great moment to evangelise? Tread carefully. It’s easy to look like an ambulance chaser, seeking to take advantage of another person’s weakened state. 

This is a time when, more than ever, you need to listen. Just listen. Don’t rush to offer solutions: a recurring theme for the people I interviewed for Positive was their passionate dislike for people saying ‘I know how you feel’. 

Many people interviewed in Positive were vehement about how painful it is, how angry it makes them feel, when well-meaning friends or family tell them to ‘be positive’. The last thing you need when you’ve been diagnosed with cancer, or someone close to you has cancer, is to feel pressured to be positive, think positive – to be superhuman. ‘Imposed positivity’ like that is light years away from an authentic positivity that starts from within.

After receiving a diagnosis of cancer, it is common to go through a cycle of emotions. Hospice founder and former chaplain Deirdre Hanna says of her own diagnosis: "I felt so alone, so isolated from the world around me; people were out there carrying on with their everyday business, and here was I. A big cloud had suddenly come down on me; I felt immersed in this cloud, it took me. I know enough to know it was the initial stages of grief, because a diagnosis brings great grief with it." 

The emotions that follow a cancer diagnosis can move from denial, anger, and depression to acceptance. Your response should respect the state that your friend, relative or colleague is in at that particular time. Don’t be surprised if next time you speak with them, they are in quite a different emotional space: people can move disconcertingly quickly from one stage to another. 

And at all times, the whole concept of ‘positives’ needs to be handled delicately. As author Stephanie Dowrick puts it, "people can be very critical of themselves or judgmental about others when it comes to crisis and how people 'ought' to respond. I would say that it is crucial to meet any loss or sorrow with a great deal of gentleness, kindness and patience, as well as compassion."

Sally Collings is the author of 'Positive', a collection of accounts from people who have seen good things emerge from their cancer journey. Sally is also the author of the bestselling 'Sophie’s Journey', and co-founder of Red Hill Publishing. Positive is published by HarperCollins Publishers Australia, RRP $27.99.