“Dear Loved Ones” #1 – Setting the Expectations

By Rob Rutledge September 9, 2018

This is the first blog addressing the issues that arise between people who have a cancer diagnosis and their loved ones (family and friends, work colleagues and acquaintances). My hope is the advice and stories you’ll read here will help you have more harmonious and fulfilling relationships with the most important people in your lives.

Watch the video: Ask for What You Want

The effect of the cancer diagnosis on the loved ones is one of the most stressful aspects of getting a cancer diagnosis. At the start of our Skills for Healing Weekend Retreats we ask each person in the circle to tell us what’s been most difficult. The young mother stops midsentence, tearing up, she whispers “having to tell our children”. At least a quarter of those in the circle will add a variation of the theme of ‘I worry more about my family than myself’.

And the loved ones (those without a diagnosis). Bless you for even showing up. It’s so hard to see someone you love suffer. You are often sidelined. Feeling useless. Yet twisted and stretched with difficult emotions. This blog is for you too. In fact, we’ve found the teachings from our retreats to be so pertinent to human journey you can adapt what we offer here to your life beyond issues related to the cancer diagnosis. So let’s get to it.

Setting the Expectations

#1 Let people know how you want to be treated.

When my mom was diagnosed with an aggressive brain tumour I sent an email out to all my work colleagues letting them know what had happened. I told them to treat me like they always do ie to keep teasing me and generally be themselves. I told them I expected to appear in good spirits at times and quiet and sad at other times. And that my Mom wanted me to return to the work that I loved.

A dear friend of mine, a medical school classmate, sent a mass email out to all her friends and family explaining why she seemed so at peace after getting a bad breast cancer diagnosis. Being proactive about how she wanted to be treated gave her a greater sense of control, and made her time with others more enjoyable. Read that email in a chapter of our Healing Circle book here – or watch her interview at https://youtu.be/Jl0_cpF6Oj4.

P.S – Karen is completely well now 12 years later.

Advice on what to include in a group email

1 – Tell the whole truth of what has happened. Acceptance is powerful!

2 – Be open and vulnerable with your feelings. Authenticity is powerful!

3 – Tell people what you want from them. Examples:

  1. Practical help. Rides for kids. Prepared food. Walk the dog etc Might even assign a point person who can coordinate the help to save getting five lasagnas the first night.
  2. What you need psychologically. Maybe it’s quiet. Maybe it’s normality ie let’s do the same activities we’ve always done together. (send another email when your needs change).
  3. Optional: Tell them to continue to tell you the good things in their lives ie just because they see you looking crappy it’s OK for them to brag about their kids.
  4. Optional: Tell them it’s OK for them to be authentic with you. Ie give them permission to say “I feel upset” “this is awful” “I’m sorry this has happened” “I feel useless”.

4 – Tell them what you DON’T want (OPTIONAL to any of these)

  1. Don’t tell me stories about what someone else did to help themselves. I’m not interested in snake oil or other alternative medicine.
  2. Don’t tell me a story about someone who did poorly or about how the medical system let someone down
  3. Don’t tell me to be positive!

By writing an email you will be clarifying what you really need and want. The cancer diagnosis can give you the permission to redefine how you want to be as a person – and especially how you want to connect with others. Take this opportunity to set your boundaries, choose where you want to put your energy, and how you want to express your loving spirit in this world.

PS – I really need your stories of how you set your expectations with your loved ones (family members and friends are welcome to contribute!). What did you tell them you wanted, and what did you say/do when they did something you didn’t want ie how did you turn it around. Please send comments/emails so I can share your wisdom – please help me!


Dr. Rob Rutledge

Oncologist, Nova Scotia Cancer Centre

Associate Professor, Dalhousie University

CEO / Chair of HealingandCancer.org


Leanne smith says

Rob, so very grateful to you and Tim for your words of wisdom. The blog on "just stay positive " really helped me, I just wish I'd seen it sooner in Sam's journey.

After hearing yet another just be positive, in the depths of fear for my radiant boy, I actually put out a Facebook post telling friends and and family, and colleagues, as well as my boss, to stop assuming to know what we need. Just ask! We will tell you.... but please stop assuming!! If I hear the words "you just need to..." (fill in the blank) one more time, I may punch someone.

We are so very grateful to have met you , and benefited from your care of Sam. We carry you in our hearts, with gratitude and love. Leanne, Clark, Sally, and our warrior, Sam.

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