My cancer story, like many others, started with a routine check-up. I turned 40 and dutifully scheduled my first mammogram. With no family history of breast cancer, I did not worry about the results. So when my doctor’s office left a message to call, I assumed it was about the insurance card mix-up on the day of my visit. A return mammogram led to a biopsy, which led to a lumpectomy, then a second lumpectomy, and eventually a bilateral mastectomy with reconstruction. It took six months from the mammogram to the final pathology, which determined that no further oncological treatment would be beneficial. I got lucky. Eleven years later, I am healthy.
Both the church I was serving as a parish associate and the church my husband was serving rallied, as churches do. Meals were brought. Cards and flowers sent. Visits were made. Our children had rides and playdates. After each surgery, I went back to work too soon, and people sent me home to rest. As stressful as the time was, the sharp memories have faded over time. Many in my current church have no idea I had cancer. Truthfully, my experience was a cakewalk next to some of their journeys.
I resisted the idea that I could write an article about how churches can care for people dealing with cancer. I’m no expert. I haven’t been through what many patients go through. I don’t specialize in pastoral care. Surely someone else is better equipped to help. Then I realized that these are some of the same worries people have when a friend or fellow church member is diagnosed. Too many, in fear of saying or doing the wrong thing, don’t offer any support at all in a time in which it is needed. So from my limited personal view, and with the insights of friends and colleagues, here are some best practices for congregations interested in cancer care.
Communication
A cancer diagnosis changes lives in an instant. Getting the word out — how, when and to whom — is a personal matter. Some people want the world to know, and appreciate help in telling them. Others want the diagnosis and treatment kept very private. The mantra in my house was this: “The one with cancer gets to decide.” Not everyone wants to be put on the prayer chain. When in doubt, ask. Church staff or friends can offer to help with communication by setting up a CaringBridge website or one similar (PostHope or CarePages). These websites allow the patient or family to update at their convenience. They also allow others a way to check in and offer words of support without needing to call or expecting a reply back. The patient and family control the flow of information; they read and respond when they are ready. Letting them decide what to tell and when provides a small amount of control in a time when much else seems out of their hands.
Connections
Churches can make valuable connections for members experiencing cancer. Teresa Wohlbruck has just completed a year of treatment for breast cancer. One of her pastors made a point of connecting her with another church member also in treatment with a similar diagnosis. They became friends after sharing time together in the Cancer Center, an unexpected blessing to both of them. A different church member connected Teresa with her doctor during the early frightening stage of diagnosis. Teresa now sees the gift of being a connection for others: “If having had this experience means that I can now help someone else, then it brings joy into this journey.”
Valuable connections within the community also happen through pastoral care networks in congregations. This can be the work of a particular staff member (like a parish nurse or pastoral care specialist) or through lay leaders. Lauren Smith serves as parish nurse at Myers Park Presbyterian Church in Charlotte, North Carolina. She says this about her role: “I utilize both church and community resources to help link patients and families to the care and support that they desire. That may be support that can be offered through the church’s pastoral care ministry teams (meal ministry team, care teams, Stephen ministry, clergy visitation and support, etc.), as well as through local community resources that may offer assistance specific to their individual medical needs.” The Presbyterian Health Network provides a starting place for congregations wanting resources to strengthen congregational health ministries.
She stresses the individual experience of cancer for patients and caregivers. “Much like the overall medical plan of care that must be individualized and customized to fit the unique needs of the individual that faces a cancer diagnosis, so must the support efforts of those who care for someone facing cancer. There is not a ‘one size fits all’ approach in what people find helpful.”
What to say and what not to say
In her book “If There’s Anything I Can Do: What You Can Do When Serious Illness Strikes,” Josephine Hicks reminds us that every situation is unique. She describes cancer as more of a roller coaster than a linear journey from point A to point B. Even what was helpful for one patient one day may not be what the same patient needs on a different day. Hicks writes honestly about what was helpful (and not) during her partner’s treatment for pancreatic cancer. From advice on the practical realities of offering food and flowers when appetites and sensitivity to smells might be heightened to how to phrase offers of help and prayers, the book is valuable resource.
Hicks shares a “hit parade” of things often said to cancer patients that are rarely helpful, such as: “You are so strong. You look so good. Be sure to stay positive. The treatments are all over; you must be so happy. It’s only hair; it will grow back. God only gives us as much as we can bear.” She reminds the reader that what patients or caregivers need, both practically and emotionally, may change from day to day. Listening, without trying to “fix it” and without blurting out platitudes, will be a gift. Hicks also provides some helpful insight on how a specific offer or action can be better than a general one. A call to say, “I’m at the grocery store right now, what can I bring you?” is more helpful than, “Let me know if you need anything.”
Helping others in the congregation know what is helpful (and what is not) is a teaching opportunity for church leaders. I’ve shared the following “ring theory of kvetching” with a number of anxious groups of friends of cancer patients. In a 2013 article in the Los Angeles Times, Susan Silk and Barry Goldman described their technique, born out of too many people saying the wrong thing at the wrong time to the wrong person during Susan’s cancer treatment.
Imagine a circle with concentric rings. In the center is the person at the center of the current trauma or treatment (the cancer patient). A larger circle around that one contains the person closest to them (a spouse or caregiver, perhaps). In a larger circle around that one are the next closest people (parents, children, etc.). The next circle contains closest friends, then one with more distant friends, and so on. They call this the “kvetching order.”
They explain the rules like this:
“The person in the center ring can say anything she wants to anyone, anywhere. She can kvetch and complain … curse the heavens and say, ‘Life is unfair’ and ‘Why me?’ That’s the one payoff for being in the center ring.
Everyone else can say those things too, but only to people in larger rings.
When you are talking to a person in a ring smaller than yours, someone closer to the center of the crisis, the goal is to help. … Ask yourself if what you are about to say is likely to provide comfort and support. If it isn’t, don’t say it.”
Following the rule of “comfort in, dump out,” friends and family can offer help and care to those in smaller rings by listening, offering food or support. They can still express their own fear or sadness with the situation – or discuss what they would do, and how they feel about it all – but only to those in a bigger ring.
Faith matters
If the church has anything unique to provide to families in the midst of cancer, it is our faith. My usual patterns of prayer were difficult in the midst of my own treatment. I found myself falling back on the Psalms, where lament and suffering had a voice. The gift of a prayer shawl from my mother-in-law’s church was an unexpected reminder that others were praying for me, even on days when my own well was dry. David Hare, who is several years out from his own treatment for cancer at the base of the tongue, said that while he prayed a lot during his treatment, it was the prayers of others that kept him going. A member of our church choir, David couldn’t sing (or eat really) during some painful months. He found solace in attending choir rehearsals anyway, hearing words of faith lifted up in song. He knew many people were praying for him, including our mission partners in Hungary whom he has visited on church trips. David says: “You can feel people praying for you. I really think you can.”
In one church I know, the congregation literally surrounded a pastor’s family in prayer during a transition from cancer care to hospice care. They gathered at the church manse, linked arms around the house, sang and prayed. Years later, the gathering is still remembered as a powerful testament of communal faith, by both the pastor’s family and members of the congregation.
In a moving collection of posts from his CaringBridge site published after his death in “Joy in the Journey: Finding Abundance in the Shadow of Death,” former Columbia Seminary president Steve Hayner wrote this: “I woke up one day this week and realized that I couldn’t locate anything like a genuine ‘faith’ inside me that would provide enough strength to pray or to reflect or to meditate. But then it occurred to me that I didn’t need any. God’s grace is not about me. So whatever God has for me is going to come from outside anyway. There are so many people who have asked us how they can help — and that morning I realized that they were helping by simply ‘being faith’ for me. They were welcoming God’s grace when I couldn’t even do that much.”
May we continue to “be faith” for one another in the midst of cancer.
JULIE COFFMAN HESTER is associate pastor for children and their families at Myers Park Presbyterian Church in Charlotte, North Carolina.
Editor’s note: Additional resources recommended by Julie Coffman Hester are “Journey into Day: Meditations for New Cancer Patients” by Rusty Freeman and the Presbyterian Health Network.
