Being There For Your Friend With Cancer

Finding out someone close to you has been diagnosed with cancer can be difficult.  We don’t want the people we love having to endure the symptoms of both the cancer itself and side of effects of treatment, and we definitely don’t want them to have to undergo it all alone. Knowing how to help and be the best friend possible during this time can feel a little confusing at times, but it’s arguably one of the most important times that you do!
We chose to interview Heidi Pen, a fellow Diva and friend who works with cancer patients on a daily basis, to get her thoughts on how to navigate being there for a friend battling cancer.  Heidi is one of the most thoughtful and caring professionals we’ve ever met, going above and beyond to take care of her patients and keep their spirits up. She gave us some amazing advice!
CSD: What is your job title and what does it entail?
Heidi: My job title is head nurse for Dr. Sai’s practice of Florida Cancer Specialists.  I am in charge of 4 other nurses and 2 pharmacies techs in our office. I do plenty of hands on care with the patients each day, but I also have management responsibilities as well. I run reports each day, look at upcoming staffing, budget, scheduling, etc. I also do prior authorizations to help get our patients’ meds covered. Dealing with insurance companies is definitely my least favorite part of my job. I have my bachelor’s degree in nursing and have worked with oncology patients for 24 years.
CSD: What do you love about your work? What do you find challenging?
Heidi: The patients are by far my favorite part of my job and always have been.
CSD: What do you find challenging about your job?
Heidi: I used to be a bone marrow transplant nurse for 21 years and losing so many young patients was extremely difficult. Towards the end, I was losing patients that were close to my own age or even much younger. Here, in Florida, my patients are obviously a lot older. We do have several younger breast cancer patients, but they definitely are the exception. I have lost many patients here as well, but they have been in their 70s or 80s. The most challenging part besides having patients die, is dealing with insurance companies who refuse to cover simple, basic meds! I do not have to get the chemotherapy approved. It’s usually low cost nausea meds or pain meds, which really makes me mad! If they are going to approve the treatment, they need to cover the supplemental meds that go with it.
CSD: What is a typical day like for someone undergoing cancer treatment?
Heidi: Unfortunately, there is no such thing as a typical day of treatment. There are literally 100’s of different medications and coordinating treatment plans. Chemotherapy can be oral, meaning patients take pills at home. Shots given in their arms or abdomen. IV treatment can be anywhere from a push over 5 minutes to an infusion which can last 8-9 hours. Shots are usually daily for 5 days in a row then 3 weeks off and then the cycle repeats itself. Infusions are either weekly or every 2-3 weeks.
CSD: How important is a cancer patient’s support network?
Heidi: It is extremely important to have a support system! So many times, I see patients come in who are elderly and do not have family nearby. Those people are definitely the sickest and most depressed. They give up earlier and usually do not have a good outcome. Those with a close family or who have good friends tend to live longer and have less side effects. When I worked in transplant, I could predict on admission who would do good and who would not. Obviously, cancer can take control over even those with a good support system. However, it’s proven that patients do much better when surrounded by family and friends.
CSD: People often say they aren’t sure how to talk about cancer when someone they know is diagnosed. What advice would you give to someone wanting to offer support? 
Heidi: Most patients tell me that they want their family and friends to still treat them like before they were diagnosed. Talk to them like normal and don’t treat them any differently. So many people tiptoe around the diagnosis because they don’t know what to say. Just be normal! Talk about yourselves as well. Now, I wouldn’t complain about stupid mundane things with someone struggling to survive, but they do want to be treated as though they are not sick. All of my patients ask about my family and ask where I am traveling to next. I feel silly bragging about my daughter or travels, but they honestly want to know about other things and not just diagnostic tests, blood work, treatment and prognosis. They do enjoy a break from reality! Now as end of life nears, they may want spiritual guidance and to just be heard. That is the time to listen and not talk about yourself.
CSD: What are the best gifts for someone undergoing treatment–such as things that help side effects, comfort items, uplifting items, etc?
Heidi: As far as gifts, I guess it depends on the person. Many patients have told me they liked when a friend just automatically did something for them instead of saying “ let me know if you need anything.” Most patients will not ask for help. However, when friends volunteered to run errands, watch their kids, brought a meal to them, it is always appreciated. Our chemo room is very small and really doesn’t accommodate guests, but I know the patients do like having someone with them for the 1st treatment.
CSD: What are some things a friend/new caregiver might not be prepared for during treatment? Are there any helpful tips?
Heidi: Things one may not be prepared for? Hmmm.. that’s a tough one. Maybe that patients often like alone time too. I had a patient that was inundated with visits and phone calls. She stated how thoughtful it was, but she was exhausted. She said she didn’t want to hurt anyone’s feelings, but that she was really tired and just wanted time to rest. Her friends were taking turns visiting with her and taking her on outings, but she really just  wanted to stay home. Fatigue is the #1 side effect from treatment and most people don’t realize that. I think most think that if patients aren’t nauseous or vomiting all of the time, they must be feeling ok. Not true! Fatigue can be very debilitating and patients need to conserve their energy.
CSD: Do you have any other advice for offering support to a friend with cancer?
Heidi:  Just be present, but not too overpowering. Patients need to know who their support system is and when they can count on them. Again, maybe make a meal and just deliver it. Don’t wait for the patient to ask for anything.  Small notes or texts are appreciated, but long phone calls are often overwhelming. I just had a patient on the phone the other day while she was receiving her chemotherapy. She must have spoken for 30 minutes and when she hung up she said “ she spoke the whole time about what was happening in her life and never once asked about me!”
Florida Cancer Specialists offer cancer treatment tailored to each individual. Their robust oncology and hematology services, as well as supporting disciplines like pathology, radiology, care management and home delivery pharmacy, RX to Go, all contribute to that personal approach to care. Dr. Padmaja Sai is Board Certified in Hematology and Medical Oncology and has participated in clinical research during her training and in her practice. She has also been a principal investigator for several research projects and is published in many peer review journals. (Source:

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