Heavy Meddle: Am I Obligated To Tell People I Have Cancer?

Welcome Meddleheads, to the column where your crazy meets my crazy! Please send your questions to advice@wbur.org. Right now. Not only will you immediately feel much better, you'll also get some advice.
Hugs,
Steve

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Dear Steve,

I was diagnosed with endometrial cancer (cancer of the uterine lining) almost two years ago. I kept everything under wraps and told only a very few people. I didn't want to be defined by the diagnosis and have a horror of pity. I didn't lie to anyone but I was pretty vague about some things in order to maintain my privacy. I chose not to pursue chemo or other conventional treatments and until about six months ago didn’t take any medication at all. Things are heating up and while I am confident of a positive outcome, I wonder at what point I should clue people in to my situation. When I say that only a tiny number of people know, I mean, like, 10, including my husband and immediate family. I am still not doing chemo or anything so there are no outward signs of illness.

I don't want my friends and family to be hurt or upset that they weren't aware of the situation but at the same time it might never be necessary to tell them at all. I am really torn and I feel like I have backed myself into a corner though I can't imagine having done it any differently. I should mention that while my husband and the people who do know respected my wishes and have been very protective of me, they didn't all agree with my decision to keep it to myself in the first place.

I didn't want to be defined by the diagnosis and have a horror of pity.

What is the best way to proceed? Continue as I am for a bit until I see what happens or start to clue people in? I own a small store and I worry about customers hearing about it and thinking that the store may close or being cornered with personal conversations while at work. I am afraid if I tell anyone it will be common knowledge in no time and that freaks me out.

My instinct is to just keep on as I am but I am afraid I am not totally clear mentally on the subject and I really don't want anyone to be upset. I'm not sure how I would feel were the situation reversed which is usually how I resolve these dilemmas.

I would appreciate your point of view on the subject.

Signed,
Keeping Mum

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Dear Keeping Mum,

You’re not a big fan of pity, so I’ll try to avoid platitudes. This is your illness and I can understand why you don’t want it to become community property, something that makes you That Poor Lady with Cancer. You’re absolutely right that some people are going to see you differently if they know you have cancer and get self-consciously pitying or solicitous around you. These people — and I’m one of them, so I should say “us people” — mean well. But cancer freaks us out. It’s this Sword of Damocles that hangs over all of us and when we find out someone has it our own fears and guilt go into overdrive. And thus we tend to direct various histrionic forms of sympathy toward That Poor Lady with Cancer. This only amplifies her sense that she is living outside the smug circle of the healthy. Thus the illness, which is already attacking your body, becomes a source of stigma as well. It sucks.

You don’t owe anyone a medical status report, especially if you sense that providing one is going to sap your energy, or try your patience.

So the short answer is: you should only tell the people you want to tell. You are the one with cancer. It is your business and the business of those you entrust to support you at this time. Period. You don’t owe anyone a medical status report, especially if you sense that providing one is going to sap your energy, or try your patience. I’ve spent enough time around people with cancer to know that their energies are better spent on matters more pressing than social niceties.

All that being said, the fact that things are “heating up” clearly has you mulling the situation. I’m not sure what “heating up” means, exactly, but it sounds like a code phrase for the unwelcome possibility that the effects of your disease may soon become more apparent to the world at large. You will then be left having to explain to certain people why you didn’t tell them sooner. They will be upset, or feel betrayed.

Here’s what I have to say about that: tough luck for them. To reiterate: you are the one with the life-threatening disease. This doesn’t mean you get to treat people like garbage. But it does mean that you can let yourself off the hook for misdemeanors, particularly ones committed on behalf of your own wellness. If it comes down to it, you can simply tell people what you’ve told me: that you didn’t want to be defined by your condition, or pitied, or stigmatized.

But I do want to introduce two other ideas worth thinking about. First, part of your reluctance to tell folks is about protecting yourself. Protecting both your peace of mind and your own identity. It’s clear that you’re a known figure in your community and interacting with people who don’t know you’re sick must provide a great deal of comfort. It’s a way of keeping the secret from yourself, if you know what I mean. Or maybe it would be more accurate to say that by keeping news of the disease under wraps you’re both limiting its “spread” and preserving the psychic possibility that it will simply go away.

In this sense, it may be significant that you’ve opted against conventional treatments, such as chemo and surgery — which is the most common course for endometrial cancer. As you yourself noted, forgoing these procedures has been one way that you’ve been able to conceal the cancer — from public view, and perhaps from yourself. But I hope that your reluctance to tell people isn’t symptomatic of an avoidance that could, in any way, deny or delay the treatment necessary to get you healthy again. I’m going to trust that those who do know about your cancer wouldn’t allow this. If you aren’t already, please consider talking with a therapist who can help you clarify your feelings about all this.

About the only good that can come out of a diagnosis like yours — aside from a full recovery — is the chance to see anew the splendor of your life, the many people who love and admire you and wish to be able to express those emotions as you face this challenge.

One final notion to think about. You talk about having a “horror of pity” which I completely get. Powerful, independent people tend to abhor pity because it’s condescending; it represents a posture of assumed vulnerability. And none of us like feeling vulnerable, especially when our bodies are under siege.

But here’s the ultimate truth, Mum. We are all vulnerable. The saddest part of the human arrangement is that disease and decay and finally death comes for all of us. And when it does, the biggest loss of all is that we don’t get to love anymore. So by all means avoid the leering pity of the masses. But please (please please) don’t shut out those who have genuine sympathy and love to bestow onto you. Don’t deprive yourself of the support you need in these coming months and years. About the only good that can come out of a diagnosis like yours — aside from a full recovery — is the chance to see anew the splendor of your life, the many people who love and admire you and wish to be able to express those emotions as you face this challenge. Letting them love you is a huge act of vulnerability. But it’s also the whole point of being alive.

Wishing you every good thing,
Steve

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Okay folks, now it's your turn. Did I get it right, or muck it up? Let me know in the comments section. And please do send your own question along, the more detailed the better. Even if I don't have a helpful response, chances are someone in the comments section will. Send your dilemmas via email.