People often get comfort from talking to each other. Talking about something can also help you understand how you feel about living and coping with cancer. Discussing your fears or concerns can help put them into perspective. Talking about something important or personal produces a bond between people and this can help both of you to feel appreciated and supported. However, it can be difficult to know how to bring up the subject of something that is worrying you or a sensitive or embarrassing topic. Sometimes the person you want to talk to doesn’t want to talk.

The following things may help:

• Before talking to someone first think about who you want to talk to, and think about a suitable time and place to have the conversation.
• At the start and the end of the conversation tell the person if you do not want them to tell anyone else.
• If people ask you about your latest news, sometimes it is good to ask them what they last heard.
• When talking with others don’t be afraid to tell people what you need.
• You could tell the person you want to discuss issues related to your cancer. You could say something like, ‘I want to talk about things that are quite difficult.’ This lets your listener know that what follows is something that’s important to you.
• You could try to be specific when talking about the things that worry or concern you. You may find it easier to take things in stages. You can start talking about awkward subjects by saying something general, such as, ‘I’m worried about how things are at the moment’ and then it’s easier to go into particular areas.
• Say if you’ve been worrying about something. For example, you could say, ‘For the last few days, I’ve really been worrying about ...’. This lets the person listening to you know how important the issue is to you and they can focus on that.
• Check every now and then that the other person understands what you are saying. You can use any phrase you like, such as, ‘Do you see what I mean?’, ‘Does that make sense to you?’ or, ‘Do you understand?’
• You could make sure what you’ve said has been heard. At the end of the conversation, if you’ve asked for something to be done, it is worth summarising. For example, ‘So you’ll come with me to the appointment on Tuesday?’

Some people feel uncomfortable approaching doctors and nurses about the psychological and emotional impact of cancer, but your care and wellbeing is their priority. They are there to look after you and it is important you get what you need from the appointment. Describing all of your symptoms and concerns will enable them to give you the best help and support they can. Fear, worry, anxiety, guilt and other emotions are very common for people with cancer, and they will be used to supporting people with these problems.

The following may help you in talking to your GP, cancer doctor, nurse or other health professional:

• Prepare for your next appointment with your doctor or nurse by first thinking about what you want to get from the appointment then writing down questions that you want to ask.
• Ask the doctor or nurse to repeat and explain things you do not understand. Do not feel embarrassed: doctors and nurses know that they sometimes forget you are not as familiar with medical terms as they are.
• Describe your emotional and psychological concerns with them, such as fear, worry and guilt. Try to describe them in an honest, factual way.
• You may want to write down their answers or it may help if you take someone to the appointment with you. If you are worried or anxious, it can be difficult to remember what the doctor or nurse has said and your relative or friend can help to fill in the gaps.
• If you found a hospital appointment unsatisfactory consider talking to your hospital Patient Advice and Liaison Service, who can help you with any questions or concerns you have about any aspect of your treatment.
• Consider asking your health professional if you can record the conversation you have on your phone or a recording device. It may be helpful to revisit what they say after the appointment.
• To help reduce feelings of pressure or time limitations ask how long the appointment is for.
• If you think your emotional or psychological wellbeing needs have not been addressed, contact your CNS team.

If your employer knows you are having difficulties because of your cancer and its treatment, they can help by giving you information about your rights and make sure you have time off if you need it.

If your employer wishes to write to your doctor or health professional for whatever reason, remember your employer cannot do this without your permission.

The following things may help in talking to your employer:

• You could ask for a meeting with your employer and prepare in advance by writing down the issues you are having and questions that you want to ask.
• Describe the challenges you have at work and what you find difficult. Try to describe the problem in an honest, factual way.
• You may want to write down their answers or it may help if you take a colleague to the appointment with you. If you are feeling anxious or worried, it can be difficult to remember what is said and your colleague can help to fill in the gaps.
• Consider if you want to speak with the Human Resources (HR) department rather than your direct line manager. Human Resource departments may have a greater understanding of your employment rights in relation to illness and cancer.
• You can find information about your employment rights in relation to cancer here Employment rights | Macmillan Cancer Support or you can find your local citizens advice centre to ensure you understand what your rights at work are before speaking with your employer Citizens Advice. Remember, cancer is considered a disability and so your employer has to make reasonable adjustments to your role if needed. More information can be found at https://www.gov.uk/rights-disabled-person/employment.

Talking about cancer and the impact it has on you can be an important way to help you and those close to you cope. But some people rather just get on with life and find that doing normal everyday things and not discussing the cancer is the best way for them to cope. It is important to know that this is normal. In short, it is OK not to talk.

While you may not want to talk about your cancer, people you care about may want to. You could try to be open and honest with them and let them know that it is hard for you to talk and there may be a limit to how much you feel able to share. If you wish to communicate with someone but find talking difficult you could try writing a letter to them to explain how you are feeling. If people you have not seen for a while are concerned and ask how you are, you could answer briefly with a simple reply like "I am awaiting test results then I will know more about my treatments".

You may also want time with your family and friends when you don’t talk about your cancer, for example if you’re going out somewhere to enjoy yourselves. It’s OK to tell your friends that you’d rather not talk about your cancer today.

If you would like to talk, but not to someone you know, you could consider joining an online cancer forum which you can find out about here Can-Empower - Online Communities or contact the Macmillan free counselling service by calling 0808 258 3485 or following this link Macmillan Free Counselling Service.