When a friend comes to us with bad news, we often struggle to find the right words. When a friend confides that they’ve just received a breast cancer diagnosis, we might struggle to find any words at all.

In the U.S., 1 in 8 women will be diagnosed with breast cancer in their lifetime. I should know—I’m that one in eight. The disease is more prevalent than asthma or diabetes, and the rate of breast cancer just surpassed lung cancer in 2021 for the first time.

When I told my close friends and family that I was diagnosed with breast cancer in 2019 at the age of 32, I encountered a range of reactions to the news. First off, let me just say that cancer makes everyone weird—especially when it’s cancer in young people. It stops us in our tracks, right? The dreaded C-word invokes emotions that can either compel someone to say things like, “hey, at least it’s the ‘good’ cancer” (whatever the heck that means) or “at least you’ll get a free boob job” (seriously, stop saying this! It’s not funny—it’s called reconstruction because they are trying to put something back together that has been damaged or removed).

Related: Pregnancy after breast cancer: What an expert wants you to know

Cancer can feel like an endless void that we sometimes think needs to be filled with whatever words come to mind in the moment. But here’s a tip: Let’s first make sure we are making room for empathy and compassion before we reach for platitudes and unsolicited advice.

Most reactions are well-intentioned and heartfelt at their core.  Believe me, I heard them all—and still do! But there are a few that I believe can be modified (or altogether tossed out) to make both the person facing this new diagnosis and their loving support group feel empowered to bridge the empathy divide.

How can a friend help take the burden off or help rebalance a few things? What can someone say to make matters better and not worse? Over the years, I’ve compiled a list of the top things to avoid saying, along with some alternatives to help support your friend through their diagnosis and treatment.

What to say to a friend diagnosed with breast cancer when you want to help

Don’t say: “Call me if you need anything.”

Don’t put the onus on the person with cancer. Saying things like this puts the responsibility of coming up with answers on the person with the traumatic experience, and just ends up causing them more stress. That’s unfair.

Instead, say: “I’m coming over with your favorite dessert!” or “I can take you to your next appointment.”

Be proactive and specific in thinking about how you can help your friend. Offer them tangible things to do together. Some really great examples include:

  • Offering to give them a ride to their next appointment.
  • Offering to take them to dinner, bringing them a meal or sending them their favorite dish from their favorite restaurant through a food delivery service.
  • Offering to help them with daily to-do’s, like walking the dog; if they have kids, entertaining them for an afternoon, doing the laundry or cleaning the house.
  • Offering to go on a walk if they’re up for it.
  • Starting a meal train.

Related: Breast health: 9 important facts every woman needs to know

When you’re trying to be supportive

Don’t say: “Everything is going to be OK,” or “Try to stay positive.”

Toxic positivity is a trigger for many people—it’s like showing up to a hurricane with a parasol (seems cute in theory but serves no real purpose). While you think you might be helping with these kinds of statements, you’re really just trivializing the gravity of someone’s experience. These sorts of sayings tend to instill false hope, and anyone beginning their cancer journey doesn’t know what the outcome will be. 

Instead, say: “No matter what, I will be here for you.”

Even if the outlook isn’t great, your friend will be immensely grateful to know they have someone by their side helping them through it.

But keep this in mind: If you promise to be your friend’s support system, you must mean it. That means checking in often, doing some of those tangible things I mentioned above, and giving your friend the opportunity to unload the emotional weight when they need it.

Related: My cancer diagnosis taught me I can’t protect my child from her feelings

When you’re trying to relate

Don’t say: “My grandmother/mother/other friend also had breast cancer.”

Although your intentions are good, don’t talk about someone else that you knew who went through cancer—especially if their experience wasn’t great. This is their story, their experience. Every person with breast cancer’s experience is unique and shouldn’t be compared against another’s.

Instead, say: “I can’t imagine what you’re going through right now—it must be extremely hard. Do you want to talk about it?”

Acknowledging the emotional and physical pain associated with cancer will mean more to your friend than you realize. Give them the space to talk about how they’re feeling.

Also, if your friend is open to talking, don’t be afraid to ask for specifics, not only about their diagnosis and treatment plan, but also how they want to handle the emotional toll that cancer has on them. Again, their experience with cancer is completely unique. While one friend or family member with breast cancer might prefer for you to only check in every once in a blue moon, another might ask you to check in more frequently.

Related: Katie Couric reveals she was diagnosed with breast cancer after missing a mammogram

When you see them

Don’t say: “But you don’t look like you have cancer.”

There’s a common misconception that all people with cancer have hair loss because of chemotherapy treatment or that we all look sickly. While this may be true for many cancer patients, it’s not true for all. All treatments differ. Some chemo treatments don’t, in fact, cause hair loss. And some treatments have side effects that are only noticeable to the person going through it.  Generalizing or commenting on appearances like this, or even sounding surprised that we still look the same can ‘other’ us and make us feel like an outlier. 

Better yet, any comments about our appearances can and should be avoided. 

Instead, say: “How are you feeling today?”

Drawing the attention inward and providing space for your friend to talk about their feelings is much more helpful. 

Remind your friend that they have a support system in you, their family and their extended group of friends. While treatment can sometimes feel isolating (especially during a pandemic), being there emotionally for your friend through thick and thin lets them know they’re not alone.

Related: How to perform a self breast exam and what to look out for

When they’ve completed surgery, chemo, radiation or any other form of treatment

Don’t say: “So you’re done with cancer!”

Survivorship has no beginning and end date.  For many cancer survivors, while life moves on post-active treatment, no one is ever really “done” with cancer.  We are constantly juggling a dueling dichotomy of emotions: devastation (and even disbelief) over “what the heck just happened to me” and the divinity of “wow, I just did that.” Cancer is always there—creeping in the back of our minds, incautiously unapologetic about the life plans it may or may not derail along the way. We can be both hyper-confident that modern medicine obliterated the last abnormal cell off our chests and simultaneously have pinholes of doubt that poke through—did they get it all? Sometimes it can feel like trying to move through life with your foot on the gas pedal and the brake at the same time. 

Instead, say: “How are you doing now?” or “How is survivorship treating you?” 

When it comes to supporting your friend with breast cancer, there is one common theme that pops up constantly: Understanding the difference between awareness and action. It’s one thing to check in right after their diagnosis, but it’s another to actually follow up on a regular basis and offer tangible support.

As a final piece of advice: Sometimes words can fail, and the best thing you can do is to show up, listen, offer your friend a hug and tell them you love them. When all else fails, just be there.

A version of this story was originally published on Oct. 27, 2021. It has been updated.