Cancer Patients Reframe the Idea of ‘Looking Sick’

So many thoughts following Kate’s first public appearance of the year.

(Photo by Benjamin Cremel / AFP via Getty Images)

When Catherine, the Princess of Wales, stepped out for the first time this year at Trooping the Colour last weekend, the conversation quickly turned to how she looked. It was an inevitable discussion for such a visible public figure and one that has been on-going since the 42-year-old princess shared in March she had been diagnosed with an undisclosed form of cancer. 

On social media (and in my DMs), people began debating what it means to “look sick.” To be sure, So Many Thoughts is about someone’s style choices — not physical appearance. But this complicated conversation, with its royal roots, brought back a rush of feelings from my own mother. She was diagnosed with ovarian cancer at the age of 50. Her subsequent treatment had a dramatic effect on how she looked, which added to the strain of the last years of her life.

With all of this in mind, I read a column in the Telegraph by Allison Pearson. The headline, stripped across the front page of the Sunday edition, leaned on the My Fair Lady reference of the princess’s Trooping ensemble. But it was the first line of the story that left me aghast: “Thank you Princess of Wales for being an absolute trouper and attending Trooping the Colour on a cold, grey day,” Pearson wrote, “when lesser mortals with your illness would have stayed home, tucked up in their jim-jams.”

There are…no words. “Lesser mortals with your illness” are exactly the people I wanted to hear from in this moment. What were cancer patients thinking? What does “looking sick” mean to them? After putting out a request on Instagram, I received a flood of emails with deeply personal stories that moved me to tears. I am so grateful to everyone who was willing to share.

Below you will find insights from eight cancer patients. It was nearly impossible to narrow these down; I hope that the stories here offers a range of viewpoints and journeys. I asked everyone three questions. First, how cancer has affected your physical appearance and what has that meant to you? I also wanted to know what they thought seeing the Princess of Wales at Trooping the Colour as well as any advice they had for how to support someone in cancer treatment, especially when it comes to changes in their appearance. I learned so very much from these nuanced responses —and I hope you do, too. Keep scrolling for how cancer treatment has changed in recent years from an oncology physician assistant.

But mostly: This insight from Emily, who you will read more about below, sums it up so well: “Normalizing the diversity of cancer survivors’ experiences is one way we can all better empathize and advocate for more advanced research, stronger resources, and more equitable treatment.”

I hope we can continue this complicated conversation — in a thoughtful and careful way — in the comments of this newsletter. Please click below to share your thoughts.

Note: Comments are open to paid subscribers. If you have a first-hand cancer story you would like to share as part of this discussion, I am more than happy to comp your subscription. Please sign up for a free one first here and then send me a note at Hello@SoManyThoughts.com.

So Many Thoughts on What It Means to ‘Look Sick’

Please note: I asked everyone to share as little or as much as they would like. Some of these responses have been lightly edited or condensed.

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Corey

Age 35, New Jersey

Breast cancer (invasive ductal carcinoma), diagnosed in 2023

Cancer + physical appearance: I’ll never forget one of my hardest days of my cancer experience. I was recovering from my second chemo; my hair had just been shaved after falling out rather quickly. I was very focused on getting back to work part time to create some sense of normalcy and that was going to include wearing a wig. I work in pediatrics and am very patient-facing. I was nervous of how my appearance would impact those interactions and didn’t want to have to answer questions constantly. I felt a pressure to get “used to” wearing my wig before transitioning back to work. I decided a simple trip to the bagel shop would be a good chance to ease into it, to tolerate it for longer than looking in the mirror.

I went to the bagel shop — something I’ve done a million times, but this time wearing a wig. It was absolutely exhausting. The whole time I was there I was worried others were looking at me, noticing I looked different, noticing the wig wasn’t sitting just right. I got home and crawled into bed and cried for an hour. Something so simple had taken me a half hour to gather courage to go do and hours after processing and grieving. I wondered when even the smallest thing wasn’t going to feel big and take mental energy. I think of this often — you never know what someone next to you is going through or how your simple routine could be something big to them. 

The physical appearance of being a cancer patient feels so public. When you have no hair, people notice. Or when someone knows what you are going through — even without the hair aspect — you’re constantly being looked at, often out of kindness and worry, but also curiosity. All of a sudden others comment on how you look and how you seem. It’s hard to describe but when someone would comment about how great I looked, it almost felt like it was discounting how not-great I felt. If I looked good, there’s no way I could feel bad or I “shouldn’t” complain. It’s hard to explain but it’s an added pressure. It’s weird to have your physical appearance all of a sudden be talked about and analyzed.

Thoughts on the Princess of Wales: I felt such a mix of emotions. I found myself stopping myself from commenting or thinking about her appearance, because I know how that felt to me. I was glad that she felt well enough to hopefully enjoy the day but also sympathized with the likely fogginess and exhaustion she must feel; admittedly, I also had feelings of jealousy. 

Advice on supporting a cancer patient through changes in their physical appearance: Honestly, just don’t comment. But if you see someone with a very short haircut, throw them a compliment about how they’re pulling it off — it could be them regrowing their hair and that compliment will carry their confidence for weeks. ;)

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Jennifer

Age 53, Seattle, Washington

Stage IV colon cancer, diagnosed at age 46

Cancer + physical appearance: I have gone through two rounds of treating cancer. Overall, I have had 28 rounds of chemo, radiation, and four surgeries. During the first round of cancer, there were no changes to my physical appearance that were outwardly apparent — most significantly no hair loss. The second time, in addition to chemo, I had a treatment that caused severe acne and a rash, especially on the face.  On my torso, which can be covered by a one-piece bathing suit, are major scars from the surgeries.

The first time I had cancer was devastating, as my initial prognosis gave me less than 10% chance of surviving. Being able to maintain a normal physical appearance was the lifeline that me and my family needed. While there were many days that I was absolutely drained by the treatment, almost every day I did what I could to look my best. I personally needed to send a message to myself, and my children, that I was going to be okay. 

At my first meeting with my oncologist, I wore a favorite outfit, did my hair and make-up, because I wanted to show her that I was a healthy and strong 46-year-old mother who would do everything she needed me to do in order to beat the cancer. It was important for me to see myself, and for my children especially to see me, as someone who was not sick. This would often be confusing to friends and family who came to visit shortly after diagnosis and during treatment because I think they expected to see (and some admitted it) someone who looked terrible. I loved being able to go places and escape it and have no one know I was sick.

I had chemo and subsequent treatment during my recurrence. The side effect was a severe case of acne; I had it as bad as it gets. This was devastating. Not only was it painful, but I could not go anywhere in public without people staring at me. I couldn’t escape the constant reminder I had cancer. Worst of all, my poor children, especially my youngest daughter, couldn’t even look at me without crying. (Side note, after it cleared up and I had massive amounts of peeling, I think of it as the most expensive, invasive, and effective chemical peel one could have).

Thoughts on the Princess of Wales: Without knowing what type of chemotherapy treatment Princess Kate was going through, of course I was curious about how she may or may not be affected. I don’t know if I would have been surprised by anything, but I wasn’t surprised that she looked normal — and her normal is fantastic.  I saw someone — on a much grander scale given her role and the public eye she lives in — doing exactly what I had tried to do. Be myself, look my best (meaning my normal best) and show my family and community that I was strong, I intended to survive and, most importantly, show that I was the same person I was before cancer. I think Kate was showing to herself, just as much as to the world, that she intends to be well. In the world Kate lives in, that was a normal day.

We also have to understand that it can be hard for people affected by cancer to see someone also with cancer looking so great. So many factors beyond personal strength — support systems, access to healthcare, money, privilege — can make a difference and affect our situations and feelings.

What is wildly offensive to me is that anyone has the nerve to make any kind of assumption about medical treatments that anyone is going through and to see people doubting Kate has cancer because she didn’t lose her hair. To speculate and judge her because she looked great is also ridiculous. Did they want her to look awful? 

Advice: No one should make any assumptions about how cancer can make one feel or look and, more importantly, how they choose to face it. Someone said to me “You don’t look sick at all” in a tone that made me feel as if I had let them down because I didn’t look like I was dying.

A cancer diagnosis is gut-wrenching and the last thing we should have to do is explain ourselves to anyone. We do what we have to do to survive. There is no right or wrong way to fight cancer, only what is right for you.

PS: Remind people to get their colonoscopy if they are over 45. I was diagnosed at 46, relatively symptomless, two months before the screening age was lowered from 50 to 45. 

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Emily

Age 22, Chicago, Illinois

B-cell acute lymphoblastic leukemia, diagnosed in December 2023

Cancer + physical appearance: I found out I was pregnant last July, was diagnosed in December, and my baby was born in February (induced at 33.5 weeks to receive another round of chemo). I became unrecognizable to myself in every way. Hair, skin, bruising… I couldn’t even look in the mirror most days. All of this on top of pregnancy and postpartum changes.

Think of all the things about your appearance that helps others identify you — what makes you so unique and beautiful — not gone, but suddenly turned into the exact opposite in the blink of an eye. If chronic pain and illness on top of pregnancy/postpartum emotions wasn’t enough already, I had to deal with my appearance completely changing, too? Cancer and chemo should pick just one symptom and stick to it. It felt so unfair and sudden.

Although I did start noticing beautiful and unique things about myself that I would have never looked too closely at before: My face shape, eye shape, how many freckles I have on my head that I didn’t know about, etc. I learned how to find myself beautiful in other ways. I noticed my resilience and how nothing can stand in the way of me being the strongest mother I can be. Even with a platelet count of two and white blood cell count of 0.1.

Thoughts on the Princess of Wales: I see the fatigue from her fight being overpowered by her resilience. I see the hard changes she has had to get used to being overpowered by joy that comes deep from within. It’s something you truly have to go through to be able to see. There is no hiding anything when you have cancer, but a new form of beauty takes over in the place of what’s been temporarily lost. I wish nothing but healing and comfort for those who know what I am talking about. It’s an emotion that doesn’t have a name that most cancer patients recognize in themselves and others.

Advice: Comfort is a priority. At first you feel like wigs and/or makeup will make you or someone else feel better about their appearance. Then a new and bigger appreciation is found for things like lotion, dry mouth mouthwash, cat-shaped bandaids, and comfortable oversized T-shirts.

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Sara

Age 40, Boulder, Colorado

Hormone positive/HER-2 negative breast cancer, diagnosed in July 2023

Cancer + appearance: For the most part, no one who looked at me would have been able to tell that I was going through cancer treatment. I didn’t dramatically lose weight or change body composition. The treatment (chemo three times) was difficult and drained my energy. It wasn’t apparent to anyone on the street that I was going through something like that. 

Except for my hair. Once I chose to do chemo, my hair was probably the thing that stressed me out most consistently (yes, this stood in for other things I was stressed about but probably choosing not to think about). 

Even though it is expensive, I chose to do cold-capping. The treatment involves a rubbery cap that goes on your head and plugs into a machine and circulates cold liquid through channels in the cap. This is then covered by an insulating cap that looks like a soft helmet. I wore this while getting my chemo infusions for about three to four hours at a time. Cold capping is VERY uncomfortable because of how cold the liquid is; the goal is to constrict the capillaries on your scalp so that less of the chemo drugs get to your hair. (I also wore ice pack gloves and booties for the same effect to lessen the chance of peripheral neuropathy, or numbness in the extremities.)

For some people, cold capping feels like a brain freeze or a terrible headache. For me, it was mostly discomfort that made me nauseous, which my care team treated with an anti-anxiety drug. 

My first cold capping treatment during my first chemo round didn’t work correctly so it only got cool, not very cold. Despite this, I think I managed to keep about half of my hair. You could see how bare my scalp was, as I lost most of it on the front top and sides of my head. But I wore hats for many months and no one would notice if I didn’t take them off. As soon as I started losing my hair, about two weeks after my first chemo treatment, I cut my longer-than-shoulder-length hair into a chin-length bob because it was getting too tangled and easy to pull additional hair out. 

I finally cut off all my longer pre-chemo hair about two weeks ago, now that my hair has regrown enough that it looks like my hair is this short on purpose. My hair is about three inches long and has grown back in VERY curly — like full-on ringlets — when it used to just be wavy. I really hated it when I first trimmed it up a couple weeks ago. But I’m getting used to it and all my friends and family seem to genuinely like it, so that is helping me to accept it a bit more. 

Through the whole process, my hair has been a constant and very visible reminder that I’ve been going through some shit. All I wanted was for my hair to look “normal” so that I could pretend none of this was happening. I still feel that way, but as my new haircut is starting to grow on me I’m beginning to see this as a new chapter. I can’t undo the fact that I had cancer and will probably constantly worry that it will come back. But I can move into this next phase as healthy and forward-looking as possible. 

Thoughts on the Princess of Wales: My first thought was, “Oh, she looks the exact same.” And then I was extremely jealous that she was able to look that way. I know she has access to tremendous resources to look the way she does and I can logically understand how she’s able to look seemingly unscathed, but my gut reaction was annoyance that her hair still looked magnificent, followed by a lot of empathy for having to be in the public eye through all of this. I can’t imagine being a public figure and dealing with cancer. 

Advice: People will tell you it’s “just” hair and that it will grow back and it’s OK to be mad about this. Yes, their intentions are probably good — but you’re allowed to feel how you feel. It doesn’t matter how your body or appearance change, it matters that they do and that it wasn’t your choice to change them. It’s OK to mourn and be angry about what you’ve lost and what has changed. 

Also find the professionals that can help you feel as good as possible. I’ve never been one to spend money on my appearance but when most of my eyebrows fell out after chemo I started getting my brows done and now I happily (and am able to) pay for fantastic brows. My aesthetician is also a wonderful and warm person who has been so accepting and helpful.

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Jessica

Age 33, Idaho

Hodgkin Lymphoma, diagnosed the summer before my senior year of high school

Cancer + physical appearance: How much time do you have? Between the obvious, typical symptoms of losing my hair and steroid weight gain, it was the smaller details in between the lines that really impacted me as a teenager. Not only do you lose your hair, but you also lose your eyelashes and brows, making the puffiness from the steroids even more awkward looking. The physical weakness and bone-deep soreness made walking and moving normally feel foreign.

As a teenager, these physical changes felt especially traumatizing, and drew even more unwanted attention from my peers. The brain fog, general exhaustion and nausea didn’t help me fade into the background like I wanted to, either. Cancer becomes your entire identity — whether you want it to or not. Not only does it occupy all your thoughts, but it becomes all people want to talk about: How are you doing? How are you feeling? What treatment is next? It becomes exhausting to have your entire identity, once dynamic, zeroed into one, single detail. Even when you have a day where you feel well enough to pretend you are “normal,” it’s all people can focus on or bring up, which is a difficult symptom in its own right. 

Thoughts on the Princess of Wales: I feel deeply for her — the pressure she must be under to maintain appearances, to continue to be public facing, to continue a sense of normalcy. For her duties, her children, her public, for everyone. That carries so much weight. I didn’t have children when I underwent treatment, but I can imagine the mental and emotional toll it takes to “put on a brave face” for your kids. 

It’s impossible to know exactly what types of treatment she’s undergoing and what side effects those have on her personally, but regardless of the nitty gritty details, I can’t fathom having that amount of public dialogue about such a personal, tumultuous time in your life. It’s the true epitome of “Damned if you do, damned if you don’t” — particularly as a woman. She either looks lovely, and clearly “isn’t that sick,” or looks awful and deals with the resulting headlines. My heart really goes out to her.

Advice: Make it known you are there for them and are a safe space to talk, vent, unload, whatever the need may be. Then, let them bring it up. If they don’t, put the focus on something else. It’s hard, I know, because it feels like cancer touches everything in your life. You can’t exactly ask, “So, how’s work going?” when you know someone’s been missing work for chemo. But try to find a neutral, not-cancer topic. Let them feel normal for a bit if they so wish. If they do want to talk or process emotions, let them, if you have the space to. Don’t compare, don’t say “It could be worse,” don’t say “At least ____!” Just let it be what it is, and be there for them.

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Emily

Age 37, Los Angeles, California 

Breast cancer, diagnosed March 2019

Cancer + physical appearance: Most people probably wouldn’t know I was undergoing treatment if I didn’t tell them. Aside from radiation burns on my chest, I was fatigued and lost my appetite on some days. I didn’t experience too many outward facing physical changes. But emotionally — good golly miss Molly, that was a tidal wave of change. When you’re forced to look your own mortality in the eye, you see and experience everything differently from that moment on. I was not the same person after that. 

Thoughts on the Princess of Wales: We have no idea what Kate is going through. And maybe we’re asking the wrong question here. What if instead we elevated the conversation? A common misconception about cancer survivors is that we all go through the same things. That couldn’t be further from the truth. Normalizing the diversity of cancer survivors’ experiences is one way we can all better empathize and advocate for more advanced research, stronger resources, and more equitable treatment. Some days, we’re feeling great and can be out and about (maybe attend a Trooping the Colour). Others we don’t. But those experiences are no one’s but ours and, quite frankly, none of anyone else’s business. 

Hearing the words “you have cancer” bonds us all together in a way that very few experiences in this world will for most. But within this community, there are so many unique experiences and each one lends a stronger voice to the narrative. Each of us can make one less person feel less alone by sharing what we went through if and when we choose to do so. And maybe even inspire or educate someone who can help make real change for survivors everywhere. If Kate chooses to share her story, I will raise my hand alongside her and proudly support her. And if she chooses to hold it for herself, I will proudly support that, too.  

Advice: Here’s my advice [for cancer patients]: Don’t take advice. Everyone’s going to have an opinion about your treatment or your experience. Sometimes solicited. Oftentimes not. Learn to block out the noise. Find your people/community to help you through it. Lean on them when it gets hard because it will get hard. But outside of that, it’s about you and your doctors and your treatment plan. Those are the voices that matter. Focus your energy there. 

One last thing: When patients are diagnosed at younger ages, it’s scarier — no doubt about it. We often hear, “But you’re so young!” And guess what? We agree! But it also means (if we’re lucky) that we have a longer survivorhood journey ahead of us. That means that we will need different, longer, and more advanced resources, too. Cancer will shape how we show up in the world forever — how we talk about it with our loved ones, how we date, how we share with our friends, how we work, how we don’t work, how we parent, how we eat, how we shop, and how we advocate. The more we talk about these things, the more we can shed light on the areas where more help is needed for cancer survivors of all ages and stages. 

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Tara

Age 48, Nixa, Missouri 

Stage IV metastatic breast cancer with mets to my liver, diagnosed at the age of 35 

Cancer + physical appearance: As a result of the surgeries (lumpectomy and liver resection), I have scarring on my breast as well as my midsection and abdomen. I had complete hair loss (all over) from the two types of chemotherapy cocktails and small dot tattoos for the radiation markers. During treatment, I did lose weight, but my hair loss was the most significant as I had great hair. I had no eyebrows, little in the way of eyelashes and was completely bald. The no shaving was a small perk. 

Thoughts on the Princess of Wales: I was shocked and immediately thought “On my best day I never looked like that during any part of my treatment and especially chemotherapy!” I was taken back at how healthy, vibrant and NOT SICK she looked. The hair was on point as usual, the make up was impeccable as usual and her ensemble was so well put together …as usual! I was triggered by it all and had to stop looking at photos and videos. I wanted to post something on social media but did not. I wanted to vent to my friends how triggered I was about my own chemo treatment and how dare she. I was a young woman at the age of 35 when I was diagnosed. Not only did my hair not come back the same as it was before chemo (I had Princess of Wales type hair pre-cancer), I also lost my ability to have children. I was immediately envious and jealous.

Then I stopped. As a young woman with a lot of experiences with cancer (my parents have both battled cancer and terminal illnesses), I know every person is different. Every patient is different. Our bodies are all different and every patient is going to react differently to treatments and therapies. Each cancer case is different …as it should be! Personalized medicine, especially with cancer, is so important because everyone is different. Not all of the side effects are visible and she was absolutely correct in saying there are good days and bad. 

Perhaps the post made the day before, with a photo of her, was a preface of what was to come. Here she is feeling good and looking good, but reminding everyone that it’s not all about the side effects that are external. We should have expected her to “look normal” after that post. The nausea, the loss of appetite, the mental part of dealing with an illness is all part of the package and sometimes forgotten — out of sight, out of mind. 

All this to say, I allowed myself to have the reactions I was feeling to then have compassion for her as a person, as a woman, as a wife, as a daughter, who experienced this awful disease of cancer myself. 

Advice: I was most hard on myself when it came to my appearance. My husband, parents, family and friends were so extremely patient and comforting. I was/am fortunate. We cannot discount anyone’s experiences with cancer because it’s extremely personal. 

Be patient with your loved one going through cancer. If they ask you to go shopping with you for a wig or hats, try to be supportive and go because as hard as it may be for you, it’s harder for them. Do not focus on the hair loss, weight loss, or any other physical alterations they may suffer during treatment or post treatment. Scars fade but they do not disappear. We have to look at them everyday as reminders. Be sensitive and self aware of your own reactions and comments remembering that how someone feels internally is also important. Be present and keep in mind the smallest of gestures is appreciated. 

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Sarah

Age 46, New Jersey

Thyroid cancer, diagnosed in 2013

Cancer + physical appearance: I was diagnosed with an unusual case of a common cancer more than a decade ago. I’ve had 10 hours of surgery and two treatments but I have a little bit still in me and have been told I always will. I get scans and blood work regularly to make sure it’s not spreading.

I was sick for a while before being diagnosed and gained a bunch of weight. Nobody knew what was wrong and I felt a lot of helplessness and shame. In treatment, I didn’t lose hair or weight and only really “looked sick” in a way that strangers would recognize, while I dealt with a post-surgical infection and then for the year after surgery when I had a long and prominent scar. In many ways, I have little standing to say much about cancer and appearance. Many, many, many people have much much much more relevant and powerful stories.

Thoughts on the Princess of Wales: I don’t think it’s Catherine’s “responsibility” to “look sick” because that’s meaningless. But I DO think it was the responsibility of the press at the very least to consider how praising her for being a “trouper” (I get the pun, but still) unlike “many lesser mortals” would land. Just about all of us have had cancer or had a close loved one who has. Many of us have lost “lesser mortals.” Did they just not try hard enough?

I’ve had the extreme good fortune of not “looking like a cancer patient” but even that has come with judgment: What are you sad / scared / tired for? You look okay. I rapidly lost count of how many times I heard that “thyroid cancer is the good cancer” and floundered through explaining my situation.

Just this April, at a check-up, my doctor said, in passing, “Your original pathology was extremely worrisome.” I stopped her and had her say it again, because it was, to her surprise, reassuring. I wasn’t crazy. It had been a big deal, even when it didn’t “look” that way. Again, none of this is remotely on par with far worse treatment journeys. There just is no “good” or “easy” cancer. 

Advice: Ring Theory is a concept in grief counseling but it applies here too. Basically, offer support into the circle of people closer to the individual, and ask for help outward. Don’t ask the diagnosed person or their family to educate you, reassure you, encourage you, be sad or afraid with you. Get that somewhere else.

Showing you care is important — but it’s almost always better NOT to say something than to put your foot in your mouth. Be a calm, loving presence. You don’t have to say the thing that might shred what they have left of their composure that day.

And finally, follow the same five-second rule you (should) follow anywhere else: only comment on someone’s appearance if it’s something they can fix in five seconds or less.

Oh, my goodness. How to even begin to thank everyone here, and those of you who reached out via email? Thank you, THANK YOU. I am so grateful for your willingness to share such personal reflections. I hope we can all keep these stories in mind as this complicated conversation continues.

I want to close with insights from Jessica Eno, an oncology physician assistant in Boston, Mass., on the changes to cancer treatment in recent years:

“Cancer care has undergone drastic changes in the past ~15 years. In this time, there have been many huge breakthroughs that have veered away from the conventional chemotherapy that many people think about when cancer is diagnosed. When conventional chemotherapy is used, many times (not always — these are generalizations that don’t speak to everyone’s experience), the chemo drugs can be less harsh and the supportive medicines to help with side effects are much better. 

I bring all of this up mainly to point out that many patients don’t lose their hair (or cold caps help prevent it), aren’t as nauseous (or meds help keep it at bay), and/or don’t lose weight because they are able to control their nausea, etc. This means that many people dealing with cancer don’t look the way people expect them to when they hear the word ‘cancer.’ Many people walking through the world don’t look sick — and unfortunately, this can be a huge problem for patients when dealing with their illness, because there is a disconnect for both outside observers and patients themselves. 

The vast majority of my patients are treated with immunotherapy. This uses the immune system to fight the cancer and is often much better tolerated than chemotherapy: no hair loss, rarely any nausea, etc. I have patients that can be on this treatment for years and are carrying on with their daily lives by working full time, continuing to be a full-time caregiver, etc. In many cases, they decide not to tell coworkers about their diagnosis and no one would ever guess. 

However, the number one side effect of these medications is fatigue. We can help, but sometimes it can be severe. And this is where the disconnect comes in for friends, family members, and even for the patients themselves. They don’t look sick — and sometimes don’t even feel that sick — so why can’t they do everything they were doing pre-diagnosis? Looking at Kate, I have flashbacks to conversations with my patients, many who are young mothers who were active before their diagnosis. They often say to me ‘I used to be able to get up, work out, get the kids ready for school, go to work, and cook dinner without breaking a sweat, but now I am so tired.’ This is where you have to reframe the situation for both the patient and their family to explain that their body is working extremely hard to fight off their cancer. 

My final thought: We should never be commenting on a patient’s physical appearance, even when we mean it as a compliment. Saying ‘you don't look sick’ is often said as a compliment that we think will make people feel better — but what does it even mean to ‘look sick?’ There have been many times where patients tell me that they get compliments on their weight loss when, in reality, they lost weight because of their tumor or their horrible nausea. It's always best to ask someone going through a health crisis how they are feeling and to take the cues from them. And when all else fails, compliment their style choices instead. :)”

I couldn’t agree more. Take care, friends.