What Do You Say to Someone with Cancer?

On a recent muggy morning, I stepped into a crowded commuter train car and searched for an empty seat. Only one remained, next to a bald woman. As I settled onto the bench, she continued to stare forward. Whether she wasn’t concerned with what I was thinking of her or was simply pretending to be unaffected, I’ll never know.


As the train hurtled toward New York City, questions pummeled my mind: What kind of cancer does she have, and what’s her prognosis? Is she nauseated from chemo? Tired? Scared? And equally pressing: How did she decide not to wear a hat, scarf, or wig to work? And is she feeling self-conscious?


Reentering everyday life post hair loss from chemo isn’t easy. I know that firsthand. Even while inpatient for my initial leukemia treatments, I felt awkward about my bald head around the nurses, who understand and are accustomed to the look—unlike strangers on a train, or in a grocery store for that matter. The first time I grocery shopped post chemo, a curious eight-year-old girl trailed me from the produce aisle all the way to the freezer section.


Returning to work proved far more challenging than venturing out for groceries, physically, but also emotionally. First, I had to pass hundreds of sets of strangers’ eyes as I traveled by train, sidewalk, and subway to reach work. And then I had to spend the day with colleagues, who despite being very supportive didn’t enable the emotional protection that anonymity provides.


Early on, I decided I felt most comfortable wearing hats, and I developed quite a collection. But especially during the summer, they could only partially hide my insecurities. Every day, the questions thrummed in my brain: Are they wondering when I’ll die? Do they pity me? Do they think I’m ugly?



Eventually, my hair grew back, and my latest test results show I’m still in remission. My beautiful collection of hats is stored in the back of my closet, though I’ve been toying with wearing them as fashion accessories once my hair passes shoulder length. I’m at a different stage in my cancer journey than the woman who was sitting next to me that recent muggy morning, and thus I was able to contemplate her circumstances with a different perspective than when I’d been in her seat.


There’s no escaping the reality that a bald head signifies a cancer diagnosis, and that it will cause strangers (and friends) to wonder how the person’s doing. But what I’d missed before, when I’d been the bald one, is that these thoughts are driven by compassion. I longed for this stranger next to me to be rid of cancer, and I admired her strength and confidence. She was beautiful; both physically, as well as in her vulnerability and bravery. Just as intensely, I longed for her simply to have a good day. And while I couldn’t cure her cancer, I could give her a good start to that one day. But how?


The train neared Penn Station, and I contemplated what to say. How could I address her condition, both to wish her an easy recovery and to share that I’d been through it too, without being rude? Having been on the receiving end of a lot of awkward silences, as well as inappropriate comments, I fully appreciated the stickiness of the cancer topic. Yet I was determined to find a way. And then it hit me. I turned to face her, smiled, and said, “Four years ago, I had that same hairstyle.”


Ten minutes later, as we ascended the stairs from the train platform, we were still chatting. Hopefully she did have a good day.


by Shelley Nolden