Reality TV star Katie Thurston, best known for her role on Season 17 of The Bachelorette, is facing Stage IV metastatic breast cancer at just 34. Since publicly revealing her diagnosis earlier this year, she’s received an outpouring of support—some heartfelt, others unintentionally hurtful.
“People keep telling me they know someone with the same diagnosis,” she says. “But then they follow it up with, ‘They passed away.’” While many mean well, comments like these highlight how difficult it can be to find the right words when someone you care about is facing cancer.
Experts say this kind of communication misstep is common. “It’s very difficult, unless you’ve been through it or have some frame of reference, to really know what to say,” says Dr. Felicity Harper, a clinical psychologist at the Karmanos Cancer Institute in Detroit. She hears it all the time from patients: “People don’t know how to talk to me.”
Harper recommends being direct and supportive without overstepping: “I heard about your diagnosis. I’m thinking of you, and I’m here for you.” A follow-up message a few weeks later helps show consistency, without pressuring the patient to respond.
Above all, avoid “toxic positivity,” Harper warns. Phrases like “You’ll beat this” or “Just stay positive” can leave patients feeling invalidated or guilty for not always being upbeat. “Cancer patients experience a huge range of emotions,” she says. “They don’t need you to fix it—they need space to feel it.”
Thurston agrees. “We need to be able to talk about hard things,” she says, including the possibility of not surviving. Yet many loved ones try to shut down those conversations, out of fear. “It’s more helpful to just say, ‘That must be so hard,’ and be there,” she explains.
Advice is another delicate area. Harper says patients often hear, “You should try this doctor or that treatment,” which implies they’re not doing enough. Instead, ask if they’re open to suggestions before offering any.
Even casual remarks can sting. “It’s just hair—it’ll grow back,” or “At least it’s a free boob job,” are common refrains for breast cancer patients. “It’s not just hair. It’s part of your identity,” Thurston says, adding that surgical and fertility decisions carry emotional weight that shouldn’t be dismissed.
Above all, silence can hurt most. “People disappear because they don’t know what to say,” Harper notes. But saying something, even imperfectly, is better than saying nothing at all. “Tell them, ‘I don’t know what to say, but I’m here,’” Harper suggests.
Practical help also goes a long way. From offering rides to oncology appointments to dropping off meals or helping with childcare, small gestures can have a big impact. “When people ask if I’d like dinner Thursday or Friday—that’s the kind of support that means the world,” Thurston says.
Ultimately, it’s not about saying the perfect thing—it’s about showing up, listening, and letting loved ones lead the conversation, even when it’s hard.
