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Discussing cancer: Online course offers tips to tackle tough conversations

Have you tried to talk to a friend or family member about cancer? It's not easy. You might have blurted out something offensive, offered advice you weren't quite sure about, or tried to minimize cancer's severity or prevalence. Or maybe you just avoided the conversation entirely.

Even those with medical training struggle with cancer discussions. In response, a London-based nonprofit has created a free online course called "Talking About Cancer", which offers strategies for discussing cancer risks, prevention and screening.

The three-hour course — which is designed for health-care workers, counselors, volunteers and others — is organized into short, self-paced modules made up of videos, quizzes, online discussions and role-playing with actors. I recently spoke with one of the course organizers, former journalist and Stanford alumni David Risser.

What does the course cover? 

The course quickly reviews cancer myths and facts, and then concentrates on how to have confident conversations about cancer prevention. It’s an important area, because more than four in ten cancer cases could be prevented by lifestyle changes. Another goal is to boost early diagnosis, by training people to encourage others to see a doctor.

We wanted to present an engaging course with varied activities, including a ‘real-life’ narrative that runs through the course. We hired improv actors to play two characters, Anita and Brian. Anita has health difficulties but is reluctant to see a doctor. Brian feels invincible, but has multiple habits — smoking, drinking too much, a poor diet, and even refusing to use sunscreen — that put him at higher risk... We were amazed at how strongly participants identified with the experiences of these characters, leading to passionate discussions about effective ways to talk about cancer.

The course is led by our cancer awareness trainers — two nurses with experience engaging doctors, nurses and people without medical training. It’s open now, but you must sign up by October 31. Otherwise, we plan to offer another free, public run of the course early next year.

What inspired you to get involved?

I am a Stanford graduate with a bachelor's in history, and a past managing editor of The Stanford Daily. I joined Cancer Research UK after a 28-year career in journalism, in part because of my own experience with several family members who have had cancer. I struggled to talk to one family member who didn’t seem to want to talk about her cancer. That made it easy for me to avoid talking about it, which wasn’t the ideal outcome.

It was also difficult to talk to another family member about being more proactive about her medical care, which was inadequate at the start. It’s still difficult to know whether or how to talk to friends about prevention.

What have you learned while working on this project?

I learned that there are widespread gaps in knowledge about cancer, from causes to treatments to chances of survival. For example, many people don’t know that obesity is the second most-preventable cause of cancer or that alcohol is linked to a range of cancers.

I think the most common mistake when talking about cancer is feeling you have to know everything. It’s more effective to say ‘I don’t know, how do you think we can find out?’ or `What have you thought about doing?’ than to avoid the subject, make pronouncements or communicate incorrect information. Another common mistake is failing to listen, listen, listen, rather than trying to fix everything. Sometimes it’s better to guide the person through what they are feeling and what they are concerned about, keeping it about them and not about you or your solutions. The bigger issue in both cases is to gently help people see what they can do that works for them.

While the course focuses on cancer information, prevention and early diagnosis, most of it is about how to have conversations about difficult subjects. The greatest lesson in the course is how to talk to people in ways that encourage behavior change. And that can save lives.

Previously: Education reduces anxiety about mammography and Oncology hashtag project aims to improve accuracy of online communication about cancer
Image by SerenaWong

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