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The Rudest Question You Can Ask About Someone With Cancer

October 26, 2010

My dad was recently diagnosed with throat cancer. Upon hearing the news, more than one person’s immediate response has been to ask, “Oh, did he smoke?”

In some ways, it’s a fair question. We know smoking can cause cancer, including lung cancers and throat cancers.

But it’s a question that is exceedingly rude and insensitive.

Yes, my dad smoked. He quit when I was a little girl, when his dad got lung cancer. He was already a teenager when the landmark Surgeon General’s report on smoking came out and grew up in a rural state where 20% of people still smoke today and tobacco was the number one cash crop.

That’s the thing: every time someone asks this question, it puts me in the position of excusing my dad, of providing a rationale for why he might have smoked. What this starts to sound like is,

“Because you asked if he smoked, I need to provide you with a rationale. You – a person who is not directly affected by the situation and probably hasn’t met my dad – deserve some sort of explanation about why my dad was so stupid and therefore deserves the cancer he is now suffering from.”

Surely that’s not what these questioners intend. I know that when faced with bad things, people like to find an explanation. They especially like the explanation that allows them to feel like they would never experience such a bad fate because they are too smart to suffer. As the family member of a cancer patient? I’m not even remotely interested in the being the mechanism other people use to dismiss their own fear of mortality, and I find it especially infuriating when anyone’s first reaction is to ask a question intended to solve their own personal anxiety: “Is there something dumb your dad did, that I would never do? I don’t have to worry about this, do I? Oh, good.”

It is not my job to be your source of abstract relief. I sure as hell don’t owe anybody a tool they can use to blame my dad for his own suffering.

Asking cancer patients if they ever smoked seems to be widely acceptable to many people who would never be so rude when people are suffering from other illnesses and misfortune. Did your mom die in a car wreck? Oh, did she drive every day? Tsk tsk. You know how dangerous driving is. Did a woman you know suffer serious illness or death in pregnancy or childbirth? She should have anticipated that possible bad outcome when she had sex. Had a seriously premature baby? You must not have done everything right. Have a heart attack? You should have exercised at least this many times per week for this long, you know.

In each of these scenarios, something *could* have been done to potentially avoid or delay the bad outcome. Perhaps these bad things don’t happen as often as smoking-related illnesses, but somehow people know it would be exceedingly rude to ask such questions when they *do* happen. As one author asks:

Are we to believe that death by cancer would be less tragic — would be, in fact, deserved — if the dearly departed inhaled a pack a day?

I haven’t yet figured out the best way to answer those who ask the dreaded question. I know for certain that I am not always going to have the mental energy to respond patiently, and yet it also seems unacceptable for the family members to explain why the question is so rude. You know, we’re just supposed to be grateful that anyone is expressing their sympathies at all. But folks shouldn’t be surprised if I answer their question with a question: “How will my answer to that question change how you are going to talk to me about this stressful family event?”

Or, on more stressful days, perhaps, “Why do you think you have a right to know?”

37 Comments leave one →
  1. October 26, 2010 10:38 am

    I’m so sorry to hear about your father and that you have to deal with people’s extreme insensitivity. Really, it blows my mind how self-absorbed some people are. Should we start asking people with other diseases what they might have done to cause them (overeating, lack of exercise, taking certain medications, etc)? It’s crazy.

    I wish you, your father, and your family the best in this difficult time.

  2. Lorrie Lewis permalink
    October 26, 2010 10:59 am

    Having been the niece of your father since I was around 8 or 9 years old and being almost 45 now, let me say that I can’t remember him smoking. Anyway, not that it matters, I just wanted to say that.
    Anyway, when I requested prayer for him at church, a lady came up after church and asked me that same question. Now, sometimes people think I’m being funny, but I was being serious when I said, ” Are you having sinus trouble today because you’re sure being nosey.” This is one of the same women that is trying to “pray the gay away” from my oldest daughter. I know how offensive and repulsive that has to be for you Rachel because you’re his daughter. I’m just his niece and it pissed me off royally.

  3. B Keeling permalink
    October 26, 2010 12:25 pm

    My mother died two years ago of lung cancer, no doubt brought on by smoking (which she was ashamed of, and hid), and when people have asked, “Did she smoke?” I have felt the same impatience and irritation you describe, especially when, after I say “Yes,” I see micro-expressions that I read as relief and smugness (blended with sympathy).

    Who among us does not do something that puts his or her life in jeopardy? Some smoke, some drink too much, some don’t get enough exercise, some drive recklessly, some eat the wrong foods, some take night walks in dangerous places. Now, why is it that we reserve our condescension for those who happen to die directly as a result of their particular gambles, while we let off the hook all those who engage in **exactly the same risky behavior** but who happen to die of unrelated causes? I agree with your analysis of the psychological basis for this unattractive human tendency.

    But your father lives, and may still beat the cancer. Best wishes to him, to you, and to your family.

    • October 26, 2010 12:37 pm

      Thank you. I’m sorry for your loss, and appreciate your comment.

  4. October 26, 2010 1:02 pm

    Love this post. As usual, you cut through the bull and get to the heart of things.

    I’m so sorry your dad has to deal with this sort of crap on top of throat cancer. Unfortunately there is the perception of good cancers: breast cancer – my genes are to blame! I’m a victim!; and bad cancers: liver cancer – you must be a heavy drinker and therefore you deserve what you got.

    You know what? Cancer is bad regardless of any lifestyle or history you may have, and no one should be judged or assumptions made about his or her medical predicament. So what if your dad smoked back in the day. Practically everyone did, but it still doesn’t mean that smoking caused his throat cancer or is related to his diagnosis in any way.

    Nothing brings out theworst (and best) in people like sharing a medical diagnosis or any other personal information.

    • October 26, 2010 1:45 pm

      Thanks, I appreciate the way you put that.

    • October 26, 2010 2:09 pm

      First, Rachel, I hope your father’s prognosis is good and that he has an easy time with treatment. In case good thoughts can really help, I am sending some his way, and your way, too, for the strength to bear a father’s bad illness.

      Second, yeah, the rudeness. And worse than the rudeness of letting those words out, the nastiness of mind that goes to that place first. Out of all places: they don’t think of “how is he doing?” or “will he need surgery or will chemo take care of it?” or “have you been able to go visit since he was diagnosed?” or anything human like that, the very first place they go is to blame? Nasty minds, those.

    • October 27, 2010 11:31 am

      Thanks, nm. Although it’s stage three, the docs are fairly optimistic based on where it has and hasn’t spread. Thanks for your good thoughts.

  5. michele permalink
    October 26, 2010 1:08 pm

    having a sick loved one is painful and exhausting but instead of being offended by people’s inquiry and feeling like you are responsible for easing their fears that it could happen to them, you should take the opportunity to educate people so that it really doesn’t happen to them. tell people your father smoked. tell people that this is what happens when people smoke. use this “family event” for good. instead of shutting people out, let them in, take their inquiries, even if the delivery of them is rude (the best way to diminish rude behavior is through education), and instead of replying with a sarcastic juvenile response of “what right do they have to know”, embrace that they do have a right to know. they have a right to learn from others. the best way to modify a health behavior is a cue to action and the best cue to action is having a tactile experience and in this case that’s you sharing your father’s story so that maybe they will not smoke and get cancer. perhaps if someone had given cues to action to your father and his father you wouldn’t be having this family event.

    • October 26, 2010 1:26 pm

      This, too, is exceptionally rude. People do *not* have a right to be educated by me, and they do not have a right to have personal questions answered just because they’re curious. Furthermore, if they are asking me, after finding out that my dad has cancer, if he smoked, then they are already well aware of the connection between smoking and cancer. It is completely inappropriate to insist that I have an obligation to use my family’s experience for the benefit of other people in a specific way as determined by you.

  6. October 26, 2010 1:24 pm

    Michele, but you can get throat cancer whether or not you smoke. So, why does Rachel owe them an education? They can look on Google and see any and all of the things that cause throat cancer.

    Really and truly, no one has the right to expect people who are suffering to meet their needs and, just my opinion, it’s disgusting and cruel to say that they do.

    Even if Rachel’s dad got cancer from smoking, cancer is not a punishment for smoking. He’s not repenting if he’s willing to reach out to others and keep them from going down his path.

    Cancer isn’t a sign of sin. We need to stop treating it as such.

  7. October 26, 2010 1:36 pm

    Thank you so much. Having gone through this with my mother, I always bristled at that comment and so did she.


  8. Coble permalink
    October 26, 2010 1:36 pm

    I am thunderstruck that people would be so RUDE. This? It’s one of the eight gajillion reasons I’m so anti anti-smoking. It’s like people have such a ghettoised view of smokers that they think such a response is okay.

    I’m so sorry for your dad. I know he’s got anasty road ahead.
    I’m sorry for you too.

  9. October 26, 2010 1:46 pm

    And just a note: I will moderate the heck out of further comments like michele’s. I really don’t feel the need to make a place for that sort of thing right now.

  10. October 26, 2010 2:58 pm

    Something I think I repressed until I read this: someone asked me the same question after my mom died of breast cancer. I think I answered, “No, and neither did her mom, who died of colon cancer. Her dad did and is still alive, so make of that what you will.”

    That shut her up.

    But still, talk about breathtakingly insensitive, intrusive, and flat-out rude. These days I don’t believe every question requires an answer, so I say “Why do you want to know?” when someone asks anything of me that I don’t appreciate being asked.

  11. October 26, 2010 9:49 pm

    Well said. I really like DanceDivam’s “Why do you want to know?” Puts it back on the rude questioner.

    Best wishes to you and your family.

  12. lilacsigil permalink
    October 26, 2010 11:14 pm

    What a repulsive thing to ask. I’m a cancer survivor and have been asked “Was it because of your weight?”

    I think it’s the same motivation that makes people try to find out what a rape victim did “wrong” – if they do everything right, surely it won’t happen to them? Surely? And, on the way to that false reassurance, they are causing pain to someone who is suffering, and continuing to ensure that all people are not treated equally and with respect.

    • October 27, 2010 11:29 am

      That’s an excellent parallel with rape, and the tendency to say, “well, if you hadn’t done this/been here/looked like this…”

  13. saraclark permalink
    October 27, 2010 10:27 am

    I am very sorry to hear about your Dad. If there is anything I can do to help or support you, please let me know. You have always been very helpful to me when I needed it.

    Thank you also for putting all of this into words in a way that I have always thought about but not been able to express. Whenever you or a friend or a family member has an illness or chronic condition, I have noticed that you do end up spending a lot of time explaining, disclaiming and educating everyone else about it and reassuring them instead of them reassuring you. You are right. I will also take your words to heart myself just in case I ever find myself doing this same thing to someone else.

    Cancer is not a punishment, it just is. It happens to all kinds of people all the time. Good Luck to your Dad for the best treatment he can get and the best health possible.

    • October 27, 2010 11:29 am

      Thank you. “Cancer is not a punishment, it just is.” -yes, this.

  14. October 27, 2010 10:43 am

    People want it to be something that the victim did, because then they don’t have to deal with the reality of a messy world where sometimes stuff just happens. It’s uncomfortable to be made aware of just how fragile and changeable life is. So we try desperately to find a connection, a logical explanation, a reason that makes the event non-random, predictable, deserved.

    And we often end up hurting people when we do this, as you’re being hurt now.

    Hope your dad recovers fully.

  15. October 27, 2010 11:33 am

    Thanks to you all for your comments and support.

  16. Rachel permalink
    October 28, 2010 3:07 pm


    I am so sorry to hear about your Dad. I too know how incredibly difficult it is for family members to be going through such a terrible thing…all too well.

    In some situations this question may very well be asked with the intent you stated, but I can’t help but wonder…. So many of my family and friends have been affected by this horrible disease at all different stages of life and I have found that even though I have had these experiences, I still find it so difficult to figure out what to say. Sometimes I think people just ask questions such as this because they don’t know what else to say. You can only tell someone so many times that you will be there for them any time that they need you and will keep them in your prayers. Maybe it is there way of talking it through, I know sometimes I wish I would have said different things…your blog is probably a good reminder to people out there to be a little bit more careful about the questions they ask. So thank you for bringing it to our attention. But be aware that maybe there might be someone like me out there that is trying to connect with you and can’t figure out what to say.

    Please don’t take this response as a way to say your feelings are not warranted, it is just something to think about. Sending strength your way!


    • October 31, 2010 5:49 pm

      I know, it’s definitely hard for people to know how to help. And it’s hard for people to know how to ask for help, too. I appreciate your comment.

  17. gked permalink
    October 29, 2010 9:11 pm

    I’m sorry to hear about your dad’s illness. I hope he makes a full recovery. Your post is a good reminder about what not to say. It can be so hard sometimes to know what to say.

  18. October 30, 2010 6:52 pm

    My first husband got lung cancer at 26 and he didn’t smoke. People tried very hard to figure out what he did wrong – but there was nothing. He was always grateful that he had no guilt on top of the physical trauma of treatment. These questions that state or imply that you did something wrong do cause damage.

  19. Sarah permalink
    October 31, 2010 1:27 pm

    Thank you for posting this. My dad was diagnosed in March. After telling friends, the first response I’d get is “does he smoke?”. I always felt like I have to defend my dad!! Yes, he was a social smoker. Yes, he quit 30 years ago. The only question I wanted to hear is “anything I can do for your family?” or simply “I’m so sorry”

    You eloquently verbalized my feelings. Thank you for that!!

  20. October 31, 2010 2:09 pm

    There’s a reason why we have two ears and one mouth

  21. Janis permalink
    November 6, 2010 11:14 am

    I am sorry for what your father and you and your family are going through. It is incredibly difficult to have a loved one be diagnosed with cancer and all that entails.
    I have a very different take on the diagnosis of lung cancer and smoking. My reaction is that they are one more person who has been taken advantage of and manipulated by the cigarette companies and that cost them their health at the very least. I know these thoughts don’t square with the current mantra of “personal responsibility”, but that is how I think of it. I prefer to place blame on the huge corporation rather than the individual, given the power differential.
    I hear the raw emotion and anger of many of the responses here, I have had similar feelings and responses. My father, a former smoker, was denied potentially life saving treatment because it was assumed, by doctors, that he had lung cancer because of a spot on his lung. He didn’t have lung cancer.
    We all try to do the best we can with difficult situations and respond as best we can. Sometimes we just don’t have the energy or reserves to educate those around us and that is okay. But when we do have the energy we can do one small part to help those around us understand and be more sensitive and perhaps not say hurtful things to the next person.
    We all say hurtful things from time to time, we must remember that, none of us are 100% sensitive 100% of the time.
    I hope your father does well, that he has a great health care team and that he survives this battle intact to fight another day.

  22. November 8, 2010 3:46 am

    My thought goes out to your family. Best of luck and may the Good Lord be with you.


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