Ask any random person to tell you the first two things that come to mind when they hear the word “cancer”. There are generally four categories of people, and their answers will differ enormously.
Category A: Actively Affected
Fortunately, this is still a rather small group, although the total diagnoses are increasing.[1] In Austria, roughly 1 in 22 people was living with cancer in 2025.[2] Even though the experience is different for each and every one, asking those affected about their thoughts will probably leave you with a lot of rather nasty words that are not suited for this article. I admit that I have even created a bunch of new swear words over the past 3.5 years I have been dealing with this disease that has changed my life in ways I never thought possible.
Category B: Passively Affected
This category is tricky, because it is comprised of a few subcategories.
(I) Healthcare Professionals and Researchers
Depending on who you ask within B-I, the answers will be very different. From “genetic mutation” to “increasingly treatable” I have heard pretty much anything, but most of the time, those belonging to this category will answer with a question and ask, “what kind of cancer?”, though. As part of Category A, I know why this inquiry is so relevant and why a lot of things that some other Category B-related people (mostly B-III and B-IV) have to say are not just hurtful, but also stupid.
Sidenote: I am immensely thankful for the work healthcare professionals and researchers do. My life – quite literally – depends on them.
(II) Friends and Family of Cancer Patients Type A
The ones who cook you a meal when you have no energy to stand up straight, who drive you to a doctor’s appointment so you don’t have to go alone, the people who really listen to you or just sit with you when you don’t want to be alone, and the ones you just know you don’t even have to ask for help because they’ll be there to support you anyway. They are rare but they are the best thing that can happen to you. Family members and friends within Category B-II will have similar answers than actively affected people, because they share their struggles.
(III) Friends and Family of Cancer Patients Type B
The relationship itself usually doesn’t determine if someone close to a cancer patient falls into Category B-II or B-III. I have found that there are generally three different reasons that are decisive: lack of knowledge, lack of intelligence, and lack of empathy. All of the above usually put people into B-III and I know from experience that it leaves you wondering why you had any form of relationship with the person in question in the first place.
There are people close to you who don’t shy away from offering unwanted advice. My favorites are those who have never held a medical textbook in hand and then tell you how you must cut sugar from your diet now that you were diagnosed because, according to them, everyone knows that sugar makes cancer cells grow. (Strangely, there’s always a reproachful undertone in the sense that “if you had only cut down on sugar earlier, none of this would have ever happened to you”. This is simply a lack of knowledge and, quite frankly, presumptuous.
Then there are people in your vicinity who don’t listen to anything you say and don’t even try to support you. They are there physically, but you could do without them just as well. Among those are the ones you have explained to about a hundred times that “You look so good, though” is not a suitable response when a person with cancer tells you they’re not feeling well, and they’ll still say it the 101st time. This is nothing other than a lack of empathy.
Last but not least there are people in your vicinity who turn out to have a maximum of about three functioning brain cells. When someone is talking to a person suffering from cancer and says something like “Oh my god, I know exactly how you feel. I had a sprained ankle once and it was hell not being able to walk in heels for a week” this is more than just an empathy-problem, this is pure stupidity and therefore a lack of intelligence.
(IV) Friends and Family of Cancer Patients Type C
The ones that vanish once they learn someone close to them has been diagnosed with cancer as if it were highly contagious. Usually these are people who have, up until that moment, connected cancer mainly to death (see Category C) and/or astrology (see Category D), and because they will just stay in hiding, you won’t even know what they have to say about cancer. Chances of them ever moving to a different category are slim, unless they suddenly decide to deal with this disease in more depth (highly unlikely) or they become associated with Category A through a diagnosis themselves (hopefully not).
Category C: Not Affected
Those who have never come in contact with cancer are lucky on the one hand, but often (a little) oblivious on the other. Lucky for them, they never had to deal with things like chemotherapy or radiation, but the problem is that not having this kind of insight can lead to behavior that is potentially offensive to Category A (and B). At the same time pretending that cancer doesn’t exist makes learning about it almost impossible, which is why Category C has a lot of perceptions that are wrong or opinions that are, for the most part, based on outdated information. This category of people will probably tell you that the word “cancer” makes them think about hair loss and death first.
Category D: Astrologists
Hearing the word “cancer” will trigger them to tell you all about how this star sign is family-oriented and caring. Good for them, that they live in a reality where a Cancer is simply someone better suited for a Gemini than a Leo (no idea if this is correct). And since this is certainly a minority, let’s not waste any time on them.
These categories show how vastly different certain groups within society perceive cancer. The word itself can trigger a variety of thoughts, depending on who you ask, and I know that everyone is entitled to their own truth. However, as part of Category A, I have to insist that scientific findings and first-hand experiences come before any other opinion, bit of advice, and so-called knowledge. What people think they know about cancer often has nothing to do with the actual reality of living with the disease. I am a 42-year-old living with metastatic cancer, and I promise you, nobody would assume I have a deadly disease. I still look like the healthy, happy adult I once was, but I have holes in my bones that sometimes make it almost impossible for me to walk. My cancer is invisible, but this doesn’t mean it’s not there. Because of what people see, though, many think I’m exaggerating when I talk about the severity of my diagnosis, they assume that I’m making up symptoms, and they wonder why I’m not working and discuss this behind my back.
Once you have to challenge someone’s truth, it always gets complicated. Navigating a life ruled by cancer is complicated enough, so that it’s just tiring having to explain how perceptions are sometimes wrong and how helpful it would be to just listen to the ones who know better. This is why I started writing about the duality of cancer. Thanks for reading!
[1] Global cancer statistics 2024: GLOBOCAN estimates of incidence and mortality worldwide for 34 cancers in 186 countries – IARC
[2] Around 409 000 people were living with cancer in Austria at the beginning of 2025
