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  • Debbie Kerr

You don't look like someone with cancer

Not everyone who has cancer looks the same, but many of us have an image in our heads about how that might look. Sometimes those mental images are wrong.

I didn’t realize I had a mental image of what someone should look like when they’re sick (not even with cancer) until I had children.

Suspicions about being sick

If you’re a parent, it’s that judgement call you have to make in the morning when one of your children says, “I don’t feel well.” With these fateful words, you put your hand on your child’s forehead to see if they’re warm. You pretend you’re a doctor and start asking for a list of symptoms. You look at your child with suspicion. At some point you might say, “You don’t look sick.” You send your child to school and then get a phone call from someone at the school to tell you that your child just threw up.

Personally, I can understand why a parent might be suspicious about a child claiming to be too sick to go to school. I can also understand why an employer might be suspicious about someone who repeatedly calls in sick on a Friday, especially when they never look sick on the Thursday. What I don’t fully understand is why, when a person tells someone they have cancer, the person responds with “You don’t look sick.”

How I looked with cancer

When I had cancer, no one told me I looked too good to have least not initially. There were the tell-tale signs of my hair falling out, being down one boob, and having drains hanging out of my body, but other than that I looked normal.

Once I had a prosthetic breast of some kind in place, a wig or hat on my head, and the drains removed, I looked like everyone else. In fact, I got so many compliments about my “haircut” that I stopped correcting people to tell them that it was a wig. I was too lazy to make a supreme effort to do a great job with make-up. I didn’t want to set the bar too high so that once my cancer treatments ended that I would have to maintain that high standard.

During tests and treatment, I pretty much looked the same as I did before cancer with the exception that now, ironically, I had better looking hair (wig).

Someone who looked too good to have cancer

I have a friend who has Stage 4 breast cancer that has metastasized to her bones and liver. She is constantly told that she doesn’t look sick. She wears her wig. She does her makeup. She wears clothes that are the perfect colour to compliment her complexion.

She does look good and frankly, when I’m with her, she’s the better looking of the two of us. Looking at her, you wouldn’t know:

  • She’s exhausted and sometimes having a shower means having to go back to bed for a nap.

  • She’s been through drug trials to find a treatment that will help deal with her cancer.

  • She’s celebrating because one of the spots on her liver has shrunk.

  • She’s got funny cancer stories that have made us laugh until we cried.

What many people don't realize is that by saying someone looks too good to be sick, they are dismissing what the person is really going through. It's like saying, "If you look this good then it can't be that bad."

Multiple Perspectives

Think back to those days when your children told you they were sick. You had to make a judgement call about whether or not your children were really sick. One decision meant your children didn’t have to go to school and you had to make arrangements for them to stay with someone. The other decision meant either teaching your children a lesson or having to pick them up at school during the day.

Children who are sick want to be believed. Parents who have been fooled in the past find it hard to take what children say at face value. There are two perspectives and it’s helpful if each person can understand and appreciate the other person’s view. 

To Family, Friends, and Medical Personnel

With cancer it’s totally different than when children want to stay home from school because they are sick.  There are no benefits to saying you have cancer when you really don’t. Yes, there are scam artists, who gain financially by pretending to be sick, but they are the exception and not likely the reason that family, friends, co-workers, will come up to you and say, “You don’t look sick.”

When cancer patients hear this phrase, they feel like they’re being told they’re lying and somehow they aren’t as sick as they claim to be. Since they look good they should be capable of doing more. They should be able to meet you for breakfast or pick up something for you at the store.  

Mentally and emotionally, if they look good and they are handling their cancer well, they are past the sick part of their cancer and they should be moving on. As someone who has had cancer, I know that dealing with cancer is a life-long process. Even if it goes away once, it doesn’t mean it won’t come back. When you think someone looks good, provide some balance to your comments. You have to acknowledge that the person may be feeling rough, but that they look good even through they are going through so much. This removes the feeling that you doubt that they are truly sick and still provides the compliment that might help the person’s self-image. 

To Cancer Patients

Sometimes when people say you don’t look sick they are actually trying to pay you a compliment. They are trying to tell you that the effort you put into your appearance has really paid off. You are looking good. They may also be using it as a coping mechanism so that the better you look the better you are from a cancer perspective. If you are getting better than they can feel less panicked and scared of losing you.  They may not know what to say and in trying to say something, they accidentally hurt you.

It’s also possible that they really are saying that you don’t look sick because they really don’t believe you are as sick as you say.  Between making the effort to look good and pushing yourself to do things you that are taxing for you, the people around you may think that you should get over it.

Only you can decide which category the comment belongs in. Don’t assume that comments about looking too good to be sick are attacks on your integrity, although it may be true.

​Be Positive

It’s better to state something in the positive so saying someone looks good is better than saying that they don’t look sick. Just like everything in life, balance is the key. For example, you could say, "I recognize that you are going through a lot right now, but I want you to know that you look good."


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