We ask writer Natalie Bulmer what not to say when the worst happens...

This is a slightly different feature for us, But we felt it was an important one given the statistics around cancer. Ever been in a situation where somebody you know is going through treatment and been stuck for what to say? I asked one of the bravest people I know, Natalie Bulmer aka @nattyboobooo, Writer-editor, swimmer & horror-film lover to answer some questions about her cancer diagnosis, peoples reaction to it and the ongoing treatment.

I also asked her to give me some idea how those with no lived experience can show solidarity and support to someone living with cancer. We are going straight in at the deep end, I hope you find this as insightful as I did. Ps. Fuck Cancer

Natalie first of all thank you for agreeing to be featured, can I ask what your diagnosis was and when it all started?

I was diagnosed with a HPV cancer in May 2022 after finding a lump in my groin over Christmas and visiting the GP the first week of January. The diagnosis followed a biopsy, but it took another three months of scans, gynae ultrasounds, a lot of prodding and poking and me saying 'I THINK YOU NEED TO LOOK IN MY ASS' before they decided to treat me as an anal cancer patient. I started six weeks of chemoradiotherapy at the end of August that year.

What was people's initial reaction to your diagnosis? Tell us the best and worst and how that impacted you?

Shock I think, for the most part! Most people who were close to me knew I'd been investigating a lump I discovered a few months earlier but I don't think anyone (other than me) thought it could be cancer. Or maybe they did and just kept it to themselves. 

My best friend thought I was joking, but realised quite quickly that I wasn't. We were going to Brighton later that day and he cried on the train there. I remember thinking I need to take this seriously as I was still dry eyed at that point because it takes me a good 48 hours to process anything! 

There weren't really any 'worst' reactions other than a bit further down the line when they had finalised the treatment plan. A colleague at the time asked me if they found the primary source of disease and when I said yes, it's anal, he laughed!

If anything, after some initial internal debate over whether to share what the specific cancer was with people at work and wider circles, his reaction cemented what I felt was the right thing to do. I wanted to stop any stigma and internalised shame in its tracks and share it with anyone who asked. Not to mention quite a few people who didn't! Having cancer is bad enough, I'm not going to hide the specifics because it may make someone uncomfortable. 

You are incredibly open about your treatment, documenting a lot of your operations, recovery and hospital visits on social media. Was that for your own sanity or to avoid having to answer the same questions over and over to individuals?

In the early days it was more about making it easier for me to find others who might be going through similar experiences but it very much became a bit of a 'news bulletin' so that anybody who happened to be interested in what was happening or how I was doing would be able to see. Perhaps without feeling like they had to ask but also so I didn't have to hear the same questions from 20 plus people.

I also tell myself that maybe someone else out there with an anal cancer diagnosis will find me and they'll feel less alone.

Are there any words or phrases used by people who mean well but that really annoy / upset and what terminology would be better?

'AT LEAST' will always and forever be my most hated. I think we're very much conditioned to be positive, especially us Brits but there is a huge gaping chasm between natural optimism and forced positivity. Someone who's just had a huge life altering operation for a disease that can potentially kill them doesn't want to hear 'at least...' before you give them something they should be grateful for. The chances are, they absolutely ARE grateful that they're not dead but it's horribly minimising to be pointing that out.

Don't feel like you have to say something positive when responding to someone, you don't.

Sit with us in our pain -- that's far more helpful although I realise it's uncomfortable. I think it's also good to be honest with yourself about why you're saying what you're saying. A lot of the time it's likely because it makes you feel better, not the other person. 

Quite often when people do not know what to say, so instead they say nothing, Is that worse?

I personally think so. I know people struggle, particularly when I'm always banging on about what not to say but honestly, I'd rather someone checked in with me and then said something mildly irritating about looking on the 'bright side' than saying nothing at all. I've been completely ghosted by people I was close to and have known a long time and that is something I will never be able to comprehend.

Can you give examples of ways to show we care for someone around us who has received a diagnosis / going through treatment ?

I think there are so many ways. If you know the person well then you'll likely know where they find their joy -- send some of it their way! Even the tiniest reminder that someone is thinking about you makes a difference. Send flowers, gifts or food. Maybe memes or voice notes that they can engage with if they feel up to it. Go and see them! Take them away somewhere or for a meal. A friend's mum paid for us to go on a spa weekend and it really touched me. 

If you think you can handle accompanying someone to radiotherapy, chemo or appointments then offer! It can be useful to have someone else present even just to write notes, as you sure as shit won't remember a thing when you leave the room.

I can't begin to put into words how isolating this disease is -- it's important to share it if you're thinking about someone, even if it's just a 'Hi!' 

I see the pictures of you on social media, between treatments, looking amazing, all glamorous in heels and looking like you are having the time of your life, is there a misconception that because you look good, you feel good?

I feel like I've become known for ranting about this in my friendship circle but I was often told during the diagnostic stages, and even in treatment that I looked great so I'd probably be OK. Please remember that what people look like isn't necessarily a reflection of what's going on inside their bodies. Cancer in particular has a well documented 'face' and I can't think of anyone, including those I know with a stage 4 diagnosis, who fit into that aesthetic, but it doesn't mean they're 'fine.' 

Natalie is an ambassador for @cancerplatform Follow Natalie on Instagram @nattyboobooo