Who Do I Tell About Life-Altering News?

Leaving the doctor's office after learning my most recent life-altering news, my mind spun with familiar questions. Having walked this road before—first as a caregiver to my husband and later through two separate previous breast cancer diagnoses—I recognized the uncertainty that comes in the first hours after receiving difficult news.

Yet one question immediately rose above all others: Who do I tell, if anyone, and in what order?

It was the same question my husband faced after learning the results of his surgery where the surgeon said probably two months to live. It was also the question I would ask myself after each of my own cancer diagnoses.

Tactic 1: Tell No One

My husband's answer was simple.

"Tell no one except my children and immediate family."

He didn't want to be treated differently in the community where we lived and worked. He didn't want every conversation to begin with cancer. He didn't want to hear endless predictions about how much time he had left.

Initially, his decision worked well.

Then, about six weeks later, a neighbor and good friend Lois approached me with a rumor she had heard about our marriage.

Residents in our townhome community had noticed that Bill was no longer going to the health club or coming and going from our home. In the absence of known information, speculation filled the vacuum. According to Lois, the rumor mill had concluded that our marriage was falling apart and that I had repeatedly thrown him out of the house.

She was genuinely concerned.

I was stunned.

Standing, holding my pruning shears, I had to make an immediate decision. Should I honor my husband's wish for privacy, or confide in a trusted friend in hopes of squelching this devastating rumor?

I chose the latter.

"If I tell you what's really happening, can you keep it confidential and help stop this rumor?"

"Absolutely," she assured me. "You can trust me."

The moment I spoke the words, I felt uneasy. I hadn't discussed this decision with my husband. But I was carrying the weight of his prognosis, the demands of caregiving, and the emotional exhaustion that comes with both.

Besides, I have never been a convincing liar.

Unfortunately, what began as a confidential conversation didn't stay private for long.

Soon, neighbors stopped me while I collected my mail, worked in my garden, or walked to my car. Questions about Bill's cancer seemed to come from every direction. The information continued to spread—to the health club, throughout our neighborhood, and eventually nearly everywhere we went.

Today as I walked home from my own doctor's appointment twenty years later, I remembered that experience and considered my options.

One possibility was to tell only close family members. I quickly dismissed it. Unlike when Bill was alive, I was now living alone in a town with no close relatives. I knew I would need the support of local friends and neighbors.

Tactic 2: TELL People AS I SEE THEM

My second option was the approach I had used during my first cancer diagnoses: tell family immediately then other people as I encountered them.

That strategy came with its own different challenges.

Once people learned about my diagnosis, most future conversations started with and revolved around cancer. Some wanted constant updates. Others shared stories of friends, relatives, or coworkers who had cancer. Many offered advice. And I was treated differently instantly.

What few people understand is that the diagnostic process is often long and uncertain. There are tests, follow-up tests, consultations, scans, and periods of endless waiting. Sometimes there simply isn't any news to report or isn’t sharable news.

Another complication is that people rarely hear the news at the same time. Beyond a few immediate phone calls, I typically shared information only when I saw someone in person. As a result, many people learned about my diagnosis second- or third-hand. A few expressed disappointment that I hadn't told them personally sooner.

What most don't realize is that announcing a life-altering diagnosis is not like planning a family vacation or a Fourth of July barbecue. There is no organized checklist. There is no communication plan. The person receiving the diagnosis is often still trying to understand it themselves.

Tactic 3: Spokesperson Disseminate Information

The third option was one I learned during my second cancer journey, and it proved to be the most effective.

I shared the news with a small number of trusted people from different parts of my life—family, friends, neighbors, social groups, and work connections—and asked if they would be willing to serve as information hubs about cancer questions for those circles.

This approach reduced the number of updates I needed to provide while allowing me to decide how much information each group received. My daughters knew everything. Other groups received only what I felt comfortable sharing.

More important, it gave me something a diagnosis often takes away: a sense of control.

A life-altering diagnosis disrupts every aspect of life.

Some people immediately throw themselves into work and activities as a distraction. Others withdraw into sadness and isolation. Many move back and forth between those extremes, sometimes within the same day.

There is no right way to process devastating news.

That is why we need to give people grace when they decide how, when, and with whom they share their situation. The order in which someone tells people is not a measure of love, trust, or importance. More often, it reflects what they are emotionally capable of managing in that moment.

This third diagnosis  was not as earth-shattering as my husband's prognosis or my first cancer diagnosis. Still, it reminded me of a quote I often share:

"There are some things I don't want to become an expert on."

Cancer is certainly one of them.

Today’s Tactic

Yet after supporting a husband who was told he would not survive and then facing cancer myself for a third time, I had learned many things about navigating difficult news.

One lesson was that I didn't have to make every decision immediately.

As my daughters called later that day from Washington, D.C., Orlando, and Dallas, I decided to wait a little longer before sharing the news more broadly.

Tomorrow would be soon enough.

For today on my birthday, I wanted to celebrate being alive and becoming one year older.