Talking to tackle taboos with Macmillan: How to have difficult conversations around death and cancer

If you’ve recently been diagnosed with cancer, starting conversations around end of life planning and death can sometimes be an awkward and upsetting conversation to have. Sometimes when people hear ‘cancer’, they think ‘death sentence’. But this is often not the case - some people can live a long time with a diagnosis and some cancers may be curable. No matter your situation or what your prognosis is, these conversations can still be important to have.

As Sian says, “people feel as though talking about dying may ‘tempt fate’” and for many people, talking about death feels uncomfortable and ‘too morbid’. But once you begin, it’s often much simpler than you first thought.

Here are some conversation starters Sian has suggested to make opening up the conversation a little less overwhelming:

• Try discussing your ‘bucket list’

January is around the corner, and New Year’s Resolutions could be a good opportunity to talk about what you want to do in the year ahead. Maybe it’s going somewhere special on holiday, maybe it’s learning to play the guitar (it’s never too late to join a band!). And if you’re coming to this towards the end of the year, you could talk about what you’ve achieved in the year so far, to help open up conversations about the future.

• Talk about your favourite song

If your favourite song plays on the radio, or your favourite artist has popped up on your yearly Spotify wrap-up, talking about how you want a particular song to play at your funeral can be a way to open up conversations in a way that feels approachable. 

We suggest saying something like: “This is my favourite ever song. I would love to have it played at my funeral. What would yours be?”. Remember! This can be a two way conversation.

• Talk about your favourite movie, TV show a recent book or news article that shows death in an interesting way

Take prompts from the things around you. Your favourite tv show, an interview you saw, a film or even a news article you’ve read. If you’re a fan of the TV show Bridgerton or of Succession, you may have noticed how often things like wills and inheritance come up. This could be a good opener because it’s relatable and doesn’t feel too serious, whilst still being important.

We suggest something like “I’ve just finished this week’s episode of Succession and it got me thinking about who will take over my things when I’m gone”.

• Use a checklist or prompt

The Macmillan and Marie Curie websites both have incredibly helpful checklists of things you could do to plan ahead. Marie Curie also sells a set of conversation cards which are designed to get the conversation flowing. They help to share wishes whilst simultaneously learning more about family and friends. 

You can find useful information on the Macmillan website and in the Macmillan booklet ‘Talking about Cancer’. Marie Curie and Hospice UK’s Dying Matters websites are also invaluable sources of information.

Sometimes prognoses are difficult to give accurately and the vagueness around them can be tricky to navigate, especially when it comes to opening up conversations with loved ones. A prognosis is the likely course of a medical condition, most often given by a specialist doctor.

In general, Sian recommends having conversations about end of life planning sooner rather than later.

It can be helpful to focus on things that you want in your funeral wishes; what song you want to play, who you want to be there. At Farewill we’ve seen that family disputes, and even higher funeral costs, are more common when conversations around end of life planning, or writing a will, haven't happened.

The impact of having these conversations with family and friends can be mixed. Some people feel relieved, now that their loved one’s wishes are known and that the practical side of end of life planning has been sorted. Others may feel upset and angry that their loved one is thinking about dying, when they should be focusing on living and getting better.

Some people won’t want to have the conversation at all whereas others may start to think and reflect on their own end of life plans. 

Although the impact of these conversations may be different depending on who is having them, at Farewill we’ve seen how important they can be.

Talking early with our loved ones about what we’d like to happen when we or they die, can help with planning a funeral that really honours the wishes of the person who has died. This can often be a big comfort to their family and friends who are grieving.

And having these conversations with a loved one who has cancer can even feel empowering; you’re coming together to protect their last and final wishes. And it can make you feel less alone too. 

Don’t forget, whether you’re the person who has cancer or if you’re supporting someone through it, being kind to yourself is important. Reach out to family, friends and support networks to ask for help. Macmillan’s Support Line is open 8am-8pm, 7 days a week, for you to talk about how you’re feeling to one of their trained advisors.