Having cancer does not turn you into a different person. You still need love, companionship and fun. You may find that friends, family and partners become even more important to you, and are a vital source of help and support. In many cases your partner, children, parents, friends and colleagues may be waiting to take their cue from you about how much you want to talk about your illness and the treatment.

People who have cancer sometimes feel that a lot of responsibility lies with them, and that this is very unfair. It can seem as though you are the one who has to be strong. You may feel you have to start the difficult conversations and help friends and family members who are having problems in facing your illness, even though it is you who is ill. If you can talk openly, they will probably be relieved and able to respond. However, if you are unwell, or feeling low, it is very difficult to take on that burden. In spite of the difficulties, you will be getting back some control if you can manage to begin these conversations.

Our section on talking about your cancer suggests ways that you may be able to talk to your family and friends.

Serious illness affects relationships and many people find it difficult to know how to respond. You may find that people react in unexpected ways. Some may try to deny the seriousness of the situation by being inappropriately cheerful, preventing you from showing how you feel. Others may try to avoid you rather than risk saying the wrong thing.

Some people may completely avoid discussing your illness, and others may seem unsympathetic or even abrupt and rude. Your parents or your partner may irritate you by being overprotective and trying to ‘wrap you in cotton wool’. Sometimes partners try to protect each other from the truth by denying it, even though both are aware of what is really happening. If you can’t talk about your situation because you become emotional, you could try writing a letter for them to read at a quiet time.

Friends and close family can sometimes feel like strangers, just at the time when you need them most. It may help to remember that everyone is shocked by bad news.

'No matter how much your family and friends may love you, living with an ill person is not always easy. Nobody can truly imagine your distress, and you must not blame them for that.'

Your family and friends are also dealing with strong emotions and their initial reactions do not necessarily reflect their true feelings.

Our section on talking to someone with cancer is written for relatives and friends of people with cancer. It looks at some of the difficulties people may have when talking about cancer.

Talking about your feelings with your partner can help to support you both through the sadness, worry and uncertainty. You may find that your relationship is made stronger, and you can face the challenge of your illness together, if you can both be open about your feelings. When words fail you, or seem inadequate for a particular moment, just being together or having a hug can say as much, and sometimes more, than words.

There may be times when you don’t get on well together. Just at the time when you need each other most, the stresses of an uncertain future, or the difficulties and side effects of treatment, can put a strain on your relationship. You may find that problems are harder to resolve because you feel you have less time to consider compromises.

Anger can be a common problem for both yourself and your partner. It may help to relieve the stress if you give yourselves short breaks from each other, to think more calmly and ‘recharge your emotional batteries’. Sometimes talking to someone else – perhaps a friend or relative, or someone completely outside your situation, like a counsellor – can help. If this seems a sensible idea, it may be best to discuss it with your partner first, so that they don’t feel excluded or that they have failed you.

Our section called cancer, you and your partner addresses some of these issues.

There is no medical reason to stop having sex because you have cancer. Cancer is not catching, and sex of any sort will not make your cancer worse. In fact, a sexually loving relationship can generate warmth, comfort and a sense of well-being that can be very supportive.

You may find that your illness has no effect on your sex life. On the other hand, you may find that you can’t or do not want to have sex in the ways you did before you were ill. This may be because of the physical effects of the treatment or the disease; for example, because you feel too tired or sick, or because your worries make it difficult to feel enthusiastic about sex. It may be that the treatment (for example, surgery) has changed your appearance, which can make you feel self-conscious and inhibited about sex.

Your partner may also have concerns about your illness and its effect on your physical relationship; perhaps a fear of hurting you while making love. But you need not deny your sexual needs and desires.

There are many ways of sharing love and finding satisfaction. If you can be honest and open with your partner, you can help each other to find ways of expressing your love for each other. Intercourse is not the only kind of physically satisfying sex. Slow, sensual touching, stroking and kissing bring as much, and sometimes more, enjoyment. Cuddles and affectionate kisses can also show how much you care for someone, even if you don’t feel like having sex.

You do not need to feel guilty or embarrassed to ask for professional advice if you are having sexual problems. People with cancer have as much right to an active and satisfying sex life as anyone else. Your doctor or nurse may be able to advise you directly, or they can refer you and/or your partner for specialist counselling, if you think that would be helpful.

You may find it helpful to look at our section on sexuality and cancer.

It is never easy, and can be very painful, to talk to your children or grandchildren about cancer. It is probably best to be honest with them and to tell them that your cancer has come back or spread. Even very young children will sense when something serious is going on. However much you want to protect your children, if you pretend to them that everything is fine, they will feel that they have to keep their worries to themselves, and their fears may be far worse than the reality. They may feel isolated and excluded and not able to tell you how sad and upset they are.

Children may feel that they are in some way responsible for a parent's or grandparent’s illness. If you can discuss your cancer with them, you can reassure them that they are not.

How and what you tell your children will depend on their age and how much they can understand. It may be a good idea to choose a time to tell them when you, your partner, close friends or relatives can all be together, so that the children will know that there are other adults they can share their feelings with, and who will support them.

There is probably no need to go into too much medical detail. You can just explain simply about your illness, and the treatment you are having. It might be helpful to warn your children about how they may be affected – for example, that there will be days when you will feel too ill or tired to be able to play with them or join in their activities. If you have to go back into hospital, you can tell them how often you would like them to visit you and that they can write or telephone. If you talk a bit about your feelings, this may help them to express theirs.

You may find it helpful to look at our section on talking to children.

Children can react in many different ways to your illness, and some of these may be hard to deal with. For example, they may start to behave badly to cover up their feelings of insecurity. They may withdraw from you for fear of being hurt, or become very clingy because they are anxious that something might happen to you when they are not there. They may be angry and resentful that you are not able to do things with them in the way you used to.

Children will need lots of reassurance that your illness makes no difference to your love for them. They will also need reassurance on practical things – who will take and fetch them from school, for example, if you are not well enough to do so. It will help them if, as far as possible, their routines are not disturbed, and their daily lives continue as normally as you can manage.

Teenagers can have an especially hard time – they often experience a range of feelings in the same way that an adult does. At a time when they want more freedom, they may be asked to take on new responsibilities. It is important that they don’t feel over-burdened, and that they go on with their normal lives and still get the guidance they need.

If they find it hard to talk to you, it may help to encourage them to talk to someone close who can support and listen to them, such as a grandparent, family friend, teacher or counsellor. Other people may also need to be involved in supporting children and teenagers. They could include teachers, social workers, health visitors or counsellors.

'No child – toddler or teenager – can remember your illness all the time. Young people are not capable of carrying a constant burden of grief. They must be allowed to put it down sometimes and laugh with their friends like other youngsters, without older people feeling any resentment.'

Some friends and colleagues will feel unsure about how to talk to you and may leave it up to you to make the first move.

A quick phone call or email will show that you are keen and able to keep up social contact. You might start by saying something like: ‘I’m afraid I’ve had some bad news about my cancer, but the treatment seems to be going well (or 'I still feel quite well') and I would like to get out and see you.’

When you contact people you can tell them whatever you want about your health. You don’t have to go into great detail.

Obviously you won’t want to talk about your cancer all the time and you may rely on your friends to carry on as usual and distract you. They will probably welcome it if you can tell them what you want or need from them, whether it is help in the house; regular visits for a chat; their company on an outing; or driving you to hospital appointments.

However, there may be some friends or family members who back away from you because they feel that they can’t cope with the situation. This can be very painful. If your attempts to make contact have been rejected, you may have to try to accept that they feel this way and that there is nothing more you can do about it. However, it’s important to realise that the reason they are doing this is nothing to do with you, but is due to their own difficulties in dealing with your circumstances.

There may be times when you simply don’t want to see people and just want to be on your own. Also, there may be some well-meaning friends whose reactions to your illness upset you. You can allow other people to protect you: for example, let someone else go to the door, or answer the telephone. If you are in hospital you may want to limit the visitors you have. You can ask a relative or the nurses to help you with this. You don’t need to feel that you have to see people if you don’t want to or if you need time to yourself.

'I find one of the worst aspects is friends who think they are helping by offering platitudes, and also those who insist upon helping you cross the road when you don't need it, and seem to find it impossible to talk about anything else.'