Madhu Neupane Bastola, Hong Kong Polytechnic University, and Margo Louise Turnbull, Hong Kong Polytechnic University
“It’s boiling hot. Why are you still wearing a wig?”
Such remarks may sound commonplace and are often not intended to cause harm. But for people living with cancer, it can affect mental well-being and undermine self-esteem. These kinds of comments are commonly referred to as verbal microaggressions.
Verbal microaggressions are harmful because they can erode confidence, reinforce internalised stigma, and make it harder for patients to trust in their recovery.
Such comments come not only from strangers but also from friends, family, and colleagues, who may also say things that can cause distress or lead to lasting emotional effects.
Verbal microaggressions look like
In a study conducted in Hong Kong, we interviewed 22 women diagnosed with cancer. Drawing on these findings and the lead author’s personal experience as a cancer survivor, we identified six common forms of verbal microaggression:
1. Appearance-based judgments
Cancer treatment often causes physical changes like hair loss, fatigue, and significant weight loss. Many patients struggle to accept these changes and try to hide them.
Sadly, these changes often lead to hurtful comments, such as:
“You look old and weak now.”
Instead of offering support, these comments can make people feel more insecure and more isolated from others.
IS TISSUE THE ISSUE?
2. Demand for explanations
Cancer patients often struggle with big questions like “Why me?” and “What did I do to get cancer?”
However, when others ask similar questions, it often adds to the pressure. Some participants in our study reported avoiding social interaction to escape such conversations.
One participant said:
“I’d rather be alone than have to answer questions like, ‘How are you feeling?’”
Another noted:
“I don’t want to talk to anybody because I can’t explain what’s going on with me.”
Yet, a 2024 study in Healthcare warns that withdrawing from social contact can negatively affect both physical health and mental well-being.
3. Doubts about capability
A cancer diagnosis and treatment often lead others to question whether a person can continue working. One common example:
“Are you still able to work?”
Though this may sound like a concern, it can undermine confidence and make patients feel less hopeful about recovery.
4. Assuming impending death
Some believe that cancer inevitably shortens life expectancy — a perception often reinforced by the media. This can prompt comments such as:
“Make the most of your time with family.”
While the sentiment may be kind, the implied message is:
“You do not have long left.”
These comments trigger anxiety. Participants in our study linked such remarks to sleep difficulties, panic, and heart palpitations.
5. Fear of contagion
The American Cancer Society clearly states that cancer is not an infectious disease. However, several patients described experiences where others avoided them out of fear, as though cancer were contagious.
One woman shared that someone once said:
“You need to clean yourself very thoroughly.”
This kind of remark implies fear of transmission and can be particularly hurtful when it comes from someone close.
6. Shallow empathy
Patients often find shallow empathy unhelpful. For example:
“I completely understand what you’re going through.”
Many say that unless someone has experienced cancer personally, they cannot fully grasp what it feels like — so comments like this often come across as insincere.
Build a more inclusive environment.
Cancer causes both physical and emotional strain. Patients often become more sensitive to what others say, and over-analyse social interactions. To help minimise the damage caused by verbal microaggressions, both patients and their communities can take action:
1. Join peer support groups
Connecting with other cancer patients helps build a sense of understanding and acceptance.
“I can talk to them about everything. Having a community that accepts you makes a big difference,” one participant told us.
2. Have empowering conversations
Cancer is only one part of a person’s life. It doesn’t need to dominate every conversation. Many participants appreciated talking about everyday topics.
They also found strength in supportive words, especially from fellow patients, such as:
“You’re strong. You can get through this.”
3. Provide practical support for the future
Cancer can create serious financial uncertainty. Patients often worry about their ability to return to work or remain employed.
Patients should feel empowered to speak with their employers. Employers and colleagues, in turn, should foster an inclusive environment, provide practical support, and ensure that the rights of cancer patients are upheld.
4. Avoid unhelpful interactions
Those without experience of cancer should avoid comments that, while well-meaning, may cause harm. For instance:
“I’m sorry to hear about your condition,”
or
“You look weak.”
Even mild remarks, when made without care, can cause distress.
We are all capable of unintentionally saying the wrong thing. Being more thoughtful and avoiding these examples of verbal microaggression can make a significant difference in how people with cancer experience social interactions.
By becoming more mindful of our words, we can help reduce the impact of microaggressions and create a safer, more inclusive environment for everyone.
This article was originally published in Indonesian, translated into English with the help of a machine translator, and further edited by human editors.
Madhu Neupane Bastola, Postdoctoral Fellow, Hong Kong Polytechnic University, and Margo Louise Turnbull, Assistant Professor of Health Communication, Hong Kong Polytechnic University
This article is republished from The Conversation under a Creative Commons license.
