Don Wilhelm, a 4-time cancer survivor, has a great passage from his new book This Time’s a Charm.

One of the observations that I made throughout my days as a cancer patient is that most people have no idea how to treat you when they hear you have cancer. I think that they must assume you’re dying and that makes them very uncomfortable. They’re probably struggling with their own mortality. They fidget and look away as they talk to you. They offer their heart felt sympathy but you can tell in their head they’re saying things like, “Did that sound sincere enough? I hope he can’t tell how uncomfortable I am. Why didn’t anyone warn me about this before I ran into him? My God I hope he changes the topic soon.”

What’s even more noticeable than people’s uncomfortablness with cancer is that most people have questions they want to ask, but they are afraid to, so they don’t. It’s like they think that you may be embarrassed about your disease and they shouldn’t ask what they really want to know.

And without a doubt, there is one thing that people you run into, who know you have cancer, do more often than anything else. They lean in towards you, put their hand on your arm or shoulder, and say in a very slow and deliberate manner, “How…arrrrrre…you?” I now just have my own fun with them. My favorite response is, “Well, would you like the small-talk answer or the whole-truth-so-help-me-God one?” Then I quickly follow that up with a big reassuring smile and a, “I’m fine, thank you. How are you?”

This is one of the reasons I really debated whether or not I should talk about my cancer publicly. I didn’t tell anyone prior to the surgery except those that really needed to know – my wife, my immediate family, my business partner and a few other close friends. My hesitation had nothing to do with a desire to remain private, but because I am not looking for sympathy and that’s the reaction I expected. I really just didn’t want people to feel bad for me.

Once I learned that the cancer spread and I would need chemotherapy, I decided to write about it - I figured I needed to address the elephant in the room sooner rather than later. Perhaps more than that, though, I wanted to show them that I am a strong person with a loving wife and family and a world-class medical team and a curable cancer. I wanted to show that while I appreciate the outpouring of sympathy, I don’t need people to feel sorry for me.

As Don puts it, cancer makes people uncomfortable.

One of the subtleties of having cancer is that people that you meet/talk with are terrified of it. Have you ever had a scenario along these lines unfold? Let's say you're out boating and you meet someone new. Within a few moments of meeting them they ask, "What's the scar on your chest from?" They are referring to the scar where your surgeon has put your mediport implant for chemo infusion. Your mind searches for a way to inform them that you're a cancer patient, without making them uncomfortable and seeing "the look" on their face. You try with all your sincerity to tell them without evoking a response of pity and fear. No such luck, there's "the look."

One thing I have been most amazed about in this whole process so far is the outreach by other cancer survivors. It’s such a complex set of emotions and, now that I’m going through it, I’m really not sure I could have comprehended this before my diagnosis. I think a lot of this comes from the common understanding of this swirl of emotions: they can feel empathy, not just sympathy.

So, talk to me like you otherwise would. We don’t need to live in denial and pretend this isn’t happening. I’m comfortable talking about it but just as happy to talk about other things. I don’t consider myself a victim and don’t want you to either. I appreciate your thoughts, prayers, understanding and support – but the one thing I don’t want is pity.