Tough Conversations About Skin Cancer

Recently, some past Saturday Night Live comedy sketches have been invading my YouTube feed. One character has hit home with me: Debbie Downer. She is the death of the party, whether it be birthday celebrations or holiday fun, Debbie finds a way to squash conversations and kill the mood with her gloomy observations and questions.

I feel like a Debbie Downer

Sometimes, I feel like I am Debbie Downer when I am talking with people about skin cancer. Whether I am talking about prevention, diagnosis, or treatment, I can see others’ eyes glaze over. I feel them changing the subject or walking away from the conversation. I have begun to ask myself, "how can I make my conversations more productive?"

Having difficult conversations

About 20 years ago, I was introduced to a book called Difficult Conversations written by three professors at Harvard Law School. These authors/lawyers are part of the Harvard Negotiation Project, which has helped arbitrate and mediate high-level international negotiations producing peace treaties in the Middle East and Europe. In the book, the authors explain how to have better conversations about really anything that is awkward and difficult. I think this applies to conversations about skin cancer.

How to approach skin cancer as a topic

People have varying levels of concern and interest about skin cancer. I think it is like anything: you pay the most attention to what affects you the most. Difficult Conversations gives you tools to make conversations more productive. Accordingly, conversations can be broken down into three parts.

The “what happened?” conversation

We need to understand that people have different access to information about skin cancer and they pay attention to what is most interesting to them. It is important to ask questions about their level of understanding and where they get their information from before telling them what we think. Changing the posture from telling to learning puts us on better footing when it comes to connecting. Whether it be understanding SPF in sunscreen, recommendations for daily sun exposure, or pursuing treatment options, people may push back based on what they believe to be true. Listen first and then tell your thoughts.

The “feelings” conversation

Difficult subjects like cancer can trigger emotions, which will affect conversation and our ability to connect with people. People (including us) can become defensive, argumentative, despondent, or aloof based on these internal feelings. It is important to realize this and empathize. It is critical to be sensitive to how our advice about safe vacation options and surgical procedures can elicit feelings of insecurity and fear, which can derail any productive conversation, if not handled well. It is helpful also to share one’s own feelings when appropriate so that people will see that our thoughts are deeply seeded within us.

The “identity” conversation

Deep conversations often involve people’s understanding of their own identity. They can go to the core of what people think of themselves. For example, speaking to a parent who feels responsible for their children’s past sun exposure about skin cancer can trigger thoughts, such as “I was a terrible mom” or “I wished I was a better dad and spent more time with the kids.” These can elicit feelings that can change the course of a conversation in a hurry. When conversations hit deep, people may lose the ability to really engage productively and may not hear you at all.

Practice makes perfect

Handling difficult conversations takes some practice, especially in the age of soundbite emails and texts. It is a skill that may take some time to master, but I think it is worth the effort not just in talking about skin cancer issues, but in any sort of meaningful conversation. People come to us with thoughts, feelings, and deeply seeded self-identities that make it a worthwhile challenge in our advocacy efforts.

How do you approach talking about skin cancer with others? Tell us in the comments