Often, satisfying interpersonal communication is thought to be second nature, something that comes naturally to all people. After all, everyone is human and humans know how to speak to each other, right?

It would be convenient to think in this way and approach sensitive topics with such a simple outlook. It is not the human condition to instantly understand how to breach sensitive topics like a cancer diagnosis.

Cancer communication is not a straightforward subject to address and the skills that follow are meant to provoke thought and self-reflection. Before jumping into cancer-specific areas of communication, there are a few basic communication components that are foundational to the success of these enhancement materials.

Verbal Messages

Verbal messages are the words chosen or spoken. Another way to think of verbal messages is that they are communicated through language. The purpose of improving verbal messages is to tell and communicate better exactly what is thought or felt. Benefits include ensuring that there is no confusion or misunderstanding between two people. Without confusion or misunderstanding in a stressful situation, like a cancer diagnosis, conflict and distrust may be minimized.

As expressed in anecdotes around the website, many times a verbal message is not what a person really wanted to hear or what they meant to say. Discomfort and frustration are likely to arise when someone says something inappropriate for the situation. It also may be scary to tell a family of cancer or let siblings know that the father could suffer less in his final days of life. Eliminating this fear is never easy but can be done by necessity and determination. Determine how important it is to share the feelings and thoughts and muster the courage to verbalize them to the correct people. Plan what to say by making it brief, direct, and organized; starting with broad information and working into the details. Take advantage of silence. Unexpected or scary news is initially hard to digest.

Everyone has heard something that wrenches the heart and leaves many people speechless. Expect silence and give space to the person receiving the news.

Paraverbal Messages

Paraverbal messages are how words are said. Tone, pitch, and pace are included in this definition. Paraverbal messages are what make someone sound sincere versus fake, interested versus bored, and supportive versus unsupportive. Paraverbal parts of speech enhance communication of emotions, such as happiness and sadness. Because this is the part of speech that makes humans sound like humans and not robots, it is especially important to be aware of how they affect communication and listening.

Individuals that are very good at paraverbal speech have a great understanding of tone of voice, the pitch of voice, and pacing of speaking. Tones can be angry or happy and have great influence on the responses received. When speaking of sensitive topics it is best to consider a calm tone, a slower pace, and an appropriately animated pitch fluctuation.

Nonverbal Messages

Nonverbal messages are the body language involved in communication. Another way to define nonverbal messages is to think of them as communication other than spoken language. Nonverbal messages often show exactly how a person feels about the present situation. Expressing correct emotions and interest in conversation helps successfully encourage honesty and foster a comfortable speaking environment. Without honesty or comfort, a serious conversation may not achieve a level of resolve, which is important when the topic is about health and caregiving.

Valuable parts of nonverbal messages are posture, facial expression, eye contact, and gesture. From the start of a tough conversation, body orientation sets the stage for conversational success. For example, orienting towards the other person but not directly at them indicates interest without intimidation. Providing appropriate eye contact is another way to assure someone that what he or she is saying is important. On the other hand, too much eye contact can intimidate or be perceived as odd. One suggestion is to look between the corners of the eyes and the tip of the nose to make the other person more comfortable in a conversation. Lack of eye contact is a major consideration during a conversation. Ask why a person would not make eye contact and consider all possibilities.

Active Listening

Active listening is a combination of hearing and psychological involvement with the person talking. Listening is a skill someone may be very good at or visa a versa. No matter the skill level, listening can always be improved. Comprehending what another person is saying and being understood by them can improve a talk with meaning. During a cancer experience, listening well can help answer questions and keep stress levels low.

Being a good active listener is good for both sides of an equation. For instance, by paying attention to body language while speaking may be more effective in speech. Body language sends messages to a speaker that help determine how the other person is feeling about the information he or she is hearing.

Good active listeners are those that:

• make appropriate eye contact.
• wait for a break in conversation to speak instead of interrupting.
• pay attention to what is said, how it is said, and body language.
• listen with an open mind and see the story from others’ points of view.
• double check understanding by saying things like, “Just to make sure I understand…” and repeat what the other person said.
• ask questions to double check understanding of the other’s feelings.

This research project was funded by a grant from the National Cancer Institute (CA144235; Dr. Wayne Beach, San Diego State University, Principal Investigator). Co-investigators included Dr. David Dozier from San Diego State University, and Mary Buller, Dr. Valerie Myers, and Dr. David Buller from Klein Buendel, Inc.