A few days ago I discussed the tricky balance between accepting the realities of cancer vs. the need for hope with Joni Aldrich on The Cancer Support Network. As someone who has lived with cancer for the past twelve years, it wasn’t academic. Rather, it’s a constant, annoying companion.

Just as with everyone else, I also have an inherent desire to wish away the difficult things in life—especially the management of my prostate cancer. In conversations with other people coping with cancer I often hear “What if they didn’t get it all?” Folks say it whose cancer is described by the medical community either as “in remission” or “cured.” I hear it from people who just completed their treatment protocol and those who have lived with cancer for twenty years.

As a friend or family member of someone living with cancer, you try to be supportive. Those of us living with cancer often hear things such as “Let’s hope for the best,” or “Don’t worry, everything will be fine.” We know you say them with the best on intensions and a compassionate heart. We want to believe it, even when logic and facts say our cancer is a formidable opponent.

There is an important place for hope in coping with cancer. I do believe that the mind can affect the body and vice versa. But there are times when being a cheerleader isn’t helpful.

Support doesn’t always have to be in the form of hope. Often, the most meaningful action can be the quiet acceptance of what we are going through. One client said to me that the most positive event in her cancer journey was her husband just holding her hand after a debilitating chemotherapy treatment.

Living with cancer doesn’t require a sugar coating. The playwright Jean Anouilh said, “I like reality. It tastes like bread.” I don’t like cancer, but for me, being realistic about how to cope does taste like a great whole-wheat country loaf.