Most women going through the ordeal of breast cancer are prepared to lose their hair, their lunch, their memory, even their breasts -- but few are primed for the possibility they may also lose previously stalwart, tried and true friends in the process.

Fortunately, this doesn’t happen to everyone, since most friends are steadfast, but if you have already, or are now going through treatment and notice someone simply isn’t showing up like they used to, either physically or emotionally, you are not alone.

What makes a friend?

Perhaps it’s important to determine exactly what “friendship” means. Webster’s defines friendship as: one attached to another by affection; one that is not hostile; an acquaintance, or one who is of the same nation, party or group. You’ll note that “friend” isn’t necessarily someone who can handle what they perceive to be heavy-duty adversity. Although this may be what we long for in friendship, it may not be what we get. It may not even be what we should expect.

Cancer and its treatment is a transformational part of anyone’s life. For the patient, it often means enduring round after round of chemotherapy and/or radiation, vast uncertainty as to outcome, and continual worry about whether the treatments are and will continue working. As a result, the patient’s role with friends often changes dramatically.

A woman who formerly planned everything down to the umpteenth detail may now not care (or notice) whether things are done correctly. The life of the party may have temporarily become a party pooper. And the former leader of the pack may simply want someone else to blaze the trails. This shift can be as frustrating for the individual undergoing treatment as it is to those affected by it. And it’s glaringly obvious that these sorts of changes can test any relationship.

Whys and wherefores

The reasons someone goes missing during your time of need are as varied as the friends themselves. And while it hurts, it may help to consider the friend’s personality and circumstances.

A friend who is...	May feel...	...and therefore
A natural "fixer"	Ill-equipped emotionally, financially or physically to make a difference to you;	They're paralyzed to do anything.
A quiet "observer"	They'll say the wrong thing;	They may say nothing at all.
A genuine "worrier"	Afraid of your illness because it makes them vulnerable, too;	They don’t want to approach those feelings (or you).

In any of these cases, the friend will likely also feel ashamed to admit they are unsure how to help you. Some friends may even be angry with you on some level for not being the same person they befriended, without realizing this has occurred. And in the worst case scenario, we regret to say that they may be a totally self-absorbed so and so, one you are better off without.

So is there something that can be done to repair friendships worth keeping? There are certainly ways to try. Perhaps the most important step is opening up the lines of honest communication. Someone has to start the conversation, and as unfair as it seems, that someone may just have to be the person dealing with breast cancer.

Friendship Avenue runs both ways

If you are the patient (and you feel up to it) give them a call, send your friend an email or card and simply say “I miss you!” That’s all you need to convey. The ball is now in their court. If they value the friendship and are up to the task, you’ve given them an opening. Sometimes something as simple as allowing too much time to pass can create an awkward situation. Reaching out without challenging them about ‘why’ they haven’t been there for you, may allow your friend the opportunity to step back into your life without feeling like they have a lot of explaining to do.

The reverse is just as true. If you are the friend, it’s not too late to pick up the phone, or send an email or card filled with the exact same sentiment. I miss you says it all and goes a long way to letting a dear friend know you would like to reconnect. If your friend is still in treatment, see if there is something you can do to make life a bit easier for them. Have a favorite funny movie? Drop off a copy. Found a new recipe you enjoy? How about preparing it and taking it over? Depending upon your friend’s current condition, it can be as simple as a book on tape, a plant – or as elaborate as a spa day or girl’s night out.

With luck and time, many of these problems resolve themselves. Unfortunately, when you are in the midst of treatment you may sincerely wish someone would wise up – and show up – and they simply can’t. While this can be hurtful, it doesn’t help you to dwell on it. If there is one thing you can learn from breast cancer, it is to allow each person the grace to be exactly who they are in the here and now – not who you wish they could be. And remember, while you are granting this courtesy to others; be sure to allow yourself the same consideration.

Don’t forget, although breast cancer may make you feel like you’ve lost some friends, you have most likely discovered new ones along the way. Going through treatment, joining support groups, even sitting in waiting rooms puts you in touch with others facing similar experiences, which often provides the seed for a new friendship. Luckily, you now have the ability (and have definitely earned the right) to define exactly what being a friend means as you move forward in your life.

If you're having friendship troubles and want to talk about it, leave a note in our Discussion Forum.