One of the most common problems in trying to help a person with cancer is that friends and relatives don't know where to start. They want to help, but don't know what to do first. In this section we'll use a logical plan that you can follow, which will help you to decide what can help most and where you can start.

It is important to first find out whether or not your help is wanted. If it is, make your offer. Your initial offer should be specific. It is best to say ‘Can I get you any shopping?’ or ‘Do you need me to pick up the children from school?’, instead of  'let me know if there's anything I can do'. It is also good to say clearly that you will check back to see if there are things you can help with.

Obviously, if you are the parent of a sick child or the partner of someone with cancer, you will know what they need and will not need to ask. However, in most other circumstances it is essential to know whether you are in the right position to help. Sometimes a distant friend or colleague is more welcome than a close relative. Don’t be upset if the patient does not seem to want your support. Don’t take it personally. If you are still keen to help, you could see if there are other family members who need support. After you have made your initial offer, it is good to check back with a few suggestions of what you could do.

To be useful to your friend, you may need some information about what the medical situation is. However, you probably only need basic information, and may not need all the details of their condition and treatment. Some people are very private and do not want other people to know all about their situation. However, they may let you know as much as you need in order to help them. An example is that they may let you know that they could be very tired for a few weeks after their treatment and that is when they may need help with housework, childcare or gardening.

Some helpers try to find out more and more details which are not necessarily relevant to their friend's situation. Sometimes this is because of their own curiosity; sometimes it is because they want to be in control of the situaution. Some people make suggestions to the person with cancer about things they should do, or treatments that they should try. This well-meaning advice can often put pressure on the person with the cancer and cause them stress, so it is best to offer advice only if the person asks for it.

You might want to collect more detailed information for your friend if they ask you to do so.

This means assessing the needs of the person who is ill and of the rest of their family. Naturally, any assessment is going to have to take account of uncertainty because the future may be difficult to predict. It is important to focus on the needs of the person who is ill. These will, of course, vary with the effect of the cancer at different times. Sometimes there will be no problems at all.

If the person has serious physical problems, there are some questions you might ask yourself.

• Who is going to look after them during the day?
• Can they get from their bed to the toilet?
• Can they prepare their own meals?
• Do they need medicines that they cannot take themselves?

It is important to think of other family members.

• Are there children who need to be taken to and from school?
• Is their partner medically fit or are there things that they need help with?
• Is their home suitable for looking after someone with the person's medical condition or are there changes that need to be made?
• Is there equipment that could help the person to do things more easily?
• Where can they get financial help if necessary?

You can check your list by going through a day in the life of your friend and thinking what they will need at each stage.

• What are you good at?
• Can you cook for your friend? Taking round pre-cooked frozen meals may be welcomed.
• Can you make meals for other family members?
• Are you handy around the house? Could you put up handrails or wheelchair ramps if needed? Could you house‑sit, so that their partner can visit them in hospital?
• Could you take the children out for the day to give the couple some time together?
• Would you be prepared to pay for, say, a cleaner for a half‑day a week to help out?
• Could you get relevant booklets or information for your friend?
• Can you find videos/CDs/DVDs that they like?
• Do they need the furniture rearranged (for instance, so that the patient can sleep on the ground floor because they cannot manage stairs.) If so, could you help them to do it?
• Will there be groceries (such as bread and milk) or flowers at home when the person gets out of hospital?
• Even a simple gesture such as offering family members a lift to and from hospital can be helpful.

Look at the list of the things you are prepared to do, and perhaps start off by offering a few of them. Offering all of them may overwhelm your friend. Pick some small tasks that are practical, that your friend might not be able to do for themselves easily. It is important that you are actually able to do whatever you offer to do and not aim to do too much.

It may need a little thought and some inside knowledge. For instance, one person, David, used to get his hair cut every week. It wasn't a big thing, but it was part of his regular routine. When he was in hospital, his friend Joseph arranged for the hospital barber to call weekly – it was a nice and thoughtful touch. There are lots of things like that: mowing the lawn when the person can’t, preparing meals, house-sitting and so on.

Time is a gift that you can always give. If you haven't already done so, read the section on sensitive listening. It can help to try to spend regular time with your friend. It is also good to think about whether in your circumstances you can spend ten or fifteen minutes once a day or every two days, or whether two hours once a month may be more realistic. The important thing is to be reliable and be there for your friend.

People with cancer are often encouraged to take someone with them when they see the doctor for the first time or for follow-up visits. If your friend wants you to be there you could offer to help them prepare for the appointment. Your friend may feel anxious when seeing the doctor and this makes it difficult to think of the right questions to ask. The following suggestions may be useful:

• Ask them to think about the questions that they want answered.
• Help them to organise and write out their questions.
• Suggest that they put their two or three most important questions at the top of the list, as time may be limited.
• During the appointment don't try and speak on behalf of your friend, unless she or he asks you to. Remember it is their questions that are important.
• Listen very carefully to the information and answers the doctor gives. It can also be helpful to take notes or to ask the doctor to record the conversation on a tape or an MP3 player. Otherwise, important details such as the date of the next appointment may be forgotten.

Your friend may find it difficult to take in all the information they are given, especially if they are given bad news. Afterwards you can help by reminding them of the information and the answers the doctor gave, as you are likely to remember things they have forgotten. Again, listening and being there to support your friend may be the most important help that you can give. You may find that you feel upset by the news given. Don't try and hide your feelings, but remember you are the person who is giving support. Later you may find it helpful to talk to someone close to you, or one of the support organisations, to get support for yourself. It can be helpful to ask for the phone number of a Macmillan Nurse or Clinical Nurse Specialist that you or your friend/relative can contact for more information later on.

Be fair to yourself and recognise your own limitations. You may really want to help your friend and this is understandable. It may be tempting to try to do more than you can really manage easily, but it is important to take care of yourself too and not to try to do too much. You can try getting other people to help with things that you would like to do but can't.

Supporting a person with cancer can be a very rewarding experience and can sometimes bring you closer together. However, it can also be very demanding and sometimes distressing.

If you feel that you need support yourself, in order to deal with some of the emotions or thoughts that you have, there are many services available to help you. Sometimes just talking to another supportive friend or family member can be enough. However, if you would like more in-depth support our support service nurses would be pleased to talk to you.

The Cancer Counselling Trust offers counselling to anyone affected by cancer. Supporting a person with cancer can be a difficult as well as a positive experience, and you do not need to feel that you have failed if you would like to have some support for yourself.

Going through this list in your mind can be helpful in dealing with a situation that may be unfamiliar to you. Whatever plans you make will certainly change as conditions change. It is important to be flexible and willing to learn as you go along, without feeling that you have to do everything perfectly.