Issue 9 | December 2018
You can either love or dread spending time with your family over the holidays, but one thing is certain: if someone in your family has cancer, other people may struggle with what to say or how to handle their own emotions in the situation.

Susan Silk is a clinical psychologist who developed something called the  Ring Theory a simple template for how to act around people in a crisis situation. Her Ring Theory can help cancer patients and caregivers have a better understanding of how to navigate their emotional needs. This can come in particularly handy at Christmas!
How to Support a Loved One with Cancer Using Susan Silk’s Ring Theory
The Inspiration for the Ring Theory

The inspiration for the Ring Theory began when Susan Silk had breast cancer. She underwent surgery for it, and during her recovery in the hospital, Susan found that she didn’t feel like having visitors. This is a common feeling for many cancer patients – they’re exhausted by treatment or the emotional toll, and simply don’t have energy to give to others.

But Susan quickly learned that her friends didn’t necessarily understand this. When she tried explaining to a colleague, who had come to visit, that she just wasn’t in the mood, it didn’t go well: her colleague responded by saying to Susan, “This isn’t about you!” Meaning that, Susan’s needs were a lower priority that those of her visiting friends’.

We can see almost immediately that this was not the right thing to say to a cancer patient! And it probably put a lot of unneeded emotional stress on Susan. And so Susan went about creating the Ring Theory to teach others what to say – and what NOT to say – during times of crisis to best help the people most in need. 

So how does the Ring Theory work?

Ring 1: The Cancer Patient
The key to the Ring Theory is that support flows inward and venting flows outward. The patient is at the centre ring. They can vent, talk, scream, cry to anyone in any of the outer rings. They do not need to support anyone. Continuing to use Susan as an example, Susan (the patient) is not responsible for supporting anyone, not even her husband. The patient receives support and is not ever required to give it.

Ring 2: Spouse, Children, and Immediate Caregivers
The next closest ring to the patient is reserved for people who are closest to the patient. So, this is often the spouse, children, and immediate caregivers. They are there to support the cancer patient – and when they need emotional support, or to vent about the situation, they can turn to the people in the outer rings. For instance, Susan’s husband is there to support her through the cancer; when he needs support, he’ll reach out to other people who are further away from the immediate situation. He will not turn to Susan.

Ring 3, 4, 5: Everyone Else Who Knows the Patient
Rings 3, 4, and 5 hold the remaining people in the patient’s life. The key to the Ring Theory is that support is given to rings that are closer to the patient. And those who are closer to the patient can vent outward. For example, Susan’s mother (Ring 3) could vent to her sister (Ring 4), but not to Susan’s husband (Ring 2). She supports those who are in the inner rings (Ring 1 and 2) and she can vent to those who are in the outer rings (Ring 4,5,6)

Ring 6: The Lookie-Loos
The very outer circle is the Lookie-Loos. This encompasses anyone with no emotional attachment to the patient: for example - the doctors and nurses helping the patient, random people like the lady at the grocery store, and other folks in the community or neighbourhood. Lookie-Loos have no one to vent to; their only job is to offer support to those in the inner circles. Despite their name and position in the outer ring, it may seem as though Lookie-Loos serve no real purpose. However, they can actually serve a very important role in support because of their emotional detachment to the situation. For instance, counsellors and therapists fall into this category.

How to Offer Support:
So what does offering support look like? Here are some examples of things you can do that support those in the inner rings:
  • Just sit and listen – let them vent!
  • Offer to do errands for them (groceries, dry cleaning, gardening, shoveling snow).
  • Bring over food or meals.
  • Offer to take the dog for a walk or take their kids on an outing.

Basically, anything that will ease their daily life is a form of support. Just be sure that they actually need it – or else your gesture goes back to being about you and not them.


How to Accept Support:
Often, we can be very willing to offer support yet reluctant to accept it. It might feel like a sign of weakness or lack of independence. But the truth is the exact opposite: being able to accept support is a sign of strength and can be vital for a successful recovery. Anything that can help you in your journey will contribute to you health and healing. Here are some ways to accept support from others.
  • Say “yes” when someone offers to do a task or errand for you, if it feels helpful.
  • Be clear about what would be helpful. If another casserole in the freezer is too much, then say that you do not need anymore. Instead tell them what would be helpful, like walking the dog or babysitting.
  • It’s okay to tell someone that you just want to talk and vent (and not necessarily receive advice in return).
  • Be choosy who you talk and vent to. Not everyone has the capacity to listen in a way that is helpful.
  • Seek professional support. If no one in your life can give you the help you need, then hire people: cleaners, gardeners, caregivers, counsellors, etc.
  • Check out support groups. There are many support networks for people with cancer and their loved ones, and lots are online so you don’t even have to go anywhere.
Did you know that CTOAM offers professional counselling services for patients and their families?
Verna's Breast Cancer Success Story
When Verna was 55, she noticed multiple lumps in both breasts. She visited her doctor, who then arranged an ultrasound-based core needle biopsy. Shortly after, Verna was told she had breast cancer: Grade 1, invasive, and estrogen positive.

Based on the results of her ultrasound, the core needle biopsy, and her history of lumps in both of her breasts, Verna felt it would be important for her to have a double mastectomy and sentinel lymph node biopsy testing .

However, her local oncologist had not provided Verna with a PET/CT as part of his initial diagnostic protocol. Verna had asked her oncologist whether a PET/CT would be helpful. She says he responded by saying that a PET/CT would not be helpful in her diagnosis and treatment because they (Verna’s treatment team) already had all the necessary information.

Verna’s instinct told her this didn’t feel right. So, just to be sure, Verna contacted CTOAM to get a second opinion before making such a life-changing decision.



In nearly a decade of helping people recover from cancer, CTOAM’s precision oncology specialists have never seen two people with exactly the same cancer.

Our specialists have seen people with breast, lung, brain, and prostate cancer, as well as other types of cancer – and, even within the same category, no two people have had the exact same mutations driving their cancer.

Therefore, each of our patients has required a unique combination of advanced targeted therapies and nutraceuticals, and sometimes in addition to other treatment interventions.
In order to have the best chance of recovery from cancer, your treatment must target your unique genetic mutations. And for that, you need genomic profiling and Precision Oncology’s gene-based approach to cancer care.
With cancer, time is of the essence. Discover how you can live longer with Precision Oncology: schedule your free consultation today!
You have nothing to lose and years to gain.

CTOAM | Cancer Treatment Options and Management
Cancer Care Consultants: Science and Support for All Things Cancer

Based in Canada, CTOAM provides precision oncology services
to cancer patients and their oncologists worldwide.

1-833-493-5463 | info@ctoam.com | www.ctoam.com