It's one of the worst pieces of news a woman can hear. Susan Quilliam advises on how you can support, understand and help a friend with breast cancer

Every year in Britain, 38,000 women develop breast cancer. That's one in twelve. Unfortunately the chances are high that at some point in the future, someone you know will develop the disease.

Coping with the news
Expect shock. Even if your friend has suspected the worst, she will still be in shock. She'll need time to cry, feel angry and even worry that it might have been a mistaken diagnosis.

Learn to listen. The most important thing you have to offer your friend is the ability to listen. Let her talk, encourage with nods and smiles, attempt to understand. If you can do this, in time she'll be able to summon her own strength in order to cope.

Keep positive without denial. Don't be a prophet of doom - cancer is not the death sentence it used to be and large numbers of people who develop the disease get cured. On the other hand, don't dismiss your friend's concerns - she needs to be taken seriously.

Take your time. You and your friend don't have to rush into anything - a couple of days' wait will not lead to her dying. It may be worth making the space for her to get her emotions together, before taking further medical advice.

Supporting during treatment
Gather information. One of the most helpful things you can do is gather information for your friend. She may well be feeling too confused and shocked to do it herself. But don't make that an excuse to give advice - just be a conduit of facts and let her think about those facts for herself.

Go along for consultations. Having someone come to appointments can be enormously helpful. Be prepared to take notes, take a list of questions and be there to help and support her. Don't try to speak on behalf of your friend - and if the news is bad, don't take up the attention with your own grief or fear.

Respect a decision. When it comes to treatment, your friend may not necessarily make the same decision you would choose. She may opt for surgery when you would go the other way. Remember that it is her life, not yours, so support her decisions.

Give practical help. Cancer treatment is far less exhausting and debilitating than it used to be, but your friend may still need practical help - cleaning, shopping, washing, babysitting, phone calls to make to family, friends and colleagues. Don't offer to do more than you can - but do offer!

Living with illness
Expect a mourning process. Whatever treatment is offered, there will be a sense of loss. Surgery can leave a patient feeling that she has lost her femininity and sexuality. Radiotherapy can remove fertility. So expect your friend to grieve.

Support the fear. Every cancer patient fears a recurrence, so don't dismiss your friend's worries, however positive her prognosis. You can again help by gathering information about her particular situation - and, as always, by listening and understanding.

Affirm life. It will also help to support your friend to live life to the full, to get out, to do things, to enjoy things. If she feels unable to do this, depression may be setting in - she may need to see her GP.

Enrol support. Don't try to do all this alone - get as many other friends in to help as you can. Also, use the health services' resources. Most hospitals now have a cancer care nurse who is fully trained to offer support.

Get support for you. Your friend will not be the only one who needs support. Don't overstretch yourself and be realistic about what you can do. Make sure that you yourself have help through your fear about her illness. Lean on others - or ring the Cancer BACUP helpline on 0808 800 1234 - if you feel that you need to talk about what is happening.

Finally, if your friend does not recover, the journey that you will both take will be a hard one. Our feature on facing bereavement will help you get through it.

More resources
BACUP, a UK-based support group, has an excellent website that gives you access to information, support groups, a telephone helpline and more. In particular, read the excellent section on how to listen to a friend who has cancer.

Breast Cancer Care is the leading provider of breast cancer information and support across the UK. If you or someone you know has been affected by breast cancer, ring their helpline or visit their website for support.Tel: 080 88 00 6000

What to Do When You Really Want to Help and Don't Know How by Susan Quilliam. My own book on how to help those around you is relevant here. Order it by ringing Vine House Distribution's credit card line on 01825 723398.

The Breast Cancer Book by Val Sampson and Debbie Fenlon (Vermilion, £9.99)