Hello Mia and thanks for your post,

I can understand that it can be a tricky situation when people assume all is well particularly when you are living with a stage 4 cancer. I can understand that this must be a difficult situation to live with.

I am not sure what type of cancer you have, but in some cancers, patients can have quite an advanced cancer controlled for some time with newer drugs such as immunotherapies.

A lot of people may not be aware of how cancer is now treated.

Depending on the nature of your friendship you may want to talk to your friends about the type of treatments you are having so they have a better understanding and are perhaps a bit more tactful when they speak to you.

It can be a support to have friends and family to help support you whilst living with this cancer.

We have a page on our website about how to stay positive with a cancer diagnosis. Within the information there are a series of videos on You Tube written by The Maudsley on how a cancer diagnosis affects different relationships. Not all of them will be relevant but you may find one or two that are helpful to listen to.

If you have a Maggie Centre near to where you live you may find it helpful to speak to a clinical psychologist who maybe able to give you tips on how to react when friends ask you how you are. They may also do online sessions so you may find it helpful to get in touch with them.

You have posted on 'ask the nurses' but if you post on another section or start your own you may find that you go more responses.

You are also welcome to ring and chat any of this through with one of the helpline nurses. The number to ring is Freephone 0808 800 4040 and the lines are open Monday to Friday 9 am to 5 pm.

All the best,

Catherine