Comedian and breast cancer survivor Dr Jo Prendergast’s tips for patients, and what to say to them

Jo Prendergast is a doctor, comedian and author. She is also a breast cancer survivor who used her experiences to inspire her one-woman show Cancer and Cartwheels, which she’s performing at the NZ International Comedy Festival.

Here, she shares the things she’s learned from her own experiences that could be useful for anyone going through their own health battles at the moment.

Support groups can be really helpful

For the first time in my life, I joined support groups when I was diagnosed with cancer.

I found Facebook support groups can be an incredible source of information, but you need to know when to take a break or leave. I had to ask myself sometimes whether it was helping or worsening my wellbeing.

But through these groups, I found out so much important information about not only surviving cancer but surviving well. It was very useful to have women with breast cancer living in Australia and the US talking about their treatments, so that I could raise these with my treatment team as options.

It’s important to find the right support group for you. It’s incredibly supportive to find people with shared experience. There’s a real closeness with other ‘pink sisters’ who have been through a breast cancer.

Dr Jo Prendergast performs her one-woman show Cancer and Cartwheels at Auckland's Q Theatre on May 24. Photo / Chris Hillary

The importance of self-advocacy in health treatment

I had never really thought about the importance of advocating for my healthcare before I was in the vulnerable situation of having cancer treatment. It made me realise how important it was to find out information, to ask questions and to get second opinions if necessary.

An oncologist talked to me about decision regret when I was first diagnosed and how the main way to reduce this is to feel like you make the best decision you can at the time, with as much information as possible.

I was very focused from the beginning on trying to minimise side-effects of cancer treatment. I found that there was much more focus on trying to keep me alive than trying to keep me alive with minimal long-term health conditions that would reduce my quality of life.

Cancer also gave me the experience of what it’s like to feel vulnerable due to being immunocompromised. I went through cancer treatment during Covid and felt very isolated at home, as it became too high risk for me to do things.

When I was severely immunocompromised after chemo, it made me realise how anxiety provoking it must be for people who are constantly in this state.

Get to know which coping mechanisms work for you

Cancer made me really think about the coping mechanisms that I used to get through the frightening experience of being diagnosed with cancer and going through surgery, chemotherapy, radiotherapy and now hormone blocker medication. I think humour, sense of purpose and acceptance were the main things that got me through.

I wrote most of my one woman show when I was going through cancer treatment, and finding the humour in my cancer experience was one of the most important things that helped me.

The day before my surgery, I wrote about it being eviction day of an unwanted squatter. This helped distract me from my anxiety about having my first ever surgery.

When I was lying in the PET scan, I focused on trying to listen to the music they were playing (it was Christmas carols in June!). I remember thinking that the song Radioactive would be ideal, given that I was radioactive at the time for my scan.

Finding a sense of purpose was hugely important and I wrote an 80,000 word manuscript during my cancer treatment to document my experience. I made video blogs regularly through my treatment to share my experience with friends, family and the general public. There was a lot of interest in following cancer stories, and I gained to following of other people going through breast cancer treatment who discussed their experiences with me.

I think that accepting that I was now a breast cancer patient and needed to focus my energy on my treatment was helpful. It’s a challenge to accept the changes in my health and body after cancer treatment but adapting to the new normal has been incredibly important.

Jo Prendergast wearing a cooling cap while receiving chemotherapy.

Reframing how we view difficult situations

The night I found out I had cancer, after crying and hugging my husband, I brainstormed all of the possible silver linings and the positive things that I could do with my cancer experience. It made me realise that there could be a silver lining in even the worst things that can happen in life and that experiences are what you make of them.

There were certainly very difficult times going through cancer treatment, when I was in severe pain after surgery and incredibly fatigued during chemotherapy. But there were also times where I was able to truly experience the moment by slowing down and not rushing around doing one million things at once.

Doing good for others helps us as well

As a doctor, I always had a sense that doing good for others was helpful for me. Even on the most stressful workday, I would come home knowing I had done something useful that day. I found the projects that I did during my cancer treatment very rewarding, as they had a “doing good for others” component. It’s really a win-win situation as there’s lots of research that shows that being kind to others or volunteering your time increases your own wellbeing.

Knowing what to say to an unwell person

I certainly learnt what not to say to someone who is critically ill.

Some people were focused on their own vulnerability and kept asking me how I found my cancer and whether they might get it. The first thing one woman said to me was that their aunt died of breast cancer.

Others were trying to be helpful with uplifting statements, but it can become “toxic positivity” when we deny or dismiss our sad, scared or angry feelings, as it makes it harder to cope with and process those feelings. So instead of “just think positive” we can try and listen more.

And instead of “it could be worse”, we can try and validate each other’s feelings with “that sounds really hard”. It’s also important to know that not everybody likes to be called a “brave warrior on a journey to fight cancer”.

So instead of endowing someone as a brave warrior, maybe just ask how they’re doing. The brave warrior expectation can make it harder for people to express their true emotions.

And when somebody’s critically unwell, it’s really important to check in with them and let them know that you care. I found people just messaging with “thinking of you” without any expectation of a reply was really helpful.

Stigma makes it harder for people to talk about cancer and women’s health

I discovered firsthand the stigma that people have about cancer. I must give a shout out here to Good Times Comedy Club in Ōtautahi Christchurch, who have been incredibly supportive of me performing comedy about my cancer experiences.

Other comedy producers were okay with comedy about illegal drug use and sexist, racist, phobic or abuse jokes but felt uncomfortable about cancer or women’s health topics.

One of the reasons I decided to do my one-woman show and to have cancer in the title was to try and break down that stigma to make cancer something that we can talk about as freely as other topics.

I’m sensitive to the fact that most people have been affected by the tragedy of losing people to cancer, or their own cancer diagnosis but I don’t think it’s helpful to make it a taboo subject.

I also talk about the “untalkable” with some of the more personal symptoms of menopause that I think women find difficult to talk about.

For example, vaginal atrophy was common in both menopause and when people are on hormone blockers. I’ve made it my mission to educate people about this through light-hearted jokes to try and break down the stigma.

It’s also important to realise that women being put suddenly into menopause through cancer surgery or medications can be incredibly difficult to deal with. This is particularly the case if women are much younger than they would naturally go through menopause.

Dr Jo Prendergast. Photo / Chris Hillary

The long-term effects of cancer treatment are often not known about

Cancer changes people. We are different after cancer treatment. Most people are left with some sort of ongoing physical or mental health issues as a consequence of treatment.

It’s important to know that we’re not just back to how we were before and to be sensitive to those changes such as mood, sexual or memory problems, or no longer having the same physical abilities.

Adaptability is incredibly important so that we are less devastated by the changes and can adjust to the new normal.

Dr Jo Prendergast performs her one-woman show Cancer and Cartwheels as part of the NZ International Comedy Festival, on May 24 at Auckland’s Q Theatre.