Colorectal Cancer or Any Type of Cancer Can Test a Friendship

Diagnosed with stage 3b colorectal, Joe Bullock underwent surgery and chemotherapy, achieving NED status. Read Joe’s blogs here!

Before my cancer diagnosis, I didn’t truly understand what could test a real friendship. Superficial friendships fade quickly in the cancer space, where emotions run high, and the reality of loss is always present. When you know a friendship has a timestamp, and there’s a real possibility you’ll be the one left behind, the depth of those connections shifts in ways most people never have to consider.

Yesterday, I tried calling a friend from my cancer group, only to find out he had passed away earlier in the week. His cancer journey was only about five months long — just long enough for us to begin bonding over his love of fishing. He had hoped to take a group of us out on his boat, but cancer stole that opportunity before we could make it happen.

At some point, I had to accept that losing friends to cancer would be part of my own journey. It’s a painful reality, but also part of survivorship. I try not to let survivor’s guilt take hold because it can prevent me from fully being present for friends who are facing the possibility of their own death.

It’s rare for someone to open up about their impending death, and when they do, it would be easy to turn away — to avoid the discomfort of that conversation. But the true test of friendship is staying in that space with them, listening and honoring their fears and wishes. These aren’t one-time conversations: they unfold over time, and they require emotional endurance. There will be tears, but also laughter. It’s okay for these moments to be filled with a range of emotions because they are real. When a friend trusts you enough to talk about what they want at the end of their life, the greatest gift you can give is simply to stay present.

Many people struggle with these conversations, often responding with phrases like: “Stay positive.” “Let’s not talk about dying right now.” “I’m not giving up on you.” “I still believe a cure will be found for you.” “God has got you — I’m praying for you.” While well-intentioned, these responses can be isolating, shutting down the person’s opportunity to express their reality.

Avoiding the conversation doesn’t stop death from coming, but it can prevent a meaningful moment of connection. A strong friendship can survive these conversations — it’s in these moments that the trust and depth of the bond become truly evident.

I recently saw a friend struggle when his best friend passed away from cancer. They had never really talked about what his friend wanted after his passing. Every time the topic came up, his friend would shut it down, afraid that acknowledging death meant giving up. After he was gone, my friend was left with unanswered questions. But when the time came, he still showed up, supporting the family in the way he believed his friend would have wanted.

A few years ago, I visited a friend who had been battling stage 4 colorectal cancer. At the time, I had no evidence of disease for a couple of years and was figuring out what survivorship meant for me. We had been working on building a platform together from a distance, and I knew we needed to meet in person. Given that less than 15% of patients with stage 4 colorectal cancer survive five years, I also knew there was a real possibility that this would be our only chance.

He was about to start treatment for yet another recurrence, and we had honest conversations about what that meant for our friendship and our platform. He spoke about the heartbreak of possibly not living to see his daughter graduate high school and college, of missing the milestones of the life he and his wife had built together. We even talked about what would happen to the platform if he were no longer here to run it.

Today, five years later, we are both still standing. He watched his daughter graduate high school and enter college, and in just a few months, his youngest will graduate as well. Our friendship has only grown stronger.

Cancer has changed how I view friendship. It has shown me that the deepest connections aren’t about avoiding pain but about standing in it together. It’s about holding space, having the hard conversations, and staying present — no matter how difficult it may be.

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