Think about the times when you've had difficult conversations in your life. Even though it was hard, did you feel a sense of relief and calm after it was over? When we think about having challenging conversations, we often fear a negative outcome. However, most people are surprised at the reaction and sense of empowerment.

As a cancer survivor, you may have already had plenty of experience with difficult conversations. Or maybe you're wondering how to initiate a tough conversation with your family, friends or health care provider.

Here are a few ideas to help you get started:

• Write out what you'd like to say — it helps to see the words on paper.
• Practice the conversation on your own or with a trusted friend — a trial run can help you form the words and think about reaction of others.
• Stick to the facts — if you're talking to others about your diagnosis and treatment especially, give the facts and what you know at the moment.
• Provide reassurance — let others know that you're comfortable talking about your cancer. This will help to ease their worries and open up the lines of communication.
• Think about questions — what do you think people might want to know from you? Anticipate the questions you might have from others.
• Be honest — give honest information about what you know and be realistic about what you don't know.

Having difficult conversations can also be a challenge for your health care provider. In fact, it can be a real barrier. If you feel that you're not getting "straight talk" from your doctor, don't be afraid to bring it up.

You might say something like "help me understand what to expect over the next 6 months to a year." This may open the conversation and may help with your sense of empowerment, reality and feeling of control over your personal situation.

What has helped you when faced with difficult conversations? I'd love to have you share your perspectives.