People often ask what they can do to help. While friends have done some truly spectacular things for me since my diagnosis, some of the most important and helpful things have been very small and simple. I figure everyone knows about hot meals and handmade hats, but here are some other small acts of kindness that have made an enormous difference to me. If the things on this list sound helpful to you, pass it on to your friends.

All friends:

• Respect the fatigue. Cancer and treatment take a toll on energy, so your friend probably has fewer waking hours in the day than previously. If your friend is using CaringBridge or a similar tool to keep loved ones posted on his or her progress, use it instead of asking your friend to repeat the same medical updates over and over. When you visit, understand that your friend may need to sleep late, go to bed early, and nap. To stay in touch, choose e-mail, text messaging, and mail over phone calls whenever possible because these allow your friend to read and respond when he or she is up for it.

• Do something nice for her family. Cancer overwhelms children and caregivers, too. Take your friend’s spouse out for lunch or a drink. Send the children mail – children love getting mail! While I was going through chemo, a friend in California sent my daughter a little package of hair bows or other shiny things every couple of weeks. It was great for her to have this special attention when I wasn’t able to take her for outings or treats.

• Listen. Let your friend say (or write, or text) whatever is on his or her mind, and don’t discuss what you hear with anyone. I value a small group of friends I call my “Snark Patrol”: I text them when I am irritated or impatient, when someone sends me a well-meaning but grossly inappropriate card or gift, or when yet another person says, “Lung cancer? Did you smoke?” They make me laugh so hard that I feel better. And I know I can trust them not to broadcast my irritation and hurt other people’s feelings.

Friends who live far away, or can’t visit:

• Send a card (or a text, or an email). I know a lot of folks wish they could do more than “just” send a card, but do they even realize how nice it is to get a card in the mail when you don’t feel good? It doesn’t have to say much – in fact, less is often more. A pretty picture and “I’m thinking of you” is all that’s necessary.

• Send money. I cried when I opened the card that had $100 in it, and a little note that said, essentially, “Spend this on the vending machines or cafeteria in the hospital, extra little supplies from the drug store, gas for the car, or whatever you need.”

Friends who live nearby or can come visit:

• Clean up the kitchen. If your friend has nausea from chemo, a sink of dirty dishes may be an insurmountable obstacle. Just the sight and smell of the food on the dishes can trigger vomiting. I loved the friends who just rolled up their sleeves, did the dishes, and wiped the counters anytime they were in the house. Especially if they made educated guesses about where to put things, and didn’t ask me exactly where everything went. (Ask first, of course. Other people are pickier and more sensitive about their kitchens than I am.)

• Take care of the pets. Our next-door neighbors took our dog for a walk every night for about six months. Others helped with vet appointments. Keeping up with a pet’s shots or grooming may be more than a family can manage while dealing with cancer. Even if you’re just visiting for the afternoon, ask if you can take the dog for a walk.

• Offer child care. The day we went to New York to meet with the surgeon, we dropped our daughter off with a friend whose kids are near her age and go to the same school. She greeted us at the door in her pajamas, fed our daughter breakfast and got her to school, helped her with homework and fed her dinner, and kept her until we could pick her up late in the evening. That was a horrible day, but I still remember the comfort of knowing our daughter was having as normal a day as possible.

I hope other cancer survivors will add more ideas in the comments! What thoughtful and helpful things did your friends do for you?