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In November of 2010 my mother sat me down on the couch to tell me that she had breast cancer. A few weeks later she had her first surgery. In May of 2011, after outpatient chemotherapy, she was declared cancer free. Just a few weeks after that, we learned that my big sister had a tumor in her knee. Over the next year we did the impossible- we dealt with cancer all over again. My sister came to live with us, had surgery, and went through nine rounds of inpatient chemo. In June of 2012 she was declared cancer free. My family was incredibly lucky that both of them survived, but the two back to back years we spent chin-deep in cancer were absolute hell. Here’s what to expect when someone you love has cancer:

Blood and guts. Cancer is often considered an invisible illness at the beginning. You can’t simply see cancer cells, so you might think it’s a fairly clean experience in terms of gore. It’s not. The cancer might be invisible from the outside but the treatment and the surgeries are not. Surgeries come with their own set of gruesome side effects. Dried blood, iodine stains, stiches, bruises, sometimes even drainage tubes that require emptying twice a day. Chemotherapy is no walk in the park either. Many patients get ports placed under the skin that attach to a large vein in their neck in order to provide fast, easy access for blood draws and chemo. This means your loved one gets jabbed over and over into the same bump located just under their collar bone. Chemo causes nausea, so expect vomit. Its accompanying drugs may make your loved one’s face swell and cause a number of other side effects. You might not be able to see the cancer itself, but you will see the treatment’s side effects. I hope you’re not squeamish.

Less attention paid to you. Your family member might be dying, which means the spotlight will be on them. If you’re a kid, in particular a mentally ill kid, this might be a harder thing to deal with than you realize. We’d all like to think we’re above selfishness, I’m sure, but getting less attention than usual is hard to death with for anyone. So please, don’t let it take you by surprise. I used this dip in attention to use dangerous coping habits that only made my mental illness worse. Instead of slipping into darkness, throw yourself into the situation by going above and beyond for your family.

Tension so thick you could cut it with a knife. Like I said, this is going to be absolute hell. Everyone in your family is going to deal with it differently. Some might withdraw, some might act out. Regardless, it’s going to feel like you’re tiptoeing on eggshells. You’re on red alert, trying to avoid causing any additional problems for your family. You’re trying to be strong for your loved one. These are all nice things to do, but it’s like walking between landmines. One is bound to go off some time or another, but pretending they’re not there is only going to make the eventuality worse.

Regret. It’s likely you’ll feel some level of regret regardless of what happens to your family. My loved ones are happily cancer free (though not without literal and figurative scars) and yet I feel a twinge of regret each time I think of what we went through. My way of coping was to shut down. I didn’t cry. I actually didn’t express any emotion at all. My time was spent awkwardly sitting at the foot of my loved ones’ beds, knowing there was more I should be doing. I disappeared when there was a problem, I looked at my feet when there were tears. I tried not to make things worse, but I didn’t help either. And I am forever kicking myself for it. It’s only now, years later, that I’m able to show my support. But I’m still not where I want to be.

So if a loved one ever has the misfortune of getting cancer, I’m sorry. But know this: you can get through it. It’s not going to be easy. But you can do it.