It’s been a few years now since I was diagnosed with multiple myeloma, but I still continuously face the dilemma of whom to share this information with.

So far I am lucky to be (outwardly) asymptomatic and, other than the steroids helping me to get a little fatter, I don’t look any different than I did before I was diagnosed and started treatment. I therefore have the option of choosing whether or not I tell people I have multiple myeloma.

Of course, the people who know about it and don’t see me very often continue to greet me with the “you look great” comment. Those who don’t know what’s going on must just attribute how I look to my natural beauty (insert joke here).

However, who to tell about my myeloma, both on the professional and personal sides of my life, was actually a serious issue for me, especially in the early days of my diagnosis.

When I was first diagnosed in 2012, I was in the early stages of a multi-year project that took a lot of time and involved a lot of meetings. I can clearly remember addressing my clients in a room and wondering if they knew that something was wrong with me. When I began my induction therapy with Velcade ^[1] (bortezomib), Revlimid ^[2] (lenalidomide), and dexamethasone ^[3] (Decadron) a few months later, having to meet with clients while in a chemo fog was really challenging!

During these early months, I had an inexplicable desire to tell all of my professional associates that I had multiple myeloma. It didn’t matter that I had no visible symptoms or limitations on my physical abilities; for some reason, I needed to let them know. Luckily, I had a good psychologist who worked with me to examine why I felt the need to tell them and to eventually talk me out of it.

It turned out that I was looking for sympathy. I also wanted to show everybody that I was strong enough to continue working even though I had this terminal disease. While this revelation about my diagnosis may have made me feel good about myself for a few minutes, it could have had serious implications on my con­sulting business, where clients trust me with large projects that usually take many months, or even years, to complete.

Not everybody would be comfortable giving a long-term project to a cancer patient, no matter that the illness has not yet begun to cause me significant disability. It’s the headline “Cancer” that they would be forced to pay attention to.

While I have made a conscious decision to never lie about my condition, I have also made the decision that I will not share the fact that I have multiple myeloma with anybody that is a professional associate. I have continued to follow this strategy to this day.

Implementing this strategy has not always been so easy. As probably is the case for most business people, the lines of who is a professional and who is a friend often cross and blur for me. However, I have been able make this distinction, and so far my medical condition is not known in my professional circles. At the same time, I have vowed that if I begin to have symptoms that I cannot work through, I will share my condition with my clients before I take their project on. I think it would be immoral of me to begin a project that I couldn’t complete.

Beyond the professional implications of the question of who to tell, there are also the problems of which friends and acquaintances to share my diagnosis with.

I mean, how do you bring this up? “I hear you caught a bunch of fish last week. That’s excellent! Oh, by the way, I have terminal cancer?” That just doesn’t work.

My insecurities before I got sick were the driving factor in my desire to tell anyone and everyone about my diagnosis. My wife and I just called up and directly told all of our close family and friends. They wanted to know the same way that we would want to know and help with any of their major problems. That part of the equation was easy and still seems pretty logical.

For our children, who were 11 and 12 at the time, we waited until we really thought we understood what I had and what I was facing, then we sat them down and shared all they needed to know as honestly and openly as we could.

The harder part has been the friends and family who are on the periphery of the “need to know” basis. With my counselor’s advice ringing in my ears, I withheld my diagnosis from anybody that wasn’t in our inner circle. As time goes by, it has gotten much easier for me to not share my diagnosis.

As of now, I no longer have the desire to tell everybody. I have gotten much more comfortable with having multiple myeloma, partly due to becoming more informed about what I am facing, and partly due to the maturity I gained by facing my own mortality.

Now I look at my disease as something that I only share if the person really needs to know. It turns out that the people who really need to know are a pretty small circle. I’m finally comfortable with that.

I have been blessed with the time of symptom-free health to figure out the answer to the question who to tell.

For those of you who are recently diagnosed, I encourage you to be patient. Tell the ones who need to know; you know who they are. Most likely they are the same people who you would hope would tell you about their life-threatening condition, not so that you could give them your sympathy, but so you could let them know that they are loved.

Aloha and carpe diem!