For people with cancer, managing holiday stress is key

The holiday season can be stressful for anyone, but for people with cancer, the merry-making and concentrated family time can present additional challenges.

The holiday season can be stressful for anyone, but for people with cancer, the merry-making and concentrated family time can present additional challenges. This time of year can serve as a reminder of physical, emotional and cognitive losses. People with cancer may feel self-conscious around friends and relatives they haven’t seen for a while. They may feel exhausted by holiday parties and large gatherings where they may not be able to eat or drink what they have in previous years.

“A lot of patients say that they don’t feel they have the emotional or physical energy to fully participate in the season, and that’s a downer for them,” says Dr. Jesse Fann, medical director of psychosocial oncology at SCCA. Here are some nuggets of advice Dr. Fann recommends people with cancer consider:

  1. Prioritize what’s most important and meaningful to you. It’s okay to prioritize certain gatherings or activities over others. You can pick and choose. Feel free to leave a gathering early. It’s fine to make an appearance and say hi, then leave in half an hour or an hour. Often it’s better than not showing up at all or staying the whole time and feeling miserable afterward.
  1. Delegate tasks to family and friends. Pick bits and pieces of what you enjoy doing and delegate the rest. Saying no is really important. A lot of people are reluctant to do this, but once they do it, they say they wish they would have done this years ago. You don’t have to roast the turkey; do a smaller part of the meal. Pick one room to decorate instead of the whole house. Break things down into smaller, more manageable pieces.
  1. Listen to your body. Pay attention to how you’re feeling emotionally and physically. If you’re feeling exhausted, take a break. Make sure you take time to relax and exercise and participate in healthy activities. We all should do that but it’s particularly important for people with cancer to do that.
  1. Create new traditions. A lot of times people have family traditions, like going out and chopping down a Christmas tree. You may not be able to do that this year. It’s a loss so it’s important to validate that, but take the opportunity to develop new traditions.
  1. Decide in advance what you want to share about your health. People often will be asked at holiday gatherings how they are doing and what is going on with their cancer. That can be awkward or uncomfortable. Practice what you are going to say. Sometimes I role play with patients about how to respond. You could send an email in advance giving some information and saying, “I appreciate that people might want to know how I’m doing, but my preference is to talk about how you are doing and not focus on my cancer.” Or you could say this at the gathering. On the other hand, if you are feeling depressed or stressed, then you should be able to talk about it. It’s important to have an outlet. It may be helpful to talk with a counselor.

People with more advanced disease may find holiday time especially taxing. “Some people feel this may be the last Christmas they’ll be able to spend with family,” says Dr. Fann. SCCA’s Integrated Psychosocial Oncology Program helps patients acknowledge, validate and address their ongoing symptoms and losses while also helping them see some of the positive aspects of their lives.

“It’s easy to focus on all the real losses and things you can’t do, but it’s also important to find things you are thankful for,” says Dr. Fann. “The holidays can be an opportunity to reflect on the fact that you are still here and able to spend time with your family and friends.”

SCCA patients interested in receiving additional emotional support should ask their medical team for a referral to the Integrated Psychosocial Oncology Program, which includes clinical social workers, psychologists and psychiatrists.