Managing cancer treatment and holiday season expectations

During the holiday season, it can be difficult to manage family meals, social gatherings and a healthy diet, but it can be especially exhausting for people undergoing treatment for cancer and their family and friends. Experts from Baylor College of Medicine provide guidance to help manage cancer during the holidays, as both a patient and a caregiver.

"The holiday season is typically a time of celebration, traditions and quality time with family and friends. It can also bring challenges or stress with various obligations and gatherings, and it can be difficult to balance these feelings with the holiday spirit," said Courtney Vastine, a social worker in breast and gynecologic oncology at Baylor.

Coping as a patient

As the holidays approach, there are many ways a patient can reduce stress and prepare for additional social obligations. Vastine shares her best tips for easing into the holiday season without becoming overwhelmed.

• Prepare emotionally. The often unrealistic expectations of the holiday season can cause a great deal of stress for anyone, particularly someone dealing with cancer. A mix of anticipation, disappointment and apprehension may arise. Preparing ahead of time for these emotional shifts can help to better cope.
• Simplify. During treatment, many tasks such as cooking, shopping and decorating can become overwhelming and create stress. Simpler, smaller gatherings are easier to manage, and, instead of cooking an elaborate meal yourself, have each person bring a dish, order food from a restaurant or ask someone else to host. Relieving some of the pressures of entertaining will result in more time to relax and enjoy.
• Find different ways to shop. If holiday shopping is a source of stress, try shopping for gifts online or give gift certificates. If finances are an issue, set a budget and stick to it. Heartfelt, homemade gifts are also a good way to let someone know you care.
• Know your limits. Don't feel obligated to participate in every holiday activity; decline some invitations to save energy for the activities that are most important to you and don't overextend yourself. It is okay to cancel plans or take time to yourself when needed.
• Let others help. You may have been the one to do most of the holiday decorating, shopping, cooking and entertaining in previous years. Being responsible for all of the preparations is physically and emotionally draining, so allow friends and family to help. Since they might not know how, prepare a list of tasks for them to help with. Chances are, you will feel relieved, and they will feel good about being able to help you.
• Anticipate reactions. Cancer can change how you relate to your loved ones and how they relate to you. There may be side effects of treatment and changes to appearance, such as hair loss and weight loss. Consider writing a letter, sending an e-mail or calling family members in advance to let them know how you're feeling to help reduce some awkward feelings when you do get together.
• Discover new traditions. Try to avoid putting pressure on yourself to maintain old holiday traditions, especially if these are demanding or create stress. Happiness can be found in old and new ways, as long as it is right for you in the moment.
• Share feelings. Expressing your feelings and concerns with others can reduce holiday stress. If you don't want to talk about your illness, let your loved ones know. If you feel a need to cry or get upset, it's okay to do so. Communicating your feelings with others can help you feel less alone and more connected.
• Set goals for the New Year. Your dreams and hopes for the future may be different now. Work together with your loved ones to make new, short-term goals, such as finishing treatment. Re-evaluating priorities can improve your outlook.

"Illness doesn't happen to just one person. It happens to family members and friends as well. During the holidays, illness can challenge each person in different ways. Therefore, as patients cope with their disease this holiday season, communication with loved ones becomes essential," said Vastine. "It is also important to remember there's no right or wrong way to handle the holidays. The patient should discover what works best for him or her."

Comforting as a family member, friend or caregiver

"The most important thing to keep in mind during the holidays is to be considerate," said Dr. Julie Nangia, assistant professor in the Lester and Sue Smith Breast Center, part of the Dan L Duncan Comprehensive Cancer Center at Baylor. "Offer a quiet place for your family member or friend to rest, and ask in advance if any foods don't sit well or if there is something in particular they'd enjoy if food has been upsetting their stomach."

• Remind your loved one you care. Give extra reassurance that they are still needed and loved and find meaningful gifts that reflect who they are apart from the disease. Nangia recommends giving gifts that center on an experience as opposed to a material item, such as books, art, music or tickets to a museum, theater or sporting events. You want to show your loved one that you see him or her as a person, not as a disease.
• Give him or her space. Invite your loved one to join in holiday activities, but don't pressure him or her to be involved in every event. If they don't feel up to an activity initially, leave the invite open should they decide to participate at the last minute.
• Offer to help. Offer to clean the house, do laundry, cook, get groceries or decorate. Give your loved one the opportunity to decide what he or she wants to do, and then help accomplish the rest. "It may be difficult for your loved one to accept help, particularly with household chores. Try saying that you'll drop by their house for an hour or two to help with errands and housework and ask what a good time would be. This is a more solid offer that many patients find easier to accept," explained Nangia.

If you aren't sure how your loved one wants to handle the holidays this year, just ask. Talk about their feelings and share your own. Working together to make decisions about holiday activities can help you both feel more connected and prepared. Those affected by cancer want to celebrate the holidays as normally as possible, without dwelling on the disease.