Everything that makes the holidays so special — family time, parties, gifts — can also make this time of year extra taxing for people with cancer. The diagnosis itself, in addition to treatment, can change how the person responds to and thinks about the world around them.
As we embark on the holiday season, millions are in that position. Nearly 2 million people are diagnosed with cancer every year in the U.S., according to the American Cancer Society.
Loved ones watching someone they care about go through cancer face challenges, too. Rouchelle Macon, a counselor at The Family Institute at Northwestern University, is living that experience. Her son was recently diagnosed with T-cell lymphoma on the same day his father was diagnosed with bone cancer.
“We’re trying to get him through treatment, and I’m trying to stay grounded so he can stay grounded,” Macon says of her son. For Macon, a big piece of staying grounded is reminding herself to avoid “fix-it mode” when her son just needs someone to listen. She’s also “in a constant state of prayer.”
If someone you care about is going through cancer this holiday season, a little preparation goes a long way. Be compassionate and straightforward with them. Don’t ignore their experience, but don’t dwell on it either.
Check yourself first
Before you talk to the person with cancer, check in with yourself first.
“Loved ones first have to be aware of how they’re feeling about things. What are their own feelings about what’s going on? Just be aware and monitor that,” says Nancy Schell, MD, psychiatrist at Cancer Treatment Centers of America.
Some people might dread or worry about talking with their loved one. If you feel that way, consider writing them a note.
“When things like [cancer] happen, sometimes the family members ought to do a little prep work themselves. If you feel like you’re going to burst out crying, maybe do that before or do that with the person outside of the family gathering. I think the person would appreciate that somebody is really upset about this. They’ll know they’re cared about and loved,” Schell says.
If loved ones find that the diagnosis is really impacting them, they should consider mental health support for themselves, whether through counseling or a support group.
“You may need to process your emotions so they don’t bleed out into your relationships and work,” Macon says.
Support groups offer a unique way to connect with people who have dealt with similar issues, providing useful information and alleviating isolation.
Look for a group near where you live — at community centers, churches, synagogues, or hospitals, for example. A local group gives you the option to meet outside of the group for coffee or lunch, “because sometimes it’s just needed to have that personal relationship or attachment to someone going through similar situations to yourself,” Macon says.
Showing up for yourself will in turn let you be more present for the person with cancer.
Once you have an awareness of how you feel, Schell says to let the person with cancer lead the conversation. How are they feeling about things? What do they need?
If you’re afraid of breaking down in front of them or simply uncomfortable with the situation, tell the person that. “You can even say, ‘Look, this whole subject makes me uncomfortable because I’m afraid of losing you.’ The more you’re holding in on the inside, the more strained the interactions are going to be. If you are uncomfortable, let them know,” Schell says.
Here are a few other ideas for supporting your loved one through cancer this holiday season: emotionally, nutritionally, and physically.
Emotionally
If someone you care about is going through cancer, check in with them and acknowledge what they’re going through — whether you’re going to see them in person or not.
“Ignoring it can make the person feel weird. It can make them feel not cared for, like nobody seems to notice,” Schell says.
At a family event or other gathering, ask the person when they arrive how they’re feeling, and — if you’re the host — how they’d like to handle things. Maybe other people attending don’t know the person has cancer, and the person would like to make a brief announcement, or maybe they don’t want to discuss it at all.
“You can always just express your concern for the person as you would other times, say, ‘I just want you to know I love you. I care about you,’” Schell says.
Most people with cancer feel hurt if they don’t hear anything from their family and friends, or if people act like everything is fine without first acknowledging what the person is going through, Schell says. “The silence is like, what the heck? They’re going to start thinking you don’t care.”
On the other hand, Schell adds that people with cancer don’t need their family and friends to become experts on everything cancer and healthcare.
“Some family members get intrusive about it. That can be very annoying and difficult. People may want to keep their doctors their doctors,” she says.
For Macon, authenticity is key, too.
“Be your authentic self. If you usually go and laugh and play with them, do that. Maybe they can’t play tag football, but we can watch football. Throw popcorn in front. Make it fun,” Macon says. “You want an environment that can fuel them as opposed to defeating them.”
She also recommends keeping an awareness of the person’s pace — just don’t lose yourself in it.
“I could easily go off and be doom and gloom and match that same energy. But that’s not who I am,” Macon says. “If you stay true to who you are, it’ll be easier, more authentic to respond to them.”
She uses humor, too. “I’m always going to be silly, but I’m also always going to be mom,” she says, of her interactions with her son. “I’m not going to allow you to use certain words that [lead to] a defeatist attitude. A sense of humor is like medicine, keeping the environment light for him.”
Nutritionally
If you’re hosting a gathering this holiday season, talk with your loved one with cancer beforehand. Find out what they can eat and what they need to stay away from.
“Just be up front. The person knows they have cancer. They know they’re dealing with it,” Schell says. “It’s more thoughtful if family and friends just ask, ‘How do I accommodate you?’ It’s much more appreciated by the patient if people are just straightforward.”
Often, people going through cancer treatment will have a sore throat and decreased appetite. They might taste metallic flavors. A host can keep extra water or tea on hand, or softer foods that go down more easily. Make fruits and vegetables available, too.
“That’s very vital to our wellbeing,” Macon says. “All those sweets are not good — boom! It’s energy and then a downer.”
The person with cancer may want to bring their own food or drinks. Let them know that’s ok, that nobody will be offended, Schell says. “They may not want the cook to feel slighted, so tell them that if they’ve found things that work for [them], bring them. Let them know they don’t have to supply it for everybody.”
Keep in mind that the person with cancer may have a negative reaction to food. They may vomit, feel nauseous, or make a disgusted face if they smell something that they suddenly can’t stand the smell of. Others at the gathering should try not to take it personally if the person isn’t reacting as they typically would.
“The person with cancer should not be a good judge of your food quality. This person may literally barf it out, and that’s ok,” Schell says. “Don’t make a big deal out of it. It’s a side effect of their treatment. If they do barf, offer them something a little while later, but nobody should be getting offended.”
Physically
Keeping your loved one with cancer physically safe during the holidays can take different forms.
Many people going through cancer treatment are immunocompromised, which makes them more prone to catching other illnesses. If you’re hosting a gathering with children, consider keeping the children confined to an area away from the person with cancer — to avoid falls and germs — or provide masks.
Encourage sanitation, too. Make sure everyone has access to soap and hand sanitizer so they can wash up before and after eating.
If you’re hosting, it’s also reasonable to ask people to be vaccinated and mask up, Schell says. “They don’t have to come if they don’t want to abide by that. People are forgetting that Covid is still there. We still have thousands of deaths from Covid.”
In addition to germs, falling can be an issue. People with cancer may have lost feeling in their feet (called neuropathy) or have other issues that affect their balance or mobility.
Decrease clutter and cords, secure rugs to avoid slipping, and make sure handrails are steady. Salt driveways, stairways, and walkways. And if possible, limit the use of stairs.
“Just keep an eye on that person. It’s really very simple for somebody to move around and then all of a sudden hear a thud,” Schell says.
But physically supporting a loved one with cancer doesn’t have to involve only safety precautions. You can create opportunities for fun, too.
“Walking or dancing is so cathartic for people,” Macon says. “If I put on some good upbeat music, I may be able to clean the whole house, and I’m dancing in the process.”
She remembers dancing while being pregnant with her son, too. “I knew he could feel the movements, experience it, hear it. All of that encompasses our mental wellbeing.”
The same movement could encourage his healing and wellbeing now, too.
And for the person with cancer…
“It’s ok if you’re not happy. You don’t have to put up a front,” Schell says.
During the holidays, people often feel obligated to meet with family they don’t see the rest of the year. Those reunions can be joyous — or not.
“If you have cancer, you deserve to have happy holidays,” Schell says. “You can reduce or eliminate the number of negative people in your life. Sometimes there are just jerks in families. If people are being judgmental or argumentative or not supportive, you can just tell them you don’t feel like visiting — whether it’s Covid, cancer, or you just don’t feel like visiting.”
Otherwise, you risk stressing yourself out. And avoiding stress is key, which can be especially difficult during a season of heightened emotion. Stress can increase forgetfulness (including when to take your medications), interfere with sleep, and create more inflammation in the body.
“For anybody with a chronic illness, stress will exacerbate that illness,” Schell says.
Stress affects all body systems, including the cardiovascular, endocrine, gastrointestinal, musculoskeletal, nervous, and respiratory systems, according to the American Psychological Association.
“So why would you want to knowingly expose yourself to this kind of stress during a holiday season when you’re supposed to be happy?”
During this time of swirling chaos, prioritize turning inward. Protect your quiet time, and practice deep breathing. “Sleep well, nourish yourself, and don’t watch too much news,” Schell says. “And go pet a dog,” she adds. “Make sure you’re nice to your animals. There’s documented evidence that they lower blood pressure and change your hormones.”
Keep the traditions that work for you, and let go of the rest. “Do something for yourself. Hang out with your friends, the people you enjoy spending time with. Re-focus on what’s important,” Schell says.
And remember: Underneath all the trimmings, a holiday is just another day.
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