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For Any Cancer Diagnosis

Q. I've been diagnosed with advanced cancer. I have five children and feel they don’t want me around for Christmas, because it makes them sad, and they don’t have the time for both me and their own families. I can’t be alone. I don’t know what to do to or what to say to them.

A.

I am very sorry to hear that you are facing these challenges this holiday season. While you feel that your children are not wanting to have you with them, you don’t say whether you have spoken with them about your concerns. It may be that they are unsure of how you are feeling or what your expectations might be concerning Christmas. If you are in need of any special assistance or equipment to facilitate spending time with them, they may not feel prepared to manage those needs. The key may be to open up a discussion with them to talk about your preferences for being with family that day and to address the practical considerations that would make it possible.

As difficult as it is to cope with cancer during the holidays, it is also possible to be joyful. For many, the idea that you can feel both sad and joyful is an unusual concept. While your family may experience feelings of sadness associated with the many issues related to your cancer, there can also be joyfulness when spending time together with those who mean so much and creating memories of a special day. The challenge can be in maintaining an awareness of the pleasures that are available in the midst of a very difficult time.

Many people face challenges like yours during the holiday season. It might be helpful for you to speak with a CancerCare social worker about your unique circumstances, so please call us at 1-800-813-HOPE (4673). We’ve also compiled suggestions that might be helpful in our fact sheet, Coping With Cancer During the Holidays.

Q. Three weeks before the holidays, my father was diagnosed with advanced cancer. Hospice care has started but I find it isn’t enough and other family members who live in town really don’t offer help. Some days seem too overwhelming - how do I focus on everyday activities?

A.

Depending on your particular family and faith traditions, there can be a lot of expectations at this time of year, many of them focused around finding joy in the season. When illness or grief interrupts those expectations, it can be difficult to manage.

Be kind to yourself during this time, and consider what is truly important to you now. That can require you to adjust your expectations about everything from shopping to housecleaning. Make a list of those things that you truly enjoy and decide which of those traditions you would like to retain. Give yourself permission to “pass“ on those traditions that generate stress or involve a good amount of effort

This may also be a time that you can ask others to provide additional support. This can include a conversation with the hospice social worker concerning what other services may be available. You might use the services of a hospice volunteer or have the ability to engage additional home care supports on your own.

While it would be ideal for family and friends to volunteer their help, it may be necessary to ask them. Consider whether there are specific tasks that you can ask others to perform which can provide you a break from the day-to-day demands of care giving. Is there someone who can stay for a few hours, offer to go to the market, or bring your father to a scheduled appointment? Many times family and friends would like to help but are at a loss as to how to be helpful without being disruptive to routines.

An additional resource you might find helpful is our Connect Education Workshop, Coping with a Loved One’s Cancer During the Holidays.

Q. I was diagnosed with cancer a few months ago and I don't feel much like celebrating the holidays. I'm worried I'll be a downer for my family and I'm not sure how to act.

A.

Adjusting to the reality of a cancer diagnosis and the changes to your life takes time and energy. It makes sense that you don’t feel like celebrating. You’re probably experiencing many feelings: some negative, such as uncertainty about the future, and also some positive, such as gratitude for the love and support of family and friends. It’s okay to not feel up to celebrating, but you should try as much as you can to not let your fears about being a “downer” keep you from staying connected with the important people in your life. Here are some practical tips that could be helpful to you:

  • Keep your expectations realistic. Know your physical limitations and give yourself extra time to rest as needed; anticipate that strong emotions will hit you unexpectedly, and give yourself permission to be less than “joyful” all the time.
  • Delegate — let others help! Create a list of tasks you can ask others to take on for you accomplishes two things: it helps distribute responsibilities in a more manageable way, and people feel more comfortable when given something specific to do to help.
  • Save your energy for the important stuff. In other words, prioritize and pace yourself. If you need to turn in early, or aren’t able to eat in your accustomed way, just let people know. Everything doesn’t have to be done all at once: enjoy what you can now, and look forward to enjoying more in the future. Maintaining holiday traditions is important, but that doesn’t mean they can’t be altered or replaced with new ones.
  • Share your feelings with others. Don’t be afraid to express your feelings and concerns to family and friends. But consider in advance how much you feel comfortable sharing, and how much the other person may be able to hear. These are judgment calls, and not easy to make, but remember that the goal is not so much about imparting information, as it is supporting and enriching relationships.

For additional tips, please read CancerCare’s fact sheet, Coping with Cancer During the Holidays.

Another source of information is available from the American Cancer Society.

Q. As caregiver for my husband, I have no interest in the holidays. I know this is a disappointment to our adult children and our young grandchildren don't understand why I just don't care about shopping, etc. What can I say to them to tell them I love them but I am just so sad, other than just that?

A.

I don’t know how things stand right now with your husband’s treatment and the extent of your caretaking duties, but it may be that you’re feeling “burnt out.” Even though it’s the holiday season, it’s hard to feel like you can take “time off” from cancer. I wonder if your lack of interest in shopping and the trappings of Christmas is a signal that you need to replenish yourself physically, emotionally and spiritually. My suggestions for you are not so different from the ones I gave previously to patients coping with the holidays: Keep expectations realistic; Let others help, even if you’re still the principal organizer of holiday activities; Set priorities and pace yourself; and Share your feelings with others.

Try not to dwell only on the cancer: remember that the meaning of the holidays is in certain ways already expressed through the care you are giving. And although you’re struggling with feelings of sadness and loss, you are still permitted to enjoy the gifts of the present: to celebrate not only a grand religious tradition, but also the moments of joy and gratitude for being with the people you love.

For more general tips on how to support yourself as a caregiver, see the previous feature on caregiving in the Ask CancerCare archive, with links to other resources and publications, or our Fact Sheet, “Caring Advice for Caregivers: How Can You Help Yourself?”

For Breast Cancer

Q. I've just started treatment for breast cancer and I need to talk about my fears and concerns with the people who are closest to me. But my family just says, "Oh, you'll be fine" and to stay positive. How I can I get them to listen?

A.

A diagnosis of cancer is a little like throwing a stone in the water; the ripples extend well beyond where the stone lands. Just as you are trying to deal with treatment and the concerns that go along with it, so, too, is your family. They may be anxious about how to help you and afraid they may upset you if they talk about your feelings or theirs. Much has been written about the need to remain “positive” for the person with cancer and family members are often concerned that if they express negative thoughts or concerns it will make the illness worse.

We’ve developed information to help address some of these communication challenges that may arise. Coping with Cancer: Tools to Help You Live and Caregiving for Your Loved One With Cancer are Connect® booklets that might be helpful to you and your family members. Our fact sheet, “What Can I Say to a Newly Diagnosed Loved One?” may also help your family members talk with you about your diagnosis. Another good resource is The Breast Cancer Companion (Avon Books, New York) by Kathy LaTour; several chapters deal with opening communication.

You might also try to set aside time to have a family meeting and allow each member an opportunity to talk about their concerns. For example, family members might meet to read aloud letters they have written about their own fears and emotions, as a way to begin the discussion.

Remember, not all families can respond in ways that will be helpful. A support group might be useful to you as a way to connect with others who understand how you are feeling. CancerCare offers groups in-person, over the telephone, or online. You can also contact us at 1-800-813-HOPE (4673) and speak with an oncology social worker.

For Cervical Cancer

Q. I'd like to connect with other women who have cervical cancer. I feel like they'll understand me best. Can you tell me where I should look?

A.

Support groups are a wonderful opportunity to speak with other women diagnosed with cervical cancer. Support groups provide a safe environment to share thoughts, ideas and feelings with others in a similar circumstance. Members in a support group often feel less isolated during their cancer experience as they exchange useful information on medical issues, resources and practical concerns.

CancerCare provides online, telephone and face-to-face support groups that connect you with women diagnosed with cervical cancer. All support groups are free and led by professional oncology social workers.

The National Cervical Cancer Coalition (NCCC) offers a Phone and E-mail Pals Program that matches cervical cancer survivors with others in a similar situation. For more information on this program, contact NCCC at 1-818-992-4242.

And finally, EyesOnThePrize.org has an email discussion group for women with gynecologic cancers.

For Lung Cancer

Q. My 68-year-old husband was diagnosed with lung cancer in 2004, had radiation and chemo, and is currently in remission. Since ending his treatment, his personality has changed drastically and he directs his anger towards me. Can chemo affect a person mentally?

A.

Chemotherapy can affect a person’s mood, as can other medications such as steroids. It is important that you and your husband inform his doctor of changes in his mood to rule out any medical causes. The change in his personality may also be a sign that he is still struggling emotionally with his diagnosis and treatment. Cancer can be overwhelming and bring up many feelings from anxiety to anger to sadness. As your husband’s primary caregiver, those feelings may be directed towards you since you are the one he is closest to and trusts. If you haven’t done so already, letting your husband know how his feelings and behavior affect you is important. Seeking couple’s counseling is also a good idea if you are having difficulties communicating with each other.

The end of treatment often can lead to many strong and conflicting feelings. When a person is first diagnosed with cancer, he/she is often focused on learning about the diagnosis and getting through treatment. This can delay the emotional impact of cancer and feelings may come up once treatment ends, as there is more time to think about what has happened. For more information on coping post-treatment read, After Treatment Ends: Tools for the Adult Cancer Survivor.

For Ovarian Cancer

Q. I was diagnosed a few years ago with ovarian cancer and have finished my treatment, but now I'm afraid of recurrence. Is this normal?

A.

After a diagnosis of ovarian cancer, a woman can feel vulnerable and experience a lot of uncertainty. The emotional, social and physical experience of having ovarian cancer can be overwhelming and living with this experience often leaves one with a fear of this happening again.

While your fears are typical, at times they many vary. For example, around the time of your check-up, blood tests, or when a milestones or anniversary is approaching you may feel sad, irritable, or anxious. Allowing yourself to acknowledge and accept your feelings is the first step. Developing ways to manage these feelings is extremely important and a way to be kind to yourself. An important act of kindness to yourself is to live in the now and find ways to balance your fear of recurrence with enjoying your life, and the hope for continued wellness.

Ways to manage fear of recurrence:

  • Get support. Many women find comfort in a support group. Share your feelings and learn how others are coping with challenging and common fears, which can provide you with a community of strength and understanding. You can also speak with a CancerCare oncology social worker about your concerns.
  • Take good care of yourself. Get enough sleep and reduce stress. Find things to do that are comforting such as meditation, yoga class, writing in a journal, or spending time with your pet. We all have activities we find soothing and it is important to develop these and do them when you need to.
  • Communicate. Share your feelings with the people who are important to you. Let them know how you are, and what they can do to help. Set limits if you need to by deciding what you can commit to and what you can do another day.

Find additional information through the Lance Armstrong Foundation and Cancer.Net.