Cancer and the holidays: Tips for understanding and coping with your emotions

By Jessica Saenz and Nicole Brudos Ferrara

The holiday season and the conclusion of another year can sometimes magnify difficult emotions, especially if you — or someone you love — are dealing with the fear and uncertainty of a cancer diagnosis.

Shehzad Niazi, M.D., a Mayo Clinic psychiatrist who works with people with cancer and their families, explains why holidays can trigger emotions and how he helps his patients cope.

Understand the root of your emotions

"Cancer is a very emotionally laden diagnosis," says Dr. Niazi. "It comes with many cognitive, emotional, psychological, spiritual, and existential conundrums and challenges." He says there are some common reasons his patients struggle more with their emotions during the holidays.

Holidays and other major events can be a time for reflection

"Cancer forces us to think about things we generally don't think about, and it raises many existential concerns," says Dr. Niazi. "These concerns can become more front and center around holidays and major life events."

Some people use the holiday season and the beginning of a new year to review goals or plan for the future. "When you are dealing with a condition that is potentially life-ending or life-changing, it colors how you perceive the future and how you think you will be able to function," says Dr. Niazi.

Some people with cancer may have had family members who have passed away due to cancer. The absence of those loved ones at holiday gatherings can be challenging for someone with a cancer diagnosis. "It reminds them of their mortality and how it might be for their loved ones if they were to pass on," says Dr. Niazi.

Holidays come with roles and traditions that may need to change

Traditions surrounding the holiday season can shape expectations for holiday gatherings. When those traditions must be altered, it can cause feelings of grief.

For example, someone who has always hosted a party for the family may be struggling with symptoms that now make it difficult to eat, let alone cook for others. Someone else may have always traveled to gather with family members over the holidays, and symptoms now prevent them from traveling. "These traditions become a stark reminder of what a person has lost," says Dr. Niazi.

When a person’s role in a family holiday tradition must change due to cancer, everyone who shares in that tradition can feel grief. "These changes are concrete reminders of the life that a person wishes to live and is unable to live, at least at present," says Dr. Niazi.

What you can do to cope

How you cope with cancer during the holidays will vary depending on how the disease affects your life. Dr. Niazi says focusing on what you can control can help.

Decide in advance what you want to share and be direct

Deciding whether to share details about your cancer diagnosis with family and friends is a personal decision. "You get to decide how much to share, when to share, with whom you want to share, or to not share at all," says Dr. Niazi. "But gatherings around the holidays can make that complicated."

Physical changes that result from cancer treatment can be difficult for people to cope with at holiday gatherings. Hair loss or weight loss due to chemotherapy treatment or changes in body shape due to surgical procedures can announce a person’s diagnosis even if they don’t wish to share it.

"It creates a lot of self-doubt regarding how to interact with people. On one hand, you may want people to care. On the other hand, you may not want to be treated like a cancer patient. You want to be treated like a person who happens to have cancer," says Dr. Niazi.

When it comes to family and friends, Dr. Niazi says it’s better to be direct and avoid assuming people will know how to handle your situation. "Some patients get upset when family members or friends don't call them and ask them how they're doing. And some patients get upset when others ask about their cancer or its treatment because they think that's all everyone talks about. Making your expectations explicit is a good idea," he says. "I tell my patients to write down what they want to say and rehearse it so they won’t feel at a loss for words."

Take a problem-solving approach when you can

Dr. Niazi recommends anticipating problems that might arise during the holidays and planning ahead. "I want my patients to have a plan A, a plan B, and a plan C," he says. Plan A might include establishing a relationship with a primary health care professional who can help with medications. Plan B could involve joining a support group. And plan C might include talk therapy with a mental health professional or seeing a psychiatrist for medication management.

No matter how cancer is affecting you during the holidays, these are Dr. Niazi’s suggestions for a problem-solving approach to coping:

• If you take medication for depression, anxiety or another mental health condition, refill your prescriptions before the holidays. If you feel your medication dose needs to be adjusted, talk to your mental health care professional. Ask: Will I be able to get any as-needed medications while out of town?
• If you don’t have a mental health diagnosis, but you feel you might need mental health support over the holidays, talk to your health care professional and create a plan for medication management or talk therapy.
• Talk to a pastor, rabbi, imam, or counselor in your faith community.
• Join a support group.
• Have the phone numbers of at least three people you can talk to at any time if you find yourself in distress.
• Create a happy memory box: Fill a box with photos, mementos, or objects that remind you of joyful experiences. When feeling down, take out the box, look at its contents and try to recreate that joy with your memories.
• Fight loneliness, especially if you live alone. Make plans with people. If you’re invited somewhere, go — even if it’s only for a few minutes.
• Participate in activities that you find relaxing and restful.
• Use a free or low-cost stress-management app on your phone.
• Take advantage of any health and well-being resources offered by your employer.
• Visit your local library to find books on stress relief and resilience, such as the Mayo Clinic Handbook for Happiness.

If caring for a loved one with cancer, take care of yourself first. Eat a healthy diet. Exercise. Sleep. Maintaining your wellness will make you a more effective caregiver.

Find support that works for you.

There is no one-size-fits-all approach to coping with cancer over the holidays. Dr. Niazi stresses that the challenges of cancer and its treatment vary from person to person, as do the resources available to deal with those challenges. What works for others might not work for you.

"Distress is a supply and demand mismatch," says Dr. Niazi. "The demands are your obligations, the problem you must deal with, or your to-do list. The supply is your financial, physical, emotional, spiritual, and cognitive resources. Sometimes, no matter how many good things you have on the supply side, the demand is so high you can't meet it."

Your coping strategy should match your reality. And if you already have a full plate during the holidays, says Dr. Niazi, don’t add anything to it.

Learn more

Learn more about how to cope with cancer this holiday season by exploring these free resources:

Articles

• "Cancer and mental health: Coping with the burden of your diagnosis"
• "Cancer diagnosis: 11 tips for coping"
• "Caregiver stress: Tips for taking care of yourself"
• "Grief and loss throughout the holiday season"
• "What to expect when caring for someone with cancer"

Mayo Clinic Connect, an online community connecting patients and family caregivers

• Cancer Group
• Caregivers Group
• Online support groups and events

Mayo Clinic Cancer Education

• "Grief and Loss"
• "Stress Management for Cancer"

National Cancer Institute

• Resources for Patients
• Resources for Caregivers