Ask CancerCare

I’d like to thank you for taking the time to write in to us and offer my condolences to all that you’re going through, both with your own cancer and your mother’s loss.

I can certainly understand the conflict of emotions present in your family this holiday season: wanting to experience joy along with everyone else when dealing with something like cancer and like grief. You shared that your family is having a hard time coping, but how about you? Since you’re the person being directly affected by this, I hope you’re making time for your own coping as well.

To address more of what it sounds like you’re inquiring about, how to help lift the spirits of your family, I have a couple of ideas I usually recommend to clients in similar situations:

• Starting new family traditions. I’m sure there are some your family already have that are the source of warm, happy memories for you. Starting a new one can help your family connect in the form that is now (without your mom, but potentially new in-laws or children) and can help your family have happy memories with/of you despite you going through cancer treatment right now.
• Celebrations of life are also very helpful in coping with grief specifically. Rather than eulogizing your mother’s death, reflecting on the moments of joy during her life and the happiness she brought each of you can help make Christmas a more positive experience for you all.

I also recommend checking out some of our resources through our website about cancer and the holidays.

• We offer a fact sheet Coping With Cancer During the Holidays
• We also have a booklet specific for the caregiver experience during the holidays. This may be helpful for your family members, if you’re interested.
• We have a Connect Education Workshop episode from a few years ago about coping with cancer for the holidays. You can listen to it on our website, though you can also find our workshop on whichever podcast app you use. (I should note that even though this was part of a series about renal cell cancer, a lot of the points about coping and emotional support can apply to your situation as well).

You can also speak to one of our oncology social workers by phone, Monday through Friday, on our HOPELINE, 800-813-4673.

A good place to begin your search for counseling for your son would be the hospital where your husband receives treatment. The social work staff may be able to provide individual counseling and/or support groups. If these services aren’t available at the hospital where your husband is being treated, they might be able to provide you with the name of a local therapist who moderates groups or who works with adolescents individually. Your general practitioner might also be a good source for referrals to these types of services. If your husband is receiving hospice care, the hospice team often provides counseling for the family.

It would likely be helpful to discuss with your son what he thinks would be the best way for him to process his feelings. Does he want to participate in a group, or would he be more comfortable talking one-on-one with a counselor? Opening up a dialogue and eliciting questions will help you understand what your son is feeling and can deepen the connection between you. Despite the difficulty of the situation, he will also see your concern and dedication to helping him bear the reality of the situation.

Additional resources that may be helpful include:

• Our podcast Helping Children and Teens Understand When a Parent or Loved One Has Cancer
• Our publication “Helping Teenagers When a Parent Has Cancer”

Although CancerCare does not provide telephone counseling to teens, you may call us to speak with one of our oncology social workers who can help support you as you help your son cope with his father’s illness. Our social workers can also help you find local resources. We can be reached by calling 800-813-4673.

It makes sense that you don’t feel celebratory–you may be coping with fatigue or pain, and feel uncertain about the future. While your self-expectation may be that you should be smiling and happy at this time of year, the truth is no one can ever be sure how he or she might feel on any given day, and cancer, especially, doesn’t go on holiday. But try not to let your fears of being a “downer” keep you from staying close to the important people in your life. Although people close to you may not know how to approach the subject of cancer, that doesn’t mean they won’t be understanding, or don’t want to help. If you are open to talking with them, you may find that friends and family are more compassionate than you anticipate. While not everyone may be equally helpful, raising the subject of cancer may bring many of your family members closer. Here are some practical tips that could be helpful to you:

Listen to your body. Gauge your physical limits to give yourself time to rest and to manage your energy.

Manage expectations. Remember that you can only do the best you can–if you are not feeling well during a holiday, remind yourself that it is just one day of the year, and that the people you want to be with will care about you just as much even if you don’t feel like celebrating. Give yourself permission to be less than “joyful” all the time.

Communicate. Talk with friends and family members a few days before you see them. Let them know how you are feeling and that you would like their understanding. Since it is likely that not everyone you know will respond the same way, spend a moment to consider how much you want to share and how much a given person will be able to hear.

Plan ahead. Don’t hesitate to ask for what you need. Most often family and friends want to help, but they may not know how, or what to say. They may be relieved if you reach out to them to let them know what will make you feel comfortable. Create a list of tasks or that you can ask others to do for you that you need help with.

Keep in mind what is most important to you. Holiday traditions are important, but that doesn’t mean altering them is bad–if you aren’t able to do exactly what you have done in the past, there is nothing wrong with starting new traditions. And while gifts are nice, it is the sentiment behind them that is most memorable. Simply being with people who care about you is a gift, both to them and to yourself.

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

Thank you for the thoughtful question. As I am answering after Christmas, I hope it will be this will be of use—perhaps at New Year’s or a birthday, but I think the same principles hold true.

The answer depends on how what your father wants—or possibly, how much you are able to figure out what he wants. If your father is aware that this may be his last Christmas (or birthday, etc.) and you feel he is able to talk with you about this, simply ask him what he wants and would make him most comfortable or happy. Would he like to have just a few people around him and a quiet dinner? Would he like to watch you and other relatives have the same Christmas routine as always? Or does he have something else in mind entirely?

Too many options can overwhelm anyone, so you may want to present only two or three choices. For instance: “Dad, what would make you feel best? Just immediate family at home? Family and close friends?” And so forth. If he can’t or won’t choose, go ahead and choose yourself. You love him. So your decision won’t be “wrong.” The most important thing is to let him know how happy you are to share this holiday with him. Tell him what you love about him. What you appreciate. Encourage other people to do so to.

If your father is unable to understand, or not willing to accept that he is near the end of his life, you will need to rely on your judgment and draw on your experiences with him. Has he ever given you his opinion about another person in a similar situation to his, or spoken about the final days of his own father? This may give you insight into what he would like now. Think back: historically, what has a holiday meant to him? Has the focus been on a family dinner, or seeing relatives from out of town or gift giving or an activity? Keeping things simple often helps. You may want to choose just one easy thing.

It sounds as if you have had many joyful holidays together, and while there is comfort in the repetition of activities from year to year, remember that not every year is the same, and that your father may not have a lot of time, but he has your love and devotion and that is the biggest, most lasting and important gift of all.

Caregiving is a difficult and an often unappreciated part of living with a person with cancer. It is physically and emotionally draining, if not exhausting, and others may not be aware of the difficulties you are facing. While the holiday season may mean time off from work for some, you may feel that there is little or no time off from your caregiving duties. It stands to reason that you may forget to buy gifts or not feel like going to parties. You aren’t being selfish, you are sensing that you need to take some time for yourself, which is necessary. You are spending both mental and physical energy caring for another person, and that is no small thing.

Communication is so important—without having a direct exchange with your friends it will be difficult to know exactly what their expectations are, or to what extent they understand your situation. One thing to do before you reach out to your friends, is to clarify how you are feeling and what you want to say. Perhaps you can set aside a few minutes to write down your thoughts and feelings about holiday pressures and expectations, and what it is that you would really like the holiday season to be for you. Having done this, you might call your friends—or send what you have written as a letter or email. It is likely that they will be able to empathize. You might begin the conversation by saying how much you appreciate their friendship, that the parties and events sound enjoyable, but that right now you would like their understanding–your responsibilities are too great to let you participate in all their activities. By stating these things simply and directly you are being sincere and won’t come across as selfish or thoughtless.

Caregiving is a difficult and an often unappreciated part of living with a person with cancer. It is physically and emotionally draining, if not exhausting, and others may not be aware of the difficulties you are facing. While the holiday season may mean time off from work for some, you may feel that there is little or no time off from your caregiving duties.

Tell your children and grandchildren that you love them as much as ever, and that you would like to do everything that you have done in the past, but that you may not be able to right now. Everyone will feel more comfortable knowing what you are thinking, and will feel reassured that while the way you need to spend your time has changed, your feelings for your family haven’t.

Explain to them what you are not up to doing, and ask them if they could help you with some of the things that you would normally do alone. Giving your adult children (and your grandchildren, to the extent that it is appropriate) new tasks and responsibilities would likely make them feel good about being able to help, and create even stronger bonds among you. You can reassure your grandchildren that although you don’t feel up to doing the things that you have normally done with them in the past, that this doesn’t mean that you won’t do those things again in the future.

If possible, see if there are people close to you who can look after your loved one while you find some rest or diversion, so that you may enjoy holiday activities with others, or just spend some quiet time alone or with a close friend.

For more general tips on how to support yourself as a caregiver, read our fact sheet “Caring Advice for Caregivers: How Can You Help Yourself?”

When coping with a cancer diagnosis, families often experience a variety of changes and adjustments during the holidays and other significant events. Discussing and preparing for these changes with your children can open up dialogue, elicit questions and help you to understand what your child is feeling. Although certain rituals or customs may change, it can also be helpful to honor old traditions as a way of maintaining a sense of normalcy for your children. Remember that cancer doesn’t have to be the focus of the holidays, and you have discretion over how much room cancer gets during your celebration.

Books can be helpful tools or supplements to reinforce language and ideas to help children cope with a parent’s cancer diagnosis, but should not replace a conversation. The holidays may be an opportunity to have such discussions, as you are likely joining together as a family to reflect on the past year and to make plans for the year ahead.

When selecting literature to help you talk to your children, consider your child’s age, developmental stage and maturity level. Being honest allows children of any age an important opportunity to ask questions and express how they feel. You may not have all the answers, but you can remind your child that you will always be available for them to ask.

For more information about coping with the holidays and communicating with children about cancer, read CancerCare’s Coping with Cancer During the Holidays and Helping Children When a Family Member Has Cancer, or review the following books to help you navigate these conversations:

• How to Help Children Through a Parent’s Serious Illness by Kathleen McCue and Ron Bonn (St. Martin’s Press: 1994)
• Helping your Children Cope with your Cancer by Peter Vandernoot (Hatherleigh Press: 2006)
• When a Parent Has Cancer : A Guide to Caring for Your Children by Wendy Schlessel Harpham, MD (Harper Collins: 2004)

People view the holidays as a time to celebrate and connect with family and friends. However, the season can be stressful if you are living with cancer and trying to manage treatment side effects such as fatigue, weight loss or gain, nausea or pain.

Fortunately, doctors have many ways to reduce and even prevent side effects. At CancerCare, we often use the word “coping” to describe how people deal with cancer. People sometimes mistakenly think that coping means just living with a problem, whether you like it or not. But coping actually means managing a problem and finding a new way to take control of it.

You can maximize your enjoyment of the holidays by letting your health care team know now about your holiday plans and ask for their help in taking control of treatment side effects. Make an appointment with your doctor to discuss your concerns and ask for guidance regarding holiday meals, travel, and conserving your energy, as well as rescheduling your treatments, if possible, so that any resulting side effects will not occur on during the holidays.

CancerCare offers publications offering additional information so that you can better manage your treatment side effects and enjoy the holiday season:

• Coping with Cancer During the Holidays
• Understanding and Managing Chemotherapy Side Effects
• Coping with Cancer: Tools to Help You Live

You can find additional information through the National Cancer Institute.

CancerCare’s social workers are here to help you with emotional support and practical help. Call 800-813-HOPE (4673) or email info@cancercare.org.

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.

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.