Coping With Cancer During the Holidays

Transcript: Coping With Cancer During the Holidays with Diane Blum, MSW
December 2, 2003, 2:00 – 3:00 PM ET

Moderator: On behalf of the American Society of Clinical Oncology (ASCO), welcome to the Cancer.Net chat on Coping With Cancer During the Holidays, a live question-and-answer session hosted by Diane Blum, MSW. During this hour, Ms. Blum will answer as many questions as time permits. Some questions may be adapted so that Ms. Blum's answers can help as many people as possible.

Ms. Blum will take questions from 2:00 – 3:00 PM ET. As you prepare your questions, please keep in mind that she is unable to give individual medical or psychological advice in this setting.

The chat is governed by all terms and conditions of the Cancer.Net website.

Good afternoon and welcome. Thank you for joining us. Ms. Blum will now begin taking questions.

Ms. Blum is Executive Director of CancerCare, and Editor-in-Chief of Cancer.Net. She has written and lectured extensively about the psychosocial needs of cancer patients and their families.

Ms. Blum, thank you for taking the time to join us today.

Guest58: This will be the first family holiday without my brother, Seth, who passed away from brain cancer earlier this year. I am looking for ways to honor his memory during family gatherings. I recognize that this may be cathartic for me but might be painful for others. Any suggestions?

Diane Blum: Many people want to honor the memory of someone who is important to them. I would suggest talking with your other family members about your wishes before the holiday. If some of them are uncomfortable with the idea, perhaps you could do something on your own. However, from experience, I would imagine that many of your relatives will want to join you in honoring Seth.

Guest5: How do you face all the food if you are nauseous?

Diane Blum: If you are nauseous, tell your friends and family that you are not enjoying food at this time. If you are comfortable speaking up about your needs, still try to enjoy the celebration, but stay away from the food that will make you sick.

Guest0: Do you think spirituality has a role in the treatment of cancer? Do you have any suggestions on where I could go for faith-based cancer support groups?

Diane Blum: For many people, spirituality is a very important way of coping with cancer. The best place to find out about a faith-based support group is to contact a local clergy person in your community. Another way to find a faith-based program is talk to a social worker at your local hospital.

Guest6: I am 37 years old and have had breast cancer for nearly one year. My prognosis is excellent, and I am looking forward to a joyous holiday season. The problem is my family. They treat me like I am a china doll who could break at any moment. I don't need or want to be treated this way. I know my family means well, but their behavior is a constant reminder that I am ill and could very well ruin the holidays. How can I get them to relax in my presence?

Diane Blum: Many patients express similar concerns. Your family has been through the breast cancer experience and continues to treat you, like you say, a china doll. I suggest choosing a family member who is closest to you and explaining to him or her that you want to be treated as you were before you had breast cancer. Then perhaps, you and this family member can talk to the other family members and explain that you are hopeful about the future and want to enjoy the holidays.

Guest413: Are mood swings common in someone who has cancer?

Diane Blum: Mood swings are common in people with cancer. The side effects of treatment and the normal responses to a cancer diagnosis can easily affect your mood. If you feel that your mood swings are really a problem for you or someone around you, seek out some professional help and talk about the things that trigger your moods.

ann: My son is recovering from sarcoma. He looks and feels different from all the other kids because of his disability. How do I help him feel as normal as possible this holiday season, especially around new friends or family who aren't used to seeing him in a wheelchair?

Diane Blum: This is a very difficult situation for you and your family. I would suggest that you continue with as many activities as were normal for you in past years. To make it easier for everyone, especially your son, talk to your friends and family before you visit with them so they expect to see him in a wheelchair. It will make it much easier for everyone if they are prepared for your son's illness.

Guest24: Are there really stages of grief?

Diane Blum:There really are stages of grief. Many people think that they should get over the loss of someone they care about much more quickly than they generally do. The best way to cope with your grief is to know that there will be ups and downs for a long period of time. Many people benefit from bereavement support groups or individual counseling to help them cope with the stages of grief. You or someone you know may also be interested in talking to a social worker at CancerCare. The toll-free number is 1-800-813-HOPE (4673).

Guest11: I have a 9-year-old old daughter and I'm also a single mom. I would like to help kids with cancer by volunteering a couple of hours a week, to provide care, love, or any kind of support I can give. Unfortunately I can't do it financially, but I thought that this would be a good way to help. I also would like to include my daughter in this volunteering, if possible. Can you please guide me on what I have to do to find out where and how I can do this?

Diane Blum: It's a wonderful idea that you and your daughter would like to volunteer to help kids with cancer. The best way to find how you can be helpful is to contact a hospital in your community and find out about opportunities for helping children and their families. You can also call organizations like the American Cancer Society (ACS) or The Leukemia & Lymphoma Society who probably have chapters in your community, and they will give you information about volunteering.

Guest7: Recently, my boyfriend was diagnosed with liver cancer. He has pushed me aside and now we are more like friends even though we love each other. Is this a common reaction? How can I get him to communicate with me?

Diane Blum: Your boyfriend is dealing with the difficult diagnosis of cancer. Often, people may not have the energy for relationships or activities they had before cancer. You should tell him that you are there for him, and ask him how you can be most helpful to him while he goes through his cancer diagnosis.

Guest45: My mother spends a lot of time caring for her father who has lymphoma. He just finished chemotherapy, and I am worried that she doesn't get a lot of time for herself. Do you have suggestions of ways I could help or things I could give her for Christmas? They both live far away from me.

Diane Blum:Your worry about your mother is understandable. Since you live far away from her, would it be possible to give her a gift of an activity she might enjoy,such as a day at the spa or tickets to a play or concert? Also, if you have other family members or friends who do live near your mother, you could call them and talk with them about ways they think they could be helpful to her.

June: My grandmother (late stage pancreatic cancer) has gotten sicker in the last few weeks and I wouldn't be surprised if she dies soon. Celebrating this holiday season seems out of place and I just want to spend the time grieving. Is there a better way to approach the holiday season?

Diane Blum: Losing someone you care about around the holidays is very difficult. Plan some activities with family or friends where you can remember your grandmother, talk about her, and have a chance to express your sense of grief. We recommend that you do make some specific plans if being by yourself at a holiday time makes your grief even more difficult.

Guest129: My elderly neighbor has cancer. What can I do to help him during the holidays?

Diane Blum: It is wonderful that you want to help your elderly neighbor. Ask him specific questions, like could you take him out to dinner, cook him several meals, or spend some time visiting with him? Suggest specific things you could do to help him out.

jp: How can I deal with cancer-related fatigue when there's so much to do around the holidays?

Diane Blum: Many people who have cancer worry about being tired around the holidays. Feel comfortable telling your family and friends that you don't have the energy you usually have. Ask for help with things like writing cards, wrapping presents, and cooking meals, and try and keep things as simple as possible. The goal is to be able to take pleasure in the holidays and not to be worn out with tasks and chores. Please read the Cancer and the Holidays for more information.

Guest27: My husband is not eating well, probably from the chemotherapy. I still want to have the entire family over for dinner for a Hanukah dinner, but I think he is embarrassed about his health. I feel I need to do this to feel normal again. Please help.

Diane Blum: Wanting to have the whole family over is understandable. It would be best to talk to your husband about your plans for the dinner and what he wants to tell the family. When you and he know how he wants to tell the family that he isn't eating well, you can invite your relatives and prepare them for the fact that he won't be as enthusiastic about the dinner as he usually is. You also might consider having a smaller family gathering so you can maintain your tradition and not wear your husband out.

Guest333: How do I prepare my children for seeing their grandmother? She has lost most of her hair and a lot of weight from treatments.

Diane Blum: Talk to your children before they see their grandmother and tell them that she is going to look different than when they last saw her. It is important to consider the ages of your children—you might want to talk to them separately, aschildren at different ages may respond with different questions. Children over age 7 will probably ask why their grandmother has lost her hair or lost weight,and you will want to answer as directly as you can. For the younger child, you can tell them that their grandmother will look different, but that she is still your grandmother, and you are looking forward to seeing her during the holidays.

Guest 44: How can you tell when normal grieving has turned into clinical depression?

Diane Blum: There is no such thing as "normal" grieving. Grief is different for everyone and can vary in intensity from day to day. If you feel that you are clinically depressed and you should be feeling better by now, it would be very helpful to seek some professional help to talk about your specific concerns. The holidays can be particularly difficult time for grieving and it may be helpful to seek professional help at this time.

Guest49: What can I do to keep my marriage strong? I heard many marriages break-up after a cancer diagnosis.

Diane Blum: Cancer is a great emotional stress for the patient and the family. Communication is crucial. Talk to your husband about the stresses that the cancer is creating for your marriage, and about what both of you can do to help one another. Most marriages that are strong before a cancer diagnosis continue long after treatment is finished, and many couples say that the diagnosis strengthens their relationship.

Guest41: I finished my last course of chemotherapy eight months ago and, so far, everything looks clean. My problem is that almost every night I have terrifying nightmares about cancer and dying. It is so bad that I hate going to sleep.

Diane Blum: It sounds like you are doing well medically, and your future should be good. These nightmares are very distressing and you should talk to a counselor about them. Talking about the nightmares during the day will hopefully help you get control over them and allow you to sleep normally again. Remember that you went through a difficult experience and that nightmares can be a response to that experience. Seek some professional help because it will help you deal with it.

Guest47: I am 19 and have cancer. I was in college, but took the rest of the year off to focus on treatment. My parents want me to go back next semester, but I want to "live life." Travel. Visit with friends. Go to concerts. I think my parents feel like if I go back to school that is a good sign for my future. I don't think I have much time left and want to have fun. What should I do?

Diane Blum: Talk to your parents about your plans. Their response is understandable and you seem to understand it, from what you have written. Explain to them that you have been through a lot for someone who is 19, and you need some time, but reassure them that you will go back to school.

Guest43: Although my husband is winning his fight against lung cancer, he has become extremely depressed and has begun drinking quite heavily. What should I do to help him?

Diane Blum: It is important that you help your husband deal with his drinking. Talk to him about your concerns with his drinking and say that you both need to talk to his doctor about the situationso that you can both get some help. If the drinking is a response to depression, professional help can help him deal with his lung cancer.

Guest127: I am a three-time cancer survivor and the holidays have always been tough. Now my mother is currently going through cancer and just found out today that after the holidays, she will start treatment. What can I do to keep her from dwelling on what's ahead and enjoy the holiday season?

Diane Blum: The holidays are going to be difficult for your mother, who is just beginning to deal with her cancer diagnosis. Ask her what you can do to help her enjoy the holidays and talk with her about your own experience. You write that the holidays have always been tough, but I'm sure you have some suggestions for her from what you've learned.

Guest14: I am a third-grade teacher and one of my students has been diagnosed with leukemia. Some students are beginning to ask questions about cancer, dying, etc. How should I best address them? Should I send a note home with the students encouraging parents to talk with their children about cancer?

Diane Blum: Once children begin to ask questions about cancer and dying, it's really important that you answer them. There are many professionals who specialize in working with children who have cancer to help you answer your students' questions. There is material on PLWC that talks about answering children's questions, such as Dealing With Your Diagnosis Talking to Your Children. The most important point is that the questions have to be answered directly in a manner that is appropriate for third graders. If you want to send a note home to the parents, you should refer them to something they can read to help them talk with their children about cancer. They would have the same questions about talking with their children about cancer that you have and will benefit from some guidance.

June: My mom's good friend just lost her 10-year battle with breast cancer last week. How can she help her friend's family?

Diane Blum:Your mom can help her friend's family by asking this family what she can do. It is very important to make specific suggestions such as preparing meals, running errands, and helping out with children. People are very appreciative of personalized offers of help.

Moderator: The chat is now ending. Thank you for your thoughtful questions, and we regret that we could not answer all of them.We hope this discussion has been valuable. We want to thank Ms. Blum for lending us her time and expertise.

SAVE THE DATE: Please join Cancer.Net for a live chat about Highlights from ASCO's 2004 Gastrointestinal Cancers Symposium on January 22, 2004, from 2:00 – 3:00 PM ET.The featured expert is Margaret Tempero, MD, Deputy Director, University of California San Francisco (UCSF) Comprehensive Cancer Center and Chief, Medical Oncology, UCSF School of Medicine.Dr. Tempero is a research group leader for pancreatic cancer and has published extensively about managing, treating, and preventing cancers of the gastrointestinal system. She is President of the American Society of Clinical Oncology.

The chat room is now closed. Thanks again for joining us.

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