Coping with Cancer During the Holidays, with Lidia Schapira, MD

December 9, 2013
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In this podcast, Dr. Lidia Schapira discusses how to cope with some of the common challenges people with cancer face during the holidays.



ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world's leading professional organization for doctors that care for people with cancer.

In today's podcast, Dr. Lidia Schapira will discuss how to cope with some of the common challenges people with cancer face during the holidays. Dr. Schapira is a medical oncologist at the Gillette Center for Breast Oncology at the Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School. She is also an associate editor for Cancer.Net.

Dr. Schapira: Hello. I'm Dr. Lidia Schapira. I'm a medical oncologist in Boston, and I'd like to chat with you a little bit about coping with the stress of holidays as the season is upon us. I'd like to address my comments mostly to those who are newly diagnosed, who are receiving treatment, or perhaps those whose loved ones are currently undergoing cancer treatment. We have a range of materials for many of you if your interests are in this area, and for those who have been dealing with cancer perhaps for a longer period of time. But what I'm going to try to do right now is just to chat with you in the same way that I do with my patients in my practice. Those who are new to this and may be feeling a little bit of stress, or may even be feeling overwhelmed as this holiday season approaches and there are many expectations, and we have ideas of what the perfect holiday perhaps ought to be like, and find ourselves unable to live up to these mental ideas, or these expectations.

The first thing that I'd like to do is just to reassure you that if you are feeling overwhelmed it's important not to worry alone. Reach out to somebody who can listen to you, perhaps give you some comfort or support. Sometimes that just means a friend, a loved one, a relative. And sometimes it means somebody from the professional care team. If you are losing sleep, or you are feeling really so overwhelmed that it's sort of hard to figure out how to get through the day, it's time to reach out to somebody from the professional team and get a little bit of help.

For most people, just receiving cancer, or having cancer, is a real disruption in their lives. And for the holiday season many of us have ideas of how it should be. Often there are travel plans, or get togethers with families. Those of you who are actively parenting young children or who have grandkids and look forward to these visits every year may feel terribly disappointed if you can't keep up your normal traditions or participate in the routines. My first advice is slow down. Be kind to yourself. It's very important that you focus on taking care of yourself. And let me tell you that your loved ones, your friends, your children will certainly understand. For those with very young children perhaps it's a little bit more complicated because you feel like running around, and getting them everything they want, and having everything beautiful for them, but for you too, slow down. Or perhaps ask a friend to do some of the tasks that you normally do.

Some of the feelings that many of the cancer patients undergoing treatment experience are related to just plain anxiety, fear, and feeling a little bit out of control. The things that you might have been able to manage other years without any effort, without even thinking about it, all of a sudden may feel like chores because in fact, you have less energy to deal with everything in front of you. So perhaps this is the year for you to do less in-person shopping and more online shopping. Perhaps this is the year for you to ask somebody close to you to use your favorite recipe and produce that wonderful dessert or meal that normally you cook. Perhaps it's your turn to ask somebody else to host a family gathering or to put off a trip to be with family, so that you can stick to your treatment schedule. And you don't need to put the additional pressure on yourself of traveling, especially traveling at a time when airports, and train stations, and roads are packed.

Often fatigue can just be the limiting factor and may not allow you to do what you normally do. And here too perhaps, instead of panicking, instead of getting anxious about it, if you just sit down maybe and make a plan and just prioritize the things that need to get done, and are really important for you to do, and you really don't want to delegate. And perhaps give your high energy time during the day, or if you're receiving chemo, on those days when your energy is almost close to normal, that's when you can do these activities that you really think only you can do well. But for the rest of the time be kind to yourself. Turn inward a little bit. Think about slowing down. Think about soothing yourself. Sometimes that means just taking naps. Sometimes that may mean listening to music, or participating in a spiritual or religious experience, or just talking to a friend. But do something that feels comforting, that brings you solace and peace of mind.

If you feel, however, that even doing all of these things still leaves you with a lot of anxiety, perhaps anxiety because you're facing an uncertain future, perhaps after the diagnosis of cancer, or while you're undergoing cancer treatment, you're having some fears. Maybe existential fears, maybe fears about what could happen, about the cancer coming back, or about having to suffer other discomforts, or potentially having to alter your life as a result of the cancer. Perhaps all of those anxieties and fears are bubbling up right now at this time when many people feel that they must feel happy and grateful. If you are feeling that kind of anxiety and experiencing that kind of pressure, again, I suggest that you bring this up with either your oncology nurse, your physician, or if you're in therapy or have a social worker with somebody who can really help you. Sometimes just talking about it openly, just talking about the fears, bringing them out in the open, can really be enormously soothing, or can at least give you an idea of who's there to help, and how you can help yourself. Just finding ways of calming the mind, those focusing on things that you are most happy about or grateful for may have an effect of making you feel a little bit more centered, a little bit more in control.

So as you feel perhaps the fatigue and physical symptoms are slowing you down and not allowing you to have the normal energy or control, and perhaps as your anxieties or your fears are also mounting, these two things together can sort of make you feel, again, a little bit out of control and can bubble up. So slow down. Be kind to yourself. Reach out to somebody who loves you, whose presence is always comforting to you, and try to find a way of pacing yourself and finding something that feels comfortable. A routine and a rhythm that feels comfortable.

For some patients going through cancer treatment, there is another problem, and that's that they may feel more lonely or more isolated because in fact, they may be unable to join their relatives, or friends, or neighbors in community events, and they may not be able to participate in some gatherings. So, again, be really kind to yourself. Find somebody who can support you. Maybe a phone call can help a little bit, even if you can't physically attend all of the gatherings that you normally do. Some of you may just feel that you don't want to see anybody because you don't look well, because you don't look the same as you typically look, and that is okay as well. Use your intuition. Talk to somebody. Try to be clear about what you want to do, what you don't want to do. Give yourself permission, perhaps, to miss a celebration or to miss a holiday party. You may not feel up to the expectations of people at work or in the family to attend a lot of parties or participate in a lot of events. So be kind to yourself. Pace yourself. Hold on to the energy. Decide how you want to use your energy. Try to minimize the anxiety through soothing exercises or soothing actions towards yourself. And above all, if you need help coping, if you don't feel supported, then reach out to somebody in your medical team and I'm quite sure they'll be able to help.

Let me take this opportunity to close by saying that the professional cancer community is here to help as well, both with physical needs, emotional needs, existential needs. So if you do need help, please reach out and ask those who are looking after you professionally to take a little time to listen to your concerns and to give you some good suggestions or some real assistance. To the rest of you and to the rest of all of us, let's get through this holiday season safely. Let's try to minimize our stresses and take a moment to think about things that we may be grateful for. And let's also take a moment to come to terms with our own anxieties and our own fears and find ways of helping ourselves and helping each other. I hope these words have been useful and helpful to you. And I would like to end with my best wishes to all of you for a peaceful and safe holiday season. Thank you very much.

ASCO: Thank you, Dr. Schapira. [music] For more information on coping with the holidays during or after cancer treatment, visit

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