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Patients and their caregivers must do a balancing act during the holidays of continuing past traditions while also conforming to the demands of cancer treatments, side effects, and doctor appointments—families are learning that with a proactive approach and family communication, the holidays can still be festive and memorable.
For Dallas librarians Paul and Carol Dumont, Thanksgiving to New Year’s is at the core of family celebrations. When Carol became ill in early November of 1999, Paul’s instinct was to maintain their traditions despite the timing.
By early December, Carol, now 63, was diagnosed with stage 2 colon cancer and underwent surgery and began radiation treatment. She was home by mid-December and began chemotherapy that January.
Adversity from a cancer diagnosis and treatment during the holidays can be overwhelming, particularly to the caregiver, says Carolyn Messner, DSW, an oncology social worker for CancerCare, a national nonprofit organization that provides free professional support to patients and families.
“Society places a great deal of emphasis on the holidays. The first thing we suggest is the family develops a plan. The important thing is the right balance between celebrating and dealing with the illness,’’ says Dr. Messner, who has 31 years of experience helping cancer patients.
It may be that the patient wants the holidays to be exactly the same as in years past, complete with extended family and eggnog. Other patients may request a toned-down holiday, replacing a large, extended-family tradition with a small, immediate-family gathering.
Side effects of treatment may also sideline traditions. If the patient is neutropenic and vulnerable to infection, holiday guests and well-wishers may need to change their plans to visit. Foods may need to be prepared elsewhere to avoid aromas that may cause nausea. Also, be aware that favorite dishes may taste different because of treatment.
The holidays can be different and sometimes difficult. Acknowledge the change and, if necessary, give the patient permission to be sad, Messner advises, but also be aware of symptoms of depression. For information on depression, including cancer-related depression, symptoms, and treatment, see CURE Summer 2004.
Messner suggests that caregivers consult the patient and health care team before the holidays about ways their loved one can feel better physically during this time. “Some newer treatments better manage the side effects of chemotherapy to reduce slight fevers and low energy," she explains.
Communication between family members proved vital for the Dumont family after Carol's diagnosis. Paul immediately called a meeting with their three daughters and son. All but their youngest, Marguerite, a high school freshman at the time, were adults.
“Before the diagnosis we knew something was wrong,” Paul says. “The concern was how Carol wanted to handle the season.”
Paul says Carol has always been crazy about the holidays, even decorating for Valentine’s and St. Patrick’s Day. Carol insisted nothing change for Christmas. “It was important to keep the routine. [The children and I did the] little traditions that she had taken care of,” Paul says. “Maybe not as well done as if she had done it, [but] it gave Carol hope. Hope is important to someone fighting cancer.”
“I remember lying on the couch where the girls insisted I perch, watching them trim the tree,’’ Carol says. “Paul insisted on doing the shopping. I was too weak. It felt good to keep Christmas going.’’
Novelist Joanne Skerrett was 31 and living in her hometown of Boston when she was diagnosed with stage 2 breast cancer in the summer of 2003. By August she had undergone two surgeries and began chemotherapy in December. Her illness came two years after her mom’s sudden death of a heart attack.
“Joanne took Mother’s death the hardest. She was still grieving when she became ill. She was so young. Naturally we worried,’’ says Desry Skerrett-Parker, Skerrett's older sister and main caregiver.
Most of Skerrett’s family lives in Boston and came to her aid. She had always been independent, says Skerrett-Parker, a clinical nurse specialist who has worked in oncology. It was clear, however, that Skerrett needed her family to get through the holidays.
“I appreciate how my family tried to not make it a ‘Cancer Christmas,’ ” she says. “During the holidays I spent time thinking about losing my hair. I tried not to get depressed. I’m going on 32; I’m going to lose my hair, and I don’t even have a boyfriend,’’ she recalls thinking. Later she penned a novel, Sugar vs. Spice, based loosely on her own cancer experience.
“We made sure that we gave her space. She realized how weak she would be from the chemo,” says Skerrett-Parker.
For Skerrett, the food part was the easiest. “My family is originally from Dominica. The whole thing about eating was great,” she says. “To keep my strength, I had to eat 3,000 calories a day. I said, ‘OK!’ ”