Facing cancer during the holidays  

Malory Lee Hi, I'm Malory Lee, and I'm a senior social work counselor here at MD Anderson. Today I'm joined by Traci Newsom, who is a senior social work counselor at MD Anderson League City. And this is the Cancerwise Podcast. Hi, Traci. Thanks for joining me today. I'm looking forward to our conversation. Today we'll be discussing navigating the holidays while dealing with cancer. And that can be going through active treatment, that can be having completed active treatment, that can be having a loved one going through cancer treatment. So, this is a big topic, a lot to talk about. So, let's get right into it. 

Traci Newsom Thanks for having me. It's good to be here with you, Malory. I think that there's so much to unpack. There are a lot of pressures that come with the holidays. I think for anybody, what we feel, the pressure of the holidays approaching and how to manage that. And then when you throw a cancer diagnosis into the mix, it becomes all the more overwhelming and heavy in terms of the emotions. Starting with the pressures, I think there's maybe a pressure to continue on the usual family traditions. Maybe you typically host the holidays and you're thinking, how am I going to find the energy to do that this year? Maybe you do all the cooking and, and same. How will you do that? Maybe you're just not in the best frame of mind, after what you've been through, and you're wondering how you find the just the emotional energy to tackle the holidays. So, I hear a lot around those pressures to begin with. And then, of course, there's the emotions that bubble to the surface for our patients and their families around the holidays. What are the kinds of emotions that you hear from families who are struggling? 

Malory Lee I hear a lot of what you shared. There's pressure that people put on themselves, you know, especially if they held a certain role in the family when it came to the holidays. There's pressure from society comparing ourselves to others. I think we often think about the holidays as, you know, time where we are expected to be very festive and happy and participating in a lot of things at all the time. And so, there's that pressure. But on top of that, there's just, and I think there's been more of a shift in attention on these complex emotions that can come up with the holidays. It's not just the festivity and the joy. It's also a lot of the difficult feelings. You know, there can be feelings of loneliness and isolation for those who maybe have lost loved ones, or for whom family might have difficult relationships or dynamics for those who are grieving, and then also those dealing with cancer, you know, there's always experiences of grief, whether it's the losses that come with cancer or if it's, you know, anticipated loss that hasn't happened yet. All of those emotions can bubble up during the holidays, and it can be triggered by that. Holidays are a milestone, so they are marker of the passage of time. So, they remind us of kind of existential concerns. One thing I do hear from patients with cancer sometimes is kind of thinking about their mortality, and the holidays can bring that up, too. I think when cancer, when you deal with cancer, it's a life-threatening illness. So, regardless of your cancer type, your cancer stage, your prognosis, it's natural to have feelings about mortality or some fears or thoughts. And so, sometimes I hear patients say, you know, I wonder how many more holidays I'll be able to spend with my loved ones. Or I wonder if this is my last holiday. And that can be a really stressful thing to think about. I think in working with patients, we often try to find opportunities. Well, how can that be an opportunity to to find meaning? You know, if this were your last holiday, what would you want it to look like? What are the things you'd want to do and how would you like to spend your time? So, there's, there's avenues to explore. But as you said, just a lot of emotions and oftentimes very complex emotions. 

Traci Newsom I hear a lot around that as well, particularly around the themes of grief, where there's loss of either people special in your life or someone not being able to be there, or maybe the grief of just how you, cancer has changed you as a person and has impacted your life. But in addition to the kind of the grief and the loss and sadness that's sometimes felt, I also have patients talk to me a lot about the gratitude that they feel for being here this year. Maybe there was a time where they wondered if that was going to be possible, and to be able to be here and spend time with their family. And so, those conflicting emotions I often encourage patients to consider that it's okay to have those conflicting emotions. You can hold space for feeling grief and feeling loss while you also acknowledge the gratitude that you have for your life and to be able to spend this time with your family, so it is heavy. It's a lot that our patients face. 

Malory Lee That's a great point to just the fact that we often have seemingly contradictory emotions at the same time, and that that's perfectly normal. You know, there's a lot of complex emotions that they might be struggling with at the same time. And so, I think a big part of, I think we're transitioning into talking about how we manage those emotions. A big part of it is being aware that we can experience a lot of emotions at the same time, being open to them and also acknowledging when they come up rather than kind of pushing them away or trying not to feel a certain way. So, can you speak more about ways that you've helped patients manage these emotions, or ways that patients have found helpful to manage emotions? 

Traci Newsom I think starting with acknowledgment is, is the first step, I guess, to to working through the way that you're feeling. There's a tendency to kind of stuff it down. You want the holidays to be a certain kind of way for your family and your friends and for it to be joyful and special. And so, if you're feeling any sort of difficult or possibly negative feelings, there's a tendency to shove those down. So, I think starting with acknowledging them and then looking for ways to release those feelings and emotions that you've got. Whether that's talking to a trusted friend or family member, sharing how you're feeling, seeking counseling, even for a few sessions just to process and work through the tremendous ways that cancer has affected your life. Reaching out to your social work counselor at MD Anderson can fill that role for you as well. And other ways may be journaling or finding ways to write out how you're feeling. That process of getting it out of your head and onto paper can bring a lot of insight and a needed release of that pent-up energy. So, I think starting with acknowledging. The next step maybe would be to think about how you can do things differently and be open to asking for help, open to communicating with your family. I sometimes hear from families that, or patients, that feeling of some resentment or frustration with the loved ones around them who maybe don't necessarily completely understand. They're empathetic and they're loving, but they don't completely understand what you've been through. And sometimes patients will tell me, well, I don't. I kind of expected them to understand that I've been through a lot, and I don't have the energy to do these things, but it doesn't feel like they're really understanding. So, I think it's important to communicate that to your loved ones and really let them know how you're feeling and have a conversation with family about how can we do things differently this year. Can we modify some of these traditions? Would somebody else like to host? Can we do a potluck style? And everybody brings their favorite meal so that it eases the burden a little bit on you. 

Malory Lee I hear that a lot, too. I think that the piece about support, about reaching out. That can be really hard when you're dealing with cancer. A lot of times you hear people say, you know, I don't want to burden my loved ones. I don't want to have to talk about it with my family who are also going through it. And that's where your suggestions of maybe talking to a counselor or joining a support group could be really helpful. I know MD Anderson has a lot of opportunities to connect with other patients, whether it's through a support group or through a program like myCancerConnection, where you can connect one-on-one with another cancer survivor or patient. But sometimes just having someone outside of your natural support system to talk about this can ease that feeling of, you know, not wanting to be a burden, but also to your point, you know, letting people know what you need is, is a huge part of the cancer journey. I think it's impossible to do this without support. So, being able to articulate what you need, being able to express how you feel to others and find support. Like you said, just kind of delegating, you know, letting people know what what tasks would be helpful that can help in sharing the burden around the holidays and just make things a little bit easier. 

Traci Newsom Definitely. And I liked what you said about reaching out to a support group or myCancerConnection. There's a real power in connecting with people who truly have walked through this. So, I love that as a means of support. 

Malory Lee I think holidays can be an isolating experience for a lot of people, whether it's because you're not with your loved ones or, you know, say, dealing with cancer treatment, if you're unable to travel or be with the loved ones that you would usually spend the holidays with. That part can be isolating, but sometimes it can, we can feel isolated or lonely, even when we're surrounded by our whole family. Just having the experience of cancer and feeling like maybe our our loved ones don't quite understand what we're going through can be an isolating experience. So, I'm just highlighting that because it can be a big step in reducing that isolation by reaching out, by just letting someone know how you feel or finding an avenue of support that does feel good to you. I think we've touched on this, but, you know, recognizing holidays may look different than they have in the past, especially when you're dealing with cancer treatment. That's a big part, I think, of of coping with the holidays. So, do you have any advice, or what advice do you have for patients and their loved ones on how to embrace this change? 

Traci Newsom I think really just being realistic about what your limitations are and what you can manage this year. I, a patient had shared with me at one point that she thinks about after cancer, she only has so much energy for each day. And so, she thinks about her energy as like a water pitcher full of energy for each day. And she really had to sit down and think about what are the things that take away from that energy or that drain the energy, and versus what are the things that really replenish them. And so, she and I think this can apply to the holidays, too, where you sit back and think, "What are the things that I can do this year that may, even if they're enjoyable, they may drain me a little bit, and maybe I need to step back a little bit or minimize some of these social activities" or whatever it may be that's draining for you, versus what are the things that are going to fill you with joy and really prioritize those things. So, maybe you take a step back from the hustle and bustle and the shopping and the grand gestures, and you think a little bit more about what are the tangible kind of things that we could do as a family that are low cost, but would be kind of a treasure that, you know, maybe you write letters, maybe you make videos for your family members. Maybe instead of buying cards this year, you make cards something tangible again that your family can take with them but doesn't take a lot of energy. 

Malory Lee Yeah, those are great ideas. And I like what you said about just kind of being aware of your, your capacity, right. Your energy levels, the pitcher. I think that goes into, kind of, knowing our own needs. And so, I often talk about kind of having a self-care plan in general, but also if we know it's going to be a stressful time, as we know the holidays often are, having a self-care plan in advance can be helpful. And what that looks like could just be first identifying what your, your needs are, your physical needs, your emotional needs, your spiritual needs, finding ways that you can meet each of those things. And so, that could be regarding food, that could be physical activity and exercise, that could be sleep, that could be making sure you're, you're taking your medications and making sure you're taking care of your health to the best of your ability. So, keeping all these things in mind, especially because the holidays can often throw those routines out the door, right? We're often having big dinners. We are often around things that might not be our normal, you know, day-to-day structure that helps us take care of ourselves and then identifying the things that help with our emotional concerns. You know, what are activities that help me feel calm and centered and grounded? Who are supports that I feel like I can trust and reach out to in a time of need? What are activities that just help me have a sense of meaning if I'm struggling? So, having kind of a plan and then being open to what comes up, I think can be helpful when we're navigating all these changes in the way holidays can look different. 

Traci Newsom Absolutely. I love the self-care plan. All of those things that replenish that energy are huge, and they do tend to fall by the wayside around the holidays, because we get so caught up in all of the hustle and bustle. So, I love encouraging patients to make sure they make that a priority.

Malory Lee And I also wanted to highlight, you said this, but kind of letting go of expectations. I think that's a huge part, just easing our expectations of ourselves, of others and remembering that there's there's no one way the holiday needs to look or should look. I often tell myself and patients, you know, "Don't should on yourself" because a lot of times the only thing that comes out of those thoughts are feelings of shame or just negative sentiments. And so, letting go of expectations, thinking, out of the box, there's no way this has to look. I don't have to do certain things. And I can create a new tradition that makes sense for me and my family in this, this holiday season. 

Traci Newsom Yeah, absolutely. I think that opportunity, the door is open to do some things differently that maybe you haven't done, and maybe it'll turn out to be something that your family really loves and you choose to carry on for years to come. 

Malory Lee Yeah. I think we often also want to limit how much we compare ourselves, whether to others or even to ourselves, former versions of ourselves or former holidays we've had. So, this might be setting limits also with social media or limits on certain activities. So, just knowing your own boundaries, knowing as you said, you know, what, what's going to, how much is in your pitcher at any given point is helpful. I think going back to thinking about traditions, how we adopt those or maybe even start new ones, think we can look at the holidays as an opportunity rather than a stressor. So, here's a time when we might be spending time with loved ones, or we might be seeing family that we don't normally see, especially in light of cancer, maybe this is an opportunity to record some memories, whether it might be photos and scrapbooking, making videos. This all goes back into what you were saying about tangible, low-cost ideas, ways that we can connect and find meaning and build a legacy. You know, what are things that you might want to leave for your loved ones? For a lot of people, food is an important part of the holidays. Whether it's food that's important to your culture or to your family traditions. So, one idea could also be coming up with recipes and building a family cookbook together. So, there's a lot of opportunities to create meaningful traditions this holiday season, even when things might look different. 

Traci Newsom I agree, and I'm just thinking about families, too, while you're talking that families can play an important role in all of this, and being open to doing things differently and taking that step of reaching out and saying to their loved one who's experienced cancer, "I know you may not feel your best, or you may still be dealing with some of the fallout of what you've been through. How can I help? How can we do things differently? How can I make things easier for you?" And so, meeting them where they are and being open to trying something different. I think is important. 

Malory Lee Absolutely. Well, we know that the holidays not only impact those who are in active treatment, but also survivors who finished treatment. In your work with survivors, what are some common questions or concerns that have come up? 

Traci Newsom It goes back a little bit to what I mentioned earlier, that sometimes there can be some feelings of frustration. As a survivor, you've put treatment behind you. Maybe outwardly you look like you're doing pretty well and seem to be feeling pretty well, but maybe on the inside you don't feel 100%. Or maybe you're still struggling with the emotional effects of all of this. And so, I think being kind to yourself and being willing to talk to your family about, "Hey, I know I look like I'm doing fantastic, but here's the way that I'm feeling, and here are some ways that you can help me through this." 

Malory Lee And it's very common, I think, for survivors to experience a lot of emotional distress. And part of that distress, I think, is caused by this idea that, "Oh, I should be feeling better, right? I'm done with treatment. I want to be back to normal. Why don't I feel back to normal?" They're comparing themselves to how they felt before their cancer diagnosis, and oftentimes how they feel now doesn't quite match how they felt before. And so, that's an area that people can be hard on themselves. Some people might also describe, after finishing treatment, that their support system isn't as strong as it was maybe during treatment, because maybe people think that things would be easier now that you're done with treatment, or maybe you're cancer-free. And so, that itself can be a really hard thing to deal with when you're a survivor, and it can be very isolating. Going back to kind of letting go of comparisons, letting go of expectations and just being open to what we experience and then knowing when when we need more support and reaching out for that when needed. But it's a very normal thing to feel. And so, acknowledging that is, is, I think, really valuable for for survivors. 

Traci Newsom I hear sometimes, too, from patients that it's challenging to stay present in the moment. Maybe you're feeling anxious. You're getting ahead of yourself. You're thinking about, "Will I be here next year? Will my cancer come back?" All of those unknowns that our patients face that cause a lot of anxiety, that you can really get in your head over, and maybe it's a struggle to stay present in the moment with your family. Do you have advice for patients who are struggling with how to stay present? 

Malory Lee A lot of times we're caught up in worries about the future. Or maybe we're ruminating about things that have already happened, things from the past. And that takes us away from the present moment, which is really the most important time. This is the time you can spend and that you have control over. I think being present and being mindful is something that can be very valuable. It's not always easy because we can't always control those thoughts, right, that come up. It could be worries about something that's going to happen, next week's treatment. The effects of chemo. What I'm going to do tomorrow for, for this, this holiday event. Or it can be thinking about things that have already happened that you can't really change. But all those things take you away from the present. Sometimes we need to ground ourselves in that moment. So, finding a way to find your breath. It might just be paying attention to your breath. Feeling that in your body. That's a good way to ground us and just get present and kind of set aside whatever might have been on our mind, whether it was thoughts about the future, worries, thoughts about the past, sometimes doing something active, doing something really physical can help us get present and take our attention away from the content of our mind into what we're experiencing in this moment. Yeah, finding activities that really engage you, that maybe get you moving and get you active and that really force you to be in that present moment. 

Traci Newsom I think those grounding exercises can be helpful where you're really focusing on the senses. What can I see? What can I feel? What can I touch? What can I smell in these moments to sort of bring you back to reality and get you out of your head a little bit? Also, going back to gratitude. I've had patients tell me it's really helpful to stay in the present just by writing. Each day they get they get up and write in a journal or on a Post-it note. What are the 2 or 3 things that I'm grateful for today? They could be the big things of having time with family and connecting in different ways, or it could just be the simple things. The sun is shining, and I got to sit outside on my back porch, or I got to pet my dog today. Just those present day gratitudes can help keep you grounded. 

Malory Lee Yeah, that's a great idea. I do want to bring up caregivers because that's a big part of our work. You know, working with caregivers. But also, it's a very difficult thing to go through and something where caregivers need a lot of support. So, can you share a little bit about what experiences caregivers might struggle with around the holidays, and how you might support a caregiver, or suggests, or offer suggestions to a caregiver? 

Traci Newsom You're right. I think caregivers also feel the pressure and at times, the burden. Many of the kinds of emotions that we've talked about with patients our caregivers are feeling, too. And they're they're wondering, how do I help? How can I be there for my loved one who's been through so much? Maybe they're feeling alone and feeling lost about how to manage the feelings that they're having. And so, I think encouraging them to tap into similar resources that we've mentioned for our patients. Seek counseling. Go and talk to someone where you can really be open and free with how you're feeling and process your own emotions about watching someone you love go through something so traumatic. Reaching out to, we do have caregiver supports, support groups. We do have myCancerConnection. There's a portion of that that's for caregivers to connect caregivers with other caregivers to help you not feel so alone. And again, that power and connecting with someone who can truly understand what you're feeling in all of this. 

Malory Lee I'm glad you brought that up, because just as patients can feel really isolated dealing with a cancer diagnosis, the experience of caregiving can be really isolating, especially if you are the sole or primary caregiver for a loved one. The holidays bring an opportunity. Most of the time you might see you might have more people visiting, or you might see loved ones that you normally don't get to see. So, finding opportunities to maybe delegate some of those tasks can help ease some of the burden on, on you if you are the primary caregiver. So, seeing that as an opportunity. Like you said, finding supports that are helpful to you because it can be so isolating, you know. Talking about your experience. Some of the conversations we had earlier about letting go of expectations can be really helpful because a lot of times we we see caregivers deal with feelings of guilt, maybe feeling like they're not providing the care, the level of care that they should be providing or that they want to provide for their loved ones. So, letting go of expectations and being kind and compassionate towards yourself, because being a caregiver is a full-time job, it's emotionally and physically taxing. It takes a lot out of you. So, being able to be kind to yourself is, is really helpful when you're coping with all of that. 

Traci Newsom As a caregiver and or a patient, it goes back to communication. So, you just need to be talking to each other. Acknowledge that you've both, you both have your own experiences and your own feelings about what's happened to your life and and talking about what those feelings are and how can we do things differently to to ease the burden for both of us so that we can truly enjoy our time together. 

Malory Lee To go off of that also is the idea that, you know, we we are only responsible for our own feelings. We can't be responsible for others' feelings. We can't control what other people are experiencing. We can do our best, right? We can offer support. We can be kind and supportive and compassionate. But in the end, that person's emotions are their own. And I talk to a lot of caregivers who struggle with not being able to take away their loved one's pain or not being able to offer complete comfort, right? And that, that can be one of the hardest things is that you have to kind of sit with the fact that your loved one might be in distress or in pain, or that you can't get rid of all the symptoms or struggles that they're dealing with. And that's really challenging. 

Traci Newsom Absolutely. And in those circumstances, I think it just comes down to being present. You don't have to have all the answers. You don't have to have the right thing to say. Just be in it with this person. Listen, be a physical presence there loving them through this.

 Malory Lee Yeah. There's often not, not the best thing to say, right? We sometimes don't know what to say in those moments, and that's okay. I think just being, like you said, being present, you know, sometimes even acknowledging, you know, I don't know what to say in this moment, but I'm, I'm here to be with you through it, you know. That, that means the world. 

Traci Newsom Absolutely. 

Malory Lee Thank you, Traci, for being here today. And thanks for a wonderful conversation. 

Traci Newsom Thanks so much for having me. 

Malory Lee And thanks for tuning in today. If you enjoyed this episode, be sure to follow or subscribe on Apple Podcasts, Spotify, YouTube, or wherever you get your podcasts. And don't forget to comment or review. For more information or to request an appointment at MD Anderson, call 1-877-632-6789 or visit MD Anderson.org. Thanks for listening to the Cancerwise Podcast from MD Anderson Cancer Center.