How to survive the holidays with cancer

Know, and honor, your limits

Limit your list. In years past, you’ve chopped down your own tree, held a dazzling holiday fête and baked enough cookies to give Mrs. Fields a run for her money. But that was before diagnosis and treatment. Now, you may not even have the energy to put on an ugly Christmas sweater much less shop, wrap, decorate, bake, clean and send out hundreds of handwritten cards. While it’s frustrating not being able to do everything you did before, try not to beat yourself up about it: your body, your brain and your budget have been through the mill.

Instead, be gentle with your post-cancer self. If you want to buy gifts, shop online instead of braving the crowds and all their cold and flu germs. Take advantage of gift-wrap services. Use email or social media to send out holiday greetings. Ask a neighbor or friend to string your holiday lights. Prioritize one or two things that are especially meaningful to you — trimming the tree? making cookies with the grandkids? — and jettison the rest.

Jody Schoger,* a metastatic lobular breast cancer patient advocate from Texas, shared these wise words: “My best advice is to cut your holiday list in half. Then cut it in half again. Staying within your limits is one of the best gifts you can give your family.”

Pull the cancer card. The holidays can be overwhelming for most people, but they can be especially tough for cancer patients, survivors and/or caregivers who may also be juggling treatment, medical appointments, side effects and the psychological and emotional toll of a diagnosis.

“Allow yourself to do less, to delegate and to let people know you may not be up for certain activities,” Syrjala said. “It’s okay to pull the cancer card although you don’t even have to say the word ‘cancer.’ Just say, ‘It’s been quite a year and I won’t be able to do things the same way this holiday.’ People will get it.”

Instead of making a holiday dinner, ask someone else to host, opt for potluck or go out to a restaurant. Limit your time with high-maintenance friends or relatives or, better yet, skip seeing them. Extend the holiday into January so you can enjoy the company of loved ones at a much less frantic pace. Too tired or overwhelmed to even think about gifts or shopping? Then don’t. People will understand.

Staying healthy under stress

Make time for yourself and keep moving. Many researchers agree that physical activity is the best way to benefit your health during the holidays or any time of year. It makes your body and your brain function better and it can even reduce your cancer risk.

Unfortunately, the holiday machine can often sideline even the best-laid plans. Don’t let it. If you normally walk a mile a day or more, depending on your fatigue/fitness level, lock those times into your schedule now.

“If you have a regular exercise plan, make sure that it’s a priority you keep,” Syrjala said. “Write it down on your calendar so that other things don’t get scheduled during that time.”

Other ideas: if you have the energy, sprinkle 10-minute mini-walks twice in your day; do a community fun run/walk with your family or other survivors or play a Wii game with the kids instead of watching TV.

Have a food/alcohol strategy. The holidays can be a lot like that old board game, Candy Land. Every time you make a move, you run into a Molasses Swamp, Peanut Brittle House or Gingerbread Plum Tree. Syrjala said survivors may want to come up with game plan to help them navigate the relentless gauntlet of holiday goodies.

“Give yourself a strategy so you don’t find yourself facing a tray of cookies when you’re hungry,” she said. “For some people, starting in on the snacks and the sugar is the road to ruin. But you can also just postpone having that cookie. Human nature rebels a lot more against ‘no’ than it does against ‘later’ or ‘a little bit is OK.’”

Other tips: Record your meals in a food journal or food-tracking app. Eat a small meal before heading off to food-focused holiday parties. Fill up your plate with fruits and veggies first when you hit the buffet. Alternate between alcoholic and non-alcoholic drinks at parties and drink lots of water (hydration lessens fatigue!). Also, balance calorie-rich snacks with exercise.

“We all indulge on treats during the holidays so just up the ante with your exercise,” said Jo Taylor, metastatic breast cancer patient and founder of the UK-based website, After Breast Cancer Diagnosis. 

Experiencing nausea, mouth sores or taste changes due to chemo? Eat whatever you can (mashed potatoes? sweet potatoes? pumpkin pie?) and put your focus on the other things that hold meaning for you: music, laughter, family, fellowship and yes, even football. More information on nutrition during cancer is available from Fred Hutch Nutrition Services.

Beware of bugs. ‘Tis the season for colds, flu, RSV, COVID-19 and who knows what else. So make sure you wash your hands — a lot — especially if you’re hanging out with little ones. Those in active treatment or who are immunocompromised may want to also mask up while shopping in crowded malls and grocery stores.

And then there’s travel. Nearly half the country intends to travel this season — gulp — and they’ll be packing their germs with them. Mask up in airports, on planes, trains and buses — and don’t forget your latest jab.

“Vaccinating cancer patients — and the population as a whole — continues to be important to slow the spread of COVID-19 and save lives,” said Steve Pergam, MD, MPH, medical director of Fred Hutch’s Infection Prevention.

One caveat: if you’re about to go through a stem cell transplant or receive CAR T-cell therapy, delay your vaccine or booster until you’re done (more info here).

“All other patients who are being treated for cancer, including those getting aggressive chemotherapy, should get vaccinated and boosted without delay,” Pergam said, adding it's also crucial for caregivers and anyone else in close contact with cancer patients to do so, as well.

Finally, food poisoning is far more common during the holidays and can be especially hard on people with weakened immune systems. Need a primer on best potluck practices? Check out these food safety guidelines from Fred Hutch. 

Get your sleep. Lack of sleep can make you cranky, clumsy and far more likely to catch a cold, flu or COVID-19, especially as the country works its way through its “immunity debt,” that is, the resurgence of “normal” viruses after pandemic restrictions were lifted. But lack of sleep can also have more serious health ramifications. People who don’t get enough sleep are more susceptible to stroke, heart disease, diabetes and obesity. And there’s even a sleep/cancer connection.

Fred Hutch’s Amanda Phipps, PhD, MPH, who investigates sleep’s impact on cancer survivorship, said it’s key not to discount the power of sleep.

“Around the holidays, there are lots of distractions and sleep is one of the first things to be compromised,” she said. “But you cannot underestimate the importance of good quality sleep. Make sure it’s a priority.”

Having trouble getting your ZZZs? Cut back on caffeine and limit booze before bedtime. Exercise regularly but not right before you hit the hay. Try yoga. Keep a worry journal. Keep “screens” (TV, smartphones, tablets) out of the bedroom. And call your doctor if you need any additional help/advice. Read more on the healing power of sleep.