Holidays are traditionally viewed as a time to celebrate. Many people enjoy reuniting with family and friends, giving and receiving gifts, and celebrating religious traditions during this time. However, sometimes people with cancer and their loved ones feel “out of step” from the rest of the world during the holidays. In fact, the holiday season can prompt new questions, such as: How do I take care of the holiday rush and myself at the same time? How can I celebrate when I have so many other things on my mind? What will my life be like next year? Sharing these concerns with the people you love and who love you can help you feel more connected.
Here are some additional tips for coping with cancer during the holidays:
Make plans to get together with friends, family or co-workers over the holidays. Trying to celebrate alone can be very difficult, so accept some invitations from others, or join an organized group activity through your local YMCA, YWCA, church or synagogue. Find the right balance between celebrating with family and friends and spending the time you may need on your own. Give yourself permission to pace your activities and to decline an invitation or two so that you have the energy to enjoy the gatherings that are most important to you.
Create a new holiday season tradition that makes the most of your energy. Change your usual holiday activities so you relieve yourself of some of the pressures of entertaining. Have a “pot luck,” with family members each bringing a dish for the meal, have someone else host the meal, or suggest eating out at a favorite restaurant.
Enjoy special moments. Try to focus on new traditions that have been established, rather than dwelling on how cancer has changed a holiday or special occasion.
Talk to your health care team about upcoming special events. They may be flexible about appointments in order to accommodate travel or other needs.
Be an innovative shopper or gift giver. Use mail order catalogues, shop over the telephone, or try online shopping this year. You can also make a gift of sharing your thoughts and feelings. Write a short note or make a phone call to let others know that you are thinking about them.
Express your feelings in ways that help you receive the support of the important people in your life.Tears can bring a sense of relief. Laughter can be relaxing. Sharing can be comforting. It is common to experience a mixture of anticipation, excitement and apprehension about the future. Let your feelings breathe, and talk them over with a loved one, friend or professional counselor.
Celebrate strengths you and your loved ones have developed. Many families who face the day-to-day challenges of cancer discover strengths and courage they didn’t know they had. Reflect on the strengths you have developed, and build on them during the holidays.
By: Elyce Cardonick, MD, FACOG
Elyce Cardonick, MD, FACOG, is a maternal-fetal medicine specialist practicing at Cooper University Hospital, New Jersey, and is a member of the Hope for Two Advisory Board. She is the creator and Director of the Cancer and Pregnancy Registry, maintaining the data and publishing the outcomes. She is available to consult with women and/or their physicians to address medical questions pertaining to their specific cancer and pregnancy situation. For more information, visit:www.cancerandpregnancy.com or call 1.877.635.4499 (toll free) or 1.856.342.2065.
Being diagnosed with cancer during one’s reproductive years raises a concern about the harmful effects of chemotherapy and radiation on ovarian function. It is commonplace for men diagnosed with cancer to preserve sperm prior to treatment and it is becoming more commonplace for women to preserve their fertility as well either by preserving a portion of unstimulated ovarian tissue, or stimulating the ovary to produce multiple follicles then fertilizing them and freezing embryos for future implantation in the woman’s uterus. Women without a current partner who prefer not to use donor sperm can also freeze oocytes for future fertilization. The risk of infertility with chemotherapy depends on several factors including the type of agent and dosage used, the age of the patient, the extent of surgery involving the cervix, uterus or ovaries. The risk of infertility after chemotherapy given during a pregnancy has not been studied.
Women enrolled in the Cancer and Pregnancy Registry are encouraged to also inform us of children born after the pregnancy during which they were diagnosed with and treated for cancer. Pregnancies subsequent to completing cancer treatment, especially after the first two years during which the risk for cancer recurrence is higher, should not increase one’s risk for cancer recurrence. Women in the Cancer and Pregnancy Registry have not reported having infertility or difficulties conceiving after chemotherapy treatment during pregnancy. In fact, 48 women in the Cancer and Pregnancy Registry who were diagnosed with cancer during pregnancy went onto have subsequent pregnancies after completing cancer treatment. The majority of women were diagnosed with breast cancer during pregnancy and the next most common cancer type was Hodgkin’s Lymphoma in 6 cases. Three patients conceived after treatment for ovarian cancer, and 2 after melanoma during pregnancy. The mean time from the primary pregnancy during which cancer was diagnosed and treated until the delivery of the subsequent pregnancy was 22 months. Thirty seven of the 48 women conceived a pregnancy subsequent to chemotherapy during pregnancy. Resumption of spontaneous menses occurred in the majority of cases and pregnancies were conceived spontaneously. There has never been a study comparing the incidence of infertility after chemotherapy given during pregnancy to infertility for women of the same age, receiving the same agents who were not pregnant at the time of treatment. The children conceived after a prior pregnancy complicated by cancer did not have an increased incidence of birth defects or complications.
To support the more than 1,000 women per year in the U.S. who are pregnant and have breast cancer at the same time, Living Beyond Breast Cancer has published a new brochure: Breast Cancer InFocus: Breast Cancer During Pregnancy. Women who have experienced breast cancer during pregnancy contributed their stories and photos to this publication. Visit LBBC.ORG to view the guide and order a free copy.
LBBC thanks Hope for Two…The Pregnant with Cancer Network for their help with this guide.
One out of every 1,000 pregnant women have cancer. It’s a situation that oncologists and OB/GYNs don’t often encounter, and one that can leave many women feeling very scared and alone, says Susan Musialowski, the patient coordinator for Hope for Two: The Pregnant With Cancer Network.
By: Elyce Cardonick, MD (published in Hopeline newsletter Fall 2013)
Many women ask about the safety of breast feeding after a pregnancy complicated by cancer. Let me start by saying that if you do require any chemotherapy postpartum, unfortunately breast feeding is not advised once you start treatment. There are case reports of children having neutropenia (low white counts) after receiving breast milk while a mother was receiving Cytoxan. There is not much information on the quantity of other types of chemotherapy in breast milk, but it is not advised.