Cancer, COVID and the holidays: Navigating a safe season

Managing the holidays with cancer
While the risk of infection from COVID-19 is still a factor this holiday season, many cancer patients may be able to rekindle their holiday traditions this year if they use common-sense practices.

Ah, the holidays. A time to feast with family and friends. A time to travel to see the folks. A time to shop for that special gift. Last year, as COVID-19 spread over the hills and through the woods, many of those traditional holiday practices were canceled or at least muted for many Americans, especially for cancer patients and others with underlying medical conditions. And while the risk of infection from COVID-19 is still a factor, many cancer patients may be able to rekindle their holiday traditions this year if they use some common-sense practices.

“Things are a lot better than last year when we didn’t have the vaccine,” says Suji Mathew, MD, Infectious Disease Physician and Chief of Medicine, at Cancer Treatment Centers of America® (CTCA), Atlanta. “We’re definitely in a better place. But cancer patients, because they are immunocompromised, should just be more vigilant.”

In this article, we’ll explore ways cancer patients and caregivers can stay safe over the holidays, including tips for:

If you or a loved one have been diagnosed with cancer and are interested in getting a second opinion, call us or chat online with a member of our team.

Reducing your risk of infection

After a holiday season in which many people missed out on gatherings with family and friends, it’s natural to want to let loose, set aside safety protocols and enjoy the festivities at holiday parties and dinners.

“Alert fatigue is a very real thing,” says Jeffrey Metts, MD, Chief of Staff at CTCA® Atlanta. “Many people have had to lose holidays and wedding ceremonies and other milestones that are meaningful. This is very impactful, not just for cancer patients, but for many people.”

But Drs. Metts and Mathew urge cancer patients use common sense this holiday season in order to reduce their risk of exposure and infection.

Cancer patients should not be shy about asking how many people will be attending events they’re invited to. What is the setting? Are those attending vaccinated?

“The logic is still to avoid crowded indoor spaces as much as possible, especially if you can’t maintain social distance,” she says.

Dr. Mathew also urges cancer patients be up to date on all their vaccines, especially their COVID and influenza shots.

Core fundamentals

Dr. Metts says the four key steps to stopping the spread of COVID-19 are:

  • Get vaccinated.
  • Wear a mask.
  • Maintain social distance.
  • Wash hands frequently.

“Those are the four fundamental tools we have to fight the virus—now more than ever if we are really smart and cautious,” he says.

Managing stress

As the song says, the holiday season is the most wonderful time of the year for many. But it may also be the most stressful. With parties and planning and shopping and cooking, there’s much to do, and of course, we tend to want everything to be just right.

Add a cancer diagnosis to all that comes with your holiday routine, and the stress may hit overdrive. Diane Schaab, Behavioral Health Specialist at CTCA Atlanta, says cancer patients should not be shy about speaking up about their goals and wishes for the holidays. 

“Patients might feel selfish when they put their own needs first,” she says. “But cancer patients need to be vocal about what their needs are and make sure their needs are met. A lot of people are worried about everyone else, and you need to reel that in and determine what’s good for you as the patient. So, a lot of time, it’s about looking inward and asking, ‘What’s really best for me right now, and how do I achieve that goal?’”

Stress isn’t just about mental anguish or anxiety. It affects human physiology in multiple ways. Stress releases hormones like adrenalin and cortisol that may raise blood pressure or make the heart race. It affects the gastrointestinal system and may cause headaches. Some research also suggests that chronic stress may accelerate the progression of existing and promotemetastasis. Stress also may raise cancer patients’ risk of infections, such as the flu and or COVID-19, Dr. Metts says.

“Stress has an impact on the immune system,” he says. “Cancer treatments have an impact on the immune system, and cancer itself has an impact on the immune system. And COVID-19 preys on weakened immune systems.”

It may be helpful for cancer patients to find time to remove themselves physically and mentally from stressful situations and grab a little “me” time.

It’s also important for cancer patients to be flexible about how to celebrate holidays a little differently and to look at the big picture, Schaab says. If a family gathering isn’t possible in December, how about a visit in the spring or summer?

“We tend to get stuck on the way things used to be,” she says. “I should be able to get on an airplane. I should be able to drive to see the grandkids. But think about how you may be able connect in a different way. It’s really important to look at the ultimate goal and if that goal is to connect with loved ones, then you may want to look at how you can achieve that goal safely. You may need to think outside the box. Zoom or FaceTime are ways to connect but connect safely.”

Tips for managing stress

Here are some other tips for cancer patients to deal with stress during the holidays:

Do what you can when you can. Some traditional holiday activities may make you fatigued. Save your energy for the ones that are most important to you. Allow others to chip in with the cooking, shopping, cleaning, decorating and other holiday preparations. It’s not all on you.

Be aware of how you cope. Consider getting outside for a long walk, exercising and confiding in others to help get through stressful times. Be careful not to turn to unhealthy habits, such as smoking, excessive drinking, drug use or overeating to deal with your cancer or holiday stress.

Get enough sleep. Rest is one of the best ways to rejuvenate your body. Try to get a good night’s sleep each night and sneak in afternoon naps when you can.

“Sleep, exercise, good food, meditation, grounding yourself and having gratitude—these are all very important,” Dr Mathew says.

Traveling safely

Managing the holidays with cancer

Millions of Americans missed traveling to be with friends and family during the 2020 holidays. This year, with three vaccines approved, traveling may now be an option for the millions of Americans who have been inoculated. Still, federal laws are in place to help reduce risk of the virus spreading.

Cancer patients and their families need to be vigilant about traveling, especially on public transportation, such as planes, trains and buses.  It’s important for patients, especially those in active treatment and/or taking drugs that suppress immunity, to consider the risks associated with traveling and rushing through crowded terminals. Family members, especially those who have not been vaccinated, also need to consider the risk of getting infected while traveling and then spreading the virus to a loved one during a visit.

“You really have to look at your own risks and the risk of those around you, your family and your neighbors, and consider how your decision will impact other people,” Dr. Metts says.

Safe travel tips

Here are some things to remember if you’re going to travel for the holidays:

  • Federal law requires all passengers to wear masks while on any form of public transportation and in all public airports and terminals.
  • Rules on mask wearing and vaccine requirements may change from state to state, so be aware of the requirements where you’re headed.
  • Monitor yourself and those in your travel party for signs or symptoms of COVID-19.
  • If you’re not vaccinated and traveling abroad, get a viral test within three days of your travel. Get tested when you return home and self-quarantine for at least a week.

Keeping your medical appointments

The holidays often provide an excuse for procrastinating. But just as cancer won’t wait for the COVID-19 pandemic to end, tumors don’t stop growing just because it’s Christmas. Cancer doesn’t keep a calendar.

Dr. Metts says too many screenings already have been delayed due to the pandemic and should not be put off in November or December, if possible.

“We know for a fact that cancer screenings during the first half of the pandemic were down up to 90 percent,” Dr. Metts says. “There was a significant decline in screening. And it wasn’t just cancer, it was screenings for diabetes or getting cholesterol checked. So, it’s really important to get those mammograms done and get those colonoscopies scheduled.”

In some cases, doctors and patients may be able to discuss adjustments in treatment regimens to allow for holiday travel. But don’t put off treatment decisions solely because of the holidays and without talking to your care team.

“We always encourage our patients to have an open dialogue with their cancer care team,” he says. “They have a long-term relationship with their patients and are really able to walk through the nuances of each individual. Cancer is an area where patients are very focused on life milestones, such as being able to attend a graduation or a wedding–very meaningful things in life. So, our cancer care teams are very experienced in working with patients to make sure they can meet their personal goals.”

He adds that the “general rule of thumb is communication is the key: When in doubt, ask your cancer care team.”

If you or a loved one have been diagnosed with cancer and are interested in getting a second opinion, call us or chat online with a member of our team.