This Month: Coping With Cancer During the Holidays

Answered by Andrew Chesler, LMSW

  • I was diagnosed with cancer a few months ago and I don't feel much like celebrating the holidays. I'm worried I'll be a downer for my family and I'm not sure how to act.

    It makes sense that you don’t feel celebratory—you may be coping with fatigue or pain, and feel uncertain about the future. While your self-expectation may be that you should be smiling and happy at this time of year, the truth is no one can ever be sure how he or she might feel on any given day, and cancer, especially, doesn’t go on holiday. But try not to let your fears of being a “downer” keep you from staying close to the important people in your life. Although people close to you may not know how to approach the subject of cancer, that doesn’t mean they won’t be understanding, or don’t want to help. If you are open to talking with them, you may find that friends and family are more compassionate than you anticipate. While not everyone may be equally helpful, raising the subject of cancer may bring many of your family members closer. Here are some practical tips that could be helpful to you:

    Listen to your body. Gauge your physical limits to give yourself time to rest and to manage your energy.

    Manage expectations. Remember that you can only do the best you can—if you are not feeling well during a holiday, remind yourself that it is just one day of the year, and that the people you want to be with will care about you just as much even if you don’t feel like celebrating. Give yourself permission to be less than “joyful” all the time.

    Communicate. Talk with friends and family members a few days before you see them. Let them know how you are feeling and that you would like their understanding. Since it is likely that not everyone you know will respond the same way, spend a moment to consider how much you want to share and how much a given person will be able to hear.

    Plan ahead. Don’t hesitate to ask for what you need. Most often family and friends want to help, but they may not know how, or what to say. They may be relieved if you reach out to them to let them know what will make you feel comfortable. Create a list of tasks or that you can ask others to do for you that you need help with.

    Keep in mind what is most important to you. Holiday traditions are important, but that doesn’t mean altering them is bad—if you aren’t able to do exactly what you have done in the past, there is nothing wrong with starting new traditions. And while gifts are nice, it is the sentiment behind them that is most memorable. Simply being with people who care about you is a gift, both to them and to yourself.

    For additional tips, please read CancerCare’s fact sheet, Coping with Cancer During the Holidays.

  • As caregiver for my husband, I have no interest in the holidays. I know this is a disappointment to our adult children, and our young grandchildren don't understand why I just don't care about shopping, etc. What can I say to them to tell them I love them but I am just so sad, other than just that?

    Caregiving is a difficult and an often unappreciated part of living with a person with cancer. It is physically and emotionally draining, if not exhausting, and others may not be aware of the difficulties you are facing. While the holiday season may mean time off from work for some, you may feel that there is little or no time off from your caregiving duties.

    Tell your children and grandchildren that you love them as much as ever, and that you would like to do everything that you have done in the past, but that you may not be able to right now. Everyone will feel more comfortable knowing what you are thinking, and will feel reassured that while the way you need to spend your time has changed, your feelings for your family haven’t.

    Explain to them what you are not up to doing, and ask them if they could help you with some of the things that you would normally do alone. Giving your adult children (and your grandchildren, to the extent that it is appropriate) new tasks and responsibilities would likely make them feel good about being able to help, and create even stronger bonds among you. You can reassure your grandchildren that although you don’t feel up to doing the things that you have normally done with them in the past, that this doesn’t mean that you won’t do those things again in the future.

    If possible, see if there are people close to you who can look after your loved one while you find some rest or diversion, so that you may enjoy holiday activities with others, or just spend some quiet time alone or with a close friend.

    For more general tips on how to support yourself as a caregiver, read our fact sheet “Caring Advice for Caregivers: How Can You Help Yourself?

  • My mom is receiving palliative care currently at home. I really am feeling the pressure with this time of year with expectations (e.g., attending holiday parties and birthdays). While I mean to be attentive, I find myself forgetting to get gifts, or just not feeling like going out. I know my friends ultimately will understand, but is there a way to explain this to them without seeming completely selfish when I just need a few days to myself?

    Caregiving is a difficult and an often unappreciated part of living with a person with cancer. It is physically and emotionally draining, if not exhausting, and others may not be aware of the difficulties you are facing. While the holiday season may mean time off from work for some, you may feel that there is little or no time off from your caregiving duties. It stands to reason that you may forget to buy gifts or not feel like going to parties. You aren’t being selfish, you are sensing that you need to take some time for yourself, which is necessary. You are spending both mental and physical energy caring for another person, and that is no small thing.

    Communication is so important—without having a direct exchange with your friends it will be difficult to know exactly what their expectations are, or to what extent they understand your situation. One thing to do before you reach out to your friends, is to clarify how you are feeling and what you want to say. Perhaps you can set aside a few minutes to write down your thoughts and feelings about holiday pressures and expectations, and what it is that you would really like the holiday season to be for you. Having done this, you might call your friends—or send what you have written as a letter or email. It is likely that they will be able to empathize. You might begin the conversation by saying how much you appreciate their friendship, that the parties and events sound enjoyable, but that right now you would like their understanding—your responsibilities are too great to let you participate in all their activities. By stating these things simply and directly you are being sincere and won’t come across as selfish or thoughtless.

  • My father has advanced cancer and this may be his last Christmas with us. How does our family make this holiday not put too much pressure on his mental state and make the focus on just trying to enjoy the time we have left with each other?

    Thank you for the thoughtful question. As I am answering after Christmas, I hope it will be this will be of use—perhaps at New Year’s or a birthday, but I think the same principles hold true.

    The answer depends on how what your father wants—or possibly, how much you are able to figure out what he wants. If your father is aware that this may be his last Christmas (or birthday, etc.) and you feel he is able to talk with you about this, simply ask him what he wants and would make him most comfortable or happy. Would he like to have just a few people around him and a quiet dinner? Would he like to watch you and other relatives have the same Christmas routine as always? Or does he have something else in mind entirely?

    Too many options can overwhelm anyone, so you may want to present only two or three choices. For instance: “Dad, what would make you feel best? Just immediate family at home? Family and close friends?” And so forth. If he can’t or won’t choose, go ahead and choose yourself. You love him. So your decision won’t be “wrong.” The most important thing is to let him know how happy you are to share this holiday with him. Tell him what you love about him. What you appreciate. Encourage other people to do so to.

    If your father is unable to understand, or not willing to accept that he is near the end of his life, you will need to rely on your judgment and draw on your experiences with him. Has he ever given you his opinion about another person in a similar situation to his, or spoken about the final days of his own father? This may give you insight into what he would like now. Think back: historically, what has a holiday meant to him? Has the focus been on a family dinner, or seeing relatives from out of town or gift giving or an activity? Keeping things simple often helps. You may want to choose just one easy thing.

    It sounds as if you have had many joyful holidays together, and while there is comfort in the repetition of activities from year to year, remember that not every year is the same, and that your father may not have a lot of time, but he has your love and devotion and that is the biggest, most lasting and important gift of all.

Answered by Other Experts

  • I've been diagnosed with advanced cancer. I have five children and feel they don’t want me around for Christmas, because it makes them sad, and they don’t have the time for both me and their own families. I can’t be alone. I don’t know what to do to or what to say to them.

    I am very sorry to hear that you are facing these challenges this holiday season. While you feel that your children are not wanting to have you with them, you don’t say whether you have spoken with them about your concerns. It may be that they are unsure of how you are feeling or what your expectations might be concerning Christmas. If you are in need of any special assistance or equipment to facilitate spending time with them, they may not feel prepared to manage those needs. The key may be to open up a discussion with them to talk about your preferences for being with family that day and to address the practical considerations that would make it possible.

    As difficult as it is to cope with cancer during the holidays, it is also possible to be joyful. For many, the idea that you can feel both sad and joyful is an unusual concept. While your family may experience feelings of sadness associated with the many issues related to your cancer, there can also be joyfulness when spending time together with those who mean so much and creating memories of a special day. The challenge can be in maintaining an awareness of the pleasures that are available in the midst of a very difficult time.

    Many people face challenges like yours during the holiday season. It might be helpful for you to speak with a CancerCare social worker about your unique circumstances, so please call us at 1-800-813-HOPE (4673). We’ve also compiled suggestions that might be helpful in our fact sheet, Coping With Cancer During the Holidays.

  • Three weeks before the holidays, my father was diagnosed with advanced cancer. Hospice care has started but I find it isn’t enough and other family members who live in town really don’t offer help. Some days seem too overwhelming - how do I focus on everyday activities?

    Depending on your particular family and faith traditions, there can be a lot of expectations at this time of year, many of them focused around finding joy in the season. When illness or grief interrupts those expectations, it can be difficult to manage.

    Be kind to yourself during this time, and consider what is truly important to you now. That can require you to adjust your expectations about everything from shopping to housecleaning. Make a list of those things that you truly enjoy and decide which of those traditions you would like to retain. Give yourself permission to “pass“ on those traditions that generate stress or involve a good amount of effort

    This may also be a time that you can ask others to provide additional support. This can include a conversation with the hospice social worker concerning what other services may be available. You might use the services of a hospice volunteer or have the ability to engage additional home care supports on your own.

    While it would be ideal for family and friends to volunteer their help, it may be necessary to ask them. Consider whether there are specific tasks that you can ask others to perform which can provide you a break from the day-to-day demands of care giving. Is there someone who can stay for a few hours, offer to go to the market, or bring your father to a scheduled appointment? Many times family and friends would like to help but are at a loss as to how to be helpful without being disruptive to routines.

  • I'm worried about how the side effects from my treatment will interfere with the holidays. Any suggestions?

    People view the holidays as a time to celebrate and connect with family and friends. However, the season can be stressful if you are living with cancer and trying to manage treatment side effects such as fatigue, weight loss or gain, nausea or pain.

    Fortunately, doctors have many ways to reduce and even prevent side effects. At CancerCare, we often use the word “coping” to describe how people deal with cancer. People sometimes mistakenly think that coping means just living with a problem, whether you like it or not. But coping actually means managing a problem and finding a new way to take control of it.

    You can maximize your enjoyment of the holidays by letting your health care team know now about your holiday plans and ask for their help in taking control of treatment side effects. Make an appointment with your doctor to discuss your concerns and ask for guidance regarding holiday meals, travel, and conserving your energy, as well as rescheduling your treatments, if possible, so that any resulting side effects will not occur on during the holidays.

    CancerCare offers publications offering additional information so that you can better manage your treatment side effects and enjoy the holiday season:

    You can find additional information through the National Cancer Institute.

    CancerCare’s social workers are here to help you with emotional support and practical help. Call 800-813-HOPE (4673) or email info@cancercare.org.

  • This is a hard time of year for us as my wife has cancer. Would you recommend any books about talking to and doing the best for our kids?

    When coping with a cancer diagnosis, families often experience a variety of changes and adjustments during the holidays and other significant events. Discussing and preparing for these changes with your children can open up dialogue, elicit questions and help you to understand what your child is feeling. Although certain rituals or customs may change, it can also be helpful to honor old traditions as a way of maintaining a sense of normalcy for your children. Remember that cancer doesn’t have to be the focus of the holidays, and you have discretion over how much room cancer gets during your celebration.

    Books can be helpful tools or supplements to reinforce language and ideas to help children cope with a parent’s cancer diagnosis, but should not replace a conversation. The holidays may be an opportunity to have such discussions, as you are likely joining together as a family to reflect on the past year and to make plans for the year ahead.

    When selecting literature to help you talk to your children, consider your child’s age, developmental stage and maturity level. Being honest allows children of any age an important opportunity to ask questions and express how they feel. You may not have all the answers, but you can remind your child that you will always be available for them to ask.

    For more information about coping with the holidays and communicating with children about cancer, read CancerCare’s Coping with Cancer During the Holidays and Helping Children When a Family Member Has Cancer, or review the following books to help you navigate these conversations:

    • How to Help Children Through a Parent’s Serious Illness by Kathleen McCue and Ron Bonn (St. Martin’s Press: 1994)
    • Helping your Children Cope with your Cancer by Peter Vandernoot (Hatherleigh Press: 2006)
    • When a Parent Has Cancer : A Guide to Caring for Your Children by Wendy Schlessel Harpham, MD (Harper Collins: 2004)

From the Archive: Questions about Lung Cancer

  • My 68-year-old husband was diagnosed with lung cancer in 2004, had radiation and chemo, and is currently in remission. Since ending his treatment, his personality has changed drastically and he directs his anger towards me. Can chemo affect a person mentally?

    Chemotherapy can affect a person’s mood, as can other medications such as steroids. It is important that you and your husband inform his doctor of changes in his mood to rule out any medical causes. The change in his personality may also be a sign that he is still struggling emotionally with his diagnosis and treatment. Cancer can be overwhelming and bring up many feelings from anxiety to anger to sadness. As your husband’s primary caregiver, those feelings may be directed towards you since you are the one he is closest to and trusts. If you haven’t done so already, letting your husband know how his feelings and behavior affect you is important. Seeking couple’s counseling is also a good idea if you are having difficulties communicating with each other.

    The end of treatment often can lead to many strong and conflicting feelings. When a person is first diagnosed with cancer, he/she is often focused on learning about the diagnosis and getting through treatment. This can delay the emotional impact of cancer and feelings may come up once treatment ends, as there is more time to think about what has happened. For more information on coping post-treatment read, After Treatment Ends: Tools for the Adult Cancer Survivor.

  • My husband has just been diagnosed with small cell lung cancer with small tumors in his liver. He starts chemo next week with 4 hours, day 1 and 2 hours, day 2 and 3. He repeats this every 18 days for six sessions. Is this the normal treatment for small cell lung cancer? Where would I look to find information on clinical trials?

    Later-stage small cell lung cancer is characterized by a spread of the disease from the lungs to other organs such as the liver, and is normally treated with aggressive chemotherapy. Since the treatment is aggressive, it must be administered over a number of days for each session, and the sessions are spaced out with non treatment breaks of 18 to 21 days to make sure that the patient’s overall health is not affected. Patients whose tumors respond well to chemotherapy may be considered for a radiation treatment to the brain called Prophylactic Cranial Irradiation (PCI) in which the entire brain receives radiation with the intent of stopping the spread of the disease. For more information about the treatment of small cell lung cancer, please visit the National Cancer Institute’s website.

    CancerCare collaborates with EmergingMed’s clinical trials matching service, which is designed to assist lung cancer patients in identifying and accessing clinical trials which may be appropriate to their medical situation.

  • How can I breathe with a lung after the pneumonectomy? Is there anything I should be doing?

    A pneumonectomy is the surgical removal of one lung in which a lung cancer tumor involves all the lobes of that lung and is confined to only that area. A person with two normal lungs would be able to tolerate the impact of the reduced lung capacity on their breathing. However, people who have a history of smoking, emphysema, or bronchitis may not be candidates for this treatment due to their diminished overall lung capactiy. Age may also play a role as people over age 70 have a higher risk of complications from this procedure.

    Be proactive with your doctor about what your recovery plan will be. A patient who has completed a pneumonectomy will be expected to undergo a course of pulmonary rehabilitation with a respiratory therapist, who will guide the patient through regular exercises and techniques designed to help maximize breathing capacity.

    Learn more about the professionals who might be part of your recovery team in our fact sheet, “Your Health Care Team: Your Doctor is Only the Beginning”.

    Listen to our podcast, The Importance of Communicating with Your Doctor About Follow-Up Care.

  • My sister has stage 4 non-small cell lung cancer as well as tumors in her liver. Are there two different chemotherapy treatments for both the lung and the liver or are they treated with the same drugs?

    Stage 4 non-small lung cancer is characterized by the spread (also known as metastasis) of lung cancer cells through the bloodstream to organs outside the lungs such as the liver, brain, adrenal glands or bones. These cells attach to the new areas and begin to grow new tumors. The cells of the new tumor site, however, are lung cancer cells rather than liver cancer cells. So the chemotherapy your sister’s oncologist has chosen to treat the main tumor site in the lungs would also be considered the most appropriate treatment for the lung cancer tumors that have grown in her liver.

    One of the benefits of chemotherapy used for Stage 4 lung cancer is not only that it’s treating tumors known to exist, but it is also working on other tumors that may be too small to be detected yet. That’s why chemotherapy is considered a systemic therapy – it treats cancer tumors throughout the body.

    Find more information about treatments for lung cancer in our booklet, Treatment Update: Lung Cancer.

    CancerCare also offers a full range of free support services for people affected by lung cancer.

  • My best friend's husband has just started chemo for lung cancer but refuses to quit smoking. This is driving a huge wedge between the two of them. Does smoking impact the effectiveness of the chemo?

    This is a common question that comes up for people diagnosed with and in treatment for lung cancer. Some lung cancer patients continue to use tobacco products either because the chemical addiction to nicotine is so strong that they are unable to quit, or they have found that smoking provides them with a soothing or calming effect in stressful situations.

    A study featured at the 2006 Annual meeting of the American Association for Cancer Research (AACR) reported that nicotine stopped chemotherapy drugs such as gemcitabine, cisplatin and taxol—all of which figure prominently in first-line treatment of lung cancer—from killing cancer cells and significantly reduced the effectiveness of the treatment, according to the researchers.

    In contrast, another 2006 research study, conducted by the M.D. Anderson Cancer Center, focused on the overall survival of late-stage, non-small-cell lung cancer (NSCLC) patients who quit smoking or continued to smoke during treatment. The study, which followed the survival experiences of 1,370 NSCLC patients from 1993 through 2002, found no significant difference in overall survival between these two groups of patients. Among those patients who did survive, however, and who had quit smoking at the onset of their treatment, the risk of developing a second lung cancer was significantly lower.

    Your shared that your friend’s husband’s smoking is affecting their relationship. CancerCare’s oncology social workers often work with couples in situations like this and are able to help them develop new communications skills which can reduce stress and improve relationships. Please urge your friend to call us at 1-800-813-HOPE (4673).

    For more information and resources about smoking cessation, read the American Cancer Society’s Guide to Quitting Smoking or visit Smokefree.gov.

  • I have stage 4 non-small cell lung cancer and now am receiving Tarceva. I'm trying to prepare for the future by exploring hospice and want support for my husband. Do you know what kind of pain I might expect?

    There is no easy means of determining how late-stage lung cancer may progress. At times the process can be relatively benign and pain free; at other times, it may cause the person with cancer to deal with discomfort and pain. You have already identified one of the most appropriate resources for managing your situation – hospice care.

    Hospice provides some of the best palliative care available and focuses on the patient’s physical, emotional and spiritual comfort. We encourage patients and family members dealing with late-stage cancer to contact local hospices as soon as possible. This gives patients and their loved ones the opportunity to develop a relationship with staff and ask questions (such as how pain and symptoms can be managed) and to determine what services could be helpful. Connecting with hospice often times results in peace of mind for both patient and family members, as needs can be assesed, questions answered, and important next steps identified.

    For more information about hospice and end-of-life care, please consult the National Hospice and Palliative Care Organization’s website, Caring Connections.

    Another resource is our publication, “Caregiving at the End of Life”. And remember that CancerCare’s professional oncology social workers assist lung cancer patients and their loved ones in situations similar to yours and can help them navigate their way through end of life care.

  • I was diagnosed with non-small cell lung cancer and am receiving chemotherapy. I've had two colds within a three-week period and also a low level of hemoglobin in my blood (the doctor has recommended erythropoietin treatments). Could these issues be diet related?

    Chemotherapy for either small cell or non-small cell lung cancer tends to be fairly aggressive and can produce some difficult side effects. While chemotherapy is focused on destroying lung cancer cells it can also interferes with the production of the three types of blood cells: red blood cells, white blood cells, and platelets. Normally, just before you start a chemotherapy session, your doctor arranges for you to have blood tests to determine the effect the chemotherapy is having on your blood cells. Low counts of any of these cells may prompt either a change in dosage or frequency of treatment, or a need to take medication that can stimulate bone marrow production of the blood cells.

    Your colds may be due to the chemotherapy’s suppression of the bone marrow’s production of white blood cells, which are the body’s infection fighters. If your doctor feels that your white cell count has significantly decreased, he or she may consider putting you on a medication for this condition. Ask your doctor whether this might be a possibility.

    Similarly, the low levels of hemoglobin you mention may be due to low red blood cell counts caused by chemotherapy. Red blood cells carry oxygen and iron to provide the body with components necessary for energy. Red blood cells are an important factor in maintaining energy levels in our bodies and too few of them can result in fatigue and anemia. It sounds like your doctor believes an erythropoietin-type drug might be helpful in boosting your red blood cell count. While extreme low red blood cell counts are not normally related to diet, you might also want to ask your doctor for a referral to a dietitian who works with cancer patients to develop a meal plan that would increase your dietary intake of iron and help you maintain a healthy weight.

    CancerCare offers publications that provide more detailed information on managing chemotherapy side effects.

  • I was diagnosed with stage IB non-small cell lung cancer. I had surgery (lobe resection) and my doctor gave me a referral to an oncologist for "adjuvant treatment," meaning chemotherapy. Why do I need to do this?

    For a long time, it was believed that only surgery was necessary to achieve a successful outcome for lung cancer patients diagnosed with stage IB to IIIA non-small cell lung cancer. However, a number of recent investigational research studies provided evidence that patients who received both surgery as their primary treatment and chemotherapy as an “adjuvant,” or secondary treatment, reduced their risk of the cancer recurring. Unlike chemotherapy used as a primary therapy, adjuvant chemotherapy is usually shorter-term and has a fixed duration.

    You should discuss any of your concerns about the side effects of chemotherapy with your oncologist before treatment starts. I do want to say that there are significantly fewer, less severe side effects in current-day chemotherapy treatments and much more can be done to address them.

    For more information on lung cancer staging and treatment, read our lung cancer publications

    View all of CancerCare’s publications about managing side effects.

  • My wife was diagnosed with stage IV non-small cell lung cancer (NSCLC) and we have health insurance. One of her chemotherapy drugs is very expensive and insurance only pays $1000 per chemo treatment. She is 63 and does not qualify for Medicare. We are looking at co-payment debt of over $100,000. Any suggestions?

    We often find that the private health insurance we have is fine when you are healthy, but not sufficient enough when diagnosed with cancer. Unfortunately, you are correct that she must either be 65 years old or determined to be disabled by the Social Security Administration for 24 months before qualifying for Medicare. I suggest you begin the disability application process if you have not already. Certain cancer diagnoses qualify for expediting the application process (called Compassionate Allowances). You can find out more about the qualifications and can apply online or call to speak with a Social Security representative about your specific situation.

    Co-pay foundations are independent charities that assist insured patients who qualify with the co-pay costs of their pharmaceutical products. Current charities that assist non small-cell lung cancer (NSCLC) patients are:

    CancerCare also offers limited assistance for transportation, homecare, and childcare for patients who qualify. Some local divisions of the American Cancer Society may also have help with transportation to treatment as well as assistance with wigs.

    The Patient Advocate Foundation’s trained case managers provide guidance and support and can intervene on your behalf regarding medical debt. They also maintain a network of volunteer attorneys.

    Lawhelp.org provides referrals for affordable and/or free legal assistance programs in one’s area and advice about bankruptcy protection and other financial issues.

    And finally, you may read our fact sheets about finding financial assistance in your community for further suggestions:

  • I'm in remission after having chemotherapy and radiation for small cell lung cancer. I've recently started having a shortness of breath when I'm at rest (doesn't seem to happen at work). Is there anything I can do?

    The shortness of breath, or dyspnea, you are experiencing can be uncomfortable and frightening. The more you struggle for air, the harder your lungs work to get oxygen, and the more distressed you feel. It is extremely important to consult a medical professional to find out what might be setting this cycle in motion. Possible causes could be:

    • a side effect of chemotherapy or radiation (which may reduce lung capacity)
    • anemia, meaning your lungs don’t have enough red blood cells to deliver oxygen throughout your body
    • a non-cancer lung condition, like asthma, COPD, or an allergy
    • anxiety caused by fears of recurrence, the lasting emotional effects of having had cancer, or other types of stress

    Contact the American Lung Association (1-800-LUNGUSA) for information on other possible causes of dyspnea. Depending on its source, a doctor may prescribe a steroidal or anti-anxiety medication, supplements, oxygen, or special exercises. The Lung Cancer Alliance has a very helpful video demonstration of breathing techniques to relieve dyspnea. Progressive relaxation, meditation, and guided imagery can all help reduce stress and anxiety. CancerCare has several Connect Education Workshops that address stress management in cancer survivors including Fear of Recurrence and Late Effects: Living with Uncertainty and Managing the Stress of Survivorship.

    To prepare for your doctor’s appointment, keep a record of your breathing problems, with these questions in mind:

    • When do you experience shortness of breath?
    • When does it feel worst?
    • How long does each episode last?
    • What is going on around you before, during, and after each episode?
    • Does anything make it feel better?

    Take your record with you to your appointment. It is very important that a medical professional review your symptoms, especially if you’re also feeling faint and dizzy, if your heart is pounding, or if it’s difficult to breathe even at rest.

    CancerCare has information on creating a survivorship care plan that can be used to personalize your post-treatment needs and communicate them to your health care provider.

    Don’t be afraid to advocate for yourself so that your medical, emotional, and practical needs are addressed, and your quality of life is maximized.

  • My husband has been diagnosed with Stage IIIA non-small cell lung cancer that had spread to the mediastinal nodes. I have heard that the five-year survival rate for this type of cancer is 15% or approximately two years. Is this correct?

    The American Society of Chest Physicians indicates that the five-year survival rate for Stage IIIA non-small-cell lung cancer (NSCLC) ranges from less than 10% to 40% and is dependent on the extent of mediastinal lymph node involvement. NSCLC type (squamous cell, adenocarcinoma or large cell carcinoma) may also influence survival rates.

    It is important to keep in mind that the primary purpose of staging a cancer is to make sure that the correct treatment protocols are utilized, rather than to predict survival. Survival rates do not represent the experience of any individual lung cancer patient. They are statistical figures which are comprised of data collected on thousands of cancer patients and then calculated to develop the average or median computation for that very large group.

    Many factors influence lung cancer survival including a patient’s age, overall state of health prior to diagnosis, healthy lifestyle, compliance to treatment regimens and response to treatment. Very often, newly diagnosed patients who join CancerCare’s lung cancer patient support groups have poor survival prognoses, yet survive for significantly longer periods than anticipated.

    One valuable coping strategy we have learned from these group members over the years is “staying in moment.” Using our physical and emotional strengths on today’s issues, rather than trying to solve the unknowns of the future, appears to be one of the most effective ways of living each day with lung cancer.

    You can also find comprehensive information about lung cancer on CancerCare’s website, www.lungcancer.org.

  • A friend and co-worker was just diagnosed with lung cancer and it's inoperable. As his friend and boss, how can I best help? What should we prepare for?

    It’s important to bear in mind that while a cancer may be diagnosed at a stage where it is not operable, it may very well be treatable. Many lung cancer patients are diagnosed at a stage where surgery is not a viable option but where appropriate chemotherapy, targeted therapy or radiation therapy may result in better survivorship outcomes.

    You may find it helpful to visit CancerCare’s website www.lungcancer.org which was created as a “first stop” for folks newly diagnosed with lung cancer in order to provide them with some basic information and the resources they may find helpful as they navigate a very new and sometimes difficult environment. You may also find that our fact sheet “What Can I Say to a Newly Diagnosed Loved One” offers you some guidance on how best to communicate with your friend.

    You mentioned that you are also his boss. The Americans with Disabilities Act provides guidelines on how employers can provide reasonable accommodations for employees disabled with conditions such as lung cancer. You may be interested in reviewing the online publication “The ADA: Your Responsibilities as an Employer” to learn more about how reasonable accommodation may help your colleague continue to work to the extent that he is able to.

  • My husband has recently been diagnosed with stage 4 small cell lung cancer and can no longer work. How do we pay our bills? I still work, but I don't make enough money. Any advice would be appreciated.

    The onset of cancer is a very difficult time for many families financially, with loss of income and the costs of treatment adding to the stress they must cope with. To locate possible resources, I’d suggest the following:

  • My mother has had colon and breast cancer. She now faces a nodule in her lower right lung. Doctors say it is definitely cancer, but are not sure what type (lung cancer or metastasis of the colon or breast). Is a lung biopsy the only way to find out what kind of cancer it is?

    Before treatment starts, it is extremely important that the doctor know exactly what kind of cancer is to be treated, as treatment varies with different kinds of cancer. The only way that the kind of cancer can be accurately identified is to have a section of tissue removed from the tumor or nodule so that it may be examined under a microscope by a pathologist, who can identify the cancer cell type and advise the patient’s doctor.

    You and your mother may find the following articles from the American Society of Clinical Oncology’s website can provide you with some helpful insights on biopsies and their results:

  • How does one get compassionate care in clinical trials when there is nothing left in the way of lung cancer treatments?

    We believe you are asking about “Compassionate Drug Use” also called “Compassionate Use,” which is the use of therapeutic drugs that have not yet been approved by the FDA to treat cancer, and no other treatments are available. These drugs are called investigational drugs and are usually only available to patients who are participating in a clinical trial. Use of these drugs outside of a clinical trials is extremely limited.

    Requests for the compassionate use of an investigational drug must be made via a request from the patient’s doctor to the drug company requesting their permission for its use and their willingness to supply the drug for the patient’s use. If the drug company consents, and frequently they do not, then the doctor must ask the FDA for their permission to use the drug for his or her patient only. The request to the FDA must include detailed medical information about the patient, why the request is necessary, a proposed plan of treatment and the patient’s signed consent. The length of time for FDA approval varies, but may be expedited in emergency situations.

    For more information on compassionate drug use, the American Cancer Society provides a helpful reference guide. Additional information can also be found through the FDA’s Expanded Access Program.

Don’t See Your Question Asked?

Browse the Frequently Asked Questions section of our Lung Cancer 101 feature for a number of shorter questions and answers about lung cancer.