Thinking About Delaying Cancer Treatment During the Holidays? Experts Say Doing So Safely ‘Depends’ on Several Factors

Karen Ballou, a Hodgkin's lymphoma survivor, talks about facing cancer during the holidays.

"This is a very difficult question to answer because it depends on the patient, the disease, the treatment, and the intent of the treatment," Joseph Califano, MD, tells SurvivorNet. Califano is a surgeon, who specializes in head and neck cancers, at UC San Diego Health. Califano discussed with SurvivorNet the factors that go into this decision and how you can discuss the subject with your cancer care team.

When It’s OK to Wait

Whether a treatment delay would affect your prognosis depends on many factors.

The Cancer Itself

Cancer refers to a broad spectrum of diseases that behave in many different ways. Doctors may safely monitor low-risk prostate cancers for many years without providing any other treatment. Some leukemias require urgent attention. Other cancers, such as certain breast cancers and lung cancers, may act more like a chronic disease once they become stable on certain medications. Whether or not a treatment delay for the holidays would affect the outcome of your care depends on the cancer.

The Rate of Change

Some tumors, even at an advanced stage, grow so slowly that waiting a few weeks for treatment won't change your prognosis at all. Other cancers may be so aggressive that doctors want to move forward with care as soon as they diagnose you.

"The tempo of the disease tells us whether or not a delay is going to make a difference, whether it's going to change the prognosis, or affect our ability to provide a cure," Califano explains.

The Type of Treatment

Putting off surgery for a few weeks may have a very different result from postponing a chemotherapy infusion. Targeted therapies and immunotherapies, which are very different from standard chemotherapy, add further complexity to the question.

The Goals of Care

Not every treatment is aimed at the same goal. "We treat people for cure, when that is possible, but we also treat people for their symptoms to make them feel better. Our treatments may not extend survival but they may help you live without pain," Califano says. Whether it's alright to delay treatment depends on the goal of your care and if a delay would prevent you from achieving that goal.

Talk to Your Doctor About Delaying Care

Your care team doesn't necessarily know what matters most to you in terms of your care and your quality of life. If you feel you need to delay your care in order to enjoy the holidays with your family, tell your doctor why. Is it the time that the treatment takes? Or is it that the side-effects will make the holidays unpleasant for you? Maybe your care team can adjust your treatment schedule, or maybe there's another solution to the problem.

Sarah Paul of CancerCare says there’s no shame in playing the cancer card this holiday season.

"Don't be afraid to communicate with your care providers and be direct," Califano says. "The clearer you are, the better."

Califano suggests writing down all your questions and concerns before your appointment. If you have not yet started care and are weighing whether you can wait till after the holidays, Califano suggests you ask these questions:

• What is this treatment going to do for me? (For example, will it help me live longer? Will it help my symptoms?)
• What's the goal of this treatment?
• What side effects can I expect and when will they happen?
• In terms of side effects of this treatment, what's the worst case scenario?
• How soon to I need to start in order to get the best results?

Related: How to Help Friends or Family Battling Cancer During the Holidays

When you have a clear picture of the intent of the treatment and the side-effects you might expect, you may get a better idea of how the therapy could affect you over the holidays and whether a delay would be necessary or worth it.

It Isn't All or Nothing

Some people can safely take a break from cancer therapy in order to take a trip, attend an important event or enjoy the holidays. But, sometimes, a treatment delay could bring risks you're not willing to take.

That doesn't mean that you the holidays are ruined.

Related: Holidays are Especially Challenging for Families who Lose Young People to Cancer and for Young Survivors

Your care team can help come up with solutions so that the holidays are enjoyable for you. If it's side effects of treatment that you are concerned about, there are specialists dedicated to relieving symptoms and keeping you comfortable. A palliative care doctor could devise a plan so that you can continue treatment and celebrate the holidays.

"Don't be afraid to ask to see a palliative care physician who will treat your symptoms and make them more manageable," Califano says. "Palliative care is not end-of-life care. It is symptom management. Even patients who have a 90 percent chance of cure see palliative care doctors."

Dr. Lisa Diver dispels misconceptions about palliative care.

Maybe you just need someone to talk to about getting through the holidays while in cancer treatment. Cancer care teams include mental health specialists who can help with his. "Sometimes people are just overwhelmed," Califano says.

Whatever your concerns about managing your cancer care over the holidays, make those concerns clear to your care providers. "We are here to serve you, and doctors and other care providers are usually more than happy to help you have the holidays you want."

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