You don’t need a cancer diagnosis to feel stressed at holiday time.

We tend to put so much pressure on the holidays to be perfect and expect our own celebrations to live up to a Norman Rockwell picture of family togetherness and happiness. But too much family, food, and the expectation of fun can make holidays a challenge for anyone.

Now, add in the uncertainty, dread, and low-level stress you carry with you at all times with a cancer diagnosis, and there is even a better chance that something will go wrong. How will I feel Thanksgiving morning? Will I have the energy to deal with cooking? Traveling? Interacting with family? Being alone? Will I have the patience for the incessant roar of the football game in the other room or cousin Cathy’s third-hand account of her friend’s lumpectomy? And how in the world can I feel thankful when I’m in the middle of a cancer ordeal?

I remember sitting around the Thanksgiving table a month after my diagnosis feeling more tearful than grateful. I was happy to have surgery and the first round of chemotherapy behind me. Some of my fears had been alleviated—the pathology report was mostly good news and the chemo was more bearable than I imagined—and I hadn’t yet lost my hair to chemo. But I still had only a timorous hold on hope. There was so much about my future and my health that I didn’t know. And I had no appetite and no energy.

How do you cope with all that when everyone wants to hear more than you want to share? Or worse, ignore the fact that you are going through an existential crisis and all they want to do is argue over the virtues of white meat versus dark meat, apple versus pumpkin pie?

There are things you can do to help yourself cope with the holidays. Whether you are spending it alone, perched on a loved one’s armchair with the parade dribbling by, gathering within a small bubble of friends and family, or traveling to a large feast, whatever the rhythm of the day, find a way to make it your own.

Take a moment to breathe. Before you jump into the day’s activities and start attacking the chores assigned to you for the festivities—even if it is just to be the guest of honor—take a moment for yourself. Lay there in bed another minute or two and luxuriate in the stillness. Sit and sip a cup of coffee or tea, inhaling the scent and really smelling it. Meditate for a few minutes, just focused on your breathing. Take a short walk or even a long run. Pull out a jigsaw puzzle that you can come back to throughout the day as something to focus on and slowly complete. Do something for yourself. Once the day gets started, it will run away with you and your calm. Claim it early in the day before you lose the opportunity.

Cook your favorite comfort food. There are so many foods we think we should prepare as part of a Thanksgiving tradition. In addition to turkey, maybe your family has always had cornbread stuffing, or roasted brussels sprouts, or pumpkin pie. But what do you find most comforting? What will nourish your soul? Perhaps it’s biscuits and gravy, or mashed potatoes. Or my favorite, the Italian answer to mac and cheese, cacio e pepe. Let someone else take charge of making the family traditions. If you have the energy—and that can be a big if when you have cancer—make your favorite comfort food even if it’s not part of the traditional menu. You will enjoy it and there’s a good chance others will too.

Set the ground rules for talking about your cancer. Maybe you don’t want to talk about it at all because you are tired of being the center of attention and would just like to get on with life. Or maybe you would like for your family to acknowledge that you are scared and overwhelmed. Or maybe you would just like to laugh about it so everyone can stop being on edge. It’s your cancer, so it’s your choice how to deal with it. You can ask someone to be your advance spokesperson and clue everyone in before you gather, slowly spread the word yourself, or make an announcement once friends and family are together. Again, your choice, but give it some thought in advance so that you can make your preferences known. There’s no guarantee that Uncle George won’t ignore your request anyway, but if he does, at least you should have a few allies ready to rally to your request.

Put it all in COVID-19 context. Unfortunately, this holiday season, there’s a good chance you and your family are also dealing with COVID-19. Whether it’s travel restrictions or limited bubble size interfering with your plans, negotiating masks and social distancing in the confines of your feast, or the reality of a loved one who is sick or even hospitalized, it’s hard to avoid the impediments of the pandemic. As a patient with a compromised immune system, the disease adds another layer of risk, and fear, and may further complicate gatherings as you try to protect yourself while enjoying friends and family who may not all be on the same page, let alone yours. Make your needs known. While they may seem obvious, it’s safe to assume no one else is as focused on these issues as you are. Unless you clue them into your thinking, they are likely to be oblivious. But there’s a good chance that once tuned in, they will respect your needs.

Find something to be thankful for, no matter how small. There is a lot we have to be grumpy about, starting with the fact that we have cancer, and that treatment, whatever it may be, isn’t a walk in the park. Add to that the fear of the unknown, the anxiety about recurrence, and staring one’s mortality in the face, not to mention chemobrain and other side effects, and it’s safe to say that cancer is a big ordeal. But perhaps your cancer has made clear to you how lucky you are to have a family member who loves you and is by your side. Or perhaps you can chuckle over the money saved on personal grooming since chemo and COVID-19 have made haircuts and manicures unnecessary. Or maybe you are just happy to be enjoying friends and family for one more occasion.

Gathered around the table on that Thanksgiving, with only the dearest of friends and family, I found it hard to be as convivial as the occasion demanded. But, I was able to muster a thin smile and raise my glass to toast just being there. I was alive, and for the moment, that seemed like enough.