Healing Diet

If you are confused about what is a healthy diet, you are not alone. There are numerous theories, many of which seem quite plausible, about what and how much to eat. My goal is to present a reasonable approach for most cancer survivors. If you have unique issues relating to your health status or your cultural, religious, or other beliefs, you may benefit from talking to your doctor or to a registered dietitian who specializes in oncology (see Advice from the Experts in the next section)....

Before Getting Started

Before starting an exercise regimen, be sure to talk to your doctor about what types of exercises you can do, how hard you should push yourself, what you should avoid, and what problems you may encounter. If you have had surgery, your doctor will probably not want you to exercise within a month or so of the operation. Of course the type of surgery makes a difference. If you have had a melanoma removed from your skin, that incision will typically heal more quickly than, say, an abdominal or a...

Increased or Decreased Appetite

Either an increase or a decrease in appetite may signal problems in a child. Because the same changes may also be part of children's normal growth stages, the matter can be confusing. If you are worried, watch your child's mood for signals be watchful not for a skipped meal here, a dinner of pizza and ice cream there, but for bigger patterns over weeks and months. Is your child gaining more weight than would be expected at this stage in development and given her or his level of activity An...

Couples and Intimacy

Couples often experience dramatic changes in their relationships following a serious illness in one partner, because of the intensity of their feelings for each other and the amount of time they spend together. Studies have yielded conflicting results about whether a cancer diagnosis leads to a higher divorce rate among married couples, but any life-threatening illness puts an enormous strain on both people in a close relationship. There are many reasons that emotional and physical intimacy may...

Pharmacological Options for Nonmalignant Pain

Nonmalignant pain may be classified as nociceptive or neuropathic. No-ciceptive pain occurs when the tissues have been injured and an immune response causes swelling and other injury-healing actions. With neuropathic pain, there may be direct or indirect trauma to nerves. For example, some chemotherapeutic agents are toxic to nerves in the hands and feet and can cause a peripheral neuropathy that may be quite painful. Pharmacological options usually come in one of three forms topical...

Western Medicine

There was a time when telling people who were ill to go to a medical doctor meant that they would be worse off than if they suffered without any intervention. Historian James Olson was diagnosed in 1981 with epithelioid sarcoma in his left arm after two recurrences, he underwent amputation of his arm. Olson recently wrote, Until the twentieth century, only the finest of lines separated doctors from quacks and science from superstition. Patients were more likely to die from medical treatment...

Vitamin and Mineral Supplements

A daily multivitamin can help to ensure that you are receiving the vitamins you need. Not everyone needs to take a multivitamin, but most people can benefit from taking one as a sort of insurance policy. For those who are anemic because of an iron deficiency, this practice can be helpful as well, since multivitamin supplements usually also contain iron. Iron can contribute to constipation, however so if you are not deficient in iron and you are concerned about constipation, choose one of the...

Table 122 Examples of Meditation Practices

This type of meditation is advocated by Jon Kabat-Zinn, who describes it in this way Mindfulness is an ancient Buddhist practice which has profound relevance for our present-day lives. This relevance has nothing to do with Buddhism per se or with becoming a Buddhist, but it has everything to do with waking up and living in harmony with oneself and with the world. It has to do with examining who we are, with questioning our view of the world and our place in it, and with cultivating some...

Traditional versus Nontraditional Medicine

To make educated choices about treatment options, it is helpful to understand what it means when a treatment is considered to be mainstream medicine versus complementary or alternative medicine. (Chapter 6 more fully explores nontraditional therapies.) Traditional medicine is based on research that has demonstrated, usually in more than one study conducted in different geographic regions by different scientists, that a particular treatment is beneficial. The process is arduous, requiring a...

Complementary and Alternative Medicine Pain Therapies

Complementary and alternative medicine therapies may help with pain, and many are focused on relieving this symptom. As noted in Chapter 6, CAM is a reasonable option if the risks are minimal and the cost is not prohibitive. Many of the CAM treatments that have been shown to be helpful in cancer patients are offered at hospitals and centers that have oncology clinics. For example, acupuncture and massage are frequently available to people undergoing cancer treatment. Be aware that neither of...

Manipulative and Body Based Methods

Osteopathic and Chiropractic Manipulation. Osteopathy was founded by a medical doctor, Andrew Taylor Still, in 1874. Dr. Still sought to develop a holistic approach to medicine that would incorporate the body's natural healing powers. Today doctors of osteopathic medicine (DOs) are trained in a similar manner to medical doctors (MDs) they also receive training in manual medicine and manipulation. Osteopaths are able to hold the same hospital privileges as medical doctors, and they are skilled...

Table 93 Assessing Fatigue

Do you feel tired when you awaken in the morning 2. Do you have a sense of overwhelming fatigue despite sleeping well 3. Is sleep nonrestorative for you 5. Do you have difficulty falling asleep or falling back to sleep 7. Do you rest or nap during the day 8. Have you curtailed or modified your activities because of a reduced energy level 9. Is fatigue affecting your home life, work, or recreation 10. Do you have difficulty with memory, concentration, attention, or finding words 11. Is your...

Biologically Based Therapies

Botanicals, Dietary Supplements, and Herbal Products. Herbs are a subset of botanicals, a term meaning plants or plant parts that are valued for their medicinal properties. Any herbal or botanical products, or phytomedicines, may be considered botanicals. In the 1994 Dietary Supplement Health and Education Act (DSHEA), Congress defined a dietary supplement as a product (other than tobacco) taken by mouth that contains a dietary ingredient, which is intended to supplement the diet. Dietary...

The Relaxation Response

Herbert Benson, a colleague of mine who is a cardiology professor at Harvard, is widely known for his work on stress and relaxation. In the 1970s he coined the term relaxation response to refer to the opposite of the stress response commonly known as fight or flight. In a stressful situation, the nervous system goes into overdrive and increases one's heart rate, blood pressure, breathing rate, and the blood supply to the muscles these are ways to help the body respond to stress. The...

Table 117 Symptoms of Post Traumatic Stress Disorder

Mental flashbacks Being startled by loud noises Anxiety or depression Poor sleep ventions to help you during this stressful time. Most doctors are also able to provide referrals to mental health professionals who specialize in treating people with serious illnesses. You don't necessarily need to go to a psychiatrist, psychologist, or clinical social worker who treats only cancer patients, but the more experience the person has in oncology, the better informed she or he will be about what you...

Table 79 continued

In that case, it is wise to avoid public places (including gyms, spas, and so forth). Your doctor may advise you not to exercise at all until your cell counts come up to a safe level. Many cancer treatments make the skin more fragile. In this situation you can help to protect your skin by wearing comfortable clothing (generally 100 percent cotton is best) and by avoiding excessive sweating, which may further irritate your skin. It may also be helpful to wrap an irritated area with a gauze pad...

Diet and Cancer

We know that diet is an extremely important component in cancer, and it is estimated that up to one-third or more of all cancers might be related to diet, exercise, and other lifestyle factors. Moreover, we have good evidence that optimal healing is hindered in people who are malnourished. Finally, a great deal of misinformation is given in books and articles dealing with cancer and nutrition it is not always easy to sort out fact from fiction and what researchers surmise from what has been...

What to Tell Children about Cancer

There is no way to keep your children, whatever their age, from being affected by their parent's cancer. Wendy Schlessel Harpham, a physician, was a young mother when she was diagnosed with non-Hodgkin's lymphoma. In her book When a Parent Has Cancer, she reminds us that the greatest gift you can give your children is not protection from change, loss, pain, or stress, but the confidence and tools to cope and grow with all that life has to offer them. Here are a few...

Nonmalignant Pain

Practically everyone who has ever had cancer has an almost unconscious pain filter that works something like this Hey, I have a pain in my fill in the body part . Could this be a recurrence What they really want to know is whether this is a safe pain or something that could be life threatening. Chloe is a middle-aged woman who had endometrial cancer more than a decade ago. At the time, she had a number of pelvic lymph nodes removed and subsequently developed problems with lymph drainage that...

What You Can Try on Your

Regardless of whether you seek out other treatment for your emotional well-being, there are things that you can do to help yourself. You may want to keep a journal see the next section, where I describe how to begin. Table 11.8 lists some other suggestions that have been helpful to cancer survivors. Also refer to the other chapters in this book they cover many of the topics listed in Table 11.8 in more depth. For example, in Chapter 7 I discuss the enormous health benefits of exercise during...

Table 79 Problems Cancer Survivors May Encounter

Lymphedema is the swelling of a limb (seen most frequently in people with breast cancer who have swelling of an arm after some of their underarm lymph nodes are removed during surgery). The swelling is caused by extra lymph fluid that collects in the limb as a result of disruption in the lymph nodes and the flow through them. In the past, it was believed that exercise, especially strenuous exercises done with the affected limb, might cause or promote this problem. But the research on lymphedema...

Special Dietary Concerns in Cancer Survivors

There are many, many issues that may play a role in the nutritional state of a cancer survivor. The treatments may cause an increase or decrease in appetite. Nausea, vomiting, diarrhea, or constipation may be present. Intestinal surgery or removal of vital organs such as the pancreas can significantly impact one's diet and nutritional status. These problems need to be addressed individually based on the person's diagnosis, treatment, current weight, nutritional status, and other issues such as...

Cancer and CAM

Cancer patients make more use of CAM treatments than the general population does, according to a number of studies. For example, in one study of women with early-stage breast cancer, the researchers found that more than half of the women reported using CAM therapies during their treatment. It probably is no surprise that many of us who have faced cancer are willing to try therapies outside of mainstream medicine. As one study in the book Evidence-Based Cancer Care and Prevention pointed out,...

Table 61 Some Experts Recommendations on CAM Therapies

All cancer survivors should avoid High-dose vitamin A and C supplements Antioxidants (anyone actively undergoing chemotherapy or radiation) Soy (phytoestrogens) (women with breast or endometrial cancer) Acupuncture (sometimes not advisable in people with a low platelet count or people receiving anticoagulant therapy) Deep tissue massage (sometimes not advisable in people with a low platelet count or severe osteoporosis or people receiving anticoagulant therapy) St. John's wort (anyone taking...

Surgery

Surgery is an excellent method of treatment for some pain problems however, because of the potential for serious side effects, it should never be done without exploring other options. Especially for people healing from cancer and cancer treatment (which may have already involved surgery), unnecessary operations should be avoided. There are times when surgery is very helpful even for such individuals, though. One of my patients is a woman with a history of breast cancer who now has lymphedema in...

How to Tell If Your Children Need Help

Various warning signs may indicate that your child needs professional help in dealing with her or his emotions and with your illness. Of course, your family members, especially children, must have the medical and psychological attention they need as they struggle with the day-to-day issues that arise when a parent has cancer. Treatment should focus on the whole family and is generally more successful for everyone when this is the case. Parents who see their children become casualties of their...

Where to Find Help

American Cancer Society 1599 Clifton NE Atlanta, GA 30329 800-ACS-2345 (800-227-2345) www.cancer.org The ACS is a nationwide community-based volunteer health organization. The ACS has state divisions and more than 3,400 local offices. The goal of the organization is to eliminate cancer as a major health problem by preventing the disease, saving lives, and diminishing suffering through research, education, advocacy, and service. The ACS offers many programs, including Reach to Recovery, Man to...

Cancer Healing and the Immune System

The immune system consists of many types of cells carried by the blood to different parts of the body. There are neutrophils, eosinophils, mono-cytes, macrophages, and natural killer cells that we believe help to keep cancer cells in check. If this theory is right, then boosting one's immune system will help reduce the risk of cancer and perhaps cancer recurrence. It is believed that at any given time there are stray cancer cells in healthy people whose immune systems are strong enough to...

Why Choose Organic Foods

We don't know much about the long-term effects of the added chemicals that are commonly used to grow or preserve food. We will probably learn eventually that such things as bovine growth hormone and irradiated or genetically engineered food are either not particularly harmful or that they can contribute to tumor growth. It is unlikely that we'll find out that these things are good for our health. Therefore, when people ask me whether they should eat organic food, I answer that it is wise to...

Sleep Problems

In my home state of Massachusetts, there is a statewide test that all children must pass to graduate from high school. When children from a school that has ranked in the top tier every year were interviewed, I was struck by how much their teachers encouraged them to sleep. I had expected the children to report that they studied hard, but I was wrong. Instead, they said they were given little homework but were encouraged to sleep ten to twelve hours a night. The moral of this story is that the...

How Physical Changes Can Affect Emotions

Increasingly we are finding that mood disturbances, such as depression and anxiety, are largely due to chemical imbalances in the brain. Read this as it's not your fault if you are experiencing symptoms of a mood disorder. Hormones such as those associated with the thyroid gland or sex hormones such as estrogen and testosterone may be affected by cancer treatment for a number of reasons. Sometimes these hormones help to stimulate the growth of tumors and need to be suppressed intentionally as a...

Working toward Emotional Balance

If you think you have symptoms of anxiety or depression, you should talk to your doctor about how you are feeling. Improving your emotional health will not only enhance your quality of life, but it will also help you to physically heal. One way your doctor can help is to consider the physical reasons behind your emotional problems. The more common physical factors are listed in Table 11.5. Just recognizing your symptoms and having a frank discussion with either your primary care physician or...

Alternative Medical Systems

Homeopathy dates back to the Greek physician Hippocrates, who founded some of its basic principles in the fifth century b.c. Hippocrates believed that it was essential to understand people's symptoms and how they reacted to disease in order to treat them. Although understanding the whole person is a founding principle in homeopathy, the field wasn't fully established until the German physician and chemist Samuel Hahnemann (1755 1843) began experimenting on himself. Dr. Hahnemann had...

An Energy Inventory

Before you begin to seriously pace yourself, it is a great idea to spend three days keeping track of what you are doing. After all, one of the best ways to see how you can save coins is to first see how they are now being spent. In my clinic, we recommend that patients keep a three-day log of their activities. They write down all their activities and also document when they are experiencing pain or feeling particularly fatigued. The occupational therapist then reviews this log with the patient...

Contents

Chapter 1 Get Your Life Back on Track 1 chapter 2 Understand Physical Healing 11 Prioritize What You Do and Pace Yourself 32 chapter 5 Seek Help from Western Medicine 47 chapter 6 Explore Eastern and Other Medical Systems 58 chapter 7 Dance, Skip, and Walk Exercise Your Way Back to Health 78 chapter 12 Tap into Your Spirituality 181 chapter 15 Look What's on the Horizon 232 Appendix Where to Find Help 243 Index 261

Conventional Medicine An Imperfect System

Although prescription medications undergo much study before they come to the market, medical doctors sometimes try other treatments and procedures that have not been rigorously tested. A well-known example occurred during the 2004 American League Championship Series. When pitcher Curt Schilling injured his right ankle, the Boston Red Sox's general manager vowed to explore every medical technique under the sun to try to get his tendon stabilized. According to the Boston Globe, here's what...

Faster Better Stronger Julie K Silver MD

The Johns Hopkins University Press Baltimore Note to the Reader This book is not meant to substitute for medical care of people with cancer, and treatment should not be based solely on its contents. Instead, treatment must be developed in a dialogue between the individual and his or her physician. Our book has been written to help with that dialogue. In order to protect the privacy of patients whose stories are told in this book, the author has changed their names and identifying...

Fatigue

Studies reveal that about one-third of the general population say they feel tired. In cancer patients, both undergoing treatment and post-treatment, the number is approximately double. So approximately two of every three cancer survivors have symptoms of fatigue and fatigue tends to hinder recovery and daily functional activities. Patients and caregivers often have different perceptions about fatigue. Caregivers are likely to underestimate its frequency, severity, and impact on quality of life....

How We Heal Best

Physical healing is affected by many things the extent of the injury, whether it is ongoing, what part of the body was injured, what the health of the person was like before the injury, and so on. We must remember that many factors play a role in physical healing it is not just a matter of doing one or two simple things. Furthermore, the recovery process will occur whether you help it or not. In other words, even if you don't follow the advice provided here, your body will work to heal itself....

Improving Intimacy

It is likely that over the past weeks and months, your conversations with your partner far more of them than previously have been about health-related issues. Both the content and the way in which conversations flow may be altered one person may be trying to protect the other, or one person (or both) may feel sad, worried, or even depressed. Reconnecting emotionally with your partner is about both what you say and what you do. Table 13.3 lists some suggestions for improving emotional intimacy....

Legitimating Some CAM Therapies

In 1993 Harvard physician and researcher David Eisenberg and his colleagues published a report titled Unconventional Medicine in the United States Prevalence, Costs, and Patterns of Use. Eisenberg reported that approximately 1 of every 3 Americans was using CAM therapies and that approximately 2 of every 3 people who did so were not telling their primary health provider about the use of these therapies. Following this landmark study, the National Institutes of Health established the Office for...

Mind Body Interventions

Meditation is the ability to self-regulate your thoughts in order to suspend the normal stream of consciousness. A common goal of meditation, which distinguishes it from relaxation, is to reach a state of thoughtless awareness during which you are passively aware of sensations at the present moment. There are a number of different methods that people use to meditate. The methods that involve the constant repetition of sounds or images without aiming for a state of thoughtless...

Mood Changes

As your family struggles with issues surrounding cancer, there will be times when family members feel glum or worried. In children, the time to worry is when these moods become persistent or are present more than they have been in the past. All of us, including children, have a baseline mood level that fluctuates as things happen in our lives. When good things happen, we feel happier when bad things happen, we are sad. In children, as in adults, the baseline mood level depends on their in...

Pacing

One of my favorite quotes on pacing comes from Hugh Gregory Gallagher, who survived polio and struggled with its debilitating aftereffects. Gallagher wrote, My muscle power and endurance are as coins in my purse I have only so many and they will buy only so much. I must live within my means, and to do this I have to economize what do I want to buy and how can I buy it for the least possible cost Regardless of where you are in the healing process, you only have so many coins. To reach the goals...

Pacing Basics

There are a few basic principles when it comes to pacing. These may seem obvious, but as you read them, ask yourself whether you are following them. They are good tools to use in the recovery process. Here are the basics of pacing 1. Organize and plan your day ahead of time. Doing this costs you Table 4.1. How to Keep a Three-Day Activity Log Step 1. Organize a notebook with space to write in for each hour of the day for three days. Step 2. Record your activities each waking hour for the next...

Past Transgressions and the Emergence of Psychoneuroimmunology

Even though embracing a spiritual life has been shown to improve health in a variety of ways, a skeptical view of this notion is understandable. Historically, religion has been used as a cover to perform truly heinous acts some of which were purported as necessary to ensure the health of a particular community (even ethnic cleansing has been promoted as a public health issue). Today, religion is often considered antithetical to modern medicine because medicine is based in science and religion...

Some Definitions

The following definitions are offered as a framework for discussion. I'll define spirituality as those things that relate to one's spirit. Spirituality may be used in a religious or a nonreligious context. Often people who are not religious nevertheless see themselves as spiritual beings and consider nature as a force to connect with their feelings of spirituality. A dictionary definition of spirit is an animating or vital principle held to give life to physical organisms. It can also be...

Spirituality

One morning, about a year after I was diagnosed with breast cancer, I was driving somewhere with my then 12-year-old son, and I asked him, Do you ever get worried about my having had cancer As I looked in the rear view mirror at this half boy half man, he said somewhat nonchalantly, No. I don't really think about it. I was a bit surprised but just chalked it up to the fact that he was a child, still very self-absorbed. We were both quiet for a few minutes and then he spoke again, But I pray for...

Step

Although it is possible and even sometimes necessary to modify your goals as you move forward, the ideal is to begin with goals that are realistic. Michael Jordan can't go back in time and play basketball the same way he once did, but for many cancer survivors it is entirely possible to become once again as active as they were in the past, or even more active. For example, let's say that before you were diagnosed, you ran two miles a day. Perhaps now you aren't able to run...

Table 133 Enhancing Emotional Intimacy

Set aside time to have a conversation about issues you have been avoiding or issues that are emotionally charged. During this date be encouraging to your partner and listen to him or her at least as much as you talk. Sharing your feelings is a great way to build emotional intimacy. Do something together that doesn't involve a lot of verbal communication. Go to a movie or a concert. Take time to enjoy nature together. Have a picnic, take an outdoor hike, or go for a walk or a bike ride. Join...

Table 134 Enhancing Physical Intimacy

Great sex is a whole-body experience or more precisely, a body, mind, and soul experience. Remember that your most important sexual organ is between the ears. Sexiness is at first mental then it goes somewhere else. Both partners need to be aroused to have a good experience. Play to your partner's dominant sense (sight, sound, or touch) to heighten his or her arousal. Make it easier to get an erection by using positions in lovemaking that take advantage of gravity, thus helping blood flow into...

The Older Child

School-age children will be able to understand more about what is happening. Once again, start with basic information about the name of your condition and what you expect to happen now and in the future. Simple diagrams and explanations from books and Web sites can help. Also, review with your children that your cancer is not their fault and that they can't catch it from you. Once you have provided this information, give some details about what is happening in your family. Who is going to take...

Fine Tuning Your Pain Filter

As I mentioned, nearly all cancer survivors have what I call a very sensitive pain filter. What a person might have ignored in the past now becomes a concern is that cancer pain I am feeling Fine-tuning your pain filter and recognizing when to seek medical advice can contribute to your peace of mind. Since most new pain will go away within two weeks, I usually advise people to monitor their pain over this time period and, if it persists, to seek help then. Here's some advice on adjusting your...

Table 104 Common Types of Injections to Treat Nonmalignant Pain

Medication is administered in specific areas of the muscle that are pain generators (for fibromyalgia, muscle pain syndromes, etc.). Medication is injected around, but not into, the tendon (for tendinitis, lateral epicondylitis, etc.). Medication is injected near the nerve but not into the nerve (for reflex sympathetic dystrophy, carpal tunnel syndrome, spinal nerve compression syndromes, etc.). Medication is delivered to the epidural space in the spine (for spinal stenosis and lumbar or...

Cancer Related Fatigue

According to guidelines published by the National Comprehensive Cancer Network, Cancer-related fatigue is a persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning. The International Classification of Disease-10 defines cancer-related fatigue as significant fatigue, diminished energy, or increased need to rest, disproportionate to any recent change in activity level. This type of fatigue is often described as an overwhelming...

The Power of Friendship

Friends can enrich your life and help you to heal. Maybe they can even help you live longer. In a fascinating study of a group of elderly Australians, researchers found that friends, not family, were the most important factor in survival. This research is not conclusive and does not address friendship in cancer survivors, but it is interesting to consider how one's relationships with others might impact health and healing. One thing that is clear is that people with strong social networks have...

Energy Therapies

Reiki is a Japanese word that comes from rei, meaning universal spirit, and ki, meaning life energy. Reiki is an ancient healing method that was revitalized in the 1800s by the Buddhist monk Hichau Mikao Usui. Practitioners believe that the health benefits of Reiki come from a universal life energy that they are able to channel to patients. Reiki masters position their hands in twelve to fifteen different places on the individual's body and hold them in each place for two to five...

The Genesis of This Book

When I finished my cancer treatment, I knew how to heal myself. I didn't start planning to write this book, however, until four days after I returned to work. The idea for After Cancer Treatment formed in my mind when the president of my hospital, Judy Waterston, invited me to attend a lunch in honor of several women, some of whom were cancer survivors, who were receiving awards for their various exceptional accomplishments. Hosted by the Boston radio station Magic 106.7, this annual event is...

Choosing the Right Treatment for

Suzanne Somers, the actress perhaps best known for her role as the stereotypical dumb blond on the sitcom Three's Company, made tabloid news for weeks when she was diagnosed with breast cancer and opted out of some of the treatments that her doctors recommended. She writes of her decision to continue hormonal therapy against her doctors' advice I'm going to continue to take my hormones, I am not going to take chemotherapy, I am going to have six weeks of radiation, and I am not going to take...

The Nccam Classification of CAM Therapies

Examples of CAM therapies in each of the five categories are described in this section (this is not a complete list of CAM therapies by any means). Note that even for CAM treatments that are believed to generally be safe, it is usually not advisable for someone with an unstable psychiatric diagnosis to use them. In addition, as I mentioned earlier, none of these healing methods should take the place of conventional medicine, especially when the underlying diagnosis is cancer. Rather they should...

Table 121 Prayers for Healing

Send me, O God, your healing, so that I may quickly recover from the illness that has come upon me. Sustain my spirit, relieve my pain and restore me to perfect health, happiness and strength. Grant unto my body your healing power so I may continue to be able to bear testimony to your everlasting mercy and love, for you, O Lord, art a faithful and merciful healer. (This nondenominational example was selected by the pastoral care staff at the Mount Zion Medical Center, which is affiliated with...

Back on Track

Over the past hundred years or so, our understanding of how to cure many ailments has dramatically advanced. Now when people go to the doctor, the prescribed treatments usually help without causing further injury. Even surgeries, after a relatively brief recovery period, generally relieve people of pain and other serious problems. Not so with cancer. People with cancer often don't even know they have a potential killer lurking in their bodies. A lump or bump, sometimes not even noticed by the...

Your Mood

Hamilton Jordan, the youngest chief of staff in American history (he served in the Jimmy Carter administration), survived three kinds of cancer before the age of 50. He titled his fascinating memoir No Such Thing as a Bad Day. After living through non-Hodgkin's lymphoma, melanoma, and prostate cancer, Jordan considers himself a lucky man. If you read his memoir, however, you'll find that in fact he had many bad days as he was struggling to cure his cancers and regain his health. Everyone who is...

Table 114 Antidepressant Medications

Selective Serotonin Reuptake Inhibitors (SSRIs) Action Increase serotonin levels in the brain. Drugs Celexa (citalopram), Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine), Zoloft (sertraline). Notable Side Effects Nausea and stomach upset, agitation, difficulty sleeping, headache, decreased libido, and other sexual dysfunction (problems with erections, etc.). Rarely there are associated suicidal thoughts. Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) Action Increase...

Table 135 Questions about Intimacy and Infertility to Ask Your Doctor

Will cancer treatment leave me with a temporary or permanent loss of sensation If so, what can I expect Will I experience painful intercourse (due to reduced vaginal lubrication or changes in the genital tissue) If so, what can I do about the changes Will I undergo premature menopause If so, how can I treat the symptoms Will I have less feeling in my genitals If so, how will it affect me Will I be left impotent or have difficulty maintaining an erection or ejaculating If so, what can I do about...

Infertility

The ability to conceive a child is an issue with many different types of cancer, may affect both men and women, and can result from both adult and childhood cancers and treatments. Infertility can also be seen as a tragic consequence (a double whammy) of surviving a life-threatening disease. For some people infertility is a source of terrific loss and may bring about intense feelings of sadness, shame, worry, and anger. Just the possibility of future infertility can interfere with...

And Other Medical Systems

Acupuncture is one of the best examples of a nontraditional treatment that has been extensively studied and is now considered a conventional therapy. It is prescribed by medical doctors for a number of conditions and symptoms, including musculoskel-etal pain. Acupuncture has been practiced for several thousand years in China. The general theory is that there are patterns of energy flow (Chi, pronounced chee) within the body that help to maintain good health, and that disruptions in these...

Treatment of Fatigue

In 1796 Thomas Ball submitted a dissertation to the Philadelphia Medical Society on the causes and effects of sleep. Ball (who was about to become a doctor) suggested a number of remedies to produce sedative effects. First on his list was bloodletting (a formerly popular procedure in which a small incision is made in a vein and some blood is removed from the sick person), which he stated should be preferred to all other depleting remedies because we have it more under command than any other. He...

Other Modalities

Modalities are treatments that can be applied to a painful area of the body. Hot and cold packs are modalities that can be used at home. Caution is needed, though, because both heat and cold can cause serious tissue damage if applied for too long or if the temperature is extreme. Hot and cold packs should usually not be directly applied to the skin. Cold packs should not be left on for more than twenty minutes at a time, and there should be a break of at least an hour between treatments. Cold...

New or Exaggerated Behaviors

You need to not only assess your child's mood, but also look for new or exaggerated behaviors. For example, you should be concerned if your child who is usually outgoing becomes withdrawn, or if your child begins to act out at home or at school. If your child is usually neat but begins to become obsessive about keeping his or her room clean, this change could be a warning sign. (The opposite change is just as significant.) If your child usually needs prompting to bathe but now completely...

Table 72 Safe and Unsafe Physical Therapy Techniques

Modalities That Might Not Be Safe for People with Cancer Superficial heat (for example, hot packs) and deep heat (for example, ultrasound) Usually not used directly over a tumor site because of the theoretical concern that increased blood flow may encourage tumor growth. However, this issue is controversial. Massage manipulation percussion soft tissue mobilization Generally avoided in the area of a malignancy. This is another controversial issue there is also the suggestion that massage may be...

Table 111 Symptoms of Grief and Symptoms of Depression

Sleep disturbances, changes in appetite, decreased ability to concentrate, less interest in social activities, alterations in usual behavior patterns (for example, more irritable or angry) Depression Symptoms similar to those of grief but also may feel hopeless, helpless, worthless, and guilty and in some instances may have thoughts of suicide Generally waxes and wanes and the person vacillates between feeling hopeful and sad still able to enjoy activities Constant feelings of intense sadness...

Prayer

Another of my colleagues who works in the field of oncology, Dr. Jerome Groopman (probably best known for his book The Anatomy of Hope), wrote in a journal article about one of his patients who had cancer. She told him, Doctor, I'm frightened. I pray every day. I want you to pray for me. Dr. Groopman didn't know what to say. He explained, None of the training I received in medical school, residency, fellowship, or practice had taught me how to respond to Anna. . . . should I cross the boundary...

Setbacks

Recall that early in this book I mentioned that setbacks are a part of the healing process. As a rehabilitation doctor, I treat many patients with serious injuries and illnesses. Some of the people who come to see me are what we call multi-trauma patients for instance, they might have been in a car accident and have sustained several injuries. It can take months or even years to heal, and the road is usually not smooth. I often see other people who have a single, relatively straightforward...

Table 101 Potential Problems with Opioid Medications

Serious side effects of opioids can include respiratory depression (slowed breathing), so it's recommended that these medications not be used in conjunction with alcohol, antihistamines, barbiturates, or benzodiazepines. (There are exceptions if you are taking opioids, just be sure to tell your doctor about any other medications you're taking that can be sedating or cause respiratory depression.) Other side effects may include rash or itching, nausea with or without vomiting, constipation,...

Beware the Charlatans Mystics and Quacks

I do not advise people to rely solely on nontraditional practitioners, though I believe that some of them can be very helpful. I do not want to taint legitimate alternative healers, but I want you to be aware of the booming CAM industry and to recognize its long and often sordid history with respect to cancer. In Bathshebas Breast, a fascinating history of breast cancer, James Olson writes about how frightened and vulnerable cancer patients have been exploited Desperation drives cancer patients...

Your Baseline Mood

My mother and father had a deep and abiding love for each other, and when my father died, my mother was truly despondent. I remember one conversation I had with her a few months after his death, when she told me about a TV interview of Dr. Joyce Brothers that she had seen. Dr. Brothers talked about how most of us have an emotional baseline, whether it's generally happy or chronically depressed or somewhere in between. When we suffer a terrible blow, for whatever reason, our emotional status can...

Fighting Fatigue with Food

Fatigue is a common problem in people who are undergoing cancer treatment or have finished with therapy and are in the process of healing. Although a person's diet may be just one factor among the many reasons for fatigue, in some people diet plays a significant role. So, what can you do diet-wise to have more energy and endurance Consider the following suggestions Be sure you are getting enough protein in your diet. Talk to your doctor and your dietitian about your protein needs. It may help...