An essential aspect of survivorship is making healthy choices. Good health habits and regular medical care help to protect survivors' health as well as lessen the likelihood of late effects from cancer treatment. A sizable number of adult cancers are linked to lifestyle choices. Eating a healthy diet, staying physically active, using sunscreen, avoiding excessive alcohol consumption, maintaining a healthy weight, and not smoking all help to keep survivors healthy and cancer-free. Wearing bike or motorcycle helmets, using seat belts, and calling a cab if the person driving has had too much to drink protect survivors from injury. Survivors have little or no control over their genetic make-up or the environment in which they live. But making healthy choices on how to live the rest of their lives gives them control over some of their own destiny.
If your child was diagnosed before she had received all of her immunizations, ask the oncologist when you should resume the regular schedule for immunizations.
My doctor said to wait a year before beginning to catch up on shots. It was nice for her to get a long break before any more pokes.
Teens need ongoing counseling on problems associated with smoking (cigarettes or marijuana) or engaging in other high-risk behaviors. Most children and teens who received anthracycline therapy (adriamycin, daunomycin, or idarubicin) are at risk for damage to the muscle of the heart. Smoking not only impacts the lungs, but it makes blood vessels hard, further decreasing the heart's ability to pump. The combination of heart damage from chemotherapy and smoking vastly increases the chance of heart disease, heart attack, congestive heart failure, stroke, cancer of the mouth, throat, and lungs, or death from sudden cardiac failure. An article on survivors and smoking contained in the Candlelighters Winter 1994 youth newsletter ends with these words:
If you've had cancer and your friends haven't, they don't face the same risks from smoking that you do. You've fought hard for your life. Don't put it out in an ashtray.
Every teen and young adult who has survived cancer should be counseled about safe sexual practices. Despite the prevalence of sexual messages in our culture, most teens are woefully underinformed about the facts. Many survivors think, erroneously, that if they are infertile, they do not have to be concerned about the use of condoms or other birth control. However, all sorts of diseases, some potentially fatal (hepatitis C, HIV/ARC/AIDS) and some not (genital herpes, genital warts, gonorrhea), can be transmitted through sexual intercourse.
One nurse practitioner at a large follow-up clinic stated:
I tell every teenager who comes through the door, regardless of his or her medical history, that I think that he or she is too young to have sex, and I explain why. But then I say, in the event that you do choose to become sexually active, you always need to use a condom, and not just any condom. I tell them to only use a latex condom with a spermicide, which is the most barrier-protective. I explain that no sex is the only guarantee to avoid the many diseases out there, but a latex condom with spermicide offers the next best protection. And I really stress that this should be done whoever the partner is, and for whatever type of sex. So many teenagers think that diseases only happen to other kinds of kids.
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