BREAST CANCER TREATMENT CHOICES

Breast cancer can be treated with a mastectomy or breast preservation surgery, lumpectomy, followed by radiation and sometimes chemotherapy.  These are the best ways to prevent reoccurrence of cancer.  The most common place for cancer to come back is in the same area where it was found the first time.

          The determination of which treatment is best for an individual is based on the pathology of the disease.  The initial biopsy, which is done when the cancer is first suspected, will tell what type of cancer is present and whether it is hormone receptive.  The knowledge of hormone receptors, or not, found will be part of the decision making information for an individual’s treatment.  Some types of tumors are stimulated by normal hormones found in a woman’s body, such as progesterone, estrogen, and HER-2.  A tumor may show a positive response to one or more of these hormones.  By knowing this information, a plan of treatment can be offered that will improve a woman’s chances of cancer free survival.

          The pathology from the surgery, done to remove the cancer tumor, will tell if the entire tumor was removed and if cancer was found in the lymph nodes.  During surgery the surgeon can see the cancer tumor, but not all of the cancer cells can be visualized.  So the tumor is sent to a pathologist who puts the tumor and the surrounding tissue that was removed by the surgeon under a microscope.  This way cancer cells that might be outside the main tumor can be seen.  The lymph nodes that were removed in surgery can also be looked at under a microscope and it can be determined if there are cancer cells found in the lymph nodes.  Often a Sentinel Node can be found, if a dye is used before surgery.  This dye is injected before surgery and will show which node is the main node that drains fluid from the cancer tumor site.  (The lymphatic system drains non blood fluids throughout the body.)

If lymph nodes are found to have cancer cells within them the cancer has moved from the tumor site to other areas in the body.  This movement of cancer cells away from the tumor indicates metastasis, or stray cancer cells that are traveling in the body.  The final pathology will offer much information about the type of cancer, the location of the cancer and how best to treat the cancer to provide a cancer free life for the woman.

          A woman who has been diagnosed with cancer, from a biopsy, then will see a surgeon who specializes in breast cancer.  Surgery to remove the tumor is always needed, as long as the tumor is in the breast it will grow and chances are the cancer cells will travel away from the main tumor and spread throughout the body.  These cells that move away from the main tumor will settle and grow into tumors in other parts of the body, not just the breast. The surgeon will ask questions about the woman’s health and ask about the woman’s family.  If a woman has family members that have, or have had breast cancer, this information will be included in treatment decisions.  The surgeon then will discuss ways to treat the cancer.  A mastectomy which is a removal of the breast that has the cancer in it, with one or more lymph nodes removed is one choice.  A lumpectomy which is removal of the cancer tumor and a small amount of tissue surrounding the tumor is another choice.    The size of the tumor, determined by the mammogram, will influence these choices.  If the tumor is large a lumpectomy may not be a good choice.  The smaller the tumor, the better the chances of survival for the woman.  The larger the tumor the more involved the surgery will need to be, such as a mastectomy.  Sometimes chemotherapy is needed before surgery; the chemotherapy will hopefully shrink the tumor and kill cancer cells that may have moved away from the main tumor (metastasized).  When this is done before the surgery, the hope is that after surgery most or all of the cancer will be gone and only radiation will be needed.  Chemotherapy may be needed after surgery depending on the type and stage of the cancer.

          Often the surgeon will ask a woman to see a radiation oncologist before her surgery.  This consultation will allow the radiation oncologist, another cancer doctor who specializes in radiation, to review the woman’s case and to offer choices of treatment.  The options this doctor may offer are whole breast radiation after surgery, or partial breast radiation after surgery, or no radiation if a woman has a mastectomy and no cancer cells are found outside the breast that was removed in surgery.

          One type of partial breast radiation is brachytherapy.  Breast brachytherapy has been available for some time, but not all doctors are familiar with it.  Brachytherapy of the breast is a good choice for some women.  The size of the tumor and the location of the tumor are two of the determinations if this is a good choice.  If the cancer is found out side of the breast, brachytherapy is not a choice for a woman.  Brachytherapy is radiation given to the area where the cancer tumor was.  This is where most cancers come back, in the same area they were to begin with.  Brachytherapy can be given over five days, where as whole breast radiation if given over 6 weeks.  This is an advantage for women who do not live near a cancer treatment center, women who live busy lives (most women do), or women who don’t want to prolong their treatments. When a woman chooses breast brachytherapy the applicator that will allow radiation to go right into the space where the cancer was; is placed at the time of surgery.  Brachy means close. It is another advantage of brachytherapy.   Only the tissue around where the cancer tumor was is radiated; the normal tissue is exposed either not at all or to such a low level of radiation it is not affected by the radiation.

The brachytherapy treatments are given two times a day, at least 6 hours between treatments, for a total of ten treatments. This type of radiation requires special equipment and knowledge, many cancer centers now have both the equipment and the radiation oncologists that are specialized in this treatment.

           The other type of partial breast radiation is accelerated partial breast radiation.  This type of treatment also requires that the tumor is small and no cancer has been found outside the breast.  This type of radiation can be given over a shortened time, days instead of weeks.  The equipment to give these treatments is IMRT, which most if not all cancer centers have.  This is external beam radiation that goes from the outside of the breast to the inside of the breast and radiates all of the tissue in the area.  The advantages to this treatment are it takes less time, although it is also two treatments a day at least 6 hours apart, and it only radiates the portion of the breast where the cancer tumor was.

          Whole breast radiation has been around for a very long time and is what all women received until the past 15 years or so.  This type of radiation involves one treatment a day Monday through Friday for 6 weeks, a total of 30 treatments.  It is external beam radiation that goes from the outside of the breast to the inside of the breast and radiates all of the tissue in the breast and surrounding area, not just the area where the tumor was.  This type of treatment is favored when the tumor is larger or the cancer cells were found outside of the breast, such as in one or more lymph nodes.  The lymph nodes can be included in the whole breast radiation.  Some women will choose whole breast radiation because it has been used for so very long.  Partial breast radiation has shown the same effectiveness in studies, when the woman is a candidate for brachytherapy.

          Chemotherapy and biological therapy or hormone therapies are needed in specific cases.  These treatment choices should be discussed with the surgeon, the radiation oncologist and a medical oncologist.

What ever choose a woman is given they need to be well understood before she makes her decision.  Asking questions of her doctors and talking to her loved ones will be helpful.  If a woman’s decision is thought out it will probably be the best choice for her.  Prayer always is beneficial.

God Bless you.

DEALING WITH DEATH

Every person will die.  All of us are mortal creatures. Many of us don’t deal with this fact, but it is true.  None of us are in any hurry to die, but the sooner we face our own mortality the better this life will be.

          This is a talk I give to the student nurses I work with.  It is after I have spent some time with each of them, one on one.  This talk is one I wish I had been given in my youth.  I was fortunate to attend a Catholic nursing school.  It was a special experience, especially since I am not a Catholic.

          I went to nursing school thinking nuns were angels sent to Earth by God to help people on this life’s journey. (I had seen nuns only in movies such as the Bell’s of Saint Mary, and the movie nuns were ever so sweet and pious and kind.)  I found out nuns are very human women who can be very determined and a bit rigid at times.  The nuns at my nursing school meant for the nursing students to walk a very narrow path and to follow the rules strictly.  Yes, I bristled at this; it was 1970 a tumultuous time in America.  Surprisingly I found myself liking the structure and doing well in school.  The discipline and study hours, along with morning prayers were just what I needed. So I learned much about the workings of the human body and how to care for its needs in a Christian environment.  This Christian atmosphere included the emphasis of treating each patient as a child of God; not just the gallbladder in room 402.  The Holistic approach was stressed, treating the whole person “mind, body and spirit”. 

          I am saying I grew a lot in the three years I lived at nursing school.  My faith deepened in the Lord and I learned to accept and respect a religion different from my own.  This is a big part of who I am today.

          When I speak to nursing students today I openly tell them I am a Christian and I believe this life is just the beginning of what is ahead for me.

I also tell them I am not preaching to them.  I am telling them my beliefs so they know I have thought of my own mortality.  I say that until each of us considers our own mortality we can not accept or deal with another person’s death.  In nursing, as in life, I have dealt with death.  Sometimes it had been very up close and personal.  Caring for some one who I have become fond of, caring for them and their family as that patient dies, I have shed many tears.  If I didn’t have a sense of my own mortality I would not have been able to continue working as a nurse.  I would have been devastated by each and every death I witnessed.  I have seen many nurses who have left nursing “because it is too hard” or the honest “I can’t handle this”.

          This is a shame because many of these nurses were very good at caring for patients.  They were well educated and knowledgeable, kind and caring, but “people aren’t supposed to die”.  One nurse told me this and I was flabbergasted.  Nurses don’t become nurses to watch people die, this is true.  We become nurses to help them recover their health.  We study and read the scientific journals to keep up with all the new fancy things that are here or are coming, to help in caring for and curing patients from their diseases.  We keep up with the evidenced based research in nursing. We are willing to work night shifts, weekends, holidays and 12 hour shifts to be there for the patients.  We are willing to endure the back aches, the running around, the anger of patients and their families, when we can’t be every where at the same time, and the over time, spent finishing our charting.  But unless we can accept mortality we just can’t keep working as nurses.  It hurts too much.

          The human body wears out.  This is a fact.  It may wear out from disease or from old age but it wears out. Some experience a trauma that can not be overcome; the damage is too much to heal from.  Each of our bodies will eventually give up the ghost.

          I suggest to the student nurses, and to each of us, to take some time and think about what happens to you when you die.  We all have a soul, some call it a spirit, and this is the essence of who we really are.  This soul or spirit is the most important part of our being.  Yet so often in our day to day lives we ignore it or don’t give it a thought.  I ask you to ponder your true existence, that of your soul.  At least figure out that you have a soul, you may call it a spirit.  I want you to know that your soul doesn’t die when your body dies.

          I listen to the radio on my way to work and often find Sister Ann Shield’s program “Food for the Journey”.  (Yes, I’m back to those Catholic nuns again.)  Her program is only 15 minutes; she reads from the Bible and talks about how to enrich life each day by drawing nearer to our Creator, God.  This reminds me of morning prayers back in nursing school and it helps me start my day in a very positive way.  Strengthened for whatever will come my way during the day.

          You may not be a Christian, but believe me you have a soul and a spirit that needs tending too.  How you go about this is your own business, of course.  But I ask you, for yourself and for your patients, to consider what will happen to you (your soul) when you die.  The time you give to this important matter will aid you in your nursing career, I promise.  You will probably still shed some tears along the way, I do.  Once you figure out your own mortality and deal with that fact, all of life will be easier.

HAVE CANCER....GET ORGANIZED

When you have cancer you will be going to many different doctors.  Each time you see a specialist this doctor will need to know your specific diagnosis and specifics about you.  Oncologists need to know everything they can about you and your individual case, so they can offer the best possible advice and treatment plan.

You probably started with your primary care doctor, and then were referred to a surgeon or urologist or medical oncologist or radiation oncologist or all of them.  Each time you meet a new doctor they will need to review all of your tests and procedures that you have had done.  The doctor’s are supposed to send all of this information to the next doctor before you arrive.  Sometimes there are delays in transferring your information to the next doctor.  This is a delay that can be avoided, and you can help.  I know you are feeling overwhelmed by your diagnosis of cancer but by getting organized you can feel more in control of what is happening to you. 

Every cancer patient has a team of doctors, nurses, pharmacists and others that are working for you and towards your cure.  Being a part of that team will help you feel that you haven’t lost control over your body or your life.  A patient often feels like they have become an object rather than a person.  You can feel like you are just following instructions: take this pill at such and such a time, be at the hospital for this test at this time, show up for chemo on time, don’t be late for your radiation treatment, etc.  Yes it is important to do all of the above things.  But you can have influence on your care by becoming a true member of this team that wants to help you get well.

One of the ways you can do this is to start a notebook or file containing your journey through cancer.  You can request and receive copies of your test results as you go along.  An example is to ask for your pathology report.  This where the whole journey starts, the diagnosis of cancer.  Each doctor you visit will need to see the pathology report to know exactly which type of cancer you have. Not all breast cancers are the same type of cancer and the type of cancer you have will determine the type of treatment you will need to have.  The same thing is true of prostate, lung, brain, colorectal, leukemia, lymphoma and other cancers.  So the pathology report is key information.

          Other things that will help determine your treatment are your diagnostic imaging reports and films.  These may include X-rays, Cat scans, Pet scans, Pet/CT scans, MRIs, and Mammograms, among others.  When you go for these tests you can ask for your own copy of the report and a CD of the images themselves.  You should be able to get a copy of the CD at the time you have completed the test.  It will take awhile for the radiologist to read and review your test so the report won’t be available immediately after the test, but may be sent to you if you request this.

          Your blood work, laboratory tests, are also important for each doctor to know.  A PSA level is essential in prostate cancer.  Blood work such as your blood counts and electrolyte levels are important when you are having chemotherapy or biotherapy.  You can ask which ever doctor orders these tests to give you a copy of these results.

          If you have had surgery, a copy of your operative report is helpful to have.  You can ask your surgeon for this when you go for your first appointment after your surgery.

          A list of all of the medication that you are taking or have taken in the past few months is essential for all of your doctors to have.  This list should include prescribed medications, vitamins, minerals, supplements and any other over the counter medicine such as pain relievers (Tylenol, Advil, Motrin, Aleve etc.) and allergy or cold pills.  Keeping this list up to date is important, so if you stop taking a medication please put a line through your list so the doctor will know you were on this medication but aren’t now.  Also if you are taking recreational drugs, it is important to tell this to your doctor.

          By having a file or notebook in which to keep all of this information, you are ready at all times to see a doctor, who with this information can be up to date with your case with a reading of your tests and results.

          Another good idea is to have a calendar to help you coordinate your life.  Since you will probably be busy with appointments relating to your cancer and hopefully you will still be able to live a real life, a calendar will help you plan.  By checking with the calendar you can find time for friends and activities that you enjoy.  It will help you organize better.  If you have an appointment, which you will be done with just before lunch, perhaps you will want to meet a friend for lunch at a restaurant in the same neighborhood where your appointment was.  Or if you get tired after chemotherapy, you may want to plan a nap before your meet with friends or family, or you may wish to reschedule meeting with loved ones until the next day.  Keeping track of appointments and planning ahead is a great way to maintain control of your life.

          Many people, but not all, find keeping a personal journal of there cancer experience helpful.  This may be a good way to help deal with the stress of cancer.  You may wish to do this in a private diary or you may wish to share your journey with friends on the web.  There are some free sites on the web that help with this such as: CaringBridge and CarePages. 

          These are some suggestions that I hope will help you to feel more a part of the team that wants to cure your cancer.

SYMPTOMS OF COLON CANCER

Symptoms of colon cancer can be sneaky, because we all have some of these symptoms once in a while.  The time to be concerned is if the symptoms persist for two weeks or more.  We all have bowel movements and it is alright to talk to your doctor about your bowel habits.

Changes in bowel habits can be a clue to the fact that our colon is not healthy.  This doesn’t necessarily mean there is a significant problem, but if these changes continue over a couple weeks, it is time to talk to the doctor. A change is anything that is different for us.  It may be constipation when this has never been a problem for you before or it may be diarrhea that lasts for two weeks.  The first thing to consider, of course, is what have you been eating?  We all have bouts of constipation, if we aren’t getting enough fruits and vegetables; so the first thing we should do is increase or start eating fruits and vegetables.  Diarrhea hits if we eat too many fruits and vegetables, or too much greasy food, or if we eat something that has spoiled.  You should decrease the amounts of fruits and vegetables, and or the amount of fried foods, when you develop diarrhea.  A bacteria or “bug” that is going around can gives you diarrhea and, in and of itself, isn’t a cause to panic about symptoms of colon cancer.  But if these symptoms go on for 2 or more weeks, then it is time to call your doctor.

Diarrhea is when you have loose or liquid stool or increased number of stools in a day.  Constipation is when you have hard stools or you haven’t had a bowel movement for 3 or more days.  Everyone’s bowel habits vary from time to time and what is normal for one person is not necessarily normal for the next person.  It is changes that you should pay attention to.

Bright red or very dark red blood in your stools is another sign not all is well.  The most common cause of blood in stools is hemorrhoids. These are tags that form in the rectum that can fill with blood and then break and bleed.  The bleeding from hemorrhoids should not last for more than a day or two at the most.  So when you continue to have blood in your stools this is a symptom that needs to be reported and checked by your doctor.

Narrow stools or stools that are pencil shaped are another sign that the colon is not healthy.  Again if this continues it is time to call your doctor.

Another sign of trouble is increased and persistent gas pain, bloating, a feeling of fullness with or with out decreased appetite and abdominal (tummy) cramping that continues for 2 weeks.

Again symptoms of colon cancer are not that uncommon to us.  We all go through times that our colons aren’t healthy, but when these changes go on for 2 weeks, it is time to go to the doctor and find out why things aren’t normal.  Symptoms of colon cancer can be caused by other things, so why worry?  Go get checked out if you have:

          Changes in your bowel movements

          Constipation         

          Diarrhea

          Blood in your stools

          Stools thinner than normal

When you are aware of what is normal and what is not normal you are better prepared to talk to your doctor about your body.

So eat your fruits and vegetables and have your colonoscopy when you are fifty and every 5 years after that.

Wishing you good colon health and God Bless you.

CANCER'S DRY MOUTH

Your doctor and nurse may have told you one of the side effects of your cancer treatment is a dry mouth.  But when this hits it affects almost all of your life.  The mouth and digestive tract is made up of fast growing cells.  Most chemotherapy drugs work by killing or injuring fast growing cells because cancer cells are these types of cells. Most cancer drugs can’t tell the difference between types of fast growing cells.  So your mouth may be sore and dry.

Brushing your teeth with a soft toothbrush, a child’s or baby’s toothbrush is best.  Even with a sore mouth keeping it clean is very important.  Infection and or cavities are not what you want ever, especially not now.  Here are some hints for keeping your mouth clean and, by the way, these will help lessen the pain too.  If a toothbrush is too painful, for awhile, ask for Toothettes.  These are soft sponges on a stick used for oral care in the hospital.

Rinse and spit at least 6 times a day with a non-alcohol mouth wash.

Alcohol will burn like fire in your mouth.  There are products on the market which will moisturize your mouth as they clean.  The most popular one I know is Biatene.  They have several products available to help moisturize the mouth; gum and artificial saliva are two of them.  I recommend and solution of salt and baking soda.  Please wait for the recipe!  Many people mix up salt water solutions but if the strength is too potent these will not only burn your mouth but they will injure the tissue in your mouth.  So the correct recipe is:

                   One (1) quart of water

                   One (1) teaspoon of salt

                   One (1) teaspoon of baking soda.

Be sure to rinse and then spit out this solution, don’t swallow this or any other mouthwash.

This is very inexpensive and should be thrown out each day and then mix new day’s solution in a clean container.  This solution will soothe your mouth as well as reduce your chances of infections, such as thrush.

This mixture will help keep your mouth at the correct PH level to keep bacteria at low levels.  At the same time it will restore fluids to the mouth tissue. 

I knew one man who carried a bottle of this solution with him at all times, yes even at work, and he did very well with only slight problems in his mouth.  You can take a water bottle with you anywhere; why not add a mouthwash bottle.  You will be able to find a restroom easy enough, to rinse and spit every couple hours.  This is safe enough to use as often as you want.

It is good to rinse your mouth before you eat as this will moisten your mouth and it will be easier to chew and swallow.  Many people have told me that when they use a mouth wash they do pretty good.

For some this will help but not be enough to get you by.  If this is the case, ask your doctor for help, doctors usually prescribe something called Magic Mouth Wash.  It has 3 ingredients in it that will temporarily numb your mouth and will also help aid in healing your mouth and throat.  This must be used as your doctor prescribes.  You may use the salt and soda or Biatene mouth wash between times you use the prescribed mouthwash.

Papaya is a fruit that contains digestive enzymes.  Many people have found eating small bites of papaya before and during their meals makes chewing easier.  Including wet foods in your diet is a good idea; such as; mashed potatoes and gravy, soft scrambled or poached eggs and puddings.

I recommend you talk to a cancer dietitian at your cancer center or hospital. These dietitians are wonderfully helpful.

There are drugs available that promote increased saliva you may want to talk to your oncologist about these drugs.  Be certain to ask about side effects of these drugs.

Wishing you lots of spit.

God Bless you and keep you.

CANCER DRY EYES

In a past post I mentioned the first rule of being a patient:  Keep No Secrets from the Nurse.  The reason this is so important is, even if you develop some of the side effects of your treatment, the nurse can help you get through them with less problems.

Recently, a patient talked to me about dry eyes.  This sounds like an every day occurrence for some of you, even without cancer or cancer treatment.

But remember the whole point of cancer treatment is to allow you to live a normal life.  Dry eyes can become more than just annoying.  They can become painful.  Some types of chemotherapy can cause dry eyes. 

Not all eye moisturizing drops are the same.  I learned this from my own eye doctor.  My eye doctor recommended “Blink” eye drops or “Restore” eye drops.  Both brands are available over the counter in drug stores and most supermarkets.  These drops cost more than a generic or “cheapie” brands and this is one of the times you really do get what you pay for.  The generics can make your eyes feel gummy and not all that good.  These drops should relieve dry eyes, if they don’t, after a few days, please talk to your cancer doctor to see if you need to go to an eye doctor.  Unfortunately more than one thing can be happening at the same time.  You may have a problem unrelated to your cancer treatment.  Your cancer doctor will be able to tell if this is the case and advise you what to do next.  Most times you just need a good eye drop.

Good Luck and God Bless You.

HAVE CANCER CAN"T SLEEP?

                           

When you have cancer there are many reasons that sleep is difficult, yet it is so important.  During sleep the body is able to heal and regenerate at its most effective.

Causes of sleeplessness, when you are dealing with cancer, are fairly self evident.  You may have trouble shutting off your mind, you have many thoughts of: what if, what now, how can it be, and a million other things.  You may be overtired, you may be on steroids (which can cause sleeplessness on their own), you may have your days and nights mixed up (too long or too many naps during the day), or you may not be getting enough exercise.

I know when I tell people they need exercise I get a lot of dirty looks.  I do understand you may be fatigued (plain old tired) and I also know that exercise can be helpful in relieving that tiredness.  Cancer nurses and patients have known that exercise gives people a sense of well being.  So there have been studies done on the effects of exercise during cancer and cancer treatment.  These have proven that 10 to 20 minutes of exercise every day or every other day help people feel better and improve people’s out look on life and may help you sleep better.

When you have cancer, naps are tempting for sure, and of course, you may nap.  Here are hints for not getting your days and night mixed up.  Your bed is for night time, if you can, nap on the couch or in a comfortable chair this is better for you.  It will help you remember you are napping, not going for a long sleep.  A nap is just an hour or two of rest not a marathon sleep.  When you are tired try sitting at an activity.  This may be watching TV, reading, crafting, or visiting with friends and family.

If you are taking steroids as part of your cancer treatment and they are keeping you awake, talk to your oncology doctor, your doctor is very aware of this problem. The doctor may prescribe a sleeping medication.  You may want to try some of these suggestions in addition to sleeping medications.  Don’t give up, there is help for you.

 Shutting your mind off from the thoughts of dealing with cancer that keep you awake, or wake you up after just a short time sleeping can be a real problem.  It may take awhile to find what will work for you.  Some people find that a routine before bed helps.  A shower or a bath, a cup of chamomile tea, or warm milk along with a set bedtime has worked for many people.

Another thing to try is to set a time earlier in the day to worry and fret about your cancer.  This may sound silly but it works for some people.  Make this time useful by listing what you are worrying about.  Then find ideas that will make these problems smaller.  Your ideas for solutions can be silly; humor can ease stress all by itself.  Laughter is a wonderful thing.  During your worrying time make a point of being positive, this may be difficult at first, when you are dealing with cancer but, it does get easier with practice.  Plan for your future after cancer during your worrying time.  Take care of things that need to be taken care of, this will make your list of worries smaller.  And give you the satisfaction of accomplishment.

If you fall asleep then awaken at night try getting up out of bed.  While you are up try reading, crossword puzzles, TV and my favorite praying.  When we pray we are turning our troubles over to the Lord, He is the One who can take care of everything in the best possible way.

Cancer causes the feeling that you are out of control but you can control how you react to this “loss of control”.  Remember that cancer counseling is available and can be very helpful.  Talk to people at cancer support groups about what helps them sleep and share what works for you.

Cancer is a bump in the road of your life’s journey.  You didn’t plan for it but it doesn’t have to be all there is in your life.

SWEET DREAMS MY FRIEND.

CANCER ANXIETY

Anxiety happens when people are under stress.  A cancer diagnosis is a BIG STRESSOR.  I’m sorry.  It is very difficult to hear the words , “you have cancer”.  Please know that cancer can be cured and you don’t have to be alone during your treatment.  I’ve been a registered nurse for 37 years and my specialty is cancer nursing.  Some form of anxiety hits almost every one when they are told they have cancer.

The first thing I suggest is to take a deep breath.  It sounds simple but people have studied what a good old fashioned deep breath can do for your mind and body.  A deep breath can help reverse the physical effects of anxiety on your body.

You can take a deep breath right now and anywhere… any time.  So take a deep breath and blow out to the count of 6.  With the next breath, breathe in through your nose and out through your mouth (like you are blowing up a balloon) to the count of 6.  Take more time breathing out than in.  You can think of it as blowing away the stress.  As you breathe out let your shoulders come down away from your ears.

Then call your doctor or cancer center and ask to speak to a cancer counselor.  Most cancer treatment centers have a stress management therapist.  I often recommend both, especially to begin with.  They can help you through your entire treatment course and afterwards, too.

Talk to your doctor about your feelings of anxiety and what it is doing to you.  Doctors are familiar with this and your doctor may prescribe something that may help you.

Please remember you are not alone and you don’t need to go through treatment with out a whole bunch of help.  Get to know your cancer team. The doctors, nurses and social workers/counselors are there for you.

Wishing you well.  You are in my prayers.

PINK OCTOBER

The trees are turning colors, the mornings are getting crisp and the days are getting shorter.  IT IS BREAST CANCER AWARENESS MONTH!

One in 8 women will be diagnosed with breast cancer in their life time, this might be scary to you but it doesn’t need to be.  One of the best things you can do for yourself is to have an annual mammogram.  This test can find breast cancer at an early stage, much earlier than can be found with a physical breast exam.  Which means if you do a self breast exam every month and a yearly mammogram along with a doctor’s breast exam every year, even if you are the one in 8 women your chances of survival are very, very high.

Every September the Susan G. Komen Race For the Cure includes hundreds of thousand of people who put on their pink shirts, hats, shoes and wigs to show support of friends, family members, co-workers and friends of friends.  People can walk, run or even sleep for the cure.  I’ll bet you didn’t know you could sleep for the cure.  I believe 2010 was the first time for this option.

This show of support raises money for breast cancer research.  What many don’t know is that the Susan G. Komen foundation also provides thousands of free mammograms for women without insurance or funds for this screening test.  If you are without funds to pay for your mammogram please contact Susan G Komen Foundation or ask your health care provider for information.

Recently a report stating mammograms don’t need to be done before a woman is 50 years old.  I feel this is wrong. That report studied the cost benefits of early breast screening.  Do you want to wait to have your first mammogram just to save money, rather than to save your life?  Many mammograms show no sign of cancer, which is what I hope for each year when I get mine.  I started getting mammograms when I was 35, because I felt a lump when I was doing a self breast exam.  It turned out that the lump was a normal part of my hormone monthly cycle … was I relieved!  But it taught me that I needed to become more familiar with my body and to pay attention to changes in it.  I strongly recommend you do the same.

Breast cancer is more likely to occur as we age, but that is not always the case, I’ve known women in their 30’s who have breast cancer.  And I’ve known women in their 90’s who have breast cancer, age is not always a factor, the report I was speaking about, saying to wait until 50 for mammograms, was based upon statistics.  I don’t want you to be a statistic.

I’ve heard from many women that they don’t have mammograms because they are afraid that they will be told they have cancer.  I can understand this coping skill.  It is called "ignore things and they will go away".  I am sorry to say this is not always true.  It can be scary waiting for your mammogram results.

Be assured most Breast Health centers notify you within a couple of days of your results.  The wait may be long but knowing the results can save your life.  Remember earlier is better when it comes to fighting cancer.

Another reason women put off having mammograms is because “they hurt”.

Well, your breasts are squeezed during the test, this is true.  The entire test takes less than 15 minutes.  If your breasts are tender please tell the technician this as you enter, she should be sensitive to your problem.  Very few women can’t tolerate a few minutes of breast squeezing.  If you are one of the very few that can’t take the discomfort for a few minutes, talk to your doctor and find out if they can have an ultrasound instead of a mammogram.  Most breast health centers are able to do this for you.

Men, I haven’t forgotten you.  What can you do about early breast cancer screening?  You have women in your life that you care about, a mom, a sister, an aunt, a friend or a wife, remind them to have a mammogram.  You can be gentle and caring with your reminder, this doesn’t have to be an embarrassing conversation.

Yes, men can get breast cancer, although it extremely uncommon.  If you have family history of breast cancer among the women in your family, please mention this to your health care provider!

EARLY BREAST CANCER SCREENING SAVES LIVES!

Have your mammogram every year at age 40 and beyond, because you want to have many years beyond 40.

October is breast cancer awareness month so why not make October the month you have your mammogram every year?

YOU CAN DO IT ... for yourself and for those who love you and want to keep you around.
You can find more resources at   The Cancer Site

CANCER TAKES A TEAM

You will have many needs now.  Some will be the same old, same old, that you have had all along.  Some will be quite surprising.  Things you never thought you would be needing.

This doesn’t mean you will be needy,…. it just means you will need some experts to help along your way.  Many people think of cancer as a real drag.  It is!  When you have people helping lift the load it is a lot easier.

I’ve been working at Legacy Good Samaritan Hospital for 32 years, yes that is a long time.  (Would you believe I was 2 when I started?  Well maybe not.)  Legacy Health system has a great cancer team, I’m very proud of it.  Where ever you are you will need some or all of what I’ve been a part of.

THE NURSES     I know you are counting on your doctor to be the team leader and you are right.  I’ll talk more about doctors later.  What I want you to know is that you will be spending more time with your nurses and they will have more time with you as you go through cancer.  Nurses who work with cancer patients are committed.  Some people think they should be committed.  That is just because many people are afraid of cancer.  Cancer nurses are not.  We know that more people are cured of cancer than ever before and more will survive in the years to come than anyone thought possible just a few years ago.

We like what we do. We love being with cancer patients.  We love being able to help with your symptoms.  We can’t always prevent you from getting a symptom but we can give you suggestions that will make it better a whole lot faster!  If we don’t know what to do for a symptom you are having we can find out real fast and put you on the right track.  This is what cancer nurses do.  And we like being there for you.

SO  as I say to my patients… the first rule of being a cancer patient is ..KEEP NO SECRETS FROM THE NURSE !!

CANCER IS A BUMMER!

When ever we are told that we have cancer it is a shock.  The doctor will tell us that treatments are available and give us reassurance that something can be done to help us.  But what we hear is YOU HAVE CANCER!

Nothing else gets through.     At least not a first.       So take a deep breath and let the tears come.  Tears can be cleansing and they leave you exhausted.  That is not a bad thing.  Get some rest so you can start to listen.  Cancer can be cured!  Cancer can be treated!  Cancer can be lived with and lived through!

You will need to be loved and treated like a person.  Give your family a chance to be there for you.

Your family will need time too.  You are not alone.  Cancer affects so very many people.  Your family, your friends, your co-workers, your neighbors and people you haven’t even met yet.

You have not met me yet but your cancer has and will affect my life.

I’ve spent over 20 years caring for people who have gone through what you are experiencing.  I’ve cried, I’ve laughed, I’ve hugged, I’ve prayed.  It has changed my life.

You won’t believe this but some people have actually told me cancer was the best thing that ever happened to them.

You will believe that cancer changes your life.  It doesn’t have to be all bad.

Hang in there!

 I want to give you the thing you need most……………HOPE…………HOPE IS REAL!

OUR NEW CANCER PLACE

This is our new cancer blog which is all about canre related things. It's for cancer nurses, cancer patients and the families.
Do you know sombody who has cancer? Do you have cancer?
If you answered yes then this is for you.
This is a test of our new cancer blog.