What Are the Best Methods To Prevent Cancer?

Cancer can be caused by many factors including genetics, environment and lifestyle. We cannot guarantee that any particular individual will not get cancer. But, there are suggestions health care providers can make to help prevent cancer or to help prevent a second cancer.

A few suggestions are provided below:

1. There is a clear link between smoking and lung cancer. Avoid smoking but also avoid being in smoke-filled places. You can develop lung cancer from excessive exposure to smoke.

2. Either drink alcohol in moderation or do not drink alcohol at all. Excessive drinking of alcohol can lead to an increase in risk of some cancers like in the mouth and throat. Also, excessive drinking of alcohol can lead to a disease called cirrhosis of the liver. Cirrhosis of the liver can increase your chances for liver cancer.

3. Avoid exposure to the sun and ultraviolet light. This can cause many types of skin cancers. This does not mean never go outside. But, during peak sun times (like 9 AM-4 PM) wear sunscreen protection (SPF 30 or greater), wear a hat, sunglasses, and long sleeves. If you live in a climate that is sunny and warm all year it is best to put sunscreen on everyday after you shower or bathe and then again when you go out in the sun. There is a cumulative effect of the sunscreen which means if you apply it every day you have better protection. Also, many people now are paying money to go to "tanning salons." Avoid tanning beds as they increase your chance of skin cancers. If you absolutely are going to use a tanning bed then apply sunscreen (SPF 30 or greater).

4. Diet may play an important role in your risk for cancer. A high fat diet can make individuals at greater risk for colon or possibly breast cancer. A high calorie diet can lead to obesity and for women an increase in risk of endometrial or breast cancer. Try to avoid high fat and high calorie diets. Ask a dietician or nutritionist to evaluate your current diet and help you adjust to it.

5. There are also certain dietary components that can help prevent cancer. Making sure you get adequate vitamin A or Beta carotene can help decrease the risk of lung cancer and some cancers of the mouth. Making sure you have adequate vitamin C in your diet may help prevent stomach cancer. Fiber is a very important part of your diet and can help decrease the risk of colon cancer. Lastly, vegetables that are called "cruciferous" can help prevent cancers. Cruciferous vegetables include brussel sprouts, broccoli, cabbage, cauliflower, collars, kale and turnips.

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Facing Uncertainty

As most people know individuals in California are battling fierce fires and the Santa Ana winds. Individuals who live near these fires are living with GREAT uncertainty as did many others last year with Hurricane Katrina as to whether everything they own will be destroyed and when should one leave your home and what should you take with you.

This is similar for individuals with cancer throughout their journey. For some individuals the constant "uncertainty" is one of the most difficult emotional aspects of the cancer journey. Most of us like to feel we are in control of our day to day life. But, with cancer, like the fires or hurricanes, we realize we are not in control.

What can you do to help with these feelings of uncertainty?

• Some people like to write everything down in a notebook (type of therapy they receive, how they feel physically, who they visited with). This provides something positive and constructive that can help you gain a sense of control and a sense of hopefulness.
• Some people like to talk to friends on the phone or go to support groups.
• Forms of distraction may be helpful (like art, painting, drawing, knitting, music).
• Pets can be a wonderful addition to the family and provide distraction as well as unconditional love (EVEN WHEN YOU HAVE NO HAIR!).
• Certainly with younger generations television and video programs can provide distraction and light entertainment.
• Some people find it hard to concentrate enough to read but enjoy being read to or enjoy books on tape. So many libraries and second hand book stores have books on tape.

The other difficult part about experiencing uncertainty along the cancer journey is that it can be experienced at any time and be repeated throughout the journey. It is not an emotion you will only feel during diagnosis or at the end of treatment. Thus, it is important to know this is NORMAL! And you can talk to your health care providers and families, friends and support groups.

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Tips For Scheduling Tests When You Have Cancer

From the time you are diagnosed with cancer and throughout your treatment and survival you will need to have various tests scheduled. These may include blood tests, ultrasounds, CAT or MRI o PET scans, breathing tests and many other types of tests. There are some tips that are important to keep in mind to make scheduling and undergoing these tests less stressful.

When scheduling a test be sure that your are clear about:

1. The time when you are supposed to arrive for your test (you may need to arrive early for preparation)

2. The place where you are supposed to go to have the test done

3. Any dietary restrictions prior to the test (like nothing to eat after midnight)

4. Any special medication that is supposed to be taken or any preparations that need to be completed prior to the test,

5. Whether you are supposed to take all your regular medications on the day of the test, and what not to take

6. Whether you will need someone to accompany you to andor from the test,

When you schedule a test, be sure that you clearly communicate to the health care provider the following:

1. A history of asthma, or allergies, especially allergies to iodine, latex

2. Any chance that you are pregnant

3. If you have a bleeding ulcer or other bleeding problems

4. If you have a tendency toward claustrophobia or a fear of needles

5. All medications you are taking, including herbs, minerals, vitamins, and drugs bought in the pharmacy without a prescription (like cold and flu medication).

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Myths About Chronic Pain Management

Many individuals with cancer who have chronic pain have heard "rumors" or "myths" about pain medications and pain management. It is helpful to have the correct information about these myths.

MYTH 1: A person should wait as long as possible before she/he asks the provider for a pain medication or intervention.

FALSE: Pain is harder to treat when it becomes severe. So it is important to get on top of the pain early, when it first begins. Ask your health provider early about pain medications. And once you have medications for pain take them regularly before the pain becomes severe. Or it may be that the health care provider will recommend another type of pain intervention (like an injection or therapy) rather than medication.

MYTH 2: Any person who takes pain medication will get addicted.

FALSE: Many medical studies show that patients rarely become addicted to pain medications. Addiction is a psychological dependence. However, individuals may become physically dependent which means their body needs the medication to control the pain. If you take pain medication do NOT stop it until you are told to do so by your health care professional. And if you do stop it slowly decrease it rather stopping all at once.

MYTH 3: If you take too much medication, it will stop working.

FALSE: Patients taking pain medication for chronic pain may have to take larger doses of take it or take it more often. This typically is necessary when the pain increases. Or it may mean that your body has built up a tolerance for the medication. Increasing the amount of medication to relieve pain does not mean that you are addicted.

Several good resources for pain information are listed below:
American Pain Foundation
www.painfoundation.org

Partners Against Pain
www.partneragainstpain.org

American Chronic Pain Association
www.theacpa.org

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Tips On Taking Pain Medication At Home

In order to help you manage your pain at home, health care providers suggest the following:

• Take the pain medication when the pain first begins.
  

• Ask your health care provider what you can expect from the pain medications, including possible side effects.
  

• Some pain medications may make you feel sleepy or dizzy, especially in the early stages of the treatment. For this reason, it is advised that you do not drive or operate any machinery of any kind while you are on the medication, unless your provider has cleared you to do so.
  

• Some pain medications may make you constipated. Here are some methods you can try to prevent or alleviate the constipation:
  

• Eat more foods that are high in fiber such as fruits, vegetables and grains.
  

• Drink plenty of liquids, at least 8-10 8 ounce glasses per day (especially water).
  

• Drink warm or hot liquids to help keep your bowels moving.
  

• Ask your provider to suggest a stool softener.
  

• Don’t suddenly stop taking the pain medication if you feeling better, especially if you have taken it two weeks or more on a regular basis. This may cause withdrawal symptoms. Please consult with your doctor or nurse how to slowly decrease your medication.
  

• Some medications may interact negatively with alcohol. Ask your provider if alcohol is allowable or not
  

• If you have a dry mouth, drink more liquids, chew on gum or suck on hard candy. It is important to keep your mouth lubricated to prevent infections or tooth decay.
  

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Simple Pain Strategies

Pain management is still a relatively new field in health care. However, great strides have been made in assisting patients in managing pain. Below are some tips for working with your health care professional which will help you get pain relief:

1. Tell the provider how the pain feels. Is it sharp or dull? Does it burn, throb or ache? Does it feel like pins and needles or is it a stabbing pain?

2. Tell the provider where the pain is located. Point to the exact area where you are having the pain.

3. Tell your provider where the pain began.

4. Tell the provider whether on not you have had the pain before. If so, what helped decrease the pain? Was it a particular kind of medication? Was it rest?

5. Tell you provider how often the pain occurs.

6. Tell your provider about any activities or conditions that cause the pain or make the pain more intense.

Many practitioners will use a rating scale to help you identify the intensity of the pain. The provider may ask if the pain is mild, moderate, severe, or extremely intense.
A sample scale used is 0-10 as shown below:

0 1 2 3 4 5 6 7 8 9 10
No pain to worst possible pain

One way to determine the meaning of these numbers is:
1-3 = mild pain
4-6 = moderate pain

7-9 = severe pain
10 = extremely intense pain

Typically, the provider will ask you about your pain prior to and after a pain intervention is used. This information will assist the provider in determining how effective or ineffective a particular intervention or drug is working. It is important for you to be as clear and honest as possible, so that the provider can find the right approach to alleviate your pain.

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A Reflection on Survivorship

I sit here on the 5th Anniversary of the September 11th bombings of the Twin Towers in New York City and wonder what can I say today that might be meaningful to individuals with cancer. Is there a connection? Is there anything appropriate to say today or should I simply wait another day or two?

I believe the connection is “survivorship”. Although we lost many wonderful people 5 years ago in New York City, there were many survivors. The same is true of cancer. Although we have lost too many lives to cancer, with new therapies and technology there is more hope now and expectation of surviving this disease. Decades ago we only talked of survivors of cancer as the family members whose loved one died from cancer. Now, rather than talking of the “cancer victim” we talk about the “cancer survivor”. We think of survivorship as the act of living on or the process of going through. The same applies to all of the individuals who are still alive after the bombings on 9/11/01 – they are in the process of living on despite the terrible tragedy.

For all survivors – whether from war, cancer, terrorism – it is a process with stages. Everyone will pass through the stages differently. Their quality of life changes as they continue to live on. They have different needs and concerns in different stages, but continued support is needed throughout the experience. And as with war or terrorism, there is often an outpouring of support for cancer survivors. Support may be found in informal or formal groups, local hotlines, educational sessions, religious and spiritual organizations, and family or friends.

As I reflect on this 5th Anniversary of 9/11/06 I believe the connection is SURVIVORSHIP and SURVIVORS.

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What Should A Cancer Survivor Know About Nutrition

I am constantly amazed by the number of healthcare professionals who care for individuals with cancer who do not discuss basics about nutrition during the cancer journey. There are different issues during various time periods in the cancer journey and they are all important.
Some of the issues that may affect you or your loved one's nutrition are:

• Loss of appetite or anorexia
• Diarrhea or constipation
• Neutropenia (low white blood cell count)
• Mouth sores and sores all the way down the gastrointestinal tract.
  

Although no one particular diet or nutritional supplement has proven to prevent cancer, healthcare professionals still need to discuss nutrition so cancer survivors may maintain their health and strength during their fight. Your mouth may get sore, your taste buds my change and foods you once loved you may now hate, but you still need to try and eat.

Some tips for during and after chemotherapy include:

• Eat smaller portions of food and eat more frequently (5-6 times per day).
• Eat 2-3 snacks between your 3 main meals.
• Eat foods that are high in protein (milkshakes, puddings, and nutritional drink supplements).
• Choose foods you like keeping any necessary dietary restictions you may have (such as low salt). Do NOT go on a diet to lose weight.
• Add cream or butter to soups, cooked cereals and vegetables to increase calories.
• Eat foods at room temperature if the smell bothers you.
• Make mealtime a pleasant time with family and friends.

One interesting resource designed specifically for cancer survivors is called "Eating Well Through Cancer," written by Holly Clegg and Dr. Gerald Miletello, MD. What is especially good about this book is it truly is designed for the cancer survivor. Any book could pick a variety of recipes and say these are the best for cancer survivors. But, Ms. Clegg has gone beyond that. She has placed her recipes based on what stage of the journey you are in (before, during and after chemotherapy) and what symptoms you are having (there are 14 recipes that can help with constipation). Under each recipe you will find the nutritional information per serving and a "Doc's Note." Also, there are many good resources on nutrition available through organizations like the American Cancer Society or local services in your area.

The most important information to remember is that YOU MUST maintain your health even if you do not feel like eating. You need calories, protein, and plenty of fluids more than ever. If you have no appetite, ask your nurse, doctor or pharmacist about nutritional supplements (Glucerna, Ensure).

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An Example of A Credible Cancer Website

In my spare time I work with organizations like the American Cancer Society, Oncology Nursing Society, and Lance Armstrong Foundation. Last week I was doing some work related to the Lance Armstrong Foundation so I decided to go back and visit the website. It had been months since I had looked at the website. This is definitely a site you or your family should visit. The URL is www.livestrong.org. There is tremendous amount of helpful information on the website that you can read, download or print.

There is information on physical topics, emotional topics and practical topics. This foundation also provides a variety of tools that you can use from the website or order for free (e.g. medical treatment summary, cancer survival health journal, living will). I especially like the area that has patient stories. It is helpful to know others are having some of the same experiences as you are. You can actually search the website for a story by someone who has your type of cancer (like lung, breast, testicular) and gender. You can read the story or watch a video. You can also sign up for the newsletter or to receive updates. It is amazing to me how many credible, wonderful ways there are to get information today on cancer. When I first started in my nursing career (a few decades ago) we had little to offer cancer survivors and family/friends other than a small pamphlet or brochure.

Knowledge is power so as the Lance Armstrong Foundation would say "LiveStrong" and go visit this website and others like the American Cancer Society (www.cancer.org)

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