Let's Make More Survivors!

Throughout the month of June we've been sharing information about survivorship and what it means to those who are given the title "Survivor" after hearing the words "You have cancer." The journey of cancer is different for everyone. Some consider the journey to be a kind of battle - a war they will either win or lose. Others look at it as just one bump in the road that they will get over and put behind them. For others it is (or becomes) a spiritual journey that causes them to look at their life differently and perhaps rearrange some of the priorities they had pre-diagnosis. And for some, it's a combination of some or all of these, or something completely their own.

No matter what the journey is to each individual, it's safe to say that the desire to become a "survivor" is universal. And for those of us who have been caregivers or who have just been around as a friend or loved-one dealt with cancer treatments, we want to do everything we can to make their journey shorter, easier, and more likely to end with the rest of a long life ahead of them. What if we told you that you have the opportunity to help potentially millions of people not only become survivors, but never be diagnosed at all? It's true... read on.

The American Cancer Society's Epidemiology Research Program is inviting men and women between the ages of 30 and 65 years of age who have no personal history of cancer to join an historic research study. The ultimate goal is to enroll at least 300,000 adults from various racial/ethnic backgrounds from across the U.S. By joining Cancer Prevention Study - 3 (CPS-3), you can help researchers understand how to prevent cancer.

The first version of this study, CPS-1, was the largest prospective mortality study of diseases caused by tobacco use ever conducted. The study, which began in 1959 and continued through September 1972, played a critical role in establishing the causal linkage between smoking and several diseases, and it remains one of the most comprehensive presentations of the disease risks caused by smoking. The laws and regulations currently in place related to advertising and sales of tobacco products are a direct result of CPS-1.

CPS-2 began in 1982 as a prospective mortality study of approximately 1.2 million American men and women. Approximately 77,000 volunteers for the American Cancer Society recruited participants into the study in all 50 states, the District of Columbia, and Puerto Rico. This study is still ongoing.

All voluntary participants in CPS-3 will be required to undergo a simple blood draw, and to complete a detailed questionnaire that will be used as a base-line for your current health and lifestyle. The purpose of CPS-3 is to better understand ways to prevent cancer. This multi-year survey will study lifestyle, behavioral, environmental and genetic factors that may cause or prevent cancer with the ultimate goal of eliminating cancer as a major health problem for this and future generations.

A local enrollment opportunity is coming up July 19 and 20 in Fort Smith. You can find more information on enrollment on the event website. Feel free to share the site and recruit your friends and family. Together, we can make an impact on the future of cancer in our world.

The "New Normal"

This week we're sharing a piece originally posted last year by one of Hope Cancer Resources' Oncology Social Workers, Lisa Manzini-Pace, LCSW.

The term "New Normal" has a special connotation for people undergoing treatment and/or survivors of cancer.  Without their consent, they have been inducted into an intense and often baffling treatment regimen, one that changes their daily routines, expectations, interactions with others and ability to predict how they will fare during and after prescribed treatments.  This is a daunting trajectory and one best faced in small doses.

As human beings we seek to predict, quantify and control.  These instincts, while often previously successful, can be impediments to smoothly navigating the cancer treatment labyrinth.  Oncologists, who the patient seeks to trust implicitly, are often the first to admit that treatment involves commonalities but that each individual tends to respond in a somewhat unique manner.  The truth is that none of us working with cancer treatment have a crystal ball.  That said, here are a few observations noted by this writer courtesy of cancer patient wisdom and research.

Undergoing chemotherapy and/or radiation will test one’s metal.  Chemo induces various side effects but the overwhelming one mentioned is fatigue.  And a close second is chemo brain.  The former is a bone weary fatigue and the latter is a passing state of impaired memory and clarity.  It is essential that one lower his/her triathlon or quiz show expectations during these phases.  There will be good days and not-so-good days.  Learning to be gentle with oneself is as crucial as any pill one may swallow.  It is an art to be cultivated along with a stalwart sense of humor. 

One’s entire arsenal of healthy coping is there to be used.  This may include but is not limited to eating well, exercise (physical, mental and spiritual), common sense, resourcefulness, courage, compassion (self first!), joyfulness, intelligence, mirth, humility, faith, hope and love.  These are the aspects of you—unlike cells—that cancer cannot touch.  Use them in large doses.

Priorities will change.  Things that once seemed important are relegated to the back seat of the caboose.  To quote Arthur Golden in Memoirs of a Geisha, “Adversity is a strong wind. It tears away from us all but the things that cannot be torn, so that we see ourselves as we really are.”  Most  patients say that such experiences were the awakening of new strength and understanding.

Avoid the naysayers.  Cancer, rather like pregnancy, invites unsolicited confidences from others.  Some will be little gems to be treasured while other “stories” will be about fear, pain and darkness.  You get to choose who you will listen to and who you will wish well and send on their merry way.

Simply, remember that your "new normal" may vary greatly from that of another person who has dealt with a cancer diagnosis. Find your comfort zone and surround yourself with people who are going to help you stay there. 

Dealing with Loss of Appetite

When a cancer patient is enduring radiation and chemo treatments for cancer they enter a seemingly endless cycle that causes them to need nourishment and healthy food options just at the time that the last thing they want to think about is putting food in their mouths. Many cancer patients lose not only the appetite for food, but the ability to taste what they are taking in. Sometimes the mere texture or smell of whatever is on their plate is enough to make them nauseous.

This aversion (both mental and physical) to eating can cause serious stress to the patient and their caregiver as they try to maintain their calories and protein intake in order to help their bodies tolerate and recover quickly from their treatments.

A healthy diet helps a body keep up its strength, prevent tissue breakdown, rebuild damaged tissue, and maintain its defenses against infection. It can also help a patient cope more successfully with side effects. Some cancer treatments are more effective in people who are well-nourished and getting enough calories and protein. Growing numbers of research studies are being done to understand the relationship between good nutrition and cancer survivorship.

We've collected some tips to help patients and caregivers plan for and manage cancer treatment and make successful outcomes more likely. Please note: this information is meant to help patients increase protein intake and calorie consumption - but not at the expense of other components of a balanced diet. Fruits, vegetables and whole grains should still be a part of anyone's meal planning, and perhaps even more so for cancer patients.

Plan ahead.
Stock the pantry and freezer with favorite foods to cut down on shopping trips. Now is not the time to worry about calories, so don't bother with low- and no-fat varieties.

Prepare meals in advance and freeze foods in individual portions. This is a great thing to ask friends to do when they offer to help out. They can kill two birds with one stone by whipping up a few things while they are visiting for an afternoon.

Snack time is ALL the time!
You may need to make a few changes in your regular meal-time routine. Try eating small meals all day long, and having healthy snacks available whenever you feel like you can keep a few bites down. A handful of nuts or peanut butter on crackers can be easy protein-builders. They can also easily be thrown in a bag for car trips. There are some great protein bars on the market now as well... try a few and see which ones you like best, then keep a stash with you all the time and eat anytime you're watching t.v., reading a book, or waiting for an appointment. Other great (easy) options are yogurt, cereal and milk, half a sandwich, and cheese and crackers.

Avoid snacks that could make your treatment-related side effects worse. Some patients suffer from diarrhea, so they might want to limit popcorn and raw fruits and veggies. Radiation can cause "road rash" on the tongue and throat's tender tissues, so you may have to avoid dry, coarse snacks and acidic foods.

Throw out the rules.
If you think some leftover chicken casserole would be perfect for breakfast, don't let anyone tell you different. Right now is not the time to worry about the "normal" ways to plan your meals - if you need to eat, and it sounds good, it's right for you. That said - be careful about taking in a too many empty calories. For example, ice cream is not bad for you, but if you're making a meal of it or polishing off a half-gallon every day, you're missing out on some nutrients you really need.

Don't wait until you're hungry to eat, because you may actually lose your appetite and never feel hungry. Eat every few hours just because you know you need to fuel your body. Just as your automobile can only go so many miles on a tank of gas, your body can only be up and active so long before needing a meal.

Examples of high protein foods:

Milk products - 
Add cheese to baked potatoes, soups, noodles, meat and fruit for added protein. Use milk for cooking in place of water for cereal and cream soups. Ladle some cream sauces on your veggies and pasta. Add powdered milk to cream soups, mashed potatoes and pudding.

Eggs - 
Keep hard-boiled eggs in the fridge for a quick snack. Eat them alone or chop and add to salads, casseroles and soups.

Beans, legumes, nuts and seeds -
There are great options on the nut aisle of the stores! Lots of individual packets and flavored coatings to enhance their taste. You can sprinkle sunflower seeds in salads and on veggies and casseroles, add peanut butter to a milkshake or make a peanut butter and banana sandwich with whole grain bread. Add beans to soups, salads and casseroles. Simple bean burritos are quick and easy to make - use mashed pinto or black beans, and sprinkle a little cheese in for good measure.

Examples of high calorie foods:

Butter and margarine - 
Now's your chance to live like Paula Deen and put butter on everything! Potatoes, rice, pasta, and veggies are a good start. Stir it into soups and casseroles and spread it on bread before adding sandwich meats and cheeses. Remember grilled cheese sandwiches? Now's your chance to pretend you're a kid again.

Milk products - 
Add whipped cream to your desserts, pancakes, waffles, fruit and hot chocolate. Fold it into soups and casseroles and puddings. Add sour cream to potatoes and veggies and the aforementioned bean burrito.

Salad dressings - 
Use regular, not low-fat or diet varieties. Put mayo on your sandwiches and make dips for fresh veggies and fruit.


Some information used in this post was pulled from the American Cancer Society's booklet "Nutrition for the Person with Cancer during Treatment".

After Treatment: What does it mean to be a Survivor?

According to a report released by the Centers for Disease Control and Prevention and the National Cancer Institute (NCI), the number of cancer survivors in the United States increased to 11.7 million in 2007. To put that in perspective - consider the fact that there were 3 million cancer survivors in 1971 and 9.8 million in 2001. Since 1999, the rate of cancer in the U.S. has dropped .5 percent each year. The death rate of adult cancer patients has also annually dropped by about 1.5 percent since that year, according to the Annual Report to the Nation on the Status on Cancer, 1975-2008.

More good news that accompanies those numbers... Study findings indicate:

• Breast cancer survivors are the largest group of cancer survivors (22 percent), followed by prostate cancer survivors (19 percent) and colorectal cancer survivors (10 percent).
• Among all survivors, 4.7 million received their diagnosis 10 or more years earlier.

All three of those of those cancers in the first bullet point are able to be found with a cancer screening. What this information tells us is that those screenings we keep encouraging you to have are working. And not only are people surviving - they're surviving longer, which can be attributed to increasingly effective treatments. Those treatments are discovered through research trials - valuable, but under-utilized tools in the fight to rid our world of cancer.


Of course, more survivors mean an increasing need for support after the battle. Survivors often deal with long-lasting effects of their treatments that can be uncomfortable, annoying, or even physically debilitating. When a patient and their family is in the middle of their treatment, it's hard to think past what they are doing right then, so the work that comes after - staying healthy, recovering and maintaining pre-cancer activity levels, and learning to accept the limitations that they may have to live with - is often nothing they want to discuss or even consider.

Support groups and information focused on survivorship are in demand more and more by patients and their families. We work to meet that demand in the support groups we facilitate and also with our licensed Social Workers on staff. They work with individuals to determine specific emotional needs, and find sources of information and support to make sure that transitioning into the new life post-cancer treatment is as smooth as possible. If you or someone you know needs some assistance and information about being a cancer survivor please contact us at 479-361-5847.

More information about cancer survivorship can be found on these websites:

• National Coalition for Cancer Survivorship
• The Centers for Disease Control and Prevention has information, podcasts, and even the ability to send an e-card here.
• The National Cancer Institute lots of information grouped by survivorship topic here and a long list of publications and resources here. 
• American Cancer Society covers a lot of information about being healthy survivors here.

Some of the information in this posting was found in this press release on the National Cancer Institute website.