Tag Archives: Treatment

Bowel Cancer

What Everyone Needs to Know


Idai Makaya looks at a current and topical issue in the media at the moment – bowel cancer. There has been a lot of discussion in recent months about bowel cancer and how to tackle the disease from a government perspective – but it would be useful to let individuals know what (if anything) they can do themselves to ensure they minimize their chances of developing this life-threatening condition.

To get to the heart of the matter I recently interviewed a respected clinical specialist with many years’ experience and expertise in the management of bowel cancer, Dr Alistair King. Dr King is a Hertfordshire-based Consultant Gastroenterologist, and is clinical lead and screening colonoscopist for the West Herts Bowel Cancer Screening Centre. He also has a specialist interest in the treatment of pancreatic & biliary disorders, viral hepatitis and other gastrointestinal cancers. Dr King knows first-hand the impact of bowel cancer on people’s lives and he kindly took the time to provide us all with some key information and practical advice which I’ll share here in Q & A format.

Q. Dr King, how common is bowel cancer (in the areas you work in, nationally and internationally)?

A. Bowel cancer is the UK’s third most common cancer. 34,900 people are diagnosed with bowel cancer in the UK every year, ie one person is diagnosed every 15 minutes. One in 20 women and 1 in 18 men will be diagnosed with bowel cancer at some point in their lives.

Q. Are there certain people who are more likely to develop bowel cancer?

A. The biggest predictor of bowel cancer is advancing age, with 85% of cases occurring in those aged 60 or over. Individuals with one first degree relative (mother, father, son, daughter, brother, sister) diagnosed before the age of 45, or with two first degree relatives diagnosed at any age also have an increased risk, and should contact their doctor to talk about possible screening.

Q. What proportion of people with bowel cancer are likely to actually die from it?

A. 50% of people diagnosed with bowel cancer die of it, usually within 5 years of diagnosis. This works out as 16,100 deaths per year in the UK with one person dying of bowel cancer every 30 minutes.

Q. What causes bowel cancer and is there anything individuals can do to prevent or avoid developing it?

A. There is no one cause of bowel cancer, but probably a complex interaction of multiple factors. Genetics are likely to play an important role, hence the disease sometimes runs in families as described previously. There is also some evidence that lack of exercise, being overweight, and a diet high in red meat, low in fruit and vegetables, and low in fiber leads to an increased risk of bowel cancer. Hence efforts to improve diet and lifestyle are likely to be helpful, however are no guarantee against developing the condition.

Q. Is there anything you as a doctor can do to help prevent the disease?

A. The earlier a cancer is detected, the more likely the patient can be cured. Bowel cancer awareness campaigns encourage people with typical symptoms to seek medical help. This can be difficult as people are often reluctant to talk about bowel related issues, nonetheless it is very important. Typical symptoms of bowel cancer would be change in bowel habit to looser, blood in the stool, anemia (low blood count), and unexplained weight loss.

The National Bowel Cancer Screening Programme is now up and running across most of the country including Hertfordshire. This consists of a free stool testing kit sent through the post to all 60-69 year olds, and from April 2010 tests will also be sent to 70-75 year olds. 2% of individuals have an abnormal stool test and are referred to a screening center for further investigations. This program is already detecting many cancers at an early stage before the patient has any symptoms. At this stage curative treatment is much more likely to be successful.

Q. Briefly, how is bowel cancer treated?

A. Most bowel cancer is treated with surgery, where the section of the bowel affected by the cancer is removed. In most patients the remaining bowel is joined together again, and the patient’s bowel continues to function as normal. Patients with more advanced cancers may also require chemotherapy (cancer drug treatment) in order to improve the chance of longterm cure. Sadly, if the tumor has spread beyond the bowel wall, or to other organs, the chance of cure is very small, but chemotherapy may be given to improve symptoms, and to improve survival.

Q. How effective/successful are the various treatments?

A. Treatments for colon cancer are very effective but are crucially dependent on how advanced the disease is at presentation. Early cancers confined to the inner lining of the bowel are cured in 85-95% of patients. However, if the tumor has spread to other organs, the chance of surviving the disease more than 5 years is less than 10%.

Proceedures Involved in Colon Cancer Screening

Colon cancer is the second leading cause of cancer death in the United States. Sometimes referred to as colorectal cancer, up to one third of people diagnosed with this cancer will die from it. Because of this very high mortality rate, extensive screening guidelines have been developed in an effort to detect colon cancer as early as possible, when treatments can be most effective.

Screening for colon cancer allows detection of the disease before symptoms appear. In addition, there are some screening procedures which can actually double as minor treatments, such as the removal of benign polyps, which can eventually turn cancerous. Current guidelines suggest that all people begin screening for colon cancer at age 50. An overwhelming majority of colon cancer develops after this age. In select high risk populations, screening procedures may begin as young as age 40.

Several factors go into making an effective screening test for colon cancer (or any other disease). The test must be sufficiently sensitive. This means that the test must be able to detect a vast majority of cases of colon cancer. A test which misses most cancers is useless. In addition, the test must be specific. A test which is positive in a wide range of different conditions is not as useful as one which is positive for only one disease.

A good screening test must also entail as little risk to the patient as possible. Cost of the screening procedure is a factor as well. Lastly, the screening test must be able to detect the potential cancer at a very early stage, when something can still be done to effectively treat it.

Because most cases of colon cancer take many years to develop to a serious level, screening can be quite effective in lowering mortality. Some screening techniques have been shown to lower risk of developing colon cancer caused by certain factors by up to 90%.

There are currently four major screening tests for colon cancer. Each of them has specific advantages and disadvantages. This review is meant to be a quick introduction to each test. For more detailed information about each screening test, and its appropriateness to your health, you should speak with your doctor.

Fecal occult blood testing

The first screening test for colorectal cancer is fecal occult blood testing. Many colon cancers will cause some degree of bleeding. Often this blood is very small and quantity and can be hard to see by just looking at your stools. The fecal occult blood test is a way to detect very small amounts of blood in your stool which would otherwise be impossible to see.

The fecal occult blood test is relatively simple and noninvasive to the patient. The patient being tested is given a set of three credit card size, chemically treated paper cards. Each card has room for two small stool samples. Each stool sample is a very small smudge. The cards are then folded up, sealed properly, and sent to a lab for testing. Picking small samples of your stools out of the toilet may be gross, but the test is relatively simple and straightforward compared to the others.

The major disadvantage to fecal occult blood testing is the very high number of false positive results. Only about 3-5% of positive results will ultimately lead to colon cancer. This is because there are many possible causes of blood in the stool, not just colorectal cancer. A positive fecal occult blood test does not mean you have, or ever will have, colon cancer. Further testing is indicated in most cases.

Barium enema

A barium enema is another screening test for colon cancer. The most accurate and commonly done version of this test is actually known as a double-contrast barium enema.

This test is a special x-ray which takes a picture of the entire colon and rectum. Before the x-rays taken, a liquid solution containing barium is injected into your rectum. The liquid will coat the inside of your bowels, and is drained out before the x-ray is taken. The coating which remains shows the lining of the bowels on the x-ray in fine detail.

Double-contrast barium enemas are able to detect about 40 to 50% of precancerous polyps in the tested area. The test itself is safe, although a bit uncomfortable for the patient. The effectiveness of a barium enema in reducing deaths from colon cancer is somewhat controversial. Data on its effectiveness is mixed. In addition, positive tests are usually followed up with a colonoscopy (discussed below).

Sigmoidoscopy

Sigmoidoscopy is the first of two screening tests for colon cancer which allow a doctor to have a direct view of the inside of your bowels. The procedure involves inserting a small, flexible fiber-optic tube into the lower part of your colon. In medical jargon the test is often referred to as a “flex sig”.

The tube which is inserted has a small camera on the end which is hooked up to a TV monitor. This allows the doctor to take video and pictures of the inside of your bowels.

A flexible sigmoidoscopy does not look at the entire large intestine. It only looks at about half of the total area of colon and rectum. There is minimal risk involved in flexible sigmoidoscopy. In rare cases, it is possible for the camera to cause a small puncture or tear in the lining of the intestine. The most significant disadvantage to the screening test is that it does not look at the entire large intestine.

Colonoscopy

Colonoscopy is very similar to sigmoidoscopy, only it is more invasive and allows the doctor to see the entire large intestine. Colonoscopy also allows a doctor to remove some small polyps, which are can be precancerous. Colonoscopy uses a similar camera to the flex sig, only it is now a little larger and longer.

Because this procedure can be uncomfortable for the patient, a mild sedative is given to keep the patient as calm and relaxed as possible.

Colonoscopy has an excellent ability to detect just about any lesion which may be cancer or precancerous. The doctor is able to see the entire colon and rectum during this exam. With this increased sensitivity comes some increased risk. The tube used to do the exam can puncture the wall of the bowel, and sedation used can have side effects as well.

You should work with your doctor to develop a screening plan and assess your risk for colon cancer. Each of these tests are important in the process of early detection for colon cancer, however you must work with your doctor to determine which of them may be most appropriate for you. If you have specific questions about the details of any of these exams, speak with your doctor as well.

A Cancer Tale

I am a survivor of that killer disease, cancer. Though not nearly as much a “survivor” as many others who’ve been ravaged by such a heart-rendering, destroying beast.

Thirty years ago, while I was working on my bachelor’s degree at a small Texas college in the Big Bend of Texas (Sul Ross State College), my wife (at the time), Lucy, also a student, had a bad case of the flu (t’weren’t no flu shots back then). So we were visiting the college’s infirmary. The college’s doctor (so many years ago I just can’t recall his name) casually noticed a dime-sized lump on my left wrist where I normally wore my wrist watch.

“Doc” looked at it, rubbing it gently with his thumb and said, “When you bring Lucy back next week I want to look at it again.

Thinking little of it, I dropped Lucy off at our little college apartment and back to the college to run a printing press as one of my part-time jobs to supplement my GI Bill income.

Next week I took Lucy back to the infirmary. The lump on my wrist had grown to the size of a quarter. “I want to do a biopsy,’ Doc said. I had no idea what he was talking about, asking my new wife, “What’s a biopsy?” as we headed for classes. At 26 I’d never had a need for a doctor (other than childhood mumps) and knew virtually nothing about cancer or any other ailment that “old folks get.”

A week later, the lump had grown to almost the size of a half-dollar. By the time Doc had sliced out a piece of the lump using a local anesthetic (I watched with fascination as he removed a small piece of the lump, grayish matter and a lot of blood, but felt nothing but giddy).

I wish I could remember his name. I can see his face, even today, mindful of some Normal Rockwell painting of a family doctor. I only remember that he did needlework to keep his fingers nimble, and had framed needlework all over his office.

A few days later, at around 5 a.m., Doc’s wife was pounding on our apartment door urging us to “get up, get dressed, and go see Doc.”

Bleary-eyed and confused, we dressed, jumped into the car and found Doc at the infirmary. “The biopsy came back,” he said. “The report is that you have a cancer called fibrosarcoma, We need to get you to a cancer hospital as quickly as possible. There are two,” he said, the Mayo Clinic in Rochester and MD Anderson, in Houston. I’ll call and make all of the arrangements. Which one do you want to go to?

Alpine, Texas, where the college is located, is a long-mile from nowhere, so I chose MD Anderson, in Houston, thinking that at the very least, it’ll still be in Texas. “Good! Go home. Pack. And hit the road,” he said. This was on a Thursday. I’ll schedule you for intake Monday morning.”

Driving from Alpine to Menard (my home town and the residence of my parents and Lucy’s parents) is 300 miles. From Menard to Houston is 350 miles, so we had a 650 mile trip to make in four days. As students we barely had enough money for gas to reach Menard. I called my parents and they agreed to loan me $1,000 (“just in case”).

From Menard to Houston we made it Sunday evening after a couple of stops for watermelon … Lucy was pregnant with our first child and she craved watermelon… to my sister’s home in Houston. She was a stay-at-home mom with a young child. Jay, her husband, was a Coastguardsman.

Monday morning we gathered what I thought I’d need “for a couple of days at the hospital” … little did we know how long it was actually going to be.

By the end of the week I’d been through two surgeries. One to remove the cancer, and another a “prefusion” of mustard and nitrogen gas on my left arm. The process, I think, is still being used today, but it was “new stuff” back then. The process, basically, is to isolate my arm from the rest of my body with a heart-lung machine and pumping the mustard-nitrogen mixture through my blood vessels to “kill” any malignant tumor still possibly in my arm.

It was an amazing experience for me. I had an anesthesiologist from England, a Japanese doctor, a doctor from Tennessee, nurses from Mexico, Texas, Colorado, and New York.

I had many room mates during the three months stay at MD Anderson. An older woman (at least she was “old” to me at the time, probably about 50), with lung cancer who smoked constantly when she wasn’t in her bed (there were smoking areas at the hospital back then), and a young man, a truck driver, with a lump the size of a football on his leg. And his young wife. He’d been treated at the Hoxsey Clinic in Dallas (an alternative medicine clinic that treated cancer patients with herbs and such). The young couple has spent all they had on Hoxsey treatments, he lost their house, his truck, and now was losing his life.

I read, played checkers, and had numerous visits from my wife, Lucy, my sister and brother-in-law, and roamed the halls of the hospital bored to tears wearing a plaster cast from my chest to my left shoulder and down to my finger tips. My left arm was plaster-frozen in a perpetual semi-salute, but above my head. But, as hard as I’ve tried to remember, I don’t remember any pain, just boredom.

After about thee months I was given an out-patient status, having to stay with my sister’s family and returning to the hospital once a day for observation and consultation. That was miserable for me, for Lucy, and for my sister’s family. There was only one bed available for the two of us in her home, a single-wide bed on which both Lucy and I would sleep at night.

For the first few nights I’d roll over and conk Lucy with my hard plaster cast, but we finally worked out a system so she didn’t get beat to death. And because it was so difficult for me to dress myself in regular clothes, Lucy bought me a brand new red swim suit I could wear around the house. And that was a total disaster! Without thinking, Joanna, my sister, washed the bright red swim trunks in with her husband’s snow white Coast Guard uniforms. They came out pink! Would you believe a Coast Guardsman in a pink uniform?

After about a month of that the cast was removed and I was free to go home!

When we first arrived back at Sul Ross I was amazed at the number of faculty (and some students) who’d heard of my cancer. There was virtually mass hysteria as they went to get checkups for possible “cancer” afflictions. Thankfully, none showed up “diseased.”

Also, thankfully, the college gave me a reprieve form my course’s finals, except for my public speaking class. I’ve always been deadly afraid of speaking in public, so with a squeaky, chattering voice my final was a speech about my “cancer.” I passed. I know not how, but I passed.

After graduation I took a job teaching at a high school in Winters, Texas, and for the next five years traveled to Houston twice a year for a check up, then for another five years once a year. From Winters to Houston is a long 380 miles. And at a teacher’s salary of only a little over $3,000 a year, the trips were costly. I made twenty 12-hour trips to Houston by bus reading and sleeping.

On my first bus trip to MD Anderson, I didn’t have enough money for a hotel room nor money for a taxi so I had to take a bus that put me in Houston at about 3 a.m., walking the ten miles from the bus station to the hospital and walking back to catch a bus back to Winters. That was the last time I’d ever try that. From that day forward I swore to save enough money without having to walk that ten miles at each visit..

I read a lot on those trips. The two I most remember was The Rise and Fall of the Third Reich, by William Shirer, a 600 page tome, and The Story of Philosophy by Will Durant.

After ten years of poking and prodding, I was declared “90% cured,” and sent home for good.

The cost for those years of care? A few pints of blood thankfully donated by friends of my sister. And that was it.

Not another reoccurrence. At least not on my wrist. I was again diagnosed with a small cancer on the left side of my right eye about five years ago. It was removed in Columbia and I’ve had no occurrences since.

Perhaps the strange part about all of this is that I not once was frightened by the cancer nor concerned that I wouldn’t be “okay”. It just seemed to be an “is” and a “was.”

Doctors and hospitals come and go, I guess, but memories remain. MD Anderson and its wonderful nurses and doctors and all of the other staff will, forever, be a part of me.

But I was one of the lucky ones.

Pancreatic Cancer

What is the pancreas?

The pancreas in a six inch oblong gland, that is located just behind the stomach. There are two types of glands that make up the pancreas, the exocrine and the endocrine glands. The exocrine gland produces enzymes that aid in the digestion of fats, proteins and carbohydrates from the foods you eat. The endocrine gland secretes insulin and other hormones that help to regulate the metabolism of blood sugars in the body.

What is pancreatic cancer?

The most common form of pancreatic cancer is exocrine tumors.

Approximately 95% of all exocrine tumors are called adenocarcinoma. Adenocarcinoma most often form in the duct of the exocrine pancreas, but it can sometimes be formed in the cells that make up the enzymes. Exocrine tumors are in most cases fatal, due to the fact that when the tumor is extremely small, it is hard to detect. By the time a diagnosis is made, the cancer has spread to other parts of the body.

Adenosquamous carcinomas, squamous cell carcinomas, and giant cell carcinomas are less common forms of exocrine pancreas tumors.

Endocrine pancreas tumors are a rare form of pancreatic cancer. This type of tumors are called islet cell tumors, with many subtypes involved, depending on which hormone producing cell it starts in. These tumors typically grow slower and are often found early. Islet tumors are often treatable even after the cancer has spread.

Who is at risk for pancreatic cancer?

There is no known cause for pancreatic cancer. However there are many known risk factors, which can contribute to this disease. Many people will develop pancreatic cancer, that have no risk factors. On the other hand, many people who have risk factors, will not develop pancreatic cancer. If you are concerned that you may have any of the risk factors listed below, talk to your Doctor. He/she will be able to answer any concerns.

1. More men than women are diagnosed with pancreatic cancer. 
2. Most pancreatic cancer is diagnosed in people over the age of 60. 
3. The risk for pancreatic cancer will triple, if anyone in your immediate family has had the disease. 
4. Chronic pancreatitis may increase the risk. 
5. African Americans are at a greater risk of developing pancreatic cancer. 
6. If you have diabetes, you are at a greater risk. 
7. Smokers are at a 50% to 75% greater chance of developing pancreatic cancer, than those who do not smoke. 
8. Those who have a diet high in fat content are at risk. 
9. Exposure to some chemicals could increase your risk of pancreatic cancer.

What are the symptoms of pancreatic cancer?

Often there are no symptoms of pancreatic cancer until the disease in the advanced stages. Once the symptoms start to appear, they will include the following.

1. Upper abdominal and upper back pain. 
2. Jaundice, which is a yellowing of the skin and the whites of the eyes and may include dark colored urine. 
3. Weight loss. 
4. Decreased appetite. 
5. Upset stomach and vomiting. 
6. Depression.

How is pancreatic cancer diagnosed?

There are many tests that your doctor may perform in order to diagnose pancreatic cancer. These include, but are not limited to the following.

1. A physical examination to look for signs of jaundice. Your doctor may examine your abdomen by feeling for changes or excessive water buildup around the pancreas, gall bladder or liver. 
2. Lab tests such as blood, urine and stool samples to check for abnormalities. 
3. An ultrasound to create images of your pancreas or other internal organs. 
4. CT scan which uses x-ray images, usually used with a type of dye that is injected into a vein This dye helps to enhance the pancreas images. 
5. MRI which creates an image of the pancreas by using a magnetic field and radio waves. 
6. ERCP is where a small lighted tube is placed into the stomach, through the mouth, to the beginning of the small intestine. Then a catheter is placed inside the lighted tube and into the ducts of the pancreas. A small amount of dye is injected into the ducts and an x-ray is taken. 
7. A biopsy may be performed, by taking tissue samples of the pancreas and checking for cancer cells. The sample may be obtained by inserting a needle through the abdomen, into the pancreas.

Staging pancreatic cancer.

Once the doctor has diagnosed pancreatic cancer through a series of tests, the pancreatic cancer must be staged. This will determine how advanced the pancreatic cancer has become. Staging will help your doctor to determine the method of treatment you are most likely to benefit from. Tests that will help to determine which stage of pancreatic cancer you have include the following. 
1. Laparoscopy is where a lighted tube which is equipped with a video camera is inserted through a small incision into the abdomen. The video is observed by the doctor, to see if the cancer has spread to your abdomen. 
2. Blood tests to determine if your blood contains tumor markers termed CA19-9. The more your blood levels of CA19-9 are elevated, the more progressed your pancreatic cancer. 
3. Chest x-ray to see if the pancreatic cancer has spread to the lungs. 
4. MRI to see if the pancreatic cancer has spread to surrounding tissue. 
5. CT scan will help the doctor to see the pancreas and help him determinine if the pancreatic cancer has spread to other areas. 
6. A bone scan may be performed to determine if the cancer has spread to the bones.

The stages of pancreatic cancer.

Stage l: The cancer has not spread from the pancreas. 
Stage ll: The cancer has spread from the pancreas to surrounding tissue and organs. 
Stage lll: The cancer has spread from the pancreas to the surrounding tissue and organs as well as to the major blood vessels and possibly spread to the lymph nodes. 
Stage lV: The cancer has spread from the pancreas to other organs such as the liver, lungs and the lining of the abdomen that surrounds your internal organs.

What is the treatment for pancreatic cancer?

The method of treatment for pancreatic varies with each patient and what stage the cancer has progressed to. Other variables include the persons age and overall health. Following is a list of options that your doctor may discuss with you, in the treatment of pancreatic cancer.

1. Surgery is not always an option with pancreatic cancer. When surgery can be performed, the type of surgery depends on the position of the tumor. A part or all of the pancreas may be removed, along with the spleen, part of the small intestine, bile duct and part of the stomach. 
2. Radiation therapy uses high energy rays to destroy cancer cells. Radiation therapy is often combined with chemotherapy before or after surgery. This combination may be recommended instead of surgery, if surgery is not an option. 
3. Chemotherapy uses drugs to target cancer cells and destroy them. Chemotherapy is often combined with radiation therapy to treat cancer that has spread from the pancreas to other organs. 
Chemotherapy may be combined with targeted drug therapy, to treat individuals with advanced pancreatic cancer. 
4. Targeted drug therapy is a new form of pancreatic cancer treatment. These drugs block chemicals needed by cancer cells to grow and divide. They are usually combined with chemotherapy in people with advanced pancreatic cancer. 
5. Clinical trials are test studies to see how a new drug, surgery or treatment will benefit pancreatic cancer. Talk to your doctor before joining a clinical trial to see if it is right for your condition.

What is the prognosis for pancreatic cancer?

The prognosis of pancreatic cancer is not a good one. The key to survival is catching this deadly disease in it’s early stages. Sadly to say, most pancreatic cancer is not diagnosed until it has reached advanced stages. The overall average survival rate of pancreatic cancer for 1 year is 20% and the 5 year survival rate is 4%.

Barbara’s Battle with Cancer

The Ups and Downs


I was in shock when my best friend called to say that she had cancer. I was dumbfounded as I listened to her telling me that she had ovarian cancer and would be having surgery in a few weeks. Numbness struck as I thought it is the week before Christmas; her favorite time of the year.

She survived the surgery and the prognosis was good. She would have to undergo radiation and chemo, but they were optimistic that they had gotten it all. I looked at her when she came home and was amazed, she was ashen and her bright eyes were dull. As usual, she was optimistic and raved about how she had lost so much weight. We joked as this was a constant battle for her.

Our lives changed drastically. We had always done shopping trips, lunches, get togethers and so much more. Little did we both realize that our lives for the next two years would revolve around doctor’s appointments, meal preparation and anything that had to do with this damned cancer.

The chemo treatments started. I took her to the treatments as I worked nights and her husband worked days, so it was easier. The chemo made her violently ill. She dreaded them as she started feeling good the day before the treatment and felt lousy the rest of the time.

Her appetite shrank as did her weight. She had no strength to cook and no interest in food. No problem, I would make extra when I fixed my families meals and bring over dinner. I tried everything and anything to tempt her appetite – nothing seemed to work. Every night I called and it was always the same, “it was good, but I just wasn’t hungry”.

The doctor’s decided that perhaps radiation would be better since the chemo was making her so ill. it did seem better she was not so violently ill, but there was no appetite. She said everything tasted like tin. I learned not to fix her favorites, to try other dishes and combinations. This seemed to work, but then nausea set in, everything made her sick. The doctor’s prescribed a pill for her that was supposed to lessen the nausea. These were like gold – $60 a pill and not covered by insurance.

During this time she developed a problem with her leg – it always ached and she never felt good. She had back problems due to her being so overweight. The leg and the back problems just added to the difficulty of her treatment.

So many times we would go for her radiation treatment to be told that the bed was not working, could we come back later, which we did. This took its toll on her as it was always the chore of getting there and having the treatment and leaving, when we had to wait or come back, it made it so much worse.

When the radiation was finally over, she went for her examination and the results were good – they could not find any trace of the cancer. It had been 6 months – we were overjoyed. Life started to get back to normal. Barbara’s appetite increased, she went back to work part time and all seemed well. We went on day trips, we did shopping and everything seemed to be back to normal. This was short lived.

I went over to take her to work one morning and she said that she didn’t feel well. I asked what was wrong and she said it wasn’t anything in particular, she just didn’t feel good. She made a doctor’s appointment and we went. They took more tests and could find nothing, maybe she was just tired. It didn’t change, she never felt good. We started going to her regular doctor, the cancer specialist, her allergist and an internist. No one could find anything. Yet, she didn’t feel good.

July 4th of 2000 came and we spent the day together. She and her husband came over for a barbecue and despite me having all her favorites, she barely ate a thing. We did a lot of laughing and enjoyed the day. The next day, she was vomiting and just didn’t feel good. Once again, we went to the same doctor’s and they could find nothing out of the ordinary. A blood test revealed that her levels were a little low. A liver scan was suggested for July 20th.

Barbara and I talked about everything, but for some reason we just could not talk about this liver scan. We did as much as we could in the two weeks before this scan. We went shopping, watched TV and just enjoyed being together. Going out was difficult as we now had a walker, cane and a pocketbook full of pills. We laughed and acted like this would go on forever.

July 19th came and we both thought that a special day would be appropriate. It was pouring that day, but we vowed not to let the rain dampen our spirits. We went up to the local farm and got some fresh picked corn on the cob and proceeded to the grocery store to get her a salmon steak – her absolute favorite. She suggested that we go to Stewart’s for lunch as she was craving their fish sandwich. As we were driving there, a deer ran in front of the car. We commented on how unusual it was to see a deer and how beautiful it was. Lunch was a disaster, nothing tasted good and she was too tired to eat. She asked if we could go home – this was not “my Barbara”.

Barbara, her walker, cane, pocketbook and I made it up the 19 stairs to her apartment and she laid down. Soon, it was time for me to go to work. We hugged each other and didn’t want to let each other go. I got called into work during the day on the 20th and could not go for her scan. She told me not to worry, her sister-in-law would take her and she would call me the minute it was over.

I called her the night of the 19th, but her husband said that she was asleep. The 20th came and I called her to wish her good luck and gave her my love. She reassured me that I would hear from her by 10:30 since the test was at 9:00. We told each other how much we loved each other. 10:30, 11:00, 11:30, 12:00; 12:30 came and went and no phone call. I called her husband at work and was told that he left and went to the hospital.

Panic set in. I called and got a wonderful operator who put me through to the emergency room where she was. She had an effect from the scan, and was not doing well. Her heart rate was not good, her breathing was shallow and she was in pain. I called again and spoke to her – she was so weak, she said “thanks, sorry I didn’t call you – I love you”. I told her how much I loved her.

Finally, her husband called, when they did the scan she had been full of cancer and the scan released the cancer into her system. She had about 48 to 72 hours. I was in shock. I went to the hospital and after much hassle finally was allowed in to see her. I was not family. I looked at her – gone was the radiant color in her cheeks, the bright, sparkly eyes never opened. I held her hand and told her that I loved her and I felt a slight squeeze on my hand. It must have been a reflex I was told, she was in a coma. Barbara left us on July 20th at 1:14 a.m.

Lung Cancer: Guide to Signs and Symptoms

When my father was rushed to the best cardiac hospital in Las Vegas, NV following an episode of chest pains and shortness of breath while he was at work, we all just sort of knew that it wasn’t a heart attack. Just like we knew that it wasn’t the Tuberculosis or chest infection that they originally thought it might be after ruling out a heart attack. And when he was sent home with medications to treat the Staph infection that the doctors all agreed was causing his symptoms, we watched him closely.

Six months went by and his cough only worsened. He lost weight. He had no energy. And he just looked ‘sick’. When he went back this time, the doctors had an answer – cancer.

The amount of misdiagnosed cases of lung cancer in the United States is staggering. Sometimes the misdiagnoses don’t affect the outcome. My dad’s lung cancer was terminal even before he was rushed to the hospital with the possible symptoms of a heart attack. Had he been diagnosed with the cancer he had, any treatment they could’ve given him would’ve only prolonged his life by a few more months.But in other cases, had a patient been diagnosed correctly and gotten the proper treatment the first time, a life could’ve been saved, or at least prolonged enough to make a positive difference in that person’s life, and the lives of their friends and family.

But to look at it another way, had my father gone to a doctor about his worsening cough instead of just passing it off as his “Smoker’s Cough” getting worse as he got older, that doctor may have found the cancer before it became terminal and took his life. Looking back, there were many symptoms that even those around him noticed that pointed to cancer long before the seriousness of his illness hit our family full force. Hindsight is always perfect. But at the time those symptoms seemed benign and were easy to brush off as something that wasn’t so serious a thought as the idea of cancer.

According to the Mayo Clinic, lung cancer does not usually show many symptoms in the early stages. Because of this, you’ll want to go for regular check-ups. Sticking with the same doctor can help someone to get to know you, as well as your body, so that they notice small changes in your health and can check for problems such as cancer should it be warranted. This is especially true if you are at risk for lung cancer because you smoke, have been around smokers, there is a family history of lung cancer or you have been exposed to radon gas, asbestos or other carcinogens during your lifetime (especially prolonged exposure).

When the signs and symptoms of lung cancer do start to show themselves, they can be varied in type and also in intensity. How you feel may lead you to think you are coming down with a cold, or it could send you to the Emergency Room. Often times the milder symptoms are overlooked or passed off as something else until there’s no overlooking the fact that you’re sick, and the idea that it might be cancer.

Cancer in general usually leads to some basic symptoms once it has spread to a certain point or is attacking the body. Unexplained weight loss should be monitored and should be looked at by a doctor if not controlled. Many signs resemble the common flu with fever and fatigue. Depending on where the cancer is, it can lead to pain in those areas – the pain can be mild or severe. The skin can also be an indicator of cancer if it becomes darker, yellow, reddened, itchy, or if you experience more hair growth than normal.

Most of those symptoms are not something that you would rush in to see a doctor about until they became excessive or started to interfere with your daily life.

Lung cancer itself can have some very distinctive signs, though. When most people think about lung cancer they think of the coughing that is usually associated with it. Coughing up blood, even just a tinge of red, can be an indicator of many respiratory illnesses and should be looked at, even if just to rule out cancer. Related to that, a steady or chronic cough is common among early lung cancer patients. If you’ve smoked for awhile, you may have what is known as “Smoker’s Cough” and if this worsens over a short period of time you’ll want to get yourself checked out. Even if your symptoms are not pointing to lung cancer, they may be pointing to another respiratory illness such as emphysema or Chronic Obstructive Pulmonary Disease (COPD) that will need treatment to keep from worsening.

Once the cancer has progressed, more definite signs of lung cancer are wheezing, hoarseness when talking, and shortness of breath. This is caused by the body being unable to get enough oxygen through the increasingly damaged lungs. Chest pain may lead many to think they are having a heart attack, especially when experienced with the shortness of breath, as in my father’s case.

What this comes down to is this… If you’re feeling any of these symptoms, it may be because of a respiratory illness, an infection, or even a chest cold. But if you are at risk for lung cancer, and you don’t feel right, you’re coughing, losing some weight, or especially if you are feeling chest pain, then get to a doctor and get yourself looked at. If caught early, lung cancer can be treated in most cases, but you’ll need to undergo a battery of tests that can include X-rays, CT scans, or even a biopsy to determine what the best treatment plan for you would be. Your doctor will give you options, and it is up to you to weigh the outcomes.

Knowing your body, taking care of it with a healthy diet and exercise, and being conscious of your risks for lung cancer can go a long way to keeping yourself healthy, happy, and productive for a long time to come.

Sources

Lung cancer

Mayo Clinic

Signs & Symptoms of Cancer

American Cancer Society

Lung Cancer Symptoms

LungCancer.Org

A Healing of Cancer and a Faith in God

Her cancer treatments began seven months ago when she was diagnosed with lung cancer. I remember coming to her home last June and seeing her with her daughter, sitting on the couch.

Tears filled her eyes as her broken words filled my ears. I heard her say, “I’m going to die.”

Being set back for just a moment, I replied with, “ok… We all are going to die one day… What’s going on?”

That’s when she told me about the cancer. I took a breath and assured her that she wasn’t necessarily going to die. It was in Gods hands as to the pending results.

I told her my twin brother had Lymphoma cancer and he was supposed to be dead 20 years ago, yet he is still running around the beaches on the gulf coast.

I think what I said to her made her feel a little better, still I know her heart was filled with unknown fear. Her future was uncertain and being a widow of cancer and loosing a son to cancer, she cried outwardly and deep within her soul.

She asked me if I would leave her as her friend. I answered that when I make a friend, it’s solid through thick and thin and I would be there for her through the whole ordeal.

I told her that she had to promise me something from the get-go. I asked her to put it completely into Gods hands. To let God work through the doctors to heal her. I asked her to believe this and for argument sake to just believe she was already healed. She again asked me to help her through and to help her believe.

Immediately, we began to read the New Testament and pray on an every day basis. It wasn’t much longer when she asked if she could be baptized at the local church. We contacted the preacher of the church, told him of her situation, and requested him to fulfill her wishes. After he discussed the mater with her, he set it up and that alone brightened her outlook to a new, positive one.

She began her treatments as required by the doctors and I encouraged her in her daily treatments of Gods word.

Time went by slowly for her and soon her fears of loosing her hair began to surface. I, being the comic I am, made jokes about it and kept her laughing. I said she could be a female Ko-jack, a GI Jane, or a real chrome dome. I volunteered to polish it for her so she could let her light shine. I know it all was stupid or silly but it kept her mind off of her problems.

She still refused to totally drop the hair thing and so soon enough we were visiting wig stores. That was fun! Have you ever gone into one of those places and just tried them on for the fun of it?

It was the visits to the cancer center that saddened me as I stood by my promise to go with her. I saw people with all sorts of cancer, people who had a cancer and refused to quit the cigarettes, people that cheerfully went about their lives and being torn up on the inside didn’t let it show. I saw people that looked like and acted like they were already dead. Still mostly, there was laughter and friendships being made as each person waited on their turn to be treated.

They compared their treatments with each other and encouraged each other as the days turned into months. Some people didn’t fair well throughout the process and some did very well, yet I saw a bonding between the center staff and the patients, a bonding of friends who shared a common foe, a bonding of Christians and Non – Christians alike.

It amazed me how even the staff and the doctors encouraged prayer. It was said by one doctor that he could only point the radiation at the cancer but it was up to God if it was to do any good. I heard another doctor say that he had done all that he could but the rest was in Gods hands.

It amazed me that each and every person working in the center felt that strongly about their faith but I didn’t stop to think that they see and go through the demons of cancer on a daily basis; that they made a career doing it.

I smile at this thought and a twinkle enters the corner of my eye. I am so thankful to have made this journey, to see and hear what I have. I am truly grateful to have been a part of these peoples lives.

My friend has finished her treatments now and after her last pet scan, she was told by the radiation doctor that there was no evidence of the cancer on the x-rays. Today, the cancer doctor told her she was doing well and that her cancer had gone into remission.

This time I saw her with tears of joy as she praised God.

It’s not over yet, she still has to follow up and be monitored for the coming years because unfortunately cancer can rear its ugly head again.

Now she feels Gods hand on her life and she knows the rest of the journey will be a good one and made with smiles. “Ain’t God Good!”

What to Eat After Cancer

One thing that helps prevent cancer and helps prevent the re-occurrence of cancer is the way we eat. Once we have been given the clean bill of health, we need to watch what we eat. How we eat makes a big difference in our health and our energy levels. Sometimes after surviving cancer or being told we have cancer we need to change our eating habits. There are dangers within many of the common things that we eat daily. Cancer makes us take a more active role in paying attention to the things we cook, and even what we eat when we eat out.

MEAT

A staple in any meal is meat of any sort. Beef has many different dangers, raw or medium rare meats can be the most dangerous thing for our health. According to E. coli: Dangers of eating raw or uncooked foods, the bacteria exists in many animals, most commonly cattle. If beef has the bacteria and isn’t properly cooked it could be passed on to us. Beef also contains other bacteria that could be very dangerous for us and cause us to get sick. One of the things my doctors told me was to never eat rare or medium rare beef.

While there are dangers of eating uncooked beef, there are benefits to eating fully cooked beef such as the proteins and other minerals it contains. Fully cooked beef and other meats could help provide the daily requirement for iron, which is something we all need. According to Benefits of beef article a research study done at Purdue University found “that that CLA (polyunsaturated fats) slows or reverses skin, breast, and stomach cancers in laboratory rats and mice at all three stages of tumor development. That study is interesting and holds a lot of importance for those of us with cancer.

VEGGIES

Fresh fruits and vegetables hold many benefits for us. They all hold different nutrients and vitamins that we all need to remain healthy. Many articles have stated that vegetables have different antioxidants that help stop certain cancers from forming in the body. That is something we all need to pay attention too. We don’t want cancer to reoccur so why not try eating more vegetables. The vitamin C in vegetables can help reduce stress and repair the body after long bouts with stress.

Vegetables have high fiber contents which help make the digestive system more healthier and toned. Vegetables also have proteins that meats do as well as amino acids that our bodies need to survive. When we have cancer, our bodies need various different amino acids, fibers, antioxidants and more to help keep our energy levels high and they can help keep us from getting very sick during chemotherapy treatments.

SUGAR

Ah sugar. We all love sugar in all forms, but sugar can be really dangerous for us especially if we have cancer. It has been found that cancer feeds off of sugar, so while going through treatments and eating after treatments we need to cut out as much sugar as we possible can. That doesn’t mean we can’t have sweeteners like honey or splenda, but we should really cut down on them. We need to learn how to control glucose levels through how we eat, exercise, supplements and if needed prescription medication.

Some things we can substitute for white sugar would be honey, splenda, sweet and low. I prefer honey because of the taste and that it is more natural than other sweeteners, but you really need to do research in order to cook with honey and make the right substitutes. It works best in teas like green tea, adds to the taste and really sweetens it better than sugar.

A great recipe to cook of Autumn Greens And Apple Salad. I know it sounds different and it is a different kind of salad than many of us are used to, but isn’t that the point to try new things? Here is the recipe for it:

INGREDIENTS

¼ cup EVOO (extra virgin olive oil)
2 tablespoon of red wine vinegar
½ shallot finely shopped
3 rib celery, thinly sliced on an angle
2 crisp Gala apples thinly sliced
1 small head red leaf lettuce torn into pieces
½ small head green leaf lettuce
1/3 cup pumpkin seeds (toasted)
1/3 cup sunflower seeds

In a large salad bowl, whisk together the evoo, vinegar, shallot, salt, pepper then add the celery and apples then toss. Add the lettuce and toss again. Top it off with the seeds.

You can easily add some nicely grilled chicken sliced or even fully cooked steak sliced for a variation of the recipe. You can try different apples or different kinds of seeds or even granola to top it off. The main point is try and take some things out of our diet and replace them with more healthy things. We need to pay close attention to what we are putting into our bodies, especially after having cancer.

Help for Those Facing Cancer or a Possible Cancer Diagnosis

Common Cancer Terms Defined


When I was young, my mom once called me “Sissy Cystie.” We did not understand I had a genetic condition causing cysts, benign tumors, and in a few cases cancers. We had hope my body would eventually grow out of the terrible phase. We were in the midst of much confusion. Upon learning I have Multiple Hamaratoma Syndromeall joking in regard to what I experienced was over. People with MHS form lumps and bumps in various places of their bodies. I am no stranger to finding lumps in various places of my body whether accidentally or on scans. I understand the reaction of confusion and fear..

The first question when finding something unusual should be “is it benign or malignant?” Because there is always a question, it is important to go to the doctor for a scan before you notice any changes in the lump. People experience confusion with the words benign and malignant at times. 
benign tumor is not a harmless tumor. Many people die due to the effects of benign tumors. Benign tumors can be dangerous because of where they grow-certain places of the brain, for example. Benign tumors can also be dangerous if they grow to be very large. I had benign cysts covering my thyroid gland and if they were not removed, I would not be able to breathe by now due to the size they were approaching. . A benign tumor is one that will not spread to other areas of the body.

Malignanttumors are the cancerous ones and because they spread to other organs in the body they are the more feared. Usually tumors work by shutting off at least some function of whatever organ from which they originate. Benign tumors stay with the same organ even though they may grow.Malignant tumors move around to other organs. If the malignancy, or cancer, is not caught in time, malignant tumors spread to other organs and eventually stop their function. When a malignant tumor has spread, it is referred to as metastasized.

Relapse and recurrenceare terms sometimes causing confusion.. To relapse means the cancer returns in a period of five years or less following cessation of treatment. Survival odds usually reflect cure rates by those who survive for a period of five years or more after treatment ceases. Cancer can return after five years. The exact odds are not known but it does happen. The dysgerminoma I was diagnosed with at age nine returned when I was fifteen, for example.

When cancer comes back after a period of five years, the technical term to use is recurrence. My dysgerminoma case was treated as a recurrence. Someone who has a recurrence is treated as having two separate cases of the disease. Because I had two cases of dysgerminoma and have been free from both cancers for longer than five years, medical statistics reflect this as two cases of survival.

Remission is the word all cancer survivors hope for and it is the word used when cancer appears to be gone. Someone in remission has been free from cancer based on scans for a period of less than ten years. St. Jude Children’s Research Hospitaldefines cure as being ten years from signs of the initial cancer. Patients become alumni and are dismissed from the hospital during their tenth year in remission. This is information I did not find online but know from personal experience.

Some long-term survivors of cancer may face asecondary diagnosis leading to more confusion. Some chemotherapy, radioactive scans, and radiation may increase the odds of another type of cancer. In my case, I was free from dysgerminoma for fifteen years the second time when I was diagnosed with ductal carcinoma in situ. The odds of a secondary cancer diagnosis are different depending on age, tumor type, strength and use of different chemotherapy types, radiation, genetic conditions that cause a tendency to form cancer, and other factors.

Secondary cancer diagnoses are a confusing condition to describe as two cancers appearing at the same time can mean metastasizedcancer or two different types of cancer. In these cases, secondary cancer diagnosis usually means the first location of the cancer is the primary cancer diagnosis and the place where it has moved to is secondary. Cases of two different types of cancer such as brain cancer and thyroid cancer appearing at the same time tend to be rare and as such may not have a medical term to define them. In some cases, two different types of cancer may be present in the same organ. When two different types of cancer are in the same organ, such as the breast, the more aggressive type becomes the major focus.

While aspects of what I have written are frightening, even to myself who has been through a recurrence and a secondary cancer diagnosis, it is important to know these occurrences are rare. Also, if you succeed in winning the battle against one cancer type it does not mean you will not win the battle against a secondary one. The important take away from this is to have unusual lumps checked out as soon as possible. If there appears to be cancer, it is important to live your life one day at a time. If the lump is cancer, do not assume it to be the end of the world. My first cancer diagnosis was 24 years ago this approaching October 7 and I am not alone among the survivors.

*A lot of personal experience

What Not to Say to the Parent of a Child with Cancer

My son was diagnosed with brain cancer in April 2006, just a month after his tenth birthday. Even though he was flown from San Antonio to Houston, TX – to MD Anderson Cancer Center no less – it took me a couple of days to get it through my head that my child had cancer. I kept thinking, “It’s going to be a benign
‘growth’ . . . nothing malignant.” Seriously, how could my perfectly healthy son have cancer, right?

Wrong. Keeghan’s tumor was malignant. But after two surgeries, six weeks of radiation, and a year (so far) of chemotherapy, he is tumor free. It will be my daily – hourly? – wish, for the rest of my life, that he stays that way.

One of the hardest things to deal with when your child has cancer is the way in which other people react when you tell them, and the things that they say. It has been proven to me time after time that most people really don’t think before they open their mouths. They’ll say things like, “Oh, I knew someone that had the “c” word. She died.”

The “c” word. I’ve heard cancer referred to that way numerous times, as though actually saying it would cause a person to get it. It’s not contagious people!

At the grocery store one day, with Keeghan standing by my side, the cashier asks me, “Did he have an accident?”

Keeghan has a very large scar on the side of his head. It’s a nice scar as far as scars go. It’s perfectly symmetrical – four inches up on one side, five inches across, and another four inches down on the other side. It’s so perfect that my husband used to joke and say that it looked like a trap door. He’d tease Keeghan by telling people that that was where he kept his wallet.

So to be asked if he had an accident seemed pretty ludicrous. “Yes, he fell out of a tree and landed on a cookie cutter. Hence the perfect scar.”

I wish I had replied that way, but alas, I didn’t. “He had a brain tumor,” I say instead.

“Oh . . . is he going to be okay?” she then whispers.

Keeghan is ten years old. He has cancer. But he’s not deaf, nor is he a complete idiot! And he’s standing right next to me! Don’t talk about him like he’s not there or can’t understand you. He can. In fact, if you talk directly to him, he can answer any questions you might have about his story quite well. Luckily for me Keeghan replied to the woman’s question with a very ten-year-old appropriate, “Yep, I am.”

After the first three months of Keeghan’s treatment was finished, and before he started his year-long consolidation chemotherapy regimen, we moved from Texas to Washington, DC. Not long after we moved into our house, we got new neighbors. The kids and I were leaving the house to head to the hospital for chemo on the day I met the new neighbor Bob. He noticed that Keeghan had no hair, and that he wasn’t looking very happy. Keeghan never looks thrilled when he’s heading for chemo. Go figure.

I am of the opinion that it is better to just tell people up front that he has cancer rather than leave them trying to figure out how to ask. So I told Bob, “He has cancer – we’re on our way to the hospital now for his chemo treatment so he’s not in a very good mood.” 
Bob asks, “What kind of cancer?” I reply that it is brain cancer.

“Oh, wow. My old boss just died of that.”

I can only imagine what the look on my face was. Incredulous I’m sure. I was so glad that the kids were in the car by that time.

Are you completely stupid?” is what I should have asked the guy.

“Well, we’re hoping that isn’t going to happen to Keeghan,” was what I actually said. I’ve come to learn in the few months that we’ve now been neighbors that Bob never thinks before opening his mouth, so it wasn’t just that one incident. But that is the one that sticks in my mind.

What’s really funny to me, however, is how other parents of children with cancer are just as bad when it comes to the things they say. Soon after Keeghan was diagnosed, I ran into a woman at the clinic that I had known at a past assignment of ours, but hadn’t seen in a couple of years. Ironically, her daughter was the same age as Keeghan and had been diagnosed with leukemia a few months before Keeghan’s diagnosis. As we stood in the clinic talking, she asked me, “So what’s his prognosis? Haley’s is 30%. If we hadn’t gotten her diagnosed when we did, she would have died.”

All of that was said very quickly, in a tone of voice that was sort of like, “I’ll bet my kid is sicker than your kid.” Like this was a competition!

“Lady, if this is a contest to you, I hope that you win!”

You’re right, I didn’t actually say that. But I should have.

“I refuse to let the doctors put a number on Keeghan like that, and I don’t want Keeghan feeling like he doesn’t have a good chance to beat this. So I honestly don’t know what his prognosis is. In my mind, it will always be 100%.”

Even though I didn’t say what I should have said, I think what I did say got my point across. But she’s not the only one that has done that. Maybe it makes parents somehow feel better to play comparison, whose-child-is-more-sick, games like that. I can’t do it though. I want them ALL to be well.

Maybe there should be an awareness ribbon for foot-in-mouth disease. What color would it be – flesh? I don’t think that color is taken yet. Or perhaps someday I’ll write a book and call it “What Not to Say to the Parent of a Child With Cancer.” I doubt anyone would buy it though. Everyone thinks they know the right thing to say all the time.

So maybe I should title it, “Hey YOU! Don’t Be Stupid!” That might at least get someone to pick it up and read the back cover.

Maybe there’s no hope at all and people will continue forever to put their feet in their mouths. But perhaps a little awareness can turn the tide of stupidity.