Tuesday, September 16, 2014

Rethinking Early Cancer Detection

For so long we have been taught that early detection was the answer. The earlier the better and the earlier the more lives saved. Now, it seems, that may not be true. As I have reported here before (We All Have Cancer-August 7th) we all, in fact, have cancer cells in our bodies all the time.

The dilemma is that the earlier we detect the presence of cancer cells the faster we get "treated" (surgery, chemo, radiation) and the faster we get disabled by cancer's many treatments. We do know that many cancer patients die of the treatment not the cancer. So what do you do? And now what should your doctor do?

This is complicated science and complicated ethics. There is now enough longitudinal study to show that 30% of women diagnosed with breast cancer would not have died even without any treatment. (The slow growing cancers) . Ok, maybe that's worth the risk versus loss. But 60% of prostate cancer is over diagnosed--meaning those men may have had disabling treatments that were unnecessary.

But how do you know? What is your risk quotient?

There is some complicated science here. As if cancer isn't complicated enough. So this article in Sunday's Wall Street Journal is worth reading. And sharing. And discussing. It may help you ask more and better questions of your treatment team. It might help you manage the fear.

The link below is to the full article. If you have any trouble with the link simply Google: "It's Time to Rethink Early Cancer Detection". Wall Street Journal.

As the article says, language is a big factor. We haven't changed our definition of cancer in many years even though medicine has progressed. And the C word scares us into acting fast when sometimes it seems we should think more slowly.

http://online.wsj.com/articles/some-cancer-experts-see-overdiagnosis-and-question-emphasis-on-early-detection-1410724838?tesla=y&mod=WSJ_business_IndustryNews_DHC&mg=reno64-wsj&url=http://online.wsj.com/article/SB10001424052970203523204580113491950100232.html?mod=WSJ_business_IndustryNews_DHC

Wednesday, September 10, 2014

More About the Book: AfterShock

A few days ago I wrote about the book, AfterShock by Jessie Gruman, Ph.D. It is such a perfect handbook and bedside/tote bag companion for day one to day 100 of any serious health diagnosis.

If you or a loved one gets bad news about cancer, heart disease, stroke, ALS, MS etc. This might be the best, first thing to read. The first chapter is on shock and can help you normalize—and manage –the unmanageable feelings and crazy thinking.

Each chapter is short—therefore readable by someone in shock or crisis, and her language is straight. She does not use the word “cuddle” once. She explains what to ask the doc, what to ask the nurse, what to ask your family and what to care about and what to ignore in the short run.

AfterShock has a chapter on work: what to say, who to tell, how to proceed with Human Resources, and what your situation may be like from the HR and coworker perspective. It helps to know that.

One of my favorite lists that Gruman includes is the Personal Health Kit. I love seeing this here because it took me a year to get my chemo/caregiver kit just right. This is the bag (shoulder straps please) you will take to every doc appointment, test, chemo visit and lab. In addition to the obvious medical stuff you include your wrapped candy, treats, pens, book, pashmina, cardigan, phone list (better than your phone directory), phone charger, and sunglasses. (Yep, at least once you’ll need the sunglasses and you will have them right there.)

As I mentioned the other day, this is a book to buy and have on hand. If you are over 40 someone you know will get bad medical news this year—friend, neighbor, co-worker, family member. And you will have the perfect thing to give them on their first day of after shock.

Saturday, September 6, 2014

What to Do When You Get Really Bad News

You may remember how you heard it.

 Were you in the hospital? A doctor’s office? Did you get a phone call? Maybe it was well and compassionately done, or maybe the doctor fumbled the news and blurted out your diagnosis or prognosis.

What so many people have said was how quickly the fog descended. They remember the dissociation and fear flowing on top of reason. When I received my cancer diagnosis I was young (in my twenties) and alone and massively in denial. I was more concerned that my married “boy friend” not know about my health issues. I definitely did not have a list of questions or a notebook or a plan.

When John got his preliminary cancer diagnosis I was in the curtained room of the medical suite, and when he got the definitive diagnosis of Stage Four cancer I was there in the new surgeon’s office as well. We were both shocked, both times—sure that such a healthy, fit guy with zero symptoms could have such a serious cancer gobbling him up.

I began writing “Love in the Time of Cancer” that year to process my feelings, to document what it was like to be in love and cancer at the same time and to become a new and better resource for others than I had been able to find for us.

You’ve seen here lots of helpful websites, articles and books. Today I want to suggest a book that is new to me that you will likely want to have handy for your family or for a friend or coworker.

The book is called, “After Shock—What to Do When the Doctor Gives You a Devastating Diagnosis.”  The author is Jessie Gruman, Ph.D. She is a scholar, researcher and the founder of the Center for the Advancement of Health—an independent health policy institute.


This is the book I wish I’d had and the book your doctor should hand you but probably didn't. And this is not just a cancer book—the guidelines, checklists and stories are helpful for a diagnosis of heart disease, stroke, multiple sclerosis, ALS—and of course, cancer.

I think this book is also something you can do for a friend or coworker when you have no idea what to do or when boundaries prohibit getting too involved—maybe at work or with an ex etc.

In the next few posts I’ll share some of the highlights and what I think is especially helpful from “After Shock”.

Tuesday, September 2, 2014

What Playing Golf Taught Me



Golf Lesson
It’s the little things.
Shifting my weight to my right foot. Not dropping my left shoulder. Not lifting my right hip.
Leading with my hands. Trusting that I'll hit the ball. Going for it.
Staying focused.
Laughing.

Sex Lesson
It’s the little things. 
Shifting my attention to his body. Not worrying what he thinks.  Lifting my gaze to him. 
Loving my body. Trusting that it will happen.
Going for it.
Staying focused.
Laughing.

Wednesday, August 27, 2014

Keeping Secrets from Your Partner


Does this topic make you nervous? It makes me nervous, I know that.

It might be who you spend time with, or what you spend money on, or how you really feel about your ex or your partner's mother. You might have a big secret like never having an orgasm with your partner, (no cheating just vibrators), or you have a seemingly less harmful one like you say you are vegetarians together  but you eat burgers when you are alone.

Are they secrets or just nobody's business? It's about the relationship--you know that. I have lied about clothes I bought, when I shopped, and yes, sometimes who I saw that day. What he doesn't know can't hurt him--I actually believe that's true. But what I know for sure (me and Oprah) is that what he doesn't know will usually hurt me.

I have had to learn that over and over. My secrets become my paranoia:  I decide not to mention the card from my ex and a week later I find myself wondering what he's reading on his phone. If  fake an "O" I'll  later wonder if he's having as a great a time in bed as he says. It always comes back to burn me and that, inevitably hurts us.

Now here are the facts so we don't feel shamed and alone in this: The Normal Bar--a statistical study of American relationships --reports that 43% of men and 33% of women have kept major secrets from their partners. And even 27% of the happiest couples (studied and confirmed happy) keep secrets from each other. The most common secrets include emotional and physical infidelity, masturbation, shopping and spending, and secret eating, smoking and drinking.

Maybe the criteria for your secret needs to be: Why and I keeping THIS secret, what do I fear would happen if I kept this behavior but not in secret, and what am I risking if and when this is revealed?

Saturday, August 23, 2014

Stand Up to Cancer on Friday September 5th

Mark Your Calendar and plan the snack menu: The celebrity hosted and star-studded tribute to cancer returns on Friday September 5th at 8pm. Yes--it's a fund raiser and packed with teary tributes and fashion moments and certainly some good music--so watch it as entertainment and to see cancer and cancer research get center stage treatment.

Trigger alert: The "battle" and "war" metaphors will get a work out, and the conceit that if cancer is cured no one will ever die will be played. But still, even with that, September 5th will be cancer's night so I'll suspend my rant for that good production.

 Be sure to Stand Up, and sit down, to watch.

Here's a link with more info:http://www.standup2cancer.org

Monday, August 18, 2014

The Family Caregiver at Work

I had a conversation with a new colleague today about caregivers in the workplace. She’s an HR (Human Resources) professional and we were talking about how many people are family caregivers and are working full-time.

It’s incredibly stressful we agreed, and we agreed that HR departments or senior managers need to know the ins-and outs of caregiving simply to better manage this big workplace issue.

The conversation got me thinking.

As the Boomer Bump moves through these next eight years we do know there are more and more people who are caregiving and many of them are in the “Sandwich Generation”—those who are squeezed by caring for children or grandchildren and also for an older adult. It’s so hard.

We do give lots of props and admiration to those folks but –at work—not a lot of really practical help. A few years ago I developed a Caregiver 101 workshop that can be delivered in an hour, or even better an hour and a half and provided in workplaces for employees.

What is especially hard for caregivers at work—even though coworkers and supervisors may be sympathetic is that there is shame attached to family caregiving. Does that sound crazy? It should be crazy. But it’s a reality. Caregiving is still done in relative isolation so folks can easily have the feeling that they should be doing it better. We have the “made-for-TV-movie” mentality that shows family caregiving as such a loving, dedicated, heartfelt thing to do that family caregivers who feel like screaming, spitting or hitting are sure that they are defective. So who wants to talk about—and admit to—that.

Right.

So at work we have to head that off. For the employees sake which is a caring and right thing to do—but also for the sake of the department, team and organization. Caregiving employees cost money. A lot of money. They need time off, they are distracted, in pain, on the phone (a lot) and they get burned out. They make work mistakes and coworkers get frustrated. A good employee can go “bad” after just a few months of caregiving. And then everyone loses.

So if you work outside the home talk to your HR department about offering a Caregiver 101 class or a lunchtime caregivers support group. There are guidelines for groups that are facilitated and also for those that operate with no facilitator. If you are a manager or director think about bringing a caregiver workshop into your workplace and make space available for a caregiver support group—weekly or once a month. The benefits will return tenfold to the health of your good employees and to your organization as a whole.

You can contact me at www.DianeCameron.info for more information.