Table of Contents

Introduction 1

About This Book 1

Conventions Used in This Book 2

What You Don’t Have to Read 2

Foolish Assumptions 2

How This Book Is Organized 3

Part I: Your Journey Through Cancer Treatments: Preparing for the Trip 3

Part II: Your Choices along the Way: Making Good Ones 3

Part III: Chemotherapy: What to Expect and How to Deal with Side Effects 4

Part IV: Radiation: What to Expect and How to Deal with Side Effects 4

Part V: Your Success Strategies: Assembling Your Support Team 4

Part VI: Your Future after Cancer Treatments: Looking Ahead 4

Part VII: The Part of Tens 5

Glossary 5

Icons Used in This Book 5

Where to Go from Here 6

Part I: Your Journey Through Cancer Treatments: Preparing for the Trip 7

Chapter 1: Recognizing the Realities of Chemotherapy and Radiation 9

Making Peace with Your Diagnosis 10

Registering your emotions 10

Taking time to process the news 10

Experiencing a range of emotions 11

Telling family and friends 11

Gathering Information 12

Shopping for Cancer Specialists 12

Finding good doctors 13

Preparing to embrace a new culture 14

Considering Options 15

Understanding chemotherapy and radiation 15

Looking into clinical trials 16

Taking a chance on a transplant 16

Exploring Virtual Chemotherapy 17

Getting started on chemo 17

Taking care of your immune system 17

Signing up for side effects 17

Trying on Radiation Therapy for Size 18

Getting set up for the first treatment 18

Managing side effects 19

Sending for Help 19

Making room on the team bus 20

Practicing good nutrition 20

Tending to your spirit 21

Finding support from strangers 21

Looking Beyond Cancer Treatments 22

Beginning anew 22

Returning to square one 23

Making peace with a new you 23

Chapter 2: The Mutants Take Over: A Primer on Cancer 25

Demystifying the “C” Word 26

Understanding how cancer develops 27

What causes cancer? 28

Listing the types of cancer 29

Differentiating among tumors 30

Watching the Immune System in Action 30

Discovering How Treatments Fight Back 32

Considering Risk Factors 34

Blaming your genes 34

Looking for other causes 35

Looking to the Future: Ongoing Research 37

Targeting genetic culprits 38

Developing fortified antibodies 38

Speaking of the “C” Word 39

Practicing saying the word 39

Scheduling pity parties 40

Comforting the people around you 41

Playing the blame game 42

Keeping Your Sense of Humor 43

Chapter 3: You Will Be Tested: What All Those Tests Show 45

Passing a Battery of Tests 46

Having blood drawn 46

Stretching out on a table 47

Undergoing a biopsy 51

Playing the Waiting Game 52

Setting the Stage for Treatment 53

Hearing your numbers 55

Ignoring your numbers 55

Recognizing Symptoms of Cancer 56

Resisting the urge to self-diagnose 57

Analyzing pain 57

Appreciating Early Detection 58

Knowing the types of screening tests 59

Redirecting anger about tests 60

Part II: Your Choices along the Way: Making Good Ones 63

Chapter 4: Defining Chemotherapy: The Anticancer Drugs 65

Getting Some Chemotherapy Basics 66

Sorting out the different drugs 67

Taking heart from new developments 68

Investigating Different Delivery Systems 69

Having intravenous chemotherapy 70

Wearing a pump 73

Taking chemotherapy by mouth 74

Looking at lesser-known forms of chemotherapy 74

Evaluating Your Oncologist’s Recommendation 75

Setting up a treatment plan 75

Determining the dose 76

Getting a second opinion 77

Making the Best Choice for You 78

Asking the right questions 79

Getting the right answers 79

Moving forward with confidence 80

Chapter 5: Defining Radiation: A Burning Issue 81

Understanding Radiation Therapy 82

Defining external radiation therapy 83

Defining internal radiation therapy 85

Exploring ways to improve radiation therapy treatments 89

Evaluating Your Radiation Oncologist’s Recommendation 89

Setting up a treatment plan 89

Determining the dose 90

Meeting the team 91

Getting a second opinion 91

Making the Best Choice for You 91

Chapter 6: Setting New Standards: The Role of Clinical Trials 93

Grasping the Importance of Clinical Trials 94

Realizing the scope of cancer trials 94

Understanding the development of clinical trials 94

Deciding Whether to Participate 96

Considering the benefits 97

Considering the risks 97

Asking questions 98

Seeking more information 99

Taking Part in a Clinical Trial 100

Meeting eligibility guidelines 100

Knowing your rights 101

Feeling Good About Taking Part 101

Hearing what participants have to say 102

Banishing the notion of guinea pigs 103

Chapter 7: Getting a Second Chance: Bone Marrow Transplants 105

Demystifying Bone Marrow Transplants 106

Defining bone marrow 106

Identifying the purpose of a transplant 107

Recognizing the source of stem cells 108

Exploring the Types of Transplants 108

Looking at autologous transplants 109

Looking at syngeneic transplants 110

Looking at allogeneic transplants 110

Looking at an alternative 110

Searching for a Donor 111

Preparing for a Bone Marrow Transplant 112

Acknowledging your emotions 112

Appointing a caregiver 113

Comparing Retrieval Methods 114

Harvesting the bone marrow 114

Obtaining peripheral blood stem cells 114

Undergoing the Rescue Process 115

Experiencing external changes 115

Experiencing internal changes 116

Keeping an Eye Out for Post-Rescue Problems 116

Part III: Chemotherapy: What to Expect and How to Deal with Side Effects 119

Chapter 8: What to Expect During Chemotherapy: A Head-to-Toe Mouthwash 121

Your First Appointment: Getting the Toughest One Out of the Way 122

Assessing your feelings 123

Preparing for your first treatment 123

Arriving for your treatment 125

Undergoing your first treatment 125

Heading for home 126

Continuing with Chemo 127

Keeping your appointments 128

Reporting changes in your health 128

Protecting your health 129

Asking for the Support You Need 129

Delegating responsibilities to your family 130

Appointing a “Chemo Buddy” 131

Allowing friends to help 131

Giving Yourself a Break 133

Keeping everything in perspective 133

Keeping an eye on the future 134

Chapter 9: Gimme a Boost: Immune and Bone Marrow Stimulants 135

Boning Up on Bone Marrow 136

Boosting the Immune System 137

White blood cells 137

Red blood cells 139

Platelets 141

An additional complication 142

Recognizing an Infection 143

Considering Supplements 143

Chapter 10: Coping with Serious Side Effects of Chemotherapy 145

Considering What’s to Come 146

Reading a firsthand report 147

Predicting your experience 147

Keeping an Eye on Kidney and Bladder Function 148

Combating Nausea 149

Eating smart 149

Drinking smart 150

Comforting yourself 150

Facing Fatigue 151

Checking for anemia 152

Conserving energy 152

Fighting Pain 154

Nailing neuropathy 154

Watching out for mouth sores 155

Dealing with dry mouth 156

Demystifying Depression 157

Facing your fear 157

Identifying other causes of depression 157

Getting the help you need 158

Confronting Infertility 159

Being proactive 159

Planning to wait 160

Losing Your Hair 160

Caring for your hair before it goes 161

Planning ahead for hair loss 162

Growing new hair 165

Chapter 11: Coping with Less Serious Side Effects of Chemotherapy 167

Considering What’s to Come 168

Battling Intestinal Disarray 168

Dealing with diarrhea 169

Dealing with constipation 170

Retaining Fluids 170

Experiencing Vision Problems 171

Fighting Fuzzy Thinking 171

Losing Interest in Food 172

Mistrusting your sense of taste 172

Boosting your appetite 173

Cutting back on drinking 174

Troubleshooting Skin and Nail Problems 174

Itching to scratch 175

Knowing how to treat nails 176

Attacking acne 176

Suffering from sunburn 176

Reacting to radiation 177

Part IV: Radiation: What to Expect and How to Deal with Side Effects 179

Chapter 12: What to Expect During Radiation: Tattoos and Moisturizer 181

Your First Appointments: Getting the Toughest Ones Out of the Way 182

Knowing what to expect 182

Mapping the area to be treated 183

Determining the dose to use 185

Getting tattoos 185

Setting up your schedule 186

Experiencing the Real Thing 187

Assessing your feelings 187

Arriving on the first day 188

Soothing Your Skin 189

Making Wardrobe Adjustments 190

Seeking the Support You Need 190

Giving Yourself a Break 191

Keeping your appointments 192

Keeping everything in perspective 192

Keeping an eye on the future 193

Chapter 13: Coping with Side Effects of Radiation Therapy 195

Considering What’s to Come 196

Identifying your type of therapy 197

Predicting your experience 197

Fending Off Fatigue 198

Learning an important word 198

Getting your timing right 199

Caring for Your Skin 200

Using protective strategies 200

Watching for warning signs 200

Soothing Inflamed Mucous Membranes 201

Experiencing Diarrhea 201

Saying “No” to Nausea 202

Making wise food choices 202

Making wise drink choices 203

Finding comfort 204

Living with Lymphedema 204

Looking Out for Pneumonitis 205

Running to the Restroom 205

Watching Your White Blood Count 206

Dealing with Hair Loss 207

Pampering your hair while you have it 207

Making plans in advance 208

Recognizing Depression 210

Asking for help 210

Working through fear and grief 211

Part V: Your Success Strategies: Assembling Your Support Team 213

Chapter 14: Your Health Professionals: Your Friends and Guides 215

Communicating with Your Doctors 216

Building a good relationship 216

Considering less-than-ideal situations 219

Seeking Help from a Psychologist 220

Allowing yourself to accept help 221

Knowing what kind of help to expect 222

Meeting Other Health Professionals 222

Making time for massage 223

Yearning for yoga 225

Renewing with reiki 227

Taking up tai chi 228

Trying meditation 229

Fitting in fitness 231

Chapter 15: Good Nutrition: Eating Right No Matter How You Feel 235

Welcoming New Members to the Team 236

Knowing When You Need Help 236

Catching Up on the Food Fights 237

Boning Up on the Benefits 238

Acknowledging the “A” List 239

Finding time for fluids 239

Pumping up with protein 239

Embracing carbohydrates and fats 240

Mulling over vitamins and minerals 242

Plumbing the Pitfalls of Poor Eating 242

Considering Problems that May Develop 242

Realizing how tumors impact nutrients 243

Seeing how surgery affects eating habits 243

Knowing how chemotherapy influences nutrition 244

Acknowledging problems caused by radiation therapy 245

Assessing effects of bone marrow and stem cell transplants 245

Chapter 16: Meeting Spiritual Needs: Turning to Prayer and Meditation 247

Defining Distress 248

Tallying Up the Benefits of Faith 248

Talking about Spirituality with Your Doctors 251

Examining Prayer Practices 252

Personalizing prayers 252

Praying in free verse 252

Meditating in a prayerful manner 253

Accepting Prayers from Others 254

Assessing the Healing Power of Prayer 254

Listening to a Doctor on Spirituality 255

Squaring Faith with Cancer 256

Chapter 17: Finding a Support Group: Realizing You Are Not Alone 257

Determining Your Level of Interest 258

Defining “Group” 258

Locating a Group 259

Asking the Right Questions 261

Seeking One-on-One Support 262

Looking at the Benefits 262

Assessing the Risks 263

Handling the hard stuff 264

Protecting yourself emotionally 264

Helping Newcomers 265

Part VI: Your Future after Cancer Treatments: Looking Ahead 267

Chapter 18: Finishing Therapy: An End and a Beginning 269

Monitoring Your Health after Cancer 270

Expecting a recovery period 270

Scheduling follow-up care 271

Keeping appointments 271

Telling the truth 272

Worrying about recurrence 273

Coping with Long-Term Side Effects 273

Fighting fatigue 273

Putting up with pain 274

Managing lymphedema 274

Making the best of mouth problems 274

Facing bladder or bowel problems 275

Accepting early menopause 275

Sorting out sexual issues 276

Reducing Your Hormone Level 277

Hearing arguments for hormone therapy 277

Considering different approaches 278

Sizing up the side effects 278

Deciding what’s best for you 279

Working Out a Wellness Plan 279

Chapter 19: Dealing with Recurrence: Here We Go Again 281

Defining Recurrence 282

Recognizing signs of recurrence 282

Getting up to speed on semantics 283

Redefining Survivor 283

Riding the Emotional Roller Coaster 284

Questioning everything 284

Moving on 285

Establishing a Treatment Plan 286

Understanding your options 286

Making the most of past experiences 287

Setting treatment goals when a cure isn’t possible 288

Considering Unconventional Treatments 288

Facing the Future, Whatever Comes 289

Finding comfort in hospice care 290

Debunking the myths of hospice 291

Traveling on 292

Chapter 20: Defining Yourself after Cancer: The New Normal 293

Looking at Life Through New Eyes 294

Reaping the benefits 294

Getting a physical boost from positive thinking? 295

Making Semantic Decisions 296

Allowing for Negativity 296

Finding Inspiration in Amazing Recoveries 297

Looking at Time Differently 298

Hearing the wakeup call 298

Living in gratitude 299

Spending time on yourself 299

Protecting Yourself Emotionally 301

Looking out for number one 301

Making friends with lingering fear 302

Defining Your Boundaries at Home and Work 302

Lightening Up 303

Part VII: The Part of Tens 305

Chapter 21: Ten Myths about Cancer 307

Myth #1: When You Get Cancer, You Die 307

Myth #2: If the Cancer Doesn’t Kill You, the Treatments Will 308

Myth #3: Cancer Treatments Are One-Size-Fits-All 308

Myth #4: You Can’t Work while You’re Having Cancer Treatments 309

Myth #5: It Takes Forever to Get Over Cancer Treatments 309

Myth #6: It’s Your Fault You Got Cancer 309

Myth #7: The Medical Community Suppresses Alternative Healing Methods 310

Myth #8: Now Your Family Will All Get Cancer 310

Myth #9: Cancer Always Comes Back 310

Myth #10: Nothing Is Ever the Same after Cancer 311

Chapter 22: Ten Ways for Family and Friends to Help You 313

Acknowledging That You Have Cancer 313

Giving You Time to Accept the Diagnosis 314

Holding You While You Cry 314

Making You Laugh 315

Seeking Help Coping from Someone Else 315

Asking for Specific Ways to Help You 315

Carrying Out Your Requests 316

Offering What You Are Reluctant to Ask For 316

Helping to Protect You 317

Celebrating with You 317

Chapter 23: Ten Things Beyond Your Control 319

Turning Back the Clock 319

Keeping the Diagnosis a Secret 320

Encountering an Alien Culture 320

Making New Friends 320

Experiencing Mood Swings 321

Facing Your Own Mortality 321

Suffering Power Outages 321

Missing Some Good Times 322

Choosing the Texture of Your New Hair 322

Receiving Help from Many Sources 322

Chapter 24: Ten Ways Life Will Be Better after Cancer 323

Cancer Goes Away 323

Treatments End 324

Fear Recedes 324

A Sense of Adventure Grows 324

Inner Strength Builds 325

People Matter More 325

Forgiveness Gains in Importance 325

Support Comes Naturally 326

The Tongue Loosens 326

Time Flies 326

Chapter 25: Ten Sources for More Information 329

Searching the Web 329

National Cancer Institute 330

American Cancer Society 330                                             

National Comprehensive Cancer Network 330

American Society for Therapeutic Radiology and Oncology 331

People Living With Cancer 331

OncoLink 331

Planet Cancer 331

Coalition of National Cancer Cooperative Groups 332

National Marrow Donor Program 332

Coping with Cancer Magazine 332

Glossary 333

Index 339