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Talking to kids about cancer

What do I tell my kids?” 

This is often the first question I’m asked by a parent with a new cancer diagnosis.  One of the most important things for parents to remember is that they know their children better than anyone else and they love them more than anyone…they can trust themselves to do this well.
 
Beyond that general reassurance, however, there are some practical tips for talking with children about a cancer diagnosis. 
 
Prepare for the conversation 
 
Think about your goals for the conversation.  What does your child need to know?  How you can help your child understand what’s going on?  How do you want your child to feel after the talk?  Who should tell your child you have cancer and can the person talking to your child stay relatively calm?
 
When and where should I have this conversation?  You don’t have to wait until you have all the answers.  Be prepared to ...

Is it ok to laugh with cancer?

“Is it okay to laugh?”

The question caught me off guard for a moment, then its meaning sunk in.  She was really saying, “Cancer is serious stuff, my breast has been cut on and radiated, and you’ve given me cancer fighting poisons in my veins. My hair has fallen out, food tastes funny, and I’m on a first name basis with the muzak at my insurance company. I’ve done my crying, but is it appropriate to laugh at it all?”

I remembered back to an intimidating nurse critiquing a tape of my very first patient interview during my second month of medical school. Her eyes were sharp and piercing and her brow furrowed as she watched the tape. Half way through she stopped it, turned it off, and said, “You are flippant…. I don’t much care for it.” My heart sank, and then she continued without a smile, but with a twinkle in her eyes, “but it works for you, so don’t mind me and keep on doing it.”

I believe that humor is therapeutic. Of  course, that is not a new idea. The saying, “laughter is the best medicine” did not originate with Readers Digest. The biblical record states, “A merry heart does good like medicine, but a broken spirit drieth bones” (Proverbs 17:22). I don’t know that a merry heart will add time to a cancer patient’s life, but I know that it will add life to the time that they have.  

We don’t know a lot about the physiological effects of humor. It does ....

Education programs after cancer

At the Swedish Cancer Institute, we understand that completing treatment for cancer presents a new set of circumstances. For this reason, we offer free education programs to help patients explore these questions with others who are preparing to complete or who have completed cancer treatment.
 
In these eight-week groups you will have the opportunity to:
  • Make peace with the impact of cancer treatment
  • Reduce the stress cancer places on relationships
  • Overcome the fear of recurrence
  • Renew hope and increase resilience
 In a safe and supportive environment, individuals who are preparing to complete or have completed cancer treatment are invited to sign up for these practical life-skills classes. We will gently explore life after treatment and share plans for survivorship.
 
ACT – After Cancer Treatment: What’s Next?
An eight-week group designed for men and women to learn practical life-skills to help rebuild after active cancer treatment is ...

5 things to know about cancer screenings

Cancer causes 580,000 deaths a year in the United States. One in eight women will develop breast cancer and one in six men will be diagnosed with prostate cancer during their lifetimes. However, many deaths can be prevented when cancer is detected at an early stage. Cancer screening and risk assessment tests are the tools we use to find cancers early.
 
How do we find early cancers?

Some cancer screenings can be done yourself at home at essentially no cost or risk. This includes regular self-examination of the breasts, testicles and skin. Home fecal occult blood testing can also be done to screen for colorectal cancer. Additional information on cancer screening and self-examinations can be found on websites such as www.cancer.org or www.webmd.com.

 
Other screening requires medical interventions. There is good evidence that well-targeted screening saves lives. However, screening tests such as mammography, colonoscopy and prostate-specific antigen (PSA) are  ...

Grieving and the holidays

A cancer doctor is very familiar with the anxious and fearful grief that accompanies a diagnosis of cancer. We are less acquainted with the lonely and empty grief that is experienced by those left behind when our patients die. However, when I wear my hospice medical director hat, I am privy to those struggles, and knowing that the loss of someone close is particularly difficult during the holidays, I have chosen to divert from subjects I am more familiar with and rely on the experts at hospice to help me present a meaningful discourse on grief during the holiday season.

For the bereaved, the joyous holidays trigger emotions of great conflict. Every act of preparing for the holidays, once a time of cheer and anticipation, becomes another stabbing reminder of ones loss. The demands of family and friends, always a bit stressful around Thanksgiving, Hanukkah, Christmas, and New Year, now are overwhelming, both physically and emotionally. Traditions, designed to create love and family unity, now seem empty and may even create divisions among the grieving. Even successful celebration may bring on a deep surge of guilt for enjoying the holiday alone. And those who have no physical or emotional reserves left for thanksgiving or joy making, may feel great pressure to “get on with their life, and join in the fun.”

It has been suggested that the key word in grief is “permission.” The bereaved need permission from themselves, and from family and friends, to grieve as long as necessary and in any way that works, remembering that what works may not always be the same. It means permission to only do what you can. A turkey and all the trimmings may just be too much this year. Eating out may be perfect. Having someone else do dinner may be better yet. 

Permission may also be needed to change some timeworn traditions. It must be recognized that ...

Resources and social support for dealing with cancer

Here at the Swedish Cancer Institute (SCI), we understand that individuals cope in their own unique ways, and that receiving personalized education and support is important in the healing process. For this reason, the SCI is devoted to providing complementary supportive services for newly diagnosed patients, those undergoing treatment, and those who have completed treatment, as well as their caregivers.

The SCI offers programs that promote education, hope, and healing. Many of these programs are offered free of charge, while others are offered on a sliding scale. These integrated care programs include:

  • American Cancer Society Patient Navigation: The American Cancer Society Patient Navigator helps patients find resources related to financial assistance, transportation, access to wigs and prosthetics, and much more.
  • Art Therapy: Art therapy is a confidential, supportive, and individualized experience for examining health issues through visual and verbal self-exploration.
  • Cancer Rehabilitation: Cancer rehabilitation integrates medical management of cancer treatment-related side effects with a variety of exercise therapies.
  • Health Education: The Swedish Cancer Education Centers offer complementary educational materials, innovative learning opportunities, and patient education classes.
  • Genetic Counseling and Testing: Genetic testing is available for individuals to determine their risk for developing certain cancers.
  • Massage Therapy: Massage therapy may help with cancer-related pain, fatigue and nausea.
  • Naturopathic Medicine: Combining modern science with natural remedies, naturopathic doctors are available for consultation and treat¬ment through coordination with the patient’s oncologist.
  • Nutrition Care Services: Nutritionists are available to help patients and caregivers make healthy dietary choices during cancer treatment.
  • Psychiatry: Psychiatrists help patients and caregivers maintain the emotional and mental well-being needed to cope with stresses of cancer.
  • Oncology Social Work: Licensed oncology social workers provide patients and caregivers ongoing counseling and assistance.
  • Support Groups: Support groups for patients and caregivers are offered weekly, creating an environment for people to share their feelings with others going through similar experiences. 

Patients often hear that it’s important to find a strong support system during and after treatment; this may include a partner, sibling, parent, child or close friend. These are ...

Cancer control and survivorship

I recently attended the Southwest Oncology Group (SWOG) meeting, a consortium of research institutions doing clinical trials on cancer. The conference highlighted how new research will remarkably affect cancer survivorship, quality of life (QOL), integrative care and our ability to predict and provide needed services more accurately and with greater cost effectiveness for cancer survivors. The tools for implementing cancer control are evolving quickly.

Here are some highlights from the meeting:

  • Biomarkers, which are any human characteristics that are measurable including everything from gene expression (or over-expression) to pain surveys, can potentially predict long term survival as well as the specific services that will most benefit patients.
  • Symptoms that are increasingly predictable by biomarker assays include fatigue, insomnia, pain, anorexia, nausea, depression and others. This means that we will soon be able to better predict the patients who will be affected by these problems and deliver interventions much earlier and more effectively.
  • Patient satisfaction is frequently not related to treatment outcome. Factors such as QOL and survivorship are important.
  • Lung cancer patients suffer inordinately high, long-term QOL deficits. Many of these respond well to interventions but interventions are frequently not provided to patients with lung cancer.
  • Symptom clusters ...
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