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    Coping With Cancer Treatments Through Summer

    Welcome summer…we’ve missed you. The official first day of summer is June 21, but hot temperatures are already here for most of us. Hot weather brings some different issues to the forefront for us as cancer patients – how hot weather and strong sunlight affect us as cancer patients and survivors.
    Sun Exposure
    Fluorouracil, commonly known as 5FU, may cause your skin to be more sensitive to the sun. 5FU is a common chemotherapy drug used to treat breast, colorectal, esophageal, pancreatic, skin and stomach cancer. Other chemotherapy drugs may also cause increased sun sensitivity. If you’ve received radiation treatments, the areas that received radiation are particularly sensitive to sun exposure for the first year after the radiation. Surgical scars are also sensitive to sun exposure.
    If you’re planning a beach vacation, be sure to take extra precautions. Use sunscreen (SPF of 30+), wear hats and protective clothing. Avoid sun exposure during the peak hours of sunshine from 10 a.m. to 3 p.m.
    Summer Fun
    Summer includes lots of outdoor activities that usually include food, heat and humidity and other people. But you might discover that you don’t tolerate heat and humidity as well as you used to. 

    Here are some helpful picnic hints:

    Wear loose clothing and choose light-weight fabrics. • Stay in the shade. If you know in advance that no shade will be available, you might want to reconsider your decision to attend. • Outdoor heat may worsen your hot flashes. • Be cautious about food at picnics, especially if you’re currently having low white counts. • Heat may trigger nausea or acid reflux. Bring your anti-nausea or antacid medicine. If you experience diarrhea, go home to cool off and drink lots of fluids.

    Heat exacerbates the symptoms of fatigue. Whether you have fatigue from chemotherapy, radiation or a recent surgery, getting hot and dehydrated may compound your fatigue symptoms to a dangerous level.
    Dehydration is not just a simple problem for cancer patients. It can lead to muscle cramping, problems breathing, confusion and even seizures – signs of a heatstroke, a medical emergency.
    It would be prudent to decline an invitation to go camping, hiking or fishing in a remote area. Should you encounter heat-related symptoms, medical help is not readily available.
    Did you know that certain chemotherapy drugs can make you more susceptible to developing cataracts? Tamoxifen and some steroids              (bexarotenedexamethasone, hydrocortisone, methylprednisone, and prednisone) given as pre-meds may hasten the development of cataracts. My oncologist advised me to always wear sunglasses even when I was driving. Be sure to wear good quality sunglasses that provide  UV protection.

    Other eye problems that may result from chemotherapy include:

    • Conjunctivitis (Pink Eye). Caused by capecitabine (Xeloda), epirubicin, methotrexate or oprelvekin (Neumega). Since pink eye is caused by an infection (viral or bacterial), patients taking these drugs might want to avoid swimming in public pools, rivers and ponds. • Photophobia (sensitivity to light). Be sure to wear sunglasses if you’re taking these chemo drugs: Cytarabine (Ara-C) fluorouracil, isotretinoin or tretinoin.
    Precautions if You’ve Lost Your Hair
    If you’ve lost your hair, you need to protect your scalp. It’s delicate as it’s not been exposed to the sun before. Always wear a good quality sunscreen if you’ve decided to “go natural.” You might try using one that your spray on since your scalp might be sensitive.
    If you’re wearing a real hair wig , consider switching to a synthetic hair one and using an open-weave cap. This is much cooler to wear during the summer months. Some patients abandon their wigs for the summer and wear a lightweight scarf or turban instead.
    The same tips about sunscreen and staying hydrated apply to gardening. But one more caution to keep in mind. Wear garden gloves and wash your hands well after gardening. This helps prevent exposure to bacteria, fungus, and mold that could potentially make you sick. Be sure to wear a mask in the Southwestern desert areas to help prevent Valley Fever.
    Foot Safety

    Don’t go barefoot. A number of strong chemotherapy drugs cause neuropathy (loss of feeling or tingling in the hands and feet). You could injure your foot due to loss of sensation in your feet.
    Hot flashes at night? Try a cold pillow . There are a number of options. These pillows depend on technology to provide cooling so they tend to be “pricy.” But many cancer patients have a difficult time going to sleep or staying asleep. A cooling pillow might be worth the investment.
    The Bottom Line… Enjoy the summer and all of the fun and family it brings. Don’t live in fear of being in crowds or eating picnic food. Taking a few precautions helps assure being safe, comfortable and staying well while you’re in treatment. And if you’ve been out of treatment for a while, these are still good tips to follow.

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    Hair Loss May Become Rare....In the Meantime, Here are Tips to Cope

    Hair loss is one of the most common side effects of chemotherapy, stem cell transplant and targeted therapy or locally from radiation therapy. Looking back at my first oncology appointment, I remember my husband asking her, “Is my wife going to lose her hair?” He was asking because he knew losing my hair would probably be distressing to me. 

    Hair Loss from Chemotherapy May Become a Rare Side Effect for Certain Cancer Patients
    The Food and Drug Administration recently approved the use of the Paxman Scalp Cooling System, which reduces the likelihood of hair loss caused by chemotherapy, for use in patients with solid tumors. This system was approved for use in breast cancer patients in April 2017. Solid tumor cancers include bladder, breast, colorectal, lung, ovarian and prostate.
    The system, known as a cooling cap, is an apparatus that fits on the patient’s head and cools the head to narrow the blood vessels in the scalp reducing the amount of chemotherapy drug reaching the hair follicles. Most patients tolerate the cold treatment but do report discomfort especially for the first 20 minutes or so. The device remains on the patients head during the infusion. Over 200 systems are in use in the United States and 65 more systems are on order.

    The bad news is that service is not currently approved for insurance reimbursement. The U.K.-based company is exploring ways to get this service approved. But patients who are able to financially able to pay the estimated $1,500-$3,000, depending on the number of chemo cycles needed, have been willing to pay to prevent losing their hair.
    There is financial help available through HairToStay.org. Help is determined by income, and the income limits are 300 percent of the Federal Poverty Level. Ask your chemotherapy center if scalp cooling is available. 
    Why does chemotherapy cause hair loss?
    Because chemotherapy targets fast-growing cancer cells, it also affects other fast-growing cells in our bodies, including our hair follicles and our blood cells. That’s why it’s so common to see patients lose hair and experience low blood counts. 
    Not all patients experience complete hair loss. Some patients experience thinning hair or hair that falls out in clumps. Some patients lose their hair all over their bodies, including their arms, armpits, legs, facial hair and pubic hair. Other patients just lose the hair on their heads. Every patient is different.
    ASCO (American Society of Clinical Oncology) lists the chemotherapy and targeted therapy most likely to cause hair loss. 
    Why are we so distressed over losing our hair?
    The cancer diagnosis shakes us to our very core. We are scared that we might die. We worry about how much treatment will cost. We are frightened by the surgery that we might have.

    But losing our hair is distressing because it changes our self-image. Outsiders may consider hair loss just a superficial loss. Friends and family may not understand what a big deal losing our hair is. They may admonish us by saying, “You’re going to be fine.” “It’s only hair.” “At least, you’re going to make it.”
    But hair loss is one of the most traumatic parts of a cancer diagnosis for many people. It is an outward sign that everything in their lives has been turned upside down. Hair loss usually begins 3-6 weeks after chemotherapy starts and is an outward announcement to the world that you have cancer.
    Losing our hair makes us feel vulnerable. For some of us, it robs us of our identity – our hair color or hairstyle might have been our “signature.” When we look in the mirror every morning, we don’t recognize ourselves. And if we lose our eyelashes and eyebrows, we feel even more destroyed. Tears are a normal part of this grieving process.
    Don’t let comments about vanity or “it’s only hair” derail you from working through your feelings. Coming to terms with our hair loss brings acceptance and peace of mind. 
    Finding the way to moving forward
    Eventually, we’ll make peace with our hair loss. 
    In my case, I already wore my hair very short. It is fine textured, and I color it to help give it body. I stopped coloring my hair when I was diagnosed because I thought that was a prudent thing to do. Every week, my hair thinned some more until finally, I could see my scalp beneath the wisps of baby fine, mousy brown hair. I admit it, “I hated the way that I looked. I felt horrible and defeated.”

    I was still working in outside sales, calling on existing clients and potential clients. Would they want to still work with me if I looked like I had cancer? I lived in my territory and only saw my boss once a month. Would he keep going to bat for me if I didn’t look like myself?
    So I asked my oncologist to write me a prescription for a “cranial prosthesis.” And off I went shopping for a wig. I found one that I loved. I felt good about myself again. The wig was my coping mechanism.
    Wigs Are Not for Everyone
    But a wig is not a solution for everyone. There are lots of other ideas:
    • Some people decide to “rock being bald.” Especially if it’s not cold, many people eventually find that it’s liberating to let their baldness show. (Remember to use sunscreen.)
    • Some patients might embrace the look of a henna-tattooed crown on their naked head. The henna is temporary. Check out this link to see if a henna crown might be right for you. https://livebetterwith.com/community/cancer-henna-crowns/

    • Baseball caps with hair or a ponytail are a stylish solution. 
    • Turbans, scarves, slouchy soft fabric hats or hand knitted caps. Express yourself – some are sparkly and some feature dramatic prints. 
    • Women of color might want to express their heritage with an ethnic head wrap. Here’s how.

    • Scarf beneath a hat. I did this several times and loved it. The scarf protects your tender head, and the hat provides style. Here’s how. 
    Feeling good about yourself during cancer treatment helps you endure side effects more easily. When you’re comfortable within yourself, it shows through your smile. 

    Whatever path you take if you experience hair loss, choose what feels right for you. 
    What tips do you have for others that are going through hair loss now? Please share in the comments below.
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    Radiation for Cancer - More Choices

    Before diagnosis, many people don’t realize that radiation therapy is an integral part of cancer treatment. It is used to kill cancerous tumors or shrink tumors before surgery. Estimates suggest that over half of all cancer patients receive radiation during their treatment. You might be wondering how radiation works and if it might work for your cancer. Consider the information contained here as Radiation 101.

    How Radiation Works on Cancer Cells
    Cancer cells are faster-growing cells than most cells in our bodies. Radiation damages the DNA in the cancer cells. Once the DNA is damaged, the cancer cells can’t divide and reproduce. Radiation doesn’t kill the cancer cells immediately. Radiation damages the cancer cells resulting in a slow death to the cells over a period of weeks to months. Even though the radiation is beamed directly at the tumor, adjacent normal cells may also be damaged, but they usually recover.

    What to Expect From Radiation Treatment

    Why Is Radiation Used?
    There are a number of reasons that radiation is recommended for patients. They include: • Shrink tumors before surgery – Surgery is often less complicated if the tumor is smaller, helping the patient to recover more quickly. • Help prevent tumors from recurring after surgery – Some types of cancer are more likely to recur locally (close to the site of the first tumor) so radiation helps prevent recurrences. For example, lung cancer patients sometimes receive radiation to the head to prevent a recurrence in the brain. During my treatment for rectal cancer, the purpose of my pelvic radiation was twofold, to shrink the primary tumor and to help prevent a recurrence. • Provide symptom relief caused by metastatic cancer – Tumors or lymph nodes may cause pain if they are pressing against a patient’s spine or tailbone. Difficulty swallowing or coughing may be caused by a tumor/swollen lymph node pressing on your windpipe or esophagus; again, radiation may provide symptom relief even if it won’t cure the cancer. When used for symptom relief, it’s called palliative radiation. • During surgery – Sometimes, radiation is done during surgery (called intraoperative radiation) so that the radiation goes directly to the cancer.

    Just like there are many different chemotherapy drugs, there are many different types of radiation. Radiology has become very specialized with more types of radiation for specific patient needs.
    External-beam Radiation Therapy. This is the frequently used type of radiation. The beam is generated externally and passes through the body to the targeted area. The machine that generates the radiation beam is a linear accelerator. Computer software allows the radiologist to adjust the size and shape of the beam. Treatments may be done every day for several weeks or just a few treatments may be required. Patients may utilize a customized mesh mask or lower torso cradle to prevent movement during treatment. 
    Some external-beam radiation therapy types are:
    • 3D-CRT (three-dimensional conformal radiation therapy). Radiologists use CT scans and MRI scans to develop a 3D image of the area to be treated. By targeting the 3D image area, higher doses of radiation are used while minimizing injury to the surrounding tissues. • IMRT (intensity modulated radiation therapy). The “I” in this acronym stands for “intensity.” The intensity of the beam is changed during the treatment so that it targets the tumor while sparing healthy surrounding tissue. • IGRT (image-guided radiation therapy). This type of radiation is “image-guided” meaning that the radiologist takes images of the treatment area during the treatment. These images are compared to the images taken during planning and setup to ensure that the tumor receives the radiation and healthy tissue is spared. • SBRT (stereotactic radiation therapy). SBRT radiation delivers a large dose of radiation to a small tumor area. The patient has to remain extremely still. Headframes or body frames limit the movement of the patient. One to five doses are given, given over a period of one or two weeks. Side effects are minimal. Internal Beam Radiation Therapy. As the name implies, radioactive substances are placed with the tumor or surrounding tissue. There are several types of internal beam radiation therapy. • Permanent. Small (the size of a rice grain) steel beads are implanted permanently, either in the tumor itself or surrounding a cancerous area. This procedure allows a higher dose of radiation in a smaller area and requires less time for treatment. • Temporary. The radioactive material is inserted by needle, catheter or a special applicator and usually only remains for a few minutes. Proton Therapy – The Newest Radiation Therapy
    The newest radiation therapy, Proton Therapy ,  utilizes protons instead of standard x-rays. Protons obit around an atom and they become highly energized through a process known as ionization. Protons contain more energy yet cause significantly less damage to surrounding tissue. Simply put, they are a superior form of radiation therapy. 

    The $64,000 question is why do protons produce less damage to surrounding tissue? The answer is complex as you’ve seen if you read the link above. Simply put, the energy distribution of the proton can be controlled and directed toward a three-dimensional target (the tumor).
      In layman’s terms, the velocity that the proton travels can be programmed to penetrate the body to a certain depth (where the tumor is located) and disperses its maximum energy. The radiation oncologist can adjust the dose distribution in the form of 3-D target delivering maximum radiation to the tumor and less to the surrounding tissue minimizing damage to healthy tissue and minimizing side effects. Set up is similar to the set up for SBRT radiation.

      When tumors are located close to significant parts of the body, such as the brain, eye, aorta or spinal cord, proton therapy allows the tumor to be safely radiated without damaging a vital organ. It’s also good for childhood cancers because it carries less risk of harm to growing bodies. 
    Other cancers that are good candidates for proton radiation therapy include:

    CNS (spinal cord) cancers like malignant meningioma • Eye cancer • Liver cancer • Lung cancer • Prostate cancer • Sarcomas 
    Proton therapy centers tend to be located in large urban cities due to their high construction cost (upward of $200 million or more). Sadly, residents in the Midwest and Mountain States will have to travel for now to receive proton therapy. Proton therapy is approved by many insurance companies and by Medicare.

      Radioembolization, Also Known as Y90
    Y90 is a highly specialized form of radiation therapy and embolization (blocking blood flow) that treats liver cancer and metastatic liver tumors. Tiny glass or resin beads are filled with radioactive isotope yttrium (Y90) and are placed in the blood vessels feeding cancerous tumors in the liver. Once implanted, these beads not only deliver radiation to the tumors but also cut off the blood supply to the tumor. The tiny beads are placed in the liver through the use of a catheter inserted in a major blood vessel in the groin (similar to the method used in a heart catheterization). The catheter is gently guided to the hepatic artery. Then the radioactive glass beads are inserted into the branches of the hepatic artery that are feeding the tumors.

      An interventional radiologist performs the procedure which takes about an hour. The beads deliver radiation for 10-14 days. The goal of Y90 is to extend the life of patients and provide symptom relief. It sometimes allows patients to become operative with curative intent. Over 90 percent of Stage IV colorectal cancer patients and patients with neuroendocrine tumors benefit from Y90 Radioembolization.
    The Bottom Line… Don’t be surprised if radiation therapy is recommended to you. Most patients agree that the benefits of radiation therapy far outweigh the side effects.

      Cancer treatment may be compared to a three-legged stool. The three legs of cancer treatment are chemotherapy, radiation therapy and surgery. I fondly call my team of doctors the Holy Trinity – my oncologist, my surgeon and my radiation oncologist. Without any one of them, I probably would not be alive today.  

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    Oral Chemo - Advantages and Disadvantages

    The first oral chemotherapy dates back to 1992 when Xeloda (capecitabine) was patented. It was first approved for the treatment of breast cancer in 1998 and approved for the treatment of metastatic colorectal cancer in 2001. In 2018, oral chemotherapy drugs are commonly prescribed for many types of cancer. It’s estimated that about over 25 percent of the new cancer drugs now in the pipeline will be oral. Is Oral Chemotherapy Covered by Insurance?

    Cancer patients may be surprised to learn that oral chemotherapy is covered in a different way than IV chemo, surgery, radiation, interventional radiology and ablations, Neulasta shots, laboratory tests and scans and MRIs.

    IV chemotherapy, like almost all of the other treatments for cancer, is covered under the medical benefit of your health insurance. Once a patient meets their deductible, they have a copay to pay (usually 20 percent) until their maximum out-of-pocket is met. At that point, the patient won’t have any more copays for the remainder of the year.

    Oral chemotherapy is part of a patient’s prescription drug plan. Most of these plans are complicated by categorizing prescription drugs in tiers. In general, these prescription drug plans are not very liberal. It’s not unusual for a copay amount to be 25 percent.

    Patients on Medicare soon learn how complicated reimbursement can be. Oral chemotherapy (chemo pills) are considered Tier 4 drugs and have the highest copay. Medicare patients also experience the Medicare donut. Fortunately, this gap will close in 2019. But in 2018, Medicare patients will find that after they have met the donut hole, they will still have to pay 5 percent of the cost – still a substantial amount for most retirees.
    What kind of costs are we talking about? Oral chemotherapy drugs cost thousands of dollars for just one month’s worth. And to add insult to injury, the cancer patient must pay the copay when they pick up their medicine at the pharmacy. 

    The good news is that most patients (even patients with incomes up to 4 or 5 times the Federal Poverty Level can get copay assistance from the drug manufacturer. Medicare recipients face more restrictions in receiving copay assistance from the drug manufacturer, but don’t be discouraged because copay assistance is available.

    What You Need to Know about Oral Chemotherapy

    Dana-Farber Cancer Institute reminds patients that oral chemo is just as strong as chemotherapy drugs that are infused. Oral chemo carries the same risks and benefits. 

    Here are some reminders about your oral chemo:

    Follow directions. Be sure that you understand the dosing instructions. Some oral chemo requires you to take several pills at the time. During my treatment for rectal cancer, I took Xeloda. My pills were 500 mg. each, but my total daily dose was 1,500 mg daily. My instructions were to take two pills before breakfast and three pills before dinner. It’s critical that patients take their oral chemotherapy exactly as prescribed. 

    Other instructions may include whether your oral chemo should be taken on an empty stomach or after eating. You may be advised not to eat certain foods (like grapefruit) or avoid certain vitamins, supplements or other prescription drugs. Be sure to find out what to do in case you miss a dose. 
    Store properly. Most oral chemotherapy needs to be stored at room temperature. Avoid the bathroom because of the humidity. Don’t store in a window where it’s exposed to direct sunlight. Be sure to secure safely so that your children or grandchildren might have access to these chemo pills.

     • Handling instructions. It’s safe for you to handle your chemo pills with your bare hands. Your caregiver should use latex gloves or empty into a small container – they should NEVER handle your chemo pills with their bare hands. Don’t crush or break them.

    Proper disposal. If you have any oral chemo pills left over after treatment is done, don’t flush them, put them in the garbage or put in the sink. Take them back to the pharmacy where you got them so they can properly dispose of them.

    Take at the same time every day. Be consistent. Take your pills at set times every day. Consistent dosing times assure a consistent level of the drug in your bloodstream to assure best results.

    * Side Effects. Be sure to call your oncologist if you experience new and/or worsening side effects.

    Other Considerations

    Older patients who live alone might not be good candidates for oral chemotherapy. They could forget to take a dose or take a dose twice. They might have difficulty swallowing their pills. Even mild confusion could result in life-threatening overdose.
    Studies show that young adults on oral chemotherapy may have compliance issues because they’ve never been taking medication on a regular basis.

    Nausea control is critical when patients take oral chemo. Patients who vomit shortly after taking their pills may not absorb their medicine.
    Because oral chemotherapy must be paid for in advance at the pharmacy, patients who experience financial difficulty may stop taking their medication. Distant family members should assure that refilling of prescriptions is done on a timely basis.
    Most patients appreciate the flexibility of oral chemotherapy. They miss less work or go on vacation. Many patients report that they experience a better quality of life rather than going to an infusion center on a regular basis.
    If you haven’t taken an oral chemotherapy drug yet, don’t be surprised if it’s offered to you at some time in your treatment. There are challenges, but some of the newest treatments for metastatic cancers are in oral form. Breast, colorectal and multiple myeloma patients are just a few of a growing number of patients who “just take a pill.”
    Do you have any experiences with oral chemo? Please share in the comments.
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    Today is National Cancer Survivor's Day - Celebrate it!

    National Cancer Survivors Day is celebrated on the first Sunday of June. This holiday recognizes the growing number of cancer survivors who integrate themselves back into a productive and fulfilling life. National Cancer Survivors Day serves as an inspiration to people who are currently in treatment, recognizes the importance of caregivers and reminds the community at large of the increasing number of cancer survivors.

    This is “Our Day” – a day for each of us whose lives have been touched by cancer. Whether we are newly diagnosed or are a long-term survivor of 5, 10 or 15+ years, most of us experience gratitude on this day as we realize the strides that have been made and the efforts of current researchers to turn cancer into a disease that is no longer feared.
    How Do We Define Survivor?
    In 1986, the National Coalition for Cancer Survivorship (NCCS) was founded. In those days, patients were frequently called “victims” and patients who lived five years past their diagnosis were considered “cured.” The coalition’s founders felt that patients shouldn’t be called victims nor should they be in limbo for five years waiting to be pronounced “cured.” The concept of being a survivor from the day of diagnosis onward was born. 
    Fast forward 32 years, cancer treatment and follow up is far more complex as new imaging techniques, exquisitely sensitive blood tests and liquid biopsies can detect lingering pockets of cancer. NED (No Evidence of Disease) is often used in lieu of cured. 

    We see more types of cancer where the treatment may span many years with no evidence of disease. Many oncologists that a day will come when cancer is treated like other chronic illnesses. 
    Most patients in active treatment confess that they don’t feel like survivors yet. Even in the months after treatment has ended, some of us don’t feel at ease with being called a survivor. The concept of survivorship is really a state of mind that differs from one patient to another. 
    Survivors in the United States
    The best estimate is that about 15.5 million people in the United States are cancer survivors. That’s an astonishing 4.7 percent of the total US population. Death rates continue to decline for some of the most commonly diagnosed cancers like breast, colorectal, lung and prostate cancers. Estimates expect about 20.3 million cancer survivors in 2026.

    Not only are more people living beyond their treatment, we are living longer. Unfortunately, we still have challenges including:
    • Late effects from treatment 

    • Obstacles to becoming reintegrated into the workforce 

    • Access and affordability of healthcare insurance

    • Cost of follow-up scans and tests• Medication costs

    • Physiological and emotional issues

    • Financial hardships – created by all of the above factors

    So What Next?
    WhatNexters are an incredible group of people. Despite the physical and mental challenges the diagnosis of cancer places upon us, we demonstrate strength, resilience and hope.
    As our numbers increase, more public awareness will push for more cancer survivor programs. Primary care physicians will provide care to more long-term cancer survivors. 

    Research will find ways to mitigate late effects from chemotherapy and radiation. Programs will evolve to increase the quality of life for survivors. Laws will address the needs of cancer survivors. Employers will come to realize that cancer survivors can be valuable team members, in spite of physical limitations. We may even see a new medical specialty aimed at proper care and nourishment of cancer survivors.
    Today is Our Day – National Cancer Survivors Day – a day to acknowledge that despite challenges, our lives can be rich and rewarding. We lose some friends, and we gain some wonderful new friends. We learn to live in the present and let worries about tomorrow slip away. We are braver than we ever imagined we could be. Be proud of being a cancer survivor.
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    World No Tobacco Day

    May 31 is the day that the World Health Organization (WHO) sets aside as World No Tobacco Day. For 2018, the emphasis is “Tobacco and heart disease,” focusing on the link of smoking to increased risk of cardiovascular disease. 

    But this is a good day for cancer patients and their families to consider the effects of smoking on their health if they are in active treatment for cancer or if they are the caregiver or another member of the family.

    1 out of 10 Cancer Survivors Still Smoke

    According to a study conducted by the American Cancer Society, 1 out of 10 cancer survivors still smokes nine years after diagnosis. Those who still smoke report that they smoke an average of 15 cigarettes daily (almost a full pack).
      Smoking habits vary by the type of cancer experienced. Patients who bladder, lung or ovarian cancer were most likely to continue smoking. Almost 17 percent of bladder cancer survivors still smoke, and 15 percent of lung cancer patients still smoke.
      The survivors who continued smoking were most likely to be female, have less education, earn less money and be younger. Clearly, smoking is addictive and even after a cancer diagnosis, it is extremely difficult to quit.

    If You Are in Treatment Now

    Some patients who smoke may be fatalistic, believing that it’s too late to make a difference. They may believe that the damage is already done. They may believe that it won’t make a difference.

    But…even in older cancer patients, the benefits begin just 30 days after stopping. After 30 days, one’s heart rate returns to normal. Within a year, wound healing returns to normal. If you need potentially curative surgery (say for bladder cancer or colon cancer), quitting smoking is essential to your treatment plan. 
    According to the Cleveland Clinic, smoking actually makes the patient’s treatment more difficult and less effective. 

    1. Smoking makes the side effects of chemo and radiation worse, not only during treatment but even six months later. Quitting before starting treatment erased the worsening of side effects.2. Smoking makes your treatment less effective. Chemotherapy is very hard on your body. Smoking increases the length of time that it takes to recover. Some chemotherapy drugs have the potential to cause cardiovascular events so smokers may face high risks during and after chemo infusions. It appears that smoking also affects the way a patient’s body processes chemotherapy drugs.
    3. Smoking after your treatment increases your risk of recurrence. Not only is this true for lung cancer, but it’s also true for larynx, throat and mouth cancers, kidney and bladder cancer as well as other cancers. 

    There’s Help to Quit…Lots of Help

    Be sure to download this Guide for Tobacco Users to Quit provided by the World Health Organization (WHO). It’s available in a PDF or e-book format.

      The first big obstacle in quitting is that a person must be committed to stop smoking. Your oncology team can’t “force” you to quit. Your caregiver can’t “sweet talk” you into quitting. This is a personal commitment that you, and you alone, can make. These are some reasons to quit:
    • If you currently are being treated for cancer or are a cancer survivor, quitting is about improving your outcome and your quality of life. 
    Smoking is expensive. Do the math and envision how you might spend the money you save by not smoking. Cigarette prices vary largely because of the state taxes imposed on cigarettes. The cost per pack averages from a high of $10.45 in New York to a low of $4.38 in Missouri.
     • According to the CDC (Centers for Disease Control and Prevention), smoking has decreased. But 38 million US citizens still smoke. It extracts an unseen toll on smokers. Smokers may be shunned by family members when going out to eat. Potential life partners may not want to marry a smoker. Parents may not want their children to visit the home of a smoker.
     • And, of course, there are the health risks of cardiovascular disease and cancer.

    How to Get Started – Develop a Plan

    Just because you’ve tried and failed in the past is not a sufficient reason not to try again. Follow the footsteps of successful people who have quit. Understand the reasons that you failed before. Avoid negative thinking and avoid negative people. 
    WHO suggests using the STAR plan: • Set a quit date. It might be your upcoming birthday or just the first day of the month. • Tell your family, friends and co-workers. Ask for their support. Ask for their understanding. • Anticipate challenges. It won’t be easy. Think about the challenges you face and develop a mental plan of who to overcome your withdrawal symptoms and temptations. • Remove tobacco products from your house, car and workplace. Ask your friends and family who smoke to not smoke around you. Use Pharmacological Therapies Withdrawal symptoms might be overwhelming and derail you. Don’t be afraid to ask your physician for help. Medications include nicotine gum or patches. Prescription medications such as Bupropion (Wellbutrin) or Varenicline (Chantix) may help eliminate cravings for nicotine. 

    Triggering Events

    Be aware that certain activities trigger the desire to smoke. Some of these “triggering” events include: • Drinking coffee • After a meal • Smoking in the car • Having a cocktail • Stress reliever

    Just remember – it’s never too late in your life to quit smoking. The health benefits begin the first month and last a lifetime. May 31 – World No Tobacco Day.
    Have you succeeded in stopping smoking? What tips can you offer others to quit? Please share in the comments below.
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    4 Reasons to Quit Smoking and Tips on How to Do It

    Question: How many deaths does smoking account for in the United States each year?

    Does anyone have any advice on how to quit smoking before treatment?