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    Dancing With Cancer For The 4th Time

    Every cancer patient has an elephant in the room, a hidden worry, a cloud hanging over them that only they can see. Every time we have a pain, a swollen lymph node, a bad headache, even a bad bowel movement, most of us probably think that the next diagnosis is here. 

    I have spent the last 11 years going through much of what I just described. There have probably been 50 different events that have turned out to be "nothing". I went to the ER once with excruciating stomach pain. With a history like mine with three previous cancer diagnoses, a TIA, and all of the many side effects I have they don't take chances when you roll in. So they performed almost any test you could think of including CT scans, blood test, etc. After about four hours they came to let me know that the terrible news was that I had a stomach virus. Are you kidding me? I just went through 10K worth of tests to hear a stomach virus?
    This routine has been repeated 4 or 5 times over the last few years. Once was a gallbladder that was trying to kill me. Another was high blood pressure that was trying to blow the top off of my head. But none of these events were ever the one that I have been expecting to come see me again, the recurrence, the 4th diagnosis, the damn thing is back. 
    So, I now have Hypopharyngeal Cancer. A surgery is set for sometime in January with treatment of some type to follow. We are still in the planning stages for all of the details and Donna and I are still in the stage of trying to keep our heads from spinning off. 
    The strange thing about this diagnosis is that it hasn't floored me, it hasn't made me break down and scream "why me"? It hasn't put the fear of dying in me. It hasn't had me worrying about what's going to happen, because I have been expecting it. For some reason going way back 11 years ago when I finished the treatments and recovery for stage III tonsil cancer, I have known that sometime it would be back. I just knew that based on all of the damage and side effects that I have from the radiation that saved me then, would be the thing that comes back to haunt me. 
    I've had 11 good years after my third diagnosis and have mostly enjoyed them all. I expect this fourth run with cancer to be extremely difficult like the third was, but I also feel confident that the fantastic Doctors and staff and Vanderbilt will bring me through just like they did the last time. 

    My biggest issue is the waiting. I'm an impatient person on any given day, add to that the idea that I have to wait another week to go see my Doctor, Dr. Sarah Rohde,Surgeon/ENT that performed my scope and biopsy to get her thoughts, then to see the oncology department two hours later to get their suggested plan of treatment, and a scheduled date to have the surgery some month to month and a half later. That's a long time to wait for the light that's coming down the tracks to get to you. 
    This will be a life altering event more than the previous three diagnoses have been, as hard to imagine as that is. I am going to lose my voice since the entire larynx will come out. There are a couple of reconstruction techniques that may be able to give me the ability to talk somewhat without the use of an electric larynx device. A stoma will be placed in my neck to breathe through which is a life altering surgery in itself. 
    A feeding tube will also be placed for at least a month for nutrition during recovery since I won't be able to swallow during that time. Swallowing is also a question mark. After recovery I should be able to swallow although some people never do swallow again after the surgery. I'm sure there will me a basketfull of challenges and side effects that we haven't even thought of or been told about. As it is with most cancer diagnoses, there will be a lot of things that just have to be dealt with when they pop up and we won't know what they are until they show up. 
    Since we got the news, we have had an enormous number of phone calls, texts, FB posts, wishing us well and most with a sense of amazement that I am having to do this for a fourth time. I agree, I am amazed that one person can be given this much to carry in one lifetime. Those who are of faith say that God won't give you more than you can carry. If that's the case he must think I'm the Hulk.

    But as the saying goes, "it is what it is". We can't change it or keep it from happening. It's coming down the tracks headed right for me like a train getting ready to knock me off the tracks. So I can stand still and quietly let it hit me, or I can deal with it one step at a time and make the best out of each day. I plan on doing my best side step and make it miss me when it gets here.
    One of the many positive things I have going for me is my previous 32 years experience in dealing with cancer issues. I don't think there's anything they can throw at me that I can't handle. I've seen almost anything and everything, so I'm ready for whatever is coming. 
    Another positive thing is the fantastic Vanderbilt University Medical Center, Bill Wilkerson Head and Neck Cancer Center, Vanderbilt-Ingram Cancer Center. There isn't any other place in the US I would rather be. VUMC is one of only two National Cancer Institute designated facilities in Tennessee. What that means is they receive funding from NCI to facilitate research to help develop treatments, drugs, and treatment protocols, and they are on the cutting edge of cancer treatment.
    Donna and I thank everyone that has called, sent texts, messages, smoke signals, and notes by carrier pigeons, etc. Your thoughts, well wishes and support are appreciated. We will keep you updated as we work through this next year. This is a heck of a way to start out a new year, but now I don't have to worry about deciding on a New Year's Resolution, this one's easy, SURVIVE! 
    So, while I'm not looking forward to this, and I believe that it's going to suck big time, I believe everything is going to be OK. #4 came to the party, so let's dance.

    The sign below is one I made a few weeks ago before I had the biopsy and received the diagnosis for #4, maybe my subconscious was trying to tell me something. 

    A few years ago I wrote out my cancer experience story in a book, at that time it covered things up through my 3rd diagnosis. It looks like I'm going to have to make a few edits to that book. 

    Read my complete cancer journey on WhatNext here. And if you're a cancer patient or survivor, please register and join the conversations. There are thousands on the site to connect with. 

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    Give In, Give Up, or Give It Your All

    A WhatNext member’s post prompted me to find out who proclaimed, “In life, you have three choices. Give in, give up or give it your all.” Charleston Parker, a self-taught theologian and author of One Soul, Many Faces
    , wrote this sage advice in 2013. 


    He probably didn’t have a cancer diagnosis in mind when he penned this quote, but his quote seems to check all of the boxes when we or a loved one has cancer.
    Give In
    The term, “give in,” has several different meanings. It can mean to stop arguing or fighting, yield to another’s wishes, surrender or to accept defeat admitting that there is nothing more you can do. Many of us react this way when first diagnosed.
    According to Thesaurus.com, synonyms of “give in” include cave in, capitulate, concede, give up, quit, or surrender.
    We know that feeling — being overwhelmed by such a daunting diagnosis and not knowing which way to turn. We have a “pity party” because it doesn’t seem fair. We ask, “Why me?” We think of people that we’ve known who died from their diagnosis and conclude, “It’s just not worth the effort because we’re going to die anyway.” 


    It’s normal, especially when we are first diagnosed, to want to “give in” to the enormity of our diagnosis. Fortunately, most of us settle down emotionally once we’ve gone through those stressful weeks of staging scans, biopsies and oncologist/surgeon/radiologist visits. Once we have a plan, it’s easier to dig in and commit to our treatment plan.
    Give Up
    What exactly is “giving up?” Definitions vary, but here are a few dictionary definitions: • Cease making an effort • Resign oneself to failure • To cease doing or attempting something especially as an admission of defeat • To stop trying to do something before you have finished, usually because it is too difficult

    Side effects from treatment or complications after surgery may tempt you to give up. Fatigue, pain or frustration over slow progress can color our decision making and tempt us not to stay the course. 



    If you find yourself feeling like you want to give up, talk to trusted family members and your medical team so that you’ll make wise decisions that aren’t distorted by a temporary situation. A different nausea medicine, better pain control or a break from chemo give many patients the opportunity to regain their spirits and their strength to continue.
    Don’t confuse “giving up” with a patient and their medical team making the decision to discontinue treatment. If a patient’s cancer continues to progress despite utilizing all available treatments, stopping treatment may be in the best interest of the patient and their family.

    Give It Your All
    To “give it your all” means that you fully embrace your treatment plan … that you try as hard as you can and give your medical team your full cooperation as they work to get you into a durable remission. Some physicians still use the word “cure” while others prefer NED (No Evidence of Disease).
    What are some of the things that you’ll do when you “give it your all?”


    • Accept your diagnosis. We can “give it our all” until we accept our diagnosis. None of us asked for cancer. While it’s reasonable to experience anger and denial when we are first diagnosed, it is counterproductive to harbor negative feelings over the long haul. It’s okay to grieve and to feel afraid about how cancer may affect your life. However, we can’t change our diagnosis so accepting cancer is the healthiest response to diagnosis. Then we can say, “What Next?” • Get an excellent medical team. With cancer, your doctor’s experience is of paramount importance. Their expertise with your particular kind of cancer may make the difference between life and death. Consider a second opinion to ensure that you’re comfortable with your treatment plan. • Educate yourself. Be sure to use trusted sources to learn about your particular kind of cancer. Trusted sources include the American Cancer Society, the National Comprehensive Cancer Network, the American Society of Clinical Oncology and well-respected cancer treatment centers like Mayo, MD Anderson, and Memorial Sloan Kettering. There are lots of “fake” cures that you might see online — shun them like the plague. Ask your doctor questions if you don’t understand. The more you know the basics of your treatment, the more comfortable and optimistic you’ll be. • Understand your insurance and its financial implications. Cancer treatment is expensive. Most treatment centers have an insurance coordinator who will help you understand your insurance coverage and estimates of your copays for treatment. Ask about copay assistance — don’t be embarrassed. Financial aid is usually available for patients whose family income is up to 400 percent of the Federal Poverty Level. For example, a couple whose family income is up to $67,640 can usually qualify for some type of financial help. A family of four whose total income is up to $103,000 may be eligible for financial assistance. Patients may not be able to continue working during treatment so be proactive to learn about the costs associated with your treatment. • Don’t borrow trouble. Worrying about what might happen tomorrow, next week or next month robs you of the joy that today might bring. “What ifs” can fill our minds with so much anxiety that we have heart palpitations and elevated blood pressure. Our oncology team is dedicated to caring for us — I realized during my active treatment that if they weren’t worried about a particular lab or scan result, then I shouldn’t be worried either. Do your best to live one day at a time and be happy for the tiniest good news or special happening. • Cultivate a positive attitude. Cultivate means acquire or develop. So while we acknowledge that cancer is a serious diagnosis, we can cultivate a positive attitude. We can learn to appreciate the small gifts of daily life – that first sip of morning coffee, that it’s not raining or snowing on chemo day or that the anti-nausea medicate does work. An attitude of gratitude truly helps every day of your cancer treatment be a better day.



    Over 4,750 people daily are diagnosed with cancer in the United States. You are not alone. All of us at WhatNext.com are here to help and support you. Give it your all.
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    Cancer has, for a long time, been a pandemic among humans. What most people don't know is that a considerable number of cancer patients often end up with dental health problems before, during, and after treatment. Cancer is a severe and fatal disease, and people often ignore anything minor to focus on their cancer treatment plan. It is, however, not a good idea to let your dental health get worse since this may lead to more complications. In such a scenario, the complications may end up interfering with the treatment.

    That is why dentists always advise cancer patients to mind their dental health if they want to have smooth cancer treatment without any complications.
    If you have no idea about the relationship between cancer and your dental health, worry not. Below is a detailed list of five ways through which cancer can affect your dental health. The information also contains some of the best ways to prevent or treat the various problems that may arise. All you have to do is make sure you consult your doctor so that he or she may help you prevent and keep them from interfering with your cancer treatment.
    Mouth sores
    One of the main effects that you are likely to experience once you begin cancer treatment is mouth sores. The problem can either be mild or severe, depending on your body's reception to the procedure. If you are unlucky, the lesions can be worse, rendering you to stop your cancer treatment as the doctors find a way to deal with the problem. Cancer-related mouth sores tend to form on the lining inside your mouth. The sores may end up causing eating and breathing problems if you don't take caution. Sometimes the wounds extend to your esophagus, making it hard for you to swallow any food or even saliva. At this stage, you might not be even able to talk, and the doctor may end up discontinuing your cancer treatment.
    So, what causes these mouth sores? The sores can happen by either radiotherapy or chemotherapy, which are the two leading cancer treatments. It may be one of the procedures or both depending on your body's response to the treatments. Both radiotherapy and chemotherapy are supposed to kill the fast-growing cancer cells, but sometimes they may end up damaging the cells in your mouth lining. Doing so leads to sores forming in your mouth and once that meets your weak immune system, it may spread to other parts of the mouth as well. The dental doctor will have to treat or minimize the sores before you can continue with your cancer treatment.
    Dry mouth
    Most cancer patients start experiencing dry mouth soon after they begin their cancer treatment. The leading cause of the problem is radiotherapy and chemotherapy, especially if they perform the procedure on the head, including neck and face. The treatment can end up damaging your salivary glands, thus leading to several problems such as sticky saliva or thick saliva and at times, a parched mouth. It may take you some time for your salivary glands to start producing saliva. While some find relief from the condition after six months, others may go up to a year. It is one of the common effects of cancer to your mouth that you can prevent.

    As soon as you start experiencing this problem, you have to consult your doctor. He or she is going to initiate palliative care, which is usually part of the cancer treatment. You are going to take certain medicines such as amifostine. The medication tends to be effective when it comes to lessening the side effects of cancer. You can also get saliva substitutes to help you handle the problems that come with dry mouth. Some patients chew sugarless gums, which act as saliva stimulants. Doing so helps your salivary glands to regain their function, and this may end up preventing dry mouth. You can also manage dry mouth by performing dental floss at least once a day, drinking water sips from time to time and use artificial saliva to soften your mouth. These can also help you to relieve the effects of dry mouth.
    Tooth decay
    Another way that cancer can affect your mouth and dental health is by causing tooth decay. Most people who end up with this problem usually don’t inform their doctors as soon as they started having dry mouths. Why? Cancer patients who exhibit tooth decay first start by having a dry mouth. If this problem is not taken care of or managed by the patient, tooth decay occurs. Dry mouth leads to a lack of saliva, which is very important in keeping food remains from your teeth. The longer the food remains on the tooth, the more bacterias form. It then leads to tooth decay, which causes tooth cavities in the long run.
    There is, however, a way you can prevent tooth decay even with a dry mouth. To do so, you need to start brushing your teeth after every meal. Maintaining this routine is going to prevent any plaque or food from remaining on your teeth long enough to cause any decay. You should also drink plenty of water and make a habit of swirling it around your mouth before spitting or swallowing. Try and chew sugarless gum to stimulate your saliva glands. You can also see the doctor so that he or she can examine your dental condition. The doctor will recommend the best ways or medicines that can help you avoid tooth decay during your radiotherapy or chemotherapy. It is among the many ways on how cancer affects your dental health. So always be on the lookout to avoid such an issue.
    In some cases where an extensive dental procedure is required, the dentist might put you on IV sedation, which is entirely safe.
    Tooth sensitivity
    There are so many things that can lead to tooth sensitivity, and one of them is cancer treatment. By now, you should be aware that radioactive rays can be quite destructive, especially when you are undergoing radioactive therapy on the face and neck. Harmful radiations can penetrate your gums and cause sensitive teeth. The rays can also cause tooth decay which can lead to cavities. Once the holes go deeper and reach the nerves, you will start experiencing tooth sensitivity. Most times, tooth sensitivity worsens whenever the affected tooth or teeth encounter cold or warm foods. These end up triggering the nerve endings, which send a signal to the brain, causing pain.
    The good news is that you can prevent your tooth cavity from extending further by brushing your teeth after every meal and rinsing your mouth more often. You can also communicate with your doctor and see if he or she recommends removing the affected teeth. That, however, happens if you take too long to inform the doctor, thus giving the teeth more time to decay. If you notify your doctor before you commence with your cancer treatment, he or she may come up with a preventative measure. That includes giving you a gel that slips between your teeth, making them strong, thus preventing cavities and exposure of your nerves.

    Osteoradionecrosis

    Osteoradionecrosis is also called the death of the bone. It is a rare dental health problem but very easy to end up with, especially if you don't inform your doctor of the dental procures you have done. For instance, if you have undergone tooth or teeth extraction or any other dental procedure that involves the jaw bone, you are likely to experience Osteoradionecrosis. The radioactive rays can end up damaging the blood vessels around the bone, causing it to die. The dental problem often occurs after the completion of your cancer treatment. It is prevalent in the lower bone since the jaw tends to have fewer blood vessels.
    To know if you have contracted the mouth problem, look out for symptoms such as swelling, pain, ulcers in the jaw, infection, and sometimes an exposed bone inside the mouth. To prevent Osteoradionecrosis, your doctor has to examine your teeth and see if there is a risk of getting the dental problem. In case you have a tooth that requires removal, you should do so before you start your cancer treatment. You should also have regular gum examinations to ensure that everything is fine. The doctor may recommend you to switch your diet; for instance, he or she may want you to avoid sugary foods. By doing so, you are going to prevent Osteoradionecrosis during and after your cancer therapy.

    Those are so far the five most common ways cancer affects your dental health. Each of the above ways can develop into something much worse if you don't take proper steps during cancer treatment. You should thus liaison with your doctor so that you know how best to prevent the problem or keep it from worsening. In case you require any dental surgery, make sure you do it before cancer treatment. That way, you don’t risk to get Osteoradionecrosis, which is quite a severe dental problem. 
    Related Articles

    Dental care of cancer patients before, during and after treatment

    Mouth sores caused by cancer treatment: How to cope

    Cancer: Taking Care of Your Teeth Before Treatment

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    Author Bio Derek Edison is a blogger and writer, a generalist who likes to share information he has gathered in various fields over the years in an engaging manner.

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    Practical Tips For Caregivers

    Most of us are not prepared for the responsibilities that we assume when a loved one is diagnosed with cancer. We instantly become a “CAREGIVER” — we don’t have any experience for role we are about to assume.

    Just remember that every patient’s reactions to treatment are different — it helps to be flexible and adjust your routine as different needs arise. Never refuse an offer for help. Cancer treatment can take a long time. Accepting help from others will help prevent caretaker burnout.
    Many of the tasks that we perform as caregivers are physical so let’s look at practical ways to help your loved one.
    Personal hygiene. Daily hygiene is an integral part of taking care of someone who is physically sick. They may not feel like bathing or showering, but good hygiene helps your loved one feel better and protects their skin.
    • Respect their desire for privacy while assuring them that you love them and want to help. • Keep bath or shower water at a comfortable temperature. • Make sure that the bathroom is warm enough. An oil radiator
    is an affordable and safe option to use in the bathroom. • Use a mild soap and moisturize dry skin. • Be gentle on the scalp – patients who are losing their hair from treatment have sensitive scalps.


    Grooming. Grooming is that little extra step beyond personal hygiene. Helping your loved one feel good about themselves and their appearance goes a long way in maintaining their self-esteem.
    • Use sunscreen whenever they are going outside. Both chemo and radiation treatments make a patient more sensitive to the sun. • Trim fingernails and toenails. If your loved one has diabetes, it’s wise to have a podiatrist trim your loved one’s toenails and check for potential foot problems from their diabetes. • Offer to paint your loved one’s fingernails or toenails. Avoid public salons due to risk of infections. Cuticles are likely to be dry — daily use of a good-quality cuticle cream or oil helps prevent broken skin. • Encourage your loved one to use a moisturizing hand lotion like Curel or Jergens. • Use an electric razor or a Gillette Treo
    , the first razor made specifically to shave someone else. • Comfy clothes are a must. Cottons are often more comfortable than polyester blends for sensitive skin. Cancer patients are sensitive to the cold — some chemo drugs make cold sensitivity worse. Be sure your loved one has warm gloves, a comfortable knit hat, and a couple of fleece jackets and pants. Don’t forget warm socks. • If you loved one has lost or gained weight, make sure that they have clothes that fit and are comfortable. Make sure that their pants or jeans fit well. • Offer to help with their makeup. Nothing perks up a woman’s feelings more than some lipstick. • Provide lip moisturizer, like ChapStick® or Burt’s Bee lip balm
    .


    Mouth hygiene. Chemotherapy or radiation may cause mouth and dental problems for your loved one. Be sure to listen to any mouth complaints that they express.


    • Mouth sore and infections are common so remind your loved one to brush their teeth after eating. • Switch to a soft-bristle toothbrush to avoid bleeding gums. • Use an alcohol-free mouthwash or use baking soda and water as a mouthwash. • If your loved one develops mouth sores, call the oncologist — they can prescribe a special mouthwash to help the mouth sores heal. These mouth sores are painful and can affect your loved one’s ability to eat.

    Eat, food and appetite. Fatigue and nausea may decrease your loved one’s appetite. As the caregiver, not only do you have to cook and provide meals for your loved one, you also have to coddle and cajole your loved one to eat enough to avoid weight and muscle loss.


    • Ask the oncologist if there are specific foods that your loved one shouldn’t eat. • Remember that a patient’s taste buds change during treatment. Our favorite foods might not be our favorites any more. • Your loved one may have their best appetite earlier in the day before they get tired. Breakfast or brunch might be their biggest meal — try to accommodate by determining when they feel most hungry. • Offer small meals more often. Many patients learn that they can eat smaller amounts more frequently. Try a grilled cheese sandwich using only one slice of bread but with the same amount of cheese. • Have some liquid meal replacements on hand. Served cold and blended with some ice cream might work for your finicky eater. • Serve whole dairy products. Usually, they are easy to digest and contain easily-digestible dairy fats. Sprinkle cheese on top of veggies. Use butter, sour cream and cheese on a small baked potato. Greek and Icelandic yogurt are high in protein — cancer patients need more protein to help rebuild muscles. • Use beef or chicken bone broth in soups and gravies. Bone broth has 10 grams of protein in a one-cup serving. It’s much tastier than canned broth. And it helps with gut health. • Practice food safety — many cancer patients have lower white blood cell counts causing them to be more prone to infections. Wash fruits and vegetables. Always buy pasteurized milk and juice products.

    Don’t forget social activities. Never forget that we, as cancer patients, are still the same person. We can still laugh and enjoy our favorite activities. We might not feel “great” every day, yet we are still the same person that you have loved. But we are carrying the emotional and physical burden of a serious, life-threatening disease. It might cause us some depression. We might get angry sometimes because we are so frustrated because we don’t have any control over our circumstances. But we still want to be included in activities whenever our energy levels permit us to do special things.


    • When the weather is beautiful, go for walks together. • Go out for coffee or an ice cream sundae. • If your loved one enjoys reading, consider investing in a Kindle
    and link it to your Amazon account so that your loved one can download books that they would enjoy reading. • Ask a relative to host family dinners and get-togethers so that your Mom, your sister, your daughter doesn’t feel the pressure to host an event. Make that famous dish together and take it so they will still feel included and part of the family. • Invite your loved one’s friends over for a buffet lunch or afternoon coffee and dessert — don’t surprise your loved one. Plan a little event together.




    Final tips. Don’t forget to take care of yourself. Caregiving in addition to a full-time job takes lots of energy. Get enough sleep, exercise and eat healthy so you’ll be able to continue your caregiver role. Take a break when you feel overwhelmed.
    The Bottom Line …
    Most caregivers agree that although caregiving is a 24/7 job that being a caregiver is one of the most rewarding things that they ever did.
    Here is a great video series for caregivers from the American Cancer Society. They cover a lot of the common issues caregivers will face while taking care of a cancer patient. 
    If you are a caregiver click the photo below to join WhatNext. There are lots of caregivers registered that can help you along by answering your questions and sharing their own personal experiences with caring for a cancer patient. 

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    Pancreatic Cancer Awareness Month - Nov. 21 Is World Pancreatic Awareness Day

    November is Pancreatic Cancer Awareness Month. Pancreatic cancer is the third leading cause of cancer-related deaths in the United States — surpassing breast cancer — and is expected to surpass colon cancer deaths in 2020. Cancer deaths for other kinds of cancer are decreasing. 

    Unfortunately, death rates are increasing for pancreatic cancer; in fact, survival rates are virtually unchanged in the last 40 years.
    Why? What can be done? Let’s learn more about why pancreatic cancer is so deadly.
    Statistics
    An estimated 56,770 people in the U.S. will be diagnosed with pancreatic cancer this year — more than 150 per day face this devastating diagnosis.
    The disease affects slightly more men than women. Pancreatic cancer cases are about 25 percent more common among African-Americans than Caucasians.
    While statistics refer to the general population and not to any particular individual, statistics are rather grim for pancreatic cancer. Pancreatic cancer is often called a “silent killer” because it doesn’t cause many early symptoms. So it’s diagnosed later than other kinds of cancer — over half of patients are diagnosed after their pancreatic cancer has spread to distant parts of their body.
    To date, there is no effective screening test for pancreatic cancer.


    What is pancreatic cancer?
    The pancreas is a gland that aids in digestion and regulates our blood sugar levels. Our pancreas is surrounded by our gallbladder, liver, small intestine, spleen and stomach. It’s rather small — about six inches long but only two inches in diameter.
    Cells in our pancreas can begin to grow out of control and develop into a cancerous tumor. The tumor can occur in the exocrine part of the pancreas, the part that makes digestive juices to help our body digest our food in the colon. A tumor can also occur in the endocrine portion of the pancreas where insulin and other hormones are produced.
    Most pancreatic cancers are the kind that forms in the exocrine part of the pancreas. These tumors occur in the ducts of the pancreas.
    What are the symptoms?
    Some of the symptoms are somewhat vague and are similar to symptoms for an ulcer or pancreatitis. Symptoms include:
    • Jaundice (yellowing of the eyes and/or skin) • Darker colored urine (often brown, even the color of coffee) • Lighter colored stools that may be greasy (may float in the toilet) • Itchy skin • Pain in the upper abdomen or back • Burning feeling in the stomach • Bloating • Loss of appetite and weight loss • Nausea and vomiting • Chills and/or fever • Recent-onset diabetes diagnosis

    If you or a loved one experiences these symptoms for 10 days-to-two weeks, be sure to talk to your doctor. Unfortunately, some of these symptoms don’t occur until pancreatic cancer has spread to the surrounding organs or even, distant organs. Over 50 percent of patients are 
    Stage IV at diagnosis.
    Early diagnosis is critical to treatment success. If you or a loved one has risk factors for pancreatic cancer, be attentive to any of these symptoms and talk to your doctor about the possibility of pancreatic cancer. Updated studies show that individuals with BRCA1 or BRCA2 mutations are at increased risk for pancreatic cancer.
    Stages of Pancreatic Cancer
    Usually, pancreatic cancer is staged by whether it can be removed by surgery or not.
    • Resectable. Between 10 and 15 percent of patients have cancer that can be readily removed with surgery. The tumor can be confined to the pancreas, or it may have spread to the surrounding area but has not invaded any important arteries or veins. • Borderline resectable. Some tumors are difficult to remove when a patient is first diagnosed. However, with chemo and/or radiation, the tumor may shrink enough for surgery. • Locally advanced. These tumors are still located in the area surrounding the pancreas, but it has invaded or grown close to critical arteries, veins or other organs so that surgery is not an option. About 35-to-40 percent of patients are diagnosed at this point. • Metastatic. Cancer has spread to other organs, including the liver, lungs or distant parts of the abdomen. About half of all pancreatic patients have metastatic disease at diagnosis.


    How is pancreatic cancer treated?
    Every patient is different. Some patients may only need surgery while others may have chemotherapy, radiation and surgery.
    • Surgery. Surgery is the ideal treatment for early-stage pancreatic cancer. Sometimes only part of the pancreas needs to be removed; other times, the entire pancreas is removed. The spleen, gallbladder and parts of the stomach or small intestine may also be removed, depending on where the tumor has spread. • Radiation. Traditional external beam radiation is sometimes used. SBRT radiation (also called the CyberKnife) may be the radiation of choice. Proton therapy is the newest type of radiation and may also be used for pancreatic cancer. A lower dose of chemotherapy may also be given along with the radiation to enhance the effect of the radiation. • Medications. First-line chemotherapy is usually the first choice of treatment for locally advanced or metastatic pancreatic cancer. Targeted therapy can help patients with particular genetic mutations. The immunotherapy drug, Keytruda, is used for patients who are MSI-high.

    New treatment guidelines for 2019 have been updated in the NCCN’s treatment guidelines for patients.
    Clinical Trials
    According to the Pancreatic Cancer Action Network (PanCAN), pancreatic patients who enroll in a clinical trial at diagnosis have better outcomes. PanCAN offers Patient Services which include helping newly diagnosed patients and those already in treatment help to find a clinical trial that may benefit the patient. Request their free educational packet to learn more about your diagnosis and the options for treatment that you may have.
    PanCAN offers free consultations through its Patient Central program. When you or a family member calls, a well-train, compassionate Patient Central Associate will help you find the services you need.
    World Pancreatic Cancer Day
    November 21, 2019 is a worldwide day for the acknowledgement of pancreatic cancer. Our beloved Alex Trebek has stepped up to the plate and make a PSA (Public Service Announcement) about the risk facts and symptoms of pancreatic cancer. He’s one of us — he is fighting for his life, yet he’s reaching out to help others avoid his experience of being diagnosed at an advanced stage of pancreatic cancer. Let’s all wear purple on November 21st in honor and memory of all those who have experienced pancreatic cancer.
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    Ringing The Bell

    Did you ring the bell after you finished chemotherapy or radiation? Or was your cancer center one of those who doesn’t provide a bell to ring at the end of treatment? Perhaps you are one of those who never even knew about “ringing the bell.”


    How did the tradition begin of ringing the bell?
    Tradition has it that “ringing the bell” began in 1996 at MD Anderson in Houston, TX. Rear Admiral and former Navy Seal, Irve Le Moyne, a head and neck cancer patient, wrote a poem and installed a brass bell at the radiation center. The poem says what many of us feel.
    Ring this bell Three times well, Its toll to clearly say My treatment’s done, This course is run, And I’m on my way.

    And so the tradition began that when patients completed their rounds of radiation and/or chemotherapy that they would ring the bell three times and recite the poem to signify that they had completed their treatment.
    At Sanford Cancer Center, a second poem (author unknown) is beside the “Ring the Bell” poem. It reads:
    I ring this bell for myself and every other cancer patients that has, or is, or will walk the journey that a cancer diagnosis brings.

    I ring this bell for my caregivers, family, friends, and perfect strangers who have given time, talents, prayer and encouragement on my behalf.

    I ring this bell for each employee that works within these walls … thank you for the compassionate care you choose to give each day.

    My praise and thanksgiving is for each of you and to God, the giver of your life and mine. I ring this bell, I ring this bell, I ring this bell for you!



    Why don’t all cancer treatment centers have a bell?
    The decision to have or not have a bell varies from cancer center to cancer center. Some centers believe that out of respect for patients who are terminal that they will not have a bell. They realize that for these patients, it is cruel and insensitive for these incurable patients to have to witness these joyous bell ringing ceremonies over and over again.
    Some terminally ill cancer patients have chemotherapy or radiation for palliative
    reasons — to shrink a tumor that is pressing on a nerve. Others with metastatic cancer are on chemo for life. New treatments are offering new hope for extended lives, but they must continue to have treatments (either oral or by infusion or both) for life. Immuno-oncology drugs provide cures for some and extended life for others. For those who remain in treatment, it must be poignant to watch celebratory bell ringing.
    The infusion center where I received treatment did not have bell. They had a sign that proclaimed “Last Chemo”
    that a patient could hold while the activities director took a picture of a patient who wanted that memento. The staff didn’t make a big fuss over a patient, and many patients slept right through others’ brief, celebratory moments. My radiation center didn’t have a bell either — instead they “awarded” each patient a certificate of graduation.


    Reasons why many centers still offer “ringing the bell”
    The location of the bell varies, from being in the infusion room to being in the hall to being in the lobby. Some centers place the bell on the outside of their building at the entrance. There are many reasons that a patient might want to ring the bell; these reasons are the reasons that many cancer treatment centers offer the bell.
    Provides hope. For those just beginning treatment, hearing a patient ring the bell offers hope and strength that they will complete their treatment and be able to ring that bell too. Hope is powerful for those just beginning treatment.
    Celebrate other noteworthy events. Some patients celebrate good scan results or improving blood counts by ringing the bell. Some patients even celebrate their birthday while having chemo by ringing the bell.
    Feeling of accomplishment. Ringing the bell is meaningful to many patients because ringing the bell provides a feeling of accomplishment. Patients feel they did what “they had to do.” Others proclaim that “they endured” their 30 days of radiation treatment. For them, it is a proud moment.
    Other ways to celebrate the end of radiation therapy or chemotherapy


    Ringing the bell is a common event in cancer clinics throughout the U.S. and Canada. Large bells are mounted on the walls of the center – sometimes, bells are donated in memory of a loved one. Sometimes, a gong is substituted for a bell. Patients might be by themselves or family members may accompany them to celebrate the end of treatment.
    Other patients might choose to acknowledge the end of their active treatment in different ways. Their family might host a family dinner to help mark the end of treatments for their family member. Some patients might decide to burn their old sweats that they wore to chemo. Other patients may get a brand new “super short” hair cut to help cope with their thinning hair. Another patient might host a party for the friends who helped them during treatment. Some patients might send token gifts to their chemo or radiation nurses to celebrate the support that these staff members provided. Other patients might celebrate with a bucket list trip afterward.
    Ways to Celebrate The End of Cancer Treatment

    Many patients are worn out by a long and harsh treatment and aren’t in a celebratory mood. Others wonder if their treatments worked. Others aren’t comfortable when their oncologist brightly tells them, “I’ll see you in three months.” The transition to being a survivor is difficult for many. Some of us feel comforted by the frequent appointments and regular lab work to ensure that we are still okay.
    I can remember a lady at our cancer center who dressed up for her last chemo— all in pink, even a pink feather boa around her neck and a tiara on her head. She was so happy to be finished, and her smile reflected her joy.
    No matter how we mark our last treatment, it’s a day that we will never forget.
    There’s no right or wrong way to mark the end of cancer treatment. Cancer patients face a myriad of emotions — from gratitude and joy to feeling a little bit lost and wondering about the future — that’s part of the reason that our website is named WhatNext.
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