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    Did you know that some types of cancer can be prevented with a vaccination?

    Yes, it’s true — but not everyone realizes that most cancers caused by HPV (Human papillomavirus) can be prevented by vaccination. August is HPV Awareness Month, and this month is the perfect time to learn more about HPV-caused cancers, and why it’s so important for our children and grandchildren to be vaccinated.
    What is HPV?
    HPV is the human papillomavirus — this virus is the most widespread sexually-transmitted infection in the world. There are more than 150 varieties of HPV, with most of them not creating symptoms or serious health problems. In other words, HPV is mostly a silent infection. The “common” wart is caused by HPV. Most types of HPV cause warts. However, about 40 types of HPV cause genital warts. These types of HPV infections are spread through sexual contact, both genital and oral.
    HPV is so widespread that almost every person who has ever been sexually active will have been exposed to HPV. So that’s virtually all of us. Studies show that by 2010, only 5% of women were virgins when they got married. An NBC study revealed that boys lose their virginity at an average age of 16.9 years, while girls lose their virginity at an average age of 17.4 years.
    For our society to make progress in preventing HPV-caused cancers, we have to be realistic and face the fact that most humans are sexually active. We, as a species, are driven to procreate; sex is a biological drive.
    What are the HPV-caused cancers?
    HPV viruses are considered either low-risk or high-risk. The high-risk ones are those that cause cancer — one of the disturbing facts about HPV-caused cancer is that these cancers occur years or even decades after a person’s first exposure to the HPV virus.

    According to the CDC, about 44,000 cancers annually are caused by the HPV virus. About 25,000 HPV cancers occur in women (cervical being the most common), and about 19,000 occur in men, with oropharyngeal cancers (cancers in the back of the throat, including the base of the tongue and the tonsils) being the frequent HPV-caused cancer in men.
    Cervical cancer. Almost all (about 90%) of cervical cancer is caused by HPV. About 70% of cervical cancer is caused by two types of HPV — HPV-16 or HPV-18. Almost 14,000 women are diagnosed with cervical cancer annually in the U.S. • Oral cancer. HPV infections can cause cancer in the mouth, the tongue, and the middle part of the throat (from the tonsils to the tip of the voice box). About 53,260 adults (38,330 men and 14,880 women) will be diagnosed with oral and oropharyngeal cancers this year. About 70% of these cancers are believed to be HPV-caused. • Anal cancer. Anal cancer is relatively rare, with just under 9,000 (about 2,700 men and 5,900 women) cases diagnosed annually. Over 90% of these cases are HPV-related. • Vulvar cancer. Vulvar cancer is another rare cancer, only accounting for about 1% of cancers in women. About 6,000 women are diagnosed annually. The HPV virus causes about 70% of these cancers. • Vaginal cancer. Just over 6,200 women are diagnosed with cancer of the vagina annually. About 70% of these uncommon cancers are caused by HPV. • Penile cancer. Penile cancer is rare — only about 2,000 cases occur annually in the U.S. Although it’s not a particularly deadly cancer (about 440 deaths a year), it takes both a physical and emotional toll. About 60% of penile cancers are HPV-related.
    The HPV vaccine, if given to every child growing up in the United States, could prevent thousands of cancer diagnoses and deaths. Yet, there is stigma and misunderstanding about the vaccine.
    The HPV Vaccine
    Papillomavirus is only able to live on certain cells of the human body called squamous epithelial cells — these are cells found on our skin’s surface and on moist surfaces, called mucosal surfaces. This viruses’ attraction to these particular cells explains why the HPV causes warts on our skin and leads to squamous cell carcinoma on particular moist surfaces of the body.
    There are many types of HPV — about 75% of them cause harmless warts — but the other 25% of them are the mucosal type, and these cause cancer.
    As of 2020, Gardasil 9 is the only approved HPV vaccine in the U.S. This particular vaccine not only protects against HPV-16 and HPV-18, the two strains that cause the most cervical cancers, but it also protects against types 6 and 11 and five other high-risk types (31, 33, 45, 52 and 58). Gardasil 9 provides the most protection against HPV-caused cancers.
    Updated Vaccination Recommendations from the American Cancer Society

    The American Cancer Society has updated its guidelines and recommendations for the use of the HPV vaccine, recommending that children 9 to 12 to get the vaccine to help prevent multiple types of cancer.

    The American Cancer Society recommends that boys and girls get the HPV vaccine between the ages of 9 and 12. Teens and young adults through age 26 who are not already vaccinated should get the HPV vaccine as soon as possible.

    “Teens who start the series late may need three shots instead of two,” said the American Cancer Society in their updated guidelines.

    The CDC recommends the HPV vaccine given between ages 11 and 12, and the CDC also recommends “catch up” vaccinations for young adults up to age 26 who were not vaccinated as a pre-teen.

    Why has the American Cancer Society recently updated its recommendation to give the HPV vaccine at an earlier age? Research shows that younger people experience an improved immune response compared to people in their twenties who take the vaccine. Additionally, the vaccine only works if given before exposure to the HPV virus. By giving the vaccine early, parents are assured that their child will develop a robust immune response. At the ages of 9-12, children are still regularly seeing their pediatricians and can get this set of vaccinations at the appropriate timing.
    The Bottom Line
    HPV-caused cancer is real. It develops years after exposure to HPV. HPV infections don’t always cause symptoms, so adults don’t know if they are at risk for these cancers. Do your family a favor. Speak up and help educate your family about the HPV vaccine. The life that you save might be the life of your child, grandchild, or niece or nephew.
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    Tips Learned During a 3 Year Journey With Breast Cancer

    Today's blog post is from Alyce Stewart, (Omalayce) at WhatNext.com. She shares her experiences with a 3 year run with breast cancer.  This is her story along with a list of Tips to help you get through your diagnosis.

    My name is Alyce Stewart and I am going to be 72 in August.
    In August of 2016 I told my GP that I had a strange pain in my armpit and going down the left side of my breast. I'd had it for several years and my masseuse and chiropractor could not relieve me of this pain, honestly I thought I had pulled a muscle. My GYN said everything was fine and advised me to put Primrose oil there and buy better bras.
    When I told my GP, he instructed me to make an appointment with my GYN even though I had a mammogram that January of 2016. My GYN was not available but her PA saw me. She examined me and said she thought it was rib pain but ordered a mammogram and a ultrasound for the same day.
    The day of the mammogram, 23 September 2016, I was told that it looked good so then I went for the ultrasound down the hall. The tech I had was beyond excellent, she listened to everything I said and targeted those areas. She finished and told me to get dressed which I was in the process of doing when she ran in the room and said the radiologist wanted more photos. I left there pretty sure my life was about to be rocked.
    The following week on 30 September 2016 I saw my surgeon who did his own ultrasound. He told me he was sure it was cancer and it would be a stage 2 or 3. Since I had a vacation out of state to see my son and his family I did not have my biopsy until 12 October 2016. This confirmed the cancer and was followed by several weeks of tests, port insertion, meeting with the oncologist and my treatment plan.
    I was diagnosed with IDC in my left axilla and DCIS in my left breast on 19 October 2016 as a stage 2 or 3B - it was 3B. My first chemo therapy was on 8 November 2016 and my last was on 14 February 2017. I had a lumpectomy on 6 April 2017 followed by 30 rounds of radiation from 19 June 2017- 5 July 2017.
    I had no issues at my first chemo, felt great and then 2 days later, wham, I was so fatigued I could hardly move. When I saw the oncologist they sent me immediately for fluids as my counts were so low. After that I would have chemo on Tuesdays, followed by fluids Thursday and Friday. I did this until I finished chemo in February. I had issues eating and drinking, wound up with a sore mouth and extreme fatigue throughout but I wasn't sick to my stomach which I was grateful for. I did lose all of my hair, and 8 fingernails, I didn't mind, I was just curious as to what my hair would be like when it grew back. I thought I looked great until the day I walked out after struggling through the grocery store and two ladies in a car rolled down their window and yelled out that they would be praying for me....wow I had no idea.

    I learned I am resilient and that I loved sharing to educate and make others aware. It was determined I have dense breasts which is why the mammograms didn't show any thing. I have made it my "mission" to share this. I also was probably annoyingly cheerful at my cancer center. I would talk to everyone and smile and be upbeat. I knew others were far sicker that I was and many were struggling so I smiled and told patients that I was a talker and if they wanted to sleep they should probably not sit next to me. What you find out doing that is that many people want to talk they just don't want to burden their family and friends.
    My family do not live close by but I knew they were very supportive of me as were my friends. My husband was awesome. He has a quick wit and great sense of humor. I especially like relating to others about the time he came home from work and I told him to feel my head as you could feel the hair starting to grow. He did, and without skipping a beat he said, oh, I have my own little Chia pet. We used humor throughout and still do.
    My friends checked in on me and my next door neighbor somehow managed to come out every time I took the dogs out in our large backyard. It was so sweet having her make sure I was doing well and didn't need anything.
    I am still in maintenance because even though I had chemo before my surgery and my pet scan said I was cancer free, I was not. The surgeon couldn't remove all the cancer along my chest wall and 4 out of 9 nodes he removed were still cancerous. So I am considered No Evidence of Disease, NED, and a higher risk. I am on medication due to being ER and PR hormone positive which due to my age the doctors said I may be on this for the rest of my life..
    I had kidney cancer 27 years ago and have had 7 major surgeries over the years so, I just add this to the list and am glad I am still here. I enjoy life. Whatever lies ahead I will handle and I hope I will do it gracefully and with a smile. Writing has become one of my favorite things to do along with taking photographs. Writing soothes me and allows me to leave a written word for my children, their families and those to come. I am at an age where I want to make and leave memories and hope others can learn from some of my experiences and just enjoy others.

    Some Tips I've learned During My Cancer Journey…by Alyce Stewart
    1. Remember all patients/survivors react differently to the treatments. Someone else's story will not necessarily be yours. 2. Use super soft toothbrush during chemotherapy. Oral B has a good one or use a child’s. 3. Mild soaps and creams without perfumes etc. 4. Use a straw to drink from. Drink a lot of water. 5. Neuropathy can develop from chemotherapy drugs. Tell doctor if you start to feel numbness and or tingling. 6. With many types of chemotherapy your hair will fall out after the 1st or 2nd treatment. 7. Nails may fall off with some chemotherapy. The nails will actually peel to a point where a new nail is starting to grow. 8. Use plastic utensils to eat with. The plastic helps with the metallic taste that can develop. 9. Use Biotin Mouthwash for dry mouth. Ask for Magic Mouthwash from doctor if you develop sores in your mouth. 10. Use an electric razor. 11. When your hair falls out ALL your hair is affected. Your nose hairs will fall out resulting in a constant nasal drip. 12. Your appetite might change. You may think you're hungry but after a few bites you are full. Protein drinks help. Talk to a dietician, your clinic should have one on staff. 13. You may feel the heat or cold more. 14. You may have night sweats. 15. Fatigue can be like nothing you ever felt before, try to move about even if only in your house. 16. If you feel "wiped out" after a treatment, make sure you tell your doctor. You may need fluids due to your low immune system. 17. Say "no" to visitors if you are not up to it or if your immune system is low. They just want to be there for you but sometimes it's harder to stay up and visit. 18. Try to not read about your diagnosis, treatments etc. on the internet. It will overwhelm you. 19. There are no silly or stupid questions, ask if you have a question. Your team is there for you, don't be afraid to ask. There are some great websites to go to and talk to others about what is going on. 20. A good skin cream will help with the dryness of your skin which can result from chemotherapy or radiation. A good lip balm. 21. If you have radiation treatment do not put on any creams in that area before your treatment. 22. Remember to put cream on both sides of your body if you have radiation-if you can't reach your back-purchase a plastic non-slotted spatula to put on with. 23. A natural Aloe spray can be very soothing on your radiated skin.

    24. Talk to your doctor about creams he wants you to use during radiation. 25. Radiation can also make you extremely fatigued. 26. If you have surgery and cannot take a shower, there are adult size wet wipes you can use. 27. Ask your doctor when you can see a dentist and/or an eye doctor after treatments. Make sure you tell both that you have had cancer treatments. 28. Sometimes cancer treatments can cause your cataracts to progress faster. Be aware of any changes to your vision. 29. Be careful of the sun and heat during treatments. You may react adversely to them. 30. If possible, take someone with you to your doctor's and surgeon's visits so they hear everything that is said. If you can't take someone with you, ask the provider if you can tape their conversation. 31. Head coverings can be very important as they protect your head from the elements. They can keep your head warm in all conditions to include having medical procedures and treatments. 32. Your scalp may itch as your hair grows, the texture may go through several changes, ask your doctor if/when you can color it if that is what you want to do. 33. Often hair will show up on your face first, under your nose, your chin and lower facial jaw. Don't panic this is normal and there are treatments and specialized facial razors you can use. 34. https://imermanangels.org/get-support A site to ask for a mentor-you will be paired with someone who had your type of cancer that is there to support you or you can be a mentor and support someone.

    35. Your friends and family will want to help, accept it but tell them specifically what you need, clothes washed, rides etc.

    Some Breast Cancer related tips:
    1. Know exactly what type of breast cancer you had and what stage. This information is important to all your doctors. 2. Keep a list of all dates -mammogram, diagnosis, port implant (if one is ordered), surgery, chemotherapy start and finish, and radiation start and finish. You are often asked for these from other providers. 3. Certain breast cancer treatments can cause your nails to peel off. You may save them if you use dark nail polish on 4. Keep your nails out of the sun whenever possible, again this may keep your nails from peeling off. 5. Discuss using ice packs with your doctor if you are to receive Taxol. This may help with your nails as well as preventing neuropathy.

    Surgical Tips For Breast Cancer Patients
    1. There are many products available to help you be comfortable after surgery. 2. There are special pillows that can help in the car and at home. Drain holders are available as well as blouses/shirts with pockets inside them for the drains. 3. A recliner may help you sleep after surgery as it keeps you from rolling on your breast area. 4. Wear loose fitting shirts/blouses and inexpensive camisoles after surgery while you are healing. 5. Ask about having IV's, Blood pressure readings, and shots in the arm that is on the side where your breast cancer was. 6. Many x-ray facilities, labs, clinics have patient portals-these can be very useful when you need information for future 7. Check your insurance policy and Medicare to see if you are qualified for free bras, prosthesis inserts and or camisoles after your surgery. You can find this information online or call your company. 

    Useful Products Found

    Some products that I have found: Moo Goo Skin Care
    Simply Beautiful Magnesium Lotion
    Premium Formulations Shower Solutions
    Bathing wipes Radia Guard Treatment Pack Sovanni Hair Loss Shampoo w/Argan oil by Chummy Supply Co Lindi Skin Line

    Zum products,
    found online and in Publix Coolibar-clothing
    to help block the sun-www.coolibar.com Lands Ends and several other stores have these items as www.softhats.com

    Amazon has very affordable hats Goat soap and lotions
    are a great choice for your skin and hair. There are body lotions, salves, hair products and body washes available. These are available online, in stores like Whole Foods, at local markets etc.
    If you feel a prosthesis is too heavy or uncomfortable there are the Knitted Knockers who knit protheses that are less intrusive and heavy. www.knittedknockers.org

    Breast MRI-a beast MRI takes 40-60 minutes-you lay on your stomach with your hands over your head, your breasts go into two holes (a hole for each breast) https://youtu.be/b64PLWO0CmA Video link of a breast MRI
    Alyce Stewart had Renal Cell Cancer and had her right kidney removed in December 1993 In July of 1994 she had Basal cell cancer removed from the right side of her nose Over the years she has had Squamous cancers removed from her nose, legs and arms In 2016 she was diagnosed with IDC and DCIS in her left axilla and breast-had chemo from Nov-February 2017, a lumpectomy on April 6, 2017 followed by 30 radiation treatments from June-July 5, 2017

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    13 Characteristics Worth Cultivating When Diagnosed With Cancer

    The diagnosis of cancer is often a shocking and traumatic experience, but we have to deal with the diagnosis. It has to be treated — ready or not; cancer doesn’t wait.

    So how do we cope? How do we learn to deal with the physical consequences of our diagnosis and the emotional ups and downs? Part of the way that we cope is with cultivating and enhancing characteristics that we have, but that may lie hidden and seldom used. We all have these traits, and with a little coaxing and development, we can bring these attributes to the surface.
    1. Common Sense. Good “ole” common sense can help prevent you from falling for scams and fake cures. Common sense is the 6th sense that people develop — it’s good, sound judgment gained from experience, not books. If something that someone tells you about cancer or its treatment seems too good to be true, it probably is. No diet will cure cancer. No spa treatment will cure cancer. And this saying is not true — it’s not cancer that kills, it’s the chemo — when someone says this to you, run (don’t walk) away.

    2. Compassion. Compassion is having a deep feeling of sympathy or sorrow for someone who experiences adversity. Compassion is what all of us here at WhatNext have — we are truly sorry that someone else is experiencing what we have experienced. We look at that new face in the chemo room and realize that it’s their first chemo, and they are scared to death. We might speak to them with an encouraging thought if we are close enough. If we make eye contact, we’ll give them a smile and a nod, acknowledging that we understand how they feel.
    3. Courage. Having courage and being brave are assets to anyone diagnosed with cancer. Courage is the ability to do something that scares you. Having chemo or immunotherapy requires courage. It takes courage to keep going to those daily radiation sessions. And to say that it requires courage to face surgery is an understatement. Surgeries are often long and complicated — the surgery leaves us with lifelong scars and disfigurements, but these surgeries are frequently the only option for a potential cure.

    4. Creativity. Why you might ask, would creativity be useful if we’re diagnosed with cancer? Creativity is the ability to transcend traditional ideas and rules. Creativity is often associated with art, but creativity helps us transform the hopelessness and despair that we experience into a more positive outlook. Creativity helps us adapt to physical changes in our life — how to put on makeup to disguise a scar, how to manage an ostomy more effectively, and the obvious, create art of all sorts to distract us from the tough realities that we face.
    5. Determination. Being resolute to stay the course during treatment and not give up can save your life. Determination helps us realize that a setback is not losing the battle or war. Setbacks require adjustments, so we must remain determined and keep on the course.
    6. Faith. Faith, whatever our belief, strengthens many people during their cancer journey. Whether we are Christians, Jewish, Muslim, or believe in a Higher Source, faith in a higher being, and the order of life provide comfort and inspiration.
    7. Grit. “True grit” will get us through the roughest spots. Grit is a blend of perseverance, courage, strength, and will to stay the course to reach a lofty goal. We’ve all hit that brick wall when we wanted to curl up in a corner. But, grit is that deep, nagging spirit within us that urges up to get back up and keep on going.
    . Intuition. Intuition is that “gut” feeling — something that we know instinctively, without having to think about it. Intuition may have first guided you that something wasn’t right with your body. You may have had a nagging feeling that prompted you to seek another opinion that leads to your cancer diagnosis. Intuition helps guide us through treatment and afterward. No one knows our bodies better than we do. So when things don’t feel right, trust your intuition, and talk to your medical team.

    9. Motivation. Cancer surely requires the motivation to go to chemo every two or three weeks. It takes a huge amount of motivation to go to daily radiation and get your throat, breast, or bum baked. Every part of cancer treatment is difficult, and there is no immediate reward. We have to trust in our medical team that the reward will come once our treatment is completed.
    10. Physical Fitness. Being physically fit at the beginning of treatment is a blessing that no one should ignore. The daily grind of treatment takes a toll on our bodies. We need to do our best not to become couch potatoes. We need to remain as active as possible because activity helps prevent loss of muscle mass and strength.

    11. Resilience. Resilience is the ability to bounce back from adversity. While resilience is somewhat inherited in all of us because every human has the will to live if we’re drowning or encounter a bear in the woods, resilience is also an acquired attribute. Those of us who encounter adversity growing up and in our young adulthood seem to cope better with the diagnosis of cancer. But it’s never too late to learn how to adjust to whatever cancer throws at us quickly.
    12. Self-Esteem. Everyone needs to have self-esteem — that inward confidence that we have in ourselves. When cancer strikes, self-esteem is even more important. Cancer can leave us disfigured and scarred. But treatment-related physical changes don’t change who are; self-esteem lets us transcend outward appearances. It may require a period of adjustment, but we will regain our “mojo” and carry on.
    13. Sense of Humor. We’ve heard that “laughter is the best medicine.” A sense of humor helps us get over the bumps and potholes in life’s road. Maintaining our sense of humor enables us to see some of the ironies of life as navigate through the complicated life as a cancer patient. We don’t need all of these skills to make it through our cancer experience, but cultivating just a few of these attributes will make our lives easier and more fulfilling.

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    Cancer Leaves a Mark - Again and Again

    You've heard that saying when someone gets smacked upside the head by a swing set or some other crazy thing happens in a video on AFV, "that's gonna leave a mark". When you have cancer it leaves a mark too. Several of them, some are obvious, some are subtle, and some are hidden. With a history with cancer that covers 32 years of my life, I have a lot of marks, these are just a few of the latest ones. 

    Speaking, or the inability to - One of the most profound marks my latest round of diagnoses has left on me is the inability to talk. A lot of people might be happy by that, they have heard me too much over all these years! But for me it has been the biggest life changing thing that has happened. 
    Just imagine yourself in this position for a minute and consider how it would affect your life. 
    Donna and I sit 6 feet apart in our living room, yet I have to text her anything that's more than one or two words. Or write it on a marker board and hold it up. If she is at the other end of the house and yells a question to me, I can't answer, I have to get up and walk to where she's at, tap her on the shoulder and mouth my answer. Any "conversation" that takes place between us must be done looking at each other so she can see my lips. I have an electrolarynx vocal device that helps some, but most people can't understand what I'm saying. Donna is getting better at it, we adapt. 
    Eating - The simple act of eating. Most people do it every day, several times a day without even thinking about it, it's like breathing, it just happens.  Normal eating and swallowing is a thing of the past for me. My throat was partially rebuilt after the laryngectomy. Muscle from my chest was taken out and used to "build" a section of my esophagus that was taken out. That section is "floppy", no muscles to assist in the act of swallowing. Some things, at some times, slide right down. Other things, at other times, don't go down at all and actually go up and out of my nose instead. I'm a hit at all of the kids birthday parties. As time goes on this issue is getting worse to the point of now I'm almost on a liquid diet. I have lost about 30 pounds so far on this "cancer diet", but it's a program that I don't recommend. 
    Breathing - like eating, is just something that we do without thinking about. It just happens, it's a part of our body physiology that is automatic. Until it becomes difficult, then you start paying attention to it. My laryngectomy was a major, life altering surgery. One of the things it did was to change how and where I breathe from. My trachea was disconnected from my sinus cavity and relocated to a stoma in my neck. So now, I am what is referred to as a "neck breather". I simply breathe through a hole in my neck. No big deal right? I can still breathe. 

    The differences are many. First, your sinus cavity does so much that you don't even know. It moisturizes the air you breathe, it warms it, it filters out things that you don't need to be sucking into your lungs. Now, I just breathe through a hole in my neck straight to my lungs six inches away. Without precautions, there is no filtering out of anything. I can take the dogs out at night without my filter in my stoma and it seems like every bug flying around outside has been waiting for me so they can land in my stoma hole. Suck one of those big bugs down and things get exciting!
    I have a device that attaches to my stoma that holds an "HME", heat and moisture exchanger. Its job is to filter air, retain heat and moisture in my lungs to mimmick what my sinus cavity used to do. It is held in place with a cloth velcro strap that goes around my neck. So now when someone looks at me the first thing that they look at is that stupid "strap thing" around my neck. Cancer left a big mark on that part of my life.
    Taste and smell - I can no longer smell most things, and what I can taste doesn't taste like it used to. Eating, when I can, is more out of habit and necessity than for enjoyment anymore. 
    Think about the sense of smell, and how many times it has brought enjoyment to your life. Have you ever been sitting outside on your patio and caught a the smell of jasmine flowers, or honeysuckle? How about the scent of your spouse's perfume or cologne? The smell of a little puppy cuddling up in your face? How many times have you had a sensation of smelling something that instantly sends you back in time to a place you loved, a spot, a point in time, or a person? You walk in the house after working hard all day and smell a pot of stew cooking on the stove. The house smells delicious. All of these are gone, boom, cancer left a mark right on my nose. 
    Working - You have probably read a quote many times that says "be thankful for everything you have in your life because in the blink of  an eye, they can all be gone". This is so true, but most people don't give it deep thought. 

    Consider your job, whatever it may be. How would you perform it from now on if you couldn't talk? How many things do you do through the course of a day that require you to speak to others. Do you use the phone? That simple act is over, no more talking on the phone. 
    For my business, I used to give estimates, that's hard to do when the customer cannot understand what I'm saying. I can't answer the phone anymore, talking to employees to give instructions, training, hiring new employees, dealing with suppliers, all require talking to people. Now most of those things are either done for, or being done in a limited way by others, or I go to a jobsite/customer's house for estimate with one of my guys that understands everything I say, he translates. It's an awkward way of doing things, but it's all I have. 
    Sleeping normal - That's over. I haven't had a "normal nights sleep" since last year. Since I had the stoma put in, I have to be careful of how I lay. If I roll over and cover up my stoma, it's like putting your thumb over a straw hole. 
    Drainage is constant, and never ending  The laryngectomy that I had changed my breathing and everything else that happens in the sinus cavity. So when you have a runny nose, I have a runny nose and mouth but I cannot blow my nose. It's a strange feeling to not be able to blow your nose. I wake up each morning with a feeling of drowning. It takes some getting used to, but I adapt and deal with what I have, there's nothing else I can do. Complaining about it won't make anything any easier and won't change the situation. 
    A Day Without Pain - Doesn't exist anymore. I wake up with pain around my neck from laying still for however long I managed to sleep that night. Sort of like when you've worked outside all day and come inside, take off your work clothes, get a shower and sit down. When you try to get up you're so stiff and sore that it takes some doing to get you up and moving. That's how my neck is in the morning. 
    It takes about 3 hours for things to get loosened up to the point of not hurting anymore. I'm usually good through the day until late afternoon when the day's activities start telling me that I'm not the body I used to be. Sometimes I can hear my body asking me "what were you thinking"? I used to work 12 to 16 hours in a day and not have the pain that I have now just getting out of bed. Cancer leaves a mark in ways you probably never even thought of. 
    Financial Mark - Cancer leaves a big mark on the family finances, you might as well say that it cut's it off and kills it. Very few American families could afford a cancer diagnosis and treatment on their own. You would have to be rich, extremely rich. We have insurance that covers about half of the bills, I have a running total at Vanderbilt that right now sits somewhere in the 350 to 400K range. I don't even keep up with the details anymore, it's like monopoly money.  Most bankruptcies are filed due to medical expenses. Anyone who thinks that we don't have a problem with our insurance system and medical system has never had to deal with a serious illness. 

    Life Changes - Our life is not recognizable compared the time prior to 2019. I have basically quit working due to not being able to. Social Security of course thinks I'm not disabled. We have weekly trips to Nashville to Vanderbilt for treatments. Some of these are all day events with appointments happening every couple of hours through the day. Other days are over in 3 or 4 hours. We have a tentative schedule that stretches out for 2 years, that will change as my condition changes or issues arise. It's hard to wrap your head around thinking that your life for the foreseeable future is revolving around treatments, doctors, scans, injections, tests, blood work, stress, doubt, fear, hope, and a positive view.
    When it comes to your basic lifestyle, daily activities, schedule, etc. Cancer leaves a big mark on that. So big you won't recognize what your life used to be like. 
    Scars and Body Changes - Most people think about scars, loss of hair, weight loss, etc. as the obvious way that cancer leaves a mark on you. And that is true. But simple scars from surgery are the least of the scars. 
    There are other scars, mental and physical. Your mind won't let you get too far through the day without reminding you that you are a cancer patient. There are times that your body will remind you of that too. Depending on how serious your cancer is/was, it may not be often or as serious. For me, it's when my eyes open in the morning. Then for the next several hours of the morning my body reminds me with everything that I attempt to do. 

    Mentally, it's a challenge to not slide down into the well of negativity. I have plenty of reasons to slide there, I am on diagnosis number 5 right now, each one has progressively gotten more challenging, I can't help but wonder how many more chances I get or when my time will run out. 
    Every time someone dies that I know I think about how their life was compared to mine. Their health compared to mine, their age compared to mine. Then I wonder why them and not me? That's a whole subject that many articles and books have been written about, "survivor's guilt". 
    If you ask most people who are not cancer patients, survivors, or haven't been a caregiver for someone how cancer affects the patient's and their families lives, they will quickly tell you about the scars and side effects they had during treatment, after that, most people don't know about all of these other ways that cancer leaves a mark. And these are just a few of them.
    Despite all of these marks cancer has left on us, I am still hopeful for the future, confident in the new treatments that are being used on my latest diagnosis, and grateful for the family and friends that have been with us through this. 
    Are you a cancer patient or survivor? How has cancer left a mark on you? Please comment below and let others know they are not alone with these issues. 
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    KarenG_WN posted a blog post

    Liquid Biopsy - What They Are, How They Work

    Most of us know what a biopsy is — a biopsy is a procedure where a sample of tissue is removed to determine if a tumor or suspicious area contains cancer cells. The tissue sample is removed by a surgical procedure (either a small sample is obtained, or the entire lump is removed) or by a needle.

    Most people haven’t heard about another kind of biopsy. It’s called a liquid biopsy.
    What is a liquid biopsy?
    Technically, a liquid biopsy is a body fluid sample (usually blood) to find significant biomarkers to personalize and more effectively treat and monitor someone’s cancer. Cancerous tumors shed ctDNA (actual tumor-derived deoxyribonucleic acids).
    Although researchers have known that circulating cfDNA is present in our bloodstreams since 1948, it was not until 1977 that researchers detected higher levels of cell-free DNA (cfDNA) in the serum and plasma of cancer patients compared to people without cancer. Yet researchers were stymied as to how to use this information. Another obstacle was that existing technology until recently was not sensitive enough to measure these tiny particles.
    The first commercial liquid biopsy became available in 2014. Fast forward to 2020, and we are seeing several emerging companies that provide liquid biopsies.
    How are liquid biopsies used?
    The biomarkers discovered through a liquid biopsy are like “fingerprints” of our particular cancer. Liquid biopsies can distinguish DNA shed directly from tumors. Liquid biopsies detect the presence of specific biomarkers for several cancers, including breast, colorectal, and lung cancer.
    Liquid biopsies help oncologists in many ways.

    • Guide and access the effectiveness of treatment. The presence of certain biomarkers, such as EGFR, KRAS mutation, or good expression of PD-L1, guide our oncologist as to which medical therapy will be most effective. Once treatment begins, a liquid biopsy can detect rise or fall in ctDNA to help determine if the treatment is effective. • Predict the risk of recurrence. In breast cancer, the Oncotype DX® breast cancer assay helps calculate the likelihood of recurrence. This assay helps determine which women will benefit from chemotherapy after surgery. For women with DCIS, this test can help forecast if she will benefit from radiation after DCIS surgery.

    Can liquid biopsies detect a recurrence?
    Due to the limitations of CT scans, tiny new tumors that recur aren’t visible on a CT scan. However, these tiny tumors may already be shedding circulating tumor DNA into the bloodstream. In theory, a liquid biopsy could detect these minuscule amounts.
    However, the technology has not reached that stage yet. The thought is tantalizing that a simple blood draw could tell us if we’ve experienced a recurrence. But several obstacles stand in the way. Because the amount of ctDNA that is shed is minuscule in a tiny, newly-occurring recurrence, the liquid biopsy to obtain a sampling for this purpose would require intense study driving up the cost to potentially prohibitive levels.
    Yet, the potential exists for liquid biopsy technology to evolve over the next five years so that it is easier to detect recurrences through ctDNA and that the costs will come down so that it is more cost-efficient than CT scans, bronchoscopes, and other imaging techniques. Some cancer types shed more ctDNA than other types of cancer — breast, colorectal, and lung cancer tumors seem to shed more ctDNA than other types of cancer. As research continues, more tumor types should be added to the list of potential cancers where liquid biopsies can be used.
    How many companies offer liquid biopsies, and are they covered by insurance?
    There are some commercially available liquid biopsy companies. Your oncologist will select the particular test most appropriate for you. Some liquid biopsies are covered by private insurance and Medicare, while many insurance companies don’t provide coverage. Your healthcare team will help you navigate through insurance issues if a liquid biopsy is necessary.
    Estimates suggest that liquid biopsies will be a $10-$20 billion portion of healthcare expenditures in 2020. Companies are investing heavily to develop this cutting-edge cancer technology further. The hope is that as costs for liquid biopsies decline that liquid biopsies will offer a less expensive and less invasive way of monitoring patients during and after treatment.

    Here are some of the commercially-available liquid biopsies (arranged alphabetically):

    • Cancerintercept (Pathway Genomics) • Cobas EGFR Mutation Test v2 (Roche) • FoundationACTTM (Foundation Medicine) • Grail (Grail Bio, an Illumina spinoff) • Guardant360 (Guardant Health) • myRisk (Myriad Genetics) • OncocEE (Biocept.com) • Oncotype SEQ (Genomic Health) • PlasmaSelect-R (Personal Genome Diagnostics)

    So WhatNext?
    The future is almost here. At some NCI-designed cancer centers, oncologists are already using liquid biopsies for monitoring response to treatment and to detect mutations in patients. The experience of these National Cancer Institute (NCI)-designated treatment centers will help formulate guidelines for the use of liquid biopsies within the near future.
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    KarenG_WN posted a blog post

    Should You Wear A Mask? Yes.

    “Should I wear a face mask?” has become an emotionally-charged question these days. You may be wondering what’s right for you as a cancer patient or survivor.

    First and foremost, follow the advice of your oncologist — they know your particular situation and condition and will advise you as to what’s best for your situation.
    Why should we wear masks during the COVID-19 pandemic?
    First and foremost, wearing a mask helps slow down the spread of COVID-19. You may see that the recommendations change as new evidence becomes available. Still, experts from around the world agree that wearing a face mask in public or at gatherings where people outside of your household are present helps prevent transmission of COVID-19.
    Why? COVID-19 is primarily spread from person to person by respiratory spray. Wearing a mask protects others when you sneeze, cough, and talk. Yes, even talking and singing pushes respiratory droplets into the air.
    But why wear a mask if I’m not diagnosed with COVID-19? The problem is that many people don’t exhibit symptoms even though they are infected with COVID-19. By wearing a mask, we are showing our respect for others by helping prevent the spread if we don’t know that we are positive for COVID-19.
    However, there is another reason why we at WhatNext should be wearing a face mask
    . People who are a high risk for serious complications if they contract COVID-19 should wear masks to help protect themselves when in public settings and small gatherings. Who is at high risk for serious complications?
    • Anyone over 60 • Anyone in active treatment for cancer • Cancer survivors, particularly lung cancer survivors, survivors who have compromised immune systems from bone marrow or stem cell transplants, survivors who have low white cell counts, survivors who have had lung mets, and had wedge resections. Ask your oncologist for specific guidance about wearing a mask. • People with heart disease • People with chronic lung disease • People who have diabetes • People who are obese • People with compromised kidney function • People who have sickle cell disease

    The truth is that it’s better to be safe than sorry. Protecting yourself from COVID-19 is particularly true in a two-person household. If you contract COVID-19, you have to self-isolate at home. How can you reasonably do that without endangering the other person in your household? 
    Here are some examples of two-person households:

    • Taking care of an elderly parent • Caring for a disabled adult • Older couple

    If you live in one of these two-person households, be cautious. Practice social distancing, always wear a mask and wash your hands frequently.

    Where am I going to have to wear a mask?
    Regulations vary and change as the COVID-19 pandemic continues to evolve. When hot spots crop up, state and local officials may issue requirements to wear face masks when out in public.
    However, there are some places where masks are going to be mandatory for the foreseeable future.
    • Cancer centers. Cancer centers have had to adapt and adjust to the pandemic to provide continuity of care because “cancer can’t wait.” Some cancer centers are prescreening patients with phone calls before your visit. They will also advise you about their visitor policy, which is now strict. Many centers don’t allow anyone (even a family member), except in extraordinary circumstances. They may ask you to, at least, wear a scarf or bandana to the center if you don’t have a mask. You can expect to be greeted at the door with a triage nurse who asks questions about symptoms, travel, and if you or a household member has been tested for COVID-19. Then, the nurse will check your temperature and replace your bandana or cloth mask with one that the cancer center provides. • Other medical facilities. Virtually all medical facilities require patients to wear masks — the facilities are providing them so that no patient faces economic hardship. You’ll see the requirement for a mask at primary care and specialist offices, urgent care, and radiation treatment centers.

    The New York Times surveyed over 500 epidemiologists in mid-June about mask-wearing, and more than half predict that masks will be necessary for the next year, or possibly longer.
    Masks are going to be required for students going back to school, whether elementary, high school or college.
    Local, state and private entities are endorsing the use of masks in public places and in retail and dining establishments (even if you are picking-up takeout).
    Wearing masks is to protect us all — our society, as we know — our way of life. Wearing masks is not an infringement on our rights.

     People can be contagious before they develop a single symptom.  People who test positive may never develop even one of the common symptoms.

    Wearing masks is for the public good. Our economy and our unfettered way of life can’t return until we curb the spread of COVID-19, and an effective vaccine is available worldwide.
    Is wearing a mask safe?
    Contrary to the rumor that is circulating that wearing a mask lowers your oxygen level, that rumor is not true. In general, wearing a mask is safe for almost everyone. Again, ask your oncologist or their nurse or PA if it is safe for you to wear a mask when you are in public.
     Masks are not recommended for children under 2 years old.  Anyone who is displaying urgent, sudden onset breathing difficulties.  Anyone unconscious or incapacitated.

    Lungevity.org is an organization supporting lung cancer patients. They recommend the use of cloth masks
    (not surgical masks or N95 masks) even for lung cancer patients — consult with your oncologist to ensure that you are following the best practice for your medical condition. Study after study shows that wearing a cloth mask or the mask furnished by your cancer center or other medical providers will NOT lower your oxygen level. This rumor is another example of fake news about COVID-19 and the ways to help prevent its spread.

    Sound Advice for WhatNexters

    Follow the 3W’s.

    • Wash your hands frequently. • Wear a cloth covering over your mouth and nose. • Wait six feet apart — aka practice social distancing.

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