Category Archives: Cancer

Managing Chronic Pain

Despite the media hype of books that promise to “banish your pain,” the reality is that chronic pain is just about impossible to extinguish, whether in “five simple steps,” “four quick weeks,” or whatever the latest tantalizing promises are. The truth, as you probably know if you have been experiencing chronic pain, is that the goals of controlling, managing and living  a satisfying life with pain are much more realistic. As both a person who lives with chronic pain and a medical writer, I have come across a useful website with a realistic, helpful approach to  chronic pain. Full disclosure: I have written some articles for this site, in consultation with several reputable medical professionals. In so doing, I have come to respect both the source of the information and the approach of the site. I have also learned a great deal.

The site is painAction.com, and here are some of the articles I wrote, although I recommend reading any others on topics that are of interest! The site covers back pain, migraine pain and cancer pain, and includes articles, lessons and interactive tools. The focus is on developing skills in self-management, gathering knowledge, medication safety, working with  health care professionals, communication and  emotional coping. Given my interest in integrative medicine, I am also pleased to report that there is information on alternative/complementary modalities to manage chronic pain.

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Filed under Cancer, Chronic Pain, Headache

Strength and Serenity for Women With Cancer

In what appears to be a perfect union between Western academic medicine and complementary/alternative treatment, a Harvard Medical School oncologist is studying the use of acupuncture to help alleviate the symptoms and side effects of cancer treatment for women. Cancer specialist and surgeon Annekathryn Goodman, MD has added acupuncture certification to her many other credentials and now offers this complementary treatment to her patients undergoing cancer treatment at the Vincent Women’s Care Division of Massachusetts General Hospital.

“My personal vision is to create a center for women with cancer that I am calling ‘Strength and Serenity,’ says Dr. Goodman. “My goal is to use complementary modalities, particularly acupuncture, to alleviate the symptoms and side effects of cancer and its treatment that we have difficulty managing with Western medicine.” She has found the treatment helpful for alleviating neuropathy—pain or burning or numbness in hands and feet, as well as nausea from chemotherapy or radiation or from the cancer itself. “Sometimes I treat women before the chemo, which seems to lessen their suffering,” she says. “Acupuncture also seems to help people who are done with their therapy but still have side effects such as fatigue, depression and anxiety as well as neuropathy. So many people are on antidepressants to help them with their stress. Acupuncture seems to help alleviate symptoms.”

Since 2004, Dr. Goodman has been transforming a sterile  Mass General exam room into a tranquil environment for hour-long sessions of acupuncture, which uses tiny needles to stimulate energy or “qi” (pronounced “chi”) points on the body, based on 5,000-year-old methods from Traditional Chinese Medicine. She uses heat lamps to warm up the needles, replaces harsh fluorescent lights with softly glowing lamps, plays soothing music and adds bamboo shoots and fabrics as decoration. “My focus is to balance the patient’s energy, or life force,” says Dr. Goodman, “This treats the ‘root’ of the problem, which then helps to alleviate the ‘branch’ symptom, whether it is constipation, nausea, headache or depression.” (Please see How Do We Heal for more details of acupuncture.)

In a recent research collaboration among the Mass General Vincent Women’s Care Division, Brigham and Women’s Hospital, and the Dana Farber Cancer Center, acupuncture was found to create a modest improvement in white blood cell counts among women undergoing treatment for ovarian cancer. (Cancer treatment tends to lower white blood cell counts, which compromises the immune system.) In a review of worldwide data about the use of acupuncture to alleviate side effects of cancer treatment, Dr. Goodman found that the evidence in support of acupuncture was “helpful but the data was mixed.” “It is hard to unify existing data in a scientific way,” she says. “But there is certainly interest around the world in studying the use of acupuncture to alleviate the suffering of cancer patients.” For her part, she hopes to continue the work of the Strength and Serenity Center to conduct education, research and clinical care not only about acupuncture, but also about other forms of complementary care for women with cancer.

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Filed under acupuncture, Cancer, depression, Healing, Health, Stories of Hope

Weeds for Health: Live from Your Garden!

The summer solstice is a wonderful time to harvest nourishment from your garden. I caught up with herbal expert Alexa Fleckentein, M.D., just coming in from her garden with an armful of grapevines (vitis vitifera), considered a bad weed here in the Northeast. “I used to swear and mutter when I pulled them out,” says Dr. Alexa. “Now I delight: A study has shown that grape leaves are even higher than red wine in resveratrol, a phytoalexin known to prolong life and prevent cancer.” The Greeks have been making little dolmades from grape leaves—stuffed with rice, herbs and pine nuts – for thousands of years. Dr. Alexa’s cooking method is simpler: She adds the grape leaves to her vegetable stir-fry (recipes in her book), and freezes them to use all winter long. “Simple, cheap, and healthy,” she says.

If you live in the South, advises Dr. Alexa, you might substitute kudzu (pueraria montana). “Kudzu has some marvelous properties too,” she says. “It is high in vitamins A and C, and also contains calcium. It comes in handy as an anti-inflammatory food (and is a much better source of calcium than inflammatory dairy products). Everybody in the South complains about this obnoxious weed. How about eating it as a revenge?”

And when you are done with your stir-fry, enjoy Dr. Alexa’s famous Garden Tea, described in her book and in this article. “I throw all the other edible weeds in my garden—as well as many plants and flowers—into my daily Garden Tea, which is filled with the healing properties of Nature’s pharmacy,” says Dr. Alexa. “Everything that’s not poisonous can go in there – from kitchen herbs to dandelions, from rose petals to pine needles. But REALLY: You have to know what you are doing and what to avoid. One hundred percent!!” Details are in her book, but she strongly advises taking an herb course to be sure you know what NOT to include!

The first time I made Garden Tea, for example, I proudly threw in a hydrangea flower—it was so pretty! Then I called Dr. Alexa while it was steeping to check on whether this was OK to include. “Throw the whole tea away!” she commanded at once. “Hydrangea leaves and flowers are poisonous.” I was sad to see it go, but I head learned my lesson: When in doubt, throw it out!

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Filed under Cancer, Healing, Herbs

To fight—or not to fight. Is that the question?

Senator Kennedy’s recent diagnosis of a malignant brain tumor has sparked an animated debate in the Boston Globe among health columnists and letter writers: Should patients diagnosed with a deadly cancer be encouraged to fight their disease, or should they focus more on quality of life and the journey towards spiritual—if not physical—healing? The “fight” proponents use the vocabulary of warfare: “vanquishing” the cancer “enemy” with every available “weapon” in the “arsenal.” One problem with this approach is that if you fight and lose, there may be guilt: Perhaps you didn’t fight “hard” enough.

The advocates of acceptance and healing say control what you can, choose your doctors and your treatments wisely, but also choose to spend time and energy on family, relationships, meaningful work, and finding joy in every moment. As one letter writer said, “Cancer is a disease, not an enemy. It also presents a deep opportunity to learn. My quest is to live each day as fully and richly as I can, to enjoy all that I have, and all the beauty and meaning of this world.”

A contrasting view came from an oncology nurse, who wrote that the notion of “fighting to win,” is too narrow: “Perhaps one’s fight could mean mustering resources against an enemy – cancer. Or it could mean winning against symptoms, or against the urge to stay at home during treatment and not work. Or beating the maze of our healthcare system, and getting the treatment you need when you need it!”

Perhaps “to fight or not to fight” is the wrong question, since there is no universal approach to illness that is right for every person. Several years ago, when I recovered from my own health challenge, and wrote my first book filled with the stories of people who fought and prevailed against cancer, paralysis, pain and deadly diseases, I thought that fighting was the only acceptable way to deal with illness.

Now, I am not so sure. Marshalling every available medical, alternative, emotional and lifestyle resource does give us more of a chance to overcome illness and injury, and perhaps to discover the latest “silver bullet” in the arsenal. But at what cost? There is also a value to the inward journey for peace, and nurturing loving connections with others. How best to combine these approaches given the limitations of energy and time?

Once, I interviewed a wise rabbi about the ways in which he helps people deal with suffering and illness. He described a state of holding two simultaneous beliefs: The desire to become well and “vanquish” the disease; while at the same time accepting the possibility of—and preparing yourself and your loved ones for—a different outcome. This is clearly very hard to do: One must gather the inner strength and energy—as well as the time—to pursue treatments, seek medical options, eat well, and think positively. All while somehow recognizing and accepting that you may not succeed. No easy answers. I’m still thinking.

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Filed under Cancer, Healing, Health

Our Lives Were in Our Hands

This is the title of an article I wrote for the current (May) issue of Prevention Magazine. It is about three women, myself included, who overcame medical catastrophes: stroke, Crohn’s disease, cancer, kidney failure. Writing these stories has convinced me yet again about the power that each of us has to “own our health.” Yes, there are times when an illness or injury is just too overwhelming, and it may be right for the person to let go. I have the utmost respect for people making that decision. At the same time, I always like to think of the possibilities of hope and fighting back, at least to increase our chances of recovery.

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Filed under Cancer, Crohn's, Healing, Health, stroke

Triumph Over Diagnosis

If you’ve ever heard a doctor deliver bad news, everything about that moment is probably seared into your brain with a permanence that rivals the moment you heard that Kennedy had been shot (if you’re that old) or the Towers had been hit (if you’re not.)

Is it because our doctors are the white-robed, high priests of medicine that their every word, frown, or raised eyebrow has the power to plunge us into the depths of despair? Is this why we scrutinize their phrases and mannerisms for clues about the future of our bodies?

Of course doctors — despite the mystique surrounding them — aren’t the high priests of medicine and they don’t have ultimate knowledge about our destinies. As one very wise doctor once told me, “a diagnosis — or a prognosis — for that matter, is just an opinion.” A well-informed opinion, to be sure, but not one that is carved in stone. If I had believed the neurologists who told me twelve years ago that I would probably never walk or fully use my left arm again, I’d be an invalid today. If my friend Janet had believed the oncologist who told her that she had one year to live, she would not now — ten years later — be writing her memoirs and enjoying her grandchildren.

The stories of triumph over diagnosis go on and on, and every time I hear or write about another one, I am awed anew at the power of the human spirit to overcome medical calamities that look hopeless. When I woke up from surgery with my half my body paralyzed by a stroke, what I thought was a calamity actually turned out to be a gift: It taught me something about myself and launched me on a new professional path. On this path, I have been privileged to meet and write the stories of courageous people who chose to disobey their diagnoses and to forge their own destinies of healing. Their very existence gives hope to all of us.

Of course we need our doctors. They are trained to make diagnoses. But they are not infallible. We should temper their opinions with what we know about ourselves. And they in turn need to recognize that their words are powerful influences on our bodies, minds and spirits, and they should be chosen wisely. We want our doctors to tell us the truth as they see it, but we also need them to be our partners in hope. Because, after all, neither they nor we really know what the future holds.

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Filed under Cancer, Doctors, Healing, stroke

Hollywood Reveals the Dark Side of Academic Medicine

The movie Wit, starring Emma Thompson, is a scathing indictment of the dark side of academic medicine. A woman with advanced, metastatic ovarian cancer is offered a powerful experimental chemotherapy protocol that is accompanied by debilitating side effects. Her doctors, passionate about vanquishing the cancer cells, seem indifferent to the fragile emotional state of the person who is housing those cells. (“She’s tough— She can take the full dose of chemo.”) They focus intently in fluid input and output, size and spread of the cancer and the extent of the damage to her remaining healthy organs. They see her body as the battleground upon which will be decided their own medical defeat or victory. And, oh yes, also as the source of new knowledge in the fight against the enemy. The only compassion comes from her primary nurse, who sees beyond the ravaged body and offers healing to the soul within.

Academic medicine and biomedical research have made tremendous, lifesaving contributions to the diagnosis and treatment of disease. What this movie illustrates is, however, is the difference between “curing” and “healing.” There can be healing even without cure. We can become whole and at peace when faced with incurable chronic or terminal illness, and we should not be afraid to ask our doctors to accompany us on that journey.

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Filed under Cancer, Healing, Health