Less is Not More
We’ve all known someone in our families, among our friends or even ourselves who have been through cancer treatment. It’s a scary road, in seemingly unchartered territory.
The fright is palpable. We want to do something – but what?
If we are directed properly, we get high quality interdisciplinary care at one of the more than 1500 cancer centers across the country accredited by the American College of Surgeons Commission on Cancer. Chances are improving for us to have a good response to whatever combination of surgery, chemotherapy and radiation therapy that is prescribed. But for most, that period is fraught with uncertainty, fear, fatigue and significant weight loss or weight gain that threatens survival itself as well as quality of life.
New evidence – and years of experience – now shows that it is counterproductive to wait until treatment is over to start to feel better. Those of us who get the right direction can focus our attention where it most pays off during treatment. A reasonable plan of activity, education, rest, sleep and good nutrition works to maintain us, instead of having to start from scratch when we’re so bedraggled.
Weight change is serious. In breast or prostate cancer, weight gain may predispose to a recurrence. Losing muscular lean body mass leaves the body too debilitated to fight off infections and cannot support the vital clotting facts that prevent hemorrhage or blood clots. Someone’s smart grandmother proclaimed that one doesn’t die from cancer but “something else”, and that something else is often pneumonia or clotting problem from huge weight losses.
Make Plan
Instead of surfing the ‘net to find information that may not apply – you can do something helpful. Get up and walk a few times a day if you can. Stretch gently so that you’re not stiff. Mac and cheese is comforting, but will not help regain lean body mass. If you can’t or are unsure, ask your cancer specialist for an evaluation by a rehabilitation specialist in your area to learn preventive activities. Speak with the nutritionist (accredited centers have them, or know who is in the area) to get you on high quality low fat proteins, whole grains, and fruits and vegetables of many deep colors. Speak with your family about what is really important to you. Choose something to make life meaningful each week; helping someone out as you help yourself. Learn how to power nap, and sleep better. Digest the information on well-vetted internet sites.
These efforts are easily organized in The LEARN SystemÒ, a quick roadmap to follow each week. L for living, E for education, A for activity, R for rest (and sleep) and N for nutrition.
Lots of Work?
If this seems like a lot of work, it really isn’t. By focusing on these goals, you gain control over things where you can have an impact, rather than those factors that are out of your sphere of influence. These assignments are the antidote against helplessness.
When you’re recovered, give forward by teaching someone else. Ask your cancer specialists to connect you to any new patients who ask to speak to someone who’s “been through it all.”
Focusing on getting better with cancer from the start is a winning plan.
About Stewart B. Fleishman, M.D.:
Stewart B. Fleishman, M.D., is the author of two books guiding supportive care and treatment during cancer: LEARN to Live Through Cancer: What You Need to Know and Do is specially made for patients and families; Manual of Cancer Treatment Recovery: What the Practitioner Needs to Know and Do, a traditional textbook for cancer specialists. Dr Fleishman visits cancer centers around the country for accreditation by the American College of Surgeons Commission on Cancer. He is the Founding Director of Cancer Supportive Services at the Continuum Cancer Centers of New York: Beth Israel and St. Luke’s-Roosevelt, and was the Associate Chief Medical Officer of Continuum Hospice Care-Jacob Perlow Hospice. He was also theVice Chair of the Quality of Life Sub-Committee of the Cancer and Leukemia Group B, and he has been an active investigator in cancer symptom control throughout his career. Dr. Fleishman has also served as the Chair of the Bioethics Committee at the North Shore-LIJ Health System, and is now the Chair of the Ethics Committee of the Continuum-Jacob Perlow Hospice Care. Prior to attending medical school he taught High School Biology and General Science for the New York City Department of Education. He is Board Certified in both Hospice and Palliative Medicine and Psychiatry/Neurology.
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