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Amanda is a Mother, Dentist, Coach, and Breast Cancer survivor. She owned her own dental practice for 10 years and now works part-time as a dentist while spending time with her blended family and helping others thrive. It seemed as if I had finally overcome the hurdle After selling my practice and building for a nice profit I could feel the breeze of freedom in my heart and I was on the high of hope that comes with big changes. I was blessed with two wonderful children and had cut off the albatross of ownership finally taking care of some needs that had been put aside. This included paying off my car, fixing some issues that had been put off due to cost at the house, getting dry eye laser treatments, finally fixing a few health nuisances I had ignored, and taking some fun trips. Then I got the call. One of my dearest friends was diagnosed with breast cancer and had just started chemotherapy. Flying across the country to sit with her in the infusion room I realized how time had flown. Surviving COVID as a dental practice owner, finally getting through a divorce that took 6 years to end…. When did I have my last mammogram? Yes, it was negative when I had mine while we were shut down for COVID, but is it every year or every three years I am due? "Breasties" In 2023 my friend and I ended up becoming “Breasties”. It started with the radiologist coming into the room immediately after my first mammogram. There were 4 lesions and we needed a biopsy. The biopsy came back positive but with good news. We thought all I would need was a double mastectomy and reconstruction. However, the path report came back a few days after my mastectomy and there was invasion into the lymph node. Now a tumor panel agreed I would face chemo which involved 7 months out of work battling cancer and waiting for reconstruction. Full-time job of fighting cancer I had finally started working as an associate and I had to step away and take on the full-time job of fighting cancer. Sitting in the chemo chair facing a myriad of uncertainties throughout the process, I came to the shaking conclusion that I could not possibly emotionally handle working in dentistry again. This is similar to the burnout or mid-career crisis experience so many face in the medical world. I knew that I could never live my life the same again and that started with how I balanced my inner purpose with my clinical practice. I am now on the journey of recreating my life, my career, and how I feel peace and joy. Most of all I am growing the connections and relationships that foster joy on this journey in life. I have found a job doing dental work part time and I am working on some creative opportunities in my life while spending more time with my family. Grateful for the chains that have been broken and the joy to come Breast cancer was like a shot to the heart giving me a second chance in life. Having support groups and other pink friends is an important part of creating a strong foundation for life after cancer. I am grateful for the chains that have been broken and the joy to come. Are you a cancer patient or survivor? Book a free call with our survivorship mentor!

Caregiver Mental Wellness, Inc. empowers caregivers to thrive and find balance in their caregiving journey, envisioning a world where caregivers’ mental and emotional well-being is prioritized, and where compassionate support and understanding is readily available in families, among friends, in communities, and our workforce. Long Distance or Distance Caregiving: In an era characterized by globalization and mobility, the traditional concept of caregiving has expanded beyond geographical boundaries. Distance caregiving has emerged as a significant aspect of contemporary family dynamics, challenging individuals to provide support and care for their loved ones from afar. This paradigm shift is fueled by factors such as career opportunities, educational pursuits, and the general dispersal of families across the globe. Distance caregiving, also known as long-distance caregiving, refers to the scenario in which individuals provide support and care for their family members or friends who live in a location that is not accessible. This type of caregiving is not limited to a particular age group or health condition; it spans various situations, including aging parents, supporting a friend with a chronic illness, or ensuring the well-being of a sibling or child living in a different city. The concept of distance caregiving is on the rise. Limited research indicates that caregivers in such situations are grappling with notable anxiety and distress, prompting the need for nursing intervention. Historically, healthcare providers have not effectively addressed the specific needs of these distant caregivers or integrated them into family-centered, quality cancer care. The omission of their involvement in the patient's care plan and the adbsence of supportive interventions inadvertently complicate medical decision-making in clinical settings, especially during challenging phases of the patient's illness trajectory. This includes the difficulties of results of scans for cancer status, chemotherapy treatments, treatments for other health conditions, and the devastating report of the advancement or return of cancer the family thought was improving. This article discusses some of the distant caregiver’s challenges, the possible complex emotions experienced by the distant caregiver, steps that may be taken to alleviate these feelings, and strategies that may support a smoother process for all participants involved in the care recipient’s journey. Distant Caregivers’ Challenges: Part-time distant caregivers often coordinate with health professionals or other family caregivers living near the recipient. These distance caregivers face numerous challenges including, but not limited to: Limited Physical Presence: Their inability to be physically present for day-to-day care, emergencies, or routine activities. This absence may lead to guilt, helplessness, and frustration for the distant caregiver. Communication Barriers: Communication becomes crucial. Time zone differences, busy schedules, and technological challenges may hinder regular updates and check-ins. The caregiver may have meetings at work and cannot be on Zoom or telephone calls to stay in the loop on the care of the loved one. Misunderstandings may arise due to the lack of in-person conversations and non-verbal communication. Navigating Healthcare Systems: It is hard enough for a local caregiver, much less a distant caregiver, to coordinate medical care, and it can be complex at a distance, especially when dealing with different healthcare systems, insurance policies, and providers. Obtaining accurate information about the care recipient, tracking care, scheduling appointments, or coordinating cancer treatments can be a daunting task. Sustaining Their Other Responsibilities in Life: These distant caregivers have multiple responsibilities in life that may include a stressful job, other children in their home to take care of, a special needs child, nurturing their partner, maintaining their social activities and friend relationships, and last, but not least, maintaining their own well-being. Caregivers’ Complex Emotions: Distance caregivers often undergo a range of complex emotions as they navigate the challenges of providing support and care from afar. The emotional landscape can be multifaceted, influenced by various factors such as the nature and seriousness of the cancer patient’s condition, the caregiver’s personal circumstances in their immediate family and their work situation, and the effectiveness of the caregiving arrangements and collaboration with the other caregiver’s and/or health professionals’ team. Nursing interventions have the potential to alleviate the unnecessary suffering and distress experienced by distance caregivers who often feel disconnected from the oncology team. A crucial step involves inviting the distant caregiver to be part of the care plan, laying the groundwork for a trusting relationship, and offering essential emotional support. Providing educational resources and guiding them to relevant websites can offer both practical and emotional support from a distance. Innovative technology is an additional connection when distant caregivers cannot physically visit the patient, including the mother, father, sibling, adult child, or close friend who would like to participate in a physician's office or treatment visits. By equipping these distant family members with knowledge about their role and facilitating much-needed support and collaboration, they can become valuable support for the cancer patient and local caregivers, ensuring success in their part-time caregiving responsibilities. Some common emotions caregivers may feel include: Guilt for being unable to be present with hands-on care, attend medical appointments or treatments or handle daily responsibilities. They feel the guilt of not doing enough and stress that the primary local caregivers may be overburdened with their loved one’s care responsibilities. Other friends and family members need to consider that the local caregiver deals with the situation daily. They should have a clearer understanding of the needs and situation involving the care recipient. Distant caregivers should be compassionate and cooperative to keep a sustainable and effective working relationship and collaboration with care partners. Helplessness for the inability to immediately respond to emergencies or be there for their loved ones in times of need can create a sense of helplessness and frustration. Worrying about the well-being of the care recipient, especially when dealing with health issues or aging, can lead to persistent worry and anxiety. Worrying that local caregivers may feel that the distant caregiver is not carrying their responsibility. For example, the aging parent is ill, and siblings living near the care recipient must carry the day-to-day responsibility of the parent's care. When scheduling conflicts or misunderstandings occur, they feel frustrated when trying to coordinate care and communicate effectively with other caregivers and health professionals. Distant caregivers may experience a sense of isolation, as they may not have the same level of in-person support and shared experience as the local caregiver. Juggling the demands of distance caregiving with personal, professional, and other family responsibilities can create a constant sense of imbalance and stress. The emotional toll of caregiving, even from a distance, as a part-time caregiver can lead to exhaustion as caregivers navigate complex emotions over an extended period. Some distant caregivers may feel relief and satisfaction despite the challenges. Caregivers may also experience moments of relief and satisfaction when they successfully coordinate care, address issues remotely, coordinate effectively with other local caregivers, or witness positive outcomes for their loved ones. The distant caregiver may feel more connection and fulfillment, maintaining emotional connection through regular communication with the local caregivers, the care recipient, and the health professionals, even when distance is a barrier. It is important that distant caregivers remain adaptable. They often need to be highly adaptable, adjusting their plans and strategies as their loved one's circumstances change, which can evoke a mix of emotions such as frustration or sadness. Trying to balance personal and professional commitments with caregiving responsibilities may lead to stress, anxiety, depression, sadness, and possibly caregiver burnout. It is important to recognize that emotions can vary widely among distance caregivers depending on the situation, including, but not limited to, the health status of the loved one, relationship dynamics within the family unit, communication and collaboration with the care recipient, healthcare team, and other caregivers who may be family or friends. It is essential to recognize that emotions vary widely among distance caregivers, and individual experiences are unique. Open communication, support networks, and prioritizing self-care and well-being are crucial to coping with the emotional challenges of providing care from a distance. Strategies for Successful Distance Caregiving: It requires forethought and planning regarding communication, utilizing technology, building a support network, and planning visits strategically. By doing this, it establishes a workable, stress-reducing strategy within the distant caregiver's life and family situation, including their job. Within this strategy, attempt to sustain a harmonious collaboration with the caregivers who reside near the care recipient and the healthcare team or partners. Communication: Establish clear communication channels to foster open, honest communication with the care recipient and other involved family members. Get regular updates and have discussions that can help all participants understand evolving needs and challenges on this journey. Utilizing technology for virtual communication might include video calls, messaging apps, and emails, which provide a means to stay connected and engaged and reduce feelings of isolation. Utilize Technology: Coordinate with the healthcare provider and caregivers who reside with your loved one to discover what technology might be available for healthcare management, such as online medical records, appointment times, healthcare team names, and locations. Consider using telehealth consultations and possibly medication management apps. Set up smart home devices for remote monitoring and assistance. Of course, all these options may not be feasible because every situation is different. Build a Support Network: Depending on the situation, and as appropriate, connect with local friends, neighbors, and professional caregivers to provide on-site support for the loved one. Investigate and utilize local resources, such as home care services and support groups, possibly including your loved ones' friends at their faith-based and community organizations. Do research to find out about all the social services in the care recipient’s community. The healthcare organization can provide information on social workers. These resources can offer practical assistance, information, and emotional support to the care recipient and their caregivers. Plan Visits Strategically: In coordination with your loved one's local support team, coordinate visits to maximize the impact. Plan around significant events, medical appointments, or times when you, as the distant caregiver, can be most helpful to the care recipient and their local support network. When planning visits, consider coinciding with important events, medical appointments, or times of increased need. The local caregiver may need a break or getaway. You can support the local caregiver(s) by managing the care and being with your loved one while they rejuvenate. This time will allow you to assess the situation, provide hands-on support, and make necessary adjustments to the caregiving plan in coordination with the local caregiver and care team. Conclusion Distance caregiving is a complex and evolving aspect of modern life, requiring adaptability, communication, understanding, proactive planning, and collaboration with the care recipients’ support network. By acknowledging the challenges and implementing effective strategies, distance caregivers can provide valuable support and maintain a meaningful connection with their loved ones, even across vast geographical distances. As society continues to evolve, so must our approach to caregiving, ensuring that distance does not diminish the quality of care and support we can offer to those we hold dear. Coping with the emotional challenges of distance caregiving is an ongoing process that requires adaptability and resilience. The journey may be smoother by planning, discussing responsibilities to assign to the local caregivers and the distant caregivers, communicating with compassion and understanding, and seeking support and available local resources. By implementing these strategies and seeking support from both local and remote networks, caregivers can better navigate the complexities of providing care from afar. Could you use a hand in your cancer journey? Book a free call with our survivorship mentor!

Jesse Dillon is a stage 4B Squamous Cell Carcinoma of the Tonsil survivor, and a dedicated patient advocate, championing increased awareness and the importance of early detection. Stage 4B squamous cell carcinoma echoed in my ears Not too long ago, I was asked by the team at The After Cancer to provide a testimonial of my battle with Head and Neck cancer, specifically Squamous Cell Carcinoma of the Tonsil. This month, they asked me to write another guest blog for Head and Neck Cancer Awareness month which happens every April, and I enthusiastically agreed, because before I was diagnosed in 2019, I was painfully unaware of what Head and Neck cancer was. As I thought about what I wanted to share with the world, my thoughts went back to the last time I met with my oncologist in August of last year, but before I go there, let me recap my story for those of you who are not familiar. In the late summer of 2019, I started having a sore throat and an earache, symptoms that I mistook as a cold or really bad allergies. However, as weeks passed, the sore throat persisted, swallowing became a challenge, and a relentless ear pain set in. After about 8 weeks of enduring the pain, I decided to see my doctor. After numerous doctor visits and tests, the words "stage 4B squamous cell carcinoma" echoed in my ears. The 'C' word carried a weight that seemed to compress time itself. The gravity of the situation was overwhelming, and the 'C' word carried a weight that seemed to compress time itself. The diagnosis process was a whirlwind, that I still don’t remember at all with the exception of a few fuzzy details that pop into my head from time to time. There are many decisions that have to be made and appointments that need to be set. It’s a chaotic time that no matter how much you brace yourself, there is no way to prepare for. My treatment regimen was aggressive: 35 radiation treatments and three rounds of cisplatin chemotherapy. Each session more painful than the last. Each day my body growing weaker. By February 2021, I emerged on the other side with an official diagnosis: no evidence of disease. Little did I know, the worst was yet to come. Now, after almost 5 years post diagnosis and 3 years post treatment, neuropathy, cervical dystonia, hearing loss, and dry mouth have made their way into my daily life. Daily reminders of the battle I endured. But even with debilitating headaches and rotting teeth caused by massive doses of radiation, I was feeling pretty vindicated. I had beat cancer. Not IF but WHEN cancer will return Then last August, I was talking to my oncologist and going through the process of transitioning from being in active surveillance with his team to preventative screening with my Primary Care Physician, he said something that has stuck with me even more than the day that he told me that I had cancer. He told me that it wasn’t a question of IF my cancer would return, but rather WHEN it will return. My cancer was brought on by an HPV infection that I probably picked up in my teenage years. While most people will never have any complications from an HPV infection, while others will develop cancer at some point in their life and we aren’t sure why. I love my oncologist. I owe that man my life. It was his open and honest approach to my treatment that helped me get to NED, and although the news of the potential return of my cancer was extremely tough to hear, I appreciated his honesty so I could remain vigilant and listen to my body. My mission to help save anyone else from having to endure what I have I have now made it my mission to help save anyone else from having to endure what I have had to. I help people to identify the symptoms of Head and Neck Cancer to help save lives. My journey underscores the critical importance of recognizing the signs of head and neck cancer. Early detection can mean the difference between life and death, and understanding these symptoms can lead to timely and effective treatment. A self-examination is easy and should be done at least every 3 months. Step 1: Check the Neck for Lumps Use your hands to palpate your neck. Feel for any lumps or swollen lymph nodes. Step 2: Inspect the Lips and Cheeks Pull your upper lip up and your lower lip down to check for sores or color changes. Use your fingers to feel the inside of your mouth for lumps or abnormalities. Step 3: Examine the Gums Gently bite down and look at your gums for any sores or unusual colorations. Feel around the gums for any bumps or irregularities. Step 4: Open Mouth and Look Inside Stick out your tongue and check the top, bottom, and sides for any swellings or ulcers. Look at the back of your throat, the roof of your mouth, and under the tongue using a flashlight and mirror⁴. Additional Tips: Compare one side to the other for symmetry. Look for red or white patches, lumps, or bumps that are different on one side compared to the other. If you discover any abnormalities that persist for more than two weeks or get larger, contact your healthcare provider or dentist⁴. Remember, this self-exam should be done regularly, and any persistent changes should be evaluated by a professional. It's an important habit that can lead to early detection and treatment. I demo the exam here: https://youtu.be/-VbqGeY5JOY?si=iV4oMXYGToDsUiB8&t=12 Here are the Symptoms to look out for: Persistent Cough: A cough that doesn't go away may be a sign of throat cancer. Changes in Voice: Hoarseness or not speaking clearly can be a symptom. Difficulty Swallowing: This may extend to breathing difficulties in more severe cases. Ear Pain: Persistent pain in the ear can be associated with head and neck cancers. Lumps or Sores: A lump in the throat or a sore that doesn't heal should be checked. Sore Throat: A sore throat that persists could be a warning sign. Weight Loss: Unexplained weight loss can sometimes be associated with cancer. These symptoms can also be caused by other, less serious conditions, but it's important to consult a healthcare provider for a proper diagnosis if you experience any of them. In addition to these symptoms, certain factors can increase the risk of developing head and neck cancer, such as tobacco use (both smoking and chewing), alcohol abuse, infection with human papillomavirus (HPV), a diet lacking in fruits and vegetables, gastroesophageal reflux disease (GERD), and a family history of cancer. If you're experiencing any of these symptoms or have risk factors, it's essential to seek medical advice. Early intervention is key to managing and treating head and neck cancer effectively. Are you a cancer patient or survivor? Book a free call with our survivorship mentor!

Dr. Lisa Jervis, MD, is part of The After Cancer's Care Team. She's board-certified in both Obstetrics/Gynecology and Integrative Medicine. Vaginal Dryness (Genitourinary syndrome of menopause) Vaginal dryness and discomfort are very common symptoms/concerns among many women of all ages. These symptoms are frequently due to hormonal changes that lead to lower estrogen levels—whether from natural menopause or cancer treatment-induced menopause. Decreased estrogen levels affect the cells and tissues in the genital tract in a way that thins out these linings making them drier, thinner, and more fragile which may cause bleeding and/or discomfort. Sometimes this process causes soreness and irritation which is not necessarily related to sexual activity. It can also cause an annoying vaginal discharge. Even if other symptoms of menopause go away at some point, the vaginal symptoms may persist throughout life. Although not everyone is affected by these symptoms, genitourinary syndrome of menopause remains the leading cause of problems related to sexual health among female cancer survivors. Non-hormonal options There are many options available for this which are available over the counter or online Lubricants are recommended and used for sexual activity. They can range from natural oils (vegetable, coconut, or olive oil) to a wide variety of commercially produced options. Some of these contain additional ingredients to enhance sexual pleasure. Vaginal moisturizing products are used on a more regular basis, usually 2 or more times per week depending on the product.  These products work by providing a protective film or attracting more water into the vaginal tissue.  This process can potentially help with lubrication and elasticity of the vaginal tissue, and it can lead to improvement of the pH of the environment.  Examples of these products are things that are polycarbophil based (like "Replens") or contain hyaluronic acid (like Revaree/Hyalogyn)  They are available over the counter but may be costly over time.  Both types have been tested in scientific studies and have been proven to be effective for some people.  There does not seem to be a strong advantage of one type over another. Compounding pharmacies may be able to make non-hormonal vaginal suppositories containing ingredients such as Cocoa Butter, Vitamin E and Vitamin A. Ask your Oncologist or GYN about help with prescribing these if interested. Hormonal options Many patients with a history of cancer may be candidates for topically placed vaginal estrogens, even patients with breast cancer! This is something that would need to be discussed with your oncologist. The estrogen can be in the form of a vaginally placed ring, creams or tablets. Vaginal estrogen has NOT been shown to raise estrogen levels above the normal postmenopausal range*. Further, a meta-analysis published in 2019 demonstrated a lack of systemic absorption of estrogen during vaginal estrogen therapy**. In patients with Triple Negative breast cancers—this is very likely to be an effective and safe option. It may (or may not) be more complicated if there are Estrogen/Progesterone receptors positive in the cancer. A very large cohort study just published in Obstetrics & Gynecology in 2023 showed that vaginal estrogen therapy did not increase recurrence rates of breast cancer in survivors even with a history of estrogen receptor-positive cancer***. The exception in the study was a slight increased recurrence when patients were also on Aromatase Inhibitors (Femara, Arimidex). Overall—the evidence is showing more and more that vaginal estrogens may be a safe and proven effective option for breast cancer survivors. Always have this discussion with your Oncologist and your Gynecologist. There is also a vaginally inserted treatment called Intrarosa, which is actually DHEA (dehydroepiandrosterone). This gets converted into testosterone and estrogen within the vaginal cells. IntraRosa has been studied in patients with a history of breast cancer, and it has been very promising with regards to safety and effectiveness****. LASER technology Another option that has been available for the past decade, is more invasive and utilizes use of office based LASER technology. One of these is the “Mona Lisa Touch”. Some patients have great success with these procedures, although some do not. The procedure can be fairly costly and may not be covered by insurance. The procedure also usually needs to be repeated over time. Remember all of this is highly individualized—but there is a lot of room for help and hope with regards to managing your symptoms. Want some more personalized support? Book a visit with a member of our Care Team 1* Laing AJ, Newson L, Simon JA. “Individual Benefits and Risks of Intravaginal Estrogen and Systemic Testosterone in the Management of Women in the Menopause, with a Discussion of any Associated Risks for Cancer Development” Cancer J 2022;28:196-203 2**Pavlovic’ RT, Jankovic’ SM, Milovanovic’ JR, Stefanovic’ S, Folic’ M, Milovanovic’ O. “The Safety of Local Hormonal Treatment for Vulvovaginal Atrophy in Women with Estrogen Receptor-Positive Breast Cancer who are on Adjuvant Aromatase Inhibitor Therapy, meta analysis” Clin Breast Cancer 2019; 19:e731-40 3***Agrawal P, Singh S, Able C, Dumas K, Kohn J, Kohn T, Clifton M. “Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer” Obstet Gynecol 2023; 142:660-8 4****Casiano Evans E, Hobson D, Aschkenazi S, et al “Nonestrogen Therapies for Treatment of Genitourinary Syndrome of Menopause” Obstet Gynecol 2023; 142:555-70

Arnel Greenberg is originally from New York, and now resides in Tega Cay, South Carolina. She describes herself as"a grateful, 67 year-old, breast cancer survivor." Life as I knew it would never be the same As the anniversary of my breast cancer diagnosis approached and then quietly passed, I reflected on the rocky slopes and the gentle paths of my journey thus far. I thought back to the hurdles I had cleared and contemplated some future hurdles still ahead for me. To recap my journey, a biopsy in July 2022 confirmed my triple-negative IDC, and life as I knew it would never be the same. Still teaching first grade, I started off my school year believing that keeping busy would keep my mind off my recent diagnosis. A whirlwind of multiple doctor visits and lab tests each week put that plan on hold. I thought it best to take a leave of absence for the first quarter and return to my classroom by the start of the second quarter following my September lumpectomy. But after being in the classroom for over 35 years, my Higher Power had a different plan for me, a new path for me to go down. My genetics testing finally came back as BRCA 1+. As luck would have it, my triple-negative diagnosis was not as good as I thought it sounded either. Since I had no hormone receptors, my only course of treatment would be six months of chemotherapy. Needless to say, I could not return to school that year and I would officially close the book on my teaching career and retire. On November 1st, my port was implanted for my first chemo infusion November 4th. Ringing the bell isn't the end of the journey I finally got to “ring the bell” on April 14, 2023, but my journey doesn’t end there. Now cancer-free, I met with my team of oncologists and surgeons to discuss my ‘high-risk’ genetic mutations and weigh out my options to reduce the risk of a recurrence or new breast or gynecological cancer developing. We decided my best course of action would be a DMX, hopefully avoiding radiation. In August 2023, I underwent a prophylactic double mastectomy and began breast reconstruction with expanders. By October 2023, it was decided that my chemo port would not be used for future surgeries and could finally be surgically removed. In November, I underwent a prophylactic hysterectomy and recuperated until my December reconstruction surgery. Everything was moving along according to plan, until I hit a rocky slope, as multiple complications occurred from what should have been a basic exchange surgery. That is where I am today… but I maintain a positive outlook following a second opinion from my new surgeon, confident that he can repair the complications that my original surgeon refused to acknowledge. I’m actually looking forward to my May 7th surgery! Gentle paths along the way The "gentle paths" along my journey that I mentioned earlier have been all the amazing people I have met along the way. My support system... composed of my fiancé, my children and grandsons, my brothers and sisters-in-law, my nieces and nephews, and my friends and neighbors, who have been there for me every step of the way. At this time, I MUST share how blessed I am and acknowledge all the “Previvors”, "Survivors" & "Thrivers" from everyone on the Supportive Oncology team at the Levine Cancer Institute, the Pink House in Charlotte, and the NothingPink Community in Rock Hill. It was through NothingPink that I connected with The After Cancer group of amazing survivors sharing their experiences and expertise. These special friendships forged, encourage me daily. These women and men have taught me how to handle life with grace, compassion, humor, and an inner strength I didn't realize I possessed. I learned to embrace each experience and be grateful for it! So now, as I physically, mentally, and emotionally prepare for my upcoming surgery, I thank you for allowing me to share my journey with you. Could you use a hand in your cancer journey? Book a free call with our survivorship mentor!

Dr. Diane Benfield, DSW, MSW, LCSW, is a dedicated therapist specializing in psychotherapy, grief, depression, and anxiety. She offers video consultations as part of The After Cancer's Care Team. Have you ever been in a large room full of people and felt completely alone? Cancer patients sometimes feel this way in their own families. To those unfamiliar with cancer, this must seem so strange, but hundreds of patients and caregivers have reported this to me. The disease of cancer is very isolating, and certain dynamics and communication styles in families can ironically enhance the loneliness a cancer patient feels. Sometimes families don’t realize that they are not being as helpful as they could be. Many patients and family members have reported to me that being the caregiver is more difficult emotionally than being the one with cancer. A sweet patient put it so well when she told me, “At least I (the patient) am doing something about the disease by having chemo, getting radiation, going to appointments etc. My husband can only watch, and he feels powerless.” Below are a few challenging family dynamics that have repeatedly shown up in my practice. If you see your family in one of them, there is hope for you! There are action steps you can take to improve how you communicate with your loved one listed at the end. 1. We must be positive all the time Some families refuse to allow themselves or the patient to utter any so-called negative words or thoughts regarding the illness as they fear it will somehow bring it into being. They believe that the power of totally positive thinking (which many big thinkers call it the tyranny of positive thinking) somehow enhances survival odds. But this notion is fantasy, not reasonable or realistic, and can lead to massive disappointment. The truth is there will be difficult times on the cancer journey for every member of a family. Not being allowed to talk about these scary and sad truths is unhelpful and dishonest and can lead to burying negative emotions. 2. Let’s pretend This dishonest style of communication usually flows from the prohibition on sharing anything deemed as “negative.” Some family members and patients will simply not show any evidence that they feel fear, sadness or anger – preferring to stuff the powerful emotions deep down. Patients and family members sometimes believe that sharing their honest feelings and thoughts will “make it worse” for the other. The cancer becomes the elephant in the room that everyone pretends to not see. 3. You have to, no matter what Some families insist that the patient get as much treatment as possible, as quickly as possible, and for as long as possible – sometimes in spite of the patient’s doubts or reluctance about the debilitating side effects. Some families pressure or cajole a patient to continue treatment against his or her wishes to satisfy their desires to “do something!” I have worked with patients who endured highly toxic treatments against their will to assuage their family member(s)’ fear that they did not do enough to “fight the cancer.” Patients are entitled to self-determination to choose their treatment or to choose not to take treatment. 4. Can’t we just get back to normal now that treatment is over? Caregivers unaffected personally by a cancer diagnosis just do not understand the concept that who the patient was before the cancer - is gone forever. That version of the patient no longer exists. After cancer, the patient is changed forever. The changes are not all bad, but there is no going back. Ever. There is no “going back to normal.” There is growing into the “new normal - the life after cancer.” Even with complete remission, the fear of recurrence and some of the long-lasting effects of the disease and treatment do not ever go away. The patient may look like they used to on the outside, and they may be smiling and laughing, but I guarantee you, they are living with the fear of it coming back and the internal and external effects of what just happened to them for the rest of their lives. Many patients have told me that survivorship is much more difficult than active treatment. 5. Refuse to prepare for the end of life Some families just will not go there. They won’t allow end-of-life discussions or planning to occur. Perhaps they fear it may hasten death, seem uncouth, or be too painful – but, paradoxically, many amazing opportunities to deepen relationships and heal brokenness are lost when this topic is avoided. Even if imminent death is not on the horizon (and most of the time it isn’t), planning and talking about what the patient wants is never a bad thing. No one is guaranteed tomorrow. If anything, cancer at least makes us face the cold reality that we are all going to die one day. A cancer diagnosis gives an unexpected, uninvited, and yet beautiful opening to explore this mysterious area together- to plan – to prepare – to bless – to heal. To create confidence, security, and harbor no regrets. Now, what can I do? Families can overcome these challenges if they are educated, willing to change, and motivated to grow. No one has to go through cancer alone – including family members. Get help. Imerman Angels will match the patient and his or her caregiver with a separate 1:1 mentor who either has the same diagnosis or who is related to someone with the same diagnosis to provide emotional support through a cancer diagnosis. Invest in inspirational books written by and for cancer survivors and their family members to read together, such as Cancer for Two by Dave Balch and 50 Days of Hope by Lynn Eib. Join a support group and open up. Through The After Cancer, you can join our virtual support groups called "Circles." These monthly sessions are safe spaces to connect with others, learn from our Care Team facilitators (all survivors themselves), and authentically discuss life after cancer with people who understand your experience firsthand. Invite your loved ones to join a caregiver support group and open up. A couple of caregiver-specific websites to get you started are: www.Caregiver.org www.cancare.org/events/cancer-caregiver-online-support-group Read The Four Things That Matter Most by Dr. Ira Byock for four excellent ideas of what to start talking about when cancer’s shadow affects someone in your family. Lastly, consider working with a therapist who has expertise in oncology or grief and loss to help you and your loved one navigate this new landscape. It’s likely you’ve never been here before, so you have a lot to learn – and it’s never too early or too late as long as we are still alive! Would you like some help in managing your family dynamics after cancer? Book a visit with Dr. Diane Benfield, or another member of our Care Team

Marie Theriault is an oncology-trained Registered Yoga Teacher and Certified Teacher of Qigong and Tai Chi with The After Cancer. Understanding Hot Flashes Hot Flashes are unpredictable! They arise suddenly and cause a feeling of warmth or heat, especially in the upper body. One moment you feel fine, the next you are sweating and peeling off layers. As the hot flash subsides, the body may feel chilly for a bit, and you find yourself reaching for those layers once again. These pesky vacillations in body temperature can range from mild and occasional to a daily occurrence that can be much more intense. The fluctuations of estrogen and progesterone levels are at the root of these temperature swings and can also trigger other problems such as anxiety and irritability, sleep disturbances, fatigue, depression, fluctuating moods, and an erratic menstrual cycle. While hot flashes are commonly experienced during menopause, they can also arise as a side effect from chemo or hormone therapy and radiation treatments. An estimated 60 percent of women do experience menopause-related problems, says Rowan Chlebowski, MD, of the Harbor UCLA Research and Education Institute in Torrance, California. About 25 percent report almost no disruption in their daily lives, while approximately 10 to 20 percent suffer severe and often debilitating symptoms. Supplements and prescription medications can be helpful for some people, but their use should always be under the supervision of your doctor. Let’s look at some Natural Solutions for Hot Flashes. Plant Medicine – Clary Sage Essential Oil Clary Sage is renowned for balancing female hormones and is sometimes referred to as “the woman’s oil.” It is the best oil for clearing menopausal heat, soothing menstrual cramps, and calming hot flashes. This oil can be applied topically but must always be diluted first. It can also be included in creams and lotions, added to a bath, through direct palm inhalation, or diffused into the air. Essential oils are commonly used in hospitals to assist with managing side effects of cancer treatment, but it is recommended to discuss their use with your cancer support team prior to using them. This informative article by David Crow, L.Ac. discusses the therapeutic qualities of Clary Sage and includes recipes. Dietary Considerations Foods such as apples, cucumbers, berries, broccoli, eggs, and green tea are considered cooling foods. As an added bonus, they are rich in nutrients and disease-fighting chemicals. There was a recent study that showed a significant reduction in the frequency and severity of hot flashes by adding soybeans to a low-fat, vegan diet. During the 12-week study period, many intervention-group participants became free of moderate-to-severe hot flashes. It is also important to stay hydrated by drinking water throughout the day. Adequate water intake will help your body flush out toxins, better absorb nutrients, and support a healthy weight. Avoiding spicy hot and fried foods, alcohol, and caffeine can also help with reducing the hot flash flame. Yoga Pranayama Many people think of Yoga as exercise that involves unique positioning of the body into a pose, but did you know that Yoga also includes breathing techniques that can be used for a variety of health concerns? Prana means Breath, Life Force, or Energy. Yama means to Control or Direct. Therefore, Pranayama is a type of breathing that directs the flow of breath to have specific effects on the body and mind. There are different styles of Pranayama that are easy to use. Here are two that can help with hot flashes. Video demonstrations can be viewed here. Sheetali Pranayama – The Cooling Breath This style of Pranayama initiates the calming and cooling mechanisms of the body. Sheetal is a Sanskrit word used to describe something cool and soothing. Think of a cool breeze on a summer evening, or cucumber slices over sore eyes. This Pranayama has a soothing effect on the nervous system and mind and a cooling effect on the skin and body temperature. It is also a wonderful way to wind down or prepare yourself for meditation or sleep. Chandra Bhedana Pranayama - Chandra (Moon) Bhedana (to Pass Through) Chandra Bhedana Pranayama invokes a cooling and calming energy. Breathing in through the left nostril while the right nostril is gently blocked affects the right hemisphere of the brain and activates the parasympathetic nervous system. This is our relaxation response which creates calmness and contentment. Breathing out through the right nostril releases body heat and will cool hot flashes or fever. Chandra Bhedana can also be helpful for heartburn, high blood pressure, and tension. It refreshes and steadies the mind. General guidelines for practicing Pranayama: It is best to practice on an empty stomach. Take a few cleansing breaths and make yourself comfortable before getting started. You can begin with 3 to 5 minutes (about 8 to 10 rounds of breath) practiced several times per day. It does not take long to do, and consistent practice will have a cumulative effect. Practicing before bedtime can help you get a good night’s rest and minimize night sweats, and that is something that everyone who is experiencing hot flashes truly wants and deserves! Remember, your breath is always with you. You don’t have to pack it or wait for it to arrive. You can use these cooling breaths to bring sweet relief and tame the hot flash flame whenever you need it. View Marie Theriault's profile and book your first visit!

Dan “Dry Dock” Shockley is a retired Navy, Operation Desert Storm, Enduring Freedom, and Iraqi Freedom veteran. He is a 12-year hereditary colon cancer syndrome WARRIOR and 3-year pancreatic cancer pre-vivor. “Challenges like my AFAP diagnosis are opportunities, not obstacles that can’t be overcome.“ It was during a routine colonoscopy at age 51 in 2012 that they found over 100 polyps embedded throughout my colon, rectum and anus. After gene sequencing DNA testing I was diagnosed with Attenuated Familial Adenomatous Polyposis (AFAP), a subtype of Familial Adenomatous Polyposis. This rare genetic condition is an autosomal dominant germline mutation. Dr. Henry T. Lynch, the founding father of hereditary cancer research, is credited with the discovery of AFAP. It's estimated to affect less than .03 percent of the worldwide population. Being intrigued by this diagnosis I took things in stages. First, by reading about the mutation to better understand this disease, then I had the surgery to remove my colon, rectum and anus and create a permanent ileostomy. Second, embracing life as an ostomate. Thirdly, understanding this rare mutation and the impact it will have on my life.​ During my 22-year Navy career, I learned that mental and physical strength are important attributes, especially in the face of personal or professional adversity. My training has taught me that being informed, prepared and maintaining a positive attitude while committed to the mission is instrumental in achieving success. ​“I also learned early on to prepare for the worst and hope for the best.“ There is an old cliché: “You can lead a horse to water, but you cannot make it drink.” I once heard there is a flip side to this saying. You can influence a horse to drink the water by providing it salt on the way. When I think of this expression it serves as a constant reminder to me that there are many references in the Bible pertaining to salt. In numerous contexts, it is used metaphorically to be a sign of permanence, loyalty, fidelity, value, purification, durability and usefulness. Of these, the contexts of durability and usefulness have had a direct impact in my life. When faced with challenges, both professionally, personally and physically, I maintain a positive attitude and utilize numerous resources that allow me to better understand the situation. Challenges like my AFAP diagnosis are opportunities, not obstacles that can’t be overcome. Moving forward, I have been able to overcome this medical challenge, adapt to my new life style and press on with my life with a business as usual approach. I maintain the same attitude today and share it every opportunity I have. I draw my strength being an example of the "salt of the earth” and realize the type of difference I know I can make in my life. I truly believe attitude determines the ability for a positive transition. My daily life is the reason for my durability and usefulness as the salt of the earth. “​​I have always had a great sense of faith – and feel that everything is for a purpose…this is my purpose. I’ve always had faith in my family, my fellow comrades, and my medical team.“ I feel blessed to have been able to live a life with purpose. Worrying did not cause my condition and worrying will not make it go away. As mentioned earlier, I look at having AFAP as a challenge rather than an obstacle. My mindset has been and continues to be not to think about the things I am unable to control, such as medical conditions. What I can control is my attitude – which has always been and will remain positive. My positive attitude had a direct impact on my faith, adapting to life as an ostomate, and my purpose in life. That said, I’ve adopted four words I reflect on daily: Attitude; FAITH; ADAPT and Purpose. Attitude Maintaining a positive attitude is instrumental in overcoming adversity FAITH Full Assurance Influenced Through Hope (An acronym I created after my diagnosis.) ADAPT ​Attitude Determines the Ability for a Positive Transformation (An acronym I created shortly after my ostomy surgery.) Purpose My purpose is to educate medical students and professionals about hereditary colon cancer syndromes and the importance of early detection continuing the legacy of Dr. Henry T. Lynch, in hopes of saving lives. It's been said that faith is eminence of the unseen. Example: We can see the tree branches swaying in the breeze. However, we’re unable to see the breeze, just the effect of it. My positive attitude and strong faith had a direct impact on my ability to adapt to life as an ostomate with a rare disease. My mantra is a positive spin on a bleak diagnosis: Always Forge Ahead with a Purpose. Stay positive, keep the faith and find your purpose. “My positive attitude and strong faith had a direct impact on my ability to adapt to life as an ostomate with a rare disease.“ In closing, here’s my analogy of life and baseball. What do they both have in common?​Neither has a time limit. If the baseball game goes into extra innings, I think of it as free baseball. My life as a colon cancer WARRIOR is in extra innings. Therefore, I’m enjoying free baseball. I have come to realize when life throws us a curve, it is a personal choice on how you handle it. That's my story and I’m sticking to it. Always Forge Ahead with a Purpose! California Senator Roger Niello authored Senate Concurrent Resolution-109: designating March as CRC Awareness Month in California. Dan and some of his colleagues were invited to the Capitol by Senator Niello when he introduced this measure on the Senate Floor. It passed unanimously, 34-0. Book a FREE call with a survivorship mentor to talk about your experience with colorectal cancer

Joe Bullock was diagnosed with stage 3b colorectal cancer in 2018. He's the COO of Man Up to Cancer and a Community Manager at COLONTOWN. I have lived through many different phases of this cancer journey After almost 6 years of being NED ( NO Evidence of Disease) from Stage 3B Colorectal Cancer. To be able to say 'I'm relieved' to have survived cancer would be an understatement. Although my life definitely has not been the same since being diagnosed with cancer. I have lived through many different phases of this cancer journey from being a person diagnosed with cancer, then battling the depression caused by it, to surviving it. It can even be quite embarrassing talking about butt stuff all the time, especially for men. As a cancer patient, your life becomes pretty exposed and then you are forced to face your own mortality. It can be all-consuming and overwhelming at times. Over the years I have trained to take part in many activities in the cancer community. I have learned to be an advocate for it, and tried to be a supportive friend to other survivors in treatment. Over the last five years, I have struggled to find the balance in life between being a cancer patient, a survivor, an advocate and to be able to live in the aftermath of it all. Once you are diagnosed with cancer your days and nights are spent focusing on your treatment and survivorship from this disease no matter the type of cancer. Then you find yourself worrying about the others you come in contact with who have heard those same three words 'You Have Cancer' and you hope they survive it as well. Over time you can find yourself caught up in the endless feelings of guilt because so many of the ones that you have supported over the last few years have been taken by this disease. I recently found myself battling the same type of depression as I did in treatment because I just don't feel I can be enough or find my worthiness as a survivor of cancer. A couple of years before I was diagnosed with cancer I found myself in that 'middle age' time in my life. I was pretty restless and I was even down right bored with myself . I would go for long walks and find myself hoping that the universe would just shake my life up a bit. Don't get me wrong I have a great life with a loving wife and a couple of wonderful kids anyone would be proud of as a parent. I just felt a bit unfulfilled at the time. As is typical for a lot of older middle-aged men. My male friendships had faded over time and I had been trying to find more people to connect with just to have a few new friendships. You might call it a midlife crisis but you should be very careful what you wish for in this life. Those life 'shake-ups' might take you to some very unexpected places. Especially being diagnosed with cancer but I have to say it brought me some of the best friends I have ever had in my life. Being a cancer caregiver and patient A few years ago my Dad was diagnosed with early onset prostate cancer. I only found out because at the time we both had the same primary care physician. I would learn of his diagnosis during a routine physical with the same doctor who had brought it up as part of my family history. My Dad wasn't crazy at the time that I had found out about his cancer diagnosis in this way and he was upset that I knew about his diagnosis. He was hoping to keep silent so as not to worry the family. As time progressed I would soon learn that my Dad's prostate cancer had gotten to the point in his disease where I would have to become one of his main caregivers. He had refused treatment early in his diagnosis and had allowed the cancer to run its course. The pain from the progression had become so unbearable for him to the point he was abusing over-the-counter pain medicine to deal with the pain. One night while he was going to the bathroom he fell and broke his hip. At first, he refused to go to the hospital to try to repair the injury because I think he was worried he would never return home. Unfortunately, this would become true because his abuse of the pain meds was causing his organs to fail. I would spend the next couple of weeks caring for him at a local hospice center until he passed away. All the while caring for my Dad I would start to have symptoms related to a colorectal cancer diagnosis. There were general symptoms like blood in my stool, changes in my bowel movements, and some unexplained fatigue. After a routine colonoscopy, I would find out that I had stage 3b colorectal cancer. I would be facing the same reluctance to get treatment as my Dad did when he was diagnosed. The difference was I chose to listen to my doctors and pursue treatment. My Dad told me right before he died that he regretted the decision not to seek treatment to prolong his life. I would think of him often when I was going through treatment for my own cancer. I just wish he had been more open to treatment early on instead of letting the cancer quickly fade him. A few months after being cancer free a friend of mine was going to the cancer center alone for his chemotherapy treatments. When I found this out I quickly offered to go and sit with him. It was odd being in the infusion room and listening to all those sounds of the monitors as he prepared for chemotherapy. I felt the hairs raise up on my arms as I realized I had been sitting in that same spot myself a couple of months ago waiting for chemotherapy. For my friend being he had metastatic stage IV colon cancer his journey was much longer than mine in that infusion chair. About a year later it would not be the cancer that failed him but his enormous heart would give up and cause him to give up the fight. An advocate for men battling cancer Being a caregiver for my Dad and being diagnosed with cancer myself I realized that the universe was setting me up to be an advocate for men battling cancer. The day I visited my friend going through chemo treatments I realized I had a greater purpose in my survivorship from my own cancer. The years following I would realize my own path moving forward as I began to accept I was cured from my own cancer. Today most of my best friends are cancer survivors and a few of them I have even helped to walk home because they left this earth because of the disease. It has been an honor to be in that space with them and I continue to be. I keep their stories alive in my advocacy work today. Over the last few years I have been involved in leading a facebook group called ‘The Howling Place Group’ that was created by one of my best friends Trevor Maxwell as a part of his manuptocancer.org website. We affectionately call ourselves a ‘Wolfpack’ because we ‘howl’ about cancer everyday in the group. It is a group for men only so they have a safe place to share their personal journeys with cancer. The goal from the beginning is to help men to understand they do not have to fight cancer alone or need to live in the self-isolation that it may bring with it. Last year Trevor created the Man Up To Cancer nonprofit of which I am currently serving as the Chief Operating officer. It has given me an even greater opportunity to serve in the cancer community. I won’t let it fade me In the last five years I have had to gain a better understanding of a work-life balance. Being an advocate in the cancer space can easily become overwhelming because the needs of the community can become suffocating at times. For my own mental health, I have had to learn to step back and delegate responsibilities to others that want to help. I have known friends to walk away from offering support because they couldn’t find this kind of balance in their lives as survivors. I believe cancer didn’t take me for a reason and I won’t let it fade me from offering the support I love giving today to so many in the cancer space. It’s why I always say "Cancer might be done with me but I’m not done with cancer." Book a FREE call with a survivorship mentor to talk about your experience with colorectal cancer

Lori Drummond is a Registered Dietitian at The After Cancer Surviving cancer is a journey Surviving any cancer -- including colon cancer -- is a journey marked by perseverance, resilience, strength, and the unwavering determination to overcome one of life's greatest challenges. While medical treatments play a vital role in battling this disease, the journey toward recovery extends far beyond the hospital or clinic walls. Nutrition plays a crucial role in supporting colon cancer survivors as they rebuild their health and vitality during conventional therapies and beyond. Nutrition plays a crucial role It’s recommended that all cancer patients undergo nutritional screening to ensure that those likely to experience unwanted weight loss are identified and can be directed toward and guided by a nutrition professional such as a dietitian or nutritionist with advanced practice training in oncology. The journey through colon cancer treatment can take a toll on the body, impacting everything from appetite to digestion. Chemotherapy, radiation therapy, and surgery can all affect the body's ability to absorb nutrients and maintain optimal health. Common side effects such as nausea, vomiting, diarrhea, and loss of appetite can further complicate nutritional intake, making it challenging for survivors to meet their body's needs. To bridge the gap during the transition phase which is immediately after treatment to the predisposition phase (surveillance stage), it remains important for a survivor to continue to eat well, get those essential nutrients, and optimize health with the right nutrition – to stay on track for the long run. It’s so vital that it should be considered a life-long commitment or simply a permanent lifestyle change. This will rebuild strength and stamina but also support the body's immune system and promote overall well-being including good mental health while reducing the risk of recurrence. How nutrition intervention supports colon cancer Here are some important ways in which nutrition intervention supports colon cancer: Supporting Digestive Health: Survivors might experience changes in digestion or in bowel habits.  Consuming a diet rich in vegetables, fruit, and whole grains – all providing fiber -- can help improve digestion and restore bowel regularity, and potentially prevent complications such as constipation or diarrhea. Boosting Immune Function: Assuring a diet that provides sufficient vitamins, minerals, antioxidants, and phytonutrients can help strengthen the immune system, which is essential for fighting infections.  Eating the colors of the rainbow including foods such as dark green leafy vegetables, red or purple berries, orange citrus fruit, and nuts and seeds are loaded with immune-boosting nutrients that play a critical role in the body’s defense mechanisms. Maintaining Healthy Weight: Obesity is a well-known risk factor associated with the development of many cancers. Therefore, recommendations are to work toward a healthy weight.  On the other hand, if weight loss during treatment results in becoming underweight, the goal is to obtain a healthy weight for your body height and type. That’s where a personalized plan created together with a nutrition professional is so important. Incorporating physical activity, if able, of 150 minutes per week of moderate exercise is recommended, or staying as physically active as your situation allows. Reducing Inflammation: Chronic inflammation has been linked to an increased risk of cancer recurrence and other health issues. Consuming a diet rich in anti-inflammatory foods can calm inflammation. These foods include herbs, spices, and healthy fats such as found in cold-water fish and olives. Others include a variety of fruits and vegetables while avoiding processed or fast food and sugar-laden beverages. Promoting Emotional Well-Being: We all know that eating isn’t only about physical health, it’s an emotional and social experience. Preparing and sharing nutritious meals with loved ones can provide enjoyment, comfort, connection, and a sense of normalcy following a challenging and stressful time. Certain foods such as dark chocolate and leafy greens have been shown to support mood and mental health. This is equally so, as all these foods mentioned above support a healthy microbiome which has been shown to improve mood. All this to help survivors cope with the emotional toll of their cancer journey. Nutrition-related recommendations for colon cancer survivors should provide personalized healthy nutrition-related guidance that includes specific measures that can help manage or prevent co-morbid conditions commonly present in cancer survivors. Seeking support from healthcare professionals, survivors can optimize their health and well-being in numerous ways as they embark on the journey toward a brighter, healthier future. Check out Lori's profile and book a FREE intro call

Brenda Burk MSN, RN, NEA-BC, CSSM, CNOR, serves on the Board of Directors for Hospice and Palliative Care for Iredell County, is a national spokesperson to reduce incivility and bullying in nursing, and serves on the Executive Round Table of the Association of Operating Room Nurses. She is a recipient of the DAISY Lifetime Achievement Award by LNRMC, where she served as Director of Surgical Services before her recent retirement. Brenda volunteers for cancer survivor events through various organizations and volunteers at RainbowKidz, serving children experiencing grief and loss. In her free time, Brenda loves to cook, bake, sew, read, do jigsaw puzzles, travel the world, and spend time with her adult children. The day that changed my life… I had my first colonoscopy on a Friday, almost twelve years ago. I knew that I was three years late in getting the colonoscopy done per the American Cancer Society guidelines, but I was not worried about it as I was fit and healthy. Additionally, my three older siblings had been screened and were cancer-free. The reason that I delayed it was that I had a hectic job in a high-pressure environment and (stupidly) did not think I could take the time off. Boy was I wrong! I remember being woken up after the procedure by the Gastroenterologist (GI Doctor) who was holding a full-page photograph. Being a surgical nurse, I was able to recognize the image… a polyp, the size of my thumb, surrounded by a mass of about six inches in my colon. I said to him, “whose is that?” and he looked at me with concern and said, “it’s yours!” Believe me, I woke from the anesthesia right now and went into panic mode. I vividly remember saying to my husband, “what are we going to do?” We have three children, two were in college and the youngest in high school, so my immediate thought was of them not having a mother if it was cancer. Believe me, I had some crazy thoughts and emotions! There was a flurry of activity in the ENDO unit, and the next thing I remember was a general surgeon walking in. He very calmly explained that I was going to need a colectomy (a surgical procedure) to remove the part of my colon with the tumor. He said he was available to do the surgery on the Monday morning. I was scheduled for a CT scan on the Saturday and was instructed to be on a clear liquid diet for the weekend. That weekend was surreal, calling friends and family to tell them the news. We did not know if it was cancer yet, as the biopsy results would not be available for a few days. I had just resigned from my position and was scheduled to start a new job in two weeks. I called my new boss to tell her that I was not sure when, if ever, I could start; she was so kind and compassionate and told me that my health came first and they would wait for me! Colectomy surgery Monday came quickly and I was wheeled into the OR to have a sigmoid colectomy, which went very well according to the surgeon. The colon, or large bowel, has three sides: the ascending colon (right side), the transverse colon, and the descending colon (left side). The left side of the colon has four sections: the descending colon, the sigmoid colon, the rectum, and the anus. The surgeon was able to remove the tumor laparoscopically and reattach my descending colon to the rectum, so no colostomy (bag), which was a fear. On the Wednesday, the surgical team came in to break the news that it was Stage 1 colon cancer. It was really pretty weird being told that you have cancer when the surgery had already rendered me cancer free!!! I was very blessed that the surgeon was able to get clean margins and that all the lymph nodes were clean, so I did not need chemotherapy. I was in the hospital for five days and was able to start my new job six weeks later. My cancer journey opened a new door for me Two years after my procedure, I walked the Get Your Rear in Gear 5k to show gratitude for my survivorship, and to walk in memory of a good friend who died 13 months after his Stage 4 colon cancer diagnosis. He was having symptoms and only went to be screened after he learned my diagnosis. The crazy thing was that I did not have any symptoms. I subsequently learned that colorectal cancer is referred to as a “silent killer” because by the time you are having symptoms you are typically in an advanced stage. I am now a big proponent for early colon cancer screening and prevention. I started this blog saying my life was changed, so let me tell you why. I really believe that my cancer journey opened a new door for me and a reborn and better me emerged. For this, I will always be grateful. Through connections made at Get Your Rear in Gear, I was able to attend a cancer wellness retreat. At this beautiful nature retreat, I was treated to a session of Healing Touch therapy. This is an energy therapy in which the practitioners consciously use their hands in a heart-centered and intentional way to support and facilitate physical, emotional, mental, and spiritual health. I do not know how or why, but I felt amazingly lighter and brighter - it was life-changing! The transformation continues to be amazing. I used to be very rigid and science-based. I am now much softer, more creative, and have channeled my focus on helping others through their cancer journeys. I look at my diagnosis as a blessing which is allowing me to live my best life. I am now a student of Healing Touch. I do a daily walking meditation in my backyard labyrinth and love to host spiritual and creative gatherings. I assist at cancer wellness workshops and retreats where I have met many remarkably brave and wonderful people. I have made many new friends through our common diagnosis of cancer. In Charlotte NC, we are truly fortunate to have wonderful programs like TheAfterCancer.com with trained professionals to support us as we navigate our cancer journeys. I now have routine colonoscopies and have had numerous precancerous polyps removed during these procedures. I often think that if I had delayed any longer the outcome would possibly have been vastly different. So please, if you are reading this blog, go for your screening on time. The ACS recommends that people at average risk of colorectal cancer start regular screening at age 45. Book a FREE call with a survivorship mentor to talk about your experience with colorectal cancer

Howard Brown is a Silicon Valley entrepreneur, best-selling author of Shining Brightly, award-winning international speaker, inspirational podcaster, survivorship coach, health technology consultant and two-time stage IV cancer patient and survivor 30 years apart. He shares the keys to leading a resilient life with hope that drives successful community leaders, business innovators and healthcare advocates. Be prepared to be inspired! https://ShiningBrightly.com A Cancer Journey is a Team Sport I am a two-time stage IV cancer survivor, 30 years apart—so I know that the moment we hear the words, “You have cancer,” everything comes to a screeching halt. I was that deer in the headlights at age 23 in 1989 with stage IV non-Hodgkin Lymphoma. My story changed after the shock of my second diagnosis. This time, I became like a Marine on a mission when I was diagnosed with stage IV metastatic colon cancer after my 50-year-old colonoscopy. Even though my awareness of what I was facing and my commitment was different than when I fought cancer in my 20s—these diagnoses both filled me with fear. Cancer I In October 1989 at the age of 23½, I was diagnosed with stage IV T-cell non-Hodgkin Lymphoma (blood cancer of my lymphatic system). I moved back home with my parents, and they became my caregivers. As we started this journey, we knew nothing—and there was little we could find, compared with today’s Internet. We kept searching for answers, because I failed all the chemo regimens the doctors tried. I kept relapsing. In February of 1990, my twin sister turned out to be an exact 10-for-10 HLA match for a bone marrow (now called stem cell) transplant at Dana Farber Cancer Institute in Boston. Miracle No. 1: My twin sister had a 1-in-25,000 chance of being a donor match for me. On May 17, 1990, I checked into an isolation room for a blasting of chemotherapy and twice-daily full-body radiation to knock out my immune system. On the morning of May 24, 1990, my twin sister had bone marrow extracted from her hip bones. That marrow was treated and infused in me at 5:44 pm that day. We watched to see if the transplant would kill me right away, cause any type of severe graph-vs-host disease—or, we hoped, begin to rebuild my immune system. My twin sister saved me and I was able to put Humpty-Dumpty 1.0 back together again. As a result, I moved far from home to Marina Del Rey, California. One important side note: Before I did one drop of chemotherapy, my liver function tests were running too high for safe infusion. While we waited for those levels to subside, my oncologist spoke to me about fertility options and going to the cryogenic center to leave a sperm sample preserved. Miracle No. 2: Because I beat cancer, that decision to visit the cryogenic center allowed me to get married—then my wife and I could call for the frozen sperm eleven years later and be blessed with our miracle girl—our daughter Emily. Cancer II Those early successes gave me 26 years of life. I got married; put my career as a Silicon Valley technology entrepreneur back on track; became a dad; and involved myself in volunteer community service. Then, lightning struck again. At age 50 in June 2016, I went in for my routine colonoscopy and was diagnosed with stage III colon cancer. Back to more surgeries and chemotherapy. This time, my wife Lisa stepped in as my primary caregiver. One year later, I was metastatic stage IV with the cancer spreading to my liver, stomach lining, and bowel. Would I get to see my daughter, who was then in 9th grade, graduate from high school? Why was I hit twice? I learned that young-onset cancer patients can develop a secondary cancer. I wish I had gotten screened for colorectal cancer years earlier. In the US, the recommended screening age was just lowered from 50 to 45, unless you have family history or symptoms. Because I learned from my first bout with a deadly form of cancer that this fight is truly a team sport—I knew that I needed to reach out for allies. In 2016 there were many more digital support options and my wife and I found www.colontown.org for patient and caregiver information and support. It was there I learned about CRS HIPEC—a massive surgery to remove all cancer cells from my stomach lining, liver, abdomen, bowel and then my doctor used heated chemotherapy placed in the pelvis and abdomen to kill micro-cells of cancer. This life-extending mother of all surgeries helped me to reach NED (No Evidence of Disease)—and has kept me there for four years at this time. Once again, I am a work in progress, reassembling Humpty-Dumpty 2.0 day by day. Battling cancer, we share a lot—but we’re each on a unique journey There is no one-size-fits-all all survivorship plan. Whether you are still battling cancer or trying to reassemble the first pieces of your old life again—or you’re somewhere along the journey toward consistent reports of NED at your checkups—you have discovered that there are many different paths we can take. Our journeys likely start with chemotherapy, radiation, surgeries, side effects and often we are placed on “surveillance” mode. Typically, there are quarterly blood tests and CT scans. For me, I have the hidden side effects of chemo brain (also called brain fog / PTSD), peripheral neuropathy and digestive / bathroom issues still persist. They are hidden. People assume you look and feel great and many days I do — but I carry with me an enormous legacy of my treatments. If that’s your experience, you are not alone! We share so many challenges: Getting our emotional well-being back on track Building our physical stamina and fitness moving forward Figuring out our finances and career situation Nurturing relationships with our family, friends and co-workers That’s all part of what I call “putting Humpty-Dumpty back together again.” Many people are overwhelmed with trying to navigate “after cancer.” Our lives are not the same after what we have just lived through. These changes may be very difficult — including finding a job again. I chose to publish my memoir Shining Brightly to help others. I speak at conferences to share my stories and experiences so that others may find inspiration for getting back up again. I started an inspirational podcast to highlight others’ human resolve and ability to help lift up others. Survivorship, like fighting cancer, is a team sport. Build your team or let others like me help you take the positive steps forward to help you shine brightly every day. My heartfelt advice to others facing cancer: Do not go at it alone. It’s time to rally the troops and build your team. Surround yourself with a care partner, mentor and people who care for your well-being. Time to be selfish in your time of need. Be able to accept help from family, friends and even strangers. Get smart and educated about your diagnosis. Online resources and cancer advocacy networks have an abundance of resources. Collaborate with your caregivers—and thank them! Care partners, doctors and nurses are your lifeline. Thank them repeatedly. Make memories. Spend time with loved ones and experience things that lift your spirit. Find your happy place and go there often. Hiking, biking, nature, art, sports, cooking, yoga, meditation, travel—whatever lifts your spirit can be your “happy place.” Love yourself and share your light Each day, go to the mirror and say “I love myself because—" More and more people are living longer with cancer, I hope and pray you will too. Cancer is a team sport where we can all join hands and face it together. Book a FREE call with a survivorship mentor to talk about your experience with colorectal cancer