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  • Majority of Breast Cancer Survivors Can Successfully Achieve Pregnancy - New Study Reveals

    A new study has found that most young women who attempt pregnancy after a breast cancer diagnosis can successfully conceive and give birth. This research, conducted by Sorouri et al, will be presented at the 2024 ASCO Annual Meeting. The study analyzed data from the Young Women's Breast Cancer Study, which included women diagnosed with stage 0 to III breast cancer at age 40 or younger from 2006 to 2016. Researchers excluded women who had prior hysterectomies, bilateral oophorectomies, or metastatic disease at diagnosis. 65% of Participants Reported At Least One Child Participants: 1,213 women, with 197 attempting pregnancy post-diagnosis. Demographics: Median age at diagnosis was 32; 74% were non-Hispanic White. Cancer Stages: 41% had stage I, 35% stage II, 10% stage III, and 14% stage 0. Treatment: 76% had hormone receptor-positive disease; 68% received chemotherapy. Pregnancy Attempts: 73% of those who tried to conceive were successful, and 65% reported at least one live birth. Timing: Median time from diagnosis to first pregnancy was 48 months. What Factors Can Influence Pregancy After Breast Cancer? Age: Older age at diagnosis reduced the likelihood of pregnancy and live birth. Financial Comfort: Greater financial comfort increases the likelihood of pregnancy. Fertility Preservation: Undergoing fertility preservation at diagnosis increased the likelihood of live birth. Why is Discussing Fertility Preservation Important? This long-term study highlights the critical importance of making fertility preservation services accessible to young breast cancer survivors. Given the significant number of women who can successfully conceive and give birth post-diagnosis, it's evident that fertility preservation can play a crucial role in their family planning. Ensuring that these services are readily available and integrated into cancer care can provide hope and practical options for survivors looking to maintain their fertility and achieve pregnancy after treatment. Are you a Breast Cancer Patient? Book a free call with Cheryl Lecroy, a breast cancer survivor part of our Care Team.

  • Fear of Recurrence - by Cheryl Lecroy

    Cheryl Lecroy is a Wellness Coach at The After Cancer. What is fear of recurrence and why do I have this? Fear of recurrence is a natural part of the normal process after a cancer diagnosis. Typically, more prevalent in survivors who are diagnosed with non-metastatic disease or with those who are deemed NED (No Evidence of Disease) through treatment. This fear often shows up after treatment is completed and a desire for a life that resembles normalcy returns. The term “New Normal” is often used when describing this stage or sometimes “Back to Normal” is used. How does it show up for cancer survivors? What are the triggers? Does it ever go away? The truth is that anxiety about the unknown is normal. Fear of recurrence can show up sporadically and unexpectedly. Research shows that up to 89 % of survivors experience some level of a Fear of Recurrence. It can disrupt psychological well-being and manifest anxiety, depression, post-traumatic stress disorder, and feelings of uncertainty and vulnerability. Some of the symptoms may include poor sleep, restlessness, scattered thoughts, diminished self-esteem or being short-tempered, among other ways. It is important to recognize this as a condition that is REAL but also have reassurance that there are effective ways to cope with the fear of recurrence. Recognizing some of the triggers that bring on the fear of recurrence is also very helpful so that steps can be taken to understand and alleviate the fear. Common triggers include: Scanxiety – the anxiety that comes with upcoming scans. Planning for the future – Ready to resume some form of normalcy such as planning a vacation but unsure that you will be physically able. Unexplained pain – Every ache and pain could be the return of cancer, even if it may be irrational. This fear can be much stronger at the end of treatment and will often lessen or even diminish over time. Research shows that many breast cancer survivors experience the fear of recurrence for 9 years. So be patient with yourself. How can I manage fear of recurrence? The GREAT news is that are effective ways to manage the fear of recurrence. Acknowledge your feelings and most importantly, be gentle with yourself. Join a positive support group. Surrounding yourself with survivors who understand what you are experiencing is powerful. Use positive self-affirmations and kind, loving words when referring to yourself. Spend more time doing the things you LOVE to do. Positive distraction with at least one pleasurable activity per day can have a huge impact on mindset and mood. Remind yourself daily that going backwards is not an option. Instead of trying to get “back to normal” try instead of embracing the NOW of Normal, at this very moment with the question. What can I be NOW? Add a self-care routine to encourage positive lifestyle choices that can reduce your risk or recurrence. Proper nutrition, exercise, and stress reduction techniques are just a few of the things you CAN implement to regain some control of your situation. Recognize that you are not a statistic, and that recurrence rates on a cancer diagnosis do not consider all the positive reinforcement and changes you are making in YOUR situation. A wonderful unique individual!!! Book an appointment with one of our care team professionals at The After Cancer. We are here for you with evidence-based practices to support you to a healthier and more resilient survivorship. Want some more personalized support? Book a visit with Cheryl or another member of our Care Team

  • May is Brain Cancer and Brain Tumor Awareness Month - by Christopher Schuler

    In a video shared with The After Cancer, patient advocate and former primary caregiver, Chris Schuler adds his voice to the many advocating for greater urgency and awareness about Brain Cancer and Brain Tumor Awareness Month. He recognizes all those whose lives have been touched by the disease – current patients, survivors, and caregivers - and acknowledges the tireless efforts of those who are working to help fight it – doctors, researchers, donors, and investors. He concludes that Brain Cancer and Brain Tumor Awareness Month is an opportunity for us all to come together in order to affect real change. “No matter how you recognize this month – through advocacy, survival, or quiet reflection – you are not forgotten, you are not alone. We need everyone pulling in the same direction and with the same persistence and unwavering focus if we expect to see change.” Chris is a staunch brain cancer awareness advocate. He was the primary caregiver to his late Dad, Donald Schuler, who was diagnosed with GBM in July 2021. He works closely with organizations across the globe, amplifying their critical work and building key relationships to further improve outcomes for patients. He's currently working with Cure Brain Cancer Foundation, an Australian non-profit dedicated to improving outcomes in brain cancer. He's a Venture Partner with Varia Ventures, working to raise awareness for emerging venture funds dedicated to uncovering and funding innovative discoveries to improve brain health. He also works closely with SageMedic, a precision oncology start-up supporting patients looking for the most effective treatment for cancer. Could you use a hand in your cancer journey? Book a free call with our survivorship guide!

  • Pelvic Pain and its Effect on Intimacy - by Dr. Katrina Heath

    Dr. Katrina Heath is a Physical Therapist specializing in pelvic floor health at The After Cancer. Pelvic Pain One of the dearest subjects to my heart that has affected so many women who have come into my office to see me as a pelvic floor therapist has been pelvic pain. According to the NIH, chronic pelvic pain continues to affect 4-16% of the population of women. These are people who live the majority of their days having pelvic pain. Physical therapy can help patients with chronic pelvic pain and with intermittent pelvic pain. Some people are misdiagnosed for years with pelvic pain just because for them it is not present all the time. So they forget it exists until it returns again sporadically. Pelvic pain may also present in individuals who have different cancer diagnoses (ie. breast, uterus, bladder, cervical, abdominal cavity). Pelvic pain also presents with diagnoses of endometriosis, dysmenorrhea (painful periods), painful bladder syndrome/interstitial cystitis. Some other diagnoses that cause pelvic pain may be irritable bowel syndrome, vulvar pain, vulvodynia, vestibulodynia, vaginismus, pelvic congestion, polycystic ovarian syndrome and pelvic pain due to undisclosed diagnoses after having a baby or a hysterectomy. Pelvic Pain and Intimacy Having pelvic pain can stress your marital relationships, place a strain on your mental health and even put you in a space of depressed mood. It can cause anxiety because you are not sure when it will return or you know exactly how it will return ie. in the bedroom. This is by far when enough is enough. It has been plaguing you for a long time but when you can no longer have intercourse with your partner and your intimacy has continued to plummet you have to do something about your pelvic pain NOW!!! Some women struggle with being afraid for your partner to touch your vaginal area because this may cause increased spasms in your pelvic floor. Others struggle with relaxing their pelvic floor muscles to empty their bowels or bladder. There is a condition called vaginismus which is categorized as primary or secondary. Primary vaginismus happens when vaginal penetration is impossible because of pain you have experienced for your entire life. No object, speculum or penis is able to enter the vaginal canal. Secondary vaginismus happens when you were once able to have penetrative intercourse, but because of life’s circumstances now you can no longer participate in the act. Pelvic Pain and Cancer Treatments This occurs sometimes after having received treatment for cancer especially if you had a decrease in estrogen hormones, total hysterectomy, or radiation. These are things that your physicians may or may not tell you. Sometimes they educate patients that this could happen but most patients are so focused on decreasing their cancer that they look over this conversation and forget that pelvic pain could come as a result of treatment as a secondary issue. Tissues may be very dry, brittle and thin following treatments for cancer and after certain hormones have been reduced in the body. Our minds are also affected by lack of intimacy. Some women are in a place where they are so super stressed and there is a lack of concentrating on relaxation and breathing appropriately. Because of this penetrative intercourse cannot happen and pelvic pain is the result. Not breathing well affects how we move in the bedroom. There is a strong connection. How to manage pelvic pain and how can your PT help? This is the place where a pelvic floor PT can help reduce pain. There are 10 practical methods to help one reduce pelvic pain. Remove unnecessary stressors from your life Learn to breathe properly through your diaphragm Learn how to relax your pelvic floor muscles with a pelvic floor physical therapist Stretch muscles of your hips, low back and abdominal wall Learn how to appropriately use a vaginal wand/dilators Use lubrication Communicate how you feel with your partner/spouse Request a Pelvic Floor PT consult - (request a visit with me) Get a mental health therapist or coach to help you talk through your intimate concerns Exercise I hope that you have found this information helpful and that you can apply some of these strategies to your daily routine if you have pelvic pain or know someone who does. Be well! Want some more personalized support? Book a visit with Dr. Heath or another member of our Care Team

  • Breast cancer gave me a second chance in life - by Dr. Amanda Kotis

    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!

  • Long Distance Cancer Caregivers - by Carolyn Dowdy (Caregiver Mental Wellness, Inc.)

    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!

  • The Unexpected Journey: The battle after the battle with cancer - by Jesse Dillon

    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!

  • Vaginal Dryness After Cancer - by Dr. Lisa Jervis, MD

    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

  • Rocky Slopes and the Gentle Paths - by Arnel Greenberg

    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!

  • Challenging Family Dynamics and Cancer - by Dr. Diane Benfield, LCSW

    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

  • Tame the Flame: Natural Solutions for Hot Flashes - by Marie Theriault

    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!

  • Stay positive, keep the faith, and find your purpose - by Dan “Dry Dock” Shockley

    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

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