reflection

Wednesday, April 30, 2008

Dispensing goodness

I’m writing this from the small Redmond airport that services all of Central Oregon. Like an obedient traveler, I arrived an hour before my flight. There are exactly two other obedient travelers in the waiting room with me. Good thing we got here early.

I’m on my way to a Susan G. Komen For the Cure grantee luncheon at the Governor’s Hotel in Portland. We (St. Charles Cancer Services) were awarded Transportation and Community grants, which will fund some pretty cool things for breast cancer patients in our region – education, screenings, and gas and lodging assistance for those traveling some distance to Bend for treatments.

There are close to 30 people in the Cancer Treatment Center where I work. There’s the medical side, made up of radiation oncologists, therapists, nurses, et al … and the Cancer Services side that facilitates a wide array of support programs and services at no charge to the patient.  

These programs and services are made possible in part by grant funds and by third party fundraisers (there are some pretty amazing people in our community who have been touched by cancer and have decided to do something about it). It is my good fortune to work with an incredibly caring team that helps dispense all that goodness to cancer patients.

The airport waiting room is beginning to fill up with travelers who look as if they slept in 20 minutes longer than I did. This will be a long day with a return flight this evening, but I am looking forward to networking with fellow Komen grantees and celebrating the privilege of being able to dispense goodness to cancer patients in our area.

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Monday, April 28, 2008

Cancer community – part II

Gary and I started attending the monthly DEFEAT Cancer meetings about two years ago. (I am now on staff in Cancer Services at St. Charles Medical Center and part of my job is to assist Dr. Bleyer with the DEFEAT Cancer program.)

I remember that first meeting well. After dinner and the guest speaker, Dr. Bleyer led a 2-mile walk around the hospital grounds and down a side street. Gary and I had already done some serious hiking by that time, but we enjoy any excuse for being outdoors.

As it turned out, we walked and chatted with a couple who were also fairly new to the program. She is the survivor; he is the caregiver. Among other factors, their friendliness was part of the reason we returned the next month.

Our friendship has grown these past couple years – we’ve hiked together; met at Barnes & Noble for conversation over soup and sandwiches; they’ve been in our home for dinner.

And so the email I got from my friend this morning totally caught me off guard. Her cancer has metastasized to her brain.   

I am going to pray and believe for the best for my friend and her husband, but there is a price to pay for being part of a community … or a family … or any close-knit group. There’s heartache at the thought of someone you care for going through any kind of suffering.

Bottom line, however, is that belonging in community with its inherent risks for heart pain far outweighs not belonging.

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Sunday, April 27, 2008

Cancer community

We hiked the Flatiron Rock trail in the Badlands east of town yesterday morning. We went with a group ranging in age from the mid-teens into the 60s. Most of us were there to increase our level of physical activity as we train to summit one of the local peaks in September. All of us are related in one way or another to the local cancer community.

At the halfway point of yesterday’s hike, we climbed Flatiron Rock with its sweeping views of the Cascade Mountains and pulled out our lunches. I counted ten distinct snow-covered peaks – from our own Mt. Bachelor to Mt. Hood near Portland.

 

The nice thing about hiking with a group is the opportunity to participate in several conversations along the way – I chatted with a 16-year-old about his recent 2-month visit to Africa; eavesdropped unashamedly on a conversation between two women who hiked in and around Bryce Canyon, Zion National Park and the Grand Canyon; and learned a little more about the family and background of a male breast cancer survivor.

My take is that the increased physical activity is a by-product of these hikes. The important piece is the camaraderie.

Community is about sharing experiences. It's about giving and drawing strength and encouragement from others who are on a similar path (no pun intended). For us, the connection with our local cancer community through the DEFEAT Cancer program has been a critical piece of how we intend to continue living well with cancer.

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Thursday, April 24, 2008

Barn door analogies

When Gary was first diagnosed, we specifically asked the medical experts about the roles of exercise and nutrition. We got some pretty interesting responses. One oncologist said to Gary, “You’re in good shape … just keep doing what you’re doing.”

My all-time favorite came from a urologist: “I’ve heard that lycopene might be good for prostate cancer and tomatoes have lycopene … so you might want to try eating more tomatoes.” Gary was really glad to hear that—“I figured I could just add more tomatoes to my Big Mac,” he reasoned.

And so we did some research. We steered clear of the extremes—no week-long cleansing fasts or coffee enemas for us—and came up with a simple plan for the nutrition piece. We increased our fruits, veggies and legumes … switched to whole grains … eliminated unhealthy fats and sugars … and eat more fish.

As for exercise, Gary read somewhere that hormone therapy treatments cause bone density loss, and walking strengthens bones. So he started walking on weekdays and we took up hiking and snow-shoeing on weekends.

And then nearly two years after diagnosis, we stumbled across a local cancer survivorship program called DEFEAT Cancer founded by Dr. Archie Bleyer with an emphasis on nutrition and exercise and living strong. Seems there’s all this peer-reviewed literature highlighting the value of moderate physical activity and good nutrition during and after cancer. And in fact, where exercise and nutrition are combined, the value is exponentially increased.

Of all the useless responses we got from our doctors when we asked about exercise and nutrition, the one that irritated me the most was: “That’s sort of like closing the barn door after the horses get out.”

Common sense would tell you that healthy eating and exercise, at minimum, can help build a stronger body to counteract the side effects of the treatments. Not to mention all those endorphins being produced while exercising that serve as a natural "upper".

In a good many cases, it’s not too late to eat healthier and start moving, so don’t give me any barn door analogies.

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Saturday, April 19, 2008

Homemade soup day

The weather report said snow. I know, I know ... we’re well into April, but this is central Oregon. And so this morning we opted to hike the river trail close to town instead of heading up into the mountains.

Sure enough, while we were walking, fluffy white stuff began to fall from the sky.  Which put me in the mood for making a pot of soup when we got home.

Gary’s a big fan of chili and since beans are considered one of the top “super foods” – a food that contains a relatively high content of nutrients for the amount of calories – I looked for an easy chili recipe.

I came across one that called for tomatoes and chunks of yellow squash and modified it to fit what was in our pantry. We ate it topped with fresh snipped cilantro and a bit of grated cheese, with hot cornbread on the side.

Half the fun of cooking is trying new recipes, and half the fun of trying new recipes is modifying them to make them a bit healthier. I’m sure Gary would prefer a meatier chili, but he gave his stamp of approval on this one. (Gary went to the school that taught if your wife tries a new recipe and asks if it’s good, the correct answer is always "yes".)

So if it’s snowing at your house in April (we’re probably only talking Alaska and Iceland here) and you like a hearty soup, you might want to try this Turkey Vegetable Chili.

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Wednesday, April 16, 2008

Mice and tumors

The article* about prostate cancer caught our eye because the headline read, “Exercise may make tumors grow faster.”

The piece reported that “scientists from Duke University in Durham, North Carolina, believe that exercise might increase the blood flow to tumors, assisting their growth.”

Immediately I thought of all the physical activity that Gary does. Do we want to take the chance that it could cause more harm than good?

I read further. Apparently there were 50 mice in the study – all fed the same diet. Half of them had membership to a gym while the other half were given recliners and remote controls. They all had very aggressive tumors and weren’t receiving treatment. “Patients would not find themselves in the same situation,” the article pointed out. Well now, there’s an important sentence buried in paragraph seven.

While the headline is true according to the research, it’s not complete. It should read, “Exercise may make tumors grow faster if you’re a mouse with an untreated aggressive tumor and have access to exercise equipment.”

One of the challenges of survivors and caregivers is to sift through all the cancer information and determine how to apply – or not apply – it. In this case, we will not be giving up our hiking anytime soon. 

*Published April 14, 2008 in The Scotsman (Edinburgh)

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Saturday, April 12, 2008

Waiting room magazines

We threw a dart at a long list of doctors and got lucky … but I’m getting ahead of the story.

Gary’s diagnosis came from a urologist. With metastatic prostate cancer, radiation and chemo weren’t options so we didn’t need to switch to an oncologist for the prescribed hormone therapy (we did get second and third opinions on treatment options, including the viability of participating in a clinical trial).

After two years of hormone therapy, the local urology guys decided not to negotiate with our insurance company as preferred providers. They were the only game in town. Consequently, it was going to be less expensive for us to travel to the next nearest preferred provider – 250 miles round trip over the Cascade Mountains – than to pay the higher rates in town.

Here’s where the darts come in - we landed on Dr. E at a urology clinic in Springfield. Turns out, Dr. E was director of urologic oncology at Yale and held a prestigious urologic oncology fellowship at USC. We liked him immediately and he didn’t seem to mind that I had accompanied Gary into the exam room. (The previous guy barely acknowledged me and when I asked questions, he always directed his answers back to Gary. Hello … I’m in the room too.)

Dr. E liked that we were incorporating more physical activity and nutrition into our lifestyle and asked if he could refer other patients to our Web site. Gary’s PSA count went up twice in a row while on hormone therapy and Dr. E had a Plan “B” and Plan “C.” And he knew of a clinical trial being conducted at the Oregon Health & Science University that was showing some promise.

Our most recent appointment was last Monday. As usual, Dr. E was attentive, positive, encouraging. He asked if Gary had any complaints and then I told him my complaint: "Why don't you have more women's magazines in your waiting room?" (A girl can only read so much of Sports Illustrated and Newsweek.) He seemed surprised and asked what I'd recommend. I reassured him that I was only kidding.

Knowledgeable. Interested in our efforts at living strong with cancer. Hope-giving. Willing to put more women's magazines in his waiting room. What more could you ask for in a physician?!

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Friday, April 04, 2008

Weekend date

I’m overlooking the Pacific Ocean from our cliff-top room in Newport. The Oregon coast is one of our favorite places to visit. The sky and sea are gray and blue this evening and the gulls are circling and squawking near our window. We just got back from dinner at Mo’s where I had the world’s best clam chowder and a side order of marionberry cobbler. Gary – who is much better disciplined than I – ordered salmon and didn’t complain about me eating dessert in front of him. I texted our kids to rub it in: “We’re at Mo’s … wish you were here!” (Did I mention that the cobbler came with ice cream?)

For us, living with metastatic prostate cancer means driving over the mountains every four months for a hormone injection (Gary, not me). And so, in an effort to defy cancer, we make a weekend date of it. We brought books to read, a knitting project (me, not Gary), sturdy walking shoes and a football to throw around on the beach.

For if cancer has taught us anything, it’s taught us that life is made up of a whole bunch of single moments with simple pleasures thrown in – marionberry cobbler being one of them – and the present needs to be lived well.

Yes, we have future goals and dreams and are rather impatient for them to come about. But mostly we are learning to live in the moment, grateful for each other and our family … and for the many simple pleasures of life.

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Tuesday, April 01, 2008

First entry

OK ... here's the first entry on our newly-created Web site. When I asked Gary what he thought was the purpose of this blog, he said it was to highlight the everyday life of a family going through cancer.

We're aware that every diagnosis carries a different challenge and that we can only share our perspective on what it's like to live with a slow-growing cancer that has metastasized (translated: there is no proven cure ... yet).

The big picture is that we have a passion to encourage other survivors and caregivers on this journey, and so we hope you'll come back to visit often!

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