Triage Cancer Mourns a Great Loss

jhollandDr. Jimmie Holland, a pioneer in the field of psycho-oncology, served as a member of the Triage Cancer Scientific Advisory Council.

Words cannot adequately express the loss. Not only was Dr. Holland a valued advisor and supporter, she was a role model for us all. During her life Dr. Holland shattered glass ceilings and truly improved the lives of many.

To learn more about her life and work:

We thank her for her service to the cancer community. We will miss her greatly.

Sexuality Concerns and Cancer

Sexuality and intimacy are important aspects of health for all people, including thoseSexuality Concerns diagnosed with cancer. For those patients currently in treatment or just recovering from surgery, there are some important considerations to be aware of before you engage in any sexual activity.

For Women:

  • When recovering from surgery, sex can cause bleeding or stress any incisions. Recovery times are different for each surgery, so check with your health care team about when is a safe time to resume sexual activity.
  • Cancer treatment often causes a weakened immune system. This makes it easier to catch all kinds of infections. Check with your health care team about the potential threat the sex poses to your immune system and ways to protect yourself.
  • Chemotherapy may thin the walls of the vagina, which can cause a small amount of bleeding. Using an unscented, uncolored, water-based lubricant can help.
  • Surgery and radiation to the vagina can cause vaginal dryness, which can cause pain and bleeding. Again, unscented, uncolored, water-based lubricant and using dilators can help.
  • Some chemotherapy can be present in some amounts of vaginal fluid. Protect your partner by using a condom throughout treatment and up to two weeks after treatment.

For Men:

  • Cancer treatment often causes a weakened immune system. This makes it easier to catch all kinds of infections. Check with your health care team about the potential threat the sex poses to your immune system and ways to protect yourself.
  • Radiation to the genital area can cause pain during ejaculation. This is not usually permanent.
  • Radiation can also cause skin irritation and a reduction in the amount of semen present in ejaculate.
  • For men being treated for prostate cancer, there may be small amount of blood in semen. This is not harmful, but notify your doctor.
  • Men treated for testicular cancer may have no semen at orgasm (dry ejaculation). This will not affect your pleasure or your partner’s.
  • Men who have been treated for testicular, prostate, bladder, colorectal, and even head and neck cancers often report having trouble getting erections after treatment. Speak to your health care team about hormone replacement (though men with some cancers can’t get have testosterone replacement).

The greatest thing you can do for you and your partner is to keep an open line of communication. Talk to your partner about how you are physically feeling, and about your emotional concerns.  Don’t push yourself.

For more information about sexuality during cancer check out: 

  1. Triage Cancer Webinar: You and Your Body: Cancer, Intimacy and Sexuality
  2. American Cancer Society:

Opioid Crisis in America

Every day, about 90 Americans overdose on Opioids, according to the National Institute Opioid-Crisison Drug Abuse. This has been termed the ‘opiod crisis.’ Opioids come in a variety of modes, including prescription pain relievers, synthetic opioids, and even heroin. The CDC estimates that the “economic burden” of prescription opioid misuse is approximately $78.5 billion a year; this sum includes the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

The opioid epidemic became prevalent in the late 90s, when healthcare providers began to prescribe them at greater rates, after the risks of addition were downplayed by drug producers. In 2015, nearly 33,000 Americans died of opioid overdose, including by prescription opioids, heroin, and fentanyl, a powerful synthetic opioid.

The opioid crisis also has an impact on the labor market. A Goldman Sachs economist found that the opioid epidemic may be responsible for the lack of people looking for work in the current job market. According to the U.S. Bureau of Labor Statistics, the number of people working or actively looking for work has fallen since the Great Recession and has stagnated near 63% for the last four years.

The United States Department of Health & Human Services (HHS) released its 5 priorities for dealing with the opioid crisis:

  1. Improving access to treatment and recovery services
  2. Promoting use of overdose-reversing drugs
  3. Strengthening our understanding of the epidemic through better public health surveillance
  4. Providing support for cutting edge research on pain and addiction
  5. Advancing better practices for pain management

In April, HHS announced that they would be administering grants totaling $485 million to all 50 states, the District of Columbia, four U.S. territories, and the free associated states of Palau and Micronesia, in order to combat the crisis. A table including the grant breakdown for each state/territory can be found here.

While the HHS’s efforts are a great start, there is a lot of work to be done. For more information on the epidemic, watch the New England Journal of Medicine special report, given by NIDA Director Dr. Nora Volkow and Dr. Collins, in May 2017.

The response to the opioid crisis by many in the health care field is to stop prescribing opioid medications.  Many cancer patients are being caught in the middle of this crisis. Patients already often underreport their pain, but those who seek assistance from their health care team for pain, are often undertreated or not taken seriously enough. It is crucial for patients to have open and ongoing conversations with members of their health care team to effectively address their pain and need for palliative care.

If you are prescribed opioid medications, here is practical information about opioids.

The Triage Cancer Conferences Are For You

Who should attend a Triage Cancer Conference?  In short, everyone in the cancer community.  We are coming to 3 different communities with a FREE program that has been designed for patients, survivors, caregivers, health care professionals, and advocates.  Whichever group you are part of, we will provide you with practical relevant information about navigating cancer survivorship, from the point of diagnosis, throughout life.

Where will we be in 2017?

What topics will we cover?

  • Cancer Survivorship: Advocacy & Being Empowered
  • Health Insurance: Understanding Your Options, Navigation, Prescription Drugs, and Appeals
  • Managing Finances & Accessing Financial Assistance Options
  • Taking Time Off Work & Disability Insurance
  • Returning to Work After a Cancer Diagnosis
  • Nutrition
  • Be Prepared: Estate Planning and Other Documents

The cost to register

$0.  Free.  Nothing.  And lunch will be provided free, too!

Are you traveling to the Conferences?

If you are a patient or survivor, we are pleased to offer travel assistance to those who would like to attend one of the 2017 Triage Cancer Conferences, but need help covering the cost of traveling to the Conferences. Travel assistance is limited and applications are reviewed as they are received or until funds run out, so we encourage you to apply as soon as possible.

Free Continuing Education Units

For oncology nurses and social workers, we are pleased to offer up to 6 contact hours absolutely free.  Our conferences have been approved though ONS and NASW, as well as the West Virginia Board of Social Work.  Again, the conferences cost nothing to attend, and offer you up to 6 contact hours free.

Still undecided?

Well, listen to what attendees of the 2016 Triage Cancer Conferences thought.

“I wish all patients could have this training.” – Attendee in Nashville

“Very good seminar! Enjoyed attending and hope that I can share these resources with other cancer patients!” – Attendee in Salt Lake City

“I would like to thank you so much for the very pleasant and informative conference. I am a 6 year cancer free survivor and I so wish that I had this information available to me when I was going through my cancer treatment. I came here today to try to get any resources I could pass on to others in order to help them through their cancer in any way I can. Please don’t stop doing what you are doing. You are so appreciated.” – Attendee in Philadelphia

Triage Cancer Conferences

We hope that we’ve made the case that attending a Triage Cancer Conference will be informative, valuable, and worthwhile.  And, we really hope to see you there!

For more information, please send an email to or visit the Triage Cancer Conference page on our website

Testicular Cancer Awareness

As we close out Testicular Cancer Awareness Month, our partners at the Testicular Cancer Foundation share valuable information about testicular cancer awareness, prevention and detection.

Did you know that testicular cancer is the most commonly diagnosed cancer for men that fall between the ages of 15 and 34? Affecting those early in their lives, it’s important to detect signs of testicular cancer as soon as possible, starting the journey to survivorship. April is Testicular Cancer Awareness Month, and in an effort to help spread the word about steps to finding, diagnosing, treating and coping with this life-altering circumstance, Tommy John is partnering with the Testicular Cancer Foundation (TCF) to continue and strengthen our support of men.

Testicular cancer is the growth of malignant cells in one or both of the testicles. This directly impacts the male reproductive system and can alter lives in many ways, just as with any cancer diagnosis. Early detection is key, and it starts by being informed. Approximately one male is diagnosed with this cancer every hour, and on average, one male dies each day from this disease. However, it’s important to note that testicular cancer is one of the most beatable cancers when identified early. That being said, let’s take a look at methods for performing a quick self-check, as a proactive step before seeing a doctor or urologist. As always, be sure to consult a doctor for a proper diagnosis.

Testicular Cancer Awareness


Self-checks are an important step to taking control of your health and staying proactive when it comes to a potential cancer diagnosis. If diagnosed, one’s life can be understandably turned upside down. A common stigma that men often face, is that testicular cancer can negatively impact their manhood. This mindset can make it difficult to ask for professional help. However, with proper treatment, one can quickly work towards a healthy recovery. As TCF confirms, “The good news is that after surgery, and the potential treatment, the majority of men return back to a normal healthy life including, recreation/hobbies, work, sex, and family life.”

If diagnosed, what comes next? Cancer affects an individual on both a mental and physical level. Survivor Scott Lazerson urges, “My #1 recommendation for anyone facing cancer is positivity. Being positive is the biggest game-changer of life.” A healthy mindset can make a huge impact when embarking on a path to full recovery. What about the physical impact? The infected testicle, and in some cases other infected areas, are removed and sent for testing to determine that stage and nature of the cancer. This will help doctors to identify the best mode of treatment, whether this be surgery, post-op chemotherapy or further testing to determine the return of malignant cells. TCF has supplied many post-op TC patients with our Tommy John underwear in an effort to encourage a comfortable recovery. Research has also shown that proper-fitting underclothes can provide several other health benefits. Check out TJ underwear here, as well as our design dedicated to TCF. A portion of these purchases go towards the treatment, research and care associated with testicular cancer. Explore our #KnowYourBalls campaign for more information.

One of the most important points to keep in mind is that there is hope. Again, diagnosis and the most-effective path to recovery will be different for every individual and can only be determined under the care of a doctor. In the meantime, TCF educates men and offers support for early detection and prevention, noting that, “living a healthy lifestyle is a huge proponent to reducing your risk for all types of disease including testicular cancer. Being an advocate for your own health and knowing your body is extremely important.” There are many resources available to stay educated on this cancer, as well as support for those diagnosed and recovered. Take action today to ensure your personal health as well as the health of the men in our lives.

Sexual Health and Pleasure With Cancer in Your Life

By Barbara Musser of

We all understand the need for physical health and how precious that can be when we Sexual Healthare on the cancer journey. Serious or chronic health issues like cancer change our lives and we have the opportunity to take responsibility for our health and wellbeing in all areas in new ways. We learn when to get help, what kind of help we need and how to create plans for health management.

Physical health includes sexual health. For many people it’s embarrassing to even have sexuality and know that we are sexual beings ~ just look at the design of our bodies to know that we are designed for sexual function and reproduction. We can take this for granted, and then it all changes with cancer treatments. We aren’t asked about our sexual health, we don’t know how to talk about it, and we don’t always know what sexual health really is. Doctors are trained to look for pathology instead of wellness, and to treat pathology. It’s easy to end up ignoring our sexuality ~ the old “out of sight, out of mind” approach. Or we can get superstitious about it, thinking things like, “What’s meant to be, will be.”

When our genitals and sexuality are altered by cancer and treatments, it’s easy to think we’re not meant to have a healthy sex life.  We may not even know what a healthy sex life is. Stop for a moment and think what you were taught about sex when you first learned. Who told you about sex? What did they say? Chances are is what all about pregnancy and disease prevention, not about pleasure. There may even have been some shaming. Most of us didn’t learn a lot about the joys of sex and how to be creative in our pleasure.

When cancer comes into the picture things often don’t work in the same ways in our bodies and genitals. The traditional ideas that sex involves penetration and intercourse can now be painful and we avoid it. After all, who wants to do something that’s painful? What can we do?

This is an opportunity to define intimacy and sexuality for ourselves and discover our capacity for sexual health. To begin, get to know what your capacity is by exploring what feels good to you now. What kind of touch and where, how much or how little pressure? Where do you feel numb or pain? Does massage feel good? Gentle stroking with fingernails or a feather? Stretching and gentle pulling? Kissing? Where? What kinds of lubricants do you like?  Is intercourse painful? Do you use any sex toys? If so, what do you use and how? What would you like to explore and learn about? Is it easy for you to talk about these matters with your partner?

Whatever state you are in with these questions and your sexuality, you can always radiate erotic energy simply by thinking about it.  This doesn’t have to be anything overtly sexual; rather, it’s a state of mind, something that is internal to you. We can tap into deep sexual energy with a partner without getting physical. You can affirm sexual health regardless of external circumstances.

Join me on April 19 for a FREE webinar all about this: “You and Your Body – Cancer, Intimacy and Sexuality.” We’ll talk about what happens in the body, how arousal happens (or doesn’t) and some ways to begin to feel pleasure again. There will be plenty of time for questions and it will be a lively conversation. Register today!

“You have cancer.” Now what?

by Aditi Narayan, MSW; LIVESTRONG Program Manager

When Ana heard the words “you have cancer” at the age of 23, she was in shock.  She told her parents right away. Her mother wanted to know whether she could still have children after treatment for cervical cancer.  Her father wanted her to get a second opinion.  Her friends wanted to know how they could support her.  Ana wanted to know whether she would live and how much having cancer would cost – financially, physically, and emotionally.

Her doctor told her about the side effects of the recommended treatments, but Ana left the appointment with more questions than answers about the myriad ways cancer would affect her for the rest of her life.

Do I have to tell my coworkers? How much time will I have to take off of work? Can I drive myself to chemotherapy or will someone else have to take me? How much will this cost? Can I afford this?

Unfortunately, Ana’s story is all too common among the more than 15.5 million people affected by cancer in the United States. While your health care team focuses on your medical needs, LIVESTRONG focuses on you, not the disease. Our free, personalized and confidential one-on-one navigation services can help with financial or insurance counseling, education on diagnosis and treatment options, access to discounted fertility preservation services, emotional support, clinical trial matching, and more. We can also help you and your family find essential resources to assist with daily practical issues. Our services are available via phone and online from 8:30am-5pm ET Mondays-Thursdays, and from 8:30am-4pm ET on Fridays. Call 1-855-220-7777 or go online at to connect with a navigator today.

Iram, Brain Cancer Survivor and a former LIVESTRONG Navigation client

Iram, Brain Cancer Survivor and a former LIVESTRONG Navigation client

Recognizing that you and your loved ones may want to look for information on your own prior to or instead of contacting a navigator, we created an extensive suite of helpful articles, videos, and tools. Explore this information at

Within one week of her call with her LIVESTRONG Navigator, Ana

  • Had a better understanding of her cancer diagnosis, the recommended treatment and the potential side effects;
  • She had received free medications to start the process of freezing her eggs at a discounted price;
  • She had scheduled an appointment with another oncologist to get a second opinion after learning her insurance would cover it;
  • She had discussed her financial options with her case manager so she wouldn’t feel overwhelmed with medical bills;
  • She had signed up for an online support group her case manager found for her to learn about ways she could take care of herself during and after treatment; and
  • By using LIVESTRONG Rally to mobilize her support network, she knew which of her family members and friends would be taking her to chemotherapy and bringing her meals for the next two weeks.

By connecting Ana with the resources she needed, LIVESTRONG saved Ana thousands of dollars in fertility preservation and stimulation medication costs, and also saved her the hours and energy it would have taken her to identify these resources and contact them. Contact us to learn about how we can help you today.


Since 2004, LIVESTRONG Cancer Navigation has helped over 115,000 people like Ana and Iram navigate their cancer at no cost in English and Spanish by being a central hub of cancer support services.

When Adult Children Get Sick, It May Be Hard For Parents To Get Information

When Sean Meyers was in a car accident on a November evening three years ago, he was flown by air ambulance to the emergency department at Inova Fairfax Hospital, in Northern Virginia. With his arm broken in four places, a busted knee and severe bruising to his upper body, Meyers, 29, was admitted to the hospital. While badly hurt, his injuries didn’t seem life threatening.

When his car went off the road, Meyers had been on his way to visit his parents, who live nearby in Sterling. They rushed to the hospital that night to wait for news and to be available if Sean or the hospital staff needed anything. But beyond the barest details, no one from the hospital talked with them about their son’s condition or care, not that night nor during the next 10 days while he was hospitalized.

“All the time he was there, the hospital staff was very curt with us,” said Sam Meyers, Sean’s dad. “We couldn’t understand why we were being ignored.”

After leaving the hospital, Sean moved into his parents’ spare bedroom temporarily to continue his recovery. About a week later, he was in their kitchen one evening with his girlfriend when suddenly he collapsed. He was rushed to the nearest hospital, where he died. An autopsy revealed that he had several blood clots as well as an enlarged heart.

For Sean’s parents, the results were particularly wrenching because there’s a history of blood clots on his mother’s side of the family. How much did the hospital staff know?

“It might have saved his life if they’d talked to us,” Sam Meyers said.

A spokeswoman for Inova Fairfax said, “We cannot comment on specific patients or cases.” But she noted that information about a patient’s care can be shared in a number of circumstances.

These days, when people think about patient privacy problems, it’s usually because someone’s medical record has been breached and information has been released without their consent. But issues can also arise when patient information isn’t shared with family and friends, either because medical staff decide to withhold it or patients themselves choose to restrict who can receive information about their care.

The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) established rules to protect the privacy of patients’ health information while setting standards for hospitals, doctors, insurers and others sharing health care information.

Stepped-up enforcement in recent years and increased penalties for improper disclosure of patient information under HIPAA may lead hospitals and others to err on the side of caution, said Jane Hyatt Thorpe, an associate professor at George Washington University’s department of health policy and an expert on patient privacy.

“For a provider who’s uncertain about what information a provider may or may not be able to share, the easiest and safest route is to say no,” she said.

However, the law is actually quite permissive about providers disclosing information to family members and others who are involved in a patient’s care, said Thorpe.

“If the physician thinks it’s in [the] patient’s best interest to share information with mom or dad or whatever, they may do so,” she said.

They may also decide not to share information, however.

Generally, if a patient is unconscious and unable to give permission to discuss his medical information, a doctor may share details about his health with family and friends. But even if the patient is alert and able to make a choice, a health care provider can use discretion in deciding how much to tell family and friends.

Dr. Wanda Filer, president of the American Academy of Family Physicians, recalled a patient who was an HIV-positive sex worker who didn’t want his family to know about his health, even as he was dying. She honored his wishes. “The family was left in the dark,” she said.

State laws may be more restrictive than HIPAA, requiring patient permission to disclose information to others, said Elizabeth Gray, a research scientist at George Washington University’s department of health policy. However, Virginia law generally follows HIPAA on disclosures, said Gray.

In Sean Meyers’ case, there are unanswered questions. For example, “we don’t know what the patient actually said to the providers,” said Filer.

“HIPAA does allow information to be shared with family or friends based on the patient’s wishes or, if the patient cannot make his/her wishes known, then based on the family member’s or friend’s involvement in the patient’s care,” the spokeswoman for Inova said. The health system’s privacy policy states that it may disclose a patient’s medical information to a friend or family member as permitted under HIPAA and provides details about how to request a form to restrict such disclosures.

There’s no surefire way to avoid lapses in communication or ensure that providers get all the relevant information about a patient’s health. Most smartphones today allow people to store health care information that can be accessed by emergency personnel, said Joy Pritts, a privacy consultant who is a former chief privacy officer in the Office of the National Coordinator for Health Information Technology at the federal Department of Health and Human Resources. In addition to listing allergies and other health concerns, people could state their wishes about disclosing their health information.

In the case of adult children, it may be useful for the child to carry a signed document that authorizes health care providers to disclose and discuss health care information with the parents for a set period of time, said Pritts.

It’s no guarantee, but if a provider is on the fence about disclosing information, “it might help,” said Thorpe.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

How to Support Someone with Cancer

Do you have a family member or a friend who has been diagnosed with cancer?

Have you been wondering how you might be able to provide support or do anything to help?

Often we don’t know what to say other than, “Let me know if there is anything that I can Triage Cancer Blog Supporting a Friend with Cancerdo.” While well-intentioned, an open-ended offer of support is unlikely to be followed up on. It can be more helpful to offer to do specific things for your family member or friend.

There are a number of helpful lists of suggestions available in the resources listed below, and we offer a few additional ways to offer practical help, here:

  • Practical help
    • Attend medical appointments and take notes
    • Sort mail
    • Sort medical bills, insurance company paperwork, and medical records
    • Make follow up calls to providers and insurance companies
    • Complete appeals paperwork
    • Apply for financial assistance programs
    • Pay bills
    • Create a spreadsheet of tax deductible medical and dental expenses ( to make tax time easier
    • Research clinical trials or treatment options
    • Schedule appointments
  • Errands
    • Provide transportation to medical appointments
    • Go grocery shopping
    • Drop off prepared meals
    • Pick up prescriptions
    • Pick up/send mail/buy stamps
    • Pick up dry cleaning
    • Pick up thank you cards (for your loved one to send to others who have helped)
  • Babysit
    • Pick up children from school
    • Take them to extracurricular activities
  • Household chores
    • Cook
    • Wash dishes
    • Do laundry
    • Vacuum
    • Dust
    • Change bedsheets
    • Change lightbulbs
    • Organize a closet
    • Rake leaves
    • Mow the law
    • Water plants
    • Feed/take care of pets


Supporting a Friend Who Has Cancer:

Helping a Loved One with Cancer Long Distance:

These websites also have tips on how to help family members and friends and have great tools like calendars to schedule meal delivery, transportation to treatment, and more:

Don’t be hurt or offended if your friend or family member doesn’t ask for your help or declines your help when you offer. Even if your friend or family member doesn’t need help, your willingness to be supportive will be appreciated.

Cancer-Related Fatigue – Fighting Those Zzzzzs

Triage Cancer FatigueHas your treatment left you feeling unusually tired? If yes, you be experiencing cancer-related fatigue.

What is cancer-related fatigue?

Cancer-related fatigue is a persistent feeling of physical, emotional, or mental tiredness or exhaustion related to cancer and/or its treatment. Some of the symptoms include:

  • Feeling tired and it not getting better, it constantly returning, or it becoming severe
  • Being more tired than usual during or after an activity
  • Feeling tired with no relation to any activity
  • Putting less effort into your appearance because you’re too tired
  • Being too tired to do the things you normally do
  • Having no energy and/or feeling weak
  • Feeling tired even with sufficient rest and sleep
  • Spending more time in bed and/or sleeping more
  • Staying in bed for more than 24 hours
  • Not being able to concentrate or focus your thoughts
  • Having trouble remembering things
  • Becoming confused
  • Feeling tired and it disrupting your work, social life, or daily routine
  • Feeling sad, depressed, or irritable
  • Feeling frustrated, irritable, and upset about the fatigue and its effects on your life

What causes cancer-related fatigue?

There are several factors that can contribute to cancer-related fatigue. Some of the causes include:

  • Cancer treatment
  • Anemia
  • High/low hormone levels
  • Loss of appetite
  • Dehydration
  • Lack of exercise
  • Anxiety
  • Depression

 How is cancer-related fatigue treated?

The first step in treating fatigue is to identify the cause. If the cause is not known, you may need to try several different methods in order to figure out which one works for you. Staying physically active can help both manage fatigue and improve strength. Over time, try to build up to 150 minutes of moderate activity (walking, cycling, swimming) per week. You can also add in strength training exercises. Make sure that you are staying hydrated, by drinking enough water.

A psychosocial care professional (e.g., therapist, counselor, social workers, psychologist, psychiatrist, etc.) can help provide you with emotional support, which may alleviate your fatigue. Many patients have also found that acupuncture and yoga can help. Cancer-related fatigue can persist months or years after treatment, so it’s important to receive both short-term and long-term care.

Although common among cancer patients, cancer-related fatigue is not something that should be taken lightly. It is important that you talk with your doctor, or other members of your health care team, if your fatigue is affecting your health and well-being.

For more information on cancer-related fatigue, click here.