Sexual Health and Pleasure With Cancer in Your Life

By Barbara Musser of SexyAfterCancer.com

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 LIVESTRONG.org/CancerSupport 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 LIVESTRONG.org/WeCanHelp.

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.

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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 (http://triagecancer.org/blog/tax-time-is-coming) 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

Resources

Supporting a Friend Who Has Cancer: www.cancer.net/coping-with-cancer/talking-with-family-and-friends/supporting-friend-who-has-cancer

Helping a Loved One with Cancer Long Distance: www.nccn.org/patients/resources/life_with_cancer/managing_symptoms/long_distance.aspx

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:

www.MyLifeline.org
www.CaringBridge.org
www.Lotsahelpinghands.com
www.foodtidings.com
www.takethemameal.com

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.

Triage Life: Dealing with Documents

Triage Life Dealing with DocumentsDealing with the large amount of paperwork that accompanies medical treatment can be overwhelming. A cancer diagnosis introduces a steady stream of new documents, such as medical bills and prescriptions, in addition to the normal mail you get and paper that piles up in your home during everyday life. So, it is very common for medical treatment to create situational disorganization- disorganization is one’s day to day life that is brought upon by a major life event, such as a cancer diagnosis.

To address this issue, Triage Cancer hosted a webinar featuring Sara Skillen, CPO and owner of SkillSet Organizing, to discuss practical and achievable ways to keep medical paperwork organized and under control. Here are several resources presented in the webinar that help minimize paperwork-related stress when facing a cancer diagnosis:

Say Goodbye to Junk Mail

  • DMAChoice is an online tool developed by the Direct Marketing Association to help people manage mail. Through this website, you can request to stop receiving entire categories of mail, such as catalogs or credit offers, or you can unsubscribe from individual companies.
  • PaperKarma is an app that helps you eliminate unwanted paper mail with your smartphone. Simply take a picture of the unwanted mail through the app and you will be unsubscribed from the mailing list.

Keep it Together

  • The Lifebook is a comprehensive toolkit for those facing a serious medical diagnosis. The 3-ring binder features 16 tabbed sections for information such as lab reports and prescriptions, a 12-month appointment calendar, a business card holder, blank pages for notes, and much more.
  • LifeWrap is another resource that helps patients sort and store various medical information. In addition to a physical filing system, LifeWrap also provides a feature that allows users to make a digital replica of their information to store on their computer.

These are just a few of the great tips Sara presented during the webinar on how to reduce paper clutter when dealing with a major life event.

You can listen to the full webinar for more tips and resources. Thanks to Sara Skillen from SkillSet Organizing for joining Triage Cancer and sharing this valuable information!

Tech Advances: The Infusionarium & Improving the Patient Experience

InfusionariumIf someone asked you “if you could get your chemotherapy treatment anywhere you can imagine, where would it be?” What would you say? Underwater? In outer space? These questions were the inspiration for the Infusionarium at the Hyundai Cancer Institute at Children’s Hospital (CHOC) in Orange County, California.

The Infusionarium offers kids and teens the opportunity to explore the world all while receiving treatments such as chemotherapy infusions, radiation, and rehabilitation. Patients are able to choose between relaxing in a healing environment, watching TV or movies, and playing interactive video games.  The Infusionarium rooms are lined with screens that can transport you to faraway places, such as the Monterey Bay Aquarium or watching the Jet Propulsion Laboratory’s “Curiosity” rover on Mars! If you choose to spend time in the jungle, when you look up at the ceiling of the room, it’s like looking at the sky through the tree tops.

As more children and teens are surviving pediatric cancers, the need for emotional and psychosocial support has grown. Many other clinics and institutions are working to implement similar strategies to normalize treatment and build positive associations with receiving care and ultimately build strong, resilient people who are not just patients.

Staff members at CHOC have noted that patients using the Infusionarium tend to ask for less medication for nausea, anxiety, and diarrhea. Psychologically, cancer confounds what is considered to be normal adolescent development. As children and teens age, they want to become more independent, but with cancer treatment and care, kids and teens often remain in the phase of needing their parents. The Infusionarium gives patients the opportunity to assert their individuality and connect with other kids and teens facing the same experiences and issues.

At CHOC, the Infusionarium has become so popular that “traffic jams” build up throughout the day, as teens and children wait to use it. This innovative and technological advancement has improved the overall experience patients have during treatment by making the time spent receiving chemo, transfusions, and other medical treatments not just bearable, but interesting and even educational.

Balance Exercises After Cancer Treatment

by Carol Michales

Exercise may be the furthest thing from your mind after a cancer diagnosis. Even if you Triage Cancer Blog Exercisehave never been active, exercise can become one of your favorite activities. With more medical professionals recommending exercise to their patients, it is imperative for cancer survivors to learn how to exercise safely. First, ask your doctor before you start because each person is unique and heals differently.

A good exercise program will help to reduce the side effects of surgery and treatments. These side effects can include fatigue, neuropathy, decreased range of motion, weakness, lymphedema, balance issues, and a significant emotional toll. In this article, I will discuss the importance of adding balance exercises to your exercise plan.

Balance exercises will help you regain function and mobility for activities of daily living. Your balance can suffer after surgical procedures , especially with the TRAM flap procedure. A TRAM (transverse rectus abdominis myocutaneous) flap consists of skin, fat, rectus muscle, and blood vessels taken from the abdominal wall and transferred to the chest to reconstruct the breast. Because these muscles help with strength, posture, balance, and flexibility, TRAM flap surgery can weaken your body’s core. After a TRAM flap operation, you will need to learn how to compensate for this change of muscle placement through a series of exercises designed to strengthen the remaining muscles.

Balance exercises can counter some of the effects of muscle imbalances and body asymmetry after surgery. Some chemotherapy treatments can affect your balance and cause neuropathy. Neuropathy, which can make your feet numb, is a common side effect of chemotherapy. If you cannot feel your feet, it becomes difficult to maintain good balance. You should incorporate balance exercises as a regular part of your fitness routine to learn how to compensate.

Balance exercises can help prevent future injuries, such as falls. Balance training will help decrease the likeliness of falling.  If you fall, it could limit your activities or make it difficult to live independently. Balance and strength exercises can help prevent falls by improving your ability to control and maintain your body’s position whether you are in motion or stationary. Cancer survivors are sometimes at higher risk for osteoporosis due to cancer medications. If you are nervous about falling, you might withdraw from your daily activities and have a lower quality of life.

Tips to improve balance and increase lower body strength

Start your balance exercise routine with the following exercises. You may want to hold a chair for support at the beginning. As you improve, you can try holding the chair with only one hand or even one finger. The goal is to eventually do these without holding the chair at all. For an added challenge, try these exercises with your eyes closed:

  • Standing on one foot: Hold for 10 seconds then switch legs.
  • Tightrope: Put your heel in front of your toe of the other foot as if walking a tightrope.
  • Calf or heel raises: Stand in place and slowly raise each calf (or heel) up and down.
  • Front, back, and side leg lifts or raises: Standing in place, lift your leg to the front, back, or side.
  • Grapevines: Step sideways while crossing one foot in front of the other. On the next step, cross the foot in back of the other.

These exercises can help improve your core strength.

  • Pelvic tilt: Lie on your back with your knees bent and your feet flat on the floor. Inhale and fill your torso with air. Exhale while pressing your abdominals downward, bringing your navel to your spine. Lower and repeat for 5 to 10 reps.
  • Bridge: Lie on your back with your knees bent and your feet flat on the floor. Squeeze your glutes to lift your pelvis and ribs off the ground, leaving only your shoulders on the floor. Hold the bridge position for a few seconds, then lower and repeat. Complete 5 to 10 reps.

Carol Michaels is a Cancer Exercise Specialist and fitness consultant with more than 20 years of experience. She has worked with physicians and other health professionals to develop a cancer recovery fitness program that is currently offered at her studio, hospitals, cancer support organizations, and community centers. Carol received her degree from the Wharton School of the University of Pennsylvania and is certified by The Cancer Exercise Training Institute, American Council on Exercise, and the American College of Sports Medicine.

This post originally appeared on Cancer.net of February 9, 2016.

Cancer Survivorship Care Plans

Triage Cancer and the California Dialogue on Cancer (CDOC), have partnered together in the development of new tools to help increase the use of cancer survivorship care plans. These new tools include:

  • Cancer Survivorship Care Plans: A Toolkit for Health Care Professionals
  • Fact Sheets for Survivors & Caregivers (English, Spanish, Chinese, & Tagalog)

CDOC is a state cancer coalition administered by the California Department of Public CDOC Survivorship Care PlansHealth’s Comprehensive Cancer Control Program. CDOC includes members from state and local governments; private and nonprofit organizations; health, medical, and business communities; academic institutions; researchers; cancer survivors; caregivers; and advocates. One of CDOC’s responsibilities is to develop California’s Comprehensive Cancer Control Plan to reduce the cancer burden in our state.

One of the specified survivorship goals in California’s Cancer Control Plan is to improve survivorship care by increasing the use of survivorship care plans. Triage Cancer led a Survivorship Care Plan Advisory Group, which included doctors, public health educators, researchers, social workers, advocates, caregivers, survivors from throughout the state of California to develop a toolkit and fact sheets to increase the use of survivorship care plans in California.

What is a Cancer Survivorship Care Plan?

A cancer survivorship care plan is a written document this is a valuable tool for patients and their health care teams to monitor and manage a patient’s ongoing physical and emotional health. It summarizes the treatment that a patient has received, describes follow up care a patient should receive, and helps patients navigate other post-treatment needs.

The institute of Medicine suggested that the following information should be included in an effective cancer survivorship care plan:

  • Treatment Summary: details of your cancer diagnosis, contact information for your previous health care providers, and any treatments received
  • Follow-Up Care Plan: specific recommendations for ongoing care, managing side effects, signs of recurrence, screenings, nutrition, exercise, chemoprevention, etc
  • Psychosocial Issues: relationships, parenting, sexuality and intimacy, body image, genetic counseling, etc.
  • Practical Issues: insurance, employment, education, finances, etc.
  • Resources & Referrals: cancer-related organizations, follow-up care providers, support groups, etc.

What is Cancer Survivorship?

The National Cancer Institute defines cancer survivorship from the point of diagnosis, throughout life. There are approximately 14.5 million cancer survivors in the United States. Cancer survivorship issues are really any issues that come up for patients and caregivers as a result of a cancer diagnosis. Those issues could be physical, emotional, and practical issues.

Cancer Survivorship Guidelines

Numerous entities in the cancer community have developed guidelines on survivorship care, such as ASCO, the American Cancer Society, NCCN. and the Children’s Oncology Group. In 2012, the Commission on Cancer released accreditation standards, which require cancer centers to provide survivorship care plans to all of their eligible patients by January 1, 2019.

Cancer Survivorship Care Plans: A Toolkit for Health Care Professionals

In order to help cancer centers provide survivorship care plans, Triage Cancer and CDOC developed a toolkit that includes these topics:

  • Introduction to Cancer Survivorship & Survivorship Care Plans
  • Elements of an Effective Survivorship Care Plan
  • Survivorship & Survivorship Care Plan Guidelines
  • Survivorship Care Plan Templates
  • Implementing Survivorship Care Plans
  • Survivorship Care Plan Implementation Challenges & Practices
  • A Call to Action
  • Survivorship Care Plan Resources

Cancer Survivorship Care Plan Fact Sheets

In addition to the Toolkit, Triage Cancer and CDOC also created fact sheets about cancer survivorship care plans, to help patients and caregivers understand what they are and empower them to talk with their health care teams about this resource.

Click here to download a free copy of the Toolkit and fact sheets.

Click here to watch a video about cancer survivorship care plans.

Resilience: Thriving, Not Just Surviving

by Ruth Bachman, The Hourglass Fund Project, Inspiring Speaker and Award-winning Author
 
In three words I can sum up everything I’ve learned about life: it goes on. ~Robert Frost
 
HourglassCancer is a very powerful and proficient teacher with the potential for profound transformation. It is a change that draws a line in the sand between the way we once looked at life and death and how we currently live life after surrendering, accepting, letting go and integrating that insight into who we are.
In his book, The Beethoven Factor, Dr. Paul Pearsall describes “Thrivers” as those who know when to hold ‘em and know when to fold ‘em.” He defines “thriving” as stress induced growth that happens when we face a challenge. The way we respond to change – both large and small – is a good indication of our level of resilience.
Resilience is navigating the complexity of everyday life with resources that promote well-being and cushion us against being overwhelmed. Most experts agree the key indicators of resilience are: self-awareness, mindfulness, purpose, self-care and relationships. Resilience is a complex set of skills and attitudes that can be enhanced and learned.  A resilient response to change is far from effortless.  Not unlike a garden, cultivating resilience requires intention, attention and effort which allows us to grow.
Within the depths of winter, it is hard to imagine spring. The beauty of nature takes time. Imagine tending a garden – your very own little plot of earth. Trust that it can be cultivated and that cultivation will bring it to its full potential. Even though it’s full of rocks and the soil is dry, you begin to plow your plot with patience, sowing the seeds of your future well-being. At the beginning, joy might be found in just feeling that your little plot of earth is workable. You stop looking for a different or better place to be. This does not mean that there are suddenly flowers growing where there were previously only rocks. It means you have confidence and hope that something will grow here. As you cultivate your garden, tending it with a quiet mind and an open heart, the conditions become more conducive to growth. Slow down, breathe deeply, listen to your heart. Have patience and faith. Something beautiful will blossom in your garden.
        
How do we increase our resilience? Primarily by putting forth the effort each day to focus on what is right – cultivating the positive. It sounds so simple. The key is focus – where are we bringing our attention?
For more information on how to build resiliency, attend our next webinar, featuring Ruth, on April 19, 2016. Register at http://triagecancer.org/webinars/. Can’t attend, not to worry, we record our webinars and post them for later viewing.