Who Can Resist a Challenge?

It has been a very long time since I have written a new post on my blog.  Nancy Stordahl who blogs at Nancy’s Point presented a summer blogging challenge. Never one to back down from a challenge and needing to get back into my blog, I decided to go for it! Thank you, Nancy, for this challenge to answer 10 random cancer-related questions. So here goes:

1. Share anything you want about your cancer diagnosis (or your loved one’s).  Share your age, cancer type, stage, when you were diagnosed, family history (if any), your reaction, how you learned the news, or whatever you’re comfortable with sharing.

I was diagnosed when I was 58 years old, October of 2004, with Invasive Ductal Carcinoma, Stage IIB, Her2+, Lymph nodes negative. My mother was diagnosed with breast cancer when she was 58 years old in 1978 and passed away at 66 years old from a pulmonary embolism secondary to Metastatic Breast Cancer. She was my best friend and I lost her when I was 38 years old. She had a lumpectomy followed by radiation that turned her breast and arm into brown parchment paper. I do not believe there was any margin checking or lymph node biopsies, but so much of that time was a blur that I can’t honestly remember many details.
As for me, I discovered my own mass. I had been for my yearly Gyn appointment in July where nothing was detected, but by October, I had a 3 centimeter mass. I was sent for a mammography (it had been almost a year since my last mammography.)  Immediately, following the mammography, I was rushed into utra-sound where the sonographer immediately went to get the radiologist. She informed me that what they were seeing was “worrisome.” Not the words you want to hear! Everything moved very fast from that point. Next step, needle biopsy with my surgeon.
I was called at work (medical social worker in a medical center working on the oncology unit at the time of diagnosis) by my surgeon’s nurse practitioner. I can remember the sound, tone of her voice, and every word she said. She was very compassionate, professional, and provided me with very limited information. “Your needle biopsy shows abnormal cells.” The surgeon would like to see you NOW. When I attempted to get her to provide me with more detailed information regarding “abnormal cells,” she would not discuss any further. Since I had to leave work and drive 45 minutes to reach my surgeon’s office, I was able to do so with some degree of denial. I mean abnormal cells might mean pre-cancerous cells. Right?  Denial can be a wonderful short term coping mechanism.

What is the most outrageous thing someone has said to you about your (or your loved one’s) cancer?

Well meaning friends and family members (who emotionally can’t think in any other terms), telling me and others that “I beat it.”  We all know that we did no such thing! Science helped our bodies go into remission, and if we’re lucky (strange word to use, perhaps, but our dear friends dealing with metastatic disease know what we mean), we will remain with no evidence of disease (NED). We are all aware that our cancer can return at any time.  Then what?  We didn’t beat it, we failed in some way? Didn’t exercise enough, didn’t eat healthy enough, didn’t think positively enough?…The list goes on and on.

3. What is your biggest cancer pet peeve? I know it is hard to choose, as there are many to pick from, right? But what irks you the most?

Where do I start? Objectification, minimization of breast cancer…reducing BC to “saving the tatas,” or any other type of sexist paraphernalia that attempts to make a profit from a potentially deadly disease.  Well meaning women who take off their bras in support (ironic?) of us.  Really?  I just don’t get the connection or the meaning! Their lack of mammary support does not make me feel supported at all.  I have no sensation at all in my right “breast,” except for discomfort. Watching other women’s natural breasts being freed (and thank God they have them) does not provide emotional support for me or financial support for finding a cure.

One more: celebrities who make BC look like “a walk in the park,” minimizing for the public the pain, trauma, and severity of a deadly disease.

4. What is something you want others to know specifically about breast cancer?

All women should “know” their own breasts and check at least once a month. This includes a mirror check.  Obviously, not all breast cancer presents as a mass that is palpable, and can present (as in the case of Inflammatory Breast Cancer) as a red, swollen, itchy breast that is tender to the touch. Invasive Lobular Carcinoma may cause a thickening of the breast.  Any change in the appearance of the breast should be addressed.  Breast cancer is not “one size fits all;” there are many different types and treatment is case specific.

Women with breast reconstruction using implants should have an MRI every two or three years following the initial reconstruction to check the integrity of the implant or implants.  Although most plastic surgeons suggest replacement after 10 years, a rupture can occur at any time.  There are two types of rupture: intracapsular (still within the implant capsule, but will eventually transcend the capsule) and extracapsular (the saline fluid or silicone gel has migrated through the capsule into the breast tissue and into lymphatics and the rest of the body).

5. If applicable, do you worry about recurrence rarely, from time to time or a lot? What is your biggest worry today, right now, this minute?

It has been 13 years since my diagnosis.  Time does help reduce the constant worry, but any new strange ache or pain anywhere in my body can still trigger anxiety. The threat of recurrence feels like a “stalker lurking in the shadows.”  You never feel completely “safe” again.

Right now my worry is I’m one of those women who did not have an MRI to check on the integrity of my implants for 10 years and I now have an intracapsular rupture. An intracapsular rupture can take 4,5,6 years to transcend the outer capsule, but since I have no particular symptoms (it was detected in a recent MRI), I have no way of knowing how long my implant has been ruptured.  I have scheduled an appointment with a plastic surgeon (my original plastic surgeon no longer practices due to an automobile accident) and I am considering not replacing my implants.

6. Do you feel cancer has made you a better person? Yes, I know this is a loaded question.  If you do, specifically in what way?

NO, I do not feel like cancer made me a better person.  I think I was a good person prior to my cancer diagnosis.  It did cause me to re-prioritize my life a bit.  I retired from my profession three years earlier than I would have considered without breast cancer.  Although my prognosis was fairly good, I wanted the freedom to spend more time with my children and grandchildren.  Not all my family live in the same state, and visiting while I was working necessitated vacation scheduling.  I was blessed that I had the financial option to retire early, but I made this decision from fear of a fore-shortened life span, not because I wanted to leave my profession.

7.  What is your favorite cancer book? (No I’m not fishing for mention of mine!)

To tell the truth I haven’t read a lot of cancer books, although I am an avid reader. During my treatment period (surgery, chemo, radiation, reconstruction) I used all my energy and concentration on getting through each day and continuing to work, except for a couple of days following each chemo treatment.  In addition, I was going for monthly massages, acupuncture, doing visualization, meditating, seated gentle yoga, and prayer.  After treatment, and before I started blogging and reading blogs, I read  Five Lessons I Didn’t Learn From Breast Cancer (And One Big One I Did) by Shelley Lewis. I have always used humor to help myself cope and this book is irreverent and actually funny in places despite the subject matter. One line from the book is “If you honestly think breast cancer is a gift, you can’t come to my birthday party.”  I recommended books on meditation and living in the moment in my blog: Going to Pieces Without Falling Apart and Going on Being both by Mark Epstein and Be Here Now by Ram Dass.

8. Besides your family, where do you turn for emotional support?

I was blessed with tremendous support from my employer, co-workers, and dear friends all during the treatment period.  Over the years, my friends have always been “there” for me.  I have also received much satisfaction from blogging and my public face book page. My fellow breast cancer “sisters” allow me the opportunity to provide information and support.  And although I didnt realize when I began both my blog and my public FB page, I have received tremendous support in return.

9. How many cancer blogs do you read and why do you read them?

I read many of the blogs and public face book pages.  The blogs I read on a regular basis are Nancy’s Point and The Cancer Curmudgeon. I read them for up-to-date information on research (and varying topics) both for myself and that I can then share with others.  I like the feeling of connection with like-minded people.  I enjoy the spunk of The Cancer Curmudgeon and seeing how she processes her anger through her writing.    

10. Do you call yourself an advocate? If so, what drives you?

I chose social work as a profession to be an advocate for the disenfranchised.  Over the years, I worked with home-bound elderly providing mental health evaluations and counseling, domestic violence victims (both in a shelter and in an office setting), provided counseling on adjustment to illness and providing resources as the social work supervisor in a home health care agency, and devoted most of my career to hospital social work.  I don’t know how “to be” without advocating.  When I realized following treatment for breast cancer that I was experiencing subsyndromal symptoms (not meeting full criteria for a diagnostic category) for Post Traumatic Stress Disorder and was experiencing a strong grief reaction, although I did not have a terminal prognosis, I felt a strong responsibility to reach out to others. The internet seemed the most wide-reaching format to educate others regarding what to expect and, especially,  when symptoms are severe enough to require professional intervention. Because social worker is who I am, not just what I did, I know no other way.

 

 

 

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Going Within

OLYMPUS DIGITAL CAMERAThe blog post from Breast Cancer Authority by Jean DiCarlo-Wagner, The Ultimate Journey In Life is Going Within, provided options on journeying within to find your truth (reblogged in my previous blog post).  But it also reminded me of an article I read from the Chopra Center by Bhava Ram. The article is called 8 Steps Into Health, Healing, and Higher Consciousness.  As in the Breast Cancer Authority<em blog it reminds us that “healing” does not always mean physical healing. Spiritual healing is  important in finding inner peace, especially when difficult life-changing decisions need to be made.  Going within can be a formal practice or it can be communing with Mother Nature, it can be prayer, or a combination of all of the above.  It is a very personal decision how one journeys inside to find their  truth.
Bhava Ram explains the 8 Steps to Higher Consciousness

1. Close your Eyes: This simple act is a transition from externalized to internal awareness. Notice what it feels like inside of you.

2. Connect With Your Breath: Breathe more deeply and fully as you cultivate a sense of awe at the miracle of your breath. See every in-breath as an empowerment and affirmation, every out-breath as a healing release.

3. Feel Your Body: Experience your body as the temple of your spirit, a sacred vessel always seeking to support you. Send your breath to all the outer edges, and flood all the inner space of you.

4. Notice Mother Earth: Notice how Mother Earth fully supports you as you sit in this meditation. Feel her in every cell of your body. Have profound gratitude for all the abundance she brings into your life.

5. Still Your Mind: Begin to silently chant the mantra I Am. This is like a yoga pose for the busy mind.  Allow it to still the turbid waters of your thoughts.  I Am.

6. Enter Your Heart: Visualize your awareness flowing down from the mind to your heart center, as if there is a golden flame there that illuminates you. Breath into that light, feeling more radiant in every breath.

7. Be Fully Present: Slip fully into the present moment: In your body, in your breath, in the palms of Mother Earth, in the light of your heart. I Am.

8. Remember Who You Are: Remember that you are fully connected, indigenous wherever you go, and that you always have been…and always will be…one with all that is. I Am.

Go to this place of inner awareness whenever you feel the need. Ask your deeper self for guidance in facing challenges and making decision. Listen to your inner “guru” as you own your power and live your truth. I Am.

Thank you Bhava Ram and the Chopra Center for this wisdom.

Ms. DiCarlo-Wagner’s mother had an innate sense of what she needed to “go within” and find her truth. She was happy to sit in her easy chair focusing on her flowers and the hummingbirds. In this way, she was able to journey within. Meditating does not always have to be a formal process. As Ms. DiCarlo-Wagner’s blog entry tells us, sitting in front of a beloved part of Mother Nature, focusing on the beautiful abundance provided by Mother Earth, helps to bring a peace that enables many to “go inside” and become aware of what living one’s truth means to them. When I was faced with my second breast surgery in the same month I went outside and sat looking out at a tributary of water that ran along my backyard. It was teeming with life in all forms, both in the water and in the reeds, even in the muddy banks that lined the shore. I breathed deeply and “went inside” to find my inner peace. I meditated with Mother Nature and I prayed, and although I was still afraid, I was less anxious and more at peace with what the future would bring. I Am now and always will be “one with all that is.” Blessings

Survivorship

I want to share a wonderful presentation by Dr. Jennifer D. Irwin, Associate Professor in the School of Health Sciences at Western University. It is entitled Survivorship: How do you want it to be? Dr. Irwin is a survivor as well as a Health Behaviorist (one who does research on health-related behaviors) and brings a dual perspective to the cancer experience. She discusses the physical and emotional impact of cancer from the moment of diagnosis: the sudden lack of control of one’s own life, the feelings of isolation and loneliness, the feeling of “horrific betrayal of one’s own body,” the sense of estrangement from all the normal daily life experiences, and how Dr. Irwin learned to regain a sense of control in her life.

Thank you to Breastcancerauthority.com for e-mailing me this presentation. Breast Cancer Authority is a also an extensive source of information for survivors.

Empowered Living

I want to share a free video series by fellow survivor, Gai Comans. Please connect at http://empoweredlivingafterbreastcancer.com/freeseries. Gai is hoping to share her series with more than one-thousand survivors. Gai has developed through her own experience, and through many interviews with other survivors and experts in various fields, the necessary coping skills for life after breast cancer. Please take advantage of this free series quickly, as the videos do not remain available indefinitely. Blessings

Knowledge is Power…Reclaim Your Life

Hi to all. The past few months in my blog postings I have primarily concentrated on coping with the trauma of breast cancer through stress reduction techniques, seeking abundance,and improving self-awareness by getting in touch with the authentic self/the Divine inside each of us. While writing these blog posts, I have continued researching updated published data regarding cancer-related Post Traumatic Stress Disorder.

In a study done at Columbia University College of Physicians and Surgeons, Dr. Alfred I. Neugut, MDPhD, an oncologist and a professor of epidemiology states “Anyone who’s had a life-threatening experience, including a cancer diagnosis can be a victim”(of PTSD). A research team led by Dr. Neuget recently surveyed 1,139 breast cancer patients in the six months following diagnosis and found that nearly one in four met the criteria for PTSD(Living with Cancer, Vol. 16, NO. 4 Fall 2013). In this study they found that approximately 25% of cancer patients and in some cases, even their caregivers are suffering the symptoms of Post Traumatic Stress Disorder. In Living With Cancer PTSD symptoms are broken down into simpler terms than the actual criteria in the Diagnostic and Statistical Manual…DSM IV(the DSM criteria is in an earlier posting from July 2013). It asks “could you have cancer-related PTSD? Talk to your cancer care team if one or more of these symptoms lasts a month or more.”

Panic attacks (both isolated and chronic), which include a racing heartbeat, trembling or shortness of breath

Avoidance of follow-up checkups and other appointments, or anything you associate with your cancer treatment

Feeling hyper-alert, almost like you’re on watch for something

Worry that any change in your body means your cancer has returned

Feeling jumpy or easily startled

Unexplainable irritability

Difficulty concentrating

Trouble falling asleep or staying asleep

Frequent nightmares or flashbacks

Additional information is from the National Cancer Institute: PDQ Post Traumatic Stress Disorder. Bethesda, MD:National Cancer Institute. Date last modified 06/15/2012. It states that the incidence of the full syndrome of PTSD (meeting full DSM-IV diagnostic criteria) ranges from 3% to 4% in early-stage patients recently diagnosed to 35% in patients evaluated after treatment. I understand this statistic as we are initially traumatized with the diagnosis and treatment, but are so physically and emotionally involved with surviving that it is not until treatment ends that symptoms of PTSD become more apparent in ourselves and possibly caregivers/loved ones. The PDQ further states that when incidence of the Post Traumatic Stress Disorder-like symptoms (subsyndromal…not meeting the full diagnostic criteria) is measured, the rates are higher, ranging from 20% in patients with early-stage cancer to 80% in those with recurrent cancer. Patients with former trauma and PTSD are more likely to experience cancer related PTSD or Acute Stress Disorder (ASD). These individuals with a history of PTSD are at a substantial risk for continued emotional difficulties. In a study of 115 patients with all stages of breast cancer, 4% met the full diagnostic criteria for PTSD; 41% met the subsnydromal criteria (not meeting the full criteria of symptoms) for PTSD. To put these statistics into my own words and easier reading: more survivors suffer from some of the symptoms of PTSD without meeting the full diagnostic criteria for the disorder. This, of course, does not mean that the symptoms from the criteria that are being experienced are not uncomfortable and/or causing avoidance of reminders of the trauma. It is the avoidance behaviors that could seriously affect follow-up care. The presence of pain and other physical symptoms has been shown to correlate with levels of intrusive thought. Late-stage cancer and cancer recurrence has been shown to increase the likelihood of stress symptoms. This, of course, would be obvious to those of us who are cancer survivors. I have found that survivors who have continued discomfort from their breast reconstruction have a more difficult time adjusting and experience more intrusive thoughts and anger. In recurrence one is experiencing the original trauma all over again, along with more intense future-oriented fears.
Protective factors in this NCI PDQ summary were greater perceived availability of social support, and the availability and timeliness of accurate-health related information. Women who were unaware of their cancer stage reported higher stress response symptoms than those who were more knowledgeable about the stage of their disease. It therefore appears that the quality of a patient’s relationship with their medical care team is a protective factor from stress related symptoms. The NCI PDQ summary correctly notes that a PTSD diagnosis is complicated in cancer patients because cancer is not an acute or discrete event, but is an experience marked by repeated traumas and indeterminate length. It continues, stating that the relative predominance of specific PTSD symptoms may wax and wane throughout the cancer experience and beyond. It concluded that there may be a delay of months or even years before symptoms appear in cancer survivors and their family members.
The NCI PDQ summary states that while no specific therapies for PTSD in the cancer setting have been developed, treatment modalities (types) used with other people with PTSD can help alleviate distress in cancer survivors. Most clinicians use a multimodal (a combination of treatment types) approach to meet the specific needs of each client and taking into account any additional problems such as depression or substance abuse (sometimes used to self-medicate the painful emotions away). Cognitive-behavioral techniques have proven especially helpful. Some of these methods include helping the client to understand symptoms, teaching effective coping strategies and stress management techniques (such as relaxation training), restructuring cognitions (thought patterns), and providing exposure to opportunities for systematic desensitization of symptoms. Support groups also appear to benefit people who experience post-traumatic symptoms. In the group setting survivors can receive emotional support and be with others with similar experiences and symptoms, thereby validating their own experiences and learning a variety of coping and management strategies. For clients with particularly distressing or severe symptoms, psychopharmacology (drugs) may provide an additional means of treatment. Anti-depressant and antianxiety medications may help reduce overall depression, arousal and anxiety symptoms. As per NCI PDQ, infrequently, antipsychotic medications may reduce severe intrusive flashbacks.

Remember, as survivors we are all here to help and inform each other. It is important to recognize the level of help that you feel you need or that you may feel a loved one needs to find relief from full-blown PTSD, subsyndromal symptoms of PTSD, depression, or anxiety. If you wish to find relief from uncomfortable emotions using more holistic methods there are a variety of sites that can assist with this: Breast Cancer Authority Blog by survivor, Diane Ross, with many knowledgeable contributors or Breastcancer.org are two excellent resources. There is also a wonderful new resource available from Gai Comans, a fellow survivor. You can access her website at Gaicomans.com. Among other valuable information Gai has just completed a compilation of inspiring survivor stories calledSurvivor Secrets-Empower Your Life.” Each survivor (including Gai) answers the question “What did you wish you had known when you were first diagnosed with breast cancer?” The answer to that question and the inspiring story that each of these 21 survivors share give us all hope and inspiration. Blessings to all.

Feel free to email me at Karenfb22@yahoo.com. All emails will be confidential.

Taking Care of Self…Body, Mind & Spirit

Aside

I was thinking again about the woman I mentioned in my previous post who “journaled” every day on Facebook as her coping mechanism and support system.  In one of her posts, she mentioned that her white blood count was low and she was feeling very weak from recently receiving her chemo.  However, she wanted to attend a social event that evening which was very important to her primarily because she said she “just wanted to feel normal” for a short while.  I think that we have all been in that situation during our cancer experience, “just wanting to feel normal” for a while.  The response on Facebook from her family and friends was overwhelmingly negative regarding attending this event.  Most of her friends and relatives were worried that she would contract something secondary to her impaired immune system and they were afraid that her attendance could be quite dangerous for her.  One person even wrote that her sister had had a low white blood count from chemotherapy, went out socially and came down with an illness and died within hours.  This person begged for the above mentioned not to go to her event.  I joined in the “conversation” posting that no one but “K” could make the decision, but that if she decided to go she could compromise by taking precautions.  No kissing or hugging and particularly no handshakes or hand holding.  Most of the people at the event would be aware of her situation and the people who are not aware did not require close contact.  I also suggested that she take into consideration that if she contracted something it could delay her last two chemo treatments, but only she could weigh the risks involved.  She tried to respond to everyone and agreed to make some compromises:  she would not make close contact with people and she would not stay out late, but she was going. 

Sometimes, we have to assert ourselves with well-meaning (and sometime correct) friends and relatives who are emotionally invested in our recovery and well-being.  In this case, “K” was not critically neutropenic or she would have been instructed by her doctor to seclude herself in her home or placed in isolation in the hospital to protect her.  Nuetropenia is a result of strong chemo drugs which can lower the number of white blood cells (and other blood cells) in your body and can put cancer patients at risk for infection from bacteria or viruses. She probably would have been better off physically if she had stayed home and rested, but what she needed was emotional.  She was taking care of her mind and her spirit by “feeling normal” for just a while.  I am not advocating ignoring doctor’s orders if your WBC is critically low.  But, if well-meaning family and friends are overprotective, it is important to use your judgment and be assertive regarding fulfilling both your emotional and physical needs.

Assertiveness can be defined as expressing oneself, satisfying one’s personal needs, feeling good about this, and not hurting others in the process(Greenberg; Comprehensive Stress Management, 1993). It is not always easy to be assertive towards those we care about deeply (or anyone else for that matter). In When I say no, I feel guilty by Manuel J. Smith has provided us with a Bill of Assertive Rights.

1.   You have the right to judge your own behavior, thoughts, and emotions, and to take responsibility for their initiation and consequences upon yourself.

2.    You have the right to offer no reasons or excuses for justifying your behavior.

3.    You have the right to judge if you are responsible for finding solutions to other people’s problems.

4.    You have the right to change your mind.

5.    You have the right to make mistakes…and be responsible for them.

6.    You have the right to say, “I don’t know.”

7.     You have the right to be independent of the goodwill of others before coping with them.

8.     You have the right to be illogical in making decisions.

9.     You have the right to say, “I don’t understand.”

10.    You have the right to say, “I don’t care.”

I think that the important issue to remember with this list is that you have to take responsibility for your actions.  In the case of going out into a crowd when your immune system is compromised can be dangerous.  At the very least, precautions need to be taken.  I worked in a hospital all through my chemotherapy treatments.  There is no place more germ filled than a hospital, but my doctor carefully monitored by WBC and the one time it was dangerously low, I was instructed to stay home until it came back up to a safe level from a Neulasta injection.  I stayed home and rested and visualized a white blood cell factory inside me just pounding out white blood cells, and the next day my count was within a normal range.  I followed all normal precautions in the hospital washing hands often, using Purell, and wearing a mask and/or gloves when the situation called for it.  I also flew to visit my son and family in another state between chemo treatments with the permission of my doctor.  I was instructed to take a mask with me and to wear it if anyone around me on the plane was coughing, sneezing, etc.  Another time my family had a large fund raising event at a local country club.  I made a short appearance and was careful to avoid hand contact, hugging and kissing.  Everyone of any emotional importance to me knew my situation.  The point I want to make is that one has to listen to their doctor, use common sense, and take care of their body, mind, and their spirit.  <
An assertive person also pauses to obtain feedback from others which is vital for effective communication. Obviously, a caregiver/loved one who is heavily invested in your health may just be assertive enough themselves to help present a workable compromise to a situation. This compromise will enable both you and your loved one to keep emotional needs intact.      

Empowerment

“Every day is a gift. Open It with Joy”

This is a lovely affirmation from a Ford Warriors In Pink bookmark and it is a wonderful reminder in which to start off each day. I actually use it as part of a morning prayer of thanks. I recognize, however, that it is harder to “open it with joy” when you are facing diagnosis, surgery, chemo, or radiation as part of your day. Cancer is often referred to as a journey because there are phases (both physical and emotional) that must be “traveled” through. There are no short cuts along the way. Each phase holds its own challenges and trauma. Often when all the treatment is completed, the life beyond cancer becomes a time of fear and uncertainty. Your medical support and testing is not as frequent. My oncologist referred to it as “your security blanket is gone” when I completed my last treatment and mentioned my new trepidation. Will the cancer recur? That’s the big question in our minds. Although the fear may never go away completely, fear of recurrence should diminish over time (unless something triggers our fear, such as a friend or relative being diagnosed with cancer or we begin experiencing a pain previously associated with cancer). I have found that the fear does diminish and using coping strategies such as exercise, massage, meditation, calming self-statements/affirmations, prayer, and yoga are all helpful in accomplishing this goal.

InCure’s 7th Annual Cancer Guide they have added an additional suggestion: creating a “WORRY LIST.”

Make a list of worries and include specific examples. Many worries look different when written out, and may seem less problematic. Even the simple task of expressing specific concerns may release some of their power.

Write down every recollection of worries that actually materialized in some concrete way. Scan the notes and find the number of times a “false alarm” outnumbered the times a worry became reality.

Every day at about the same time, revisit the list, carefully noting how, since the day before, nothing actually happened. Allow a specific amount of time for this activity and cut down the time allowed for “worry list” review each week until it is diminished to one minute each day.

Seek out someone who is dealing with cancer and share this approach with them. Showing others that worry is a drain on energy may lift the spirits of other survivors, as well.