When Do I Become a Cancer Survivor?

By DebiLyn Smith www.debilynsmith.com Author of Running From Cancer: a tilted memoir. A breast cancer "treatment survivor" since May 2011, DebiLyn strives to reduce the 50% of life-style induced cancer patients. "You can run, but you can't hide," she says.

What Happens After Cancer Treatment?

When does one begin to say they are a breast cancer survivor? I have finished the treatments. The medical profession has cut, poisoned and nuked the part of me that contained the psychotically rapid dividing cells known as cancer. I did survive that, with some scary moments of wondering involved. Or do I have to wait until the recommended five years of drug therapy is finished to declare "I made it!" If, that is, I do make it?

I don't want to be ridiculed at a cancer march or a run for the cure as they applaud the champions who beat this disease when I have yet to find out if indeed we did "get it all" or if there is some little piece that survived, starting to multiply someplace else as we speak. It's a very real concern. Worse than the nightmare about going to Sunday school without my underwear on.  I don't know what to trust anymore. My body let me down once. Will it do it again?

They say that one third of women with hormone dependent tumors (like mine) will have a recurrence. Better than half of those five years or more after surgery. Because I opted for the adjunct therapy (the chemo and radiation) combined with surgery my chance of the cancer coming back goes down. I think I'm at a 3-5% chance. It's still enough to make you worry. I've beaten lower odds before in the luck-less life lottery.

Beginning Life-Long Learning to Stay Healthy

Saying you're a survivor implies the war is over but for me, the battle has just begun. This is going to be a life-long assault of learning and doing what I can to survive not just now, but for as many years as I can squeak out of this body.

So despite everything that's been done, I'm determined to keep the numbers on my side. It's a betting game with no guarantees and you must do what you can to help. Swallow large fish oil and Green Tea capsules (anti-oxidants), stuff in the blueberries by the handful, drink the green spirulina/algae with your pinched, drag your butt to the swimming pool, fill those lungs with good clean fresh air, drink water not wine and whatever you do... don't sweat the small stuff.

Possibly when I'm on my  last breath, when I have lived a much longer life, I will finally declare myself a breast cancer survivor. Until then... Game On!

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Footwear Recommendations for Patients with Chemotherapy Induced Peripheral Neuropathy

by Paul Mäkinen, C.Ped.(C), C.Ped.Tech.(C)
Certified Pedorthist, Atlantic Region - LifeMark Health Halifax

Proper fitting footwear is a good starting point to help reduce symptoms of Peripheral Neuropathy

Numbness in Feet? Changes to Your Footwear May Help

Peripheral nerves are those that connect to the nerves that travel from the central nervous system to the further areas of the body (legs and arms). When a person suffers from Peripheral Neuropathy they typically present with symptoms of altered sensation, numbness/tingling, and some burning pain.

When these symptoms present in the feet, there are many things that can be done to help reduce the effects. The first thing to consider is the overall mechanical function of the feet and how that may affect the foot structures. There are many options to help address foot mechanics including custom orthotics, off the shelf orthotics and proper fitting footwear.

Proper fitting footwear is likely the best starting point to help reduce some of the symptoms, according to LifeMark/Centric Health Certified Pedorthist for the Atlantic Region, Paul Mäkinen.  “The most common area of concern with Peripheral Neuropathy, in the feet, is the metatarsal region commonly referred to as the 'ball of the foot' area. These bones and joints will often present with pain, tenderness, and some form of numbness/tingling in the region. The use of a shoe with a stiff forefoot rocker will help to alleviate pressure off this area and will often reduce symptoms by reducing pressure on the metatarsals”, he explains.

Proper Shoe Sizing Includes Width as well as Length

It is also very important to be sure that you have the proper sizing when you select shoes. Not only do you want to be sure that you have the proper length, but the appropriate width is crucial as well. When the width is not correct, you often compress the nerves and structures in the area causing more symptoms.

Some brands/styles of shoes that will offer you good forefoot rocker soles and width options are:

New Balance 928

New Balance 840

Dunham 8000

For additional information regarding footwear and neuropathies in general, please refer to http://www.pedorthic.ca/foot-health/diabetes/?. The footwear considerations for someone with CIPN are very similar to the neuropathies that diabetic’s experience. 

If you have specific questions about footwear/orthotic options for your CIPN related symptoms, contact our Atlantic Region Certified Pedorthist, Paul Mäkinen, by email at Paul.Makinen@centrichealth.ca.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Challenges and Rewards of Exercising With Chemo Brain

The challenge of doing regular exercise can be overwhelming for a patient with chemo brain

Managing Cancer Rehab Takes A Team Approach

Sometimes the opportunity to work collaboratively from seemingly disparate rehab specialties comes when we least expect it. This is often the case when treating cancer survivors and cancer patients in Cancer Rehab clinics, where we all work together as Physiotherapists, Acupuncturists, Kinesiologists, and Occupational Therapists to help cancer survivors recover from the side effects of their cancer treatment.

Treating an Individual's Frozen Shoulder Also Uncovered Chemo Brain

Recently one of our clinics received a referral for a physio asssessment and physical treatment when the treatment needed was also for chemo brain - requiring both a kinesiologist and occupational therapist.

• The kinesiologist who works with cancer patients will encourage them to exercise to aid in their recovery, but exercise routines are not always easy for cancer patients. The role of the kinesiologist involves recognizing when a patient is having difficulty with proper technique or remembering exercises. These patients may need more one on one instruction, and it is important to provide them with a detailed home exercise program with pictures and instructions that are easy to understand. We know from experience that when a client is having difficulty with the exercise while in the clinic they are definitely going to have trouble at home. Lastly, the kinesiologist will follow up each visit - since repetition is key - and communicate with all team members on progress.

• The occupational therapist treating cancer patients for chemo brain will teach cancer patients how to focus on the positive aspects of what they are doing, recognizing the small gains they make each day. They help patients to organize their thoughts by writing them down and creating a structure or plan, breaking it down in order for it to be less overwhelming. They also ask patients to time their daily activities to allow for complete cognitive rest, away from all mental stimulus including computers and television.

More Awareness of Chemo Brain Needed

Many people, including doctors and insurance companies, fail to recognize the impact chemotherapy can have on the brain and the way we think. It interferes with patients' abilities to multitask and also impairs memory, so that one day they are shown an exercise and the next day cannot recall it. This is not only due to their fatigue and loss of mobility and strength, but due to the mental confusion that comes with chemo brain. The challenge of doing regular exercise and getting back into a normal routine can be overwhelming for a patient with chemo brain.

We have found that managing cancer rehab isn't always what we expect. A lot of education is still necessary, and helping patients get back to living their lives takes a team approach.

There is More to Rehab Than Meets the Eye

Utilizing specialized rehab techniques to assist in the recovery from cancer side effects is still a relatively new field. Cancer patients who utilize rehab services for their recovery benefit from qualified specialists in physiotherapy, kinesiology, occupational therapy and acupuncture to get back on their feet.

Help us to create awareness of cancer rehab by following us on Facebook, Twitter, Google Plus and LinkedIn - help us spread the word!

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Alcohol and Cancer

By DebiLyn Smith www.debilynsmith.com Author of Running From Cancer: a tilted memoir. A breast cancer "treatment survivor" since May 2011, DebiLyn strives to reduce the 50% of life-style induced cancer patients. "You can run, but you can't hide," she says.

Drinking Alcohol on a Regular Basis Can Increase the Risk of Breast Cancer

Exceeding the three weekly maximum recommended alcoholic drinks affects cancer risk

It's talked about in women's magazines and on the television and radio, but it isn't really news. Like the fact that smoking can cause lung cancer, the fact that there is a relationship between women drinking alcohol and breast cancer has existed for some time now. As with smoking, it takes a while to open everyone's eyes about how dangerous playing with that weekend cigarette or that second or third drink in one day can really be. Will we have to resort to pictures of mastectomies on wine bottles to get the point across? Hopefully not.

Alcohol Fuels Cancer in a Number of Ways

The number of breast cancer cases has been rising sharply, possibly due to the amount of Baby Boomers approaching or being in menopause. All those hormone levels fluctuating. The majority of breast cancers are fed by hormones like estrogen or progesterone. When I read this, I thought, "Bingo!" I had been peri-menopausal for months, meaning my periods were becoming unreliable in length, timing and appearance. I used to think PMS was bad. This next phase had me humming like a mental patient. Nothing was right in my life. My friends all drove me crazy, my husband intentionally, I was sure, did everything wrong and the entire world was stacked against me. It was easy to slip into drinking three glasses of wine in one evening. On weekends, there were glasses of wine at lunch. More at the lounge after skiing, then more with dinner and socializing. Little did I know they were fueling a cancer that had decided to grow within my breast.

Alcohol may contribute to breast cancer in a number of ways. One of its metabolic byproducts, acetaldehyde, is thought to be carcinogenic. Alcohol may also boost blood estrogen levels, which can feed cancer growth. As well, alcohol may inhibit the ability of cells to repair faulty genes and make breast cells more vulnerable to carcinogens.

Exceeding Weekly Maximum Recommended Alcoholic Drinks Affects Cancer Risk

What's recommended? A maximum of three alcoholic drinks a week for women, seven to fourteen for men. The worst of the bad news is for women who have already been through breast cancer. For them, playing with any alcohol can be detrimental, especially if they have a hormone-fed type of cancer (ie: estrogen or progesterone). Therefore, women who drink regularly, like every day, will have chronically elevated levels of estrogen circulating in their bloodstream. And since estrogen is the equivalent of light, sweet crude for the breast cancer engine, it's easy to see why regular alcohol consumption is directly linked to an increased risk for breast cancer. In fact, there does not appear to be any "safe" level of alcohol use: even a half glass of wine per day increases the risk for breast cancer.

I hate to be the heavy here, but a fact is a fact. Please keep this in the front and not the back of your mind the next time you raise that second glass of spirits to your lips. And let's all drink to our health! Make mine a double water, heavy on the anxiety-free, please.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Chemo Brain is Real

There appears to be a tie between chemotherapy and the cognitive processes of the brain

Mental Fogginess After Chemotherapy Can Provoke Feelings of Insecurity

Chemo Brain is real.

One of my strongest memories of returning to work after receiving 6 months of chemotherapy is the feeling of fogginess. I was happy to be back in the saddle, surrounded by supportive co-workers, but I had this sense of being dazed and distracted for the first several months. I would sit in front of my computer screen and simply stare, wondering why it was taking me so long to respond to an email. Approving the bimonthly payroll took me three times as long as I knew it had previously, but the numbers just never added up as easily as they used to. I would call someone and then forget what I was calling them about, or I'd forget the name of someone I know well during the conversation. It left me feeling insecure, inadequate and unsure as to whether I should be there or not.

Chemo Brain Symptoms Include Poor Memory, Difficulty Focusing and Problems with Multi-tasking

I had challenges with things such as:

• Multi-tasking
• Word/name recall
• Numerical calculations
• Difficulty focusing
• Poor memory

Chemo Brain Is As Real As the Problems It Causes

Many cancer survivors struggle with mental fogginess or "chemo brain" that occurs during and after their cancer treatment. Although the exact cause of it is still not known, there does appear to be a link to the effect that chemotherapy has on cognitive processes of the brain. These symptoms can range from being very vague to being a major impairment, and they can last only a short time or years. An MRI of the "chemo brain" will show actual changes to the grey matter. Chemo brain is as real as the problems it causes, so don't let anyone tell you otherwise.

5 Suggestions to Help You Cope With Chemo Brain

As a result of the challenges brought on by chemo brain, it is not surprising that many people are unable to cope like they used to - and begin to feel anxious and depressed. In my experience, the changes were subtle and not that noticeable to an outsider, but very evident and upsetting to me. A real blow to one's self-esteem. Here are some of my strategies to try and overcome these challenges.

5 simple suggestions to help you cope with chemo fog:

1. Get adequate rest and plan to do challenging mental activities when you are well-rested.
2. Be present in the moment, focus on the task at hand and learn to ignore the background noise and confusion. Many cancer survivors benefit from regular meditation. I found that having a quiet work space was essential.
3. Exercise regularly to keep your mind clear and feeling more alert. Get outside when you can, as I found the fresh air really helps bring clarity.
4. Create "to do lists" to keep track of tasks at hand. I became reliant on my phone, adding notes constantly to help get me organized and on task.
5. Slow down your mind and your body. This is a difficult one to do when you are feeling anxious already. I found that deep breathing is really great - three deep breaths will bring everything into clear focus.

Treatment is Available For Ongoing Cognitive Problems Experienced After Receiving Chemotherapy

If your problems persist, you may require a cognitive abilities evaluation and have a rehab professional, such as a neuropsychologist or occupational therapist, work with you to provide cognitive enhancement training. Recent research shows that there is a great deal that can be done to improve an individual' memory and other brain functions. At Cancer Rehab Canada, we believe in your ability to retrain your brain and and encourage you to seek treatment for ongoing cognitive problems. Please contact us to find the clinic nearest you.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

The Best Treatment for Cancer Related Fatigue

Studies indicate that 80% of people who received chemotherapy or radiotherapy will have some degree of fatigue

Cancer Related Fatigue Remains Number One Problem

The most prevalent side effect of cancer treatment is fatigue. Studies suggest that eighty per cent of individuals who have received chemotherapy or radiotherapy will experience some degree of persistent fatigue. In Dead Tired, Dr. Jane Poulson describes her experience of cancer fatigue as "unlike any fatigue I have ever known, not only in severity and longevity but in its effect on my mood and spirits".

 Exercise Lowers Reported Fatigue Levels by 40 - 50%

Physical exercise has been suggested as helpful in reducing fatigue

Although it seems counter-intuitive to most people, the best cure for fatigue is exercise. The scientific evidence supporting exercise as the best intervention for fatigue is very strong. However it is often difficult for those overwhelmed by fatigue to know how to get themselves going again. They need guidance to start slowly and gradually increase their exercise over weeks and months. Every individual is different and some people have medical precautions which make finding their safe level of exercise more challenging. Appropriate screening and modifications of prescribed exercise is extremely important.

Cancer Exercise in the Community

At Cancer Rehab Canada we encourage you to get out there and get active. We want you to find a safe and engaging way to exercise. For some people this may be doing Yoga or Pilates at a local gym, and for others it might mean walking the dog. Exercising with others in a group setting is often an excellent way to take your mind off your fatigue and motivate you to get going, but you need to be mindful that you are an individual and everyone is unique.

If you have any doubt about your abilities to do certain exercises, please consult with a rehab professional at Cancer Rehab Canada. Starting an exercise program after an illness isn't easy, and often a few simple strategies can get you safely on your way to a full recovery. Before you know it you will be able to enjoy increased energy and much less fatigue.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Limited Joint Mobility Can Be Improved With Cancer Rehabilitation

Celeste Petrusevski, Registered Physiotherapist at LifeMark Physiotherapy on Bay, guides a patient in range of motion exercises

Joint Stiffness and Reduced Range of Motion Can Happen Months or Even Years After Patients Have Already Completed Their Cancer Treatments

One of the impacts of cancer treatment sometimes experienced by patients after cancer treatment is limited range of motion, or the reduced ability to easily move their limbs from particular joints. This reduced ability to move occurs due to joint stiffness, pain, swelling, or muscle aches. These are among the less recognized problems that can occur after chemotherapy, radiation, hormone therapy or biotherapy treatments. Sometimes side effects of cancer treatment can arise months or even years after the treatment has already ended. Cancer rehabilitation specializes in assisting patients to recover from those side effects and improve their quality of life.

Cancer physiotherapy can help improve limited range of motion through specialized exercise techniques called "range of motion" exercises. These exercises, which are done very gently, are designed to move the stiff joints through to their full range of movement. When working with a cancer rehab physiotherapist, a patient will be prescribed range of motion exercises that are required to be done daily in prescribed repetition according to their individualized treatment plan.

"Many patients will experience loss of mobility and strength following cancer treatment and/or surgery", says Celeste Petrusevski, a Registered Physiotherapist at LifeMark Physio on Bay. "This can greatly affect daily activities and lead to pain and weakness over time. As Physiotherapists we work closely with our patients to guide them through specific exercises that are prescribed on a daily basis and completed at home or in the clinic. These client specific exercise programs will work to restore full mobility to the joint in a safe and effective way. Clients can then return to work, activities and hobbies pain free. Having a health professional such as a Physiotherapist address and improve the functional limitations associated with cancer treatment is an integral part of a full recovery."

Every joint has its own normal range of motion, and when joints are functioning properly it is possible to move around freely and perform regular activities without pain. Early rehabilitation can often prevent problems such as joint stiffness from developing, so please don't wait - it is best to seek treatment in the early stages.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.