You received a diagnosis of cancer.  Where to go now?  Because of our own experiences with this dreaded disease, my wife, Nancy, and I have some suggestions to share with you.

Nancy, my wife and my hero, and I will celebrate our 40th wedding anniversary this September 25.  It has only been over the last 10 years that I have come to appreciate and admire her heroic qualities brought to fruition through tremendous personal adversity.  To accomplish this it is imperative that the doctors and hospital chosen possess unique skills and procedural methods to make the cancer victim’s survival possible.

Many know me as the author of the “Managing My Fibromyalgia” Website and Forum in which I describe my life dealing with the effects of what is now termed fibromyalgia, for more than 30 years.  My life has been challenging and I find myself now permanently disabled due to this chronic pain and fatigue disorder.  What I have had to face with my illness pales in comparison to what Nancy has dealt with successfully over the past 10 years. 

Nancy was diagnosed with the dreaded big “C” in 1999.  It was both colon and pancreatic cancers.  She was initially devastated.  This was something she feared since 1973 when she found out she had a condition called familial polyposis.  Until that point, Nancy thought her rectal bleeding was due to hemorrhoids as her doctors had told her since she was in her teens.  She had thousands of polyps in her colon, too many to be removed.

[Familial polyposis or familial adenomatous polyposis [FAP) is a premalignant disease.  This means that a person with FAP, if left untreated, will invariably develop cancer.  Individuals with this disorder grow hundreds of polyps throughout their large intestines.  The polyps, also called adenomas, commonly develop just after puberty.  Approximately half of all FAP patients will have polyps by age 14.  Ninety percent will have detectable polyps by age 25.  Usually by age 35-40, one or more of these polyps will become cancerous.]*

[FAP is a rare disease.  One in 8,000 people in the United States have FAP.  However, it may be very common in affected families.  FAP is inherited in an autosomal dominant pattern.  This means that a person with FAP has a 50% chance of passing the condition down to each of their children.  [Our son Gregg inherited this abnormal gene and had his colon removed by the time he was 22].  FAP can also develop in someone with no family history of the disorder, due to a new genetic mutation in that individual.  It is thought that approximately one percent of all colorectal cancers in the United States can be attributed to FAP.]*

Nancy had surgery back in 1973 to remove her colon.  The doctors created what they term a “J-pouch” out of her intestine to replace her colon and to restore normal bowl function.  It was now necessary for her to be monitored for the rest of her life.  Any new polyps that developed, while in a precancerous state, required removal and testing.

This treatment worked for many years.  Since moving to Virginia, however, she became uncomfortable with the doctors she met.  Nancy became remiss on going for her checkup appointments, even after my protests that she not neglect her follow-ups.  This is what undoubtedly led to her developing colon and pancreatic cancer in 1999.

Nancy’s initial reaction to her diagnosis was immediate devastation.  It lasted until she met her new doctors at the Sloan Kettering Memorial Cancer Hospital in New York City.  She saw the doctors at Sloane after getting the recommendations of family and friend based on their experience with the hospital. 

After talking to the doctors and meeting other patients with the same condition, her feelings of devastation became one of hope and steadfastness in the face of cancer, an attitude she has strongly maintained until the present.

Since 1999, Nancy was treated and had surgery and several related procedures for colon, pancreatic, and lung cancer.  Through it all, she is now cancer free.

The past two years, polyps where found developing in Nancy’s stomach.  They were removed, tested, and found to be showing mild dysplasia.  At the time, it was thought that they could be controlled this way, which was until the polyps became more and more numerous.

After several consultations and much consideration on Nancy’s part, to prevent any cancer of her stomach developing to threaten her life, she opted for a total gastrectomy [surgical removal of the stomach and the connecting of her intestine directly to her esophagus] on Oct 7, 2008.  This radical surgery would extend her life and assure that the polyps in her stomach would not turn to cancer.  Her surgeon told us that she should expect to be in the hospital for 5 to 10 day, possibly a week, after having her surgery.

As it turned out, this was not the case.  From Oct 7, 2008 till when she returned home December 9, 2008, she spent a total of 8.5 weeks in the hospital with only a couple of short stays at her sister’s home in New Jersey.  There were complications due to leaks in her new digestive tract, slow healing, abscesses filled with fluid in her torso and related infections.  In fact, Nancy returned home to Virginia with two drains still in place. 

The doctors in New York City gave us the name of a surgeon in Winter Park Florida.  Dr. Timothy Childers, was going to follow up on her case.  We moved from Virginia to Chuluota Florida to live at my sister’s home on December 13, 2008.  We gave up our apartment in Lorton, Virginia due to financial reasons; going to stay at my sister’s home in Florida would give us extra hands to help in Nancy’s recovery. 

Within several days of seeing Dr. Childers for the first time and before having her drain apparatus removed, Nancy ended up once again in the hospital [Florida Hospital Orlando South] for another week.  She had developed fever and it was determined to be an on going infection from a previously undetected abscess filling with fluid.  She finally left the hospital on December 27, 2008.

It is now January 6, 2009 and we are thanking God that Nancy is making slow but steady progress [some days better with occasional set backs] in achieving some sort of normalcy.  She will never be able to eat the same way as before, but many times a day in much smaller portions and will probably need supplements to reach the goal of 2000 calories a day.

This last surgery turned out to be the hardest on Nancy that I have witnessed.  It took a toll on her emotions and determination, but I know in my heart that her steadfast resolve to live will make the difference again and she will continue to be cancer free.

Nancy’s surviving cancer has come at a financial cost.  Even with her good insurance coverage from her employer, we have been financially devastated over these past 10 years.  We gave up our home in Stafford Virginia in 2005, used up my entire 401k plan from my once employer, over extended my credit on my main credit card to pay medical bills and are at a point of considering declaring bankruptcy [although it goes against everything I believe in].  We now realize we may never get to travel during our retirement as we had planned, nor have a place of our own nor live our remaining years together without tremendous financial stress and pressure.

I am not complaining though.  We look to God for comfort with thanksgiving.  Even if I knew back then, what I know now, I would, without hesitation, do it all over again and ask Nancy to be my wife. 

After nearly 40 years of marriage, I love and cherish my hero wife even more than before.  I would truly be lost in this world without her.

Based on Nancy’s experience with her cancer and my own experience with prostate cancer, that was treated successfully this past year, there are several things that are important if one is to successfully fight the cancer battle:

1.    Early detection through regular examinations and testing is essential.
2.    Know your risks [family history, etc].
3.    Learn everything you can about your particular cancer.
4.    Always obtain a second or third opinion.
5.    If you do not feel comfortable with a doctor, move on to another; if you do not have any confidence in your cancer doctor, find a new one.
6.    Research cancer doctors and cancer hospitals.
7.    Ask friends and professionals for their recommendations on same.
8.    When declared cancer free, do not become complacent.  Continue regular examinations and tests to detect any reoccurrence early.

*Gale Encyclopedia of Medicine, Published December 2002 by the Gale Group.  The Essay Author is Ellen S. Weber, MSN.

Cancer is second only to cardiovascular disease as the leading cause of death in the Western world.
Although Cancer is primarily a disease of the elderly with more than 60% of deaths from cancer occurring in those over the age of 65, cancer can strike even the youngest of children.

Cancer appears to occur when the growth of cells in the body is out of control and cells divide too rapidly. Cancer can develop in almost any organ or tissue, such as the lung, colon, breast, skin, bones, or nerve tissue.

Most common sites are:
Prostrate 24%
Breast 13%
Lung 13%
Colon and Rectum 9%
Bladder 3%
Uterus 2.5%

The cause of Cancer is believed to be a combination of genetic factors and outside carcinogens such as tobacco, viruses, infection, asbestos, vinyl chloride, inappropriate diet.

Cancer often has no specific symptoms, so it is important that you limit your risk factors and undergo appropriate cancer screening. The signs and symptoms will depend on where the cancer is, the size of the cancer, and how much it affects the nearby organs or structures.

If a cancer spreads (metastasizes), then symptoms may appear in different parts of the body. As a cancer grows, it begins to push on nearby organs, blood vessels, and nerves. If the cancer is in a critical area, such as certain parts of the brain, even the smallest tumor can cause early symptoms.

But sometimes cancers start in places where it does not cause any symptoms until the cancer has grown quite large. Pancreatic cancers, for example, do not usually grow large enough to be felt from the outside of the body.
By the time a pancreatic cancer causes these signs or symptoms, it has usually reached an advanced stage.

A cancer may also cause symptoms common to many other problems, such as; fever, fatigue and weight loss. This may be because the cancer uses up much of the body s energy or it may cause the release of substances which affect metabolism.

Some lung cancers make hormone-like substances that affect blood calcium levels, affecting nerves and muscles and causing weakness and dizziness.

It is important to know what some of the general (non-specific) signs and symptoms of cancer are, but remember that having any of these does not mean that you have cancer.

Most cancers can be treated and some cured, depending on the specific type, location, and stage. The earlier the cancer is found, the better the prognosis.

A good example of the importance of finding cancer early is melanoma skin cancer. Skin cancer can be easy to remove if it has not grown deep into the skin, and the 5-year survival rate (percentage of people living at least 5 years after diagnosis) at this stage is nearly100%.

Screening for breast cancer with mammograms has been shown to reduce the average stage of diagnosis of breast cancer in a population.
Colorectal cancer can be detected through fecal occult blood testing and colonoscopy, which reduces both colon cancer incidence and mortality, presumably through the detection and removal of pre-malignant polyps.
Similarly, cervical cytology testing (using the Pap smear) leads to the identification and excision of precancerous lesions.
Testicular self-examination is recommended for men beginning at the age of 15 years to detect testicular cancer.

SIGNS and SYMPTOMS

Pain may be an early symptom with some cancers such as bone cancers or testicular cancer.

Long-term constipation, diarrhea, or a change in the size of the stool may be a sign of colon cancer.

Pain with urination, blood in the urine, or a change in bladder function (such as more frequent or less frequent urination) could be related to bladder or prostate cancer.

Skin cancers may bleed and look like sores that do not heal.

A long-lasting sore in the mouth could be an oral cancer and should be dealt with right away, especially in patients who smoke, chew tobacco, or frequently drink alcohol.

Sores on the penis or vagina may either be signs of infection or an early cancer, and should not be overlooked.

Unusual bleeding can happen in either early or advanced cancer.

Blood in the sputum (phlegm) may be a sign of lung cancer.

Blood in the stool (or a dark or black stool) could be a sign of colon or rectal cancer.

Blood in the urine may be a sign of bladder or kidney cancer.

A bloody discharge from the nipple may be a sign of breast cancer.

Many cancers can be felt through the skin, mostly in the breast, testicle, lymph nodes (glands), and the soft tissues of the body. A lump or thickening may be an early or late sign of cancer.

While they commonly have other causes, indigestion or swallowing problems may be a sign of cancer of the esophagus, stomach, or pharynx (throat).

A cough that does not go away may be a sign of lung cancer.

A cancer may be suspected for a variety of reasons, but the definitive diagnosis of most malignancies must be confirmed by histological examination of the cancerous cells by a pathologist.

TREATMENT

Once diagnosed, cancer is usually treated with a combination of surgery, chemotherapy and radiotherapy.

Radiation therapy may be used to treat almost every type of solid tumor, including cancers of the brain, breast, cervix, larynx, lung, pancreas, prostate, skin, stomach, uterus, or soft tissue sarcomas.

Most forms of chemotherapy target all rapidly dividing cells and are not specific for cancer cells, although some degree of specificity may come from the inability of many cancer cells to repair DNA damage, while normal cells generally can.

Contemporary methods for generating an immune response against tumours include intravesical BCG immunotherapy for superficial bladder cancer, and use of interferons and other cytokines to induce an immune response in renal cell carcinoma and melanoma patients.

Pain medication, such as morphine and oxycodone, and anti-emetics, drugs to suppress nausea and vomiting, are very commonly used in patients with cancer-related symptoms. transmission and disease.

Advances in cancer research have made a vaccine designed to prevent cancer available. The vaccine protects against four HPV types, which together cause 70% of cervical cancers and 90% of genital warts.

The consensus on diet and cancer is that obesity increases the risk of developing cancer. The cancer-fighting components of food are also proving to be more numerous and varied than previously understood, so patients are increasingly being advised to consume fresh, unprocessed fruits and vegetables for maximal health benefits.