Coming to the end of the week, the weather outside is bleak.  So I am taking advantage of the autumn mood and going through some recent communications.  below is an interesting link to an important message about the relationship between chemicals and cancer.

I hope this finds you well.

Given the enormous reach of your blog platform, I wanted to share this with you and hopefully your readers as well. Are you already familiar with the connection between chemicals and cancer? Studies are regularly being conducted that demonstrate an environmental linkage to cancer, and that rates have increased alongside the use of synthetic chemicals. The Breast Cancer Fund annual completes a report on the matter: Victories

Do you know that over 80,000 chemicals on the market today that are included in products have never been adequately safety tested? Science has been showing for years that exposure to these chemicals are linked to major illnesses including cancer. And last year the President’s Cancer Panel finally decided that exposure to toxic chemicals is an important and under-recognized risk factor for cancer, and recommended that the government take immediate action to reverse this trend.

The Panel advised Congress to reform the Toxic Substances Control Act, commenting that this law is “the most egregious example of ineffective regulation of chemical contaminants” and noting that weaknesses in the law have constrained the U.S. Environmental Protection Agency from being able to properly regulate known and suspected carcinogens.” It has also been found that the increase in childhood cancer parallels the proliferation of toxic chemicals.

So why does this matter? I work with Environmental Defense Fund and over 300 health and environment organizations that are working to get Congress to do just what the President’s Cancer Panel advised, that is to overhaul our flawed policy for chemicals – and make chemical companies ensure their products are safe BEFORE putting them on the market.

I’d love to see if there’s a way for us to share this information with your readers whether it’s by syndicating one of our blog posts on here: What do detergents and fragrances have to do with breast cancer? – Not a Guinea Pig – Environmental Defense Fund, or providing you with information that someone there might be interested in pulling from, or writing something specifically for your website.

Thank you in advance for considering. Look forward to hearing your thoughts.

Rachel Pappas sent me a note about her informational website: 1 Up On Cancer.  It is an excellent resource on a number of different cancers.  I especially appreciated her section on “Freebies and Discounts for Cancer Patients”.  I sent the link to our BMT social worker.

Trish DeFosse, a student at Endicott College in Massachusetts, wrote to me about her new, one entry so far,  blog Cancer.  Her first post is reprinted below.

My Father’s Battle With Cancer

My dad was the kind of person who hated going to the doctor’s office, or any other check-up for that matter, and he was extremely stubborn, so it was nearly impossible to get him to do anything that he did not want to do. My dad took care of himself, but in his own way and on his own time. Little did he know, however, that for the last two years of his life he would spend the majority of his time in one the places that he hated the most- the hospital.
During my freshmen year of high school I remember my father complaining about a tooth ache for months, but when we suggested that he go to the dentist to get it looked at, of course he refused. My sister, Danielle, and I finally got him to go, but we were completely unprepared for what the dentist was about to tell us. The painful tooth ache that my dad had been complaining about was actually oral cancer caused from smoking cigarettes.
My sophomore and junior year of high school consisted of many trips to Massachusetts Eye and Ear Infirmary in Boston, as well as the local hospital in my hometown, called Central Maine Medical Center (CMMC). At Mass. Eye and Ear, my father underwent surgery to remove the cancer from his mouth and to reconstruct his jaw using bone from his leg. He was cancer free for a few months, which is when he visited CMMC for radiation and chemotherapy. Unfortunately, the cancer came back, now in his lungs, and began spreading throughout his entire body. On February 13, 2009, four days after my mother’s birthday and two days after mine, my dad passed away. He fought long and hard for his life, and for that I am so thankful and proud. My dad is, and will forever be my hero.
I cannot even begin to imagine the pain that my dad went through, but I know that he is in a better place right now, watching over me and protecting me to this day. Experiencing my dad’s battle with him, along with the rest of my family, has really opened my eyes and made me realize how precious life really is. Many people do not realize this and take many aspects of life for granted until they are faced with their own death or the death of a loved one. Everyone should life live to the absolute fullest, because life truly is too short to be anything but happy.

This entry has to come under the “Shameless Plugs” category.  It is an email from Andrea, a double cancer survivor, whose post “Fear of Death” was reprinted here on Monday, the 26th.  It is always gratifying to know that our little website can have some impact in this complicated world.

It’s me, Andrea (see above post), I’m back to thank you for everything that you’ve done for me, for taking the time to read my blog, for deciding to feature it on your site, for giving me the oportunity to have a voice.
English is not my first language and writing that blog is difficult, and I’m in pain, I’m fighting my tumours and I’m sick, and it’s not easy. By sharing my experiences my only hope is that I might, one day, be able to help a worried woman, someone, somewhere, even in the smallest way.
I’m so grateful for what you’ve done for me, Dennis, thank you!
In only 2 hours I had over 140 views! This is the gift that your site and your reputation has given me, the joy of sharing, the feeling of being useful and the voice to educate and inform.
Thank you, Dennis
Very grateful, forever.
Andrea

New Bedford harbor

Here’s a little update on my situation and on some interesting cancer news that I have received in emails lately.

Headline:  1 in 20 Americans is a cancer survivor (CNBC)

Looking for Work:

I am beginning to understand the frustration of America’s unemployed.  The loss of a substantial portion of my disability benefits has left me scrambling for some kind of part-time employment.  All the news about the aging of the Baby Boomers coupled with steady talk about a nursing shortage would seem to indicate that I should have no problem returning to the field.  Intuitively, yes.  In point of fact, no.

The economy seems to have made the healthcare industry cautious.  As an old-timer my first impulse was to search the want ads.  But the classified section is skinny even  if it shows up in the daily paper.  And cruising through the newspaper reveals more ads for training schools than for actual jobs.  A recent announcement of EMT  jobs listed a requirement for a $10 application packet fee.

My next step was to look to the web.  I have signed up for numerous nursing groups resulting in daily deposits in my electronic mailbox of a broad range of nursing positions.  Problem is all are full-time and almost none of them are local.

The whole application process has been streamlined as well.  You set up accounts with various healthcare employers, establishing and electronic application and resume.  Then you must reapply for each new listed job that you interested in.  There are generally no contact names or numbers.  In fact you are advised that you will only be contacted if you are offered an interview.  Your resume must be simple and streamlined in order for it to be correctly scanned int the company’s database.

I am looking for 8-12 hours of professional (nursing) work per week or perhaps 20-25 hours of non-professional work.  It looks like I will only be able to secure very part-time nursing work through networking.  So if any of you out there have any connections, please let me know.  I have 25 years healthcare experience mainly in oncology but also in mental health.  I have been a clinical nurse, a nurse manager, a nursing educator, a speaker and consultant, a project developer, and I run two websites.  I can work from home on my computer.  I can travel locally.  Maybe there is a job out there that can use some of my talents.

Launchpad Winner:

From my email box came news that Anne Cheung was one of the winners of this contest which annually makes a cash award to five individuals who have designed projects to transform their community.  Anne’s Big Idea: Cancer patients face tremendously daunting tasks in managing and coping with their disease. Chinese-American cancer patients with limited English proficiency suffer additional uncertainty and emotional stress because of a lack of information and support in their native language. In a 2005-2007 survey, 65 percent of working-age Chinese adults and 90 percent of elderly Chinese in New York had English limitations. I would like to help to develop a Chinese cancer support group, which will provide information and psychosocial support in Chinese to these patients in New York.  (http://launchpad.encore.org)

Unraveling:

A while back we published our first fictional work by a woman who was inspired by the struggles of her mother and brother, both diagnosed with astrocytomas.  We are sad to announce that Marissa’s brother passed away last month.  The following is excerpted from her eulogy: I’m going to be travelling on a long trip, starting this summer. I asked Mickey what peaks he would climb if he was still able. We agreed on a list of 11 peaks, throughout the Pacific Coast of both North & South America. So, leave a message to Mickey on the sheet, and it’ll be cut into 11 pieces. I’ll leave a piece at the summit of each peak. As many of us can attest, sometimes the people that inspire us the most, are our next door neighbors, our football coaches, our siblings, or our ski instructors. So, thanks in advance for participating in this journey, dedicated to Mickey, and my luckiness to have him as brother.

But, no matter what, I feel the same as most of you feel: Mickey always wanted the best for everyone. I didn’t just lose a brother; like you, I lost a friend. A friend that knew me my whole life! - Unravel Cancer: Experiences with family battling cancer

Shared Cancer Experiences:

Terry Halsey wrote me recently.  Terry has an interesting website, an experimental resource, a repository of personal cancer stories.  Some stories are written by blog-authors.  Others are by persons who simply responded to this offer to share their stories.  What is unique here is a collection of accessible experiences organized from one cover page.  It’s a good place to start from someone just diagnosed, someone with an impulse to share.  Terry is looking for ideas and more stories.  If you haven’t had the opportunity to tell your own story, if your own blog seems like too big a step, this could be a good outlet. Even if you have your own blog, this is yet another avenue to be heard.  And the link to Steve Dunn’s work is worth the visit.  The internet is big enough for all our collected narratives.  – Shared Experience Cancer Support Database

National Cancer Survivors Day:

It’s coming up in a couple of months.  Information and merchandise at www.ncsd.org

Winter can be a bleak time for cancer survivors.  The death of Daria Maluda cast another shadow over our community recently.  The preceding post dealt with grieving over a child’s death.  Therefore I am sorry to report the passing of three more cancer bloggers.  Some of these are not recent but only recently came to my attention.  All three were exceptional writers and human beings.  Each was a member of our Honor Roll for Excellence in Cancer Writing, having published Guest Posts on these pages.

~ Barry Fraser, An Explorer’s View of Life, an esophageal cancer survivor, left us last July.

~ Christine Lynds, On The Edge Of Light, a Canadian breast cancer blogger, died peacefully in September.

~ Erik Ludwinski died just shy of his twenty-fifth birthday last February.  In having lived that long, Erik was a hero and spokeperson to scores of young children who struggle with neuroblastoma.

If you know of any other bloggers that have passed recently, please let me know via email (beingcancer@att.net) or by commenting below.

Social Support Research Opportunity:

Hello Dennis.  My name is Jessye Cohen and I am a doctoral student at
Virginia Commonwealth University. Under the supervision of my advisor,
Dr. Kathleen Ingram, I am conducting a study of social support of
individuals who have been diagnosed with cancer.

I am writing to ask if you would be willing to share the following
description by posting it on your website or passing it along via
email. I am really interested in hearing from a variety of people
living with cancer:

Researchers at Virginia Commonwealth University are conducting a
survey of individuals who have been diagnosed with cancer in order to
understand use of different social support resources. If you are over
age 21 and have been diagnosed with cancer, you are eligible to
complete a 30-minute survey about your experiences using web-based and
other tools or support groups. Please follow this link for more
information and to participate in the survey:
http://tinyurl.com/SupportSurveyVCU  Please feel free to contact me
with any questions or for more information.

New Writing Awards Badge

My second antibiotic is starting to kick in against my latest upper respiratory infection.  So I have crawled out of bed.  It’s about time to work on one of my New Year’s Resolutions: creating an award badge to recognize some of the outstanding work of cancer survivors who blog about the experience.  Last year I created the Honor Roll for Excellence in Cancer Writing. (You can navigate to the Honor Roll page from the site map at left or menu above, under “Community”)

My greatest revelation in starting a “blogroll” for Being Cancer was the quality of writing that I found week after week.  I started printing examples of this writing as our Guest Post feature, one of the most popular and widely read features on our site.  For the most part these are not professional writers.  They are just folks who started blogs and were somehow able to connect deeply with what they were experiencing as cancer survivors.  They were then able to convey the depth of that experience in elegant, moving prose.  Excellent, compelling writing has always been my sole criteria for selection.

Working over the holidays with my son from Boston who knows HTML code far better than I,  we managed to create a Writing Award Badge.  It features the Being Cancer Network lighthouse logo against a royal blue background.  From now on bloggers who are placed on the Honor Roll will be allowed to display this award on their own website.  I plan to spend the next few days sending out award pages to past recipients. I will also be working on updating the Honor Roll listings.

Be patient, try to enjoy the snow, and start having a great New Year.  Take care, Dennis

Debbie

We passed a couple milestones recently.  And the occasion was made even more special by an email from a grateful reader.  It’s the sort of thing that keeps us going.  The visit counter just ticked over 70,000.  About the same time I recalculated the blogs on all the lists.  I have discovered quite a few new ones lately.  The new total comes to over 1200 personal cancer blogs!

Just before I wrote this post I finished doing some redesigning of the Cancer Blogs Lists.  I have combined the cervical and ovarian lists under a new “Gynecologic Cancers” section.  I renamed “Widows and other Survivors” into the more direct title “Grief Blogs”.  I edited the “Uncommon Cancers” section, moving many of the blogs to other more appropriate lists (for instance, “Wilm’s tumor” blogs to the “Kidney Cancer” section as this is a type of childhood cancer of the kidneys).  Diseases with smaller number of blogs – bone, bladder, pancreatic, testicular, etc – move to the “Miscellaneous Cancers” page.  Finally, the now smaller “Uncommon Cancers” list resides on the “Miscellaneous” page also.

What I am really excited about today is the following email:

Hi Dennis,
I found your blog a little over a year and a half ago. After being diagnosed with oral cancer on January 20, 2009, I started frantically searching the web for any information I could find. I found a blog of a young woman who had a diagnosis of cancer almost identical to mine, hers was the one and only blog I found, at that time, that was so close to my diagnosis. I found her blog to be so critical in my understanding of what I was going to be facing. Since then my computer crashed and I have been unable to locate her blog again. I did, however, after viewing her blog, create one of my own to chronicle my experience in the hope of not only keeping our many family, friends and acquaintances informed in how I am doing, but also to hopefully be a help to anyone who may receive this horrible diagnosis in the future. I have tried to be very informative on by blog including some graphic and very unflattering pictures of my cancer journey.

I check your blog daily, excited to read each new post. I can’t tell you how much help and comfort I have received from reading the blogs of other cancer patients you have made available from your web site. It was so wonderful to find your web site at a time when I was desperately seeking to hear from others who have been through what I was facing. I don’t know if you would be interested in including my blog on your site or not. It has been my desire, in writing it, to possibly be a help to anyone else facing this rare form of oral cancer. My blog is    There Will Be Grace

Once again THANK-YOU for taking the time to set up and continue to add to, and maintain your web site!!!! It seems as if every post I read, touches my life in some way.

Today’s entry, Cancer Symptoms Endure, is so relevant to what I have been experiencing lately. It is wonderful to know I am not alone in the things I am experiencing a year after finishing treatments. Before my cancer diagnosis I hadn’t been to the doctor in probably five years, but now sometimes, I find myself wondering if I have been sick for so long that these symptoms are somehow only in my mind. Then I read something you or one of your guest speakers have written and it helps to know I am not so unusual!!! Wow, I can’t say thank-you enough!!!

Sincerely,
Debbie Ruppe

A new blog section has been added to the Cancer Blogs Lists – a Miscellaneous Cancer Blogs section.   This is devoted to blogs that are ancillary to the main body of disease categories.  One section features a blog that is devoted to the needs of cancer caregivers.  The next section offers a selection of cancer blogging communities, places where survivors add their collective voices to a community dialogue rather than maintaining an individual blog.  We needed a place to put blogs by cancer doctors and nurses to offer their own unique take on the cancer experience.  And finally there is a section to help children deal with a family member’s cancer.

I still need to look for ways to improve the listings under “Uncommon Cancers”.

An update of my life:  we returned last Monday from our trip to Boston.  The drive never gets shorter.  But the twins at eleven months were a delight.  I have an appointment at the transplant clinic this week.  One of the topics for discussion – whether it is time to come off of disability.  My insurance company, Unum, has just about completed their evaluation, collating information from six physicians and tax returns for the past two years.  And, no, this website is showing no signs of profit so no additional income worries there.  So I may be facing a decision to return to nursing in some capacity or else seek an early retirement.

Still waiting for thoughts and suggestions about resuming the Cancer Book Club.  I will be writing a post in the near future on issues related to writing a critical review of a cancer book, especially of the always heartfelt cancer memoir.  With the coming of cold weather I seem to be easing into a  more comfortable writing schedule – posts on Monday, Wednesday, and Friday with maybe a short news post on Sundays.  As always,

Take care, Dennis

1st day back at pre-school

Disability woes

Sorry I have been away from the computer for a while.  Came down with another viral thing – just a bad cold but without a fever.  Still it slowed me down.  I figured out that my new job – working at a gourmet wine and spirits shop a few hours a week – is mainly for my mental health.  Unnum, the insurance company that I receive my disability income from, figures this is a good time to do a complete review of my case.  I spent an hour in a phone interview with a nice-enough “case specialist”.  The company wants to make sure that I am able to live up to my full potential.  Working three hours three evenings a week pouring wine at the tasting bar has sent up a red flag from them.  Of course I only make 1/3 per hour and 8% a year of what I would be making if I were able to work full-time in my chosen profession, nursing.  And I have had to call in sick a number of days since I started work three months ago.  They plan to contact all of my physicians and get back in touch with me.  I guess they’re just doing their job.  It’s a reasonable enough request.  Yet somehow I sense that their primary agenda has more to do with their financial health than with my reaching my full potential.  I’ll keep you posted.

New thyroid blog

Another email from a new blogger:  Hi,
My name is Ann Dunlap, and I’d like my blog to be included on your wonderful website.  It’s a thyroid cancer blog, and the link is:   Strong in Weakness, Glowin’ in the Dark
I really appreciated finding your website today, as I’ve been recently diagnosed, and looking for anything I can find.

Author, Richard Schimmel, dies

I heard on the news today that Richard Schimmel, author of Cancer on $5 a Day, died of injuries sustained in a car accident.  His book was reviewed as our January Book Club selection.

Site plans

Plans are coalescing for streamlining the look of this site.  I want to put more focus on the Cancer Blog List as it is our most used resource.  I am working on ways to make it easier to navigate.  Coming it soon will be a couple of book reviews.

Somewhere on the road

I find it gratifying that Being Cancer still get over a hundred visits a day even when I don’t write new posts for days at a time.  Of course, the most popular feature of this site is the list of personal cancer blogs, my mega-cancer blogroll that has become a unique resource on the web.  This feature takes a lot of time and energy to maintain and build.

So I would like to make a special appeal to blog visitors to help me to build and expand this list.  Please refer me to blogs that are not yet on my list.  The most convenient way might be to copy and paste the URL or web address.  Or else you could just refer me to the blogroll on a particular website.

As the summer winds down, I plan to wind up my efforts to build the Cancer Blogs lists.  My goal is to build past 1000 cancer blogs.  I will probably break the feature down into three or four separate pages to make them easier to navigate, maybe even changing the tabs to reflect on which page a particular cancer can be found – i.e.  Cancer Blogs A – D, E – K, L – O, P – U.

Halfway through the history of this blog, I changed my criteria to include cancer blogs which were no longer active but were still published and accessible.  Blogs can cease to be active due to the death of the blogger, but also because the blogger is in remission and no longer feels the need to blog.  These blogs are still valid and useful as legitimate, honest histories of persons who endured specific episodes of cancer.  Nonetheless, I will strive to include the status of each blog, the date of diagnosis, and the specific sub-type of the cancer.

We are all in this together.  Together we can do things that can’t be done individually.  Take care, Dennis

Columbines

I have fallen behind in my correspondence as well as with the blog.  Here are some recent emails.

~ Kristy has been fighting renal cell (kidney cancer) since 2007.  She writes at ♥ FOREVER KRISTY ♥.  See her listing of other renal cell survivor blogs.

~ Randy Perry has been fighting stage IV colon cancer since 2009.  He writes a blog about his extended treatment at Fighting Cancer

~ Lynda is a brain tumor survivor who writes at My Brain Tumour.  “I was actually diagnosed with a benign parasagittal meningioma in July 2006. I was very lucky that as it was positioned on the top of my head it was very accessible and successfully completely surgically removed in the same month. I have my own Ebook which relates my journey through the whole episode which can be found at http://www.mybraintumour.com”

~ from the site Navigating Cancer: “I work for Navigating Cancer and am writing to follow up on an email we sent earlier this week inviting you to preview a new feature we launched for patients; a free online medical history form. So far we’ve received great feedback from oncology clinic staff, some of them are even considering replacing their paper intake forms with our online forms.
As someone who has worked with cancer patients, and personally experienced leukemia, we’d love to get your perspective on this new feature. We’re also looking for quotes that we could use in an upcoming press release, which would generate more exposure for your blog.
The purpose for creating this feature is to provide a safe and secure application that patients can complete at their convenience, saving them hours filling out forms in waiting rooms and providing a comprehensive and accurate medical history to their health care team. When doctors have a complete picture of a patient’s health they can provide the best care.
Thanks for your time and support, I look forward to your feedback so we can continue to improve the site and provide the best experience for cancer patients.
- Medical History Form Overview – click the link to learn more, or log in and check it out”

~ Michelle Burns describes herself as a Health and Wellness guide, healer and teacher. She writes “Thank you so much for all the work you have put in to bring so many resources together in one place.
I am a uterine cancer survivor and I work as an advocate/navigator for people living with, through and beyond life threatening long term illnesses.  I often refer them to your site or a resource I have found through your site.  It is truly a gift.
I have a blog about my experiences regaining my life again after cancer, as well as information gained from clients that I would like to add to your list.  My blog can be found at: http://prohealthguide.wordpress.com/”

~ Megan writes a new blog about her husband’s sarcoma at The Cancer Wife.  Here is a sample:“Papa has a bump, a bump filled with bad cells.” This is what we told our children 6 & 4 when we discovered this May that my man has cancer. He is a healthy 37 year old. He had a small hard bump on his pubic bone for a while and suddenly noticed in January that it had gotten bigger. He ignored it a while longer and then in April finally went to the doctor.

We thought it was a hernia.The doctor ruled out hernia and ordered blood work and a CT scan. The blood work came back fine and I sighed a huge sigh of relief! Silly me. After the CT scan my man met with a surgical oncologist who believed it was a Desmoid Tumor, a benign form of sarcoma. My man had a biopsy on May 12th and on May 18th I received a call from the doctor. She wanted to discuss my husband’s biopsy results with me, I immediately burst into tears.

We are told he is lucky in many ways; the tumor isn’t attached to anything important, it is operable, it hasn’t metastasized, but it is high grade which means it wants to. Since the original diagnosis we have had nothing but good news. But it is still cancer and it is still the scariest thing that has ever happened to us. My mother died of cancer when I was 24. It is hard to separate this cancer from hers, it is hard to believe doctors when they say my man will be fine, I have heard that before.

My man is German, and he is a Data Analyst. Thank god for small wonders. He is so calm and rational through this. I joke that I am freaked out enough for both of us. I hope to relieve my body of the physical hardships of being freaked out 24 hours a day by writing this blog. Maybe it will be useful for others as well. I do respond to stress with sometimes inappropriate/black humor so consider yourself warned.”

~ And this from Lauri Panopoulis: “I work for Cancerdirectory.com, a contemporary lifestyle and well respected cancer information website.  The site includes survivor blogs as well as cancer treatment news and website reviews.
We are dedicated to helping those affected by cancer by providing a community of patients, survivors, family members and health professionals who share individual stories with each other and the world.“   CancerDirectory.com

Finally news of a new book by oncologist, Keith Block.

Preventing a Recurrence of Cancer
by the author of Life Over Cancer: The Block Center Program for Integrative Cancer Treatment

According to the National Cancer Institute, there are over 12 million cancer survivors in the US today.  And that number is expected to grow, as the population ages, treatments improve, and tests find the disease earlier.

Cancer survivors face a myriad of health challenges, not to mention the daunting fear the cancer will return.  However, once a patient is deemed “in remission,” they are typically disconnected from care — as well as any attending support — and told to come back in three to six months where diagnostic scans or blood tests will determine if the cancer has returned.

We suggest a far more pro-active, empowered approach: a remission maintenance plan that offers cancer survivors a personalized program to regain control of their health, restore vitality and protect against the cancer returning. At the Block Center, once a patient has completed their treatment, we personally tailor a comprehensive Remission Maintenance program for them that includes: therapeutic nutrition, exercise, mind-spirit care, and anti-tumor therapies.

Understandably, after hearing that they are “in remission,” patients may want to retreat psychologically to a “cancer- free” zone and never think about the disease again.  But this is why they shouldn’t:  Cancer is as much a microscopic and molecular disease as it is a visible one. Thus, a patient in remission may still harbor malignant cells (ones that were resistant to chemotherapy or radiation, and therefore survived the attack phase). These cells unfortunately have the ability to show up with a vengeance, even when one least suspects. Not placing far greater emphasis on containing and addressing these cells from the get-go is a significant omission of mainstream treatment. But while preemptive treatment strategies may only exist in integrative clinics, when it comes to the diagnostic side, a new technology has begun demonstrating the relevance of these virulent escape cells.

Enter CTCs (circulating tumor cells)! Over a decade ago, the Block Center was one of a few that were performing bone marrow biopsies to evaluate for malignant cells in both the marrow and in circulation. It took several years, but eventually this evolving diagnostic technology made it into conventional care. While easier to perform today and more reliable as well, we continue to use this in our clinic. This technology allows us and others the ability to measure in our patients the number of these detached cells circulating freely from the main cancer mass.  Though not yet approved for all cancer, research studies have shown that an increase of these cells is prognostic of a patient’s survival.

For instance, a CTC count may be a better prognostic indicator for survival among prostate cancer patients than a PSA level — the test used presently to determine and follow the course of prostate cancer growth.

By comparing the levels of CTC in 37 men with metastatic prostate cancer, researchers at Thomas Jefferson University found that for the men with 5 CTCs or more, the median overall survival was only 8.4 months. Whereas, if these men were found to have less than 5 CTCs, the median survival was 48 months!

The relevance of CTCs is also relevant to other cancers. For instance, CTCs were measured in 151 women with metastatic breast cancer. The MD Anderson Cancer Center’s researchers found that those patients with 5 or more CTCs had a median survival of only 13 months, whereas those with less 5 survived over 29 months!

Controlling, preventing or overcoming these detached and disseminating cells is possibly the biggest conundrum facing cancer scientists. While these cells are generally addressed during treatment, the first steps of recurrence prevention should start with strategies to counter the survival of these residual cells and inhibiting their potential proliferation. In fact, CTCs that have gone through the onslaught of treatment and have nonetheless survived have the potential to evolve into more aggressive clones encouraging a more virulent malignancy. So what to do?

Aggressive Monitoring

We recommend regular monitoring of patients’ status with lab tests and imaging to detect early signs of disrupted biochemistry or a recurrence of disease, especially in the year or two after remission.

Being “diagnostically aggressive” may allow us to be less invasive therapeutically. In the first years after remission, therefore, we recommend:
Clinical visits with your oncologist, at least every three to four months in the first and second year and every six months for the next several years
Scans and blood tests of tumor markers every three months.
Complete blood count and chemistry test every three months.
Nutrition status, including weight changes, body composition, and albumin levels, every three months.
Internal terrain monitoring, every three to six months for the terrain factors that are most problematic.
While monitoring, there is no reason to wait anxiously for the other shoe to drop.  So immediately implement a full integrative program.
Make sound dietary changes toward adherence of a whole foods diet.  Reduction in dietary fat has already been shown to cut recurrences in different cancers. Controlling refined flour, sugar and junk food is a necessary step to avoid the recurrence risk of elevated blood glucose and spiking insulin levels.
Introduce aerobics, strength and flexibility training into your daily schedule. Yoga, pilates, chi gong or any number of fitness approaches is an essential step towards recurrence prevention. Considerable research supports that risk, response, recurrence and outcomes are tied to physical care.
Mitigate stress through progressive relaxation, meditation, or simply easing the load on an excessive work schedule. Elevated cortisol levels are associated with poorer outcomes in breast cancer patients. So do what it takes to transform less healthy patterns.
Get rest and adequate sleep. The more active you are in the daytime, the better you’ll sleep at night. Few of us get enough sleep

- Keith I. Block, M.D. is Director of Integrative Medical Education at the University of Illinois College of Medicine; Medical Director of the Block Center for Integrative Cancer Treatment in Evanston, Illinois; and founder and Scientific Director of the nonprofit Institute for Integrative Cancer Research and Education. He is also editor in chief of the peer-reviewed professional journal Integrative Cancer Therapies and a member of the National Cancer Institute’s Physician Data Query Complementary and Alternative Medicine (CAM) Editorial Board.