September 10, 2008 — The use of positron emission tomography (PET) scans led to changes in disease management for more than half of all patients with suspected or proven recurrent colorectal cancer, according to the results of a study published in the September issue of the Journal of Nuclear Medicine.
In this large multicenter trial, PET scanning detected additional disease sites in 48.4% of patients in 1 study group (group A) and in 43.9% of patients in the second study group (group B). The use of PET scanning also changed the planned disease management in 65.6% of patients in group A and 49.0% of those in group B.
"The data from our study, as well as from other studies, clearly demonstrates that PET can alter management decisions, and in many meaningful ways," lead study author Andrew M. Scott, MD, director of the Centre for PET and the Ludwig Institute for Cancer Research, Austin Hospital, Melbourne, Australia, told Medscape Oncology in an interview. "It can help confirm the presence of disease, identify additional sites of disease, and assist in making the most appropriate treatment decisions."
"It should be emphasized that some patients have isolated disease that can be resected, which will allow them to have long progression free survival periods or even a potential cure," Dr. Scott added. "PET scanning can more appropriately identify patients that will benefit from these treatments."
Prompted Changes in More Than Half of Patients
PET scans have been shown to demonstrate a high degree of accuracy in the detection of recurrent and metastatic colorectal cancer, and although sensitivity is comparable with a computed tomographic (CT) scan in the detection of metastases to the liver, it is superior in the detection of extrahepatic disease. Previous reports estimate that the use of PET has changed estimates of the extent of disease in approximately one third of patients and that it can influence management decisions in patients with metastatic colorectal cancer.
However, few prospective studies evaluating the use of PET in patients with recurrent colorectal cancer have been performed, and none have been large multicenter trials. The study authors note that the effect of PET on patient outcomes, such as progression-free survival, has also not been previously reported.
The goal of the current trial was to evaluate the effect of PET on management change in patients with proven or suspected recurrent colorectal cancer and to assess the effect of management change on disease-free survival.
A total of 191 patients from 4 institutions were enrolled in the study between November 23, 2003, and August 12, 2004, and they were subsequently separated into 2 study groups. Group A consisted of 93 symptomatic patients with a residual structural lesion suggestive of a recurrent tumor, whereas group B consisted of 98 patients with potentially resectable liver or lung metastases.
Lesions Detected by PET, Management Changes
In group A, 90 (96.8%) patients underwent both PET and CT scans, whereas 3 (3.2%) patients underwent a PET scan only. In group B, 83 (84.7%) patients underwent both PET and CT scans, whereas 15 (15.3%) patients underwent a PET scan only.
Additional disease sites were identified in 45 (48.4%) patients in group A, and in the second group, additional sites were detected in 43 (43.9%) patients. Undergoing a PET scan also resulted in changes in disease management plans. On the basis of PET scan results, 61 (65.6%) patients in group A had management plans altered, and in group B, 48 (49.0%) patients had a change in management plans. In 96% of the patients participating in this study, the treatment management plan that was actually implemented was consistent with the stated post-PET management plan.
Progression-Free Survival
At 12 months, the investigators evaluated clinical outcomes by comparing the progression-free survival of patients in both groups. The researchers found that patients who had additional lesions detected on PET scan had poorer progression-free survival vs those who had conventional imaging. On follow-up, 60.5% of patients in group A had progressive disease, with additional lesions identified by PET scanning vs patients who underwent conventional imaging. In group B, progressive disease was identified in 65.9% of patients with additional lesions that were detected with PET scans.
Patients in group B who had localized disease to the liver or lungs on PET scan had a better prognosis vs those with more disseminated disease. The researchers also noted that these data clearly showed the powerful prognostic ability of PET to accurately stratify patients who are thought to have localized disease on conventional imaging. Stratification into curative and palliative groups was also improved after PET scans for patients in both groups. In addition, those in group B who planned to have surgery after undergoing a PET scan had superior progression-free survival vs patients who planned surgery before undergoing a PET scan.
"The data from our study shows that using PET scanning can impact outcomes and therapeutic decisions, and while our study did not look at cost effectiveness, there is substantial data showing that PET scanning is cost effective," said Dr. Scott.
Inappropriate treatment not only has a substantial effect on patient well-being, but also can be very costly, Dr. Scott emphasized. "PET scanning can contribute to more appropriate treatment decisions and ultimately be cost saving, but that was not specifically examined in our study."
This study was funded by the Australian Government Department of Health and Ageing.
J Nucl Med. 2008;49:1451-1457.
Wednesday, September 17, 2008
Tuesday, September 16, 2008
The Size of a Pea
The Size of a Pea and a Lot More Dangerous
Colorectal polyps are small, noncancerous (benign) clumps of cells that grow in the rectum and colon. Over the course of 10-15 years, some of these polyps -- usually the ones that are larger than a pea -- can become cancerous. Fortunately, regular screening for colorectal cancer helps to identify and remove polyps, often before they progress to cancer.
It is not known why polyps develop, but some people are more prone than others. For instance, the older you get -- especially after age 50 -- the more likely you are to have polyps. You're also more likely to develop polyps if you've had them before (polyps tend to recur) or if someone in your family has had polyps or cancer of the colon.
Your behavior also influences your risk: Eating a lot of fatty foods, smoking cigarettes, drinking alcohol, not exercising, and being over weight can all contribute to the formation of polyps.
Q. I've had a colon polyp removed. What can I do to prevent colorectal cancer?
A. One crucial step is to have a follow-up colonoscopy every three to five years, depending on the number and size of your polyps.
You also need to get moving. The American Cancer Society stresses the importance of exercise for those trying to prevent polyp recurrence. Excess body weight and inactivity are linked with shorter survival times; one study found that people who exercised regularly were about half as likely to die of colorectal cancer within four years as those who did not exercise.
No diet is guaranteed to prevent colorectal cancer recurrence, but experts suggest this recipe to help lower your risk:
* Get most of your foods from plant sources (fresh vegetables, fruits, and nuts).
* Avoid processed foods and limit those high in saturated fats (especially beef).
* Choose chicken, fish, or beans as your main protein sources.
* Avoid junk foods, including sodas and sugar-laden snacks.
* Have no more than one alcoholic drink per day.
* Get most of your nutrients from foods rather than supplements.
Finally, although some research has suggested that NSAIDs may prevent colorectal cancer, the U.S. Preventive Services Task Force recently concluded that the risks of long-term NSAID use -- such as gastrointestinal bleeding, kidney problems, and hemorrhagic (bleeding) stroke -- exceed the potential benefits for people at average risk for colorectal cancer.
Johns Hopkins Health Alerts 09.16.08
Colorectal polyps are small, noncancerous (benign) clumps of cells that grow in the rectum and colon. Over the course of 10-15 years, some of these polyps -- usually the ones that are larger than a pea -- can become cancerous. Fortunately, regular screening for colorectal cancer helps to identify and remove polyps, often before they progress to cancer.
It is not known why polyps develop, but some people are more prone than others. For instance, the older you get -- especially after age 50 -- the more likely you are to have polyps. You're also more likely to develop polyps if you've had them before (polyps tend to recur) or if someone in your family has had polyps or cancer of the colon.
Your behavior also influences your risk: Eating a lot of fatty foods, smoking cigarettes, drinking alcohol, not exercising, and being over weight can all contribute to the formation of polyps.
Q. I've had a colon polyp removed. What can I do to prevent colorectal cancer?
A. One crucial step is to have a follow-up colonoscopy every three to five years, depending on the number and size of your polyps.
You also need to get moving. The American Cancer Society stresses the importance of exercise for those trying to prevent polyp recurrence. Excess body weight and inactivity are linked with shorter survival times; one study found that people who exercised regularly were about half as likely to die of colorectal cancer within four years as those who did not exercise.
No diet is guaranteed to prevent colorectal cancer recurrence, but experts suggest this recipe to help lower your risk:
* Get most of your foods from plant sources (fresh vegetables, fruits, and nuts).
* Avoid processed foods and limit those high in saturated fats (especially beef).
* Choose chicken, fish, or beans as your main protein sources.
* Avoid junk foods, including sodas and sugar-laden snacks.
* Have no more than one alcoholic drink per day.
* Get most of your nutrients from foods rather than supplements.
Finally, although some research has suggested that NSAIDs may prevent colorectal cancer, the U.S. Preventive Services Task Force recently concluded that the risks of long-term NSAID use -- such as gastrointestinal bleeding, kidney problems, and hemorrhagic (bleeding) stroke -- exceed the potential benefits for people at average risk for colorectal cancer.
Johns Hopkins Health Alerts 09.16.08
Tuesday, September 9, 2008
Improving Survival after Colon Rectal Cancer
African Americans are between 30 to 50 percent more likely to die from Colon Rectal Cancer than their white counterparts. Finding explanations for this disparity has been the focus of many studies.
Is it access to health care?
Is it education?
Is it due to the type of cancer treatment?
Researchers have not solved this mystery.
09-09-08
Quoted from the Northern California Cancer Center 2007 Annual Report.
Is it access to health care?
Is it education?
Is it due to the type of cancer treatment?
Researchers have not solved this mystery.
09-09-08
Quoted from the Northern California Cancer Center 2007 Annual Report.
Can Colorectal Cancer Be Prevented?
Can Colorectal Cancer Be Prevented?
American Cancer Society
Even though we do not know the exact cause of most colorectal cancer, it is possible to prevent many colorectal cancers.
Screening:
One of the most powerful weapons in preventing colorectal cancer is regular colorectal cancer screening or testing. From the time the first abnormal cells start to grow, it usually takes about 10 to 15 years for them to develop into colorectal cancer. Regular colorectal cancer screening can, in many cases, prevent colorectal cancer altogether. (See the American Cancer Society screening guidelines in the next section "Can Colorectal Polyps and Cancer Be Found Early?"). This is because polyps, or growths, can be detected and removed before they have the chance to turn into cancer. Screening can also result in finding colorectal cancer early, when it is highly curable.
People who have no identified risk factors (other than age) should begin regular screening at age 50. Those who have a family history or other risk factors for colorectal cancer polyps or cancer need to talk with their doctor about starting screening at a younger age and more frequent intervals.
Diet and exercise:
People can lower their risk of developing colorectal cancer by managing the risk factors that they can control, such as diet and physical activity. It is important to eat plenty of fruits, vegetables, and whole grain foods and to limit intake of high-fat foods. Physical activity is another area that people can control. The American Cancer Society recommends at least 30, preferably 45 to 60 minutes of physical activity on 5 or more days of the week. If you are overweight, you can ask your doctor about a weight loss plan that will work for you. For more information about diet and physical activity, refer to the American Cancer Society document, American Cancer Society Guidelines for Nutrition and Physical Activity for Cancer Prevention.
Vitamins, calcium, magnesium:
Some studies suggest that taking a daily multivitamin containing folic acid, or folate, can lower colorectal cancer risk. Other studies suggest that increasing calcium intake may lower risk. Some have suggested that vitamin D, which you can get from sun exposure or in a vitamin pill, can lower colorectal cancer risk. Of course, excessive sun exposure can cause skin cancer and is not recommended as a way to lower colorectal cancer risk. Calcium and vitamin D may work together to reduce colorectal cancer risk, as vitamin D aids in the body’s absorption of calcium. In addition, one recent study suggested that a diet high in magnesium may also reduce colorectal cancer risk in women.
Nonsteroidal anti-inflammatory drugs:
Many studies have found that people who regularly use aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve), have a 20% to 50% lower risk of colorectal cancer and adenomatous polyps. Most of these studies, however, are based on observations of people who took these medications for reasons such as treatment of arthritis or prevention of heart attacks. Two recent studies have provided even stronger evidence regarding the ability of aspirin to prevent the growth of polyps. The advantage of these recent studies is that people were randomly selected by the researchers to receive either aspirin or an inactive placebo. One study included people who were previously treated for early stages of colorectal cancer, and the other study included people who previously had polyps removed.
But NSAIDs can cause serious or even life-threatening bleeding from stomach irritation. Currently available information suggests that the risks of serious bleeding outweigh the benefits of these medicines for the general public. For this reason, experts do not recommend NSAIDs as a cancer-prevention strategy for people at average risk of developing colorectal cancer. However, the value of these drugs for people at increased colorectal cancer risk is being actively studied. Celecoxib (Celebrex) has been approved by the US Food and Drug Administration for reducing polyp formation in people with FAP. One advantage of this drug is that it causes less bleeding in the stomach. However, celecoxib may increase the risk of heart attacks and strokes. A similar drug, rofecoxib (Vioxx), was taken off the market because people who took it had an increased number of heart attacks and strokes. Please check with your doctor before beginning to take aspirin and other NSAIDs on a regular basis.
Female hormones:
Hormone replacement therapy (HRT) in postmenopausal women may reduce their risk of developing colorectal cancer. But those women on HRT who do develop colorectal cancer may have a fast growing cancer.
HRT also lowers the risk of developing osteoporosis, but it may increase the risk of heart disease, blood clots, and breast and uterine cancers. For these reasons, the decision to use HRT should be based on a careful discussion of benefits and risks with your doctor.
Other factors:
There are other risk factors that can't be controlled, such as a strong family history of colorectal cancer. But even when people have a history of colorectal cancer in their family, they may be able to prevent the disease. For example, people with a family history of colorectal cancer may benefit from starting screening tests when they are younger and having them done more often than people without this risk factor.
Genetic tests can help determine which members of certain families have inherited a high risk for developing colorectal cancer. Without genetic testing, all members of a family known to have an inherited form of colorectal cancer should be screened early and frequently. However, with genetic testing, family members who are found not to have inherited the mutated gene can be screened with the same frequency as people at average risk.
People with FAP should start colonoscopy during their teens. Most doctors recommend they have their colon removed when they are in their 20s to prevent cancer from developing.
The lifetime risk of developing colorectal cancer for people with HNPCC is about 80% compared to near 100% for those with FAP. Doctors recommend that people with HNPCC start colonoscopy screening during their 20s to remove any polyps and find any cancers at the earliest possible stage. People known to carry the genetic mutation associated with HNPCC may be offered the option of yearly screening with colonoscopy or removal of most of the colon.
Ashkenazi Jews with the I1307K APC mutation have an increased colorectal cancer risk, but do not develop these cancers when they are very young. And, as a group overall, Ashkenazi Jews (even those without the I1307K APC mutation) are more likely to develop colorectal cancer than other ethnic groups. For these reasons, most doctors recommend that they carefully follow the usual recommendations for colorectal cancer screening, but earlier or more frequent testing is usually not suggested.
Since some colorectal cancers can't be prevented, finding the disease early is the best way to improve the chance of a cure and reduce the number of deaths caused by this disease.
In addition to the screening recommendations for people at average colorectal cancer risk, the American Cancer Society has additional guidelines for people at moderate and high risk of colorectal cancer. These recommendations are described in the section "Can Colorectal Polyps and Cancer Be Found Early?" Ask your doctor how these guidelines might apply to you.
American Cancer Society
Even though we do not know the exact cause of most colorectal cancer, it is possible to prevent many colorectal cancers.
Screening:
One of the most powerful weapons in preventing colorectal cancer is regular colorectal cancer screening or testing. From the time the first abnormal cells start to grow, it usually takes about 10 to 15 years for them to develop into colorectal cancer. Regular colorectal cancer screening can, in many cases, prevent colorectal cancer altogether. (See the American Cancer Society screening guidelines in the next section "Can Colorectal Polyps and Cancer Be Found Early?"). This is because polyps, or growths, can be detected and removed before they have the chance to turn into cancer. Screening can also result in finding colorectal cancer early, when it is highly curable.
People who have no identified risk factors (other than age) should begin regular screening at age 50. Those who have a family history or other risk factors for colorectal cancer polyps or cancer need to talk with their doctor about starting screening at a younger age and more frequent intervals.
Diet and exercise:
People can lower their risk of developing colorectal cancer by managing the risk factors that they can control, such as diet and physical activity. It is important to eat plenty of fruits, vegetables, and whole grain foods and to limit intake of high-fat foods. Physical activity is another area that people can control. The American Cancer Society recommends at least 30, preferably 45 to 60 minutes of physical activity on 5 or more days of the week. If you are overweight, you can ask your doctor about a weight loss plan that will work for you. For more information about diet and physical activity, refer to the American Cancer Society document, American Cancer Society Guidelines for Nutrition and Physical Activity for Cancer Prevention.
Vitamins, calcium, magnesium:
Some studies suggest that taking a daily multivitamin containing folic acid, or folate, can lower colorectal cancer risk. Other studies suggest that increasing calcium intake may lower risk. Some have suggested that vitamin D, which you can get from sun exposure or in a vitamin pill, can lower colorectal cancer risk. Of course, excessive sun exposure can cause skin cancer and is not recommended as a way to lower colorectal cancer risk. Calcium and vitamin D may work together to reduce colorectal cancer risk, as vitamin D aids in the body’s absorption of calcium. In addition, one recent study suggested that a diet high in magnesium may also reduce colorectal cancer risk in women.
Nonsteroidal anti-inflammatory drugs:
Many studies have found that people who regularly use aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve), have a 20% to 50% lower risk of colorectal cancer and adenomatous polyps. Most of these studies, however, are based on observations of people who took these medications for reasons such as treatment of arthritis or prevention of heart attacks. Two recent studies have provided even stronger evidence regarding the ability of aspirin to prevent the growth of polyps. The advantage of these recent studies is that people were randomly selected by the researchers to receive either aspirin or an inactive placebo. One study included people who were previously treated for early stages of colorectal cancer, and the other study included people who previously had polyps removed.
But NSAIDs can cause serious or even life-threatening bleeding from stomach irritation. Currently available information suggests that the risks of serious bleeding outweigh the benefits of these medicines for the general public. For this reason, experts do not recommend NSAIDs as a cancer-prevention strategy for people at average risk of developing colorectal cancer. However, the value of these drugs for people at increased colorectal cancer risk is being actively studied. Celecoxib (Celebrex) has been approved by the US Food and Drug Administration for reducing polyp formation in people with FAP. One advantage of this drug is that it causes less bleeding in the stomach. However, celecoxib may increase the risk of heart attacks and strokes. A similar drug, rofecoxib (Vioxx), was taken off the market because people who took it had an increased number of heart attacks and strokes. Please check with your doctor before beginning to take aspirin and other NSAIDs on a regular basis.
Female hormones:
Hormone replacement therapy (HRT) in postmenopausal women may reduce their risk of developing colorectal cancer. But those women on HRT who do develop colorectal cancer may have a fast growing cancer.
HRT also lowers the risk of developing osteoporosis, but it may increase the risk of heart disease, blood clots, and breast and uterine cancers. For these reasons, the decision to use HRT should be based on a careful discussion of benefits and risks with your doctor.
Other factors:
There are other risk factors that can't be controlled, such as a strong family history of colorectal cancer. But even when people have a history of colorectal cancer in their family, they may be able to prevent the disease. For example, people with a family history of colorectal cancer may benefit from starting screening tests when they are younger and having them done more often than people without this risk factor.
Genetic tests can help determine which members of certain families have inherited a high risk for developing colorectal cancer. Without genetic testing, all members of a family known to have an inherited form of colorectal cancer should be screened early and frequently. However, with genetic testing, family members who are found not to have inherited the mutated gene can be screened with the same frequency as people at average risk.
People with FAP should start colonoscopy during their teens. Most doctors recommend they have their colon removed when they are in their 20s to prevent cancer from developing.
The lifetime risk of developing colorectal cancer for people with HNPCC is about 80% compared to near 100% for those with FAP. Doctors recommend that people with HNPCC start colonoscopy screening during their 20s to remove any polyps and find any cancers at the earliest possible stage. People known to carry the genetic mutation associated with HNPCC may be offered the option of yearly screening with colonoscopy or removal of most of the colon.
Ashkenazi Jews with the I1307K APC mutation have an increased colorectal cancer risk, but do not develop these cancers when they are very young. And, as a group overall, Ashkenazi Jews (even those without the I1307K APC mutation) are more likely to develop colorectal cancer than other ethnic groups. For these reasons, most doctors recommend that they carefully follow the usual recommendations for colorectal cancer screening, but earlier or more frequent testing is usually not suggested.
Since some colorectal cancers can't be prevented, finding the disease early is the best way to improve the chance of a cure and reduce the number of deaths caused by this disease.
In addition to the screening recommendations for people at average colorectal cancer risk, the American Cancer Society has additional guidelines for people at moderate and high risk of colorectal cancer. These recommendations are described in the section "Can Colorectal Polyps and Cancer Be Found Early?" Ask your doctor how these guidelines might apply to you.
My Bucket List
The Bucket List movie stars Jack Nicholson and Morgan Freeman as two terminally ill men who escape from a cancer ward determined to complete everything on their "Bucket List" -- a list of things to do before they "kick the bucket."
For as long as I can remember, I have dreamed of visiting foreign lands. I have seen Europe, most of the USA, Canada, Hawaii and Mexico. My outdoor adventures have included scuba diving in the Mexico and Hawaii, water skiing, snow skiing in Colorado and Utah, hiking volcanoes and the Napili Coast, sailing, swimming with dolphins, ocean kayaking with sea otters and camping. I rafted down the Colorado River and backpacked in Alaska.
I have fallen in love, married wonderful women and enjoyed many happy years with both wives. I have no regrets about my decision to divorce when the marriages ended. I have had several successful jobs and have worked with some terrific people. I also have been fired and quit a few jobs when it has been time to move on. I enjoy good books, movies, art, theatre and music. I love teaching. I have many terrific friends and family members.
I am 58 years old. I am cancer free. I am dating a terrific woman who truly enjoys life and she loves me for who I am. My life is in balance. I feel truly blessed.
The author Richard Bolles calls this “life planning” in his book, The Three Boxes of Life. I highly recommend it.
For as long as I can remember, I have dreamed of visiting foreign lands. I have seen Europe, most of the USA, Canada, Hawaii and Mexico. My outdoor adventures have included scuba diving in the Mexico and Hawaii, water skiing, snow skiing in Colorado and Utah, hiking volcanoes and the Napili Coast, sailing, swimming with dolphins, ocean kayaking with sea otters and camping. I rafted down the Colorado River and backpacked in Alaska.
I have fallen in love, married wonderful women and enjoyed many happy years with both wives. I have no regrets about my decision to divorce when the marriages ended. I have had several successful jobs and have worked with some terrific people. I also have been fired and quit a few jobs when it has been time to move on. I enjoy good books, movies, art, theatre and music. I love teaching. I have many terrific friends and family members.
I am 58 years old. I am cancer free. I am dating a terrific woman who truly enjoys life and she loves me for who I am. My life is in balance. I feel truly blessed.
The author Richard Bolles calls this “life planning” in his book, The Three Boxes of Life. I highly recommend it.
Road Trip Be Prepared
What to pack for a road trip is more difficult after cancer treatment. To some degree side effects will continue. I will eat something exotic that will give me diarrhea. I have a emergency diarrhea kit in the car. While traveling I will find restrooms with no toilet paper, no soap and no towels. Pack it.
After cancer treatments I thought I could resume my regular activities of camping and hiking and swimming and riding my bike. Wrong. Recovery is a slow process filled with surprises.
After cancer treatments I thought I could resume my regular activities of camping and hiking and swimming and riding my bike. Wrong. Recovery is a slow process filled with surprises.
A Good Stick for a Blood Test
As a colon cancer patient, you will be getting many blood tests. I recommend you find the most experienced staff to take your blood. Experienced patients call it a “good stick.” Remember the staff who do their job well and thank them. You will want to find them next time you need a blood test.
I like to keep a file copy of the requested lab tests and make sure the results are sent to all the doctors that need to know the results. File folders track my progress and organize my papers. This helps me with billing and taxes time.
As the technician is drawing blood, review what lab tests are going to be conducted on your blood and find out when the results will go to your doctors. An exceptional patient is proactive with your health care.
If the lab technician is inexperienced they will keep trying to find a vein and end up bruising your arm. This is called a bad stick. Not a big deal if you just need a blood test for routine lab work and you can go home and calm down.
I like to keep a file copy of the requested lab tests and make sure the results are sent to all the doctors that need to know the results. File folders track my progress and organize my papers. This helps me with billing and taxes time.
As the technician is drawing blood, review what lab tests are going to be conducted on your blood and find out when the results will go to your doctors. An exceptional patient is proactive with your health care.
If the lab technician is inexperienced they will keep trying to find a vein and end up bruising your arm. This is called a bad stick. Not a big deal if you just need a blood test for routine lab work and you can go home and calm down.
Back to Balance
Life after cancer for me means that I enjoy each day. I really don’t know when I will die. Could be when I am riding my bike to work. If I want to live a long vibrant life, I choose to change old habits.
1. Exercise
I need to exercise each day. Back to balance means to choose the right exercise and knowing my limits. I know when I overdo my workout because I wakeup with leg cramps in the middle of the night or have a sore back. This is called feedback. I can change my exercise plan for tomorrow. Knowing my limits before injury is an art. I enjoy hiking, swimming, ride a bike, walking, dancing and go to the YMCA to move my body.
2. Eat Right
Back to balance for food is to eat limited portions of low fat organic food. I monitor my weight daily and I am an active member of weight watchers. This group of friends help me learn to gain control over portions and eat right. I need food to nourish my body and support my brain function. Balance is needed so I can maintain my best body weight.
3. Get Enough Sleep
No more long 4-hour commutes and then nine-hour workdays for me. Overwork brings burnout and sleep depravation. I am done with that lifestyle. This burnout behavior lowered my immune system and led my to colon cancer. I bike to work through a city park in ten minutes. I take naps during the day.
4. Simple Housing
Back to balance with housing for me is living in a small studio. Living simply. No more big real estate property to manage. A small studio means I collect less stuff. I keep hauling out boxes of clothes to donate to goodwill. Less clutter more clarity. I live in an old building with wooden floors and old radiators. No air conditioning needed. I use fans.
5. Healthy Relationships
Back to balance with relationships means I end toxic relationships that suck out my life source. I do not have to fix someone else’s problems. The reason I have healthy friendships is that our relationship is respectful and supportive.
6. Don’t Sweat the Small Stuff
Back to balance with my daily routine is making a list of things to do each day and getting my nap out of the way first. Balance makes my life peaceful and a lot more fun. Most things I worry about don’t happen. Does it take McDonalds ads to convince me that I deserve a break today?
7. Learn to Laugh and Have Fun Daily
Back to balance with overwork is planning leisure. Keep a list of fun things to do. Go see the movie The Bucket List. If today were the last day you would be alive, what would you do with your time?
8. Choose the Right Job
I am fifty-seven years old. I will be working a long time before I retire. If I want to have balance with my employment, I need to limit my stress level and work hours so my work life is sustainable.
1. Exercise
I need to exercise each day. Back to balance means to choose the right exercise and knowing my limits. I know when I overdo my workout because I wakeup with leg cramps in the middle of the night or have a sore back. This is called feedback. I can change my exercise plan for tomorrow. Knowing my limits before injury is an art. I enjoy hiking, swimming, ride a bike, walking, dancing and go to the YMCA to move my body.
2. Eat Right
Back to balance for food is to eat limited portions of low fat organic food. I monitor my weight daily and I am an active member of weight watchers. This group of friends help me learn to gain control over portions and eat right. I need food to nourish my body and support my brain function. Balance is needed so I can maintain my best body weight.
3. Get Enough Sleep
No more long 4-hour commutes and then nine-hour workdays for me. Overwork brings burnout and sleep depravation. I am done with that lifestyle. This burnout behavior lowered my immune system and led my to colon cancer. I bike to work through a city park in ten minutes. I take naps during the day.
4. Simple Housing
Back to balance with housing for me is living in a small studio. Living simply. No more big real estate property to manage. A small studio means I collect less stuff. I keep hauling out boxes of clothes to donate to goodwill. Less clutter more clarity. I live in an old building with wooden floors and old radiators. No air conditioning needed. I use fans.
5. Healthy Relationships
Back to balance with relationships means I end toxic relationships that suck out my life source. I do not have to fix someone else’s problems. The reason I have healthy friendships is that our relationship is respectful and supportive.
6. Don’t Sweat the Small Stuff
Back to balance with my daily routine is making a list of things to do each day and getting my nap out of the way first. Balance makes my life peaceful and a lot more fun. Most things I worry about don’t happen. Does it take McDonalds ads to convince me that I deserve a break today?
7. Learn to Laugh and Have Fun Daily
Back to balance with overwork is planning leisure. Keep a list of fun things to do. Go see the movie The Bucket List. If today were the last day you would be alive, what would you do with your time?
8. Choose the Right Job
I am fifty-seven years old. I will be working a long time before I retire. If I want to have balance with my employment, I need to limit my stress level and work hours so my work life is sustainable.
Angels: Becoming Aware of Spiritual Support
I never really had the experience of being surrounded by angels until my cancer diagnosis. This was an intense period of prayer. Asking God for help.
Friends would ask, “Is it OK if my church holds you in our prayers?” Of coarse I said, “Yes, thank you very much. That is very kind of you.” At this point in time, I was pretty skeptical about the prayer and the existence of angels.
I was raised Roman Catholic. Today I am more a Buddhist and mixture of other spiritual traditions. Prayer really was not part of my life until cancer. I began praying with friends at work. I would pray during radiation treatments. Usually my prayers were asking for the power to fight this disease. I asked God for help guide me on this path of treatment and healing.
I did plenty of praying during my cancer treatments. I saw many angels arrive with God's grace.
Friends would ask, “Is it OK if my church holds you in our prayers?” Of coarse I said, “Yes, thank you very much. That is very kind of you.” At this point in time, I was pretty skeptical about the prayer and the existence of angels.
I was raised Roman Catholic. Today I am more a Buddhist and mixture of other spiritual traditions. Prayer really was not part of my life until cancer. I began praying with friends at work. I would pray during radiation treatments. Usually my prayers were asking for the power to fight this disease. I asked God for help guide me on this path of treatment and healing.
I did plenty of praying during my cancer treatments. I saw many angels arrive with God's grace.
WHY ME? Survivor Guilt
Why do I get to live on and others die? October 2006 two close friends were killed instantly in automobile accidents. Both were my same age. Today another friend is dying of cancer in hospice. I feel lucky to escape the grim reaper but I question why has my life spared? What am I doing with my life and talent right now? Why me Lord? What should I do with my new lease on life?
I remember when I finished surgery, chemo and radiation treatments in 2004 I felt sooooo lucky to be alive. I was musing this same question….What to do with my life now that I successfully fought cancer?
I asked my good friend Lisa. “ Should I join the peace corps and go help somebody on the other side of the world?”
Lisa thought for a moment, then replied, “Doug how about just making a difference in peoples lives here in Oakland? You don’t have to join the peace corps.”
What a good idea. How about writing a book about my cancer experience and helping other people who have to either prep for their first colonoscopy of recover from treatments. As I reflect upon this question, I get more answers.
1. Be generous to others and yourself.
2. Enjoy each moment of life and urge others to do the same.
3. Cook meals for friends
4. Play lots of music
I remember a few years ago I had the pleasure of hearing Jimmy Carter speak. I find his life to be very inspirational. I remember to this day one quote from his talk. He said that he was standing on the shoulders of his father, who is standing on the shoulders of his father and so on. Because we have this foundation we can reach much higher than the previous generation.
So to answer the original question, Why Me? Just because. “Nothing personal. Your name just happened to come up.”
I remember when I finished surgery, chemo and radiation treatments in 2004 I felt sooooo lucky to be alive. I was musing this same question….What to do with my life now that I successfully fought cancer?
I asked my good friend Lisa. “ Should I join the peace corps and go help somebody on the other side of the world?”
Lisa thought for a moment, then replied, “Doug how about just making a difference in peoples lives here in Oakland? You don’t have to join the peace corps.”
What a good idea. How about writing a book about my cancer experience and helping other people who have to either prep for their first colonoscopy of recover from treatments. As I reflect upon this question, I get more answers.
1. Be generous to others and yourself.
2. Enjoy each moment of life and urge others to do the same.
3. Cook meals for friends
4. Play lots of music
I remember a few years ago I had the pleasure of hearing Jimmy Carter speak. I find his life to be very inspirational. I remember to this day one quote from his talk. He said that he was standing on the shoulders of his father, who is standing on the shoulders of his father and so on. Because we have this foundation we can reach much higher than the previous generation.
So to answer the original question, Why Me? Just because. “Nothing personal. Your name just happened to come up.”
You got the whole world in you hands
Introduction to Semi-colon
Semicolon was written for patients who are diagnosed with colon cancer. I want this book to be a resource to help you and your care-givers to develop plans to fight colon cancer and inspire you to heal completely. I encourage you to not just survive but thrive. My intention is to point the way to healing from the disease so you can continue living a vibrant life.
“Humans must rise above the Earth…to the top of the atmosphere and beyond. For only thus will we understand the world in which we live.” Socrates, 400 BC
I have traveled this road and won the battle. As a Colon Cancer Patient you have the power to heal completely. You will choose the right cancer treatment for your body. During this journey you will discover what needs healing and find the right path and proper pace for your recovery. You will find others who will help you with healing practices during and after your treatment. You have many choices to make during this journey. Remember, “You got the whole world in your hands.”
Semicolon was written for patients who are diagnosed with colon cancer. I want this book to be a resource to help you and your care-givers to develop plans to fight colon cancer and inspire you to heal completely. I encourage you to not just survive but thrive. My intention is to point the way to healing from the disease so you can continue living a vibrant life.
“Humans must rise above the Earth…to the top of the atmosphere and beyond. For only thus will we understand the world in which we live.” Socrates, 400 BC
I have traveled this road and won the battle. As a Colon Cancer Patient you have the power to heal completely. You will choose the right cancer treatment for your body. During this journey you will discover what needs healing and find the right path and proper pace for your recovery. You will find others who will help you with healing practices during and after your treatment. You have many choices to make during this journey. Remember, “You got the whole world in your hands.”
You miss 100% the shots you never take
I met Tom in Silicon Valley in 1995. Tom was the Director of Manufacturing at Cisco Systems. He hired me to help coordinate a big computer project. Cisco was growing quickly and their information systems were a disaster. The manufacturing line shut down for one week so the board of directors gave Tom 10 million dollars to build a new ERP system. We had nine months, like the birth of a baby to build a world-wide Oracle Enterprise Resource Planning system.
I helped Tom setup systems and problem solve. I only had one hour each week to meet with him and plan my work. I was really impressed with how Tom made quick decisions and solved problems. Later I found out that Tom was fighting cancer. He was working part-time with the ERP project and would fly down to Southern California for chemo treatments.
I remember Tom had a great CD music collection and that he played classical guitar. When I would meet with Tom and go over what I was doing to solve problems, he would listen carefully to my report and then say, “Great, make it happen!” I had to find ways to get this ERP project going ASAP. We were hiring computer programmers to write code, planning meetings to decide how to build this world-wide system of ERP. This was fast track everything. Get a computer TODAY for a programmer when it would take purchasing two weeks. I did not have two weeks to wait. So I would lease a computer and have it delivered the next day. I learned from Tom to cut through bureaucracy and get it done. He would always back me up.
Tom would slice through the politics and dramas quickly and help the team stay on focus. The T shirt you see above is still in my closet. I never knew why I chose to keep this T shirt. Eleven years later, after I fought Colon Cancer and won, now I know why I still keep the T-shirt…. To remember Tom and to thank Wayne Gretzky for the quote.
Wayne Douglas Gretzky, OC (born January 26, 1961) is a retired Canadian professional ice hockey player who is currently part-owner and head coach of the Phoenix Coyotes.
Born in Brantford, Ontario and nicknamed "The Great One," Total Hockey: The Official Encyclopedia of the NHL calls Gretzky "the greatest player of all time". He is regarded as the best player of his era and has been called "the greatest hockey player ever" by sportswriters, players, coaches, and fans. Along with his many awards and achievements, he is the only player to ever have his playing number, 99, officially retired across the entire National Hockey League.
Identified as a hockey prodigy at a very young age, Gretzky regularly played at a level far above his peers.[7] He became a full professional at the age of 17 in the World Hockey Association, leading to a long career in the NHL. He set 40 regular-season records, 15 playoff records, 6 All-Star records, won four Stanley Cups with the Edmonton Oilers, and won 9 MVP awards and 10 scoring titles. He is the only player ever to total over 200 points in a season (a feat that he accomplished four times in his career). In addition, he tallied over 100 points a season for 15 NHL seasons, 13 of them consecutively. He retired from playing in 1999, becoming Executive Director for the Canadian national men's hockey team during the 2002 Winter Olympics. He also became part owner of the Phoenix Coyotes in 2000 and following the 2004-05 NHL lockout became their head coach
From : http://en.wikipedia.org/wiki/Wayne_Gretzky
I helped Tom setup systems and problem solve. I only had one hour each week to meet with him and plan my work. I was really impressed with how Tom made quick decisions and solved problems. Later I found out that Tom was fighting cancer. He was working part-time with the ERP project and would fly down to Southern California for chemo treatments.
I remember Tom had a great CD music collection and that he played classical guitar. When I would meet with Tom and go over what I was doing to solve problems, he would listen carefully to my report and then say, “Great, make it happen!” I had to find ways to get this ERP project going ASAP. We were hiring computer programmers to write code, planning meetings to decide how to build this world-wide system of ERP. This was fast track everything. Get a computer TODAY for a programmer when it would take purchasing two weeks. I did not have two weeks to wait. So I would lease a computer and have it delivered the next day. I learned from Tom to cut through bureaucracy and get it done. He would always back me up.
Tom would slice through the politics and dramas quickly and help the team stay on focus. The T shirt you see above is still in my closet. I never knew why I chose to keep this T shirt. Eleven years later, after I fought Colon Cancer and won, now I know why I still keep the T-shirt…. To remember Tom and to thank Wayne Gretzky for the quote.
Wayne Douglas Gretzky, OC (born January 26, 1961) is a retired Canadian professional ice hockey player who is currently part-owner and head coach of the Phoenix Coyotes.
Born in Brantford, Ontario and nicknamed "The Great One," Total Hockey: The Official Encyclopedia of the NHL calls Gretzky "the greatest player of all time". He is regarded as the best player of his era and has been called "the greatest hockey player ever" by sportswriters, players, coaches, and fans. Along with his many awards and achievements, he is the only player to ever have his playing number, 99, officially retired across the entire National Hockey League.
Identified as a hockey prodigy at a very young age, Gretzky regularly played at a level far above his peers.[7] He became a full professional at the age of 17 in the World Hockey Association, leading to a long career in the NHL. He set 40 regular-season records, 15 playoff records, 6 All-Star records, won four Stanley Cups with the Edmonton Oilers, and won 9 MVP awards and 10 scoring titles. He is the only player ever to total over 200 points in a season (a feat that he accomplished four times in his career). In addition, he tallied over 100 points a season for 15 NHL seasons, 13 of them consecutively. He retired from playing in 1999, becoming Executive Director for the Canadian national men's hockey team during the 2002 Winter Olympics. He also became part owner of the Phoenix Coyotes in 2000 and following the 2004-05 NHL lockout became their head coach
From : http://en.wikipedia.org/wiki/Wayne_Gretzky
What is an Exceptional Patient?
What is an Exceptional Patient?
Person is confident they will beat back the disease and resume a normal life. They hold an optimistic view of their prognosis. They involve themselves in creative activities. They believe in the power of the mind to overcome disease. They refuse to participate in defeat. Their every thought and deed advances the cause of life. Peace of mind sends the body a “live” message. They take charge of their lives. They work hard to achieve health and peace of mind.
“They do not rely on doctors to take the initiative but rather use them as members of a team, demanding the utmost in technique, resourcefulness, concern, and open-mindedness. If they are not satisfied, they change doctors.”1
Exceptional patients are loving. They will give you a hug. They love themselves and others. They love life and accept the fact they will not live forever. Exceptional patents heal themselves. “ True healing not merely reversal of one particular disease.”2
1 Love, Medicine and Miracles Lessons Learned about Self-Healing from a surgeon’s experience with Exceptional Patients by Bernie S. Siegel,MD Perennial Library Harper Row Publishers 1986 Page 3
2 Love, Medicine and Miracles Lessons Learned about Self-Healing from a surgeon’s experience with Exceptional Patients by Bernie S. Siegel,MD Perennial Library Harper Row Publishers 1986 page 4
Person is confident they will beat back the disease and resume a normal life. They hold an optimistic view of their prognosis. They involve themselves in creative activities. They believe in the power of the mind to overcome disease. They refuse to participate in defeat. Their every thought and deed advances the cause of life. Peace of mind sends the body a “live” message. They take charge of their lives. They work hard to achieve health and peace of mind.
“They do not rely on doctors to take the initiative but rather use them as members of a team, demanding the utmost in technique, resourcefulness, concern, and open-mindedness. If they are not satisfied, they change doctors.”1
Exceptional patients are loving. They will give you a hug. They love themselves and others. They love life and accept the fact they will not live forever. Exceptional patents heal themselves. “ True healing not merely reversal of one particular disease.”2
1 Love, Medicine and Miracles Lessons Learned about Self-Healing from a surgeon’s experience with Exceptional Patients by Bernie S. Siegel,MD Perennial Library Harper Row Publishers 1986 Page 3
2 Love, Medicine and Miracles Lessons Learned about Self-Healing from a surgeon’s experience with Exceptional Patients by Bernie S. Siegel,MD Perennial Library Harper Row Publishers 1986 page 4
Monday, September 8, 2008
Colon Cancer Claims Leroy Sievers
Colon Cancer Claims Veteran Journalist Leroy Sievers
Leroy Sievers, a veteran broadcast journalist, former executive producer of ABC News' "Nightline" and the author of a popular and candid daily blog about his battle with cancer, "My Cancer," has died at age 53. He died on August 16, 2008.
His daily Blog “My Cancer” www.npr.org/blogs/mycancer/
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