semicolon the art of healing

2009 Johns Hopkins Colon Cancer White Paper

noreply@blogger.com (semicolon) — Fri, 29 May 2009 19:49:00 +0000

The 2009 Johns Hopkins Colon Cancer White Paper
Colon cancer patients and their families have a new resource.

The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).

Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.

The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.

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Doc Says Doug’s Done

noreply@blogger.com (semicolon) — Wed, 15 Apr 2009 05:08:00 +0000

Doc Says Doug’s Done
March 3, 2008

Mr. Beckstein, let me take a moment to look at your chart.

Here are the results from my last Colonscopy.

OK.

Here are my CEA lab tests from 2007.

OK.

I had a CAT scan in March 2007, and there was no evidence of cancer.

I see that. No evidence of disease.

It has been five years since my colon cancer diagnosis.

Mr. Beckstein, you are done.

What.

You are done with cancer.

No more CEA tests?

Yes every six months but you will need a reading of 10 before I would be concerned.

What about CAT scans?

You really don’t have to go through that test anymore.

So I am done with cancer?

Yes. Doug you are done.

I left the doctor’s office a free man.

I've Nothin' To Do

noreply@blogger.com (semicolon) — Wed, 15 Apr 2009 04:10:00 +0000

I've Nothin' To Do
by Douglas Beckstein

I opened my eyes and saw my brother, David, napping in the chair in the corner of my hospital room. This was day two after my abdominal resection.

My hair was soaked with sweat. Pain meds worked great, but I had had wild dreams last night. I had no idea what kind of day it was outside the hospital. Food did not appeal. A young doctor making his rounds entered my room. “Good morning, Mr. Beckstein," he said. "What are you reading?”

I had to look at the book open on my bed to answer his question. “Gods and Demons,” I replied, with a very dry mouth. I took a sip of water through a straw.

“Is it any good?"
"I don't know,” I said. “I can't really read on this pain killer.”

Ignoring my brother sprawled in the chair, the doctor walked over to the window and stood with his back to me. “How’s the view from here?” I asked.

"I can see the highway and the roof of this hospital,” he responded. Then he turned to face me again. “Is that an iPOD you have there?"

"Sixty gigs!" I said proudly.

"Cool. I want one," he said, inspecting the device closely.

The doctor sat on my bed, lifted the sheet covering my incision, and inspected the tubes connected to my body. I was very relaxed due to his engaging conversation. There was a nine inch incision in my body; staples held me together.

He stared at my drainage tube. “You don’t need this thing anymore,” he said. He placed one hand on my belly, grabbed the tube with his other hand, and yanked. Then he stood up, wrapped the tubing and collection pouch into a ball, tossed the mess into the hazardous medical waste garbage can, and returned to my bedside.

“You are doing very well. Healing right on schedule," he said, applying a band aid to my belly. Then he was gone.

My brother woke up. “Who was that guy?" he asked.

“I think he was a doctor.” Song lyrics entered my brain. "David, do you remember the artist who sang this song?"

Countin' flowers on the wall, that don't bother me at all
Playin' solitaire 'til dawn, with a deck of fifty-one
Smokin' cigarettes and watchin' Captain Kangaroo
Now don't tell me
I've nothin' to do.

"Statler Brothers," he replied, opening yesterday's newspaper.

Waiting

noreply@blogger.com (semicolon) — Thu, 26 Feb 2009 22:19:00 +0000

Waiting

Waiting for an appointment
Waiting for a parking space
Waiting for an elevator
Sitting in a waiting room
Signing yet another medical form
Looking for my health insurance card
Glancing at magazines that have nothing to do with my life
Waiting to see the doctor
Waiting for the diagnosis
Wondering, is this test accurate?
Looking at numbers on a page
Wanting to understand
Lying on my back for a CAT Scan
Trying to be brave
Asking for a second opinion
Crying quietly
Wanting you to make it better
Worrying about dying
Waiting for a cure
Wanting something sweet
Waiting for a blood test
Wanting to run away
Waiting for a prescription
Cursing side effects
Looking for solutions
Wasting time
Wishing my life was different
Wondering how long will I live?
Praying to God
Talking with friends
Telling my story
Recovering
Living more
Loving deeply

Colon Cancer

noreply@blogger.com (semicolon) — Fri, 02 Jan 2009 21:45:00 +0000

Colon cancer is the #2 cause of cancer-related death among BOTH men and women in the United States. Yet this cancer is highly treatable if detected early. I would like to introduce you to an invaluable resource in our ongoing war against colon cancer:

The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).

Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.

The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.

The key to preventing and treating colon cancer is current, accurate, reliable knowledge.

John's Hopkins University 2008

Cancer will Overtake Heart Disease as World's Top Killer iby 2010

noreply@blogger.com (semicolon) — Wed, 10 Dec 2008 14:04:00 +0000

ATLANTA – Cancer will overtake heart disease as the world's top killer by 2010, part of a trend that should more than double global cancer cases and deaths by 2030, international health experts said in a report released Tuesday. Rising tobacco use in developing countries is believed to be a huge reason for the shift, particularly in China and India, where 40 percent of the world's smokers now live.

So is better diagnosing of cancer, along with the downward trend in infectious diseases that used to be the world's leading killers.

Cancer diagnoses around the world have steadily been rising and are expected to hit 12 million this year. Global cancer deaths are expected to reach 7 million, according to the new report by the World Health Organization.

An annual rise of 1 percent in cases and deaths is expected — with even larger increases in China, Russia and India. That means new cancer cases will likely mushroom to 27 million annually by 2030, with deaths hitting 17 million.

Underlying all this is an expected expansion of the world's population — there will be more people around to get cancer.

By 2030, there could be 75 million people living with cancer around the world, a number that many health care systems are not equipped to handle.

"This is going to present an amazing problem at every level in every society worldwide," said Peter Boyle, director of the WHO's International Agency for Research on Cancer.

Boyle spoke at a news conference with officials from the American Cancer Society, the Lance Armstrong Foundation, Susan G. Komen for the Cure and the National Cancer Institute of Mexico.

The "unprecedented" gathering of organizations is an attempt to draw attention to the global threat of cancer, which isn't recognized as a major, growing health problem in some developing countries.

"Where you live shouldn't determine whether you live," said Hala Moddelmog, Komen's chief executive.

The organizations are calling on governments to act, asking the U.S. to help fund cervical cancer vaccinations and to ratify an international tobacco control treaty.

Concerned about smoking's impact on cancer rates in developing countries in the decades to come, the American Cancer Society also announced it will provide a smoking cessation counseling service in India.

"If we take action, we can keep the numbers from going where they would otherwise go," said John Seffrin, the cancer society's chief executive officer.

Other groups are also voicing support for more action.

"Cancer is one of the greatest untold health crises of the developing world," said Dr. Douglas Blayney, president-elect of the American Society of Clinical Oncology.

"Few are aware that cancer already kills more people in poor countries than HIV, malaria and tuberculosis combined. And if current smoking trends continue, the problem will get significantly worse," he said in a written statement.

By MIKE STOBBE, AP Medical Writer Mike Stobbe, Ap Medical Writer – Tue Dec 9, 5:43 pm ET

CEA test used for tracking Colon Cancer

noreply@blogger.com (semicolon) — Tue, 11 Nov 2008 01:06:00 +0000

The carcinoembryonic antigen (CEA) test is a laboratory blood study. CEA is a substance which is normally found only during fetal development, but may reappear in adults who develop certain types of cancer.

Purpose

The CEA test is ordered for patients with known cancers. The CEA test is most commonly ordered when a patient has a cancer of the gastrointestinal system. These include cancer of the colon, rectum, stomach (gastric cancer), esophagus, liver, or pancreas. It is also used with cancers of the breast, lung, or prostate.

The CEA level in the blood is one of the factors that doctors consider when determining the prognosis, or most likely outcome of a cancer. In general, a higher CEA level predicts a more severe disease, one that is less likely to be curable. But it does not give clear-cut information. The results of a CEA test are usually considered along with other laboratory and/or imaging studies to follow the course of the disease.

Once treatment for the cancer has begun, CEA tests have a valuable role in monitoring the patient's progress. A decreasing CEA level means therapy is effective in fighting the cancer. A stable or increasing CEA level may mean the treatment is not working, and/or that the tumor is growing. It is important to understand that serial CEA measurements, which means several done over a period of time, are the most useful. A single test result is difficult to evaluate, but a number of tests, done weeks apart, shows trends in disease progression or regression.

Certain types of cancer treatments, such as hormone therapy for breast cancer, may actually cause the CEA level to go up. This elevation does not accurately reflect the state of the disease. It is sometimes referred to as a "flare response." Recognition that a rise in CEA may be temporary and due to therapy is significant. If this possibility is not taken into account, the patient may be unnecessarily discouraged. Further, treatment that is actually effective may be stopped or changed prematurely.

CEA tests are also used to help detect recurrence of a cancer after surgery and/or other treatment has been completed. A rising CEA level may be the first sign of cancer return, and may show up months before other studies or patient symptoms would raise concern. Unfortunately, this does not always mean the recurrent cancer can be cured. For example, only a small percentage of patients with colorectal cancers and rising CEA levels will benefit from another surgical exploration. Those with recurrence in the same area as the original cancer, or with a single metastatic tumor in the liver or lung, have a chance that surgery will eliminate the disease. Patients with more widespread return of the cancer are generally not treatable with surgery. The CEA test will not separate the two groups.

Patients who are most likely to benefit from non-standard treatments, such as bone marrow transplants, may be determined on the basis of CEA values, combined with other test results. CEA levels may be one of the criteria for determining whether the patient will benefit from more expensive studies, such as CT scan or MRI.

Precautions

The CEA test is not a screening test for cancer. It is not useful for detecting the presence of cancer. Many cancers do not produce an increased CEA level. Some noncancerous diseases, such as hepatitis, inflammatory bowel disease, pancreatitis, and obstructive pulmonary disease, may cause an elevated CEA level.

Description

Determination of the CEA level is a laboratory blood test. Obtaining a specimen of blood for the study takes only a few minutes. CEA testing should be covered by most insurance plans.

Preparation

No preparation is required.

Aftercare

None.

Risks

There are no complications or side effects of this test. However, the results of a CEA study should be interpreted with caution. A single test result may not yield clinically useful information. Several studies over a period of months may be needed.

Another concern is the potential for false positive as well as false negative results. A false positive result means the test shows an abnormal value when cancer is not present. A false negative means the test reveals a normal value when cancer actually is present.

Normal results

The absolute numbers which are considered normal vary from one laboratory to another. Any results reported should come with information regarding the testing facility's normal range.

Abnormal results

A single abnormal CEA value may be significant, but must be regarded cautiously. In general, very high CEA levels indicate more serious cancer, with a poorer chance for cure. But some benign diseases and certain cancer treatments may produce an elevated CEA test. Cigarette smoking will also cause the CEA level to be abnormally high.

steps to avoid cancer

noreply@blogger.com (semicolon) — Wed, 05 Nov 2008 21:48:00 +0000

Some do’s and don’ts for helping to avoid and fight cancer.

Your mental state
* Be positive.
* Resolve stress and past traumas.
* Accept yourself and your emotions, including the negative ones.
* Practice meditation, yoga, tai chi or some other form of relaxation.

Your diet
* These vegetables have great cancer-fighting characteristics: beets, Brussels sprouts, cabbage, garlic, kale, leeks and scallions.
* Also good are onions, blueberries, raspberries, cherries, red wine, soy.
* Increase your intake of omega-3s, typically found in fish (herring, trout, sardines, mackerel, halibut) and flax seeds and oils.
* Avoid sugar, white flour, vegetable oils, white rice and non-organic animal fat (meat, eggs, milk, cheese).
* Filter your tap water.

Your activity
* Spend 20 to 30 minutes a day on a physical activity like tennis, swimming or walking.
* Be out in the sun for 20 minutes every day.

And...
* Avoid being surrounded by people who smoke.
* Use cosmetic products that don’t contain parabens or phthalates.
* Use skin-care products without estrogens or placental by-products.
* Use cleaning products without synthetic chemicals.
* Don’t prepare food in a scratched Teflon pan.
* Reduce the influence of cell phones by using a headset consistently.

Source: David Servan-Schreiber, Anticancer 11-05-08
David Servan-Schreiber | November 2008 issue of ODE Magazine

How Often Should You Get a Colonoscopy?

noreply@blogger.com (semicolon) — Tue, 07 Oct 2008 15:29:00 +0000

If you are at low risk for colorectal cancer, how long should you wait between colonoscopy screenings? Johns Hopkins looked into this question and provides advice.

Most of us grudgingly accept the need for regular colonoscopy screenings but may wonder: Is it really safe to wait a decade before your next colonoscopy? Some researchers have wondered as well.

The 10-year interval, the gold-standard period between screening colonoscopies for people at low risk, is based in part on the amount of time it usually takes a benign polyp to become cancerous. Until recently, there was little evidence to support this practice in people whose previous colonoscopies showed no evidence of cancer or polyps.

But new research suggests that the 10-year standard is more than adequate. In fact, it may be safe -- although not recommended -- to wait up to 20 years between colonoscopy screenings. For example, a Canadian study that reviewed colonoscopy records of 35,975 people confirms that those with a negative (cancer-free) test result had a 72% lower risk of developing cancer over 10 years than the general population.

A German study that spanned more than a decade confirmed this finding and went even further: For people with a prior negative colonoscopy, the low-risk period can extend to 20 years. We're not suggesting that you allow 20 years to pass between your colonoscopy screenings. But if you have a normal colonoscopy result, you can most likely wait at least a decade before undergoing the procedure again.

Important: If a screening colonoscopy catches even one polyp, your risk of colon cancer goes up and so does the recommended frequency of screenings. The same is true if you have a family history of colorectal cancer or other risk factors for colorectal cancer.

Posted in Colon Cancer on October 7, 2008

PET Scans for Recurrent Colorectal Cancer

noreply@blogger.com (semicolon) — Wed, 17 Sep 2008 16:49:00 +0000

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.

The Size of a Pea

noreply@blogger.com (semicolon) — Tue, 16 Sep 2008 12:35:00 +0000

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

Improving Survival after Colon Rectal Cancer

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 21:38:00 +0000

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.

Can Colorectal Cancer Be Prevented?

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 14:18:00 +0000

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.

My Bucket List

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 14:10:00 +0000

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.

Road Trip Be Prepared

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 14:08:00 +0000

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.

A Good Stick for a Blood Test

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 14:05:00 +0000

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.

Back to Balance

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 14:02:00 +0000

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.

Angels: Becoming Aware of Spiritual Support

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 13:55:00 +0000

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.

WHY ME? Survivor Guilt

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 13:51:00 +0000

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.”

You got the whole world in you hands

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 13:49:00 +0000

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.”

You miss 100% the shots you never take

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 13:44:00 +0000

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

What is an Exceptional Patient?

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 13:41:00 +0000

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

Colon Cancer Claims Leroy Sievers

noreply@blogger.com (semicolon) — Tue, 09 Sep 2008 05:28:00 +0000

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/

Too Old for Colorectal Cancer Surgery?

noreply@blogger.com (semicolon) — Sat, 19 Jul 2008 15:12:00 +0000

How Old Is Too Old for Colorectal Cancer Surgery?

When a reasonably healthy octogenarian gets a diagnosis of colon cancer, the issue of age is bound to come up. How old is too old for colon cancer surgery? What are the risks? What kind of recovery and quality of life can the very elderly expect afterward? Is it worth it? Johns Hopkins explores these questions and others in this Special Report.

Few studies have looked at how the elderly fare after colorectal cancer treatment and pursued these hard-to-ask questions. But in the ones that have, the short answer is that octogenarians and even nonagenarians can fare as well as younger seniors, if they are in otherwise good health.

It is true that the risks of colorectal cancer surgery are higher for some older people. An analysis of 28 studies found lower survival rates among the elderly who have coexisting health conditions, are diagnosed at an advanced cancer stage, and have to undergo emergency procedures. Another study found that octogenarians with early stage cancer survived 10 or more years after colorectal cancer surgery if they had no chronic illnesses.

It appears that quality of life after colorectal cancer treatment can be as good for octogenarians as it is for younger seniors -- even in the face of coexisting illness, according to a Canadian study that compared the outcomes of people over age 80 with those in their 60s. The average age of the older group was 83 years at the time of colorectal cancer surgery, while the "youngsters" ranged in age from 65-69. People in both groups underwent comparable surgical procedures and had similar coexisting health problems (such as hypertension and diabetes), although the older group had somewhat less advanced (lower-stage) cancers.

The responses to a survey on quality of life and functioning before and after colorectal cancer surgery were remarkably similar in both groups. Before surgery, both worried about pain, becoming a burden, and death. After colorectal cancer surgery, there were no major changes or differences between the groups in terms of their ability to perform daily functions or their overall health, sexual function, or quality of life.

Too Early To Draw Firm Conclusions?

The Canadian researchers emphasize that their study findings are preliminary, and some results may be biased. While the results are preliminary, the study provides further ammunition for the argument that determining which patients are candidates for colorectal cancer surgery shouldn’t be made solely on the basis of chronological age. High-functioning elderly people who undergo colorectal cancer surgery appear able to retain their ability to function and maintain a good quality of life.

Experts note that regardless of age the outcome of colorectal cancer surgery is likely to be better under these conditions:

* The cancer is at an early stage. Most people in the study had stage 0, I, or II cancer; none had stage III or IV.

* The person about to have treatment is functioning at a high level before surgery and in good general health, without multiple serious chronic diseases. People who have three or more chronic diseases -- such as diabetes, rheumatoid arthritis, or heart disease -- tend to have poorer outcomes.

* The surgery is seen as a positive action, and the person with cancer is aware of the procedures to be performed and the potential outcomes. Other issues that could affect outcomes at any age include a family history of longevity and a good support system of family and friends.

Posted in Colon Cancer on July 15, 2008

My Colon Cancer Abdominal Resection

noreply@blogger.com (semicolon) — Thu, 17 Jul 2008 22:18:00 +0000

My Colon Cancer Abdominal Resection
November 2003

My first surgery was for tonsils. Maybe I was seven. I remember wanting popcorn after surgery but my mom brought ice cream. I think I stayed overnight in the hospital.

In my thirties I had two hernia repair surgeries. I had to rest a few days. No big deal. In your thirties you still think you can live forever. Hernia repair was just a speed bump in my race through life. I had stitches in my crotch so it was hard to sit up and it hurt to laugh. I did not want my friends with a sense of humor to come see me in the hospital. One friend brought me lilies and made me watch the Night of the Living Dead.

In my forties I had three nasal polyp surgeries. These were outpatient and easy because I had no real fear of dying. Surgery was quick and recovery was a short duration. I had support at home and was surrounded by friends.

Preparing for colon cancer surgery was scary. My cancer diagnosis felt like the kiss of death. I carried the intense fear of dying on the operating table during my abdominal resection. I did not know if they would be able to remove all the cancer from my body. Maybe the cancer was spreading. Maybe I would die slowly wasting away as cancer spread through my body.

After my diagnosis I got a second opinion from another doctor. He confirmed I had colon cancer. Next step was to find a surgeon to do the procedure. Carrie and I met with the doctor. I asked questions and Carrie wrote down answers. I was still overwhelmed about my cancer diagnosis. The doctor who did my colonoscopy called me on my personal cell phone to make sure I got my abdominal resection surgery scheduled as soon as possible.

I made sure my health insurance would cover my procedures. The night before my surgery I had to empty out my lower intestine and colon. No food or water after midnight.

Early in the morning, Carrie, my brother, and Carrie’s parents brought me to Sutter Hospital in Sacramento. An armband was placed on my left arm. When you enter a medical center for surgery, you submit to the surgical procedures. I took off my street clothes, glasses, watch, and changed into a blue and white hospital gown. I was just another medical patient now. I gave my medical files, my wallet and car keys to Carrie. I call this my surrender to surgery.

I laid down on a gurney. I tried to relax. I was really cold. The nurse covered my legs with a warm blue blanket. Then another nurse brought elastic stockings. These were to be worn to prevent blood clots. Then my legs were surrounded with a device that massaged my legs.

Next step to prepare me for surgery was for a nurse to start an IV. Unfortunately for me a young nurse in training was assigned to me to find a vein. After several failed attempts I asked for a more experienced nurse. I noticed Carrie was getting squeamish. Carrie had fainted during one of my earlier surgeries. I suggested she find my brother David to keep me company. An experienced nurse arrived to start my IV. She found a vein immediately. She connected the needle in my arm to clear tubing and a bag of glucose.

I tried to relax. My brother and I were surrounded with a curtain. This was supposed to provide privacy in a crowded surgical waiting room. I looked into my brother’s blue eyes to draw upon his strength. We were both scared. We both were trying to be brave.

My surgeon opened my private curtain and said “Good Morning.” He looked at my medical chart. A surgical mask hung around his neck. I was probably ab resection number two on his list. For him this was just another medical procedure.

“Do you have any questions, Mr. Beckstein?” he asked.

“No.” I replied.

Another nurse appeared through the curtain to position adhesive strips on my body. These were for the EKG machine and other electronic devices. She disappeared.

My anesthesiologist arrived. He looked at my chart.

Is he old enough to practice medicine? I thought to myself. He looks so young! Hope he knows what he is doing I thought.

“I am Doctor Saunders. We spoke on the phone last night. I will start a drug to help you to relax and then when we are in the operating room you will go to sleep. “Do you have any questions, Mr. Beckstein?” he asked.

“No.” I replied. I am ready for my surgery Doctor.

I was glad my brother David was by my side. We listened to the noises coming through my privacy curtain. The anti-anxiety medicine was starting to smooth the edges of my experience.

One month before my surgery a friend recommended “Successful Surgery.” A compact disk by Belleruth Naparstek. This guided imagery and affirmations helped me prepare for this day. I played the CD at home several times to help me relax and to prepare for this stressful surgery. The day of the procedure, I forgot to bring the CD into the operating room but I could recall Belleruth’s voice.

“You will see a shimmering….” I could hear her voice telling me to relax. Her entire message was there in my brain ready to recall before my procedure.

My body began to relax as the IV medication helped me feel warm and safe. I felt like I was in a movie. My brother disappeared from view like a ship floating out to sea. My gurney rolled through big stainless steel doors and I entered the operating room. The room was very bright. I saw my surgeon and my anesthesiologist looking at me as the nurse hooked up my electrodes to the EKG.

“Ready Mr. Beckstein?”

Yes.

Fade to black.

Notes from my medical record…

A small bowel resection was performed while the patient was under general anesthesia. A nine inch incision was made in the abdomen. The diseased part of the colon was removed and the two healthy ends were sewn back together. The abdominal incision was closed. The Abdominal Resection was successful. Twenty-five lymph nodes were removed for testing.

Post-OP

“Can you hear me Mr. Beckstein?”

The recovery room nurse’s voice was far away. Maybe I could understand every other word. Like a spotty cellphone connection. I was surrounded by muffled voices drifting into my field of hearing.

A machine was inflating and deflating the blood pressure cuff squeezing my right bi-cep. It recorded a reading of 130 over 79. Pulse 60.

“Can you open your eyes Mr. Beckstein?”

“I rather not Nurse, I thought to myself. Leave me alone. I do not want to wake up. Let me sleep a little longer.”

Out of focus lights appeared through the fog covering my body.

“If you can hear my voice blink your eyes Mr. Beckstein.”

I blinked.

I was officially awake following my abdominal resection. My body felt heavy. I considered trying to move my arms but I felt like a lead blanket was covering my chest and arms like a dentist office x-ray procedure.

Nurses and doctors were walking back and forth around my gurney. Other patients were wrapped in white sheets like Egyptian mummies. No dead people here. Think I am in the recovery room. No privacy curtain here. Big wide open room where the nurses watch patients like bees buzzing in a field of flowers.

I was bored looking at the ceiling tiles, I had a wild idea. Maybe I could move the fingers of my left hand! I wiggled a few fingers. Hey they moved. Next I tried to bend my elbow and move my fingers. Success. Do I dare explore my belly to feel the incision? I was curious and scared at the same time. Conflict. What to do? I pushed away the hospital blanket to bravely explore my midsection only to be stopped with bandages and gauze and wide strips of adhesive tape. Better not to proceed to the incision just yet. Maybe too much information.

Beep. Beep, beep.
The EKG recorded my heart beat with the latest digital display for the nurse.

I was breathing.
My heart was beating.
I was alive.
I was done with surgery.
I did not die on the operating table.
Do I still have cancer in my body?
Did they dig it all out?

“You are doing very well Mr. Beckstein” my surgeon and my primary physician were looking at me. They both had a big smile. Both in surgical scrubs.

“In a few minutes they will move you to your hospital room. You get some rest. We will talk to your family now. Do you have any questions?”

“Did you remove all the cancer during this surgery, doctor?”

“Yes.”

I thanked them and drifted off to sleep. I felt no pain. Morphine floated into my bloodstream and I was grateful. I was grateful to be alive.

Someone pushed my gurney into a huge elevator. A few moments later my body was transferred from gurney to my hospital bed.

I was alone.