Articles by G van Londen, MD

Dr. van Londen is a cancer provider/medical oncologist and a cancer survivor. Born and raised in The Netherlands, she has migrated to the USA where she completed a medical residency, as well as fellowships in medical oncology and geriatric medicine. She has practiced medicine in the USA for nearly 20 years at a large health care system in Pittsburgh, PA, USA. Her background has prepared her to handle diverse and complicated cases. She specializes in: 1) Treating newly diagnosed, older breast cancer patients by performing a geriatric assessment and creating a personalized, multidisciplinary treatment plan that aims to respect patient’s preferences and desire for independence. 2) Cancer survivorship care to prevent/support the late/long-term post-treatment needs of cancer survivors of any gender and tumor type (and their caregivers). Together with a village of various supportive care providers, she performs clinical, research, and educational activities to empower cancer survivors (and their caregivers and providers) to support the post-treatment emotional, physical, and functional needs of cancer survivors. The content of this domain is protected. Entries and replies are not endorsements. Views are mine. No COI.
Animals and Illness – Hormone Replacement Therapy, Mastectomy Reflection

Animals and Illness – Hormone Replacement Therapy, Mastectomy Reflection

Dear fellow traveler! Hope this week has treated you well.

Over the last few months, our household has been having an ongoing discussion about the pros and cons of having a pet. Also, we’re wondering what kind of animal would be best for our lifestyles. Since pets come in all kinds of shapes and breeds, we began to consider size, activity level, and maintenance. We live in an apartment and are all busy busy, including my boys. They are often on the road for their baseball activities, so the pet and I will probably become best buddies! Having grown up on a farm, I know that having an animal around would rekindle some happy memories for me. Eventually, after lots of thinking and talking, we decided to start off with a cat, a calm breed who loves cuddling but can also be alone. The Dutch word for milk is melk and we’re fans of this MLB baseball player. Hence, the cat’s name will be Melky. Our pet-to-be is now a few weeks old and will come to us in December. We are all so excited! 

Pets can play a significant role in the lives of human beings (and hopefully vice versa)! Animals may improve the quality, and even quantity, of life! Dog ownership has recently been associated with better (heart) health (likely due to dog walks)! Furthermore, pets may distract and soothe us, allow us to release and process our feelings, and remind us of the fragility of nature and life. They can function as role models in terms of resilience, gracefulness, and self-care. Pets often love to receive and give affection in an unconditional and nonverbal manner.

More than that…..pets play a meaningful role in society:

  • Service animals are trained to support their disabled owners.
  • Emotional support animals provide therapeutic benefits to those with emotional difficulties.
  • Therapy dogs do not have the legal access rights that the above mentioned animals do, but they provide great comfort to people suffering in medical facilities and nursing homes. In fact, training your dog as a therapy dog is a fulfilling way to give back to your community.

Whether you decide to get your own pet or spend more time with someone else’s, please check with your healthcare provider about which kind may be best for you. You and your loved ones may have sensitivities or allergies. In addition, your previous or current cancer therapies may increase your risk of acquiring an illness from your pet.

Continue to be kind to yourself and others! Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Follow me on social media for ‘extra treats’ (@CancerSurvivorMD on Facebook, Instagram, Pinterest, and Twitter)!  

Learn and Think:

For those of you who are going through the change of life prematurely, perhaps as a result of cancer therapies, please find here the results of a recent major study that provides updated guidance on hormone replacement therapy. Being educated on this topic can help you talk with your healthcare provider.

Live and Feel:

A survivor’s reflection on her mastectomy.

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Describing Symptoms Accurately – Link between Vacation & Disease, Taylor Swift, Shore Birds

Describing Symptoms Accurately – Link between Vacation & Disease, Taylor Swift, Shore Birds

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Dear fellow traveler! 

As a physician I am expected to know all about symptoms. However, I have found myself having difficulty describing my own symptoms this week. And even though I have very supportive healthcare providers, this made me feel a bit inadequate. Why I would feel this way? I have been thinking it over for a bit, and even explored a little online, but did not find too much written about this topic. My husband told me that I ended up asking my provider several times “does this make sense to you”? (which I discovered is one of the recommended tips when describing symptoms to doctors) and now I am wondering, dear reader, do I still make sense to you? I have given this topic a place within my heart and head and hope that my writing may comfort you. 

We see the world and we sense our bodies in our own unique ways, colored by our genes (nature) and our past (nurture). It is not always easy to translate our feelings into words. There is even a formal name for it: alexithymia. Some of us may experience this difficulty expressing ourselves more often and more deeply than others. Many factors contribute to this challenge, such as: 

  • education
  • brain function
  • pain thresholds
  • vocabulary (I never know how to answer a question about the character of my pain – dull, burning, sharp?) 
  • self-awareness (which may be affected by traumatic experiences)

I think there may be an extra layer of complexity to this. What if your body has been damaged or altered by your disease or treatments? I can imagine that altered anatomy, myofascial planes, blood supply, lymph drainage, and nerve routes, may change the ‘normal’ (if there ever is any) or expected presentation of a symptom. These physical transformations may further challenge the often already difficult communication about symptoms between the provider and the patient, making illness harder to diagnose and treat.

It can be daunting for a patient to know when a chronic symptom has worsened to the point of needing to seek help. If you wait too long, your illness may become more severe. Also, you may find that you’re unable to explain when and how the symptoms started changing (over the course of days/weeks/months?) or how exactly this presentation is different from before. If you seek help too early, you may worry that you’ll earn the reputation of “the boy who cries wolf“. 

Physical and emotional symptoms can coexist, interact, and synergize with each other. You may be upset about the effect a symptom may have on your life, as well as be wondering why it is happening (Is it a sign of the cancer recurrence?) and will it ever go away? But then, stressing over it will not help your body either.

Symptoms may not always have associated objective findings on diagnostic testing. And even if they do, how do we know for sure they are related and not a coincidental finding? The description of invisible symptoms is not unique to cancer, as described by this Multiple Sclerosis blogger. 

Take home points:

  • Find yourself a provider who actively listens and treats you with respect.
  • Ensure that life-threatening problems will not be not missed, while your emotional toll is not being ignored. 
  • Be accepting of your new reality. Accept that your body may be irreparably damaged and your situation may be chronic.
  • If a therapeutic intervention is being proposed, carefully balance the pros/cons (high potential to help coupled with a low risk to do harm). 
  • Be aware that there are a lot of expensive and time-consuming scams out there that prey on people who are rather desperate for relief. To me this is cruel beyond words. 
  • Learn to balance uncertainty (as to etiology/prognosis) with the hope that there might be options out there to take the edge off and make your symptom(s) a bit more bearable. 

I hope this blog entry will allow you to 1) feel that you are not alone in this experience and 2) be empowered to go out there and find yourself a personalized treatment plan! Continue to be kind to yourself and others!

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. And I share ‘extra treats’ via social media!  

Learn and Think:

Even though the cause/effect relationship is not confirmed yet, a recent publication has revealed a (not very surprising?!) association between more frequent vacationing and a reduced metabolic syndrome risk. Metabolic syndrome is associated with the risk for heart disease and likely many other diseases, including some cancers. Try to utilize all your available vacation time! 

Metabolic syndrome is a collection of risk factors for cardiovascular disease. If you have more of them you are at higher risk of cardiovascular disease. This is important because we are actually seeing a reduction in the risk for cardiovascular disease the more vacationing a person does. Because metabolic symptoms are modifiable, it means they can change or be eliminated. Bottom line: A person can reduce their metabolic symptoms – and therefore their risk of cardiovascular disease – simply by going on vacation. We are still learning what it is about vacations that make them beneficial for heart health, but at this point, what we do know that it is important for people to use the vacation time that is available to them. “One of the important takeaways is that vacation time is available to nearly 80 percent of full-time employees, but fewer than half utilize all the time available to them. Our research suggests that if people use more of this benefit, one that’s already available to them, it would translate into a tangible health benefit.

Source

Live and Feel:

“It’s taught me that there are real problems and then there’s everything else. My mom’s cancer is a real problem. I used to be so anxious about daily ups and downs. I give all of my worry, stress, and prayers to real problems now. It’s really interesting because I don’t think I have written a song quite like that before. And it’s just sort of, like, it’s just a tough one. It’s just not something that we deal with until we have to, until we see it, until we experience it, until someone close to us is going through something like that. And so, writing about it was really emotional. And I’m just gonna stop talking about it now.

Source CBS News and Source Today

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Guilt – Reflective Lectures

Guilt – Reflective Lectures

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Dear Neighbor!

I have had a conversation with different people about the same topic, guilt, a few times this week. I always wonder why that happens Did I steer the conversation in that direction because it’s on my mind? Was it a coincidence? Anyhow, I thought I might try to write about guilt. I hope it may help you.

Feeling guilty is often associated with a feeling of shame or regret. It’s not easy to try to make sense of the whirlwind of feelings and thoughts that you may have when you have survived or are living with cancer:

  • Could I have noticed symptoms earlier or gone to the doctor sooner?
  • Did my lifestyle choices or habits increase my risk of developing cancer?
  • Why didn’t my treatment work the way I had hoped?
  • Why did I survive when others have not? 
  • Am I a burden to my family or caregivers? (Sorry we needed to cancel our family trip, boys!)
  • How will I handle the financial costs of treatment?
  • What will my boss and coworkers think about all of the time I have to spend time away from work for treatment?

Source

Caregivers may also feel guilty. They are healthier and may wish to to take the place of the cancer survivor. Often they regret that they can’t do more to help or even take away the pain or illness. Also, they may hide their feelings/thoughts, since they do not want to put more stress on the survivor. They may skip out on fun outings to avoid stinging the survivor who cannot join. 

Feelings of guilt are normal and can come and go. Working through them will allow you to release them  so they don’t interfere with your well-being and healing. Several tips to allow you to help yourself with this are outlined here. Finding ways to soothe, comfort, and distract yourself by engaging in activities that bring you joy and relaxation may help. Sharing your thoughts/feelings in a journal or with people who care about you can be beneficial, too. However, if guilt paralyzes you, causing social isolation or preventing you from functioning, you should talk with your healthcare provider who can connect you with a talk therapist and/or a local support group. 

Remember that cancer is not your fault—or anyone else’s. Experts do not fully understand why most types of cancer develop. Sometimes people with cancer feel guilty about having given their “bad genes” to their children or having made bad lifestyle choices in the past, such as cigarette smoking. In these situations, please tell yourself that:

  • Even though we live in the 21st century, there are so many things in our body’s black box that we still don’t understand.
  • We cannot always control nature, no matter how much we try. 
  • Our previous decisions made sense at the time, driven by knowledge and circumstances. 
  • We are not perfect. We must forgive ourselves. 

This brings us to the next topic that can get me really fired up: stigma! Sadly, certain cancers are more associated with stigma than others, in particular those to which we attribute a certain sense of responsibility (e.g. nicotine and lung cancer). However, not everyone who smokes gets lung cancer, and not everyone who gets lung cancer has smoked, which attests to the notion that there are so many different factors involved in the development of cancer that are beyond our control. Plus, over time we may discover that many of today’s widely-accepted practices might need to be changed since they may be found to be associated with the development of diseases. I don’t feel there is any room for judgment, because it usually does not result in anything meaningful or positive. 

Furthermore, you may feel an urge or even obligation to find a purpose in the ‘extra’ time you were given. Or is it the other way around—were we spared for a purpose that we may not know about yet? We will never know. We all tell our own story in a way that gives our lives meaning and purpose.

You can’t connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something—your gut, destiny, life, karma, whatever. Source.

Enjoy creating and telling your life story! Please be kind to yourself and others! 

Thank you for visiting me! Please, below find a few things to educate and entertain you!

 

Learn and Think:

It’s cucumber time, or a slow-medical news-season. Give your brain a rest!

 

Live and Feel:

Two men who died at a young age from pancreatic cancer gave inspiring lectures that I would like to share with you:

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Missing in Action

Missing in Action

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Dear Neighbor!

A few loyal readers had checked in on me this week, because they noticed that my weekly posting did not take place last weekend! This experience was heart warming and led me to write this brief entry. I am sorry for my radio silence. As many of you are very much aware, our bodies do not always cooperate. I am on the mend, prioritizing my employment and healing. As a result, there was no time/energy for ‘extra’ things such as social activities and writing a blog entry….but I hope to release a new post in a few days – stay tuned!

In the mean time,  you may enjoy watching this conversation between two male tv personalities who shed tears when they speak about grief (this message is not politically motivated). Please let me know if you cannot view the link.

Be kind to yourself!

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Simple Life – Always Remember Us This Way

Simple Life – Always Remember Us This Way

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Dear neighbor! 

As I write this, the crickets are chirping energetically, clouds are slowly moving in the sky, the light effects are beautiful at this golden hour before the sun goes down, creating a peaceful atmosphere. Earlier this week, I had a conversation with another cancer survivor in which we both expressed our admiration of the complexity of our universe and the beauty of life…everyone and everything has their place, meaning, and purpose….all seems to be perfectly orchestrated, in an almost unimaginable manner….allowing you to trust its automation and to focus on the busy-ness of life….in cruise control mode…..

But when your body goes out of sync…..and develops cancer…..then we get reminded again of the fragility of life, the world, and the universe….a humbling experience.

At that point, when you find yourself facing a disease that has the potential to alter the course of your life, nothing else may seem to matter anymore….values that you used to pursue with great strategy and devotion (e.g. career, wealth, societal expectations) lose their priority practically in an instant…..and values such as love and time become more important…

Love. An encounter with cancer makes us feel more vulnerable. And may encourage us to seek from and give comfort to persons all around us….anyone….loved ones, but also strangers….it may allow us to see the beauty in people and things around us that we did not really pay attention to before….

They May Forget What You Said, But They Will Never Forget How You Made Them Feel. Source.

Time. In the end, we are always running out of time….a 24 hour day is never long enough…..we may have lost so much time to being sick that we would like to catch up on life…..we may not know how much time for living we may have left, or how much precious energy you may have to make it through the day…..these uncertainties may urge you to prioritize the essentials…..and to keep life as simple as you can and/or want…..the things you would both want and need should be pursued, while those that you don’t want nor need should be avoided….and matter that you either would want or need should be reevaluated.

There is something very refreshing and liberating about a healthy and personalized dose of minimalism in every aspect of our life.

Minimalism is a tool that can assist you in finding freedom. Freedom from fear. Freedom from worry. Freedom from overwhelm. Freedom from guilt. Freedom from depression. Freedom from the trappings of the consumer culture we’ve built our lives around. Real freedom. That doesn’t mean there’s anything inherently wrong with owning material possessions. Today’s problem seems to be the meaning we assign to our stuff: we tend to give too much meaning to our things, often forsaking our health, our relationships, our passions, our personal growth, and our desire to contribute beyond ourselves. Want to own a car or a house? Great, have at it! Want to raise a family and have a career? If these things are important to you, then that’s wonderful. Minimalism simply allows you to make these decisions more consciously, more deliberately. Source.

We are all unique…..we all have our own set of values, principles, obligations, and desires…..I encourage you to feel free and allow yourself to follow your passions….and make new memories that will carry you and your loved ones!

Thank you for visiting me! Please…find below a few things for education and entertainment!

Learn and Think:

Its cucumber time, or also a slow-medical news-season. Give your brain a rest!

 

Live and Feel:

The lyrics of Lady Gaga’s song “Always remember us this way” fit well with this blog’s content.

 

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Pity vs. Compassion – Wild Horses, Journaling

Pity vs. Compassion – Wild Horses, Journaling

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Dear neighbor!

How are you today? This week I shared a meal with another cancer survivor. We ended up talking about how we try to carefully gauge when, how, and what we share to avoid becoming a conversation stopper or the object of pity. But not sharing our pain can lead to feelings of ‘self pity’ and isolation. On the other hand, the sharing of our stories can also make us feel worse or even compelled to comfort the other person, in particular when sharing our pain triggers negative judgment (such as ridicule, inferiority, failure, or pity).

The bad press received by pity concerns both what pity lacks, namely, actual assistance, and what it implies, namely, a feeling of superiority and satisfaction with our own position. Source.

And this brings us to compassion. Pity and compassion are two reactions (to seeing someone suffer) that overlap and are on opposite ends of a spectrum that also includes sympathy and empathy. I like the following graphic, which visualizes the relationship between these 4 terms:

inforgraphic
Designed by Robert Shelton.  Source

 

These different terms correlate with different perspectives on life that one may have been born with and/or acquired over time.

Someone who has compassion senses a cancer survivor’s suffering and has an active desire (and ability !) to:

  • Allow one “to just be” (which may take a survivor already quite a bit of energy/effort!),
  • (Often silently) provide company (while respecting boundaries),
  • Universalize the situation (because life is not fair for many),
  • Create temporary distractions from problems (with e.g. silly activities),
  • Allow one to feel less of a nuisance,
  • Take on the challenging task of knowing when and how to help, since a cancer survivor may not always need instant help or a solution. And may even (stubbornly!) prefer to first try to sort things out on their own (perhaps needing you as a listener or a sounding board),
  • Jump in if you see HELP signals, e.g. trouble taking care of oneself, dysfunction in their family or society, posing a danger to self/other,
  • Be comfortable with the unsatisfied desire to help. In particular, if the survivor is not (just yet) open to accepting help (you can bring water, but cannot force one to drink), or if there is no clear solution at this point in time.

Compassion is one of the main drivers of altruism, which in its turn can facilitate well-being. Altruism can be a noble (or even self-motivated) initiative to alleviate suffering, but helping others can also be a defense mechanism in which one distracts themselves from their own thoughts/feelings. The helper needs to also care for him/herself to minimize risk for caregiver burnout.

Compassion for me translates into a few key words and noble goals that we all should aim for: honesty, unconditional love, genuine care, and passionate generosity. But please remember that you are only human – it’s the reaction to and recovery from our unavoidable mistakes and failures that count and allow us to grow!

Won’t you be my neighbor…?

Please…find below a few things for education and entertainment!

Learn and Think:

Its cucumber time, or also a slow-medical news-season. Give your brain a rest!

 

Live and Feel:

  • Enjoy this video of one of the few remaining herds of wild horses – the Chincoteague ponies and Assateague’s wold horses!
  • Visible Ink offers Memorial Sloan Kettering Cancer patients to express themselves in writing with the individual support of an experienced writing mentor. Their initiative has been described in the NYT. Journaling may be one way in which one can write their thoughts and feelings away to facilitate healing!

 

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“The Other Shoe” Phenomenon, Glass Half Full/Empty – Implant associated Lymphoma, Mr. Rogers

“The Other Shoe” Phenomenon, Glass Half Full/Empty – Implant associated Lymphoma, Mr. Rogers

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Dear neighbor!

The summer is passing quickly. Many of you are likely already starting to prepare for the next 6 months – health, school, work, family, house, car, travel, and the Holiday season….etc!

Life can feel like a never-ending whirlwind at times – pulling you in many different directions, leaving you to organize and streamline the chaos.

Having been told that you have cancer, one of life’s “worst case scenarios”, you may have, unconsciously, lost trust in your body or life, and started to be more ‘on guard’, ready for “the other shoe to drop” or deal with whatever or whenever the next ‘worst case scenario’ may be. You may also know this as the Fight-or-Flight response. But this response can go into overdrive at times, affecting all aspects of your life, even the routine ones. Perhaps you used to be a glass-half-full person, but now you may have become more of a glass-half-empty person.

I hope this writing will allow you to try to Stop-and-Think-First before you act, when you feel your body tensing up for a ‘fight’….(unless, of course, there truly is a life-or-death emergency, like a lion chasing you!).

Pause to get yourself e.g. a delicious meal, a good night’s rest, a meaningful conversation with a loved one, whatever it takes to regain a more neutral and realistic perspective….and then rethink your decision-making again….you may discover that your glass is neither half-full, nor half-empty…..it may actually be refillable, maybe even to the top….!

Life is not always fair….some people may have more suffering on their path than others….but some may also choose to keep their suffering more private….please don’t give up hope….and find “neighbors” who can help you carry your backpack!

Won’t you be my neighbor…please? Please…find below a few things for education and entertainment!

Learn and Think:

Certain breast implants have been in the news this week due to a FDA recall:

Based on the currently available information, our analysis demonstrates that the risk of breast implant associated lymphoma (BIA-ALCL) with Allergan BIOCELL textured implants is approximately 6 times the risk of BIA-ALCL with textured implants from other manufacturers marketing in the U.S.

At this time, the FDA does not recommend removal of these or other types of breast implants in patients who have no symptoms due to the low risk of developing BIA-ALCL. The FDA will continue to evaluate any new information and may, as a result, take action regarding other breast implants, if warranted. Source

If any questions or concerns, it may be best to contact your plastic surgeon.

Live and Feel:

Lately, I have become fascinated with Mr Rogers’ legacy, probably encouraged by the upcoming release of the Its a Beautiful Day movie in which Tom Hanks portrays Mr. Rogers. Mr. Rogers courageously displayed his own vulnerability/sensitivity and preached “love” to encourage “being”, acceptance, respect, confidence, and health. His award-winning messages and poetry are simple, yet deep, and just as helpful as they were 50 years ago, independent of your age! His thought-to-be-last video message to his grown-up fans gently encourages “the expression of feelings in ways that will bring healing”.

Fred Rogers once said:

“Part of the problem with the word ‘disabilities’ is that it immediately suggests an inability to see or hear or walk or do other things that many of us take for granted. But what of people who can’t feel? Or talk about their feelings? Or manage their feelings in constructive ways? What of people who aren’t able to form close and strong relationships? And people who cannot find fulfillment in their lives, or those who have lost hope, who live in disappointment and bitterness and find in life no joy, no love? These, it seems to me, are the real disabilities.” Source

 

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Being (a) Patient – Colonoscopy, Happiness, Lion King

Being (a) Patient – Colonoscopy, Happiness, Lion King

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Dear Travel Buddy!

Great to see you have stopped by to check in – always appreciate the company! This weekend, my family (thank you!) assembled a few pieces of furniture….which inspired me to write about ‘patience’….! 

When my patients express concern that their medical care is moving (too) slowly or their recovery is taking longer than expected or desired, I often ask them if they know why a patient is called ‘a patient’. Usually this results in an inquisitive, speechless gaze. The word patient is derived from Latin:

Adjective: Able to accept or tolerate delays, problems, or suffering without becoming annoyed or anxious.

 

Noun: Person receiving or registered to receive medical treatment.

Citation

 The precise meaning of the medical definition of patient continues to be inconsistent, likely as the medical field and society continue to evolve. As such, a renowned medical journal had even devoted an article in 1999 (!) to the discussion of the pros and cons of finding a new word for patient. The article’s conclusion was that the massive undertaking of changing the word ‘patient’ to something else (requiring it’s own research, implementation, and distribution efforts) is likely not worth the diversion of time, effort, and resources away from providing and innovating patient care.

A similar discussion is ongoing about the ‘cancer survivor’ label. For some, the term cancer survivor may allow recognition and unity. For others, it may result in discomfort, because they don’t feel that their journey was heroic enough or because the label may allow division among survivors or represents survivors’ guilt or even a Post-Traumatic Stress Disorder trigger. 

The reason for your impatience may change over time:

  • Initially, when you are newly diagnosed (and undergo testing, await treatment plan decisions and insurance authorizations), being impatient may be a reflection of a fear of the unknown, lack of control, or feeling overwhelmed. Starting cancer therapy is usually the best remedy to provide some relief. But in the interim, it may help to know that only a few cancer types and situations represent a true medical urgency/emergency. Even though anyone would like to have their cancer treated as soon as humanly possible, for the majority of cancer diagnoses, it is more important to be strategic. The quality performance of a number of strategically selected and rapidly evolving imaging, laboratory, and pathological tests will facilitate informed decision-making and the creation of a personalized cancer treatment plan that aims to optimize benefit and minimize harm. Furthermore, it also may help to know that there are many official organizations that hold cancer centers accountable for administering cancer treatments in a timely manner (e.g. the Commission on Cancer in the USA).  
  • Next, as you transition from the active treatment phase into the post-treatment phase, impatience may become more reflective of a frustration with the slow or incomplete recovery process, a need to gain more control over your life (and survival), or a desire to catch up on life that was abruptly put on hold for the cancer treatments. With respect to a frustration with delayed/incomplete recovery/healing, I would like to refer to a previous post on acceptance. The instinctive urge to catch up on lost time could be interpreted literally, since some cancer treatments can be really intense and prolonged. But it can also be interpreted figuratively: the cancer experience may have increased one’s awareness of their own mortality and ignited an urge to get certain things done ‘before time runs out’. It may help to know that your priorities will often change after a cancer diagnosis, allowing you to live closer to the essence of your life, catch up with (and perhaps even surpass) your pre-cancer trajectory! 

Please try to be more patient with yourself…..this is not a sprint, but a marathon! And I sincerely hope you will feel comfortable enough to ask your health care providers for help, if you feel ‘your mind is becoming your worst enemy’ and leads to dysfunction. There is no need for shame or embarrassment in this current time and age. You are only human – everyone has a breaking point!   

Together we stand strong! Please find below a few things for education and entertainment!

Learn and Think:

  • Health maintenance alert! The American Cancer Society recommends that most people – those at average risk – start regular colon cancer screening at 45. People with an increased risk may need to start screening before age 45. Please discuss this with your health care providers! 

Live and Feel:

  • This non-profit organization, Action for Happiness, is devoted to making the world a happier place by providing various insightful tools and resources that promote the 10 essential keys to happier and more resilient living (for free or low cost).  
  • The original Lion King movie from 1994 is one of my favorites. Its music and story themes (circle of life, the good prevails) resonate with me. [The Lion King 1 1/2 movie is hilarious, which tells the Lion King story from the perspective of Timon and Pumbaa]. This weekend the Lion King movie’s remake premiered – I didn’t get to see it yet – did you?! I love the Circle of Life song – click here for the video, see below for the lyrics! 

“Circle of Life”, partial lyrics

From the day we arrive on the planet
There's more to see than can ever be seen
More to do than can ever be done
There's far too much to take in here
More to find than can ever be found
But the sun rolling high
Keeps great and small on the endless round

It's the Circle of Life
And it moves us all
Through despair and hope
Through faith and love
Till we find our place
On the path unwinding
In the Circle
The Circle of Life

I create and maintain this platform on my own. Please help by nudging me if you encounter technical problems.

 

 

Acceptance – Nutrients, Perfectionism, Photo Ark

Acceptance – Nutrients, Perfectionism, Photo Ark

 

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Dear travel buddy!

How is the summer treating you so far? If you are able to go outside, please protect your skin. In addition, for those undergoing active cancer treatments, please explore with your cancer provider if these could increase your skin sensitivity. On the other hand, if you are watching the summer pass by from the side of the pool, or even inside, then please know you are not alone! I am sure there are many other persons, including myself!, who prefer or are in need (for e.g. physical reasons) to stay on the side-line, which may result in feeling like an outsider.

But what are we trying to “fit into”, really? And who defines or decides who does or does not fit? This makes me think of Hans Christian Andersen’s  Ugly Duckling story about a swan’s egg that ended up in a duck’s nest! Other ducks gave the “ugly duckling” a hard time, because he appeared and behaved differently. But when the ugly duckling encountered other swans, his perspective changed. His self-image and confidence improved for the better: he wasn’t ugly after all! The humbling experience also led to a silver-lining insight:

He felt quite glad that he had come through so much trouble and misfortune, for now he had a fuller understanding of his own good fortune, and of beauty when he met with it. [Source].

For me the morale of the story is that trying to ‘fit in’ may not be the best approach, because it has a moving target of which the standards are driven by the constantly changing societal norms and pressures. Furthermore, striving to fit in may force us to portray ourselves differently to the outer world than we feel on the inside. This facade may result in us losing touch with our inner values and principles, and drain our soul.

This is valid for every person, but perhaps more so for cancer survivors who may not always be able to conform to society’s expectations. Their bodies may have been disfigured. Dysfunction or disability may interfere with one’s ability to climb the career ladder. Cancer treatment related infertility or financial difficulties may ruin one’s ability to create the picture-perfect life.

Instead, pursuing acceptance and belonging may be a healthier approach, although it still requires effort (as does every meaningful relationship!). But this pursuit may be easier to sustain, because it is ideally based on authenticity and thus may allow you to remain more true to yourself. But determining where you belong starts with you finding the “new you” and accepting this “new you” in the post-treatment phase!

Life is a journey….enjoy your personal rediscovery, frank conversations with your loved ones about your (likely altered) abilities/needs/wants, and the expansion of your social circle with more people who ‘like you just the way you are‘! [sorry – I could not help myself as a Pittsburgher].

Together we stand strong! Please find below a few things for education and entertainment!

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Weight – Nature Therapy, Survivor Story

Weight – Nature Therapy, Survivor Story

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Dear co-traveler!

How have you been? I hope you were able to spend the Holiday weekend making new memories, doing the things you love (including doing ‘nothing’!?) with people who are meaningful to you. If you had to work, then I would like to thank you for your service – and wish you happy preparations for your next Holiday weekend!

This week, I will share a bit about my weight challenges. I know I am not the only one! As we age, maintaining and losing weight might become (much?!) more challenging than when we were younger. In addition, some cancer treatments can also lead to weight gain, directly or indirectly.

And that brings it back to me! I have gained quite a bit of weight in the aftermath and it seemed that my weight was only going up and up, seemingly independently of what I tried. I tell my patients general principles that I have shared with you before. Even though I am a physician who is supposed to know how to do this (“do as I say, not as I do!”), I realized there is still a lot I need to learn and I may need a little help!

Everyone is different, and so everyone needs to find the tools that work best for them and fit best with their personality/lifestyle. And that may take some trial-and-error efforts. In the current time and age, there are so many different help tools out there. I wish for you that, with patient persistence, you will gracefully find what works for you. But at the end of the day, motivation and ability are crucial.

In terms of motivation, the following proverb says it all: “You can lead a horse to water but you can’t make him drink”. You cannot force someone to accept an offer or opportunity. The timing has to be right and only you know when you are ready.

And last but not least one’s ability is crucial. Your motivation may be on target, but you may be hindered by factors such as your physical or financial abilities. Your body may not (yet?) allow you to move or eat the way you would like or even need to. We all have to find and accept that happy medium that is different for everyone and can vary over time.

For now, I think I have found strategies that seem to be able to help me turn the course, resulting in my child-like excitement (in sharp contrast to my family’s speechless response) when the scale showed a long-desired drop in weight, even if it was only 0.2 lbs! It’s the little things that matter – babysteps!

Please keep in mind the following key concepts:

Until the next time! In the mean time, please find below a few things for education and entertainment!

I create and maintain this platform on my own. Please help by nudging me if you encounter technical problems.

Learn and Think:

Live and Feel: