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Pain

Cancer: Touch

Cancer: Touch

Humans crave touch, which can mean different things to different people…

Someone may desire to be touched physically in a manner that reflects passion, desire, love, or care, releasing hormones that promote trust and bonding. The physical touch can be delivered by a loved one, a random person (when standing close to each other in the elevator, for example), or even an animal. A lack of physical touch may result in touch starvation or skin hunger. 

Emotional touch is when a living creature, whether an animal or another human being, is able to connect with your thoughts, feelings, intellect, mind, or soul in a way that makes you feel valued, appreciated, and respected. This can take the form of a meaningful look exchanged in line at the grocery store, a random conversation with a stranger in a coffee shop. Moments like this may make you feel like you have known this person for years while you have just met for the first time. These brief moments cannot always be acted upon and may just remain random memories that you hold onto as a trail of lights illuminating your path through life, but sometimes, when the time or place is right, they may lead you to expand your social circle by finding more like-minded people with whom you share priorities and values. 

Cancer survivors may have a conflicting relationship with touch. They may desire more touch to help soothe and comfort themselves, but may be concerned to be a burden to loved ones. Survivors may be apprehensive given contamination risk from infections (please ask your provider for advice). Physical touch may also release negative emotions or repressed memories that have kept one from progressing in their healing.  Touch can be physically painful depending on the nature and lingering effects of cancer treatments.

The point I’m trying to make is that cancer survivors are still human, although our preferences for touch may have changed. Please be kind to yourself and openly communicate with loved ones to ensure that your needs, wants, and boundaries are being respected. Let them know how you’d love to stay in touch!


And now…..drum roll…..! I am very excited to be able to announce today’s launch of our Facebook group for post-treatment cancer survivors, who have completed their active therapy phase (i.e.. surgery, radiation, chemotherapy). For now, we will only focus on this specific group, but please note that there are other Facebook groups for those living with cancer and/or undergoing active therapies. My hope is that this Facebook group will provide a sense of community, validation, empowerment, and a safe place for healing. We are stronger together! Please let others know about this resource. This group does not offer medical advice (see Facebook group rules and disclaimers on https://cancersurvivormd.org/disclaimers/).


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Cancer: Why Me? Why Now?

Cancer: Why Me? Why Now?

Many of my patients understandably wonder and ask, “Why did I get cancer?” I do not necessarily have a medical or scientific answer. I wonder if the question behind the question is, “Why me?” From that question comes others: “Why now? Can it happen again? What can I do to prevent that?” 

There are certain risk factors that predispose one to cancer. These factors (including genetics, environment, and lifestyle) are also associated with poorer outcomes for certain patients. However, there is not always a cause-effect relationship. 

My late mentor taught me a simple way to explain the different levels of cancer risk; it can also be applied to those who carry a cancer diagnosis. On the one end is the general population for whom gender/age appropriate cancer screening guidelines apply. On the other end are those whose families transmit the cancer gene. For this group, we have proactive and comprehensive approaches to try to decrease the risk. Lastly, is the in-between group whose cancer risk is unknown. These are people who have had one cancer diagnosis. This puts them at an undefined higher risk than the general population to get another cancer, but at lower risk than those who harbor the cancer gene. (Unfortunately, data is lacking for those “in-between” individuals, so we resort to general population guidelines). 

Even though we are in the 21st century, nature and our bodies remain a mystery with many unknown variables. Sometimes we just really don’t know why cancer happens to you or why it happens when it does. Questions that probe the why are good, though. Our why questions reflect how we cope with our diagnosis and try to make sense of it. They indicate our curiosity to try to understand the mystery of life. This is healthy as long as we acknowledge that life’s mystery is one that likely won’t be unraveled entirely for another few generations, if ever.

A cancer diagnosis never comes at the right time. (If not now, when?) It can happen to anyone. (If not you, who?) As the current pandemic teaches us, we are not invincible or immortal. Life is not fair. Embrace your curiosity and let it empower you without letting it overwhelm you. 

Be kind to you and others….

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Cancer and Intimacy

Cancer and Intimacy

Sexuality plays an important role in society, facilitates reproduction, and helps us to feel connected to our partner as well as to ourselves. When you are told that you have cancer, it can affect the desire of either or both partners. For some people, desire decreases (as they are distracted and not in the mood), while for others physical intimacy may sooth or provide welcome distraction.

Cancer therapies can affect sexuality in many ways. Qualitatively, your routine sexual act may need to be adapted due to anatomical changes (e.g. pelvic or breast surgeries) or functional changes (e.g. erectile dysfunction, vaginal dryness or scarring). Quantitatively, the frequency and duration of sexual acts may change, usually lessening. Reasons for the latter can be due to the experience of pain, discomfort, shame, or guilt, but also because one’s desire may be decreased when going through premature menopause/andropause, anxiety, or depression.

Oftentimes, I see couples, whether in brand-new or long-lasting relationships, in which I sense that both partners are longing for a connection but are not communicating about this out of concern for disrespecting or hurting the other. Finding a safe environment for this communication may help healing to begin. Also, it may encourage a cancer survivor to feel confident enough to talk with a health care provider to find if there is anything that can be done to improve matters.

There are medications and devices that can improve, if not resolve, anatomic/functional deficits. (As a gentle reminder, hormone replacement therapy is not an option for those who are survivors of tumors that are fueled by hormones.) Talk- and/or pill-therapy can emotionally support partners.

However, at the end of the day some things may not be fully restored to the pre-diagnostic state. Some emotional and physical scarring may be permanent. In these situations, partners may have to work harder and be more creative in finding ways to connect with each other in ways that are enjoyable, pleasurable, and satisfying for both. In addition to intimacy, identity and security can also be altered by cancer. Therefore, even couples who have been together for a long time may need to reset and rekindle their relationships. Keep in mind that sexuality is one form of physical intimacy. You may want to explore other forms of physical intimacy, such as sensuality and eroticism.

There are many other ways of being intimate that can enhance or compensate for the impaired ability to connect physically. Examples of these alternative forms of intimacy are emotional (connecting with someone else in spoken or unspoken ways that express your love), intellectual (participating in communication about a topic that both parties are passionate about), and experiential (sharing activities and making memories together).

Enjoy connecting!

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Learn & Think, Live & Feel:

My family decided to go all in. For years we have held ourselves back due to various issues including active or anticipated medical issues. Recently, we decided to get some more love in our house. A month ago, we expanded our family to include our beloved cat, Melky. In another month, we will be expanding again with a dog, Cookie. We are fully aware that having a pet may bring more responsibilities, worries, and expenses, so we have backup plans in place, but we do not want to miss out anymore on the therapeutic joy pets can bring. Stay tuned for our adventures!

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The Freedom to Move….!

The Freedom to Move….!

Not all of us are meant to be ballet dancers, but being fit as well as having stamina, strength, and range of joint motion contribute to one’s ability to dance through life. Cancer treatments may have affected you physically and emotionally. Pain, malaise, fatigue, low blood counts, difficulty breathing, etc., resulting in the loss of muscle mass and stiffness and painful body movements keep this vicious cycle of deconditioning going. You may not ever be able to regain your pre-cancer diagnosis level of fitness, strength, and flexibility, but it can often be improved upon.

Be sure to first discuss with your doctor if more diagnostic testing may need to be performed and which one of these following options might be a best choice for you given your health, availability of resources, and/or insurance coverage. Upon reconditioning, the eventual goal is to try to participate in a safe and consistent exercise program.

You can work with professionals to rehabilitate your strength, ability, and balance. This can be through e.g. physical therapistoccupational therapist, cancer-certified exercise trainer, or an exercise physiologist

It can feel frustrating when you have pain, stiffness, and a limited range of motion, especially when no clear biological explanation or helpful remedy can be found. It’s persistence can lead to dysfunction, disability, and emotional distress. One option to consider is a technique called Myofascial ReleaseThe evidence has shown this techniques to be safe, gentle and effective.  The essence of the technique involves the professional application of gentle pressure or a pulling motion  (“telescoping”) that will allow the careful release of tight myofascia

Most likely you are familiar with the plastic wrap that is commonly used in the kitchen and that can get wrinkled up before you are able to cover the intended target resulting in needing to get a new piece of plastic wrap and starting the process all over again! Your body has a similar “wrap”, called myofascia, that covers your organs, bones, tendons, and muscles. It can become tight due to stress,  physical and emotional trauma, medical procedures, or injuries. These may result in stiffness, a limited range of motion, and pain in areas that may not make anatomical sense. Since this fascia is connected through your whole body like a web, you may not feel the symptoms in an expected location (for example, if you pull on the bottom of your shirt, you might feel that in your shoulders). Your nerves and blood vessels run through this web, which can produce unique symptoms, when the ‘web’ tightens.

To find relief, you can 1) try various self-help myofascial release methods that can stand on their own and/or 2) consider working with a professional. Having someone to partner with in developing a plan, such as a dedicated professional can alleviate not only your pain but also the stress. Locating a professional can be challenging depending on your location. There are a variety of providers that can offer myofascial release such as physical therapist and chiropractors. As with any field, please be sure to seek out someone who has undergone and continues in their specialized training and certifications, such as those providers trained in the John Barnes Method of Myofascial Release.

Enjoy moving through life, with grace, one dance at a time!

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