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TAKING
CARE
of your
CANCER
POCKET GUIDE
RESOURCES
TAKING CARE of YOUR CANCER
TAKING CARE of YOUR CANCER
Use this guide
for info on cancer care,
to organize your data
and as a quick resource.
TABLE of CONTENTS
DEALING WITH THE DIAGNOSIS
1
YOUR ROAD TO RECOVERY
2
KNOWLEDGE IS POWER
3
MY CONTACTS
4
TEAM UP
7
KNOW YOUR
TREATMENT OPTIONS
9
TAKING CONTROL
OF YOUR TREATMENT
12
MANAGING YOUR MEDS
13
Daily Medicine schedule
15
CHANGES AHEAD: WHAT TO
EXPECT FROM TREATMENT
17
THE BENEFITS OF
NUTRITION THERAPY
23
STAYING ACTIVE
29
PAIN MANAGEMENT
32
COMMUNICATING: TIPS FOR
TELLING FAMILY AND FRIENDS
33
ANXIETY AND STRESS
34
DEALING WITH
DEPRESSION
35
WORK CONCERNS
36
LIFE GOES ON: WHAT TO EXPECT
AS A CANCER SURVIVOR
37
QUESTIONS TO ASK
MY DOCTORS
40
NOTES
41
DISCLAIMER. This book provides general information about cancer
care and related issues. The information does not constitute medical
advice and is not intended to be used for the diagnosis or treatment
of a health problem or as a substitute for consulting with a licensed
health professional. Consult with a qualified physician or health care
practitioner to discuss specific individual issues or health needs and
to professionally address personal medical concerns.
1
DEALING
With
the
Diagnosis
YOU’RE NOT ALONE
There’s no doubt that receiving a diagnosis of cancer is life
altering. Many things are about to change in a big way. But
millions of people battle the disease each day, leading
productive lives and winning the fight.
HOPE IS ON YOUR SIDE
Cancer is a struggle and a challenge unlike any you’ve probably
ever faced. But you’ve got hope on your side. Experts continue
to understand cancer’s causes and cures. New treatments are
developed that enable patients to live better for longer.
Depend on your support team
resources during this time:
Your doctors, specialists
and health care team
Family
Friends
Caregivers
Church groups
Fellow patients
These people will support and
guide you through the process
and make your personal road
to recovery a lot less bumpy.
CANCER FACTS
CANCER FACTS
There are more
than 100 types of
cancer. Any part of
the human body
can be affected.
2
YOUR ROAD TO RECOVERY
YOUR ROAD TO RECOVERY
ONE IN THREE
One out of every three adults in the U.S. will receive a cancer
diagnosis in his or her life. Each year, more than a million people
get the scary news and have to deal with its effects. Survival rates
keep getting better as new treatments and medication improve.
NOW IT'S PERSONAL
The journey you’re about to set out on is as unique as you are.
Cancer is a complex condition, and how you and your health care
team deal with it could be just as unique. The road you take from
diagnosis to recovery may be swift and straightforward. It also may
have a few detours and take a while to get there. The healthcare
team working to get you cancer-free may use a number of different
methods. New therapies and medicines are helping people beat
cancer, or live longer with less pain while dealing with the disease.
YOUR ROAD, YOUR QUALITY OF LIFE
Think of your cancer cycle in four parts:
DIAGNOSIS
Your health team runs tests to confirm
the cancer and find out where it is, its
type, how widespread it is and its traits.
TREATMENT
Your doctors will work closely with
you to decide the best options for
treating your cancer: surgery, radiation,
chemotherapy and other therapies.
RECOVERY
This return to normal includes a plan
for preventing your cancer’s progress
or return, making healthy lifestyle
decisions and attending follow-up visits.
AFTERCARE
Making your quality of life better by
working with caregivers and managing
any long-term side effects of the treatment.
The milestones on this cycle are different for everyone.
You may spend more time at one while others speed
by. Each journey is different for different people.
3
KNOWLEDGE IS POWER
ORGANIZATION IS KEY
BATTLE ONE
Conquering cancer is a full-scale
campaign with many battles
to win. Your first defensive
strategy is to get informed
and stay informed. Fear of
the unknown is often one of
our greatest enemies. Learn as
much as you can about your
type of cancer. This will help
put your mind at ease and help
you figure out your options for
treatment. Find info online or
through your treatment center.
Yo u r second strategy is to
get organized. Gather your
health care team and empower
your family and friends to come
to your aid. Keep contact info,
appointment dates and times,
medication schedules, exercise
logs and other vital info written
down and easy to access. There
are places in this guide to keep
track of some of these items.
ONLINE
INFO
OVERLOAD
The Internet is a great source
for info on cancer and caring for
the disease. Message boards,
chat rooms, support groups
and resources on specialists,
health care coverage and
medications are useful online
tools. Because of the wealth
of info there, the Internet
can be overwhelming. The
Internet can’t take the place
of your doctors, pharmacist
or insurance provider. But you
can use your research there
in conversations with your
health care team. Knowledge
is indeed power. Arm yourself
well and you’ll be better
prepared for the battle.
CANCER FACTS
CANCER FACTS
The word “cancer” is related to the Greek word “crab”
because its finger-like projections were similar to the
shape of the crab.
MY CONTACTS
MY CONTACTS
( )
( )
( )
( )
( )
( )
( )
( )
4
MY CONTACTS
Emergency Contacts
Emergency response: 911
Name:
Relationship:
Cell Phone:
Home Phone:
Name:
Relationship:
Cel
l Phone:
Home Phone:
Medical
My General or Family Doctor:
Phone:
Cancer Specialist:
Phone:
Hospital:
P
hone:
Social Worker:
Phone:
5
MY CONTACTS
MY CONTACTS
MY CONTACTS
( )
( )
( )
( )
( )
( )
Health Insurance Provider:
Phone:
Website:
Case Manager:
Phone:
Other Professional Contacts
Name:
Service/ function:
Phone:
Na
m
e:
S
er
v
i
ce/ function:
Phone:
Name:
Service/ function:
Phone:
Name:
Serv
ice/ function:
Phone:
MY CONTACTS continued
MY CONTACTS continued
MY CONTACTS continued
6
( )
( )
( )
( )
( )
( )
Family Members
Name:
Phone:
Name:
Ph
one:
Name:
Ph
one:
Name:
Phone:
Name:
Ph
one:
Name:
Ph
one:
7
CANCER FACTS
TEAM UP
BUILD YOUR CANCER CARE
DREAM TEAM AND SCORE
WINNING RESULTS
FIGHTING FOR YOU
Did you know that before you enlist the help of doctors, nurses,
specialists, family members and friends, you already have a strong
ally fighting to keep cancer away from you? It’s your own body. It has
built-in fighters that routinely kill off cancerous and pre-cancerous
cells on its own each day. You can help this amazing warrior by
feeding it healthy foods and keeping it physically and mentally active.
Next up: Your doctor and health plan will refer specialists and
health care providers to care for you during your entire treatment.
If you don’t have these important people in your life yet, ask your
insurance provider or talk to those you know who’ve dealt with
cancer and see who they recommend.
STAFFING YOUR
SUPPORT TEAM
Now that you know your star
player is already on the case,
it’s time to gather the rest of
your team. Your network of
family, friends and support
groups can be a key source of
info, encouragement and help
during your therapy. Depend
on these people for their love
and support. They will want to
help, from emotional support to
aiding in daily responsibilities.
CANCER FACTS
Researchers believe
that more than half
of all cancers and
cancer deaths are
preventable.
8
LIST IT
Make a list of the activities you’ll need help with and assign
each task to a helper. These may include:
Housework
Transportation
Yard work
Pet care
Laundry
Shopping
Preparing
meals
TA SK HELPER PHONE #
Learn how to accept help if you’re used to taking care of yourself
without the help of others. If you’re not comfortable asking
for or accepting help, have a spouse or close friend arrange it.
Accepting help gives you the support you need and gives those
who love you the chance to share the load, encourage and help
get you well again.
9
KNOW YOUR
TREATMENT OPTIONS
CONVENTIONAL AND ALTERNATIVE THERAPIES
Your doctors will help you decide on the treatment plans best
for you and the type of cancer you’re dealing with. Conventional
therapies are the basis of most cancer treatment plans. These are
science-based medical practices that have been proven to be effective.
Alternative therapies can also add healing benefits. These methods
aren’t always scientific in nature but they aim to work alongside
conventional therapies to help the body’s immune system heal naturally.
CONVENTIONAL THERAPIES
SURGERY
Removing part or all of a tumor
through operation
CHEMOTHERAPY
Powerful prescription drugs that can
damage or destroy cancer cells
RADIATION
Targeted energy that can damage or
destroy cancer cells
IMMUNOTHERAPY
Stimulating the body’s immune
system so it can better fight cancer
HORMONE THERAPY
Adding, blocking or removing
hormones from the body to stop the
growth of cancer cells, used mostly
on breast and prostate cancer
CANCER
DEFINED
Oncology (
ahn-kol-uh-jee
); noun: The study
and treatment of tumors
Oncologist (
ahn-kol-uh-jist
); noun: A doctor
who specializes in treating people with cancer
KNOW YOUR CANCER CARE SPECIALSTS
Medical oncologist: Specializes in treating cancer with chemotherapy
(drugs that kill cancer cells) or other medications, such as targeted
therapy and oral (pill form) chemotherapy.
Radiation oncologist: Specializes in treating cancer with radiation therapy
(the use of high-energy x-rays or other particles to kill cancer cells).
Surgical oncologist: Specializes in removing tumors and surrounding
tissue during an operation.
Hematologist: Specializes in blood disorders
and blood cancers.
10
FAST STATS
About 70 percent of people with cancer use a type of
alternative medicine such as diet supplements and nutrition
therapy along with conventional treatment.
Supporting the mind, body and spirit with natural therapies is
being used by more people than ever. These complementary
methods promote the body’s natural healing process. They
treat the causes of illness rather than just the symptoms.
For cancer patients, these treatments have been known to
ease the pain and discomfort of side effects. They’ve also
been shown to make conventional therapies work better for
a more successful overall treatment.
ALTERNATIVE THERAPIES
NATUROPATHIC
MEDICINE
Using the power of nature to help
heal the body
NUTRITION
THERAPY
Using wholesome foods for their
healing power
DIETARY
SUPPLEMENTS
Using nutrients, herbs and other natural
food supplements as effective medicine
ACTIVITY
Staying active in order to boost the
immune system
MIND-BODY
MEDICINE
Using the power of the mind as a
source of healing the body
SPIRITUALITY
Finding comfort from nurturing your
spiritual side
ACUPUNCTURE
Using small needles inserted into
the skin to ease pain and treat
various conditions
Ask your doctor if these treatments are right for you.
11
These complementary and alternative cancer treatments aren’t
usually strong enough to do the work of conventional cancer
meds. Talk to your doctor about a balance of them to help with
other conditions and side effects.
IF YOU HAVE TRY
Pa i n
Acupuncture, aromatherapy,
hypnosis, massage, music therapy
Anxiety
Hypnosis, massage, meditation,
relaxation techniques
Tiredness
Exercise, massage,
relaxation techniques, yoga
Nausea and
vomiting
Acupuncture, aromatherapy,
hypnosis, music therapy
Trouble
sleeping
Exercise, relaxation techniques, yoga
Stress
Aromatherapy, exercise, hypnosis,
massage, meditation, tai chi, yoga
Ask your doctor wha
t to expect after chemotherapy,
radiation or any type of cancer treatment.
QUESTIONS TO ASK YOUR HEALTH
CARE TEAM ABOUT CONVENTIONAL
AND ALTERNATIVE THERAPIES:
FIND OUT MORE
National Cancer Institute:
Complementary and Alternative Medicine in Cancer Treatment
cancer.gov/about-cancer/treatment/cam/patient
12
CANCER FACTS
TAKING CONTROL TREATMENT
of
YOUr
GETTING PERSONAL
Treatment paths and strategies are different for different patients.
Thankfully, there’s no assembly line care. You’re a unique person.
Your treatment should be too. Your doctor will assess…
Your diagnosis
Your medical history
Your age
Your current health
…to develop a treatment
plan that’s best for you.
CANCER FACTS
Worldwide there
are 28 million
cancer survivors.
You have options when choosing a treatment strategy. In the past,
some conventional treatments were very harsh on the system.
Advancements in medicine have made these easier to take. Side
effects have been greatly eased with the advent of new drugs,
relieving the pain and nausea and promoting quicker healing.
Good food and fitness, as you’ll see later in this guide, go hand-
in-hand with treatment and recovery. Keep them at the front of
your mind as you take control of your treatment.
1
5
13
MANAGING YOUR MEDS
MEDICATION MISTAKES
TIPS FOR MAXIMIZING YOUR MEDS
MANAGING YOUR MEDS
RULE #1
Always follow your doctor’s or
pharmacist’s instructions on when and
how to take your medications. They’re
more likely to work well by doing so.
During your treatment you
may have many different medications to take at home, to treat
the cancer and to ease the side effects of treatment.
MEDICATION MISTAKES
Not following the exact instructions of doctors
Deciding to stop taking prescription meds because you’re
feeling better
Not staying on schedule and taking meds at the
prescribed time
Not taking meds because you don’t think they’re working
Missing or skipping a scheduled med and not knowing
what to do
Skipping doses or limiting them as a way to save money
TIPS FOR MAXIMIZING YOUR MEDS
Use these tips for getting the most benefit from your
prescribed treatment:
1
Read the entire label of the medication container to make sure you
are taking the right dose. Double-check with your doctor, health
team or pharmacist if you’re not sure about how much to take.
2
Take your pills at the same time each day, such as first thing in
the morning or with lunch.
3
Use a weekly pill case so you know
if you’ve taken that day’s meds. Keep
the original container for reference.
4
Use a chart or schedule to
keep track of when you take
your medication. Some drug
manufacturers make apps that
can be downloaded to your
smartphone. These allow you to
keep track of when you take your
medications, as well as reminding
you of doctor appointments.
5
Keep daily reminders around–
such as on a bulletin board,
the refrigerator or in a day
planner–to help you remember
to take your medication.
6
Ask family members or
friends to help remind you.
7
Use technology to remind
you. Set up an automated
reminder on your computer
or phone.
2
3
4
6
7
14
Q: A:
HOW CANCER IS TREATED
HOW CANCER IS TREATED
Chemotherapy treatment is usually given in cycles. The cancer cells are
attacked when they’re at their weakest. Cycles allow the body’s normal
cells to heal and repair from the damage. Cycle time is made up of:
Duration of the cycle: Chemotherapy drugs may be given on a
single day, fo
r many days in a row or ongoing on an outpatient or
inpatient basis. Treatments could last minutes, hours or days.
Frequency of the cycle: Chemotherapy may repeat weekly, every
two weeks or once a month. Cycles are most often defined by
months. So two biweekly sessions are considered as one cycle.
The number of cycles: The length of chemotherapy from start to
finish is determined by research and lab tests, as well as how the
cancer responds to the treatment.
A WORD ON DRUG
INTERACTIONS
Before you start treatment, talk with your doctor about all of the meds
you’re taking. This will help prevent drug interactions. A drug interaction
occurs when two or more drugs conflict with each other in your system,
causing side effects. A sleep aid may mix badly with an allergy drug.
The results can produce an adverse reaction, such as slowing down your
reflexes, making driving a car dangerous. Drug interactions can be more
likely for cancer patients who may be on many medications. Follow the
instructions of your doctor and pharmacist.
Q:
For how
long do I
have to
take my
medications?
A:
Because there are so many
factors involved, you’ll
work with your doctors
to determine the length of
your treatment.
IMPORTANT!
Even though you may be focusing on treating cancer, you must
manage all health-related issues and care for maintaining your
general health. This means you can’t forget regular mammograms,
dentist appointments and blood pressure or diabetes
medications or treatments.
For how
long do I
have to
take my
medications?
Because there are so many
factors involved, you’ll
work with your doctors
to determine the length of
your treatment.
Q: A:
Q: A:
15
ROTATE ME!
DAILY MEDICINE SCHEDULE
Use this page to keep track of your medicines and when you take them. Enter the name of the
medicine in the first column and put a check mark in the boxes for the time(s) you take that
medicine each day. Keep this chart with you when you travel and go to doctor appointments.
MEDICINE BEFORE
BREAKFAST
Enter time:
WITH
BREAKFAST
Enter time:
BEFORE
LUNCH
Ent
er
time:
WITH
LUNCH
Enter
time:
BEFORE
DINNER
Enter
time:
WITH
DINNER
Enter
time:
BEFORE
BEDTIME
Enter
time:
AT
BEDTIME
Enter
time:
DURING
NIGHT
Enter
time:
DAILY MEDICINE SCHEDULE
Use this page to keep track of your medicines and when you take them. Enter the name of the
medicine in the first column and put a check mark in the boxes for the time(s) you take that
medicine each day. Keep this chart with you when you travel and go to doctor appointments.
16
ROTATE ME!
MEDICINE BEFORE
BREAKFAST
Enter time:
WITH
BREAKFAST
Enter time:
BEFORE
LUNCH
Enter
time:
WITH
LUNCH
Enter
time:
BEFORE
DINNER
Enter
time:
WITH
DINNER
Enter
time:
BEFORE
BEDTIME
Enter
time:
AT
BEDTIME
Enter
time:
DURING
NIGHT
Enter
time:
17
CHEMOTHERAPY
CHANGES AHEAD
WHAT TO EXPECT FROM TREATMENT
Very few battles are won without some changes along the way.
Cancer is one that will throw more than its fair share of changes
at you. How you deal with these changes can mean the difference
between winning the battle and heading for a setback.
Cancer patients have a better chance of a positive outcome when
they’re able to stay on their chemotherapy plan and work through
the many treatment cycles and high doses of radiation therapy.
If a patient is not strong enough to continue with treatment, the
physician usually stops the patient’s therapy until they get stronger.
CHEMOTHERAPY
You’ll meet with a medical oncologist before treatment starts. He or
she will review your records and do a physical exam. The doctor will
come up with a specific schedule based on your age, your overall
health and where the cancer is. This treatment schedule may consist
of a number of cycles given over a certain time period. Treatments may
go on for as long as your cancer responds to the chemo. The doctor
will also talk to you about the risks and benefits of chemotherapy.
You’ll learn what you should and shouldn’t eat or drink on the day of
your treatment so the chemotherapy will work best. Tell the doctor
about all medications and dietary or herbal supplements you’re taking.
What to watch for:
Your doctor might want to
plan for the most common side
effects of chemotherapy.
Nausea and vomiting: The best way to manage nausea and
vomiting is to prevent it. Talk with your health care team about
your risk of this side effect before treatment begins. There are many
medications that can prevent nausea and vomiting in most patients.
Dental health: Chemotherapy can cause mouth sores
and dry mouth. It can also make the body’s ability to
fight infection weaker. It’s best to have a complete dental
checkup and cleaning before starting chemotherapy.
Heart health: Some types of chemotherapy affect the heart. It may help
to measure your heart health before treatment. An echocardiogram
uses ultrasound waves to create a moving picture of the heart.
18
What to watch for: CONTINUED
HELPFUL TIP
Reproductive health: Some types of chemotherapy can affect fertility
(a woman’s ability to conceive a child or keep a pregnancy going
and a man’s ability to father a child). Both men and women should
discuss their options for maintaining fertility before treatment.
Hair: Hair loss affects many people on chemotherapy. Ask your
medical oncologist whether your treatment is likely to cause this
side effect. If it will, you may want to think about whether you’d
rather keep your head covered during treatment and whether
you’d like to buy a wig or hat before treatment begins.
HELPFUL TIP
Most communities offer resources for wigs, when losing
hair due to chemotherapy, as well as bras following breast
surgery. You can also find resources online.
During
treatment:
You may want to bring a friend or family
member on the day of the treatment. This
person can support you and help you
remember the info given you by the oncology team. You can
also bring items like music players, DVDs, books or a blanket
to make your treatment time comfortable.
If you’re getting chemotherapy by IV injection, you will:
Meet the nurse or other health team member giving
you the chemotherapy
Have a quick physical exam to check your vital
signs (blood pressure, pulse, respiration rate and
temperature)
Have your height and weight measured to figure
the right doses of chemotherapy
Have an IV catheter inserted into a vein in your arm
Have a blood sample drawn
Meet with your oncologist who will review the
results of your blood tests, consider your condition
before each treatment and order the chemotherapy
After treatment:
19
After treatment:
After your session is finished, the IV catheter will be taken
out and your vital signs checked. Your oncologist or nurse will
review what side effects to expect throughout the cycles of
chemotherapy and give you medication and tips to manage
them. Instructions may include:
Not being around crowds of people or with children
(especially those with illnesses or infections) while
your immune system is temporarily weakened.
Drinking lots of fluids over the next 48 hours to help
flush the drugs through your system.
Making sure to properly dispose of urine, stool, vomit,
semen and vaginal secretions because chemotherapy
typically remains in your system for 48 hours after
treatment. Flushing the toilet twice after use will help
protect family members from waste or other body
fluids that may contain chemotherapy particles.
Your medical team can tell you what type and level of
activities they recommend on trea
tment days. Make sure you
have the phone number of the oncologist’s office so you can
contact the doctor with any questions or concerns.
Side effects:
After chemotherapy,
side effects may include:
Nausea and vomiting
Hair loss
Bone marrow changes
Mouth and skin changes
Changes in sex drive
Fertility problems
Memory changes
Emotional changes
The good news is that there are things you can do to keep
from having these side effects, or at least lessen them. Talk
with your doctor or nurse if you have any side effects.
20
HELPFUL TIP
Side effects: Continued
Keep in mind that not everyone gets the same chemo drugs.
Chemo given for some cancers may cause more side effects
than chemo for other cancers. Your general health and fitness
will also affect how your body reacts to chemo. Some people
are able to go on with what they always do while getting chemo.
But some people need to be in the hospital so doctors can
watch them closely and treat certain side effects.
Most people have to change their work schedules to get chemo.
Ask your doctor and nurse what you’ll be able to do while you’re
being treated, on chemo days and in between treatments.
HELPFUL TIP
Check with your case manager or community or care
coordinator as they may be able to provide transportation
for chemotherapy, radiation or surgery.
FATIGUE
Extreme fatigue and tiredness following cancer
surgery, chemotherapy or radiation is common. It’s
the most common side effect of treatment. Fatigue
is described as feeling:
Tired
Wea k
Wor
n ou t
Heavy
Slow
Without energy
It’s important to know that fatigue felt from cancer treatment
is different from fatigue felt by healthy people. Cancer patients
get tired after less activity than people without cancer. Cancer-
related fatigue is often caused by anemia and is not wholly
eased by sleep and rest. It may last for a long time. The fatigue
gets better after cancer treatment ends, but patients may still
feel some fatigue for months or years.
Some people with cancer are not able to get enough sleep. These
problems related to sleep may cause fatigue:
Waking up during the night
Not going to sl
eep at the same time every night
Sleeping during the day and less at night
Not being active during the day
Getting help with fatigue may prevent some of these problems
and improve quality of life.
21
WEIGHT LOSS
WEIGHT LOSS
Along with cancer fatigue come changes in weight and loss of muscle
tone. These symptoms can be treated, making you feel better and
letting you carry on with your usual activities and keeping up your
strength to finish treatment.
The cancer itself can cause weight loss. In fighting the cancer, your body
creates a substance that can lead to weight loss, muscle loss and loss of
appetite. Because radiation and chemotherapy can cause a loss of appetite,
nausea and mouth sores, weight loss is likely with these treatments.
Yo u r
nutrition counselor should address with you the issues
affec
ting your therapy, especially if you’ve had side effects from
chemotherapy and high doses of radiation. These issues are:
Fatigue
Changes in tasting foods
Metallic taste in the mouth
Mucositis (low levels grade 1 and 2,
and severe levels of grade 3 and 4)
Nausea and vomiting,
how to eat when you don’t want to
Severe weight loss
Maintaining your weight and building strength
Along with taking your cancer medicines, there are many things
you can do to help your body stay strong. Good, balanced
nutrition and proper hydration are very important. So try these:
Eat a balanced diet. Include protein to protect lean body mass. Beef,
pork, tofu and soy nuts are great sources of protein. So are dairy
products. Try Greek yogurt, which is higher in protein than regular
yogurt.
Eat more calories. Choose nutritious foods you like. If you have little or
no appetite, try eating smaller, more frequent meals. Make milkshakes,
smoothies, and purees, and add milk or protein powder to your foods.
Drink plenty of liquids throughout the day. Water is best. You can
also get fluids from soups, Popsicles, sports drinks and Pedialyte
®
.
Physical exercise helps in building new muscle and decreasing fatigue.
Start off slowly. If you’re really tired or weak, start with just a few
minutes of walking at a time and build up from there. Some upper
body exercises while sitting in a chair can also help you regain strength.
Keep a journal. Note the type of exercises or other physical activities
you do and how they affect your mood and energy level. Seeing the
positive benefits may encourage you to keep moving.
22
ROTATE ME!
Use this log to record your physical and emotional feelings after treatment.
POST TREATMENT LOG
TREATMENT
TYPE
DATE of
TREATMENT
HOW I FEEL:
NEXT
DAY
HOW I FEEL:
1 MONTH
LATER
HOW I FEEL:
3 MONTHS
LATER
23
CANCER FACTS
WHOLESOME = HEALING
THE BENEFITS OF
NUTRITION THERAPY
WHOLESOME = HEALING
FOOD AS MEDICINE
As mentioned earlier, one of the easiest and most powerful
ways to better your chances in the fight against cancer is to eat
a wholesome and varied diet.
Cancer-fighting compounds are found in vegetables like cabbage
and broccoli, and in fruits like berries. These can fight the
spread of cancer cells.
CANCER FACTS
The National Cancer Institute recommends eating at least five
servings of fruits and vegetables a day.
Conventiona
l therapies have been shown to be more effective when
working with the nutrients in unprocessed foods. Fruits and veggies
that are bright in color and cold water fish have compounds that can
make chemotherapy and radiation treatment more powerful, while
protecting healthy cells from the toxic effects.
Adversely, eating an excess of foods such as sweets, refined
carbohydrates and alcohol can promote the spread of cancer.
These foods can get in the way of your immune system’s ability
to fight cancer cells.
FOOD ALERT!
Steer clear of foods with trans fats. You can find
these in many processed foods and margarines.
Look for trans fats and other saturated fats on
labels. They’re so unhealthy, food makers must
list their amounts on packaging.
24
MY NUTRITION
Healthy eating is a must, no matter
your condition. Here are some healthy
eating tips from ChooseMyPlate.gov:
TIP
Make half your grains whole
Foods made from wheat, rice, oats, cornmeal, barley or
other cereal grains are thought of as grain products. These
foods are bread, pasta, oatmeal, breakfast cereals, tortillas
and grits. Eating whole grains as part of a healthy diet has
shown a reduced risk of some chronic diseases.
TIP
Vary your veggies
Vegetables supply vitamins and minerals and most are low in calories.
Make one-fourth of your plate veggies. Veggies bright in color are vitamin
and mineral-rich, as well as tasting great and being great for you.
TIP
Focus on fruit
Like vegetables, fruits lessen the chances of disease as they
supply nutrients vital for health. Most fruits are naturally
low in fat, sodium and calories and don’t have cholesterol.
TIP
Get your calcium-rich foods
Milk, yogurt and cheese make up the dairy group. They have
calcium, vitamin D, potassium, protein and other nutrients
needed for good health all through life. Soymilk is a good
dairy substitute for people who are lactose intolerant.
TIP
Go lean with protein
We all need protein, and most people ages 9 and up should
eat 5 to 7 ounces of protein foods each day. Protein foods
come from both animals (meat, poultry, seafood and eggs)
and plants (beans, peas, soy products, nuts and seeds).
FAST STATS
30 percent of cancers could be prevented by
staying away from alcohol and tobacco, eating
healthy foods and getting physical activity.
25
2
1 3
4
WHEN NUTRITION
MATTERS MOST
Cancer releases chemicals into your body that can wreck your
appetite. At the same time, they raise the calories and nutrition
levels you need. Some conventional cancer treatments can hinder
your appetite, make you nauseous and tired and get in the way of
digesting food and absorbing the nutrients.
More bad news: If you’re malnourished, you may get less benefit
from chemotherapy and have more side effects, generally feeling
worse overall. So it’s critical that you make sure the foods you’re
eating are as nutritional as possible. Talk to a dietitian or nutritionist
if you’re concerned about your nutrition. They will work with you
on a plan for healthy eating.
FOUR TIPS FOR A HEALTHY, ANTI-CANCER DIET
FOUR TIPS FOR A HEALTHY, ANTI-CANCER DIET
Use these tips for getting the most benefit from your
prescribed treatment:
1
Eat lots of fruits and
veggies: Eating five to 10
servings of fresh or frozen
vegetables and fruits is
best. Juices and smoothies
count and are a great way of
getting the needed nutrients.
2
Switch to unsaturated fats:
Essential fatty acids in olive oil,
canola oil and flaxseed oil is
crucial for good health. They
also make cancer treatment
more effective. Saturated
fat from animal products,
fatty meats and processed
hydrogenated fats have
been linked to cancer.
Other good forms of
essential fatty acids:
Fish and shellfish
Soy
Pumpkin
Sunflower seeds
Walnuts
3
Get enough lean protein:
Extra protein during treatment
boosts your immunity and
protects lean muscle mass.
Limit your amount of red
meat and choose these forms
of lean protein:
Eggs
Yogurt
Fish
Soy
Beans
Lean mea
ts
4
Focus on the whole grains:
Essential nutrients can be
found in whole-grain cereals,
breads and rice. These
help regulate blood sugar,
eliminate waste and boost
immunity.
26
MEATS & BEANS
MILK & DAIRY
BREADS & GRAINS
F
VEGET
FRUITS
ABLES
ATS, OILS & SAUCES
HEALTHY FOODS
SHOPPING LIST
MILK & DAIRY
Fat free or low-fat milk
Low-fat yogurt
Low-fat cheese
Cottage cheese
BREADS & GRAINS
Whole wheat bread
Whole wheat
English muffins
Corn tor
tillas
Whole wheat tortillas
Multigrain cereal
Brown rice
Enriched pasta
MEATS & BEANS
White meat chicken
(no skin)
Whit
e meat turkey
Lean beef
Pinto beans
Navy beans
Black beans
Fish
Eggs
FRUITS
Bananas
Grapes
Oranges
Pears
Peaches
Strawberries
Apples
Canned frui
t in
light syrup
Watermelon
Cherries
VEGETABLES
Carrots
Broccoli
Spinach
Let
tuce
Tomatoes
Green beans
Canned or frozen
vegetables (no salt)
Collard greens
Celery
Peppers
Onions
Mushrooms
Cucumbers
FATS, OILS & SAUCES
Salsa
Low or
nonfa
t
salad
dressing
Mustard
Vegetable oil
Vinegar
GRAINS
27
FRUITS
VEGETABLES
MY HEALTHY
SHOPPING LIST
GRAINS
VEGETABLES
FRUITS
MY HEALTHY SHOPPING
LIST continued
28
DAIRY
PROTEIN
NUTRITIONAL SUPPLEMENTS
DAIRY
PROTEIN
NUTRITIONAL SUPPLEMENTS
NOTE: Nutritional supplements may be covered under your
insurance plan. Depending on the type of cancer, plans often cover
vitamins and nutritional supplements.
FIND OUT MORE
National Cancer Institute: Nutrition in Cancer Care
cancer.gov/about-cancer/treatment/side-effects/appetite-loss/
nutrition-pdq#section/all
STAYING
ACTIVE
29
STAYING
ACTIVE
FAST STATS
Exercise such as walking
can lessen the risk of breast
cancer. Any exercise that
raises your heart rate to
the “break a sweat” level
is good for you and helps
fight off cancer.
Q
What's the best
boost for your
immune system?
A
Physical
activity.
THE BOOST
During treatment and recovery, any physical activity is helpful.
From a full gym workout to light resistance exercises, it’s
important to stay active and give your immune system the boost
it needs. When your body is strong, it can better stand the rigors
of conventional treatment and heal quicker.
Health care providers now know that…
An immune system strengthened by exercise may respond
better t
o conventional therapies.
Exercise may ease pain and nausea, while improving
endurance and mood.
Exercise produces needed red blood cells.
Staying active can help you stay mobile, keeping you as
independent as possible during and after treatment.
CAUTION
Check with your oncologist before
starting a new exercise program.
A physical therapist can suggest
appropriate exercises if your treatments
limit what you can do.
30
THE BENEFITS OF
FITNESS THERAPY
Physical
therapy
Improves flexibility and coordination,
rebuilds strength, eases pain. Can include
aerobic exercise such as walking, swimming
or jogging to training with resistance bands
and light weights.
Occupational
therapy
Returns you to normal daily functions and
activities, restoring your independence.
Speech
pathology
Helps you regain speech and communication
skills that may have been affected by cancer.
It can also help with eating and swallowing.
Manual
therapies
Massage can ease pain and anxiety, as well
as some side effects such as swelling.
Three parts of a complete fitness program:
1
CARDIOVASCULAR: Aerobic exercise that raises your heart
rate, such as walking, cycling, climbing stairs and jogging.
BENEFITS: Increases stamina; may protect the heart and
lungs from the toxic effects of chemotherapy.
2
STRENGTH TRAINING: Building muscle strength and tone.
Resistance bands can be used anywhere and come in a variety
of lengths and tensions.
BENEFITS: Can help protect against the loss of muscle mass
during treatment; fights osteoporosis or bone loss that can
be brought on by chemotherapy.
3
STRETCHING: Flexibility exercises that target muscle groups.
BENEFITS: Improves flexibility; eases soreness; helps prevent
injury; makes blood flow and oxygen flow to the brain better.
SET YOUR GOALS
Setting goals that you can work to achieve is a crucial part
of your fitness program. Your goal may be to compete in the
Olympics or simply to be able to walk again. Focus on a single
activity at a time and your recovery will get a little easier.
31
EXERCISE CHART
MY FITNESS/ACTIVITY GOALS:
EXERCISE CHART
Use this chart to keep on track
with your exercise routine.
Date Exercise
Repetitions/
Time Spent
Finished
32
PAIN
MANAGEMENT
CONQUER PAIN AND WIN THE BATTLE
IF YOU
FEEL PAIN…
PAIN
MANAGEMENT
FAST STATS
According to the American Cancer Society, 90 percent of people
with cancer pain are able to find relief.
CONQUER PAIN AND WIN THE BATTLE
Many people connect cancer with pain. It doesn’t have to be that way.
Early stage tumors produce little if any pain. If you do feel pain, there
are ways of beating it and improving your quality of life. There are
pain clinics set up in large hospitals and specialized treatment centers
that help people cope with cancer pain and feel better. Your doctors
can also arrange many pain management strategies. Pain specialists
are trained to help ease pain and discomfort and should be available
to you as well.
ACUTE PAIN:
Brief and sharp
CHRONIC PAIN:
Long-lasting and dull, aching
Cancer patients may feel both types of pain at different
times. Both can be treated.
Q
Does pain mean
the cancer is
getting worse?
A
Not necessarily.
Cancer-related pain
could be caused by the
tumor pressing upon
nerves or organs. It
could be a side effect
of treatment.
IF YOU
FEEL PAIN…
Don’t sit and suffer.
Talk about it with
your doctors. Speak
up. You won’t be
wasting his or her
time. Conquer pain
and you’re more likely
to finish your therapy
and improve your
quality of life.
33
COMMUNICATING
TIPS FOR TELLING FAMILY AND FRIENDS
IN YOUR OWN TIME
It’s hard enough coming to terms with a cancer diagnosis. Now
you’ve got to tell your family and friends. Don’t feel pressured
to share your news. You can wait until you’re ready. The best
time will be when you feel comfortable talking about it. Here
are a few tips to make telling others go easier.
Think about your own feelings first.
Before you talk to others about your cancer, consider your
own feelings and your reasons for telling others. Also think
about what you expect of them. Be ready for a range of
reactions. Your family and friends will have many different
feelings when you share your news.
Think about telling those closest to you first.
Thi
s may help you start accepting the reality of your
condition. By talking it out, you may be able to solve
problems and get a valued opinion, as well as bringing up
other issues you hadn’t yet thought of.
Make a list of people you want to tell.
Thi
s helps you get organized and keep track of who
you‘ve talked to. Make another list of less close friends
that can be told by others.
Decide how much you want to share.
The t
ype of cancer you have, your treatment options
and the outlook are subjects you might choose to tell
others. You may also decide to let them know you’re
going to do whatever it takes to fight the cancer and
that you’ll need their help and support.
Don’t be afraid to say,
“I really get tired of talking about cancer
.
Let’s talk about something else.”
STRESS
ANXIETY
34
ANXIETY AND STRESS
AND
It’s natural to feel a good deal of anxiety when coping with a cancer
diagnosis. Fear of the unknown is a powerful force. If not lessened,
this stress can build and lead to fatigue and depression. Even if for
short periods of time, it’s important to find ways to ease the stress.
JUST BREATHE
Try this simple breathing technique to calm you:
Sit down and put one hand on your chest and
the other over your midsection.
Ta k e three breaths and notice your breathing.
Your chest area should raise more than your
abdomen.
Next, take in a deep breath and lengthen your
abdomen. Think of your lungs as long, skinny
balloons, filling up from the bottom to the top.
Hold the breath and silently count to five, then
breathe out loudly.
Do this for three breaths.
Sit quietly for a moment. If you feel lightheaded,
hold the next breath for a shorter time. Most
people notice a calming feeling that follows.
You can do this exercise anywhere, anytime.
Returning to your natural breathing state eases
the stress. And that’s the goal here.
If you have anxiety, talk with your doctor or case manager.
They may refer
you to a mental health specialist for help.
FIND OUT MORE
National Cancer Institute: Anxiety and Distress
cancer.gov/about-cancer/coping/feelings/anxiety-distress-pdq
DEALING WITH
DEPRESSION
35
DEALING WITH
DEPRESSION
WHAT’S UP WITH
FEELING DOWN?
Depression is a disorder described as feeling down or deeply sad.
One may feel hopeless and have little interest in doing things.
These feelings often linger for a few weeks and negatively affect
daily activities and relationships. The signs of depression may show
up shortly after diagnosis or anytime during or after treatment.
FAST FACTS
About 15 percent of people experience depression. That number
is at least two to three times more common in cancer patients.
THE MANY MOODS
Those with cancer may find
themselves battling depression.
It’s important to know that
depression is treatable and not
a typical part of living with
cancer. Share your moods and
concerns with your doctor
during and after treatment. He
or she will want to check if you
have any signs of depression.
TIPS:
Talk with your health care
team if you feel any signs
of depression in between
your appointments.
Depression can be managed
with therapy, meds or a
combination of the two.
Know that depression
lowers your quality of
life, and can get in the
way of your treatment’s
effectiveness. Identify and
deal with depression as a
part of coping with cancer.
FIND OUT MORE
National Institute of Mental Health: Depression and Cancer
nimh.nih.gov/health/publications/depression-and-cancer/index.shtml
36
FMLA
WORK CONCERNS
Cancer can do a number on your bank account and cause
problems with one’s job. There are some protections in place
to help with work situations.
FMLA
On the job, you may need to take time off of work
during your recovery. The Family and Medical
Leave Act (FMLA) provides for eligible workers to take up to 12
weeks of unpaid leave every 12 months, and sometimes more,
in addition to paid sick time for a serious health condition,
including most cancers. This act makes sure you’ll have a job to
go back to, as long as you’re able to do it. If you were covered
by insurance before the leave, you’ll have it again upon your
return to work.
CONDITIONS:
You must work for an employer with at least 50 employees
You must have been on the job at least 12 months
DISABILITY
If you are disabled
from cancer but can
still do your job with
some modifications,
you could be covered
by the Americans
with Disabilities Act
(ADA). You must tell
your employer what
changes you need in
order to do your job
but you can’t be fired,
have your pay cut or
be denied a promotion.
YOUR OPTIONS
Working full time after cancer
recovery may be too much for you.
This is a personal decision to discuss
with your loved ones and health
care team. Some options:
Ask your work about part
time work or flextime,
adopting a flexible schedule
for you so you can work
when you feel best
Ask about working from
home
Explore other possibilities
with your employer that will
benefit both sides
LIFE GOES ON
CANCER FACTS
37
LIFE GOES ON
WHAT TO EXPECT AS A CANCER SURVIVOR
IT’S ALL ABOUT THE FOLLOW-UP
Beating cancer means a new devotion to making sure you stay cancer-
free for the coming years. And that means follow-up visits with your
doctors and care team. They will review your medical history and
perform routine physical exams. Some exams may include:
Imaging (taking pictures of the inside of the body)
Endoscopy (using a thin tube to look into the inside of the body)
Blood work
Other lab tests
Follow-up care can help find changes in your health. It can check for a
recurr
ence or return of your cancer or see if it has spread to other areas.
Early detection can also find and stop other forms of cancer. Simply
put, all cancer survivors should have regular follow-up care.
Follow-up is crucial for your health. Schedule regular checkups for
good general h
ealth and prevention. Get regular mammograms
and flu shots and keep all of your dental appointments.
During each visit, tell your doctor about:
Any sympt
oms you think may be a sign your cancer has returned
Any pain you’re having
Any physical problems getting in the way of daily life (fatigue;
bladder, bowel or sexual problems; difficulty concentrating;
memory changes; trouble sleeping; and weight gain or loss)
Any medicines, vitamins or supplements you’re taking and any
other treatments you’re using
Any anxiety or depression or emotional problems you’re having
Any changes in your family medical history, such as any new
cancers
CANCER FACTS
Cancer recurrences aren’t always found during follow-
up exams. Recurrences are often found by the patients
themselves between doctor visits. Be aware of changes in
your health and let your health care team know right away.
Your doctor can decide if these problems are due to cancer
or the treatment or are an unrelated issue.
LIFE GOES ON
WHAT TO EXPECT AS A CANCER SURVIVOR
IT’S ALL ABOUT THE FOLLOW-UP
Beating cancer means a new devotion to making sure you stay cancer-
free for the coming years. And that means follow-up visits with your
doctors and care team. They will review your medical history and
perform routine physical exams. Some exams may include:
Imaging (taking pictures of the inside of the body)
Endoscopy (using a thin tube to look into the inside of the body)
Blood work
Other lab tests
WHAT TO ASK YOUR DOCTOR AFTER YOUR
CANCER TREATMENT ENDS
38
WHAT TO ASK YOUR DOCTOR AFTER YOUR
CANCER TREATMENT ENDS
Ask your doctor for a follow-up plan once your treatment
has ended. Ask these questions and gather the answers.
These will help you understand what to expect next.
What treatments and drugs have I been given?
How often should I have a routine visit?
Which doctor should I see for my follow-up care?
What are the chances my cancer will come back
or that I’ll get another kind of cancer?
Will I need follow-up tests? If so, which ones? How often?
39
What symptoms should I watch for?
Who should I call if I have any of these symptoms?
What are the long-term effects of the treatment I received?
What should I do to keep up my health and well-being?
QUESTIONS TO ASK MY DOCTORS
QUESTIONS TO ASK MY DOCTORS
40
NOTES
41
42
NOTES
RESOURCES
RESOURCES
National Cancer Institute
cancer.gov
American Cancer Society
cancer.org
Medicare
medicare.gov
800-633-4227
Medicaid
medicaid.gov
Centers for Medicare &
Medicaid Services
cms.hhs.gov
Social Security:
Benefits for People
with Disabilities
ssa.gov/disability
© 2015 Centene Corporation.
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photocopying, recording, or otherwise, without the prior written
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any trademark, copyright or other notice. V.2
MCARE15-00026E
There’s a lot to know
when dealing with the
demands of a cancer
diagnosis. Step one is to
get organized and create a
game plan. This pocket
guide will set you up with
a quick overview of some
basic things to know to get
you on the road to recovery.
CONTACTS
MANAGING
MEDICATIONS
FITNESS TIPS
TREATMENT
OPTIONS
HEALTHY FOODS
AS THERAPY
DEALING WITH
STRESS, ANXIETY
AND DEPRESSION
INSURANCE
WORKING
AND MORE
MADE IN
THE U.S.A.
Because Where’s It @? Media cares
about the environment, this book
was printed on recycled paper.
Created by MICHELLE BAIN
Design by SAM WASHBURN
ISBN: 978-0-9862116-1-4
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