Wendy Harpham on Healthy Survivorship

Relieving Major Depression in Cancer Patients

An Oncology Times article caught my eye: "Relieving Major Depression in Cancer Patients: Specific 'Biopsychosocial' Method Found Useful."  It reviewed a study that addressed the impact of an intervention developed to treat depression, reduce stress and help patients develop coping strategies.

To Survive with Cancer

James C. Salwitz, MD doesn't use the term Healthy Survivor. Still, the story he tells offers a name and face to the idea that patients in difficult circumstances can find Happiness in a Storm.

Grief and Acceptance - Part IV (PEACE tool)

The preceding post discussed grief experienced in the setting of bereavement. Let's return our focus to grief and acceptance at the end of life.

Grief and Acceptance - Part III (Prolonged Grief Disorder)

A blogger commented on part I of this series, "One friend, after five years of grief and going to therapy is still grieving, and it is hard for me to deal with what to say to her." Is this normal?

Scan Anxiety and Healing Hope

In my January 21st post, I shared a vignette that illustrates the notion that what you hope for affects whether your hope helps or hurts you.

Now let's look at the challenge of coping with the evaluation of a worrisome symptom. What can Healthy Survivors hope for? 

Ranting and Healing - Part II

In yesterday's post, I shared my reaction to a rant found on a cancer-related listserv. I explained my concerns regarding such expressions of anger, disappointment and frustration.

So what are Healthy Survivors to do if, for example, they learn they had not received important information about aftereffects of treatments they received?

Ranting or Healing

A recent thread on a cancer listserv included the rants of listserv members who were angry they hadn't been better warned about the possibility of developing aftereffects. This is a problem.

Revoking FDA Approval: Conclusion

The FDA revokes approval of Avastin for breast cancer. What's a survivor to do?

Searching for Hope - Part II

In a provocative 242-word essay -- Interruptions --  that prompted my November 13th post, Lucy Stanovick fishes for information about how hopeful her oncologist feels regarding her recovery. Is her doctor trying to cure or contain her cancer? Or just to keep her comfortable?

Calming the Fear of Recurrence

Fear that cancer will return is a near-universal fear of patients whose cancer is in remission. This fear can interfere with getting good care and/or living fully. For Healthy Survivors striving to calm this fear, a 6-minute video may help.

Managing Communication

An interesting press release from the University of Texas supports my long-standing contention that it is better to ask a patient, "How are things?" than to ask "How are you?"

Easy to Forgive

I'd like to pass along some wise, low-tech advice for dealing with a family health crisis or family member's chronic illness: Be quick to forgive.

Does PSA Testing Save Lives or Not? - Part III

While the furor over PSA testing plays out in the media, my sympathies lie with men newly diagnosed with prostate cancer . At the end of the day, the patient has to decide what to do.

Hope or Letting Go - Part IV

Perhaps most troubling to me of  Hope or Letting Go, was Dr. Youn's question about whether the patient and his wife should be given a chance to say good-bye. 

Hope or Letting Go - Part II

In my last post, Hope or Letting Go, I shared the story of a physician, Dr. Youn, still troubled by an incident that happened ten years ago. Since reading it, I've been bothered by some of the questions he posed.

For example, Dr. Youn asked if concern for the needs of the patient's loved ones ever take precedence over the patients' needs?

2011 Cancer Resource Guide

Cure in association with the American Cancer Society has published a superb booklet for people with cancer: the 2011 edition of their Cancer Resource Guide.

Fundamental Challenges of Life After Cancer

Sometimes it helps everyone if the most basic challenges of a situation are clarified. So today I'll distill the essential challenges that people face after completion of cancer treatment:

Derek Miller's Posthumous Post

Like Randy Pausch of The-Last-Lecture fame, Derek Miller loved his life and was ready to die. Only 41 years old, Miller prepared his last blog post to be published after he died of stage IV colorectal cancer, leaving behind a beloved wife, two precious daughters and extended family and friends.

Warning Strangers

Walking down the jetway, I hear a woman's voice behind me, "Umm, excuse me. May I ask if you work in the sun?"

The man behind me answers, "Huh? I work inside, but I play outdoor sports."

With a micro-chuckle of embarrassment, the woman says, "Gosh, I hope you don't think I'm crazy or overstepping my bounds, but were you aware of the black spot on your earlobe?

Free Toolbox

We are not born knowing how to become Healthy Survivors. We aren't taught in school how to get good care and live as fully as possible when living with, through and beyond cancer or other serious illness. I wish we were.

Understanding Post-Treatment Survivorship

If a picture is worth a thousand words, this 17-minute video by Eric Slade Productions is worth at least an undecillion (1 followed by 36 zeros). 

Recovery

A member of Best Buy's Geek Squad repaired my corrupted files and recovered my addresses and emails. Hallelujah! The stressful two weeks offered lessons on Healthy Survivorship. Here's one:

Stigma of Illness (Part III)

My last post offered tips for recognizing stigma. My key message was that Healthy Survivors have a right to choose whether or not they advocate to destigmatize the disease that has become part of their life.

Today I'll tackle the challenge of dealing with this stigma.

Stigma of Illness (Part II)

In my April 11th post, I refer to an article in Women's Day titled, "The Stigma of Illness."

Stigma can keep patients from becoming Healthy Survivors, so let's talk about dealing with stigma in healthy ways.

What Not to Say to a Cancer Patient

The Dallas Morning News ran a story on the front page of today's Health section entitled, What Not to Say to a Cancer Patient.  For the article, special contributor Melissa T. Schultz interviewed me, two other survivors (scroll through photographs) and Dr. Walter Baile of University of Texas MD Anderson Cancer Center (MDACC).

Empathy and Weight Loss

Obesity is linked to many serious medical conditions. Yet many physicians refrain from talking about "the elephant in the room" for fear of offending patients. 

Healthy Responses in The Gray Zone

When symptoms or signs are not dramatic, patients often find it stressful to decide whether or not to call the doctor or go straight to the emergency room. As a patient, I found it more stressful when a new problem put me in what I call "the gray zone" than when a sign or symptom was clearly a serious problem demanding immediate attention.

What's a Healthy Survivor to do?

Mistreated Patients

This is a painful topic for me to address,. But I will, since it is about a challenge for some patients:

What can Healthy Survivors do if mistreated? 

Helping Misguided Survivors

On my January 28th post, Lori commented about one's obligations to survivors whose belief in the power of positive thinking precludes their getting effective therapies.

Disabusing Patients' Belief in the Power of Positive Thinking

In my last post I promised to address whether linking health to personal virtue is "good" or "bad" medicine. Followers of this blog know what I'm going to say:

A Fighting Spirit

A NYTimes op-ed piece entitled A Fighting Spirit Won't Save Your Life concludes, "Linking health to personal virtue and vice not only is bad science, it’s bad medicine."

Sharing Laughter

Theresa Brown is a nurse who appreciates the healing power of patients' humor. In a December 1, 2010 article for the NYTimes' Well blog, Brown shares a few anecdotes that illustrate how she is often amused by patients' stories that others might consider offensive.

A Little Empathy, Please

If you're sick, you need people to empathize with you, right? Maybe not.

A Healing "Best"

Healthy Survivors (1) get good care and (2) live as fully as possible. The second criteria can pose quite a challenge in the face of losses, especially if you feel you are no longer at your best. 

Beads of Courage

Jean Baruch is a remarkable nurse who understands how to help children with serious illness become Healthy Survivors.

The Big Picture

I chose internal medicine as a career because I love having "the big picture."

One of my great concerns about the changes in modern medicine is this: It is becoming increasingly common for none of the clinicians on a patient's healthcare team to have that big picture so vital to expert and compassionate care.

Abigail's Alliance

On my recent post about clinical trials, commenter Steve Walker wrote, "The Phase III trial is being run primarily to satisfy the rigid, formulaic and in many cases scientifically obsolete requirements imposed by the FDA's Office of Oncology Drug Products for most cancer drugs...." 

Is the randomized clinical/controlled trial (RCT) obsolete?

The Problem with Accelerated FDA Approval

In Phase I trials researchers test an experimental treatment in a few patients for the first time. The purpose is NOT to see if the treatment kills cancer cells, but only to:

• evaluate the drug's safety
• determine a safe dosage range
• identify side effects

What if the patients in a Phase I trial experience shrinkage of their tumors? Should this speed up FDA approval of the trial drug?

Witholding Rx in Clinical Trials

Sunday's NYTimes ran an article tackling a complex ethical dilemma in cancer care: The witholding of treatment in clinical trials. Because I was treated in 3 clinical trials in the 1990s, the topic is close to my heart.

Vacation From Late Stage Cancer

When a parent has late-stage cancer with limited life expectancy, everyone wants to rewrite the expected ending. The doctors and nurses, the parent with cancer, the family's loved ones and especially the children want to make it "all better."

The Jack and Jill Late Stage Cancer Foundation

If fairy godmothers existed, cancer survivors with late-stage disease who are rearing children might ask: "Fairy Godmother, can you give my family a vacation from my illness? Please?"

Now some parents can.

Baby, Do You Remember?

When my three children were young, every night I put them to bed one at a time. We'd talk for a few minutes before beginning our ritual interactive songs, tucking-in, kisses, "Nighty night" and lights out.

One evening as I began the routine with my youngest, he said something that practically stopped my heart: "Mom, do you remember when...."

When Losing a Loved One Leaves a Hole

After losing a loved one, you might feel that you've been left with a huge hole in your life. The "hole" houses your sadness, loneliness and emptiness along with other painful thoughts and feelings.

Naturally, many people try to get rid of the hole, say, by trying to fill in the hole or trying to run away from the hole. Not me.

Researching Clinicial Trials

People who hear my story often say, "You had an advantage getting into those clinical trials, because you were a doctor with connections." Given the paucity of patient-centered resources in 1993, this was true. 

Today a plethora of excellent resources can help patients and families learn about clinical trials and find any available trials that might be right for you. Resources include:

Open Notes: "Our" Chart

My recent posts set the stage for asking: Does the opportunity for patients to read their medical charts help or hurt patients' ability to become Healthy Survivors?

The OpenNotes Project - Why Do We Need It?

In my August 9th post, I introduced you to the OpenNotes project. If you are wondering why we need the study, here is a two-word answer: informational technology.

The OpenNotes Project - Introduction

Have you ever read what your physicians and nurses have written in your medical chart? If not, would you want to?

For the next few posts, we'll explore the OpenNotes project in the context of Healthy Survivorship.

Judging Others

Rabbi David Wolpe writes a wonderful blog called "Off the Pulpit" that often offers useful messages for patients. This week, Wolpe offers a tool that can help foster healing relationships, an essential element of healing for Healthy Survivors.

Costs and Benefits of Counseling

In Razing and Rising, I mention that Healthy Survivors "seek guidance and support." What if you've never needed professional counseling before?

HON

Patients wanting to learn about their illness used to search high and low for a few drops of patient-centered information. The dilemma for modern patients has become how to sort through the flood of information available on the Internet.

HON certification can help.