Wendy Harpham on Healthy Survivorship

New Nutrition and Activity Guidelines for Survivors

Up-to-date, science-driven guidelines on nutrition and exercise after cancer were published in the April 12th issue of Ca - A Journal for Clinicians, a publication of The American Cancer Society. Although addressed to healthcare professionals, the material is accessible to patients (free, online) and includes a section written specifically for lay readers.

Choosing Wisely Campaign - Part II

In my last post, I introduced the Choosing Wisely™ campaign, an effort by clinicians to avoid overuse or inappropriate use of tests and therapies. Obviously, a successful campaign would save lots of money. But the campaign is motivated by a higher goal that reflects the mission of Healthy Survivorship.

Problems with Generics

Did you know that when you take a generic drug, you essentially forfeit the ability to sue the company making the drug for damages if you experience an adverse event?

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.

Be a Good Patient; Study Up

Usually I refrain from criticizing human interest stories or online videos, instead staying focused on all that is good and right. But today I'm making an exception because I know what the person interviewed meant, and I want to clarify. 

Grief and Acceptance - Part II (Realistic Goals)

Yesterday's post linked to an editorial by two well-credentialed psychiatrists with special interest in end-of-life care. Their studies led them to consider grief as "the state of emotional unrest and frustration associated with wanting what one cannot have."

Grief and Acceptance

Illness is often associated with loss, even when the medical outcome is excellent.

Since prolonged grief is associated with distress and dysfunction, an understanding of healthy ways to deal with loss may propel patients' pursuit of Healthy Survivorship -- and happiness. Reading a 2008 editorial in the British Journal of Psychiatry might further this understanding.

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.

The New Me

During my first remission I began work on After Cancer, a book to help patients understand and respond in healthy ways to the medical, practical and emotional challenges of recovery and long-term survivorship. The subtitle was Your Guide Back to Normal.  

But as I struggled with my own aftereffects and then recurrences, I realized my original approach wasn't going to work well for me.

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?

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.

Does PSA Testing Save Lives or Not?

A message about the value of PSA tests in healthy men creates problems that might have been avoided with a better choice of words.

My Bad?

My August 6th post shares a report on a new technology for breast cancer screening. I confess: I did not check out the story.

Talking About Side Effects of Cancer Treatments

Effective communication is an essential element of Healthy Survivorship. So I felt honored when MD Anderson Cancer Center's Dr. Walter Baile invited me to write and narrate an audiovisual module titled TALKING ABOUT SIDE EFFECTS OF CANCER TREATMENTS

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.

Healing after a Doctor Visit Gone Awry - Part II

There is no one right way to obtain knowledge, nourish hope or take action. So, too, there is no one right way to heal a rift between you and your physician.

But there are good ways -- and maybe even a best way -- for you and your physician. What follows are my suggestions to the patient who, at her last doctor visit, raised her voice in frustration:

Healing After A Doctor Visit Gone Awry

Although I didn't have a magic answer for the patient in my last post who emailed me about her doctor visit gone awry, I was able to offer her some thoughts about moving forward as a Healthy Survivor.

Ammunition for Your Doctor Visit

I find it troubling when Healthy Survivors describe obtaining sound knowledge (the first step to Healthy Survivorship) as "arming themselves with ammunition" to make their case to their physician.

And the problem is....?

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). 

The Waiting

In a NYTimes essay titled The Waiting, David Rakoff writes about the waiting patients are forced to endure.

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).

Mantra for Healthy Survivors: "We'll See."

In yesterday's post, I shared a short story that has changed my life. Ever since I first read it, when unwanted change or loss seems to be ruining everything, I've thought, "We'll see."

A Parable for Healthy Survivors

A short story for Healthy Survivors:

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? 

Talking With Your Doctors About News in the Media

In my last post I shared my response to a reader who was upset by the media reports of a new study. The commenter expressed ambivalence about discussing it with her physicians: "I don't know if it would be healthy or not to ask my doctors...if [knowing what we know today] I would have been spared this surgery."

The 5 Rs to Healthy Survivorship

For smokers, snubbing out their last-ever cigarette is a key element of "getting good care" in their pursuit of Healthy Survivorship. But smokers often feel miserable while quitting, enough that most relapse.

Treating Chronic Pain

A NYTimes article about ways to manage the costs of treating chronic pain also offers Healthy Survivors some tips on managing chronic pain itself.

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."

When a Healthy Survivor Feels Like Quitting

My 1/14/11 post refers to a post -- Why We Quit -- by a Buddhist physician who believes we quit when we can no longer avoid paying attention to the idea of quitting. He recommends building resilience by "trying again, no matter what the reason you failed before."

Why We Quit

When I jog, I feel as if I'm running for my life.

Sacrificing for Healthy Survivorship

In some situations, your best choice is one that still involves some hardship, loss and/or pain. Perceiving such difficulties as a sacrifice can help patients on the road to Healthy Survivorship.

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.

Ultra-Rare Cancers

My recent posts discuss the trouble with the adjective "rare" when talking about types of cancer. What's a researcher, clinician or patient to do?

Good news for Healthy Survivors! Now, along with ultra-strong hairsprays and ultra-rich ice-creams, we have:

Cognitive Override

Healthy Survivors (1) obtain sound knowledge, (2) find and nourish hope and (3) take effective action.

As a physician, I'm fascinated by the ways patients overcome the many obstacles to acting on sound knowledge in life-enhancing ways.