Wendy Harpham on Healthy Survivorship

Redefining Strength for the Trauma Sufferer

Samira Rajabi talks about what it means to be strong. As a survivor of many brain surgeries for cancer, she first asks, "What if strength lies in being honest, being vulnerable and being ourselves?" Then, she shares insights you might find useful in your pursuit of Healthy Survivorship. Click here to read complete post on my new website. 

Happy Despite Brain Cancer Diagnosis

Journalist Jeffrey Weiss offers testimony to the benefits of "hopeful acceptance"--accepting a poor prognosis while hoping for the best possible outcome. In "How I'm Happy Despite My Brain Cancer Diagnosis," Weiss shares his personal path to Healthy Survivorship: 

Making the Best Medical Decisions

Making the best medical decision for you is vital to Healthy Survivorship, and not only because doing so optimizes your chance of the best outcome. If you end up with a disappointing treatment result, your prior decisions affect--and may determine--your happiness.

When Minutes Matter

Dr. Toby C. Campbell offered a useful insight on end of life in "When Minutes Matter." The oncologist's essay opens with: "The day I realized I had bucket lists all wrong..."

How to Minimize Scanxiety

My prior post addressed steps clinicians can take to help minimize their patients' scanxiety. Here's an excerpt from my patient handout, Waiting for Test Results:

The Real Issue Behind Redefining Precancerous Conditions

My August 14th post responds to Scientists Seek to Rein in Diagnosis of Cancer, in which Tara Parker-Pope discusses the recommendations of an NCI panel that some premalignant conditions should be renamed to remove the word "cancer" or "carcinoma." The move was prompted by concerns about patients being over-diagnosed and over-treated, a problem for both Healthy Survivors and public health.

For some people, the issue is money. Increasing the use of tests and treatments helps those on the prescribing/delivering side and hurts patients and insurance companies footing the bill. They object to lobbyists and politicians having any say in determining what's best for patients.

As a Healthy Survivor, I believe the fundamental issue is captured by a Memorial Sloan Kettering oncologist, Dr. Norton: "...doctors do need to focus on better communication with patients about precancerous and cancerous conditions. He...tells patients that even though ductal carcinoma in situ may look like cancer, it will not necessarily act like cancer — just as someone who is “dressed like a criminal” is not actually a criminal until that person breaks the law.

I've devoted much of my writing life to demonstrating how substituting one word or phrase can make a world of difference to patients. Yet I still believe that changing the language cannot replace effective communication.

If dealing with the uncertainty and high stakes of a potentially life-threatening disease that requires  life-altering treatment, nothing replaces the time-consuming weighing of risks and benefits for the individual and developing a personalized plan of action.

Redefining Precancerous Conditions

A rose is a rose, but is a cancer a cancer? 

Letting Go Part IV

We're talking about what it means to "let go." Because if patients run out of treatment options or they are nearing death, "letting go" plays a major role in Healthy Survivorship. So here's another definition:

Letting Go Part III

For cancer patients who run out of treatment options, how can "letting go" help in the pursuit of Healthy Survivorship? How can it hurt?

Knowing You Carry a Cancer Gene -- Part II

In my last post, I responded to an article in the NYTimes Well Blog by Emma Pierson, who shares how learning she carries a cancer gene has transformed her life. 

Faced with "the cruel weight of a paradox: you can never know whether you want to know until you already do," what do Healthy Survivors do?

Altered Immune Cells Beat Leukemia - Part II

Here are more reflections on the December 11th  NYTimes article about the 11th-hour rescue of a dying 6-year-old girl with an investigational treatment. I hope you find them useful in the pursuit of Healthy Survivorship.

How We Die: Natural Law

Dr. Nuland opens Chapter 2 of How We Die saying, "No one dies of old age, or so it would be legislated if actuaries ruled the world."  Later in the chapter he introduces a perspective on aging that can serve Healthy Survivors well.

How We Die: Naturally Bad Responses

In Chapter 2 of How We Die, Dr. Nuland illustrates how sometimes the body's natural response to injury or illness is maladaptive, a notion critical to a Healthy Survivor's understanding of treatment.

A Firm Diagnosis of Frailty

A recent article by NYTimes columnist Karen Pennar focuses on an ordinary word that has specific meaning in the context of healthcare: frailty.

"Doctor, I Use Dietary Supplements"

What are Healthy Survivors to do if they want to go against their physicians' medical advice and take dietary supplements? 

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.

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."

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: Right or Wrong? - Part VII

Let's tease apart some of the sticky-wicket issues of FDA approvals and revocations. For one, how does the FDA measure success?

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.

Metavivor Healthy Survivors

What we call ourselves impacts how we see ourselves. So I was intrigued but not surprised when I heard a new word to add to my survivorship lexicon: metavivor.

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?"

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.

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:

When the Patient is the Expert

In response to my June 10th column, one commentor wrote: "The doctor may or may not be in expert in his or her field...."

Does a Healthy Survivor ever go to a doctor who is not an expert in his or her field?

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:

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?

The Waiting

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

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

How can patients who feel stigmatized become Healthy Survivors?

Tolerating Treatment

Your doctor dictates into your chart, "The patient is tolerating treatment well." Huh? After every treatment you feel nauseated, lightheaded, weak, headachy and, in a word, miserable. What does your doctor mean by "tolerating treatment well"?

Diane Rose, Model Healthy Survivor

A picture is worth a thousand words. But what if you can't see the picture? It didn't stop Diane Rose.

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:

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 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. 

How Rare is "Rare"?

What does it mean to say a cancer is rare? 

105-Year-Old Healthy Survivor

Esther Mauzy can teach us all a thing or two about how to become a Healthy Survivor.

Promise Me

Regular readers of this blog know if I review a book, I'm going to recommend it. Today's post is no different. Thumbs up for Promise Me by founder and CEO of Susan G. Komen for the Cure Nancy G. Brinker, with best-selling author Joni Rodgers.

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.

Not Waiting for Answers

How can Healthy Survivors get good care -- the first criterion of Healthy Survivorship -- if the data needed to make sound choices in their particular situation is not yet available?

(Genetic) Testing My Children

In a piece entitled"The Genes That Bind" (summer issue of CURE magazine), Journalist Charlotte Huff covers the emotionally charged topic of when and how to share information on genetic risk with children.

Reacting to Post-radiation Risks

How did I go from rattled to relaxed in a matter of hours after learning about my risk of carotid disease due to radiation therapy I received 18 years ago? First, by putting the piece of information in perspective, as outlined in my last post. Second, by making a plan of action.

Cancer Survivorship Research: Recovery and Beyond

What a three days I've had here at the 2010 Biennial Conference. While packing my suitcase for the return home, I'm thinking about all I've heard.

"Right" or "Best"

Healthy Survivors make the best decisions, not the right ones. They take the best steps, not the right steps.  Right? Best? Is there any difference?

A Work in Progress

When I was a child, I thought people over 40 years of age were very old. I believed they were done growing up and knew everything one needs to know. Wrong.

Now over 50 years old, I often say, "I'm a work in progress." 

Life is Good

What would you say if you got a flat tire on your way to an interview for your dream job? Or if you (or your wife) began bleeding two weeks after in-vitro fertlization? Or if you learned you or a loved one needed more chemo?

Does "Life is good!" come to mind?

Rob Pardi Responds

My April 6th and April 11th posts focused on a  NYTimes story about Dr. Desiree Pardi, a palliative care physician who refused palliative care when dying.

Today let's look at her husband's view of the article. Robert Pardi's comments were posted on Pallimed to enrich -- or shall I say, to straighten out -- the discussion about his wife's decision. Although he doesn't use the term, he's telling us his wife was a Healthy Survivor.