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LivingHealthy Life-changing tips to help you: Eat to thrive Exercise for energy Work while in treatment Improve body image Manage pain ... and more

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saturDAY, March 5, 2011

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2 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

FEATURES 9 Lifestyle Changes to Avoid Cancer IDAHO’S SOURCE FOR ALL YOUR FITNESS NEEDS!

FITNESS EQUIPMENT SALES AND REPAIR

BPA-Free! Concern surrounding the presence of a harmful chemical in plastics, metals waned when laws restricted its use in baby products in 2008. Now, attention is turning to everyday products, and how BPA might affect adults

Eat to Prevent Cancer You are what you eat when it comes to warding off cancer, especially when what you’re eating is processed foods and deli meat

Healing Moves Exercise aids in breast cancer recovery

Understanding the Stages of Cancer Doctors apply numbers to describe the severity of cancer, and understanding those digits can go a long way toward easing the minds of the afflicted

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Working while undergoing cancer treatments is a harsh reality. Here’s how to be at your best on-the-job when you’re not at your physical best

From the Mouths of Survivors Check out these heartwarming lessons learned celebs who have battled – and beaten – cancer

Pain, Pain … Go Away Coping with pain is one of the biggest hurdles for cancer patients. Here’s how to find relief

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Mirror, Mirror on the Wall … Who Is That? Overcoming body image issues when the person in the mirror has cancer

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IdahoStatesman.com • Idaho Statesman

saturDAY, March 5, 2011 • living healthy 3

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4 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

NINE Lifestyle Changes to Avoid Cancer By Matthew M. F. Miller CTW FEATURES

Postmenopausal women who follow nine recommended guidelines for diet and lifestyle significantly lessen their risk for developing and dying from cancer than women who don’t. The guidelines are based on data from nearly 30,000 women ages 55 to 69, who were studied for 13 years. One in three women will develop cancer in her lifetime. “Our study suggests that older women may be able to have a fairly large impact on their cancer risk by not smoking, controlling body weight, exercising and eating a healthy balanced diet,” says Dr. James Cerhan, of the Mayo Clinic College of Medicine, Rochester, Minn.

1. Having a body mass index less than 25. 2. Having gained no more than 11 pounds since age 18. 3. Engaging in daily moderate and weekly vigorous activity. 4. Eating five or more servings of fruit and veggies a day. 5. Eating more than 400 grams (14 ounces) of complex carbohydrates a day. 6. Limiting alcohol to one drink a day. 7. Limiting red meat to less than 3 ounces a day. 8. Limiting fat consumption to no more than 30 percent of total calorie intake. 9. Limiting salt intake to less than 2,400 milligrams a day. © CTW Features


IdahoStatesman.com • Idaho Statesman

saturDAY, March 5, 2011 • living healthy 5

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6 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 Concern surrounding the presence of a harmful chemical in plastics, metals waned when laws restricted its use in baby products in 2008. Now, attention is turning to everyday products, and how BPA might affect adults

BPA-Free!

By Angie Jaime CTW Features

Though the chemical is the object of much public outcry and caused many retailers to remove products containing BPA from their shelves, for many, questions surrounding the chemical remain unanswered. What exactly is BPA? What, if any, are its potential dangers for adults? According to the Food and Drug Administration, the plastic known as bisphenol A, has been used in many consumer products including reusable drinking bottles and baby bottles as well as in the lining of metal cans. According to the Professor Carlos Sonnenschein, Tufts University, Boston, fetal and neonatal exposure to the chemical increases the likelihood of development of malignant tumors later in life. Other studies have connected it to both breast and prostate cancers. In January of 2010, the FDA issued a statement regarding its current position on BPA, recognizing that research interpretation is at best, uncertain. “These uncertainties relate to issues such as ... differences in the metabolism (and detoxification) of and responses to BPA both at different ages and in different species, and limited or absent dose response information for some studies,” it read. Six months later, in July of 2010, the Environmental Working Group issued a study that found high levels of what they call the “endocrine-disrupting” chemical in 40 percent of receipts sampled from such outlets as McDonalds, CVS, KFC, Whole Foods, Walmart and the U.S. Postal Service. “A typical employee at any large retailer who runs the register could handle hundreds of the contaminated receipts in a single day at work,” said Jane Houlihan, EWG Senior VicePresident for Research. “While we do not know exactly what this means for people’s health, it’s just one more path of exposure to this chemical that seems to bombard every single person.” Though other major retailers such as Target, Starbucks and Bank of America ATMs appear to not be using BPA to coat their receipts, determining wheth-


saturDAY, March 5, 2011 • living healthy 7

IdahoStatesman.com • Idaho Statesman

IT’S FLU SEASON AGAIN er a receipt has BPA can be difficult. As of November 8, 2010, Appleton Inc., the nation’s largest and only producer of BPA-free, thermal paper announced the introduction of “easy-to-see red fibers� to its products. Appleton had dropped the use of BPA in its papers in 2006, but now adds the red fibers as a way to give consumers an easy way to detect the chemical. In 2008, the National Toxicology Program and the NTP Center for the Evaluation of Risks to Human Reproduction warned of “some concern for effects on the brain, behavior and prostate gland in fetuses, infants and children at current human exposures to bisphenol A.� Dr. John Butcher, Associate director of the of the NTP says that “some concern� is a point along a five-level gradi-

ent of concern ranging from “negligible� to “serious.� Tests run on animals do not, as of yet, provide conclusive evidence as to how they will translate to human effects and risks, he says. However, “the fact that we’re seeing these at levels of bisphenol A exposures that are not particularly far different from those that are experienced by humans, would indicate to us that these effects can not be completely dismissed at this point.� For now, BPA bans are in effect in Japan and Canada, as well as a growing number of American states. Whether or not a Federal ban on BPA in food and beverage containers or in paper products will be in enacted is unclear. (c) CTW Features

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8 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

Eat to Prevent Cancer You are what you eat when it comes to warding off cancer, especially when what you’re eating is processed foods and deli meat By Bev Bennett CTW FEATURES

A typical brown bag lunch, such as a ham sandwich, salted chips and a

soft drink could put you at greater risk for cancer, according to a recent scientific report looking at food, nutrition, lifestyle and cancer prevention.

Processed meats, including lunch meats, bacon and sausage, are linked to colorectal cancer. If you add a bag of salted chips, you’re getting sodium, which is associated with stomach cancer. Caloric soft drinks can pack on the pounds, another red flag in the cancer war. No wonder the American Institute for Cancer Research and the World Cancer Research Fund recommend you change your menu. But if your lunch-making skills

haven’t evolved from tucking a couple of slices of bologna between bread, you may be at a loss for fast and healthy alternatives. The good news is that you have a wide variety of options, including deli fare, if you select meat products that are free of preservatives and added sodium, according to Dee Sandquist, MS, registered dietitian. However, you can also improve on your usual menu. “For most Americans who are eat-


IdahoStatesman.com • Idaho Statesman

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

Preventative Meals Here are three healthy and easy lunch menus 1. Hummus wrap: Spread 1/4-cup hummus on a multi-grain tortilla. Cover hummus with baby spinach leaves. Thinly slice 1 plum tomato and arrange over spinach. Roll up and wrap in plastic wrap. Add 3 fresh or dried figs and a small bag of baby carrots. Add tea or water for a beverage.

saturDAY, March 5, 2011 • living healthy 9

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2. Chicken pockets: Buy or cook skinless, boneless chicken breast. Cut into strips. Pack into 2 or 3 mini whole-wheat pita breads. Add a small carton of tomato salsa and top the chicken pockets just before eating. Add a bunch of grapes. 3. Tuna lunch: Buy a small bag of baked, unsalted pita chips. Pack with a small pouch of tuna fish or salmon and a small bag filled with grape tomatoes. Add a small carton of low-fat plain yogurt for dipping. ing a lot of convenience foods, creating a home deli will help a lot,” Sandquist, spokesperson for the American Dietetic Association, Washington D.C., says. “Roast a turkey breast, slice and freeze in single portions,” she says. On a positive note, eating more fruits, vegetables and beans may be beneficial. You’ll get the dietary fiber and antioxidant vitamins in plant foods and you’ll probably be consuming fewer calories. How about hummus instead of meat in a sandwich? Spread the bean

paste on whole wheat bread or a whole-grain tortilla. “If you’re ready to abandon the sandwich, it’s easy to pack a soup. You can experiment with different kinds of soup, lentil or black bean, for example,” says Sandquist, a dietitian in Vancouver, Wash. Don’t forget to add fruits and vegetables to the lunch bag. Pack an apple or orange or a carton of salsa for dipping with raw cauliflower or mushrooms. © CTW Features

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10 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 By Taniesha Robinson CTW FEATURES

Exercise aids in breast cancer recovery

Healing Moves

Treatment for breast cancer often leaves survivors with stiffness and pain in their arms and shoulders, restricting movement. Fortunately, there’s an everyday solution to this common problem: exercise. Physicians have long prescribed arm and shoulder exercises after surgery to prevent pain in the areas surrounding the cancer, but a new review of 24 research studies comprising 2,132 breast cancer patients finds that exercise programs can also help patients recover shoulder and arm movement. Today, a team comprised of a wide range of health professionals including surgeons and oncologists work together to provide optimal care after breast cancer treatment. “This review demonstrates that early involvement of a new team member who manages exercise or physical therapy is also useful for the best outcome,” says Douglas Blayney, M.D., medical director at the University of Michigan’s Comprehensive Cancer Center. According to the review, starting exercise within the first to third day after surgery might result in better shoulder movement in the early weeks following surgery. However, “starting exercise that soon after surgery may cause more wound drainage and require drains to remain in place longer than if exercise is delayed by about one week,” says lead review author McNeely, an assistant professor of physical therapy at the University of Alberta and clinical researcher at the Cross Cancer Institute, Canada. Wounds healed, on average, a day later with early exercise. Fourteen of the reviewed studies compared improvements in shoulder and arm movements of post-treatment groups of women that received an exercise pamphlet with those who did not. Those who followed structured programs including physical therapy regimens in the early postoperative period showed a significant improvement in shoulder range of motion. Blayney said that he finds few things as disheartening as witnessing breast cancer survivors in longterm follow-up who are burdened with a “frozen” shoulder or daily use of a lymphedema sleeve, an elastic compression garment worn over the arm to help move fluid and reduce swelling. “Implementation of modern primary treatment strategies – including early intervention with suitable exercises – should reduce the incidence of these heartbreaking complications,” Blayney says. The Cochrane Collaboration, an international organization that evaluates medical research, published this review, which drew evidence-based conclusions considering the content and quality of existing medical trials on the topic. © CTW Features


saturDAY, March 5, 2011 â&#x20AC;¢ living healthy 11

IdahoStatesman.com â&#x20AC;¢ Idaho Statesman

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12 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

Understanding the

Stages of Cancer

Doctors apply numbers to describe the severity of cancer, and understanding those digits can go a long way toward easing the minds of the afflicted

Cancer Stage

Progression of the Disease

0

Cancer is only present in the layer of cells in which it began

1

Early, often curable with surgery

2 - 3 Cancer is spreading to nearby lymph nodes and or adjacent organs and may require chemotherapy or radiation 4

The Cancer has spread beyond the original site to another organ

“Staging is meant to help determine treatment strategies, not [to persuade the patient] to give up.” — Alan Dosik, M.D., oncologist at New York Methodist Hospital, Brooklyn, NY

By Bev Bennett CTW FEATURES

When a public figure is diagnosed with cancer you often read about the cancer stage. Cancer staging is one way physicians measure the extent

or severity of the disease through the body. Staging is also a gauge used when medical experts plan the appropriate treatments for their patients. “Staging is a shorthand way of

describing how far the cancer has progressed,” says Kay Washington, MD, PhD., professor of pathology at Vanderbilt University Medical Center, Nashville. However, without knowing the specifics of any case, it’s difficult to make a generalization about a cancer stage, say medical experts. Although it’s easy to assume the worst, it helps to put cancer staging into perspective. Cancers can be described as stage 0, which is early cancer that is only present in the layer of cells in which it began. Stage 1 is still early and often curable with surgery, according to Dr. Washington. As the numbers get higher to stages II and III, the cancer tumor may be growing or the cancer may be spreading to nearby lymph nodes and/or adjacent organs and may require different treatments such as chemotherapy or radiation. Stage IV means the cancer has spread beyond the original site to another organ and is the diagnosis that causes the most anxiety, sometimes to the detriment of the patient, according to Alan Dosik, M.D., oncologist at New York Methodist Hospital, Brooklyn, NY.

Patients who are told they’re in stage IV often rush to the Internet to get more information. Unfortunately the generic prognosis can be so dire, they lose hope, says Dr. Dosik. “Staging is meant to help determine treatment strategies, not [to persuade the patient] to give up,” Dr. Dosik says. He is reluctant to discuss stages because it can depress his patients. In Dr. Washington’s experience, however, patients want to know how advanced their cancer is and accept the concept of stages as a way to describe the disease. Whether or not stages are part of the dialogue, the physicians want people to know that stage IV isn’t necessarily a death sentence. Some patients can live a long time with stage IV cancer, if treated appropriately. One goal is to turn cancer into a chronic disease that is ongoing or recurring, but treatable and not fatal, say cancer experts. For more information on cancer, visit the government website, www.cancer.gov © CTW Features


saturDAY, March 5, 2011 â&#x20AC;˘ living healthy 13

IdahoStatesman.com â&#x20AC;˘ Idaho Statesman

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14 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

Just Another Day at the Office Working while undergoing cancer treatments is a harsh reality. Here’s how to be at your best on-the-job when you’re not at your physical best

By Anna Sachse CTW FEATURES

Whether the motivation is maintaining health insurance, personal finances, a family or simply a beloved career, at some point most people battling or recovering from cancer will have to go back to work. But when your future also includes myriad medical appointments and unknown treatment side-effects, the prospect of returning to your 9-to-5 can make your anxiety levels work overtime.

In order to make the process of easing back into your job a whole lot easier, it’s important to know what to expect, understand your rights and research the resources available to you. Here’s your welcome back starter kit.

Shaping a Smooth Transition Most cancer survivors are eager to return to work as soon as possible, not only to retain income and benefits, but also to maintain a sense of identity unrelated to their illness, says Barbara Hoffman, JD, a professor at

the Rutgers – Newark School of Law and founding chair of the National Coalition for Cancer Survivorship (CancerAdvocacy.org). That said, while some people may find it easy to transition back into working full-time, for others it may take some adjustment. “You may find that you tire easily or have trouble focusing at first,” says Kimberly Stump-Sutliff, RN, associate medical editor for the American Cancer Society (Cancer.org). Talk with your doctor honestly about the realities of your job and any problems you have

that could potentially affect your productivity. You also might decide that it would be helpful to share your situation with your employer and discuss possible options like flextime, job sharing, working from home, starting with shorter workdays or working fewer days a week, says Stump-Sutliff. The Americans with Disabilities Act of 1990 (ADA) may help make your case for these alternatives. Once you’re on the job, take time during work to relax for a few minutes, says Michael Feuerstein, PhD, a


saturDAY, March 5, 2011 • living healthy 15

IdahoStatesman.com • Idaho Statesman

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 you start working and employers are required to engage in an interactive process to determine the best fit for the individual.

professor at the Biometrics Uniformed Services University of the Health Sciences, Bethesda, Md, and editor of the compilation “Work and Cancer Survivors,” (Springer, 2010). He suggests going for a walk, taking a break to get some water or visiting with a coworker. Getting exercise or utilizing alternative medicines like acupuncture during non-work hours can also help with energy levels and pain.

Managing Continuing Care

Sharing the News Deciding to share your diagnosis with your boss and coworkers is an entirely personal decision. “Your boss is entitled to know only enough information (if any) to assure that you can perform your job safely, and must keep any medical information private,” Hoffman says. Kate Sweeney, executive director of Cancer and Careers (CancerAndCareers.org), recommends that you first meet with your healthcare team and get the specifics on your treatment schedule. If the time involved or likely side effects (e.g. fatigue or hair loss) will have an impact on your performance or be impossible to miss, it’s a good idea to inform your supervisor so he or she knows what to expect, Sweeney says. And be sure to provide a list of potential solutions, adds Feuerstein. For example, if you think it will be difficult to multitask, propose alternating between focusing on a necessary task for an hour and then taking 15 minutes to make or return calls. If you opt to share your experience with coworkers, it’s a good idea to be prepared for a variety of reactions, Stump-Sutliff says. While some people may respond with understanding and offers of help, others may react awkwardly out of a vague uneasiness about cancer, resent that they had to take on extra duties because of your absence, ask inappropriate questions, or avoid you because they’re afraid of saying the wrong thing. If faced with an intrusive response, Stump-Sutliff suggests politely but firmly setting boundaries by preparing a response that changes the topic

or cuts off the conversation if it goes too far. If the problem is an uncomfortable coworker, suggest that they learn more about the realities of the illness at Cancer.org.

Asking for Special Accommodations Under Title I of the ADA, a reasonable accommodation is any modification or adjustment to a job or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions, Sweeney says. (Acceptable accommodations vary depending on the individual and job, but to qualify, your place of work must have 15 or more employees.) Before invoking any legal protection, Sweeney recommends speaking with an expert such as the Cancer Legal Resource Center (DisabilityRightsLegalCenter.org), which provides free legal advice. The next step is to request the specific accommodation – such as permission to telecommute, flextime to accommodate medical care, change in job hours or duties and workplace modifications – in writing, Hoffman says. You will have to disclose your disability, but you may ask for accommodations at any time before or after

If you’ll need more than your allotted sick/vacation time to attend continuing treatment and/or follow-up appointments, talk to your employer about your needs, Stump-Sutliff says. Under federal and state laws, some employers may be required to allow you to work a flexible schedule. “For example, if your company has 50 or more employees, the Family and Medical Leave Act (FMLA) allows many people with serious illnesses to have up to 12 weeks total of unpaid leave per year, while retaining health benefits and job protection,” Sweeney says. Check with your human resources department to learn more about FMLA and other possible options, such as short-term and long-term disability insurance. Don’t wait until your work performance is already suffering. “If doing a poor job gets you fired, you’ll also lose your health insurance and you can’t collect disability benefits,” Stump-Sutliff says. “If you need time off to focus on getting well, take it.”

Rethinking Career Goals If, after returning to work, you discover that your old job is too difficult to maintain at the present time or you simply find that your priorities have changed, it’s time to start thinking about a new career. Sweeney suggests determining what types of work you might enjoy, your financial needs (including benefits), whether you’d prefer to work from home or part-time, and what you can physically handle. Then, make a list of positions that fulfill those priorities and reach out to your network of friends, family, former colleagues, etc. “It can also be helpful to talk to an expert,” Sweeney says. “Cancer and Careers offers free career coaching provided by a roster of professionals, some of whom are cancer survivors themselves.”

Other Resources CancerCare (CancerCare.org), Job Accommodation Network (AskJAN. org), Lance Armstrong Foundation (LiveStrong.org), National Cancer Institute (Cancer.gov), Ulman Cancer Fund for Young Adults (UlmanFund. org), and the U.S. Equal Employment Opportunity Commission (EEOC. gov/facts/cancer.html). © CTW Features

Getting a new job while you’re still undergoing treatment or recovering Rights: A fundamental principle of the ADA is that people with disabilities who are qualified to work must have an equal opportunity to work, StumpSutliff says. But you still have to meet the employer’s job requirements e.g. education, experience, skills or licenses. “Employers are not required to lower their job standards to accommodate someone with cancer.”

Work History Gaps: If your gap is less than a year, list years instead of

months of employment on your resume to mask the missing time, Sweeney says. You’ll also want to be prepared with a short, clear response for work history questions in the early rounds of interviews; however, an upside to the current economy is that numerous candidates now have job gaps for a variety of reasons, so employers may not even ask about them.

Timing: Per the ADA, a potential employer cannot ask about your health status and you are not required to disclose it, notes Feuerstein, so it may be in your best interest to get the job first, and then determine any necessary accommodations, without mentioning your illness until your value to the organization is clear.


16 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 Scott Hamilton

“You feel more in touch, focused and courageous than you ever would have dreamed you could be. You want to face this and beat it back no matter what.” By Lisa Iannucci CTW FEATURES

Scott Hamilton

From the Mouths of

Survivors

In the world of sports, no one exudes such positivity and strength as figure skater Scott Hamilton. After his 1997 diagnosis and treatment for testicular, cancer he learned that he had a benign brain tumor, called craniopharyngioma, and had it removed in 2004. Last year, a reoccurrence forced another surgery, yet Hamilton keeps going, inspiring others through his experiences and as a spokesperson for the Cleveland Clinic Taussig Cancer Institute. He is also the founder of the Scott Hamilton CARES Initiative, the Cancer Alliance for Research, Education and Survivorship. “Going through any cancer treatment is frightening and takes everything you have,” Hamilton says. “Doing it in the public eye changes things quite a bit. Where many feel a level of isolation and feelings of having to face something alone, people of 'familiarity' receive a lot of attention, prayers and support from not only friends and family, but countless people they have never met.” When Hamilton was diagnosed, he had an idea of how he wanted to approach his treatment and journey back to life. “I never expected the amount of support I got from skating fans and other cancer survivors who knew who I was,” he says. “I chose to think of that as an advantage. I wanted to be in people’s minds, hearts and, most importantly, their prayers, but the


IdahoStatesman.com • Idaho Statesman

saturDAY, March 5, 2011 • living healthy 17

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 Colleen Zenk Pinter

one thing that I had in common with everyone facing chemotherapy and a large surgery, famous or not, was the journey.” He explains that the first thing to come with diagnosis is fear. “No, this only happens to other people,” he says. “'Will I die? Will I suffer?” Next, he explains, is the wave of courage and determination that changes you forever. “You feel more in touch, focused, and courageous than you ever would have dreamed you could be,” he explains. “You want to face this and beat it back no matter what.” But it’s not without its emotions. “There are rough days when the side effects shake your confidence. Those times when you feel that quitting would be best, but a second later you may feel a rush of determination that makes you feel more powerful than ever,” he says. “There are times when you can’t believe the blessing that is your

life and in the same breath you wonder how you could be so cursed. Ultimately the positive emotions win out.” To others going through the same thing, he suggests surrounding yourself with love, laughter and light. “Cancer doesn’t like positivity; it thrives on negativity,” he says. “The main thing to embrace is the knowledge that the day you are diagnosed, you are a survivor! Life is precious! We are here for what seems like minutes. Take advantage of those minutes. The human body is so fragile and so resilient. The human spirit is pure power. We decide the quality of our lives, so decide to love every moment. That is the one thing you completely control.”

Colleen Zenk Pinter On any given day, the soap opera world is filled with drama, intrigue and suspense. Unfortunately,

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18 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 Colleen Zenk Pinter, who has portrayed Barbara Ryan on "As the World Turns" since 1978, has experienced quite a bit of that in her personal life over the last few years. Yet she’s come out a survivor and an inspiration. In 2007, the actress was diagnosed with stage two oral cancer, a shock to someone who never smoked or chewed tobacco, and her only possible risk factor was HPV, or the human papillomavirus. “The first thing they said after my diagnosis was ‘don’t go home and get on the Internet,’ so I went home and got on the Internet,” she says. Zenk Pinter discovered the Oral Cancer Foundation website (oralcancerfoundation.org) where she learned that close to 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year and it will cause more than 8,000 deaths. Her first treatment was removal and restoration of part of her tongue, radiation and the

implantation of multiple tiny radioactive rods into her tongue. She not only stayed positive, but she was already willing to help others in the same situation. “When I went to the ‘people’ on the website, there were only two women listed and I knew that was a problem because if I can get it there had to be other women who had it, but weren’t talking about it.” After reaching out to the foundation, its founder Brian Hill urged Zenk Pinter to get well and then come back and help others. So she did. After treatment, she started doing interviews and PSAs about oral cancer and her character was even diagnosed with the same condition. She wasn’t without her struggles though. “I was OK during the scenes of the PSA, but after I got the words out I fell apart,” she says. “After that I pulled myself together and I talk about it as much as I can to anyone who can listen. Whether people saw my story or

my character’s story, I feel like I’ve helped.” Through difficult times, Zenk Pinter says that her saving grace is not thinking about herself. “I concentrate on someone else whose needs outweigh what I’m going through at a time,” she says. “There’s so much on my plate to deal with, that I also only allow a certain amount of time to worry.” She is still acting and is committed to her charity work.

Marissa Jaret Winokur When you see Marissa Jaret Winokur on a screen, you can’t help but feel happy. Her incredible smile, bubbly personality and positive attitude have carried her through a successful career as an actress, Broadway star and recent co-host of “The Talk.” Most importantly, it’s carried her through since her diagnosis and treatment for cervical cancer. While others might feel sorry for themselves, Jaret Winokur looks at

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the last decade as ‘extraordinary.”“I have no complaints about how my life has gone,” she says. “It would be ungrateful to say that. I have a great career, the love of my husband and now a baby and I don’t want to put any negative energy out there.” Jaret Winokur decided to go public about her cancer once she was in remission because, she says, keeping a secret made it seem worse than what it was. She also wanted to become more proactive and encourage other women to get a pap smear. “I knew that my career wasn’t at risk and I wanted others to see what happened in my life and how it’s the vision of health and happiness now.” Of course she admits that there were days that were “close to impossible to maintain a positive attitude while it was going on,” but she said that she stayed proactive with the doctors and made sure to get opinions and not waste time. “The doctors were talking about


saturDAY, March 5, 2011 • living healthy 19

IdahoStatesman.com • Idaho Statesman

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 Marissa Jaret Winokur

waiting and trying to save my uterus, but I just wanted the cancer out of me. I had those moments where it totally sucks, but I focused on what I was doing to do to combat that.” Today, her biggest challenge is managing her work and being mom to her two-and-a-half year old son. “I don’t keep it together physically too much right now,” she says. “I just try to get as much sleep as possible, because no matter how much you diet or exercise, it’s sleep deprivation that will get you.”

Reality Shows Reality television might show us the ugly side of competitions, backstabbing and gossip, but its stars also have faced the realities of cancer in a big way. “When my husband, Bobby, was diagnosed with cancer our family came together to support him,” says Jill Zarin of The Real Housewives of New York, whose husband has fought both

thyroid and prostate cancers. “When he was first diagnosed we wanted to offer him as much encouragement as possible by staying strong and focusing on treatment. There are so many medical breakthroughs in treatment today that helped my husband survive and we focused on curing the disease rather than allowing the diagnosis to take control. Other reality show personalities, such as Survivor’s Ethan Zohn, have become an inspirational face in a fight against cancer. Zohn, now in remission, went public with his battle against Hodgkin ‘s disease, even videotaping his treatment and daily medicines. American Idol winner David Cook’s brother, Adam, lost his battle with brain cancer and since then Cook has been involved in Race for Hope, which supports brain tumor research © CTW Features

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20 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

Pain, Pain…

Go Away

Coping with pain is one of the biggest hurdles for cancer patients. Here’s how to find relief By Jeff Schnaufer CTW FEATURES

After 56-year-old Daphne Groos was diagnosed with Stage II breast cancer in May 2009, she underwent chemotherapy and radiation treatments. But the pain was just beginning. “My doctor offers no concrete remedies for what has at times been debilitating pain in my joints, muscles and bones, especially while I was taking an aromatase inhibitor,” says Groos, who lives in Manhattan. She turned to acupuncture in June 2010. “The acupuncture treatments have relaxed muscles and boosted my energy, thereby increasing my ability to function physically,” says Groos, who receives the treatment once a week. “The effects of the treatments are subtle, but consistent, and apparently cumulative. My acupuncturist uses a combination of needle and massage techniques. The massage relieves pain and stiffness in the short term. These ‘alternative’ therapies have been the best aftercare treatments for my pain and for that of many of my peers.” Indeed, more and more patients like Groos are turning to complemen-


saturDAY, March 5, 2011 • living healthy 21

IdahoStatesman.com • Idaho Statesman

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22 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

tary and alternative medicine and treatments for cancer-related pain. “One reason cancer patients seek out acupuncture for pain rather than traditional painkillers is that it does not create dependence, there are no side effects to contend with and with regular application, the effects last longer than the short term effects of medication,” says MaryJo Johnson, a licensed acupuncturist who treats cancer survivors and others in her Manhattan acupuncture, herbology and massage practice. Some cancer patients are also attracted to the increasing number of medical studies illustrating the impact of these treatments. Even the prestigious National Cancer Institute and other NIH institutes and centers are supporting research in the efficacy of other alternative treatments for cancer pain, such as soy rich diets for chronic post breast cancer pain, impact of Chinese herbal formulas

and the effects of acupuncture on chemotherapy induced pain, says Dr. Ann O’Mara, head of pallative care research in the Division of Cancer Prevention at the National Cancer Institute in Bethesda, Md. Meanwhile, doctors like Carol L. Roberts in Tampa, Fla., have been finding success with a variety of alternative treatments and medicines for cancer pain. “I recommend acupuncture a lot. Yoga, conscious breathing and meditation, by improving body awareness and relaxation, allow the mind to soften and relax around the pain. This diminishes the contribution of fear and resistance to the pain signal,” says Roberts, medical director of Holistic Medical Associates. “Much of what we interpret as pain is muscle tension due to fear. If a muscle is tight it can cut off its own blood supply. Then it will hurt just from the accumulation of toxins and the need for oxygen.

When those muscles relax we find the underlying pain is much less intense than we thought.” Experts say the pain varies with the type of cancer. Cancer causes pressure symptoms in almost any tissue, especially when the capsule of an organ is being eroded or stretched, Roberts says. It also invades all kinds of tissues, most notably bone and nerve tissue. Bone pain is especially painful, since bones do not expand or “give” as a soft tissue would. Nerve pain can be the most excruciating pain, since it affects the sensory system directly. Shooting pains, burning pains and numbness can coexist, Roberts says. One of Roberts’ favorite treatments is called D-phenylalanine, a protein derivative which, when concentrated in capsule form, increases the activity of the body’s own “endorphins”, which act like opiates and can reduce the need for pain medication. For

nerve pain, Roberts says the homeopathic remedy “hypericum perforatum” can be very helpful in reducing pain, is safe to use with other medicines and can be bought in most health food stores. “Homeopathic remedies act in a way that is very different from the drugs and medicines we are used to,” she says. “They are energy modalities and work more like music to energize the body and address specific problems. For cancer pain they may not do the whole job, but if it cuts down on the pain by 50 percent, well, that’s a good thing.” Roberts has even used high dose Vitamin C IV’s as a complementary cancer pain treatment for a 64-yearold man with prostrate cancer. “He probably had three months to live at the time,” Roberts recalls. “He took hormone blocking meds from his urologist and high dose Vitamin C IV’s from us. Unlike chemotherapy,


saturDAY, March 5, 2011 • living healthy 23

IdahoStatesman.com • Idaho Statesman

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 which is destructive to all rapidly growing cells, it targets cancer cells, while supporting normal cells. His pain level went from 10 (out of 10) to 2. He remained in remission for about 20 months, and has recently suffered a recurrence. He continues to outlive his prognosis by many relatively pain free months.” And for those who think pain is all in the mind, there is hypnosis. “Hypnosis has been used successfully in many areas of oncology,” says Dr. Ellyn Gamberg, a licensed psychotherapist and certified hypnotherapist in New York City. “The largest body of research concludes that patients with metastatic breast cancer benefitted from self-hypnosis and from participation in group support. As a result of pre and post-hypnotic suggestions, women benefitted with significantly less pain and an increased duration of survival.” Which form of complementary or alternative treatment for cancer pain is best? That depends in part on the

type of cancer, experts say. “The best candidates for alternative treatment are the bone related cancers and with metastatic spread in the bones,” says Dr. Neil B. Kirschen, director of the Pain Management Center of Long Island in Rockville Centre, N.Y., which uses acupuncture, herbal remedies, homeopathy and exercise modalities. “There is less success with blood borne cancer pain. Somatic pain types also respond well to acupuncture – like ovarian, stomach, pancreas, lung, breast.” The first step to relieving cancer pain, holistic health experts say, is for patients to be willing to explore the alternatives. “My patients tend to be more involved in their own treatment choices than most,” Roberts says. “They come to me because they want to know what other choices for pain management and treatment they have.” © CTW Features

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24 living healthy • saturday, March 5, 2011

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L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

Chemo with a Side of Bananas Cancer patients often suffer from a lack of appetite, but overcoming eating obstacles is key to recovery By Bev Bennett CTW FEATURES

Her mouth burning and her sense of smell acute, swallowing medications was a trial for Shari Ichelson Silverman. To ease the discomfort Silverman was advised to tuck the pills inside banana chunks, which are slippery and go down easily. “To this day the smell of a banana makes me throw up,” says Silverman, an Ontario resident, who was diagnosed and treated for acute myeloid leukemia (AML) less than two years ago. You may be fortunate to not have a reaction like Silverman’s during your diagnosis or treatment for cancer. However, you may lose your appetite or be in too much pain to eat; certain aromas or flavors can be unpleasant. Regardless of your unique circumstances, your goal should be to stick with a healthful diet to the extent you can. Protein foods and plant foods along with adequate calories and fluids all play a role in the healing process, say health experts. Here are tips on foods to incorpo-

rate into your meals. Read the sidebar for ideas on overcoming some of the common obstacles to healthful eating. Start with protein, which your body needs to grow tissues and muscles. Skimp and you may feel weak and have muscle wasting, according to

Karen Collins, MS, registered dietitian, nutrition advisor to the American Institute for Cancer Research (AICR). “It [lack of protein] can play out in problems healing,” Collins says. You can get protein from simple easy-to-eat foods like cottage cheese, hard-cooked eggs, nuts and peanut

butter, says Kristina Ratley, registered dietitian with the Dietitians on Call program, American Cancer Society’s South Atlantic Division. Take simple steps to add protein to foods you enjoy. “Add cheese to toast, crackers, sandwiches and soup. Add [diced] turkey to canned soup, ” says Dee


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26 living healthy • saturday, March 5, 2011

Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

Challenges to Eating Well If your cancer or treatment is affecting your ability to eat healthfully, a dietitian specializing in cancer care will suggest strategies to overcome common obstacles, such as taste alterations, appetite loss and nausea. You may lose interest in your favorite foods, including coffee, red meat and even chocolate, according to Kristina Ratley, a registered dietitian in South Carolina who works with American Cancer Society’s South Atlantic Division. Food may taste metallic, a frequent problem when you’re undergoing treatment. Try using plastic instead of metal utensils and avoiding canned food, Ratley says. Sharp flavors may be more appetizing, especially if food tastes bitter or like cardboard. Marinate chicken in Italian dressing or sprinkle the dressing over cooked vegetables, says the cancer society dietitian. Eating may be unappealing, causing you to lose too much weight. Choosing foods you’re familiar with and that provide comfort can help, says Daniela Fierini, a registered dietitian specializing in cancer care. “If you’re Italian, put olive oil on your vegetables. Switch from skim to whole milk,” says Fierini, with Princess Margaret Hospital, Toronto, ON. Find a time of day when your appetite is at its peak and eat then. Or, try smaller, more frequent meals, Fierini says. Getting enough fluids is important, but make sure you’re not drinking yourself full so you’re not hungry. “If you’re losing weight because you’re not eating, but drinking a lot of water, you can drink a nutrient-rich beverage instead,” Fierini says. You can drink less during meals so you’re not satiated, and sip fluids the remainder of the day, says Dee Sandquist, a spokesperson for the American Dietetic Association. Those frequent sips may also calm a rocky stomach. But if you’re still nauseous Sandquist recommends starting the day with dry toast or crackers. Even with the changes in appetite during cancer treatment you may once again appreciate your favorite foods. “I’m just beginning to get back my taste for chocolate,” says Shari Ichelson Silverman, a Canadian who underwent cancer treatment during the summer of 2009.

Sandquist, registered dietitian in Fairfield, Ia. and spokesperson for the American Dietetic Association. Eating more fruits, vegetables and whole grains is always good advice. Plant foods, rich in fiber, can help prevent constipation resulting from some types of chemotherapy. But see what you can tolerate. High-fiber foods may cause diarrhea and some fruits and vegetables may irritate mouth sores, according to Collins.

Select frozen, peeled and chopped fruits and vegetables, which may be easier to prepare and eat. As with solid foods, your fluid needs will depend on your health and comfort level. With some types of chemotherapy and radiation you “need more fluid volume to rid your body of waste from the treatment,” Collins says. In addition, you’ll want to replace lost fluids if you have nausea and/or

managing your weight Although rapid and extreme weight loss is a problem for many people who are dealing with cancer, you could instead gain weight during treatment, especially if you have breast or prostate cancer, according to Karen Collins, a dietitian specializing in cancer awareness. “Or you could see a drastic change in body composition in which people are gaining fat, but losing muscle, as you would when you age, but rapidly, within a few months,” Collins says. Talk to your dietitian about excessive weight gain. You want to make sure your meals are based on nutrient-rich foods, says dietitian Daniela Fierini, co-author of “Goes Down Easy,” (2006) a Princess Margaret Hospital fund-raiser cookbook that provides recipes organized by symptoms.

diarrhea. Smoothies, milk and chicken broth may be good options for you. You may have been counting calories half your life, but if you underwent surgery you may need more calories now for the healing process. “If you don’t get enough calories your body will burn protein for energy,” Collins says. However, try not to worry about what you can or cannot eat,

say the experts. “When you’re facing cancer treatment, [we] still encourage people to eat healthful foods, but realize they may have appetite limitations. We don’t want eating to be another stress for people,” says Ratley, certified specialist in oncology and coauthor of “What to Eat During Cancer Treatment” (American Cancer Society, 2009). © CTW Features


saturDAY, March 5, 2011 • living healthy 27

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L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1

Mirror, Mirror on the Wall…

Who Is That?

Overcoming body image issues when the person in the mirror has cancer

By Dawn Klingensmith CTW FEATURES

“One of the first things that pops into people’s head when they’re diagnosed with cancer is, ‘I’m going to be bald’,” says breast cancer survivor Julie Grimm, Golden, Colo. Grimm later learned she’d need a double mastectomy, yet for a time it was the hair loss that bothered her most. “If I passed my reflection, it was startling,” she says. Grimm’s friend Patty Ellerby, also a survivor, was so apprehensive about changes to her appearance that she would not part with her wig even after it had begun to wear out. After chemotherapy, it is not uncommon for hair to grow back a different color and texture than it was before. Cancer changes how patients feel and look, which can affect how they perceive their bodies and appearance. Physical changes are caused by the disease as well as its treatments; depending on the type of cancer, they can include surgical scars, hair loss from chemotherapy, weight loss or gain, facial disfigurement, loss of a body part or swollen limbs. “It’s very hard for patients to prepare themselves even if they’re told what to expect,” says psychologist Michelle Cororve Fingeret, an assistant professor in the behavioral science department at the University of Texas MD Anderson Cancer Center in Houston. Fingeret’s research reveals that body image concerns are prevalent among cancer patients; a sizable majority feels embarrassed about bodily changes at some point following diagnosis. Her findings led to the establishment of the Body Image Therapy Program at MD Anderson, where she helps cancer patients with various body image issues.  Body image is not just about how a person views his or her appearance, but it also includes the way a person feels about his or her entire


saturDAY, March 5, 2011 • living healthy 29

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L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 body and the way it functions both inside and out, Fingeret says. Cancer patients generally feel fatigued, and many lose interest in or are unable to have sex. These conditions often cause feelings of deficiency. And a diminished sex drive and certain surgeries can make a person feel less feminine or masculine, says Gloria Nelson, senior oncology social worker at the Montefiore-Einstein Center for Cancer Care, New York. Grimm’s double mastectomy and reconstructive surgery left her with significant scarring and no sensation in her breasts. Her hormone therapy suppresses her libido, and though her spouse is supportive, she sometimes fears her relationship will suffer. “Here I am all chopped up and yucky and I have no sex drive whatsoever,” she says. Grimm is reluctant to wear short sleeves because of lumpiness beneath her arms. But even chang-

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Idaho Statesman • IdahoStatesman.com

L i v i n g H e a lt h y I s s u e N o . 2 2 0 1 1 es that are not easily visible, such as the loss of a testicle or a hidden scar, can affect a person’s body image and cause feelings of insecurity. Some people imagine that others see them differently because they have cancer, even if they look the same, Nelson says. Indeed, there can be a significant discrepancy between the way a patient views his or her body and how others perceive the patient. Ellerby was self-conscious about her appearance simply because her looks had been altered, though not in any abnormal way. Some of her clothing did not complement her darker hair, so with a friend’s guidance she made some wardrobe changes. The friend told her she looked gorgeous, and meant it, but Ellerby wasn’t quite ready for her big reveal. First, she spent a Saturday running errands, sans wig, in a different part of town so as not to be recognized. By gauging strangers’ reactions, or non-reactions, Ellerby start-

ed to regain her confidence and feel comfortable in her own skin. “Disfigurement is all in the eye of the beholder,” Fingeret says. When body image issues arise, “It doesn’t matter what (a perceived defect) looks like to everyone else; it matters what it looks like to the patient,” she adds. “I can have someone with a tiny scar that’s barely noticeable but it bothers them a lot, and someone else will lose an eye and be just fine.” Three years after completing her treatment, Grimm won’t allow her husband to touch her scars. “I wish I had at least talked with the doctors about whether they could have done a better job hiding them,” she says. In some cases, such conversations may indeed bring about better results, says Dr. Philip Bonanno, director, The Breast Institute, Northern Westchester Hospital, Mount Kisco, N.Y. Increasingly, patients are address-

ing issues of appearance at the onset of treatment, which suggests they are more confident they will survive and have a life after cancer. “From a patient’s perspective, they are now more concerned about the effects of the treatment of cancer than the cancer itself,” says Bonanno, adding that those concerns have given rise to “aesthetic oncology,” which combines the goals of cancer surgery and aesthetic surgery. Because bodily changes are inevitable, it is recommended that patients talk with cancer survivors about how they coped. It is also advisable to be prepared for questions and comments and to rehearse some appropriate responses. The national “Look Good…Feel Better” program provides cancer patients with skincare and makeover tips such as how to pencil in eyebrows. The Personal Care Products Council Foundation, along with the National Cosmetology Association and the American Cancer Society,

sponsors the program. Eating well, getting enough sleep and exercising tend to help patients look and feel better, Nelson says. In addition, the American Cancer Society recommends keeping up regular grooming habits such as shaving and applying makeup, even when confined to bed. A patient who loses or gains weight should get his or her clothes altered in order to feel comfortable and perhaps less conspicuous, the society suggests. When concerns about physical appearance become overwhelming or interfere with normal activities, a patient should consider speaking with a counselor. Grimm regained confidence by sharing her concerns with family and friends, who were reassuring. “You have this idea in your head how horrible you look,” she says, “and they can reverse that.” © CTW Features

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Meet our new Physicians Dr. V. Susan Bradford Dr Susan Bradford attended Medical School at University of Alabama at Birmingham, and completed her residency at Seattle Children’s Hospital at University of Washington. She spent the last 12 years in Pocatello and through her practice she discovered a need in that community for an abuse treatment center with a focus on educating young female parents how to overcome substance abuse problems. Through an AAP CATCH grant, Dr Bradford worked with the community to analysis this problem and to create a day treatment program for parenting women in Pocatello. Because of her involvement in helping these women, Dr Bradford came to realize that many of these young women turned to drugs to deal with sexual abuse that occurred during their childhood. While she enjoys all aspects of her pediatric practice, working with abused children is the area she feels she can help a child cope with abuse and start the healing process, and make the most impact. In 2006, Dr Bradford was Idaho Pediatrician of the Year and currently serves as a board member for the Perinatal Project. Dr Bradford is Board Certified in General Pediatrics and is accepting new patients.

Dr. Heather D. Owens Dr Heather Dominguez Owens is a native of southern New Mexico, where she completed her Bachelor of Science with Honors from New Mexico State University, and completed her medical training at Baylor College of Medicine in Houston, TX. Dr Owens’s focus early on was pediatrics which enabled her to garner a wealth of pediatric subspeciality training at Baylor. During her medical training, she also served as a research assistant at the Children’s Nutrition Research Center. She then finished her residency in pediatrics and took her first position as a hospitalist as well as community physician at Colorado Health Sciences Center in Denver. Dr Owens then relocated to the Napa Valley in northern California, where she worked in a busy private practice. In 2009, Dr Owens, her husband and two children moved to Boise, Idaho, their new home chosen for its respected medical community, family friendly outdoor activities and hometown family values. Dr Owens’ medical interest include asthma and allergy as well as assisting young families with optimizing the development of their newborns. Dr Owens is Board Certified in Pediatrics and is accepting new patients.

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