Life-changing

tips to help you:

Eat to thrive
Exercise for energy
Work while in treatment
Improve body image
Manage pain
think
The Lima News | Sunday, Oct. 2, 2011 | Section G
Local help:
See inside for Breast Cancer Awareness
events, support groups, resources
T H I N K P I N K
G2

Sunday, October 2, 2011 The Lima News

By LINDSEY ROMAIN
CTW Features
A breast cancer diagnosis is a painfully
surreal jolt into the complicated infra-
structure of medicine and doctors. To
add to the already horrifying ordeal, new
research shows that recently diagnosed
patients frequently face challenges get-
ting an appointment with an oncologist,
regardless of their health insurance status.
The research, which comes from the
Perelman School of Medicine at the Uni-
versity of Pennsylvania, shows that only
22 percent of callers with private health
insurance obtained a slot, in contrast to
the 29 percent of uninsured patients and
the 17 percent of patients on Medicaid.
Given the typical pre-appointment
expectations for new patients, both
insured and uninsured patients must con-
tend with many challenges that delay care
with a specialty cancer provider, said
Keerthi Gogineni, M.D., the lead author of
the research and an instructor in the divi-
sion of Hematology-Oncology at Penns
Abramson Cancer Center.
Research assistants posed as patients
for the study, calling 160 U.S. hospitals
under different circumstances, varying
their insurance status and saying they had
an inoperable form of liver cancer. Only
29 percent received appointments, and of
those, 35 percent required multiple calls
to get scheduled.
Reasons for appointment denial
included the demand for medical records
at 39 percent, not being able to reach
appropriate schedulers at 24 percent and
referral requirements at 18 percent.
Gogineni and her co-author, Dr. Katrina
Armstrong, made note of the number of
patients living with cancer and the num-
ber of available oncologists, saying that
this study helps show the urgent matter
at hand. They suggest patient navigator
systems that coach the diagnosed through
the first stage of the disease.
Patients who are newly diagnosed with
cancer may be confused or frightened,
said Armstrong, chief of the division of
Greater Internal Medicine and associate
director of Outcomes and Delivery in
the Abramson Cancer Center, in a press
release. Cancer centers should be pre-
pared to provide help with those prelimi-
nary steps.
Obstacles confront the newly diagnosed
New study notes
difficulty getting
in to see specialist
By BEV BENNETT
CTW Features
When a public figure is diagnosed with can-
cer, 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 medi-
cal 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, its difficult to make a generalization
about a cancer stage, say medical experts.
Although its 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, some-
times to the detriment of the patient, according
to Alan Dosik, M.D., oncologist at New York
Methodist Hospital, Brooklyn, NY.
Patients who are told theyre 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. Washingtons expe-
rience, 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 dia-
logue, the physicians want people to know
that stage IV isnt 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 dis-
ease that is ongoing or recurring, but treatable
and not fatal, say cancer experts.
For more information about cancer, visit
www.cancer.gov.
Stages of cancer
describe severity,
chances of recovery
ABOUT THIS PUBLICATION
WHO: Stories and photos in this section are by Content That Works.
LOCAL LISTING: The local events and resources listing was compiled locally. To
include your event in future listings, email amcgee@limanews.com.
INDEX
Diagnosis obstacles . 2
Body image .......... 3
Local events ......... 4
BPA risk ............... 5
Pain management 6
Weak appetities..... 8
Returning to work . 9
Exercise benefits 10
Prevention tips ... 11
T H I N K P I N K
The Lima News Sunday, October 2, 2011 G3
By DAWN KLINGENSMITH
CTW Features
One of the first things that pops into
peoples head when theyre diagnosed
with cancer is, Im going to be bald, says
breast cancer survivor Julie Grimm, of
Golden, Colo.
Grimm later learned shed need a dou-
ble mastectomy, yet for a time it was the
hair loss that bothered her most.
If I passed my reflection, it was star-
tling, she says.
Grimms friend Patty Ellerby, also a sur-
vivor, 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 differ-
ent 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.
Its very hard for patients to prepare
themselves even if theyre 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.
Fingerets 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 find-
ings led to the establishment of the Body
Image Therapy Program at MD Anderson,
where she helps cancer patients with vari-
ous 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 body and the way it func-
tions 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.
Grimms double mastectomy and recon-
structive surgery left her with significant
scarring and no sensation in her breasts.
Her hormone therapy suppresses her
libido, and though her spouse is support-
ive, 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 changes that are not easily vis-
ible, such as the loss of a testicle or a hid-
den scar, can affect a persons body image
and cause feelings of insecurity. Some
people imagine that others see them dif-
ferently because they have cancer, even if
they look the same, Nelson says.
Indeed, there can be a significant dis-
crepancy 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 abnor-
mal way. Some of her clothing did not
complement her darker hair, so with a
friends guidance she made some ward-
robe changes. The friend told her she
looked gorgeous, and meant it, but Ellerby
wasnt 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 strang-
ers reactions, or non-reactions, Ellerby
started 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
doesnt 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 thats
barely noticeable but it bothers them a lot,
and someone else will lose an eye and be
just fine.
Three years after completing her treat-
ment, Grimm wont 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 addressing
issues of appearance at the onset of treat-
ment, which suggests they are more confi-
dent they will survive and have a life after
cancer. From a patients 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 ques-
tions 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, spon-
sors 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 regu-
lar 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 appear-
ance 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.
Cancer patients face
body image issues
Here I am all chopped up
and yucky and I have
no sex drive whatsoever.
Julie Grimm
breast cancer survivor
G4

Sunday, October 2, 2011 The Lima News

Real
American
Strength
Think Pink
As we recognize October as Breast Cancer
Awareness Month, we commemorate and
appreciate those individuals, agenies and
organizations that have dedicated their
lives to providing hope...
We also celebrate who we are...
We are more than a city, more than a county,
we are a place thats more than the simple sum
of all its people and places. Here, our strength
comes from our Midwestern work ethic and values.
Our productivity, culture and way of life are
sacred gifts passed down to us from those who
came before. Theyre the kinds of things
all Americans want - but few
actually possess.
From staff reports
October is Breast Cancer Awareness
Month, and the area has several events in
support. Here is a listing of events, sup-
port groups and resources in the area.
Events
The 15th annual Hope Garden Cel-
ebration will begin at noon Oct. 20 at
Lima Memorial Health Systems Womens
Health Center at The Medical Park, 525
Eastown Road, Lima. Celebrate Breast
Cancer Awareness Month and Ohio Mam-
mography Day. Visit with breast cancer
survivors. Reservations are due Oct. 14 at
419-998-4497.
Pink Hair for Hope booths will be at
football and volleyball games in Putnam
County this month. Run by Guys & Dolls
Hair Co. of Ottawa, the stylists are put-
ting in pink hair extensions for $10. The
extensions are also available at the salon.
Proceeds benefit Putnam County Cancer
Assistance Program, which helps county
residents affected by cancer with medica-
tion costs and more.
Save a Life Pink Party for Cancer
will be from 10 a.m. to 1 p.m. Oct. 16 at
Walmart, 1950 Havemann Road, Celina.
Sales of Pink Sugar Cookie Gold Can-
yon candles with 20 percent going to
research.
Tailgate for Cancer will be Oct. 14
and 15 at the Eagles, St. Marys. Doors
open Oct. 14 at 6 p.m., with Nashville
Crush from 8 to 11:30 p.m. Admission for
the kick-off is a donation. The main tail-
gate begins at 11 a.m. for the Ohio State
vs. Illinois game on a jumbo screen.
Tickets are $15 at the door ($10 presale).
Free Rider, The Staples and Bubba and
Hoss will entertain. Proceeds benefit
the Stefanie Spielman Fund for Breast
Cancer Research, the OSU Arthur James
Hospital, the Richard J. Solove Research
Institute and local cancer charities. Visit
www.tailgateforcancer.com for details.
A Boggle tournament will be from 9
a.m. to noon Oct. 15 at St. Ritas Auxil-
iary Conference Center, 730 W. Market
St., Lima. Cost is $20 per team of two to
four people. Registration is due by Oct.
13. Call 419-226-4500. Proceeds will be
donated to the Northwest Ohio Affiliate
of Komen for the Cure to be used for
breast health services in our community.
Panera Pink Ribbon bagel sales will
be all month. Bagels are $1 each, and
Panera will donate 20 cents from each
bagel sold at either Lima location to St.
Ritas Medical Centers Little Miracle
Fund, which provides financial assistance
to women going through breast cancer
treatment.
Support groups
The Im Special breast cancer support
group meets at 7 p.m. Oct. 18 at Lima
Memorial Health Systems Medical Park
conference room. Group meetings pro-
vide facts, encouragement and practical
hints through presentations and group
discussions. For details, call 419-221-
6197. The group meets third Tuesdays.
The Life After Cancer support group
meets at 1 p.m. Oct. 12 at St. Ritas
Regional Cancer Center, 803 W. Mar-
ket St., Lima. The meeting will feature
speaker Dr. Wayne Feister on Fats and
Oils. The group meets second Wednes-
days.
A cancer patient caregivers sup-
port group meets at 3 p.m. Oct. 18 at St.
Ritas Regional Cancer Center, 803 W.
Market St., Lima. The meetings are held
in the garden conference center on third
Tuesdays.
The Girlfriends womens cancer
support group meets monthly in Putnam
County. Call 419-523-3709 for details.
Resources
The Look Good ... Feel Better Pro-
gram by the American Cancer Society is
held in a variety of places in the region.
Call 888-227-6446, ext. 5101, for details.
A wig boutique in Lima Memorial
Health Systems Medical Park is open
10 a.m. to 1 p.m. Mondays, Wednesdays
and Fridays. Headcoverings are free for
women undergoing treatment.
Reach to Recovery by the American
Cancer Society is available at 888-227-
6446, ext. 5101. This hotline provides
information and support to anyone fac-
ing breast cancer through one-on-one
contact with American Cancer Society
volunteers.
The Patient Navigator Program by
the American Cancer Society is available
at 888-227-6446, ext. 8056. This helps
patients, families and caregivers find help
with the many needs that could arise
during the cancer journey. Trained navi-
gators link those dealing with cancer to
needed programs and resources.
The Womens Preventive Health Proj-
ect by the Allen County Health Depart-
ment offers help with mammograms.
This project provides free screening
mammograms to men and women with
specific income guidelines and without
insurance. Call 419-224-4500 for details.
The Cancer Association of Auglaize
County offers many resources for county
residents. Call 419-394-3556 or visit www.
cancerassociationofauglaize.com.
Think pink, locally
T H I N K P I N K
T H I N K P I N K
The Lima News Sunday, October 2, 2011 G5
730 W. Market St., Lima, OH 45801 419.227.3361 www.stritas.org
The Regions Leader In Health Care.
1-419-226-9056
1-800-858-0500
Schedule a mammogram today.
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Medical Related
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Newest Techniques in
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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, ques-
tions surrounding the chemical remain
unanswered. What exactly is BPA? What,
if any, are its potential dangers for adults?
According to the Food and Drug Admin-
istration, the plastic known as bisphenol
A has been used in many consumer prod-
ucts including reusable drinking bottles
and baby bottles as well as in the lining of
metal cans.
According to Professor Carlos Son-
nenschein, 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 breast and
prostate cancers.
In January 2010, the FDA issued a state-
ment regarding its current position on
BPA, recognizing 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 spe-
cies, and limited or absent dose response
information for some studies, it read.
Six months later, in July 2010, the Envi-
ronmental Working Group issued a study
that found high levels of what they call the
endocrine-disrupting chemical in 40 per-
cent 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 vice presi-
dent for research. While we do not
know exactly what this means for peo-
ples health, its 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 whether a
receipt has BPA can be difficult.
As of Nov. 8, Appleton Inc., the nations
largest and only producer of BPA-free
thermal paper, announced the introduc-
tion of easy-to-see red fibers to its prod-
ucts. 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 Pro-
gram and the NTP Center for the Evalu-
ation 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 some concern is a
point along a five-level gradient 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
were seeing these at levels of bisphenol A
exposures that are not particularly far dif-
ferent 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.
Banned for baby items, BPA risk unclear
T H I N K P I N K
G6

Sunday, October 2, 2011 The Lima News

Proud Supporter of
Breast Cancer Awareness
2600 Allentown Rd., Lima (419) 224-2265
2565 Shawnee Rd., Lima (419) 221-1312
105 S. Greenlawn Ave., Elida (419) 331-8015
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 con-
crete 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 treat-
ments have relaxed muscles
and boosted my energy, thereby
increasing my ability to func-
tion physically, says Groos, who
receives the treatment once a
week. The effects of the treat-
ments are subtle, but consistent,
and apparently cumulative. My
acupuncturist uses a combina-
tion of needle and massage tech-
niques. The massage relieves
pain and stiffness in the short
term. These alternative thera-
pies 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 complementary and alterna-
tive 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 depen-
dence, there are no side effects
to contend with and with regular
application, the effects last lon-
ger than the short term effects
of medication, says MaryJo
Johnson, a licensed acupunctur-
ist who treats cancer survivors
and others in her Manhattan acu-
puncture, herbology and mas-
sage practice.
Some cancer patients are also
attracted to the increasing num-
ber of medical studies illustrating
the impact of these treatments.
Even the prestigious National
Cancer Institute and other NIH
institutes and centers are sup-
porting 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 chemother-
apy induced pain, says Dr. Ann
OMara, head of pallative care
research in the Division of Can-
cer Prevention at the National
Cancer Institute in Bethesda, Md.
Meanwhile, doctors like Carol
L. Roberts in Tampa, Fla., have
been finding success with a vari-
ety of alternative treatments and
medicines for cancer pain.
I recommend acupuncture
a lot. Yoga, conscious breath-
ing and meditation, by improv-
ing body awareness and relax-
ation, allow the mind to soften
and relax around the pain. This
diminishes the contribution of
fear and resistance to the pain
signal, says Roberts, medi-
cal director of Holistic Medical
Associates. Much of what we
interpret as pain is muscle ten-
sion 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 under-
lying pain is much less intense
than we thought.
Experts say the pain varies
with the type of cancer. Can-
cer causes pressure symptoms
in almost any tissue, especially
when the capsule of an organ is
being eroded or stretched, Rob-
erts 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 treat-
ments is called D-phenylalanine,
a protein derivative which, when
concentrated in capsule form,
increases the activity of the
bodys own endorphins. which
act like opiates and can reduce
the need for pain medication.
For nerve pain, Roberts says the
homeopathic remedy hyperi-
cum perforatum can be very
helpful in reducing pain, is safe
to use with other medicines and
Pain presents one of the biggest hurdles for cancer patients
See PAIN G7
T H I N K P I N K
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ALLEN COUNTY
An ACR Breast Center of Excellence
offering comprehensive services
including same day biopsy results.
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 prob-
lems. For cancer pain they may
not do the whole job, but if it cuts
down on the pain by 50 percent,
well, thats a good thing.
Roberts has even used high
dose Vitamin C IVs as a comple-
mentary cancer pain treatment
for a 64-year-old man with pros-
trate cancer.
He probably had three months
to live at the time, Roberts
recalls. He took hormone block-
ing meds from his urologist and
high dose Vitamin C IVs from us.
Unlike chemotherapy, which is
destructive to all rapidly grow-
ing cells, it targets cancer cells,
while supporting normal cells.
His pain level went from 10 (out
of 10) to 2. He remained in remis-
sion for about 20 months, and
has recently suffered a recur-
rence. 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 suc-
cessfully in many areas of oncol-
ogy, 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 signifi-
cantly less pain and an increased
duration of survival.
Which form of complementary
or alternative treatment for can-
cer pain is best? That depends
in part on the type of cancer,
experts say.
The best candidates for alter-
native treatment are the bone
related cancers and with meta-
static 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 acupunc-
ture like ovarian, stomach,
pancreas, lung, breast.
The first step to relieving can-
cer 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.
PAIN from G6
T H I N K P I N K
G8

Sunday, October 2, 2011 The Lima News

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 slip-
pery and go down easily.
To this day the smell of a
banana makes me throw up,
says Silverman, an Ontario resi-
dent, who was diagnosed and
treated for acute myeloid leuke-
mia less than two years ago.
You may be fortunate to not
have a reaction like Silvermans
during your diagnosis or treat-
ment for cancer. However, you
may lose your appetite or be in
too much pain to eat; certain aro-
mas or flavors can be unpleasant.
Regardless of your unique cir-
cumstances, 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 incor-
porate 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.
It [lack of protein] can play
out in problems healing, Collins
says.
You can get protein from sim-
ple 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 Societys South
Atlantic Division.
Take simple steps to add pro-
tein to foods you enjoy.
Add cheese to toast, crack-
ers, sandwiches and soup. Add
[diced] turkey to canned soup,
says Dee Sandquist, registered
dietitian in Fairfield, Ia., and
spokeswoman 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 che-
motherapy. 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 chemo-
therapy and radiation you need
more fluid volume to rid your
body of waste from the treat-
ment, Collins says.
In addition, youll want to
replace lost fluids if you have
nausea and/or diarrhea. Smooth-
ies, milk and chicken broth may
be good options for you.
You may have been count-
ing calories half your life, but if
you underwent surgery you may
need more calories now for the
healing process.
If you dont get enough calo-
ries 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 youre facing cancer
treatment, [we] still encourage
people to eat healthful foods, but
realize they may have appetite
limitations. We dont want eating
to be another stress for people,
says Ratley, certified specialist in
oncology and co-author of What
to Eat During Cancer Treatment
(American Cancer Society, 2009).
Challenges to eating well
If your cancer or treatment
is affecting your ability to eat
healthfully, a dietitian specializ-
ing in cancer care will suggest
strategies to overcome common
obstacles, such as taste altera-
tions, 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 Car-
olina who works with American
Cancer Societys South Atlantic
Division.
Food may taste metallic, a
frequent problem when youre
undergoing treatment.
Try using plastic instead of
metal utensils and avoiding
canned food, says Ratley.
Sharp flavors may be more
appetizing, especially if food
tastes bitter or like cardboard.
Marinate chicken in Italian dress-
ing or sprinkle the dressing over
cooked vegetables, says the can-
cer society dietitian.
Eating might become unap-
pealing, causing you to lose too
much weight.
Choosing foods youre familiar
with and that provide comfort
can help, says Daniela Fierini, a
registered dietitian specializing
in cancer care.
If youre 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 fre-
quent meals, Fierini says.
Getting enough fluids is impor-
tant, but make sure youre not
drinking yourself full so youre
not hungry.
If youre losing weight because
youre 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 youre not satiated, and sip flu-
ids the remainder of the day, says
Dee Sandquist, a spokesperson
for the American Dietetic Asso-
ciation.
Those frequent sips may also
calm a rocky stomach. But if
youre still nauseous Sandquist
recommends starting the day
with dry toast or crackers.
Even with the changes in appe-
tite during cancer treatment you
may once again appreciate your
favorite foods.
Im just beginning to get back
my taste for chocolate, says
Shari Ichelson Silverman, a Cana-
dian who underwent cancer treat-
ment during the summer of 2009.
Treatments can take away your appetite
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 aware-
ness.
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, says Collins.
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.
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 myr-
iad 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,
its important to know what to expect,
understand your rights and research the
resources available to you. Heres 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 (Can-
cerAdvocacy.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, associ-
ate medical editor for the American Can-
cer 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 youre on the job, take time dur-
ing work to relax for a few minutes, says
Michael Feuerstein, PhD, a 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.
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 infor-
mation 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, its
a good idea to inform your supervisor so
he or she knows what to expect, Swee-
ney 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, its 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 inappro-
priate questions, or avoid you because
theyre 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 environ-
ment that will enable a qualified applicant
or employee with a disability to partici-
pate in the application process or to per-
form 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 invok-
ing any legal protection, Sweeney recom-
mends speaking with an expert such as
the Cancer Legal Resource Center (Dis-
abilityRightsLegalCenter.org), which pro-
vides 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 accom-
modations at any time before or after you
start working and employers are required
to engage in an interactive process to
determine the best fit for the individual.
Managing continuing care
If youll 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 protec-
tion, Sweeney says.
T H I N K P I N K
The Lima News Sunday, October 2, 2011 G9
Anytime Fitness will be
DONATING 10 FOR EVERY MILE
logged on our pink treadmill to Breast Cancer
Research Foundation in the month of October
- Public Welcome -
DOUBLE DOWN
Saturday, October 15, 2011
We will be donating 20 per
mile logged on our pink treadmill
We will also be accepting donations
927 N. Cable Rd. Suite B
Anytime Fitness is located in the Clocktower
Plaza by Wal-Mart next to Rays Market
419.221.0030 www.anytimeftness.com
Back to work a hard reality for many patients
WHAT TO EXPECT
Getting a new job while youre 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, Stump-Sutliff says. But you
still have to meet the employers job requirements e.g. education, experience, skills
or licenses. Employers are not required to lower their job standards to accommo-
date 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. Youll 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 numer-
ous 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 inter-
est to get the job first, and then determine any necessary accommodations, without
mentioning your illness until your value to the organization is clear.
T H I N K P I N K
G10

Sunday, October 2, 2011 The Lima News

By MATTHEW M. F. MILLER and ANNA SACHSE
CTW Features
Katie Mangan was a stay-at-home mom
when she was diagnosed with Stage 3
invasive ductal carcinoma breast cancer
in 2009, at the age of 30.
You know, there are no [insurance]
benefits for stay-at-home moms, says
Mangan, of Waukee, Iowa. Unsure how
she was going to pay for her treatment,
she got help from friends looking for a
way to ease her financial burden.
They wanted to help offset the pay that
was going to come out of our pockets,
she says. Her friends organized a 5K run/
walk, and through fundraising and the
help of 300 people, they raised $10,000.
The following year, she and her hus-
band, Tim, decided to pay it forward, rais-
ing $18,000 and giving it to four families
dealing with breast cancer. Today, Man-
gan runs a nonprofit organization called
Katies Crusaders that awards scholar-
ships to help families meet expenses
following a breast cancer diagnosis.
Our goal this year is to raise $25,000,
Mangan says. Last year we really didnt
know what to expect, and so we thought
we were just going to play it by ear. We
have a goal now.
Breast cancer walks have become an
integral part of awareness and fundrais-
ing. One of the most notable, the Susan
G. Komen for the Cure, which holds
more than 130 events worldwide, raised
$365 million in the 2009-2010 fiscal year.
Walking has become the symbolic event
of hope for survivors and their families.
Everyone knows someone with breast
cancer, or has a direct link to it of some
sort, Mangan says. She believes walking,
especially as a unified group, puts the
power to heal and celebrate lives back
into the hands and feet of survivors.
For some, walking as a solitary, daily
activity has its own healing powers.
Award-winning journalist Carolyn Scott
Kortge was 58 when, sitting alone in the
sauna after a workout at her athletic club
in Eugene, Ore., she decided to perform
a routine breast exam. Kortge discovered
a small, hard lump in her left breast and,
that day, scheduled an appointment with
her doctor. He was concerned enough to
order an immediate lumpectomy.
At 5 a.m. the next day, two hours before
her surgery, she took an hour-long walk
and focused on her breathing, repeat-
ing silent mantras like Im strong, Im
calm, and Im well. It was an active
meditation technique Kortge herself had
previously extolled in her book The Spir-
ited Walker: Fitness Walking for Clarity,
Balance, and Spiritual Connection (Harp-
erOne, 1998), inspired by her experiences
as a competitive Masters racewalker.
The years I spent competing taught me
how the mind and body work together,
Kortge says. Of course I was frightened
that morning, but I knew that exercise
would also help me to be more present,
trusting and receptive.
On April 17, 2000, Kortge received news
of a relapse: Stage II breast cancer that
had metastasized to the lymph nodes
under her left arm. As a consequence, she
would need further treatment, including
eight chemotherapy treatments and six
weeks of radiation. Kortge was crushed,
confused and terrified. It took me a little
while to believe the diagnosis was real,
she says.
Over the next three days, she walked a
lot in her favorite spots and finally came
to the realization that by writing The
Spirited Walker, it was almost as if shed
created a guide for herself on how to
make it through her cancer experience:
Keep your feet on the ground, take one
step at a time and keep moving forward.
Kortge did exactly that, walking every
single day throughout her treatment, even
if it was just one mile. Thanks to her good
health, Kortges oncologist was able to
give her the type of aggressive chemo-
therapy that they would normally give to
younger people. She has been eight years
in remission.
By TANIESHA ROBINSON
CTW Features
Treatment for breast cancer often leaves
survivors with stiffness and pain in their
arms and shoulders, restricting move-
ment. Fortunately, theres an everyday
solution to this 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 exercise can also help patients
recover shoulder and arm movement.
Today, a wide range of health profes-
sionals including surgeons and oncolo-
gists 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 Michigans Compre-
hensive Cancer Center.
According to the review, starting exercise
one to three days 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 profes-
sor of physical therapy at the University of
Alberta and clinical researcher at the Cross
Cancer Institute, Canada.
Fourteen of the reviewed studies com-
pared improvements in shoulder and arm
movements of post-treatment groups of
women that received an exercise pam-
phlet 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 he finds few things as
disheartening as witnessing breast cancer
survivors in long-term 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 treat-
ment strategies including early inter-
vention with suitable exercises should
reduce the incidence of these heartbreak-
ing complications, Blayney says.
Walking
helps ease
pain, fears
Exercise plays
a major role in
treating cancer
T H I N K P I N K
The Lima News Sunday, October 2, 2011 G11
JAMES L. KAHN, MD CHARLES R. RYAN, MD
WILLIAM E. SCHERGER, MD SCOTT C. STALLKAMP, MD
VANESSA L. STALLKAMP, MD ROSEMARY PINTO PA-C
COURTNEY HOOVER PA-C
Take time to get
cancer screening.
It can save your life.
It did mine!
Take time for yourself with massage
therapy an investment in your
future health and well-being!
How massage can beneft
people with cancer
Reduces anxiety Eases pain
Improves sleep
Helps the immune system
Marlene Niese,
Licensed Massage Therapist
Healing Touch
Massage
Kalida, OH 419-532-2800
Hours by appointment
By BEV BENNETT
CTW FEATURES
Once your physician pronounces you
cancer free youll want to do all you
can to avoid a recurrence. However, you
shouldnt obsess about what to eat.
Jumping on every piece of nutrition
research can drive a cancer survivor
crazy, says Alice Bender, MS, registered
dietitian and nutrition communications
manager for the American Institute for
Cancer Research in Washington, D.C.
Instead, you can follow the same guide-
lines for anyone trying to reduce cancer
risk, say the experts.
Get more exercise, maintain a normal
weight, eat less red meat and more fruits,
vegetables, legumes and whole grains.
If possible, you should get at least 150
minutes of moderate-intensity aerobic
activity a week, according to recently
revised guidelines from the American Col-
lege of Sports Medicine.
Exercise helps your quality of life,
Bender says. It can help you stick to
a healthy weight. Researchers know
avoiding overweight reduces potential
for developing breast cancer, though not
whether it could help prevent a recur-
rence, Bender says.
Weight control is also one of the reasons
why you should consume a plant-based
diet. In addition to having a wide range of
nutrients, plant foods are low in calories,
according to Clare McKindley, clinical
dietitian with The University of Texas MD
Anderson Cancer Center, Houston.
At the same time, McKindley advises lim-
iting your intake of red meat to 18 ounces
a week (one modest serving a day; six days
a week). Eating large amounts of red meat
could increase your risk of colon cancer.
Avoiding old habits
During your cancer treatments youre
focused on taking whatever steps are
necessary to get well. However, youll
want to remain vigilant even after youve
recovered, say healthcare experts.
Some studies show that four to five
years after cancer treatment, patients
havent made that many lifestyle changes,
according to Alice Bender, a registered
dietitian, specializing in cancer and diet.
If you feel youre falling into potentially
risky patterns, examine your habits and
see how you can make positive changes,
says Clare McKindley, registered dietitian
at MD Anderson Cancer Center.
You may be stressed and eating errati-
cally or poorly, or maybe you think you
dont have time to exercise.
Eat regular meals. Pick up healthful
options from your supermarket salad bar
if you dont have the energy to cook.
CUT YOUR CANCER RISK
Postmenopausal women who follow
nine recommended guidelines for diet
and lifestyle significantly lessen their
risk for developing and dying from can-
cer than women who dont.
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 can-
cer 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.
1. Keep body mass index less than 25.
2. Gain no more than 11 pounds after
age 18.
3. Engage in daily moderate and
weekly vigorous activity.
4. Eat five or more servings of fruit
and veggies a day.
5. Eat more than 14 ounces of com-
plex carbohydrate a day.
6. Limit alcohol to one drink a day.
7. Limit 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.
Commit to cancer-prevention lifestyle
T H I N K P I N K
G12

Sunday, October 2, 2011 The Lima News

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