After assessing all the information yourself, you may well decide that what your practitioner first recommended is indeed the best choice for you. It might seem easier just to say: ‘Doctor knows best—I’ll do what he or she says.’ Don’t fall into this trap. Your practitioner has many reasons for recommending a particular treatment and I’m afraid that they do not all centre around you as a unique individual person.

Most practitioners have a series of set recommendations for various set types of patient. From their own experience and attitudes, and from the knowledge gained from their reading of the latest reports from all around the world, they decide on what they believe to be, generally, the best form of treatment for a particular type of cancer. Because practitioners are individuals with different priorities and beliefs, they do not all reach the same conclusions.

*17/40/1*

1 cup oat bran

1 cup LSA mix (crushed linseed, sunflower seeds and almonds)

1 cup lecithin granules (unbleached)

1 cup psyllium husks

1/2 cup slippery elm

1/2 cup rice flakes (optional)

1/2 cup almonds, pecans, sunflower seeds and pumpkin seeds

A handful of dried apple, thinly sliced

Mix all of the ingredients together and keep in a sealed container in the fridge. Serve in a bowl with chopped fruit, fresh juice/soy milk/nut milk or low fat milk. Use manuka honey or brown rice syrup for extra flavouring, if desired.

Curried Mushroom and Tomato Omelette (serves one)

1/4 onion, finely chopped

25 ml of vegetable stock

20 grams mushrooms, chopped

1 tomato peeled and diced

1/4 capsicum, finely chopped

2 egg whites

2 teaspoons curry powder

2 tablespoons low fat milk

1/2 teaspoon of olive oil

Place the chopped onion and half of the vegetable stock into a fry pan. Simmer until the onions become soft, adding extra stock if necessary. Add the mushrooms and cook until stock has almost evaporated. Dice the tomato and capsicum, and add to the pan. Cook for 1 minute and then set the mixture aside.

Now beat the egg whites and milk together until they are well combined, but not too frothy. Add the curry powder to this mix. Lightly oil the pan with the olive oil. Pour the mixture into the hot pan and cook until almost set. Pile the filling into the centre of the omelette and gently fold over. Turn the omelette out onto a plate and serve immediately.

*221/34/5*

Magical thinking persists into adulthood and superstition into the modern era because of their ability to offer comfort and a sense of control over things that are beyond human control.

The belief that you will never be in an accident, because you are charmed, provides comfort beyond that offered by wearing seat belts and driving defensively. The belief that your thinking, “I am going to see my daughter graduate from school” or “I am going to finish this project,” will make it so relieves understandable but unproductive anxiety about dying before important times.

Are Magical Thinking or Superstition Ever Harmful?

Magical thinking and superstition are harmful when they

• keep you from doing the right thing

• cause strained relationships

• cause additional fear or anxiety

• make you feel depressed

• keep you from functioning normally

One woman had been told as a child that she would never get hurt in a car. Believing that she was charmed, as she grew up, she never wore a seat belt. Magical thinking protected her from anxiety about the dangers of driving, but prevented her from taking proper precautions. Another woman believed that her cancer was caused by the routine vaccination she had received prior to her diagnosis, and so she refused any further vaccinations. Magical thinking, which offered her the comfort of an answer to the “Why me?” question, kept her from getting important vaccinations.

The belief that your occasional thoughts of recurrence will cause you to have cancer again magnifies your normal fear of recurrence and can paralyze you if not recognized. If you should have a recurrence, this irrational belief would add an unnecessary burden of guilt during an already stressful time.

Superstitions that prevent you from doing the right thing are dangerous. One man with heart and lung disease developed appendicitis, but refused to have the necessary surgery, because it was the thirteenth day of the month. His routine appendicitis developed into a ruptured appendix with peritonitis, and he died.

Superstitions that cause or exacerbate fear, anxiety, or hopelessness are harmful. If every episode of car trouble or leaf falling off a houseplant portends your imminent death, you will waste enormous energy trying to repress or relieve the anxiety inflamed by superstitious thinking.

Let magical thinking and superstitions bring you comfort. Do not let them keep you from doing the right thing, or adding unnecessary stress, strain, anxiety, or guilt.

*176/32/5*

Diarrhea can be due to

• medications

• inadequate dietary fiber

• changes in your diet

• radiation changes to the digestive tract

•chemotherapy-related changes in the intestines or colon that cause poor absorption of food

•cancer-related changes in the intestines or colon that cause poor absorption

•shortened intestines from surgery

• infection in the digestive tract

• lactose (milk sugar) intolerance

If I Have Diarrhea, What Can I Do for It?

Your doctor has to determine why you have the diarrhea in order to advise treatment. If it is due to medication, your doctor may change your medication and/or add dietary fiber. If it is due to radiation changes, dietary changes and/or antidiarrhea medications may help. If diarrhea is due to infection, you may need antibiotics.

What Causes Constipation?

Constipation can be caused by

•medications, such as pain medications

• inadequate fluids in diet

• inadequate dietary fiber

• damage to the nervous system affecting the gut

• inactivity

•obstruction (blockage) of the lower gastrointestinal tract by a scar

What Can Be Done about Constipation?

Talk with your doctor about

• stool softeners

• increased oral fluids

• dietary fiber, if there is no contraindication

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Many factors contribute to the aftereffects often seen in the first year or so after radiation. Radiation causes damage to rapidly dividing tissue in the parts of the body exposed to the radiation such as the lining of the digestive tract, the lining of the airway and the skin. This is seen as a dry mouth, a sore throat, trouble swallowing, a cough, and radiation “sunburn.”

Radiation causes generalized changes in the blood and immune system. This can be seen as anemia (low red blood cell count and low white blood cell counts.

Changes that are not due directly to the radiation but that commonly occur during and after radiation treatments include

• changes in nutritional status and eating habits

• changes in activity level (deconditioning)

• changes in sleep patterns

• an increase in emotional stress

• pain or discomfort

•energy demands of healing (every place that had cancer is now healing to return to its precancerous state or become a scar)

How Does Radiation Cause Late Effects (Changes Seen Months to Hears following Completion of Radiation)?

Late effects of radiation are due to changes in the radiated regions of your body that occur during and after your radiation. Some of the changes that can result in late effects include

•changes in the circulation that cause malfunctioning, scarring, or narrowing of an organ •loss of normal cells from an organ

•changes in normal cells that cause them to become cancerous, especially the bone marrow (leukemia) and soft tissue (sarcoma)

•changes in the thyroid that predispose to hypothyroidism (too low thyroid) or hyperthyroidism (too high thyroid)

•scarring of the lungs

•changes in the small vessels of the brain causing cognitive deficits (thinking problems)

•damage to the bone marrow that causes low blood counts

Except for the short-term changes in the blood counts and immune system, radiation causes changes and problems only in the areas that were radiated. You will not develop radiation-induced thyroid problems if your thyroid gland was not radiated.

*55/32/5*

There are many reasons for checkup anxiety. The obvious one is your fear that the checkup will reveal recurrent cancer. Other factors contribute to checkup anxiety:

•You have to reenter the realm of patient.

• Even the most well-suppressed memories of your cancer experience are rejuvenated

somewhere between the fasting the night before, the waiting room filled with patients, the

blood tests and X rays, and the interactions with uniformed doctors and nurses.

•You know that in the time it takes to relay your test results, your world can go from normality to

chaos.

• Those around you may be anxious about your checkup, thus straining relationships and making

you more anxious.

• You may have to juggle your checkup with other responsibilities, which just creates more

stress.

• You feel out of control when you are being evaluated.

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There are many potential benefits to exercising. Exercise

• increases how much you can do (your functional capacity)

• minimizes or prevents disabilities associated with treatment and with being out of condition

• preserves muscle mass, strength, and endurance

• improves circulation

• possibly enhances the immune system

• improves your appetite

• enhances your sense of well-being

• helps reduce stress

• relieves tension and anger

• releases endorphins; which are your body’s natural pain killers and antidepressants

• helps restore your sense of control •improves your self-esteem and self-image

What Kind of Exercise Should I Do?

Your choice of exercise will depend on your level of fitness, any physical limitations, the available facilities, and your preference. Walking, stationary cycling, and swimming are especially good if you are beginning an exercise program. A basic exercise program should include

• a warm-up period with stretching exercises and light aerobics

• aerobic exercise such as walking, cycling, stair stepping, or swimming

• strengthening exercises such as weight lifting using resistance equipment

• a cool-down period

Are There Any Risks to Exercising?

You must be cleared for an exercise program and advised regarding its specifics, in order to prevent

• bleeding complications if your blood counts are too low

• injury to muscle, bone, or ligaments if you are not ready for certain exercises or not supervised in their proper execution

• heart problems, such as heart attack or heart failure

• lung problems

In general,

• you should start off slow and easy, building up gradually

• you should not be very winded, stiff, or exhausted following your exercise program

• you should check with your doctor before continuing an exercise program if you have a new pain, a new symptom, or an aggravation of a preexisting symptom or problem

• if you have been sick, such as with a cold, flu, diarrhea, or other temporary illness, wait until you have felt well for two days before resuming exercise

• do not exercise if you have a fever

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