•  Depression and Cancer •  Pain and the Elderly

To many people, the word "cancer" represents their worst nightmare.

For Ken Lloyd, a 56-year-old firefighter, the nightmare began with his father, who had prostate cancer, and a sister who had breast cancer. Lloyd knew his risk of getting cancer was elevated, because his job as a firefighter in Napa, California often exposed him to toxic materials.

"Cancer rates in firefighters are fairly high. I was always concerned," Lloyd says. "You don't want to be diagnosed with it, because a lot of people have been diagnosed, and a lot of them have died. You just pray to God you don't ever get it."

But when he went in for a routine test in 1997, his doctor gave him the worst news he could hear: Although Lloyd had no symptoms, he too had cancer.

Fortunately, for Lloyd as for millions of other Americans, his cancer wasn't fatal. You have only to open the pages of a magazine or newspaper to realize that cancer isn't the inescapable death sentence it used to be. Many diagnosed with cancer do survive and even grow from this illness: former Republican presidential hopeful Sen. John McCain disclosed that he had a melanoma skin cancer removed in 1993; and two-time Tour de France winner Lance Armstrong in 1996 was diagnosed with cancer of the testicles. It later spread to his lungs and brain, but he survived.

Although the death rate for seniors with cancer has increased slightly over the past few decades, many are surviving serious forms of cancer. In fact, there are currently 10.5 million survivors of cancer, the American Cancer Society (ACS) reports, and nearly eight out of 10 of them are 55 or older. The number of new cases and deaths from most forms of cancer in the United States declined between 1990 and 2003, according to ACS, including the rates for three of the top four most common cancers: colorectal, prostate, and breast cancer. Lung cancer is the most prevalent cancer for both men and women. While it has declined significantly for men since 1984, it has steadily increased for women and just now is reaching a plateau.

You can improve your odds of avoiding cancer by eating lots of produce and fiber, exercising regularly, and taking care of your body. Early diagnosis and actions you take after the diagnosis of cancer can also improve your chances of surviving.

If you have cancer, you probably have a great many justifiable fears. You may be anxious about surgery to remove a tumor, or dread the well-known side effects of radiation and chemotherapy -- hair loss, pain, and nausea, to name a few. You may also fear being isolated, or deserted by your friends and relatives when they find out you have a life-threatening disease. But there's a lot you can do to take more control of your illness.

To begin with, ask as many questions as you can. Learning more about your cancer will probably allay some of your fears, and it will allow you to make informed decisions about your treatment. Coming to grips with the disease will involve taking in a lot of information; when you see your doctor it's helpful to bring along someone else who can help you remember your questions and the answers.

Ask your doctor the name of your cancer, what the course of treatment will be, how long it may take, what kinds of side effects you may suffer, and whether there are any alternative or complementary treatments. What are the odds of long-term survival with treatment? Write down the questions if you wish, or bring a tape recorder, so you can listen to the answers later. If you're diagnosed with prostate cancer, for example, you may want to ask, "What kind of prostate cancer do I have? Is it invasive? What tests were done on my tumor?"

Feeling comfortable with your doctor can be an important factor in your treatment. If you're not satisfied with the answers or with the way your doctor is giving you information or treatment, you may want to switch to another physician. Ask your doctor or a recognized cancer research center to refer you to an oncologist -- a cancer specialist -- who has experience treating your particular illness.

Much of this information is confusing, so you may want to do some research about your illness yourself. There are at least 100 different types of cancer, but lung, prostate, breast, and colorectal make up slightly over half of all new cancer cases.

Whatever type of cancer you have, the American Cancer Society, the National Cancer Institute, and cancer research centers such as the University of Pennsylvania in Philadelphia have extensive sources of information on their Web sites. Many cancer centers have searchable sites on the Internet where you can find out more about your particular illness and how it is treated. These sites may also contain chat rooms and the phone numbers of support groups you can contact later.

Don't underestimate the power of talk therapy. One cancer survivor group rated emotional support second in importance only to medical care for patients with cancer, and research shows that people with cancer who join support groups tend to live longer and have a better quality of life than people who don't. Support group members can also share tips on managing cancer that you may not want to discuss with others, such as when or where to get a wig if you encounter hair loss after chemotherapy.

One cautionary note about support groups, though: Don't believe everything you hear. Although new treatments are widely discussed in chat rooms and among support group members, you should ask your doctor about new drugs or treatments you discuss in these forums before jumping into anything. And let your physician know if you're taking any herbs or supplements, since they can have powerful adverse interactions with prescription and over-the-counter drugs.

As you're searching for information about your particular cancer, you may want to pay attention to sites that discuss clinical results of treatment for your type of cancer. The NCI has more than 2,000 clinical trials listed in its database. The trials generate data on new drugs, new approaches to surgery or radiation therapy, new combinations of treatments, or new methods such as gene therapy.

For certain types of cancer, one advantage to getting into a clinical trial is that you may be eligible to take part in experimental cancer research long before the treatments are widely available to the public. Participating in such a study could even save your life. Because in most states, private health plans don't pay for experimental drugs, sometimes your best chance for survival is to pay for them out of pocket or participate in a drug test financed by a company. Participants in clinical trials are carefully monitored for side effects of the treatment. Of course, a clinical trial is just that -- an experiment -- and results are not guaranteed. The strategy you are testing may turn out to be ineffective or even harmful, so consider all your options carefully.

Many people suffer fatigue and nausea from chemotherapy that requires treatment for those side effects. You may also feel pain from surgery or from a tumor pressing against a nerve or bone.

If you do feel pain, speak up. Many people don't tell their doctors how intense their pain is. But your doctor needs to know as much as possible about what kind of pain you're experiencing before prescribing painkillers. Keep a record of your pain, recording details such as when it began, where it is located, what kinds of activities it prevents you from doing, and what makes it worse. Your doctor can prescribe painkillers that will help you cope. You may also want to see a pain specialist who can help you understand more about the body's pain mechanisms and how to manage the pain you feel. These days, many physicians recommend complementary treatments such as biofeedback and self-hypnosis, which, combined with medication, can often help you keep your pain under good control.

Many people, like Lloyd, lose some function during cancer treatment. After Lloyd went through surgery to remove his prostate gland in 1998, he experienced impotence and bladder control problems, most of which he was able to manage through medication.

While cancer can be devastating to your emotional health, you may not be the kind of person for whom a support group is necessary. Some people find comfort in their family, their religious or spiritual community, or in the network of friends they have built up over the years. But if you do find yourself alone and need the company of others who also have cancer, there are many support groups for people in your situation.

"One thing's for certain, you need to have something or somebody. I don't know how anyone goes through a disease that's life-threatening by themselves," says Lloyd. Soon after his diagnosis, his brother and uncle were diagnosed with cancer as well. "I had my family as a support group, and I had my firehouse family as a support group."

Lloyd continued to work as a firefighter after going through surgery. Recently, he retired from his job as a battalion chief with the city fire department. He now talks to community groups about cancer, and he strongly advises other firefighters to get tested. Every six months, Lloyd gets tested to see if the cancer has returned.

"Every time you go, you worry just a little bit. You can't help it," Lloyd says. "But you just live life every day... I feel absolutely fantastic. I hike, I hunt, I golf, I work out regularly. It hasn't slowed me down a bit. There is a life after this."

-- Sue Rochman is a veteran health writer based in San Francisco. Her work has appeared in MAMM, The Advocate, The Journal of the American Medical Women's Association, and Pharmacy Practice News. Psyche Pascual, a former Los Angeles Times reporter, is the book and articles editor for Consumer Health Interactive.

Further Resources

National Cancer Institute

301/496-6641 American Cancer Society

212/382-2169 Surveillance, Epidemiology and End Results, SEER

http://www-seer.ims.nci.nih.gov/

Centers for Disease Control and Prevention

770/488-5131 North American Association of Central Cancer Registries

217/698-0800 Food and Drug Administration

http://www.fda.gov/oashi/cancer/trials.html

University of Pennsylvania Cancer Center in Philadelphia

http://www.oncolink.upenn.edu/

References

First published July 28, 2000
Last updated April 19, 2007
Copyright © 2000 Consumer Health Interactive

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