Iowa Health Book: Cancer Center
National Cancer Institute
Peer Review Status: Externally reviewed by the
National Cancer Institute
Contents
In the back of every cancer patient's mind is the possibility that the disease may return. And yet when it does, most patients think, "How can this be happening to me again?"
The shock is back. The fears are back - of telling your family and friends, of more treatment, and possibly of death. The anger is there too - after all you've been through, it should have been enough. And the unanswered question is, "Will the treatment work this time?"
Even though you may feel some of the same things you felt when you were first diagnosed, now there's a difference. You've been through this before. You've faced cancer and its treatment and the changes that came to your life. You know that medical and emotional support is available to you. Facing cancer again is difficult, but it is a challenge you can handle.
This booklet is about cancer that has returned - its diagnosis and treatment, suggestions for coping, and where to get help. The glossary at the end of the booklet explains some of the terms that you will read or that you may hear in talking with your treatment team.
As you read this booklet, remember that there are more than 100 different types of cancer. Each is different, and each person responds to treatment differently. No booklet can cover every situation for every person. For this reason, the information given here is general, and some of it may not apply to you. Still, a lot of people have found ways to handle recurring cancer in similar ways, and their experiences may help you.
Many people who have faced the return of cancer say that learning more about your illness and its treatment helps you to take part in your care. Having a positive attitude toward treatment may help you control some of your emotional and physical reactions to it. Drawing on your own strengths and the support from the people and resources around you can help you meet this challenge again. You can call the Cancer Information Service (CIS) at 1-800-4-CANCER to get the most up-to-date information about treatment for your type of cancer and to talk with someone who can offer suggestions on how to cope.
Why Cancer Can Recur
"Recur" means to "happen again." When cancer recurs, it means that
the disease that was thought to be cured, or at least to be inactive
(in remission), has become active again. Cancer may recur after
several months, a few years, or many years.
Cancer that has recurred is very much like the first cancer in the way that it starts: Abnormal cells begin to grow and multiply quickly. If not stopped, cancer cells can destroy normal tissues and organs.
Recurrent cancer starts from cells that were not killed by the original therapy. Your previous treatment was meant to destroy the original cancer and the cells that may have broken away from it. However, a small number of cancer cells may have survived and only now have grown into large enough tumors to be detected.
The cancer that recurs is the same type as the original cancer, no matter where it is found. For example, if colon cancer recurs in the liver, it is not liver cancer; it is colon cancer that has spread to the liver.
Where Cancers Can Recur
Not every cancer cell that breaks away from a tumor is able to grow
elsewhere. Most are stopped by the body's natural defenses or
destroyed by treatment. Cancers differ in their ability to recur and
in the places where they may recur. For this reason, recurrent
cancers are classified by location: local, regional, or metastatic.
Local recurrence means that the cancer has come back in the same place as the original cancer. The term "local" also means that there is no sign of cancer in nearby lymph nodes or other tissues. For instance, a woman who has had a mastectomy could later have a local recurrence of breast cancer in or around the area of the surgery.
A regional recurrence involves growth of a new tumor in lymph nodes or tissues near the original site but with no evidence of cancer at distant places in the body. A man who has had a melanoma removed from his arm, for instance, might have a regional recurrence in the lymph nodes under his arm.
In metastatic recurrence, cancer has spread to organs or other tissues far from the original site. For example, a man with prostate cancer could have metastasis to his bones.
Diagnosing Recurrent Cancer
Over the past several months or years, you may have had a number of
tests and checkups. Most likely, your doctor told you to watch for
changes in your body and to report any unusual symptoms.
You may have noticed a weight change, bleeding, or constant pain, or your doctor may have found signs of further illness while examining you. In either case, tests are used to find the exact cause of the problem and decide on the best treatment.
Specific procedures and tests help your doctor answer these questions:
Because certain types of cancer tend to recur in certain parts of the body, your doctor is likely to check those places first. Information from physical exams and tests helps the doctor make an accurate diagnosis and choose the treatment that is best for you.
In addition to the routine physical exam (feeling for lumps, swelling, and so on), your doctor may need to look at your colon, stomach, bladder, breathing passages, or other organs. A number of instruments are used for viewing different parts of the body. The names of most of the instruments end in "scope" For example, a bronchoscope is used to view the air passages of a lung. In some cases, the doctor may even take a tissue sample (biopsy) through the scope and look at the sample under a microscope.
A number of lab tests are used to help diagnose recurrent cancer. For example, blood samples can be tested to check the levels of certain proteins or enzymes that may change when cancer recurs. The carcinoembryonic antigen (CEA) a test that detects changes in the body that often accompany some cancers.
Other tests, such as the examination of a stool smear, can detect internal bleeding that may be too slight for you to notice. If blood is found, a series of x-rays or another type of test is done to learn if the bleeding is caused by cancer or by some other problem.
These are only a few examples of lab tests used to diagnose cancer and other health problems. Your doctor will select those that may be helpful in your case.
X-Rays and Scans
To learn the location and size of suspected cancer, the doctor can
use x-rays, computed tomography (CT) scans, nuclear scanning,
ultrasound, or magnetic resonance imaging (MRI).
These tests use radiation, computers, magnets, and other sophisticated equipment. If you have questions about how they are used, their risks or benefits, or what you should expect during the procedure, be sure to talk with your doctor, nurse, or technician about your concerns.
X-Rays
Tumors that cause a change in density of a normal structure can often
be seen with the standard x-ray; for example, decreased bone density
from breast cancer that has spread or increased density of lung
cancer that has grown into the air spaces of the lung. Other tests
combine x-rays with a barium solution, dye, or air to give sharp
pictures of organs such as the stomach, kidney, and colon that cannot
be seen clearly with x-rays alone. An example of this kind of study
is the "lower GI (gastrointestinal) series" (barium enema followed by
an x-ray).
CT Scan
In a CT scan, a series of x-rays are taken from many directions and
combined into one cross-sectional picture with the aid of a computer.
The CT scan gives more detailed pictures than standard x-rays for
certain body parts and is often used for tissues such as the liver
and brain.
Nuclear Scanning
Nuclear scans are often used to see many parts of the body. A
substance that is very slightly radioactive is swallowed or injected
into the bloodstream. A machine called a scanner then takes pictures
of the areas of the body where the substance is taken up. A cancer
can show up in the pictures as an area of more or less radioactivity
than the tissue around it.
Ultrasound
An ultrasound test uses a microphone-like device that sends sound
waves that bounce off internal organs. The sound echoes to form a
picture of the organ.
MRI
Instead of x-rays, MRI uses radio waves and a powerful magnet to
create images of internal organs. Like a CT scan, MRI uses a computer
to combine many images into a single picture. That picture may
include organs, muscles, blood vessels, and other parts of the body
that are hard to see with other kinds of scanners.
Biopsy
A biopsy is often the best way to tell if cancer is present. While an
abnormal area may be seen through scopes or on x-ray films, a biopsy
shows whether it is made of cancer cells.
For some cancers, the doctor uses a needle to withdraw fluid (aspirate) or remove small tissue samples (needle biopsy). A surgical biopsy, done under local or general anesthesia, removes the entire tumor or a piece of it. The sample of cells or tissues that is removed is examined under a microscope.
If your cancer has recurred, an accurate diagnosis is the first step in determining the best course of treatment and getting the disease under control again.
Treatment Methods
In planning your treatment for recurrent cancer, many of the same
factors that affected treatment decisions for the original cancer
will be taken into account. How your cancer is treated depends on the
type of cancer, its size and location, your general health, and other
treatments you've had.
Your doctor may recommend surgery, radiation, anticancer drugs (chemotherapy), or a combination of these treatments. For certain cancers, such as those in the reproductive organs, the doctor may suggest hormone therapy. In other cases, biological therapy may be considered.
It is important that you take an active part in your treatment by asking questions and expressing your feelings. Talk to your doctor about treatment goals, methods, and side effects to help determine which treatment will be best for you.
The following paragraphs describe the most common treatments, some of the newer methods now under study, and "unproven" treatments that you may have heard about. You will also find a list of questions that patients often ask about the various treatments.
Surgery
Surgery is often used to treat cancer when it is first diagnosed, but
it is used less often in recurrent disease. Your doctor may recommend
an operation to remove a recurrence if it seems to be limited to a
single spot on the skin or in the lung, liver, bone, brain, or lymph
nodes. For many sites of recurrence, other methods such as radiation,
chemotherapy, or biological therapy have been shown to be more
effective.
When cancer recurs in a weight-bearing bone (such as in the leg), there may be a threat of fracture caused by the growing tumor. In such a case, the doctor may suggest an operation to support the bone and prevent a break. This procedure can help relieve pain and keep the patient active while waiting for other forms of treatment to take effect and control the cancer.
Radiation Therapy
Radiation treatment directs high levels of radiation (tens of
thousands of times the amount used, for instance, to produce a chest
x-ray) at a cancerous tumor to destroy the cancer cells. Both normal
and cancer cells are affected by radiation, but many normal cells
replace themselves quickly while cancer cells do not.
Doctors use radiation to treat cancer in almost every part of the body. Sometimes radiation therapy is used before surgery to shrink a cancerous tumor. After surgery, it may be used to stop the growth of any cancer cells that remain in a certain part of the body. In some cases, doctors use radiation and anticancer drugs, rather than surgery, to destroy a cancer and prevent it from returning.
The type of cancer, location, stage (extent of disease), and other factors will determine whether radiation therapy is right for a patient. Sites that may be treated with radiation include the brain, lung, and bone.
Although radiation treatment can cause side effects, most are not serious. They usually disappear within a few weeks after treatment ends, although some last longer. The type of side effects will often depend on the part of the body that is being treated and the amount of radiation received. Fatigue and skin irritation are common side effects among patients receiving radiation therapy. Many patients have no side effects at all. If radiation therapy is prescribed for you, ask your doctor to explain the side effects that might occur and how you can best manage them. Radiation Therapy and You, a booklet available from the National Cancer Institute (NCI), answers many questions about this type of treatment.
Chemotherapy
Chemotherapy is the use of drugs to treat cancer. These drugs may be
used alone or in combination with radiation therapy, surgery, or
biological therapy.
Chemotherapy may be given by mouth or by injection into the veins or muscles. The drugs reach and destroy cancer cells in nearly every part of the body. Treatment may consist of a single drug or a combination of drugs.
Because anticancer drugs can reach sites that are far away from the original cancer and can destroy cancer cells throughout the body, chemotherapy is the primary treatment for many kinds of recurrent cancers that have spread beyond a single site or region.
Chemotherapy can affect any rapidly growing cells in the body, normal as well as cancer cells. The normal cells most likely to be affected are the blood-producing cells in the bone, cells lining the digestive tract and reproductive organs, and hair follicles. Again, the normal cells are able to replace themselves while the cancer cells cannot.
Every person reacts differently to chemotherapy. Some people have few or no side effects; others say their side effects are less severe than they expected; still others have a more difficult time. Ask your doctor, nurse, or pharmacist about side effects that could occur with the specific anticancer drugs prescribed for you. They can give you suggestions to help manage problems that may occur during treatment. Most side effects gradually begin to stop after treatment ends. However, the fatigue that some patients experience during chemotherapy sometimes lingers for a while.
The NCI's booklet Chemotherapy and You provides further information about this type of cancer treatment.
Hormone Therapy
Some cancers are sensitive to changes in hormone levels. By adding,
removing, or limiting the activity of a certain hormone, doctors can
slow the growth or therapy is often used to treat cancers of the
breast and prostate.
Sometimes surgery or radiation treatment is used to stop the body from producing hormones that cancer cells need to grow. Hormone therapy can cause a number of side effects, depending on the type of drug or surgical procedures. Patients may have nausea, swelling, or weight gain. In some cases, the treatment interferes with the body's production or use of hormones. For example, breast cancer patients taking tamoxifen may have some symptoms of menopause, such as hot flashes.
Biological Therapy
Biological therapy - sometimes called immunotherapy - is a promising
new area of cancer treatment. It uses both natural and manmade
substances to boost the body's own immune (defense) system against
cancer. Called "biological response modifiers" or BRMs, they help the
body's immune system fight the growth of cancer cells. Researchers
are studying biological therapies in clinical trials to learn how
BRMs work best and against which cancers.
Supportive Therapy
When you were first treated for cancer, you may have had physical
therapy or used the services of a psychological counselor or social
worker. You may want to consider seeking those kinds of help again.
Two other types of supportive therapy that could also be important to
you are nutritional support and pain management.
Nutrition
Eating well during cancer therapy is very important. Studies have
shown that patients who eat well may be able to cope better with the
cancer and its treatment.
Eating well means choosing foods that have the protein, calories, and other elements needed to keep the body working normally. Dieting during treatment is not advised because it deprives the body of needed calories and nutrients.
You could have problems with eating and digesting food because of treatment side effects. There are ways to ease some of these side effects, however. The NCI publication Eating Hints has many suggestions for healthy eating habits during treatment, as do the booklets Chemotherapy and You and Radiation Therapy and You, which discuss specific nutrition problems associated with those treatments.
If eating enough to stay at your normal weight continues to be a problem in spite of your efforts, ask a dietitian at the hospital where you had your treatment to help plan a diet for you. For severe nutrition problems, special treatments can be given at home or in the hospital.
Pain Control
Although many people with cancer do not have serious problems with
pain, others need help managing their pain. Pain from cancer or its
treatment may need only a light medication - such as Tylenol
(acetaminophen) or another medication with acetaminophen - to
relieve it. If the pain is not helped by light pain relievers, ask
your doctor about prescription medicines or other methods of pain
relief. Some individuals can use intravenous medications received
through a catheter where they can control the amount and rate of
medication. These and other methods are being studied to see if they
can help cancer patients.
Many patients try to avoid using pain medicine on a regular basis. Bear in mind, though, that the medicine works best if taken before the pain becomes severe. Talk with your doctor if you are concerned about how often to take the medicine or if it doesn't seem to be working. If you're having radiation therapy or chemotherapy, be sure to check with your doctor before taking any medicines.
When describing a pain to your doctor, be as specific as you can. To recommend the best pain treatment for you, your doctor will want to know the following things:
Because pain can be worse when you are frightened or worried, you may find some relief by using relaxation exercises or meditation. These activities, which usually involve deep, rhythmic breathing and quiet concentration, can be done almost anywhere.
A number of nonmedical ways to reduce pain have been gaining attention in recent years. Hypnosis and biofeedback have been helpful for some people with serious illness. If you want to learn about them, ask your doctor or nurse to refer you to a health professional who is trained to teach these methods. The NCI publication Questions & Answers About Pain Control provides many suggestions for managing pain.
Investigational and Unproven Treatments
The words "investigational" and "unproven" may be similar in meaning,
but there are important differences when they are used to describe
cancer treatments. Understanding the difference can help you when
discussing and choosing among your treatment options.
Investigational Treatments
Investigational treatments are new methods of treating disease that
are given under strict scientific controls. These methods have been
tested on animals and have shown promise for treating humans. Doctors
test the value of new treatments with the help of cancer patients who
take part in studies called clinical trials.
Patients who take part in clinical trials may be the first to benefit from improved treatment methods. They also can make an important contribution to medical care because the results of the studies may help many people. Patients participate in clinical trials only if they choose to and are free to leave the trial at any time. More information about these studies is provided in NCI's booklet What Are Clinical Trials All About?
Examples of investigational treatments of cancer being studied in clinical trials at this time include new combinations of drugs, biological therapies, and bone marrow transplants. If proven effective, the investigational treatments of today could become standard treatments in the future.
Unproven Methods
A treatment method described as "unproven" is one for which the
substance used (a vitamin, food, etc.) or the way it is given has not
been shown, by accepted scientific methods, to be effective. Unproven
methods you may have heard about use various diets, vitamins, and
herb mixtures.
The American Cancer Society (ACS) has developed a list of clues to help you know whether a new treatment is "investigational" or "unproven." One way is to look at how results of the treatment are reported. Findings from clinical trials are usually first reported in medical and scientific journals and may later be reported in newspapers and magazines directed to the general public. Unproven methods are usually reported only in newspapers and magazines. They generally rely on first-person accounts by patients and do not discuss scientific data. Using these unproven treatments may actually be harmful because they may cause dangerous reactions or may delay or interfere with treatments proven to be effective.
Call the CIS if you want to learn more about unproven methods. The booklet Unproven Methods of Cancer Management, available from ACS, provides information about many of these treatments. Be sure to carefully consider the list of suggested questions below as you think about your treatment options.
Questions To Ask the Doctor
Before you and your doctor agree on a treatment plan, you should
understand why one treatment is recommended over others. Compare the
possible benefits, risks, side effects, and effect on the quality of
your life of the recommended treatment with other treatments.
The questions listed below are examples of what patients often want to know about their treatment. You may want to add your own questions to the list to discuss with your doctor, nurse, or social worker. Family members or others close to you may have questions, too.
Questions to ask about any recommended treatment:
Questions about radiation therapy:
Questions about chemotherapy and hormone therapy:
Questions about biological therapy:
Questions about investigational treatments or unproven methods:
Helping Yourself
Gathering Information
You may remember that much of the fear and anxiety that you felt the
first time cancer appeared in your life was "fear of the unknown."
You can help yourself again by gathering information, taking part in
your treatment as actively as possible, and finding the support you
need to deal with your feelings about the recurrence of your cancer.
If you know how your illness can affect your body and if you stay informed about the progress of your treatment, you have a better chance to take part in your care.
Learn as much as you can about what is happening to you. If you have questions, ask your doctor and other members of your treatment team. Your pharmacist is a good person to talk to if you have questions about your medicines. If you don't understand the answer to a question, ask it again.
Some patients hesitate to ask their doctors about their treatment options. They may think that doctors do not like to have their recommendations questioned. Most doctors, however, believe that the best patient is an informed patient. They understand that coping with treatment is easier when patients understand as much as possible, and they encourage patients to discuss their concerns.
When you see your doctor to talk about possible treatments or to get help for problems that come up during treatment, take your list of questions and ask a friend or relative to go with you. You'll get the most useful advice if you and your companion speak openly with the doctor about your needs, expectations, wishes, and concerns.
Taking Part in Your Treatment
Taking an active part in your care can help you have a sense of
control and well-being. You can be involved in many ways. One is to
follow your doctor's recommendations about caring for yourself such
as staying on a special diet or avoiding alcohol.
Another way you can help is to keep your doctor informed. Report honestly how you feel, and if problems arise, be as specific as possible when describing them. Don't ever hesitate to report symptoms to your doctor or to ask advice about what to do about them. Although many health-related signs and symptoms may not seem important to you, they could provide valuable information to your doctor. Know what signs you should look for, and if any of them appear, tell your doctor as soon as possible.
Remember the difference between "doing" and "overdoing" Rest is very important to you now - both physically and emotionally. Some things you can do to keep up your strength are to:
Managing Your Emotions
The diagnosis of cancer, whether for the first time or when it
recurs, can threaten anyone's sense of well-being. Some people, when
they first find out that cancer has returned, feel shock and denial.
Many had put their experiences with cancer completely behind them,
and the new diagnosis hits them as hard as &emdash; or even harder
than &emdash; it did the first time. Others are not surprised, as if
they had been expecting it all along.
There may be times when you'll feel overcome by fear, anxiety, depression, or anger. These emotions are natural. They are common ways to cope with a difficult situation, and many people with recurrent cancer experience them. Feel free to express these feelings if they occur. None of these is a "wrong" reaction, and letting them out will help you deal with them.
Starting cancer treatments again can place demands on your spirits as well as your body. Your attitudes and actions really can make a difference. Remember that you have coped with this situation before. Keeping your treatment goals in mind may help you keep your spirits up during therapy and see you through "down" spells that may occur.
As you go through treatment, you're bound to feel better about yourself on some days than on others. The uncertainty of living with recurrent cancer can sometimes contribute to ups and downs. When a bad day comes along, try to remember that there have been good days, and there will be more. Feeling low today does not mean you will feel that way tomorrow or that you are giving up. At these times, try distracting yourself with a book, a hobby, or plans for a new garden. Many people say it helps to have something to look forward to - even simple things like a drive, a visit from a friend, or a telephone call. Sometimes, however, you may just want to cry, and that's okay, too.
You may need to rely more on the people closest to you to help during your treatment, but this may be difficult at first. You may not want to accept help, and some people may have trouble giving it. Many people do not understand cancer, and they may avoid you because they're afraid of your illness. Others may worry that they will upset you by saying the wrong thing.
At a time when you might expect others to rush to your aid, you may have to make the first move. Try to be open in talking with others about your illness, your treatment, your needs, and your feelings. Once people know that you can discuss these things, they may be more willing to open up and help.
By sharing your feelings, you and your loved ones will be better able to help each other through a difficult time. Another booklet from NCI, Taking Time, offers useful advice for cancer patients and their families.
Sometimes it is easier to talk to someone outside your family or your friends. Try talking to health professionals such as your doctor, nurse, psychologist, social worker, or a clergyman with whom you feel comfortable. These professionals care about your emotional as well as physical well-being. When they know about your personal concerns, how your home life or lifestyle has been affected, and what changes in your situation you'd like to see, they will be better able to support you emotionally.
At times you are likely to feel stressed by the continuing changes in your life. Some stress can help because it may push you to take action. Too much stress, though, can harm your health and make you feel like you are losing control. You may not be able to remove all the stress around you, but you can try to limit it. Relaxation techniques can be used to reduce stress and help you cope better with your illness. Rhythmic breathing, imagery, and distraction are among the techniques that are easy to learn and use whenever you need them. If you are interested, ask your doctor or nurse to refer you to someone trained to teach these techniques. The local library also has useful books on relieving stress.
There are many reasons for cancer patients to feel sad, worried, or depressed. You can probably manage some of these problems on your own or with the help of family, friends, or clergy, but for others you may want professional help. A counselor trained to help cancer patients deal with their feelings can offer the support you may need. These counselors understand the special problems that go along with serious illness as well as the various ways of coping that others have found useful. If you think this kind of professional support could help you, ask your doctor or nurse for the name of an appropriate counselor.
Employment and Insurance Issues
If you have a job, you may want to return to work as soon as you can.
You may even find it possible to continue to work during the time you
are receiving treatment. This depends on the kind of treatment you
are getting, what side effects you have, and how you feel about
working.
Sometimes cancer patients find that they are treated differently on the job because of their medical condition. If this happens to you, be aware of your rights. Your employer may be violating laws that protect people against such unfair practices.
Although as many as 1 million cancer patients in the United States experience some form of employment discrimination, this practice is illegal. Find out the legal facts on equal opportunity by contacting your local department of employment services.
You need to fully understand your insurance rights, not only as a cancer patient but also as an employee of your company. Carefully read the health insurance policy provided by your employer. If you have any questions, contact your state insurance commission or department. This agency determines what types of insurance policies must be offered and when rates may be raised.
If you have trouble learning what your rights are, or if you have any questions about employment issues, contact the Cancer Information Service, the American Cancer Society, or the National Coalition for Cancer Survivorship (NCCS). They can help you find local agencies that respond to problems cancer survivors face regarding their rights. The addresses and telephone numbers of these groups are listed in the next section.
Resources for Patients and Families
General information about cancer is widely available. Some of the
resources and publications listed below might be helpful to you. You
may also wish to see what the local library has to offer and contact
support groups in your community. You don't have to be an active
member of these groups to use their information services.
Cancer Information Service
1-800-4-CANCER
The National Cancer Institute-supported Cancer Information Service
(CIS) is a nationwide telephone service that responds to inquiries
from cancer patients and their families, health care professionals,
and the public. Information specialists can provide information and
publications on all aspects of cancer. They also may know about
cancer-related services in local areas. By dialing 1-800-4-CANCER
(1-800-422-6237), you will be connected to a CIS serving your area,
where a trained staff member can answer your questions and listen to
your concerns. Spanish-speaking CIS staff members are available.
People who have cancer, those who care about them, and doctors need up-to-date and accurate information about cancer treatment. To help these people, NCI has developed Physician Data Query (PDQ). This computer system gives quick and easy access to:
To get information from PDQ, doctors may use an office computer, the services of a medical library, or call the CIS. Patients can also get PDQ information from the CIS.
Publications
You may also want to read some other NCI booklets and fact sheets
that discuss various aspects of cancer, cancer treatment, and patient
concerns. Available free of charge, the publications may be ordered
by calling the Cancer Information Service at 1-800-4-CANCER or by
writing to the National Cancer Institute, Building 31, Room 10A24,
Bethesda, Maryland 20892. The following booklets might be especially
helpful:
Support Programs and Organizations
Health professionals and patients alike have learned the value of
mutual support among patients. When someone with a serious illness
feels frightened or depressed, it often helps to discuss those
feelings with another person who has been through the same
experience. This can help patients get practical information,
understand their feelings, and develop their own ways of handling
their problems. The following programs and organizations provide
support for patients, family members, and others who are close to
someone with a serious illness.
American Cancer Society
The American Cancer Society (ACS) is a nonprofit organization that
offers a variety of services to patients and their families. Through
ACS's CanSurmount Program, people who have recovered from cancer are
available to talk with newly diagnosed and recurrent cancer patients
about cancer-related problems and treatments. The ACS also offers the
I Can Cope Program, which is a course designed to address the
educational and psychological needs of people with cancer. To find an
ACS chapter near you, check your local telephone book or contact the
national office at the following address and telephone number:
American Cancer Society
National Headquarters
599 Clifton Road, N.E.
Atlanta, Georgia 30329
(404) 320-3333
Leukemia Society of America, Inc.
The Leukemia Society offers supplemental financial assistance and
consultation services to cancer patients with leukemia and related
disorders.
Leukemia Society of America, Inc.
733 Third Avenue
New York, New York 10017
(212) 573-8484
Make Today Count
This program brings together patients with cancer or other
life-threatening illnesses and their families to help them cope with
their illness and the changes in lifestyle that it often requires.
Support is provided through group meetings, home visit programs, and
newsletters. To receive information about this program, contact Make
Today Count at the following address and telephone number:
Make Today Count
101 1/2 South Union Street
Alexandria, Virginia 22314
(703) 548-9674
National Coalition for Cancer Survivorship
The National Coalition for Cancer Survivorship (NCCS) is a network of
cancer survivors and related organizations across the country. It
provides cancer survivors and their families with local support
groups; a national clearinghouse of resources on support and on life
after a cancer diagnosis; advocacy to reduce cancer-based
discrimination; and a unified voice of cancer survivors. To find a
local group of NCCS, contact the national office at the following
address and telephone number:
National Coalition for Cancer Survivorship
323 Eighth Street, S.W.
Albuquerque, New Mexico 87102
(505) 764-9956
United Ostomy Association
The United Ostomy Association is a network of local chapters that
offers emotional support, aid, and education to those who have had
colostomy, ileostomy, or urostomy surgery.
United Ostomy Association
36 Executive Park, Suite 120
Irvine, California 92714
(714) 660-8624
(local chapters listed under "Ostomy")
Home Health Care Services
Some patients will need help caring for themselves during or after
their cancer treatments. Many state and county health departments
have programs that provide instruction in caring for the cancer
patient at home. Such knowledge may be very useful after surgery or
during bouts of illness. Commercial services, such as visiting
nurses, may be listed under "home health agencies" in your telephone
book.
American Red Cross
The American Red Cross (ARC) provides instruction in first aid and
home nursing. Your local chapter may be able to help you locate
someone to assist with activities such as personal care, housework,
and shopping, if you need this type of help. To receive information
about ARC, contact the national office at the following address and
telephone number:
American Red Cross
National Headquarters
17th and D Streets, N.W.
Washington, D.C. 20006
(202) 737-8300
Glossary
Anesthesia: a procedure in which a patient receives medications that block out pain.
Antiemetic: a medicine to prevent or relieve nausea and vomiting.
Benign tumor: a growth that is not a cancer and does not spread to other parts of the body.
Biological therapy: treatment by stimulation of the body's immune defense system.
Biopsy: the removal and microscopic examination of tissue for diagnosis.
Cancer: a general term for more than 100 diseases characterized by uncontrolled, abnormal growth of cells that can invade and destroy healthy tissues.
Chemotherapy: treatment with drugs to destroy cancer cells.
Dietitian: a specialist in nutrition and diet counseling.
Hormones: substances made by the body that regulate the activity of certain cells or organs. They are largely responsible for sexual function and the aspects of appearance (such as facial hair) that distinguish the sexes.
Linear accelerator: a machine that creates and uses high-energy x-rays to treat cancers.
Lymph nodes: small, bean-shaped organs that filter harmful materials such as bacteria; located throughout the body in places such as the neck, underarm, and groin.
Lymphatic system: a chain of organs, including lymph nodes, that carries lymph fluids throughout the body; makes and stores cells that fight infection.
Malignant: cancerous (see cancer).
Metastasis: the spread of a cancer from one part of the body to another; cells in the new cancer are like those in the original site.
Oncologist: a doctor who is a specialist in the treatment of cancers.
Palliative therapy: a treatment that may relieve symptoms without curing the disease.
Pathologist: a doctor specially trained to examine cells and tissues to find changes caused by disease.
Radiation oncologist: a doctor who specializes in using radiation to treat cancer.
Radiation therapy: the use of high-energy penetrating rays to treat disease; sources of radiation include x-ray cobalt, and radium.
Recurrence: reappearance of cancer at the same site (local), near the initial site (regional), or in other areas of the body (metastatic).
Tumor: an abnormal mass of tissue that results from uncontrolled cell growth and performs no useful body function; tumors are either benign or malignant.
X-ray: a type of radiation that can be used at low levels to diagnose disease or in its high-energy form to treat cancer.
The production of National Cancer Institute publications is supported in part by contributions to the National Cancer Institute Gift Fund, Box P. 9000 Rockville Pike, Bethesda, Maryland 20892.
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