According to an article in CANCER, mental illness and emotional distress in patients with advanced cancer is often overlooked by oncologists, but proper management can improve a patient's quality of life.

The review article was written by Dr. Michael Miovic and Dr. Susan Block from the Dana Farber Cancer Institute and Brigham and Women's Hospital in Boston.

Miovic and Block found that 50 percent or more of patients with advanced or terminal cancer suffer from at least one of three major disorders: adjustment disorders, anxiety disorders and depressive disorders. Medical management of cancer has improved in the last decade, but management of mental health issues has lagged, according to the authors. Studies show that depressive symptoms can even impact patients' lives even more than pain.

The authors recommend listening as the most important screening tool in the oncologist's toolkit.

I promised two weeks ago when I wrote Sunday Seven: Seven ways to fine-tune your health that I'd be back to offer seven more grand ideas for optimizing your physical and emotional well-being. Here I am, with a mini-list of suggestions I gathered a while back from a newspaper article. If you don't already practice these strategies, then why not give them a try.

Eat breakfast

It's the most important meal of the day -- really. A breakfast high in complex carbohydrates and protein creates energy. Energy kick-starts metabolism and helps our bodies burn fat. We all know what fat does. It weighs us down and contributes to all kinds of health problems.

Get your sleep

Sleep restores our bodies. Sleep-deprived folks secrete more leptin, a protein hormone that increases appetite. Larger appetites increase food consumption. Increased food consumption spikes the risk of obesity. And so on. You know the drill.

"What one thing did you learn at Canyon Ranch?" my dad asked me the other day. We hadn't yet fully discussed my April trip to this Arizona health and healing destination and so he wanted to know what I had absorbed during my four days in the desert. I couldn't possibly name just one lesson I'd learned. But I could sum up all of my lessons in one broad category. This is what I told him: I learned how to change my lifestyle.

I learned how to change the way I live while at Canyon Ranch. I've since come to realize this is what most of us need to do to rid ourselves of our bad habits, our unhealthy ruts. There's nothing temporary about getting healthy. It's takes a lifetime commitment. I lacked commitment before Canyon Ranch. I have commitment now.

I'm committed to eating right, exercising, minimizing stress, processing my anxiety, focusing on family, prioritizing, and so much more -- all because of cancer and what I learned at Canyon Ranch.

When you're knee deep in the mess of stress, anxiety, disappointment, panic, fear -- you name it -- isn't it nice to escape for a moment, to feel relief from the burden of heavy emotion? I think so. And I happen to know from personal experience a few techniques that have a calming effect on the most overworked of minds. I'll make it brief, because I know reading volumes of self-help advice is not what's on your worried mind.

• Listen to a favorite song, or any song. It will shift your focus and put your mind in the context of the song. You may even feel recharged and motivated.

• Write down your thoughts. Just write. Don't worry about grammar, spelling, or sentence formation. Just jot down what's on your mind. Transfer your emotion to paper -- or the computer screen -- and see how relieved you can feel.

Colposcopy, usually performed after a Pap smear shows abnormal cells, allows a doctor to examine the cervix with a special microscope. This procedure can be highly stressful and cause anxiety both before and during the examination.

Researchers at the Cochrane Collaboration examined data from 11 trials and determined that listening to music during colposcopy produced a significant reduction in anxiety levels. Pre-test counselling, pamphlets and video information had no effect on anxiety levels.

This makes sense to me. Counselling, pamphlets and video information could just make a woman focus more on the upcoming procedure. I can see how distraction through music might be a better option.

A new study out of Britain shows that though many men with prostate cancer recognized they had symptoms of a serious disease, they were hesitant to go to the doctor because they felt it wasn't 'macho.' Another reason? Fear. It's a natural reaction--wanting to bury your head in the sand and ignore your gut when you're afraid something might be seriously wrong--yet it's dangerous and it's killing thousands of men every year. This fear may not be unfounded though -- the study also showed that men's GPs were often unsympathetic and gave off negative vibes when it came to their male patients.

The men in my life are all brave, but I can see them being the same way when it comes to their health -- avoiding the doctor and the bad news they may hear. How do we change this sort of thinking and save our men? What do you think of these findings?

Danish researchers, in a new study in Value in Health authored by Dr. John Brodersen, studied the effect of false-positive cancer tests, including false-positive results on mammograms.

Brodersen and colleagues found that false-positives caused significant psychological harm in "six psychosocial dimensions; anxiety, behavioral impact, sense of dejection, impact on sleep, breast examination and sexuality."

Brodersen says, "Women should be better informed both before breast cancer screening and during the screening process. This should include a discussion about the implications of a false-positive result, as well as the benefits of early detection of breast cancer."

I couldn't agree more.

A new and official report shows cancer is the leading cause of death and disability in Australia.

The Australian Institute of Health and Welfare reveals that cancer is taking more lives -- about 19 percent -- than cardiovascular disease, currently at 18 percent. Cancer is the now to blame for Australia's burden of disease, according to the report, and the disease doesn't appear to be slowing anytime soon.

Burden of disease refers to not only mortality but also takes into account impact of illness and disability. Essentially, this means cancer takes away from healthy life years.

Partners of cancer survivors may be at risk for depression and are susceptible to the same stresses as cancer survivors themselves, says a new study in the Journal of Clinical Oncology.

The study showed that similar numbers of partners and survivors show signs of clinical depression, but partners were less likely to receive mental health treatment. Previous research has found that partners of cancer patients can experience as much anxiety, distress and depression as the patients themselves.

Michelle M. Bishop, Ph.D., Research Assistant Professor and the study's lead author says "We need to acknowledge that cancer occurs in the context of a family that is profoundly affected by the experience, and that needs intervention for their own well-being".

Don't give up that daily cup of coffee just yet. Studies show drinking coffee may reduce your risk of developing Parkinson's disease, diabetes, cirrhosis of the liver, and colon cancer. It's even been linked to a decreased risk of inflammatory and cardiovascular disease in postmenopausal women.

Why? According to an article in the March 2007 issue of Ladies Home Journal, it's because coffee contains large amounts of flavonoids and antioxidants -- and these combat a whole bunch of illnesses.

Now drinking too much coffee can have adverse side effects, like restlessness, anxiety, and headaches, but limiting yourself to one to four brewed cups per day seems to be a safe practice. Although for those with high blood pressure, consuming between two to four cups per day maybe a bit risky because coffee causes blood pressure to rise immediately after consumption. And all coffee drinkers should fight the urge to add sugar, flavored syrup, and whole milk to to their beverages.

A daily cup of tea seems to be healthy too. Researchers are investigating its use in the prevention of cancer, and we already know both black and green tea have significant quantities of disease-fighting flavonoids -- although not as much as coffee.

Cancer sent me into a state of depression. And it took more than a year of counseling and treatment with an anti-depressant to bring me back to a balanced and healthy level of functioning.

My type of depression -- the kind that shows up just after a cancer diagnosis -- is not uncommon. And neither is the spillover that depression can leave on the children of moms depressed because of their disease.

A study at the University of Pittsburgh -- the first to examine the relationship between children's concerns and a mother's cancer-related depression -- found children of depressed breast cancer patients were more likely to be concerned or anxious about their mother's cancer and about how the disease affects their families.

It's not surprising that kids worry about their moms during times of illness. What startled researchers, though, is the fact that children's' anxieties extended to concerns about the entire family.

The results of this study, funded by the National Cancer Institute, has clear implications. As a society, we need to think about how depression affects whole family units. Oncologists must learn to spot depression early and must swiftly assist women in finding appropriate treatment. And parents should talk openly about cancer and it's emotional side effects with their children in an effort to protect them from withdrawing, hiding their concerns, and suffering in silence.

Most estimates indicate nearly one quarter of women diagnosed with breast cancer have young children. And about 100,000 kids will be affected by a cancer diagnosis this year alone.

I had no idea my February 10 post Some children's bath products linked to cancer would spark such great debate. At the very moment I write, the post has received more than 64,000 hits and 70 comments.

I must admit when the comments started rolling in, I was a bit nervous. Even though I merely reported the facts on this topic, had no claim to any of the information, and didn't even share my opinion on the matter, the highly charged words written by so many well-meaning readers made me feel a bit like I was caught in the middle, like I started an argument and needed to jump back in, sort things out, and create harmony among those responding to my words.

But then I realized debate is not such a bad thing. It sheds light on all sorts of valid viewpoints. It educates. It raises awareness. And that's what cancer causes are all about.

Having read all the comments that now are officially assigned to this one post, I am so much more enlightened than when I summarized the story I came across revealing that some bath products contain a bit too much of a chemical called 1,4-dioxane, a probable human carcinogen that is already known to cause cancer in animals.

All I really knew at the time I wrote the post is that the FDA has no regulation over this chemical and that cosmetic companies must monitor themselves. Some don't do such a good job, and herein lies the debate.

Some readers say big deal, what's the harm really in a little extra dash of chemical in a whole tub of water. Perhaps if our children soaked all day for many days in this chemical, cancer might strike. But a quick bath with a tiny trace of 1,4-dioxane is not likely to do any harm. One reader wrote that we shouldn't stress so much about headlines that scare us into believing everything causes cancer, that we'll probably live a whole lot longer just living our lives free of constant worry.

Another camp of readers say a little bit of something bad is still too much. Over the course of a lifetime, how do we know our children won't pay for our mistaken belief that this hype is just -- hype. Some cancer surviving readers wonder if their cancer was caused by their plentiful childhood bubble baths. And some go to great lengths to find natural, organic, chemical-free products, whatever the financial cost.

A few consultants for these natural products left their own comments, claiming to help those consumed with anxiety. Others scolded these business people for capitalizing on the fears of others with products that have not been proved any safer.

There are advocates of moderation who wrote. And individuals seeking more information. And people who located resources for others to investigate.

There is indeed a rich commentary on the link between bath products and cancer that follows one short post I wrote late one night, after my own children were bathed -- with Dove soap and generic shampoo -- and put to bed. And I am indeed happy to know my small contribution on the topic has generated such a powerful windfall of thought and concern.

Cancer-related fear once consumed my mind. Now it sits lodged in the back of my brain and only presents itself on rare occasions.

I handle my fears so much better now than when cancer was new and fresh and raw. My fears hardly ever cause me real anxiety, they don't cripple my mental functioning anymore, and more than ever, they serve to focus my efforts in life. When fear strikes, it's usually a wake-up call of sorts, a reminder to leave no stone unturned, a summons to keep on living.

Although so much less threatening than they once were, my fears still exist. And I like to review them once in awhile, lose myself in a little emotional housekeeping, tidy up some of the mess cancer made. I always feel better when things are in order -- fears included.

• I fear a breast cancer recurrence, the return of a tumor that rises to the surface of my skin and presents itself again underneath my fingertips -- or in my worst-case scenario is lost among dense breast tissue, undetected by self-exam, and caught too late by some combination of mammogram, ultrasound, and MRI.

• I fear more than anything another cancer -- something entirely different from breast cancer, something buried in my body and not as responsive as breast cancer to treatment. I am prepared for a second visit from breast cancer because I know how to proceed, know I will succumb to treatment that is familiar, know I will remove both breasts in the most radical of life-saving approaches. But cancer in my lungs, brain, bones, blood, ovaries is out of my realm. And these cancers -- among many others -- really scare me.
  

• I fear that my mom and my sister -- my first-degree female relatives -- will one day follow in my breast cancer footsteps. I once thought family history trickled down from above, from older family members. Now I know the disease can start with anyone. I am the anyone in my family. I am the reason my mom and sister are closely watched and monitored and tested. I am the one that put the fear of cancer into their hearts and minds -- and into mine.
  

• I fear having another baby. I fear the return of cancer during pregnancy, leaving me with difficult choices regarding my health and my baby's health. I fear cancer returning after a baby is born, leaving me with one more child and more treatment to manage. I fear another cancer would lead to a decreased chance of survival and another baby would leave my husband feeling stranded should I die too soon. And I fear having a baby girl who would inherit the very real chance of developing breast cancer at some time during her life.
  

• I fear not having another baby. I fear the regret I may feel one day, perhaps 50 years from now when I am healthy and cancer-free and without the child I longed for. I fear I am being overly cautious, too tentative, a bit selfish. A fellow cancer survivor once wrote me, "I learned that my family continues, even if I do not. I also learned that they are at least as tough as I am so will cope with the genes I pass to them and their own cancer battles if needed. Finally, I learned they look out for each other just as I looked out for them. No matter what your future, you will never regret giving another child a place in your family." I fear this man may be right.
  

• I fear dying at a young age. I fear leaving my children before they are grown. I fear leaving my husband a single parent, my mom someone who has lost a child, and my sister an only child. I have been told over and over again that my chances of survival are great, fantastic even. I have a 93 percent chance of not dying from breast cancer. This does seem great -- until I take into account that this percentage is good for only five years. My five years will expire when I am 39 years old. What happens then, I am not sure. The only thing I am sure about is that five years is not enough time. I want more, need more, demand more. Yet I fear my days may be numbered.
  

These are the fears that keep me focused. And while they are sometimes not-so-pleasant, I am in no hurry to resolve any of them. I am thankful really to have these fears swirling in my head -- because it means I am alive. And for me, being alive with fears is better than not being alive at all.

Survivorship is the new cancer buzz word -- and what an important word it is. Once left to each individual to define, manage, and transcend, survivorship is now recognized as a distinct phase of cancer recovery -- just as important, and maybe even more so, than diagnosis and treatment.

Linda Griggs, a 13-year breast cancer survivor, clearly remembers the day her chemotherapy ended. With her therapy complete, her hair growing back, and her medical team sending her off to have a nice life, she thought she'd be fine. But she wasn't.

Three months after her last dose of chemotherapy, Griggs was depressed, consumed with worry about how her cancer might come back. And she realized that the end of treatment is not really the end. It's just the beginning.

Griggs told her doctor about her anxiety, about how she was just trying to make it to her next three-month-check up. When her doctor told her, "that's not living," something clicked for Griggs who instantly decided to start living -- really living.

Surviving is about self-nurturing, says Griggs, who has created a kit to help others survive cancer. On her website, she writes that there are a couple of other breast cancer survivor kits out there -- containing tissues, herbal teas, meditation tapes, medical appointment books, and breast cancer resource materials.

"This is not that," she says of her kit that focuses on the emotional upheaval cancer creates.

Griggs' kit is full of hands-on creative materials -- like an inner child notebook, complete with magic markers for journaling and expressing emotions. If you're angry, you can write down angry thoughts. If you're sad, write what makes you sad. Save the pages, tear them up, burn them, do what you wish -- but allow your emotions to flow, Griggs says.

The kit also includes a wooden box with instructions on how to create a healing shrine, a copy of Griggs' non-fiction account of the first five years of her cancer journey, and so much more.

Griggs, who also teaches healing workshops, guides others to understand cancer as a hero's quest. She says when something happens to us -- death, divorce, disease -- we are receiving a call to adventure. All bet's are off. We must start fresh, gather our spirit guides, collect ourselves, dive into the underworld, overcome, and then emerge full of wisdom of growth.

Griggs has emerged -- full of her own wisdom and growth. She is a hero -- on a quest to help others survive a disease that threw her way off track for way too long.

There are about 150,000 women in the United States living with advanced breast cancer. Musa Mayer and Susan E Grober, consultants for the study called Silent Voices: Women with Advanced (Metastatic) Breast Cancer Share Their Needs and Preferences for Information, Support and Practical Resources, say that over the years many of the women living with metastatic disease have expressed that they feel isolated, marginalized and alone.

The study found that nearly one-third of the women living with advanced breast cancer do not know where to access programs or medical treatments and emerging research. This study's finding is among several that could impact healthcare professionals and advocates who serve women living with Stage 4 disease.

Women in the study said that many of the support and information networks for breast cancer focus mostly on early-stage disease. The information on metastatic disease is often hard to find. There is not one website dedicated to bringing together the existing resources on advanced breast cancer.

A survey was given to the women in the study. Here are some of the findings:

• 75 percent of the women look for information about advanced breast cancer either daily or weekly.
• 69 percent said they find it helpful to listen or read about the experiences of other women living with advanced disease.
• 44 percent prefer online support groups while 38 percent prefer in-person groups.
• 57 percent of women with the lowest level of knowledge about their advanced breast cancer report feelings of anxiety, whereas only 19 percent of those with the highest level of knowledge report anxiety.