Cancer patients will inevitably develop some sort of fatigue while going through chemotherapy or radiation therapy. The problem is that it is difficult for health care professionals to accurately assess its severity. There is a new method being studied to help nurses and physicians provide an instant measurement of a patient's fatigue.

The method is called ecological momentary assessment, also known as real-time assessment. The National Comprehensive Cancer Network defines fatigue as "an unusual, persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning".

Do you want to know your risk for developing invasive breast cancer? If so, you can use an online interactive tool for measuring your five year risk and also your lifetime risk of developing the disease.

There are seven questions to answer to calculate your risk. It should not be used by women who already have had a breast cancer diagnosis. This tool has been used successfully in clinics for women with a strong family history of breast cancer.

Keep in mind that other factors also affect the risk of developing breast cancer that are not accounted for by the online tool. Women who do not get mammograms will have a lower chance of having their breast cancer detected.

My own oncologist did it just two days ago. He checked in on my mental health, asked how I was surviving, and eased my fear of cancer recurrence and possible death. He reached beyond the medical scope of our relationship -- literally. He placed a hand on my shoulder. He offered me a hug. He cared.

Yet many doctors refrain from reaching too far into the lives of the patients they treat. They stay at a distance. They focus on merely replacing illness with health. This is, after all, the purpose of medicine -- to fix people.

Dr. Jeremy Geffen, author of The Journey Through Cancer: Healing and Transforming the Whole Person, shares in his book that "at present, doctors focus primarily on the physical characteristics of their patients -- bones and organs, tissue samples, test results, height, weight, and age. Yet in each of us, there is a rich mental, emotional, and spiritual reality that influences, even directs the course of our lives."

Conventional medicine responds to cancer patients with surgery, chemotherapy, radiation, and other treatment protocols to essentially get rid of the cancer. Physical signs, symptoms, and responses are carefully monitored -- while other areas of patients' lives receive little attention.

A whole component of true medical care is missing -- as doctors may feel unprepared to address emotional issues, and time restraints allow for limited interaction between doctor and patient.

Geffen believes the ultimate purpose of medicine is to help all beings "experience unbounded love, joy, and inner peace, and to know this is the essence of who we truly are." This purpose, he believes, deserves as much attention as the purpose of treating symptoms and curing disease.

And so Geffen created a program based on his Seven Levels of Healing -- a program that includes both the relative and ultimate purposes of medicine, both the doing and the being.

Level One: Education and Information -- provides basic information about cancer and treatment options and encourages patients to actively participate in and obtain benefit from their care.

Level Two: Connection with Others -- explores the importance of reaching out to others for comfort and support on the journey through cancer.

Level Three: The Body as Garden -- invites patients and family members to see the human body as growing and evolving, as a complex garden rather than a machine. This level touches on good nutrition, exercise, massage, acupuncture, and a variety of complementary and alternative approaches to healing.

Level Four: Emotional Healing -- enters the realm of the human heart, shedding light on fear, pain, anger, self-love, and forgiveness.

Level Five: The Nature of Mind -- examines how life with cancer is influenced by our thoughts, beliefs, and the meanings we give events.

Level Six: Life Assessment -- delves into aspirations, goals, and purposes of our lives.

Level Seven: The Nature of Spirit -- embraces the spiritual aspects of the healing process.

As a physician, Geffen aims to bring his vision of medicine and healing to cancer patients everywhere. And he uses his book as an instrument of communication -- so readers can participate in his vision, so they can learn to settle for nothing less than medical care that centers on the whole person. And not just the parts.

To read previous posts on the same topic, visit:
The Journey Through Cancer: Introduction
Sunday Seven: Seven Levels of Healing on Cancer Journey

Stay tuned for:
The Journey Through Cancer: Beverly Is Every One Of Us

I love it when seven of something lands before me, offering me potential material for the Sunday Seven series. In fact, it just happened. And I can't wait to start writing about the Seven Levels of Healing common to cancer patients and those who love them.

I have a new book. It's called The Journey Through Cancer: Healing and Transforming the Whole Person by Jeremy Geffen, MD.

Dr. Geffen knows cancer. He lost his father just three months after a stomach cancer diagnosis. He became an oncologist. He founded a cancer research center. He travels and speaks and writes about health and wellness. And inside the pages of his newly revised and updated paperback, he details the Seven Levels of Healing -- a blend of conventional and complementary principles-- and the true stories of cancer patients who have directly experienced them.

It occurred to me while first flipping through this book that I might read it in its entirety and then write a review of the material. Then I determined it would take much too long for this approach. With two small children, a few jobs, an exercise routine I must revisit, and all the other bits and pieces of life that keep me occupied, this would be quite an undertaking -- the actual reading, the remembering, the writing. Somehow, this would be too much to manage. But small steps. I think I can handle small steps. So this is how it's going to work.

I will present to you in this post the Seven Levels of Healing. I don't know much about them yet -- although by title alone, I am sure I have lived most of them in my own cancer journey. So I will simply lay the groundwork. And then I will start reading. And as I read, I will write. This will be my own one-woman book club -- with an open invitation for new members. Read my posts and reflect on them. Agree. Disagree. Leave comments. Buy your own book. Read with me. Apply what you learn to your own life. Share what you learn with others. The possibilities are endless as I journey my way through this new book in search of peace, clarity, and comfort -- all of which flow from these seven levels.

Level One: Education & Information
Level Two: Connection with Others
Level Three: The Body as Garden
Level Four: Emotional Healing
Level Five: The Nature of Mind
Level Six: Life Assessment
Level Seven: The Nature of Spirit

And so that's what I have to offer for now. I'm sorry to keep you hanging. But rest assured, I am hanging right along with you, eager to find a moment to dive into this book. To sink my teeth into the words, sentences, paragraphs, chapters. To relay it all to you. I can't wait -- to really understand the Seven Levels of Healing.

Stay tuned for:
The Journey Through Cancer: Introduction

Breast density has something to do with breast cancer. This is not really news. It's clear there is some kind of link, some kind of relationship, some kind of risk related to breast density for both pre- and post-menopausal women. It's just not clear how exactly breast density -- how much fat tissue fills the breast compared to other tissue -- contributes to breast cancer risk. But once it is clear, medical professionals will have a whole new arsenal of power in the fight against this deadly disease.

Cancer News in Context, a regular series of podcast commentaries produced by the Harvard Center for Cancer Prevention, highlights two recent studies that add weight to the fact that breast density is an important tool in breast cancer prediction and identifies two areas that with futher study might help determine why breasts that are very dense are associated with higher risks for breast cancer -- and why density may be as important a factor as age in determining risk.

Currently, mammograms are the chosen method for measuring breast density. But measurement is not required, and there are no national standards for how to measure. Once federal groups issue requirements and direction on how to classify density, women will receive more accurate assessments of their personal risk.

There is also speculation that altering breast density through hormonal therapy may lower risk. Perhaps genetics are the strongest indicator of risk, making short-term solutions ineffective, but perhaps certain interventions can override genetics, helping women protect themselves from breast cancer.

There are many issues that must be ironed out before we really understand how breast density affects breast cancer. There is no doubt that density, when added to other risk factors, will surely help improve the accuracy of prediction. It's one tool, among many, that is poised to open all sorts of doors.

I have had a hard time keeping my counseling appointments lately. Life keeps getting in the way, and counseling keeps getting pushed to the side. The last time I called my counselor to cancel -- due to an emergency room trip with my three-year-old -- I mentioned that my inability to keep up with sessions was perhaps a precursor to an eventual termination of our counseling relationship. My counselor -- Lindsay -- said this was maybe an accurate assessment, that we should discuss the possibility of an ending point. We haven't yet discussed it, though, because I have not made the time to contact her. I have continued to leave counseling on the back burner.

But today Lindsay sent me an e-mail to check in. She wrote that I am probably going to be okay on my own now -- in the aftermath of cancer -- and that we should have one final session to reflect on my progress over the past 16 months. I have not replied to Lindsay -- not because I am busy with other things but simply because her words made me cry. They still make me cry, hours later. I'm not exactly sure why. And I'm not exactly sure how I will follow up on scheduling my very last session.

I assume my tears -- my sadness -- are part of the healing process, part of the separation anxiety I feel each time a part of my treatment ends and a part of my life moves on. I assume I am sad at the prospect of leaving a vital part of my recovery behind, about leaving the comfort of my counseling chair, about leaving Lindsay. The possibilities are endless. And I suppose we will cover all possibilities when Lindsay and I sit down for our last, final, concluding session -- when we recall how much I have grown since the day we first met, when I could barely mutter a word about cancer without weeping uncontrollably, when I could barely manage to find pleasure in my days, when I could barely imagine that life could -- and would -- offer me peace and happiness.

Today, life is good. And it's clear that counseling is no longer necessary for my survival. But that doesn't make it any easier to make my final appointment. To contemplate saying my last goodbye. To tackle life completely on my own. Which is what I will do -- in time -- so I can continue moving on, away from breast cancer.

The Prostate Cancer Research Foundation of Canada has launched an interactive web resource to assist men in facing prostate cancer and in finding answers regarding prostate cancer diagnosis, treatment and survivorship.

Called Prostate Cancer Assessment Tools (PCATs), each of the 12 PCATs provides individualized information that will help each man better understand prostate cancer.

A sampling of the PCATs are as follows:

• Based on age, PSA, percentage of free PSA, and DRE findings what is the likelihood that I have cancer, if a biopsy is performed?
• Based on the characteristics of my cancer, what is the likelihood that the Gleason sum found on biopsy is higher than the Gleason sum on final pathology, when the prostate is removed?
• Based on the characteristics of my cancer, what is the likelihood that the cancer has spread beyond the capsule of the prostate?
• Based on my PSA, cancer stage at DRE, biopsy Gleason sum, the cumulative length (mm) of cancer on all biopsy cores and on the percentage of positive cores, what is the likelihood that my cancer is clinically significant (i.e., one that may kill)?
• Based on my cancer characteristics what is the likelihood that my cancer represents a (TZ) transition zone cancer?
• Based on the characteristics of my cancer, what is the likelihood that my PSA will increase and indicate a relapse of my prostate cancer after radical prostatectomy?
  

To learn more, and to make use of this interactive tool, visit the Prostate Owners Manual.