Hope is a complex concept and one that is often misunderstood by many people including health care professionals. Many people tend to interchange the terms of wishing, optimism, and hope, but the three have significant differences.

Wishing is usually specific in that you wish for something you desire. It is positive in nature. Optimism emphasizes the positive aspects of a situation and is considered to be a positive trait. Both of these have places in our lives but to live with a disease like cancer and to get through treatments, navigate health care systems, and to overcome society's negative views about cancer as a death sentence, a person must have a strong sense of hope.

In stumbling upon an article published by the National Coalition for Cancer Survivorship written by Elizabeth J. Clark, PhD entitled "You Have The Right To Be Hopeful", I realized that without this inner strength, this determined will power, this drive, that hope creates, there would be a lot less survivors in this disease. It is a good read and I am passing along the link to the free PDF file for others to enjoy and learn from.

1. Hope constitutes an essential experience in the human condition.
2. Hope means desirability of personal survival and the ability of the individual to exert a degree of influence on the surrounding world.
3. Hope is necessary for healthy coping.
4. Hope is a cognitive affective resource that is a psychological asset.
5. Hope is a mental willpower and is a sense of mental energy that helps move a person toward a goal.

As evidence mounts, it's becoming more and more clear that chemo brain, a mental fogginess that can result from chemotherapy, is a real concern and not just a convenient excuse cancer patients use to explain away their flighty and forgetful tendencies. It seems the brain really can suffer cognitive damage from the poisonous drugs that fight off deadly cancer cells. And sometimes, this damage is present years after treatment.

Add to chemo brain the normal aging process as well as brain conditions such as mild cognitive impairment and even schizophrenia and the brain might not stand a chance of ever remembering anything. Unless we buy into the new concept of mental training -- somewhat like physical fitness training -- in which case we may be able to bring back a level of sharpness to our lives.

Research suggests this type of training may delay mental decline. And Betty Hall, 85, who is taking a brain fitness class at her senior living complex in Illinois, says brain-enhancing activities are definitely helping her.

Hall is participating in an eight-week program where she spends one hour per day, five days per week using a computer to match words and listen for details in stories. She says it's helping her remember where she places her keys and her grocery lists -- and it's even helping her in her bridge club.

"I've won four times out of the last five at bridge club, and I think the players are going to shoot me because I keep remembering the cards people have," she said. "It's much easier for me to concentrate . . . and I brag about it everywhere I go."

One clinical professor of neurology says brain health programs will explode over the next few years because of the stunning findings on this front. One study shows relatively short training regimens, lasting just five or six weeks, improve functioning for as long as five years. And booster sessions help advance these gains. Study participants says their everyday tasks, like managing finances, are much easier after mental workouts. Another study of the computer software Hall uses shows the program shaves an average 10 years off the mental age of users.

Not all mental training is alike, and different cognitive difficulties may call for different training protocols. But the simple fact that I can work out my brain like I can work out my body gives me hope that I can possibly reverse the effects of chemotherapy on my own foggy brain, that I can one day not worry anymore that I might find my check book in the refrigerator and my cell phone in my sock drawer. Bring on the workouts!

Thanks to Bev, my brainy friend, for this story tip!

I never predicted counseling would be part of my treatment for cancer. I am well-acquainted with the practice of talk therapy -- I have a graduate degree in counselor education and spent seven years counseling college students with presenting issues such as roommate conflicts, alcohol use and abuse, sexual assault, and depression -- but I never envisioned myself on the receiving end of such a relationship, never imagined I would be the one prescribed an anti-depressant and referred for cognitive-behavioral therapy.

Yet I have spent the past two years talking candidly -- and at times weeping uncontrollably -- with a talented young woman who has given me the tools to cope with life in the aftermath of a cancer diagnosis. And on Tuesday, the culmination of these two years will result in one final session. Together, my counselor and I will recount what has happened to me, how I have handled it, how I will proceed for the rest of my life.

At the end of my one-hour session on Tuesday, I will be set free. I will walk the white, sterile halls of a hospital basement, travel in an elevator up one flight, and exit a building I never knew could become so familiar. I will allow the outdoors to greet me, and for the very first time since cancer invaded my life, I will accept the challenge of living forward -- without the therapy that helped save my life.

On Tuesday, my case will be closed. On Tuesday, a new version of my life begins.

Sometimes drinking alcohol is healthy. And sometimes drinking alcohol is harmful. Studies show that one drink per day -- compared with no drinking at all -- can reduce a woman's risk for heart disease and stroke by 50 percent. And other research indicates that older women who drink moderately have better cognitive skills. But there are also downsides for women who drink even moderate amounts of alcohol.

Even as little as one-half drink per day increases the risk of breast cancer -- possibly because alcohol raises estrogen blood levels which can promote growth of breast tumors. Women are also more likely than men to become dependent on alcohol and to experience other consequences too -- including damage to the brain and other organs. One in 13 adults in the United States has a serious alcohol problem -- and at least six million of these adults are women. And because the risk for alcohol-related health issues increase with age, older women should be especially careful of their alcohol intake for the purpose of maintaining health and limiting the odds of a breast cancer diagnosis.

In the interest of balancing the healthful and harmful effects of alcohol, The Harvard Women's Health Watch suggests that women over the age of 65 limit themselves to one drink per day. Or less.

When I first started going to counseling, I was told I would need eight to 10 sessions of cognitive behavioral therapy to help me deal with my anxiety, my panic, my fear of breast cancer recurrence. My first session was in May 2005 -- and I am still going. Those initial sessions are possibly all I really needed -- and perhaps I could have stopped the therapy long ago. But stopping never came up and no one told me I had to call it quits so I kept on marching into territory I had never before traveled. I have a degree in counseling -- but I'd never been counseled. I know how to listen to others and share empathy and ask open-ended questions -- but I'd never been the one talking and sharing and venting and crying and answering questions. Until last May -- when I discovered the appeal and the comfort of the counseling chair.

I marched into one of my sessions yesterday and plopped into a brown faux leather recliner. I talked about my recent graduation from Herceptin therapy and about how I might manage in life now that treatment is over. I talked about my jobs -- as a writer and a preschool teacher -- and how they fit into my world. I talked about the level of stress in my days and about how my once constant fear that cancer was trailing me has largely diminished. I talked about how breast cancer is no longer my constant companion -- about how it is now just an acquaintance. And I talked about how counseling was once so necessary and about how it is now just a luxury that helps me maintain peace as I live forward.

I am not sure when I will stop going to counseling. But I'm not completely sure of much anymore. And I've learned from counseling to not really question the future -- to just live in the moment and to give thought primarily to the here and now. And right here, right now, I'm sticking with my sessions, my one hour every month, my comforting counseling chair.