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.

It feels like summer here in Florida. Our temps topped 86 degrees last week and this kind of heat prompts my little boys to request their favorite summertime activity: swimming.

My kids don't quite understand that the temperature outside is not the same as the temperature of unheated water. And so as soon as warm weather arrives, they dash for their suits and insist we make a trip to the neighborhood pool. I oblige, convinced they'll want to head home once they submerge their piggy toes in pure ice.

But somehow, the temperature doesn't register. They plunge right in, dunk their heads and kick and flop and float. They are happy as clams, quivering lips and all. I am happy too as I watch their joyous moments from the privacy of my lounge chair, tucked away in the shade that borders my kids' perfect playland.

Thanks to chemo, I am the mommy who hides in the shadows during any sunny event. It's been two whole years since my last dose of toxic drugs, but something about the sun and the heat and the residual effects of my infused poison causes my skin to produce red, itchy, unsightly bumps. It happened last year and already this year and I'm wondering now if this will be a life-long nuisance, if I will be seeking shade for the rest of my years.

It's all OK really. Secluding myself from the sun's rays is a pretty healthy venture. And I'm not a real pool enthusiast. Any my boys are old enough to swim independently. And it's peaceful in the shade. So I'm not bitter about this unexpected side effect of chemo -- it's called UV recall -- and I'm not complaining. I'm merely marveling at the power of the drugs that hopefully killed all the cancer in my body, the drugs that seem to creep back year after year, perhaps reminding me that in the whole scheme of things, red, itchy, unsightly bumps are not such a bad life condition.

Boise State basketball player Coby Karl, son of Denver Nuggets coach George Karl, had surgery 13 months ago to remove his thyroid after he was diagnosed with papillary carcinoma, a form of treatable cancer. And while Karl received chemotherapy to kill off any lingering cancer cells, he must undergo cancer surgery once again.

Karl, who plans to play in the NABC All-Star game in Atlanta on March 31, will return to Boise on April 2 for surgery to remove cancerous lymph nodes.

The lymph node cancer was identified in January, but Karl, 23, kept his condition private until his team lost to New Mexico State in the Western Athletic Conference tournament semifinals. This ended the Broncos' season. And now begins Karl's second go-round with cancer.

You may remember Karl as one of last year's NBA draft hopefuls. He worked out for three teams, including his dad's team, but eventually withdrew his name from the draft and returned to Boise State for his senior year.

The American Cancer Society has happily announced that cancer deaths have declined for the second straight year. This is big news -- mostly because our population is growing and aging and it's entirely possible this could have led to an increase in cancer deaths. Not only is this not true, but the drop in deaths for this second year is eight times greater than the drop during the first year. Amazing.

It's hard to imagine in light of this great news that there are still less hopeful statistics out there on the cancer front. But there are so many dimensions to this disease -- prevention, detection, diagnosis, treatment, survival -- that the numbers can vary tremendously depending on perspective.

From the perspective of diagnosis, one in two men and one in three women in America today will develop cancer during their lifetimes. These staggering statistics, based on data collected during 2001 through 2003, are detailed in a pivotal paper appearing in The Oncologist -- a monthly peer-reviewed journal for doctors devoted to cancer patient care.

Dr. Matthew Hayat and colleagues, who worked on this paper for the National Cancer Institute, reveal other worrisome numbers and facts.

It seems the number of new cancer patients is expected to more than double from the current 1.36 million in 2000 to almost 3 million in 2050. Five-year survival for all cancer stages combined ranges from as low as 16 percent for lung cancer patients to 100 percent for prostate cancer patients. And black Americans are reported to have the highest cancer incidence and mortality rates for men and women for all cancers combined.

So while less people are dying from cancer, diagnosis of the disease seems to be on the rise. Not exactly a perfect scenario -- but if science and research can keep up, perhaps those diagnosed with cancer will need to prepare not for death, but for the management of a chronic condition.

Battling cancer can at times feel like slowly paddling upstream against currents that are both forceful and unforgiving. Sometimes reprieve comes only when we find others in the same boat, others submerged in their own rough waters, others who truly know what it's like to navigate a dreadful disease.

I am lucky -- in an odd sort of cancer way -- because I had breast cancer. Many women have breast cancer. And while this really is a horrible fact, it makes for a great sea of support. At times when I felt I was drowning in cancer, I reached for my lifeguards -- the women who paddled before me, the women paddling alongside me -- and they coached me, guided me, saved me from one the worst side effects of cancer. Isolation.

I have rarely felt isolated in my cancer journey and as a result, I have not thought much about this lonely cancer consequence. But I am thinking about it now -- thanks to a reader who has courageously shared her story with me, in hopes of locating someone in her same boat, in hopes of creating connections with other survivors who share the challenges of her disease.

Tanya has anal cancer. She was diagnosed one year ago -- during a routine colonoscopy -- with squamous cell carcinoma in-situ in her anal canal, on the wall between the anus and vagina. Previous abdominal discomfort, much like dull menstrual pain, preceded Tanya's screening but she was sure it was due to menopause. She was 53 at the time.

But it wasn't menopause. It was cancer. And it was devastating for Tanya who was spared radical surgery in exchange for a combination of radiation and a chemotherapy called the Nigro Protocol. First came a mitomycin push followed by four to five days of 5-Fluorouracil. Radiation came next -- for six weeks -- and then Tanya endured another round of the same chemotherapy regimen.

"The treatment was brutal," Tanya says. "By the end of the sixth week, I was in a lot of pain, especially since the affected area had a lot of traffic and could not exactly be decommissioned and allowed to heal."

Although she was told by her oncologist she tolerated her treatment well, Tanya says it was pure hell.

Tanya's treatment ended in March and an August biopsy revealed she is doing just fine. Her cancer appears to be gone. What is not gone, however, is the discomfort that still plagues her -- both physically and emotionally. And while the physical scars are simply terrible -- she feels pain during urination and bowel movements and is currently unable to have intercourse with her knight-in-shining-armor husband -- the emotional isolation is overwhelming distressing.

"I have not shared this experience with too many people since I feel awkward discussing that part of my anatomy and because the condition is so uncommon," Tanya says. "I would, however, be most grateful to discuss any or all of this with someone who has been through the same experience."

If you have been in Tanya's same cancer boat, have paddled similar waters, or know someone with whom she might connect, please consider contacting this brave survivor at sultana@cyberight.net.

Safety Reggie Nelson is headed to Arizona where he and his Florida Gator teammates will battle the Ohio State Buckeyes for the 2007 National Championship title. It's a chance of a lifetime for Nelson -- who says he would give it all up if if his mom was headed on the road to recovery.

Nelson's mom has been battling recurrent breast cancer and is confined to her home as a result of chemotherapy and other cancer treatment. She can't sit in the stands and watch her son in all his glory but she still plays an active role in his life. She calls him after every game and is known for offering both critiques and motivation. What she doesn't offer is much detail on her condition -- because she doesn't want her son to worry.

Nelson says he would do anything to save his mom from the ravages of her disease. He has little power over her fate, however, so he pours his blood, sweat, and tears into football -- with his mom just a phone call away.

"I talk to my mom 24/7," Nelson said. "My mom's my life and my best friend. Everything I do is because of her. She's always in my mind."

There's no doubt she will be on Nelson's mind on January 8 -- when he takes to the field in one of football's greatest battles, in honor of his mom and her own great battle.

Lymphedema is a chronic condition that causes excess fluid to collect in tissue and produce swelling. In breast cancer survivors the swelling can occur in the arm or hand because the lymphatic system has been compromised by surgery or radiation. Its an unattractive and painful reminder of having breast cancer that never goes away.

Robin Miller, 23, and Rachel Levin, 36, are young breast cancer survivors that developed lymphedema after their breast cancer treatment. They were required to wear an uncomfortable, beige orthopedic-looking sleeve. They decided that there had to be a better solution for the look and feel of the sleeves they would have to wear. They approached Kristin Dudley, a Drexel fashion design graduate, with the idea of creating fashionable compression garments that would bring together form and function.

These three friends have made it their mission to help breast cancer survivors manage their lymphedema in a fashionable way, and inspire them to feel confident and attractive with their company called LympheDIVAs. The armsleeves are made of high-tech fibers and come in fashionable colors and designs.

"The look and style of the sleeves has remained the same for over 30 years" said Rachel Levin. "There is absolutely no reason it can't look stylish and still be an effective medical device"

TIME magazine has faithfully followed the issues defining cancer. The topic has made the covers of many issues, and it receives plentiful press on the pages in between. Stories spotlight an array of different cancers, address research and new developments, and offer personal glimpses into the lives of both everyday survivors and those with celebrity status. A look into the archives of TIME magazine -- seven specific issues -- illustrates a proven commitment to the cancer cause. And it proves the mystery of cancer is much the same today as it was many years ago.

Studies exist that link acid-reflux conditions to cancer of the larynx -- or voice box -- but authors of a new study say they all suffer shortcomings in methodology.

The new study, published in the American Journal of Medicine, was intended to make up for these shortcomings by comparing 96 men and women with laryngeal cancer to a group of adults without the disease. All participants were matched by age, gender, and ethnicity -- three of the most important risk factors for this cancer. Overall, the study found people with GERD -- gastroesophageal reflux disease -- were twice as likely to develop laryngeal cancer, compared to those without the condition. GERD has long been considered a possible risk factor for this cancer, mostly because GERD is common among people with the cancer. More definitive studies are on the horizon.

GERD, which occurs when the muscle of the bottom of the esophagus fails to close properly, allowing stomach acids to leak into the esophagus, is also linked to esophageal cancer.

I really do believe deep down in my gut that I will survive breast cancer -- that I will witness the wonder of my children growing up, that I will be married long enough that the years blur together, that I will live to a ripe old age. But I still have moments of doubt -- moments powerful enough to make me think I should not have a third child, just in case cancer comes back. To combat these moments -- that seem to surface more now that my treatment has stopped -- I try to keep busy, keep my mind occupied, keep living. My steps for surviving in the short-term include writing, journaling, exercising, relaxing, and spending time with family. But I also follow some steps for long-term survival -- steps that transcend the moment and give me purpose and direction. And here are seven of them.

Chloe is a little girl conceived through in vitro fertilization -- not because her parents could not conceive in the traditional manner but because they wanted to make sure Chloe had no predisposition to cancer in her genetic makeup. And in vitro fertilization is one method of almost ensuring this. There is still a three percent chance of failure but Chloe's parents felt confident in the elective process that would mostly prevent her from inheriting a genetic mutation for colon cancer that has devastated her family -- Chloe's father carries this mutation, and his mother, grandfather, and two uncles have all died from colon cancer.

A growing number of couples are using preimplantation genetic makeup to detect a predisposition to cancers that may or may not develop later in life. Using this procedure, parents subject their tiny embryos to genetic tests to determine whether or not they harbor defective genes. Essentially, parents get to pick and choose from embryos in a petri dish which one they want. Since the embryo that became Chloe did not test positive for any defective genes, she was the chosen one. And she is now a healthy two-year-old girl.

It's an ethical minefield -- this scientific creation of human life and the picking and choosing of which embryos will survive and which ones will not. One expert says the issue centers around what is considered serious enough to warrant such testing -- and who gets to make this decision. Ethical dilemmas surrounding this issue will only continue to grow as more and more options become available. Already embryos are tested for predisposition for obesity and deafness and a mild skin condition. Some clinics even screen for gender. Some fear this practice may lead to a genetic class divide where the wealthy will become more genetically pure than the poor -- because this process is difficult and expensive, costing tens of thousands of dollars without insurance coverage.

Chloe's parents are happy they made the choice they did. Her father says he doesn't know if he could handle being told his daughter has cancer -- especially with the knowledge that he could have prevented it.

In the past year, I have had three severe skin reactions characterized by red, itchy, burning bumps that start on my chest and without fail climb over my shoulders and onto my back. They last for a few weeks, are irritated by the Florida heat, and have had no known cause -- until today when I visited my dermatologist for a skin cancer screening and briefed her on this bizarre condition that has kept me away from sunscreen and out of the swimming pool and in hiding from the sun. I have suspected that sunscreen, chlorine, the sun -- or some combination of the three -- have been my potential irritants. So I've been avoiding them altogether. But I learned today that the sunscreen and the chlorine are not to blame. That leaves the sun, which is the most likely culprit -- and only because I have received chemotherapy with one very toxic drug. Adriamycin.

My dermatologist told me about a phenomenon called UV Recall that is associated with Adriamycin. Apparently the toxicity of this drug, even though administered long ago, can be recalled, causing a reaction when the UV rays of the sun soak into my skin. Sunscreen may help, my doctor told me, but she cautioned me that it is just a screen -- it does not offer full protection. And she said the best suncreen option would include zinc oxide. I think for me, though, staying out of the sun is my best bet. It's not ideal -- it means I will remain on the fringe of the swimming pool, hiding in the shade, while my boys swim their little hearts out. And tropical vacations will be off my wish list. And I will seek outdoor fun mostly after the sun goes down. But this is okay -- I knew there were long-term side effects of chemotherapy drugs. I am just thankful for now that my heart has not been compromised -- a side effect of both Adriamycin and the drug Herceptin that I have also received. And it's also not a bad thing that the steps I must now take to prevent skin reactions are also the steps that protect me from skin cancer. So in some sort of round-about way, my inconvenient skin issues may just help me stay healthy. And that's just fine with me.

Several boxes containing injections of Neulasta have lined the bottom of my refrigerator for more than a year. They are left-overs from chemotherapy -- from a time when one needle pierced the skin on my arm after each chemo treatment to keep my blood counts in a safe range. I've looked at them day after day after day, and I've allowed them to sit in the same exact spot for all this time. But today, they are in the trash -- not because I made a conscious choice to throw them away but because water spilled all over the inside of my refrigerator and left them soggy and damaged. Surely I would not have used them in this condition, I thought -- so I tossed them. But really, I would not have used them anyway. They were old -- probably past their expiration date -- and I am not receiving chemotherapy anymore. I had absolutely no use for them. But I kept them for safety or comfort or some other impractical reason -- for the same reason I keep a basket full of old medication in my kitchen cupboard. It's all cancer-related -- most of it never touched because I don't really like taking medication, even when necessary. So this stock-piling tendency defies all logic for me. Until today -- when part of my past sits in a white trash bag, ready for the curb, and the rest of it is soon to be trashed. So I can continue moving forward. Away from cancer. For good.

I received a comment today on my Sunday Seven post about how inspiring sentiments help me survive. The comment was from a women who is surviving lung cancer and she asked a question to all readers really -- when will the fear of recurrence ever go away? How do you out there deal with it? So I replied to her private e-mail address and shared my thoughts about fear and recurrence and how I deal with these issues as a cancer survivor. She replied and wrote, your e-mail was so uplifting. I think I just found you on a really bad day and I am thankful that I did. And so I realized that maybe I should not limit my thoughts to just one person when others are surely in her same boat -- my same boat. So here is what I wrote to this one reader who -- like so many others on my journey -- has helped me by allowing me the chance to help her.

Just want to say that I think you are already dealing with the fear-of-recurrence thing because you have been surviving for as long as you have been traveling this bumpy road. So while you survive, you just need to live each day like it's your last and fight for your life at the same time. Someone once told me to think of cancer as a chronic condition -- something we will live with for the rest of your lives. And we just keep treating it, wherever it pops up. And the longer we survive, the more resources there are to help us survive even longer. As for getting through each day, I recommend counseling (I go once per month but at one time I went each week). I also take an anti-depressant (Zoloft) which I do not push on anyone, but for me, it has helped. I went to my oncologist one day and asked him how to live peacefully without worrying constantly that cancer is coming back to haunt me -- he said many cancer patients take anti-depressants to take the edge off so I began the drug and began counseling too. Neither completely take away the fear -- but they help me manage and that's all I can ask for. I also have two little boys who keep me busy and distracted from feeling sorry for myself. And I try to keep busy in other ways too. Helping others with cancer -- or others who just need help -- is healthy too!

Helping others with cancer does help me. It reminds me that I am not alone and that others have fears like me and that collectively, we can all survive better if we lean on one another and borrow from one another and inspire one another.