I like to be in control sometimes -- not always, but sometimes. I don't ever wish to be the top boss in any work scenario. I prefer to have a job and do it well without the stress of managing a whole operation. But I do like to be in charge of my schedule, my kids, my thoughts and emotions, the way my life progresses. Cancer? I'd love to have direct supervision over this pesky subject. Sadly, I don't. So I do my best at controlling the factors that might increase my risk of cancer recurrence. I do it through exercise and diet.

Recently, I realized that controlling my diet is best done at home. I can buy the most nutritious foods at the grocery store, bring them home, prepare them in a healthy fashion, and concoct the perfect portion sizes. Take me out of this home element and I get a little scared.

The other night, my husband and I went to Red Lobster for dinner. We had a gift card and were eager for a night out. Before we escaped our crazy kid household, though, we went online to investigate the nutritional values of Red Lobster dishes. We were shopping for the healthiest options, and we were quite shocked to learn there aren't so many. Now we knew the all-fried fish platters would top the charts in calories, fat, and such. But fresh fish and veggies? Also fairly high in these same categories. We surmised it's the butter and oil used to cook our normally healthy fares that compromised these items and while we weren't so happy about the situation, we still went and did the best we could.

Telling your doctor or nurse about pain is not a sign of weakness and you should not accept pain as a normal part of having cancer. You have a right as a cancer patient who is experiencing pain to ask for pain relief. When you are free of pain, you can sleep and eat better, enjoy the company of those around you, and can continue on with work and hobbies.

If your doctor suggests no other options to reduce your pain after discussing it with him, then ask to see a pain specialist or ask your doctor to consult with a pain specialist which may be an oncologist, anesthesiologist, neurologist, or neurosurgeon.

Use a pain scale when talking with your doctor. For example, your pain might be 5 on a scale of 0 to 10. Other important factors you should discuss with your doctor include ...

Don't delay. There's no better time than the present to get your weight in check. Especiallly now that The American Cancer Society is reporting that maintaining a healthy weight is at the top of their cancer prevention list.

"We know that obesity is related to a number of different cancers, breast cancer among post-menopausal women, colon cancer, esophageal, kidney cancer," says Colleen Doyle of American Cancer Society spokeswoman.

This makes the ACS recommendations more urgent than ever.

The ACS urges individuals to eat a diet rich in fruits, vegetables, and whole grains and to exercise at least five days per week.

There are no guarantees, of course, that these practices will hold off cancer. But "the good news is that a lot of people think they don't have any control over their risk of cancer and we're here to tell people that absolutely you do have some control," says Doyle.

It is estimated that poor diet and lack of physical activity cause about one-third of cancer deaths each year, about the same number of cancer cases caused by smoking.

President Bush, in a recent press release, declared April Cancer Control Month. It's a month for educating Americans about cancer, for raising awareness about treatments, for renewing the commitment to fighting this deadly disease.

Bush makes no mention in his release of the millions he just cut from the National Cancer Institute budget and how this might hinder this month's initiative, but he does offer a few relatively inexpensive ideas for individuals who wish to minimize their risk of developing the disease that remains the country's second leading cause of death.

"Individuals can reduce their risk of developing cancer by practicing healthy eating habits, exercising, limiting sun exposure, avoiding tobacco, knowing their family history, and getting regular screenings from the doctor," he writes.

Bush goes on to honor those lost to cancer and commends the strength of the 10 million people in the United States surviving the disease. He extends his gratitude for medical professionals, researchers, family members, and friends who support cancer patients. And he closes with a little history -- and his very own proclamation.

"In 1938, the Congress of the United States passed a joint resolution (52 Stat. 148; 36 U.S.C. 103) as amended, requesting the President to issue an annual proclamation declaring April as 'Cancer Control Month.'

NOW, THEREFORE, I, GEORGE W. BUSH, President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do hereby proclaim April 2007 as Cancer Control Month. I encourage citizens, government agencies, private businesses, nonprofit organizations, and other interested groups to join in activities that will increase awareness about the steps Americans can take to prevent and control cancer.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-ninth day of March, in the year of our Lord two thousand seven, and of the Independence of the United States of America the two hundred and thirty-first."

GEORGE W. BUSH

Newer versions of oral contraceptives -- with lower levels of estrogen and progestin -- reduce the risk of ovarian cancer more than older concoctions of birth control pills

Researchers at the University of Hawaii in Honolulu, whose work is published in the Journal of Obstetrics & Gynecology, say birth control pills have long decreased the risk of ovarian cancer. But over the years, doses of hormones in these pills have been decreased to reduce side effects -- and this seems to have an even stronger protective effect against the disease.

Studies show for women who had used any oral contraceptive a 50 percent reduction in risk of developing ovarian cancer compared to women who had never taken the pills. This risk was reduced by 38 percent
for women who took high estrogen and high progestin pills and by 81 percent for those taking pills with low levels of these hormones.

"Up to 42 percent of ovarian cancers might have been avoided if all women used some form of combined oral contraceptive pills," say researchers.

"An estimated 73 percent of ovarian cancers might have been avoided if all women used oral contraceptive pill formulation of low estrogen and low progestin."

Patrick Dempsey may play a doctor on television's Grey's Anatomy but in real life, he is much like all of us -- especially when it comes to caring for a loved one with cancer.

Dempsey's mother had cancer, received treatment for the disease, and has been surviving for nine years. Yet memories of the journey, and the overwhelming process of it all, are fresh in his mind.

"It's overwhelming because it's like, there's too many options sometimes," Dempsey said. "It's like, well, why should I believe the doctors? Shouldn't I get a second opinion? Shouldn't I find a specialist?"

Dempsey recalls feeling naive and childlike and powerless in many ways. And now, partnering with Breakaway from Cancer -- a support initiative founded in 2005 -- he is helping others take control of life with cancer.

"You need a support system in to encourage you, to get you up and out of bed in the morning," Dempsey said.

Findings from an international study suggest that women with a waist size of more than 34 inches are more likely to develop cancer of the womb than women who boast slimmer waistlines.

The study, funded in part by the British charity Cancer Research UK, sized up 223,000 women worldwide and determined that women with a waistline less than 31 inches have half the risk of developing womb cancer than their heavier counterparts.

There has been a significant rise in cases of womb cancer in Britain. And the link between the disease and weight gain is most prevalent among postmenopausal women who have never used hormone replacement therapy or the birth control pill.

According to the National Sizing Survey conducted in 2004, the average British woman now has a 34-inch waist. This is more than six inches bigger than the average size of a woman in the 1950s, says Dr. Lesley Walker of Cancer Research UK.

"Women are larger than they were when they existed on a wartime diet and were generally more active and this is having serious consequences," Walker says.

More than 6,000 women in the UK are diagnosed with womb cancer each year. The disease kills about 1,000 annually.

There is a general belief that opioid use to control pain around the time of death causes the patients to die sooner. "Hospice providers, families, and patients should not be afraid of opioid drugs because of the belief that their use to control pain shortens life" says, Dr. Russell K. Portenoy, of the Beth Israel Medical Center, New York.

Dr. Portenoy and his colleagues examined the relationship between opioid use and survival using data from the National Hospice Outcomes Project (NHOP).

After analysis of all the factors, opioid use accounted for very little in differences of times of death. He believes that opioid therapy by itself contributes very little to the time before death occurs in hospice programs.

"Opioid drugs," Portenoy concludes "can be used aggressively at the end of life to relieve pain and suffering, and this use should not be constrained by inappropriate fear of serious consequences like earlier death".

Health care provider Dr. Anthony Vendryes wrote Monday in the Jamaica Gleaner that he is distressed at the growing number of young women developing cancer -- especially breast cancer. He believes women are not working very hard at preventing the disease. He thinks we are just waiting for the problem to surface and then treating it with "painful and often ineffective" efforts.

According to Vendryes, research indicates a woman's risk of developing breast cancer is under her own control. If we live a lifestyle that promotes cancer, we are apparently likely to get the disease. Such a lifestyle would include gaining more than 11 pounds after the age of 18, exercising less than one time per week, eating less than five servings of fruits and vegetables per day, eating more than three ounces of red meat per day, ingesting too much fat and salt, consuming more than one alcoholic drink per day, and smoking cigarettes.

I am all for healthy living. And I believe achieving good health is under our control. I would personally recommend every woman take charge of her life in a healthful manner. But I do not believe as Vendryes states, "most women actually give themselves cancer by making poor choices in life." I think it's the word most that bothers me.

Obviously, there is a connection between lifestyle choices and chronic disease. And of course our level of health is under our control -- to some extent. But I don't believe it's fair to claim most women ask for breast cancer. I know I didn't.

I did not choose cancer. It chose me. Vendryes might say I am one of the disillusioned people who think cancer is entirely a matter of chance or entirely a matter of genetics. Actually, I suspect it's a combination of all factors. All I know for sure, however, is that my own lifestyle choices were pretty darn healthy prior to my diagnosis.

My weight has always been in a normal range -- and while I did gain more than 11 pounds twice in my life, it was due both times to the more-than-ten-pound babies I delivered into the world. I have always eaten a fairly healthy diet. I consume sweets, salt, and fats in moderation. I have never smoked and have consumed alcohol only minimally. And I have always consistently exercised.

I admit I have eaten red meat, although never daily. And I'm sure I fall short on the recommended intake of fruits and vegetables. But really, I cannot even begin to imagine that my lifestyle was an invitation for cancer. And it makes me sad that most other young women, shocked by a diagnosis of breast cancer like me, might think they asked for such a horrible disease.

It's been two years since my breast cancer diagnosis and subsequent "painful and often ineffective" treatments. And although I have made some lifestyle changes -- I never drink alcohol now, I exercise a little more, and I don't choose to eat red meat if other options are available -- my life is much the same as it was prior to cancer. And I am certain that if cancer makes a return visit to my body, it will not be because I asked for it.

Results of a phase II clinical trial, published in the Journal of Clinical Oncology, says that breast cancer patients who experience worsening of bone metastases during bisphosphonate therapy can improve pain control by switching to another bisphosphonate called Zometa (zoledronic acid).

Researchers conducted the trial among 31 patients with metastatic breast cancer and wanted to see the effect of switching from one bisphosphonate to another. All study participants have been treated with one of the bisphosphonate drugs -- Aredia or Bonefos. Zometa was administered once a month for three months.

After eight weeks of Zometa, 13 of the 31 patients, 42 percent reported a reduction in pain. Researchers concluded that for breast cancer patients with worsening bone metastasis switching to Zometa can improve pain. Results of this trial need to be confirmed by a Phase III clinical trial.

There are various risk factors that can contribute to the development of breast cancer. Being female is the single biggest risk factor that on its own puts all women in jeopardy. But there are other risks -- many beyond our control and some more significant than others -- that can help explain why some women are diagnosed with the most common cancer in women in the United States. And why others are not.

Smoking is the biggest risk factor for lung cancer -- and 90 percent of all lung cancer cases are related to smoking. But family history is a risk factor too and can nearly double the risk of developing the deadly disease.

A study published in the October issue of Chest found by studying a population of Japanese adults that people with a first-degree relative -- mother, father, or sibling -- who had lung cancer had a 95 percent higher risk of contracting the disease. Those who smoked had the greatest risk, but those who did not smoke were still at risk. And women were more at risk than men. The type of lung cancer most associated with family history is squamous cell carcinoma.

The results of this study do not yet translate into recommended guidelines for screening. But those with a family history of lung cancer should make their physicians aware of their history. And perhaps one day people with family history will be identified as high-risk for lung cancer and will be included in further studies. In the meantime, these individuals should avoid all contact with all inhaled and second-hand smoke and should protect their children from all forms of tobacco smoke.

The U.S. Centers for Disease Control and Prevention estimates that more than 180,000 cases of lung cancer are diagnosed each year. About 170,000 die from the disease every year. It's the second leading cause of death for men and the third leading cause of death for women.

Adriene Hughes was diagnosed with breast cancer shortly after her 44th year of living. She found her lump after participating in a 5K walk, which for some reason, caused her breast to swell. The swelling led her to the lump -- and that's how she discovered her cancer. Adriene lives in Southern California, works as a media specialist, and spends her time taking photographs, knitting, and baking cookies and breads.

I have never met Adriene, have never spoken with Adriene. But we have communicated through our on-line journals and through e-mail ever since November 2004 -- when we each received a breast cancer diagnosis that changed the course of our lives forever.

Adriene is a gem, a treasure, a true inspiration. And here are her words.

There's a bit of breast cancer news in just about every magazine out there -- news about treatments and protocols and studies, news about celebrity diagnoses, news about lives lost to breast cancer and lives conquering breast cancer, news that is scattered here and there and everywhere. But now, there is a magazine all about breast cancer -- and just about breast cancer. All sorts of breast cancer wisdom is conveniently packaged into one slick, glossy publication that debuted on newsstands yesterday, September 19.

Beyond: Live & Thrive After Breast Cancer is a semi-annual publication from Meredith Special Interest Media, part of the Meredith Corporation -- a leading media and marketing company and home to magazines such as Better Homes and Gardens, Ladies' Home Journal, Parents, and Fitness. Meredith's new breast cancer venture provides women living with the disease -- and those who may one day encounter it -- with support and with the latest information on treatment and recovery.

The Fall/Winter 2006 premiere issue of Beyond features a cover story about Dallas Mayor Laura Miller, a survivor forging ahead into a life beyond breast cancer. Also filling the pages are inspiring real-life profiles and stories, nutritional advice, up-do-date medical information, fashion tips, the Pink Pages -- a resource guide that details upcoming races and products that support breast cancer -- and much more.

Behind the scenes of this issue is an advisory board of leading experts in the breast cancer field. Experts include Susan Brown, the health manager at Susan G. Komen Foundation; Carolyn M. Kaelin, director of Comprehensive Breast Health Center and breast cancer survivor; and Lillie Shockney, Administrative Director at Johns Hopkins Breast Cancer.

If there is one theme common to women surviving breast cancer, it must be the desire to live beyond the control of this life-threatening and life-changing illness, to recapture an existence that resembles something normal, to embark on a journey outside the confines of cancer. Tips, techniques, strategies, and inspiration for accomplishing these feats are printed on the pages of this new magazine that is sure to reach its intended audience -- that today includes two million women who are living with breast cancer.

Rectal cancer usually involves surgery. The surgery that is performed has the possibility of causing the loss of bowel control. The idea behind giving chemotherapy before surgery (neoadjuvant) is to shrink the tumor so that the surgery will be minimal to avoid the loss of bowel control. Researchers have been evaluating the effects of chemotherapy or radiation therapy prior to surgery in attempt to combat this after effect of surgery.

The article recently published in the New England Journal of Medicine says that survival of patients with rectal cancer fair the same whether or not the chemotherapy is giving before of after surgery. Most patients with rectal cancer are usually treated with radiation before surgery.

Researches affiliated with the European Organization for Research and Treatment for Cancer (EORTC) conducted a clinical trial that included 1,011 patients with rectal cancer. The researches split the patients into four groups. Those receiving chemotherapy and radiation before surgery, those receiving only radiation before surgery, those that received radiation before surgery and chemotherapy after surgery and those that only received chemotherapy before surgery.

The five year survival rate for those who received chemotherapy before surgery and after surgery were both 65 percent. Local recurrences occurred less in those patients who received radiation plus chemotherapy before surgery.

The impact on long-term survival with the use of neoadjuvant chemotherapy has not been well established. The article did not mention if the radiation or neoadjuvant chemotherapy did at all affect the loss of bowel control after surgery.