Good Morning America coanchor Robin Roberts returned to work on Monday, a little more than one week after her breast cancer surgery. Some think her return was a bit hasty. Some think it was the absolute right thing to do. I'm of this camp -- the jump-back-into-life approach. It's exactly what I did after my surgery and throughout every step of my treatment. And while there were surely days I could have cut myself some slack, I tried to keep on my toes. It was the only way I knew how to manage the chaos of cancer.

In the spirit of helping women cope with their breast cancer diagnoses, Roberts' very own doctor offers some insightful words of wisdom. Click here for guidance about returning to work, managing through surgery and radiation, maintaining emotional health, and the importance of mammograms and self-exams.

What is your take on how Roberts is handling cancer and how her doctor is handling the topics that become critical in the fight against this disease?

Way to go Wake Forest University scientists -- for adding to the body of evidence connecting stress to illness and for reporting before anyone else that the stress hormone epinephrine causes changes in prostate and breast cancer cells that may make them resistant to death.

Emotional stress contributes not only to the development of cancer, says lead researcher George Kulik, D.V.M., Ph.D, but it also reduces the effectiveness of cancer treatments.

Previous research shows levels of epinephrine, produced by the adrenal glands, are sharply increased during stressful situations and can stay elevated during long-term stress and depression.

During this study, published in the on-line Journal of Biological Chemistry, Kulik and colleagues found that a protein called BAD -- the cause of cell death -- becomes inactive when cancer cells are exposed to epinephrine.

This is huge for patients and researchers.

"It may be important for patients who have increased responses to stress to learn to manage the effects," said Kulik. "And, the results point to the possibility of developing an intervention to block the effects of epinephrine."

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.

My blood looked good. My weight is normal. My temperature was 98.2. My blood pressure was perfect. And the physical exam conducted by my oncologist revealed that for another three-month stretch, I have survived cancer.

There are other exams ahead in the next few months -- a breast MRI, a mammogram, an ultrasound, a follow-up with my radiation oncologist -- but mostly, my life revolves around the every-three-month visit with my medical oncologist. He's the one who plotted the course of my treatment, responds to my physical and emotional ups and downs, and checks my every piece and part. He is the one who will declare my remission in five years, if warranted. He is the one who told me today I am doing very well.

And for the next three months, I will assume I am just that -- very well. And my hope is that on May 21, when I depart his office once again, I am able to report that not one thing has changed.

I just heard someone say that time doesn't heal all wounds -- it just makes them worse. I guess it depends on the wound. I imagine losing a child is one wound that never really heals. But I've found that my cancer wounds -- both physical and emotional -- have healed with time. And a trip down memory lane proves it.

Two years ago I wrote about my wounds, fresh and raw and painful, on my Breast Cancer blog.

Confession
Wednesday, February 23rd, 2005

International pharmaceutical company AstraZeneca is donating $10 million to the American Cancer Society (ACS). The donation is one of the largest gifts ever received by the ACS and will help provide support for patients in United States hospitals.

Support will come in the form of specially-trained ACS employees who will work in 60 different hospitals and cancer centers and will offer social, emotional, financial, and transportation assistance in medically underserved Atlanta areas.

London-based AstraZeneca, maker of breast cancer drug tamoxifen and other breast and prostate cancer drugs, made $26 billion in sales last year, the same year the company gave $7 million to a Boston Cancer Society for the development of a Hope Lodge.

I used a written journal and then a blog to record the stops along my cancer journey. I kept a file for financial paperwork, and I made lists of questions in anticipation of medical appointments. I saved all prescription instructions to track the abundance of drugs entering my body, and I earmarked a large white cardboard box as my cancer treasure chest. The contents of this box include cards, gifts, newspaper clippings, books, literature, and more. It's practically spilling over with stuff -- the stuff of cancer.

My system -- which may seem a bit unorganized and splintered -- worked well for me as I tried to keep my head above water following my cancer diagnosis. For others, a more central system may work -- a system that incorporates all pertinent information in one convenient location.

The LIVESTRONG™ Survivorship Notebook, offered by the Lance Armstrong Foundation, is one option for those seeking a clean, concise way to manage the details of cancer. It's designed to organize and guide. It's portable. It's available for the cost of shipping and handling only. And it includes the following:

Survivorship Tools -- this section includes a personal health journal, an appointment diary, a list for medications, a summary section for health and financial information, and a medical history and treatment area.

Survivorship Stories -- this section features stories of cancer survivors that will inspire and empower.

Survivorship Topics -- this section offers readings, answers to questions, and resources about physical, emotional, and practical issues related to cancer.

This yellow notebook -- a symbol of one man's fight and victory against a mighty disease -- could be the perfect accessory for someone facing the unknown. Sometimes all it takes is a bit of organization to calm nerves, minimize anxieties, soothe fears, and instill a sense of control over an otherwise uncontrollable journey.

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.

From houseplants to raised beds, to plant a seed, tend the soil, and watch a plant grow is one of the most inspiringly hopeful of activities. In hopefulness is found a kind of healing. According to the American Horticultural Therapy Association, horticulture therapy is defined as "a process utilizing plants and horticultural activities to improve social, educational, psychological and physical adjustment of persons thus improving their body, mind, and spirit." The American Cancer Society offers a list of some of horticulture therapy benefits one can expect from gardening that include:

• Feelings of hope.
• Stress reduction.
• Social interaction.
• Pain relief.
• Improved muscle tone, flexibility, and cardiopulmonary capability.
• Creativity and self-expression.
• Enhanced self-esteem and improved mood.
• Motor skill development.
  

As the New Year arrives, so do the gardening catalogs in the mail. Interested in receiving gardening catalogs but not certain where to start? Cyndi's Catalog of Garden Catalogs lists over 2,000 mail-order gardening catalogs for the home gardener.

Two of my favorite gardening websites and online catalogs are found at Seeds of Change and Seed Savers Exchange.

At Seeds of Change, you can find garden seeds, seed collections, cover crops, seedlings, fruit trees, garden tools, kitchen items, and a bookstore. All organic. In addition, Seeds of Change publishes a newsletter.

Seed Savers Exchange is a nonprofit organization that saves and shares heirloom seeds. According to Seed Savers Exchange, "Our organization is saving the world's diverse, but endangered, garden heritage for future generations by building a network of people committed to collecting, conserving and sharing heirloom seeds and plants, while educating people about the value of genetic and cultural diversity."

But, wherever you start, once you catch the gardening bug, you will understand why horticulture therapy is becoming an integrated part in healing programs adopted at some of the medical centers across the country.

Support group facilitator and social worker Susan Abrams gives you the inside scoop on support groups and what to expect if you join.

Support groups may not be for everyone but each year thousands of women diagnosed with breast cancer join a support groups to help them cope with the disease. Some are informal gatherings and some are facilitated by a trained professional.

Years ago no one discussed breast cancer and women felt isolated. They had to deal with breast cancer completely on their own. These days women have many outlets for talking about their breast cancer, some women however still remain isolated and would benefit from joining a support group.

Some support groups might be larger and have a guest speaker on occasion to discuss specific topics. Some women like to use a support group for a year or longer after their cancer diagnosis. Usually at this time the patient doesn't want to discuss their breast cancer with friends and family, who may have had enough of the subject. They feel comfortable discussing their fears and concerns with other survivors.

Some benefits of joining a support group:

• help in coping with the disease.
• hear new information to discuss with your physician.
• hear of new treatments or clinical trials.
• reduce stress.
• receive understanding.
• emotional support.

Why you might not want to join a support group:

• you feel that you would benefit more from one on one therapy.
• you find others stories make you more anxiety-provoking than helpful.
• you are too fragile to see someone in worse shape.
• you might begin to doubt your own decisions when listening to others.
• someone in the group could die which could bring on anxiety and fear.

The best way to find a support group is through your physician. Hospital-based support groups are usually very good. Trust your instincts when looking for a group, if you don't feel comfortable with one, try and find one that feels more fitting.

Sarita Zouvas knows what it's like to have a child in the hospital. Her daughter, Isabella -- who died while receiving treatment for cancer -- spent many days in the hospital, and Zouvas says it's hard to anticipate what items from home will make a child's stay more comfortable.

"We don't go prepared," she says. "You don't take clothes; you don't know what's going on. You get there and they put a gown on them. My first response is, 'I want to make them comfortable because they're scared.'"

Zouvas has found a way to bring comfort to the lives of children at her local Children's Hospital. And her goal is to make sure every child admitted to the hospital during the holiday season gets a complimentary pair of pajamas.

After the death of her daughter, Zouvas became involved with the Friends of Scott Foundation (FSF) -- a non-profit organization founded in memory of Scott Delgadillo who lost his life to childhood cancer. FSF strives to help children with cancer and their families with emotional and financial support in order to cope with this devastating disease. Zouvas became a part of the FSF support team and is thrilled she can help bring comfy jammies to sick children.

Zouvas says the response to her call for help has been overwhelming. Most pajamas are donated and have come from as far away as Boston. Employees of the San Diego Padres, Southwest Airlines, and the district attorney's office have also helped Zouvas in the endeavor she hopes will continue year-round.

For more information on the Friends of Scott Foundation and Zouvas' pajama drive, click here.

Florida safety Reggie Nelson said recently he would give up football if he could ensure his mother would survive the breast cancer she had been battling since October 2003. Sadly, such a trade was not possible.

Mary Lakes died Thursday night, just after her son arrived at her Melbourne home following the second-ranked Gators' final pre-Christmas practice in Gainesville.

Lakes, whose illness prevented her from regularly witnessing the wonder of her All-American son -- a possible first-round draft pick -- was able to see Nelson play in September. And while she rarely got to sit in the stands, Lakes and Nelson had a very close relationship.

"Reggie had a special relationship with his mother," Florida coach Urban Meyer said. "She was a tremendous person and an inspiration for Reggie and many others. Our entire football program is deeply saddened and in mourning. We will remain by Reggie's side and provide emotional and spiritual support for him during this difficult time."

Nelson will soon head to Arizona where he and his Florida Gator teammates will take on the Ohio State Buckeyes for the 2007 National Championship title.

Holding Tight, Letting Go: Living with Metastatic Breast Cancer is a book written by Musa Mayer, a breast cancer survivor. Few books discuss the realities of metastatic breast cancer. Women with breast cancer live in fear of recurrence. For at least a third of those diagnosed, the disease will eventually spread. When this happens, most people assume it means an immediate death sentence.

The voices in this book speak of a different reality: that women with metastatic disease generally go on to live with their disease, often for many years, and that the time they have can be full and meaningful.

This is a great book for anyone dealing with metastatic breast cancer or even those who have been diagnosed and have a fear of recurrence. I read this book and it helps because my imagination can be far worse than the reality of the situation.

Here are a list of the chapter titles:

• Voices of a Forgotten Population
• Dread, Uncertainty and White-Water Rafting
• Seventeen Stories of Metastatic Breast Cancer
• The Shock of Recurrence
• The Problem of Knowledge: Doctors, Information-Seeking and Statistics
• Medical Treatments and Choices
• Hope and Healing for the Rest of You: Complementary Therapies
• Living with the Side Effects and Symptoms
• Families and Friends Speak: "Its happening to us, too."
• Light and Shadow: Stories of Remission, Work and Identity
• Final Gifts: Disease Progression, Hard Choices, Last Days
• Still Here: The Anatomy of Courage

New research suggests that it is not uncommon for cancer caregivers to suffer emotional or psychological problems as a result of caring for a loved one battling cancer, and they often suffer in silence. According to study results, the anxiety and stress of caring for someone with cancer is comparable to caring for someone with Alzheimer's disease. This news will come as little surprise to caregivers but it might be a blindspot of need traditionally overlooked by others in the community and medical fields. In USA Today Cancer hurts caregivers, several caregivers stories are featured highlighting the challenges faced as family members struggle to take care of a loved one in cancer treatment.

Aside from the emotional trauma of learning a loved one has been diagnosed with a disease that may cut life short and the psychological effects that can manifest in feelings of hopelessness and unrelenting fear, New York's Memorial-Sloan Kettering Cancer Center psychiatrist Jimmie Holland points out that hospitals are currently discharging cancer patients sicker and quicker when they are still in great pain before their wounds have healed. As a result, family members, who are not trained medical professionals, are left to provide the level of medical care of experienced nurses.

In reaching out to cancer caregivers, the answer might start with something as simple as providing a talk therapy environment where caregivers have a safe place to open up and share their thoughts and feelings. A resource of trained counselors and nurses who can offer reassurance and practical help in navigating the inner terror, and at times, the physical exhaustion of cancer care. For additional information and support resources for caregivers, visit the Cancer Caregivers category of this blog.

Flowers can lift spirits, brighten days, and heal hurting souls. They can actually make us healthier too. And while there is not a lot of science backing this fact just yet, it's long been understood that flowers really do help us Get Well Soon.

In ancient Egypt, physicians ordered walks in gardens for patients with psychological problems. Currently, horticultural therapy is a well-established method of rehabilitation for patients with physical and mental difficulties. Medical institutions all over have created flowering spaces intended as therapeutic gardens. One study determined that 100 percent of women presented with a flower bouquet reacted with a genuine smile that involves the eyes and the mouth and indicates changes in the brain. There was no such common happiness reaction among women presented with other gifts. Further studies found that men also reacted positively to flowers. A study of cardiac patients found flower therapy improved mood and lowered heart rates, possibly reducing stress that contributes to heart disease. It seems some patients seem to forget about their pain when strolling through gardens. They forget about their pain medication too. One flower expert's research brightened her own world at a time when chemotherapy and surgery for breast cancer had her feeling pretty low. Studying flowers gave her a whole new, brighter look at the world.

Flower therapy includes almost any contact with plants. Color, texture, and scent all play a part in the relaxation and healing that results from a little flower time. Why it works is a mystery -- it could be that we associate flowers with pleasure, that flowers fulfill emotional needs, that they are the pets of the horticultural world. We breed them for traits that please us and then capitalize on how they lighten the load and enhance our moods.

The bottom line is this -- we just don't know exactly why or exactly how flowers do what they do. We just know intuitively that they work, that they spread hope and renewal and peace like nothing else.

For more information on the healing power of flowers, pick up a copy of the November 2006 issue of The Oprah Magazine.