Almost five years later, the memory is still as vivid as if it were happening now as I tell you that while showering, I discovered a lump in my breast. My hand stopped, my breath caught, and my stomach clenched in terror. Instinctively, I knew I was in trouble. After mammogram, ultrasound, biopsy and the first of three surgeries, the diagnosis of breast cancer was not the most optimistic one. My lobular breast cancer had spread beyond the breast into lymph nodes -- and perhaps elsewhere not yet clearly detected.

I would spend the next four years peering over my shoulder, wondering if the shadow of death would visit me with another cancer diagnosis, and if so, where would it settle in this time. If I ate pizza topped with jalapenos for that extra kick of flavor and got a stomach ache, I wondered -- had cancer spread to my liver? If I spent a day met with seemingly endless frustrations and annoyances and got a headache -- had the cancer spread to my brain?

While there is nothing rational about these leaps to a cancer conclusion based on evidence suggesting I suffered from logically explainable modern life maladies that antacid or aspirin might easily cure, for the newly-diagnosed surviving breast cancer, it is not uncommon for the mind to immediately race to an impending cancer-based doom for every day aches and pains. I am here to tell you that for the first few years it will be quite normal to have totally unreasonable fears.

Not willing to subject myself to this screeching fingernails on the blackboard fear without finding something to muffle the sound, I began creating personal rituals that suggested hope and affirmed life. With each one I was stating the value of my life and staking my claim to my future. For each woman, the personal rituals will be different. Here are a few I created that might give you some ideas for your own:

I think it's safe to say that a large amount of women in this world lack self confidence. Tack on a few incisions and scars, some lop-sided or altogether missing breasts, a handful of scattered blue tattoos, a head full of newly sprouting hair, swelling arms, drug-damaged fingernails and toenails, damaged veins, alien-like ports protruding from underneath skin, unpredictable hot flashes, and a foggy brain and it's clear that women surviving breast cancer may have a few of their own issues concerning self confidence. It doesn't take science to prove this reality -- although there are studies out there that do confirm and validate that breast cancer survivors struggle with positive self images.

Results of a study released Wednesday reveal that the vast majority of breast cancer patients in Taiwan lose self confidence after having their breasts removed. The study shows that 90 percent of participants feel they have lost their beauty and femininity following a mastectomy. Women worry about their partner's perception of them after such radical appearance changes. They doubt their roles in their workplace and families. They are even afraid of having sex with their partners. And if the patients' relationship with their spouses are not good in the first place, breast removal surgery will lead to divorce about 10 percent of the time.

There is no doubt that female roles vary from country to country -- and what studies show in Taiwan may not be completely applicable to women in the United States. But there is one universal truth that knows no boundaries -- all women recovering from the ravages of breast cancer will encounter struggles. Because breast cancer does not discriminate when it comes to compromising the self esteem of its targets.

In 1967, when Beverly Hlavka was 12 years old, her mother Naomi Poppe Kopke was diagnosed with breast cancer and given six months to live. She remembers how helpless she felt wanting to help her mother and not knowing what to do.

Earlier this year, Beverly lost a friend, Holly Elizabeth Remmers to breast cancer. Again, she had felt helpless because she did not know what to do for her friend as her friend struggled to survive cancer. This is when Beverly decided to create a way to help others help women facing breast cancer. Based on the Pay it Forward concept, made famous with the book and movie, she has launched Gift it Forward.

"If people have done nice things for you, don't give it back, Gift it Forward. This project is a way for people to give money to a cause, receive a fantastic piece of fabric art in return and help women diagnosed with breast cancer." From the money raised, individual women with breast cancer will receive a new mastectomy bra; visit to a wellness retreat; new wig; facial, massage, manicure or pedicure at a day spa; tank of gas to get to chemotherapy; some pretty jewelry; new outfit or makeup; phone card to call the grandkids or anything that puts a smile on her face.

Beverly's intention in Gift it Forward is to help women with the issues that surround keeping a positive attitude, self-esteem and concentrating on the idea of wellness instead of the disease of cancer. She includes instructions on how to make a fabric postcard and how to start a Gift it Forward project of your own. For more information, visit Gift it Forward.

A ninth Hole in the Wall camp is in the works -- thanks to actor Paul Newman who started the first camp for critically-ill children in Connecticut in 1988. Hole in the Wall camps host thousands of children for free and are now scattered all over the map -- in California, New York, France, and other locations. And one will soon open in Israel.

Each Hole in the Wall camp is a separate entity with its own distinct personality and name -- like The Victory Junction Gang in Randleman, NC and Camp Boggy Creek in Eustis, Florida. All camps share a common goal of building self-esteem and restoring joy in the lives of seriously-ill kids. And typical camp activities -- for kids whose diagnoses range from cancer to muscular dystrophy -- include rope climbing, face painting, horseback riding, swimming, and sports. It's a typical camp where children can enjoy childhood, without compromising their medical needs, due to state-of-the-art medical care.

Newman makes periodic visits to the camps and only partially funds the camps that mostly survive on their own through charitable contributions. He clearly loves the camps that have served more than 100,000 kids from 34 states and 31 countries and says he wants the camps to be the legacy he one day is remembered for. And what a legacy it will be.

Angela Lemke was a young woman of 33 when she was diagnosed with breast cancer and she went through a range of emotions in the challenges of cancer surgeries, chemotherapy and radiation. She speaks about feeling sick -- physically, mentally and emotionally. Lemke admits she felt shame and embarrassment at no longer fitting in and looking different after chemotherapy hair loss.

Lemke became frustrated at the hair loss alternatives available, and with her sister-in-law, designed the Inspired by You Ponytail Hat. She loved wearing it as it made her feel like her old self again. Lemke now offers individually created ponytail hats for other women experiencing chemotherapy hair loss. At the time of purchase, a woman can choose from over 288 variable combinations in creating a customized ponytail hat.

You can find out more about Lemke's ponytail hats and create one of your own online at her website. At Inspired by You the motto is: Hope Matters ... Courage Counts!

Makeup artist Lori Ovitz has taken her twenty years of cosmetics experience in making celebrities and top models look beautiful, and written Facing the Mirror with Cancer, a book of tips and techniques to help cancer patients look less tired and create a natural glow at a time when cancer treatments can take a physical toll.

Ovitz began volunteering at University of Chicago hospitals working with cancer patients to teach them how to enhance their personal appearance using makeup. According to Ovitz, "Makeup is a very accessible, inexpensive way to make significant changes to your appearance. The tremendous gratitude that I've received from each patient I've worked with inspired me to write Facing the Mirror with Cancer -- A Guide to Using Makeup to make a Difference."

To publish her book, Ovitz and her husband Bruce, a 35 year cancer survivor, created Belle Press -- named to honor the memory of her grandmother Belle Michel -- so that 50 percent of the profits from the book could go to cancer research.

"Cancer does not have to rob you of self-esteem or beauty. By teaching cancer patients how to apply makeup, I've seen firsthand what an incredible transformation occurs in their appearance and how much better they feel about themselves. I've written this book because I want to reach cancer patients everywhere so they can learn the tricks of my trade," Lori Ovitz states with assurance.

You can order Facing the Mirror with Cancer, a 200-page book featuring step-by-step tips and techniques for dealing with appearance issues during cancer treatment and beyond, here.

As if the horrors of breast cancer are not enough -- surgery and recovery, chemotherapy and recovery, radiation and recovery, additional treatments and recovery -- weight gain often comes along and rounds out the full breast cancer package. It is most common for women who have chemotherapy -- the curse is not often seen for women who have surgery alone or surgery followed by radiation -- and while it may seem the lesser of all evils for some women, others may be plagued by an additional battle with weight. In addition to the self esteem blow that breast cancer delivers -- complete with scars and removal of breasts and reconstruction and hair loss -- weight gain in this body-image obsessed era can take its toll. There are also health concerns related to weight gain -- and an excess of weight is reported to sometimes influence a return of breast cancer and can be a risk factor for other cancers too.

The American Cancer Society reports that the average weight gain is five to eight pounds over a year's time -- but that gaining 25 pounds is not uncommon either. This phenomenon is somewhat of a mystery, although there are some theories about why women are at risk for this not-so-pleasant side effect of breast cancer. Some women get nauseated during chemotherapy and don't eat much -- but others have intense food cravings and tend to eat more. Body composition may also change and research shows that chemotherapy possibly diminishes lean body mass and increases fatty tissue. Menopause may also be to blame -- natural and chemically-induced menopause operate the same and both slow metabolism. So it takes more physical activity to burn what less activity accomplished prior to chemotherapy. Women experiencing treatment also tend to exercise less which can contribute to weight gain. And some women fault the Tamoxifen they take following chemotherapy -- although research does not support a strong link between the two. There are many possibilities. Yet none of them are definite. There is one definite, though -- a healthy menu, a healthy exercise routine, and a healthy support team can help women ward off this unfair consequence of an unfair disease.

According to a report from the Boston University School of Medicine, children who are overweight by the age of six are more likely to have overly-rigid insensitive disciplinarians as parents. Meanie parents cause stress, and small children overeat to relieve the stress. This leads to excessive weight gain. In addition, these children are learning health-damaging ways of dealing with stress and setting themselves up for a life-long pattern of emotional eating and weight problems, including obesity and diseases linked to obesity. Or disciplinarian parents can have such strict rules about food and exercise that are so unrealistic children turn off internal messages that tell them when they are full. But what are these children supposed to do in an environment that causes them that kind of stress? They have few options. Eating is one of the most readily available. It's not like they can walk out the door and hop on a bus for a better life.

According to a Look Good Feel Better survey, women who are undergoing treatment for cancer believe they are being treated differently at work because of the physical appearance changes that often occur due to cancer treatments. The survey is being released as part of  National Cancer Survivors Day. Some of the findings in the survey report that:

• 69 percent of women indicated their appearance changed during chemotherapy or radiation.
• 83 percent of women indicated they were self-conscious of their appearance during treatment.
• Almost 50 percent of women indicated that the change in their appearance during treatment resulted in friends and co-workers treating them differently.
• Less than 50 percent of women sought help to cope with appearance-related side effects of cancer treatment.
  

Look Good Feel Better is a free, nationwide cancer support program that matches volunteer beauty professionals with small groups of cancer patients to show them how to use cosmetics, wigs and head coverings to camouflage the hair loss, skin discoloration and extreme dryness that can result for cancer treatments. When you go from struggling with a momentary bad hair day to a continuous no-hair day, or unflattering skin conditions that you did not have before cancer treatments, it can get your spirits down. It can be shocking to look in the mirror and not recognize the person staring back. Look Good Feel Better helps 50,000 women each year. For more information about the program, go here.

Hey U.G.L.Y. Unique. Gifted. Lovable. You., an organization that develops self-esteem building tools for teens, asked celebrities to donate their laughter for a fundraising CD of contagious laughter called Laugh It Off. According to the president of Hey U.G.L.Y. Betty Hoeffner, "We know the healing powers of laughter and how it can improve health and relieve stress." Past research has shown, from a biological standpoint, that laughter and humor do have healing power.

Why a CD of celebrity laughter? "When we saw other charities asking celebrities to donate things like purses, shoes and even bras, we thought celebrities donating their laughter would be a perfect fit," explains Hoeffner. Produced and directed by award-winning filmmaker Rick Erwin, the 60-minute CD and includes the laughter of: Jimmy Neutron voice talent, Debi Derryberry; Emmy-award winning actor/comedian Ben Hollis; JBTV host, Jerry Bryant; and commercial voice talent, Richard Schoen; Saturday Night Live's Tim Kazurinsky; Frank Sinatra's opening act comedian, Tom Dreesen; nationally syndicated radio host, Mancow Muller; and Late Show with David Letterman regular, Bob Sarlatte. One woman wrote Hey U.G.L.Y. that her brother, who has cancer, listens to the CD three times a day and loves it.

Can laughter cure cancer? Not by itself -- but there are numerous studies that show laughter initiates a powerful biological process of feel-good healing chemicals that support and strengthen the immune system. We have done several posts here, here, here, here, here and here about the healing power of humor and the laughter associated with it.

A few years ago -- I can't remember exactly when -- I cut bunches of red wavy locks from my friend's head. I tied Amber's thick hair into one big ponytail, and I cut away. It was an extreme haircut for sure. Amber's long hairstyle was transformed into a shoulder-length bob, and for good reason.

Amber sent her 10-inch ponytail to Locks of Love, a non-profit organization that creates human hair wigs and hairpieces from donated hair and gives them to children under the age of 18 who have lost their hair due a medical condition. This was the first time I'd heard of Locks of Love, and I've since met many others who have purposely grown their hair in order to donate it. I have a neighbor who has done it three or four times now. I know two teenage brothers who have cut their long, dark hair for this great cause. And I've known toddlers whose parents have waited for that first haircut until 10 inches could be cut.

Ten inches is the magic number. Once tied into a ponytail, there must be 10 inches of hair hanging beneath the rubber band. The ponytail is cut off and what remains can be cut into a new style. Locks of Love provides the procedures for mailing the hair, and the details can be found on the Locks of Love website.

I was bald this time last year -- after receiving four rounds of toxic chemotherapy for breast cancer -- and I know how devastating hair loss can be. It affected my self-esteem, and I can only imagine how it affects children whose self-esteem is just forming.

You might consider donating your hair so that a child's confidence can be restored during a time that is so difficult and challenging. I will consider it too -- but I must say that for now, I am enjoying watching my new short, brown, curly hair grow and grow and grow.