It what seems like an obvious result, a recent U.S. study found that breast cancer survivors who received both chemotherapy and radiotherapy were the most apt to have severe fatigue. In addition, that fatigue lasted for prolonged periods of time.

Over 221 women in the early stages of breast cancer were looked at in this study, with the expectation of the greatest amount of fatigue just after initial treatment.

But, when chemo was combined with radiotherapy, fatigue was pronounced for longer periods of time. No wonder depression is often a side effect of traditional cancer treatment.

Cancer made me tired. It's a common side effect of the disease and its accompanying treatments, and it's been known to linger long after therapy stops. In order to combat my own drowsiness, I get plenty of sleep at night, I exercise just about every day -- physical activity, even when you feel too pooped to lift a finger, can increase energy levels -- and I try to eat only the healthiest foods, nothing that might make me feel sluggish. I'll take a stab at anything that might give me a boost. Maybe even lemonade, if I can find one low in sugar.

Research indicates that the taste of lemons can fight fatigue by stimulating a nerve in the nose, which then sets off "wake-up" sensors in the brain. So next time you need some extra pep in the morning or a lift during the afternoon, think about about sipping on some lemonade. And then let us know if it works.

Source: Family Circle, July 2007

I recently received an e-mail from a friend, about a friend of hers who has just been diagnosed with throat cancer. After a little thought about the content of her message, I sat down and typed a response. I share our back-and-forth communication with you today because it may help you, a friend, a family member, someone. And it may motivate some of you to contribute your own wisdom on the topic. If it does, by all means -- please share by leaving a comment.

Jacki,

Hope all is well with you. Nick and I have a close friend that has recently been diagnosed with cancer. It's in his throat and neck area. He had his tonsils removed and showed they are the source of the cancer but he will still be undergoing chemo and radiation.

The reason I am reaching out to you is because I wondered if you had some good recipes for keeping your energy levels up during chemo and radiation. He said he needs to eat a lot of protein -- I want to make him some things, or buy the right food for him that are high in protein -- what should I be doing? How can I help? His throat is going to be very sore due to the location of the cancer and eating is going to be an issue. What do you suggest?

The American Cancer Society estimates that approximately 16,600 new cases of myeloma are diagnosed each year in the United States. Bone pain is the most common early symptom of myeloma. Most patients feel pain in their back or ribs, but it can occur in any bone. The pain is usually made worse by movement.

Patients fatigue more easily and often feel weak. They may also have a pale complexion from anemia which is a common medical problem for patients with myeloma and may contribute to the fatigue. If the disease progresses, the concentration of normal cells in the blood may also decrease. Headaches, bruising, nose bleeding, gastrointestinal bleeding, and tingling or numbness in extremities are all symptoms of myeloma.

Patients may have repeated infections because antibodies to invading viruses, bacteria or other disease agents are not made efficiently of in adequate amounts. Urinary tract, bronchial, lung, skin, or other sites of infection may be the first sign of the disease. In addition, recurrent infections may complicate the course of the disease.

Cancer patients will inevitably develop some sort of fatigue while going through chemotherapy or radiation therapy. The problem is that it is difficult for health care professionals to accurately assess its severity. There is a new method being studied to help nurses and physicians provide an instant measurement of a patient's fatigue.

The method is called ecological momentary assessment, also known as real-time assessment. The National Comprehensive Cancer Network defines fatigue as "an unusual, persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning".

Exhausted, weary, tired, lethargic -- cancer patients are all this and more when undergoing treatment, and it's a problem that may be fixed with some light activity. While rest is encouraged, it's now thought that the overwhelming fatigue experienced by those with cancer can be alleviated with activity, at least according to this video. Don't get me wrong .... you don't need to run an Ironman marathon or anything, but how about going for a walk, or doing a few light resistance moves?

Think about this:

A few gentle activities can help boost your energy, and can have positive systemic benefits in your body that hopefully will help your body fight the disease. Dick, the prostate cancer patient in the video, is part of a study to prove the benefits of exercise in cancer patients and he believes that his lack of fatigue is a result of his staying active during treatment.

What do you think? Should you take it easy or get up and about?

I've always heard the use of herbs and supplements and alternative therapies can be a potentially dangerous pursuit when combined with cancer treatment. But this may not be entirely true.

Think about this:

Using Chinese herbs alone or in conjunction with chemotherapy may help protect a breast cancer patient's bone marrow and immune system. It may also improve the overall quality of life for women, say researchers at the Chinese Cochrane Centre in Chengdu, China.

It is well known that women receiving chemotherapy for breast cancer experience significant short term side effects such as nausea, vomiting, fatigue, inflammation of the gut lining, decreased numbers of red and white blood cells, and decreased numbers of blood platelets. Those is search of some relief may wish to give Chinese medicinal herbs a try.

Researchers say there is conventional evidence indicating that these medicines are safe and effective. Still, "further trials are needed before the effects of traditional Chinese medicines for people with breast cancer can be evaluated with any real confidence," says one professor involved in this area of study.

Green peas are bursting with nutrients. They provide very good amounts vitamin K, vitamin C, vitamin B1 or thiamine, vitamin A vitamin B6, B3, and B2 and lots if dietary fiber, manganese, folate, phosphorus, magnesium, copper, iron, zinc and potassium. Green peas are that little food that is supercharged with nutritional and can supercharge your health.

Green peas are one of the important foods to include in your diet if you oftentimes feel fatigued and sluggish. That is because they provide nutrients that help support the energy-producing cells and systems of the body. They provide nutrients that are important for maintaining bone health. With its great source for iron green peas build normal blood cell formation and function. Low amounts of iron can result in anemia, fatigue, decreased immune function, and learning problems.

Vicki's Green Pea Salad
2 cups fresh green peas. (You can substitute with a 16 ounce package of frozen green peas. Rinse and thaw them for use in the salad.)
1 cup chopped fresh cauliflower ( make sure pieces are chopped about the same size as the peas.)
1 - 8 ounce can sliced water chestnuts (drain and rinse thoroughly and cut into strips)
1 - 8 ounce container sweet grape tomatoes or cherry tomatoes sliced in half
1/2 onion minced
1/2 cup chopped celery
1/2 cup mayonnaise
1/4 cup lemon juice
1 teaspoon dry dill

Whisk together the lemon juice, dill, and mayonnaise.
In large bowl mix all of the vegetables. Pour in the mayo and dill dressing and toss.

Surely, everyone can benefit in some way from yoga. Women with breast cancer that has spread beyond the breast, however, may benefit greatly from a tailored program featuring gentle yoga postures, breathing exercises, and meditation.

The great benefits: less pain and fatigue and more vigor, relaxation, and acceptance," says Dr. James W. Carson from Duke University Medical Center and lead of a study published in the Journal of Pain and Symptom Management.

Carson says women with advanced breast cancer need effective methods for curbing cancer-related symptoms.

The pilot study included 13 women who attended yoga classes once per week for eight weeks. The women, with an average age of 59 and with diagnoses occurring an average of seven years earlier, were helped significantly. They felt more invigorated and gained a greater sense of acceptance. They also found they felt better not only on the day they practiced yoga but the next day too.

This study offers the first, small-scale evidence for yoga's potential benefits for women with limited life expectancy.

It's March. And that means it's the national month for Brain Injury Awareness, Endometriosis Awareness, Nutrition Awareness, Eye Health and Safety Awareness, Multiple Sclerosis Awareness, Sleep Awareness, Problem Gambling Awareness and my favorite, for the purposes of The Cancer Blog -- Colorectal Cancer Awareness.

Colorectal cancer -- cancer of the colon or rectum -- is a disease that affects both men and women and is preventable nearly 90 percent of the time.

Starting at age 50, men at women at average risk for the disease should get screened. Those with increased risk, like African-Americans who typically develop colorectal cancer at younger ages, should be screened even earlier.

Screening -- by way of fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy -- is critical because colorectal cancer often occurs with no symptoms. Symptoms do sometimes present themselves in the later stages of the disease and include rectal bleeding, bright red blood in or on the stool, change in bowel habits, stools that are narrower than usual, general stomach discomfort, diarrhea, constipation, frequent gas pains, unexplained weight loss, constant fatigue, and vomiting. Persistence of any of these symptoms for more than two weeks warrant an immediate visit with a health professional.

Treatment for this disease, which strikes about 153,000 people and causes about 52,000 deaths each year, includes surgery, radiation, and chemotherapy.

In the spirit of this National Colorectal Awareness Month, experts recommend remembering these important points:

• Colorectal cancer can be prevented.
• Screening for the disease can identify polyps -- grape-sized growths in the colon and/or rectum -- that can be removed to prevent cancer from developing.
• The magic age for screening is 50 -- unless you have an increased risk for the disease.
• Colorectal cancer is treatable.
• Regardless of your age, know the risk factors, know the symptoms, and know your family history.
• Talk with your health professional about colorectal cancer and your own risk for the disease.

What a gift it would be if it were possible to sleep through cancer, literally sleep through the entire experience -- from diagnosis through the end of treatment -- and wake up on the other end of the bad dream. Unfortunately, this isn't possible. We must be alert and aware and active in our own plans for survival. All we are typically permitted are now-and-then naps and nighttime sleep -- if we can manage to actually sleep at night.

My sleep was never disturbed during my cancer journey. Night after night, just after my head hit my pillow, my body drifted right to sleep -- only waking for brief trips to the bathroom and to get out of bed the next day. I might have had an occasional sleepless night. But for the most part, I count myself as one lucky cancer patient, blessed with restful and regular sleep.

Not all cancer patients are privileged sleepers. And with all I was enduring during my own cancer ordeal -- emotions, hospitalizations, treatments, side effects, and pain -- it's a wonder I was able to manage so well in the sleep department.

Sleep is critical for maintaining strength and energy while fighting cancer -- while living life in general really. When nighttime sleep is disrupted, interrupted, or downright impossible, normal functioning and healing are compromised. So the quest for good, quality sleep should make its way to the top of your cancer to-do list. And if you are not sure just how to begin such a quest, consider these seven strategies for sleeping through cancer -- compliments of Marie-Helene Savard, doctoral student in psychology, and Dr. Josee Savard, associate professor and researcher of psychology at Laval University Cancer Research Center in Quebec, Canada.

• Set aside at least one hour to relax before going to bed.
• Go to bed only when you feel sleepy -- which is not the same as fatigue.
• If you can't fall asleep or can't go back to sleep after 20 or 30 minutes, get out of bed and leave the bedroom. Do something else -- and only go back to bed when you feel sleepy again. Repeat as necessary.
• Get up at the same time every day -- regardless of how much sleep you got. Use an alarm clock to wake.
• Use your bedroom only for sleep and sexual activities. Avoid reading, working, watching TV, or listening to the radio in the bedroom.
• Avoid napping. If you must take a nap, do so before 3:00 PM and for less than one hour.
• Keep realistic expectations about sleep -- avoid worrying about the amount of sleep you should have or the amount of time it takes you to fall asleep -- and try to become tolerant of your lack of sleep.

Sweet dreams.

Just before my radiation therapy began, my oncologist ran through a long list of potential side effects I might experience from the treatment. The only two significant short-term possibilities were fatigue and burned, blistered skin -- I went on to encounter them both -- but there were other more long-term effects my doctor told me might one day creep up on me.

She told me the range of motion in my arm might be compromised -- it was -- and that lymphedema or swelling could occur -- not yet -- and that I could feel numbness and tingling in my arm -- I do -- and that I should forever take precautions on the left side of my body. No needle sticks, no blood pressure cuffs, no excessive lifting -- all because of radiation and the missing lymph nodes that further complicate matters.

My doctor also told me that while radiation would target one intended area -- my left breast, just where my cancer was found -- other areas would suffer some degree of exposure. My heart, my lung, and my ribs all bordered the location of my tumor and despite measures to protect these areas, they would be zapped, at least minimally.

This all seemed a bit overwhelming 18 months ago when it came barreling at me. But something fortunate happened with the passage of time -- I began to forget about most of this. And while this a blessing really -- to not be burdened by the what ifs -- I realized yesterday when my three-year-old son kicked me with all the force he could muster right in my ribcage that I really must remember the side effects of radiation -- because they could serve to haunt me at any moment.

I remember clearly now my oncologist telling me that my ribcage could be damaged by radiation in such a way that an injury to the area could easily result in broken ribs. But I don't think about this regularly. And I wasn't thinking of it when I snuggled up to my 35-pound baby boy, knowing full well he could strike at any time. But not until he struck did I recall one of the downsides of radiation.

I feel happy and healthy and strong. Like cancer never landed in my lap and threw me for a loop. But somewhere in the back of my chemo brain -- an entirely different side effect story -- I must remember the dangers of the treatments that are keeping me alive. Because the last thing I want is another complication from cancer. I just want smooth sailing -- and smooth snuggling.

New York Yankees legend and sports broadcaster Bobby Murcer will undergo surgery today at MD Anderson Hospital in Houston for a brain tumor, according to a New York Daily News published report. Murcer, who is 60, had been experiencing headaches and a lack of energy. The tumor was found during an MRI performed on Christmas eve.

Murcer is quoted by the newspaper as saying, "I'm feeling OK and we're just going to have to see what this surgery will bring. I'm hopeful that everything will turn out OK and I'm thankful to have so many friends who are rooting for me."

Murcer played professional baseball for 17 seasons. According to Wikipedia's profile, "A shortstop in the minor leagues, Murcer was slated to be the Yankees' third baseman but ended up being the center fielder following in the footsteps of Mickey Mantle and Joe DiMaggio. Almost anyone would suffer in comparison to those members of the Baseball Hall of Fame, but Murcer did well enough during the years the Yankees finished in the second division to become one of the team's most popular players of that era."

Murcer played for the New York Yankees, San Francisco Giants, and the Chicago Cubs before returning to play for the Yankees again. He retired and became a sports broadcaster for the Yankees, going on to win three Emmy Awards for live sports coverage.

If you live near the Philadelphia area you can attend Living Beyond Breast Cancer's next networking meeting called Nutrition for the New Year: Managing Weight and Nutrition Through Diagnosis and Beyond.

The event will be held on Tuesday, January 30, 2007, from 6:00 p.m to 8:30 p.m. at the Philadelphia Marriott West in West Conshohocken. Debra Demille, an oncology nutrition counselor at the Joan Karnell Cancer Center at Pennsylvania Hospital will discuss the benefits of adequate nutrition during and beyond treatment and will answer questions about nutrition and fitness.

Ms. Demille will help women understand how to use eating strategies and exercise to maintain weight and well-being during treatment, manage side effects and reclaim their bodies after treatment. She also will discuss nutritional needs of families affected by breast cancer, strategies for adopting healthier eating habits, healthful eating and workout tips to reduce the risk of developing a new or recurrent breast cancer.

Contacts for the event: Janine Guglielmino or Anna Shaffer. Email janine@ibbc.org or anna@ibbc.org.

I was diagnosed with cancer on my thirty-first birthday, December 18th, 2001, five years ago today. Those diagnosed with cancer might be receiving a diagnosis at this time, undergoing treatment or they even might be finished treatment and are on there way to starting their new normal life.

Whatever the case may be, dealing with cancer during the holidays can be rough. Emotionally speaking, it can be very hard to get in the mood and be joyous over the holiday season. Activities like shopping, social events, family gatherings and traveling can lead to high levels of physical effort and stress.

Sometimes it might seem so much easier to avoid social gatherings all together. Remember though, that family and friends are there to encourage and be supportive. It can be hard when you keep hearing how great you look, when you feel like it is not the truth. I believe that those that make that comment really do mean it. When your diagnosed with cancer I think people expect you to look a wreak! Usually that is not the case.

The holiday season could cause some thoughts to creep into your mind--Is this my last year to celebrate with my family? At this time of year it is common for those diagnosed with cancer to think about the future. Its OK to have those what if? questions. Its not negative thinking. Its normal. There is not one best way to deal with these thoughts or anxiety attacks you might be experiencing. Relaxation techniques can help and sometimes anti-anxiety medications can do the trick.

If you are feeling fatigued, let your family know this so they can help. Don't push yourself to do what you have always done in past years, be comfortable with yourself doing less. Set some clear priorities, things you think are most important that you want to accomplish. Always tell your oncologist or another physician how you are feeling. Tell the truth. Don't try and be brave. There are certain medications that can be administered if you are experiencing fatigue that developed from anemia, a common side effect from chemotherapy.

For me this holiday season is a special one. I'm so thrilled to be celebrating the five year milestone of survivorship along with my birthday. I'm so happy to be alive!

Happy Holidays!!