There are many things we tend to write off as normal signs of getting older. The aches and pain, the slow-but-steady weight gain, feeling cold all the time, getting the occasional sniffles. Sometimes I wonder if these are things I should pay more attention to, but I tend to cast that thought out of my mind because going to the doctor is inconvenient. And usually, ignoring symptoms is ok, but there are some that, according to the Mayo Clinic, you should never ignore, including:

• Unexplained weight loss
• Persistent fever
• Shortness of breath
• Unexplained changes in bowel habits
• Mental status changes
  
• Severe headaches
• Loss of vision, movement or speaking control, even if it's short-term
• Flashes of light
• Feeling full after eating little
• Hot, red or swollen joints

I definitely agree that these should be cause for alarm. My dad started to exhibit several of these symptoms a few months before he passed away, but explain them away as normal aging. Don't make the same mistake.

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.

Our bodies are good at telling us when something is wrong most of the time. It is important to listen to those messages and seek medical attention when specific symptoms arise. The June issue of the Mayo Health Letter covers symptoms that should not be ignored.

Seven symptoms not to ignore:

• Unexplained weight loss: This could be a symptom of such conditions as an overactive thyroid, depression, liver disease, cancer or other noncancerous disorders that interfere with how well your body absorbs nutrients.
• Fever: A fever can point to underlying infections. A fever accompanied by chills or one that is greater than 103 degrees should be evaluated immediately.
• Shortness of breath: Gasping for air or wheezing are medical emergencies. Shortness of breath can be caused by asthma, heart problems, anxiety, panic attacks, or a blood clot in the lungs.
• Severe headaches: A headache accompanied by a fever, stiff neck, rash, mental confusion, seizure, vision changes, weakness, numbness, speaking difficulties, scalp tenderness or pain when chewing are medical emergencies. Causes vary for headaches and may include stroke, blood vessel inflammation, meningitis, brain tumor, aneurysm or bleeding on the brain. Most headaches, are just that, headaches but it is important to know the warning signs for more serious underlying conditions.

As evidence mounts, it's becoming more and more clear that chemo brain, a mental fogginess that can result from chemotherapy, is a real concern and not just a convenient excuse cancer patients use to explain away their flighty and forgetful tendencies. It seems the brain really can suffer cognitive damage from the poisonous drugs that fight off deadly cancer cells. And sometimes, this damage is present years after treatment.

Add to chemo brain the normal aging process as well as brain conditions such as mild cognitive impairment and even schizophrenia and the brain might not stand a chance of ever remembering anything. Unless we buy into the new concept of mental training -- somewhat like physical fitness training -- in which case we may be able to bring back a level of sharpness to our lives.

Research suggests this type of training may delay mental decline. And Betty Hall, 85, who is taking a brain fitness class at her senior living complex in Illinois, says brain-enhancing activities are definitely helping her.

Hall is participating in an eight-week program where she spends one hour per day, five days per week using a computer to match words and listen for details in stories. She says it's helping her remember where she places her keys and her grocery lists -- and it's even helping her in her bridge club.

"I've won four times out of the last five at bridge club, and I think the players are going to shoot me because I keep remembering the cards people have," she said. "It's much easier for me to concentrate . . . and I brag about it everywhere I go."

One clinical professor of neurology says brain health programs will explode over the next few years because of the stunning findings on this front. One study shows relatively short training regimens, lasting just five or six weeks, improve functioning for as long as five years. And booster sessions help advance these gains. Study participants says their everyday tasks, like managing finances, are much easier after mental workouts. Another study of the computer software Hall uses shows the program shaves an average 10 years off the mental age of users.

Not all mental training is alike, and different cognitive difficulties may call for different training protocols. But the simple fact that I can work out my brain like I can work out my body gives me hope that I can possibly reverse the effects of chemotherapy on my own foggy brain, that I can one day not worry anymore that I might find my check book in the refrigerator and my cell phone in my sock drawer. Bring on the workouts!

Thanks to Bev, my brainy friend, for this story tip!

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.

I'm headed for a Saturday morning workout with my fitness trainer. For one hour, I will physically challenge my body and emotionally charge my spirits. I will sweat and pant and if I am required to do the inner thigh exercise, I will scream. I will also whine -- it's in my nature -- and I will push, pull, bounce, balance, lift, squat, lunge, and run until it's quitting time. I will fall short on some of my exercise expectations. And I will surprise myself and exceed others. In the end, I will feel accomplished, strong, motivated, and ready to tackle the day.

I'm making a comeback. I have come back from the depths of cancer and all of its accompanying treatment, and I have invited this powerhouse of a girl to transform me. She has accepted the challenge -- and she has helped me evolve from a weak, shaky, dizzy cancer patient to a semi-strong, 5K-running breast cancer survivor with biceps that are almost visible at a close distance.

This spunky fitness girl -- also an accomplished kick boxer, wife, and mom of two little ones -- has accepted another one of my challenges. I asked her to share some of her health and fitness expertise so that we all may reap the benefits. And so she kindly extracted some important tidbits from her vast library of knowledge and concisely crafted the responses that follow.

Take it from Fitz Koehler -- exercise and healthy eating habits are key for survival. For all of us. Cancer survivors included.

Why is fitness important for everyone?

100% of the population needs to exercise in some way. For the most part, if you're not working to get stronger, you're going to get weaker. Whether it's tummy time as an infant, gym class as a kid, weight training as an adult, or short walks as a senior, in order to live well and live long, we must eat well and exercise. Plus, a fit lifestyle prevents so many horrible ailments and diseases -- heart disease, some cancers, diabetes, GERD. Who wants any of that?

My own oncologist did it just two days ago. He checked in on my mental health, asked how I was surviving, and eased my fear of cancer recurrence and possible death. He reached beyond the medical scope of our relationship -- literally. He placed a hand on my shoulder. He offered me a hug. He cared.

Yet many doctors refrain from reaching too far into the lives of the patients they treat. They stay at a distance. They focus on merely replacing illness with health. This is, after all, the purpose of medicine -- to fix people.

Dr. Jeremy Geffen, author of The Journey Through Cancer: Healing and Transforming the Whole Person, shares in his book that "at present, doctors focus primarily on the physical characteristics of their patients -- bones and organs, tissue samples, test results, height, weight, and age. Yet in each of us, there is a rich mental, emotional, and spiritual reality that influences, even directs the course of our lives."

Conventional medicine responds to cancer patients with surgery, chemotherapy, radiation, and other treatment protocols to essentially get rid of the cancer. Physical signs, symptoms, and responses are carefully monitored -- while other areas of patients' lives receive little attention.

A whole component of true medical care is missing -- as doctors may feel unprepared to address emotional issues, and time restraints allow for limited interaction between doctor and patient.

Geffen believes the ultimate purpose of medicine is to help all beings "experience unbounded love, joy, and inner peace, and to know this is the essence of who we truly are." This purpose, he believes, deserves as much attention as the purpose of treating symptoms and curing disease.

And so Geffen created a program based on his Seven Levels of Healing -- a program that includes both the relative and ultimate purposes of medicine, both the doing and the being.

Level One: Education and Information -- provides basic information about cancer and treatment options and encourages patients to actively participate in and obtain benefit from their care.

Level Two: Connection with Others -- explores the importance of reaching out to others for comfort and support on the journey through cancer.

Level Three: The Body as Garden -- invites patients and family members to see the human body as growing and evolving, as a complex garden rather than a machine. This level touches on good nutrition, exercise, massage, acupuncture, and a variety of complementary and alternative approaches to healing.

Level Four: Emotional Healing -- enters the realm of the human heart, shedding light on fear, pain, anger, self-love, and forgiveness.

Level Five: The Nature of Mind -- examines how life with cancer is influenced by our thoughts, beliefs, and the meanings we give events.

Level Six: Life Assessment -- delves into aspirations, goals, and purposes of our lives.

Level Seven: The Nature of Spirit -- embraces the spiritual aspects of the healing process.

As a physician, Geffen aims to bring his vision of medicine and healing to cancer patients everywhere. And he uses his book as an instrument of communication -- so readers can participate in his vision, so they can learn to settle for nothing less than medical care that centers on the whole person. And not just the parts.

To read previous posts on the same topic, visit:
The Journey Through Cancer: Introduction
Sunday Seven: Seven Levels of Healing on Cancer Journey

Stay tuned for:
The Journey Through Cancer: Beverly Is Every One Of Us

I have a new friend who is a new breast cancer survivor. She is surviving a new diagnosis, a recent lumpectomy, and the moments leading up to another surgery to further investigate the margins surrounding the tumor removed from her breast. She is surviving the first phase of her breast cancer journey. A phase full of uncertainty and fear and panic. A phase so new and so fresh and so raw, her mind is whirling. A phase that has her grasping for any bit of direction she can find as she navigates a terrifying, unfamiliar road.

My friend is a young wife and mother whose worries are consuming her. She e-mailed me today and asked if I ever have moments when I look at my young children and worry that cancer will take me from them while they are young. She asked if I have always been so sure I will be okay. And so I replied with this candid cancer confession.

I've written twice before about a young woman named Diem Brown. I first wrote in August about her appearance as a contestant on MTV's Real World/Road Rules Challenge reality show. I wrote about how despite a recent diagnosis of ovarian cancer, she took herself to Australia to compete in physical and mental challenges with other spunky 20-something competitors. Brown, 25, fought for a cash prize of $250,000 -- while fighting cancer at the same time.

Brown did not win the grand prize, but she did win the admiration and respect of her castmates who on an MTV reunion show applauded her tireless and heroic efforts. In my second post, in September, I wrote about Brown's presence on the reunion show, about her strength, about the great mindset she acquired prior to returning home from Australia for treatment. I wrote about her foundation -- Live for the Challenge -- a wedding-type registry that allows patients to register for prescriptions, wigs, anything that helps them manage their illnesses. I did not write about the wig Brown wore on the show -- but it was apparent she had lost her long, blond hair and was masking the most visible side effect of chemotherapy.

Brown reluctantly yet powerfully unveiled her head on national television just a few nights ago during the beginning of another MTV Real World/Road Rules Challenge. During this installment -- The Duel -- Brown competes again, this time with the shortest of brown hair covering her scalp and with a fierceness that rivals anything she's offered on past shows.

Brown is back. She's in Brazil. And she is beating cancer.

Chemobrain, a term used to describe the mental fog and confusion some women experience after chemotherapy treatment, is very real and researchers who studied the frontal lobe brain activity of women suffering from the occurrence have an explanation for why chemobrain happens. Based on a study done by University of California researchers, chemotherapy drugs disrupt the brain's metabolism and blood flow.

"The same area of the frontal lobe that showed lower resting metabolism displayed a substantial leap in activity when the patients were performing the memory exercise," said Daniel Silverman, the UCLA associate professor who led the study. "In effect, these women's brains were working harder than the control subjects to recall the same information."

In Chemobrain: when a fog settles over your mind, I described my personal experience with the mental confusion and the fog that settled over my mind in the first years after chemotherapy treatment for breast cancer. Chemobrain does not affect every woman who undergoes chemotherapy, but for the women it does affect, the struggle with the temporary damage suffered from chemotherapy on brain function, in diminished capacities of comprehension, concentration, and memory can be frustrating. The fog does eventually lift and patience, as well as engaging in mental activity that promotes concentration, seemed to help.

The current study is published in the online edition of Breast Cancer Research and Treatment.

I just ran three miles on my treadmill. I have never been the athletic one in my family. My sister is the one who was born with the athletic streak -- she played softball and lettered in tennis after giving the sport a try with no previous experience and may have helped her high school basketball team win a state championship if it weren't for the major knee injury she suffered just before the big game. I, on the other hand, was born with a streak that has something to do with hair, nails, and lots of shoes. I was never interested in sports, gym shorts, or sweating -- which is what makes running three miles a big deal for me.

I wish I had started running long ago -- because I really like it. I like the loud music that pumps through my MP3 player and the change in my cadence as each new song begins. I like the motivation of knowing I'm pushing my body and accomplishing a physical challenge. I like that my endurance improves with each mile I travel. I like the mental release and the thoughts that run through my head and the cleansing effect I get from running. And I like sweating.

It's possible running would not have appealed to me long ago, even if I had given it a try -- because times were different long ago. I was healthy. I was happy. And I had no reason to marvel at the possibilities of my body. Without a natural impulse for physical fitness and challenge, I was completely satisfied with the status quo. But now I have an acquired impulse -- because cancer has threatened the very body I once took for granted. And I want it to be strong. I want it to be healthy. I want it to stand up to any possible threat. So I run. And when I am not running, I look forward to running.

In just a few weeks, I will run in the 5K Making Strides for Breast Cancer event with my athletic sister. I will run by her side. With my loud music for motivation. With the inspiration that I am making a difference for my body and for women everywhere. With my gym shorts on. And a ball cap covering my hair. With sweat dripping down my face. I can't imagine a better feeling.

I have made on-line visits to Wikipedia many times -- mostly for information on cancer. And what I've found are endless resources, thoroughly-covered topics, and material that is easy to read and easy to understand. Wikipedia, a free on-line encyclopedia -- where readers can participate in editing and changing content -- offers information on just about any topic you can imagine. And here are seven stops you might make in pursuit of cancer-related material.

Some campaigns just make me sad. UK's Age Concern, a charity that works to promote the health and welfare of older citizens, has launched a campaign called Hungry To Be Heard because it seems nine of of ten nurses do not have time to make sure elderly patients are getting enough to eat during their stay in the hospital. As a result, over half of the elderly patients are at risk for malnutrition. As hospital patients, if the elderly are malnourished, they simply are not going to recover or heal as quickly; they are at greater risk for post-surgical complications and they suffer a higher rate of death.

A chemical found in hard plastics -- such as CD cases, baby bottles, food-storage containers, and even electronics parts -- has been loosely linked to incidences of breast cancer. Popular opinion cautions that if we were not worried about this news yesterday, we should not be worried about it today -- because studies are preliminary and nothing is definitive at this point. But there are definitely two sides to the debate over how harmful these hard plastics may be.

The chemical in question -- a pseudo-estrogen called bisphenol-A (BPA) -- appears to be absorbed by breast tumor cells, according to a new study published in the August 28 issue of Chemistry & Biology. Previous studies have linked small exposures of BPA to prostate abnormalities in mice that suggest a link between the plastic chemical and human prostate cancer. Some studies even theorize that embryonic and fetal exposure might influence mental retardation and birth defects. And because this pseudo-estrogen is a synthetic material that in human cells can trigger estrogenic effects, breast cancer now comes up as a disease that may result from this questionable chemical.

Critics say that average levels of the chemical found in urine is infinitesimally small -- about one part per billion. Some say the results of this research come from in-vitro studies that one expert says can never fully explain human disease. Yet the real crux of the matter, according to another expert, is that we are surrounded by all sorts of chemicals that are pseudo-estrogenic -- not just BPA -- and it's the cumulative effects that we do need to worry about.

I have heard the term chemobrain many times -- even here at The Cancer Blog when Dalene wrote about it. And I've started using the terminology myself -- to explain my new-found odd behavior. Like when I put a carton of ice cream in the refrigerator with no recollection of it. And when I took a cap off a pen, couldn't find it, and discovered it on top of an egg carton in the refrigerator. I don't think this is a refrigerator theme -- just a coincidence -- because I've also lost a clipboard at work, forgotten to hand a guest her glass of water immediately after I prepared it, lost library books and movies, and failed to remember responsibilities time and time again. This may seem like minor forgetfulness -- this is what my oncologist believes may be at work -- but for me, this is odd. I have always had a good memory, have always delivered on my promises, and have never felt as scattered as I do now. So I call it chemobrain -- a good excuse, I figure -- and am now trying to determine what exactly this word means.

My oncologist tells me he doesn't really like this term. He thinks it puts a negative spin on regular functioning. He believes those of us who have experienced chemotherapy look more closely at our post-chemo behavior and may interpret quirky stuff as more serious than it is. It probably existed before chemotherapy, he says. But now, we are more sensitive to it and find chemotherapy a good explanation. He may be right. But for me, something in my head has definitely been altered.

One patient advocate for Hurricane Voices: A Breast Cancer Foundation believes that something doesn't have to be scientifically proven to exist. And while chemobrain may not be completely proven, there are still studies that support its existence -- which manifests itself through aging-type memory problems, forgetfulness, distraction, and loss of the ability to calculate quickly. Some studies show that 20 to 30 percent of women who undergo chemotherapy for breast cancer, and some who receive similar treatment for lymphoma, score lower than average on mental function tests for as long as 10 years after chemotherapy. ''There's enough data now to at least know it's a real effect,'' said Dr. Ian F. Tannock, a psychiatrist who has studied this issue at Princess Margaret Hospital in Toronto. Some suggest that typical aging may be at fault -- and for premenopausal women who may be rushed into menopause, this effect may be due to hormonal issues. Regardless, it seems to stem from chemotherapy -- somehow. And somehow, this topic needs more attention, more research, and maybe a more positive name.