Here's what might be a typical train of thought for someone surviving cancer. That someone, in this case, is me.

I have been getting sicker and sicker for the past three days. Sore throat, sore ears, and a heavy head made me think at first it was some sort of sinus issue. Add a cough, a rumbling and painful chest, sore gums, chills and sweats, and a fever roaring past 102.8 and the worries start rolling in. I feel like I did twice before, just before I was admitted to the hospital with dipping white blood counts.

The worst of it hit Friday night and since I just couldn't make myself sit in the ER for hours on end, I overstepped my boundaries, tracked down my hospital's on-call oncologist, and listed off my symptoms. Since my treatment for breast cancer concluded one year ago, the doctor wasn't worried. He called it an infection and called me in a prescription. In a few days, when my course of antibiotics run out, I should be fine.

Yesterday, I saw my oncologist for one of my every-three-month follow-up visits. As always, I went armed with my list of questions -- which is really my list of worries -- and one by one, I rattled them off. On a little sticky note, I had written:

• Lymph node
  
• Digital mammogram
  
• Next MRI
  
• Heart
  
• Colonoscopy

And this is what my doctor had to say about my concerns of the day:

There are 100 lymph nodes in the neck region. That's what my radiation oncologist told me during my recent follow-up exam. At any given time, one or more of these nodes may be palpable. This isn't always bad news. A cold, allergies, even dental work can cause them to react. This is good news for me.

When I saw my medical oncologist eight weeks ago, he felt a swollen lymph node on the right side of my neck. He wasn't worried about it. I was. So we talked, and I learned that changes in lymph nodes are normal. He would know -- one of his primary diseases of study is lymphoma -- so I set my fears aside.

My enlarged lymph node slowly disappeared. At times, though, I'll feel it resurface. It's small when it presents itself, but it's still there. My radiation oncologist agreed: it's there. But it's elongated. It's not swollen in a round, tight, puffy way. These are the nodes that signal cancer.

Cancer on my mind is an article written by Dr. Albert Lim Kok Hooi, a consultant oncologist. He opens his article by saying:

As a doctor, I am interested in how the human mind works. As an oncologist, I am interested in the lure of alternative medicine. And so I have tried to understand why, in spite of all the scientific evidence at hand, there are many amongst us who do not want to undergo conventional cancer treatment – surgery, radiotherapy, chemotherapy and targeted therapy – but instead risk being treated by unproven and potentially dangerous alternative therapies.

He goes on to say that this happens because sometimes science is not very well understood. He talks about confirmed bias, a phenomenon in cognitive science, the science of how the mind works. He describes it as a person that -- notices the hits and ignores the misses in support of his own beliefs. So, basically someone might have a strong bias against chemotherapy, for no other reason than what they have seen on television, without really knowing the true facts.

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 ...

Many cases of ovarian cancer are diagnosed at advanced stages, its one of the gynecological cancers that is hard to diagnose in the early stages of the disease. Ovarian cancer needs to be treated correctly from the get -go for the best chance of survival.

It seems that some women are not receiving appropriate surgery in the United States based on an article in Journal Watch by Andrew M. Kaunitz MD.

A study found that out of 10,000 women diagnosed with ovarian cancer from 1999 to 2002, only forty two percent underwent surgery at teaching hospitals. Almost half of the patients in the study were operated on by surgeons who performed fewer than 10 ovarian cancer surgeries each year. Scarier yet, the study showed that about 25 percent of these women underwent surgery by very-low-volume surgeons -- less than one annually.

Dr. Kaunitz advice is to seek out a gynecological oncologist to get comprehensive care that is needed.

Don't be afraid to ask a surgeon -- How many times have you performed this surgery?

If you have just been diagnosed or are ready to go through treatments it is important that you understand your disease and the therapies recommended. A great website, www.webmed.com has a list of questions that you should bring along to your next appointment.

Remember -- Knowledge is power!

10 Cancer Questions for Your Medical Oncologist About Chemotherapy, Hormone Therapy, or Immunotherapy

1. Why are you recommending this treatment for me? Why is it preferable to others?
2. What does this treatment do, exactly? How well does it usually work?
3. What are the risks and side effects of this treatment?
4. How long will I need this treatment?
5. Where will I go to get this treatment?
6. What should I expect from the treatment itself? How long will it take?
7. Should I bring a friend or family member with me to treatment?
8. After treatment, will I need time to recover? Will I be able to drive myself home? Will I need to miss work?
9. Should I make any changes to my diet or lifestyle during or after treatment?
10. How can I reach you if I have concerns or further questions?

10 Cancer Questions for Your Surgeon or Surgical Oncologist

1. Why are you recommending this surgery for me? Why is this treatment preferable to others?
2. What will this surgery accomplish, exactly? How well does it usually work?
3. What are the risks of this operation?
4. How should I prepare for this surgery?
5. What will happen during the procedure?
6. How long will I need to stay in the hospital?
7. What will my recovery be like?
8. What complications should I look for?
9. When can I go back to work?
10. How can I reach you if I have concerns or further questions?

10 Cancer Questions to Ask the Radiation Oncologist

1. Why are you recommending this treatment for me? Why is it preferable to others?
2. What does this radiation therapy do, exactly? How well does it usually work?
3. What are the risks and side effects of radiation therapy?
4. How many weeks will I need this treatment?
5. Where will I go to get this treatment?
6. What should I expect from the treatment itself? What will happen? How long will it last?
7. Should I bring a friend or family member with me to treatment?
8. After treatment, will I need time to recover? Will I need to miss work?
9. Should I make any changes to my diet or lifestyle during or after treatment?
10. How can I reach you if I have concerns or further questions?

---

Elizabeth Edwards, wife of Democratic presidential candidate John Edwards, has had many routine medical follow-ups since her 2004 breast cancer diagnosis. And all of them -- until just a few days ago -- resulted in what is generally termed a clean bill of health.

The term doesn't always come with a sense of relief for those of us surviving breast cancer -- or any cancer for that matter -- because it only really defines what our bodies are telling us at one specific moment. There are no magic blood tests, no special body scans, no conclusive ways of determining whether or not cancerous cells have gone astray and will one day surface again.

I asked my oncologist after my first six-month follow-up how he would know if my cancer returns. He told me it's really up to me to determine whether it comes back. It's up to me to get mammograms and ultrasounds and MRIs. It's up to me to report any symptoms and suspicions. It's up to me to track my general well-being so that it will be clear when something feels not-so-right. If I have a persistent cough or headaches that won't subside, my doctor will take action with X-rays and scans and tests. But as long as I feel fine and nothing troubling presents itself, then I remain in the clean-bill-of-health club.

Edwards no longer has a clean bill of health. But she is determined to use her newest diagnosis -- stage four metastatic cancer of the bones, considered treatable but not curable -- to work toward the best health she can acquire for as long as she can hold onto it. And that is about as good as any of us can do.

OK, we all know young women get breast cancer. But the way some talk about the pair -- young women and the deadly disease -- it would seem finding a young one living with this type of cancer is like locating that needle in a haystack. Many a young woman -- like me -- have heard doctors and nurses and technicians and family and friends remark, "you are too young for the disease," and then dismiss cancer suspicions as needless worry.

The median age for women diagnosed with breast cancer is 65. But think about this fact, published in the Spring/Summer edition of Beyond: Live & Thrive After Breast Cancer.

More than 240,000 women in the United States age 40 and under are living with breast cancer. Each year in this country, more than 14,000 women 40 years old and younger are diagnosed with breast cancer, says Boston oncologist Ann Partridge, M.D., of the Dana-Farber Cancer Institute.

That's a lot of young women. That's a lot of breast cancer. And yet, mammograms still are not recommended for women under the age of 40.

A doctor found something suspicious when she read the results of the breast MRI I had on Friday. What she found is of unknown significance. This means something caught her attention. She just isn't sure what it is.

This doctor does know that whatever it is inside my right breast appears to be a low-risk something. But still, there's a concern looming in the air -- for her and for me.

I spoke with my oncologist about this concern, and he told me anything suspicious must be pursued by further testing. I'm thankful for that. He also said he expects that nothing actually significant will come of this. But if it does, it will have been caught early.

On Friday, I will report for further testing -- a mammogram and an ultrasound -- and then I will learn more about this unknown something that inhabits my breast, this something that takes me back more than two whole years when another something turned out to be what I feared more than anything. Breast cancer.

My gut hasn't always guided me through life's most difficult decisions and dilemmas. It wasn't until I felt a lump in my breast more than two years ago that my gut kicked into gear and told me something very important.

"It's cancer," my insides told me one week before the surgeon who did my biopsy called.

"It's cancer," the surgeon said. I didn't tell him, but I thought it: "I know."

I also knew prior to surgery that my cancer had not spread to my lymph nodes. My gut told me this too. It also told me the chemotherapy drug Taxol was not right for me -- since my cancer had not spread -- despite the urging of one oncologist that I accept this treatment. I would have gone on gut instinct alone in my rejection of this medication but another doctor weighed in and agreed with my gut, so I had solid backing on this decision.

Many have dismissed hunches like these and have written off those who believe in them as screwballs, says writer Chip Brown in the March 2007 issue of The Oprah Magazine. But as Brown shares after peering into the world of gut instinct, there are 100 million nerve cells in the gut. They run on autopilot, regulate digestion, play a critical role in the body's immune system, and control mood-altering neurotransmitters identical to those in the brain.

The gut is essentially a second brain. It was a "gut feeling" that led Fred Smith, founder of Federal Express, to begin exploring the possibilities of overnight delivery and Howard Schultz, founder of Starbucks, to begin mass marketing coffee. Wall Street professionals make millions on their gut feelings, sportscasters make startling predictions based on gut guidance, and entrepreneurs launch thriving businesses because of the inklings that rumble in their tummies.

You may or may not be a gut thinker yourself. But I've stumbled upon a gut exercise -- thanks to psychotherapist Nancy Napier --and I'd like for you to consider it the next time you find yourself stuck at a crossroads, unsure of where to turn. You never know, the direction you seek may be swirling around in your midsection, just waiting for a call to action.

Think about this:

You are wavering between two choices. Find yourself a quiet, serene place where there will be no disruptions. Now sit down. Take a moment to settle and focus on the issue you want to explore. Then choose one side. Think about this side and notice what happens in your gut. Do you feel a tightening and gripping or a softening and warming? Are the sensations pleasant or uncomfortable? Notice your thoughts. Are they positive or negative? Give yourself some time to feel your gut and your mind responding.

Now shift to the other side. Think about the previous questions, and try to chart what your body gut is saying.

While you may not get a gut answer at first, if you come back with the question several times, you'll likely hear just what your gut wants you to know.

Chemo is tough stuff. That's what my oncologist told me the day I tracked her down on the phone and told her how awful I felt. I was weak, dizzy, pale, and as close to incoherent as I'd ever been. I was so out of sorts I was convinced I would jump out of my skin at the very moment this doctor implied all I needed was a firm grip on reality.

"Do you have enough support?" she asked. "Yep," I replied. I told her my mom lives right around the corner, my sister just a few miles away. I told her friends were delivering meals and my husband was coming home from work whenever I called for him. Help was just a phone call away, and I had plenty of it. What I didn't have was medical guidance about how my body was tolerating chemotherapy. That's why I needed her.

I hung up the phone that day having accomplished nothing. And I woke up the next morning barely able to walk. I crawled into my kitchen, grabbed a banana, sprawled out on the floor, inhaled some nutrition, and called my mom. I told her I needed to have my blood examined.

My mom transported me to my oncology clinic -- we had a genetic counseling appointment there anyway so it was convenient timing -- and before long, I was hand-delivered a mask and was swiftly escorted to my very own hospital room where I stayed for five days.

The day I was admitted to the hospital, my white blood counts were 700. My body was not tolerating chemotherapy. And I'll never know why my oncologist didn't know this, didn't call me in for an evaluation when so many signs were presenting themselves, didn't offer me more than her steadfast declaration that "chemo is tough stuff."

Yes, chemo is tough. And there are all sorts of expected side effects of the dreaded treatment that patients must endure. But there are many effects patients should not have to suck up, effects that warrant immediate medical attention and can be alleviated with the right intervention.

It took days of antibiotic treatment and a blood transfusion for my body to recover from its chemotherapy attack. I often wonder what would have happened had I toughed it out at home. I suspect the outcome could have been tragic.

If I ever have the occasion to preach about the dangers of chemotherapy, which is what I am doing here, I offer a firm warning about how difficult the treatments can be, how anyone with any string of worrisome side effects should seek medical help immediately, how any oncologist who doesn't respond to an outright cry for help should be fired.

I learned many lessons from my chemo crusade. I learned how to better help myself, and I learned to report right to the emergency room the second time my blood counts plummeted. I learned to demand the care I deserve, and I found an oncologist who is a warm and caring partner in my pursuit of health. And I learned that chemo is tougher than I ever imagined, too tough for some -- like me -- to go it 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.

North Carolina State women's basketball coach Kay Yow is still in the game, despite her difficult match-up with a fierce opponent -- breast cancer.

Yow is fighting for the third time a disease that has been spreading throughout her body since last fall. She has sores in her mouth, hasn't been able to eat, and receives regular doses of pain medication, antibiotics, and nutrients to combat the effects of three chemotherapy drugs that are cycling through her tired body.

Still, Yow is never far from the sidelines.

She was right there in the mix the day NC State named its women's basketball court in her honor. Shortly after, she was wheeled off the court on a stretcher, headed for the hospital so she could be pumped full of drugs. She was at work the next day. And at the unveiling of the Kay Yow Court. And at her game that same night. And at the end of the night, with an oncologist and nurse, she was accompanied to her office where she was once again hooked up to an IV so drugs could once again drip into Yow's exhausted body.

Yow, 65, is tough and determined.

"I know people are saying I'm doing too much," Yow says. "I know I have to take care of myself. But it's not like I have a cold or pneumonia and if I rest it will get better. Rest is not going to cure cancer. If rest were just the answer, that's what I would do."

"But if someone can be involved with something that is a passion for them, then I don't think there's anything wrong in trying to do that. Coaching lifts me up. Once the ball is tossed up, I forget pretty much about everything and just focus on the game. If I just do nothing, I feel like I'm giving in to the disease."

For anyone keeping score on the battle between Yow and cancer, it's clear Yow is a winner.

Previous posts about Kay Yow are as follows:
NC State coach takes leave to fight breast cancer
NC State basketball coach Kay Yow back in the game

I like to exercise. I like the challenge, the sweat, the mental release, the physical results, the time to myself. I like everything about it -- practically.

What I don't like about exercise is the pressure to accomplish the feat over and over again for the rest of my life. For years, the pressure I put on myself was palpable. I thought about exercise all the time. I stressed about what to do and when to do it. I fought to convince my kids to climb into a double stroller long after they were too big to sit comfortably in the wobbly contraption and when I found time to exercise all by myself, I struggled with an overwhelming desire to spend quality time with my little boys. I felt rushed to complete my workouts -- because my kids were waiting, dinner was waiting, work was waiting.

I was faithful about exercising -- even through treatment for cancer -- because of my self-induced pressure and despite the stress and worry it caused me. And then something happened.

It was probably a combination of cancer and my relentless push for physical fitness that caused my body to crash. I became tired and exhausted and could barely lift my legs to walk up the neighborhood hills I typically conquered with ease. My oncologist told me to stop, to give my body a break, to let go of my high expectations. He advised me to exercise two to three times per week -- and that's it.

It took some time but I have finally embraced this approach. I have abandoned schedules and routines and plans and I now exercise when I can, when it fits into my day, when I really want to do it. My fitness trainer friend Fitz, a new blogger on That's Fit, wrote in one of her first posts that we should all stop trying to get fit -- and we should just do it. "Don't wake up tomorrow with the idea of trying to go for a jog," she says." "Get up and go for a jog! Put it in your planner and make it happen."

Fitz might not like my approach, but I have stopped putting exercise on my planner. For me, this works. It takes away the pressure, the stress, the worry. It gives me peace to confront each day free of exercise anxiety. It makes me happy to tackle exercise on my own terms, without some preconceived notion of what I should be doing.

I should share something else about myself. I am a perfectionist. I want everything to be just right. As child, I tore up drawings that may have had one stray mark. I wouldn't leave my house for school until my ponytails were flawless. My house is clean and neat, my toenails are pedicured and painted, my hair is styled just so. Perfectionism, sometimes just a step away from obsession, can be an unhealthy practice. And for me, exercise was becoming an emotionally unhealthy endeavor.

I am confident my perfectionist tendencies will keep me in the exercise loop for all of time. Just knowing I need exercise will propel me to conform. But I must say that I am so relieved to have let go of some of my exercise burden.

I like exercise. I really like it. And today, when I ran three miles -- because I had the time and felt up for the task -- it was refreshing, empowering, cleansing. I think it's the lack of pressure that allowed me to lose myself in the moment today. For me, letting go of exercise has lightened the load.