When you're knee deep in the mess of stress, anxiety, disappointment, panic, fear -- you name it -- isn't it nice to escape for a moment, to feel relief from the burden of heavy emotion? I think so. And I happen to know from personal experience a few techniques that have a calming effect on the most overworked of minds. I'll make it brief, because I know reading volumes of self-help advice is not what's on your worried mind.

• Listen to a favorite song, or any song. It will shift your focus and put your mind in the context of the song. You may even feel recharged and motivated.

• Write down your thoughts. Just write. Don't worry about grammar, spelling, or sentence formation. Just jot down what's on your mind. Transfer your emotion to paper -- or the computer screen -- and see how relieved you can feel.

There may be another explanation for the recently announced decline in breast cancer rates. And it's not nearly as promising as the first explanation may be.

A day after researchers announced that the significant drop in breast cancer cases is primarily due to fewer women using hormone replacement therapy (HRT), some experts suggest breast cancer rates are not dropping at all. Just as many women may have breast cancer, they say. They just aren't being screened for it.

"We have been aware for several years that the number of radiologists who specialize in mammography have been decreasing, and that there are places in the United States where women have difficulty getting access to mammography," Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, wrote on the society's blog just after the public announcement.

"If mammography use has reached a peak and is now decreasing, we may actually be diagnosing fewer cancers when they can be most effectively treated, Lichtenfeld said. "If you don't get a mammogram, you don't diagnose a cancer."

The research linking the decline in HRT to the drop in breast cancer came from the M.D. Anderson Cancer Center in Houston and was discussed at a breast cancer conference in San Antonio on Thursday. The research, based on a report by the National Cancer Institute, showed a seven percent drop in new breast cancer cases between July 2002 and August 2003, corresponding with the results of a 2002 Women's Health Initiative study.

With media reports citing HRT as the direct cause of the drop, some worry the public is getting the wrong message -- specifically women still taking hormones or those who have taken them in the past. While women not taking hormones are breathing a sigh of relief, others are in a panic.

Dr. Katherine Sherif, director of the Drexel Center for Women's Health at Drexel University College of Medicine in Philadelphia, has spoken already with 15 patients worried about this news.

"What I have told them is that three years is too short of a time to measure the effects of a drug on breast cancer," she said. "Cancers take decades to develop, and conversely, withdrawing hormones could not result in a decrease in breast cancer in three years -- it's actually absurdly short." There are also concerns women will experience anxiety about other therapies using estrogen, such as in vitro fertilization (IVF).

The study on HRT and breast cancer may be raising more questions than answers -- which could be a good thing. More questions prompt more investigation, more study, more research. And this will hopefully help us figure out one facet of the mystery of breast cancer.

Previous posts on the topic of HRT and breast cancer are as follows.

• HRT use drops breast cancer rates drop
• Hooray for HRT!?
• HRT and smoking dramatically increases breast cancer risk
• HRT increases breast cancer risks

Dear Lindsay,

I had no idea what awaited me the day I arrived at the Psychology Clinic nearly 18 months ago. Fresh out of the hospital, deeply distressed about my existence, and wanting so badly to stop the tears that poured from my eyes at the slightest mention of cancer, I landed in your care. How lucky for me.

I arrived fragile -- perhaps already broken -- with emotions that were wildly unmanageable. I was anxious, worried, consumed by panic. In search of peace, I told you I wanted more than anything to acquire an easy state of mind, to survive the cancer that faced me, to live without fear that I may once again encounter this disease.

You told me my search could be successful and with a healthy dose of your guided therapy -- and a whole lot more than our intended eight to 10 sessions -- I happened upon the gift of serenity. And my mind is now easy. And I have you to thank.

Thank you, Lindsay, for tending to my wilting spirit, for bracing my fall, for helping me reshape my thoughts and visions, for offering me an abundance of coping tools, for coaching me back into a world where I can bloom.

Your work may be done -- officially. But you will always be at work in my mind. You will always be the one who saved me from a lifetime of darkness. And for that, I am honored to have been your client.

Forever grateful,

Jacki

Some mechanism has been at work in my body for the past month, some sort of filter that has somehow warded off the crippling panic that typically overcomes me during health scares. It's the panic that allows me to turn a simple cough into a symptom of lung cancer, a stomach pain into a sign of ovarian cancer. It's the curse of surviving cancer, I guess -- the continual worry that the disease is coming back, that it is going to strike someone dear to me.

Yet cancer never entered my mind when my husband and I began noticing our three-year-old Danny's strange eye movements, the strikingly odd manner in which one eye rolls upward when he gazes toward the ceiling -- this is normal -- while the other only crosses -- this is not normal. Surprisingly, I was not overly worried about this and was sure it was something that with glasses or eye exercises could be fixed. Never did I fear cancer.

We started with our pediatrician who quickly knew this issue was out of his league. I was calm. He moved us on to a pediatric eye specialist who was stumped by these eye movements that are typically congenital and occur much earlier in life. If not congenital, it must be something acquired, this doctor told us. He looked around a bit at Danny's eyes, dilated his pupils, and tested his vision. He determined his eyesight is perfect. And his gaze is a complete mystery. He ordered an MRI.

Still I was okay -- until my husband shared one evening with me that he was worried about a tumor. Why I hadn't yet obsessed about this is its own mystery, for which I am thankful. It allowed me to function for a short time independent of fear and anxiety and only a short time ago did I let panic seep into my consciousness.

When I scheduled the MRI for Danny and was told it was an urgent case that must be scheduled quickly, my stomach sank. When the doctor who would read the MRI met with us this morning to talk about this diagnostic procedure, he shared that a mass is what they would be looking for. I'm not sure how for all these weeks I missed this opportunity to get all worked up. But I did. And I got to act like a normal worried mother, not an over-the-top this must be cancer obsessed mother. It felt good.

And it felt good when the doctor read the MRI right in front of us this morning, sharing that there is no mass. He was not able to share what is causing this mystery eye condition that still must be investigated, but he assured us it's nothing serious, nothing life-threatening, nothing like cancer.

Perhaps the fact that my handful of recent health scares have not resulted in malignancies is allowing me to cool my guns a bit, to relax, to realize that not everything comes with a worst-case-scenario result. So maybe -- just maybe -- I am approaching some normalcy in my life, two years after my own worst-case-scenario sent me on the most terrifying ride of my life.

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.

The Lung Cancer Alliance -- the only national non-profit organization dedicated entirely to lung cancer patient support and advocacy -- asked pulmonary clinical nurse specialist Donna Wilson to help educate the lung cancer community about healthy breathing. Wilson agreed and her breathing tips, available on podcast, are intended to relieve shortness of breath related to pain or activity. Her three breathing techniques -- detailed here -- are simple, easy-to-understand, and truly relaxing.

Before beginning this series of breathing exercises, stop whatever you are doing and sit down or lean against a wall.

• Place chin to your chest to relax your neck muscles. Breathe 10 short bursts of air in and out of your lips. As you expel air, neck and chest muscles should relax.
• Place chin to your chest. Breathe three times in through your nose and out through your mouth.
• Place chin to your chest. Close your mouth, and breathe four times in and out only through your nose.
  

After completing these exercises, lift your head, breathe normally, and let your shoulders relax. In a few minutes, your entire body should start to relax -- and shortness of breath will resolve.

I don't have lung cancer -- but I do have moments of anxiety and panic. So I plan to save these tips. And I plan to use them. And I plan to share them. Because we all can benefit from a dose of relaxation.

On August 9, Patty was diagnosed with breast cancer. She is 36 years old, a wife, a mother of four children -- and already a fighter in her battle that has just begun. So far, she has endured surgery, and she will soon proceed through months of intensive chemotherapy, one year of Herceptin treatment, and weeks and weeks of radiation. It's a familiar path for so many women -- a path marked by devastation, fear, worry, and panic. Yet if there is a gift that flows from cancer, it must be the support and concern and love that can cushion the blow delivered by this disease.

Patty has an abundance of support -- and it all starts with her husband, ironically an administrator of two cancer centers, who is blogging her journey with great strength and an overwhelming love for his wife whose own mother died of breast cancer in 1992 at the age of 46. Patty and her husband have been vigilant about monitoring her health over the years -- in light of her family history -- and Patty had been tested, screened, biopsied, and examined many times before her diagnosis. When her recent tests and biopsies revealed breast cancer, it was both shocking and expected.

Now Patty and her husband -- who authors the blog Patty's Journey -- are expecting the best of outcomes on this journey of a lifetime.

My mammogram and ultrasound today revealed nothing but normal, healthy tissue. The doctor said my pictures looked beautiful -- and she could find not one thing to worry about. She really looked for something -- because I was convinced there was something wrong when I found a lump-like bump in my left breast two weeks ago. So convinced that I was riddled with anxiety and panic and fear. But now I am happy and content once again -- and relieved that my fears were unfounded.

The explanation my doctor offered for the lumpiness I detected goes like this: my breast has been swollen and plump ever since my lumpectomy and radiation over the course of almost two years. Slowly, the swelling is disappearing and so all the tissue hidden under the plumpness is coming to the surface. It's always been there -- she could see it when she looked at my previous mammograms -- but I haven't noticed. Now, it's become more apparent as my breast returns to its normal size and shape. And so it seemed new to me. And suspicious. And wrong. But it's okay. It's normal. It's nothing to worry about.

And so I am not worried. I am settled and calm and thrilled to be surviving breast cancer, without fear that the disease is coming back. At least for today.

On Friday, I was full of anxiety and panic and worry -- all over a lump I feel in my left breast that my oncologist says is probably just scar tissue from my lumpectomy two years ago. I don't like the word probably and the more I thought about it, the more unsettled I became. Too many young women hear that the suspicious bumps and lumps they detect in their breasts are nothing to worry about -- and too many women go on to later discover that these same bumps and lumps are in fact cancer. Sometimes it's in enough time to treat the cancer -- and sometimes it's too late.

I am a young woman -- 36 years old -- and I have already had breast cancer. I do not wish to obsess for my entire life about cancer but when I feel a lump in my breast, I want to know it is definitely nothing to worry about. Or I want to know that it is definitely something to worry about -- so I can treat it early.

So when I first got a mammogram and ultrasound appointment scheduled for a week from Friday, I accepted it and wrote it down in my calendar. And then panic set in. I realized I could not wait one week and that I should be able to demand a quicker response. So I called my doctor's office, spoke to the receptionist through uncontrollable tears, and somehow ended up with the doctor herself on the phone. "What's wrong?" she said. "I'm freaking out," I told her. "What do you want to do?" she asked. "Do you want to come in right now?" She told me she had a busy day, had a biopsy to perform that would take a while, but that I could come hang out in her office until she could get to me. Or I could come in on Monday, she said. I let myself calm down a bit and told her Monday would be good. She asked me what time I wanted to come -- she offered me any time that fit my schedule. I chose 9:00 AM.

So tomorrow morning, I will find out what exactly sits underneath the skin on my left breast, near my armpit -- what exactly it is that feels to me like a little mound of tissue that just doesn't seem right. Maybe it's scar tissue -- and I hope it is -- and maybe it's something else. I can only hope that at the end of my appointment I look foolish for pursuing something that doesn't deserve the attention I'm giving it. But if it does deserve attention, I will know I've done the right thing by vigorously pursuing an appointment I just couldn't wait one week for.

In the moment of despair, the cliche time heals all wounds may seem anything but comforting. But that's because it's true. It takes time to heal and we are not in the right frame of mind just as something unfortunate has happened to accept -- or believe -- this advice that might come flowing from a well-wisher's lips. It's popular wisdom. It's commonly offered as comfort. It's easy to spit out. And while our wounds do not exactly fade with the passage of time, we are able to put a more positive spin on them. But it's tough to appreciate this until the unfortunate moment is long gone.

According to a recent study -- summarized in the September 2006 Ladies Home Journal magazine -- memories of distressing events, like the death of a loved one, don't go away but they do gradually get colored by more hopeful emotions. As time passes, we tend to remember strongly emotional experiences as positive even if they were once harrowing. "People are resilient," says one researcher. "We come to terms with our experiences in as positive a way as we can." So we may eventually see the death of a friend as something that made us stronger, something that reminds us to treasure our friendships. Our ability to find such meaning in the saddest of times helps transform it into a valuable experience -- and not just a sad one.

And this is exactly how I feel about having had cancer. No one could have convinced me at the time of my diagnosis that time would heal my wounds. I wasn't even sure how much time I had left on this planet. I was panic-stricken and frightened and tended to defeat conventional wisdom. But now that two years worth of time has passed me by and I am pretty certain I will continue surviving for a long time, I realize time is responsible for my positive outlook. Time did not completely heal my wounds -- I still have days when my wounds are raw -- but it surely bandaged them. And so I do believe time heals all wounds -- in a way -- and I am thankful for each moment of time I have to marvel at this truth.

Hair colorist Jason Backe hopes hair dye does not cause cancer -- because he is covered in it every day in the Manhattan hair salon where he works. But the topic of hair dye and cancer has been on his mind lately -- because he has been fielding questions from clients about the possible link between the two ever since an American Journal of Epidemiology study was released and caused nationwide panic about hair dye upping the odds that women might contract lymphoma -- a cancer of the lymphatic system. But on Thursday, a New York Times article summed up opinions from both experts and hair stylists, revealing that most everyone believes this panic is not necessary.

Recent studies found that those who had ever used hair dye were 1.19 times more likely to get lymphoma than those who had never used it. Those who colored their hair before 1980 -- before then-questionable chemicals were removed from hair dyes -- were 1.39 more times likely to get the disease. Ann Curry on the Today Show said, "These are scary numbers," but Dr. Barnett Kramer, associate director for disease prevention at the National Institute of Health said, "Compared to risk factors for other diseases, those numbers are very small." Smoking makes people 10 to 60 more times likely to get lung cancer. According to Dr. Joseph K. McLaughlin, president of the International Epidemiology institute, if these numbers are true -- and that's a big if -- it would mean that using hair dye may present a remote risk to your health. But it would still be less risky than crossing a street, driving a car, not wearing a seat belt, or drunk driving.

I am not exactly in a panic about this whole issue. But before I heard the news about hair dye and cancer, I did dye my hair -- once. And I don't think I will do it again -- even though the risk may be small -- because I have already had cancer. And any amount of risk associated with any type of cancer is just something I don't want to mess with.

When I was first diagnosed with breast cancer almost two years ago, my greatest fear was losing my hair. The fear was consuming, painful, over-the-top. That was long ago -- and I survived. I can look back now and realize that the panic about losing my hair was such a small-scale fear -- compared to what I fear now. Now I fear a recurrence of cancer. And it's a whole lot more disabling than a little worry about being bald.

I have a few techniques for settling my fears when they get out of control. Sometimes I take deep breaths. Sometimes I distract myself and occupy my mind with something more pleasant than anxiety -- like writing, exercising, playing with my little boys. And sometimes I read about others who have come before me and have handled the same distress I sometimes feel about cancer taking up residence in my body again. Mostly I learn from stories of other women who have survived breast cancer. And I learn that I can handle the fear, that I can handle cancer if it does come back. And the women I find most inspiring are those who have had a recurrence -- or two or three -- and who still manage to happily tackle the life they have in front of them. They give me hope that if a recurrence comes my way, I too can conquer it. And here are seven snippets of hope from the book Hope Lives! The After Breast Cancer Treatment Survival Handbook -- from women who keep on surviving breast cancer.

I never colored my hair -- until after cancer, when my once-blond hair lost to chemotherapy grew in mousy brown with touches of gray. I thought it needed some spark and dazzle so I doused my head -- and my bathroom counter and walls too -- with hair dye in an effort to brighten up my look. It worked. And I like it. But I don't like what I've now heard about a possible link between hair dye and cancer. And this is what I told a reporter from the New York Times who called me the other day. She had read my post here on the Cancer Blog about this news story -- about hair dye and cancer -- and she wanted to know more about my personal feelings as a cancer survivor and as a person with colored hair.

I told this reporter that it's a bit ironic that in 36 years, I had never applied hair dye to my hair and that only after cancer did I take the plunge -- only to learn that hair dye may be cancer causing. I told her that I wouldn't do it again -- dye my hair -- although I don't think one application of coloring chemicals will really affect me when research indicates a risk only when women use hair dye 12 or more times. But still, I don't choose to take even the smallest of risks when it comes to my health -- which has already been compromised once. I told the reporter that I have not witnessed any widespread panic among the public about this issue. And I think the people I know who color their hair will continue to do so. That's okay with me. Because when it comes down to it, I am responsible for my hair only, my health only, my life only. That's really all I can manage.

And once my colored hair grows out -- the colored hair that was photographed today for the story this reporter is writing -- I'll manage to live on with my mousy brown hair with natural gray highlights. It won't have much spark or dazzle. But it will be safe.

I've been keeping a journal ever since I was first diagnosed with breast cancer. I first wrote by hand in a pink fabric-covered book, sprinkled with multi-colored polka dots. It looked feminine -- which is why I bought it -- and it's vibrance made me feel inspired, motivated, eager to write down the dreaded details of the beginning of my journey. Then I stopped writing in this book and began typing my words in an on-line journal -- a blog. My husband designed the presentation of it, with a pink banner that serves as the backdrop for the title -- my Breast Cancer blog. My first entry was completed on December 21, 2004 and I am still chronicling my journey here. I am also writing for this site -- the Cancer Blog -- and I write whenever and wherever else I can record my words. I do it because it helps me process information in a quiet, calming, introspective way. It soothes me, helps me work through panic and anxiety, helps me heal, and helps me chart my progress. When I look back at what I've written, I realize how far I've come -- or haven't come -- and it helps me move forward. I recommend journaling for everyone, and I recommend these seven simple suggestions for getting started.

When I first started going to counseling, I was told I would need eight to 10 sessions of cognitive behavioral therapy to help me deal with my anxiety, my panic, my fear of breast cancer recurrence. My first session was in May 2005 -- and I am still going. Those initial sessions are possibly all I really needed -- and perhaps I could have stopped the therapy long ago. But stopping never came up and no one told me I had to call it quits so I kept on marching into territory I had never before traveled. I have a degree in counseling -- but I'd never been counseled. I know how to listen to others and share empathy and ask open-ended questions -- but I'd never been the one talking and sharing and venting and crying and answering questions. Until last May -- when I discovered the appeal and the comfort of the counseling chair.

I marched into one of my sessions yesterday and plopped into a brown faux leather recliner. I talked about my recent graduation from Herceptin therapy and about how I might manage in life now that treatment is over. I talked about my jobs -- as a writer and a preschool teacher -- and how they fit into my world. I talked about the level of stress in my days and about how my once constant fear that cancer was trailing me has largely diminished. I talked about how breast cancer is no longer my constant companion -- about how it is now just an acquaintance. And I talked about how counseling was once so necessary and about how it is now just a luxury that helps me maintain peace as I live forward.

I am not sure when I will stop going to counseling. But I'm not completely sure of much anymore. And I've learned from counseling to not really question the future -- to just live in the moment and to give thought primarily to the here and now. And right here, right now, I'm sticking with my sessions, my one hour every month, my comforting counseling chair.