We have written here at the cancer blog about Courtney Nicole a few times. You can find posts here and here. Courtney passed way about eight months ago. Her mom still keeps a journal of what is going on in her life and how she is coping with the loss of her nineteen year old daughter.

I find myself going to her site often to see how she is doing. It is heartbreaking to read her words at times and encouraging at other times. She is trying to go on -- but how, without her daughter?

Recently, Court's mom posted Its Like a Scab! on her website. Here's what she said:

You've surely known kids whose parents smoke declare their repulsion for the habit. The health risk, the expense, the filth of smoking seem to deter many youngsters from following in the footsteps of mom and dad. Theoretically, anyway. In practice, these same kids may fall prey to the very act they vowed to reject.

How about kids raised in households filled with sugary snacks and drinks, foods packed with fat, salt, and calories, and parents with expanding waistlines? Seems only natural these children, despite good intentions, end up struggling with healthful eating and weight management.

We are what our parents teach us. It's all we know for a good many years. And by the time we are able to make our own independent decisions, it's often too late. Our parents' actions and values are already programmed within us -- and it takes hard work to switch things up.

So here's my plea for this Sunday morning: do your kids a favor and become a positive role model. Don 't just tell your little ones what is right and healthy and virtuous -- show them. Let your behavior be the gold standard now, so that later, it's likely to be what your sweet babies will fall back on.

Here are seven ways to get started:

Feed 'em well
If kids learn healthy eating habits early, they're likely to stick with them. Offer whole grains options (rice, bread, pasta) and snacks that are not in the junk food group. Don't even buy the stuff you may later wish to clear out of your cupboard. Guests at our house are offered two drink options -- water or milk. Why? Because if we have juice (it's loaded with sugar) or soda (also sugary and calorie-laden), our kids just can't hold back. But if we don't have these beverages, they are never an option. Out of sight, out of mind.

Keep 'em moving
Take your kids to the park, get them running around your backyard, take them swimming, organize a kid-friendly football game, invest in a kite. Quiet activities are also good -- and necessary -- but when in doubt about how to entertain your busy little bees, make them move!

Let 'em see you sweat
You need to keep moving too. Not only for your own well-being -- that's obvious -- but so your kids see your physical activity as a staple of healthy living. Teach your kids to do push-ups and sit-ups and do them together. Jump rope, run laps at a local track, ride bikes, or dance. Just don't expect your kids to stay active if your idea of exercise is flipping through TV channels.

No TV
Turn off that TV. Rid your household of junk-food commercials, mind-numbing content, and addictive inactivity. Let TV be a treat -- a small one -- and not an expectation.

No smoking
Need I explain? It's unhealthy, costly, dirty, and a sure contributor to cancer. Try with every ounce of your being to keep this habit away from your impressionable children.

No stress
Some stress is unavoidable. Some is even healthy. But the kind of stress that hurts our tummies, gives us headaches, and threatens our health should be minimized. We must do our best to control our own stress so its effects don't spill over. And we must teach our kids how to cope too. Fortunately, some of the techniques listed above also work for this category -- physical activity, for example, does wonders for lowering stress. We can become experts at deep breathing -- have your kids practice with you. And we can teach a bit of distraction. If homework is making kids crazy, go with them on a short walk where they can regroup and return to the task with a clear head.

No double standards
We simply cannot say one thing and do another. Smoking while preaching the dangers of the habit just doesn't make sense. Saying "no" to sweets with your hand in the cookie jar is downright unfair. Carrying around extra weight and demanding physical fitness is simply ineffective. So make a commitment to yourself and your kids that you will do as you say. It's the only way.

Cancer sent me into a state of depression. And it took more than a year of counseling and treatment with an anti-depressant to bring me back to a balanced and healthy level of functioning.

My type of depression -- the kind that shows up just after a cancer diagnosis -- is not uncommon. And neither is the spillover that depression can leave on the children of moms depressed because of their disease.

A study at the University of Pittsburgh -- the first to examine the relationship between children's concerns and a mother's cancer-related depression -- found children of depressed breast cancer patients were more likely to be concerned or anxious about their mother's cancer and about how the disease affects their families.

It's not surprising that kids worry about their moms during times of illness. What startled researchers, though, is the fact that children's' anxieties extended to concerns about the entire family.

The results of this study, funded by the National Cancer Institute, has clear implications. As a society, we need to think about how depression affects whole family units. Oncologists must learn to spot depression early and must swiftly assist women in finding appropriate treatment. And parents should talk openly about cancer and it's emotional side effects with their children in an effort to protect them from withdrawing, hiding their concerns, and suffering in silence.

Most estimates indicate nearly one quarter of women diagnosed with breast cancer have young children. And about 100,000 kids will be affected by a cancer diagnosis this year alone.

Merck, maker of the cervical cancer vaccine Gardasil, is backing off its lobbying campaign following pressure from medical groups and parents who believe the vaccine should not be mandated as a school attendance requirement for adolescent girls.

The public outcry that caused Merck to announce its stop order on Tuesday stems from the fact that the vaccine protects against the sexually transmitted human papilloma virus (HPV), which causes cervical cancer. School-mandated vaccines are typically for diseases spread through casual contact, such as measles and mumps.

Merck's medical director for vaccines, Dr. Richard M. Haupt says, "We're concerned that our role in supporting school requirements is a distraction from that goal, and as such have suspended our lobbying efforts," adding that the company will continue providing information about the vaccine upon request.

Gardasil, launched in June and the first vaccine to prevent cervical cancer, has inspired controversy since day one. There's the cost -- $360 for three required shots -- and all sorts of insurance concerns and conservative groups who worry the vaccine encourages premarital sex and interferes with parental rights. Even those in support of the vaccine -- like the American Academy of Pediatrics and the American Academy of Family Practitioners -- question Merck's quick push to market this drug, especially in light of the company's withdrawn painkiller Vioxx.

"I believe that their timing was a little bit premature so soon after (Gardasil's) release, before we have a picture of whether there are going to be any untoward side effects," says Dr. Anne Francis, who chairs an American Academy of Pediatrics committee.

Legislatures in 20 states have taken steps to mandate the vaccine for young girls. And with the exception of Texas governor Rick Perry's February 2 executive order requiring Texas girls entering the sixth grade in 2008 get vaccinated, nothing has been made official so far.

I guess the concept is happy -- the public urging for our world's policy makers to make cancer a top priority -- but the fact that becomes all too apparent on this World Cancer Day is quite sobering. More than seven million people die from cancer and close to 11 million new cases are diagnosed worldwide each year. In 2006, cancer killed more people than AIDS, malaria, and tuberculosis combined.

So today is both happy and sad. But for now, let's focus on the happy.

The Geneva-based International Union Against Cancer (UICC) and member organizations in 86 countries are launching a five-year campaign to impart life lessons to children so they can prevent cancer later in life. Parents are critical in this campaign and must take an active role in teaching their children techniques for saving their lives.

Forty-three percent of cancer cases can be prevented through healthy lifestyles that begin in childhood. The World Cancer Campaign slogan -- Today's Children, Tomorrow's World -- underscores the possibility that a concerted effort among world leaders, parents, and their children can make a real difference through four key actions -- providing a smoke-free environment for children; ensuring children keep physically active, eat a healthy diet, and avoid obesity; educating children about vaccines for virus-related liver and cervical cancers; and limiting children's exposure to the sun.

Former First Lady Barbara Bush, Her Royal Highness Lalla Slama of Morocco, Nigerian President Olusegun Obasanjo, and tennis star Steffi Graf are some of the powerful voices powering this campaign that UICC president Dr. Franco Cavalli says can save so many lives if embraced by those at the highest decision-making levels.

"Complacency and inaction on the part of world community will effectively contribute to more than 10 million deaths every year by 2020," he said.

Jack Osbourne, son of rock legend Ozzy and colon cancer survivor Sharon Osbourne, recently stated that he blames his alcohol and drug addiction on his father. During his mother Sharon's diagnosis and treatment for colon cancer, the young Jack used alcohol and the powerfully addictive prescription painkiller OxyContin as a way to cope.

Jack is quoted as saying, "My problems peaked when mom was sick and dad was dealing with his problems the same way as I was, by drinking, so I had no one to turn to. I was just hanging out with my crowd drinking and doing drugs." Jack ended up in an addiction rehab clinic to get clean and sober.

This is no way excuses the badly-decided choices that Jack made when he turned to alcohol and drugs as a way to cope with his feelings, but there is a sharp focus and more than a bit of snarkiness to the news reports concerning Jack's blaming comment that misses a great opportunity in regard to discussing the impact a parent's cancer diagnosis has on children.

As the American Cancer Society (ACS) states, "Families face many complex issues when one of their members has cancer. There will probably be a time during a family's experience with cancer when psychosocial support services will be helpful in meeting the emotional needs of the family. There are teams of experts, each with a different focus, who offer support and are trained in how cancer affects a family." ACS offers a terrific resource for the family with the online publication of Helping Children When A Family Member Has Cancer.

The Family Doctor states, "Every person has a different way of handling news that a loved one has cancer. Many people react with shock, disbelief and even anger when they're first given the news." The Family Doctor's Cancer: Helping Your Family Help You offers advice on different questions a parent might have, such as:

• How will my family react to the news that I have cancer?
• Should I tell my children that I have cancer?
• How do I tell my children that I have cancer?
• How can I help my children cope with their feelings?
  

In 2002, when I drove home after being told I had cancer, I wondered and worried about how I was going to tell my children, how I could avoid the unavoidable shattering of innocence in their world, how to protect them from their own fear and pain? I sat outside in the car, trying to stare through the walls of our home, knowing that in the next five minutes I would be changing our lives forever with the news of my cancer diagnosis. I wanted to freeze time, to save the innocence, to keep the awful news from being true.

In the ACS online resource for families, it states, "Parents can have a powerful effect on how their children react to a crisis in the family. In the beginning this responsibility can feel like a huge weight, but it is possible for family members to learn how to deal with and even grow through the experience of having cancer in the family."

Support services can include individual counseling, family counseling, and support groups. If you do not know where to start, ask your physician or call the local hospital or local ACS office. Someone will be able to help you help your children, and all family members, navigate through the crisis of cancer, so that everyone becomes a survivor of cancer in the best way possible.

The Susan G. Komen Breast Cancer Foundation College Scholarship Award Program offers college scholarships of up to $10,000 a year over a four-year period to students who have lost a parent to breast cancer.

To qualify, the applicant must be a high school senior or graduate -- aged 25 or less -- and reside within the service area of an established Komen Affiliate that is participating in the Scholarship Program.

The application deadline is November 1st. To learn more and download an application online, visit the Susan G. Komen Breast Cancer Foundation College Scholarship Award Program webpage.

The vaccine for cervical cancer was approved by the Food and Drug Administration in June for the use in girls and women and has been hailed as a breakthrough in cancer prevention. The vaccine prevents infections from some strains of the sexually transmitted human papilloma virus (HPV), which can cause cervical cancer.

Michigan girls entering the sixth grade next year would have to be vaccinated against cervical cancer, this would be a first of its kind of legislation for the United States.

The American Cancer Society estimates 9,700 women nationwide will be diagnosed with cervical cancer in 2006, and 3,700 will die.

Some say that making the vaccine mandatory infringes on parents' rights and encourages teen sex.

What do you think? Should the vaccine be mandatory or should the parents be able to decide?

There have been many strides over the years when it comes to treating childhood cancer. Many are surviving but some children will still die of their disease.

Parents of dying children have certain issues that are very important to them when going through the end of life process. The quality of care that is delivered at the end of life plays a critical role in the well-being of both child and parents prior to the child's death. It can also influence how the parents cope with their grief after losing their child.

Researchers surveyed 56 parents of children who had died in pediatric intensive care units in the Boston area. One of the most important aspects was that the care included honest and complete information. One woman noted "What we cannot handle is not knowing what is going on".

The parents need ready access to staff, communication and care coordination, emotional expression and support by staff. One parent said "Parents need to feel that people really care, not that it's just a job". Faith also played an important role when the parents said that chaplains and community clergy can be an important resource for parents.

The parents that were in the study were asked if they had any advice for other parents. Parents encouraged other parents to make decisions based on their own values and beliefs and to sustain hope, trust and love.

George W. Bush declared five years ago that no federal funding would be allocated for embryonic stem cell research. He has not changed his mind -- and two weeks ago vetoed a bill that would allow this research. He says that supporting the bill would be supporting the taking of innocent human life in order to find medical benefits for others. For Bush, it crosses a moral boundary. But most Americans support stem cell research and would like to see the Bush White House loosen its restrictions, says Kathy Hudson, director of the Genetics and Public Policy Center at Johns Hopkins University in Washington. Until this happens, though, scientists and researchers find themselves in an ethically-charged minefield, operating carefully and responsibly and ethically.

Dr. Peter Dirks -- a neurosurgeon specializing in childhood brain cancer at Toronto's Hospital for Sick Children who has been making headlines around the world for isolating brain cancer stem cells two years ago -- is one person weighing in on controversial issue of stem cell research. Dirks does not use embryonic stem cells but instead uses cells from tumors removed during brain surgery that would otherwise be discarded. But he says embryonic stem cell research is critical for his success. It's what has led to the findings that exist today -- and it holds the clues for further discovery. It's a delicate matter, though, regardless of the politics surrounding the issue. Before he harvests stem cells from any patient's brain tumor, for example, Dirks asks parents to sign a three and a half-page consent form. And that's just the beginning.

Federally-funded embryonic stem cell research does not yet have its beginning here in the United States. Maybe the tides will change. Maybe we will see progress. Maybe we won't. Only time will tell.

Researchers are beginning to tell us that being overweight increases cancer risks for a number of cancers. But then being overweight increases our chances of developing a number of diseases. While there are all kinds of diets, and gurus who claim they know the way, the remedy for long-term weight loss isn't going to change -- it's all about moving more, and eating less.

But what if you are moving more and eating less and the pounds stubbornly refuse to fall away? Amy Paturel, an expert in nutrition and public health, recently reviewed the top ten reasons why when you do all the right things, you aren't getting the expected results. The ten reasons Paturel discusses that can prevent weight loss are lack of sleep, synthetic chemicals in the environment, weather effects in temperatures being too hot or too cold, not smoking, prescription medications, giving birth at an older age, natural selection and overweight parents having overweight children.

Of course, this doesn't mean you are doomed to weight gain or being overweight but it might mean that you will need to take a look at some of the possible causes of why you are experiencing weight gain and not experiencing weight loss.

Paturel goes into an explanation of each of these causes in Ten More Fat Factors: It's Not Just the Cupcakes.

When children diagnosed with cancer undergo radiation treatments at the Hospital for Sick Children and Princess Margaret Hospital it can be scary -- the unknown is scary at any age. Traditionally, to help make a child more comfortable, they are given a plush animal as a radiation buddy.

Now Toronto hospitals have something more to help in the way of an animated interactive CD-ROM that shows what will be happening during radiation treatment.

Called Radiation for Kids, it is also written to ease concerns of parents about what their child will be facing in treatment by providing a glossary of medical terms and tips on how to talk to their child about cancer.

In Radiation for Kids, a child creates an animated character and follows it on a virtual tour into treatment. The program is written with different levels of age-related information, puzzles and games so that young children and teens can both benefit from Radiation for Kids.

According to the children and parents who have viewed Radiation for Kids, the information provided does lift fear and gives everyone a sense of confidence in what lies ahead. For information about obtaining a copy of the CD, visit the CBC News feature on Radiation for Kids.

Parents may want to save their kids' baby teeth for more than just nostalgic reasons -- they may want to save them because they are rich in stem cells and the pulp tissue could provide the means to treatment for injuries and disease. BioEden Inc. is a new company out of Austin, Texas pioneering this effort that is so new some doubt science will ever catch up with the expectations of this firm. But President Jeff Johnson says all evidence indicates that baby teeth are a wonderful source of stem cells -- cells that doctors and researchers pursue for their capability of replicating and morphing into specialized cells that can be used to repair the body. Experts think baby teeth stem cells might one day be used for bone, teeth, and even nerve cell regeneration which could hold potential for spinal cord injuries and Alzheimer's and Parkinson's diseases.

Parents may find brochures in their dentist offices featuring the benefits of banking their children's teeth once they fall out. And pursuing tooth banking is no different than pursuing any other dental procedure. There are fees involved, of course -- banking fees and perhaps referral fees from dental offices -- and other considerations that each parent must weigh. Dr. Phil Hunke, president of the American Academy of Pediatric Dentistry and pediatric dentist for 32 years, says the idea of removing cells and freezing them holds true promise -- and he may want to bank the tooth of a child or grandchild once he learns more. Dr. Kevin Donly, a professor of pediatric dentistry, says he sees some potential but will not be banking teeth for his three little boys. He just doesn't think he's at the point where it's necessary. Another pediatric dentist -- Dr. John Updyke -- believes that if money were not an issue, all parents should bank their kids' teeth. But many young families can't afford the initial $595 and the $89 annual storage cost it requires. And without a solid scientific backing, tooth banking might not come up as a priority for many when it may take 10 years or more to even determine how useful these specific stem cells will be.

Japanese-American actor Mako Iwamatsu, who received an Oscar nomination for best supporting actor when he played the Chinese character Po-ha in the 1966 movie The Sand Pebbles, is credited for Hollywood's acceptance of Asian-Americans as serious actors, not merely caricatures or stereotypes. Last Friday, Mako died of esophageal cancer.

During Mako's career in film and theater, he co-founded the first Asian-American theater company, East West Players, where he trained aspiring actors and playwrights. Mako had roles in the films Conan the Barbarian, Seven Years in Tibet, Pearl Harbor and the Japanese film Owls Castle.

Mako was the voice of evil demon Aku in the animated series Samurai Jack, and as the parody of Aku, Achoo, in Duck Dodgers, as well as Uncle Iroh in Avatar: The Last Airbender.

According to artistic director Tim Dang of East West Players, "If it wasn't for Mako there wouldn't have been Asian-American theater. He is revered as sort of the godfather of Asian-American theater." Born in Kobe, Japan, Mako was the son of noted children's book author and illustrator Taro Yashima. He has a star on the Hollywood Walk of Fame. Mako was 72.

My little boys love candy -- and sometimes I think they eat healthy food only to earn sweets. Their constant badgering about candy has led to a recent ban on artificially-sweetened stuff in our house. If it's not in the house, they can't have it. No arguments. That's it. Fortunately, they also love fruit. So what we lack in candy we now make up for with fruit -- apples and bananas and grapes and peaches and strawberries are favorites. And just today at lunch, three-year-old Danny cleared his plate of strawberries and then proclaimed, "I love strawberries!" And I love that Danny loves strawberries -- especially in light of the news that hit papers today.

It seems that candy lovers are more likely than salt lovers to eat fruit. A study published in the journal Appetite found that people who eat candy, cakes, and other sweet snacks eat more fruit than people who prefer salty snacks like chips and nuts. Maybe that's the reason for my boys' equal affection for both candy and fruit -- and their indifference about salty treats. Apparently, the craving for something sweet is satisfied by both candy and fruit -- which is hopeful for kids whose parents might now steer them in the direction of the more healthy option. And for dieters who might incorporate more fruits into their menus in an effort to cut calories. And for anyone really who is concerned that a diet rich in candy, cookies, and cakes might contribute to illness and disease while fruits and vegetables encourage healthful living.

An apple a day.