I write a lot about exercise. That's because it's clear the practice prevents all sorts of illness and disease, including cancer, and I think you should know all about it. I also write so much about the topic so the health lessons pertaining to physical fitness sink deep into my brain because I, like everyone else, need a reminder now and then about how importance it is to stay fit. So, here I am, back with another morsel about this noble endeavor we call exercise.

Think about this:

Making a habit out of exercise may help you stick with a routine you find hard to keep. It can be hard -- to create a ritual in an already-hectic schedule -- but it's possible. Experts suggest piggybacking any desired behavior, like exercise, with already firmly-established tasks. Perhaps you can forgo a shower until you have exercised for the day or watch TV only after you've mastered some endurance training on the treadmill. How about turning a nightly stroll with your dog into a brisk power walk -- this workout will benefit not only yourself, but your pet too. Maybe huff and puff a bit every evening before dinner. Reward yourself with a refreshing fruit salad after every strenuous workout. You get the drill. Now get those tennis shoes on and give it a go!

Source: Canyon Ranch Connection, Spring 2007

Democratic presidential candidate and former North Carolina senator John Edwards missed an Iowa campaign event on Tuesday so he could be with his wife as she prepared for a medical appointment the following morning.

Elizabeth Edwards, diagnosed with breast cancer just before the 2004 election, when her husband ran for vice president, has survived chemotherapy, surgery, and radiation and has written a book -- Saving Graces -- about her entire journey.

Edwards' campaign crew has insisted Wednesday's appointment was a routine follow-up to a medical visit his wife had the day before and that Elizabeth Edwards, 57, has been living cancer-free.

Today at noon, Edwards will hold a press conference about his wife's health and how it may -- or may not -- affect his candidacy.

I just took the Great American Health Challenge -- an on-line quiz offered by the American Cancer Society -- and after just a few minutes of answering a few questions about my age; weight; height; family history; and eating drinking, smoking, and exercise habits, up popped my very own Health Action Plan.

My plan was quite revealing and listed both the good and not-so-good facts about my lifestyle.

I learned that my weight is normal -- whew! -- and that I seem to have an active enough fitness routine. More is always better, though, I was informed. I digested the fact that I don't eat enough whole grains and probably need more low-fat dairy in my diet. I was commended for not smoking and not drinking. And I was encouraged to limit sugars because they are high in calories and low in nutritional content.

My plan came to me ready to print so I can take it to my next medical appointment where my physician can help guide me toward healthier living.

American Cancer Society experts say the Great American Health Challenge can help those who take it to lower their risk of cancer. Get checked, get moving, nourish your body, and quit smoking, they say.

It only takes five minutes to get started. So click here and start now.

The 1998 guidelines on breast cancer follow-up has been updated by the American Society of Clinical Oncology. They state the most reliable way for detecting a recurrence is to receive physical exams and educating patients on the symptoms of recurrence.

All women should perform monthly breast exams. Genetic counseling is recommended for high risk women, including those with Askhenazi Jewish heritage, family history of breast or ovarian cancer, or diagnosis of bilateral breast cancer in the patient or relative.

Study results show no survival advantage for intensive verses conservative surveillance. Complete blood counts (CBCs), liver function tests, imaging studies, and assessment of tumor markers are not recommended for routine surveillance.

Breast cancer can recur within 15 years of the initial diagnoses and beyond, surveillance is a lifelong process for breast cancer survivors.

"I have a mammogram on Friday," I told my husband just two days before the test I will receive every six months for the rest of my life. The test I should not have even needed for another four years, when I hit the age of 40. The test that helped find a cancerous lump in my breast two years ago and will hopefully catch any future lumps in enough time to save my life.

The mammogram. It's a big test that hinges on one moment of disclosure from the technician who performs the procedure. The disclosure -- everything is fine or the doctor would like to see you -- predicts whether or not life goes on normally or is derailed by uncertainty. Mammograms are a big deal.

"Are you worried?" my husband asked after my announcement. I thought for a moment and then replied, "No."

For some reason, I am not worried about this mammogram. Perhaps it's because I am monitored so regularly by the medical establishment and I'm confident anything suspicious in my breasts will be caught early and treated successfully. Perhaps the routine of it all makes mammograms not so eventful anymore. Maybe I'm just coping better with the seriousness of it all, and mammograms have become one more mundane appointment that requires my presence.

It doesn't matter really. What matters is that I am calm about my mammogram, that I am not giving it serious thought, that I am free of anxiety.

What matters is that I am not worried.

I am in a slump. I feel tired and slow and unmotivated. And ever since October 14 -- when I ran in the 5K Making Strides Against Breast Cancer event -- I can't seem to find the inspiration to exercise. I am making myself do it -- here and there -- but my usual drive and push and spunk are missing. Typically, I crave exercise and feel lethargic if I don't accomplish some sort of daily physical challenge. But for the past week or so, I have no craving, no desire to walk or run or lift weights, no appetite for my usual fitness routine. I am just plain tired.

Fatigue is a common side effect of cancer treatment -- even years after treatment ends, according to some experts. So perhaps my drop in energy and enthusiasm is due to the cumulative effect of my own treatment for breast cancer that just ended in June. My treatment spanned almost two years. Maybe it's no surprise my body is lagging behind my expectations for physical health.

Experts also say exercise helps combat fatigue. I believe this -- it's why I usually like exercise. It boosts my adrenaline, perks me up, makes me feel alive. If only I could get back into the swing of things, these feelings might come flooding back. But right now, I am not even thinking about how to find my old groove. I am just too tired.

Suzanne Pleshette's agent reported on Friday that the actress is currently undergoing treatment for lung cancer. The cancer was discovered during a routine X-ray and was no bigger than a grain of sand. Pleshette apparently feels very lucky and is in great spirits as she receives outpatient chemotherapy at Cedars-Sinai Medical Center -- where the cancer was diagnosed.

Where does the time go? Even though most of us have been experiencing the height of the summer season in the form of a nationwide scorcher of a heat wave, summer is almost over for school kids and teens leaving for college. Yes, in less than a month, it's back to school. There are advertisements everywhere you look for new school supplies and new school clothes. In preparation for the new school season, Duke Health has published Back to School Tips for Healthy Eating.

The experts say it is not about counting fat grams and calories but portion control and choices. According to pediatrician Dr. Terrill Bravender, "You don't have to be obsessive about it. If you generally eat healthy, there is room for some foods that aren't as healthy."

Dr. Bravender offers these basic common sense tips:

• Involve kids in lunchbox planning. If you let them make some choices about what goes into their lunchbox, they are more likely to eat it.
• Avoid the peanut butter and jelly rut. Nothing wrong with the traditional, but try new foods. Make it a food adventure.
• While everyone is still on summer break, encourage children to prepare their own lunch. Dr. Bravender suggests easy-to-make ideas like graham crackers with peanut butter and a glass of milk; fresh fruit with cheese cubes; a hard boiled egg with whole grain crackers; yogurt with a sliced banana; granola bars with milk; or tortilla chips and bean dip made without hydrogenated oils.
  

Ultimately, as the mother, what foods come in to the home are my choosing, so I try to make nutritious choices in food purchases. But I have found great success over the years by taking my kids to the grocery store with me, and allowing them to choose between several choices I offer. We also take a look at new foods, and talk about the food item. We read ingredients. Some we decide, by group vote, to bring home and try. During the growing seasons, they are with me when I stop at a roadside stand to buy local produce straight from the field, and each year we have an annual tradition of blueberry picking enough blueberries to last most of the year ahead. Food can be fun, and learning about good food a lifetime benefit in cancer prevention.

It seems like common sense to me -- that lifestyle choices can affect a person's risk for contracting cancer -- but apparently, many people are not aware of this. Or they are aware but are not heeding the advice that might just save them from this life-threatening disease. According to Carolyn "Bo" Aldige, president of the Cancer Research and Prevention Foundation, in Alexandria, Va., it's not undiscovered treatments and therapies that are key to fighting off cancer -- it's likely that the toll cancer takes can be reduced by lifestyle changes and routine screenings. Aldige reports that nearly half of all cancer deaths are preventable. And she urges us to consider these facts.

• Smoking is the most preventable cause of death in the United States and causes nearly one in five deaths, killing about 438,000 Americans each year. Yet 45 million adults still smoke -- 23 percent of them men and 19 percent of them women.
• Poor nutrition, inactivity, and obesity account for one in three of the 564,830 deaths from all cancers. Experts say that excess calories cause mutations that start genes traveling down pathways that cause cells to divide out of control -- and that's what cancer is. According to Aldige, if each person could magically acquire the perfect body mass index, there would be a whole lot less colorectal, breast, and prostate cancers.
• It requires little time and not much discomfort for certain screenings that can detect cancer at an early enough stage that it can be successfully treated. There are already screenings for breast cancer, colon cancer, prostate cancer, testicular cancer, cervical cancer, and skin cancer. And soon, there may be a simple screening for lung cancer too.
• A diet rich in nutrients and vitamin supplements helps maintain health and prevent cancer.

There are some highly effective defenses against cancer -- but they require some attention and effort on the part of each individual. Not everyone will make health-conscious choices -- some for reasons out of their control (lack of access to screenings, for example) and some for reasons I personally do not understand. But maybe that's because I have already had cancer and I know that I don't ever wish for it to return. So for that reason alone, I plan to adhere to the considerations listed above. It seems like common sense to me.

For the almost two years I have been receiving treatment for breast cancer, I have traveled the same path -- over and over and over again -- from my house to the hospital and back again. And while I have seen different doctors and received different treatments and visited various departments and locations for all sorts of surgeries and tests and scans and X-rays, the path has remained the same. And after all the time that has passed, the power of the path has never diminished -- despite how familiar it has become.

Today I drove from my house to the hospital for a counseling appointment. I drove the same stretch of highway for a few miles, got off on my usual exit, drove for a few more miles past all the typical shopping centers and restaurants, and came to the light where I always turn left into the Cancer Center. I drove into the parking lot, found a parking space -- thankfully -- and displayed my yellow patient parking permit that allows to park without fear of a $20 ticket. I got out of my car and began my walk to the main hospital where the psychology clinic is located. I passed -- as usual -- the startling crowds of people smoking outside the Cancer Center, the groups of medical students who gather outside the medical facilities, the masses of people in white coats racing around and checking beepers and talking on cell phones. I entered the hospital, traveled to the ground floor, and turned a few corners until I reached my clinic. I checked in, paid my $25 co-pay, and waited for a just a few minutes until I was greeted by my counselor. We walked to a private room, talked for an hour, and then I followed my path in reverse.

The path is always the same. It is routine and predictable and rarely varies. But it has never become dull and I have never become numb to it -- because the power that is wrapped up in my drive and my subsequent steps that take me to and from my destinations still has a tight hold on me. I can travel the same path for other purposes -- to shop or have dinner -- and the power is lost. But when I travel for reasons all about cancer, the power overwhelms me. It happened today -- as I drove listening to the same CD I always play on these missions, as tears filled my eyes. I was not sad -- just overflowing with emotion. Emotion about all that I've encountered -- the encounters with fear and dread and total repulsion and the encounters with hope and joy and pure contentment. Today I felt powerful. Simply powerful. Because I have overcome what has faced me so far and because I am still traveling the same road, the same path to ensure my future health and well-being -- which is something I hope to become all too familiar with.

Just before my treatment for breast cancer began and during a consultation about what chemotherapy drugs I was about to receive, my oncologist stepped away from my exam room to check on something. When she returned to the room, she told me that she was determining whether or not I qualified for a clinical trial. I had no idea what this meant at the time. All I knew was what she told me -- that my prognosis was too good at that moment to qualify for anything currently under study. I did not fit a profile for anything. I was not a candidate for a clinical trial.

I now know that clinical trials are a critical component of research -- they validate a drug's success or weakness and they provide hope for many who may be at the end of their treatment rope and need something new to consider. A clinical trial is a comparison of standard treatments to newer treatments in an effort to discover better methods for the diagnosis and treatment of cancer. Doctors, scientists, and other health professionals conduct these tests according to strict guidelines set by the Food and Drug Administration -- which establishes mandatory guidelines to ensure the maximum safety of the patient.

Clinical trials rely on volunteers -- and sadly, there is a current shortage of patients willing to participate in trials. Experts say that, for the past few decades, just five to 10 percent of all cancer patients in the United States have joined a clinical trial. There is an urgent need -- because the demand for willing, eligible participants far exceeds the supply. Some experts are even recommending that the small pool of candidates that does exist be rationed to only the most important cancer studies -- leaving other studies with no hope for completion. There is no good solution in sight. But the reasons for the shortage are becoming apparent. It's not that patients are unwilling to join. It's that they are unaware, uninformed, not even sure this opportunity is possible -- because doctors are not suggesting trials to their patients. Treatment on a protocol is more demanding for doctors than routine medical care. And it costs doctors to submit to a trial. And trials burden doctors with regulations and paperwork. And some doctors worry about litigation if something experimental goes wrong. So they often don't approach the topic -- and the result is that a wonder drug may sit in a dark freezer because there are not enough people to test it. This potential wonder drug may never show promise, may never save a life, may never see the light of day.

So I guess my oncologist was ahead of the game in this matter -- she compared my diagnosis and prognosis with the needs of all available clinical trials and found that there was not match. Had she not done this, I would have never thought to ask about the possibility -- which is exactly what patients should do instead of waiting for a doctor to make the suggestion. Because it may never happen.

For more information on clinical trials, please visit the Coalition of Cancer Cooperative Groups.

Mammograms may not be solely for detecting breast cancer anymore -- they may also lead to detection of heart disease. Calcifications may be detected in the arteries of the heart during routine mammograms. Essentially, this indicates hardening of the arteries and can be a sign of heart disease. This is nothing new, really -- doctors have long thought that hardening of breast arteries relate to heart disease. But this relationship had never really been studied -- until recently. Several large studies and many smaller ones have shown a correlation between these vascular calcifications on arteries in the breast because of the similar size to the arteries in the heart. And this correlation revealed itself for one woman -- Bunnie Gleiman -- when she went for her annual mammogram and learned that she had these calcifications on the arteries in her breast. She says her mammogram saved her life -- but not from breast cancer. Now on medications for cholesterol and blood pressure, Bunnie reports that she is happy and healthy. Thanks to her mammogram.