In 2003, 29 percent of the American population had only basic prose literacy skills and 14 percent had below-basic skills.

Prose literacy measures the skills needed to understand texts such as new stories, brochures, and instruction manuals. People with basic skills can perform simple, everyday literacy activities. Those with below-basic skills are proficient in only the most simple and concrete literacy.

How is it that these individuals, when they are diagnosed with a disease such as cancer, are able to understand the medical jargon thrown their way, the literature that piles up in front them, the complicated process we call the medical system?

They aren't. And this leads to increased chances that people will be hurt, even killed, in the course of their medical treatment.

There are many barriers that lead to miscommunication -- cultural differences, language problems, and overall poor literacy skills -- and experts in this area are recommending some changes. They urge more education and training for health care professionals who may not ever imagine someone might not understand their words. They suggest health teams use medical interpreters. And they seek to embrace a culture of easy-to-understand communication in all aspects of medical care.

Toni Cordell, a nationally-known health literacy advocate, says humiliation and shame washed over her three decades ago when her gynecologist told her she needed a simple repair and she woke from surgery to learn she'd had a hysterectomy. Struggling at the time with dyslexia and a poor education, Cordell never asked any questions of her doctor. She just accepted the course of action, without knowing anything about it.

"Ignorance is not bliss," she says. "It's not a good place to be."

If you are trying to ward off cancer by making a change in your smoking habits, cutting back isn't enough. Cutting out cigarettes altogether is the only way to really protect your health.

Think about this tidbit I found in the March 2007 issue of Woman's Day Magazine.

A 20-year-study of more than 50,000 people in Norway recently revealed that patients who smoked fewer cigarettes -- even those who cut back by half -- were just as likely as heavy smokers to suffer from early death due to cardiovascular disease, cancer, and other tobacco-related problems.

Luanne Austin says chemotherapy is not all it's cracked up to be. She doesn't mean it's cracked up to be something really great but is far from such a thing. She means it's cracked up to be something pretty horrible but is really not all that bad.

Austin says the day her doctor announced she would receive chemotherapy was almost as bad as the day she learned she had breast cancer. That's because she had heard nothing but bad things about the treatment. She expected to be laying in bed with her life in the balance -- nauseated, vomiting, sick -- as the "cure" killed her.

All expectations aside, Austin decided to tackle chemotherapy with a positive attitude. This may seem a daunting task -- turning a dreaded chemotherapy protocol into a not-so-bad experience -- but Austin mastered the task. And here are seven of her positive thoughts about a treatment that is not all it's cracked up to be.

• Austin talked to people who had traveled journeys similar to hers. What she learned is that many women continued working through treatment. Some suffered very few side effects. One woman even told Austin her experience was super. Austin was inspired by the positive women she tracked down. And now she inspires others.
  

• Austin did some reading. She learned that chemotherapy drugs target quickly-dividing cells, like cancer cells, red and white blood cells, blood platelets, and digestive tract cells. Learning about the process helped her realize chemotherapy was intended to make her well, not make her suffer.

• Austin learned how to support her body through treatment. She came to understand that the best chance of surviving breast cancer comes from conventional medicine -- surgery, chemotherapy, radiation -- but that alternative treatments can complement the traditional approach. She recommends the book Breast Cancer: Beyond Convention and considers her pursuit of a healthy diet, exercise, supplements, and a good night's sleep some of her most helpful chemotherapy add-ons.

• When Austin felt weak, tired, and just plain zoned out, she retreated to her bed with a good book and a cup of tea. Instead of considering it a setback, she called this downtime a good excuse to spend hours reading.

• Austin found relief from her nurses. They were terrific, she recalls, and professional and friendly and respectful too. Getting to know her medical crew -- and receiving hugs from them at the end of her treatment -- confirmed chemotherapy has some good points.

• For Austin, God -- who carried her through her whole journey -- was instrumental in her positive outlook. She felt lifted up and carried, she says.

• And then there's love -- pure and simple love from her husband and family members -- that allows her to conclude that chemotherapy is not so bad. "I'd have to say chemotherapy hasn't been all that bad," she says. "Not bad at all."
  

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

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

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

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

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

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

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

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

Recent research indicates that obesity makes ovarian cancer deadlier and more likely to recur. According to physician and senior author of the study, Dr. Andrew J. Li of the Cedars-Sinai Medical Center, maintaining ideal body weight is important for many reasons. This is just one more reason to reduce obesity -- because obese women suffering from advanced ovarian cancer are more likely to die than women at healthy weights. They also suffer recurrences more quickly. On average, women in the study considered overweight or obese saw an average of 16 months before recurrence while those considered underweight or at a healthy weight saw 25 months.

Perhaps it's the secretion of adipose tissue that makes tumors less sensitive to chemotherapy. Li said there are ideas on the table -- and his team are looking into them. One fact they feel certain about is that obesity does not increase the chances of contracting ovarian cancer. It just shows the odds of survival are diminished once the disease has been contracted.