The important thing is to take that first step. Bravely overcoming one small fear gives you the courage to take on the next. -- Daisaku Ikeda

When your diagnosed with cancer you sometimes feel that you don't know how to take that first step. What is the first step? For many it is very different. You might need time to accept what is happening, or you could be the kind of person to jump right into researching your disease, you'll probably need to find a surgeon and an oncologist and maybe even a plastic surgeon. Getting through the first steps can lead to making the rest of the journey easier.

One thing I have learned throughout my cancer experience is that I surprised myself at what I could actually handle. I took a scary step and got my port put in my chest so I could receive chemotherapy. I dreaded the fact that I had to get that port. I felt like such a freak. Even though the port was under my skin completely, it was protruding from my chest and I really felt like a cancer patient at that point.

A report has been released by Breast Cancer Action (BCA), a grassroots education and advocacy organization, on the side effects of aromatase inhibitors (AIs). The report is called "Side Effects Revealed: Women's Experiences with Aromatase Inhibitors". The study analyzed 612 women's responses to an online survey of AIs and their side effects. You can find the report online at http://www.bcaction.org/AIreport.

The results showed that 92 percent reported at least one side effect. Nearly 30 percent reporting stopping the use of AIs--84 percent of those that stopped taking the drug reported that it was because of the intolerable side effects. Almost fifty percent of those that stopped taking the drug because of side effects complained of joint-related problems. Other side effects included stroke, cough, swelling of extremities, flu-like symptoms, and anxiety. Many women said they had joint related issues, vaginal atrophy and dryness and general pain.

Many of the women said they did not receive information about short or long term side effects from their physicians. Executive Director of BCA, Barbara Brenner, said "Patients know about the side effects before their doctors do--they experience them firsthand. Now that hundreds of women taking aromatase inhibitors have spoken, it's time for the medical research community to respond with additional research on the side effects of these drugs."

A previous post related to this topic:

Breast cancer survivors reject chemoprevention drugs

It can be a bit overwhelming and scary to read all the side effects on the sheet that the pharmacist gives with the medicine that has been prescribed by your physician. There always seems to be so many side effects that CAN happen. The thing is that most of the side effects are not life threatening and are mild. Some medications however do have severe side effects that if you are not aware of can prove to be deadly. This shouldn't happen of course if you are listening to what your doctor says and are being monitored closely.

It is important to read all the side effect information yourself and know what to look out for. In case something does happen that is abnormal, you will notice it sooner than later, and you can call or see your physician immediately.

In a report issued Tuesday, the Journal of the American Medical Association estimates that 700,000 people a year, especially the elderly, experience adverse drug events that lead to emergency room visits. In patients 65 or older, one-third of the drug reactions were caused by three medicines: Coumadin, a blood thinner, insulin and Digoxin, a heart medication.

The important thing to remember is to ask about any other drugs you are taking and the interactions with the newly prescribed drug. The report I saw on this issue mentioned that about 30 percent of us are taking around five pills every day.

So ask the nurse at the doctors office to explain the side effects and you can also talk to your pharmacist about the drug. I went and got a prescription filled the other day and the pharmacist asked me if I had any questions about that specific drug. I didn't this time, but I liked that he asked.

Many patients either want to know everything that is going on with their diagnoses and treatment or they don't want to know any details and just will go along with what their trusted physician tells them.

I found myself as being the former patient mentioned and an extreme one at that. When I was diagnosed with breast cancer I researched as much as anyone possibly could. I wanted to know all the treatment options, prognosis, side effects and I wanted to know what chemotherapy drugs were available for my cancer and everything about them.

Robert Hudick is a patient that wants to know everything about his diagnosis of prostate cancer. He, like me, did all the research about his many options for treatment. Not everyone is lucky enough to have options but when you are faced with making your own treatment decisions it can be very difficult.

These days patients are becoming much more involved in the decisions that make up their treatment plan. Mr. Hudick decided to go even further with the way he took part in his own treatment. Robert not only researched but he changed his life completely. After an estimated 1000 hours of research, he decided he wanted a radical retopublic prostatecomy. Robert also lost 47 pounds to lessen the risk of his upcoming surgery, took yoga and imagery classes and tried Chinese medicine massage techniques.

These things are not for everyone, I myself did not go the alternative route to compliment conventional therapy, but being proactive in our own care is the message.

Fighting for Our Future:How Young Women Find Strength, Hope, and Courage While Taking Control of Breast Cancer. Beth Murphy spent two years studing young women with breast cancer and her book gives young women a valuable resource.

Fighting for Our Future talks about many issues related specifically to women under forty diagnosed with breast cancer. Some of this issues are fertility, pregnancy, negotiating treatment, living with the illness, sexuality and dating. It reaches out to the newly diagnosed and those living with metastatic disease to all in between.

Breast Cancer patients tell their own stories throughout sections of the book. They decribe treatment and procedures and give the real information that the young women need to know.

The Cancer Research UK conducted a survey of breast cancer survivors and found more than half admit they have missed taking the scheduled doses of chemoprevention medication. The three most common reasons the women gave for not taking the medicine were: tablets hard to swallow, difficulty in coping with side-effects and the fact that drugs were a constant reminder of illness. In addition, some women simply forgot to take the prescribed medication in a timely manner.

Experts believe a lack of communication with women in regard to handling the side effects of drugs and the importance of staying with treatment the entire length of time prescribed to prevent recurrence, might be lacking. They also feel that more needs to be done to understand why women would willingly chose to discontinue or interrupt long-term chemoprevention drug treatment.

The study was a small one involving 131 women who were at least two years past initial breast cancer diagnosis, but I am certain that given a larger study researchers might realize the same findings. In my opinion, after breast cancer diagnosis -- surgery, chemotherapy, radiation -- or a combination of all three treatments -- is not only a physical challenge but an emotional one. Once past active treatment, the resources and support for breast cancer survivors can fall off dramatically while the difficult issues of being a breast cancer survivor remain.

It may be possible to learn happiness -- like we might learn to cook or learn to dance -- by merely taking a class. Some refute this idea and believe you can't actually pursue happiness. You either have it or you don't. But some psychologists are embracing a whole new approach to psychology -- they call it positive psychology -- and they say it focuses on training the mind to focus on the past as very positive. It's completely different from traditional psychology where time is spent trying to determine why someone is so horribly sad. This movement, invented by University of Pennsylvania psychologist Martin Seligman in 1998 when he was president of the American Psychological Association, provides a scientific validated set of exercises -- known as interventions -- that lead happiness seekers to their ultimate destination.

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.

The tunnel was long. And dark. And winding. And foggy. And ominous. It seemed to last forever -- at the time -- and at moments, time seemed to stand still. I was not sure if I'd ever pass through it and be okay -- if I'd ever see the light at the end. But I did. I tunneled through it all -- somehow -- and I came out feeling more alive than ever before. Now, some time after my escape from the fog, I am already taking for granted the fact that I am breathing, that I am healthy, that I am living. And when my fitness trainer noticed yesterday that I do not get dizzy and lightheaded anymore during my workouts -- when I once had to sit down, breathe, collect my whereabouts -- I realized that some of my progress since exiting my breast cancer tunnel is already lost on me. And I don't want to lose sight of where I was and how far I've come. I want to remember it and measure it and never forget how alive I am at this very moment. So I have started to really think about how things have changed since I felt stuck in time, in a dark place. I am thinking about my times in a hospital bed when I was barely able to stand up, barely able to walk a few steps without feeling like I would collapse. Now I can hop out of bed at a moment's notice, half asleep in response to a demanding child screaming from his bed. I am thinking about my once challenging pre-cancer exercise routine and how a time came when my legs felt so heavy I could not even contemplate walking down my street. Yesterday, I completed an hour of weight training. Today I ran for 20 minutes. Tomorrow, I go back for more weight training. And I remember feeling incoherent, unable to conjure of meaningful thoughts or sentences. And now, despite some potential chemo brain forgetfulness, I am back on track.

I have only just touched the surface. There is so much more to reflect on. So I plan to think more about my travels so I can better appreciate how I arrived at the exact place where I am right now -- where it's light and clear, where time passes at normal speed, where I feel lucky to be alive.