Walking into my cancer center waiting room is one of my most sobering experiences. I enter this room -- jam-packed full of men, women, and children -- every three months for a breast cancer follow-up. It never gets easier. It always startles me, stirs my emotions, makes me realize how so many people are touched by such a treacherous and all-consuming disease. The fact that I sit in this room, that I am one of these many people, still doesn't seem real.

It's been almost three years since I got a phone call from a surgeon declaring, "You have cancer." I didn't believe it then. Even after all I've been through -- surgery, chemotherapy, radiation, and more -- I hardly believe it now. But it's real. I have scars and new hair and a whole new set of worries to prove it.

Walking into that waiting room proves it's real. There's nothing like it. There's also nothing like walking out, with a clean bill of health and the promise of three more months.

Research published in the international medical journal Addiction showed that moderate exercise, such as walking, significantly reduced the intensity of smokers' nicotine withdrawal symptoms. Just five minutes of exercise can get the smokers past that need for a nicotine fix.

Nearly anything that distracts people from smoking is thought to help, but scientists have long suspected that exercise might have a more potent effect. Exercise could produce a mood-enhancing hormone dopamine, which could, in turn, reduce the smokers' nicotine dependence.

When you're dying for a cigarette, try some exercises or a walk to get past the craving. Remember, if you are trying to quit, a craving will only last about three minutes!

Regular. Strenuous. Exercise. Memorize these three words. Live these three words. And abandon all thoughts of a fitness routine that is easy, moderate, or periodic.

Brisk walking, golf, and volleyball are considered moderate forms of exercise. Swimming laps, aerobics, and running are considered strenuous. And these are the activities we should be taking part in -- for the rest of our lives -- if we really truly wish to prevent breast cancer.

A new study, published in the February 26 issue of the Archives of Internal Medicine, shows women with a long-term history of engaging in strenuous exercise for more than five hours per week were 20 percent less likely to develop invasive breast cancer and 31 percent less likely to develop in situ breast cancer than those logging less than 30 minutes of strenuous exercise per week.

It seems strenuous exercise most affects estrogen-receptor negative breast cancer. But clearly, everyone can benefit from vigorous fitness training -- the American Cancer Society recommends moderate to strenuous exercise five days per week for at least 30 minutes each day -- and this is exactly why I am headed out for a run. Today!

Calorie counting may be a bit tedious for some -- like me -- but for others, it may be just the ticket for the management of weight and overall health.

Charles Stuart Platkin, author of the new book The Diet Detective's Count Down, takes calorie counting one step further and offers the exercise equivalent of a nutritional label.

His 341-page book offers charts that detail the number of calories, fats, and carbohydrates in more than 7,500 foods and drinks and then translates these details into what it takes, in terms of minutes, to burn the calories with walking, running, biking, swimming, yoga, or dance.

Platkin, a syndicated nutrition and fitness columnist, says he is not trying to encourage people to count every calorie consumed in a day and to exercise until each calorie melts away. His goal is to help those who exceed their daily calorie budget -- the number of calories they can eat each day without gaining weight.

The Count Down goes like this -- you consume one martini at your New Year's celebration, pushing you beyond your allotted calories for the day. All you have to do is walk it off the next day in a mere 71 minutes. Or you can run it off in just 39 minutes. If a single cracker with one slice of Genoa salami and cheese tempts your palate, go for it -- then plunge into a 55-minute yoga class.

Before taking a stab at the diet detective's approach, there are several considerations to take into account. First, the book is based on a 155-pound person. A person carrying more weight would burn more calories per minute, and a person carrying less weight would burn less. Second, a person's basal metabolic rate (BMR) must be calculated -- Platkin offers formulas for this task -- so it's clear how much activity output is required by each person. And third, the exercise equivalents are based on scientifically researched metabolic equivalent tables that try to measure what is being burned versus a person's resting metabolic rate. So this is not just a crazy gimmick. It's science -- with a touch of personal perspective too.

Platkin, clinically obese for most of his life, lost 50 pounds a few years ago and came to realize that people just don't know what a calorie is. He wishes the U.S. Federal Drug Administration (FDA) would include exercise recommendations on food labels and says, "I think that we are so confused in general as a population as to what's healthy and what's not, we confuse the term healthy with low-calorie. Sometimes they don't mesh. There's so much confusion out there that I think that it needs to be more defined. We need to have some sort of reference points so that people can make decisions before they consume."

Until the FDA delivers on Platkin's wish, he is taking matters into his own hands for those who choose to borrow from his wisdom.

Some of his wisdom includes eating calorie bargains (air-popped popcorn) instead of calorie rip-offs (potato chips) and substituting mustard for mayonnaise on a burger -- it will save 2,000 calories per month for someone who eats fast food three times per week.

Platkin's hope is simple -- he wants people to ask themselves whether certain foods are worth the cost. Is it worth a 54-minute run to burn the 510 calories in a McDonald's Quarter Pounder with Cheese? How about a 144-minute walk to rid yourself of a Subway six-inch Meatball Marinara sandwich?

It's a worthy hope, I think -- although this method is still a bit tedious for me. I think I will stick with my own formula -- eating moderate portions of what I enjoy and intensely exercising several times per week. I don't need to know how many calories I am consuming. I don't even need to know how much I weigh. As long as my clothes fit and my fitness routine keeps me sweating, I'll be a happy girl.

Stapling the stomach of an obese child is a last resort, but the National Institute for Health and Clinical Excellence (NICE) has issued a stamp of approval for bariatric surgery as part of a national guideline aimed at reducing obesity in children and minimizing the long-term adverse health effects that being overweight has on health.

This is the NICE organization's effort to find solutions to England's rising obesity epidemic where the number of overweight and obese people in the last quarter century has tripled.

Stomach stapling is not the only solution, but it is now an approved option. Other recommendations include the following: local authorities working with local partners, such as industry and voluntary organizations, to create safe spaces for physical activity; providing cycling and walking routes, cycle parking, area maps and safe play areas; creating pedestrian-friendly streets; designing building and spaces to encourage more physical activity; requiring schools to provide an environment that promotes healthy eating and physical exercise; healthcare professionals taking the time to educate and give advice on how to maintain a healthy weight; raising public awareness and encouraging daily physical activities such as walking, cycling, swimming, aerobics or gardening.

Obesity cannot go unchecked and it is a threat to the health and welfare of children and adults alike, as obesity is linked to greater increased risks for a number of life-threatening diseases like heart disease, diabetes and cancer. But, it is uncomfortable to think that one of the solutions to childhood obesity is a scalpel. The NICE press release New NICE guideline calls for urgent action to stem the rising tide of obesity in England and Wales is available as a pdf document here.

Approximately 3 percent of all new cancers in the United States are linked to obesity, according to the US National Cancer Institute. Stay trim to cut cancer risk, that is what the headline reads. Researchers hypothesis that fat might be preventing apoptosis -- the process in which cancer cells perform a sort of suicide. But it's all untested speculation at this point as to how fat might affect cancer development and growth.

Recently, Rutgers University researchers conducted tests on mice and found leaner mice were less susceptible to developing cancer. Cancer cells in fatter mice died much more slowly, twice as slow as their skinny counterparts. The study is published in the National Academy of Sciences.

In other weighty health-related news, University of Pittsburgh researchers are reporting that overweight middle-aged people who walked briskly for 30 to 60 minutes a day lost 7 pounds in 18 months, while similar adults who didn't exercise consistently gained seven pounds in that time.

During the study, the participants were advised to eat healthy foods but not to restrict the amount of food beyond the norm. Seventy-five percent chose walking as their form of exercise.

Walking is a wonderful exercise for the body, mind and spirit. Most people do not walk alone, and this is a leisurely time to visit and enjoy each other's company. In addition, it's a way to slow down and reconnect with the world around you. Walking is a time to take deep breaths. Living Out Loud author Keri Smith, who blogs The Wish Jar Journal, often blogs about her many observances and adventures in walking and uses it as an exercise in creativity and a renewal of wonder in the every day. Delightfully, she collects things on her walk.

I am a fan of walking. Anyone can walk. During breast cancer treatments (except for the time my red blood cell count dropped so low I didn't have enough steam to make it across the room) walking was something I could do even if I did not have the stamina or will for more formal exercise.

Caregivers are quiet heroes, helping and caring without asking for anything in return. Caregivers step in when there is a need and they bring with them a sense of hope and comfort during the challenges facing a loved one diagnosed with cancer. In the selflessness of love, they sometimes forget to take time to care for themselves. To avoid caregiver depression, frustration, resentment, illness and burnout, here are six ways a cancer caregiver can care for themselves while caring for someone else:

Take a daily walk. Exercise is a great stress reducer. Taking the time to stroll through the neighborhood or local park is like a deep calming breath for the body and emotions. If you are a jogger, go jogging. The point is to get away for a moment, get the body moving, and enjoy a change of scenery as you go.

Keep a journal. Daily journaling is a way to outwardly express your thoughts and emotions and can act as a relief value for emotions that are building up inside. It can also give you a better perspective. Sometimes we need to see what we are thinking and feeling to sort it all out.

Pursue personal interests. If you have a hobby or activity -- like writing poetry, photography, crafts, painting, knitting, reading, gardening, or listening to music, that has always been fun and brought you a sense of joy and contentment -- make time each day for your personal pleasurable pursuits.

Maintain friendships. We need our connection to others for the enjoyment of company and for comfort and support. Make regular weekly dates with friends and meet for coffee. Join a book club or start a book club. If there is a caregiver support group in your area, or a support group for families affected by cancer, consider joining.

Learn ways to relax. Try breathing exercises and muscle relaxation exercises. Schedule a massage. Take a weekly yoga or tai chi class. Cannot get away? Pop in a yoga or tai chi video and follow along.

Make your health a priority. Eat well-balanced meals, get plenty of rest, drink plenty of fluids. Find inspirational quotes that lift your spirits and display them where you can read them each day. Remember to laugh each day. Hug and be hugged.

To offer the very best care for your loved one, you must take care of yourself too. It's not selfish, it's wise.

If you are a caregiver that has found unique fun ways to take a moment to take care of yourself while taking care of someone you love, please share your ideas with other caregivers in the comment area following this post. If you are a reader with fun tips or ideas on ways a caregiver can take care of themselves while caring for someone else, please share in the comment area. We are all in this together, and we will get through the challenges and struggles of cancer much better with each other's support and encouragement.

Phil Goddard is blogging Coast to Coast as he walks over 4,000 miles across America in memory of his wife Jayne, who died of cancer in January 2006. He is raising money for the Association for International Cancer Research as he walks. He started in New York on June 25 and has met with sweltering triple-digit heat, shin pain and as he describes them -- people of extraordinary hospitality.

In a solo foot journey that will take him up to nine months to complete, Goddard has made it as far as Pennsylvania. There are no vehicles following him and no official support awaiting him on the road ahead. Goddard goes it alone.

According to his sister Jacqui Goddard, "This grueling odyssey is his idea of a healing experience, an off-beat form of bereavement therapy by which he can make life without Jayne meaningful, rather than filling his days with the pain of her loss. It will also raise more than £10,000 in sponsorship for the Association for International Cancer Research."

Goodard believes that if it had been him who died, his wife Jayne would have found a way to turn it into something positive too. Jayne was diagnosed with advanced colon cancer but it wasn't discovered in time to save her. Jayne, who used her maiden name Comins, was a speech therapist and psychotherapist, and held the professional status as a leading expert on the human voice, writing books and articles, making regular TV and radio appearances and lecturing throughout Britain.

Join Goddard on his walk across America as he blogs Coast to Coast.

University of South Australia researchers have good news for people trying to lose weight, or maintain a healthy weight, in improving their health and reducing their risks for diseases like cancer. With no other lifestyle changes, taking omega-3 fish oil supplements and engaging in moderate exercise helped people struggling with weight issues -- who are overweight or obese -- effectively burn off extra pounds.

The researchers used tuna oil and sunflower oil in the study, and compared the effects of the two oils with exercise to weight loss results. The participants engaged in exercise that is considered moderate exercise -- walking or running for 45 minutes -- three times a week for three months and were given either tuna fish oil or sunflower oil. The participants who were given tuna fish oil lost weight faster.

The researchers believe that fish oil, which is rich in omega-3, helps the body burn fat, and estimates that most people do not get enough omega-3 in their daily diet. Omega-3 is also found in wild salmon, flaxseed, and certain nuts and seeds.

I have tried to exercise most of my adult life -- at times because I felt obligated to participate in what I knew was good for me and at times to justify eating my favorite foods while maintaining an appropriate weight and at times because I wanted to actually have a toned, healthy body.

At this exact time in my life, I exercise with all of these motivations in mind -- plus a few more. I like to sweat and know I am accomplishing a physical feat. I like the mental release I get when I push my body to perform. I like the time to myself, the loud music I hear on my MP3 player, and the results I see from a little bit of hard work. And lately -- as a result of a new weight training program -- I know I am benefiting my body more than ever before.

The following are just seven of the many gifts that come from weight training. Gifts that will make me a happier, healthier cancer survivor.

Noticeable physical results -- Mostly, walking and occasional jogging have been my methods of exercise. And I've seen results from this type of workout -- leaner legs, more defined calf muscles, and the knowledge that I am increasing my cardiovascular health, as confirmed by the technician who performed an ultrasound on my heart in preparation for my Herceptin treatment for breast cancer. He told me he could tell I exercised regularly because of my low resting heart rate. But until I started weight training a few months ago, I never witnessed quick results. Yet after a few weeks of resistance exercise -- lifting 20-pound weights for my arms, shoulders, back, and chest -- I could see definition and tone that clearly would not have resulted from my purely cardio workouts.

Improved strength and endurance -- Lunges and squats and jumping with resistance bands have strengthened my legs. Lifting weights has strengthened my arms -- and I can now lift heavier weights than when I first started my new routine. I can do more push-ups now too -- not girl push-ups on my knees but real push-ups -- than I ever could have imagined doing when I could barely lower my own body weight and would crash to the floor on my stomach. My strength has improved. My endurance has improved. I feel more powerful.

Increased energy -- Fatigue (or maybe it's laziness) sometimes prevents me from happily jumping up to begin exercising. But when I push myself and exert myself and get lost in my exercise routine, my energy returns -- and not just during my workout but for some time afterwards too. Some say energy increases from strength training because it contributes to loss of fat which means we have less to lug around each day.

Burning of more calories -- Weight training raises basal metabolism which causes more calorie burning over a 24-hour period of time. Calories even burn during sleep as a result of weight training.  For every additional pound of muscle you gain, your body burns 50 extra calories every day -- 50 more calories than the few hundred that might burn from aerobic exercise. Research shows that regular resistance training can increase your Basal Metabolic Rate by 15%. So for someone who burns 2000 calories per day, that's upwards of 300 extra calories burned every single day. 

Decreased onset of illness -- Weight training can reduce the risk of adult onset diabetes and the risk for developing colon cancer and can improve the functioning of the immune system and the efficiency of the heart. It decreases the risk of low-back injuries, decreases resting blood pressure, increases good cholesterol (HDL), and improves posture. The list goes on -- and so does healthy living if weight training becomes a way of life. As a young person already having experienced a life-threatening illness, this comforts me.

Prevention of osteoporosis -- My recent bone density test revealed that I am not at this moment at risk for developing osteoporosis. I don't want this to change. Strength training can help me maintain this status because it can significantly increase bone mineral density -- which is important because we naturally lose bone density as we age. Strength training helps protect against osteoporosis. And age should not be a deterrent. Individuals who begin training late in life -- at age 65, for example -- can restore bone loss.

Improved outlook on life -- As a result of toning and shaping my body, burning calories, enjoying greater strength and energy, and working toward a disease-free future, weight training gives me an improved outlook on life. And weight training has recently been reported to significantly improve the quality of life of women recently treated for breast cancer. A May 2006 study indicates six months of twice weekly exercise was enough to improve the overall physical and emotional condition of patients.

Twice weekly is my weight training goal. I will continue to walk and run -- and bike on occasion too -- but strength training will be my priority. Because health is a priority.

I am fairly certain each one of us knows by now that exercise is good for a body that was designed to move in order to function at top efficiency and maintain health. Extolling the virtues of exercise is in the news almost daily now. There are organizations devoted to raising awareness about the benefits of exercise. Our government has launched programs to get people up and moving. There is a huge commercial industry built around exercise. Exercise is one of the single best ways to reduce risk of many diseases, including cancer. Common sense might be enough to support the message about the benefits of exercise, but it is interesting to know why it works as well as it does -- and that it isn't just the latest lifestyle fad of the decade.

Australian researchers report that exercise promotes an increase in a protein that blocks cancerous cell growth and induces cancerous cell death. The beneficial protein, IGFBP-3, that increases with exercise, blocks a different protein, IGF-1, from stimulating cancerous cell growth and forming new blood vessels that feed tumors. So the next time we are deciding whether or not to take that walk or run -- as the couch is beckoning us to sit and rest a spell -- just imagine we might be deciding which team of proteins we want to help do its job. In the fight against cancer and for cancer prevention, it's enough to make a body move.

I think I would feel pretty alone if it weren't for all the support out there for cancer. All the recognition given to cancer patients and survivors. All the cancer information floating around. And all the survivors who hold each other up in times of distress and despair. What a horrible thing that cancer is so widespread that there has to be so much focus on this life-threatening disease. But how wonderful that all this attention can have such great outcomes. At the infusion center I visit every three weeks for a dose of Herceptin for breast cancer, there are two social workers available for patients. There are genetic counselors and psychologists. There are signs and posters all over the medical facilities advertising support groups and studies. There are organizations like Sacred Cliffs and Chemo Angels. And there is Team Survivor.

Team Survivor, started in 1995 in conjunction with the Danskin Women's Triathlon Series, exists to provide free weekly exercise programs and periodic fitness events and education for all women affected by cancer. Programs have grown throughout the U.S. and in my city alone, women can attend events such as yoga and tai chi and walking groups. Some travel all over the state to participate in dragon boating, biking, and triathlons. They also gather for social camaraderie and support. Their goal is to encourage physical activity for women of all ages and stages of fitness and in all stages of cancer treatment and recovery.

Team Survivor grew of out the unfortunate existence of cancer.  But it helps women grow and develop and succeed physically.  And that is a gift.

Women and girls On the Move Across the Nation is a virtual race where women participate by following routes across the country without leaving their hometowns. The WOMAN Challenge event, which begins May 14 and ends July 8, is sponsored by the Office on Women's Health in the U.S. Department of Health and Human Services as part of National Women's Health Week challenging women and girls to become more physically active.

You register online here, choose a route, wear a pedometer, submit your pedometer reading at the end of each day at the WOMAN Challenge website and see the progress you are making in completing the route. You will receive updates on your progress weekly, as well as motivational emails and valuable health information. They even provide a conversion chart for some activities that are difficult to measure using a pedometer such as riding a bike, gardening or water activities. Did you know that each minute of bike riding is equal to 148 steps -- or -- that each minute of gardening is equal to 73 steps?

All women and girls are welcome to participate, including wheelchair bound women. They have armband pedometers -- so, no excuses. Not sure how to increase the amount of steps you take each day? They offer some suggestions to increase your daily physical activity. Here are a few ideas:

• Park your car in a parking space farther from your destination than you normally would.
• Take your children, dogs, etc. outdoors to play or for a long walk.
• Do some yard work or housecleaning.
• Bike, walk, or wheel to work, to run errands, or to visit friends.
• Take the stairs instead of the escalator or elevator.

Let's get moving! It will be fun. See you at the race. Physical activity and exercise are cancer prevention.

I like this doctor! At the 2006 Magnolia Tea, the keynote speaker was Dr. William Rayburn. He spoke to 60 women who attended the luncheon, and when I read what he had to say, I wished he had been talking to 600 thousand women. Dr. Rayburn started out by telling the women, that despite all the emerging medical knowledge, it is important for women to listen to their own bodies and to pay attention to anything that does not seem normal. He said the longer he has been in practice, the more he has realized how little he knows compared to how much women know about themselves. "Trust your instincts," the doctor said. Thumbs up for this doctor!

He also challenges some of ways the media explains research findings to the public, and specifically, the study findings of the Women's Health Initiative, WHI, a long-term national health study sponsored by the National Institutes of Health and the National Heart, Lung and Blood Institute. I have questioned some of their findings. Contrary to the WHI stating that diet and exercise do not have an impact on health, Dr. Rayburn believes diet and exercise indeed have a positive affect on health. Of course it does -- what you eat and how much you move is going to make a difference -- it's common sense. You can read more about what the good doctor had to say in the feature Doctor tells women to trust their instincts.

Research has proven obesity and the lack of exercise puts people at greater risk for developing cancer. In looking around the internet, I found a well-designed and impressive resource called America on the Move, AOM. As a national initiative created to support individuals and communities across our nation in making positive changes to improve health and quality of life, the organization offers an excellent online resource of education and free tools to help with the eat less move more lifestyle. It's easier than you might guess.

In two simple changes of taking 2000 more steps a day -- about one mile of walking -- and eating 100 fewer calories a day -- equal to a pat of butter -- you are on your way to making a positive health difference in your life. AOM provides motivating tools, healthy eating advice, a health newsletter, a place to record your progress, daily health tips and more. Did I say it was free? Go see what you think. I am considering getting a pedometer to record how many steps I take a day during normal activity, and simply increasing the amount of movement accordingly. While I am not a formal exercise routine type individual, this program is one I can work into my daily life -- simply by taking more steps.