UNDERSTANDING CANCER

The Complete Guide

Every year, 12.7 million people in the world learn that they have cancer. Even though cancer is a widespread disease, each individual who suffers from cancer is uniquely affected. Family and friends of loved ones who are fighting cancer are often confused and worried. It can be difficult to cope with a diagnosis of cancer.

Today there is hope, thanks to millions of other survivors and the doctors and researchers that work to find solutions and effective treatments everyday. Even for those with a serious prognosis, there are many treatments and solutions available to provide comforting care throughout the process. The complete guide to understanding cancer is a resource for anyone who may think they have cancer or have already been diagnosed, and are unsure of where to start.

Getting Started

The starting point for every cancer diagnosis is realizing that you are not alone. Every year, more than 1 million people in the United States are diagnosed with some form of cancer. A medical diagnosis of cancer serves as one piece of a greater, more complex puzzle. The emotional effects and life changes that occur from a cancer diagnosis can be just as difficult as the inevitable physical issues.

Though cancer is often associated as one disease that can affect many parts of the body, in reality, each type of cancer is considered its own disease. There are more than 100 types of cancer, yet all are caused by rapidly dividing abnormal cells that invade other tissues and spread throughout the body. Understanding the disease will help you understand your diagnosis and what to expect from treatment.

Could I have cancer?

If you suspect that you may have cancer, it is probably because you have noticed a recurring abnormality in your health. Certain signs and symptoms are associated with the development of cancer and can indicate what part of the body is being affected. While you may identify with the following signs and symptoms, it does not mean that you definitely have cancer. It is important to seek help from a trusted healthcare provider and alert them of your suspicions. If a diagnosis is confirmed, you can then work with your physician to plan a course of action. If it turns out that your issue is not cancer-related, you will still have made a good choice for your health and potentially prevented another illness or problem.

One of the most telltale signs of a cancer is a malignant tumor that grows so large, it can be physically detected by a person and can begin to cause issues within the body. However, sometimes symptoms can be detected before cancer reaches that point of severity. If any of the signs and symptoms below appear and persist for more than two weeks, it may be time to visit the doctor.

Signs and symptoms include:

Chronic pain – Unexplained pain in bones or other areas of the body may be a symptom of cancer early on. Usually the type of pain you are experiencing can be a good indicator of where the cancer is originating. A relentless headache could be a brain tumor, and back pain may indicate cancer of the colon, rectum or ovary.

Unexplained weight loss or loss of appetite – If you suddenly lose 10 pounds or more for no apparent reason, it could be a sign of cancer. This sign is frequently symptomatic of pancreatic, stomach and lung cancer.

Persistent low-grade fever – If you suffer from a fever that is either constant, or happens to occur intermittently over a long period of time, you are experiencing a very common cancer symptom. Chronic fever often occurs after cancer has begun to metastasize to other parts of the body or is in the bloodstream, like leukemia or lymphoma. It is almost certain that every cancer patient will experience a fever at some point, either from the cancer itself or the treatment employed.

Persistent fatigue – Feeling constant tiredness could mean you need to get more sleep at night, or could be a sign of a more serious issue. Disease places stress on the immune system and some types of cancers can cause blood loss, both of which cause the patient to be chronically tired.

A change in bathroom habits – Any significant changes to urinating or excretion can be a sign of colon, bladder or prostate cancer. Pay attention to these changes and be sure to report them to your physician.

Skin changes – In particular an apparent change in the size, shape or color of a mole, wart or mouth sore. You might notice changes to your skin like darker pigment, yellowish skin and eyes, reddened skin, itchiness, or even excessive hair growth. Smaller areas, like moles or freckles, that have changed in any way should be seen by a doctor immediately.

A sore that does not heal – Sores on the skin, in the mouth or on the genitals can be common in infections, but if you notice a sore that doesn’t seem to be healing, it may be time to get it checked. What might have initially looked like something harmless could be a manifestation of cancer.

A lump or tumor – While some lumps may be benign, a doctor should see anything that resembles a lump or tumor immediately, as it may be a sign of a malignant tumor.

Coughing, shortness of breath and hoarseness – Any symptoms related to the chest or throat could mean that cancer has spread to your lungs or throat. If you begin to cough up blood in the sputum, seek medical attention – it could be a sign of lung cancer.

Other unusual bleeding or discharge – Bleeding with an unknown cause is a common occurrence in a variety of cancers. Bloody stools usually mean rectal or colon cancer, while abnormal vaginal bleeding could indicate cervical cancer. Bloody urine could mean bladder or kidney cancers. The only way to know the cause is to consult a medical professional to help pinpoint the source of the bleeding.

What is Screening and How Can it Help?

Another way that cancer is often detected is through screening processes that take place at routine doctor’s visits. Screening is checking for cancer or abnormalities in people who show no symptoms of the disease. It is important to go through recommended screening tests at the appropriate time and frequency, because they can detect cancer in early stages – or can even help identify conditions that lead to cancer. From there, preventative treatments and measures can be taken to help stop cancer from developing, and will encourage you to be aware of cancers to which you may be susceptible.

Below is a brief list of different screening procedures for select cancer types. The testing that you will undergo will be determined at your doctor’s discretion based on age, medical history and risk factors. Do not be afraid to ask your doctor why they recommend the screening procedure, and inquire about any risk factors associated with the procedure itself. Your physician should also be able to give you an idea of when you will receive the test results.

Mammogram: A mammogram is a tool used to detect the early stages of breast cancer by taking an x-ray of the breast. Women ages 40 and older are encouraged to have mammograms annually or biannually.

Pap Smear: A pap smear is a test that involves scraping cells off of the cervix to check for abnormalities that could lead to cervical cancer. Women should begin having pap smears at the age their doctor recommends. The common standard is age 21 or three years after women begin having sexual intercourse.

Colonoscopy: A colonoscopy is a procedure where a doctor examines the inside of the rectum and colon using a long lighted tube. This is done to check for colon and rectal cancer, and any growths – called polyps – can be removed during the screening. A procedure called a sigmoidoscopy can be conducted to examine just the rectum and lower part of the colon. These tests should begin at age 50 and older.

New advancements in technology allow for a more personalized approach to cancer treatment and prevention. Another preventative measure that can be taken is genetic testing. These tests are recommended by a health professional called a genetic counselor and check for inherited gene changes that may increase the probability of cancer development. You can seek the help of a genetic counselor to determine risk factors based on your genetic makeup and discuss preventative measures that should be taken based on test results.

Confirming Your Diagnosis

Once you are able to visit your doctor and they confirm that cancer may be a possibility, you will most likely undergo a series of tests and procedures to confirm a diagnosis. The most basic testing will be your physical exam. Your doctor may feel for lumps/tumors and check other vital statistics to gauge overall well being. If a tumor is detected they may attempt to determine the location, size and spread using a variety of imaging techniques. These methods take pictures inside your body, and most developed tumors will be visible when one or more of the following techniques are employed.

Imaging techniques used may include:

X-rays of the chest and abdomen: X-rays are used to view organs and bones inside the body. They are more common than other forms of imaging procedures.

Computed Tomography (CT) Scans: These scans are more sophisticated forms of x-rays. An x-ray machine connected to a computer will take pictures of your organs, and you will ingest dye to provide contrast, making the pictures easier for medical professionals to read.

Positron Emission Tomography (PET) studies: Your doctor will inject you with a small amount of radioactive material, and pictures of chemical activities within your body will be taken. Cancerous tumors are often found in areas of high chemical activity detected from the scan.

Magnetic Resonance Imaging (MRI) Scans: A strong magnet linked to a computer is used to make detailed pictures of areas in your body. Your doctor then analyzes these scans for abnormalities.

Ultrasound Scans: An ultrasound functions by emitting inaudible sound waves that bounce off of the tissues in the body like an echo. A computer synthesizes the waves into a picture called a sonogram.

Laboratory Tests

Laboratory tests will be used in conjunction with imaging studies to pinpoint where the cancer is located in your body, and how much it has spread. Your doctor will run a series of tests to analyze your body’s sugars, fats, proteins, and DNA at the molecular level. High amounts of certain substances can be biological markers of cancer. Your blood, urine, body fluids, and tissues may be examined to assess how well your organs are functioning and to look for additional biological markers of tumors. After doctors have been able to determine the size, location, and possible spread of your cancer, they may need to look inside the affected organ with lighted, flexible tubing called an endoscope to visualize the tumor. Your doctor will then order a biopsy.

What is a Biopsy and Why Do I Need One?

A biopsy is a procedure that involves extracting cells or a sample of tissue from the tumor. Performing a biopsy is necessary, because it is the only absolute way that doctors are able to diagnose cancer. A pathologist will examine the extracted cells under a microscope to determine if the growth is cancerous. They will also analyze and report its stage of development. Many biopsies are performed with a needle. However, some situations require that a piece or all of the tumor be removed surgically.

Methods to acquire a biopsy include:

• Removal with a needle: Your doctor will use a needle to collect the sample
• Removal with an endoscope: While doctors examine the affected organ, they may remove tissue or cells through the tube
• Excisional or incisional surgery: In some cases, surgery will be performed to conduct the biopsy. During this procedure, a surgeon may remove part or all of a tumor. When a surgeon removes an entire tumor, it is known as an excisional biopsy. An incisional biopsy is when the surgeon only removes part of the tumor.
• You may want to ask your doctor what types of biopsy they recommend and why. Also be sure to ask about any risks associated with the procedure or if there is any chance of infection or complications.

Setting the Stage for Diagnosis

Once your doctor confirms the diagnosis of cancer, it is just the beginning of the journey. Many doctors and survivors describe diagnosis as being a process rather than an event. Since cancer occurs on the cellular level, you will have to undergo a variety of steps to rule out other illnesses before you are tested for cancer. Initially, doctors will let you know that you may have cancer or probably have cancer. An initial diagnosis of cancer may provide little detail as to the type or severity of the disease. These details will be discovered through additional procedures. Despite modern medical advancements it may take some time before your doctor can confirm all of the prognostic factors of your cancer.

Though they sound similar, diagnosis and prognosis are different terms. A diagnosis is confirmation that you do have cancer . Your diagnosis is confirmed by a series of tests and ultimately, a biopsy. Prognosis is the likely course and outcome of your disease. It is the predicted outlook on the chance that the disease will be treated successfully. Prognosis is primarily determined through the part of the process known as staging, an assessment of the severity and spread of your cancer.

You may experience anxiety and fear about your diagnosis, but understanding your prognosis will provide some comfort and help you develop a realistic outlook on your situation.

What Happens After My Doctor Confirms My Cancer?

As previously mentioned, there are different parts to the diagnosis process. As you move through, it will be important to find out:

• The medical name of your cancer
• The stage of your cancer
• The grade of your cancer
• Any other pertinent prognostic factors that relate to your treatment plan

To plan treatment for cancer your doctor will need to know how far the disease has progressed. This measurement is known as the stage. The stage is typically based on the size of the tumor and if it has spread to other parts of the body or the lymph nodes. It determines your prognosis and helps evaluate what treatments will be best and most effective for your situation.

Though there are many types of staging systems that exist, the most common is known as the TNM system. In this system, each cancer is given a letter or number to describe the tumor, node and metastasis.

Tumor: T (1-4) indicates the size and direct extent of the primary tumor. Tumor size is measured in centimeters and each number describes the tumor size and the amount it has spread into nearby tissues. The higher the number, the larger the tumor.

Node: N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes. The higher the number, the more lymph nodes affected.

Metastasis: M (0-1) indicates whether the cancer has metastasized to other organs in the body. M0 means no distant cancer spread was found, and M1 means that the cancer has spread.

For example, a small tumor that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0). While most Stage 1 tumors are curable, most Stage 4 tumors are inoperable or untreatable. Some cancer types – like cancers of the blood and brain – have variations of this staging system, so know that not all cancers will be classified in this exact manner. However, once the TNM values have been assigned, they will be combined in order to give an overall stage ranging from I-IV. Stage I indicates a smaller amount of cancer in less areas of the body, while Stage IV means more cancer is present throughout the body. This also means that the cancer is more advanced, and thus will be much more difficult to treat.

Additional factors that affect the stage include the grade, cell type and tumor location. The grade is the measure of how abnormal the cells look under the microscope – cancers with more abnormal cells tend to grow and spread faster. For some types of cancer, the grade is not just based on differentiation, but also how many of the cells appear to be dividing and how much of the tumor is made up of dying tissue. This gives doctors an idea of how fast the cancer is growing and how quickly it is likely to spread.

Will the Stage of My Cancer Change?

An important point some people have trouble understanding is that the stage of a cancer does not change over time, even if the cancer progresses. A cancer that comes back or spreads is still referred to by the stage it was given when it was first found and diagnosed—information about the current extent of the cancer is added to it.

At some point you may hear the term “restaging.” Restaging is the term sometimes used for doing tests to find the extent of the cancer after treatment. This is rarely done, but it may be used to measure the cancer’s response to treatment or to assess cancer that has returned. Often this involves the same tests that were done when the cancer was first diagnosed: physical exams, imaging tests, biopsies, and maybe surgery. After these tests a new stage may be assigned. It’s written with a lower-case “r” before the new stage to note that it’s different from the stage at diagnosis. The original stage at diagnosis always stays the same. While testing to see the extent of cancer is common during and after treatment, actually assigning a new stage is rarely done, except in clinical trials.

Understanding Your Prognosis

Prognosis is measured by looking at the characteristics of the patient’s disease, available treatment options, and any health problems the patient may have that could affect the course of the disease or its ability to be treated successfully. Doctors base a great deal of their prognoses off of existing research and data, including statistics from patients who have had similar cancers in the past.

Cancer survival statistics are frequently given in terms of 5-year survival relative to the general population. No two patients are entirely alike, and their treatment and responses to treatment can vary greatly. Because survival statistics are based on large groups of people, they cannot be used to predict exactly what will happen to an individual patient. In addition, the statistics a doctor uses to make a prognosis may not reflect the effectiveness of current treatments that haven’t been available to patients often in the past.

A favorable prognosis is likely if information from a large group of past patients suggests that your cancer will respond well to a certain type of treatment. A prognosis may be unfavorable if the cancer appears that it will be difficult to control or may have limited treatment options, for example, a very late stage mesothelioma prognosis. It is important to keep in mind that a prognosis is only an estimate. While you should be realistic about the outlook on your cancer, recognize that doctors cannot be absolutely certain about the outcome for an individual patient when it comes to this unpredictable group of diseases.

An In-Depth Look at Cancer

Cancer is a term used for diseases in which abnormal cells uncontrollably divide and invade other tissues. Cells are the body’s basic unit of life and make up every organ and tissue within your body. These cells grow and divide in a controlled way to produce more cells, as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells. Cancer occurs when there is an upset to the process of cell death and cell regeneration. The genetic material – known as the DNA – of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them, creating tumors or infiltrating the blood or bone marrow.

These abnormal cells are transported to other parts of the body through the blood and lymph systems. With more than 100 different types of cancer affecting millions of people, it is evident to doctors that no two cancer diagnoses are exactly alike. Most cancers are named for the organ or type of cell in which they start – for example, cancer that begins in the colon is called colon cancer; cancer that begins in melanocytes of the skin is called melanoma.

There are five main types of cancer. They are classified based on where the cancer starts in the body.

1) Carcinoma – A cancer that begins in the skin or in tissues that line or cover internal organs.

2) Sarcoma – A cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

3) Leukemia – A cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.

4) Lymphoma and myeloma – These cancers begin in the cells of the immune system.

5) Central nervous system cancers – These cancers begin in the tissues of the brain and spinal cord.

Treating Cancer

Many people with cancer want to take an active part in making decisions about their medical care. You will want to learn as much as possible about the treatments available to you and the risks, costs and benefits associated with each one. Your treatment plan depends primarily on the type and stage of your cancer. Like staging, it is based on the knowledge of your doctor, past plans that proved effective for patients with your type of cancer, and your unique situation.

Usually the goal of treatment is to cure the cancer. In some cases, it may be to temporarily control the disease or reduce symptoms for as long as possible. Your doctor will adjust your plan to fit your needs and general health. Treatment is either local or systemic. Local means that the treatment will be targeted to a specific area, while systemic therapy refers to treatment that will work throughout the whole body. A typical treatment plan includes:

• Surgery, local
• Radiation Therapy, local
• Chemotherapy, systemic
• In unique cases, treatment may also include:
• Hormone Therapy, systemic
• Biological Therapy, systemic
• Stem Cell Transplantation

Do I Need Surgery?

In many cases, a surgeon will remove the tumor and tissue around it to avoid allowing the tumor to grow back. Some of the local lymph nodes may also be removed. Doctors will provide you with medicine for the pain and can answer any questions you might have about the details of your surgery. One thing to note, is that surgery will not allow the cancer to spread, as surgeons take many precautions to ensure that cancer cells will not transport into other areas of the body.

Radiation Therapy: Radiation therapy is treatment where high-energy rays are used to kill cancer cells, and includes several types:

• External radiation: A large machine provides radiation outside of the body.
• Internal radiation: Radiation is provided through materials inserted internally in the body near the site of the tumor.
• Systemic radiation: Radiation through liquid or capsules is injected into the body. It is a more rare form of treatment.

Chemotherapy: Chemotherapy is a method where drugs are used to kill cancer cells and it is administered via mouth or vein. It is usually given in cycles and takes places in part of a hospital, doctor’s office or can be done at home. Chemotherapy is one of the most common forms of cancer treatment and can be highly effective in conjunction with other forms of therapy. The side effects of chemotherapy treatment, like hair loss and fatigue, will go away with time. However, some of the mental side effects may not. It may also cause infertility in men and women.

Hormone Therapy: Hormone therapy works by stopping cancer cells from receiving the hormones they need to grow. This works by administering drugs that will stop the hormones from being produced, or conducting surgery to remove the organs that make the hormones.

Biological Therapy: Biological therapy is a type of systemic therapy that helps the immune system fight cancer. Solutions that contain live, weakened bacteria are administered to the affected site to stimulate the immune system to kill cancer cells.

Stem Cell Transplantation: Stem cells are transplanted into the body to allow patients to receive high doses of chemotherapy, radiation or both. The high doses of treatment destroy cancer cells and normal blood cells, so inserting new stem cells help create new blood cells. It can be performed before or after treatment.

Coping with Side Effects

Learning to live with cancer can be difficult for the person affected and their friends and family. Life will not be the same, but there are many measures that can be taken to help educate yourself and your loved ones, because you are both likely still attempting to understand the basics of your diagnosis, prognosis and treatment. It is important to stay mindful of emotional effects that cancer can have in addition to the physical effects that are usually a result of treatment. Your mental health is just as important as your physical health. At a time when you may feel more despair and depression than ever, it’s necessary to try to surround yourself with those who can support you and keep a positive attitude despite the challenges you face. You are not alone. There are support groups for every form of cancer.

What Physical Effects Will I Experience?

The physical side effects you experience will depend primarily on the type of treatment you receive. Below are a list of common side effects that are experienced from chemotherapy, radiation and surgery.

Pain: Pain can be caused from the cancer itself, or from surgical procedures used to remove the cancer. Most doctors will encourage patients to monitor their pain.

Nausea and Vomiting: One of the most common, but easily treated side effects of chemotherapy and other treatments.

Hair Loss: Your hair may fall out due to chemotherapy and radiation treatments.

Fatigue: This type of tiredness from cancer treatment is more than just feeling tired day-to-day, and will be one of the more difficult changes to adjust to.

Anemia: Having a lower-than-normal number of red blood cells in your bloodstream is known as anemia. You may feel weak, tired and short of breath, because red blood cells transport oxygen throughout the body.

Lymphedema: Surgery or radiation therapy can cause the build up of lymph fluid in the fatty tissues underneath the skin. The build up leads to swelling, most often in the arms and legs.

Infections: People fighting cancer can be susceptible to infection, and they will have a harder time fighting it due to an already suppressed immune system. Always take precautions to avoid infection and stay healthy.

Chemo Brain: People refer to the memory loss and other mental side effects from chemotherapy as “chemo brain.” After rounds of chemotherapy, the patient may have a lack of mental clarity and may not have the short term memory capacity that was available before treatment.

Cell Damage: Treatments can cause damage to healthy cells in the body, which could increase a person’s risk of developing more cancers later in life.

Sexual Side Effects: Because of the other side effects, treatments, depression and stress, libido often lowers in both men and women. It can also affect fertility and the person’s ability to have children.

How Can I Reduce or Lessen the Physical Side Effects?

One way to reduce or soothe the physical effects of cancer is through palliative care. Pallative care is relieving symptoms of a disease with treatments not intended to cure the disease itself. This type of care is meant to improve the quality of life for cancer patients like you, and relieve suffering. While most people associate palliative care with late-stage and untreatable cancers, it’s quite common to provide palliative care at any stage of cancer and can be used to comfort patients and help them tolerate nausea and vomiting, pain, fatigue and shortness of breath.

As a patient, you have options and should be active in making decisions about your treatment and care. Make sure that your needs are addressed on a physical, emotional and spiritual level and communicate with your support system and healthcare professional if you need additional help or comfort to help combat the effects of your cancer. You may also want to alter your diet, lessen your schedule and incorporate time to relax, meditate or engage in a form of complementary therapy.

Complementary approaches to cancer treatment include therapies that can assist with treating the physical and psychological pain of undergoing cancer treatment. Often referred to as alternative therapies, healthcare professional caution that these therapies should not be used as a substitute for recommended medical therapies. They can, however, help with treating your cancer through non-traditional methods in support of the treatment you are already receiving.

Acupuncture: A technique in which very thin needles are put into the body to treat a number of symptoms like pain and nausea.

Aromatherapy: Essential oils are used to alter mood or improve symptoms such as stress or nausea.

Art therapy: People with physical and emotional problems can use their creative abilities to express emotions. Art therapy is usually conducted by a counselor or therapist who is specially trained in this area.

Massage therapy: This therapy involves manipulation, rubbing, and kneading of the body’s muscle and soft tissue. Some studies suggest massage can decrease stress, anxiety, depression, and pain and increase alertness.

Meditation: A mind-body process in which a person uses concentration or reflection to relax the body and calm the mind.

Prayer and spirituality: Prayer and spirituality can provide people with an awareness of something greater than the individual self. There are many paths to spiritual exploration that can be used to provide comfort and understanding throughout cancer treatment.

Tai chi: This mind-body system uses movement, meditation, and breathing to improve health and well-being. It can relieve stress and strengthen patients.

Yoga: A form of non-aerobic exercise that involves a program of precise posture and breathing activities. Yoga can be a useful method to help relieve some symptoms of chronic diseases such as cancer, arthritis, and heart disease and can lead to increased relaxation and physical fitness.

What Emotional Side Effects Will I Experience?

After a cancer diagnosis, you may feel a variety of feelings and emotions. You might feel sad, confused, guilty, anxious, depressed or hopeless. It can be hard to stop yourself from asking questions about why this is happening to you. Dealing with the emotions and feelings that are a result of a cancer diagnosis is an important part of coping. Even though cancer affects your body, it affects your emotions and feelings too.

Your attitude and mood can change from day-to-day, one minute feeling hopeless and the next feeling like you can take on the world. Your best benefit will be recognizing that you will feel a rollercoaster of emotions at times, and preparing yourself for facing the ups and downs. Be open and honest with your healthcare professionals and support system about how you are feeling. Seeking help from mental health professionals or social workers to gain emotional support can be effective for some patients.

Treatment that deals with our emotions and relationships can help people with cancer feel more upbeat and have a better quality of life. It can also help you determine the best way to share the diagnosis and progress with friends and family in a way that makes you feel comfortable and keeps the lines of communication open. Mental health treatment that claims to alter tumor growth is not recommended as the only form of cancer treatment, nor should it be sought just because someone thinks it might prolong life. However, mental health care and emotional support can help patients and their loved ones better manage cancer and its treatment. Things like imagery, hypnosis, or relaxation can be used to help reduce the distress that often comes with a cancer diagnosis.

Living with a serious disease such as cancer is not easy. You may worry about caring for your family, keeping your job, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, and other members of the health care team can answer questions about treatment, working, or other activities. Sometimes it also helps to talk to other survivors who are going through the same things you are facing.

Friends and relatives can be very supportive, but some people find it helps to talk with others who have cancer. Support groups offer a community of people dealing with cancer, who can understand the struggles and issues each other face. They might take place over the phone, on the computer or in-person. Research cancer support groups online and ask your doctor if there are any in the area they recommend.

If any form of emotional assistance does not seem to be improving your state-of-mind or helping ease the stress of your cancer, do not continue the program. Every person is different, and not all mental and emotional support will be effective for everyone. It is important to do what is best for you much as possible during this stressful time. Though many people stress that staying positive is important, it is realistic to recognize that it won’t be possible to be positive everyday. Face your emotions and do not feel guilty about feeling sadness, depression, fear or anxiety. Do not try to numb or ignore these feelings, but strive to find ways to communicate to your friends and family in your support system and find helpful ways to cope with the changes happening in your life.

How Do I Tell My Family and How Will They React?

Up to this point, you have read about how each type of cancer is unique, just as is each individual who suffers from the disease. Your friends and family members are no different. The effects of cancer on your relationships will depend on a variety of factors, but it is important to communicate clearly despite the anger, confusion and emotion that you are feeling. Ultimately, you are in charge of your decisions and have the final say in what you choose to share and not share with your friends and family.

It is important to start conversations with your family and friends about your cancer. You decide how and when to tell them, but with the array of changes happening in your life, it is important to let those close to you know what is going on. You can let them know when you feel like talking about cancer and when you do not feel like talking about it. Know that your relationships with people will change, and some of your loved ones may not be able to offer the support you need and expect. However, others will amaze you with the help and support they offer. Be specific and direct with the help that you need, whether that means asking for more help or asking for distance in order to rest.

Being a parent while dealing with cancer presents a whole new set of challenges. Children can be scared, upset, or perhaps are too young to understand what is going on or why their parent is sick and cannot do all of the things they used to do. Resources recommend discussing your diagnosis openly and honestly with your child in a way that is appropriate and in line with your values and your child’s personality. Regardless of what you decide to tell your child, realize that they are coping with this diagnosis just like you, your family and friends. It can be helpful to give them idea of what changes they will see, or will affect them – like your physical appearance, fatigue or changes in your schedule.

On the other hand, if you are a parent of an older child, you may experience role reversal where your child now becomes your caregiver. It is important to keep the lines of communication open and refer to other resources that can help you navigate this new journey.

Finding Treatment

Finding a doctor is an important step in your cancer treatment. You want to ensure that you find someone who is a specialist in the type of cancer you have, and is the best possible option given your health insurance and other factors. The doctor who diagnosed your cancer may be able to provide some suggestions on cancer doctors you could see, and you can also search on the website of your health insurance provider. There are a few other resources you can refer to in order to find a doctor that can fit your needs:

The American Medical Association: The doctor finder tool on the AMA website can provide detailed information about a variety of cancer medical professionals.

The American Society of Clinical Oncology: The ASCO website provides an oncologist directory of all members of their society.

Local Cancer Centers: A quick search of cancer centers in your area can provide a list of places you can call and find out more about the doctors that comprise their service offerings. You can ask to speak with doctors who work with your specific type of cancer, and you can also find helpful information via their physician referral lines or websites.

Personal Network: Ask friends, family, doctors, colleagues and co-workers and everyone in your network (if you feel comfortable doing so) if they have any recommendations. Another idea would be to refer to any social media sites that you regularly engage with to see if your followers or friends have suggestions.

Some things to take into consideration when choosing a doctor is what their specialty is and if they are board certified. The more experience a doctor has in your type of cancer, the more likely they will be able to prescribe an effective treatment plan. In addition, those that have experience with a particular type of cancer may be able to connect you with other patients undergoing similar treatment. You’ll also want to inquire about how long the doctor has been practicing and the average number of patients they have seen – the more experience, the better. Additionally, you’ll want to know policies about what will happen when your doctor leaves for vacation or time off, and if they are comfortable working with other healthcare professionals that are already on your support team.

How Will I Choose a Hospital?

Once you have chosen a doctor, you will want to look into the hospital where you’d like to be treated. You may want to simply go to the hospital that is home to your chosen doctor. However, if you do choose a different hospital, you will want to make sure that your doctor will be able to access admitting privileges to be able to assist you at the hospital of your choosing. In addition, you’ll want to make sure that they accept your insurance.

How Will I Pay For My Treatment?

Thinking about how you will pay for treatment is an inevitable. Some people must work out money issues before they can even start treatment. It takes time and energy to manage your medical bills, insurance, and finances – time and energy that are already being sapped by your cancer treatment. In addition to treatment, you have to take into account the cost of traveling, lodging, meals, childcare costs and specialty food and medical resources. However, there are some financial assistance resources available to you, including support from your health insurance, charities and loans.

If you have health insurance under a group or individual plan, you may be eligible for cancer treatment and management under a “catastrophic illness” clause. These policies cover major medical care needs and can be beneficial for people with chronic illness. In addition, you can look into purchasing a short-term plan to cover large expenses, While this won't’ cover typical doctor visits or medication, it can help with a larger expense, like surgery.

If your insurance plan has a high deductible, you may also have access to money that has been stored in a health savings account. The higher the deductible, the more likely you are to have control over your choices with access to a wider variety of doctors and services.

If you currently do not have insurance, you can look into government-funded assistance programs or begin to work towards obtaining a private insurance plan. In addition, if you are a young adult or if your spouse has private insurance, you can look into being added onto their plans.

Can Charities Help Me?

There are many charities that dedicate their service to helping cancer patients. Below are a few sites that you may use to navigate between all of the charities that have programs available to you. These may include scholarship resources, grants, funding, treatment coverage and more:

• Charity Navigator
• American Life League
• LoveToKnow Charity

Can I Take Out a Loan?

Some banks and financial institutions offer programs where your life insurance policy can be used as collateral for a loan to finance treatment. These loans are primarily granted to people who have advanced stages of cancer. A bank that offers this specialized service will review your records to see if you qualify. These loans are available no matter what type of treatment you will receive, and can even be used for clinical trials or experimental therapy. You can also look into taking out a loan through your bank or another trusted lender.

Where Can I Learn More About Cancer?

• American Cancer Society
• National Cancer Institute
• Cancer.net
• Inside Cancer
• Susan G. Komen
• LiveStrong