Caring Currents

When you're caring for someone with cancer, of course you're going to focus on the physical side effects first. Pain, fatigue, nausea, inability to eat -- these are urgent concerns that demand our attention.

But for many cancer patients and those caring for them, the mental fog known as "chemo brain" can be just as frustrating and debilitating. Chemo brain shows up as a host of problems: memory loss, lack of concentration, mood swings, and impaired intelligence. According to the American Cancer Society, at least 30 percent of cancer patients say chemo brain impairs their ability to work and function. 

Until very recently, though, doctors didn't take chemo brain very seriously. That's changing fast, as new studies come out that show that some chemotherapy drugs are much more toxic to brain cells than previously believed...  Read more

During these rocky economic times, an increasing number of people are sacrificing their health to save money and cut back on spiraling health care costs, reports the Wall Street Journal.

When faced with skyrocketing premiums, deductibles, and prescription drug costs, more people are choosing to skip doctors visits and forego their prescription drugs, according to the article, which found that:

• 22 percent of people surveyed said that they were going to the doctor less often because of money woes, while in a different survey, 11 percent said they were cutting back on filling their prescriptions.
• The number of total prescriptions filled fell 0.5 percent in the first quarter and 1.97 percent in the second, compared with the same periods in 2007 -- the first negative quarters in at least a decade.
• Drugstores like Walgreens are reporting slower sales of prescription drugs.
• Health services company LabCorp...  Read more

When Paul Newman died on Friday, we lost yet another truly great man to cancer. Newman, age 83, died Friday at home in Westport, Connecticut with his wife of 50 years, actress Joanne Woodward, and his five daughters by his side. Yet until reports of Newman's illness surfaced in June, the public wasn't aware that the revered actor and philanthropist was battling the disease.  

A slew of reports in June speculated that Newman had lung cancer after he appeared looking gaunt at a fundraiser for his Hole in the Wall Gang camps for children with life-threatening illnesses, and the photos were published on Martha Stewart's website. However, his publicity rep refused to confirm the rumors.

Here's the thing: It's wonderful when a celebrity publicly acknowledges having cancer. In the past, having cancer was something people were frightened and secretive about. And even today, many people choose to keep a cancer diagnosis private...  Read more

It starts the minute you or someone you love gets a diagnosis of breast cancer: Decision after exhausting decision. Lumpectomy plus radiation, or mastectomy? Partial or full mastectomy? Reconstruction during or following mastectomy, or not at all? Then there's the biggest decision of all for those with early stage cancer: chemo or no chemo?

The agonizing choices are one of the biggest reasons breast cancer can be so stressful for both cancer patients and those trying to help them negotiate the treatment maze. That's why we all reacted with so much excitement yesterday when a group of researchers unveiled a new predictive tool called the PEPI score that doctors and patients can use to determine what treatment is necessary.

PEPI (which stands for the mouthful "preoperative endocrine prognostic index") offers a way to gauge a woman's risk of recurrence, which is the $64,000 question that must be answered in order to determine who needs chemo and who doesn't...  Read more

A coincidence last week leads me to mention a new addition to Caring.com -- and one that’s already making a difference in at least one person’s life.

A close buddy’s step-dad, 84ish, went to the hospital with vague symptoms of tiredness and lower body pain. He was admitted and a couple of days later diagnosed with kidney cancer that had metastasized to his intestine and possibly other places. His prognosis is terminal.

This same week Caring.com launched a new feature: “To-Do” lists. These online checklists guide you through a variety of challenging caregiving situations including What to Do When a Loved One is First Diagnosed With Cancer, and What To Do When Someone Dies. A complete list is below.

My friend had never dealt closely with a cancer diagnosis. His main “job” is to support and steer his mother, who is caring for his step-dad...  Read more

If Caring.com expert Laura Juel has one regret about her own recent caregiving experience, it's that she and her family didn't contact hospice sooner.

As I wrote in last week's post, Juel's mother, who had terminal cancer, suffered a stroke last summer, just weeks after her oncologist concluded there was no point in continuing treatment. But Juel's family had reservations about calling hospice. "To my sisters, hospice meant giving up on my mother and turning on the morphine drip. We just weren't ready for that," Juel recalls.

It's common for families to resist calling in hospice when a loved one is gravely ill. In many cases, the family has been joined in battle for months, even years, to keep the patient alive. Turning to hospice can feel like giving up -- not only on the patient, but also on our own fantasies about cheating death and defying the odds -- at least this time. In many ways, calling hospice represents the first step in letting go...  Read more

When the FDA announced on Monday that it had approved the first anti-nausea medication available as a patch, cancer patients and those of us who are caring for them reacted with perhaps more excitement than the news seems to deserve. Why?  Not only because it offers us a new -- and much-needed -- option, but because it's further proof that the research community is finally taking seriously one of the most debilitating side effects of cancer treatment.

Nausea, I'm sorry to say, is a bigger deal than most people not living in "Cancer World" realize. Until you see firsthand how completely constant, unremitting nausea (and the consequent lack of appetite) can undermine a person's quality of life, you can't have a full appreciation for the power of this particular side effect to sideline a normally high-energy, effective person.

The patch, known by the brand name Sancuso, uses granisetron, an anti-emetic already in wide use in pill form both as brand name Kytril and as a generic...  Read more

Laura Juel isn't intimidated by the world of medicine. As an occupational therapist at the Duke Medical Center in Durham, North Carolina, she deals with doctors all the time, and she's used to navigating the often-bewildering ins and outs of the medical bureaucracy. Her familiarity with medicine isn't just professional, either: Her husband is a physician as well.

Nevertheless, Juel, who is also an expert at Caring.com, didn't realize how daunting it can be to oppose "doctors orders" until this past August, when her own mother was dying. Her mother, who had been diagnosed the year before with esophageal cancer, suffered a stroke in early August and was rushed to the hospital. As soon as Juel heard about the stroke, she left her husband and three young children in North Carolina and traveled to New York to help with her mother's care.

Not long before the stroke, the oncologist told Juel's mother that there was nothing more he could do, and the family knew she didn't have long to live...  Read more

A close friend is currently undergoing cancer treatment, including a mastectomy and chemotherapy, to remove a tumor that her doctors now believe grew for several years undetected by regular annual mammograms. The reason? She's among the one quarter of women who have dense breast tissue, which prevents tumors from showing up on routine mammograms.

My friend is one of many women who stand to benefit from a new technology called MBI, molecular breast imaging. Researchers at the Mayo Clinic released results from a large study this week showing that MBI found three times as many tumors as mammograms in women with dense breasts.

Molecular breast imaging, or MBI, is a relatively new tool that's only been in use for about five years. It's more expensive than mammography, but considerably less expensive -- about one fifth the cost -- as a breast MRI. The way it works is that a woman is injected with a short-lived radioactive agent that's absorbed by the breast tissue and "lights up" cancer cells when tracked with a special camera...  Read more

When it comes to caring for older adults, signs of overall health and well-being often come in unexpected places. Here's a clue: Have you checked out your parent's toes lately?

It seems the little things matter big time for seniors. That's the premise of an eloquent article by Atul Gawande, The Way We Age Now, in the New Yorker last year, which showcased the systematic and thoughtful practices of physicians who specialise in caring for the aging and ailing. The piece has done more to advance the cause of geriatric physicians, one geriatrician told me, than any medical association could ever do (with all due respect to the American Geriatrics Society).

In the story we meet geriatrician Juergen Bludau, who spends a good deal of time carefully examining 85-year-old Jean Gavrilles' feet -- the soles, the toes, the web spaces -- though she presented with a myriad of ailments, including back pain, arthritis, high blood pressure, glaucoma, incontinence...  Read more