WHAT CAN CANCER PATIENTS CAN LEARN FROM HEART PATIENTS?

When my mother was diagnosed with heart disease, she learned she had to manage her illness. The damage to her heart was real, and even though some was reversed through treatment, she had to accept that her heart was going to be vulnerable from that point on. It never occurred to her that, short of a heart transplant, she could be cured. Her outlook was tempered by that reality.

A lot of cancer patients feel that anything less than a cure is a failure. While the ideal is to find a cure, sometimes learning to accept what cancer is and finding ways to manage it means you maximize your potential, instead of surrendering it to the power cancer has over you. You break through the fear and frustration of cancer and seek ways to live, so that your life has meaning.

Heart patients know that they have to pay attention to the signs their bodies exhibit, in order to get treatment when problems arise. Cancer is a disease that benefits from this approach. When you notice something is different, get it checked out. Don't assume that a potentially new cancer means that your time is up. Some cancer patients take a fatalistic view of their cancer and assume the worst. But I've met many people who lived years with cancers popping up in different parts of their bodies, even Stage 4 patients. The secret is to manage the symptoms as they show up, without waiting, without hesitating. If you thought you had a blockage in an artery, you'd get it treated, wouldn't you? Your cardiologist might order a stent or a bypass, to help the heart function better. Going to your oncologist to see what solutions are available when there is a problem is a smart thing to do. You're looking for ways to survive the cancer.

Heart patients also know that lifestyle changes can often improve their survival rate. When they avoid harmful behavior, they help themselves to prevent new damage. Diet and exercise are critical in managing heart disease, but they can also help cancer patients. I say that as someone who sees some of the patients from the cancer center working out at my gym. One of the women, who was going through chemotherapy more than a year ago, is showing up regularly and looking healthy. Her hair has grown back and she's hitting the exercise machines with some gusto. If you have the energy and your doctor's approval, this is a great thing to do. Even getting out for regular walks can improve your mood and relieve stress.

Managing the stress of heart disease helps patients stay in the game of life because it reduces the wear and tear on the body. Cancer patients can also benefit from this. When you lie awake at night, fretting over your fate, that tension builds up in your body. It effects your blood pressure, your immune system, and your attitude. The more you can manage your stress, the better your outlook will be.

Stress is a very big part of cancer. It's hard not to think about what is happening inside your body, to imagine the worst. Having healthy ways to take control of that stress is important for cancer patients. Stress can eat away at your resources and cut into your ability to manage your cancer.

Understanding your cancer and its effects is important. It's also important to remember that sometimes cancer takes years before it shows up in tests. Not all cancers are aggressive. But even when they are, there are new treatments that can help you manage the disease, to give you time.
Time is the friend of cancer patients. With it, there is always hope for a better tomorrow.

KIDS, CANCER AND SUMMER CAMP (ADULTS, TOO!)

It's never too early for parents to start thinking about their kids and what they will be doing in summer. But if you're a parent of a child with cancer, you know planning for the coming months isn't an easy task. Where will your child be six months from now?

And what about adults with cancer? Do they have any options for summer fun?

There are many great organizations that offer camping experiences for kids and adults with cancer.

Hole-in-the-Wall Gang Camp is a wonderful place for kids with cancer and other serious illnesses ages 7-15. And they also offer family weekends for the cancer patient, siblings, and parents:
http://www.holeinthewallgang.org/page.aspx?pid=471

If you want a great list of cancer resources for kids, created by parents, try Pediatric Oncology Resources Center:
http://www.acor.org/ped-onc/index.html

They also have a very thorough list of cancer kids camps across the country:
http://www.acor.org/ped-onc/cfissues/camps.html

There are even day camps for kids with cancer, including Sunrise Day Camp, that works with children 3-16 during the day, but the children sleep at home:
http://www.sunrisedaycamp.org/

What is nice about some of these camps is they allow siblings to join cancer patients. That can be a nice bonding experience for the family.

Just don't forget your other kids when you're caught up in the cancer treatment puzzle. Sometimes it's helpful to give them a break from the worry and wear of having a cancer patient in the family. If your other children have an interest in horseback riding or outdoor sports, consider giving them a little break for a week or two. They will come home with new energy and enthusiasm.

But what about adults with cancer? If you are a parent with cancer, or caring for a spouse with cancer, consider the benefits of sending the kids to summer camp, especially if there's no chance you'll be taking a "real vacation" this year. Many times when a loved one is in treatment, plans are put on hold because the physical limitations of the disease prevent the whole family from enjoying a trip. But also consider taking advantage of some of the offerings for families with a loved one.

The American Society of Clinical Oncology created a resource list for cancer patients and their families. Whether you want to go on a retreat or get together with the family, there are places you can go to have fun with people who understand what you are going through:
http://www.cancer.net/portal/site/patient/menuitem.169f5d85214941ccfd748f68ee37a01d/?vgnextoid=22f241eca8daa010VgnVCM100000ed730ad1RCRD

Whatever you do, don't let cancer stop you from having some fun. Get out there and put a smile on your face. You deserve it!

THE POWER OF A NAP

I've met cancer patients who have felt like they were weak if they gave in to the effects of chemotherapy and took a nap. They would have their treatments and spend the next several days fighting the effects of the drugs coursing through their veins. My mother probably fought harder than anyone on this subject. The fatigue made her feel weak and submissive, not only to the cancer, but also to the side effects of cancer treatment. It was frustrating for her, until she learned some very important secrets about chemotherapy from some experienced cancer patients.

Many had multiple courses of cancer treatment and managed the disease several over years. These were my mentors in navigating the mysteries of cancer. These were the experienced veterans, battle-scarred, but knowledgeable about the secrets of surviving.

Almost every one of these patients swore by the power of a nap. In fact, many said that if they tried to fight the fatigue that often accompanies chemotherapy treatments, they wound up being even more exhausted. By accepting the reality of the effects of chemotherapy on the body, they were able to pull themselves back together sooner and get on with their lives.

Think about it. When you fight the fatigue, you are actually creating stress for your body. When you realize that it is not weakness on your part that causes the fatigue, but the medicine's effects, you realize that you can actually conserve your energy by going with the flow. If you try to swim upstream, you'll spend a lot of time fighting the currents. What will you have left when you're done swimming?

One of the wisest veterans of cancer I met was a woman who had been Stage 4 for years. Her cancer had spread throughout her body, but every time it showed up, she would get treatment and go on with her life. And whenever she had chemotherapy, she would come home, put herself to bed when the fatigue hit, and her husband would take care of her until she was back on her feet. She understood that fighting fatigue wasn't fighting the cancer. Living well was her goal, and she realized the importance of taking good care of herself.

Don't be afraid to admit you need a nap now and then. Listen to your body and understand that when you take care of it, you have a better chance of managing your cancer and living longer. If you don't believe me, ask some cancer veterans the next time you're in for treatment. Not only can they give you some great advice, they will inspire you with their war stories and courage.

WHY CANCER PATIENTS NEED TO EMBRACE THEIR INNER CHILD

Cancer is like that big, grumpy adult who sees everyone having fun and shuts down the party. One minute, we're all having fun, hooting and hollering, and the next minute, we're all miserable. Nothing puts a damper on life faster than cancer.

My mother always loved to go out and about, whether it was to the movies, a restaurant for a good meal, a picnic, or even just to people watch. She was the mother who took us to swim in creeks and brooks, the grandmother who would reach into a pond to retrieve a frog. Sitting on a lawn chair, feet in the lake on a fine day, was bliss for her. And when she got cancer, nothing was more heartbreaking for her than the thought that she would give all that up and stop having fun.

The truth is that fun is wonderful medicine for so many reasons. Cancer patients need the chance to kick cancer to the curb once in a while. Living with cancer is tough. Thinking about cancer means thinking about how cancer robs you of the good times. You have enough time to think about cancer when you have your check-ups or you go for radiation or chemo. That's why embracing your inner child is a valuable tool in the fight against cancer.

Am I suggesting that you completely stop being an adult and just indulge every whim, every emotion, every moment of heartbreak that cancer has brought into your life? Heavens, no! I am suggesting that you take your inner child out to play on a regular basis. Go places as your energy allows. Follow your dreams. Indulge that urge to get out and explore the world. If you wait until your cancer is cured, the time may never come. The truth is people live longer with cancer now because it can be managed better. What is the point of managing your cancer if you don't take that bull by the horns and use it to enrich your life? Laugh more. Hug more. Love more. Live more. Put a hat and coat on that inner child of yours and have some fun now. Don't let that grumpy old adult spoil your life party.

GORDON MURRAY'S TRIUMPH

Gordon Murray passed away on January 15, 2011, just days before his book on investing was due to come out in hardcover. The paperback version sold out in the fall of 2010. He had glioblastoma, an aggressive brain cancer. He was only 60 years old. But he left a legacy of which every cancer patient can be proud.

So often, cancer patients often feel defeated by their disease. Life isn't fair, and cancer patients understand this more than most people. Cancer takes away so much of what matters, and then cancer treatment often takes almost all of the rest. But Gordon Murray wasn't willing to accept this fate. He wanted his life to count for something. He wanted all those years he spent learning his trade to have meaning. He wanted to leave the world a better place than what it was and he wanted investors to avoid the pitfalls of a volatile market. He chose to create a legacy in spite of the cancer. Or was it the cancer that pushed him to create it?

What does Gordon Murray want the world to know? Most people invest haphazardly, taking far too many risks on unknowns -- hot stocks and bonds without solid histories of performing, and they end up buying and selling at the wrong times. He believed that investors benefit from taking a simpler, more regimented approach. For decades, Gordon Murray had embraced an aggressive trading philosophy on Wall Street, but toward the end of his life, he chose a different approach for his own portfolio. Why is this important? Because he wanted to take care of his family in the best way he could, protect the assets he had spent decades accumulating, and how he made his investment decisions changed as a result.

When brain cancer first came to him in 2008, he understood his time might be short. A new tumor in 2010 brought home the reality of his terminal illness. He chose to use the time he had to share what he had learned about investing through the years, and he wanted people to know he had evolved his financial philosophy. He wanted people to understand that in an age of glitz and glamor, where what is popular and pretty seems like instant success and people rush to get a piece of the action. He believed there was a better way, and before he died, he wanted people to what it was.

But maybe even more important than the book, "The Investment Answer", was the fact that writing it gave him purpose and mission. Every cancer patient needs to believe that his or her life still has meaning. Whether you paint, dig ditches, catch bad guys, write, build bridges, teach, run a business, solve diplomatic crises, or slay dragons, you need to believe that your life matters to someone. In believing that, you have the impetus to move forward, to focus on what is important, to make choices and decisions about what you want your legacy to be. Even if you live another twenty years or more, just getting pointed in that direction can be a transforming experience. All of us should "live like you are dying". That way, when our time finally comes, and it will for all of us, we will have left a legacy of which we can be proud.

When you choose to do this, you get rid of the regrets and the anger. You focus on the positive and you move ahead, past the limitations of the cancer and its debilitating effects. You say, "This is what I want to do and cancer isn't going to steal that from me." When you succeed in reaching your goals, that's a victory.

WHY YOU CAN NEVER THANK AN ONCOLOGY NURSE ENOUGH

They are on the front lines of the cancer battle, the oncology nurses who dispense the chemotherapy drugs at cancer centers across the country. They are the women and men who see patients come and go over time, but never really have the chance to know what a difference they make in the lives of cancer patients everywhere.

I was at the grocery store the other day when I spotted a family face from the cancer center. My mom had ended treatment long ago, but suddenly there was one of the oncology nurses, pushing her carriage up and down the aisles. I had to stop her and thank her. I had to tell this woman, who sometimes treated my mother, that what she does matters. We both got a little choked up as I thanked her, and I told her she could never hear it enough.

Think about it. Oncology nurses deal with the cancer battle every day, just as the rest of the teams at cancer centers do. They see patients come and go. Sometimes patients are cured, and that's the end of the contact. Often, patients return because cancer has spread. Always cheerful and supportive, always there to offer a kind word and to answer questions, oncology nurses are the people you count on to help you get through the rigors of chemotherapy. They're a very special breed of nurses. Do they know how much their work is appreciated? Do they know what an important role they play in the lives of their patients?

My mother wasn't cured of her cancer, but she gained much from cancer treatment. She got time to finish unfinished business, to make decisions and to choose what she wanted. Her youngest grandson was accepted at the college of his choice, and she lived to know that he would not only graduate, but do so with good grades. She had the chance to share that joy with him, to celebrate his monumental achievement. There were birthdays she attended as a result of her cancer treatment, and laughs shared, stories told, and memories made. She and my father even made it to their sixtieth anniversary because of her cancer treatment.

How easy it would be to think that cancer treatment didn't cure her, to feel cheated or robbed. But the truth is that we packed a lot of living into those extra months, and it's carried us through the loss. Had my mother been younger, she'd probably still be alive and kicking, still feisty and funny. Cancer was just the last straw on a big pile of health troubles. But because it was treated as well as it was, we had that extra time with her.

It must not be easy to put on your game face every day and see the numbers of people coming through the doors of the cancer center, to know that some will make it and some won't. Oncology nurses keep on doing what they do, often without ever knowing what happens to the people who never return. They don't always know about the little miracles they help to happen with their caring and their compassion. For all those nurses out there, who sometimes wonder if it's all worth it, let me tell you the truth. Every time a family has the chance to make a new memory, it's worth it. We may not have forever, but a little more time can make a big difference. Thank you.

USING CANCER MANAGEMENT AS A SURVIVAL TOOL

I spent many winters doing battle with the squirrels, and every time I sought to thwart them, they found ways to slip past my defenses. What does this have to do with cancer management?

Think about how much energy it takes to wage war with an enemy that can maneuver through tight spaces, can outwit your best efforts, and that can jump long distances. I wasted more time at the window, waiting for the squirrels to arrive, so I could attempt to frighten them away. The truth is that I had little real impact on these rodents with attitude. They still arrived in droves. They still found ways to get the bird seed. I can't tell you the number of times the feeder poles were bent, the feeders were sent crashing to the ground, and the seed was lost. In the end, the very birds I wanted to feed were the ones who suffered the most. They were frightened away by my squirrel-chasing antics. They lost out when the squirrels took over their feeding ground.

What's the solution to the squirrel situation? As you can see by the photos, the pole is still bent in the winter snow. The reality is that I had to learn to manage the squirrels in a reasonable way. Oh, don't get me wrong. They still get the bird seed. They still climb onto the feeders and they try to get as much as they can. But now I have ways to feed the birds that circumvent the squirrels.

I have a squirrel-proof feeder on a nearby tree limb. This is for the birds when the squirrels are taking over the pole feeders. The birds don't like this feeder as much, but it allows them to still feed when they are blocked on the feeder. I also have a thistle feeder for the little song birds, something the squirrels aren't interested in accessing. One of the pole feeders is easy for the squirrels to get at, and they do. They shake the seed onto the ground below and have their little feasts. And then there is the "squirrel cage" feeder, designed to prevent them from accessing the seed. Does it work? Sometimes. As long as the squirrels can get some seed from the easy feeder, however, they tend to leave this one alone.

You might not think so, but I have actually cut down the amount of seed I use for the birds and squirrels. That's what squirrel management can do. Am I admitting defeat by allowing them to get at some of the seed? Not really. I am acknowledging that I cannot control all of them, but I can control the amount of energy I expend and how I expend it.

Cancer management is a lot like that. Should you waste your time putting all of your energy and attention on curing the cancer? Or should you use the time to direct the energy and attention to the life you and your loved one want to live? It's really about quality of life, more than quantity. It's about conserving resources and improving the ways to use the resources.

In cancer treatment, there are things you can control and should control. But there are also things that will happen over which you have little control. Changing your focus allows you to meet the important needs of cancer patients in meaningful ways. When you direct your energy towards using the life you and your loved one have to pursue good times, you lessen the direct impact of bad times. You accept that bad things can happen to good people, so you look for the opportunities to find the goodness that's available.

The truth is we can't always change our circumstances, but we can change how we live within those confines, and in doing so, we take control over the quality of the lives we live. It's our decision, not cancer's.

SKIN CANCER IS STILL CANCER

A lot of people categorize skin cancer as a less serious disease than many other types of cancer, and it usually is, unless it is a deadly form of melanoma. But that doesn't mean that skin cancer should be taken lightly.

Very often, if you develop one spot of skin cancer, others will follow. Many people find they need constant check-ups to catch these as they grow.

What are the risks of ignoring the questionable patches on skin?
Pre-cancerous spots are easier to treat than cancerous ones. And cancerous spots that are left to grow in place often require surgery that can leave significant scarring, because removal requires deeper cutting.

The trouble with skin cancer is that it can pop up anywhere on the body, even between the toes, and the better the management of skin cancer, especially for someone who has had more than one spot diagnosed, the better the chances of catching it as it develops and halting its progress.

I know many people who have had skin cancer for decades. They get their annual checks and follow the regimens prescribed by their doctors. They pay attention and they make appointments as soon as they discover a suspicious patch of skin or a mole that looks unusual. They have skin biopsies when it's necessary. They don't take skin cancer lightly. It may be one of the most survivable types of cancer, but it's still cancer. It still needs to treated, because left unchecked, the results can be dangerous. Being proactive increases your chances of surviving cancer.

MAKE TIME TO DANCE....

It's hard when your loved one is going through cancer treatment to find a good balance between meeting real physical needs and feeding the soul. Some days it can feel like you spend all of your time at medical appointments or in hospital rooms.

The worry and anxiety of cancer and its treatment can weigh heavy on the hearts and minds of family members. We tend to project our fears onto the future, imagining what will come and how it will come, or we bury our heads in the sand, like ostriches, convinced there is no serious threat to life as we know it. The actual view is more balanced than that. There will be good days and bad days, just like real life. And just like with real life, you need to make an effort to continually connect to your loved one who is going through cancer treatment in meaningful ways.

It's easy to give in sometimes to the darkness, to believe there is little hope or little to be gained from the struggle. Caregivers need to understand that nurturing the heart is every bit as important as nurturing the body of a cancer patient. But how do you do that?

Inside every cancer patient, there is a person waiting to get out and about again. If he or she is hiding out at home, chances are good he or she is not living life. Caregivers can be a very positive influence on cancer patients when they find creative ways to encourage them to get back to the living. Sometimes, you just have to forget about the cancer and make time to dance, to laugh, even to sing.

We all need reminding sometimes of what we are inside -- we have hopes and dreams and desires waiting to be fulfilled. When cancer comes along, it can knock your loved one off his or her feet, and all that gets put aside. But sometimes the best way to get through cancer treatment is to pick it up again, to seize the day and declare that it's time to get back to the dance of life. That's how you take back the control. Cancer may take its toll on your loved one's body, and even mind at times. Finding ways to get around those limitations and enjoy life is can make a big difference in motivating your loved one to get through the tough times.

CANCER MAKE YOU FEEL LIKE A LITTLE DOG IN THE SNOW

All this snow is beautiful if you're tall enough to see over it. But if you're a little dog, it can be scary. You can't really see what's hiding behind the snow banks. All you can hear are big trucks and fast cars zipping past. It can leave you feeling very vulnerable.

Navigating the sidewalks after this much snow is a lot like finding your way through the maze that is cancer.  It can be overwhelming. 

How do you keep yourself going when you feel your most vulnerable? Get yourself a pack. This little dog is no dummy. She has her canine friends. She's even been known to cuddle up to a Great Dane. She knows she needs friends to look out for her.

Cancer isn't a matter of survival of the fittest. It's a matter of surviving, and you need a lot of support to get it done. Don't feel guilty for needing people to help you through it. Often just having the chance to be part of the pack is the best reward.

HANGING ON TO HOPE

Hope is such a critical tool in fighting cancer. With it, the mind works with the body, focusing attention on surviving both the disease and its treatment rigors. Without it, the mind and body fracture their relationship and go their separate ways. Gloom and despair take over, and the days grow dark and endless.

I stepped out this morning to fill the bird feeder and noticed the little statue popping up in the snow. My mother used to refer to her as Cuckoo, the Bird Girl. The chickadees and sparrows love to perch upon her head as they flit to and from the bird feeder. She was a "treasure" found in a resale shop, a garden statue that needed a home. And now, in the cold, cold months of winter, she still earns her keep.

The first thing I thought of this morning as I saw her there, buried up to her neck in snow, was that soon it will be spring. She is a reminder that the lush pachysandra, rhododendron, and hydrangea will bloom again. She is the messenger that these cold days will soon end and a new cycle of life will begin.

Hope is the desire that lives in all of us. It is part dream and part reality. When we feed it, nurture it, and believe in it, it is the tool that can help us rise above adversity. It is the rope that can pull us out of a hole. But we have to see the rope and use it in order to get the greatest benefit from it.

Often in cancer treatment, families long for a cure and are disappointed daily that it takes so long to see results. They often forget that by the time most cancers are discovered, they have been steadily growing over time, hidden from view until they became a noticeable threat to life. We don't always see the slow improvements of our loved ones as they begin to fight back the cancer. We expect big miracles, and when they don't immediately manifest themselves, we give in to the sadness, the sorrow, the ache that things aren't the way we wish them to be.

When I look at this little statue in the snow, I know there will again be a spring. I cannot tell you when, but I know it will come. I will begin to see the end of winter as the days grow longer and the sunlight lingers with me.

When you look at your loved one struggling with cancer, remember to also look for the little changes that tell you things are going on deep within. Is there improvement in pain? In breathing? Is the color of the skin better? Is there an increase in appetite? These are the signs of spring for a cancer patient. There will be sunny days to come. Rejoice. Celebrate and appreciate the good fortune you have now and in the opportunities that will come. Don't think about the years left. Think about the season ahead. Let hope live.

N Y TIMES -- NEW WAYS TO FEED CANCER PATIENTS

The New York Times had a great article on feeding cancer patients today. It's especially relevant for parents who have struggled to get kids on chemo to eat. If you want a little inspiration and understanding, take a look:

http://www.nytimes.com/2011/01/16/nyregion/16sloan.html?_r=1&scp=2&sq=cancer%20patients&st=cse

PREVENT TRIGGERING OPPOSITIONAL BEHAVIOR IN CANCER PATIENTS

Caregivers sometimes feel that micromanaging loved ones during serious illness is the best way to get compliance. It's hard to see a cancer patient angry or frustrated or scared, overwhelmed by the disease and its limitations. So caregivers take charge, issuing orders. "It's time to take your medicine!", or "You HAVE to eat!" Why is this not a good idea?

Whether you are dealing with adults, teens, or children, cancer patients are people who have had significant freedoms taken away from them. Cancer has exerted tremendous control over their lives and it's stolen their choices of how life will go. You may be worried that your loved one isn't doing everything he or she could to "get better". Some patients go through periods of rebellion against their disease, and sometimes that rebellion extends to the people trying to help them manage their cancer.

Why does that matter? People without the opportunity to make choices will often vent their frustrations at the most available targets. It's about looking for a chance to control something, anything. Caregivers can come to represent an oppressive force in the lives of cancer patients, especially when they try to get the cancer patient to cooperate with care. Suddenly black is white and white is black. Emotions run high and things can get complicated when you lose sight of what the real problem is.

When you recognize the position your loved one is in, and you understand the human need to have choices -- even small ones -- you can begin to offer opportunities that allow your loved one to take some measure of control over what happens in his or her life.

Empower your loved one to make reasonable choices in everyday life. When you want to go out to eat, let your loved one make the decision about where to go. It may sound silly, but having the opportunity to choose can be very therapeutic. If you're in charge of everything when your loved one is physically vulnerable, the relationship changes in a very negative way. You start to become the adult of the relationship and fear, partnering with frustration, can push your loved one into becoming the disobedient child.

Help balance out the imbalance of the relationship during cancer treatment by finding activities that your loved one still can enjoy and share them. It's important to find ways to positively bond. You need to feel connected and invested in each other. If all of the focus is on the cancer, and not on the relationship itself, the cancer is in charge. When you put it aside and have fun together, you reestablish what matters to both of you. If your loved one doesn't have the energy to do anything strenuous, don't let that stop you. Get out and about -- don't stop living in the moment. Even if you just go out for ice cream cones, let it be pleasurable. Go see a comedy at the local theater or watch one at home together. Nuture the relationship in healthy ways. Make the time to share events, just like you make the time for medical appointments. Don't let cancer be the only thing you two share. Whether you're taking care of a parent, a spouse, or a child, feed the relationship and make it as important as caregiving is.

When it comes to non-compliance with medications and treatments, remember that sometimes it's easier for cancer patients to feel that they can capitulate on medical issues if they feel that they are getting positive results in other areas of their lives. The more they have the opportunity to make decisions for themselves on everyday issues,  the easier it is to agree to cooperate on cancer treatment.

Cancer is an enemy that struggles for power over your loved one. Patients fight the battle every day. The more you help your loved one remain capable of achieving, even through cancer treatment, the less you look like a prison warden, and more like a team player. Provide the caregiving your loved one needs, but also remember to step out of that role once in a while. Be a companion who values the company of someone who just happens to have cancer. Never forget the person behind the illness. A spoonful of sugar really can help the medicine go down.

WHY IS FOOD A CRITICAL TOOL IN CANCER CARE?

Anyone undergoing cancer treatment can tell you there are times you just don't feel like eating. And anyone caring for a patient undergoing cancer treatment can tell you that it's worrisome to see appetite levels fluctuate or disappear.

Why is nutrition such an important part of cancer care? Patients can lose so much weight, their ability to withstand the rigors of chemotherapy and other treatments can be seriously compromised.

How do you encourage a cancer patient who has no appetite to eat? How do you avoid creating extra pressure on the patient? This is especially important in the case of children Even normal children often resist parental efforts to make them eat.

In order to best address the nutritional issue for cancer patients, it's helpful to understand the reluctance to eat. Did you know:

1. Chewing can be tiring, especially when chemo fatigue sets in. The easier it is to get the food into the body, the more likely the patient will consume it. Shakes, especially if you can enhance them with extra calories, are easy to swallow and to absorb. This is often good for children with poor appetites. Word of caution -- supplemental shakes, like Boost and Ensure, are often overly sweet and patients can be turned off by this -- save these as a last resort or for emergencies.

2. If your loved one has good energy in the morning, that could be the time to load on the calories. Sometimes a hearty breakfast will go down more easily than a big dinner. Which matters more -- when your loved one eats, or IF your loved one eats?

3. The type of food you offer can make a huge difference. Most breakfast foods are tasty, but don't require a lot of hard chewing and can offer a lot of calories. Pancakes, waffles, eggs -- these foods are soft. Steak, roast pork, and chicken require effort to masticate. That takes precious energy, which many cancer patients don't have. A dish of ice cream is easier to eat than a lamb chop. A Sloppy Joe is easier to eat than a hamburger.

4. Some patients are more comfortable eating small meals throughout the day. Have easy-to-eat snacks available -- pudding cups, protein bars, cheeses

5. When your loved one is thirsty, offer liquids with lots of calories -- milkshakes (use whole milk, not skim), hot cocoa, and juices. Clear juices, like cranberry, apple, and grape juice can offer a lot of calories but go down as easily as water.

When a loved one starts losing a lot of body weight, the biggest hurdle for caregivers to get over is the idea that healthy eating the most critical thing for cancer patients. While it's true that nutrition is important to overall health, you want your loved one not to lose any more weight, so getting calories into him or her, regardless of the source, is necessary. When your loved one has started to recover from the hardships of cancer treatment, and his or her appetite has returned, that's the time to start reintroducing a more balanced diet.

Think of it this way. Calories are calories. If you only offer nutritional foods, but your loved one refuses to eat, how have you won the battle? If you understand just how difficult it is to eat during cancer treatment, you will understand that calories matter. Cancer treatment isn't forever, so while it lasts, maximize the positive benefits of this approach.

Cancer patients can feel pressured to eat and that's a turn-off. Think small. Don't go overboard and overwhelm the senses. An 8-ounce milkshake isn't scary. A milkshake in a huge glass, with a caregiver hovering, can be. Did you know you can add a little peanut butter to a milkshake to boost the calories and add good nutrition? Make milkshakes with flavored whey powder and throw in some ice cream. The calorie count goes up, but it isn't overwhelming for your loved one. Here are some foods that may appeal to your loved one during times when he or she doesn't feel like eating:

Scrambled eggs with cheese
Grilled cheese
Peanut butter and jelly
Waffles or pancakes with butter and syrup
Ice cream with chopped walnuts and fudge sauce (grind the nuts)
Pudding with whipped cream
Mashed potatoes
Candied sweet potatoes
Poached or baked white fish or scallops
Crab meat or tuna salad
Stews with meat finely cut
Pot pies (make sure the meat or poultry pieces are very small)
Shepard's pie (make sure the hamburger pieces are small)
Macaroni and cheese
Souffles
Quiches

6 TIPS ON HOW TO LIVE IN THE MOMENT

One of the hardest things for cancer families to do is learn to live in the moment. How do you do that? How do you let go of the panic and fear long enough to enjoy the hours of the day with your loved one?

Anyone who has cancer can tell you it's tough to do. And anyone who loves someone who has cancer can tell you it's nearly impossible to forget that you might lose someone to this insidious disease.

1. Recognize what is in the immediate future --
Is cancer treatment viable? What will be the side effects and how can they be managed to provide the best quality of life for your loved one? If you understand how cancer treatment affects your loved one, you can figure out ways to keep him or her energized. When do the side effects of chemotherapy kick in? That's not a good time for getting things done. When do the side effects of chemotherapy drop off? Use that as the time to get moving and get active. Appreciate what you have and use it to get to tomorrow, and next week, and next month. Build on segments of time.

2. Concentrate on what your loved one can do, not on what he or she can't --
Will you waste precious time and energy on things that can't be done, or will you move forward with the knowledge that there are things you and your loved one can still enjoy and succeed in doing? Make a list of things that are doable and then do them. If you have to take it slowly and adapt the list, that's okay. What's important is to accomplish things that matter.

3. Be realistically optimistic --
As a caregiver, can you find the sunny side of the street to walk upon? How you view your loved one's cancer will have a tremendous impact on everyone. It's easy for cancer patients to feel overwhelmed by their experiences. If you look for the silver lining in every cloud, you can help direct the family to experience positive things during your loved one's cancer treatment. Lead the way.

4. Get help if you need it --
If you feel depressed or fearful of your loved one's cancer, your care-giving will reflect that. Find a safe outlet other than your loved one, so you can discuss these issues and sort them out. Many cancer centers have valuable resources and there are support groups online that will share their cancer experiences with you and your loved one. Don't bottle it all up. Deal with it.

4. Learn more about cancer and how it effects the entire family --
Talk to the professionals at the cancer center. Talk to other experienced caregivers.  Do the research. You need to be able to meet your loved one's real needs, and the best way to do that is to understand and appreciate what those are. Cancer doesn't just affect your loved one's physical health. It takes a toll on the whole person and it can change how a person sees the world.

5. Seek wisdom from other cancer survivors --
Many patients have lived with cancer for decades. You probably already know several. How do they do it? Many have learned to manage their symptoms and have found ways around the big obstacles. They have much wisdom to share with cancer patients and their families, and they are wonderful resources.

6. Don't let cancer isolate the family from the living world --
Help your loved one to stay connected to family and friends during cancer treatment and beyond by reaching out. It's important for your loved one to still engage in as many normal activities as possible, but sometimes you have to adjust those to allow for the side effects of cancer treatment. If your loved one begins to emotionally withdraw, it can have a negative effect on his or her opportunities to manage the cancer. Find out what's going on and then help your loved one overcome these difficulties in a realistic way.