18 May 09 DEFINITIONS OF SOME EXPRESSIONS YOUR DOCTOR MAY USE – SOME FACTS ABOUT PAINKILLERS (PART 1)
Here is a table telling you some facts you will need to know about painkillers.
In the first column I have listed their chemical names. If the name of your painkiller is not on this list, it is most likely because you have been given the proprietary (drug company) name and/or because it is a mixture. Ask for the chemical name(s) of your painkiller(s).
In the second column is the dose which, if taken by mouth, is likely to relieve the pain of a person who is just starting on painkillers. These doses are all of about equal strength, so you can work out what dose of another painkiller will have about the same effect if you switch from one to another. Injections are two to four times stronger than tablets or syrup of the same drug.
The third column shows how long each dose usually lasts. Remember, everybody is different. These figures are average, just to give you the general idea.
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15 May 09 WHY YOU ARE THE BEST PERSON TO MAKE DECISIONS ABOUT YOUR OWN TREATMENT – IMPORTANCE OF THINGS
However good and caring your practitioner is, he or she can only consider the medical side of things when recommending treatment. You are the only person who can combine the facts about possible treatments with your own ‘inside’ knowledge in order to arrive at the best decision for you. You know whether it is important for you to live as long as possible whatever the cost. You know how important the changes in lifestyle likely to result from your disease or treatment are to you. You know how important your body image is to you and what things about it are most important for you. Provided you can get the necessary ‘outside’ information, this all makes you, without question, the best person to make the decisions.
I’ll just mention one thing that makes these decisions difficult for anyone, not just for you. Nobody can look into the future and predict definitely what will happen to you, as an individual, if you take a particular course of action. Your practitioner should be able to tell you what is average or likely, what is possible but unlikely and what is so unlikely as to be a miracle if it happens. To start with you should base your decision on what is likely. All patients hope they’ll be the exception—the one who makes a miraculous recovery. By all means keep hoping for this, but base your decisions realistically on what is likely or average. Say your practitioner tells you that one in ten patients get a remission on a particular treatment— that means that nine in ten patients do not. If you have this treatment, you are not likely to get a remission.
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23 Apr 09 CANCER: COLORECTAL CONCERNS
No site is very pleasing for a tumor, but the notion of a cancer taking up residence in your bowel is extra queasy. Why, of all places, is it there?
For one thing, this is a place with a high cell turnover rate, so the likelihood of cancer developing is increased. Another reason is that the colon is full of bacteria that produce carcinogens. Cancers in either of those two bowel parts are usually lumped into the “colorectal” category. About 54,900 deaths from colorectal cancer were predicted for 1997, about 10 percent of all cancer deaths.
But actually, people are getting less colorectal cancer these days. The total incidences dropped from about 149,000 new cases in 1994 to an estimated 131,200 cases in 1997. This may be due to adopting healthier lifestyles, says Dr. Wurzelmann.
Early detection and removal of precancerous polyps are also likely playing a role. “I’m not seeing the big, bulky, extensive cancers that I used to 15 or 20 years ago,” and the reason is early detection, says Bruce Wolff, M.D., professor of surgery at the Mayo Clinic and Mayo Foundation in Rochester, Minnesota, and a member of the American Society of Colon and Rectal Surgeons.
If you want to increase your odds that there won’t be anything to detect-early or later-doctors recommend taking these steps.
Ask for aspirin. Popping a baby aspirin once a day seems to help with a lot of things, including colorectal cancer. According to Dr. Wurzelmann, aspirin increases the rate at which cancer cells kill themselves off. Some doctors are reasonably concerned about stomach bleeding or discomfort from daily aspirin doses. But, says Dr. Wurzelmann, “if you can tolerate aspirin, it may be a reasonable way to prevent cancer. Further research is needed, however, before final recommendations can be made.” Check with your doctor before you start popping aspirin.
Cool it with the booze. Heavy drinking has been connected with esophageal cancer, but it also increases the likelihood of the polyps that are precursors to colorectal cancer. “People who drink a lot can get more polyps,” Dr. Wurzelmann says. “Several different studies support that connection.”
Bulk up with fiber. The verdict is in on high-fiber diets, and it’s a good one for colorectal cancer prevention. Canadian researchers, looking at 13 studies involving more than 15,000 people, found that adding 13 grams of fiber a day to your diet could reduce your risk by 31 percent. The National Cancer Institute suggests that you increase your fiber intake to between 20 and 30 grams a day.
Embrace brassicas. For colorectal cancer, there is convincing proof that vegetables decrease risk. It’s a kid’s nightmare. Eat lots of different vegetables but be sure to include broccoli, Brussels sprouts, cabbage, and cauliflower. All are members of the brassica vegetable family, and they could be a grown-up guy’s salvation. They contain chemicals that appear to reduce the risk of colorectal cancer. “Eat as much as you can enjoy,” suggests Dr. Wurzelmann.
Do calisthenics for your colon. One of the more proven ways to reduce colon cancer is to get moving. No, not that kind of moving. We’re talking physical activity here-exercise. The Centers for Disease Control and Prevention and the American College of Sports Medicine recommend 30 minutes of moderate exercise daily. Even if that exercise is divided into 10-minute segments, it’s enough to reduce the risk of colon cancer.
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23 Apr 09 BREAST CANCER: INVESTIGATIONS AND DIAGNOSIS
Asking questions
Always ask questions if you are unsure about anything. Never feel embarrassed or foolish, and never go away not having understood something; it will only cause you to worry. Almost all your questions can be easily answered with simple explanations, but if answers are not known, your doctor should be able to discuss with you the reasons.
People tend to forget what they had wanted to ask until they are at home again. It may therefore be a good idea to write your questions down as you think of them, and be prepared with a list next time you talk to your doctor. Uncertainty and confusion cause anxiety which, in most cases, is unfounded, and any good doctor will be happy to answer all your questions, no matter how trivial you think they may seem.
Being told you have breast cancer
Do not be afraid to speak frankly to your doctor. Some doctors avoid mentioning the word ‘cancer’, and feel the need to shield patients from any unpleasant truths. Some will not tell you unless you ask, believing that you would ask if you wanted to know. Most breast care nurses have experience of women who, having been told their diagnosis by the specialist, express relief at discovering that they have a ‘tumour’, and not cancer. Although a tumour is strictly any abnormal swelling, some doctors use the word when they actually mean a malignant tumour -a cancer.
If you are anxious about a lump or do not understand what you are being told about it, it is best to be frank: ‘Is it cancer, doctor?’ should elicit a direct and truthful answer, although it is a question many people will find difficult to ask.
Women who have been told that they have breast cancer will need – and should expect – to talk to a breast care nurse. Coming to terms with this disease is easier if you are given accurate information by a sympathetic, informed professional.
Help and counseling for women with breast cancer and for their families are also available from a variety of organizations. The breast care nurse, your GP or consultant will be able to give you information about these services.
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