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CANCER AND THE HOLIDAYS

It’s hard to have cancer at the holidays. If you’re undergoing active treatment, sometimes the side effects are overwhelming. If your cancer has spread, you may be limited in energy and emotional strength. How do you face the holidays with cancer?

One thing I learned as a caregiver for someone with cancer is that you must, as a family, be flexible. Some things are what they are. If you try to continue with family traditions, as if nothing has changed, you’re likely to find your plans sadly undermined by reality. There’s nothing worse than having your loved one feel more miserable because he or she can’t enjoy the gathering.

You need to make an honest assessment of your loved one before you do any planning for the holidays. First, what is your loved one’s energy level and what affects it? If he or she is having treatments, when do the side effects kick in? You may find that if you’re planning a gathering and it’s the day that your loved one is most likely to be affected by treatment side effects, you’re going to cause more problems than you solve.

Sometimes changing the date of the gathering is more important than having it on the actual holiday. If you’re used to celebrating on Christmas Day, but you know your loved one is going to be wiped out because of chemo, celebrate on Christmas Eve or Boxing Day this year instead.

If your loved one’s energy is lower because he or she isn’t functioning as well as past years, it’s important to take this into consideration while making plans. Maybe what you really need to do is scale back the festivities this year. Make the celebration easier all around.

If you’re hosting the party, keep the menu simple, but tasty. It’s sometimes easier for your loved one to have a shorter family visit. Have the food ready to heat. If folks are used to coming at three, ask them to come at four-thirty. This gives your loved one a chance to rest before guests arrive. Instead of having lots of hors doeuvres, offer one or two choices and serve dinner twenty minutes later. Put the coffee in a thermal carafe or two, and keep your desserts uncomplicated.This way, your loved one doesn’t have to dread the holidays. It’s easier to be “up” for a party lasting two hours than one lasting four, if you have limited energy.

It’s important that family members are supportive of the game plan and that they understand the need to shorten the festivities. You’ll be amazed at how much fun you can pack into a couple of hours when you eliminate the complications.

If you’re going to a family gathering, make an effort to gently explain the needs of your loved one and work with your hosts to find ways that will allow your loved one to enjoy the party without being physically or emotionally overwhelmed. Maybe the other guests can arrive at the normal time, but you and your loved one can arrive twenty minutes before dinner is served. Sometimes having the opportunity to skip some of the party means your loved one has enough energy to enjoy the important part of the occasion.

You may, however, come upon a brick wall with a relative who doesn’t want to be flexible. Some people insist on following traditions, regardless of the needs of your loved one. In that case, you may have to explain that you just can’t do things as you would in a “normal” year.

If the big party is too much for your loved one to handle, why not ask people to stop by for dessert and coffee with you and your loved one? By arranging for the group to come to your home after the dinner, your loved one still has the chance to socialize. Let’s be honest. Dessert is usually the best part of dinner anyway, isn’t it?

The important thing you need to always remember is that cancer patients don’t want to be treated like the skunks at the party. They may need to rest more, they may not be able to cope with holiday stress as easily as they might have before cancer, but that doesn’t mean they shouldn’t be part of the party. Find ways to empower them to enjoy themselves — leave the cancer behind for a few hours and just have a good time. 

A WORD OF CAUTION — IF YOUR LOVED ONE IS VULNERABLE BECAUSE OF IMMUNITY ISSUES OR LOW BLOOD COUNTS, YOU MAY NEED TO PUT PLANS ON HOLD FOR THE HOLIDAYS, ESPECIALLY IF FAMILY MEMBERS HAVE COLDS OR EXPOSURE TO THE FLU. ALWAYS CHECK AHEAD OF TIME.

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The Practical Caregiver — Cancer: IS “THE JOURNEY FORWARD” PROGRAM FOR CANCER PATIEN…

The Practical Caregiver — Cancer: IS “THE JOURNEY FORWARD” PROGRAM FOR CANCER PATIEN…: “I saw an ad in today’s New York Times for a program that is aimed at helping cancer patients after they finish active treatment. It’s called…”

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IS “THE JOURNEY FORWARD” PROGRAM FOR CANCER PATIENTS A LIFE SAVER?

I saw an ad in today’s New York Times for a program that is aimed at helping cancer patients after they finish active treatment. It’s called “Journey Forward”, part of the Wellpoint effort to improve health care for cancer survivors. Teaming with UCLA Cancer Survivorship Center, the National Coalition for Cancer Survivorship, and Genentech, they created a program that expects to improve coordination and communication between cancer patients and their oncology and primary care physicians.

The program provides tools to help patients to have the important discussions with their medical team on what steps can be taken by patients to manage the physical and emotional issues that arise for cancer survivors:

http://journeyforward.org

The goal of the program is to “…Prevent recurrent and new cancers as well as other late effects; Intervene for symptoms that result from cancer and its treatment; Coordinate the work of specialists and primary care physicians to ensure that all of a Survivor’s health needs are met.”

This means that each cancer patient will have a Survivorship Care Plan, and that will allow them to know they will continue to receive the same level of care even after active treatment of their cancer ends. Journey Forward promises to provide a bridge of care to help cancer survivors know what to expect for their future.

Components of the program include a survivorship tool kit, a medical history builder, a resources directory, and tips on talking to your doctor. This can help tremendously in understanding not only how cancer affects you, but what you can expect when active cancer treatment ends, and you’re no longer making the trips to the center.  

On the surface, it sounds like  a great idea. How many cancer patients end active treatment and then feel like they are left dangling off of a cliff, unable to climb up or safely get down? With a plan in place, with information on what to expect and signs that are critical to monitor, won’t this be a benefit to cancer survivors? There is surely nothing as frustrating as trying to figure out how to get back to living after cancer treatment. In the back of one’s mind is always the fear that cancer will return, maybe in a different location. This program appears to tackle that issue, by offering a way to coordinate not only with the oncology team, but also with the primary care physicians.

The question is how will cancer patients view this program? Would it be helpful, after you are discharged from active cancer treatment, to know that your primary care physician will participate in your care and will be part of the team that supports you? I wonder how many cancer patients hesitate to call their oncology team when they notice a little symptom pop up here and there. Would it be less terrifying to call your primary care physician for a check-up?

For many cancer patients, there are long-term side effects from treatment, and some can linger for a long time, affecting one’s quality of life as much as the cancer itself. Wouldn’t it be wonderful to have a plan on how to address these issues and help you get on with your life?

The real test of the program will be in its beneficial results for cancer survivors. As more and more patients get involved and they begin to utilize the tools, it will become obvious whether the program offers a real opportunity for cancer survivors. My hope is that it is so well-planned and so careful about the little details of cancer management that it saves lives. The sooner cancer survivors notice what isn’t right and get treated, the better. What good is surviving cancer if your quality of life isn’t improved by the treatment? I hope this program does that.

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TUMOR –TRYING NOT TO THINK ABOUT IT



“Now THAT’S a growth!”

 How can you not think about a tumor that is growing inside you when you’ve been diagnosed with cancer?

My mother faced this problem. Her tumor interfered with her ability to swallow food and even to breathe comfortably. For her, that tumor was a huge problem. Would it grow larger? Would it take over?

It’s hard to tell yourself not to think about it, isn’t it? After all, you know it’s there. The scans confirm it. You’ve probably been tested for it. How do you cope with the reality that there is a growth inside you?

Sometimes the best way to cope with a situation is to meet it head-on. Information can be a lifesaver. When my mother found out she had this tumor, she also found out what treatment could do to it. Radiation made a difference. Chemotherapy made a difference. We made a point of asking a lot of questions. We wanted to know what her best options were. Slowly, but surely, she began to feel better as her cancer treatment kicked in. When she started, she needed oxygen round the clock, to help her breathe. But as the tumor began to shrink, she could leave that tank behind. She was able to resume a more normal life and do many of the things she loved to do.

It’s hard to cope with your fear about a tumor. Some people may tell you to put it aside, not think about it, or even let it go. But sometimes confronting that fear can be helpful. When you understand what the goals of your cancer treatment are, when you communicate effectively with your oncology team, you have a better understanding of how that tumor will affect your life. Much of the time, there will still be unknown factors. Will you have weeks, months, or years? Can the tumor be kept in check? And if it does grow, how will the oncology team continue to help you?

Every day, there are new ways of attacking cancer. Over the years, I’ve met people who have survived for decades with different forms of the disease. I’ve even met several Stage 4 patients, alive and kicking, despite receiving a terminal diagnosis years earlier. The truth is everyone is different. The more you understand about your own situation, the better. Sometimes the hardest thing about having a tumor isn’t the tumor, but the fear of the tumor and what it means for your life.

As for that tree, I’ve watched it for several years now. It continues to survive, despite that enormous growth. I am always amazed that it is still there when I come upon it during a hike. I expect it to die, but it doesn’t. In the spring, the leaves still come out. In the summer, I am still shaded by its canopy. In the fall, it still sheds its leaves like all of the other trees in the forest. Somehow, it goes on. Maybe you will, too. Be hopeful. Fight hard. Embrace life. With cancer, it’s important to see the forest AND the trees.

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CANCER TAUGHT ME TO “ENJOY THE PARTY”

We don’t always think of cancer as being a teacher, but it taught me some important lessons. One of the biggest was that it’s important to “enjoy the party”.

For many years, I spent a lot of time in the kitchen at the holidays. Coming from a family of non-cooks, I was the one in the kitchen with my mother, fixing the feast for the holidays. Even my mother wasn’t a big fan of cooking, although she was good at it. Usually, she would bake her pies the day before, and then get up early in the morning, to start the turkey. I often filled in with the rest of the dishes, with relatives contributing their specialities.

Over the years,  I cared for her when her health began to fail. She still wanted to participate in the cooking process, but her energy was limited. That’s when I became her sous chef, chopping and slicing, so that she could do the actual cooking. It was important for her to feel that she was making a meaningful contribution to the gatherings.

But when she was diagnosed with lung cancer, everything changed. She was too fatigued from chemotherapy to stand in the kitchen, cooking for hours. Neuropathy robbed her of the use of her hands and feet. It’s hard to cook when your fingers can’t even do simple things, like button your own shirt or tie your own shoes.

And yet, my mother was still determined that we would entertain the family. There was nothing she loved more than a big gathering with lots of laughter. I learned to get the meal together in stages, so that most of it could be re-heated when the guests arrived.

As time went on, I continued to sharpen my organizational skills, trying to find ways to make my life easier. After all, my mother was still going for treatments and medical appointments, and that meant we spent a lot of time at the hospital and in doctors’ offices. I didn’t have a lot of time to fuss with food.

But more than that, I learned over time that it wasn’t so much the food that made the party. It was the people. Without family and friends gathering to share, a meal is just a meal. With the people you love all around you, there is laughter and love.

This year, Thanksgiving is going to be less complicated. I’ve got my pie crusts thawing in the refrigerator, ready to become apple pie when I chop my apples tomorrow. I made them in the Cuisinart earlier this week, with Julia Child’s food processor recipe. My corn muffins are in the freezer, baked fresh last week. I made a double batch of cheese sauce, used half for tomorrow’s cheddar broccoli and the other half for tonight’s macaroni and cheese. I cooked the turkey today, so it can be sliced up, piled on the big casserole dish of stuffing I will make tonight, and moistened with the canned gravy I bought to save myself some time. Tomorrow, I will try my first pumpkin souffle, as a side dish. One of the guests is bringing a wonderful cranberry-walnut tossed salad with gorgonzola. I’ll slice some cheddar cheese and make a platter with whole wheat crackers and red seedless grapes. If I have the time, I might even make a dip to serve with carrot and celery sticks. But one thing I’m not going to do is stay in the kitchen tomorrow.

Cancer is a big disease and the lessons it teaches us are big, as well. Tomorrow, I will join the party. I will listen to the stories, share the laughs, and be a part of the moment. I will appreciate the opportunity because time is promised to no one, and I know now that I should not wait until the next party to get out of the kitchen. We have to seize the day and embrace it. In the end, it’s not the little things that really matter. It’s the life you have. Make the most of it. Enjoy the party.

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CANCER IS LIKE AN AUTUMN HIKE

You’re probably wondering how in the world I can compare cancer to an autumn hike.
I’m not talking about the early autumn days, when the leaves are still on the trees and everything is painted in glorious color. I’m talking about the later days, when the leaves have fallen upon the trail, and when you look around you, the trees are bare.
This is the time of the year when footing is precarious. You never know what lies beneath the leaves, but every step of the way brings the crunching sound of your boots on the ground. Sometimes you slip, lose your balance, and start to slide.

It’s the time of year when the trail disappears under the vast sameness of the ground cover, and you have to rely on your keen eye to find the subtle dips and rises of the ground to guide you.

I go hiking with my little Yorkie friend. Any other time of the year, she is scampering through the woods, bold and curious. She climbs boulders and hops right over big logs across the trail. She feels confident in the woods, exploring every nook and cranny and hole. But in the fall, she has trouble moving through all those dead leaves. Even she doesn’t know what lies under them, and sometimes she falls over tree limbs and rocks. She becomes timid. The crackle of the leaves must be deafening to her.

With cancer, you never really know what lies beneath the surface. You hope for the best, but sometimes you can stumble over the unseen obstacles. It’s hard to know what to do and where to go, because when you look out on the horizon, all you can think about is that cancer. You sometimes wait for it to crop up unexpectedly. And it’s so hard to think straight, until you know that it is in remission.

And that’s why cancer is like an autumn hike. You go slowly. You study the terrain. You look for the clues to point you in the right direction. You try to find your way using all of your senses.

But there are also trade-offs to being on the trail in the fall. This is the time of year there is more sky above you. You can see further, because the trees are bare, so you get a broader view. In the vast sameness of the woods, where all you see are dead leaves on the ground and bare trees, you can also begin to see other things when you look. The treasures of the forest begin to reveal themselves to you. There might be a small grove of new pines emerging, or an unusual mushroom with a crooked cap on its head. You might discover, as I did today, the remnants of an old stone wall, from a couple hundred years ago, half-buried on the wooded hillside. It could even be something as simple as an aerial dance performed by winged insects, caught in a sunbeam. These things only appear when you look for them. Sometimes you have to force yourself to find the beauty in the never-ending brown landscape of fallen leaves.

To a hiker, the forest is never the same experience twice. Every hike looks and feels different. Things change, sometimes evolving over time. But you come to rely on your senses to help you navigate the unseen and unexpected. You train yourself to look for the pleasant surprises along the way. Let cancer be more than just a disease that affects your life. Let it be an opportunity of which you take charge. You may not be able to change the season of your life, but you can choose what you discover within it. Find the treasures that life offers along the way. Appreciate the goodness you stumble upon. Celebrate the love that shows itself. These are the things that really matter most.

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BATTLE FATIGUE FOR CANCER PATIENTS

I was having a conversation recently with a couple of baby-boomers who had been walloped by the economic crisis that is squeezing the middle class. After a sustained unemployment situation challenged their savings, they were starting to get back on their financial feet, but it will be a long struggle for them to regain economic stability. With new income going out to pay financial obligations as soon as it arrives, it’s hard to feel like there is much reason to carry on. Add to this some other stressful changes in their lives, with the death of a loved one and an empty nest as their child entered college, and they are right smack dab in the middle of a psychological obstacle course.

How does this apply to cancer treatment? The subject arose as to what they would do if either developed a serious illness. The feeling was that they wouldn’t bother to take extreme measures to treat the illness, because who wants to live a long life if it means suffering?

In reality, this couple is suffering from what amounts to battle fatigue. People who face prolonged struggles often come to have this kind of mindset. When it occurs during treatment for a manageable disease, it can imperil the outcome.

Sometimes patients who have been treated for cancer more than once come to feel that it’s not worth the effort. Or that they are burdening their families by seeking treatment for a recurring disease. When this kind of situation arises, it’s important that caregivers appreciate what is really happening and why.

If your loved one seems reluctant to seek treatment, perhaps the biggest problem isn’t the cancer itself, but the battle fatigue that accompanies it. What are the chances that your loved one can get past the obstacles and go on to live comfortably with the disease under control for several more years? Is there a reasonable expectation that the cancer can be brought into remission with treatment?

Sometimes the hardest job for a caregiver is to understand the real prognosis for the disease. When people talk about quality-of-life care, some will avoid it until the last minute, because they hope desperately for a cure. They’re willing to fight the fight and take on all the discomfort that goes with that. Some of these people would benefit from understanding the reality of their prognosis, that end-of-life care can be a better option. Sometimes people need to live their lives more than they need to pursue the potential brass ring. But other people sometimes opt for surrender long before that may actually be the best option. If a disease is manageable and the quality of life can be good with treatment, people need to understand that a negative mental attitude can prevent them from pursuing viable opportunities. If there is battle fatigue, patients often won’t see the potential for a future. If they are scared from their emotional and physical battles, they will think it isn’t worth fighting anymore.

Cancer treatment is always more than just surgery, radiation, and chemotherapy. It’s about helping the patient and the family understand that there are so many details in treating the disease.

Every combat veteran on the battle field dreams of the day he or she can go home again, to live in peace and leave the war behind. Your loved one is really no different. Cancer is an enemy that wages war with a ferocity that can intimidate. Help your loved one to recognize the realistic opportunity to survive. Keep the home fires burning. Work on the morale of your loved one. That what real support is all about.

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LOSING INDEPENDENCE DURING CANCER TREATMENT

My mother lost her confidence in herself when she was on chemo, and with good reason. She was weak and had great difficulty just walking any distance. But she wanted to drive her car again. She was extremely frustrated that the doctor suggested she practice off-road first, to make sure she would have the strength to stop the car suddenly and to make sure she had enough concentration to keep her attention on the road. One day, I took her out driving. It was a disaster. She had no idea where she was. Her rhythm was off. It was like watching a movie in slow motion. She was close to tears when she accidentally scraped the car mirror on the side of a building. For me, it was rather like taking a teenager out for driving lessons. I had held my breath several times as we came perilously close to objects. The truth was she was in no condition to drive, and it had little to do with her age. It was all about the chemo and its effects on her nervous system.
If your loved one is going through chemotherapy, it’s important to be sure that he or she is capable of doing tasks like driving. The last thing you want to do is send someone on the road who poses a risk to the public. Having to tell your loved one that he or she shouldn’t drive is tough. There’s no real upside to losing your independence, even if it’s for a couple of months. Suddenly, you go from being an adult with a life and the capacity of making decisions for yourself, to someone who requires transportation wherever you go and you are forced to rely on the kindness of the people who love you, without really being able to give back. That little imbalance creates a real sadness in a lot of people, and rightly so. Imagine being too weak to do your normal activities, and now suddenly, you actually are dependent on people for everyday needs. For some people, chemotherapy isn’t this devastating. They manage to function quite well while chemotherapy drugs are coursing through their systems. They continue to work, exercise, and drive without problems. Others are totally knocked off their feet.  For most people, though, the effects are somewhere in between. Different chemotherapy drugs have different side effects. But they all have one thing in common. They are designed to affect the cancer. It’s difficult for your loved one to keep that in perspective when it means giving up his or her independence. Your job, as caregiver, is to help balance that sense of loss.
How do you do that in a reasonable way? If your loved one has the energy and the inclination to get out and about, but can’t drive, the solution is simple. You can drive your loved one or arrange for family and friends to do the driving. But if you want your loved one to feel less guilty and more relaxed about his or her dependence, make it a social event. Don’t make it seem like it’s a chore for you.
I learned this the hard way. Sometimes, when my mother was most frustrated, she would pick a time when I had already made plans to do something, and then she would announce she wanted to go out. Part of this was the self-pity she felt. She was mourning what she couldn’t have — the independence to pop out to the store when she wanted to go. But it was inevitably when I was on my way out the door to do something I needed to do for myself. Sometimes, I would offer to take her where she wanted to go hours before I had to be somewhere. And inevitably, she would be late. I would feel myself getting frustrated because it was going to ruin my plans. It took me a while to realize that it was her way of feeling some power, albeit at my expense. That’s when I realized that I had to do what I had to do, but I could adjust my plans to times when I knew she wouldn’t be able to stop me.
My mother was not a morning person, especially during chemotherapy, and I learned that if I made my plans during the hours she was too fatigued to want to get out and about, I could have my own life and still meet her needs. She seemed to come alive from 11 AM to about 3 PM, but after that, she needed a nap, especially if she had been very active during the day. That window of opportunity kept me sane. I made it to my own medical and dental appointments, got to the gym for my daily workouts, and took the dog for her walks, all while keeping my mother as active and social as possible. I also did my best to help her channel her energy in more positive ways, to help her feel more in control of her life, so that she didn’t try to regain her sense of power by thwarting me.
When people are under great stress, they will say and do things that are counterproductive. As a caregiver, you have the responsibility to be the voice of reason, and that requires that you exercise your mental facilities to figure out what that is. Sometimes it’s hard to know where the frustration is coming from and what the solution to the problem is. Imagine what that’s like for someone on chemotherapy, with your nervous system under attack as the drugs flow through your body in search of cancer cells. Your body is going through changes that don’t necessarily feel good to you, and you’re expected to endure these side effects without falling apart physically. What about your emotional well being? What about how you feel?
That’s the problem with chemotherapy. It affects your body in ways that can be confusing and upsetting, and when your body feels like its been turned upside down, your emotions can run rampant, all while you don’t necessarily have the capacity to understand what ails you. Many people vent their frustrations on the people taking care of them. At times like these, it’s a good idea to develop a thick skin, bite your tongue, and recognize what you’re seeing in your loved one.  You have to stand up for yourself in an appropriate manner, so the relationship can regain a more natural balance, but you have to choose your words carefully and appeal to the goodness in your loved one. No decent person enjoys losing emotional control of himself or herself, and when it’s compounded by a loss of physical control, it’s even scarier. That fear can add to the confusion of the situation. But if you recognize it for what it is, you can help your loved one avoid bad behavior that is driven by fear and frustration.
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SAVING MONEY DURING CANCER TREATMENT

A number of families find their expenses go up significantly when a loved one is undergoing cancer treatment. Obviously, there are prescription drug costs, in addition to bills for medical treatments, and a lot of these aren’t always covered by insurance. But there are also often a lot of out-of-pocket expenses. These can wreak havoc with family budgets. How can caregivers manage these changes?

I noticed a big change in the family grocery bills when my mother was having cancer treatments. Why? Because a number of her medications had severe side effects that required buying over-the-counter remedies to treat them. Prescription drugs like Prednisone, which help with related breathing issues, require an over-the-counter drug like Prilosec to address the negative side effects, such as acid reflux disease.  Some drugs cause side effects like constipation, so the use of laxatives and fiber may be directed by the physicians. Every cancer patient’s needs will be different, according to his or her situation, but one thing is certain. There will be an increase in spending, to accommodate these changes.

If you’re used to shopping at a traditional supermarket, you’re going to have to find ways to cover the added expenses that cancer treatment can bring. Plan the weekly grocery shopping carefully. Shop the weekly specials and buy in bulk if these are items the family usually uses. Clip coupons for more savings. A number of over-the-counter remedies can be bought at reduced prices, through manufacturer’s coupons and discounts or by purchasing them in larger quantities.

Consider joining a warehouse club, like Sam’s, B. J.’s, or Costco. Normal household items, like paper goods and laundry products, are expensive, and if you buy these at a warehouse club, you can cut your costs. It’s also true for fresh produce, dairy items, and prepared or frozen meals. This will save money for the overall family budget, but if you also purchase over-the-counter remedies in bulk, you can really cut down on costs.

If your loved one has lost a lot of weight and needs to have products like Boost or Ensure, you can save money at warehouse stores, or even at Walmart. My mother hated the cloying sweetness of nutritional supplements, so a nurse shared her recipe for protein shakes with me. The shakes gave my mother the extra calories and protein she needed, but tasted better to her, especially when I added ice cream to them. I bought the protein powder in big cans. At the supermarket, it was $22, but at Walmart, the same product was under $14. That’s a big savings when you’re mixing up shakes two or three times a day. I saved the nutritional supplement drinks for emergencies, and that worked out well. Sometimes you have to be creative in how you approach the situation, and you have to make it work for you.

It’s also helpful to realize early on that your loved one’s cancer treatment will have a cumulative effect on the family finances. If you can understand this, you can avoid some of the pitfalls that a number of families fall into at one point or another. Cancer treatment is expensive, and by conserving the financial resources of the family in little ways, you will be better able to meet the unexpected costs that crop up along the road. 

If your loved one did the “heavy lifting” for the household, mowing the lawn, raking the leaves, doing the garden, you may have to take over some of these responsibilities or temporarily hire someone to do it. If you live in an area of the country hit by rough wintry weather, you may find yourself shoveling snow, chopping ice, and sanding the driveway and sidewalks, or paying someone to do it for you. These bills can add up quickly, which is why it’s really helpful to conserve money where you can throughout the cancer treatment. 

What if you don’t actually need the money you’ve saved during cancer treatment? Why not use it to take a family trip? Reward yourself and your loved one by having some fun once your loved one gets through with chemotherapy, radiation, and surgery. Not only will you have a chance to make some happy memories, you won’t spend your time worrying about how you’re going to pay for it all.

And sometimes if your loved one knows there is a rainbow at the end of the storm, it makes it easier to get through it. Why not start planning for a celebration trip during your loved one’s treatment? You don’t have to dream big. Sometimes that can be overwhelming. But think about something that you’d both enjoy doing together. Maybe it’s a weekend at the shore, just enjoying quiet walks on the beach and family cookouts. Maybe it’s a few days with the kids at Disney World or Universal Studios. Maybe it’s a trip to the city, to see a musical, visit a special art exhibit, or enjoy a concert. Maybe it’s a cruise to the Caribbean or a trip to Bermuda. It’s a lot easier to pinch pennies when you have a positive goal, and your loved one will be able to appreciate your efforts if he or she thinks a trip is your main purpose in cutting expenses. Cancer patients often feel guilty that they are using up the family’s financial resources. By giving your loved one hope for the future and by protecting the family budget, you’re extending your care-giving above and beyond the physical needs of your loved one. You’re also taking care of the heart, the head, and the spirit. We all need to feel free to be more and experience more, but in order to do that, we have to appreciate how things can build up into problems if we don’t take preventative measures to prepare for the rainy days ahead. 

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HOW CAN CANCER PATIENTS STAY PRODUCTIVE IN THE WORK PLACE?

How many cancer patients waste their work expertise and experience during cancer treatment? How many are forced to quit their jobs as a result of being physically incapacitated? How can they be supported in the work place, so that cancer doesn’t take from them their livelihoods and their future opportunities?

Many people manage to get through cancer treatment while still working. They make arrangements and handle the rigors with grace. But there are others for whom the personal cost of cancer treatment is much more severe.

If your loved one is struggling with this issue, consider a few things before throwing in the towel. Analyze the strengths and talents he or she brings to the job. It may help provide opportunities to keep working during cancer treatment. Can his or her employer provide administrative duties that allow your loved one to be productive while still conserving energy? Can your loved one reasonably scale back some of the normal responsibilities of the job, just long enough to allow the cancer treatments to have a positive effect?

Consider the plight of a teacher who may be going through chemotherapy. How can a school system accommodate the issues he or she might have? We know that kids often are a breeding ground for germs, and a teacher under chemotherapy treatment, with a weak immune system, really shouldn’t be exposed to such risks. Is it possible for the school system to offer this teacher a temporary position, possibly as an educational coordinator, a developer of curriculum, or as a long-distance tutor? Maybe a teacher can teach home-bound students, via Skype or another Internet service. It not only cuts down on the risk of infection for the teacher, it provides a home-bound student with appropriate educational resources that might otherwise be missed. Having a teacher who is also a patient can be inspiring.

Sometimes it’s hard for patients in the service industry to continue working. Chefs and cooks need to be physically capable of moving about in order to perform their duties. Restaurant work can be demanding. In the interim, what about your loved one working as a personal chef? If you pitch in and help with the grocery shopping and driving duties, would this work?

Nurses and other professionals who are going through cancer treatment have a difficult time remaining on the job in their normal capacities, but certainly there are other opportunities within the medical field, even on a temporary basis. Maybe your loved one can scale back his or her work load to a half day until physically capable of resuming a regular shift.

What about cancer patients who serve in law enforcement? Can’t they also be accommodated in practical, useful ways by their employers? Certainly, it’s not wise to send a cop out on the street if he or she can’t run or keep up with the rest of the team, but there are always cases that could use another review by a seasoned investigator, who can pursue information that was never followed up, and even make phone calls to clarify cases. It’s certainly not ideal, but having the opportunity to remain on the job in some form is usually preferable to being cut loose. Maybe there is a law enforcement study that needs doing, or community services that can be improved. It’s important for cancer patients who are willing to work to be reasonably accommodated.

If your loved one has a job that allows for Internet communications, it may be possible for him or her to telecommute to work, handling a lot of the normal duties of the work place from home. Even if he or she needs to occasionally go to the office for important meetings, it makes it a lot less stressful if the bulk of the work can be done in between periods of rest. Salespeople, financial advisers, stockbrokers, and others can still function on the job, even if it’s in a more limited capacity. Sometimes it’s a matter of scaling back the number of clients who can be served, or joining with other colleagues to get the job done in the interim.

Real estate agents may feel they have few options while undergoing cancer treatment, but what about pairing with a partner during cancer treatments? If there is another agent who works part-time and is willing, why not share the load together? Maybe it’s a mom who wants to be home for her kids or a retired realtor who doesn’t want a full-time position. Your loved one could continue to work part-time, with a lot of the work done on the Internet. Having a partner could help make the sales.

It’s important for your loved one to feel like he or she is able to stay abreast of developments in the field. That means keeping one’s hand in the game somehow. By working part-time, even if it means job-sharing, it may allow your loved one to have a smoother transition back into the work force, when the cancer treatment is ended.

Another option is to take university classes for credit. There are a number of opportunities to pursue online education for people in many professions. Some employers would welcome the opportunity to allow cancer patients to use their down time to improve their professional skills. Some employers may even want to pay for these courses.

There are also times when employers appreciate creativity on the part of employees who show initiative. If your loved one has a special project he or she thinks will help the company or agency, why not encourage pursuit of this goal? Maybe your loved one had a great idea to try a new management training module, or wanted to develop a new client list. Now’s the time to offer it up. Or maybe your loved one has an idea for a new product or service. Why not use the time during cancer treatment to do the research and put together a package?

Just because your loved one is going through cancer treatment and finds it too overwhelming to work full-time, that doesn’t mean he or she has to retire or quit. Working is important to the psyche, and feeling like a contributing member of society is very important. Cancer patients just sometimes need support and accommodation to help them remain in the work place. Employers who recognize this and encourage it will often find that this is a win-win situation. Cancer patients are still living, breathing people with a lot to offer, and when they feel they have a future, they often will pour themselves into the opportunities they find.