CANCER – Part IX
Challenges facing Cancer Survivors
Now that you know most cancers are treatable and even curable, the general advice to cancer survivors is “prepare to live the rest of your life.” Many cancer centers have a ritual of celebration when a patient has finished their primary therapies and the cancer is controlled. However, the transition from the end of treatment to the next phase in life and future itself does present a few challenges.
The story of Tom, one of my patients, is noteworthy. At the age of 52, he presented with a little hip and thigh pain that turned out to be from “osteogenic sarcoma,” a serious type of bone cancer. After extensive surgery followed by adjuvant therapy at Moffit Cancer Center and subsequent rehabilitation stretching over a few months, he came to my office in a wheelchair with a prosthetic leg. “I am cured of cancer now but I have to wear this long prosthetic leg for the rest of my life. My wife drove me here today,” he said. Over the next year, he learned to walk normally with his heavy prosthesis and even drive his car. In other words, he had fully adjusted to his new life as a cancer survivor. He reorganized his job too – from a travelling insurance salesman to an office-based manager, so he can settle down and work in one place
An essential prerequisite for a good, happy life after cancer is to take charge of all your affairs and bring a sense of control in life. You will do everything to lead a healthy life and not become obsessed with recurrence. According to Richard C Frank, M.D., a renowned cancer specialist and author, “The five major elements of preventing cancer and surviving the disease are to remember, ‘Survival is spelled LMNOP’.” Here is what it means.
- L is for low fat diet: As I have mentioned before, many diseases, including heart disease and cancer, tend to occur in those who consume a high-fat diet that often leads to obesity, a causative factor in cancer. Saturated fat in your diet, especially red meat, is one culprit.
- M is for more fruits and vegetables. They are a good source of vitamins like vitamin C and folates, minerals like potassium and a rich source of fiber that helps to maintain the health of your gut and prevent constipation. It also reduces the risk of bowel cancer. (M, in my lingo, is also for Meditation that can help lessen your, pain, anxiety, depression, fatigue and insomnia, all too common in cancer patients.)
- N is for ‘No Smoking.’ You already know ‘tobacco abuse in any form’ is a leading cause of cancer and stopping this bad habit will reduce the incidence of cancer significantly. Smoking can cause cancer in any part of the body -- not only the lungs but other organs like throat, stomach, urinary bladder, etc. can also be affected.
- O is for organizing your life: Choose your oncologist and cancer center that you like and can relate to. Your oncologist will be your trusted adviser and help make important decisions. And chose a cancer center closer to home. If necessary, get a second opinion, especially if you have a complicated cancer, so you won’t have any cause for repentance. Prepare a living will and trust ahead of time. Organize a support system: you will need a few close friends and relatives to help you with your household chores, transportation, shopping, etc. Organize your finances so you don’t run out of money. And finally, learn time management skills – you need ample time for running around to doctor’s offices, hospitals and labs in addition to your personal needs.
- P is for physical exercise. Yes, you may be tired and drained after a session of chemotherapy or recent hospitalization but do what you can to keep the body moving. Simple walking is one of the best forms of exercise but you can do stationary bicycle, gentle swimming, etc. if you feel up to it.
Ultimately, you need to learn to live with the cancer diagnosis, manage the recurrences without despair and keep a positive outlook in everything you do. Even if you don’t get a total cure, you can convert it into a chronic disease like coronary heart disease or chronic bronchitis that can be kept under control with medications. Consider each day is a gift and live to the fullest extent.
Ref: Richard C. Frank, MD: Fighting Cancer with Knowledge and Hope (Yale University Press) 2013
To be continued …
M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. For further reading, “Second Chance - A Sister’s Act of Love” by Dr. Nathan from Outskirts Press, can be found at www.amazon.com
Very Nearsighted? Thin Corneas? Dry Eyes? No Problem
The Food and Drug Administration has approved a new technology called EVO ICL to help patients with extreme nearsightedness, dry eyes and thin corneas to see without glasses and contact lenses.
Among the first in the world, I have been involved with ICL technology since early 1990s when it was designed by a Russian company. It caused a paradigm shift in eye surgery by helping people with extreme glasses prescriptions see without glasses/lenses. We had shared our experience with different varieties of these Phakic implants (lens implants that are placed in the eye while you still have your natural crystalline lens) produced and invented in different parts of the world like the French “Domilens,” Japanese “Momose” Lens and Dutch “Worst” Lens.
The original Phakic implant underwent numerous advances over decades to become successful as the FDA approved, Vision ICL (Implantable Collamer Lens) for nearsighted patients who are not candidates for Lasik surgery. This technology did involve the need to make an opening in the patient’s iris (laser or surgical) for safety and prevention of induced glaucoma. The recent FDA nod allows for this already successful ICL technology that does not need that uncomfortable procedure so patients can enjoy vision with least intrusion.
Like a miniature contact lens, it is surgically implanted into the eye to correct the nearsighted vision and even astigmatism and you won’t feel it or need to maintain/clean once it is in the eye. The surgery is brief (minutes) and performed with just numbing drops and no stitches and permanently eliminates the need for patients to remove or replace lenses every day.
The material this ICL is made of is Collamer, which contains collagen that is biocompatible with the eye (and hence not rejected inside the eye) and provides exceptional quality of vision. That’s because it is placed close to the nodal point of the eye’s refractive system, which sometimes even provides vision better than patient’s glasses or contact lenses.
As long as you are more than 21 years of age and stable in refraction and your natural lens is clear (not a cataract) and have had no history of diseases such as glaucoma, iritis or diabetic retinopathy or any severe anatomical dysfunction, you could be a candidate.
If you have the following conditions that prevent you from being a candidate for Lasik eye surgery, ICL technology is ideal for extreme and even normal nearsightedness:
High nearsightedness: Since there is a limit to how much tissue can be removed during Lasik surgery, the ICL safely corrects all the nearsightedness and even associated astigmatism.
Thin corneas: The front clear, viewfinder of your eyes that Lasik surgery is performed on is completely bypassed since the ICL technology is placed inside the eye.
Dry eyes: Since there is no cutting of a corneal layer or disturbance of the nasociliary nerves, the ICL is ideal for patients with dry eyes.
Besides the straightforward nearsighted cases, I have even combined ICL with Lasik surgery in extreme cases, and additionally, used it in certain Keratoconus cases as an off-label indication.
Though safety and efficacy of this technology has been documented by over a million cases outside of USA before FDA approval, there can be side effects in some cases like glaucoma, inflammation or residual astigmatism. These can be treated successfully and ICL even removed as a reversible option, if needed.
One more important factor to understand is that as you age and develop a cataract (previous Khaasbaat article), ICL technology can be easily taken out during cataract surgery. You can then proceed with premium lens implants in most cases to enjoy vision without glasses permanently.
Find out if you are candidate for the new EVO ICL technology and have a no-maintenance contact lens inside your eyes.