Here are some common sense tips to consider when you or a loved one is diagnosed with cancer. These are just some suggestions and are no way meant to be a comprehensive or exhaustive list.

Being at Your Best When You Are at Your Worst

Consultations with doctors and other clinicians take on critical importance as you gather your facts to make informed treatment decisions. But, there is a problem. During these sessions people are stressed and emotional. Yet, it is at this very same time that you must be calm and decisive. You have to be at your best when you are feeling at your worst. These tips were designed to help.

Recording Consultations

When critical decisions are at stake, conversations with oncologists and other physicians take on enormous importance. In addition, sometimes these conversations take place when the doctor is very busy. Given the hurried bedside manner of some physicians and the emotional intensity for the patient and family, it can be very hard to listen, understand, and ask appropriate questions during these critical consultations. Tape recording important conversations with your doctor(s) about treatment options is an excellent way to provide a record so that you can: 1) concentrate on listening; 2) do not have to worry about taking notes; 3) can focus on your questions; 4) can share the conversation with a family member or friend who could not attend the consultation; 5) and can replay and review the conversation in a less stressful environment such as your own home to fully comprehend what was communicated. An added benefit is that recording the conversation can facilitate more time with the doctor. When the doctor knows that the conversation is being taped they may be more courteous, patient, and provide more information and options. Furthermore, it provides an advantage to both you and your doctors if there is ever a question later about what was or was not said.

You should not secretly tape record anyone. In many jurisdictions this is against the law. You should always obtain permission by asking everyone in attendance at the consultation that you want a tape recording of the meeting. In fact, it is always a good idea to use the first few seconds of the recording to have all the parties acknowledge on tape that the meeting is being recorded with their permission.

Questions During Treatment Consultations

Typically, during these consultations, the doctors control the conversation. They have participated in these meetings many times before. So, while it may only be the first or second time for you, it may be the thousandth time for the doctor. This means that doctors will typically share with you the information that they think, based on their experience, is important. The problem is that this may not be the information you want. Therefore, here are some basic questions to consider asking:

Pathology Second Opinions

The pathology of your tumor cells tells pathologists whether you actually have cancer and what kind. Having a second look/opinion by another pathologist from another hospital helps ensure that you have been properly diagnosed. There have been unfortunate situations when patients have been treated inappropriately because the wrong kind of cancer was diagnosed. In many hospitals it is standard practice to "send the slides out" for a second opinion. You may want to ask to ensure this step was taken in your case and find out who rendered the second opinion and what they concluded. Or, if this step was not taken, why the doctor thinks it is unnecessary.

Treatment Track Record

With any treatment, even a clinical trial, there is a track record. The only exception would be if you are the very first patient to be placed on this therapy. This is rarely the case, so there are records, data, and often published medical articles pertaining to the performance of nearly every therapy. This is information you may want to have and the following questions address this:

* How many patients have you treated with my exact same cancer? Were they the same age and in the same general state of health?

* Which treatments did you use?

* Did any patients have side-effects from the treatment? What were they? What was the worse side-effect? Did anyone die from the treatment, not the cancer? (Note: Some patients do not die from their cancer, but die from the treatment. You should ask questions to learn how toxic the therapy is.)

* What were the results for both survival and quality of life?

* Can you show me where the survival information comes from? Is it reported in the peer-reviewed published medical literature? Can you give me a copy of the article?

* Are any of the patients still alive? Can I speak with them? (Note: Other patients (like you) who have been administered the same therapy by the same oncologist(s) can provide valuable insight into what to expect.)

* Are these drugs FDA approved for treating my cancer? (Note: Many cancer drugs are not FDA- approved for the use for which they are prescribed. (This is called "off-label" use.) In fact, some drugs that are widely used for a particular cancer may never have been approved for safety or efficacy for that use by the FDA. It is valuable to know if any of the drugs the doctor intends to prescribe would be used "off label" and if so, why the doctor is comfortable with that use.)

Treatment Conflicts of Interest

Drug companies sometimes pay doctors a certain amount of money per patient for each patient placed on the drug company's clinical trial. In addition, some doctors are involved in oncology companies as owners or consultants. Furthermore, the chemotherapy concession allows oncologists to make profits on various chemo drugs they prescribe. For all of these reasons you may want to ask your doctor if they have any financial or research interest in the treatment they are recommending.

What is the Prognosis With No Treatment?

Comparisons are very seldom made between treated and untreated patients. When survival and quality of life comparisons are made, they are usually made between two or more treatments, not between patients who received a treatment like chemotherapy and patients who received no treatment at all. It is very difficult, therefore, for a doctor to objectively answer the question how long did the treated patients live and what was their quality of life compared to those who received no therapy. Nonetheless, if you are discussing a therapy that has serious side effects, it may be of interest to ask your doctor for a reference/study that discusses this. Be advised that such studies may not be available. In fact, we recently asked an Associate Professor of Clinical Epidemiology at Columbia University to suggest articles on this very topic. So far she has provided only one.

In conclusion, it is your body and your life. Don't be intimidated by the doctors. Get the answers you need to make an informed treatment decision.

Those long, dreary January days might do more than give you a case of the winter blues. New research finds that staying indoors too much might actually affect your risk of developing lung cancer.

Although cigarette smoking is by far the biggest cause of lung cancer, accounting for more than 85 percent of cases according to the National Cancer Institute, a lack of vitamin D might play a significant role in most of the remaining cases, says Cedric F. Garland, DPH, professor in the Department of Family and Preventive Medicine at the University of California, San Diego.

Dr. Garland and his colleagues recently looked at lung cancer incidence rates for 111 countries using a global cancer database. After controlling for cigarette smoking, they found that lung cancer incidence was higher in northern latitudes, and exposure to the sun's ultraviolet B (UVB) rays was associated with reduced rates of lung cancer in both men and women.

Cellular Glue

The majority of vitamin D in the body is produced when the skin is exposed to sunlight. Vitamin D affects cancer risk by regulating the secretion of a substance called e-cadherin, which is a sort of glue that causes cells to stick together, says Dr. Garland. "When cells are stuck tightly to one another, they inhibit one another's growth. This is called contact inhibition," he says.

Without adequate vitamin D, the cells start to separate, giving them room to reproduce. As they reproduce, the cells have to compete for limited resources. "Some cells divide faster than others. Those that divide fastest will eventually predominate as a crowded, disorganized mass of rapidly-dividing cells competing for nutrients and oxygen," Dr. Garland says. "The most aggressive cells overwhelm the more normal cells. The mass develops a blood supply and becomes a malignancy [cancer]."

This isn't the first study to find a connection between vitamin D and cancer. Previous research by Dr. Garland and his colleagues linked adequate vitamin D to reduced rates of colon, breast, kidney, ovarian, and endometrial cancers. Research also has found that vitamin D intake can improve survival rates in people who already have lung cancer.

Get Outside

The best way to ensure that you're getting enough vitamin D is to get outside in the sun for 10-15 minutes every day between the peak sun hours of 11 a.m. and 1 p.m., says Dr. Garland (African American people should stay out twice as long, because they only make one-fifth the amount of vitamin D as Caucasians).

Sounds easy, but there are a couple of catches: First, at least 40% of your body must be exposed to sunlight in order for it to be absorbed appropriately. That means you'd have to wear shorts and a t-shirt (or no shirt for men), which is difficult to do if it's 25 degrees in the middle of January.

You also can't wear sunscreen, because it will block your skin's ability to absorb sunlight. Considering that prolonged sun exposure can lead to skin cancer, Dr. Garland recommends always wearing a wide- brimmed hat when you're outside, and putting on sunscreen and protective clothing as soon as you've gotten your 15 minutes of unprotected sun exposure. "The sunscreen should have a protection factor of at least 15 in the ultraviolet A (UVA) part of the sun's spectrum, as well as the usual protection in the ultraviolet B spectrum," says Dr. Garland. "UVA is about 97% of solar ultraviolet, and blocking it after the short time spent making vitamin D daily is a key to preventing skin cancer. Clothing blocks UVA better than sunscreen."

If you live in a northern climate, or you have a history of skin cancer or sensitivity to the sun that would preclude you from getting outside, ask your doctor about taking a vitamin D supplement. Although research still needs to determine the optimal dose, 2,000 IU daily should give you what you need. Also add food sources of vitamin D, such as milk and yogurt, to your diet.

The best advice when it comes to lung cancer is to quit smoking. "But for non-smokers, vitamin D is the best thing they have. There isn't any other practical way to reduce risk of lung cancer in nonsmokers," Dr. Garland says.

Before embarking on any supplement, dietary, or solar health program you should consult with your professional clinician.

Source
Mohr SB, Garland CF, Gorham ED, Grant WB, Garland FC. Could ultraviolet B irradiance and vitamin D be associated with lower incidence rates of lung cancer? J Epidemiol Community Health, 2008;62:69-74.

People with cancer have been joining mycancerplace.com, the free cancer networking website, to begin friendships (some actually meeting each other in "real life,"), exchange treatment information, rally emotional support, and provide financial relief to those in need.

In fact, MyCancerPlace the "MySpace for cancer," has recently hit several impressive milestones. The site has had over 50,000 visitors from 46 different countries, over 200,000 visits, and over 6 million page views.

"It's a wonderful positive community where anyone dealing with cancer is invited to join," explains Michael Horwin, the manager of Cancer Monthly the organization that sponsors the site. "The website allows people to share information and resources which can be critical when making treatment decisions; and it gives people the chance to create friendships and network with others who are facing the same challenges. You are not alone anymore. Plus we don't accept advertising so you are not bombarded with ads."

Unlike the better known MySpace and Facebook, the members of MyCancerPlace are not just teenagers or 20 somethings. Members range in age from teenagers to adults over 70. "Because cancer strikes anyone of any age, we had to make sure our site was user friendly to everyone, regardless of computer experience. Most of our members are in their 40's to 60's, but we also have many over 70," Horwin explained.

Members of MyCancerPlace can do all of the things that one expects from a site like this - create a profile, write a blog, upload pictures, participate in forums and groups, post events, and invite others to join. "Thanks to this technology, nobody should feel they are alone with cancer," Horwin said.

If you are a cancer patient or a loved one of a cancer patient you are invited to join My Cancer Place. It's free. Just click here.

Cancer Foundations

Mesothelioma Research Foundation of America - The mission of the Mesothelioma Research Foundation of America is to fund research that will lead to the quickest cure for mesothelioma. Mesothelioma, a cancer of the lining of the lungs caused by asbestos exposure, has very few treatment options at this time. Since the year 2001, the foundation has funded the opening of the Mesothelioma Laboratory under the supervision of Dr. Parkash Gill at the USC/Norris who is currently investigating Veglin, an anti-angiogenesis agent. A Phase I study of Veglin has demonstrated some success in patients suffering from lymphoma, sarcoma, and colon and lung cancers. Phase II studies are on-going with the hope they will demonstrate continued clinical efficacy in mesothelioma and other cancers. For more information about the Phase II study of Veglin you may contact Dr. Gill through the Mesothelioma Research Foundation of America. 1-800-909-Meso (6376) http://www.mesorfa.org

Immune Boosting Products

Get Healthy Again.com - This company provides a variety of immune boosting nutritional supplements designed to enhance the immune system. http://www.health-reports.com/cancer- conquest.html

Polyerga® Plus - Polyerga® Plus is a unique nutritional supplement for supporting the immune system. Although this German-developed spleen peptide technology has been used in Europe and Asia for decades, it is only now becoming available in America. Laboratory and clinically tested to improve key immune system parameters, these peptides help to regulate and stabilize the immune system. http://www.polyer gaplus.com

Legal Services

Brain Cancer Misdiagnosis Information Center - Brain Cancer Misdiagnosis Information Center provides information on the frequency of brain cancer misdiagnosis, how you can find out if you have been misdiagnosed, and what you can do about it. The Center is run by the law firm of Webb, Scarmozzino & Gunter. http://www.brai ncancerlaw.com

Goldberg, Persky & White, P.C. - This law firm (and its predecessor law firms) has been a pioneer in asbestos litigation in the United States. The attorneys of Goldberg, Persky & White, P.C. (GPW) have been involved in asbestos and mesothelioma lawsuits since 1978. Their experienced mesothelioma lawyers participated in the gathering of evidence, such as the testimony of corporate executives and doctors, and the accumulation of corporate documents, that helped create the basis for successfully suing the asbestos industry. GPW has represented thousands of mesothelioma, lung cancer, and asbestosis victims. Because of their involvement in asbestos litigation from the beginning, GPW has a clear understanding of what is required to succeed. In addition to outstanding trial experience, GPW is backed by a large arsenal of corporate documents, depositions, and medical articles with which to vigorously prosecute your asbestos case. http://www.gpwlaw. com/cm

Paul & Hanley LLP - Paul & Hanley LLP has built its reputation has built its reputation on mesothelioma-asbestos litigation-representing individuals diagnosed with mesothelioma or serious asbestos-related diseases. They have an outstanding track record of success and have garnered many of the most significant California verdicts. Their lawyers are known for their honesty, integrity and compassion. They handle a select number of cases at a time and represent workers and families with the extra special attention required for the best possible outcome in each case. They understand your case is unique, so they take the time to get to know you and your family. Contact them today for a free and confidential consultation. They will discuss your specific case and give you honest answers to your important questions. Their toll free telephone number is 1-800- 281-9804. They look forward to helping you. http://www.phhlaw.com

Nutritional Support

Haelan Products offers Haelan 951, an international award-winning, super nutritious, fermented soybean protein beverage. Clinical research and numerous reports from doctors and cancer patients have demonstrated that Haelan 951 helps protect cancer patients from the toxic side-effects of chemotherapy and radiation treatments. In addition, one study found that the soy isoflavone genistein (which is found in Haelan 951) produced greater apoptosis with both chemotherapy and radiation treatments. Apoptosis means "programmed cell death" and it is a goal of most orthodox cancer therapies. Because Haelan 951 is a nutritional supplement, not a cancer treatment, it was used in this study to offset the toxicity of the treatments, not as a cancer therapy. http://www.haelan9 51.com