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136355_Schlembach_P.JPGBy Pamela J. Schlembach, M.D.

"I just want a good night's sleep, doctor." This is something I hear very frequently from my cancer patients on our weekly visits.

Insomnia is common in cancer patients as well as the general population. Chronic lack of sleep can lead to a host of medical problems, including chronic fatigue, depression, obesity, diabetes and heart  disease.

Insomnia can be caused by a number of medical conditions, medications, stress, lifestyle and diet. Before assuming all sleep issues are due to medical conditions alone, I frequently run through the following healthy sleep hygiene list with my patients. Many make some of these adjustments, and their sleeping problems vanish.


amanda42.jpgBy Amanda Woodward

As a melanoma survivor, I know how important it is to find the right dermatologist. After all, I've spent my fair share of time doing just that. My husband is in the Army, and we move often. Each time, I have to find a new dermatologist. It is one of the most stressful parts of moving around for me. It takes a while to build mutual trust.

But I've been fortunate to find some really great dermatologists who listen to my concerns and whom I trust to find any abnormal moles that could lead to skin cancer recurrence.

Here's what I look for in dermatologists:

Are they listening to me?
Like really listening. I spotted the abnormal mole that led to my original melanoma diagnosis. It was just a gut feeling. No, I'm not a doctor, but I do know my body and expect my dermatologist to at least listen and acknowledge my questions and concerns. In the same breath, however, I need my dermatologist to hear me when I say I'm anxious. I would have them remove all of my skin if that were a possibility! So, I also need my dermatologist to reign me in and help me determine what really needs to be examined or removed.

mindfulness.jpgBy Eric Tidline, social work counselor

Coping with cancer isn't easy. So, how do you build the mental strength to cope with everything you're facing? Mindfulness is one thing that may help.

How mindfulness helps

Mindfulness allows us to step outside of our own minds and observe how we think about things. Over time, those who practice mindfulness learn to become less attached to their own thoughts, perceptions and beliefs. People begin to take actions based on the true nature of people and events, rather than how they wish or hope them to be.

By focusing on the details of our experiences, we are better able to understand what is happening in each moment. This new understanding will allow you to spot and avoid negative reactions. Mindfulness also better enables us to see the many ways we can positively respond to our situations. This helps us achieve inner peace and balance.

Studies show that patients who practice mindfulness begin to feel better despite their medical problems. Physical symptoms don't necessarily go away, but that's not the aim of mindfulness. Rather, the goal is to help you find a different perspective and a new way of coping with your illness.

What is mindfulness? And how do I do it?
Mindfulness is the practice of focusing on your thoughts, emotions and feelings in the present moment with acceptance and without judgement.


It is one simple coping technique that's been found to reduce stress, boost energy and improve well-being.

While it may sound complicated, mindfulness practices are simple. One easy way to stay mindful is to focus on your breath.

yasupport.jpgBy Wendy Griffith, Social work counselor

Appointments. Side-effects. Medications. Side-effects from medications. More sickness. Lengthy tests. Hospitalizations. It can be a lot at any age, but for young adults (generally those ages of 18 to 39), it can be especially so at a time when it feels like life is just really getting started. How are you supposed to manage all of that, much less cope with it?  

The answer is different for every person. But if there is one thing that can help young adults cope with cancer, it's social support. In fact, that's true for cancer patients of all ages.

What is social support?
Social support essentially refers to the feeling of comfort, care and connection that you get from others. "Others" could be immediate family, extended family, close friends, acquaintances, neighbors, coworkers, and yes, even strangers. These individuals might help you by providing emotional support, physical support, financial assistance, laughter, motivation, distraction or a combination of all of the above. It all depends on what you need or want, and that can completely change from day to day.

Why social support is important

No matter what your exact situation is, being sick can get lonely.  

Even patients with incredible support systems feel alone from time to time, or need a little extra boost from outside their network. We need different things, at different times, from all kinds of different people.

Peterson_Trackers_140.jpgBy Carol Bryce

Imagine if you could monitor your health between clinic visits and quickly share the details with your care team.

That's the premise of research that's being conducted here.

"We're looking at new ways of data collection that are grounded in real-world challenges," explains Susan Peterson, Ph.D., in Behavioral Science.

This may help address health issues and behaviors that change when you you're not at the hospital or your doctor's office. For example, patients with head and neck cancer usually don't develop swallowing difficulties while they're at their doctors' offices. And former smokers may not struggle with relapse while they're sitting in clinic waiting rooms.

So our researchers are looking at ways to use modern technology to monitor patients' vital signs, side effects, symptoms and treatment adherence between medical appointments.

Research that's based in reality
In their first study, the researchers tested the use of mobile sensors like fitness trackers and other portable devices that enable patients to monitor their health at home. The study was conducted by researchers from MD Anderson, the University of Alabama at Birmingham and the University of California, San Diego.

Researchers created a system that used mobile applications to gather daily data from patients and send the information to their health care teams. The system, called CYCORE (CYberinfrastructure for COmparative effectiveness REsearch), enables patients to directly enter their personal health information into various devices.

"Using CYCORE, we've been able to gather behavioral, environmental and psychological data that's typically not collected in research trials," Peterson says.

experts.jpgNo matter where you are in your cancer journey, you're likely curious about cancer prevention and treatment. Or, maybe you're trying to figure out how to manage an unexpected side effect or whether or not you can exercise during cancer treatment.

Whatever the case, you're sure to find wisdom, guidance and hope in the insight of our doctors and other experts, many of whom shared their expertise here on Cancerwise and in our Cancer Newsline podcast series in 2014.

Below, we've pulled together some of the most helpful insight and advice our doctors and other experts shared this past year. We hope you find something here that helps or inspires you in your cancer journey.

Immunotherapy: Unleashing the immune system to attack cancer
We're making great strides in immunotherapy, a new way of treating cancer that targets the immune system rather than the tumor itself. And, this innovative approach, developed by Jim Allison, Ph.D., professor in Immunology, will open doors for treating all types of cancer. Learn more in this podcast with Allison and Padmanee Sharma, M.D., Ph.D., associate professor in Genitourinary Medical Oncology and Immunology.

Understanding the new HPV vaccine
Recently, the U.S. Food and Drug Administration approved a new vaccine targeting nine types of HPV, including five that haven't been covered by other vaccines. And, for those who get the vaccine, that means even better protection against cervical cancer, oral cancers and other cancers linked to HPV, says Lois Ramondetta, M.D., in Gynecologic Oncology and Reproductive Medicine. Find out what you should know about the new HPV vaccine.

By Lindsey Garner

No matter how you like to get your heart rate up and work up a sweat, exercising for at least 30 minutes every day can help lower your chances for many common cancers. If you're looking for ways to get your 1/2 hour in, check out how some of our busy employees stay active.

Triathlon training
"I like to exercise with a triathlon coach to prepare for my long distance races. It helped me prepare to swim 1.2 miles, bike 56 miles and run 13.1 miles for IRONMAN Texas 70.3 and IRONMAN Florida 70.3. Now I'm training for my second IRONMAN Texas 140.6, which includes a 2.4-mile swim, 112-mile bike course and a 26.2-mile run. Having a coach helps provide me with the discipline I need to improve my swimming, cycling and running. I get better results and my workouts are challenging." -- Corinna Perez, fitness center liaison

corinnaperez.jpg
Moderate cardio and fitness classes
"I recently had a baby, so I've been focused on moderate cardiovascular exercise, like working out on an elliptical machine, walking, moderate jogging and core strengthening exercises. I also enjoy exercise classes that are fun and upbeat, like Zumba, night club cardio and step aerobics."-- Kimberly Tripp, director, Acute Care Services Administration


1215kimberlytripp.jpg

Dollarphotoclub_60743674.jpgBy Eric Tidline, Social Work Counselor

Cancer-related fatigue is one of the most common issues patients face. Even among patients who have completed cancer treatment, fatigue is one of their foremost concerns.

Fatigue describes a physical and/or mental state of being tired and weak. Physical fatigue and mental fatigue are different, but they often exist together, which can make the experience even more frustrating.

However, it is often possible to curb cancer-related fatigue. Although it may sound counterintuitive, moderated exercise is the number one treatment for cancer-related fatigue.

For some, walking, weight lifting and cycling are great ways to exercise. But if you aren't ready or aren't able to participate in such activities, you might find progressive relaxation exercises helpful. Progressive relaxation is one type of exercise that is often gentle enough to meet most people's needs.

What is progressive muscle relaxation?
Progressive muscle relaxation is based on the idea that the body responds to anxious thoughts by tensing muscles, and the tense muscles add to the anxiety, creating a cycle of stress.

Conquest Garden photos (1).JPGFrom the gardens to the skybridge to our leading doctors and kind volunteers, there are many things that set MD Anderson apart and help our patients feel at home. 

Whether it's your first appointment or you've become an old pro, you're likely to appreciate these 17 unique features.

1. Our 69 aquariums. The 66 freshwater and three saltwater live coral reef aquariums in our clinics are home to 3,000 fish -- mostly cichlids, angelfish and rainbow fish. The largest freshwater aquarium, by the Pharmacy in the Main Building, holds 850 gallons.

2. The Observation Deck.
Located on the 24th Floor of the Main Building, the Observation Deck offers peace and quiet, as well as a scenic view of Houston. You're also welcome to play the piano up there.

3. Our volunteers. MD Anderson is fortunate to have more than 1,200 volunteers who contributed  193,921 hours of service last year. Stop by our Hospitality Centers for a cup of coffee and to visit with these caring individuals, many of whom are survivors or caregivers themselves.

4. Our pianos. Twenty-five of our volunteers play the piano in The Park and the Mays Clinic between 10 a.m. and 5 p.m. Mondays through Fridays. They also play at the Rotary House each day. If you're lucky, you may hear our harpist or one of our two flautists as well.

5. Room service. Inpatients -- as well as their families, caregivers and friends -- can order whatever they want from room service each day from 6:30 a.m. to 9:30 p.m. Our classically trained senior executive chef comes up with the menu of fresh, cooked-to-order meals.  

friends walking.jpgResearch shows that exercise is safe and beneficial for most cancer patients and survivors. In fact, in most cases, it is important to keep exercising during cancer treatment.

"Exercise has the potential to help reduce some of the fatigue experienced during and after treatment, especially if you're undergoing radiation therapy. And, it can help prevent weight gain commonly experienced during chemotherapy treatment," says Carol Harrison, senior exercise physiologist.

Exercise also has the potential to improve your psychological outlook and improve your quality of life. But you may need to make some adjustments before you exercise during cancer treatment.

"It depends on treatment, type of cancer and when you need to get back into what you were doing before," Harrison says.

Use this advice to help you get started.

Neuropathy.jpgFor many of our patients, peripheral neuropathy is among the unexpected side effects of cancer treatment.

It's caused by damage to your peripheral nerves -- that is, the nerves that are farther away from your brain and spinal cord. Certain complications of cancer or cancer treatments can cause or worsen neuropathy. So can some health conditions, such as diabetes, alcoholism, AIDS, hypothyroidism, rheumatoid arthritis and carpel tunnel syndrome.

We recently spoke with Julie Walker, advanced practice nurse in Neuro-Oncology, about peripheral neuropathy. Here's what she had to say.

What causes peripheral neuropathy in cancer patients?

The nerve damage that causes peripheral neuropathy may be the result of many different factors, including some chemotherapy drugs using vinca alkaloids, platinum compounds, taxanes and thalidomide.

iStock_000019589751Small.jpgBy Brittany Cordeiro

The summer sun is shining. But as you head outdoors to enjoy it, be mindful. More than two million Americans will be diagnosed this year with a cancer that is almost totally preventable -- skin cancer. The primary cause of skin cancer is too much sun exposure.

"If you're a cancer survivor, you should take extra precaution," says Jeffrey E. Gershenwald, M.D., professor in Surgical Oncology and co-leader of our Melanoma Moon Shot. While the same sun safety tips apply to those with or without a history of cancer, survivors of skin cancer, including the most aggressive type -- melanoma --, are at increased risk of developing a second skin cancer or melanoma.
 
We asked Gershenwald what you need to know about sun exposure and sun protection if you're a cancer survivor. Here's what he had to say.

How common is melanoma as a secondary cancer?
The median age of diagnosis of melanoma is about 50. Of those individuals diagnosed, melanoma may or may not have been the primary cancer. Really, everyone is at risk for skin cancer.

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