ANDREW:
Hello, and welcome to the American Cancer Society's Cancer Survivors' Network, a service created by and for cancer survivors. In Seattle, I'm your discussion leader, Andrew Schorr. Our topic is colon cancer in women under 50. On the phone with us are four colon cancer survivors from across the country, women in their thirties and forties who have completed treatment for colon cancer. Over the next few minutes, we'll discuss issues such as: breaking the myth that young people don't get colon cancer; using the Internet to get information and support; using supplements and herbs to better handle chemotherapy treatments; dealing with permanent vs. temporary colostomies; being your own advocate; and helping others to talk about colon cancer openly.

Let's begin. I'd like to introduce Kim from Overland Park, Kansas. Kim, I know you're married and you have a child at home. You're just 38 now, and it was three years ago...I guess at 35, that you found out you had colon cancer. I understand it happened as an emergency, and before you knew it, you'd had a colostomy. Then you were headed to chemotherapy and radiation. How did all this come about?

KIM:
Well, I had been feeling kind of strange for a number of months and just didn't feel things were quite right. I had been going to my family doctor and trying to determine if there was something wrong. Was I anemic? Was anything wrong? Just one game of tennis would make me feel very tired, and just somewhat fragile. My doctor kept saying, "Oh, it's not anything, it may be this, you know, it may be that. It's nothing serious." He just continued to treat me for a virus, or a cold, or something minor. Through my own persistence, I was referred to a very good gastroenterologist. I did have to persuade him, because of my young age, to do further testing. When he did the additional testing, he did find cancer. He was shocked, the other physicians were shocked, and of course I was devastated, as was my family.

ANDREW:
And then did they rush you into surgery right away?

KIM:
They did. They did the necessary tests to see if the cancer had spread. Through CT scans, X-rays, and just the normal barrage of tests that they do. Then they determined that the cancer had not spread to the other organs of my body. So, I did go into emergency surgery at that time.

ANDREW:
Well, this would certainly make your head spin. And you're a young mother. All this happens to you and, I understand through your lifestyle, you were a vegetarian.

KIM:
That is true.

ANDREW:
Well, you're young, and you had a proper diet. It sounds like you played tennis. You exercised. So, were you feeling, "Why me?" Did you feel victimized at all?

KIM:
I didn't really question it. I have a very strong faith in God so I didn't really question... You know, the Lord doesn't ordinarily give you more than you can handle. It was just one of those things in life that was happening to me for some reason. Something good was going to come from it. I didn't let myself get down. I was totally scared to death, but I didn't let myself get too down. I knew all along I could live through it. I could make it. And I just maintained a very positive attitude through it all.

ANDREW:
It might have been something you could cope with...but I imagine for your child and for your husband...they must have been very worried.

KIM:
Oh, I think it's harder actually on the family than the person that has the cancer. Because I'm doing something. I'm going to have surgery. I'm getting treatment. And they just stand by and hope that it all works. They don't really know what's going on. You go behind the big doors and you have your radiation. And you go and get your chemo. It's like...my parents wanted to do it for me. My sister, everybody, wanted to go through it for me, because they felt so helpless.

ANDREW:
And so, you find yourself with a colostomy. Which, three years later, you still have.

KIM:
I do. I'll have it for the rest of my life. It's irreversible and it's actually not a problem. I still run every day, I swim, I do everything that I've always done. I'm one of the fortunate ones. I've learned how to cope with it, and now I try to counsel other people who get them. I see a lot of...it's not really the incompetence of caregivers. It's just that, if they haven't gone through it themselves, they haven't learned the tricks of the trade. How to deal with it. So I try to help others who are facing that.

ANDREW:
Tell us what you mean by that. Are you talking about advocating for yourself when you have a health concern?

KIM:
Well, I'm talking about the colostomy. I'm a volunteer for the American Cancer Society, so I do a lot of work with other cancer survivors. I've been able to meet a lot of other survivors that have colon cancer. They've received colostomies and, in the first year or two, your nurses and your physicians may not know how you should dress. How to take care of it so that you can do things such as swimming. Like...wearing a suit and being very discreet so not everyone knows. You don't want to announce to the world that you have this condition. And so there are things that you can do as an ostomist to help yourself...and not feel self-conscious.

ANDREW:
We will be having an audience of younger women, some of whom may be dealing with an ostomy. What are some of the tricks that you would tell them?

KIM:
Well, I would tell them not to stick with one product. It's just like anything else. With your hair...when you use one shampoo all your life, you'll build up a resistance to it. I've had to switch products numerous times. With a lot of us...our skin gets conditioned, and then the pouches-or the adhesives on the waist-don't seem to hold as well. You don't want that to slide off when you're swimming, or when you're in a sport or activity. So, take those precautions. Also, there are body shapers that you can buy now for women. I don't know about men...they probably make something like that for men too. But for women, it's made to be worn with short skirts. But they also work very well for covering up a colostomy. So, you can dress in your tightest blue jeans, and nobody will ever know that you have a colostomy underneath.

ANDREW:
Those are good tips. Now, here you are. It sounds like you're a pretty active mom. How old is your child?

KIM:
She's twelve.

ANDREW:
So, I imagine there's a lot to do with a twelve-year-old. Do you talk about this? Are people aware of it? Your close friends? Do you talk about it in the community? How outspoken have you been about what's happened to you?

KIM:
I'm very outspoken about it. My family and my close friends know about it. I do speak about it publicly when I'm asked to. For the American Cancer Society, I've traveled to Washington DC. I've talked about it there, and at different conferences for the ACS.

ANDREW:
Why do you do it? Because some people might feel, especially in a younger woman, that this is very personal. It may be uncomfortable to talk about. It sort of deals with a bodily function. And, of course, it's cancer at a young age.

KIM:
Right. I talk about it because I want to be there for somebody else that's going through what I went through. When I was diagnosed, there was absolutely no one that I could talk to. I asked my doctor, "Is there anybody else my age, or near my age, that's gone through this? Can I talk to them?" He didn't know of anyone. The American Cancer Society in my area did not know of anyone. Since then, I've gone to people's homes. I've talked to other patients who are newly diagnosed...because I don't want this to be an embarrassing disease anymore. We can prevent this disease. I just don't want anybody to have to go through what I went through.

ANDREW:
And part of what you went through was having to advocate for yourself. When there was something wrong, you got to the bottom of it.

KIM:
Absolutely. And then I continued to be an advocate for myself. And I still do. I'm a computer person by trade so I'm on the Internet all of the time. I'm doing research, and doing everything that I can, to contribute to my wellbeing.

ANDREW:
Well, it sounds like you're very positive about it. You're taking command of your own health care. And you also have a great attitude as you go on with your life. I certainly applaud you for that.

KIM:
Thank you.

ANDREW:
Let's bring in another member of our discussion group. Janet is from Bala Cynwyd, Pennsylvania. Janet, thank you for joining us. Janet, I know you have a husband and three children. You're 48, and it was six years ago you found out that you had, not only colon cancer, but that it had also spread to your liver. Very scary. I'm sure that was a real fear and a fight for your life. What happened?

JANET:
I went in for a routine hernia repair. My internist picked up an elevated liver function on my pre-op blood work, and asked me to repeat the test again as soon as I was recovered from the hernia repair. There were no other symptoms or signs. I went back in April of '93 for blood work, and was told my liver function was still elevated. It was probably nothing, but they wanted to do an ultrasound to rule out gallstones. And, on that ultrasound, they picked up an 11cm by 11cm mass on my liver.

ANDREW:
Quite large.

JANET:
Grapefruit size. And looking at it, they said they didn't see anything else. Everyone was sure it was a benign tumor. I looked too healthy. I felt too healthy. They sent me for an MRI and then a biopsy of the tumor. I was then told that, not only was it malignant, but it was not coming from my liver...but from somewhere in my GI system.

ANDREW:
And here you were, I guess about 42.

JANET:
It was a month before my 42nd birthday.

ANDREW:
So, they hadn't really been looking into colon cancer. You weren't being checked regularly for the risk of colon cancer at that time.

JANET:
No.

ANDREW:
It was almost one of these stories...as I was saying earlier...that young women don't get colon cancer.

JANET:
Right. I had a very similar experience to Kim's. No one I knew, knew of anyone who was either young, or a woman, who had colon cancer.

ANDREW:
I have a couple of questions about that. First of all, it sounds like you felt pretty alone?

JANET:
No, I didn't feel alone. I felt alone with the diagnosis, but I was hardly alone. I had incredible support.

ANDREW:
But as far as..."This is happening to me, and the doctors don't seem to know anybody else like me." Also, did you feel betrayed somehow that your condition had become so advanced? Simply because it wasn't expected? Or, did you feel that that's just the way it goes?

JANET:
Well, I feel in retrospect...I feel like something could have been done. I would hope that doctors will start doing some earlier screening. I was chronically constipated for years, and it was always explained as either from one of my pregnancies, or my eating habits. Or I didn't drink enough. Or it was just the way I was. And every time I'd go to a doctor, I was always asked, "Has there been any change in your bowel movements?" Which is something they all ask in a general screening. And I'd say, "There hasn't been a change, but I'm still constipated." I can say that, now, I'm no longer constipated. I know that that was probably due to my illness. I just think it's something that no one looks for in a young woman, or in young people. They don't think about it. And people don't talk about it.

ANDREW:
Janet, so here we are now, six years later. You went through quite a trauma with the liver surgery, and the scare of its spreading to your liver, as well as it originating in the colon and being very advanced. How are you doing now?

JANET:
Now I'm great. I'm fine. I do similar things...I was listening to what Kim just said. I take calls through the Block Cancer Hotline, which is out of Kansas City, and I talk to people who have had metastatic colon cancer. They only put me in touch with people who have colon cancer that has already metastasized. It's really just so people can talk to a survivor. I would have given anything to have been able to do that back then.

ANDREW:
What's your message to people who have colon cancer that's metastasized. I guess part of it is...you're talking six years later. You're with us. What else do you say to them?

JANET:
I say, "Don't take no for an answer." There are a lot of doctors who really didn't want to touch me. Or they looked at me with gloom and doom, and with very little hope. Like Kim, I felt I had to be my own advocate. I had to be aggressive, I had to network. I went to different doctors to get second, and third, and whatever opinions I needed. I've talked to a number of people who have said, "Oh, my doctor says there's nothing I can do." And I'd say, "There may come a point where that's true, but until you're at the very end, there's always hope." My doctors-my surgeon and my oncologist-explained to me that, if there is one person who has survived a disease, then anyone can. You don't look at the percentages. You are either a 100 percent and you survive, or a zero percent. The 30 percent survival rate, or 60 percent survival rate, really doesn't mean anything. I kept that with me. I knew there were people out there who had survived metastatic colon cancer. If they had done it, I could do it. That's what I tell other people: that they can do it too.

ANDREW:
What's your outlook for the future?

JANET:
I feel great. I'm healthy. I've never been told that I was cured. They never use that word. But I'm told that I'm probably a long-term survivor...and that I will probably die of something else. I feel very lucky to have been diagnosed, and lucky now that I am checked regularly. I still go every four months...this has been for years. Besides having the liver surgery, I had colon surgery. I had a year of chemo: six months between the surgeries, and then six months after the second surgery. I have not had any treatment since May of '94, but I get checked regularly. I get a chest x-ray. I get a mammogram yearly. I get a pap smear and a gynecological checkup regularly. I get my blood work done every four months, to check my CEA level, which is a marker for colon cancer.

ANDREW:
I bet you're quite an advocate for yourself as you go through those exams.

JANET:
I am. I found that people, when they hear my history, are much more attentive to me. So, I feel very lucky about that. Anything that's wrong...people go the extra step or do the extra test. It's a shame that that's not done for everyone.

ANDREW:
Let's bring in another member to our discussion. That's Pati, who's down in Harvey, Louisiana. Pati, thank you for joining us.

PATI:
Thank you for having me. Glad to be here.

ANDREW:
Pati, I know you're 48. And it was back in 1998, fairly recently, that you were diagnosed with colon cancer. What treatment did you have for that?

PATI:
I had the deluxe version. I had chemo-enhanced radiation, then resection surgery, then nine months of chemo. I just finished all my treatments last month. I still have one more test to go, and so far there's no evidence of any disease.

ANDREW:
As you look forward now to being a colon cancer survivor...what's your plan for how you're going to carry on, and keep yourself cancer free, and be as healthy as you can be?

PATI:
Well, I have made some lifestyle changes. I'm really following the recommended food pyramid, and trying to get in as much exercise as I can. I used to be a couch potato, and now, at the very least, I walk. I am active with the Colon Cancer Alliance, which sprang out of the Colon Cancer list serve ACOR provides. And I'm a Buddy. I talk to people by phone and e-mail. I'm a Buddy chat hostess, and I also do proofreading for the Pubcom committee. One of my little gimmicks is to wear my semicolon T-shirt, and of course that attracts a lot of attention. People want to know what it is. I'm just trying to get the public aware that early detection is so important. No one should have to go through all this.

ANDREW:
Now, for other younger women who've dealt with it...it sounds like in this Buddy system, you really reach out to other people who, maybe as the other ladies have said, didn't know anybody else in their age group who have dealt with this.

PATI:
Yes, that's true. I've been very lucky to find this. We try to match people by similar age and staging situation, that type of thing. It's just been wonderful.

ANDREW:
Well, let's describe for our listeners, who may not understand exactly all the intricacies of the Internet, some of the terms you used. I know you mentioned that you're part of a list serve. That's a sort of posting of e-mails on a certain topic. Is your group facilitated by the Association of Cancer Online Resources, or ACOR?

JANET:
That's correct. ACOR.

ANDREW:
And there's a website, ACOR.org. You can go there, and there would be this colon cancer group, and there are other cancers that are there as well. You can meet people like Pati, who are discussion leaders, and then also talk to them over the Internet individually. I know that can really make a difference for someone, especially if they're not as outspoken as you are, and simply want to make a connection with someone else who's dealt with this disease.

JANET:
Right.

ANDREW:
Now, Kim, are you active on the Internet as well?

KIM:
Only through the American Cancer Society...just helping them with their website.

ANDREW:
Janet, how about you? Have you found the Internet to be of help to you?

JANET:
When I was first diagnosed I spent time...mainly my husband spent time...researching, looking around. I have not been on as much, lately.

ANDREW:
Pati, you were talking about people that you communicate with. Are there some down there in Louisiana? People you meet with in person? Where you lend support to one another?

PATI:
That's a possibility. It hasn't happened like that so far, but certainly I would be open to meeting with someone in person.

ANDREW:
Well, let's bring in the final member of our discussion group today. That's Colleen who's in Stone Mountain, Georgia. Colleen, I know we're actually catching you at the tail end of a support group meeting. Is that right?

COLLEEN:
That's correct.

ANDREW:
And, just to give a little background, I know you're 36, and married with two kids. It was three years ago that you had emergency surgery for colon cancer, and then chemo and radiation. I think you also have an ostomy as well?

COLLEEN:
That is correct.

ANDREW:
So, tell us about the support group and what role that has played as you go, now three years hence, and try to go on with your life. Some people would say, "I'm not going to talk about it, I'm just going to go on with my life." Why do you feel the need to be part of a group?

COLLEEN:
What's essential to me, in being in a support group, is to achieve a balance in my life. As a cancer survivor, I can't deny that I've had cancer. What is wonderful to me, is to come to the support group once a week and to be with people to gain encouragement, to give encouragement, to have a forum to discuss information we get off the Internet, and to discuss different types of alternative medicine. It's an exchange of information: what's being done, what can we do. And, as one woman mentioned earlier, being a strong advocate and investigating other avenues for our own healthcare.

ANDREW:
I mentioned that you had emergency surgery. I think both you and your doctor were quite surprised when it turned out to be colon cancer. I'd asked the question earlier of one of the ladies...whether they felt victimized that this had happened to them in their youth. How did you feel about it?

COLLEEN:
I did feel victimized in a similar way. We'd just adopted a child, a month later I was pregnant, and ten months later I was diagnosed with cancer. I could not believe, could not even understand, what was happening to me.

ANDREW:
So, on the one hand you were being given the gift of life, the pregnancy, the child you'd adopted as well, and then there was this dark shadow that came over your own house.

COLLEEN:
Absolutely, that I was not going to be with them.

ANDREW:
So, that was the fear, that you would be leaving them?

COLLEEN:
Absolutely.

ANDREW:
Deserting them, almost.

COLLEEN:
Absolutely.

ANDREW:
How did you come to terms with the depression that would come along with it? How did you build yourself back up?

COLLEEN:
Again, I was fortunate. I was referred to a support group, and I saw other people who were survivors. I realized, "That could be me." The only thing that really can heal you is time. It's surviving that first year. It's getting through chemo and radiation, surviving your second year, and your third year, and achieving a little bit of distance.

ANDREW:
Yet here you have this ostomy that you deal with on a daily basis. That would be a reminder, I guess, of the pain you went through with this diagnosis. And at the time of these children coming into your life. Have you gotten past that...even with dealing with the ostomy all the time?

COLLEEN:
I have, and actually it is a reversible ostomy. And I do have the option this year...well, I guess I always have...if I want to have it reversed. And I'm not so sure, because the repercussions of anyone having surgery...with staph infection...if that's what I'll do. But in terms of...is it a daily reminder? It's a daily reminder of what I have survived, not of the pain that I've endured.

ANDREW:
Having this colon cancer in your past, and then the dealing with the colostomy on a daily basis, that doesn't slow you down in your ability to be a parent?

COLLEEN:
Absolutely not. And as a matter of fact, I just went back to work full-time this year. Teaching.

ANDREW:
Here's a question that I wanted to ask. Kim, I understand when you went through all of your treatment, and I think you talked about being a vegetarian as well, an issue for you was how to have the appropriate diet. How to supplement your health through supplements and herbs as you went through chemotherapy. Tell us what role that's played in your health.

KIM:
Well, I think that the supplements have certainly helped. I think they've helped me to continue to be strong and healthy throughout. Especially during the chemo and post the chemo, because I still take probably 11 to 15 tablets a day of different antioxidants, phytonutrients, and herbal remedies. I logged onto the Web site, shortly after my diagnosis, of Dr. Andrew Weil, who is very much into the herbal remedies and alternative medicines. He's also an MD, Harvard educated, very well-known physician, who does believe in these types of alternative treatments or therapies. So, I take numerous things, and I started taking them almost immediately after I got home from the hospital from my surgery. And I was able to continue working through my chemo and radiation. I didn't miss a day of work, and I just continue to feel very, very healthy. All the medical tests I had, they'd be like, "Wow, what are you doing? Everything looks so good and your tests are just so incredible." I don't know if the alternative things I was doing were helping or not, but it certainly made me feel like they were. My oncology team, they were so supportive. They were like, "Well, you know, we don't have a lot of research that proves this to be a real big help. But if it makes you feel better, please, it's not going to hurt you, go ahead and continue."

ANDREW:
Well, that's good for people to look into. Pati, on your Internet group, did they discuss alternative treatments or complementary therapies as well?

PATI:
No, we don't. We stick to just the proven medical treatments. If people wish to pursue that, they can go to other sites.

ANDREW:
And one of them would be, Kim, as you were saying, Dr. Andrew Weil's Web site.

KIM:
Yes. And there are many other sites. Just go and do a search on homeopathic or herbal remedies, or herbal medicines, and there are tons of Web sites out there.

ANDREW:
Let me ask you a question about relationships...and this would be for anyone to comment on. So, here you are, in younger years. All of us, I think, starting out hope we can live to be very old. I've got a dad who's 91 and I'd like to keep up with him. So, there you are in a marriage, and cancer intervenes. You go through the surgery, and maybe there's some lasting effect...maybe a colostomy, maybe not...maybe aftereffects of recovery from the surgery, or chemotherapy, or radiation. And before any of this happened, you had a relationship, hopefully a good one, with a spouse. How has it changed since then? Or has it gotten better, stronger? And, in the mix of your relationship, and how you communicate and do things together, I think it's fair to ask: Has it affected your sex life as well?

KIM:
Well, this is Kim in Kansas. I'll go ahead and let you know that oftentimes, when you have the pelvic radiation, it does damage the lining of the tissue that lines the vagina. It does cause problems when you have sex. But if you have a good radiation oncologist, they will hopefully closely monitor that so there's no long-term damage. There have been patients who have had so much radiation that they have had long-term damage...where they can no longer be sexually active. There are a number of things that play a part in that. I think it's just about having an open and honest dialog with the radiation oncologist so that they stop the radiation if that's a big concern...before it gets to that point. Because forty treatments may not do it, but sixty might. And, in my case, I was lucky. We were monitoring that, because that was something that was important to me. I didn't want to lose that ability. My husband was just so supportive throughout the ordeal. One thing...when I did begin to get well and we wanted to have relations again...it was something that we had to take slowly. Because he was concerned he was going to hurt me.

ANDREW:
Has he gotten past that fear?

KIM:
Yes, we have. We have worked through that.

ANDREW:
How would you say your relationship is...beyond the sexual relationship? After, obviously, you must have had a fear that you wouldn't be with him. Wouldn't be his life's partner...because you'd had this terrible word creep into your life: cancer.

KIM:
That's right. We have a much stronger relationship now, I think, than what we did. We realize how precious every day is, and that every day is a gift. We try to get as much in every day as we can, and just not take anything for granted. And I think maybe the other listeners, participants, experienced this as well. I did also have the early onset of menopause. I think most people that have pelvic radiation do have that. So, I had to make those decisions about the hormone replacement therapy...and that's very controversial. I don't know if everyone else has had to deal with that. And so, you know, there's so many things to work through. But you do begin to build your relationship, and you just don't take anything for granted anymore.

ANDREW:
Comments from someone else?

PATI:
I agree completely. It just totally strengthens your relationship. I mean, you think you have a great relationship, and you find out how much deeper it gets. We're so much more patient with each other, more open, and honest. And the radiation damage...we're just coming out of that. Things are improving. There's hope. There's sex after radiation! We can attest to that. But I did go ahead with the hormone replacement. You just have to be patient with it.

JANET:
I did not have radiation. I am 48 and have still not begun menopause. I would agree with the other women that my relationship was wonderful beforehand. I don't know that I could have gotten through the fears and the treatment without my husband. And, if anything, it strengthened our relationship. He's just wonderful, and I just couldn't have done it without him. We often talk about the cancer. It's not an "I," it's a "we." It's definitely strengthened our family.

ANDREW:
Colleen, did you have a comment?

COLLEEN:
Yes, I was going to say...cancer has changed, in some respects, some of the core beliefs that we had about our marriage. While we believed we had a good relationship, maybe we were blessed by this. We became better communicators. But some of the things that rocked our marriage were the financial issues. At 32, we had still talked about having a third child, and some of these things were no longer possible. Maybe I would still want a child, but my husband wasn't sure he would want to be there with three children by himself. So, while some of the things have gotten better, cancer itself brought up a number of issues that rocked our marriage. Of course, we wish we hadn't had to experience them.

ANDREW:
How are you doing now?

COLLEEN:
We're doing fine, but it is a daily struggle. There are always issues that come up. We went and saw my daughter's pre-K graduation, and I looked at her and was just in tears, thinking, "Will I be here for her high school graduation?" Now that's not a daily thing, but that's something that can creep into my thoughts. Of course, that would upset my husband...because he wants to believe, and does believe, that I'm going to be there for that. There are good days and bad days.

ANDREW:
Janet, you were saying?

JANET:
I was just there for my eldest child's high school graduation, and just sent him off to college.

ANDREW:
And was that in your thoughts too? Would you be there for his college graduation?

JANET:
Definitely. Well, just everything, every life cycle event. But I also have become much more emotional about everyone and everything. When I talk about my children, tears run down my cheeks. I had thought it was due to the chemo while I was undergoing chemo, but I'm five-and- a-half years out of chemo and I am still incredibly emotional. I teach second grade and it's just a given fact that when ever anyone comes in for a conference, whenever I talk to parents, I cry. I'm not sobbing crying, but I'm emotional. I tear up.

ANDREW:
Janet, you mentioned that you have a child who just graduated from high school. So, with older kids...and maybe some of the other ladies have some children that are aware of the health of Mom as well...how is the relationship changed when a child has seen you go through this sort of thing? They must have some worries about Mom's future and their future with Mom as well.

JANET:
I think they had those fears when I was going through it for the first few years. I think that now our lives have pretty much returned to normalcy. I think it's...we know that anything can change at any time. They know I have my cancer friends, I have my cancer life, I take time to take calls, so that kind of thing is in our day-to-day life. But in terms of fears of losing me, I think we just don't think about losing me. We think about the gratefulness that we are all here. And I certainly talk with my children about their diets, and that they will have to undergo early screening, and really watch themselves.

ANDREW:
Does anyone feel though, with children who've been part of your life as you've gone through this, that there's almost an anger or a feeling of lost innocence that they had to see this happen? Of course, Colleen, your kids were really little... But, to grow up and know about hospitals and surgery, and Mom or Dad worried about things. Do they just accept it and, "Okay, this is what happened." Will they be resilient as it seems like Janet's kids have been?

KIM:
I was going to say, from my own experience, there's just been so much cancer among our friends, and folks that we go to church with, and my daughter's schoolmates and their parents...I think kids are around it so much these days. My daughter certainly was just so glad, and so thankful, that I lived. Because two of her classmates lost their parents about the same time I was diagnosed. So, that just made a big difference in our lives. She just rallied that much harder around me, and is just so grateful that I'm here.

ANDREW:
Anyone else?

COLLEEN:
My children grew up with Mom having been diagnosed with cancer. They probably didn't realize at the time...obviously, they were ten months and two years old. But they have grown up with a Mom who's different. At night, after we read our story, I go in the bathroom and I have to take care of myself...that's the way we refer to it. I have to irrigate the colostomy. Or, when I'm changing into a swimming suit, they obviously see that I still have the cap or the pouch. So they've grown up with it kind of on the periphery. It'll be interesting to me to see as they get older...it's because they've lived with this. It won't have that frightening connotation with death, but more like cancer is a chronic disease.

ANDREW:
Let's talk about some final thoughts that you would like to leave with younger women who have dealt with colon cancer, and are now looking toward their future. Maybe they can't be as outspoken about it as you are, and maybe they feel somewhat alone because they don't know anyone else in this age group who's dealt with it. Kim, how about if we start with you?

KIM:
Well, I would tell them...if they don't feel like they can get involved in an activity where they can go and do volunteer work, or do like many of us do that are on the phone, there are subtle things they can do. They can go to an event and help out. Serve food. They can become involved in so many ways with these support groups. I think, nowadays, there's a support group among every community for the different types of cancers. And, certainly, if they've had colostomy, they can get on the Internet. There's a United Ostomy Association. I've been to their Web site. It's wonderful...has lots of success stories about people living with colostomies every day. Read books, go to the Web sites of all these different community service programs. There are so many, and the main thing is not to give up. Because if they continue to search, they will find someone that can be their soul mate, or that they can talk with, to share their experience. I do believe that talking about it brings healing.

ANDREW:
It sounds like you're ready to go on, and have a full life, and put this behind you. Even though I guess you always have an awareness that you are a cancer survivor.

KIM:
Right. I don't want to put it behind me. You know, it's my life, and I live it every day. Like the other lady said: I do have my cancer buddies, I have my cancer life, and my family is a part of that. And it's just wonderful. It's a support. It's like we're all in this club together, and it's not a bad club. It's a special club. We're all special. We're still here.

ANDREW:
Right, amen. Pati, some final thoughts from you.

PATI:
The best thing I could say is: Get on the Internet. Go to www.ccalliance.org. Or, there's a phone number, (212) 439-1101. They will find a lot of help there.

ANDREW:
And that will connect them with buddies and people like yourself?

PATI:
Yes, it will give them information, factual knowledge, length, buddies. They can read other people's stories. There's a tremendous amount of information there.

ANDREW:
And the main thing is to know that they are not alone. That there are other younger women who have dealt with this, and dealt with this successfully.

PATI:
Right. There's a lot of hope out there.

ANDREW:
Good points. Colleen, how about hearing from you next?

COLLEEN:
Right, I would have to agree with Kim. My advice to someone on being diagnosed with cancer: if you can't join a support group, find some way to associate yourself with cancer survivors. You need to see people who have been there. You need to meet people who have lived three years, six years, ten years, twelve years. To be a survivor, you need to believe that you can survive. So, if you're out there, find some way as Kim has said...someway, somehow...see people who have done it, and believe that you yourself can be that survivor.

ANDREW:
Janet, you get the parting shot. Some thoughts from you?

JANET:
I agree with everything everyone said. I think attitude has a lot to do with it. I think you have to be able to talk about it. You need to be able to find other people to either talk to online, or by phone, or in person. And I think...there's so much cancer out there...there are people all over, and there are survivors all over. It's a wonderful feeling, and hopefully we'll all still be here many years in the future.

KIM:
One final comment. This is Kim in Kansas. I did my first volunteer event just a few weeks after my cancer diagnosis, or cancer surgery. It was the Relay for Life, which is an American Cancer Society sponsored event. My advice would be to...even if you don't want to get involved as a volunteer, you can find the local Relay for Life in your community. It's a very therapeutic event. They have a survivor's lab where you can go. You can walk as a survivor, and be honored. Then they have a luminary ceremony. It's just one of the most uplifting events I've ever been to as a survivor. They make you feel so special and so honored.

JANET:
I do that also. This is Janet. I go to Relay for Life in my area, and it's wonderful.

ANDREW:
It sounds like when you start to get involved, and speak to others, and speak out and participate in these events, what you get back is very helpful to you as you deal with your own personal concerns as you go forward with cancer. It's very rewarding. Ladies, I want to thank you, each of you, for your time and for sharing your personal stories. We wish you all the best for you and your families. With that comment, we will have to end this very rewarding discussion. Thanks to you for sharing those experiences and insights. I know it will benefit our listeners. For the American Cancer Society's Cancer Survivors' Network, and from our HealthTalk Interactive Studio in Seattle, I'm Andrew Schorr.