SCHORR:
Hello, and welcome to the American Cancer Society's Cancer Survivors Network, the service created by and for cancer survivors. In Seattle, I'm your discussion leader, Andrew Schorr. Our topic now is caregivers who have a spouse with cancer. On the phone with us are three caregivers of cancer survivors from across the country... two men and one woman. Over the next few minutes we'll discuss such issues as the limitations of what you as a spouse can do and can't do. The need to overcome isolation and talk about what you, as a caregiver, are going through. The difference between being someone who provides physical care, and one who provides emotional care. Being comfortable facing cancers that affect sexuality, and what you can do to help.

Well, let's begin. Andrew joins us from Roswell, Georgia. Andrew, I know you are 38 and your wife, Sonia, is a breast cancer survivor. I understand she went through mastectomy and reconstruction, and six rounds of chemotherapy. And that you're, even now, weighing with her whether she should go ahead and have a drug such as tamoxifen. Andrew, what's your role been as Sonia has gone through treatment? And also, continuing now with this decision-making on whether some ongoing therapy is beneficial?

ANDREW:
Well, I played multiple roles. I guess the most obvious role has been as a support to her emotionally as she's had to deal with difficult choices around her cancer. You know, the treatment after the cancer was surgically dealt with. Then chemotherapy and now, even 5 years out, considering tamoxifen as a kind of preventative measure. I guess other roles include being a medical advisor. Although I'm certainly not qualified to give her medical advice, I do a lot of research and discuss things with her before decisions are made. Such as the decision that we're facing now of whether or not for her to take tamoxifen for the next five years. And also, just logistical support. I was very involved in visiting her when she was in the hospital, and certainly taking her back and forth to doctors. I continue to do that to this day. So there really is a range of roles that I play on an ongoing basis in dealing with her cancer.

SCHORR:
Now, I want to share a few things. First of all I know, having talked with Sonia, that the nurses say you're her advisory board. They're joking about that. And a little more emotional issue... I know that you were married just 3 years when Sonia was diagnosed with breast cancer and you'd been trying to have a child. Now, this intervenes and you're wondering, based on the chemotherapy and all that, what to do about children. These are tough issues to face for a spouse so new in a marriage, or at any time. How have you coped with that yourself?

ANDREW:
Well, I think that I'm just glad that she's alive. When she was first diagnosed, of course, my immediate concern was for her remaining healthy and surviving. Now that has occurred for the last five years, and we hope that that occurs for many more years. You know, I just pray that will continue to be the case. Obviously, there are some marriages, at any stage or particularly if they're fairly new, that can't withstand this kind of a shock. I'm very thankful that ours has, and it's been mutual. I mean, I think that Sonia's been very understanding of me.

We've discussed this, obviously, numerous times... I think that we've kind of reached a conclusion that, barring miraculous intervention, we probably will not have children. We will probably just be a couple. I think that what her cancer has done for us as a couple is really given us perspective. I now realize that in the twinkle of an eye she could be gone or I could be gone, and that we ought to enjoy every day that we have together, whether or not there are children in the marriage. We certainly had hoped for children when we got married, but now, according to doctors, it's really not medically advisable for her. But that's okay. It was a hard thing to deal with at the time, but I think that we have a growing acceptance of it is a decision that we've made together, based on the reality of her medical situation.

SCHORR:
Andrew, how do you get the support you need as a spouse? There's so much that Sonia can give, but she's been through a lot herself. How do you deal with it, after all? Though it sounds like you have a great marriage, it's not the way you expected things to be. And there's obviously some angst as you go through the transition and acceptance of that.

ANDREW:
Well yeah, that's true. When you're going through the cancer and the treatments, and you're dealing with doctors every day, and you're in hospitals, you don't have time to think about longer-range issues. You just focus on the here and now. And it's almost easier in some ways, because you have a very immediate objective, and that is to get well. So you don't think about family or larger things. And at that time, by the way, Sonia's parents were with us and they were an enormous help just in terms of their comfort, and the fact that I didn't have to face it alone. I had other people who were very caring and loving toward my spouse and toward me, to help us emotionally cope with the ups and downs of treatment. Of course, they went back home after Sonia was done with her treatments, and I was left behind with a wife who wasn't entirely healed. That healing process has taken a number of years. I think it's really then that it sort of sinks in and you begin to realize what has occurred. You begin to have some depression. You begin to have some thoughts of, "Why did this happen to us as a couple?" But at that time you really have to rely on yourself, and to some extent on your spouse... but I think mostly on your faith and your friends and your family, the extended family, to really support you. You yourself have not had cancer, but you've been through a lot. You've been as close to cancer as you can come without actually having it.

SCHORR:
So how do you deal with that depression, and what kind of support or intervention do you get?

ANDREW:
Obviously there is a traditional path such as talking to a guidance counselor or speaking with close friends and relatives. I think that for me a lot of it was taken care of through my work, which I enjoy very much. And with activity of other sorts to distract your mind, such as exercise or listening to music, reading. When my wife had cancer we were far away from relatives, though those that came were with us. But we really didn't have family in the area, and that's really hard. You have to rely a lot on friends then because you don't really have any support network other than yourselves and people in the immediate vicinity.

SCHORR:
So, let's just do a little role play for a second here. Say I'm a friend and I say, "Andrew, how you doing?" And there's a lot of folks behind me asking how you're doing. A lot of people would say, "Oh, okay," and just keep within themselves. Is that a good strategy or would you recommend a more open, frank discussion with friends who really want to know how they can help?

ANDREW:
I think that with the general public you need to say you're okay. It's just not possible to share intimate details with everybody, particularly coworkers. The good thing that I had in my work was that I could separate work from the cancer treatment. So I wanted to keep my work environment the same and not affect it by too much discussion of my wife's treatment.

As far as needing to talk to people and really tell them how you feel... On the bad days when things are not going well, you need two or three people that are close friends, to be able to relate intimate details. It's very helpful if those people have some medical training, or have experienced cancer in their own lives. Either themselves or through relatives. For instance, there was a lady that I knew that had been through breast cancer and we relied on her a great deal. In terms of finding doctors, finding hospitals, finding out if it was okay that my wife was not reacting well to certain treatments, that sort of thing.

SCHORR:
Well, let's continue our discussion with Patty, who's been down this cancer road all too often. Patty's in Vades Heights, Minnesota. Where is that, Patty?

PATTY:
It's a suburb of St. Paul.

SCHORR:
Patty's 65. And Patty, I know your husband had colon cancer when he was 34, very much earlier in your marriage, and then 25 years later has it again. Then three years ago he was diagnosed with prostate cancer. To add on top of all that, one of your children died of cancer just last year. So, lots of crises, being a caregiver to all of them, in all those events. How have you dealt with those experiences? And how do you keep the stress of this word cancer, and what it means to your family, from just becoming overpowering for you?

PATTY:
Well, of course the first time he was diagnosed it was 30 years ago and I was 34. We had four young, very young, children at that time. It was a horrible shock, but he had the surgery. He had a rather large tumor. They had to take 12 inches of his colon. The prognosis was not real bright, because the doctor told me that at his age his chances of living real long were not good. And at that time there was not the support there is today. People didn't talk about it. I mean, they looked upon it as an immediate death sentence, and your friends would avoid talking to your about it. It was just a whole different scenario. But as time progressed and he was getting good checkups... he's always been faithful about his checkups... the years went along and we just basically almost kind of forgot about it and put it on a shelf.

When it recurred, at his 25th anniversary, actually, it was a real shock. And this was a new colon cancer, it wasn't the same spot. He had the surgery again. Both times he had the surgery he did not require any further treatment. It was intact and had not broken through the wall of the colon. So at least that was a positive. He didn't have to have any chemo or radiation treatment, so the recovery is much faster. But that time we were both thrown by it emotionally.

Keith decided that he would like to do some volunteer work with the Cancer Society. He felt like that was a way that he could expel some of his worry and energy into something that was positive. So he and I started attending "I Can Cope" classes, and I went with him. In many cases, caregivers do come along with the patient. Then we just share stories, and that was very helpful to both of us. Fortunately we have good communication in our marriage so we talked about it a lot. That helped. We felt that talking with close friends helped and we were fortunate that our close friends were very caring and concerned about it.

SCHORR:
Patty, I just want to interrupt for a second. When you say talking... Can you give me an example of an interaction where you sense Keith is feeling something, or you know you're feeling something, and you want to talk about it? Is there a way you do that, or a time or a place, or did you establish a regular time when you talk about things? How'd you do it?

PATTY:
No, we just kind of did it based on how we were feeling. Sometimes, I could sense he was troubled. I'd ask him what's the matter and he'd say, "Well, I'm just thinking about the cancer and what's going to happen next." But, it was only a year after that second surgery when our daughter was diagnosed. That kind of took our minds off of him a little bit. We had to go on to that.

When he was diagnosed with the prostate cancer, which was two years after the second colon diagnosis, that was a tougher deal. Because he had had a checkup and a PSA... It had been 3.5, and then eight months later it had gone to 12.5. So the doctor called. We went and met with the doctor and the urologist, and he said that he felt strongly that... We talked about the different options because there are different options with prostate cancer. And he felt, because of Keith's history of cancer, and because he had jumped so fast from a 3.5 to a 12.5, he felt that it was best that the prostate be totally removed. And Keith was real hesitant about it and very concerned. At that point I think I was a better help to him then than I had been at any other time. Because I just flat out said, "We don't have a choice. I want you alive."

SCHORR:
So, where are you now? Your daughter was taken from you, your husband has had 3 incidents of cancer. Having been through all that, how are you doing? In looking back, what are some things that you would say to a spouse of someone with cancer now? You know, things that are clear to you now but maybe they weren't clear through this very long period.

PATTY:
Well, actually I feel like how we dealt with it was the right way to deal with it. I don't have any regrets like, maybe we should have done this or we should have done that. We have gotten very heavily involved in fundraising for research for cancer. And we meet people every day. Our phone's ringing off the hook all the time, with people that are newly diagnosed. Everyone says, "Well, call the Warners." Keith and I have really worked hard to try and guide other people, and I think sometimes when you do that it helps you to deal with your own worries. Now, when it's time for him to have a checkup, I notice he gets very tense. But I do, too. I always go to his checkups with him and when he has to have a colonoscopy I go to the hospital with him to have it. You know, we talk about it, we talk about the fears.

SCHORR:
What could caregivers invite friends to say or do that would be especially helpful?

PATTY:
Well, that's a good question.

SCHORR:
I've heard some people say, like Andrew, when he was making all those trips to the hospital... certainly you did... If they can make a meal and deliver it to your house, that might be a big help. Or, if you have kids... Is it that sort of thing?

PATTY:
Yes, that's a tremendous help. And I have had people ask me, "What can I do?" And if they're around, I have asked for help. I think that's one of the hardest things for caregivers to do-is to ask for help. I learned that you have to ask. When our daughter was sick, our little granddaughter was just six months old at that time, and I needed help sometimes with her. And I just called. Friends kept saying to me, "Let me know what can I do to help." So I'd call and ask them, and they came through for me every time.

SCHORR:
Patty, you mentioned the passing of your daughter, Laurie. And you were just talking about your granddaughter, her child. What would you say to a spouse who's dealing with someone with cancer where it really doesn't look very good? I think you knew after a time that it probably was a terminal condition with Laurie. How do you take care of yourself, and how do you support the person who's really in their final days?

PATTY:
Well, I found that one of the things that's the easiest is to kind of go by the flow of the conversation with the person with a terminal illness. You want to do everything for them, but sometimes they don't want to be hovered over. So you have to really listen, and be careful as to how you approach them and do things for them. And that's a tough thing to do. But as you listen to them more closely, and really pay attention to what they're saying, I think it helps you to know what's the right thing to do at the right time. It's a very difficult time.

SCHORR:
And for you, as the caregiver in that, how do you take care of yourself? Do you confide in a special friend, or go to a preacher or clergy person? What do you do to keep yourself strong in such a difficult time?

PATTY:
Well, first I think that prayer is a great thing personally for me. My husband and I have a very strong faith, and prayer has helped me through a lot. Also, we did go for counseling from time to time when we felt like it was getting to be almost too much. Or when we had concerns about how to handle a certain situation. We did find a grief counselor who was absolutely fabulous, and she guided us through many difficult times. I happen to think that talking to friends that are close to you... that helps. To talk it out. We have some close friends that stayed right by us, and a couple of them had lost a child themselves. So they were right there for us. They helped us through it.

SCHORR:
Patty, let me bring into our discussion the third member of our group: Don, who's married and lives in San Jose, California. Don, I'm sure you were listening to Patty talk about her husband's prostate cancer, because you have prostate cancer. And I know you've researched it so much. But before your own bout of cancer, you were married twice previously. Both women died of cancer, one after you had divorced, the other during the marriage. So you've really been through the mill yourself as well. What advice would you have, as a spouse, on how to go through these very serious illnesses, although not always fatal? And certainly we hope with Andrew and Sonia that they go on to a long and happy life together as Patty and Keith. But whether it ends up that way or not, it's still rough. What are some things you've learned that you'd like to share with spouses who are going through this?

DON:
I think one of the things that was important to us, and I think both of these people have mentioned it, or have talked a little bit about it... You have to remember now that my first wife Sue's diagnosis with breast cancer was in 1968, so we're talking about over 30 years ago. At that time, there was nobody talking about breast cancer. At that time, you didn't talk about breasts! So when she got diagnosed with breast cancer, and immediately had a total mastectomy, with only one breast remaining, it was something that nobody talked about.

But we did. It was talked about in the family, it was talked about over the dinner table. At that time our kids would have been 8 and 11. It was wide open for discussion wherever we went. Sue and I owned a business. It was talked about in the business because they were interested in what was going on with her. If we saw friends, they found out pretty soon that they could ask, "How are you doing?" And they knew they'd get an answer. It was open for discussion. And so we were very open about it, much more so than what other people were doing at the time. And I think that helped us cope with everything that was going along. The word "caregiver" is a new word, and I never considered myself as a caregiver. I never even thought of it from that standpoint, and I'm sure these other people did not either. It's just a matter of: that's your loved one, that's your wife, or that's your son, or that's your daughter. You do what you have to do and your life goes on.

SCHORR:
Let's flip this around for a second, Don. As I mentioned, you're the member of this conversation who is dealing with cancer, prostate cancer, right now yourself. What do you look for in your wife, now, as a caregiver? What helps you? What's your expectation of them? And what's your expectation of what they might do for themselves to keep themselves healthy while you go through this process?

DON:
You know, I don't expect anything from Michiko, nor does she from me, except for love. Total love, with the two of us. As you know, I have 5-year-old and 8-year-old children on top of everything else. And the devotion and the love that you have between the two of you, and both of these people have talked about it, answers most all of the questions that are there. There's no doubt in the love. It's a total love. So there's never been a problem with Michiko and I, as there was never a problem between Sue and I, in talking about the cancer. In discussing it and making joint decisions about which way we were going to go. And at all times we know that our lives may be limited and it makes us different. In the ways that you live. You live more in the day by day. And I've said many a time: The eight years that Sue fought cancer were the happiest eight years of our 25-year marriage.

SCHORR:
Why's that?

DON:
I've said so often, I've had two absolutely perfect marriages. Some people don't ever even get one. Sue and I never fought, Michiko and I never fight. But you then realize, as was said earlier, that in an eye blink, somebody could be gone. When Sue was diagnosed she was given 18 months, and she lived eight years. She was told that if she lived for five years she'd be cured. She lived for five years and the next month it came back. But you live on a day-to-day basis. And I say that in the most positive way that I can. You look at things differently, you enjoy life differently, you do things more today, rather than putting them off until tomorrow.

SCHORR:
I have a couple of questions for Andrew and Patty, as spouses whose mates had cancer types that affect body image or sexuality. Andrew, your wife went through mastectomy, and now reconstruction following. But still, your wife talked to me in an earlier conversation, wondering whether she was as much of a woman, and as much of a woman for you.

ANDREW:
Well, you know, there are a lot of people in Hollywood who pay a lot of money for expensive plastic surgery. I guess I can be a member of that club because I've done the same thing for my wife. The thing is that, you know, I'm just very thankful that they did have the reconstructive surgery available because I think that it's helped a lot. I think that without it, it would have been much more of a tragic event and both she and I would have felt, I think, cheated and more wounded. I think that... not being a woman I really can't say... but I think that it's very important for one's self image as a woman to have at least the appearance of womanliness, and certainly she has that.

SCHORR:
What about for you as a husband?

ANDREW:
You know, I was probably okay with her not doing it simply because it was such an enormous commitment in terms of the surgery. I mean, the mastectomy took one quarter of the time, about an hour and a half, that the reconstruction did. So it extended her surgical day to almost 8 hours. Which was really her decision, and I'm glad that she did it, but I certainly didn't compel her to do it. I think we're both happy with the result. And I think it has, frankly, made a difference in how she feels about herself, how I feel about her, and how we feel about each other.

SCHORR:
Okay. Patty, you were the one to say to Keith when he was diagnosed with prostate cancer, "Go get the surgery." Yet we all know... and Don is somewhat of an expert in prostate cancer with all the research he's done, and his own experience... that there's often impotence and even incontinence. There can be some serious side effects, and certainly sexual ones. But you said, go have the surgery. Was this potential, and maybe actual, loss of that aspect of sexuality something that was troubling, or that you stopped to worry about?

PATTY:
It was troubling for him. It wasn't for me. To me there was no choice. He had to go with that type of surgery because his history was such that there was just too much risk. I just said to him, and I meant it from deep in my heart, I said, "I love you. I love all of you and I don't want to lose you. This is just another thing we have to deal with, and we will deal with it." And we did. It bothered him. Yes, he had some incontinence for some time, and impotence, that's a problem. But there are other ways to have sexuality and to work with it. And we read a couple of books together and we talked about it and everything has just been fine. You know, I think when you're dealing with life and death situations, you have to cut through the flak and take a good hard look at it and make a decision and then that's it. There are worse things that can happen to you in life and we had that happen. We lost a child. And that's the worst. We have a very, very close relationship and have not had any problems. Once he came calmly to terms with everything, he did very well. And I think I was a help to him in that. I know I was.

SCHORR:
Andrew, it's still pretty early in your marriage. How do you think about the future as a spouse? Do you still have your dreams of a long future? How has that been affected by the intervention of breast cancer in your life and Sonia's?

ANDREW:
Well, it certainly makes you aware of your mortality, and therefore I agree with the earlier comment that you live for the moment. You don't put things off. You do things now rather than later. You know, we've been married now eight years. I think it's been a wonderful eight years and I just hope it continues. There has been a sense of loss, there's no question about it. But there's also been a sense of gain. I think we've gained a tremendous amount of intimacy and closeness through this ordeal, and that's very helpful to us as we look forward to the rest of our lives. Whether it's one year or fifty years together in the future, I think we're going to make the best of it.

SCHORR:
Did Sonia ever express to you, at any point, feeling guilty that this had happened? You married her and then early on she gets cancer... obviously through no fault of her own. But did she feel that she'd let you down somehow?

ANDREW:
Yes, often. And I think that one of my biggest roles is to constantly reassure her that this is not a failing as a spouse or as a woman. That this is simply a reality and that we need to both work together as a team to deal with it rather than blaming each other or someone else. Because there's really nobody at fault here. It's just what has happened, and we as mature adults have to reconcile ourselves to it and deal with it and go forward.

DON:
One of the things that I think that cancer does is: If you've got a good marriage, a strong marriage, it brings you closer together and you enjoy each other more as time goes on. If your marriage is weak to begin wth, I think it draws you apart.

I have seen men... For example, I did some counseling following Sue's death... Men who said, just frankly, why me? Why did she do this to me? What did I do? Very angry at the wife for having breast cancer. We saw marriages being pulled apart. And I see this today in my work with prostate cancer. I'm talking to men all the time and I hear some of them say, "Well, my wife doesn't touch me any more. We've lost all that intimate relationship. Sure, I may be impotent right now but there's nothing else going on." So it goes both ways, it either makes you stronger or pulls the marriage apart.

SCHORR:
Well, are there some tips you would give as far as salvaging that so it doesn't get pulled apart? There's the man with prostate cancer, he's feeling... Or the wife who wants to touch him, and doesn't know what to do. Let's talk about that. What would you advise a caregiver specifically in that situation? Her husband doesn't seem to want to talk about it, or it could be Andrew's situation. And breast cancer... Patty, you can imagine some situations. How does the spouse break through that so that they don't pull away? Don, you want to take a shot at that first?

DON:
You know, in my case with Sue, the fact that we took it out into the open made all the difference in the world. It was easily talked about within the family. My children could have easily asked what was going on. They knew she's going in and out of the hospital all the time. But I think that the comfortable feeling between Sue and I made it possible to talk about it. With Michiko, who is Japanese, and perhaps a little bit more conservative than what we would be here... She tends not to talk too much about it, but if I bring it up she gladly enters into the conversation. But she never really brings it up herself. She kind of waits for me. So you have to play each one of them. But in both marriages, it brought us closer together.

SCHORR:
Patty, is communication the key to keeping the marriage going, through this trauma of cancer?

PATTY:
It is, and I totally agree: If you have a good marriage, it will make it stronger, and if you don't, you have to work at it. But you know, you have to work at a marriage. None of us has any guarantees in life. And one thing I've learned about cancer: People who have had cancer are very unique people. They have such a strength. I know so many, because we are so heavily involved in raising funds for cancer. And every one that I meet-they have such a strength. And I think that a lot of it is that they've faced their mortality and they realize that the things that were important to them before aren't as important any more. They get more enjoyment out of the little things of life. The simple things in life.

SCHORR:
All of you are in a pretty strong place right now. Don, unfortunately, is dealing with prostate cancer. But you've made knowledge power in what you're doing. But somebody is going to listen to us who is not in such a strong place and they, as a spouse, are exhausted, bewildered, don't know what to say, what to do. So what would be some specific things, and I'll just ask each of you, that they could do for themselves? And what would be some specific things they could do for their partner? Andrew, you want to try that?

ANDREW:
Sure, I mean there was a circumstance during Sonia's treatments where she was very sick. I don't think it was so bad she was about to die, but it may have felt that way. I made sure to carry on with my life, and not be just totally absorbed by her life. I went with some friends to the 4th of July fireworks, and I took a day off from seeing her in the hospital. And that's perfectly fine. You cannot feel guilty about that. You have to live your own life as well as supporting your spouse.

As far as for the spouse, I think that anything you can do to make them feel handsome or pretty is very helpful. I know that that's very important to my wife, and I think it's important to a lot of women and men. If you get them something that is beautifying, something that is enhancing of their beauty even when they maybe aren't so beautiful. Because they're going through chemotherapy, and they've lost their hair or something like that. It could be as simple as a button or pin or a piece of clothing. Or, in my wife's case, she wore a lot of headdresses because she didn't want people to see her bald, and I would get her very nice ones like that. That can really help lift their spirits.

SCHORR:
Patty, specific things that a caregiver might do for themselves, and then specific things to help their partner?

PATTY:
I think it helps sometimes to be more of the aggressor, when you have a spouse that is going through feeling they don't have the self worth or the self esteem that they had. I think it helps to just say in the morning when they are getting ready for work, "My, you look very handsome today." Or once in a while plan a special meal in the evening. Or say, "We're going out to dinner... we're going to have a special dinner tonight." And if couples are having problems they really need to deal with, and they don't know where to turn, I would suggest seeing some type of a counselor together and talking it out. Because sometimes a third person who is trained in this can help them to look at it from a different angle. I find that people open up more with a counselor sometimes than they would with each other.

SCHORR:
I just want to echo that. Patty knows, because we've talked before, that I have a condition called chronic lymphocytic leukemia. Although I've had no treatment, when I was first diagnosed, it was a major shock. And it was my wife who said, "I know a counselor. This gentleman, his wife had leukemia, and he said he'd be very understanding. Maybe he can really help us deal with some issues that we can't articulate ourselves." And it was a big help. I know it was a big help for my wife, and it helped me, too.

PATTY:
I totally and firmly believe that there are times that you do need that help.

SCHORR:
Don, what's your point of view on specific things that are helpful for the caregiver, the spouse? And then things they can do specifically to be helpful to their partner?

DON:
I think that we have something now that we didn't have 30 years ago, and that's the Internet. For every type of cancer, or any other disease, there are support groups on the Internet. People who've been there, done that, who are willing to come out and help. I've been extremely active on the Internet in helping other people with prostate cancer. Wives are working on the Internet. They take some information off the net, or if they need some information they ask a question. They get an answer back and print it out and carry it back to their husbands. The husband may or may not be active on the Internet. I've seen children active on the Internet. They ask a question and they take it back to Daddy and say, Well, Daddy, I learned this today." I think it's a great way of opening communication when somebody in the family is doing that.

The same thing with me, when I find something on the Internet that's interesting, I carry it to Michiko. And we lay it out and talk about it. So there's all kinds of information available on the net. You'll find mailing lists, for example, or a discussion group in which you'll have patients who've gone through the whole thing. They'll know more than what most doctors in this country know. Not the ones who specialize in breast cancer or leukemia or any other cancers, but those who are the local practitioners in the local town. They don't have all of the information. They don't have time to study all the information. But let me tell you, when you have cancer yourself, or your loved one does, you have time to study that information and you can share it.

SCHORR:
Those are all great points that you've made over the last many minutes. With that comment, we will have to stop. It's been an extremely rewarding discussion and I know it will help many caregiver-spouses around the country. Thank you all for sharing your experiences. Andrew, thank you.

ANDREW:
Thank you very much.

SCHORR:
And Don, thank you for sharing your perspective both as a patient and as a spouse. And also, Patty, thank you once again for being with us. For the American Cancer Society's Cancer Survivors Network, and from our HealthTalk Interactive Studio in Seattle, I'm Andrew Schorr.