Dr. Harpham: Hello, and welcome to American Cancer Society's Cancer Survivors
Network. I'm Dr. Wendy Harpham, your host. Today we'll be talking with three
women from across the country, all between 35 and 46 years old, who have experienced
or are now experiencing, a recurrence of lymphoma or leukemia. As a doctor of
internal medicine, and also a ten-year lymphoma survivor myself, I'm ready to
have a great conversation with these women. First, let me introduce briefly
our guests. And then I'll open up the discussion as we talk about issues such
as: keeping your energy up during and after treatment, dealing with fear of
recurrence, long-term or permanent side effects of treatment, how your emotional
responses to life situations change over time, the role of will power in healing,
and the role of humor in healing. Our first guest is Susan, a 42-year-old woman
from Dallas, Texas, who went in for gall bladder surgery in 1992, and was discovered
to have Non-Hodgkin's lymphoma. She was married and had a two-year-old daughter
and a five-year-old son at home at the time.
 Susan
was treated with CHOP chemotherapy and her lymphoma went into remission. Three
years later, in 1995, she had her first recurrence, which was treated with a
different chemotherapy, Fluderabine. She then went into four years of remission.
In 1999, her cancer returned, and she was treated with Rutoxin, the new monoclonal
antibody, but it didn't work well enough, so her lymphoma has been kept under
control with low dose oral chemotherapy, Leukeran . Susan, thanks for joining
our show today.
Susan: Thank you. Glad to be here.
 Dr.
Harpham: Our second guest is Mary. Mary is also from Dallas, and is now
forty years old and the mother of an 11-year-old boy and 8-year-old girl. In
1994, after months of unexplained itching and multiple misdiagnoses a chest
x-ray was done and revealed a mass which biopsy showed was Hodgkin's lymphoma.
Mary underwent six months of radiation and chemotherapy, at the end of which
her cancer was in remission. She had an uneventful recovery and was doing well,
when in 1997 at a routine checkup, she was discovered to have recurrent disease.
She then underwent stem cell transplant and has been in remission since. Mary,
I'm looking forward to hearing what you have to say about today's topics. Welcome
to the show.
Mary: Thank you, Wendy.
 Dr.
Harpham: Louise is our third guest. Louise is a 13-year survivor of AML
leukemia. In 1987 she was just 33 years old, and suffering from repeated infections
and some bone pain. Despite multiple doctor reviewuations, her leukemia was
not discovered for many months until a bone marrow biopsy was done and the leukemia
was discovered. She was treated with chemotherapy, during which she had to have
her gall bladder removed. In 1988, after a short remission, she had a recurrence
and was treated with a bone marrow transplant. Louise's course was complicated
by infection, such as CMV pneumonia. Back then, this complication was usually
fatal, but Louise received what was then experimental antiviral therapy and
she pulled through. This therapy is now part of the standard treatment for stem
cell transplant patients. Although her leukemia has stayed in remission since,
Louise has had to tackle many medical problems related to her treatment: shingles,
a mini-stroke, osteoporosis, diabetes and cataracts. One year ago, she had to
have a lung transplant because of treatment-related lung disease. It's been
a long hall. We really appreciate Louise taking the time and energy to join
us today and share her insights and experiences. Welcome, Louise.
Louise: Thank you. It's wonderful to be here.
Dr. Harpham: Well, let's start with you, Louise. With
all your illness and your debilitating treatments, I'm sure you've had
to deal with energy limitations. Can you share with us how you handled
the change in energy, what you've done to try to keep your energy up
at various times?
 Louise:
Yes. On the day that I really felt the worst were the days that I tried to push
myself a little harder, and always made sure that I would get up and get out
of bed and get active, even if it for that day it was doing laundry. That was
my activity for the day, and I always took a positive attitude, and knew that
every day was going to be better and better. And I would try, I did some walking,
I did some actually took physical therapy at a rehab hospital in order to get
prepared for my lung transplant, and that helped a great deal. I did a lot of
walking, even pulling my oxygen tank, that kept me going and I was very active
and productive in the Leukemia Society and I would look forward to different
functions and stay involved and attend meetings...
Dr. Harpham: Did people ever make you worry that you were
doing too much?
Louise: No, in fact I was always encouraged to do
as much as I could. The only time they ever told me to be careful was
around flu season, not to go to crowded malls, or if I was going to
go to a theater or shopping, try to go at off peak times when there
were not a lot of people around..
Dr. Harpham: But that was more an issue of catching
an infection as opposed to pushing yourself too hard energy wise...
Louise: There were a couple of times when family members
said, you've got to slow down, you can't be doing all this. And I just
said, I'm gonna do whatever I can do as long as I can do it.
Dr. Harpham: So being busy and staying as active as possible
was very positive for you in terms of your energy.
Louise: Exactly. And it made me feel very vital and
like I was in control and as long as I was able to control my physical
being, then I could keep the disease away. I mean I had a lot of affirmations
with positive thinking and visualization of a healthy Louise, and I
always kept that in mind. I'm not always gonna be like this, there's
gonna be a day when I am gonna be better, and I'm gonna work towards
that every day.
Dr. Harpham: And that's something we're going to go
into in more detail later on. Mary, you've had chemo, radiation and
a transplant, and you have two young children. You also have a job.
Can you share with us how energy has played into your survivorship?
 Mary:
Well, I feel like I've been pretty lucky overall but it has been an ongoing
struggle to kind of figure out a way to balance, like Louise said, the vitality
you get from staying busy and being engaged in life and at the same time, not
overdoing it. And I've sort of been, I've had to tinker with things for a couple
of years. I really didn't feel like I got my energy back for a good two and
a half or three years after the stem cell transplant and I did different things,
I tried to be very careful about drinking water every day. That's sort of a
small thing but it can make a big difference. I'm very careful about getting
my sleep, I uh...
Dr. Harpham: Did your sleep requirements change after your
transplant?
Mary: Yes. Although, it's been pretty manageable,
I really must have eight hours every night, and I used to be able to
get by on five or seven. And now seven hours feels like two. But as
long as I get my eight hours, I'm really pretty energetic most of the
day, able to exercise, able to do my routine and keep up with my work,
but come nine or ten o'clock, I don't work anymore, even if I have a
deadline. I just go to bed.
Dr. Harpham: So you draw limits?
Mary: Yeah, I have to draw limits.
Dr. Harpham: You drink a lot of fluids but you draw
limits and make sure you get the sleep that you need. Do you think your
energy is continuing to change?
Mary: Yes, it seems like just six months ago it took
a big jump,. And I'm not really sure why. Maybe some dietary changes.
I do a little changeup of my hormone therapy. So you know, maybe some
combination. Maybe I had just reached the point where I was recovered
enough that it was better. But...
Dr. Harpham: Which brings up the point that many different
things contribute to energy? And even though you've had a transplant,
you could say, well, I'm gonna be tired because I've had a transplant.
Looking at other things such as your hormone balance and all, and taking
care of things that can be effective, may be helping your energy.
Mary: You know, I actually went so far as to keep
an energy diary for a few months. I kept a diary of everything I ate,
how much I slept, when I took my medications, I mean, everything I could
think of; whether I exercised, how much water I drank. I tried to keep
track of everything I could think of that could possibly affect my energy.
Dr. Harpham: And what did you learn from your diary?
Mary: Water. Water was a BIG thing.
Dr. Harpham: When you had enough fluids it really helped.
Mary: Yes. And it was not like I was not ever drinking,
but if I didn't get that good six to eight glasses a day, it just really
made a big difference. I was surprised.
Dr. Harpham: Did you deal at all with other people
telling you to take it easy, slow down when you were trying to do things?
Mary: You know, I grew up in a family that thinks
you were given a certain amount of energy when you were born and once
you use it up, you die. So, (laughing) I got a lot of that from my parents,
and even now I exercise really regularly and they say, You're gonna
die! You're pushing yourself too hard, you're sweating! Oh, my gosh!
So yeah, I dealt with that, but not too much in my immediate family.
Dr. Harpham: How did you deal with that personally,
though? Did you just blow it off, you didn't worry about it, or did
it make you nervous at all that maybe you were pushing yourself too
much?
Mary: Well, you know, I've gone back and forth. Sometimes
I've felt that maybe I was pushing myself too much, but I've also had
days when I've thought, you know, I'm really cutting myself too much
slack! I'm not afraid to do that.
Dr. Harpham: No vacuuming, right?
Mary: Well, not even so much that, the other thing actually I get really,
I'm very sort of anal about it, I don't let myself get stressed out. Cause I
feel like being tired physically at the end of the day is not nearly as hard
on my body as being tense all day. So, and I don't let things bother me, and
people have commented on that. They say, Wow, you're really calm. You know,
the deadline is coming or something's going wrong with a project at work, and
you know I say, Hey, look, nobody's gonna die! Nobody's gonna lose their job.
Put it in perspective.
Dr. Harpham: So it's not even the physical energy demands so much as
the emotional and practical stresses. And you've actually relearned how to deal
with those things since your cancer diagnosis.
Mary:
Yes. Yes. Cause I really feel like it's very rare that I physically wear myself
out. And that's one way I've been lucky. I mean, I have a pretty good amount,
especially now, of physical energy, but I just, you can get tired really quickly
when you're anxious over something or..
Dr. Harpham: How DO you combat stress?
Mary: Well, I've cut back. I don't do nearly as much
as I used to. I'm very, very protective of my time and if something
looks like a waste of time, I just get away from it really quickly.
So mostly I make sure I do things that nourish me, and I have some freedom
financially, I don't absolutely have to work full time by any means,
so that's been a real luxury, I've been really lucky in that way.
Dr. Harpham: What about, I mean, you have two kids at home.
I know they're perfect, but...
Mary: Laughs raucously.
Dr. Harpham: But when you're having trouble with the
kids. Or when something comes up. I mean, cars break, and faucets leak.
What do you do with those unavoidable stresses?'
Mary: Well, I do tend to get angry and frustrated by I
kind of, you know I just let it blow off.
Dr. Harpham: Meaning you express it and let it go?
Mary: Yeah, let it go. And I feel like dealing with
my kids is what I want to do. It's not like, How did I get myself in
this situation where I'm dealing with the stress and I didn't even want
this job, or I didn't want to be on this committee or that kind of situation,
so I really feel committed to the work with my kids, so that takes a
lot of the stress out of it right there.
Dr. Harpham: I understand. Excellent. Susan, you've
been on chemo the past year, and I'm guessing it's affected your energy
to some degree. Can you share with us a little bit about your experiences
with fatigue and cancer therapy?
 Susan:
Well, I think I've been pretty lucky. There have been times, certainly where
I go do, times I have less energy than others, but most times I do feel I have
pretty good energy. But like Mary, I really do try to take care of myself. I
exercise also, I take vitamins, I try to eat right and I try to get at least
eight hours sleep. And that helps, too. I'm gonna add the water to my curriculum
and see if that helps, too.
Dr. Harpham: Now the vitamins. Did you just do that on your
own or under your doctor's supervision?
Susan: Well, a lot of reading, and then I would check
with my doctor and make sure I wasn't doing anything that would be detrimental.
Dr. Harpham: Good. So you really kept your doctor informed
of everything you were doing.
Susan: Yes. Usually, though, they'd just say, yeah,
fine. I mean, neither doctor that I've had encouraged me to take certain
kinds of vitamins, but I would read through books, cancer books and
stuff, which vitamins would be beneficial and just ask him, is this
okay? And they always said, sure that's fine. So. I wish sometimes that
they were more nutrition oriented, nobody's given me, oh, you need to
do this, or, unfortunately I haven't had that, but they say, if you
want to take those, that's great. So, to me, I feel like it has helped
me. I think vitamins have made a difference.
Dr. Harpham: I want to go back to Mary. You know,
we talked about controlling stresses, and one stress that cancer survivors
deal with is checkup anxiety. Most every cancer survivor has at least
some degree of checkup anxiety, namely, fear or worry in the days or
weeks preceding a checkup, that are generated by the possibility that
something may be found. And for you this is a real possibility, because
you've had that experience. Why don't you tell us about your fear of
recurrence after your first bout of cancer and then after being treated
for your recurrence, which was picked up at a routine checkup?
Mary:
Well, I actually find the recurrence anxiety is worse, now, because with Hodgkin's
you have such a high cure rate and we did go after it quite aggressively the
first time, so I really thought I was probably cured. And so I'm more anxious
now about checkups, although, as time goes on, it's been three years that I've
been in remission, as time goes on it gets a little bit less every time.
Dr. Harpham: When it was at its worst, what was it
like. Meaning, can you describe for us what checkup anxiety feels like?
What it made you do or think or feel, how it makes you different than
when you don't have it.
Mary: One thing I notice some funny things that happen.
I'll get angry about something totally unrelated. and I'll get unreasonably
angry and I notice I've fired three or four sort of baby sitter type
helpers all at checkup times, and something went wrong. There was always
sort of an explanation, but I just noticed this pattern and I felt normally
I would have just dealt with the problem. It's almost like its negative
energy that just has to come out somewhere, comes out in unexpected
places.
Dr. Harpham: Do you have any other symptoms? Either...
Mary: Well, you know, itching was my main symptoms,
and if you think about itching, you're gonna itch. Oh, it's a very mental
sort of symptoms. So I tell people I wish I would do something much
more obvious, like break down in green spots because the itching, you
know, your skin gets dry or you can itch for any number of reasons,
and I've always had sensitive skin.
Dr. Harpham: Have you had any checkups when you've been itching
and the checkups turned out fine?
Mary: I itch before every checkup. I literally do.
My skin gets itchy. It's just, it's like, if I'm not waiting for a checkup,
if I get itchy, I don't even notice it.
Dr. Harpham: So since you've had the experience of
itching but also having a good checkup, does the itching cause less
fear now than it did before?
Mary: Well, it's almost like, no, I guess it's kind
of like it sit there and listen to it almost and go is this Hodgkin's
itching or is this dry skin itching? Or some other form of itching.
So, no I mean, yes, the fear in general has lessened, but I'm itching
right now! Let's move on. (laughs)
Dr. Harpham: What about changing your sleep before checkups.
Mary: I sleep. I sleep every night. I do not lose sleep over it. It's
amazing. I just. I literally say, I'm gonna worry about that when I get to the
office. And I walk in the office and cold sweat and shaking and my heart rate's
always really high.
Dr. Harpham: Is there anything that makes it worse? Meaning the anxiety
before a checkup? Is there anything that you have found if you do or hear or
see it tends seems to make it worse, and also are there any specific tricks
that help you get through it?
Mary:
Well, I noticed I'm almost superstitious. Like, one of my big stresses was my
two year checkup and the reason was because my recurrence showed up two years
after the first treatment. So I had a little story in my head which was it takes
two years for my cancer to grow big enough to be seen. So I just have. You know,
it's like, I won't wear the dress that I wore, I just have all these
Dr. Harpham: Sort of magical things, superstitious...
Mary: Yeah. And you know I kind of recognize them
for that, but they just keep coming up. I guess that's the way human
beings are wired.
Dr. Harpham: Well, I think it's partly wanting to
have control. If you had your recurrence wearing the pink dress, then
if you don't wear the pink dress, it feels like it decreases the chance
of having another recurrence. Which you know rationally there's no relation
to at all between pink dresses and recurrent Hodgkin's.
Mary: Exactly. But it's just you know, ball players all
have these things. It works!
Dr. Harpham: Susan, how about fear of recurrence in your survivorship?
Susan:
Oh, I really do experience that. I get very nervous. Like you're heart's pounding,
and it's like waiting for a death sentence or something. I mean, just waiting
to hear if you've got another three or four months of just, yeah go, or you've
got to deal with it all over again. Once I leave an office with a good report,
then I'm fine until a couple weeks before, and then it just hits this quick
decline of anxiety until I go back again. I do think thought, after, I worried
about it more after I got the very first remission, and now that I've dealt
with the recurrence and survived, and we got back in remission, I think it was
easier for me to deal with now. I mean, I still get very anxious but I'm not
as anxious as then...
Dr. Harpham: So it was actually worse before you ever had
a recurrence?
Susan: Well, I lived in so..
Dr. Harpham: So you survived a recurrence and you see that
it is not a death sentence, it's just another illness.
Susan: Exactly. Almost like a chronic disease, sometimes
you're gonna be dealing with it and other times not. You know, that's
just the roller coaster ride of life with cancer.
Dr. Harpham: What about you, Louise? As you've dealt
with all your ongoing medical problems, which many patients consider
reminders of their disease, how does fear of recurrence affect your
days, if at all?
Louise:
Well, actually I did just have a scare in September, my lymphocytes kept coming
back abnormally high and we had three options, rejection of the lung; relapse
of the leukemia, or an infection of unknown origin. And I had to have my first
bone marrow biopsy in six or seven years, and that really got me anxious again,
because I hadn't had one in so long.
Dr. Harpham: So what sort of things were you thinking
or feeling when you knew you needed that bone marrow biopsy?
Louise: I thought, if the leukemia is back I don't
think I have the will in me any longer to go through chemotherapy again.
After going through the chemo, the bone marrow transplant, the C&D
pneumonia, the lung transplant, and all the chronic problems. I just
thought, you know, I think I might really have to toss in my chips this
time. I just don't know where I would find that will to fight again,
and I hoped that my spirit would come out, that I would be able to face
the challenge. Fortunately, there were no lymphs or no blasts or anything
in the cells and everything looked fine and the lung was fine and it
turned out I had pneumonia. But that fear, and when I get that fear,
I clam up and I will not discuss it with anyone, I won't tell any members
of my family, I won't discuss it with anyone until it's just right down
to the last minute.
Dr. Harpham: Tell us why.
Louise: I think I'm more afraid for them having to
go through it again as well. Because it's been thirteen years that we've
been dealing with this for thirteen years. And I just thought, Jeez,
I don't want to put them through it again either. I think, one of my
sisters was my bone marrow donor and she's been basically my primary
caregiver, my parents are both deceased, and it's just been real tough.
I've always felt like I almost had to deal with this whole thing by
myself as it was, not having parents, and having family members that
worked or lived out of the city that weren't here, and most of the time
I was driving myself to my doctor appointments.
Dr. Harpham: Cancer is very inconvenient, isn't it?
Louise: It IS, inconvenient. And I'm so independent because of that
that I don't want anybody else of course to be a burden on them.
Dr. Harpham: So you were thinking about all these
things when you had that scare. Now, was your sleep affected?
Louise:
Yes, it was, until I had the bone marrow operation and the bronchoscopy.
Dr. Harpham: How long a wait was there between your
getting the hint that something might be wrong that you might have recurrent
disease and your actual test that showed you did not?
Louise: It was about three weeks. I started having
a real bad cough the beginning of September and kept on coughing. And
I couldn't quite, but my lung x-ray was clear, they couldn't figure
out where the cough was coming from, and then that was when the leukocytes
were showing 53% and they said, well we think if might be rejection
of the lung. That was the first thing, I thought, Oh, NO, after it had
been a year everything would have been fine and then they said, well,
of course, it could be your leukemia coming back. Of course that would
be even worse. And then I had the bone marrow biopsy on Wednesday and
had the bronchoscopy on a Friday and both came back negative. So then
on Sunday I was in the hospital with pneumonia.
Dr. Harpham: How did getting the good news affect you?
Louise: Oh, it can just make you do an about face
so quickly. It's just amazing what one little ounce of good news you
just grasp onto it and it just elates you. And I got all positive attitude
again, and I think okay, that's not so bad, just a small little bump
in the road, ..
Dr. Harpham: How did you feel about the fact that
you'd been so scared, or had all those thoughts about, what would I
do, and I couldn't do it again.
Louise: I thought, How silly of me to act like that.
I mean, I've got to keep this positive attitude. But then I think, "Gosh!
You're human." You're allowed to kind of get some dark thoughts
every once in awhile, because I've been so positive throughout the whole
treatment. I mean, even when I was on a respirator with C and V pneumonia
with both lungs whited out, my doctor standing over me, telling me,
You're going to be okay. I believed him. And nobody had ever survived
C and V pneumonia before on a respirator. And I just shook my head and
said okay, and, and, I lived. And got that "you're gonna be okay"
attitude around my illness.
And when I was on the operating table with my lung transplant,
at one point I woke up during surgery, right after surgery and heard
the doctors say, "She's crashing. Her blood pressure is over forty."
And I literally felt the life going out of me. And I heard him say,
"Give her some dopamine" and they did and it was kind of like
being plugged back in again. I've relayed that story to my doctors three
days after surgery and they said, "who told you that?" And
I said, "No, I was awake. I woke up. I heard that and I felt that,
and I thought I was going to die, and I came back. And I thought, I
keep thinking all this time, "I'm gonna stay" I'm supposed
to be here. I'm going to make it. I'm gonna beat whatever comes my way.
Dr. Harpham: You told us about having negative type
thoughts but you kept them to yourself. After you got the good news,
did you ever share what you'd been thinking or feeling with your family
or your close friends?
Louise: Yes I did. Afterwards. Usually after the fact
I can talk about it but beforehand it's just something I always just
keep to myself and then I'll tell them, boy, that was a pretty good
challenge there, I wasn't sure which way it was gonna go. And eventually
right like the day before the bone marrow biopsy I told everybody just
to keep me in their prayers, it was a big day and I needed a lot of
positive thoughts and it seemed to work.
Dr. Harpham: Well, though you are not dealing with
cancer right now, you are dealing with the challenge of chronic and
late effects of cancer treatment. And chronic effects are medical problems
that persist, they continue after completion of treatment, and late
effects are medical problems or changes that first occur months or years
following completion of treatment. Can you share with us about dealing
with your, how it's been to deal with chronic after effects of your
treatment?
Louise: Well, my sister, who was my bone marrow donor, she tells me
since I'm usually at the medical center, at least once a week or you know, two
or three times a month for sure. She tells me, you know, that's your job, it
is your job to stay well, and that's really kind of how I deal with it. I mean
it's a daily routine, it's taking care of yourself, making sure you take your
meds. I have three huge pill-boxes that I have to sort my twenty odd pills that
I take three times a day. Remember to take them and which pills go at what time.
And it's a job, you really have to stay alert and mentally focused on the various
things that can go wrong, the various meds that they give you. Because they
change quite often especially with the solid organ transplant, getting the right
amounts adjusted, the anti rejection drugs--I've been on three different anti
rejection drugs in a year. And getting that fine tuned is a big ordeal.
Dr. Harpham: Can you share with us some of the emotions
you have felt about dealing with these other non -cancer medical problems?
Some survivors feel angry. I mean I had to deal with cancer and now
I have to deal with diabetes or and other people feel overwhelmed, other
people feel a tremendous sense of it being unfair, or just having to
keep pulling it up and doing more. Other people want to escape the patient
role, and though they're not a cancer patient, if you're going to doctors
for diabetes or minor surgeries or whatever it is, you can't escape
the patient role. I would like to hear more about the emotions that
have accompanied this series of medical complications and chronic problems
that you've faced.
Louise: Well, it's a big thing to face. I know that
when I first started having the breathing problems, I was very upset
about that because I had two good years after my bone marrow transplant
of feeling wonderful, feeling very healthy and active and then just
one day woke up and couldn't breathe. And that was alarming to me, it
was very frightening because I didn't know what was going on and what
was changing and why my lungs were like that.
Dr. Harpham: How did you feel when you found out you
had a really serious medical problem and it was related to your cancer
treatment? This lifesaving treatment gave you a new medical problem.
Louise: I know. Actually I was pretty angry about that and I was pretty
angry about the fact that basically the doctors know that this is gonna happen
somewhere down the line and they kind of leave that part out when they're telling
you about a bone marrow transplant. They know that you're gonna have graft vs.
host disease 75% of the time and they kind of left that part out. I think that's
what bothered me more was the fact that my sister that was my donor was more
upset, because she said the one thing that I thought I was doing to save her
life, is now killing her. And she felt a lot more guilt about that than I was
angry. I mean, I wasn't angry at her. I was just angry that this was something
I was gonna have to deal with forever.
Dr. Harpham: What got you through that anger, and how did you help your
sister? Who helped your sister?
Louise: Well, I always hope that I helped her because
I said, Sue, if you hadn't given me the bone marrow transplant, the
bone marrow, then I wouldn't be here to gripe about it.
Dr. Harpham: Exactly.
Louise:
So we dealt with it with a lot of humor and love and compassion, and just the
fact that I told her I would do anything to keep going. If I had to have the
lung transplant, I will. And now there's a possibility I may have to have a
kidney transplant. And she's already stepping up to the plate and saying, Okay,
I'll be your donor! So, I mean, it's just something that every day I have to
deal with. It's something I don't like, I don't like sticking my finger every
day to check my blood and I don't like giving myself insulin shots, and but
I don't want to suffer the consequences, either. And knowing what the outcome
could be if I didn't take care of myself, that far outweighs what I have to
go through. And yet I still keep an active life going. One of my friends told
me I could be the poster babe for just about every disease there is no. Leukemia,
diabetes, osteoporosis, lung transplant, pick a day, pick a calendar, I could
be it.
Dr. Harpham: You sound as vibrant as anybody I've ever spoken
with.
Louise: Like tomorrow night I have a meeting with
the Leukemia Society for a concert that we're doing in January and looking
forward to that, in fact, I'm calling them saying, we haven't had enough
meetings lately, what's going on? Let's get going.
Dr. Harpham: So illness does not define you, it's just part
of your life.
Louise: It is. It's just secondary to my life. You
know, I'm gonna live my life first and do as much as I can. I've got
weddings to attend, I've got babies to see born, I've got children graduating,
nieces and nephews and I just have...
Dr. Harpham: So you give the illnesses their very
proper attention, but you work them in with your life so they don't
define you. Mary, what about after effects or chronic effects for you?
Have you had any chronic problems related to your cancer therapies?
Mary:
Really pretty minor ones, and I, listening to Louise's story, I really admire
her courage.... because I get angry about relatively minor things.
Dr. Harpham: You've had asthma at some point.
Mary: Yes and it's been pretty mild. In fact I've
not even thought about it for the last six months or so, and it hasn't
really slowed me down. It doesn't seem to be set off by exercise, it
seems to be just allergy related or if I get a cold, so that's been
pretty minor to deal with. I went in, the stem cell put me into early
menopause, so I have to take medication for that, but I mean, really...
Dr. Harpham: How did you feel about that?
Mary: Well, I wasn't really seriously planning on
additional children, so it wasn't a huge thing. But it does sometimes
just make me feel like, I kind of got aged about ten years in the course
of one month, and I've put on some weight and you always wonder, well,
do I have a 50-year-old metabolism instead of a 40-year-old metabolism,
but you know, ...
Louise:
Mary, can I add something to that? Because I was 34 when I went through my bone
marrow transplant, and actually at the time they were giving me a choice of
whether to do more chemotherapy or do a bone marrow transplant, which was still
pretty much experimental in 88, and very risky to begin with. But the total
body radiation, I knew I was not going to be able to have children. And that
was one of the reasons why it took me, I was relapsed in June, it took me until
August to make up my mind what I was gonna do, because of the very fact that
I couldn't have children. And my doctor and I were talking about it and he was
asking me, Why are you having such a tough time making this decision? And I
said, Because I can't have children. And he said, Well, what does that have
to do with it? And I said, Well, I'm in mourning. I'm mourning for the Louise
that I'll never know, as a mother or a grandmother, and that's such a difficult
thing to go through and I just can't picture myself not having children. And
that was, THAT was the toughest thing, after my relapse.
Dr. Harpham: To whom did you turn for help to deal with that
powerful mourning?
Louise: I kept it in. Unfortunately, I kept a lot
of that in, and I didn't talk about it.
Dr. Harpham: It's a very hard, hard loss. Even if
rationally you know it's the best choice for you. It's a very painful,
hard loss for a lot of people.
Louise: That was one of the hardest decisions I made, was
having to give that up.
Dr. Harpham: Did you ever talk to your physician about it?
Louise: I did. He of course being male, said, that never occurred to
me. I never thought of it in those terms. So I hope he does now to his other
patients seeing how devastating this is to a young woman of childbearing age
that wanted to have children.
Dr. Harpham: Which brings us to the idea that when you share with your
physicians, you hopefully change how your physicians deal with their other patients.
Louise:
That's what I have always hoped.
Dr. Harpham: That patients are physicians' teachers?
Louise: Yes.
Dr. Harpham: Susan, what about you? Have you dealt
with any chronic problems or late effects of your treatment.
Susan:
I haven't had to deal with too many of those. It did change what Louise was
saying the childbearing. We had planned on three children and my youngest was
two. When I was diagnosed, that changed the plans. Not that I, the chemo that
I did not put me into menopause but just health issues. Pregnancy was hard on
me and I just felt like it wouldn't be a good choice all the way around to put
myself through that. But you do mourn that loss, because it changes your whole
family image. And it was hard to deal with. But health-wise, sure there've been
times when I have less energy than others, but I seem to bounce back. You know,
being 42, it seems like I've got plenty of energy, but I know I don't have near
what I had in my thirties. So it's hard to tell whether it's cancer-related
lack of energy of if it's just being in your forties.
Dr. Harpham: And that's often a problem for patients.
Is this related to my treatment, or would this have happened anyway?
Dr. Harpham: I'm gonna shift gears just a little bit,
and talk about something that Mary touched on a bit ago, and that was
changes in your reactions to life situations as a result of having gone
through the cancer experience. Many patients find cancer a life-altering
experience, reshaping how they see their world, changing how they feel
about every day events. Susan, can you describe for you some ways in
which your outlook or your approach to life, your philosophies of life,
have changed as a result of going through cancer?
Susan: Oh I think that they have changed immensely.
You know we were talking about stresses earlier. I really, of course
I get stressed out. But the things that cause me to get stressed out
have to be really large. Just because I seem to, I really enjoy each
day and I'm grateful for each day and I'm so glad I'm here for my kids,
and that's just been my wish through this whole thing. They were so
young, just to be here to raise my kids. And I'm so grateful that I've
seen the advances they've been through and the changes they've made
and now they're 13 and 10, and it's been wonderful. And also, just,
I've had so many things...My religion has, my religious beliefs have
really increased. Just things that have happened to me that just seemed
like God was speaking directly to me. And I do feel like things are
going to be okay and that he's there with me, and that has been remarkable
for me.
Dr. Harpham: So your faith has strengthened?
Susan: Very much so.
Dr. Harpham: Going back to the practical things. Do you deal any differently
with people who are rude or just everyday frustrations like we mentioned, the
faucet leaking, or a flat tire? Have any of those every day frustrations changed
in your life?
Susan:
Again, I do get frustrated. But it takes more to set me off I think than before
dealing with cancer. And people that are rude are something I try to be nicer
to them, because who knows what they're going through? They may have a checkup
in a week for their cancer, you know, to find out how they're doing. So I give
people more the benefit of the doubt, I think.
Dr. Harpham: Has it changed how you feel about money?
Susan: Well, it just doesn't mean as much, I would
say. I don't think any of the material possessions mean as much as your
health. I mean you've always heard that, if you have your health, you
have everything, and you really don't understand that until your health
is threatened.
Dr. Harpham: It's amazing how many of those corny sayings
sound different after you've been sick.
What about your relationships with your family members? Or
friends?
Susan: Oh I think it brought my family and my friends
much closer. Here's the amazing thing. I had so many friends that were
so just there for me in so many ways, but to me it was incredible. The
people that I just sort of knew on the outskirts, didn't really know
that well, that stepped up and were just amazing people and that through
cancer I got to know them. And I might not ever have had that opportunity
if this wouldn't have happened. But it's always so amazing when someone
you just barely know, or a friend of a friend, comes and does something
incredible for you, just because they heard you were sick and needed
help. And that to me was very uplifting. And I had a lot of instances
like that that really meant a lot to me.
Dr. Harpham: Mary, how has your outlook or approach to life
changed?
Mary:
You know when I was in the hospital with the stem cell, I remember going through
a magazine and finding a picture of a family eating spaghetti at a table and
I just cried over that picture. I just wanted to enjoy my family life, just
kind of a normal, every day family life, and I missed that when I was in the
hospital. I think I was kind of more ambitious, frankly, and all that ambition
seemed kind of useless up against the thought of not being there for my kids.
So I think I simplified my life and just focused more on my family because there's
nothing I can do or accomplish career wise that would really be the least bit
significant against the possibility of not being with the kids.
Dr. Harpham: What about the daily frustrations of
life? Has that changed or has your sense of time changed? Do you feel
like time is moving faster or slower?
Mary: I feel like I take time every day to just really appreciate just
being here and being, you know, every day I sit down and do my prayers and write
out my thanks, and every day I write: Thank you for another day of feeling good.
I'm so grateful for just that. Which is something that I of course like everybody
else, just took for granted before I got sick. So..
Dr. Harpham: You actually went and made a thank you journal.
Mary: Well, I have a sort of a little prayer notebook
and it has a section for thanks.
Dr. Harpham: When did you start that, Mary?
Mary: Probably about a year and a half ago. And I've
just really begun to appreciate how important it is to be grateful.
When I was sick one of the things I was grateful for were the people
that kind of like what Susan said that came out of, not out of nowhere,
the people you didn't necessarily know, and even your doctors. I mean
it occurred to me one day that you know, here I have this disease and
here's somebody two miles from my house who has spent his life preparing
to treat someone with this disease. And I just feel so grateful.
Dr. Harpham: Louise, how about you?
Louise:
Well, I always was an upbeat person and very positive in all my daily life.
So when I got my very first diagnosis and my sister was Sue was with me and
she said, Lou, do you think you're gonna be okay? No, she said, Do you think
you're gonna die? And I said, No, I don't think I'm gonna die. I think it's
gonna be tough, but I think I'm gonna get through it. And that was basically
day one of diagnosis and I kept that attitude the whole time. And as far as
everyday stresses, they just don't seem to matter any more. People that are
rude, I won't be rude to them, I'll be just as nice, just as Susan said. I'll
go out of my way to be even nicer. You don't know what their problem is. And
I used to have this wonderful, glorious, natural curly thick hair, and of course,
I've got this straight mess now that I'm cursed with, and I remember once seeing
a young woman walking down the street with very, very short hair and thinking,
Oh, that poor thing. Gollee, uck, why would anybody wear their hair that short?
And inwardly said that, and then of course, that was me
a few years later. And being grateful for that very short hair! So everybody's
got their own story, and everybody has their own little world that they
live in. And sometimes you might be a part of it and I'll let them have
their space and I'll be just as kind to a stranger, because you never
know when you might be entertaining an angel.
Mary:
If I could jump in Wendy, kind of echoing what Louise just said. I had a chat
group that I was part of that, cancer survivors. And I got involved with this
chat group in 94, and that was about when the Internet was really getting popular.
And I would also just sort of tool around and look at some of the other chat
groups, and I just found a lot of the chat groups, and I hate to make generalizations,
but you've got a lot of, people are sort of, oh what are you doing? Oh, not
much. You know, kind of bored, cynical, angry, cause who knows, fighting over
things, and I just found that the chat group for the cancer survivors was the
most upbeat, happy, engaged group. I thought there was a lesson here.
Dr. Harpham: And actually that would lead me right into what I wanted
to bring up, which is that anyone with or without cancer deals with frustrations
and setbacks and complications in life, and one tool that many people use is
humor. And I'd like to talk about how humor helps people get through the cancer
experience. Mary, you brought it up. You said that humor on the Internet was
really most striking in the cancer groups as opposed to the non-cancer groups.
Mary:
Yes. Well, it's hard to, I'm not sure how to shed any light onto it other than
I think it gets back to the fact that you are so grateful for what you have
just for this day, then you want to put whatever energy or humor you can in
it, to make it more enjoyable. One of the stories I tell people is, my cousin
went through breast cancer and did a stem cell transplant a couple of years
before I did, and right before I went into the hospital, I called her and I
said, Pat, tell me exactly what this involves. Just tell me the words and help
me to like kind of mentally prepare for this. And we talked for about two hours,
and we laughed the entire time! I'm not really sure I can recreate it and explain
why, other than Pat is a funny person, and the way she retold all of her experiences,
you know, a lot of potty humor about the diarrhea she had to deal with. Like
I said, I don't know if I can, you had to be there. But it was one of the funniest
conversations I ever had in my life.
Dr. Harpham: Why do you think it was so helpful to her and
to you?
Mary: Because,
Dr. Harpham: Well, laughing which feels great.
Mary: I think there's a sense of power, which is,
if you can laugh about something, it can't quite overtake you. You know,
you're always a step ahead if you're still laughing. That's what we
did. I can't think of a more gruesome subject and we were laughing our
heads off.
Dr. Harpham: And Susan, I understand you had some
pretty funny situations arise during otherwise grim times yourself.
Susan:
Yeah, definitely. And I think that Mary's right. If you can laugh about it.
And they say laughter releases endorphins and I did try to keep a sense of humor
about it. But I mean probably Wendy you're thinking of a story I told when they
called about the interview, that my wig. You know I got my wig and within a
couple weeks had a friend over for dinner. And I had my wig on and you feel
self conscious anyway with that on and I was reaching into the oven to get out
the casserole or something, and my synthetic wig, the bangs just ZIP! And went
all the way up to the top of my head and they just melted! So I had no bangs.
I had to get through the rest of the night with this no bangs, fringed, singed
bangs. It was so funny.
Dr. Harpham: Did you have a camera?
Susan: You know, we did not get a picture. But I laughed
about it then sort of, but then we laughed so hard. My mother was in
town and we laugh about it now so much. You know, the doorbell rings
and you run and take your turban off and put your wig on and answer
the door. I mean you can't help but see the humor in some of the instances
that you have to go through.
Dr. Harpham: And it also lightens up your memories.
Your memories of very difficult times are not pure hardship and suffering,
but they have these funny interludes.
Susan: And well, probably the funny times, when I
think back of the wig and all that, it's more the funny times that come
out of my mind than the worst times.
Dr. Harpham: Louise, what about you? How did humor play into
your survivorship?
Louise:
Oh, big time with humor. In fact, I majored in drama when I was in college and
have a lot of good acting buddies that I still hang around with. And one particular
girl that I went to school with I think is just, she never went into professional
acting but she should have, she's just the funniest person I know. And I would
call her to come up and visit me on day before I was gonna have a bone marrow
aspiration. And knowing that I had to have good blood counts and wanted to get
my white blood cells up, and I knew that laughing was the best exercise I could
do, and she'd come up and spend a couple hours with me and we would literally
laugh the entire time! And I probably couldn't even tell you what we laughed
about but I've chosen to always see the humor in things rather than the negative
in things. And even think sometimes when you have this great, nasty stuff, and
would want to puke and you couldn't, to me that was funny. And any other kind
of... I remember one time I was so sick that I couldn't get up and go to the
bathroom. And one of my doctors was in the room and I said, I really need to
go to the bathroom, and he said, well, what do you want me to do about it? And
I said, well, do you think you could help me? And he says, Well, okay. And so
he helped me and I said, I think I'm gonna faint, he goes, Aah! What do I do
now?
I said, My lord, you don't know? Then what are we gonna
do? So I just choose to see the lighter side, and the funny side and
I've had, when I had my graft vs. host disease and I was just red all
over and bald headed as could be, I didn't wear a wig, and I got some
pretty funny looks, though.
Dr. Harpham: So it's really okay to share the humor
and share this side of what's happening with you with your caregivers?
Louise: right. You can always share the humorous side, but the dark
side I kind of chose to keep to myself.
Dr. Harpham: Well, humor obviously has been an important element for
all of you.
Another element in healing that's difficult to quantitate
is will power, the will to live. The will to overcome challenge. As
a doctor myself I see patients with terrible medical conditions, they
seem to will themselves better, or at least, they seem to live longer
than expected. What do you think this is all about? How do you see will
power playing into your survivorship. Louise, you've mentioned that
you had a near death experience. I've seen patients who seem to will
themselves better or at least to live longer than expected. What is
this about? How do you see will power playing into your survivorship?
Louise, you once had a near death experience you shared with us and
the doctors more than once did not expect you to live. How do you think
willpower played into your beating the odds?
Louise:
Well, one of the things that I did was a lot of affirmation and I've always
had a good positive attitude, but a lot of imagining that I was going to be
well, imagery played a good part. One of the things that I did was I made my
white blood cells killer, great while killer sharks, and would line them up
at the top of my head and tell them to go attack. I'd seen a slide of what leukemia
cells looked like and they were purple. And I would tell them, go attack anything
purple in my body. And I just kept that will to live, I had at the time, my
oldest niece was 13 years old and when I heard her voice on the phone, when
I told them that I had leukemia and I heard her little voice say, "Hello."
That gave me so much will to live, knowing that I wanted to see her grow up,
and she turns 28 tomorrow! And it's just been one of those. Just a desire inside
that's so strong, you keep on going.
Dr. Harpham: And it was a desire that was fueled by
your connection to people and your picturing goals or picturing future
events that you wanted to experience.
Louise: I had a niece and a nephew graduate this past
May, and I kept thinking, gosh, you know, the year 2000. Laurie and
Michael will be graduating that year, I mean, this was 1988. And I'm
thinking, I'm gonna be here in the year 2000. And I had to keep that
positive goal and go for it! I remember at one point, after the bone
marrow transplant, in 88 and I had gotten an appointment, some doctor
wanted to see me in 1989. And at first that kind of alarmed me and it
kind of shocked me and surprised me and I thought Gee, somebody thinks
I'm really gonna be alive in 1989! Wow! I mean, gosh, they put that
much faith that I'm gonna be at this appointment in 1989! And you know,
then to reach the year 2000, it was just a big milestone. And every
anniversary of the bone marrow transplant, and now the lung transplant.
It's amazing to me, but I've never lost that will to live.
Dr. Harpham: So unlike people who are afraid to grow
older, you celebrate milestones that mark the passage of time.
Louise: I announce my birthday with pleasure. I'll say,
I'm 46 years old and happy to be here!
Dr. Harpham: Susan, what about you? What about will power
and your survival?
Susan:
Well, I think being diagnosed with two young children, the will to be there
for them and for my husband was so strong. And I did imagine things like my
daughter, who is my youngest child, I would imagine being at her wedding or
something. Just set a goal like that that you want to accomplish, and like I
say, I'm just so grateful for each day that I am there. For with each problem
that comes up I think, Oh, I'm here to help them through this. And to help solve
it. And I'm just so glad that I'm able to do that.
Dr. Harpham: Did you ever feel a weakening of your will power?
Susan: No I really haven't. You know you get frightened
and you get anxious and you feel like the wind's been knocked out of
you, but the will stays there. For me it has never weakened. In fact,
sometimes when I've had a recurrence it almost strengthens the will.
Dr. Harpham: The bigger the enemy the bigger the will.
Susan: Exactly.
Dr. Harpham: What about you, Mary?
Mary:
You know, I think I have mixed feelings about will power. I guess it's because
I'm a person without a lot of will power, or I seem to have it in some ways
and in other ways I don't. so I have some mixed feelings about it. I think sometimes,
I've known people I felt like were much stronger than I was spiritually and
mentally who didn't do as well as I did, medically. And I felt, you know I also
feel like, I didn't really beat the odds, I actually sort of the opposite. So
I have mixed feelings about it. But I do feel like if I can keep my spirits
up and kind of always have something to look forward to, that just physically
I feel better. So it must have some impact. But, I have different thoughts about
it different days. But..
Dr. Harpham: Well, was there ever a sense of guilt
when things went wrong, when you had your recurrence, that sort of a
sense of, if my will power was really good, it wouldn't have happened?
That people connect will power with a successful medical outcome?
Mary: Right. Or like having a certain attitude.
Dr. Harpham: How did you deal with that? How did you find
a sense of peace about that?
Mary: As I said, I know people who had, who had attitudes
as good as you could humanly possibly have and who didn't do well, and
you know, we all know people too mean to die. So I just, I guess sometimes
I feel like I wish we had more control than we do. And sometimes that's
what seems....
Dr. Harpham: Well, did that experience affect your
sense of will power when you went into your transplant? Knowing that
will power does not control all? Did that affect how easy or difficult
or easy it was for you to strengthen your will to live when you went
into this frightening transplant?
Mary: I think so. Because I was more passive the second
time around. Not that it made any big difference. But I think I was
more sort of a fighter the first time around. And something didn't work
the way I wanted it, even if it was just sort of a matter like comfort,
I would be more likely to speak up or try to get things changed. And
I just felt like the second time around I was kind of going through
the paces. So. I don't know. On the other hand I feel like sometimes
the whole idea of will power almost puts an extra burden on cancer patients?
You know, like I must never, ever let my positive attitude go down,
or I'll get sick. And some days you just feel crummy, and you just give
up.
I know, there were days when I'd say, You know, I'm just gonna go to bed. And
I don't think that's so bad. I find even now at the end of the day, I'll feel
just discouraged, or resentful and I'll say, you know what? You need to go to
bed. It's just fatigue. I think it's unfair for people who don't have cancer,
to say, "you've gotta have a positive attitude", that's what's gonna
save you." Well, you go through that and see if YOU have a positive attitude.
It's an expectation that I don't think is always helpful. Yes, it's good to
have a positive attitude. Having one helps you to stay with your treatment,
it helps you to get through it more easily, but on the other hand, you've got
to cut yourself some slack sometimes and just, when you're feeling bad, you're
feeling discouraged, rest. Maybe it's your body's way of telling you to just
rest.
Dr. Harpham: Well, we're dealing with stress and uncertainty
and risk, faith, spirituality, is another area of survivorship, and
it's an area that can't be measured with a blood test or a scan. Like
willpower. Mary, what role did spirituality or faith play for you? Do
you feel like your faith has changed as a result of having cancer?
Mary:
Interesting. It's hard to pin down for me. I feel like in some ways I was impressed
by almost the randomness of life. You know, things just aren't fair. And I'm
a Christian personally and the teachings of the bible are that things aren't
fair, but we still have that expectation, that somehow if you do the right things
in this life, you'll get your reward. And but I realize that things aren't fair,
sometimes, and it's not for us to know to understand that. So in some ways things
seem more random but I also find myself more consistent and more in my prayers
and more close to God. So it's kind of a mixed bag.
Dr. Harpham: What about you, Susan? How did spirituality or
faith play into your survivorship?
Susan:
Well, I think my faith has definitely increased over the years. Quite a bit
right a first. I had two people that entered my life that I did not know very
well that I just felt like were angels from God, and they kept telling me I
was gonna be okay. And I truly felt like god was speaking to me through them.
And just things that happened. It would be too long to go into, but it was wonderful.
And it really helped me in those first few months of CHOP chemotherapy and the
shock of this diagnosis and just getting through everything. It was an incredible
help to me. I don't know that I could have gotten through it without that. And
still it made me want to look for more answers, I guess. I attend more Bible
studies now and I'm just more active in the church as the result of all this.
I just want to be there, I want to help other people and so it's just a good
place for me to be.
Dr. Harpham: What about you, Louise?
Louise:
Well, I felt like my faith has increased, also, and I felt many times that because
of some of the choices I made, were not made by me alone. At the time that I
was trying to decide to have the bone marrow transplant, the decision I had
come up with on the day of my deadline was to not make a decision that day.
And those weren't acceptable answers, but that was all I could come up with
because I just didn't feel right about it. And it was one of those times that
you just have to let go and let God help you.
And so then the burden was lifted off of me and I was
so relieved that I didn't have to come up with that choice, and I was
just, that eventually I was going to get an answer. I mean it's just
like being spoken to by God, was I was in the shower, taking a shower,
washing my hair, and I just got this overwhelming voice that said, DO
IT, YOU'LL BE OKAY. And quick as I could get out of the shower I called
my doctor and told him I was ready, I was ready to fight and let's do
it, and called my sister to tell her, you know, get ready, you're gonna
be the donor. And it was so overpowering and so uplifting that I felt
like I wasn't alone when I made the decision or that the decision was
made for me.
Dr. Harpham: So faith helped you make your decision and also
get in a frame of mind to undergo the challenge.
Louise: Right, that it was gonna be okay. That's always,
that's the message that I got. And the same thing happened to me with
my lung transplant. I mean, I had no idea when it was gonna take place,
and I was listed on July 12, last year, and the night of the 15th
of September, I was here, alone at the house. My brother was in the
hospital, just having had open-heart surgery the week prior. And again,
I got this overwhelming sound and this voice, clear as could be, that
said, GO GET READY. I'm thinking, it's 11:15 at night, what am I gonna
get ready for? And of course I was on oxygen and everything was an ordeal
to do because I was so slow so I went and took a shower and got ready
for bed basically, but the next morning at 5:30 a.m.
I heard on the news about the killings at that Fort Worth
church in Wedgwood Baptist Church, and one of the family members was
going to have their daughter's organs preserved for donation, and I
said, out loud, I'm gonna get a lung today. And then at 3:15 that afternoon
I got my page, and I had gotten the message at 11:15 the night before
to go get ready, otherwise it would have taken me a good two hours to
get down there to the hospital to shower and just preparation time was
enormous being on oxygen means being run down so I was sitting there
with makeup on and hair fixed and ready to go when the pager went off.
Dr. Harpham: Louise, that's an amazing story.
Louise: Well, and even more amazing is the fact that
a book was written about these killings, and my donor got lost, out
of four hospitals, her parents couldn't track her down, and it wasn't
until 11:15 that night that she was identified. What a connection. I
mean more than once have I been blessed, I've had my faith enter into
it that I think god has directly spoken to me.
Dr. Harpham: Well, we've talked about a lot, from
energy to fear of recurrence, to side effects of treatment, to will
power and humor and spirituality and faith. Cancer can affect every
sphere of life. I hope our discussion has helped you sort through some
of the issues that may be a part of your life. A big thanks to our guests,
Mary, Susan, and Louise, for their willingness to share their thoughts,
feelings, and parts of their lives with us today. I hope that some of
their experiences will help you think about and talk about your own
concerns in healing ways. I encourage you to listen to our discussions
we have available on the web-site, or by telephone. For the American
Cancer Society's Cancer Survivors Network, I'm Wendy Harpham, wishing
each of you a great day, today and every day.
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