From MayoClinic.com
Special to CNN.com

After your cancer treatment, you were eager to nurse your body back to health. But beyond your initial recovery, you might be interested in ways to improve your long-term health so that you can enjoy the years ahead as a cancer survivor.

The advice for cancer survivors is no different than the advice for anyone who wants to improve their health: Exercise and improve your diet. But for cancer survivors these strategies have added benefits — research shows these simple steps can improve your quality of life, smoothing your transition into survivorship. Follow this guide to what you can do to take care of your body after cancer treatment.

Exercise

Regular exercise increases your sense of well-being after cancer treatment and can speed your recovery. Cancer survivors who exercise often experience:

• Increased strength and endurance
• Stronger immune systems
• Fewer signs and symptoms of depression
• Less anxiety
• Reduced fatigue
• Less difficulty sleeping
• Improved mood
• Higher self-esteem

Adding physical activity to your daily routine won’t take a lot of extra work. Focus on small steps to make your life more active. Take the stairs more often or park farther from your destination and walk the rest of the way. Check with your doctor before you begin any exercise program.

With your doctor’s approval, start slowly and work your way up. The American Cancer Society recommends adult cancer survivors exercise for at least 30 minutes five or more days a week. As you recover and adjust, you might find more exercise makes you feel even better.

Sometimes you won’t feel like exercising, and that’s OK. Don’t feel guilty if lingering treatment side effects, such as fatigue, keep you sidelined. When you feel up to it, take a walk around the block. Do what you can, but know that rest is important to your recovery as well.

While exercise has many benefits, there’s no evidence that exercise can keep your cancer from coming back. Many cancer survivors are concerned about cancer recurrence and want to do all they can to avoid it. It’s not clear why cancer recurs in some people but not in others. Exercise won’t stop your cancer from recurring, but it can make you feel better and help prevent other diseases, such as heart disease.

Eat a balanced diet

Vary your diet to include lots of fruits and vegetables, as well as whole grains. When it comes to selecting your entrees, the American Cancer Society recommends that cancer survivors:

• Eat five or more servings of fruits and vegetables every day
• Choose healthy fats, including omega-3 fatty acids, rather than saturated fats or trans fats
• Select proteins that are low in saturated fat, such as fish, lean meats, eggs, nuts, seeds and legumes
• Opt for healthy sources of carbohydrates, such as whole grains, legumes, and fruits and vegetables

This combination of foods will ensure that you’re eating plenty of the vitamins and nutrients you need to help make your body strong.

While it may be tempting to supplement your diet with a host of vitamin and mineral supplements, resist that urge. Some cancer survivors think that if a small amount of vitamins is good, a large amount must be even better. But that isn’t the case. In fact, large amounts of certain nutrients can hurt you. If you’re concerned about getting all the vitamins you need, ask your doctor if taking a daily multivitamin is right for you.

No special diet is known to prevent cancer from recurring. However, some preliminary research in breast cancer survivors indicates that a low-fat diet may reduce the chance of breast cancer recurring. In this study, which has yet to be completed, it isn’t clear whether the slight reduction in breast cancer recurrence was from women eating less fat or from women losing weight on the restricted diet. It also isn’t clear if a low-fat diet has any application to other cancer survivors.

Maintain a healthy weight

You may have gained or lost weight during treatment. Try to get your weight to a healthy level. Talk to your doctor about what a healthy weight is for you and the best way to go about achieving that goal weight.

For cancer survivors who need to gain weight, this will likely involve coming up with ways to make food more appealing and easier to eat. You and your doctor can work together to control nausea, pain or other side effects of cancer treatment that are preventing you from getting the nutrition you need. Losing even more weight can reduce your quality of life and make recovery more difficult.

For cancer survivors who need to lose weight, take steps to lose weight slowly — no more than 2 pounds a week. Control the number of calories you eat and balance this with exercise. If you need to lose a lot of weight, it can seem daunting. Take it slowly and stick to it. Any amount of weight loss can help you feel better about yourself and improve your health.

Stop using tobacco

Kick the habit once and for all. Smoking or using chewing tobacco puts you at risk of several types of cancer. Stopping now could reduce your risk of cancer recurrence and also reduce your risk of developing a second type of cancer (second primary cancer).

If you’ve tried quitting in the past but haven’t had much success, seek help. Talk to your doctor about resources to help you quit.

Drink alcohol in moderation, if at all

If you choose to drink alcohol, keep it to a minimum. At most, women and anyone over 65 should drink no more than one drink a day, and men should drink no more than two drinks a day.

Alcohol does have health benefits in some people — for instance, consuming a drink or two a day can reduce your risk of heart disease. But it also increases the risk of certain cancers, including those of the mouth, throat, liver and breast. While it isn’t clear whether drinking alcohol can cause cancer recurrence, it can increase your risk of a second primary cancer.

Weigh the risks and benefits of drinking alcohol carefully and talk it over with your doctor.

Do what you can

While you may fear it will take an entire overhaul of your lifestyle to achieve all these goals, do what you can and make changes slowly. Easing into a healthy diet or regular exercise will make it more likely that you’ll stick with these changes for the rest of your life.

· Cancer survivors: What to expect with follow-up care

· On the job with cancer: Managing common workplace challenges

· Cancer survivors: Relationships with family and friends after treatment

· Cancer survivors: Late effects of cancer treatment

· Cancer survivors: Managing your emotions after cancer treatment

· Sexuality after cancer treatment: What women can expect

· Sexuality after cancer treatment: What men can expect

· Cancer recurrence: What it means and how to cope

October 05, 2005

From MayoClinic.com
Special to CNN.com

Whether it’s cuddling, kissing or sex, intimacy with a loving partner can help you feel better about yourself as you go through cancer treatment. During and after your treatment, you may find that your libido has changed. Loss of libido is the most common problem affecting cancer survivors looking to continue or resume sexual intimacy.

Losing interest in sexual activity can create tension between you and your partner, adding to the stress of treatment. Identifying the causes of your disinterest is the first step toward finding a solution. Open communication with your partner and your doctor can help you regain your libido or help you redefine what it means to be intimate.

Physical changes that can cause loss of libido

Loss of libido may be caused by physical changes to your body as a result of cancer treatment. For instance, women may experience symptoms of early menopause, such as vaginal dryness, and men may experience erectile dysfunction. Discuss these changes with your doctor.

Feelings that can cause loss of libido

Cancer is a physical disease, but going through a cancer diagnosis and treatment can be very emotional. You may worry about your future, stress over your treatment decisions and find joy in the small triumphs in overcoming your cancer. All of these emotions influence how you feel about yourself and your attitude toward intimacy. Some common feelings that can negatively affect your libido include:

Guilt
You may feel guilty because you feel previous sexual experiences caused your cancer. Cancer can’t be transmitted sexually. Although some cancers are more likely in people who have human papillomavirus (HPV), which is transmitted sexually, many people live with HPV and never develop cancer. Other sexually transmitted viruses that put you at risk of cancer include hepatitis C, HIV and Epstein-Barr virus.

Fear
You may fear that sexual activity can cause a recurrence of your cancer or that you will pass your cancer on to your partner. Sexual activity has no influence on whether you’ll experience a cancer recurrence. Your doctor can discuss your prognosis and chances for a cancer-free life. You can’t pass your cancer on to another person.

Depression
Sadness or feelings of worthlessness are common signs of depression, which causes a loss of libido and decreases the pleasure you experience during sex. People with cancer are more likely than others to experience depression. Depression is treatable, so talk to your doctor about your feelings.

Self-consciousness
Changes to your appearance after cancer treatment can make you feel self-conscious. For instance, the loss of your hair from chemotherapy, the loss of a limb, breast, or testicle, scars from surgery, and ostomies can make you feel less attractive. Many people find that their partners aren’t as concerned about these changes as they are. Still, it takes time to become comfortable with the changes in your appearance. Your doctor may have suggestions to help you regain your self-confidence. Talk with other cancer survivors for ideas on ways to make you feel more sexually attractive.

Grief and loss
Feelings of grief and loss can result if you feel cancer treatment has significantly changed your body. Some people might say they feel less feminine or masculine. For instance, a woman who has a hysterectomy may feel a sense of loss and perceive herself as less of a woman. A man may feel he’s less of a man if he has his testicles removed (orchiectomy). For some people, treatments alter how they view themselves and make them very dissatisfied with their bodies. Although some sense of grief and loss is expected with the physical changes, you can and should feel satisfied with your body and feel positive about yourself. Talk to your doctor about how you feel. Ask him or her for a referral to a clinical health psychologist if you have strong feelings of dissatisfaction with yourself and your body.

Stress
Being diagnosed with cancer and beginning your treatment is stressful. This makes it difficult to get into an intimate mood because your mind is distracted. If you’re in a relationship, stress can exacerbate any pre-existing problems you may have had. Talk with your partner about how you feel.

Anxiety
The thought of resuming sex after your cancer can cause anxiety. You might be unsure of how you’ll perform. If you have a partner, you might find yourself avoiding all intimacy. If you’re single, you might be hesitant to date because you aren’t sure how or when you’ll reveal your cancer experience to a new partner. Anxiety is common, and it may help to talk through your feelings with your partner, your doctor or a clinical health psychologist.

Consider your partner’s feelings toward sex

Many times, cancer survivors say their partners go through cancer with them — standing by them and supporting them from the first diagnosis through the uncertainty of life after treatment. It’s an emotional time for your partner, too, and sometimes partners feel afraid or reluctant to resume sex. Your partner may be afraid that he or she will hurt you or that you’ll interpret his or her advances as pressure to have sex. Your partner’s role as caregiver during your treatment can make him or her see you as a vulnerable patient, rather than the partner you think of yourself as.

In many cases, communication about how both of you feel can make situations like these easier. But many couples didn’t spend much time discussing sex before, and adding cancer to the mix makes it all the more difficult. Couples therapy may help you open the lines of communication and better understand your situation.

What you can do to regain your libido

If you’ve experienced a loss of libido, you may feel alone. You might not want to talk about your feelings, but you should. The problem won’t resolve on its own. It will take cooperation between you, your partner and your health care team to ensure that you feel comfortable resuming sexual activity. Consider trying to:

• Talk with your doctor or nurse. If your doctor hasn’t discussed sexuality, take the lead. Your doctor or nurse can help you find resources and refer you to a clinical health psychologist.
• Talk with your partner. One of the best ways to improve libido is to open the lines of communication between you and your partner. For instance, your partner may fear hurting you during sex and may avoid initiating sexual activity. You may believe your partner is no longer interested in you. A conversation about the issue can clear the air and restore emotional and physical intimacy.
• Talk with other cancer survivors. People who have had your same cancer and have endured your same treatment are likely experiencing the same loss of libido. Look for other cancer survivors in support groups in your area, or you may be more comfortable connecting with other survivors on Internet message boards. Contact the American Cancer Society for information.
• Change your definition of sexual intimacy. Maybe you aren’t ready for sex. Talk about this with your partner and look for other ways you can be intimate. Simply spending quality time together may help you reconnect and slowly move toward resuming sexual intimacy.
• Track your desire. You might think you’ve lost all interest in sex, but you may have sexual thoughts throughout your day that you ignore. Make a note of times during the day when you think about sex. If you find certain times of the day or certain situations rouse your interest in sex, use those cues to help put you in the mood.

Loss of libido is common after cancer treatment, but that doesn’t mean you can’t regain the sexual intimacy you once enjoyed. Broaching the subject with your doctor, partner or even members of a support group may help you work through your emotions and enable you to resume a satisfying sexual relationship.

Fatigue from chemotherapy can range from a mild to extreme feeling of being tired. Many people describe fatigue as feeling weak, weary, worn out, heavy, or slow. Resting does not always help.

Many people say they feel fatigue during chemotherapy and even for weeks or months after treatment is over. Fatigue can be caused by the type of chemotherapy, the effort of making frequent visits to the doctor, or feelings such as stress, anxiety, and depression. If you receive radiation therapy along with chemotherapy, your fatigue may be more severe.

Fatigue can also be caused by

• Anemia
• Pain
• Medications
• Appetite changes
• Trouble sleeping
• Lack of activity
• Trouble breathing
• Infection
• Doing too much at one time
• Other medical problems

Fatigue can happen all at once or little by little. People feel fatigue in different ways. You may feel more or less fatigue than someone else who gets the same type of chemotherapy.

Ways to manage

• Relax. You might want to try meditation, prayer, yoga, guided imagery, visualization, or other ways to relax and decrease stress.
• Eat and drink well. Often, this means 5 to 6 small meals and snacks rather than 3 large meals. Keep foods around that are easy to fix, such as canned soups, frozen meals, yogurt, and cottage cheese. Drink plenty of fluids each day–about 8 cups of water or juice.

Plan time to rest. You may feel better when you rest or take a short nap during the day. Many people say that it helps to rest for just 10 to 15 minutes rather than nap for a long time. If you nap, try to sleep for less than 1 hour. Keeping naps short will help you sleep better at night.

• Be active. Research shows that exercise can ease fatigue and help you sleep better at night. Try going for a 15-minute walk, doing yoga, or riding an exercise bike. Plan to be active when you have the most energy. Talk with your doctor or nurse about ways you can be active while getting chemotherapy.
• Try not to do too much. With fatigue, you may not have enough energy to do all the things you want to do. Choose the activities you want to do and let someone else help with the others. Try quiet activities, such as reading, knitting, or learning a new language on tape.

Sleep at least 8 hours each night. This may be more sleep than you needed before chemotherapy. You are likely to sleep better at night when you are active during the day. You may also find it helpful to relax before going to bed. For instance, you might read a book, work on a jigsaw puzzle, listen to music, or do other quiet hobbies.

• Plan a work schedule that works for you. Fatigue may affect the amount of energy you have for your job. You may feel well enough to work your full schedule. Or you may need to work less–maybe just a few hours a day or a few days each week. If your job allows, you may want to talk with your boss about ways to work from home. Or you may want to go on medical leave (stop working for a while) while getting chemotherapy.
• Let others help. Ask family members and friends to help when you feel fatigue. Perhaps they can help with household chores or drive you to and from doctor’s visits. They might also help by shopping for food and cooking meals for you to eat now or freeze for later.
• Learn from others who have cancer. People who have cancer can help by sharing ways that they manage fatigue. One way to meet others is by joining a support group–either in person or online. Talk with your doctor or nurse to learn more.

• Try not to do too much. With fatigue, you may not have enough energy to do all the things you want to do. Choose the activities you want to do and let someone else help with the others. Try quiet activities, such as reading, knitting, or learning a new language on tape.

• Keep a diary of how you feel each day. This will help you plan how to best use your time. Share your diary with your nurse. Let your doctor or nurse know if you notice changes in your energy level, whether you have lots of energy or are very tired.
• Talk with your doctor or nurse. Your doctor may prescribe medication that can help decrease fatigue, give you a sense of well-being, and increase your appetite. He or she may also suggest treatment if your fatigue is from anemia.

ScienceDaily (May 18, 2007) — It turns out Mom was right – you should eat your broccoli. But what Mom may not have known is why broccoli is so healthy, and how its lesser known, younger offshoot may be a powerful anti-cancer agent.

Researchers at the Linus Pauling Institute at Oregon State University have found that sulforaphane – a compound found in cruciferous vegetables such as broccoli, bok choy and brussels sprouts – has strong anti-cancer properties.

Even more promising results have been found in broccoli sprouts. The tiny, thread-like broccoli sprouts sold at stores next to alfalfa sprouts have more than 50 times the amount of sulforaphane than found in mature broccoli.

Emily Ho, a researcher with the Linus Pauling Institute and an assistant professor in the Department of Nutrition and Exercise Sciences at OSU, will describe these dietary inhibitors for cancer prevention at the conference on “Diet and Optimum Health,” organized by the Linus Pauling Institute. The conference will be held May 16-19 at the Hilton Hotel in Portland. Ho will speak at 10:30 a.m. Friday, May 18.

Ho’s main area of research is on the dietary prevention of prostate cancer. The Asian diet could be a key in this prevention. White males born in the United States have dramatically higher rates of prostate cancer than Asian men. But when Asian men live in the U.S. for five years or more, their rates of prostate cancer rise significantly, Ho says.

Past studies in Ho’s lab have focused on dietary elements in cancer prevention such as green tea and soy.

In her new study, which was published in the Journal of the Society of Experimental Biology and Medicine, Ho and her colleagues at Linus Pauling Institute looked at cruciferous vegetables. While many cruciferous vegetables have sulforaphane, broccoli and broccoli sprouts have the highest amount and thus could be a major player in the prevention of prostate and colon cancer.

Ho said drugs classified as histone deacetylase (HDAC) inhibitors are being looked at as potentially preventing cancer. She said their research shows that these same effects of inhibiting HDAC might be obtained by consumption of cruciferous vegetables.

“I would say if you’re at all worried about cancer or at high risk of cancer, especially of prostate or colon cancer, then increasing your dietary intake of broccoli and other vegetables could be a good idea,” Ho said.

“It certainly can’t hurt. And drugs can have negative side effects and be difficult to administer.”

While Ho said the research is not at the point where she can make a specific recommendation on how much broccoli or bok choy to eat, she personally tries to have two servings of cruciferous vegetables a day.

In human subjects, just eating some broccoli sprouts on top of a bagel with cream cheese resulted in HDAC inhibition.

“The compound in broccoli may be one of the strongest anti-cancer fighters we have,” Ho said.

Adapted from materials provided by Oregon State University

By-Jane Gross

Published: April 29, 2007

On an Internet chat room popular with breast cancer survivors, one thread — called “Where’s My Remote?” — turns the mental fog known as chemo brain into a stand-up comedy act.

Michael Houghton for The New York Times

When she can’t remember where she parked her car, Lu Ann Hudson uses a key fob that sets off a beep in it.

Narayan Mahon for The New York Times

“I had a mind like a steel trap, and I ended up with a colander for a brain,” said Linda Lowen, who underwent chemotherapy 13 years ago.

Bob Hewitt for The New York Times

Terry-Lynne Jordan leaves herself voice mail messages as reminders.

One woman reported finding five unopened gallons of milk in her refrigerator and having no memory of buying the first four. A second had to ask her husband which toothbrush belonged to her.

At a family celebration, one woman filled the water glasses with turkey gravy. Another could not remember how to carry over numbers when balancing the checkbook.

Once, women complaining of a constellation of symptoms after undergoing chemotherapy — including short-term memory loss, an inability to concentrate, difficulty retrieving words, trouble with multitasking and an overarching sense that they had lost their mental edge — were often sent home with a patronizing “There, there.”

But attitudes are changing as a result of a flurry of research and new attention to the after-effects of life-saving treatment. There is now widespread acknowledgment that patients with cognitive symptoms are not imagining things, and a growing number of oncologists are rushing to offer remedies, including stimulants commonly used for attention-deficit disorder and acupuncture.

“Until recently, oncologists would discount it, trivialize it, make patients feel it was all in their heads,” said Dr. Daniel Silverman, a cancer researcher at the University of California, Los Angeles, who studies the cognitive side effects of chemotherapy. “Now there’s enough literature, even if it’s controversial, that not mentioning it as a possibility is either ignorant or an evasion of professional duty.”

That shift matters to patients.

“Chemo brain is part of the language now, and just to have it acknowledged makes a difference,” said Anne Grant, 57, who owns a picture-framing business in New York City. Ms. Grant, who had high-dose chemotherapy and a bone marrow transplant in 1995, said she could not concentrate well enough to read, garbled her sentences and struggled with simple decisions like which socks to wear.

Virtually all cancer survivors who have had toxic treatments like chemotherapy experience short-term memory loss and difficulty concentrating during and shortly afterward, experts say. But a vast majority improve. About 15 percent, or roughly 360,000 of the nation’s 2.4 million female breast cancer survivors, the group that has dominated research on cognitive side effects, remain distracted years later, according to some experts. And nobody knows what distinguishes this 15 percent.

Most oncologists agree that the culprits include very high doses of chemotherapy, like those in anticipation of a bone marrow transplant; the combination of chemotherapy and supplementary hormonal treatments, like tamoxifen or aromatase inhibitors that lower the amount of estrogen in women who have cancers fueled by female horemones; and early-onset cancer that catapults women in their 30s and 40s into menopause.

Other clues come from studies too small to be considered definitive. One such study found a gene linked to Alzheimer’s disease in cancer survivors with cognitive deficits. Another, using PET scans, found unusual activity in the part of the brain that controls short-term recall.

The central puzzle of chemo brain is that many of the symptoms can occur for reasons other than chemotherapy.

Abrupt menopause, which often follows treatment, also leaves many women fuzzy-headed in a more extreme way than natural menopause, which unfolds slowly. Those cognitive issues are also features of depression and anxiety, which often accompany a cancer diagnosis. Similar effects are also caused by medications for nausea and pain.

Dr. Tim Ahles, one of the first American scientists to study cognitive side effects, acknowledges that studies have been too small and lacked adequate baseline data to isolate a cause.

“So many factors affect cognitive function, and the kinds of cognitive problems associated with cancer treatment can be caused by many other things than chemotherapy,” said Dr. Ahles, the director of neurocognitive research at Memorial Sloan-Kettering Cancer Center in New York.

The new interest in chemo brain is, in effect, a testimony to enormous strides in the field. Patients who once would have died now live long enough to have cognitive side effects, just as survivors of childhood leukemia did many years ago, forcing new treatment protocols to avoid learning disabilities.

“A large number of people are living long and normal lives,” said Dr. Patricia Ganz, an oncologist at U.C.L.A. who is one of the nation’s first specialists in the late side effects of treatment. “It’s no longer enough to cure them. We have to acknowledge the potential consequences and address them early on.”

As researchers look for a cause, cancer survivors are trying to figure out how to get through the day by sharing their experiences, and by tapping expertise increasingly being offered online by Web sites like www.breastcancer.org and www.cancercare.org.

There are “ask the experts” teleconferences, both live and archived, and fact sheets to download and show to a skeptical doctor. Message boards suggest sharpening the mind with Japanese sudoku puzzles or compensatory techniques devised to help victims of brain injury. There are even sweatshirts for sale saying “I Have Chemo Brain. What’s Your Excuse?”

Studies of cognitive effects have overwhelmingly been conducted among breast cancer patients because they represent, by far, the largest group of cancer survivors and because they tend to be sophisticated advocates, challenging doctors and volunteering for research.

Most researchers studying cognitive deficits say they believe that those most inclined to notice even subtle changes are high-achieving women juggling careers and families who are used to succeeding at both. They point to one study that found that complaints of cognitive deficits often did not match the results of neuro-psychological tests, suggesting that chemo brain is a subjective experience.

“They say, ‘I’ve lost my edge,’ ” said Dr. Stewart Fleishman, director of cancer supportive services at Beth Israel and St. Luke’s/Roosevelt hospitals in New York. “If they can’t push themselves to the limit, they feel impaired.”

Dr. Fleishman and others were pressed as to why a poor woman, working several jobs to feed her children, navigating the health care system and battling insurance companies, would not also need mental dexterity. “Maybe we’re just not asking them,” Dr. Fleishman said.

Overall, middle-class cancer patients tend to get more aggressive treatment, participate in support groups, enroll in studies and use the Internet for research and community more than poor and minority patients, experts say.

“The disparity plays out in all kinds of ways,” said Ellen Coleman, the associate executive director of CancerCare, which provides free support services. “They don’t approach their health care person because they don’t expect help.”

But approaching a doctor does not guarantee help. Susan Mitchell, 48, who does freelance research on economic trends, complained to her oncologist in Jackson, Miss., that her income had been halved since her breast cancer treatment last year because everything took longer for her to accomplish.

She said his reply was a shrug.

“They see their job as keeping us alive, and we appreciate that,” Ms. Mitchell said. “But it’s like everything else is a luxury. These are survivor issues, and they need to get used to the fact that lots of us are surviving.”

Among women like Ms. Mitchell, lost A.T.M. cards are as common as missing socks. Children arrive at birthday parties a week early. Wet clothes wind up in the freezer instead of the dryer. Prosthetic breasts and wigs are misplaced at the most inopportune times. And simple words disappear from memory: “The thing with numbers” will have to do for the word “calculator.”

Linda Lowen, 46, had a hysterectomy and chemotherapy for ovarian cancer 13 years ago, and says she still cannot recognize neighbors at the grocery store. “I had a mind like a steel trap, and I ended up with a colander for a brain,” said Ms. Lowen, a radio and television talk show host in Syracuse.

The other night, Ms. Lowen set out to find a good place to store her knitting supplies. She began emptying a cabinet of games that her teenage daughters no longer played. Meanwhile, she noticed a blown light bulb and went to find a replacement. That detour led to another, and five hours later she had scrubbed every surface and tidied the contents of eight drawers. But she still had no storage space for her knitting supplies.

“I have an almost childlike inability to follow through on anything,” Ms. Lowen said.

Solutions come in many forms for women whose cancer treatment has left them with cognitive deficits.

Sedra Jayne Varga, 50, an administrative assistant in family court in Manhattan, is part of a research study of the stimulant Focalin, which she said had helped. But Ms. Varga also plans to have laser surgery on her eyes so that losing her glasses will no longer be an issue.

Lu Ann Hudson, 44, a designer of financial databases in Cincinnati, relies on a key fob that sets off a beep in her car when she is looking for it in parking lots. Terry-Lynne Jordan, 43, who analyzes environmental incidents for an oil company in Calgary, Alberta, uses the calendar on her computer and voice mail messages to herself to remind her of meetings.

And Debbie Kamplain, a 32-year-old stay-at-home mother in Peoria, Ill., hired a $30-an-hour personal organizer to help her sell a house, buy another and get ready to move her family to Indiana next month.

But it is Ms. Kamplain’s 2 ½-year-old son, Daniel, who sees to it that she stays on task. Long before Daniel could talk, he would pull her over to the refrigerator if she got distracted while getting him a drink.

“Poor kid,” Ms. Kamplain said. “I say I’m going to do something, forget about it immediately, and he’s the one who has to remind Mommy about stuff.”

“Chili’s Heat Kills Prostate Cancer Cells”, Forbes, March 16, 2006,
Link: http://www.forbes.com/lifestyle/health/feeds/hscout/2006/03/16/hscout531595.html

Capsaicin, the component that gives jalapeno peppers their heat, may also kill prostate cancer cells, a new study suggests.

Initial experiments in cancer cells and mice show that capsaicin causes prostate cancer cells to undergo a kind of suicide. Researchers speculate that, in the future, pills containing capsaicin might be used as therapy to prevent prostate cancer’s return.

According to their report, capsaicin caused almost 80 percent of prostate cancer cells in the mice to die. In addition, prostate cancer tumors treated with capsaicin were about one-fifth the size of tumors in untreated mice.

“Capsaicin inhibits the growth of human prostate cancer cell in Petri dishes and mice,” said lead researcher Dr. H. Phillip Koeffler, director of hematology and oncology at Cedars-Sinai Medical Center and a professor of medicine at the University of California, Los Angeles. Based on the findings, Koeffler believe the next step is a trial to see if it works in patients with prostate cancer.

The report appears in the March 15 issue of Cancer Research.

Capsaicin probably has several effects, Koeffler said. Most noticeable is its effect in blocking NF-kappa Beta, a molecular mechanism that promotes cancer cell growth, he noted.

In addition, capsaicin also was effective against leukemia, and might be effective in slowing or preventing the growth of other cancers as well, he added.

But it’s still too early to reach for the chili sauce, Koeffler said.

“I am not recommending that people increase their consumption of peppers,” he said. “Our calculation is that you would have to eat 10 habanera peppers three times a week, which would be equivalent to the amount of capsaicin we gave to the mice.”

The researcher believes capsaicin could someday gain a place in adjuvant prostate cancer therapy. For example, it might be used after prostate surgery to kill cancer cells in patients whose blood PSA levels start to rise, indicating the presence of tumors too small to be seen, he said.

The study does highlight the crossover that can occur between conventional and alternative therapies. “We should take note of herbal medicines and then use modern-day techniques to find what the active compounds are and bring them into clinical trials,” Koeffler said.

One expert thinks it’s too early to know if capsaicin will ever be an effective prostate cancer treatment, however.

“Since large amounts of capsaicin have never been given to people, we don’t know what the side effects might be,” cautioned Dr. Len Lichtenfeld, deputy chief medical officer at the American Cancer Society. “We don’t know about the right dose or anything.”

Lichtenfeld believes that any trial should be done in patients who are not responsive to other standard therapies. “We are ways away from a clinical trial,” he said. “We need more basic research before we start treating patients.”

Another expert concurred.

“This study does not prove that capsaicin will prove effective in the treatment of prostate cancer in humans,” said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. “Nor does it tell us that eating peppers rich in the substance will help prevent such cancer, or forestall its growth. But it provides a compelling argument for clinical study of capsaicin in human prostate cancer to put these questions to the test.”

“This paper should serve to remind us that herbal remedies and pharmacotherapy are often of common origins, differing only in our capacity to identify, purify and package the active ingredients,” Katz said. “This work suggests that the conventional medical community should turn a discriminating eye, rather than a jaded eye, toward time-honored herbal treatments. Many will doubtless prove ineffective when put to the test of high-quality research. But some will pass that test, and we must meticulously distinguish between them.”

David Douglas, “Low vitamin D tied to cancer risk in men”, Reuters, April 13, 2006,
Link: http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2006-04-13T165404Z_01_COL360235_RTRUKOC_0_US-VITAMIN-D.xml

In men, low levels of vitamin D appear to be associated with increased cancer incidence and mortality — particularly cancers of the digestive system — researchers report in the April 5th issue of the Journal of the National Cancer Institute.

Co-author of an accompanying editorial, Dr. Gary G. Schwartz of Wake Forest University, Winston-Salem, North Carolina told Reuters Health that “these observations add to a growing body of evidence that vitamin D, whose major source is casual exposure to sunlight, may play important roles in the natural history of many cancers.”

“The idea that sunlight might inhibit the growth of human cancers, proposed by several epidemiologists, and once widely scoffed at,” he concluded, “now appears to be having its rightful day in the sun.”

Dr. Edward Giovannucci who led the research effort told Reuters Health: “Vitamin D deficiency is common and is important to identify and treat for multiple reasons. An increasing body of evidence suggests that a reduction in risk of some cancers may turn out to be another benefit.”

Giovannucci of Harvard School of Public Health, Boston and colleagues note that vitamin D has potent anticancer qualities.

To help quantify its effect, the researchers first correlated determinants of vitamin D exposure with serum levels in some 1000 men. Items involved were dietary and supplementary vitamin D, skin pigmentation, adiposity, geographical residence and leisure-time physical activity, and hence sunlight exposure. The researchers then computed vitamin D levels for 47,800 men in the Health Professionals Follow-Up Study.

From 1986 to 2000, the researchers documented 4286 incident cancers and 2025 cancer deaths in the cohort. These figures excluded organ-confined prostate cancer and non-melanoma skin cancer.

An increment of 25 nmol/L in the predicted blood level of vitamin D was associated with a 17 percent reduction in total cancer incidence, a 29 percent reduction in total cancer mortality and a 45 percent reduction in digestive system cancer mortality.

Total cancer rates in men with the lowest predicted vitamin D level was 758 per 100,000. The rate in those with the highest levels was 674 per 100,000.

For total cancer mortality, the corresponding figures were 326 and 277 per 100,000. For digestive system cancer mortality, the rates were 128 and 78 per 100,000.

SOURCE: Journal of the National Cancer Institute April 5, 2006.