Think Before You Play
Planning activities in advance can help keep you going.

“I’m tough. I’m not going to be tired,” thought Jane O’Harra, who was diagnosed with cancer in September 2003. But Jane was quickly surprised by the fatigue resulting from her treatments. She soon realized her routines and personal and work schedules needed to adjust accordingly.

Thinking ahead and planning activities is extremely important, especially for those with chronic disease. Your personal limits and abilities depend on your individual situation—whether you’re well, in recovery, or undergoing treatment. But as Maggie Frey, occupational therapist at Salem Hospital, notes, “It’s better to be reserved than to set yourself back.”

The more you plan ahead and pace yourself, the more you will be able to do.

Frey offers the following tips for planning activities, whether you’re healthy or managing chronic disease:

• Pace yourself. Start slow and don’t go beyond your capacity. Conscious pacing “increases your awareness of what you’re able to do,” says Frey. Listen to your body.
• Prioritize. First decide what’s most important to do. Then break bigger tasks into smaller parts. For example, don’t go to the nursery and plant your garden on the same day.
• Perform challenging tasks when you have the most energy. If you feel best in the morning, reserve that time for your most strenuous activities.
• Don’t “push and crash.” Avoid pushing yourself so hard that your progress regresses. Balance activities. Mix some
  light activities in with the strenuous ones each day.
• Alternate your activities. Let yardwork be your exercise for Monday, and on Tuesday go to the gym. Your body will enjoy the variety.
• Sit down. If you can be productive while sitting down, do so. For instance, pull up a stool at the kitchen counter, grab a bench in
  the garden, etc.
• Gather your tools. Limit trips back and forth by gathering all your needed items before beginning a task. Use a cart on wheels to decrease the amount of carrying.

Whether you’re easing back into household duties, preparing for vacation, or beginning an exercise regimen, putting advance thought into your plans can make a big difference in your ability to keep going!

Destination: Healthy Knowledge
Tips for navigating the vast sea of healthcare information so you can take an active role in your own care.

Today, information is everywhere. With the growth of the Internet, the volume of healthcare information available to the public has grown exponentially—and making sense of it all has only gotten harder.

But while navigating this sea of information may seem overwhelming at first, there are a number of simple steps you can take to keep your ship on course and become confident in your healthcare decisions.

The importance of being well informed
It is extremely important to determine which information is accurate, relevant, and actionable for you. Why? Because “In this day and age, the patient is in charge,” says Dr. Ted Williamson, radiation oncologist at Salem Hospital. “The doctor’s role is to offer quality options; the patient’s role is to make good choices,” he says. And one must be well-informed to do so.

“I chose to educate myself as much as I possibly could, because I’m the one who is ultimately responsible for my own healthcare,” says Salem Hospital prostate-cancer patient David Perry. “To get information from my doctors, I needed to ask intelligent questions.”

Gathering information
The first challenge is finding accurate information. “At best, inaccurate information can do you no good, and at worst it can do great harm,” says Carol Jones, Medical Librarian at Salem Hospital. That’s why it’s critical to scrutinize the source of information. Jones suggests asking these questions when browsing online or reading an article in a magazine or newspaper:

1. Who is responsible for the content?
2. What are the qualifications of the author(s)?
3. What is the purpose of the source? Profit? Education?
4. How current is the content?
5. Is the information intended for consumers—not medical professionals?
6. How professional is the Web site or publication overall?
7. Does it offer reliable, credible references for its information?
8. Is this information consistent with other credible information you’ve received?

Still, “Information alone is no substitute for a trusted partnership with a healthcare professional,” says Jones. Balance your independent research with the information you gather from your doctors.

Talking with doctors
It is your responsibility to ask questions and become an active part of your care team. Come to your appointments prepared with any questions you would like to ask.

“My attitude is that I’m not simply a patient,” says Perry. “I hire a doctor the same way I’d hire a lawyer.” Make sure that all your concerns and questions, no matter how small, have been asked and answered before you leave.

Dr. Arnella Hennig, radiation oncologist at Salem Hospital, tells her patients to “bring a friend or family member with you to your appointments, and ask them to takes notes. They’re an important extra set of ears during a challenging time with so much information.”

Deciding which treatment options make sense for you
Your treatment will be entirely based on your unique situation and type of illness.

“Each patient has unique needs,” says Bill Beck, Ph.D., Director of Cancer Services at Salem Hospital. “In any given situation, there may be several potential treatment options, each with its own potential benefits and risk for side effects. Our goal is to develop an individualized treatment that strikes the right balance for the patient,” he added.

Before starting, ask about the goal of treatment. Is the purpose of the treatment to cure the illness, control it, or treat symptoms? Sometimes
the goal of treatment can change over time.

Finding support systems
The importance of having support—both emotional and physical—during chronic illness such as cancer cannot be overstated. Jane O’Harra, who was diagnosed with breast cancer in September 2003, says, “Have your support people there with you through the
whole process, because sometimes you need to talk to someone who knows what you’re going through.”

A wide range of support systems exists for those with chronic disease, from family counseling to educational classes, offering various approaches. You can choose which method best meets your needs.

Beverly Smith, RN, OCN, clinical manager of Radiation Oncology at Salem Hospital, promotes patient and family education by facilitating “I Can Cope,” a series of supportive, educational classes sponsored by the American Cancer Society. “I Can Cope” includes cancer education by doctors and nurses, and encourages the patient to “become actively involved with their healthcare
team, so their medical plan can be customized for them,” Smith says.

For Elaine Gersch, who received breast cancer treatment at Salem Hospital and is an “I Can Cope” graduate, it was “really important to keep my attitude healthy,” she says. “Having a strong support system helped me stay positive, and reminded me that one day I would get through it,” she added.

Making sense of the vast world of healthcare information is no easy task, but a vitally important one. Take charge of your healthcare—ask questions, gather information, and make the decisions that work for you.

Asking Questions

In addition to asking your doctor for basic information about your condition, consider asking the following:

• What is the goal of the recommended treatment—cure or control of my symptoms?
• What are the possible risks or side effects of treatment?
• Are there other treatments for me to consider?
• Will I need to make changes in my work, family life, and leisure time?
• How will you know that my treatment is working?
• What are the chances that my illness may recur (come back) with the treatment programs we have discussed?
• What can I do to be ready for treatment?

Remember that you have the right to a second opinion about your diagnosis and the recommended treatment. Asking for one does not
mean that you don't like or trust your doctor.

Understanding and Preventing Cancer
What you do—and don’t do—makes a difference.

While cancer is one of the most talked-about, researched, and feared diseases, doctors today are identifying cases earlier, using highly effective new treatments, and better understanding risk factors—and those with cancer are living longer.

Still, the best way to beat cancer is to take steps to avoid it. Invest a moment in understanding what cancer is, and what you can do to prevent it.

What is cancer?
Cancer is an abnormal growth of cells that reproduce rapidly to form tumors. While there is no single cause for cancer, scientists believe that cancer results from the interaction of many factors together, including genetic, environmental, or constitutional characteristics.

An ounce of prevention…
As Benjamin Franklin said, it’s worth a pound of cure.

Don’t smoke. “Smoking is highly associated with many if not most types of cancer,” says Bill Beck, Ph.D., Director of Cancer Services at Salem Hospital. Cigarette smoking is associated with at least 30% of all cancer deaths, and 87% of all lung-cancer deaths.

Moderate alcohol consumption. Limit to no more than two drinks per day for men and one for women. Having even a few drinks per week is associated with an increased risk of breast cancer in women.

Manage your weight. Control portion sizes, eat five or more servings of vegetables and fruits each day, choose whole grains over processed grains and sugar, and avoid high-fat foods.

Increase physical activity. Get your body moving. With moderate to vigorous levels of physical activity, you’ll lower your risk of developing colon and breast cancer.

Get less sun. Minimize your exposure to the sun, especially between 10 a.m. and 4 p.m. when UV rays are strongest. Cover up, use sunscreen with SPF 15 or higher, and wear a hat and sunglasses. This is especially important for children. Exposure as a child is often the most significant risk factor in serious sun-related skin cancers that show up later in life.

Know your family history. While it’s clear that you can’t control or change your genes, being aware of your family medical history is an important step toward controlling your own risk.

“People have difficulty believing ‘it really means me,’ when they think about family medical history,” notes Dr. George Miller, Medical Director at Salem Hospital. Know your history and adjust your precautions accordingly.

Prostate Cancer: A Treatable Reality for Men

When David Perry of Albany was diagnosed with prostate cancer in 1999 and his urologist began monitoring his PSA (Prostate Specific Antigen) levels, Perry became an insatiable student of the disease. “I’m the type of guy who was determined to become as informed as I possibly could,” he explained. “Prostate cancer is a man’s disease, but it affects your whole family.”

And today, prostate cancer is affecting countless families across the country. In fact, it is likely that every man may encounter some type of prostate problem in his lifetime. According to the American Cancer Society, 220,900 men in the United States will be diagnosed with prostate cancer this year. It is the most common form of cancer in men over age 50, and is the second leading cancer killer. Fortunately, with quality healthcare, it is also one of the most treatable cancers.

Prostate cancer is best treated when caught early—nearly 60 percent of all prostate cancers are discovered while they are still confined to
the prostate. The five-year survival rate for men diagnosed with prostate tumors at this stage is close to 100 percent.

PSA screenings and watchful waiting
PSA blood tests are known to detect prostate cancers at a very early stage. However, because not every case of prostate cancer requires treatment, opinions on early PSA screening are varied. While treatment may improve the condition of the cancer, it may also create side effects and undesirable lifestyle changes. As Dr. Ted Williamson, radiation oncologist at Salem Hospital, notes, “It’s often hard for patients to accept the fact that they have cancer, and it might be best left untreated.”

As a result, some doctors and patients choose to practice “watchful waiting,” during which PSA levels are monitored until they reach a level that the patient and doctor agree warrants treatment. Today, however, “watchful waiting,” has become a less popular practice, as more patients are opting to address their cancer upon diagnosis.

David Elmgren, M.D., of Willamette Urology, recommends that men 50 or older have an annual rectal exam and PSA test. “If there is a strong family history of prostate cancer, then it’s important to keep an eye on it earlier,” he says. “In those cases, we’ll start the surveillance at age 40.”

Early prostate cancer may not present any symptoms and can only be found with regular prostate examinations. Do not let fear and anxiety keep you from having the tests that can often detect, or help rule out, prostate cancer.

Treating prostate cancer
Prostate cancer treatments range from curative to palliative. Curative treatments such as surgery and radiation therapy are aimed at eliminating cancer. Palliative treatments include hormonal therapy, certain types of radiation, and chemotherapy, but are focused more on improving quality of life than curing.

“Sit down with your urologist and figure out which treatment is the right option for you,” recommends Dr. Williamson. “It’s a tough decision, and that’s why it’s so important for the patient to be informed.”

David Perry and his urologist decided surgery was his best option. This was followed by a PSA test every 90 days. When Perry’s PSA levels began to rise and his doctor recommended treatment, Perry was able to make an informed decision based on the research he had done. He chose to utilize Salem Hospital’s IMRT (intensity modulated radiation therapy) capabilities—a powerful technology that targets tumors precisely, minimizing damage to surrounding tissues.

IMRT wasn’t available to Perry near his home in Albany, but because it was available at Salem Hospital’s Regional Cancer Care Services, Perry didn’t have to leave the Valley to receive this innovative treatment. “The Salem community is fortunate to have a cancer treatment team and technology that are world class, as well as an extraordinarily highly trained and experienced group of doctors,” says Bill Beck, Ph.D., Director of Cancer Services at Salem Hospital.

Six weeks into his IMRT treatment, Perry’s PSA test showed a 40% decrease. It was his lowest PSA reading in three years. He’s thrilled that his quest for quality information and treatment was successful. He’s looking forward to years of good times with his family.

Home Cooking
From apricots to tomatoes: Foods that protect.

It’s no secret that a diet low in fat is a key component to general health. But what you may not realize is that certain foods—particularly fruits and vegetables—have protective qualities that not only help keep waistlines in shape, but may also prevent chronic diseases such as cancer.

According to the American Cancer Society, evidence suggests that diets rich in vegetables and fruits are associated with decreased risk for cancer. Experts recommend choosing colorful vegetables and fruits that are dark green, yellow, orange and red, as well as cruciferous vegetables, such as broccoli, cauliflower, brussels sprouts, and kale.

Vegetables and fruits are also high in antioxidants such as vitamin C, vitamin E, selenium, carotenoids and others, which appear to protect against tissue damage. Lycopene, for example, is a carotenoid compound that gives tomatoes (as well as apricots, guava, watermelon, papaya, and pink grapefruit) their color. With twice the antioxidant activity of beta carotene, lycopene appears to help people who consume diets rich in tomatoes—particularly cooked tomatoes—have a lower risk of certain types of cancers.

So next time you’re looking for a snack, do your body a favor: Reach for the crisper instead of the cupboard.

Edamame Broccoli
By Denise Cedar, RD, CDE
Edamame (sweet green soybeans) can be found in the frozen vegetable section of most grocery stores.

Preparation time: 15 minutes

11/2 pounds of fresh broccoli, cut into bite-sized pieces
11/2 cups frozen sweet green soybeans (edamame), removed from pods
2 tablespoons rice vinegar
2 tablespoons soy sauce
2 tablespoons sesame oil
2 tablespoons sesame seeds, toasted
2 teaspoons granulated sugar

Directions:

1. Bring a large pot of water to a boil. Add frozen green soybeans and boil for 5 minutes, then add broccoli and simmer until desired tenderness. Drain and set aside.
2. In a large bowl, whisk together the vinegar, soy sauce, oil, sugar and sesame seeds. Add broccoli and soybeans, and toss to coat.
3. Serve warm.

Yield: 8 Servings

Nutritional analysis per serving: 130 calories, 12 g carbohydrate, 3 g fiber, 6 g fat, 8 g protein, 227 mg sodium. Also a good source of folacin, vitamin C, potassium, thiamin, and iron.

Print This Recipe: Edamame Broccol