Learning to be Thankful After Cancer




Written by Cameron Von St. James

Cameron wrote to me asking if he could post articles on my blog about his family’s story…. Thank you Cameron for sharing.

The holiday season has always been my favorite time of year. It’s the time of year for friends and family to gather and give thanks for life’s blessings. It’s the time of year for continuing or beginning family traditions. With the birth of our daughter in August of 2005, my wife Heather and I began to think about family traditions we wanted our new baby, Lily to experience. Unfortunately, we were forced to put those plans on hold. Three days before Thanksgiving, we were dealt a major blow: Heather was diagnosed with cancer.

Lily hadn’t even been with us for four months and suddenly her mother was in a fight for her life. The doctor told us it was malignant mesothelioma, and while I didn’t know much about that type of cancer at the time, I knew enough to understand that our once bright and exciting future now looked bleak and uncertain. I hoped for the best, but I knew that there was a strong possibility that Lily and I might lose her forever. The realization that we had a real fight on our hands made it very difficult to feel thankful for anything that year.

Despite the terrible news, we did manage to have a Thanksgiving celebration that year. Heather’s parents came into town and made an attempt to help us salvage what would have normally been a joyous day. During their holiday visit, we sat down and had one of the most difficult conversations of my life. While her parents were willing to help with some of our expenses, it became clear to me just how out of control things were getting. We no longer had two incomes, and all of the traveling to Boston for treatments would take a toll on the money that we did have. We discussed which assets we could liquidate to stay afloat over the coming months, and I felt ashamed and embarrassed to be having this conversation with my family.  In that moment, I once again felt that I had nothing to be thankful for that year.Screen Shot 2012-07-26 at 8.01.25 AM

It took years before I was finally able to look back on that day and realize how mistaken I had been to view it that way. While I wallowed in feelings of shame and helplessness, I wasn’t able to see just how blessed we truly were. When we needed support, our loving and generous family answered the call. In a moment’s notice, our family was willing to put all other things aside and stand with us. My pride blinded me from seeing the beauty in something that was so amazing. Fortunately, I am able to see it now.  With the love and support of our friends and family, Heather was able to beat the odds and overcome mesothelioma.

This year, I want to make it a point to give thanks for all that I have. I am thankful for the wonderful friends and family that are in our lives. I am thankful for the seven Christmases I have gotten to spend with Heather and Lily. I look forward to many more Christmases and will continue to be thankful for all that the future holds for my family.

Loss of Libido

Extracted from Breastcancer.org
Perhaps the most frustrating change in your sexual life is the loss of libido, of “those urges.” You’ve lost your hair, your breast is altered or gone, you’ve put on weight, you have no energy, you’re tired, you’re nauseated, and you hurt in new places. No wonder you’re not feeling sexy.

 Your sex life may be altered by vaginal pain resulting from breast cancer treatment, especially after bone marrow transplantation. Certain chemotherapies can cause short-term ulcers in the body’s mucous membranes (mouth, throat, vagina, and rectum). Physical changes may result from treatment-induced menopausetamoxifen therapy, or the end of hormone replacement therapy. Add the psychological stress, and pleasure from sex may seem like ancient history.

Advice from your doctors, or from friends who’ve been down the same road, may help, but some impairment of sexual function is generally unavoidable. Over time, however, things do get better.

Depression and libido

Depression is a common result of both the diagnosis and the treatment of breast cancer, and it directly affects your interest in sex. If you’re depressed, sex may be the last thing you want to deal with. (You may even develop a real aversion to sex.) A sensitive partner picks up on this and holds back. But then, when you’ve recovered, your partner may continue to show no interest in sex, and you may assume it’s because you’re no longer desirable, which is most likely not the case.  Being sensitive to your feelings, your partner may be waiting for you to make the first move, safeguarding that you are ready to begin intimacy again.

If you are depressed and unable to turn the corner, you need help. Try to consider therapists or group support. You’ve undoubtedly heard of the success of new medications, but you’ll have to be careful. Some therapies for depression may cause loss of libido, including Prozac (chemical name: fluoxetine) and Zoloft (chemical name: sertraline). Medications must be carefully administered and monitored by a qualified medical professional (usually a psychiatrist). Effective dose levels are important and not always appropriately prescribed, and for many medications it takes three weeks or more for you to feel the benefit.  Discuss with you doctor the side effects of anti-depression medications available and select one that will best benefit you.

Depression, however, is too debilitating a condition to ignore, so be sure to seek help. There are some things that time alone doesn’t heal.

If you are taking tamoxifen, talk to your doctor about which antidepressants are safe for you to take. Some antidepressants — including Paxil (chemical name: paroxetine), Wellbutrin (chemical name: bupropion), Prozac, Cymbalta (chemical name: duloxetine), and Zoloft — interfere with the body’s ability to convert tamoxifen into its active form, preventing you from getting the full benefit of tamoxifen. For more information, please visit the Tamoxifen page.

Hormones and libido

You may find that it has become harder to get aroused, and even harder to experience orgasm. “It takes so long to make it happen,” said one woman. This dullness of response—if you can call it a response—is a consistent complaint. You must be open with your doctor, so that he or she can suggest appropriate medical solutions. Loss of desire and drive may be directly related to your lower estrogen, progesterone, or testosterone levels, brought on by your breast cancer treatment.

If you’re having problems with sex, you might want to try downplaying the importance of orgasm, at least for a while. While you’re recovering, try concentrating on pleasure from touching, kissing, and imagery, rather than penis-in-vagina orgasm. De-emphasizing vaginal orgasm may actually allow it to happen again sooner than you expected.

For some women who’ve had minimal interest in or opportunity for sex before all this happened, loss of libido may not be much of a problem. But if it is for you, talk to your doctor about the possibility of a hormone evaluation. A woman’s sex drive is somewhat dependent on the hormone testosterone (the primary hormone in men), produced in the ovaries and the adrenal glands. A little goes a long way, and an adjustment may help restore sexual interest.

But if your testosterone level is within normal range, more testosterone probably won’t help. In fact, too much testosterone can produce acne, irritability, and male characteristics such as facial hair or a deepened voice. In addition, it’s not known if “testosterone replacement therapy” is safe for women with a personal history of breast cancer.

Pain, nausea, and libido

Painful intercourse can destroy your interest in sex faster than anything else. Vaginal ulcers that arise during certain chemotherapies (such as 5-fluorouracil) are a major source of such pain. The ulcers may be particularly severe in women who have had bone marrow transplantation, but they do go away when treatment ends. Women with genital herpes may have an outbreak of the disease brought on by stress and a weakened immune system. Steroids and antibiotics can cause yeast infections in the mouth and vagina. Pain medications, narcotics in particular, can also reduce libido.

Menopause, whether natural or treatment-induced, can cause thinning and shortening of the vaginal walls. Vaginal dryness (lack of natural lubrication) is another menopausal side effect. These conditions can contribute to pain during sex.

Nausea, a side effect of chemotherapy, can kill your interest in anything, particularly sex. And some anti-nausea medications depress libido.

Breast Cancer Treatment and Bone Loss

Bone_lossExtracted from Breastcancer.org.

Certain breast cancer treatments can speed up bone loss or cause you to lose more bone than you normally would:

Chemotherapy: Some chemotherapy medicines can have a direct effect on your bone health. In other situations, some women who are close to menopause and get chemotherapy may have significant bone loss because the chemotherapy causes early menopause. If chemotherapy pushes your body into menopause, bone loss may begin while you’re still having treatment and continue after treatment is done.

Aromatase inhibitors (hormonal therapy):

  • Arimidex (chemical name: anastrozole)
  • Aromasin (chemical name: exemestane)
  • Femara (chemical name: letrozole)

Aromatase inhibitors work by preventing the formation of estrogen. The loss of estrogen can lead to bone loss during treatment. Aromatase inhibitors are used most often in postmenopausal women diagnosed with hormone-receptor-positive early breast cancer.

Ovarian shutdown using medication or surgically removing the ovaries: Ovarian removal causes irreversible menopause. Your bone density may drop suddenly after ovaries are removed. Ovarian shutdown using medicine temporarily stops your ovaries from producing estrogen.

Other hormonal therapy medicines known as SERMs (selective estrogen receptor modulators) can actually help protect your bones by slowing bone loss. SERMs are:

  • tamoxifen
  • Evista (chemical name: raloxifene)
  • Fareston (chemical name: toremifene)

If an aromatase inhibitor or chemotherapy would have benefits for you, talk to your doctor about ways to protect your bones during treatment. This is especially important if you have any of the risk factors for bone loss:

  • being older
  • being postmenopausal
  • being small and thin
  • a family history of osteoporosis or broken bones
  • having low bone mass (osteopenia)
  • smoking
  • not getting enough calcium or vitamin D
  • not exercising
  • having more than 2 alcoholic drinks several times a week
  • having one of the following medical conditions:
    • hyperthyroidism or hyperparathyroidism
    • chronic lung disease
    • inflammatory bowel disease
    • Cushing’s disease
    • multiple sclerosis
    • arthritis

Different hormonal therapy and chemotherapy medicines can be used in your treatment plan, depending on your unique situation. And your treatment plan can change over time based on your needs, the benefits you’re getting, and any side effects you may have. If you’re worried about the effects of treatment on your bones, ask if you can change your treatment plan.

You’ll probably have a baseline DEXA scan before you start treatment with hormonal therapy or chemotherapy. If you don’t, talk to your doctor to see if having one makes sense for you. During follow-up visits during treatment, ask your doctor about your bone health and whether protective measures are right for you.

Skin Care Tips

Extracted from Breastcancer.org

Here are a few things you can do to make the skin less sensitive during radiation treatment and to help it return to normal after radiation treatment is over.

Prevent irritation before and after daily treatments

  • Wear loose-fitting shirts, preferably cotton.
  • Use warm rather than hot water while showering.
  • Try to not let shower water fall directly on your breast.
  • Avoid harsh soaps that have a lot of fragrance; instead use fragrance-free soaps with moisturizers (such as Dove).
  • To help prevent redness and skin irritation, avoid having skin-on-skin contact. This most often happens:
    • where your arm presses against your armpit and the outer portion of your breast
    • along the bottom crease of your breast, where your breast might droop a bit and lie up against your upper belly wall
    • along your cleavage where the breasts snuggle up against each other

    To avoid skin-on-skin contact:

    • Try to keep your arm away from your body whenever possible.
    • Wear a strong bra without an underwire to keep your breasts separated and lifted.
    • If you have large breasts, when you’re not wearing a bra, stick a soft washcloth or piece of flannel or soft cotton under your breast.
  • Regularly dust the breast area and inside skin folds with cornstarch to absorb moisture, reduce friction, and keep you smelling fresh. You can use baby powder made from cornstarch (don’t use talc) or sifted kitchen cornstarch. Apply it with a clean makeup brush or put some cornstarch into a single knee-high nylon or thin sock and knot it at the top. Gently tap the sock against the skin to dust the surface. If your doctor has recommended using creams or salves, apply those first, then dust the area with the cornstarch.
  • With or without radiation, yeast infections are common in the skin fold under each breast — particularly during warm weather in women with large breasts. Signs of yeast infections are redness, itchiness, and sometimes a faint white substance on the skin. If you have a yeast infection, take care of it before radiation starts so it gets better, not worse. An anti-fungal cream (such as athlete’s foot medicine) usually works well.

Manage irritation during and after your course of radiation

  • At the beginning of treatment, before you have any side effects, moisturize the skin after your daily treatment with an ointment such as A&D, Eucerin, Aquaphor, Biafene, or Radiacare. You also can put it on at night — wear an old T-shirt so the ointment doesn’t get on your bed clothes.
  • For mild pinkness, itching, and burning, apply an aloe vera preparation. Or try 1% hydrocortisone cream (available without a prescription at any drugstore). Spread the cream thinly over the affected area 3 times a day.
  • If areas become red, itchy, sore, and start to burn, and low-potency cream no longer relieves your symptoms, ask your doctor for a stronger steroid cream available by prescription. Examples include 2.5% hydrocortisone cream and bethamethasone.
  • Some people get some relief by blowing air on the area with a hair dryer set to “cool” or “air” (no heat).
  • Don’t wear a bra if there are raw areas.
  • If your skin becomes dry and flakey during the course of your treatment, moisturize frequently and cleanse skin gently.
  • If your skin forms a blister or peels in a wet way, leave the top of the blister alone! The bubble keeps the area clean while the new skin grows back underneath. If the blister opens, the exposed raw area can be painful and weepy. Keep the area relatively dry and wash it with warm water only. Blot the area dry and then apply a NON–ADHERENT dressing, such as Xeroform dressings (laden with soothing petroleum jelly) or “second skin” dressings made by several companies. To relieve discomfort from blistering or peeling, take an over-the-counter pain reliever, or ask your doctor for a prescription if you need it.

What about sun exposure during radiation therapy?

  • During radiation, it’s best to keep the treated area completely out of the sun.
  • Wear a bathing suit with a high neckline.
  • Wear a cover-up when you’re not in the water.
  • Wear an oversized cotton shirt to cover the treated area and allow it to breathe.
  • Avoid chlorine. Chlorine is very drying and can make your skin reaction worse.
  • If you do swim in a pool, you might want to spread petroleum jelly (a product like Vaseline) on the treated area to keep chlorinated water away from your skin.

After your radiation treatment is done, the skin that has been exposed to radiation may be more sensitive to the sun than it was in the past. You can go out in the sun and have fun, but continue to protect your skin:

  • Use a sunblock that is rated SPF 30 or higher on the area that was treated. (A strong sunblock is a very good policy for every inch of your body.)
  • Apply the sunblock 30 minutes before you go out in the sun.
  • Reapply the sunblock every few hours, as well as when you get out of the water.

Bathing Suit Tips and Breast Forms for Swimming

As we head into the winter months, be thinking about summertime and the small alterations that need to be made to your swim suit.  Swimming is a good form of exercise — any time of the year — is a terrific way to strengthen your body before, during, and after breast cancer treatment.  There’s nothing like a cool swim on a hot day to relax your mind and refresh your spirit — just be sure to check with your doctor before starting any new exercise program.Before you start thinking about bathing suits, remember this comforting thought: most women are self-conscious in a bathing suit, whether they’ve been through breast cancer treatment or not. Still, we put up with them because they’re part of the summer package that also includes swimming; a warm, relaxing environment; and outdoor fun.

Sure, there are some women who are completely at-ease in a bathing suit. But if you’re having any feelings of insecurity, look up and down the beach or around the poolside. You’ll see all kinds of bodies: small, medium, large, extra-large. They’re all okay; remember perfection doesn’t exist, well maybe after they have been airbrushed in a magazine, which are not real women. So don’t waste your precious energy on feeling insecure. Instead, use it for pleasant and interesting thoughts, fun, and sharing time with friends and family.

If you’ve recently had surgery for breast cancer, you may be wondering what your options are for buying a bathing suit that’s comfortable for you.

Several bathing suit brands are designed for women who have had breast cancer surgery (mastectomy or lumpectomy). These suits have higher necklines and armholes, to conceal scars. They also have built-in bra pockets for securing breast forms (prostheses) if you have not had reconstruction.

Amoena and It Figures are companies that make bathing suits designed for women who have had breast cancer surgery. Lands’ End offers built-in pockets in many of their swimsuit styles.  You may not need a specially designed bathing suit. If you find standard swimwear that you like, the retailer might be able to add a breast form bra pocket to the inside of the suit. Some stores charge for this service, others don’t. 

For those who want a do it yourself and can sew a straight seem; buy a remnant of Lycra type material used for lingerie (ensure it has stretch capabilities).  Measure the breast area of your suite, cut the material approximately ¼ of an inch larger, to make a pocket once sewn.  Line up the seams of material to the breast area of your suite and pin on the sides and bottom, insert the prosthesis to measure, make adjustments if needed, then sew the seams.  Leave the opening at the top to enable your prosthesis to fit snugly into the pocket, and “ta da” you are done.

If you have not had reconstruction and do use breast forms, you may consider getting a swim form, which is like a conventional breast form but much lighter. Although weighted forms are good for everyday use — to maintain balance and protect against back and neck pain — they may be uncomfortable or just downright heavy when swimming.

Swim forms are less dense and float better than weighted forms. Made from clear silicone, they’re designed to allow water to flow naturally across the chest. Some attach into the bathing suit with fabric tabs, to prevent unexpected “pop-up” moments. Built-in pockets also hold them in successfully.  Whichever suite or prosthesis you choose to wear, remember, summer is about having fun with friends and family.  Enjoy yourself and laugh!  As my friend, Sandy always said, “laughter is the best medicine”.

More Side Effects – Anemia and Dizziness


Anemia means you have a low red blood cell count or your red blood cells don’t have enough hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that carries oxygen from your lungs to the rest of your body. If you’re anemic, you might experience the following:

You may bruise easily and may bleed more or longer than normal. You also might have frequent nosebleeds.

Anemia can be caused by breast cancer treatments:

Managing anemia

Medications like Epogen (chemical name: epoetin alfa),Aranesp (chemical name: darbepoetin alfa), and Procrit (chemical name: epoetin alfa) can help your body make more red blood cells. Talk to your doctor to see if a medicine like that might be right for you. You can also ask your doctor if an iron supplement would help you.

To help increase your body’s iron levels and ease anemia, try to eat foods that are rich in iron:

  • spinach
  • peanuts, peanut butter, or almonds
  • lean beef
  • eggs
  • fortified cereal
  • lentils

Also try to eat foods that are rich in vitamin B12:

  • liver (cooked)
  • clams (cooked)
  • vitamin-fortified cold cereal
  • wild caught rainbow trout (cooked)
  • sockeye salmon (cooked)


If you’re dizzy, you may feel lightheaded or lose your balance. If you feel that the room is spinning, technically you have vertigo, a related condition.

Dizziness can be caused by a sudden drop in blood pressure or from being dehydrated. If you get up too quickly from a sitting- or lying-down position, you might feel lightheaded. Some women feel dizzy while they’re having a hot flash.

Several breast cancer treatments can cause dizziness:

In addition, some antihistamines, antiseizure medications, antidepressants, and tranquilizers can cause dizziness. Many pain medications can also make you dizzy.

Managing dizziness

In most cases, dizziness caused by medicine to treat breast cancer usually goes away by itself after you’ve received the medicine a few times. If it doesn’t, talk to your doctor. You may be able to take another medicine. If your dizziness is caused by something else, you may be able to do exercises or change your diet to help.

Other tips to manage dizziness:

  • Sit or lie down immediately when you feel dizzy.
  • Ask for help if you need to be somewhere and feel dizzy.
  • Avoid rapid changes in position, especially from lying down to standing up or turning around from one side to the other.
  • Avoid moving your head quickly, especially from side to side, or moving it as far as it will go up or down or from side to side.
  • Remove clutter from areas where you spend the most time.
  • Avoid driving a car or operating heavy machinerywhen you feel dizzy.
  • Keep areas well-lit so you can see clearly. It’s especially good to have a bright lamp near your bed in case you have to get up at night.
  • Use a cane or walker for stability.
  • Wear sturdy shoes to avoid tripping and slipping.
  • Avoid using caffeine, salt, alcohol, and tobacco. These substances all can restrict your blood vessels and worsen any feelings of dizziness you may have.
  • Carry a cell phone or cordless phone with you in the house in case you fall and need help.

Extracted from BreastCancer.Org