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Revolutionizing Cancer Treatment: University of Michigan's Breakthrough Histotripsy Technique Receives FDA Approval for Noninvasive Liver Therapy



Method developed at the University of Michigan offers a noninvasive substitute for surgery, chemotherapy, and radiation treatments for cancer


The U.S. Food and Drug Administration has sanctioned the utilization of sound waves to disintegrate tumors—a method termed histotripsy—in humans for liver treatment.


Pioneered at the University of Michigan, histotripsy presents a promising substitute for cancer treatments like surgery, radiation, and chemotherapy, which frequently entail notable side effects. Presently, FDA officials have granted approval to HistoSonics, a company co-established in 2009 by U-M engineers and doctors, for the application of histotripsy to eliminate targeted liver tissue.


A human trial in progress since 2021 at the U-M Rogel Cancer Center and other sites has managed patients with primary and metastatic liver tumors through histotripsy, illustrating the technology's ability to fulfill the trial's primary effectiveness and safety goals.


"Histotripsy is an exciting new technology that, even though it is in early stages of clinical use, may provide a noninvasive treatment option for patients with liver cancer. Hopefully, it can be combined with systemic therapies for a synergistic therapeutic effect," said Mishal Mendiratta-Lala, professor of radiology with Michigan Medicine and principal investigator on the U-M trial.


HistoSonics can now promote and sell its histotripsy delivery platform, named Edison, to hospitals and healthcare professionals for utilization in liver treatments. The company is headquartered in Minneapolis, with advanced research and development situated in Ann Arbor.


Histotripsy functions by employing targeted ultrasound waves to generate microbubbles within the tumor. The forces produced as these bubbles form and collapse result in the fragmentation of the mass, annihilating tumor cells and allowing the immune system to clear away the debris.


What this might signify for patients is treatment without the physical toll of radiation or chemotherapy, fewer concerns about drug compatibility, considerably briefer recovery periods than with surgery, and decreased treatment discomfort.


This is feasible because ensuring that histotripsy treatments accurately target the tumor, not healthy tissue, is much simpler compared to radiation or invasive procedures. Histotripsy relies on concentrating acoustic waves of high-energy ultrasound to form bubbles, and the Edison machine ensures that the energy is confined to the tumor region. Conversely, radiation impacts everything in its path through the body.


Furthermore, the histotripsy system integrates diagnostic ultrasound imaging, akin to that employed for visualizing babies in the womb. It is used for planning and monitoring the treatment in real time. Physicians have a live view of the "bubble cloud" and how tissue is responding to the therapy.


Histotripsy's potential benefits extend beyond tumor destruction. Over the past year, two preclinical studies in rodents suggest that during the cleanup process, the immune system learns to recognize cancer cells as threats. This can empower the body to persist in combating the initial tumor and activate a natural immune response to the cancer.


In the initial study, even after demolishing only 50% to 75% of the liver tumor volume through histotripsy, the rats' immune systems successfully eliminated the remainder, with no indications of recurrence or metastases in over 80% of the animals.


Earlier this year, a subsequent study demonstrated that histotripsy disintegrates the cancer cell wall's "cloak"—unveiling proteins that the immune system can deploy to recognize threats, referred to as antigens. These antigens are eliminated during surgery or eradicated during chemotherapy and radiation. By instead disassembling a cancer cell's outer wall, histotripsy exposes the tumor antigens for the immune system to identify and employ for targeted attacks on other cancer cells.


"We want to leverage histotripsy's immuno-stimulation effects and hopefully combine them with immunotherapy or drug delivery," said Zhen Xu, U-M professor of biomedical engineering, an originator of the histotripsy approach and a co-founder of HistoSonics.


"That will transition histotripsy from a local therapy into one that can treat tumors globally all over the body and eventually into a cure. In terms of cancer treatment, that will be the next step, and I feel very excited about the potential."


Xu and the University of Michigan have a financial stake in HistoSonics. The company was established with support from U-M's Coulter Translational Research Program and Innovation Partnerships, U-M's center for research commercialization.


The University of Michigan Histotripsy Group


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Avoiding Drugs - Curing Cancer With Herbs - Part 2



As modern-day drugs are derived from plants and chemicals, it actually makes sense that when herbs are correctly administrated by a competent herbalist, there seems to be no unjust reason as to why they should not work to help cure illnesses.

The main benefit which traditional medicines hold over modern-day medicines, is that they usually offer far less harmful side-effects to the user, if any at all.

The following herbs are considered to help either cure, or prevent cancer from developing - (1. Turmeric, 2. Garlic, and 3. European Mistletoe have previously been discussed in part-1 of this series).

4. Cat's Claw - is a woody vine that can be found growing throughout Central and South America. It's bark and root have been used by Native American tribes for many hundreds of years to cure an array of illnesses from rheumatoid arthritis, dysentery, fevers, stomach ulcers, to inflammation, etc.

Studies have shown that cat's claw may actually help stimulate the immune system (whether too high or too low), lower the blood pressure (by dilating blood vessels), promote the production of urine (diuretic), relax the muscles of the intestine, and kill both tumor and cancer cells.

It's anti-oxidant properties also help to neutralize and rid the body of the free radicals (particles that damage cells) that may contribute to the development of cancer and heart disease when taken in the form of tea, capsules, or tincture (an alcohol-based derivative product of fresh herb) form.

Studies continue into its use for other illnesses, such as: Crohn's disease, endometriosis (abnormal pains during menstruation), systemic lupus erythematosus ([SLE/ lupus] inflammatory auto-immune disorder), kidney disease, Alzheimer's disease, and HIV.

5. Black Cohosh - a flowering plant also known as: Actaea racemosa, black snakeroot, bugbane, bugwort, rattleroot, rattletop, rattleweed, and macrotys is mainly found growing in the woods of Eastern North America.

It has been used for many years to alleviate menopausal irregularities, headaches, infertility, rheumatism, and stomach problems; although, there is still a lack of understanding to how its curative properties actually work.

Once thought that black cohosh was a phytoestrogenic plant that could help fight breast cancer, by possessing its own estrogen-like chemicals that acted as a substitute for the body's estrogen level, has now been dismissed.

But, because research has shown to be less than 100% conclusive with this dismissal, black cohosh is still used to treat breast cancer today.

It can be administered over a period of time (not exceeding 6-months) in the form of capsules, at 40 mg per day, tea, or tincture. However, black cohosh can also be over-dosed, should not be mixed with Aspirin, and can offer side-effects such as: dizziness, headaches, and nausea.

6. Green Tea - is the most consumed beverage in China and Japan, due in main to its many anti-cancer and anti-oxidant properties, including the chemical polyphenol, which is known to inhibit both the promotion and migration of tumor cell growth, helping to reduce the risk of cancer developing in human beings.

It is also believed that women who drink green tea on a regular basis are up to 10-times less likely to develop certain forms of breast cancer than those who do not. However, bearing this in mind, green tea's intake should not exceed more than 800 mg, two times a day.

Note: Doses are given only as examples previously used in cancer cases, and are not recommended to be taken as such without prior medical advise being given first.

Other herbs such as: Flax Seed, Maitake, and Kelp are discussed in "Avoiding Drugs - Curing Cancer With Herbs - Part 3" which also concludes this 3-part series.


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Telomeres and Cancer, New Cancer Treatments



The comparison between the different types of cancerous tissues with the normal with regard to genomic instability, shortening of the telomere and the expression status of telomerase indicates that the telomere problem is intricately associated with malignancy. It has become so significant in the cancer etiology studies that the measure of the length of telomere has been used as one of the routinely used biomarkers to understand the telomere dysfunctioning and the associated risk of cancer. There are enough evidences available to implicate the telomere length with cancer and hence it can be targeted for successful therapeutic approaches.

Pre-existing knowledge

There are available literatures to suggest that the telomere shortening and telomerase absence share a direct correlationship with increased cell divisions and as a result the cells senesce with a fixed number of multiplications. It has been suggested that crossing a threshold limit of shortened telomere length results in telomere repeat loss which is regarded as DNA damage cue and hence the decision to withdraw from cell cycle and resultant apoptosis. Accordingly, the role of the telomeres has been implicated to that of a biological clock determining the multiplicative lifespan of the cells. The study by the group of Bodnar further confirmed this theory when they introduced telomerase catalytic units into human fibroblasts lacking in telomerase and found elongation of the telomeres with an enhanced ability to replicate. The imposed restriction of cell cycle in these cells is maintained primarily by the tumor suppressors Rb and p53 which recognizes the DNA damage and halts its progression. It has been found that the cells transformed with viral agents like E1 or SV40T could bypass such regulation and undergo additional cycles of division although not indefinitely. Besides, the telomeres have been found to be active both in the germ line and stem cells but that in the somatic cells it isn't so.

Cancer diagnostics based on telomeres

Telomeres have now found its way into the field of cancer prediction and diagnostics. Recent advances in the field have made them more efficient and precise tools for use in that purpose. In a very recent work, it was proposed that repeats of single stranded DNA molecules C circles that constitute the telomeres can be highly significant in cancer prediction. It was found that higher positive C circles were observed in ALT positive human cells. The formation of diagnostic tools based on telomerases is likely to be more in use in the future.

Association between telomerase activity and cancer cases

Biopsies of 12 different types of human cancers demonstrated the existence of telomerase activity. Clinical data from patients with metastatic or primary cases of cancer indicates a dormant stage before an aggressive progression towards metastatic growth. Some studies have implicated the activity of telomerase with cancer dormancy. Recently, it was found that 73% of lung carcinoma patients (stages III and IV) and 72% of colon cancer patients have active telomerase by Gauthier and his colleagues. Stage IV breast cancer patients revealed similar results. Therefore, telomerase activity detection is a good indicator of cancer progression. While the telomerase-/- cells provides valuable insights into the stage of cancer dormancy, the positive cells can be useful in the prediction of the recurrence of the disease. On a more generalized form it has now been accepted that the shortening of the telomere limits the life of the normal cells and the telomerase activity can overcome this imposition of replicative restriction and make them immortalized. It becomes imperative to study the underlying mechanisms of the regulation of telomerase in order to target them in cancer cases.

Telomerase activation and cancer

Telomerase has become a hot target for cancer related therapeutic interventions considering the fact that it is expressed only poorly in normal cells while is required at an enhanced levels for the maintenance of telomeres for rapid cell proliferation that is associated with cancer progression.

However, with these pieces of evidences there may be high apprehensions regarding the use of telomerase activity enhancing supplements with respect to the increase in chances of cancer. The regulatory mechanism of telomerase activity is still very paltry to suggest a one-on-one relationship between cancer progression and the need of telomerase activity. Reports are also now accumulating for anti-aging related telomerase activity increment without increasing the cancer chances. According to a very recent report published in the EMBO Molecular Medicine, a group of researchers from Spain demonstrated that telomerase can be manipulated to increase longevity without the risk of cancer. There are also other arguments that favor the safe and effective use of telomerase activators. Scientists are of the opinion that although telomerase is needed for the maintenance of the rapid growth and proliferation of cancers, it has often been found to be mutated in a plethora of human cancers which are arguably more aggressive than the rest. Therefore, there needs to be valid comparison of the roles of the mutated and normal telomerase activity from the viewpoint of cancer regulation. There are also suggestions that the telomerase in the first place would try to maintain a healthy DNA away from damage that is not susceptible to cancer. Researchers are of the opinion that infact the activation of telomerase can be used to prevent cancer. Therefore, the active use of telomerase stimulators is quite valid and worth a try given the promise it holds in the rejuvenation of youth and the alleviation of a number of age and non-age related disorders in humans.


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Amazing Nutrition Facts Of Soursop Fruit



Sopusop is native to South America and West Indies, but this amazing life giving fruit is also harvested in Australia, Africa and southeastern Asia. These fruits offer countless positive contents for human health. They are exceedingly rich in vitamins and fiber which is why they can cure diseases, enhance immunity, slow aging process, reduce hair fall and most essentially, can control the deadly cancerous syndromes. The subtle sweet and sour flavors make it a favorite and fundamental essential in a variety of beverages and juices. The white, creamy and fleshy pulp of this powerful curing combatant helps to keep your health issues at bay. Let's see how!!

  • Boosts immune system- Suorsop fruits contain substances like annocatacin, acetogenins, anonol, anomurine, annonacin, caclourine, linoleic acid and muricapentocin which helps in keeping our body remain fit and improved and put up a victorious fight against diseases.
  • Kills malignant cancer cells- The leaf of the plant can be targeted to kill 12 types of malignant cancerous cells including prostrate, colon, lung, breast and pancreatic cancer. When measured against the conventional chemo therapy and adriamycin drugs, the power of soursop was found to drive near about 10,000 times stronger. Further probing is being carried out in medical field for finding out the actual elements in its sweet pulp that offer marked resistance to cancer.
  • High vitamin C content- Health conscious individuals can increasingly consume this fruit flesh antioxidant to increase endurance and slacken the aging process.
  • Rich in Fiber- Besides containing nutritional components, soursop fruits are also rich in non nutritional components like fiber that can aid your digestive process.
  • Cures health ailments- Soursop juice, if taken twice daily, can help knock out liver problems, urinary tract infection, kidney diseases, and hematuria. The fleshy part, when applied on cuts prevents bacterial infection and accelerates the healing process.
  • Maintains a healthy heart and prevents nerve damage- Vitamin B1 in the fruit accelerates metabolism, prevents nerve damages and can even restore central nervous disorders. The Vitamin B2 content accounts for fat storage, body's energy production, maintenance of heart muscle and proper functioning of nervous system.
  • Puts a check on osteoporosis- Extremely high in calcium and phosphorous contents, it works amazingly to maintain bone health.
  • Increases energy- Fructose content in the fruit greatly helps in draining energy and keeping you fresh and active throughout the day. That's because monosaccharide in fructose acts as a natural source of carbohydrates for the body.

The popularity of soursop has been increasingly growing in the recent years. It can be used for making tropical drinks that blend the fruit with unsweetened or sweetened milk or water. Its other applications include custards, smoothies, sherbet, ice creams, jellies, nectar blends, syrups and tarts. The fruit also finds widespread uses in exotic desserts; owning to its clean and refreshing taste. It seamlessly amalgamates with other fruits; thus making it to be an essential ingredient for any fruit portfolio. You may also try some exciting combinations of this fruit with coconut, acerola, passion fruit, orange or strawberry.

Although abstinence from alcohol, junk food and caffeine can keep you in good health; including fruits like soursop in your diet can impart a fresh and nourishing angle upping your glamorous quotient. Let the sweet fruit tune in with your needs to eradicate the ill effects of your hectic life so that you can rejoice life to the fullest.


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Hey! You Wanna Get Well or What?



Recently, I was speaking with a neighbor friend who has successfully battled cancer in her appendix. So, I sat down with her and asked her how she did it. This is the story she shared with me.

Sandy (name has been changed to protect her identity), was told she had cancer about a year ago. Thankfully, she was in the early stages of her dis-order so there was a lot she could do naturally. She opted to go with her doctor's suggestions and have surgery to remove a small cancerous tumor on her appendix. Once the tumor was removed she was told she was cancer free. What a relief, or so she thought. She was still feeling ill and her quality of life was not better. Going back to the doctor she realized that the other health issues she had before the cancer were still to blame for her physical condition. Sandy, had issues with her kidneys, parathyroids, tumors on her glands and hypertension. She was overwhelmed and did not know what to do. Her medications now numbered in the double digits to a total of 18!. Literally, being sick and tired of being sick and tired she cried herself to sleep.

The next day she decided she had to make a decision. Was she going to live or was she going to slowly die? Before answering that question, she thought, how did I get here? She took out a pen and paper and began to write. She wrote about her childhood at the hands of an unloving mother. The pain and shame of domestic violence at the hands of her third and final husband. Her 'Wasband' as he is called, was a drug addict who lied and stole from her quite often. Then there is her 'Wasband's' grandchild she is raising, at 14 she is the only mom he has ever known. Actually, she writes, "I need to mention my own children. Dealing with their selfishness and ungrateful attitudes really angers me!"

After about 3 hours of writing non-stop she realized that she wrote out her entire life on the pages that stared back at her. Reading the words she wrote she realized where her dis-ease was coming from. She passed on to her children and grandchild the same unloving traits she was exposed to as a child. She spent more time shopping than she did trying to love herself. She looked for the love her mom did not give her in places where it did not exist. Having realized this, she was relieved, yet, knew that now the real work of healing can begin.

She sought solace and support in the arms of her journal and her church. She did the work of healing herself so she could heal her relationships. Seeking guidance from her pastor and others with similar experiences she was able to see a little joy in her life. Funny thing began to happen, the more and more she began healing her emotional traumas, the better she felt. She then began changing how she ate to allow her body to fight off the tumors that grew as a result the emotional trauma she held onto for so many years.

Sandy is still cancer free, yet, her organs are slowly beginning to function better and the tumors are beginning shrink. Her quality of life is improving and slowly so are her relationships. "It has been a long and difficult road", she shares with me; "Yet, I am glad I choose to embark on this journey". "Sounds like you made the decision to live", I say to her. "No, I made the decision to heal. Then life just followed suit."


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Why We Have Been Losing the War Against Cancer



The sun rises and the sun sets. It seems like the sun rotates around the Earth.

Cancer cells rise and are killed by surgery, radiation and chemotherapy. It seems like cancer is a disease.
The sun does not rotate around the Earth, and cancer is not a disease.

The many forms of cancer cells are the products of the disease neoplasia that can emerge in any of our organs and tissues.

When the normal cycles of life and death of our body cells go awry, unruly cells undergo neoplasia and become benign or malignant tumors... cancer. Although the forms of cancer cells vary widely, the underlying disease... neoplasia... is the same throughout the body. Neoplasia occurs when our bodies' immune systems fail to recognize and destroy aberrant cells.

If the "War against Cancer" organized in the late 1930s had become a "War against Neoplasia" when the latter was clearly identified as the process that produces cancer in the 1970s and 1980s, we may well have had cures for the many forms of cancer today. Words influence actions.

In 1963, Dr. Joseph H. Burchenal of the Sloan-Kettering Institute for Cancer Research pointed out that "It is unlikely that chemotherapeutic agents against cancer will be any more effective, unless there is some sort of an active immunological response that can be evoked." Antibiotics reduce the number of bacteria, but our immune systems are needed to cure the diseases they cause. The same principle applies to chemotherapy and cancer cells.

Following the theory affirmed by Burchenal, some scientists have been successfully studying what is called immunosurveillance and immunoediting as a counterpoint to the dominant "search for and destroy cancer cells" model. They are finding ways to help the immune system do its job through immunotherapy that prevents neoplasia. Michael Sporn, professor of pharmacology and medicine at Dartmouth Medical School, holds that the best strategy is to prevent neoplasia from entering the deadly stage of cancer in the first place.

For this reason in 2011, the American Society of Clinical Oncology (ASCO) declared in its report Accelerating Progress Against Cancer that "cancer research and patient care could be vastly more targeted, more efficient and more effective. But this vision is possible only if we transform the way cancer research is conducted."

On March 23, 2013, twenty-one oncologists pointed out in a New York Times editorial that "this year, more than 1.6 million Americans will receive a diagnosis of cancer. Their treatment will consume at least 5 percent of the country's health care spending, at a cost that is growing faster than all other areas of medicine. Doctors and patients recognize that this is unsustainable and that we need to change the way we deliver care." They added, "many expensive tests and treatments are introduced without evidence that they improve survival or reduce side effects, and with poor information about which patients should receive them."

After decades of neglect, immunotherapy finally was recognized appropriately at the 2013 American Association for Cancer Research meeting. In her plenary lecture, Dr. Suzanne Topalian of Johns Hopkins University said that despite the current dogma that cancer is a genetic disease, it also can be viewed as an immunologic disorder. She said, "In many ways the adaptive immune system is an ideal anti-cancer therapy." She affirmed in 2013 a concept first advanced in 1957 by Dr. Frank Burnet and reiterated in the 1980s and 1990s.

Fortunately, immunotherapy now can interrupt neoplasia that produces some forms of cancer cells.

Unfortunately, the dominant approach still is to "search for and destroy cancer cells" by surgery, radiation and chemotherapy. Research on immunotherapy also has been overshadowed by research that focuses only on the genes of cancer cells, which actually are constantly changing.

ASCO's 2011 report went on to say that, "if today's new understandings of cancer biology are to benefit cancer patients on a broad scale, they must be coupled with a modernized system for conducting cancer clinical trials."

As it now stands, clinical trials rely on prospective, randomized, controlled trials. For a lethal disease this approach is neither scientifically justifiable nor practical and guarantees that new information will have a 5- to 10-year lag while studies are constructed, conducted and interpreted.

The general public also is not served well by those who point to increased five-year survival rates as indicating significant progress in the cancer field. Millions of lives have been lost because of decades of misdirected and underfunded basic research.

A paradigm shift in the cancer field is needed based upon two fundamental principles of medical practice: 1) do no harm (chemotherapy destroys normal cells and suppresses the immune system with debilitating side effects) and 2) base research and treatment on diseases not on their symptoms or signs. Cancer cells are signs of an underlying disease: neoplasia. The variety of factors in cells and their microenvironments that induce and that fail to block neoplasia in organ systems and tissues should be the focus of research and treatment.

Words we use determine our perceptions and our actions. Simply fighting cancer by killing cancer cells is not enough and is gravely misleading.

Public awareness and pressure are needed to adequately fund cancer research and treatment focused on the underlying disease neoplasia.


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Getting Prepared for a Cancer Journey - It's ALL About You!



This article is for and about you and as you begin your cancer journey.

The first step of the cancer journey relates to health concerns and beauty issues for you to evaluate. You will want to answer the following basic questions. The answers to these questions will help you make good choices for yourself.

Question 1 In what way will my body change with surgery and/or treatment?

Explanation - For some of you, surgery and/or treatment will not affect your external body a great deal. Perhaps your most bothersome external side effect will be generalized swelling that will call for looser fitting clothing and elasticized waistlines. Others of you will have external body altering surgeries and/or treatment. Be sure to utilize local resources available to you related to clothing, undergarments and special needs garments.

Question 2 Will I keep my hair, have partial hair loss or complete hair loss including eyebrows and eyelashes?

Explanation - Different treatments and drugs will dictate the amount of hair loss, if any, during your cancer journey. Ask your oncologist what to expect based on the treatment and/or drugs in your program. Think about what amount of hair loss ("alopecia" is the medical term) you will experience. Once you know the answer to this question, you will be able to make headwear choices that suit you, and know if you will need (and want) to consider replacement eyebrows and eyelashes.

Question 3 During what season(s) of the year will my surgery(s) and/or treatment be?

Question 4 What type of climate do I live in? Is it generally hot, cold or moderate during the months I will be having treatment?

Explanations for questions #3 and #4 - These questions are asking the same thing, but in a different way. For some of you, your treatment will take longer, so it is important to look at each of the seasons your treatment will span. If your treatment regimen is only going to span one or perhaps two seasons, your considerations will be different from those whose treatment regimens will span multiple seasons. I have first posed the question from the standpoint of what special days and holidays your treatment period will encompass. Consider whether your anniversary (what anniversary it is), birthdays (again what birthdays they are), work related conferences, special events and so on will take place during treatment. Although you may choose not to wear a wig for everyday, you may want to go ahead and get a wig for these special occasions. There will be additional things to consider such as the best clothing choices for your lifestyle and profession, whether false (prosthetic) eyelashes and eyebrows are something you are interested in trying and other image issues. Secondly, I am asking you to consider some different things if you live where it is going to be cool to cold the majority of your treatment time and you are going to lose all of your hair. The cold weather will dictate things like a sleeping cap for nights and warmer hats or a wig during the days. Conversely, if you live where it is warm to hot the majority of your treatment time, you may want to consider options to wigs for headwear. Wigs are very warm so lightweight scarves and cotton turbans may be a viable part-time or full-time alternative to a wig. Make your clothing choices based on both comfort and ease during treatment, keeping in mind the season(s) you will be having your treatment - whether surgery, chemotherapy, radiation or a combination of the above treatments..

Do not become overwhelmed with these questions and issues. At a time when most every part of your life is out of control, you can have control over these areas - so have some fun!

Question 5 What kinds of hairstyles look good on me? Do I wear my hair very short or do I like having a lot of hair around my face?

Question 6 Do I like hats?

Question 7 Am I a risk-taker with my wardrobe and accessories?

Question 8 Do I love simple, natural clothing or am I more dramatic?

Question 9 Do I always wear makeup no matter the day?

Explanations for questions #5 through #9 - This is a fun series of questions to ponder. That is because they are truly ALL about YOU!.

Think about what hairstyles you have gotten the most complements on over the years. Also, do you love to wear hats or just see other people wearing them? Your answers may lead you to choose a wig as your only type of headwear (if the other factors already considered are right) or hats, turbans and scarves instead. Wigs are beautiful, natural looking and safe emotionally because they offer a bit of privacy during your cancer journey. Hats, turbans and scarves are beautiful, and they make a bold, confident statement about how you feel about yourself. That is because, headwear choices other than wigs generally let others know that you are on a cancer journey. You will need to decide if you are comfortable with that.

Those of you who are risk-takers with your wardrobe and accessory choices love trends and the latest styles. The majority of you are more comfortable in classic styles of clothing and accessories. I am certain you are beginning to see some patterns in how you answer these questions. The more daring and dramatic you are the more you will be ready to make a "cancer treatment fashion statement". On the other hand, if you tend toward classic, you will choose things that are very similar to your pre-cancer journey outfits. Neither is right or wrong, they are simply your choice... isn't that wonderful?!

If you love very simple natural fabrics, patterns and accessories, and if you have chosen not to wear a wig, you will tend to choose scarves of soft cotton in solids or with a simple pattern. You will surround yourself with clothing, headwear and accessories that are not fussy and require no special care. I suggest everyone adopt a comfort policy during this time in your life even if you are most comfortable emotionally in dramatic, make-a-statement outfits. You can accomplish both of these at the same time, as you will see in chapter three.

I am certain some of you always wear makeup no matter the day. If makeup is as important to you as the clothes you wear, then you may want to take a few extra steps with your makeup during treatment. Look at your choices and choose a makeup regimen that will make you the happiest with your appearance!

Others of you choose to go sans makeup often. Makeup may elevate your mood during treatment, so you might want to choose a very simple makeup regimen during treatment. Make certain your skin gets the moisture and nutrition it needs whether you wear makeup or not.

Question 10 Will I work part-time, full-time or not at all during treatment?

Question 11 If I will work, will I be in front of groups of people on a regular basis?

Explanations for questions #10 and #11 - Generally, your care team will be advising you to try to lighten your workload, if financially feasible. For many of you not working during treatment will not be an option for you.

My purpose in posing this question is to have you think about work in terms of your work image. If your work demands you be in contact with many people on a daily basis in a professional atmosphere; a wig, false (prosthetic) eyebrows and eyelashes or a makeup regimen that includes using eyebrow stencils and eyelash techniques are as important as professional clothing. If however, your work situation keeps you behind the scenes you can choose how much or how little you want to do in terms of dealing with these beauty issues... and do not forget that whether you are in the limelight or behind the scenes, you will want comfortable, easy to care for clothing.

Question 12 Do I exercise moderately, aggressively or not at all?

Explanation for question #12 - The final thing you will want to consider before beginning treatment is your level of physical fitness. Do you exercise several times a week? Do you work out at a health club or are you a "do-it-at-homer"? Perhaps exercise is more of a hit-and-miss event for you? Maybe it has been years since you did any formal type of exercise. You will want to ask your doctor about exercise and the benefits it can offer you while you are going through cancer treatment.

Now that you have a good handle on your answers to these questions, you can start preparing for your journey. You are in the fight of your life, and for your life - being prepared, as much as possible, will allow you to focus on that fight with all your strength.


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