CT Scans Tomorrow

More on the rest of getting to where I am soon, but first a note that I've figured out the CT scans and am going tomorrow for them.  I don't know for sure what's going on in my chest/abdomen/pelvis, but I do know my body and how I've felt recently and the pain I've experienced (and that is likely a great deal from chemo), and that hasn't been good.

So throw a coin in the fountain for me (Trevi) and I'll check back in in a couple of days.

I Love SNL, But They Crossed a Line With the "Heroin Mom" Skit

Since I was diagnosed with severe, aggressive prostate cancer two years ago and then went on chemotherapy to try to lengthen my life, I've been plagued by chronic, severe pain in my extremities.  Nueropathy such as this is a common side effect of treatment with docetaxel, a chemo drug that has been used for decades to treat breast cancer. While killing cancer cells, it also damages nerve cells. I use 5 different drugs to deal with the pain, two of them narcotics.  The narcotics I currently take are Opana time release (oxymorphone...a molecule or two away from Dilaudid) and generic Percocet (oxycodone and acetaminophen) for what's known as breakthrough pain.  They allow me to actually get out and do things; shop, go to the gym, have lunch with a friend, clean house,  and do what I feel up to and, yes, do something as simple as brush my teeth and shower.

I've never used heroin.

These are serious drugs and not too distant from heroin. I understand and respect that and I haven't always had the best relationship with narcotics.  But I need them to function as a result of my disease and the ensuing treatment. I've always loved Saturday Night Live.  They've pushed the edge from the beginning.  But they crossed a line with their "Mom uses heroin" skit. There is nothing funny about it.  Too many people need pain killers and can't get them so they turn to the street.  Too many people don't need pain killers and go to pill mill clinics to get them. Too many "pain specialists" are lured by the money and the ethical, compassionate pain specialists who work so hard to help their patients are pushed into a very narrow corner. And, most seriously, too many people die from heroin use every day in this country.  But addiction and subsequent death isn't funny and it hits too close to home to this terminal cancer patient, SNL.

http://www.cnn.com/2016/04/18/health/saturday-night-live-heroin-skit-outrage/index.html

A Little Humor - Potty Chairs and Significant Others

The garage apartment I'm staying in uses a septic tank and with the tremendous rain we've had in Austin the last few days, it's managed to overflow the tank which makes the toilet useless.  My landlord, a very kind, sweet man, pulled a hospital type "potty chair" out of his attic and set it outside my back door for use until the plumbers come to fix the septic system.  It made me think of this:

 2 years ago when I was first diagnosed, they discovered I had cancerous cells in my lungs too.  They felt it important to determine if they were the same cancer as in my prostate or a different type.  I went through 3, YES 3!, lung biopsies.  I was in Seton hospital for just over 2 weeks.  During the last 2 biopsies, they collapsed my right lung (once by accident and once on purpose) to get the cancerous tissue they needed for testing.  When your lung is collapsed, they insert a tube about a half inch thick and about 10 inches long into your back running down the backside of the collapsed lung.  It sucks out any fluid that builds up so the lung can slowly heal and reinflate.

As you might imagine, the pain of having this tube rubbing against your lung EVERY time you breath was just horrendous!  SO they had me on IV pain meds that I got every 3 hours or so.  VERY constipating.  My soon to be husband was there with me almost every hour he wasn't working (he was my rock through that horrible experience) and he happened to work at a physical rehab facility so he could do just about anything short of what nurses do.  He'd helped me sponge bath myself (I was attached to a machine and had the IV so I could only get about 3 steps from the bed), so he'd seen me quite naked in the hospital and, of course, at home.

I told him I thought I might actually be able to have a bowel movement (I hadn't in several days) so he got me the potty chair and sat it next to the bed.  I'd never been in this situation before and was a little unsure about potty chair protocol so I asked the brilliantly stupid question, "What do I do?" He looked at me like I was an imbecile and said, "Scott, you sit your butt on it and shit.  Understand?"  I shook my head yes and he kept piddling around the room doing stuff.  I finally said, "Are you going to step out of the room?"  He replied, "Oh just go ahead.  I deal with people crapping all the time at rehab."  I said, "Well you may be ok with being in the room while I poo, but I'm NOT ok with it, so please step out till I tell you I'm done."  He rolled his eyes and left the room and I took care of my business. 

Some things are best done in private.

Median Life Expectancy

My Oncologist provided some eye opening stats on Median Life Expectancy for men with Stage IV, metastasized (to a major organ i.e. lungs), aggressive, Gleason 8 prostate cancer.  They are as follows:

No Treatment – 12-18 months

Hormone Therapy only – 32 months

HT and chemo – 49 months

.

2015 Continued

2015 was a difficult year.  I'd become depressed and angry.  My wonderful relationship was crashing, I was plowing through savings and 401k and, yes, living beyond my means.  Still living in the somewhat expensive duplex with the view of downtown Austin by myself and footing the whole bill.  My employer, Kinnser Software, finally reached the limit of FMLA and terminated me.  Friends and family got on with their lives and I was on my own.  Some of this was mine to own; it always was and continued to be very hard for me to ask for help.  I've always been able to do everything I needed to by myself.  So I rarely asked for help.

My PSA stayed immeasurable for the first few months, then rose to a .27, then to a .97 and I began 2016 with a rise to 1.27.  While PSA is only one indicator, in someone with my history, I knew what it meant.  Now I have to figure out the over $600 for the CAT scans of my chest, abdomen and pelvis to see what's going on.  Difficult on a $1505/mo income.

I moved from the duplex the beginning of December by myself except for the two guys I hired off Craigslist to help with the king sized bed, couch and dresser. I cleaned the whole place by myself and got the majority of the deposit back.  Then I stayed in a generous friend's spare bedroom and was wiped out for a week from moving everything to storage.  She and I had a falling out and I began to move to and from a series of cheap motels and friends couches.  Finally I was rescued by a dear set of friends.  I had a "home" to stay in.

These two ladies are parents to my favorite "adopted" nephew, their son who is almost 6 years
 old.  They have an RV that is 16 miles out in the country outside Fredericksburg, Texas.  I'd lived in Fredericksburg with my parents in the early 1980s.  It's a very conservative, tourist attraction town.  The RV was 16  miles outside the town on a sloping set of about 5 acres.  It had electricity and propane but no running water.  I learned quickly that there was a gym just inside town with a shower, so I spent $45 so I could have a place to shower and have the added benefit of a place to exercise.  I learned where to refill water jugs for 25 cents a gallon ("low price" Walmart was .37 cents) and, not having TV and very unreliable internet, NPR on the radio became my best friend.  But I was incredibly grateful for their thoughtful generosity and not having to live in my car.

It was a long, lonely 2 months.  My escape from purgatory to follow soon.

So What Happened in 2015 After the Treatments ?

I ended 2014 relatively optimistic.  I'd taken all the recommended treatments (Lupron and Docetaxel) and the cancer was, at the very least, stabilized.  There was no evidence of lung mets anymore, my PSA was 0, the tumor seemed to have shrunk some and there was no longer evidence of extra-capsular extension or seminal vesicle involvement.  That was the good news.

The bad news was I had little to no energy, had gained almost 20 pounds (despite having no appetite and having to be reminded to eat by my husband), my muscle mass was vanishing.  I rarely got out of the house, was close to losing a job I loved dearly and the strain of taking care of me as well as dealing with his own new illness (seizures) was becoming too much to bear for both of us.  The chemo had left me with severe neuropathy as well as chronic fatigue.  I decided since I was done with chemo and, thankfully, not a candidate for another round but was due for another Lupron treatment, I would take a vacation and see if I couldn't get back to the old me.  After a second consult at MD Anderson in Houston, I advised my oncologist here in Austin that I would no longer take Lupron and unless he had any other ideas, I'd focus on eating right, exercise, meditation and explore cannabis oil.  He advised against all this and really wanted me back on Lupron, but I told him I'd rather die feeling like Scott than live longer feeling like Scott's withering away, female counterpart.  I stand by that decision.....and if I had it to do over again, I wouldn't do the chemo either.

There are numerous blogs of women who took docetaxel who YEARS later report fatigue and extreme pain from the damaged nerves thanks to the chemo drug.  This is what I struggle with now. Yes, I AM alive, but I have to take no less than 5 medications (narcotic and non-narcotic) to keep the pain manageable enough that I can be semi productive.  I now live on $1505/month thanks to having worked hard since age 15 and paid into Social Security each year of my life.  But more on that and where things are headed later.

I'm alive and getting to where I enjoy some days.  That's the important thing.

Great Resource - The Prostate Cancer Foundation

http://www.pcf.org/site/c.leJRIROrEpH/b.5699537/k.BEF4/Home.htm

The Prostate Cancer Foundation site is a wonderful resource with info on treatment options both for those newly diagnosed as well as those like myself with advanced disease.  Also links with into for caregivers and loved ones, research and many more.  Give them a visit.

Bringing You Up To Date and a Mini Refresher for Those Who Haven't Read My Story

In January of 2014, I was a strong, healthy, happy 52 year old guy with no major health issues.  I ate good food, I worked out 4 to 5 times a week, I had gotten into running, was 3 years into a great job with this little tech startup called Kinnser Software and was also 3 years into the best, most loving relationship of my life.  Life WAS great!

Then I went in for my yearly physical.  I wasn't one of those guys who avoided the doctor at all costs; rather, I was one who went happily as I had good health and a great primary care physician who I genuinely liked as a doctor and a friend.  He noted that my PSA had risen from 1.45 in 2011 to 4.91 in late 2013. At the time of the physical in 2014, it was 5.2.  During a DRE my friend and physician noted a lump and abnormalities in the prostate.  So off he sent me to a urologist who talked me into a biopsy of the gland.

I was diagnosed with a Gleason 8, stage IV cancer with extracapsular extension, suspected seminal vesicle involvement, very aggressive type of PC and, to top it all off, cancerous nodules in my lungs.  Three lung biopsies (never again!) confirmed the nodules were indeed metastasized cancer cells from the prostate.  The most simple way to put it was, I was in deep shit with few options.

At first, the only option I was given was hormone treatment with Lupron.  I agreed and within a month, my measurable testosterone was 0.  As in none.  As in most women now had more testosterone than I did.  I felt horrible; weak, losing muscle, gaining body fat,  body aches and pains, libido gone and just not like a guy or like Scott anymore.

By May 2014, my PSA was also unmeasurable, but I was advised there were no guarantees it would stay that way and would likely become Lupron resistant at some point.  I was also told the FDA had approved the first chemo treatment for "castrate resistant" (lovely marketing term, eh?) PC and it was using a drug called docetaxel, a highly toxic but effective drug that has been used on women with breast cancer for decades.  FDA studies showed that this chemo treatment (8 sessions, 3 weeks apart) had a positive effect on PC cells and extended average life expectancy by 3-5 months.  Not having any better options, I agreed to it.

By the end of chemo treatment (don't forget, I was also doing the Lupron/no male hormone thing at the same time), I was bald, had little to no energy, had clouded mental function ("chemo brain"), couldn't work, was on disability, and had begun to have severe pain from chemo induced neuropathy in my feet/hands, wrists/ankles, and arms/legs.

So I ended 2014 with good numbers, medically speaking. As I wrote in December of '14:

• * My lungs appear to be cancer nodule free
• * My prostate and the associated tumor appear to have shrunk substantially
• * The tumor is no longer "extracapsular"
• * The tumor no longer appears to have seminal vesicle involvement

But I had traded one problem for others.  Horrible neuropathy as mentioned above, extreme fatigue and depression.

So that's where I left off blogging.  In my next post I'll cover the events of the last 16 months and where I'm at now.

7 Facts About Prostate Cancer All Young Men Should Know - See more at: http://www.prostate.net/2016/prostate-cancer/7-facts-about-prostate-cancer-all-young-men-should-know/#sthash.gfhHfUeV.dpuf

I was 52 when diagnosed with Gleason 8, extra capsular, Stage IV, metastatic (to the lungs) prostate cancer.

Many men 55 and younger are under the mistaken belief that their risk of developing prostate cancer is practically nonexistent. However, although the vast majority of prostate cancer cases develop in men age 65 and older, more than 10 percent are diagnosed in men age 55 and younger.
All men, regardless of age, should be aware of what experts have learned about the risks of prostate cancer among younger men. This is especially true if there is a history of prostate cancer in your family.

Prostate cancer among younger men is rising

A University of Michigan Comprehensive Cancer Center study recently reported that the number of younger men being diagnosed with prostate cancer has increased sixfold over the past two decades. This finding was coupled with the discovery that men who develop this disease early have more genetic variants (genes such as BRCA1 or BRCA2, associated with breast cancer) than their older peers. Therefore, men who have a family history of prostate cancer are encouraged to seek genetic counseling or talk to their doctor about regular early monitoring.

High-risk younger men need to be screened early

Men who have a family history of prostate cancer have a two- to threefold increased risk of developing prostate cancer, and that chance rises even higher among young men who have several relatives with the disease. While men with an average risk of prostate cancer are advised by the American Cancer Society to be screened for the disease at age 50, men at high risk, including African Americans, should start at 45.

Prostate cancer can be more aggressive among younger men

It may seem unusual, but the younger you are when you develop prostate cancer, the greater your chances of dying of the disease. One major reason is that prostate cancer typically has no evident symptoms in its early stages. Therefore, when aggressive prostate cancer is discovered in younger men, it often has already progressed to a more advanced state and therefore is more challenging to treat. Another reason is that some types of prostate cancer appearing in younger men grow more rapidly and can be more deadly than those that are diagnosed in older men.

Early prostate cancer often does not have symptoms

A big reason why prostate cancer can sneak up on you is the lack of symptoms, especially during the early stages. As the disease progresses, symptoms can include urinary issues (e.g., difficulty urinating, urinary frequency and/or urgency), erectile dysfunction, and blood in the urine. However, since these can be symptoms of other conditions that commonly occur in men, such as an enlarged prostate, they can be overlooked. So when in doubt, check it out!

It’s never too early to help prevent prostate cancer

Prostate cancer doesn’t appear overnight; even aggressive forms of the disease develop over time. Therefore, it’s never too early to adopt a healthy lifestyle that can help reduce the risk of a diagnosis in the future. Based on scores of studies around lifestyle that can affect a man’s risk of and survival from prostate cancer, there is some evidence that the following factors have a role: diet high in red meat and/or high-fat dairy, high calcium intake, smoking, pesticide exposure, excess alcohol intake, being sedentary, and being overweight.

There are pros and cons of prostate cancer screening

First of all, the current prostate cancer screening methods are simple; a blood test for prostate-specific antigen (PSA) and a digital rectal exam to detect any unusual lumps or other abnormalities in the prostate. However, there’s considerable controversy surrounding these guidelines for prostate cancer screening, including the accuracy and reliability of PSA and how often screening is needed. New techniques to measure PSA are under investigation, but for the majority of men, the traditional methods will have to do for now. All men should have a frank discussion with their healthcare provider about the pros and cons of screening as it pertains to their unique situation.

Watchful waiting can be a wise choice for young men

Early onset prostate cancer can be aggressive, but in most cases it is not. That’s where watchful waiting comes in. Because treatment for prostate cancer, including radiation, hormone therapy, and chemotherapy, is associated with serious, life-altering side effects (e.g., erectile dysfunction, urinary incontinence, infertility), younger men who have been diagnosed often want to avoid treatment until it is necessary. Watchful waiting, in which men choose to monitor their disease with regular PSA and digital rectal exams (and sometimes a biopsy) while also following a healthy lifestyle, can keep men’s quality of life at its best for as long as possible. If necessary, multiparametric magnetic resonance imaging allows doctors to keep an eye on prostatic lesions when conducting a biopsy and to track any changes. Whether to choose watchful waiting is a decision men need to make with their healthcare providers and loved ones.
Prostate cancer is not just an “old man’s disease.” If you have a prostate, you are at risk for prostate cancer, so stay in tune with your body tuned to your body and see your doctor if you have any concerns or questions.

- See more at: http://www.prostate.net/2016/prostate-cancer/7-facts-about-prostate-cancer-all-young-men-should-know/#sthash.gfhHfUeV.dpuf

Long Time No Update - But News To Be Had

It's hard to believe that it's been 15 months since I last posted.  So much has happened in my life that the blog took second (tenth?) place.  But I AM STILL ALIVE!

I am 15 months out from Lupron and about 17 months out from chemo.  The good news WAS that my PSA for many months dropped to unmeasurable and my testosterone rose to stratospheric levels so, in some ways I began to feel like me again.  Then over the last year my PSA began to creep back up.

On top of that, the chemo (docetaxel) caused horrific neuropathy in my hands/feet, arms and legs.  The pain is debilitating and requires 4 different meds to keep at bay.  In reading blogs from women who have had this drug, this sometimes persists for years or never goes away.

So I have traded extra length of life for lack of quality.  If I had it to do over again, I'd take neither drug and just ride out my life.  The only option I seem to have is cannabis oil which, living in the very "progressive state of  Texas" makes that difficult to pursue.

I plan to start writing again as I continue this journey to bring you up to date on the events of the last year as well as my plans for the future.  I appreciate any and all comments and forms of support.

3 Months Later and Post Chemo, Some Good News for a Change

My apologies for the long hiatus but in all honesty, as I went through the last few wretched chemo treatments, I simply needed one less reminder that this had become my life.  That said, there is some good news finally.  I had a CT scan of my chest, MRI of my prostate and a visit with the same physician at MD Anderson/Houston this past Thursday that I saw in April and here's what we know now:

• * My lungs appear to be cancer nodule free
• * My prostate and the associated tumor appear to have shrunk substantially
• * The tumor is no longer "extracapsular"
• * The tumor no longer appears to have seminal vesicle involvement

Considering the beating chemo and hormone deprivation has done to my body, this is indeed relieving news.  With MD Anderson doctor approval, I will take a "holiday" from Lupron.  He suggests I may be good for 9 months to a year or more before I might need to consider hormone deprivation again.  Additionally, I'm done with chemo.  In summary, this means that I can focus on healing my treatment ravaged body and mind.

And this is truly good news.

Chemo 3 and Lupron 2....and Then a Break

I hate to be so long in posting but that's just how it is when one is lost in the hazy world of chemo, hormone deprivation, pain and  aintianxiety meds.  My how the time flies.  So I'm sitting in a recliner at the oncologist's office with a burning IV in my arm with about an hour's worth of toxic chemicals left to course through my veins and then I have the unmitigated joy of another Lupron shot which will keep my testosterone non-existent for about another five months.

But then I'm fairly certain I have decided (against onc's recommendation) to skip Lupron for a few months.  I'll be done with chemo by late November and would be due for a Lupron shot January 1.  But I need a break.  Now.  So certainly by 2015 the need will be greater.  I need to feel like me and I need to feel normal again, if even for a little while.  I'll roll the dice

More later.  Stay strong folks.

A Largely Improved Me But The Hair Is Going!

I finally started to turn a corner in the last few days.  Starting Sunday I began to feel incrementally better and today felt (comparatively) marvelous!  Got out and ran errands, helped Derrell hang a door, got burgers for us from WiFiBurger.  Delish!  Additionally, a friend and coworker invited me to go to a taping of Austin City Limits at the ACL Moody theater located in the W Hotel downtown.  The only sour note is that after I showered to go out to the ACL taping, I was drying my hair with a towel and felt something all over my shoulders.  It quickly dawned on me that the loss of my hair due to chemotherapy was in process.

So, I'll be breaking out the clippers tomorrow and the Scott Needs Hats party happens Saturday.  Pics and post to follow the party.

Five days after Taxotere #1

I wish this could be a positive post, but I gotta be real here folks.  The chemo drug, Taxotere, has won today.  Despite six or seven hours of sleep, my fatigue level is 9 out of 10.  The runs have commenced with vengeance.   While no vomititus, food doesn’t look or sound good although I’ve managed to eat a meal and a cookie. Random, shooting pains hit various parts of my body on top of the general aches and pains that commenced after hormone therapy started some three months ago and the current pain med, Nucynta, is not touching them. I’m so clouded mentally….just slow.

Don’t know what else to say.

The Day After

 

I woke this AM about 8 to a good friend and coworker dropping off Torchy’s Tacos, one of Austin’s finest.  Not being hungry at that moment, I went directly back to sleep and didn’t move again until about 4  Jay, once again, showed up with grilled salmon, new potatoes and tortilla soup and a couple of wonderful additions: Burts Beeswax hand cream and some ultra chic lip balm all in a beautiful basket..  Derrell got home about 6:30pm and we’ve been chilling on the couch ever since.

 

I’m thankful that today all I feel is tired. No, exhausted.  Little nausea, no diarrhea.  But tired like I’ve never been tired before.   Sleep soon, will come easily.

So Taxotere scores one for fatigue and I score one in that I’m not dealing with any of the rest of the side effects.

But it is still early.

Chemo Starts Thursday

I need thoughts, prayers, food and love,

Please use the following link to access the Meal Train for Scott Miller.

https://mealtrain.com/dgvw4

and for any other way in which you can help, please contact me directly.  It's hard for me to ask for help, but I have to learn to do so.

Also, please come to the Hat Party:


Additionally, Derrell has planned a Hat Party on 6/14 for this soon to be bald guy. 

 

"Your friend and my boo, Scott L Miller, will soon lose his hair due to 18 weeks worth of chemo treatments. Rather than let it just fall out, Scott is going to shave his noggin and just own the chrome dome. As he only owns one hat, a baseball cap from the Hawaiian island of Lanai, he needs to stock up.

So please bring you choice of hat, be it ball cap or Stetson, Ascot or Beanie, Berets or Fedoras, Panama hats or Top hats, shoot even one of those frilly thing you see at the Kentucky Derby.
It is 7 3/8” hat size or a 23” head! Bring the hat, you’re favorite cocktail and any nibbles you’d like and let’s celebrate lack of hair!

This is a celebration of life as its lived! Please join

I'm Really Thinking I Should Make an Appointment Here (shhhhhh! Don't Tell My Oncologist!)

Today I Feel Better and Life, Lemons and Lemonade

Today I feel better.  Now better is a marginal thing.  I'm still fatigued and I have pain in my joints extremities but not to the degree I did yesterday.  Small things have to be appreciated.

Other things to be appreciated are a "Meal Train" that was started for me by the folks at Kinnser Software:

"As many of you already know, our dear friend, Scott L Miller, is experiencing a health issue that necessitates treatment over the next few months which will likely cause him to feel weak and unwell. If you want to help Scott through this period by dropping a meal off at his home, click this link to learn more and to sign up.

What is a meal train? There are times in our lives when friends and family ask, "What can I do to help out?" The answer is usually to help them with a meal. When many friends give a meal, this is a meal train.

If you are inclined, please sign up to deliver a meal to Scott on one of the days indicated. There may occasionally be errands and other needs Scott has (e.g., yard work, ride to the doctor's office), so please reach out to him directly if you're available to help in other ways.https://mealtrain.com/dgvw4

On behalf of Scott Miller, Thank You!"

Additionally, Derrell has planned a Hat Party on 6/14 for this soon to be bald guy. 

 

"Your friend and my boo, Scott L Miller, will soon lose his hair due to 18 weeks worth of chemo treatments. Rather than let it just fall out, Scott is going to shave his noggin and just own the chrome dome. As he only owns one hat, a baseball cap from the Hawaiian island of Lanai, he needs to stock up.

So please bring you choice of hat, be it ball cap or Stetson, Ascot or Beanie, Berets or Fedoras, Panama hats or Top hats, shoot even one of those frilly thing you see at the Kentucky Derby.
It is 7 3/8” hat size or a 23” head! Bring the hat, you’re favorite cocktail and any nibbles you’d like and let’s celebrate lack of hair!

This is a celebration of life as its lived! Please join."

 

I'm a lucky man,

How I Feel Today

The alarm went off at 6am but I was already starting to wake.  I could tell I didn't feel 100%. Feet and ankles/legs wobbly and sore......sore all the way down the stairs.  Went to a dentist appointment and just ached.  I have clean teeth though!  Drove to work and slowly got out of the car.  Still sore and wobbly despite the current regimen of Celebrex and Tramadol.

So that's how I feel today: wobbly, unfocused, achy, sore and slow.

Because People ask "What Can I Do?"

So many have asked me, "What can I do?" and they want to help.  Their desire to help is often impeded by my (and Derrell's) strange feeling we should do it all ourselves which is often possible, but getting less and less so, particularly after the 7/31/14 chemo start.

So here are the suggestion:

Supporting a Friend Who Has Cancer

If you have a friend who has recently been diagnosed with cancer, or is living with cancer, you may be wondering the best way to support him or her. Even though you want to help your friend through this difficult time, it can be hard to know what to say or do. While there are no set rules when it comes to supporting a friend who has cancer, this article will help you find ways to show your support, including ideas of what to say and how to provide practical help, as well as suggestions for thoughtful gifts.

Preparing yourself

 

A good first step is to learn more about the diagnosis beforehand. Your friend may not want to talk about the details for many reasons, including that it is physically and emotionally tiring to repeat the same information to different people. If possible, the person’s spouse or a mutual friend may be able to give you the basics. Write it down and repeat it back to them to be sure you’ve gotten the correct information. And if there’s information that is unknown or not shared, don’t push for more.

Before a visit, you may want to remember a time when you were really scared or felt really sick. Think about what it felt like. What did you want to talk about? How did you want to be treated? You may also want to prepare yourself for changes in your friend’s appearance. Fatigue, weight changes, and hair loss are common side effects of cancer and many treatments. Start your visit by saying “It’s good to see you” instead of commenting on any physical changes.

 

Helpful tips when supporting a friend

 

Although each person with cancer is different, here are some general suggestions for showing support:

• Ask permission—before visiting, before giving advice, before asking questions. And make it clear that saying no is perfectly okay.
• Make flexible plans that can be easily changed in case something comes up or your friend needs to cancel or reschedule.
• Don’t be afraid to make plans for the future—this gives your friend something positive to look forward to. Be careful not to come across as pushy or demanding though.
• Be humorous and fun when appropriate and when needed.
• Allow for sadness—do not ignore uncomfortable topics or feelings.
• Make time for a weekly check-in phone call. Let your friend know when you will be calling, and let your friend know that it is okay to not answer the phone.
• Offer to help with specific tasks, such as  preparing a meal or many of the ones listed below. Many people find it hard to ask for help, and your friend will likely appreciate the offer. However, if your friend declines an offer, don’t take it personally.
• Follow through on a commitment to help.
• Try not to let your friend’s condition get in the way of your friendship. As much as possible, treat him or her the same way you always have.
• Ask about interests, hobbies, and other topics not related to cancer—people going through treatment sometimes need a break from talking about the disease.
• If you aren't sure how to help, ask.

What to say

Here are some simple guidelines to use when talking with your friend.

Avoid saying

*I know just how you feel.

• How are you feeling? (multiple times).
• You need to talk.
• I know just what you should do.
• I feel helpless.
• I don't know how you manage.
• I’m sure you’ll be fine.
• Don’t worry.
• How much time do the doctors give you?
• How long do you have?
• Let me know what I can do. (Instead, offer specific ways you can help or other things you can provide if they need it.)

Do say

• I'm sorry this has happened to you.
• If you ever feel like talking, I am here to listen.
• What are you thinking of doing, and how can I help?
• I care about you.
• I’m thinking about you.
• I don’t know what to say. (It is better to be honest than to simply stop calling or visiting out of fear.

Practical help

 

Your assistance with daily tasks and chores is valuable help to a friend going through cancer treatment. Be creative with the help you offer. Remember that your friend’s needs may change, so be flexible in shifting your plans as needed. Here are some suggestions:

• Shop for groceries and pick up prescriptions.
• Help with chores around the house, such as getting the mail, taking care of pets, cleaning, doing laundry, taking care of plants and flowers, and taking out the garbage.
• Cook dinner and drop it off at your friend’s house.
• Schedule a night of takeout food and movies together.
• Take them to and sit with them during chemo
• Take them to Drs appointments when they can’t drive.
• Organize a phone chain and/or support team to check on your friend regularly.
• Help the write thank you notes
• Prepare a meal for the spose even if thee patient doesn’t want to eat.
• Call, email, or text regularly. Let your friend know it’s okay if he or she doesn’t reply.
• Offer to run errands, grocery shop, do laundry, clean how or mow the lawn.
• Find out when their chemo days are and the time and send them a small gift to the oncologists office not to be opened until they arrive.
• Offer to sort through and keep up with coordination of medical bill.
• Drive your friend to an appointment or a support group meeting. You can take notes during a doctor's appointment or keep your friend company during a treatment session.

• Offer to be the designated point person to email friends and deal with multiple calls.
• Go for a walk together.
• Think about the little things your friend enjoys and makes life “normal” for them. This could be helping to decorate for a holiday or weeding the garden. If there is something your friend would usually do, there are many ways you can make it a bit easier for him or her to do it.

Forming support teams

Organizing a support team is a great way to help a friend living with cancer. Some online communities offer tools to coordinate tasks among friends and caregivers, and shareable online calendars may help you organize activities among your group of friends and family. Or you can always make a paper calendar and write in the various activities and commitments by hand. Make sure your friend has access to the calendar so he or she knows what to expect and when.

Gift ideas

 

There may be times when you want to give your friend a gift. As with any gift, keep in mind the interests and hobbies of your friend and your relationship to that friend. For instance, a close friend may be able to give something really silly or unusual, whereas a neighbor or work colleague may want to stick with something more traditional.

While giving a gift is one way to show you care about someone, be careful not to give your friend anything that promotes a specific treatment or philosophy as a cure for cancer. People make decisions about their disease after a lot of thought so it’s important to respect their choices and their coping process, whether it is what you would do in the same situation or not. Keep gifts fun, interesting, serious, or light, depending on what your friend needs the most at that moment.

Some ideas include:

• Magazines, audio books, novels, books of short stories or poetry, or gift cards to purchase reading material
• CDs or gift cards for downloadable music
• DVDs of movies, TV shows, or documentaries
• Accessories (ties, hats), or beauty items
• Crosswords
• Note cards or a journal
• Arrange a mani/pedi together
• A video message from family and friends
• Gift certificates for massage, spa services, restaurants, or museum/art gallery passes
• Gift cards to grocery stores
• A housecleaning service
• Portable hobby supply kits (scrapbooking, drawing, needlepoint)
• Pajamas or robe
• Flowers or plants

Friendship makes a difference

 

Continuing friendships and regular activities after a cancer diagnosis is a great way to further the healing process. But don’t forget that friends also need encouragement and support after cancer treatment has finished. After treatment your friend will be trying to find his or her "new normal" in this next phase of life, and friendships are an important part of that. With these practical suggestions in mind, your friendship can make a lasting difference to a person living with cancer.