Archives for October 2013

A study published recently in the Journal of Clinical Oncology in March of this year and sponsored by the American Cancer Society has reported that patients with localized colorectal (large bowel ) cancer had improved overall survival with increased physical activity; whereas a more sedentary lifestyle was associated with reduced survival.

In this study, participants completed detailed questionnaires regarding their physical activities and leisure time before and after being diagnosed with cancer of the colon or rectum. There were 3 categories of activity -walking less than 1 hr/wk, walking 1 to less than 2.5 hrs/wk and 2.5 hrs or more walking/week. Leisure time categories were sitting less than 3 hrs/day, 3 to less than 6 hrs/day and 6 or more hours/day. Patients were followed over an extended period of time (up to 16.1 years).

In patients with the highest activity level, there was a 42% reduced risk of death from all causes. In patients who reported sitting for 6 or more hours/day, there was a 62% increased risk of dying from complications related to colorectal cancer.

The authors acknowledged certain limitations of the study, but concluded that physicians should consider counseling colorectal cancer survivors to adopt a physically active life style aiming to achieve 2.5 hrs or more of moderate intensity activity per week, such as walking, and to avoid prolonged sitting.

I have to admit that in my practice, I need to be more proactive in talking to my patients about the benefits of physical activity and better understand the obstacles to a less sedentary lifestyle.

It is no surprise that men and women are profoundly different in a variety of ways and one of these key differences is the area of grief. It can be helpful to understand how gender differences play a part in how we grieve, whether we are the person grieving or if it a family member or friend.

Women frequently express that they feel their male counterparts are not grieving or supportive; often men say that they do not know how to best support their female loved ones, or how to handle the emotion and pain that stems from grief.

Men tend to be more comfortable attending to life changes by taking on new roles and responsibilities that result from the death of a loved one. Learning new non-traditional roles such as cooking, cleaning or becoming a single parent can be a distraction from their grief.  Males often view social relationships as more of a time to share activities than emotions. So often they state that they know the story in their head and they don’t need to retell it. They tend to want to “fix it” and will rely on their own resources—often keeping feelings and emotions to themselves.

Women, on the other hand, tend to be more emotional and will work on their grief by talking about it. They will tell their story over and over again because they say it helps them process and work through their grief. Women confide in friends, outwardly express their feelings and emotions, and “feel” their way through grief.

Men say that they limit their expression of emotion because they may not want to appear weak. Women report frustration with men demonstrating little emotion and not wanting to talk about the person who died. Women may view this as cold and think that the man is not grieving. Men often feel the expectation to be strong and so may be given or may accept little social support. Society has traditionally taught little boys not to cry while   comforting little girls who do. Hopefully as we educate more, this message is changing. These conflicting gender messages can carry through one’s entire life and may cause misunderstandings between males and females who are grieving. This can lead to frustration, anger, and feeling isolated in one’s grief for both genders.

Men are generally “inward” thinkers; they think of the “situation” not the emotional responses. This does not make them less emotional, or less responsive to those around them; they just have a different method of looking at the emotional response.  The woman in grief is traditionally looking for support. She will look to those that can understand and listen to her express her emotions. She is not looking to “FIX” anything, but to regain her perspective and understand some purpose in her grief. Both men and women need support in grief. They need to hear from others their emotions are normal, their responses to the emotions are normal, and that they will be able to live and love again.

It is critical to stress that whether you are a male or female dealing with a loss of a loved one, if you are unwilling to express grief in any form at all, you will likely face serious consequences during your future journey. It is a make-or-break choice for those of us who lose someone and are willing to express our grief fully, in whatever way we are comfortable. Not to express our grief is to potentially set ourselves up for a lifetime of illness, bitterness, anger, and lack of connection to life.

When we look at gender differences in grief, what is important to remember is that neither way is right or wrong, just different. Both genders can learn from the other.  If we learn to understand and accept one another’s differences, we can learn to support one another without trying to change them. Grief is a very personal and individual experiencewith everyone navigating through this journey in his or her own way. The hope is that those walking this journey can experience comforting support along the way.

Unity, leaders in hospice and palliative care, announced on October 14th, 2013, the selection of Green Bay Oncology as the 2013 Unity Guardian Angel award winner for its contributions to the organization. Green Bay Oncology was honored during a recent presentaion to President, Dr. David Groteluschen and Chief Operating Officer, Jenifer Kolar.

“Green Bay Oncology is proud to accept the Guardian Angel award. End of life care for patients and their loved ones is an essential component of quality medical care. Throughout the years, Unity has and continues to provide exceptional hospice and palliative care in northeast Wisconsin. We greatly value our relationship with Unity, and look forward to continued collaboration in the service of our Community,” said Dr. David Groteluschen, President of Green Bay Oncology.

Each year, since 1997, Unity has recognized as Guardian Angels an individual or group of individuals who have supported Unity’s patients and families through collaboration, monetary donations or the gift of time, knowledge and skills.

“Green Bay Oncology has a long history as the region’s largest group of cancer specialists who bring the world’s latest treatments to their patients,” said Alisa Gerke, Unity’s Executive Director. “We are grateful to them for their expertise and willingness to collaborate for the best patient outcomes possible.”

Green Bay Oncology shares the distinction as a Unity Guardian Angel with other noted community members and organizations. Past honorees include:  Cellcom, Kay Ferguson, Paul Koch, MD; Sue and the late Michael Mietzel, Dr. Bill and Sandy Schneider, Bill and Marge Galvin, James McGovern, MD; Carol Bush, Cornerstone Foundation, AXA Advisors/Voyageur Group, Howard and the late DeLane Hansen, Rick and Ginny Baer, Jack and Engrid Meng, Elaine Le Duc, Merrill Lynch, and Schreiber Foods.

About Green Bay Oncology

Our mission at Green Bay Oncology is to provide the best oncology care in the Midwest.  By building empathetic, caring relationships, we will enhance the physical, psychological, and social well being of our patients, our employees and the community we serve.  We embrace even the most difficult of cases because we are determined to partner with patients and their families, our employees and the community, to relentlessly battle cancer.

About Unity

Unity is a not-for-profit provider of palliative, hospice care and grief support in 12 counties in Northeast Wisconsin and has offices in the Green Bay area, Marinette, Shawano and Sturgeon Bay. A continuation of the former Bellin Hospice program founded in 1977, Unity is a partnership of Bellin Health, St. Mary’s Hospital Medical Center and St. Vincent Hospital. Unity is a member of the National Hospice and Palliative Care Organization (NHPCO). For more information call (920) 338-1111 or visit www.unityhospice.org.

A century ago, when illness struck, patients were sent to bed, isolated and ‘let’ of blood.  Fortunately, sanatoriums and leeches have been done away with, but the concept of bed rest or inactivity is still one that has been debated until just recently.

Historically, there have been concerns that exercise could make cancer spread or cause the cancer to return. It has also been felt that exercise may cause treatment side-effects to worsen, leading to more fatigue, more pain.

Research in exercise and cancer has changed our attitudes towards activity and illness. In 2011, cancer experts joined with exercise experts to review the current research.  These experts clearly found that cancer survivors (including those undergoing treatment) can experience a multitude of benefits from exercise.

The National Cancer Institute reviewed over 45 studies. Virtually all of the studies showed that exercise decreased the risk of cancer-related death as well as death from other causes.  In other words, exercise made it less likely that cancer survivors would die from a recurrence of their cancer.  Exercise was found to improve blood sugar levels, decrease inflammation, and increase the number of immune system cells thought to attack cancer cells. Contrary to early concerns, patients reported feeling less fatigue, less nausea and pain, and a better quality of life. 

What can you do?

It’s actually quite simple.  Moderate activity–every day for about 20 minutes–can make a difference.  In a majority of the studies reviewed, walking was the main form of exercise.  However, household activities such as gardening, cleaning, raking, and so on, count toward your 20 minutes per day.  Gentle weights twice a week, as well as stretching throughout the week, are also recommended.

Check out your local YMCA.  Many local YMCAs have ‘LIVESTRONG at the YMCA’ programs available.  This is a research-based physical activity and well-being program designed to help adult cancer survivors reclaim their total health. Participants work with Y staff trained in supportive cancer care.  The Green Bay LIVESTRONG at the YMCA contact information is: livestrong@greenbayymca.org. Or contact Stacy Ryan, Member Experience Director at 920-436-1231

Of course, before beginning an exercise program talk to your provider.  There may be some restrictions you should be aware of given the site of cancer.  Just get moving!