A Message of Hope:

Coping With Cancer in Everyday Life

More than 11 million Americans alive today have faced a diagnosis of cancer. Some of them have just been diagnosed or are going through treatment, while others no longer have active symptoms of cancer or are thought to be cured.

No two people with cancer are alike -- just as no two friends or family members are alike. Each person has his or her own way of coping with cancer. Here we will review how some people facing cancer have dealt with their feelings and their individual situations. This information comes from many people who have shared their thoughts and feelings about coping with cancer. They've shared because they believe it's helpful to hear from others who have been in their shoes.

The American Cancer Society can give you information about different types of cancer and cancer-related topics. At the end of this document, we have listed some resources that cover some other topics in depth. We also offer many patient service programs in communities throughout the country. To get the information and resources you need, call us anytime, day or night, at 1-800-227-2345, or visit our Web site at www.cancer.org.

The emotional impact of a cancer diagnosis

Delores, cancer survivor: "There is a fear that goes through you when you are told you have cancer. It's so hard in the beginning to think about anything but your diagnosis. It's the first thing you think about every morning. I want people diagnosed with cancer to know it does get better. Talking about your cancer helps you deal with all of the new emotions you are feeling. Remember, it's normal to get upset."

When you are told you have cancer, the diagnosis affects not only you, but also your family and friends. You may feel scared, uncertain, or angry about the unwanted changes cancer will bring to your life and theirs. You may feel numb or confused. You may have trouble listening to, understanding, or remembering what people tell you during this time. This is especially true when your doctor first tells you that you have cancer. It is not uncommon for people to shut down mentally once they hear the word "cancer."

There is nothing fair about cancer and no one deserves to have it. A cancer diagnosis is hard to take and having cancer is not easy. When you find out you have cancer, your personal beliefs and experiences help you figure out what it means to you and how you will handle it. As you face your own mortality and cope with the many demands of cancer, you may look more closely at your religious beliefs, your personal and family values, and what's most important in your life. Accepting the diagnosis and figuring out how cancer fits into your life is challenging.

After you are diagnosed with cancer, you may feel shock, disbelief, fear, anxiety, guilt, sadness, grief, depression, and anger. Each person may have some or all of these feelings, and each will handle them in a different way.

Your first emotion may be shock, because no one is ever ready to hear that they have cancer. It is normal for people with cancer to wonder why it happened to them or to think life has treated them unfairly. You may not even believe the diagnosis, especially if you don't feel sick.

You may feel afraid. While some people fear cancer itself, others may be afraid of cancer treatments and wonder how they will get through them. Fear of pain and suffering is one of the greatest fears people with cancer and their loved ones have.

You may feel guilty. You may ask yourself if you could have noticed your symptoms earlier, or wonder what you've done that may have caused the cancer. You may wonder if you were exposed to something at home or work that led to cancer. Or you may worry that other members of your family will also get cancer. At this time we do not know what causes most cancers. But a few are known to be hereditary, or passed from a parent to a child. This means if one family member develops it, others in the family may have a higher risk of developing it, too. This can cause even more concerns for the person newly diagnosed with cancer.

You may feel hopeless or sad if you see cancer as a roadblock to a life full of health and happiness. It is hard to feel positive and upbeat, especially if the future is uncertain. Just thinking about treatment and the time it will take out of your life can seem like too much to handle. Feelings of sadness or uncertainty can be made worse by your past experiences with cancer.

You may have a sense of loss linked to your cancer diagnosis and treatment. Cancer can change your sense of self, that is, how you think of your body, yourself, and your future. Grief is a normal response as you give up your old ideas of yourself and begin to develop ways to cope with the new, unwanted changes in your life. It may take time for you to become aware of these losses and changes. It can help if you share your grief with someone close to you. If there is no one near you that you want to confide in, you might want to see a mental health professional. Your feelings need care too, just like your physical body needs care.

You might feel angry. While some people may not outwardly express their anger and frustration, others may direct their anger toward family members, friends, or health care professionals. This is usually not done on purpose. If you are only trying to vent your feelings, let people know that you are not angry with them and that it is not their fault. Also let them know that you don't expect them to solve your problems -- you just need them to listen.

Coping with your emotions

The best prescription is knowledge.

-- C. Everett Koop, MD, former United States Surgeon General

Some people find it is easier for them to face the reality of a new or scary situation if they learn as much as they can about it. This is especially true when you are dealing with a complex group of diseases like cancer. There is often a great fear of the unknown and uncertainty about what is going to happen. Knowledge can help lessen the fear of the unknown. You can learn a lot about the type of cancer you have, its treatment, and your chances for recovery.

Be your own advocate. Even though people facing cancer cannot change their diagnosis, they can seek out reliable, up-to-date information and talk to family members, friends, and their health care team. Finding good sources of support can help people with cancer take control of their situation and make informed decisions.

It's important to work through your feelings about cancer, because how you feel can affect how you look at yourself, how you view life, and what decisions you make about treatment.

These tips can help you make your medical appointments as useful as possible:

• Make a list of questions to ask your health care team.
• Bring a family member or friend along to appointments. They can serve as an extra pair of ears, help you remember things later, and give you support.
• Ask if you can record important conversations.
• Take notes. If someone uses a word you don't know, ask them to spell it and explain it.
• Ask your health care team to explain anything you don't understand.

You will not be able to change many things in your life. Focus on what you can change to gain a greater sense of control over your situation.

Delores, cancer survivor: "Daily walks and, later, running helped me keep my sanity after I was diagnosed."

Other things you can do to deal with your emotions:

• Ask for support from family, friends, and others. Just having someone who cares and will listen to you can be very helpful. If friends or family members are not able to be supportive, find others who will. Health care professionals (such as social workers, psychologists, or other licensed health professionals) and support groups can be extra sources of support.
• Get spiritual support through prayer, meditation, or other practices that help you feel more at peace. You may want the guidance of a chaplain, pastor, rabbi, or other religious leader.
• Pay attention to your physical needs for rest, nutrition, and other self-care measures.
• Find ways to express your feelings, such as talking or writing in a journal.
• Allow yourself private time and space.
• Walk or exercise. Be sure to talk with your cancer care team about your plans before starting a new exercise program or activity.
• Find out what helped other patients and families cope with cancer, and/or talk with other people diagnosed with the same type of cancer.
• Make changes at home to create a healthier environment, and/or talk with your doctor about making healthy lifestyle choices.

Feeling sad all the time, having trouble sleeping, or thinking about suicide are signs that you need professional help. Other symptoms that may need treatment include feelings of panic, intense anxiety, or constant crying. If you think you might need professional help, talk with your doctor.

Making informed treatment decisions

Is there time?

People with cancer often feel the sooner they get rid of the cancer, the better. They may feel like they need to make decisions right away. They may be concerned that extra tests and appointments with other doctors will take time that could be spent treating the cancer.

So how long is too long? Cancers grow at different rates. Most cancers do not grow very quickly, so there is usually time to gather information about your cancer, talk with specialists, and make a decision about which treatment is best for you. Talk with your health care team if you are concerned about not starting treatment right away.

Cheng, cancer survivor: "What was helpful for me was taking the time to step back and see the big picture. Getting information and the answers to my questions allowed me to make to make the best decision for me and my family. I lived up to my expectations and desires. I did things that made me feel comfortable, not what others thought I needed to do to be comfortable."

Getting cancer information

When looking for information about any type of cancer, first know exactly what type of cancer you have. Talk with your health care team. Ask them for information about your specific type of cancer, including the cell type and the stage (extent) of your cancer. This is helpful because your cancer treatment will be designed for just you.

The stage and type of cancer, along with other factors, will help determine the goal of treatment. Most types of cancer treatment have 1 of these 3 goals:

• Cure the cancer
• Control the cancer
• Ease symptoms of the cancer and help make the patient comfortable

Sometimes the treatment goal changes after treatment has started. Talk with your doctor, and make sure you understand what your treatment options are, so you can make the best decisions for you and your family.

We live in an information-packed age. Cancer information can be complex and confusing. To find accurate and up-to-date information, use reliable sources, such as journals or Web sites from well-respected cancer centers, national cancer organizations, health professional organizations, and government agencies like the National Cancer Institute. (See the "Additional resources" section for some suggestions.) The information from Web sites, message boards, and online support groups can be very helpful, but it varies widely in quality and accuracy.

Look for information that has been reviewed by medical experts, is updated often, and states the purpose of the information. When you get information, discuss it with your health care team to find out if and how it applies to you. Remember, written information cannot take the place of medical advice from your doctor or cancer care team.

Getting information from your health care team

Learning all they can about you and your cancer is the first step your health care team will take. A biopsy and other lab tests, physical exams, and imaging tests will be done to figure out the stage (extent) of your cancer. Next your doctor uses all of this information to narrow down options and recommend treatment. Your doctor may talk with other doctors and health care professionals to help plan your treatment. You may also wish to get a second opinion at another treatment center. Getting a second opinion may help you feel more comfortable when deciding on your best treatment option.

Talking to doctors, nurses, and other members of the health care team is very important for people diagnosed with cancer. Your health care team can tell you where to look for information about your type of cancer and its treatment. They can answer your questions, give you support, and refer you to community resources. Allow yourself to take in information at your own pace. You decide when you are ready to talk, when you want to learn more about your cancer, and how much you want to learn.

Ask questions

Doctors and nurses are good sources of information when you have medical questions. Before appointments, write down any questions you may have about your type of cancer, treatment, side effects, and any limits on activity you might have during treatment. Other members of your health care team, such as pharmacists, dietitians, social workers, physical therapists, and radiation therapists are experts in different areas. Don't be afraid to ask them questions, too. Asking questions shows you want to learn and take an active role in your treatment. If the health care team member does not have time to answer all of your questions, ask when a good time would be to finish your conversation or ask about other ways to get the answers you need.

Judith, caregiver for her husband: "No question is too small or too silly to ask. I never was afraid to call the doctor or staff with questions about anything...even questions about our bills and insurance. I found that our doctor and his staff were willing to answer any question. It was also very helpful to speak with our pharmacist. He made special arrangements when we needed to get prescriptions, especially pain medicine, filled after regular business hours."

Know how to reach your doctor any time

People with cancer must know when they need to call the doctor. Ask which side effects or unusual signs need to be reported right away. Some things can wait until the next office visit, or until regular office hours when you can call and speak to a nurse. But if you are having severe or unexpected side effects, you need to know how to reach your doctor when the office is closed. Be sure you have this phone number and that your loved ones have it, too. If your doctor is not available after hours, find out what you should do if you have problems.

Family members may wish to speak with members of your health care team. This can help them answer questions and find support to deal with their feelings. Your health care team is bound by law to keep information about your health confidential. They will not discuss your health status with family members and friends unless you give your permission for them to do so. Let your doctors and nurses know which family members and friends may be contacting them and with whom they can share information.

Feel comfortable with your health care team

In an ideal world all health care professionals would be patient, understanding, have all the time in the world to answer questions, and know how to explain things to you so you could easily understand. But finding all of this in one person is rare. Still, it is important for you to trust your doctor and other members of the health care team. If you feel a lack of trust and open communication is keeping you from getting good medical care, ask for a referral to another doctor with whom you feel more comfortable. Also, don't be afraid to ask your doctor for a referral for a second opinion. You will need to be an active member of your health care team. As an active team member, you will need to do things like keep your scheduled appointments, take medicines as prescribed, and report side effects.

Telling your family and friends

People who have been told they have cancer may wonder who to tell and how they should tell them. They often feel pressured to share their diagnosis, but most people are able to wait until they are ready. There is no set time when people begin to feel comfortable enough to discuss their cancer with others. It is different for each person.

Delores, cancer survivor: "Telling friends and family was really hard. Since my mother had died from breast cancer it felt like I was saying, 'Here we go again.' My sister-in-law had died from lung cancer the same month I was diagnosed with breast cancer. This made it hard to tell my husband's family that cancer had struck again. I was sad for my husband."

If you have been diagnosed with cancer, only you know the right time and the right words to use to tell your family and friends. You may find that sharing the news of what you are facing leads you to people who become key sources of support and encouragement. Sharing this experience with loved ones gives them a chance to offer their support. Your honesty and openness can help open new lines of communication and make relationships stronger and better.

It's very hard to hide a diagnosis of cancer. Friends and family might suspect you have cancer when they become aware of symptoms or different types of tests you have had. Often when people do not know what's going on, they imagine the worst possible situation. But when you do share the news, they may still be stunned and not know how to react or what to say.

Before you talk to others about your illness, think about your own feelings, your reasons for telling others, and what you expect of them. Be ready for a wide range of reactions. When you share information about your diagnosis, your family and friends will have many different feelings, too. They also need support at this time. They might be able to express their feelings to you, or they may try to hide them.

Delores, cancer survivor: "The first time you say, 'I have cancer' out loud is the most difficult. The more you say it, the easier it gets to say the words. The more I talked about my diagnosis of breast cancer, the easier it was for me to accept what I was going through. Sometimes I thought it was ironic that I felt like I was the one who was cheering up the recipients of my news."

Other people's reactions

Each person reacts and copes differently when they learn someone they care about has been diagnosed with cancer. You may find that family members and friends are ready to talk about the cancer before you are. But no one should rush you. Simply thank them for their concern, and tell them you are not ready to talk about it yet.

Some family members or friends may feel uncomfortable talking about cancer. You may notice changes in how people act around you after you tell them the news. People may feel uncomfortable because they do not know what to say or how to act. This is new for you and for them, too. Not everyone has faced cancer before, and even those who have might not know anything about the kind of cancer you have or its treatment. Some friends may act awkward and distant, while others will continue to be themselves. Some may even seem to be too nosey or overly helpful. It will take time for all of you to adjust to cancer and get more comfortable talking about it. With time most people are able to share understanding, compassion, and friendship. Giving your loved ones information and a chance to ask questions can be helpful as you work through this time together.

If someone's reaction disturbs you, try to talk with them about it. Explain exactly what type of response is most helpful to you. Don't be afraid to tell people about what's happening with you. Teach them. Explain what kind of cancer you have and the treatments you'll need. Tell them that cancer is not a death sentence, nor is it something they can "catch." The best thing you can do for each other is to be honest about your feelings. People often have fears about the future. Once these feelings are shared, most people find it easier to talk about hopes and plans for the future.

Cheng, cancer survivor: "I simply told my family this was not going to be a deathbed watch. I was in this for the fight no matter what and expected their full support and understanding. I feel their active involvement and full inclusion in what was going on was what helped my family cope with the experience."

After sharing the news of your diagnosis, family and friends may offer practical help such as helping out with household chores, cooking, child care, or shopping. Friends might call to see how you are and ask that you let them know if there is anything they can do to help. Try to take them up on these offers if you could use some help -- they are asking for a job to do, and for direction. But they need to know how best to help. Some patients keep a list of things they need help with by the telephone. Then when someone offers, they can tell them exactly what they need.

If you enjoyed walking or hobbies with friends before your cancer diagnosis, remind your friends that you still enjoy those activities. But don't be afraid to tell them when you don't feel up to talking or other activities. If you want them to ask again later, tell them that, and ask them to keep inviting you. A lot of people will be happy to do that for you. Let them know it feels good to be asked -- even on the days you’re not up to it.

Marisol, cancer survivor: "I was in a daze a lot of the time. Just dealing with the possibility of my own death was a lot, so I relied on friends to give people updates and concentrated on my immediate family."

Telling your children

Judith, caregiver: "I wish I had been more open with my children instead of trying to protect them. I think I could have prevented some of the acting out behaviors that I saw. I think they needed to be more involved to help both themselves and me."

Children and teens need to understand and be involved to the degree they can, based on their age and coping skills. Talking with them about cancer is very important. Children have the chance to learn that their families are there for support, and they can count on their families to be honest with them. Children should be encouraged to talk about their feelings. Some parents who tried to spare their children from knowing the truth later regretted not discussing things more openly during the course of the illness.

Why tell your children about a cancer diagnosis?

When families choose to hide information about a cancer diagnosis, children may still pick up on the tension and stress. As a result, they may suspect something is being hidden from them. Children may listen in on adult conversations to get information. Or they may just hear bits and pieces, or things that they were not intended to hear. They may not understand what they hear, and just know that something is wrong.

Wendy experienced cancer in her family as a child: "My dad did not want to tell my older sister or me that he had cancer. Even though I didn't know he had cancer, I definitely noticed the changes in our house. I remember he had blue and purple marks on his neck and chest (for radiation treatments) and a catheter in his chest. His skin was pale, his hair fell out, and his usual round belly disappeared. My mom and I made a lot of trips to our local pharmacy and it seemed like he was always taking medicine."

It is normal for children to see the world only as it relates to them. And it is common for children to think something they said or did caused the cancer. Be aware of this and talk about it with the child when he or she learns about cancer in a loved one.

Cancer is usually not something children understand or have experienced. They tend to understand concrete information and make broad generalizations. So children may not realize there are many types of cancer, that each person's cancer is different, and that having cancer does not mean the person will soon die. They get information and ideas from other children and what they see in everyday life, including what they see on television. Without the right information, children may fill the gaps with their imagination. Many times what they imagine is far worse than reality.

How to talk to children about cancer

Parents often struggle with what to tell their children when they are diagnosed with cancer. How much they need to know and can handle depend on the child's age and maturity level. Give children a small amount of information at a time, in words they can understand. Then give them time to take in the information and a chance to ask questions. Ask them if they have heard any words that they don't understand or find scary. Listen to their concerns. Help them express their feelings and reassure them of your love. It is often easier for younger children to show their feelings using activities, such as puppets or painting. Older children might prefer writing poetry or drawing.

Peter, caregiver for his wife: "Telling your children is the hardest part. It is important that you think through what you're going to say -- the words and emotions will have a significant impact on how they'll react. The calmer you are, the less frightened they will be. My wife and I told our kids (our son was 15 and our daughter was 11) at the end of a Christmas ski vacation.

By that time, we had made arrangements to get a second opinion at a top cancer center, had dealt with necessary legal papers, and had talked with our closest friends. We calmly told the kids, in easy to understand words, what the first doctors had told us and that in a few days we were going to Texas for more tests. As calm as we were, the revelation of cancer was a huge shock to our kids and was met with fear and tears. It is essential that kids are reassured that their parents are going to do everything possible in the way of treatment, that they are still deeply loved and always will be, and if necessary, assured none of this is their fault."

What to say about cancer

Adults can tell children what's going on in just a few sentences. "My doctor told me I am sick with cancer. The doctor is going to do what he/she can to make me better. I'll have to go to the doctor a lot to get a special kind of medicine so I might not be able to spend as much time with you. Sometimes the medicine might make me feel bad so I might not feel like playing much, but I'll still be here. I want you to know how much I love you." If the person with cancer does not feel comfortable telling a child about their cancer, a close relative or friend may be able to explain things to the child. This often depends on the relationship of the person with cancer to the child (for example aunt, grandparent, or parent).

Keep life as normal as possible

Children might have problems coping with cancer in a parent or another family member for many reasons. The person with cancer might be getting treatment at a hospital far away from home, or they may be recovering at home and be uncomfortable or look different. Children may also be asked to help out more or be on their best behavior, especially if people other than their parents are helping to care for them. They may question or even resent any loss of attention.

If friends or other family members want to help out, getting your children to school or to other activities when you can't is a great way to do so. This can help keep your children's routines as normal as possible.

Younger children may focus on death. Children often worry who will take care of them if something happens to their parent, and need to know about the plan. Older children and teens who are becoming more independent must deal with the changes taking place in their everyday life, and also the possibility of long-term separation or even the death of someone they love.

Although it is important to try and maintain a normal routine and lifestyle for children, they also need to be included as part of a family that is fighting cancer. Children may ask to see where treatment will be given and may ask questions about any changes they notice in the person.

Peter, caregiver for his wife: "My wife and I tried to help our kids by trying to keep as normal a routine as possible. When you have new information or when they ask questions, discuss the illness in language that they can understand. Frequently reassure them of your love and that they will always be loved and cared for. Involve them in helpful activities, like selecting a wig! Perhaps most important, enroll the kids in a local support group for kids whose parents have cancer. The sharing of experiences with the help of professionals worked wonders in helping our kids cope."

Many children try to act like adults so life will be easier for their parents. A support group for children might give them a safe place to air their frustrations. Hospital social workers, nurses, psychologists, clergy members, and school counselors are good resources to ask about support groups in your area.

For more information about how to talk with children about cancer and a list of suggested reading materials for parents and children, see the "Additional resources" section at the end of this document.

For the person who has cancer

People facing cancer often find themselves facing the possibility of their own death. At first, some people focus on dying from cancer instead of living with cancer. As one woman explained, just after she was diagnosed with lung cancer she isolated herself from her family and spent a lot of time alone in her room. Before long, she realized the cancer wasn't going to go away on its own. She decided that she could either keep pulling the covers over her head or she could tackle cancer the way she did her other challenges. This adjustment in thinking takes time.

Cheng, cancer survivor: "It is very easy to get absorbed in a sterile system of tests, procedures, and treatments and lose your individual perspective. Always remember your humanity, allowing yourself the feelings and emotions that are you. By doing this, you will make life-changing self-discoveries that you were never aware of. These discoveries will bring some understanding of the experience, motivation to face the most difficult challenges, and inspiration to others who will marvel at your never-before-seen spirit and character."

Taking care of yourself

With the stress cancer causes, it is important that you take care of yourself -- the whole person -- not just the cancer. Some people may want to become more "in tune" with themselves, or just do things that take their mind off the disease. Do what you need to do. Physical activities such as walking, dancing, and yoga can improve your sense of well-being and make you more aware of your body. Poetry, music, drawing, and reading are also creative ways to express yourself and keep your mind off cancer. Meditation and relaxation training can help with anxiety and symptom control. Taking on a new and challenging activity can give you a sense of accomplishment, as well as help reduce stress.

Let your doctor know if you are thinking about trying an alternative or unproven treatment. There are many herbs, supplements, or treatments that claim to cure or treat cancer. Some of these treatments are harmless, while others clearly have been shown to be harmful. Also know that some of these treatments can interact with other medicines you may be taking and can cause unexpected effects. Talk to your health care team before starting anything new.

Marisol, cancer survivor: "I had 6 months of chemotherapy and during that time I tried to keep my life as stress-free and as normal as possible. I also took a ballet class during treatment. It was good exercise, I made new friends, and it really kept my mind off myself."

Taking care of yourself also means accepting help from others. When a person is diagnosed with cancer, he or she may need to ask for and accept help for the first time ever. This can include help from friends and family or outside help. Asking for help does not mean you are a weak person. Arranging transportation to and from treatment, getting medical equipment to use at home, hiring a home health aide, or finding someone to watch the children while you are being treated are just a few of the many tasks that may need to be done. Handling all of these changes along with your regular responsibilities can be stressful. To manage well, you often need help.

Adjusting to changes in your body and self-image

Cancer and its treatment can cause physical changes. Some people feel insecure about how these changes affect their body and their self-image. Surgery can change the way you look. Other treatments can affect how you feel. Side effects from cancer treatment, such as weight loss or weight gain, hair loss, and skin changes can also change the way you look. Partners, family members, and friends can help their loved one work through their feelings about these changes by offering their love, support, and understanding. It takes time for people with cancer to adjust to the way they feel about themselves and how they look.

The type of treatment, the drugs and their dosages, and the schedule of treatment all have an impact on the side effects a person may have. Just how bad the side effects are can vary from person to person. The same treatments may cause side effects in some people and not in others. Be sure to let your doctor and nurse know which side effects you have, if any, and how bad they are. Your health care team can help manage side effects when they know how treatment is affecting you physically and emotionally. Sometimes cancer treatments cause more illness or discomfort than the cancer itself. Ask your doctor what side effects you should expect and which side effects you need to report right away. You also need to know how to get in touch with your doctor after regular office hours if needed.

Some people find it hard to be hopeful when their treatment makes them feel bad. People with cancer can become frustrated when they do everything right but it does not help, or when treatment must be delayed because their body is unable to handle any more. Sometimes changes in your mood are caused by certain medicines, while other times they may be part of the stress of coping with cancer and treatment. It is normal to have ups and downs during cancer treatment.

Body changes from cancer treatment can range from hair loss to the loss of a limb. These kinds of changes can be difficult to handle because others can see them. Many people who lose hair choose to wear scarves, wigs, or hats. Some people choose artificial limbs (prostheses) and reconstructive surgery after cancer surgery. Both short- and long-term solutions like these draw less attention to or hide a person's physical differences.

Sean, cancer survivor: "I had 2 surgeries; the first to remove the cancerous testicle and the second to remove lymph nodes in my abdomen. The lymph node surgery affected how I feel about my body and self-image more than the first surgery. I'm more self-conscious about the scars on my abdomen. I was given the option of reconstruction of the testicle after my first surgery but I wasn't interested."

When making difficult decisions, it can be helpful to talk with others who have had the same type of reconstructive surgery or wear the same type of prosthesis. Ask your surgeon if he or she is able to share photographs that show actual results of reconstructive surgery.

Check with your health insurance company about coverage for reconstructive surgery or prostheses. If you do not have health insurance, your hospital social worker may be able to help you find other ways to pay for it. Insurance coverage can be limited either by dollar amount or the number of prostheses (that is, mastectomy bras and breast forms) you can purchase in a certain amount of time.

Sexuality and cancer

Personal traits, such as a person's sense of humor, attitudes, honesty, and spirit, are a large part of what makes someone attractive to their partner. Cancer treatment may seem to change these qualities, but the change is usually short-term. It is important to remember those traits are still there, but for the moment may be overshadowed by the cancer experience.

If your partner has cancer

Some people fear physical closeness because they think they can get cancer from their partner, or they are afraid they will hurt their partner. Cancer is not contagious -- you cannot catch it from someone. A person cannot pass their cancer to their partner through sex. In some cases, you may be told to not have sex for a short period of time, for example, when a person is recovering from certain types of surgery or when they are more likely to get infections. Ask the doctor if you need to take any precautions based on the treatment your partner will get. And talk with your partner about your concerns about causing pain or discomfort. While he or she may not feel like having sex for a time, cuddling, holding hands, and other gentle forms of touch are ways to show your love.

Fertility and birth control

If you think you might want to have children later, it is very important to talk with your doctor about fertility and birth control issues before you begin treatment. Many cancer treatments can result in infertility or sterility. For most people, there are ways to preserve their ability to have children, but they must be done before starting therapy.

Keep in mind that even when sterility is a possible side effect of treatment, it is important to use an effective method of birth control. Even if the risk of pregnancy is very small, birth control must be used during and for some time after cancer treatment because many cancer treatments can harm a developing fetus. It is not safe to get pregnant during most cancer treatments.

Side effects can change your sex life

Side effects of cancer treatment can also affect a person's sexuality. Some side effects that can do this are fatigue, lack of desire, and feeling physically unattractive. Women may have vaginal dryness, and men may notice the inability to have or keep an erection. Physical side effects, such as fatigue and nausea, can decrease a person's desire for sex. Fear, anxiety, or depression can affect your sexuality, too. These side effects, like most other physical and emotional side effects, can often be managed or helped with treatment. Although you may feel embarrassed, it is important to talk to your doctor about them.

Changes in the way you look can affect your feelings about your sexual appeal. You may feel as if you are no longer sexually attractive. Although sexual intimacy is one way to express love for someone, there are other ways to express this feeling.

When sex becomes possible, let your partner know what is comfortable for you and when you feel up to it. Your partner may want to give you the space and time you need to adjust to changes in your body and self-image. Your partner may not want to rush you or seem to be insensitive, so it helps if you tell them of your desire for physical contact. Be specific about what you want. Physical contact other than sexual intercourse, such as hugging, kissing, and touching over time may help you feel more comfortable about being close.

The effect of cancer on your relationship with your partner

If you are single when you are diagnosed and recovering from cancer, you may be unsure about how and when to tell a new romantic interest. Only you know if and when you trust someone enough to share this part of you. Whether you tell someone early in a relationship or later on is up to you. You may find it helps to practice what you will say with someone else before saying it to your new partner.

Some people are afraid their partner will avoid physical contact with them. Others may fear their partner will leave them or find someone else. If there were problems in the relationship before a cancer diagnosis, they will still be there after the cancer diagnosis. Likewise, if a couple works through problems well, chances are good they will face this challenge in much the same way. When a couple communicates with one another, they can usually work toward resolving their feelings and the added stress that cancer can place on a relationship.

Facing cancer as a couple can also strengthen a relationship. Cancer can help people realize what is really important to them. Priorities or problems they once saw as important may now seem less important or smaller.

Delores, cancer survivor: "Cancer has a way of making you take an inventory of your life. It has made some good changes in my life. I think that my husband and I are closer as a result."

It is not unusual for people with cancer to withdraw from their partners when they have changes in their body and self-image. People with cancer who have changes that affect their sexuality want to know their partners still care for them and are still attracted to them. As a partner of someone with cancer, there are several ways you can convey these feelings. Talk about your feelings and let the person with cancer talk about changes in their sexuality, body image, and self-image.

People who are not able to get support from their partners can find support elsewhere, such as through counseling, a support group, or friends. Counseling can help explore ways to improve communication and resolve problems in relationships. For those who are unable to work through these issues alone, professional counseling for individuals or couples is an option. Support groups that are offered by licensed or trained professionals may also be a source of practical advice and ideas about coping with changes in sexuality. Groups are available for people with cancer, for partners/spouses, and for couples.

For more information about sexuality, the American Cancer Society has 2 booklets available: Sexuality for the Woman With Cancer, and Sexuality for the Man With Cancer. Both are available free of charge from our toll-free number or can be found on our Web site at www.cancer.org.

For spouses, families, and friends

Telling a loved one he or she has cancer

Sometimes family members are the first to learn of a loved one's cancer diagnosis. How does a family decide if they should or when they should tell the person who has the cancer? Are some people too emotionally fragile, too young, or too old to know? Most people can handle the news that they have cancer, but each person needs time to adjust and figure out what the diagnosis means to them.

If you are a family member trying to decide if you should tell a loved one they have cancer, consider this: you may think you are sparing them bad news, but they probably will sense something is wrong, especially if they start having a lot of tests done and/or don't feel well. The person with cancer may resent it when they find out family members kept the diagnosis a secret. Although you may think you are protecting them, that person might see this as dishonest.

When people with cancer are not told about their diagnosis, they are unable to make important decisions about their treatment and their life. There may be things they want to do, personal matters they want to take care of, or legal papers that may need to be updated. Even when a person has a cancer with a good outlook, families still need to discuss decisions about end-of-life care, including advance directives (living will and durable power of attorney for health care).

The family's feelings about cancer

People usually need time to sort out feelings before they can be expressed and shared in the way they want. During this time, friends and family members may be the targets of their loved one's strong, overwhelming feelings that are being vented. If you are the target of anger and frustration, remember you are not the cause of this anger -- you are a trusted person on whom the anger can be let out. Your loved one is angry about the cancer and how it has affected her or his life. Even though family members and friends usually try to respond with love and friendship, it is natural for them to feel their own anger and frustration, and sometimes express it, too.

Friends and families may also have a hard time adjusting to the cancer diagnosis. They may have to cope with increased responsibilities while trying to manage many different emotions. On top of this, they want to try to be sensitive to the needs of their loved one who has cancer. If you are close to the person with cancer, simply saying something like, "I'm here when you are ready to talk" will keep the lines of communication open and offer your loved one the chance to share this experience with you. Your presence is also a way to show your support for the person with cancer. Don't be afraid to share your fears and worries with your loved one with cancer. Being honest about these feelings can allow everyone to work through difficult times together.

Talking with someone who has cancer

You may struggle to find the right words to say to someone who has been diagnosed with cancer. Know that there is no right way to act or perfect words to say. Just listening to the person with cancer is often more helpful than anything you can say. Assuring them of your love and support is one of the most important things you can do. Most people with cancer do not want to face the experience alone and will need support from their family and friends. "I'm here for you" may be the best thing you can say to show your support for someone with cancer.

Keep in mind that not everyone with cancer wants to talk about his or her feelings. They may have other ways to express their emotions, such as writing in a journal, music, art, or yoga. Some people just prefer to keep their feelings private. People with cancer might just want you to help them maintain their normal routine as much as possible. Just be yourself and continue to do things with them as you would if they didn't have cancer.

Sean, cancer survivor: "I did not like to talk about my cancer with my friends or my family. I just wanted to get it over with. My oncologist had one of his patients who had been diagnosed with testicular cancer a few years ago call me. He had the same treatment I did and was my age so we could easily relate. He told me it would be a tough 6 months but I would get through it. Knowing that he made it through the same treatment was helpful."

Changes in the family

A diagnosis of cancer changes a family forever. Figuring out what's for dinner or what your plans are for the weekend is suddenly less important. Family and personal values are questioned and priorities are tested and changed. Unsettled feelings and arguments may resurface during a family's struggle with cancer. Often a family must sort out and revisit old, unresolved feelings before they can start to battle cancer together, as a family unit.

Cancer can cause role changes in the family, too. The head of the household may now be more dependent on other family members. Others may need to work outside the home or work different hours. When family members take on new roles, the way they interact within the family can change. New responsibilities may overwhelm some family members.

Parents might look to their children for support. If the children are old enough, they may be asked to take on more responsibilities within the household. These requests often come when children themselves need support. Children might start acting younger and less mature in response to the stress on the family. This may be their way of dealing with cancer and how it has changed their family. Adolescents, who are often rebelling and spending more time with friends, may instead cling to their families for support.

As a friend or family member helping to take care of the patient, you also have needs. Taking care of yourself will allow you to care for others. When your needs are met the patient will also benefit. Overdoing is different from doing. Know your limits and rest when you need to. This rule applies to both caregivers and patients.

Peter, caregiver for his wife: "As a caregiver, your life is not going to be the same. It is essential that you maintain a healthy, high-quality level of physical and mental fitness so that you can still carry on with your life, while also helping the one in treatment. Find compassionate and understanding friends who you can talk to relieve your stress. This way, you will be more available, physically and emotionally, to help your cancer partner and to have those candid discussions that are so important. In short, take care of yourself at the same time, paying attention to diet, exercise, and sleep, to better help others and yourself. While being realistic, try to remain optimistic."

Often families find themselves treating the person with cancer like an invalid, even when the person is fully capable of doing for him- or herself. Sometimes people will not want you to help them with things like bathing and dressing. These wishes should be respected if at all possible.

Although the person with cancer may not want to get outside help, friends and family members should look at their own limits and get any help needed. Certified nursing assistants, home health aides, and other resources can help care for the patient. Local churches may be able to help with cooking, shopping, transportation, and general housekeeping. Home health aides may be helpful, but there usually is a fee involved and this is rarely covered by health insurance.

Coping within the family

How a family handles cancer is depends a lot on how the family has dealt with problems in the past. Those who are used to communicating openly and sharing feelings are usually able to talk about how cancer is affecting them. Families who solve their problems as individuals instead of a team might have more trouble coping with cancer.

Cancer treatment includes care for the patient and the family, not just the cancer. A mental health professional may already be a part of the cancer care team. If not, talk with the doctor or nurse to learn about other resources that can help you and your family cope with cancer.

People with cancer often say that lack of communication in their families is a problem. Changes in responsibilities can cause resentment and anxiety. Some family members may not feel comfortable openly discussing their feelings. Other family members may avoid the person with cancer because they feel as if they have nothing to offer, don't know how to act, or feel they can do nothing to help make the situation better. These factors can all make families more distant at a time when they need to pull together. Many families need help with this. Through family counseling, members can be helped to learn to deal with changes within the family and discuss their feelings more comfortably.

Family and friends can find ways to relieve their stress by taking part in activities outside the home. Resources outside the home, such as individual counseling or support groups, can serve as outlets for the frustrations you may be facing within your family.

Finding support

Many resources are available for people with cancer and their families. Support can come from family and friends, as well as from health professionals, support groups, or your place of worship. Asking for support is one way you can feel in control of what's going on in your life.

You may live alone or just feel alone. You may feel as if you have nothing to live for. If your friends and family are not supportive, find others who are. There are probably others in your community who need your companionship as much as you need theirs. The mutual support of others with cancer might also be a source of comfort. Check with your health care team, a member of the clergy, or call your local American Cancer Society office for resources in your community.

Types of support programs and groups

Support programs can be found in many formats and include individual or group counseling and support groups. Some groups are formal and focus on learning about cancer or dealing with feelings. Others are informal and social. Some groups are made up of only people with cancer or only caregivers, while others include spouses, family members, or friends. Other groups focus on certain types of cancer or stages of disease. As mentioned earlier, cancer support groups for children are also available in some areas. Groups can meet for a certain number of weeks or the program can be ongoing. Some programs have closed membership and others are open to new, drop-in members.

Health professionals (a social worker, nurse, or other licensed professional), trained facilitators, or a group member may lead the group. The leader of a group should have some type of training before taking charge of a support group.

For those who cannot attend meetings or appointments, counseling over the telephone is offered by organizations such as Cancer Care, Inc. (see "Additional resources"). Some people may find online support groups helpful because they like the privacy. It may be comforting to chat with other people facing situations much like yours. But keep in mind that chat rooms and message boards are not the best source of cancer information, especially if they are not monitored by trained professionals or experts.

No matter what kind of group it is, everyone taking part should feel comfortable in the group and with the facilitator. If you have any fears or uncertainties before entering a group, try to discuss them with the group's facilitator ahead of time.

Kay, cancer survivor: "As soon as I was diagnosed, I told anyone who would listen, and everyone was great at just listening. I'm not very good in group situations. I enjoy one-on-one interaction. I think talking about my disease to different family members and friends was MY support group and a good way for me to get some positive feedback. I never found it difficult to talk about cancer. Maybe that was because my mother had also been a breast cancer survivor. After the diagnosis of my recurrence, I did attend several support groups. Although I could see that this truly helped other members of the group, I just felt like it wasn't for me."

Along with support programs, other means of support may be available in your community such as:

• Home health nursing services
• Social services, such as counseling and financial aid
• Nutrition services that provide meals or allow you to talk with a registered dietitian
• Rehabilitation services provided by physical and occupational therapists
• Spiritual services from chaplains or religious figures in the community

Support in any form allows you to talk about your feelings and develop skills to cope with the changes taking place in your life. Some studies have found that people who go to support groups have an improved quality of life, including better sleep and appetite.

Self-help groups

Self-help groups are most often run by non-professionals who have been through the same kinds of problems or crises. The people in these groups can relate to your experience firsthand and often have treatment-related tips and advice that may help you. For example, they may offer a home remedy that helped with their nausea, or know where to get the best prices on wigs and turbans. If their family members are not in the group, patients are free to express exactly how they feel. Family members can also benefit from sharing their feelings, fears, and anxieties with other families affected by cancer.

Self-help groups also give people recovering or recovered from cancer a chance to help others with cancer. With some training, many people with cancer have found that helping others makes them feel better about themselves. They may go on to become group counselors or facilitators.

Delores, cancer survivor: "I am a Reach To Recovery volunteer. When you talk to someone who has been through what you are going through and they are healthy and happy, it can be very comforting. By sharing my experience it helps calm the fears of newly diagnosed patients. It's a joy to hear the fear leave their voices."

Choosing when to take part in a support group is important. Some find it difficult to join a support group when they are first diagnosed. The stories that other patients may share, after months or even years of treatment, can be overwhelming and upsetting. If you try a group and it doesn't feel right, you may want to try again later or try another group.

Marisol, cancer survivor: "After treatment I found a support group to be an excellent way to keep up-to-date on the latest treatments. We recently celebrated our 10th anniversary and invited our spouses to attend. There are 7 of us that are breast cancer survivors of 10 or more years."

Religion

Religion can be a source of strength for some people. Some find new faith when diagnosed with cancer. Others find their cancer experience strengthens their existing faith or their faith gives them newfound strength and hope. Others who have never had strong religious beliefs may not feel an urge to turn to religion at this time. A minister, rabbi, other leader of your faith, or a trained pastoral counselor can help you find spiritual support. Some members of the clergy are specially trained to minister to people with cancer and their families. Some hospitals also have chaplains available.

Ask your health care team about the resources available at your hospital. You can also contact your American Cancer Society to find out about sources of support that are available in your community.

Life after cancer treatment

Delores, cancer survivor: "Your last day of treatment is a day to celebrate! When treatment is over it can be difficult sometimes to get back to your normal pre-cancer life. The diagnosis of cancer dominates your life for so long, when treatment is over it takes a while to get back into your regular routine. I think I find my anniversary of being diagnosed a time of mixed emotions. You are thrilled to have made it another year of being cancer-free, yet you are also reminded of the anguish you went through."

When treatment ends, people begin a new chapter in their lives, one that can bring hope, happiness, and maybe fear. The fear of recurrence or relapse is common among cancer survivors and can sometimes be quite intense.

Delores, cancer survivor: "The most difficult thing for me as a survivor is having a 'history.' Any aches or pains I have result in numerous tests. I am a runner and I was having pain in my hip. I went to the doctor and after a couple of appointments I had a bone scan followed by an MRI. I was very fortunate that it was not cancer and I just needed a new pair of shoes!"

Follow-up appointments with your doctor and anniversaries of your cancer diagnosis can bring mixed emotions.

Kay, cancer survivor: "I have regular follow-up tests to be sure that I'm cancer-free, which gives me peace of mind. Even though my dermatologist tells me that she would be comfortable checking me out every 6 months or even annually, she was also very agreeable to seeing me every 3 months at my request -- for my own comfort level. I admit that for the first few years, every time my anniversary came around my anxiety level increased, mostly because I went through a battery of tests. To help me through this, I always had someone go with me to the tests. However, the anniversary of my diagnosis is not a special date to be recognized or feared any more. I feel fortunate to be a survivor of many years and I'm grateful for each morning I awake and am able to get out of bed."

Returning to everyday life

Although each person with cancer looks forward to getting back to a more normal life, the process can be challenging. Everyone deals with these challenges in their own way.

Kay, cancer survivor: "Getting back to the normal activities of life, especially playing sports, was the greatest therapy for me. When I was diagnosed, I just wanted to get the operation and treatment behind me so that I could get on with my life. Although I never dwell on my situation or the possible outcomes, the reality that this disease could come and take me at any time is always present. I can't keep myself from thinking these thoughts. Still, I do make a conscious effort to think positive, make plans for the future, make sure to have regular follow-up testing for early detection, eat a healthy diet, and get regular exercise."

Relationships outside the family

Cancer can change the pattern of relationships outside the family as well as those within. Friends may not keep in touch for a variety of reasons. They may not know how to respond to a change in how you look or may avoid you so they don't have to think about the possibility of your death or be reminded that we all must die someday. Your cancer may also bring back memories of a loss or death they had in the past. Some people may shy away from you and not know how to talk to you. Still, the fact that your friends don't know how to talk to you right now doesn't lessen the hurt and frustration of being isolated or singled out. Some people may say things that sound insincere, trite, or hurtful. Remind yourself that they are probably trying their best. If you are open to talking about your experience with cancer, they may relax too.

If your career is an important part of your life, going back to work as soon as you are physically able is one way to return stability to your life. If treatment has made you unable to go back to your previous job, look into rehabilitation and retraining programs in your community. When you do go back to work you may find that your relationships with your co-workers have changed. You may feel "back to your old self," but they may not be as comfortable around you as they were before. Some may act like you didn't have cancer, and not talk about that part of your life. Or, they may see you look well and are able to function and underestimate the seriousness of what you've been through. Co-workers may be unsure of what to do or say or may try to protect your feelings. For more information on this topic, please see our document, When Someone You Work With Has Cancer.

Questions about future employment and health insurance may also come up. There are resources available to help answer these questions. Organizations like the Job Accommodation Network, the National Coalition for Cancer Survivorship, and the Patient Advocate Foundation provide much-needed resources for cancer survivors. If you feel you have been discriminated against, either on the job or in dealing with insurance, find out about state laws where you live and the Americans with Disabilities Act. Many people are able to keep their jobs during cancer treatment due to the provisions of this law. Others may need help with time off from work, which the Family and Medical Leave Act can make easier for some people. See the "Additional resources" section, or contact your American Cancer Society to get more information. as well as phone numbers and Web site addresses for these organizations and others that can offer valuable services for people affected by cancer.

Finding hope

Today cancer is not a death sentence. Cure rates continue to improve as new medicines and treatments are discovered. Some types of cancer have better prognoses (outlooks) than others, but overall, people with cancer are living longer.

Doctors cannot predict how long a person will live. They can only make an educated guess based on what they have seen in other patients in similar situations. Even when a person's prognosis is poor, encouraging test results, new research discoveries, and treatments that can control the disease can give hope. If a loved one has cancer, your continued love and support can also provide hope. Regardless of the prognosis, this time is a chance to do things you've always wanted to do and to spend quality time with family and friends.

Kay, cancer survivor: "My children have been my greatest motivation for staying healthy. I think they are more compassionate and sensitive individuals from having to deal with my cancer. I pray that they have learned to take care of their own health and take preventive actions to ensure their own survival. I am a 13-year survivor of breast cancer, and a 3-year survivor of a bone marrow transplant for metastatic breast cancer. I've had doctors tell me how lucky I am to be alive, considering how extensive my cancer was. I have to admit that my immediate thought both times, was that I was going to die -- and soon. I would like every person who hears this dreaded information to know that they don't have to be a statistic. Just because the statistics say something, there are always exceptions. I've also had basal, squamous, and melanoma skin cancers and cervical cancer. I'm still here to watch my children grow, and I plan on seeing my 6 year-old have children of his own."

Keeping the focus on what you can do rather than what you can't, leading an active life, and having a sense of purpose help most people cope with cancer. It is not always possible to do things you did in the past, but there are usually ways to make each day count.

Cheng, cancer survivor: "Always carry a good laugh inside, as humor is the foundation for successfully facing life's challenges. Funny things do happen in the most desperate circumstances. We just have to take the blinders off. Of course this does not mean that cancer is a laugh-a-minute experience because it certainly is not. We just need to be receptive to all parts of our life and not only the bad."

Additional resources

About the American Cancer Society

The American Cancer Society is here for you -- before, during, and after a diagnosis of cancer. We help people by giving them up-to-date cancer information, programs, and referrals. Check your local phone book for an American Cancer Society office near you or call us anytime, day or night, at 1-800-227-2345 to learn more about these programs and what we can do to help you get well and stay well.

American Cancer Society Patient Navigator Program

The health care system can be hard to figure out on your own, but there is help. The American Cancer Society Patient Navigator Program offers personalized support to help you stay on track with your treatment and care. A navigator is a trained staff person who meets with you one-on-one, identifies your specific needs, and provides information, resources, and support. All of this help is free to you and your caregivers in your cancer treatment facility or hospital. Call us to locate the patient navigator in your facility or in your area.

Cancer Resource Centers

A Cancer Resource Center is a place in your community for you to get free answers to many of your questions about cancer. These centers have trained American Cancer Society volunteers and staff who can help you find the programs and services you and your family need.

Cancer Survivors Network^SM

The Cancer Survivors Network is a free online community created by and for people with cancer and their families. This online community is a welcoming, safe place for people to find hope and inspiration from others who have "been there." Services include discussion boards, chat rooms, and personal Web space to tell your story, blog, post images, exchange private messages with members, and much more. Check it out at http://csn.cancer.org.

Children's Camps

The American Cancer Society sponsors camps across the country for children who have been touched by cancer. These camps are specially equipped to handle the needs of children who are in treatment.

College Scholarships

The American Cancer Society invests in the future of young cancer survivors by offering college scholarships. Students are selected for the scholarships by a committee of educators, business people, and health care professionals.

Hope Lodge

The American Cancer Society Hope Lodge Network offers people with cancer and their families a free, temporary place to stay when their best hope for quality care is far from home. By not having to worry about where to stay or how to pay for lodging, Hope Lodge guests can focus on getting well. And Hope Lodge offers much more than just free lodging. It provides a nurturing, home-like environment where patients and caregivers can retreat to private rooms or connect with others who are going through similar experiences. The Society can tell you if there are other resources offering free or low-cost housing in cities where a Hope Lodge is not available.

I Can Cope^®

This is a free educational program for adults with cancer and their families. Doctors, nurses, social workers, and other experts teach classes on different topics, such as cancer treatments, dealing with side effects, eating healthy, sharing concerns, finding resources, and more. I Can Cope classes are also offered online at http://cancer.org/onlineclasses.

Look Good…Feel Better^®

Some cancer treatments can change the way you look. At a Look Good...Feel Better session, you can learn ways to help with side effects like hair loss and skin changes. There are also programs for men and teens. This free program is offered jointly by the American Cancer Society, the Personal Care Products Council Foundation, and the Professional Beauty Association | National Cosmetology Association. For more information, call 1-800-395-LOOK (1-800-395-5665) or your local American Cancer Society office.

Man To Man

Man To Man is a free prostate cancer education and support program for men newly diagnosed with prostate cancer, men currently in treatment, and for the growing number of survivors. Program offerings vary by location. Some programs offer regular group meetings or one-on-one calls with a prostate cancer survivor.

Reach To Recovery^®

If you have breast cancer, you may want to talk to someone who knows what you're feeling -- someone who has been there. The American Cancer Society can help through our free Reach To Recovery program. We can match you with a volunteer who will talk with you about coping with your breast cancer diagnosis and treatment. Every volunteer is trained and is a breast cancer survivor. They know what it is like to hear the words "You have breast cancer."

Road To Recovery

Every day, thousands of cancer patients need a ride to treatment, but some may not have a way to get there. If finding a ride is a problem for you, we may be able to help. Our Road To Recovery program provides free rides to and from treatment for people with cancer who do not have a ride or are unable to drive themselves. Volunteer drivers donate their time and the use of their cars so that patients can get the lifesaving treatments they need.

"tlc" magalog

The "tlc" magalog is the American Cancer Society's catalog and magazine for women. It offers helpful products made for women fighting cancer. Products include wigs, hairpieces, breast forms, bras, hats, turbans, swimwear, and accessories. You can order by phone at 1-800-850-9445 or online at www.tlccatalog.org. All proceeds from product sales go back into the American Cancer Society's programs and services for patients and survivors.

More information from your American Cancer Society

We have selected some related information that may also be helpful to you. These materials may be viewed on our Web site or ordered from our toll-free number 1-800-227-2345.

After Diagnosis: A Guide for Patients and Families (also available in Spanish)

Talking With Friends and Relatives About Your Cancer (also available in Spanish)

Americans With Disabilities Act -- Information for People Facing Cancer

Family and Medical Leave Act

Health Insurance and Financial Assistance for the Cancer Patient

Surgery (also available in Spanish)

Understanding Chemotherapy: A Guide for Patients and Families (also available in Spanish)

Understanding Radiation Therapy: A Guide for Patients and Families (also available in Spanish)

Home Care Agencies

Caring For the Patient With Cancer At Home: A Guide for Patients and Families

Caregiving: Caring for a Loved One With Cancer -- and Yourself

Anxiety, Fear, and Depression

Sexuality for the Man With Cancer (also available in Spanish)

Sexuality for the Woman With Cancer (also available in Spanish)

When Someone You Work With Has Cancer (also available in Spanish)

Helping Children When a Family Member Has Cancer: Dealing With Diagnosis

Children Diagnosed With Cancer: Dealing With Diagnosis

Books

The following books are available from the American Cancer Society. Call us at to ask about costs or to place your order.

Caregiving: A Step-by-Step Resource for Caring for the Person With Cancer at Home

Cancer in the Family

What Helped Me Get Through: Cancer Patients Share Wisdom and Hope

Couples Confronting Cancer

Eating Well, Staying Well During and After Cancer Treatment

Pain Control: Understanding and Managing Cancer Pain

National organizations and Web sites^*

Along with the American Cancer Society, other sources of information and support include:

Job Accommodation Network

Toll-free number: 1-800-526-7234

TTY: 1-877-781-9403

Web site: www.jan.wvu.edu

Offers information about asking for help (accommodations) to keep working when people have disabilities and limitations; also offers information on how to approach employers for accommodations

National Cancer Institute (NCI)

Toll-free number: 1-800-4-CANCER (1-800-422-6237)

Web site: www.cancer.gov

Offers current information about cancer and cancer treatment, living with cancer, children with cancer in the family, cancer research; help with quitting smoking, and more

National Coalition for Cancer Survivorship (NCCS)

Toll-free number: 1-888-650-9127
Toll-free number: 1-877-NCCS-YES (1-877-622-7937) (for Cancer Survivor Toolbox orders)

Web site: www.canceradvocacy.org

Offers information on work, health insurance, and more for people with cancer. The Cancer Survival Toolbox is a free, self-learning audio program developed to help cancer survivors and caregivers develop the practical tools needed to deal with the diagnosis, treatment and challenges of cancer. Listen online or order CDs. Also available in Spanish and Chinese.

Patient Advocate Foundation

Toll-free number: 1-800-532-5274

Web site: www.patientadvocate.org

Helps mediate between the patient and insurer, employer, or creditors to resolve insurance, job, or debt problems related to their cancer. Helps people get access to care and keep job and financial stability.

No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-227-2345 or visit www.cancer.org.