The Big "C": Cancer

I remember when I had a biopsy done on a mole. Two days later I answered the phone and the nurse said, “The doctor wants to speak to you.” Alarm bells went off in my head. Hey, I was just expecting one of those postcards saying your tests came back negative, not a personal call. “Linda, there's good news and bad news.” Never a good opening. I went for the bad news first. “Linda, you have malignant melanoma, and it spreads very fast. You need to see an internist right away to see if it has. I also want you to see a plastic surgeon for a wide excision of your back.” It's amazing how you process this type of information. It really feels like hearing a verdict—only you missed the trial. It's also like an out-of-body experience. We went on to the good news: The cancer was a Stage II, meaning it hadn't progressed very far. He felt we had caught it in time. I had the surgery and a battery of tests; five years later I'm in the clear.

Your Parent's View

I share this with you because, although we all dread cancer, it's estimated that 40 percent of the adults diagnosed with cancer do survive. Every year, as a result of aggressive cancer research, new methods to stave off the progression of cancer are being discovered. Your parents, however, come from a generation where cancer wasn't talked about. They might have felt ashamed if their parents had it so they didn't tell their friends. It was common for families to engage in a conspiracy of silence, believing it was in the cancer victim's best interest not to know he or she had cancer.

Times have changed dramatically; however, your mom and dad's views might still be back in the 1950s. They might not tell you or their doctor that they have symptoms for fear of finding out that they have cancer. Just as it seemed as if I was given a verdict, they think that it's a death sentence, given what they saw when they were young adults. They're trapped thinking, “There's nothing that can be done anyway, so why bother? Better not to know.” The message for you? Probe for symptoms, and encourage—if not take—your mom and dad to get regular checkups that screen for cancer. You also can reassure them that plenty of cancers can be stopped dead in their tracks—if you act in time. They also need to know that the therapies used today to treat cancer are far more advanced than the horror stories they might have heard or saw when they were younger. I recall how shocked I was when a colleague of mine came to work in the afternoon following his morning of chemotherapy. I, too, was back in the dark ages remembering how deathly ill my grandfather was after his chemotherapy. Your parents need to know how much times have changed!

What Is Cancer?

Cancer is basically cells gone haywire. We have zillions of cells that grow and reproduce everyday. Cells get their orders on how to reproduce through the cell's DNA— kind of like a company's CEO. If cancer-causing substances like tobacco, alcohol, or some other toxins get to the CEO, his or her orders get hijacked. The message is mutilated and the cells that get this errant message start reproducing themselves. They aren't very popular with their co-workers (normal cells), so they take the hint and break away. They happily keep reproducing their mutated selves, and before you know it they've created their own spin-off company, what we call a tumor. Some of these tumors are satisfied just hanging out with themselves so they stay benign and harmless. But there are others that are very ambitious and they want to penetrate the market everywhere they can. These are the malignant guys. Their goal is to tear down their competition—their normal-cell neighbors—and take over your whole body. And that's a deadly scenario.

The Danger Signs

For years, the American Cancer Society has been warning us about the danger signs of cancer. Their message worked for me—I knew that a change in a mole was a sign and acted on it. Just to remind you, here's the list you and your parents need to keep in mind.

The Danger Signs of Cancer
(from the American Cancer Society)

• A sore that won't heal
• Obvious changes in a mole or wart
• Blood in the urine or persistent difficulty in urinating or having bowel movements
• Unusual and persistent constipation or a change in the usual frequency of bowel movements
• Persistent indigestion or stomach discomfort
• A sore throat and difficulty in swallowing
• Unusual bleeding or discharge anywhere in the body
• A nagging cough, hoarseness, difficulty in breathing, and coughing up blood in the sputum
• Pain that is persistent and without apparent cause
• A thickening or lump in the breast, vulva, neck, head, or other part of the body

If Mom or Dad complains of any of these symptoms, make sure he or she sees a primary physician. If you can't be with your parent during the appointment, most doctors will talk to you during or following the office visit. It's a good way to check on how your parent is doing and to make sure your parent didn't forget to bring up troublesome symptoms that he or she might think are just due to old age. Let your parent know you'll be calling. My Dad appreciates my sister getting on the phone because she's a nurse and can explain procedures to him, and she won't let him go through anything that isn't necessary.

Getting the Diagnosis

Whenever your parents are getting results of diagnostic tests, especially those to rule in or rule out cancer, you need to be there. If not physically, then by way of a conference call with the physician. When people hear they have cancer—and I've been there—they find it pretty hard to soak in everything they're being told.

It's like a stuck record—they can't get past the word “cancer.” A cancer diagnosis will become a family affair, so you must be part of it early on.

Here are some questions you should ask the doctor:

• What's the medical name for this cancer? How do you spell it?
• How was the diagnosis made? Based on what tests?
• What stage is this cancer? Could you please explain the stages?
• Has the cancer spread (metastasized)? Where has it spread? Where did it originate—in other words, what is the primary site of the cancer?
• Can this cancer be cured?
• What treatments do you recommend?
• What's the goal of the treatment? Will it cure the cancer, stop it from spreading, reverse its effects, or simply make life more comfortable while it continues to spread?
• What are the side effects of the treatment? How will it affect other conditions that my parent has?
• What's the outlook (prognosis) for my parent?
• Could your office staff tell me if this treatment is covered under Medicare and my parent's Medi-gap policy?

Getting Treatment

No one is too old to receive some form of cancer treatment. Options range from managing pain and buying quality time to beating the cancer. Get involved in finding out about the wealth and range of treatment options for your parent's type of cancer. Work with your parent's doctor and do some homework on your own, too. Split the work up ,a href="/aging-parents/family-time/50355.html">among your siblings. Have one person check out local support groups and treatment centers. Somebody else can surf the Net.

I've searched the Net for you and identified two excellent picks. The first place to call is the Information Service offered by the National Cancer Institute (NCI). They'll tell you about the nearest NCI designated cancer center that can treat your parent's type of cancer. By meeting the Institute's standards, these centers are up on the latest forms of treatment for specific cancers. The Institute will locate a center that's less than a day's drive away.

The NCI will also provide you with excellent information about your parent's cancer, including methods of diagnosis, staging, and treatment. They'll also tell you if a clinical trial is available to your parent.

Medicare is launching a new initiative to encourage more older folks to participate in clinical trials. Only 1 percent of the elderly participate in clinical trials, yet they are the ones who bear the brunt of the majority of the diseases in this country. Their participation is key to making future advances in medicine. If traditional treatment isn't working for your mom or dad, perhaps a clinical trial would be beneficial. There are some downsides. If the trial involves a control group that gets a “dummy” treatment known as a placebo, your parent could be assigned to the placebo group and not receive any treatment. Ask the physician to clearly explain to you the pluses and minuses of the trial. Medicare pays for all patient costs associated with a clinical trial and any complications that arise from it.

Never Too Old to Prevent Cancer

No one is too old to prevent cancer! You're never too old to stop smoking, take antioxidants such as Vitamin E, and eat a kick-cancer-butt diet of high fiber and low fat. Loads of research has been pouring in identifying the cancer culprits in the food we eat and the environment. Dietary habits are hard to break, no doubt about it, especially if your parents come from an ethnic background where fatty foods are celebrated (like my Irish roots of meat, potatoes, and lots of gravy). But as parents get older, they don't prepare big dinners every night. You could treat them to a catering service that delivers balanced meals on a weekly basis—your parents just pop the meals into the microwave or oven. Or if you're up to the task, do it yourself. You could also call Meals on Wheels at your local senior center, or offer to pay a neighbor who loves to cook.

One of the best ways of staying ahead of cancer is to get regular checkups and cancer screenings. Your parents have absolutely no excuse for not being screened for breast, prostate, and colon cancer. These and other screenings are paid for by Medicare.

Excerpted from The Complete Idiot's Guide to Caring for Aging Parents © 2001 by Linda Colvin Rhodes, Ed.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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