Although I have posted about body image once before, I think it is definitely important enough to discuss again. While the moving forward videos do a good job of covering the general idea of body changes caused by cancer and cancer treatment, I think the specifics are where the challenges come in. Since each person faces different physical changes, and each person reacts differently to those changes, it is difficult to prepare yourself for what may happen to your body.

For example, while most people lose all their hair with chemotherapy, I kept a great deal of my hair when I went through treatment as a child. When I relapsed at 13 years old, I knew I was going to lose my hair because my chemo regimen would be more rigorous than it was the first time. So, I was not worried. However, I was very worried about the fact that I would have a second big scar on my chest from having my second port put in a different place than when I was little. I was also worried about what would happen with my skin and weight by going from the extreme loss of appetite while on chemo to the extreme quantities of food I would consume while on steroids.

On the other hand, a friend of mine, a lymphoma patient who I met in the teen room at the outpatient clinic, was terrified of losing her hair. She was not worried about scars, radiation burns, weight, etc. No, she just could not wrap her brain around losing her hair. Now, she had this beautiful, waist-length blond hair, which I would be sad to lose too. However, I thought I had pretty hair as well, but had lost it all by the time I met her, and it did not phase me one bit. When I met her, I pulled off my hat, showed her my bald head, and told her it would grow back, as I showed her my practically nonexistent hair.

It is very difficult to psychologically prepare yourself to face the physical changes because you don’t really know, at the beginning, all of the physical changes you might face. You also are never sure of which changes are temporary and which ones will be permanent.

I think that, no matter what physical change you face, the most difficult thing to deal with is the looks from people. Whether you are walking around the mall with no hair, sitting on the beach with your scars exposed, or sitting in a wheelchair missing a part of your leg, you feel like you stand out in that way that no one wants to stand out. I know that feeling and it is really tough to deal with.

However, you can prepare yourself by trying to relax and simply accept whatever comes your way. As they say in the videos, you can get outside help if necessary, either by just talking to your doctor, family member, or priest/faith counselor about your concerns, or by getting professional help from a therapist. After going through everything I did, I found that there is also another way to make it better.

You have to make a conscious decision about how you will think about yourself. If you can learn to love your scars, your bald head, your lack of eyebrows, your prosthetic, learn to love your body for all that it has gotten you through, you may just find yourself more content.

More importantly, you may just find yourself with even better body image than you had before your treatment. There is a saying I learned from my mother:

       “God grant me the Serenity to accept the things I cannot        

In the past 2 weeks, I watched all 8 Harry Potter movies with my parents, just because we had never really seen them sequentially and we thought it would be fun! Having now watched the “Fear of Recurrence” videos from Moving Forward, I am going to get a little nerdy and relate cancer to Voldemort. In my case, I had beat “him” over a decade ago and never anticipated he would threaten my life ever again. However, little did I know, he must have been gaining power all those years because he returned very suddenly, and attacked without hesitation or mercy. Much like Harry in the last Harry Potter movie, I had the choice to fight him myself or cause all of my family and friends to suffer unimaginably. Since the clear choice was to fight, that was precisely what I did.

Yet, despite the fact I am almost a 4 year relapse survivor, I sometimes find myself worrying if he will ever return again. If I see bruises on my legs, or I feel unusually tired, or I get dizzy when I stand up, that anxiety creeps up on me. While that anxiety used to be more of a challenge for me, in the past year or so, I decided in the past year or so, not to dwell on it. The Livestrong video above best expresses the reality of this fear but also the many ways in which you can deal with it so that it does not take over your life. Unfortunately, it seems we hear of relapse happening more often than we'd like. But, what is far from the truth is that relapse means death. I remember when I first relapsed, my friends from school would tell me that someone in class said that the leukemia relapse I had might be fatal because they knew someone who had died from it. THAT IS NOT TRUE!!

First of all, get the facts from your doctor. While I am not a huge fan of statistics (simply because I had less than a 10% chance of relapse but it happened anyway), it might make you feel better to know the statistics for your cancer. More importantly, though, you have to maintain hope and positivity. This quote from baseball player Mickey Rivers clearly describes why such hope and positivity is essential:

“Don’t worry about things that you have no control over,         because you have no control over them. Don’t worry about things that you have control over, because you have control over them.”

You have no control over whether or not you relapse, SO DON’T WASTE YOUR TIME WORRYING ABOUT IT!!! You have complete control over your attitude and outlook on life, SO DON’T WASTE YOUR TIME FEELING ANXIOUS OR AFRAID!

However, I definitely acknowledge that this is easier said than done. Therefore, I highly recommend, as do the videos, that you get extra help if you need it! There are many resources out there to help you deal with the fear and anxiety caused by the uncertainty of relapse, so don’t hesitate to get help before you lose yourself in fear. Think of it this way: I lived 10 awesome years after my first treatment ended before confronting cancer again because I never worried about relapsing. When I relapsed, I just fought it as best I could and now I am back to living a full life again! Take advantage of every day, week, and year, there is so much you can do with your time that is so much more worthwhile!

My dad told me this saying he heard recently, and I think it sums up all of this very well: 

For all teens diagnosed with cancer, fertility is a super important subject! I know for some, it is a little uncomfortable to talk about, but I am going to write about it anyway! 

The videos above, from the Moving Forward series, introduce the topic of fertility during cancer treatment very well and definitely cover the most important aspects of the issue. However,  they do so more from the perspective of a young adult, someone who is old enough to think about eventually having a family. If you are a young teenager like I was, it can be really difficult for you and your parent(s) or guardians to think ahead, about the fact that you may, in the future, want to have a family of your own. Nonetheless, my number one piece of advice is that you and your parent(s) or guardians consider and talk about this with your doctor at the very beginning of your treatment. If your doctor does not know how to address fertility during cancer treatment, ask him/her to find you someone who does, or find that second opinion yourself. In any case, it is crucial that you address this at the very start of your treatment. Waiting even 3-4 weeks can cause all the eggs or sperm to be killed by the chemo.

Related to this, I’ll tell you my story of dealing with fertility and cancer treatment. Yes, this is a personal topic, but I think it can help to hear another person’s story either way!

When I relapsed, I was at an age at which my treatment was going to affect my fertility. Because I had to start my treatment right away and in order to try to protect my reproductive system, I was put on birth control pills immediately.  However, because I was lying down so much in the hospital and at home due to the intensity of my chemo, those pills gave me a blood clot in a large vein in my hip. Because of the blood clot, I was put on blood thinners. Unfortunately, needing those blood thinner shots required me to get numerous platelet transfusions. To summarize, the pill stopped being effective for me in the same week that I was about to begin the most serious phase of my treatment, the one that would be the most dangerous to my fertility.

Therefore, thanks to my mom who was thinking about my body and my future, we met with a reproductive specialist who had a great deal of experience working with cancer patients trying to protect their fertility. We talked about all of the options and decided to use a monthly shot called Lupron Depot, which would basically stop my entire reproductive system from functioning. In this way, it would “hide it” from the chemo, enabling me to retain my fertility. The doctor said this had been one of the most successful methods of protecting the reproductive system for many teen patients who had gotten the chemos I was going to receive. She also noted that it would be much more effective than the pill. Another consideration was that this option was a lot less invasive than freezing eggs or ovaries, so we opted for the monthly Lupron shot.

Now that I have been done my treatment for the last 4 years, I can happily say that Lupron was effective for me. While I don’t know what will happen in the future, whether I am able to have kids or whether infertility becomes a problem that I do eventually face, I am so glad my mom took the time to get the help we needed. Thanks to her, I was able to make a decision that would protect my reproductive system, for the near future at least!

In terms of what you should do, it can vary greatly between people, gender, and types of cancer. Therefore, it is best you talk with your doctor about what method of protecting your fertility is best for you. If you don’t think your doctor has enough experience with the subject (typically, pediatric oncologists don’t have as many patients in the reproductive age), don’t hesitate to find someone who has the necessary knowledge.

So, when thinking of the bigger picture, what does this have to do with coping with cancer treatment? EVERYTHING! Making the right decision in regards to protecting your fertility means you and your support system have to be actively involved in your treatment. Although oncologists are often amazing at what they do, they cannot be experts at everything, meaning you and your support system have to pay attention to your body too, making sure to ask questions. Remember, oncologists are focused on treating your cancer. It is up to you and your support system to ensure your overall health needs are addressed.  If necessary, you should not hesitate to reach out to physicians in other specialties.

I know it has been a while since my last post, so I apologize for the delay!  I guess the end of my freshman year of college got busier than I expected!  As summer begins, it is my goal to post more frequently, since I definitely feel bad about my lack of posts!  So, here it goes :)

In my efforts to share new and useful resources with you, I have come across a video series for young adults with cancer from the American Society of Clinical Oncology.  In my next several posts, I will be posting a video from the series and writing a blog relating to the topic of the video!  While you are welcome to follow through the series along with my posts, you are also welcome to view the series on youtube at http://www.youtube.com/watch?v=F7kHCaPAsF4&list=PLD3FB007EC0755947.

As an intro to my series of posts, here is the introduction to the Moving Forward video series from ASCO.