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Nana, What's Cancer?
By Beverlye Hyman Fead, Tessa Mae Hamermesh, Shennen Bersani
American Cancer Society / Health PromotionsCopyright © 2010 American Cancer Society
All rights reserved.
"Nana what's cancer?"
My granddaughter, Tess, and I sat in my kitchen, eating Girl Scout cookies and drinking chamomile tea. She liked the Tagalong cookies — round, chocolate-covered cookies with peanut butter in the middle. They were her favorites!
I could tell Tess had a lot on her mind. I had been having treatment for cancer, and Tess wanted to know more about it. She said she wanted to ask me some questions about cancer — about the things that bothered her.
"It might help if you write out your questions," I told her.
She nodded and with a look of great concentration, jotted down the first question: "What is cancer?"
"I think this is the best way to explain it," I said. "Our bodies are made up of cells that grow, divide, and die. But cancer cells don't go through this cycle. They continue to grow and divide and form new cells that are abnormal — these cells act differently than normal cells. Cancer starts when the abnormal cells clump together in a person's body and form a tumor."
"But, Nana, what is a tumor?" she asked.
Of course, I thought, she wouldn't know the meaning of that word, so I said, "From now on, when we don't know what a word means, let's look it up.
"A tumor is a swelling or mass of tissue in the body. Tissues are groups of cells that have a specific job to do.
"There are two kinds of tumors: benign and malignant. Benign tumors are not cancer. They may grow larger, but they do not spread to other places in the body. But malignant tumors arecancerous. They contain abnormal cells. That's because cancer causes cells in the body to change and grow out of control."
Tess thought for a moment, and then asked, "Those bad cells spread, don't they?"
"Yes, they can enter the bloodstream and travel to different parts of the body. When the cancer spreads, it can destroy the body's healthy tissues. Healthy cells usually keep themselves under control, but unhealthy cells multiply.
"Now, it's time to use your imagination. Do you want to show an example of what we mean and draw a group of tennis balls? And then, imagine those tennis balls as tumors?"
"Yes, that would be easy, Nana! First, I'll draw the normal ones together, and then the abnormal ones that grow apart and spread."
"Great," I said. "That makes it easier to understand."
"What causes cancer?"
Later that afternoon, Tess and I decided to go to a movie. On the way to the theater we listened to Louis Armstrong singing "Cheek to Cheek." I had played that song for her in the car since she was a baby.
Tess was singing along, "Heaven, I'm in heaven." Then she stopped and said, "Nana, there's something else I want to ask you."
"Sure," I answered. "Ask away."
"What actually causes cancer?"
"Tess, we don't always know exactly what causes a person's cancer, but we do know that cancer occurs because of certain interactions between genetics, environment, and behavior."
"What do those words mean, and why are they so important? Do they apply to everyone?" Tess asked.
"Yes, they do. Genetics is the study of how parents pass on certain traits to their children — like the color of our eyes and hair, as well as how tall or short we will be when we grow up. Genetics may also tell us if we'll have any serious health problems and what they might be."
Tess looked at me and said, "I know what environment means! It's our surroundings, like the air we breathe and the places we live and play."
I smiled. "That's right. Very good! And then there's behavior, which is what we do, how we act or how we react to things that happen to us — to a new situation or challenge.
"Here's another way to think about cancer," I said. "In a book called The Guide to Fighting for Recovery from Cancer, cancer is described as a tiger that's escaped his cage. Picture him prowling and growling right in front of you."
"That sounds too scary!"
"It doesn't have to be scary," I said, "especially if you know what to do. You may want to run away, but that won't help the situation. We want to get that tiger back into his cage!"
Tess said, "I get it! You have to try to fight the tiger."
"Of course! Can you help me think of ways to outwit him?"
"How about eating healthy food, Nana?"
"That's a good one." I smiled. "Also, taking care of your body by exercising every day."
"We are on a roll now!" Tess said.
I laughed. "And don't forget the right medical care! And you can help, too. Encourage your loved one or your friend with cancer to do everything possible to keep the tiger in the cage. The lesson here is that we can't always beat the tiger but sometimes we can put it back into its cage and prevent it from harming us."
Tess's eyes met mine, and said, "You're lucky, Nana. You've kept your tiger in the cage now for seven years. Do you know what I think helps you a lot? Laughter."
"You're right! You and I love to laugh together. It helps me feel better."
"You mean that if we tell funny jokes or riddles to our loved ones, they'll get better?"
"Not always, but it will sure make them smile and that's a good thing."
"Can you catch cancer?"
A few weeks later, Tess came to visit me in Montecito. One morning, we walked down Coast Village Road and stopped for some breakfast at our favorite place. Tess ordered a bagel with cream cheese and hot chocolate, while I had my usual oatmeal with berries.
We took our meal outside, where we could watch the bicyclists passing by. As Tess sipped her hot chocolate, she said, "Nana, there are still some things I'm wondering about. Will cancer keep you from kissing and hugging your mom or dad, your grandmother or grandfather, or anyone else you know who might have cancer? Is getting cancer like catching a cold or the chicken pox?"
"No," I said emphatically. "You can't catch cancer from someone you love, or even from a total stranger. Cancer only happens inside the body of the person who is sick with the disease. It cannot be passed from one person to another.
"In fact, if someone you love has cancer, it's actually good to give that person lots of hugs and kisses because it will make him feel better. Also, you don't need to worry about drinking from a cup or glass that belongs to a cancer patient, or cuddling up with him or her to watch a movie, or sitting in that person's lap and reading. Isn't that good news?"
"That is good news, Nana! But how do people know if they have cancer?" Tess had that serious look on her face once again.
I wanted to ease her fears. "Well, first of all," I said, "a doctor figures out whether a person has cancer. When the doctor identifies what is wrong, it's called the diagnosis."
"The diagnosis happens after the doctor does some tests and examines a patient, right?" Tess asked.
"Yes," I said. "The doctor will study the person's symptoms, too. When the diagnosis is cancer, more tests may be done. After these tests and more visits with the doctor are completed, then the patients get their treatments.
"The doctor recommends the kind of medical treatments that will help the person with cancer get better. Now, you have a special job to do, too — a job that is almost as important as the doctor's. Give the person who has cancer all the comfort you can. You can say the words 'I love you,' or you can write something nice on a note or a card."
Tess added, "You can also send a book or make a special gift to make the person who is sick feel better."CHAPTER 4
"Can anyone get cancer?"
That evening, sometime after dinner, Tess and I sat on my bed to watch TV and have this weird snack combo that we like: Goldfish and carrots.
We were watching a show about a family whose teenage son had a mysterious illness. That got Tess to thinking. She knew a lot about my cancer experience, but she said she sometimes wondered if people of any age could get cancer. The answer was yes.
Surprised, Tess asked, "You mean anyone? From little kids to moms and dads and old people?"
"That's right. There are no age limits for cancer, but there's something you should remember about who gets cancer. The most important thing is that the average age of a cancer patient is sixty-six years."
She couldn't hide her smile. "Kids think that's really old."
I grinned at her. "And we both know it's not, don't we?"
She laughed. "Well, you're not old, Nana. That's for sure."
"Do you remember our trip to Washington, D.C.?"
"Yes, it was cool."
I agreed. "At the American Cancer Society's Celebration on the Hill, we saw that cancer patients and cancer survivors come from every age group, from every race, and from every walk of life. We saw babies in strollers, elderly people in wheelchairs, and all the ages in between, and every one of them wore what?" I prompted.
"Survivor T-shirts," Tess supplied.
"Because they all have survived cancer!"
"Right you are, Tess."
"When you have cancer, do you have to stay in bed?"
A week after our visit, Tess came down with a cold, so I went over to her house to provide some TLC with my homemade chicken soup. I found her in her room, propped up with pillows and surrounded by books.
"Nana," Tess said proudly, "I just read a book about two little girls whose mom had breast cancer. Their mom felt so sick from the treatment that she had to stay in bed. Did that happen to you?"
I smiled and said, "No, I was lucky. I needed to stay in bed only at the beginning, because of some procedures I had right after my cancer was diagnosed. Now, I take a pill and get a shot, and I lead a normal life. Sometimes people with cancer can go on with their lives, just like before. They don't have to stay in bed. They go to school or to their jobs, or just live happily with their families.
However, treatments can make people feel sick; then, they have to stay in bed until they feel better."
"So the treatments can make you feel sick?" Tess asked.
"They can, but not always. Everyone is different," I said.
"Two of these treatments are radiation and chemotherapy. But there are also new chemotherapy treatments that don't cause sickness."
Tess said knowingly, "I've heard that some people have surgery. What happens then?"
"Then, they do have to be in bed while they heal," I answered. "They have to listen to the doctor and do whatever he or she says. The doctor might tell them to walk a little every day after surgery because that will make them get stronger. And he might say to get a lot of rest. Rest and exercise are really important for a cancer patient."
Tess nodded in agreement. "Do people with cancer sleep a lot?"
"Sometimes they do. Cancer and its treatments can tire a person out," I explained. "The combination of resting and getting some exercise is really the best thing for many people with cancer.
They might prefer to take a stroll and breathe some fresh air with you. You should ask someone with cancer if he or she would be more comfortable in bed. Tell your friend or loved one to be honest with you."
Tess seemed excited. "I think I know how I could help. I could read with my friend. Or I could get my mom to help me by renting some movies to take over, or by baking something. That would make me feel very good about what I did."
"Can you get cancer when you already have another disease?"
One day, when Tess was feeling a lot better, I suggested we go to a bookstore and do some browsing. We ended up briefly in the medical books section where there were books on all types of diseases, including cancer. Tess pointed to one of the books about cancer and said, "These books remind me of something I've been meaning to ask you. Can people who already have a disease still get cancer?"
"Yes, unfortunately you can get cancer even if you have another disease," I told Tess.
I went on to explain, "Let's say your Uncle John has heart disease. He takes medicine for it and is doing fine."
"So, can he still get cancer?"
"Yes, he can. In fact, some elderly people get cancer in their eighties and nineties, when they already have other diseases like heart disease or diabetes."
Tess shook her head and said, "I'm definitely going to have to look in the dictionary to find out what those words mean!"
"That's a good idea," I said.
"The best advice I can give is that we have to take very good care of ourselves, no matter what we get. If we are in good health, we can better fight any disease or illness. You know all of the good things to do, right?"
"I sure do!" Tess said enthusiastically. "Exercise and eat green vegetables. What else, Nana?"
"Drink lots of water. Eat fewer high-fat foods. Use sun protection every day. Avoid x-rays if you don't need them — of course, you should get an x-ray if you have a broken bone. Avoid as much stress as possible. Don't smoke. And drink alcohol only in moderation."
Tess looked shocked and said, "Nana, kids don't smoke or drink alcohol!"
"Yes, I know that," I said sheepishly. "But it's important to hear this when you are young so you will start your good habits early."
"Is it okay to feel sad when someone you love has cancer?"
As an artist, I spend a lot of time in my studio. Sometimes, Tess and my grandsons come up to visit and paint with me. One day, when Tess was with me in the studio, I noticed that she was a little quiet. She had just found out her grandfather's (Papa Lew's) lung cancer had come back. "It's only natural to feel sad, Tess," I said. "After all, someone you love or care about is not feeling well. That's why cancer is often called a family disease."
"Why would you say that, Nana?" asked Tess.
"Because cancer affects everyone in the family," I answered. "It's natural to feel angry, disappointed, and sad. You may even feel like you could have caused the cancer in some way. But remember, people don't cause cancer.
"It's okay to cry if you need to," I told her. "We don't like to tell our friends that someone in our family has cancer. But maybe it would help to tell someone, and then you wouldn't feel so frustrated, scared, and alone. If you share bad news with a friend, afterward your friend might say something nice to make you feel better.
"Here are some other things you can do," I said, pulling out a pen and note pad to make a list.
"Be sure to tell one or both of your parents how you feel. They can reassure you that you didn't cause this illness. Also, you will feel better if you talk about your feelings.
"Tell a friend or a teacher who may be able to understand your feelings. People want to help. They know it's too hard to go through it alone.
"Don't feel guilty about continuing your activities. Being active will make you feel better, and your friend or family member with cancer wants you to live your life as you normally would.
"Talk with your parents about how your daily routines may change. This may happen when someone in your family or a close friend is ill. Find out as much as you can about schedules and activities that might change.
"Talk to a doctor or a counselor. They're trained to help and have seen many people who are sad or scared."
"What else can we do, Nana?" Tess said.
"It's nice to ask how you can help the person who is sick. Greeting cards, phone calls, and visits can cheer a cancer patient. What else do you think would help?" I asked.
Tess smiled. "Writing down your feelings or drawing pictures helps a lot, too!"CHAPTER 8
"Why are some cancers worse than others?"
We were together in a restaurant. Tess had a Limonata, and I had sparkling water. The last few months, Tess had been very sad about her grandfather. He had had lung cancer, one of the toughest cancers there is. Sadly, he had passed away.
Tess wanted to know why some people do well with cancer and others do not. "There are all kinds of cancers and different treatments for those cancers," I answered. "We don't always know why some people respond better to cancer treatment than others."
Tess asked, "But if you find out you have cancer early, can it be fixed right away with medicines and treatments?"
"Sometimes," I replied. "There's a term for finding cancer early — before it has spread. It's called early detection. Some cancers, however, cannot be cured, even when they are caught early. I know that's very hard to hear. But we always want to be truthful with one another.
"The doctors work really hard on treating every type of cancer, and they try many different kinds of medicines. They try everything they can. "Sometimes the medicine makes the people look and feel very sick. They might get thin, lose their hair, or become very pale and weak. This is scary to see, and you might feel sad when you see these changes. Sometimes people don't feel as bad as they look; other times, they do. And sometimes, after everything has been done, a patient still may not get better; unfortunately, he might even die. If this happens, remember that we carry our loved ones in our hearts forever."
Excerpted from Nana, What's Cancer? by Beverlye Hyman Fead, Tessa Mae Hamermesh, Shennen Bersani. Copyright © 2010 American Cancer Society. Excerpted by permission of American Cancer Society / Health Promotions.
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