Cancer and the Holidays: Keeping it Simple, Keeping it Real

By: Kevin Berrill, LCSW 

Ready or not, the holidays---Thanksgiving, Chanukah, Christmas, Kwanzaa, and New Years---are just about the corner. Even the healthiest people can feel overwhelmed or overstimulated by the frantic pace, unrealistically high expectations, and the sensory overload of holiday music and muzak, advertisements, food and drink, decorations and displays, and social obligations.

Bane or Blessing? The experience of cancer during the holidays affects each person differently. Some glide through the season with ease and a feeling of joy; for others, it is a hard slog to endure. One of the most common reactions is ambivalence.

On the one hand the holidays can be a welcome departure from routine. They afford an opportunity to look more deeply into life, take less for granted, reset priorities, renew spiritual faith, or connect more deeply with loved ones and strangers alike. On the other hand, for many the holidays are a source of added stress and uncertainty. People with cancer (and other serious illnesses), along with their caregivers, often feel out of sync with the celebratory atmosphere all around them and have unrealistic expectations of themselves and others.

Looking Back and Ahead. The holidays mark the end of one year and the beginning of another. They are a time when we look at the past and toward the future. Those who are newly diagnosed, especially those with cancers that are difficult to treat or have a poor prognosis, may look to the coming year with trepidation. Fear that “this will be the last” can weigh heavily and lead some to overexert in order to make the season perfect. The prospect of a new year also raises questions for those who have finished treatment or who have an excellent prognosis: “Will it come back next year?” “If it does, how will I manage it?

Old Traditions, New Circumstances. Some in the midst of cancer treatment---and their caregivers---may wonder if they have the stamina to get through the holidays and another round of chemo, radiation, or some other therapy. Those who once avidly shopped and entertained might now dread the prospect of doing either.

Visiting with loved ones for the first time since undergoing treatment can be comforting and heartwarming. For some it can also be awkward and anxiety provoking, especially having to deal with others’ reactions to their diagnosis or changed appearance (e.g., loss of hair, weight loss or gain). These reactions may include discomfort, avoidance, pity, fear, unwelcome medical advice, or lectures on what to think or feel in order to get well.

Finances. Cancer treatment is expensive, unmanageably so for those who have no medical insurance or who are underinsured, or who find themselves unable to work. Those under financial stress, especially whose tradition it is to exchange gifts, face difficult choices about what, if anything, they can afford. For parents of young children these choices are all the more difficult.

Despite medical advances, much about cancer that cannot be controlled. To find a sense of balance in the midst of cancer and the holidays requires forethought and planning. If you or someone you love is facing cancer, consider the following suggestions:

Allow your feelings: Life threatening illnesses such as some cancers, change the world as we know it. It is natural feel sad, angry, despairing, confused, numb, guilty, or lonely. Ignoring and suppressing your feelings and pretending to be cheerful are likely to make the holidays more difficult. Sometimes when we accept rather than resist our feelings, moments of happiness break through the clouds. If so, give yourself permission to enjoy those moments.

Respect your needs. If you have concerns about whether your usual holiday plans are right this year, it is okay to break with tradition. Allow yourself to change where, when, how, and with whom you spend the holiday. If you used to host holiday dinners, consider a potluck instead. Give yourself permission to decline party invitations and to avoid people and situations that leave you feeling depleted, irritated, or depressed.

Let others know if you don’t if you don’t have the energy or the financial means to buy presents. If you choose to participate in holiday gift giving, keep it simple. For example, shop online, buy gift cards, or buy the same item for each of your intended recipients. Limit your spending to what you can afford and will not regret having to pay for.

Make a plan. It matters less what you plan to do than that you have a plan. Spontaneity is great, but having a plan, even if you decide to change it, is likely to give you a greater sense of control, making it less likely that you will end up feeling isolated or blindsided by others’ expectations and decisions. Be sure to let others close your plan. Be gentle. Pace yourself. Perhaps your plan will be the start of a new, simpler, and saner holiday tradition---or maybe it will be just enough to help you muddle through until January 2.

Take care of your body. Try to get enough rest, nourishment, and exercise. Be mindful of your alcohol consumption. Alcohol is a depressant and can worsen your mood. Limit sugary treats as they too can leave you feeling depleted and depressed. Stick as much as possible to your routines and eat sensibly, including plenty of vegetables, fruits, and whole grains.

Be supportive. If there is someone in your life who has cancer offer the gift of your listening and care. When it comes to holiday plans, let them lead. Refrain from fixing, giving advice, or pushing a holiday agenda; rather, explore with them what would offer the greatest healing and comfort. If you offer a holiday invitation and they decline, let them know they can change their mind at the last minute. A thoughtful phone call, card, or email can also make a meaningful difference. If you want to offer help, be specific: “Can I pick up anything for you while I’m at the grocery store?” or “Would you like me to take the kids out so you can get a nap?” is much more helpful than “Let me know if there is anything I can do.”

Pause and breathe. At a time when so many around you are caught in an endless round of buying presents, give yourself the gift of presence, taking a sacred pause several times a day to refresh yourself and just be.

Reach out. If you need practical support, reach out to understanding loved ones. They may be eager to help but not know how. Let them know what you need---a cooked meal, help with shopping or hosting, someone to babysit the kids, prayers, or kind and supportive listening. Delegate responsibilities whenever possible.

In a world that extols health and vigor and promotes the illusion that life is controllable, the experience of cancer sometimes brings with it feelings of isolation and stigma. The antidote to loneliness is connection. To the extent you can, open yourself to others’ attention and affection. If you have the energy, offer your care to someone else---a loved one or a stranger. Compassionate speech and action help us all to transcend difficult circumstances and enter more fully into our shared human condition. For those with a particular religious faith or spiritual practice, cancer is an invitation to explore and deepen.

Solitude can quiet the mind and body, help us to recharge, and tune in to what matters most. Allow yourself time alone when need it.

It helps to be around people who “get” what it feels like to be affected by cancer. Ann’s Place in Danbury, CT, offers individual counseling, support groups, and a myriad of wellness activities to those affected by cancer and who share their lives. Our services, which are offered free of charge, are there for you this holiday season and all year long. Reach out to us if you think we might be able to help. Doing so may help the holiday season---and the year ahead---look and feel brighter.

Kevin Berrill is a clinical social worker at Ann’s Place which serves living with cancer and those in their lives.

Rebuilding with Purpose - Update

In the spirit of keeping our donors informed of our building progress after the flood, here are a few updates:

Liz Hayes and Sue Chabot help pick out rugs and flooring options for our rebuild.

• We would like to thank ServePro for coming out Easter Sunday through that week to clean up the mess. Their team was there to make sure the flood had minimal damage. We have also had them come back and spray for extra mold remediation and run dehumidifiers through the summer.

• Our insurance was finally able to approve most of our building needs and we have hired TJ & Sons to complete the majority of building repairs. We hope that the core repairs will be completed in November.

• We have identified several important upgrades needed for the rooms that have to be done now, or have significant benefits to doing while the walls and ceilings are open. For example, we installed a radon mitigation system while the wall was open, and the floor removed.

• We are especially blessed to have Sue Chabot, Interior Designer (and lead designer on the building 12 years ago) back with us to pick out colors, flooring and layout. She was joined by Liz Hayes to pick out rugs and floors. Thank you Sue and Liz!

• Projects not covered by the insurance will cost approximately $227,000 and will be divided into two phases, with the second phase happening in 2023. Costs will fluctuate both ways in the next few months due to supply issues and much appreciated donated labor, when available. For a full list of these projects click here.

• Some time in November-December, we will need to have a large team of volunteers come and move saved furniture back into place, clean toys and kitchen items and unbox and build our replacement furniture.

We will be officially kicking off our Capital Campaign to raise the needed funds in our October mailing. Thanks to some generous donors who gave early, we already have over $60,000 towards our goal!

If you would like to help in any part of our rebuilding campaign, or have questions and suggestions, please reach out to me at shannon@annsplace.org or 203-790-6568 x103.

A Pain Turned To Love

A few thoughts about the passing of an Ann’s Place visionary

This week, we lost a very good person. Ron Olsen never liked to be in the spotlight but the work he inspired has grown to serve thousands of people facing cancer.

His story is very familiar to those of us at Ann’s Place. In the late 80’s he was young and married and trying to start a family but all those dreams and plans were interrupted by a terrible disease. Cancer took his young wife, Ann, but Ron didn’t let his sorrow settle into his soul. He decided to turn his pain into love and help those struggling like he did.

In 1987, he started the Ann Olsen Endowment with many of Ann’s friends and family, including colleagues from Boehringer Ingelheim, where Ann worked.  Through Ron’s vision, they raised funds to help families facing cancer and to make life a little better for them. The endowment partnered and later merged with another agency, I Can, to become Ann’s Place, Home of I Can and later shortened to Ann’s Place. Together, these organizations achieved incredible things that they never could have alone.

Through his work, Ron let his natural joy for life and love for others guide him. He could always be found helping at a fundraiser or guiding the next generation of leaders.  He gladly shared his vision but also allowed others to lead and shine.

Ron’s ability to partner with others and let them make his vision their own was the greatest gift he gave Ann’s Place. This tradition, heavy with community involvement and volunteerism, continues today.  In more recent years, he would affectionately say to us, “This is your generation’s time. Make Ann’s Place what you think it should be.”

Thank you Ron for your many years of encouragement, guidance and care for others. We promise to carry on your legacy and keep turning pain into love.

We will miss you.

The Ann’s Place Staff and Board

Read Ron Olsen’s full obituary here.

9/1/22 Update: The family reports there will be a private Fall memorial, followed by a Ronald Remembrance Day celebration at Ann's Place in the Spring after Ann's Place reopens its doors to the public. Details will be provided closer to the event.

The family thanks you all for the many acts of kindness and support following Ron's passing. The family also requests new tribute donations in Ron's honor be directed toward a fund to update the entrance doors with automatic openers for handicap access.

Rebuilding After the Flood

By Shannon Cobb, President and CEO

Over Easter/Passover weekend, a hot water pipe burst at the seam in the wall behind the first floor kitchen counters at Ann’s Place. Nobody was present to see it fill up the kitchen, or watch it pour into the Olsen Hayes meeting room. The water silently filled the lobby, gathering room, library and spirituality room. It then rained down– destroying walls, ceilings and floors in the entire lower level, including the children’s room, the movement room, board room and the art room.  After weeks of demolition, two full floors have been gutted in order to dry out the building and keep mold from growing.

There are positives in this bad news. Our clinicians and facilitators have already become experts at providing online programming. The vast majority of our services are offered on zoom including counseling, support groups, yoga, tai chi, speaker series, dance, and even horticulture therapy among others. We were able to switch in-person programming to online within hours of the flood.

We will rebuild our rooms again and this gives our experienced staff and volunteers an opportunity to look at each room to see how it can serve as an even better place of healing and care for those facing cancer.  

One of our dreams was to have a special room where a counselor can meet with someone when they are losing their hair - to try on wigs and scarves, at this very emotional time. We now have an opportunity to build this thanks to the generosity of donors at our 2022 Fashion Show who raised over $30K for this room and other improvements! This new “Salon” will be a place our clients can feel beautiful again and we are so excited to roll it out this year.

We also want to reimagine our children’s room so we can have an interactive therapy room for kids of all ages. We have so many creative ideas for what would delight and help heal our youngest clients.

The activity and movement room will get a beautiful new yoga floor that didn’t exist a decade ago.

We have a lot of work ahead of us, but with the support in this incredible community, we will make it to the other side…and have a fresh coat of paint in the process!

There are a lot of similarities between what is happening to Ann’s Place and what our clients go through. One day they find some minor bump or pain – often hardly noticed… but it causes so much damage. Then, in order to rid their bodies of cancer, the doctors have to remove anything that could be a risk – making them feel gutted and disfigured.

What Ann’s Place does is to help them rebuild their life, to feel beautiful inside and out – and make sure nobody has to face cancer alone.

We are very grateful to the Ann’s Place supporters who walk on this journey with us and make the rebuilding of lives and our space possible.

We will keep our supporters updated in the coming months as we make progress forward. Thank you.

Attending To Our Overwhelm

By Alison DiPinto, MA LPC

Overwhelm synonyms:   submerge, engulf, bury, deluge, flood, inundate, clog

I was thinking of the word overwhelm recently as it seems to be used quite often to describe current states of being with both my clients, as well as friends and family.  So, in preparation for writing this I looked it up.  I was surprised (and not so surprised with further thought) of the synonyms that were listed beside it. 

What beneficial information can be provided to us if we take overwhelm as an emotional state of being and consider its synonyms? Words like submerge, engulf, inundate, bury and flood conjure up imagines of being overtaken by something that feels uncontrollable, such as fire, quicksand, or water. 

We may feel overwhelmed by anger because of illness or loss.   We may feel submerged in feelings of worry and uncertainty, and we may feel like we are drowning in a sea of sadness.  These words and images help us to clarify how we feel, but not so much about what to do about it.   

Let us consider the physical state of overwhelm to help us find solutions.  Consider how does it feels in your body to be engulfed by anger.  Some words that come time mind are tense, contracted, overheated.  How does it feel to be buried by feelings of uncertainty or drowning in sadness?  We may have some difficulty taking a deep breath, or a feeling of being disconnected or unmoored, resulting in difficulty focusing or sleeping.   

Clog was another synonym for overwhelm and to me that has a different feel to it.  It suggests a “stuckness” or an inability to move. That we may feel like our emotions are clogged up inside of us with nowhere to go.

Attending to the physical sensations that pair with our emotional states is a pathway to coping and healing.  Let us explore some ways to attend to some of the sensations discussed above. 

First, it is important to identify what you are feeling in your body that feels like overwhelm   Find a moment or two of stillness and ask yourself how you feel with the focus being on body sensations that seem connected to emotions. See if you can let go of any judgement here and be curious about any information you are receiving.

Maybe the prominent sensation is muscle tension. A simple way to release tension is to do a tense and release exercise with each muscle of the body. You can do this seated, lying down or even standing. You can start at your feet and create tension in the muscle, hold for several seconds and then completely let the muscle relax. Then move up the body to the next muscle group (lower legs, upper legs and so on). It always amazes me how good the muscle feels when it gets to release all that tension. 

This physical exercise reminds us that after a contraction there is always an expansion and that sometimes we contract around our pain to protect ourselves but if we allow and not resist the inevitable expansion, we can find relief in allowing our feelings to have the space to be felt. 

We can couple the above exercise with attending to our breath. Sometimes we can have a tough time finding a deeper breath. It is important not to force it or “over focus” on how we are breathing. I know for me, that has led to feelings of a more labored breath.  But if we pair it with a simple tense and release exercise our brain has something else to focus on.  Try, on an inhale making a fist with both hands, then try a slower exhale as you slowly release your hands.  Do this at least 5 times.  During this exercise you could identify what you are letting go of as you exhale and release the fist: “I let go of my anger in this moment” or something we want to expand and nurture: “I expand around gratitude and love”.

If there is a feeling in the body of drowning or drifting and feeling untethered, we can simply turn our focus to our feet.  We can become aware of how the distinct parts of the feet connect to the floor, feeling all ten toes, the outer and inner edges of the feet and the surface of the heel. For additional sensations of “groundedness”, try standing outside with your bare feet directly on the earth. (Maybe we wait for spring!)  It can help to imagine the exchange between your unique energy and the energy of the earth.

If the body sensation of overwhelm feels more like clogged or stuck emotions, consider moving your whole body like dancing to a favorite song or “shaking out” stuck energy, (think Hokey Pokey) If dancing or shaking is not your thing consider journaling or talking to a trusted friend or counselor.  The important thing is to externalize the trapped feelings somehow.

It seems that if you feel all those emotions and you’re short on time, the suggested exercises could be done all at once!  Here’s an example: Stand or sit and notice your feet on the ground, then do the tense and release with your fists and breath 5 times, then shake out your whole body.  Repeat as necessary.

Most times it takes a little awareness of not only how we feel but where we feel to start the process of feeling unburdened and less overwhelmed. 

Alison DiPinto MA LPC

Alison is a licensed clinician at Ann’s Place. Alison also is a certified yoga instructor, certified Grief Yoga® instructor, and a certified Healthy Steps® instructor all of which she shares with the Ann’s Place community. 

The Metamorphosis of A Butterfly

The beautiful butterfly tree was a delight for many children at Festival of Trees!

If you were at Festival of Trees, you saw the beautiful Monarch Butterfly Tree that was a real treat for adults and kids alike. There was a fun story behind that wonderful tree told here by Janet Capozzola:

“In July the Senior Center had been open for an entire month after being shut down from the Corna Virus in July 2021. We were excited to be allowed to have a float in the Lion's Club Fourth of July parade. We decided butterflies would be a great representation of how we all felt coming out of isolation. We named our float, "We Have Emerged". We had all parts of the stages of the butterfly, Kathy Stram marched in the parade as a caterpillar. We had a section of the float with a tree with chrysalis hanging in it. The seniors wore beautiful wings and loved riding on the float flapping their wings sitting under the huge Monach butterfly. We had lots of flowers for the butterflies to nibble on. We won a trophy for first place in the parade.

After the parade we moved the butterfly into our Senior Center where it decorated the great room and reminded everyone how great it was to have emerged from isolation.

In October we decided the butterfly needed to move on to spread it's wings and bring joy to others. A couple of seniors worked to attached the Monach's wings to a black Christmas tree and strung it with white lights and added the antennas. They made a "tree skirt" with the flowers and added some more smaller butterflies and was delighted to donate it to the Festival of Trees to raise money for Ann's place and move onto a new home. It received a lot of attention at the Festival because it was so big and unusual. 

I was shocked when my daughter's boyfriend won the butterfly tree with just one ticket he placed in the tube. He decided to donate the tree to "The Monach in Southbury”, a Senior Living Facility where it has found a new home in the facility's main room.”

Janet Capozzola, Program Coordinator
New Fairfield Senior Center

Choosing the Right Foods

Image by Jill Wellington from Pixabay

By Samhita Shirsat

Maintaining healthy food choices as you make your way through cancer treatment can help you reduce side effects and give your body more strength when it needs it the most. The articles below will give you some different perspectives on some of the best foods to include in your diet.

What are some foods that fight cancer? 

Although there is not one specific food that can protect against cancer, a combination of fruits and vegetables as well as limiting alcohol and excess sugar consumption can help build a strong protection. For an excellent visual display of choosing the right foods, read more here at the American Institute for Cancer’s . 

What are healthy options for different meals of the day? 

No matter what the meal, choosing to include a source of protein, as well as a variety of produce will make the meal healthier. Easy ways to incorporate this are through salads, soups, and sides for meals. For suggestions of quick recipes and proportions for healthier meals, these recipes for the American Institute of Cancer Research can help.   

How can I be better prepared to make healthier eating choices in my day-to-day life? 

Healthier choices start with availability of nutritious food. The first step would be to start buying healthier snacks and ingredients for your home. To help with this, this video from the American Cancer Society explains some of the ways you can stock your kitchen with healthier foods. 

It can be hard to find healthy options when dining out, how can I stay healthy when I am not at home? 

This is completely understandable, and there are a few simple ways you can still choose healthier options when not at home. Making sure to choose the right portion size, choosing meals with more fruits and vegetables, and packing healthy snacks to take on the road are all great options to stay healthy outside of the house. To learn more about these options, this video from the American Cancer Society can help! 

Men Get Breast Cancer too? Yes, they do.

By Bob DeVito

Would you please allow me to introduce myself properly first?  My name is Bob DeVito.  And I have stage 4 metastatic breast cancer.  Perhaps you knew men could get breast cancer, and maybe you didn't.  I wanted to take this opportunity to share my story and accept feedback and questions at the end. It's Breast Cancer Awareness month.  We are awash in a sea of pink.  We need to add some blue to that sea of pink to represent all men who get breast cancer.  

"The American Cancer Society estimates for breast cancer in men in the United States for 2021 are:

• About 2,650 new cases of invasive breast cancer will be diagnosed

• About 530 men will die from breast cancer

Breast cancer is about 100 times less common among white men than among white women.  It is about 70 times less common among Black men than Black women. As in Black women, Black men with breast cancer tend to have a worse prognosis (outlook). For men, the lifetime risk of getting breast cancer is about 1 in 833 .”2

You need to know your bodies and see the doctor if anything changes.  It would help if you did a breast self exam, examine your testes, have your colonoscopies when you are supposed to. It's better to know than to not know when it comes to cancer (or any disease, really).

My journey to cancer land started in the Spring of 2012.  Well, that's not entirely true.  Years before, I'd reported to my primary care doctor that I had a pea-sized lump at the 12 o'clock position.  He examined me and told me that "perhaps it's a cyst or a calcium deposit.  You have some manboob (being a bigger guy) going on, so you have some gynecomastia. We'll watch it." Famous last words, "we'll watch it." Several years later, I went in for a sick visit for my right ear, having some impacted wax.  He was precepting 2 Yale Medical students and a student nurse that day.  They all took turns irrigating my right ear using a large chrome syringe and one of those tiny kidney cup basins to catch the water and any wax that had been dislodged.  I got soaked with water.  When they were done, I just happened to remember to tell him that my pea-sized lump was still an issue but had gotten larger, asymmetrical, and hurt to the touch.  He said, "take your shirt off. Let's look.".  He palpated it and mumbled "inverted nipple" to the med students and student nurse.   He told me he would set up a referral to the hospitals' cancer center to get a mammogram and an ultrasound.  The ultrasound proved to be suspicious.  The tech brought in the radiologist on duty to have a look.  She said, "I'm going to call the office right now and give them my verbal report".  I replied, "It's quarter to 5 PM on a Friday, I am certain they aren't in the office." 

She said, "Still, I want them to have these results as soon as possible." A week later, my primary care doctor called me with the mammogram results and the ultrasound and told me to see the surgeon that was across the hall from where I had the mammogram and ultrasound done.  He did a biopsy then and there.  It hurt like hell.  And then, he did an FNA (Fine Needle Aspiration) of the two suspect lymph nodes. It was on a Tuesday.  That Friday, about a quarter to five, the surgeon called me back with the biopsy results.  I told him to hold on, we were at Walmart and just loading groceries in the car, and I wanted to give him my full attention.  He waited, I got in the car and sat down in the driver's seat. 

He told me what he would need to do.  His voice trailed off to the Charlie Brown cartoon teachers voice. "Wah waaah wah wah".  I remember he told me "It's not good news.  You have breast cancer." He proceeded to summarize what he would need to do surgically to remove my left breast and left lymph nodes.  I managed to tune back in.  I was crying, my husband was crying.  He told me he would have the girls in the office call me to schedule a time to come back in and talk about the surgery.  Which they did.   I went home and was sobbing.  I researched male breast cancer on "Dr. Google".  I had a hard time finding any information.  We went in that following Tuesday to talk about surgery.   I went in with a list of questions to ask the surgeon before surgery, at the time of surgery and after surgery that I'd found on a website.  So, one of the questions on the list was, "I want a second opinion. Who would you recommend?" He looks disappointed.  Maybe because I tied him up so long with the surgery explanation and questions or maybe because he felt he would lose a "paying customer".  Anyway, he gave me the names of three breast surgeons closer to my home.

I picked one and got an appointment at 5 PM since I was already diagnosed. They needed to go through their surgical opinion after doing a clinical exam and her own ultrasound.   The medical assistance stayed and drew blood for a BRCA 1&2 mutation test.  I was negative for all the genetic mutations, including others I found out later after being given the Myriad Genetics My Risk Panel.  So how did I get breast cancer?  Who knows?  I felt confident in this new surgeon.  I didn't get out of there until 8:45 PM.  They are that thorough. The next day I dropped off my leave of absence paperwork. They gave me a list of "To Do's," including blood work, seeing a plastic surgeon who was going to be scrubbed in to close my surgical incision and see what she could do about making me flat, the date of the surgery when I'd be discharged.  Amazing.  I said to the Medical Assistant, "Didn't you go home last night? How did you get all this done so fast?".  

On Wednesday, June 13, I had a radical modified mastectomy with sentinel node biopsy and a lymph node dissection.  On Friday, June 15, I was discharged home with 2 Jackson Pratt (JP) drains to drain off fluids.  A visiting nurse came every day to check the amount of fluid that had drained off and make sure I was bandaged properly.  This was all followed by six rounds of aggressive chemotherapy once every three weeks.  I received Adriamycin (the red devil), Cytoxan, and Taxotere.  After about a month's break, they started me on 25 generous daily doses of radiation.  I was left hairless and exhausted, but I was alive.  The cancer was stage 3a.  I had visits with the medical oncologist about every 6 to 9 months.  I started on Tamoxifen on 1/1/2013.  I was on it until September 17, 2020. I'd seen my oncologist, and he wanted me to have a CT scan.  On September 17, I got a call after the CT scan, and it was my oncologist saying, I think we need to talk about this CT scan.  I am now stage four metastatic.

There is a mass on my left chest wall, the 2nd rib with a lytic lesion, my T1 and T12 vertebrae have lytic lesions, a lymph node below where my airway splits into each lung, and a nodule in the right middle lobe of my lung.  What they've biopsied shows it's same cancer I had in 2012. It's ER/PR positive, HER2 Neu negative.  I asked the wonderful interventional radiologist to look back at my previous CT scans to see if they showed metastatic spread.  I remembered reading my reports and seeing that 2nd rib having lytic lesions before.  Sure enough, the CT scan in 2018 and 2019 showed lytic lesions, and I was told they should have picked up on it in 2019 for sure. It was obvious to me that the images showed the 2nd rib had a pathological fracture.  So, I've probably have had stage 4 metastatic as far back as 2018. At least since 2019.  I guess that's why it's called "practicing medicine."  

1 https://breastselfexams.org/ 

2 https://www.cancer.org/content/dam/CRC/PDF/Public/8584.00.pdf

About Bob

After almost 10 years, a gay marriage, and having (male) breast cancer, I have NO privacy left.  I've been poked, prodded, stuck, scanned, and X-rayed over and over again.  I always tell people, "When I got breast cancer, I had to come out of the closet twice.  Once, as a gay male introducing my husband to each of my doctors. Secondly, I had to come out as a man with a "woman’s" disease when I would appear in a pink decorated women’s' imaging center."   I now say, "my closet doesn't even have a door anymore".  We need to add some blue to all the pink, especially in October, for all the men who are living and dying with male breast cancer.  I am now one of those statistics.  I'll be in treatment the rest of my life.  Some people, don't understand what being stage 4 metastatic means.  I wish people wouldn't ask "how much longer do you have to have chemo?", or "It will be okay."   I want them to become educated about it and meet me where I am in my journey. 

Samhita’s Steps Toward Healthy Eating

Written by: Samhita Shirsat

Saturdays are for Salad Lovers!  

Hi everyone! My name is Samhita Shirsat, I’m a rising senior at Brookfield High school, and I am a current intern at Ann’s Place.  I’m honored to be writing about some of my experiences cooking various healthy recipes as part of a new blog series for Ann’s Place. In this series, I will be cooking and reviewing some recipes I have researched that are both nutritious and hopefully delicious for those affected by cancer. This way, you all can decide if it might be something you would like to recreate on your own!  

For my first week, I thought I might start with a meal that was able to combine a lot of amazing and nutrient filled vegetables together—a salad. As I was researching possible options to recreate, I came across this Citrus Quinoa Avocado Salad from the American Institute of Cancer Research and I was immediately intrigued. I love everything avocado related, so I was really interested in trying this one out! *As a side note, for everyone following this blog, feel free to change, add, or remove any ingredients according to specific dietary needs and guidelines * 

My First Step in this process was : Buying My Ingredients  

As I thought about making this recipe, I considered different options for where I could get my ingredients. Although for some ingredients (quinoa, spices, cheese), I had to visit a local supermarket, for most vegetables, I was able to get them at an amazing farmer’s market in Bethel, CT. The address is 67 Stony Hill Road, in case any of you would like to visit.   

I’ve included some pictures I took at the market.  There was such a great variety of produce, and most were locally grown! 

There was even a garden you could visit to see produce growing.  

Overall, this experience was very interesting for me. I normally don’t shop at farmer’s markets, but everyone was extremely friendly and helpful! I highly recommend it as an option to get your produce, because you can know where your food was grown.  

Step 2 in my process was: Gathering my Ingredients 

The ingredients:  

• 1/2 cup cucumber, diced 

• 1 cup cherry tomatoes, cut in half 

• 2 small cloves garlic, minced 

• 1/4 cup red onion, chopped 

• 1 bunch cilantro 

• 2 cups spinach, thinly sliced 

• 1 15.5 oz can no salt added garbanzo beans (drained and rinsed) 

• 1 cup cooked and cooled quinoa 

• 2 medium avocados, diced 

For the dressing: 

• Juice of 2 lemons 

• Zest of 1 lemon 

• 2 tsp. Dijon mustard 

• 1 Tbsp. olive oil 

• 1 tsp. honey 

• 1/2 tsp. ground cumin 

• Dash of cayenne pepper (optional) 

• Salt and pepper, to taste 

As I began to collect these ingredients, I made a couple changes to the original recipe based on some of my own personal tastes and preferences.  I added some radishes for a different vegetable, I swapped out the red onion for a white onion, and I thought that lime would personally taste better on the salad than lemon.  Feel free to make any of these changes to your salad as well or stick to the original recipe if you would prefer their original ingredients! 

Once I decided what I wanted in the salad, I gathered everything on my counter, so that I could begin preparing the recipe.  

I just love how colorful all the ingredients looked before I started making the salad! 

Step 3: Cook my quinoa 

Confession time everyone: I have never actually made quinoa before. Because of this, I had to enlist the help of my mom (resident chef) in order to do it right.  

My mom recommended that to cook quinoa, I should start by rinsing it in water for approximately 30 seconds, and then draining the water.  

The next step was beginning to cook the quinoa, in boiling water for around 10 minutes.  

After this, we let the quinoa cool down for 10 minutes before assembling the salad, so that it wasn’t too hot when it went in.  

All in all, this was an easier-than-expected process for me, and now I’m glad I have learned another cooking skill I can add to my collection :) 

Step 4: Chopping up my vegetables 

As I was waiting for the quinoa to cool down, I began to work on my other ingredients, mainly cutting up my veggies to put in the salad.  I don’t know about you all, but for me, cutting onions always leaves me in tears. So, the onion I used in the recipe, I left in the fridge overnight so that it didn’t cause too many tears...and it worked.  Just a quick tip in case it could make your cooking experience easier! 

Also, cutting with a sharp knife was important for me to be able to cut the vegetables without fear of the knife slipping. It would be important to be careful with the type of knife you choose, so it won’t cause any problems while you are cutting.  

Step 5: Putting it all together 

Ok, here comes the fun part for me. Once I finished cutting up my vegetables, and the quinoa was all cooled down, I got to put the salad together! I got to mix all my delicious and colorful ingredients together, as well as mix together the amazing dressing.  

Step 6: Finished Product  

Here’s what our final salad looked like, and I was so excited because it looked amazing! There was such a diversity in color, vegetables, and food groups too.  I was so proud of myself at the end of this experience, because I was able to create something with a good nutritional content, that I was excited about eating.  

I also have the nutrition information of the salad from the American Institute of Cancer Research to the right.  

I was a very happy chef and taster!  

Final Thoughts 

Overall, this salad was amazing. I truly thought the tomatoes we purchased at the farmer’s market added a great level of freshness and flavor to it. The avocado and lime in the dressing worked great together, and I found myself loving the quinoa for texture.  Personally, I made a little more dressing than the recipe suggested (by adding one more teaspoon of olive oil and honey), because I wanted more of the flavor to come through in the salad, but of course it is up to personal taste.  I’m so glad that I was able to share this first recipe with each one of you, and I’m looking forward to creating more in the future!  

Pride Month at Ann's Place

By Pete Carney, LCSW

Welcome to June, where we celebrate the 52nd anniversary of LGBTQ pride, celebrating the LGBTQ community throughout the month. At Ann’s Place we are taking a renewed look at our work serving the LGBTQ community and making sure that their unique experiences with cancer are met with support and care.

Pride is a commemoration of the 1969 Stonewall riots, where a group of LGBTQ individuals, having faced decades of police brutality and the constant threat of physical violence for the mere act of existing, collectively said “no more!” to the oppressors through a night of civil disobedience in Greenwich Village, NY. This one night served as starting point for the modern LGBTQ movement including Marriage Equality and Transgender Rights.

Today, LGBTQ individuals enjoy greater visibility and acceptance in our larger society, but for many, particularly those in the most vulnerable groups (youth, transgender/gender non-conforming, communities of color), pervasive homophobia/transphobia still exists, too often in their daily lives.

As an openly gay men, for 21 years, I can still remember the fear and uncomfortable feelings of being in a doctor’s office and being asked questions about my personal life, that at one time, I was not able to ask myself, much less discuss with another person.

As time went on and I became more comfortable with my gay identity I found two extremes in healthcare that left me struggling to meet my healthcare needs. On one hand was the healthcare provider, who while comfortable with the word “gay”, would become visibly uncomfortable with any discussion of my sex life and its potential impact on my risk for cancer. On the other hand, was the healthcare provider so focused on my sex life and risk for HIV, that other medical concerns were ignored or minimized to the point that it felt like my only concern as a gay man should be not to contract HIV.

As a gay man, as it relates to my heightened risk for anal cancer, I have needed to do my own research, presenting this info to medical providers, often being met with a lack of knowledge or direction of next steps for minimizing my cancer risk and obtaining early screenings. I have, at times, had to travel long distances, to highly LGBTQ populated areas, to meet with medical providers who regularly treat LGBTQ folks, to get fully informed care as well as certain cancer screenings. As a well-educated, employed, gay, white male I recognize that many in the LGBTQ community do not have the same privilege and opportunity that I have, to gain access to this level of care.

When we at Ann’s Place turn our attention to the LGBTQ community and Cancer, we can see a variety of health disparities that put LGBTQ individuals for higher risk of cancer and poorer treatment outcomes.

In a 2017 national survey of the LGBTQ community, 8% of lesbian, gay, bisexual, and queer individuals and 29% of transgender individuals reported that a doctor had refused to see them because of their sexual orientation or gender identity. In this same survey, 9% of lesbian, gay bisexual, and queer individuals and 21% of transgender individuals reported that a doctor or other healthcare provider used harsh or abusive language when treating them. 23% of transgender respondents reported that a doctor or health care provider intentionally misgendered them or used the wrong name.

These negative experiences can leave LGBTQ individuals untrusting of medical providers, and less likely to access medical care, particularly preventative services.  Additionally, LGBTQ individuals have significantly higher rates of being under insured or uninsured, than their straight and CIS gendered counterparts, limiting their access to healthcare services, including cancer screenings. Too often LGBTQ individuals do not get their cancer diagnosis until they are severely ill and treatment options are limited or ineffective. LGBTQ individuals continue to have higher rates of obesity, smoking and drug/alcohol abuse, all precursors to many common forms of cancer.

Moving form NYC to Putnam County 2 years ago, in many ways I started my “coming out” process all over again, needing to make decisions in each new community encounter, including with medical providers, whether I should disclose my gay identity, and how this disclosure could impact my safety, comfortability and access to the services I may need. So, in celebration of LGBTQ Pride, I ask everyone to take a moment and ask yourself, how well do you and the place where you may work welcome LGBTQ folks into your environment? Do you have a Pride Flag up? Do you have images on your websites, in your workplaces that recognize and celebrate the LGBTQ community? We all can play a part in creating a more inclusive community for everyone! To learn more about the impact of cancer on the LGBTQ community and ways to create more welcoming and inclusive environments, check out these great resources:

National LGBT Cancer Network: https://cancer-network.org/

Queering Cancer: https://queeringcancer.ca/