Laura Linney plays a cancer patient forced to reexamine her priorities in Showtime’s new series.

By Diana Price

What do you truly value? If you were presented with a finite timeline for your life, how would you choose to spend that time? Are there experiences you wish you could rewind or undo? What will you do going forward to ensure that you don’t have any regrets?

If you’re Cathy Jameson, the lead character in Showtime’s new series The Big C, and you’ve been diagnosed with terminal cancer, you build a pool in your backyard. You also decide to eat a lot of onions, teach your teenage son how to plunge a toilet, and order solely from the dessert menu—among other things.

Cancer as Catalyst
The new series, which premiered August 16, takes on a weighty subject while highlighting the humor and the absurdity that is present in our lives even as we face our greatest challenges.

Laura Linney, who appears in the lead role alongside a cast that includes Oliver Platt and Gabourey Sidibe, says that the questions that Cathy confronts during the course of the season are universal and very relevant today—whether or not one is facing a cancer diagnosis. “I think there is a focus now on people reexamining what is important,” Laura says, “a reexamination of priorities: What is acceptable? How do you want to live your life?”

It was these themes that sparked Laura’s interest in the show when she was originally approached with the script, despite the fact that a television role was not on her radar. Having recently received her third Academy Award nomination (in the lead actress category for her role in the box office hit The Savages), Laura had wrapped another feature film (Sympathy for Delicious) and was about to appear on Broadway in Time Stands Still in a role that would garner a Tony Award nomination for Best Leading Actress in a Play. “I wasn’t looking to do a series,” Laura says. “It really hadn’t crossed my mind. And then Showtime stubbornly sent me this script, and I read it and it just intersected with a lot of things I have been thinking about and obsessing about anyway. And I had a moment when I thought, I really need to pay attention to this.”

Proceeding from the idea of cancer as a catalyst, the storyline follows Cathy as she examines the choices that have landed her in the life she now leads. She is someone, Laura says, for whom “life has just become a function—she’s not really living her life.” Now, dealt this brutal blow, she must examine “the kookiness that her life has become and the absurd choices that she’s made along the way that have resulted in what her life has become.” Her marriage, her work, her relationships with family and neighbors—all are put under the microscope. Ultimately, Laura says, the show answers the question: What happens when you have an opportunity to rework all of that?

Especially significant to Laura is the idea—central to the show’s storyline—of highlighting the privilege of growing old. “I have never understood when people say to me, pityingly, ‘Oh, you’re over 40.’ I just find that insane. Insane! Literally cuckoo.” Instead, Laura says, her innate reaction is, “Yay! Hooray! I’m over 40! It’s a privilege to grow old. I don’t know how we have gotten away—particularly in our American cultural view—from that idea. I’m hoping that the show will examine that opinion.”

Professional and Personal Challenge
Laura is also the executive producer of The Big C, and she relishes the opportunity to be involved in the broader production process, beyond her role as an actress. “I can contribute in a way that I haven’t been able to before,” she says, “and it gives me the opportunity to learn about a lot of the production-end things that I don’t know about.”

Laura’s dedication to the project speaks to her obvious work ethic, which has no doubt contributed to her success as an actress on both stage and screen. Her résumé is impressive: television roles that include a 2004 Emmy-winning guest appearance on the long-running series Frasier and an Emmy Award for her role as Abigail Adams on the HBO miniseries John Adams, among many other noteworthy appearances; a film career that includes critically acclaimed roles in Dave, Primal Fear, The Truman Show, You Can Count on Me (for which she was nominated for an Oscar, a Screen Actors Guild Award, a Golden Globe, and an Independent Spirit Award), The Squid and the Whale, and The Nanny Diaries; theater credits that have resulted in a host of awards and three Tony nominations.

The scope of Laura’s work displays the actress’s talent for understanding and conveying a broad range of human experiences. Now, in playing a woman who faces a cancer diagnosis, Laura and her co-stars present not the standard media-ready view of the “typical” one-dimensional cancer experience but rather the many-layered emotional space that cancer creates. Because the reality—which The Big C takes care to acknowledge—is that patients are people first, whose lives are already full and complex when they confront a diagnosis.

In preparing for the role, Laura has drawn from her interest in reexamining her own priorities, from her experience with friends who have dealt with cancer and other illnesses, and from memories of her own childhood, when her mother was a private-duty nurse at Memorial Sloan-Kettering Cancer Center. “[My mom] became very close to many of her patients and their families, and consequently I knew some of them as well,” she says.

With these experiences as background, Laura looks forward to the creative opportunity that this role presents. It is a “delicious challenge” she says, to play such an obviously dramatic role intertwined with “the foibles of life and the comedy of human frailty.” It’s a delicate balance, but one that sheds light on the breadth and the depth of the emotional experience attached to a cancer diagnosis. “We’re exploring a tone that is a little daring and a little off-center—and hopefully enjoyable,” Laura says.

On a personal level, Laura has found that her decision to take part in this project has led her to consider many of life’s big questions herself: What will I do with the time I am given? What do I need to be healthy? To be happy? Her answers, she has found, are actually quite simple: “I’m getting back to the basics. I’m examining how I eat, how I spend my time. I’m exercising and trying to be a little more responsible for my own health and my body, which is something you can really take for granted.”

In addition to paying closer attention to her physical well-being, Laura has realized the value of the activities that stimulate her mentally and emotionally. “I have realized that I need to be around my friends. I need to be around art—I need to go to the theater; I need to go to museums—I need to be stimulated and fed in that way.” Ultimately, Laura says, she is focused on making choices that “make your life meaningful in a way that is not about career or money. It’s about your connection to life and what life means to you.”

The Big Picture
Though cancer provides the framework, Laura hopes that The Big C will bring something to those currently facing a diagnosis while inspiring much larger conversations. “It’s really about more than cancer,” she says. “It’s about what happens to someone who realizes suddenly that they’re not going to be around. How does that make them look at their families, their relationships, their job, their sense of self, what they have contributed to their family, the world, and to their community?”

Her family, her culture, and the inspiration of strong native women—some breast cancer survivors—reminded Jackie of her own strength. Now, having completed her treatment, these same resources have helped her find peace with her prognosis.

“I went into fight mode for nine months, then all of a sudden everything just stopped,” she says. “It was surreal—eerie—and every now and then I ask myself, Did I really go through all that?” Her mantra—I am a strong, healthy woman—helps keep her mind from returning to that sense of dislocation, but she says it takes work. “I try to keep myself from going down that road of insecurity and uncertainty.”

For many breast cancer survivors, the uncertainty of long-term prognosis can be the hardest part of recovery. When treatment ends, often so does the regular interaction with and supervision of the medical team, leaving many women feeling vulnerable.

To be reminded that you have choices, to be supported in those choices, and to hear how other women have managed their cancer diagnosis can be of tremendous help.

Smoothies are a popular choice among busy people looking for a quick, nutritious meal. But often these drinks are loaded with sugar and actually end up being lower in nutritional value than we might think. Think about it—if you throw a bunch of fruit and some juice in the blender, you’re getting a hit of sugar without a lot of substance and it’s not likely to take you all the way to lunch. But a few simple adjustments can help you build a better smoothie—one that’s nutrient dense, satisfying, and energizing.

Choose a Better Base
Instead of making your smoothie with fruit juice or worse, frozen yogurt, try some alternatives that are both delicious and nutritious.

• Almond milk (or any nut milk): You can make your own nut milks or buy them at the grocery store. Nut milks offer protein and other nutrients and create a delicious, creamy base for a smoothie.
• Kefir: Kefir is a creamy, probiotic-filled drink similar to yogurt. It is filled with healthy bacteria and typically contains far less sugar than yogurt. Many people who have difficulty digesting dairy find that they can drink kefir.
• Yogurt: Look for yogurts that are low in sugar. In fact, consider choosing plain, unflavored yogurt since you’ll be adding several delicious ingredients.
• Water: This may sound boring, but depending on what you’ll add to your smoothie, you may just need a little water to reach the right consistency. This is a far healthier option than most juices, which are often loaded with sugar.

Fruit
There is no limit to what you can add to the blender. A banana often helps lend a thicker, creamier consistency to your smoothie. Berries are a popular choice. Think outside the box. Any fruit you like is fair game for a smoothie. Frozen or fresh fruit will work. Consider freezing your own fruit during the peak of the season – there is nothing like pulling out some delicious peaches mid-winter! Some popular smoothie options:

• Berries (strawberries, blueberries, raspberries, blackberries, and more)
• Peaches
• Mangoes
• Papaya
• Kiwi

Vegetables
A smoothie may not seem like the proper vehicle for vegetables, but you’d be surprised! If you find it hard to get your servings of greens, consider throwing them in the blender. A handful of spinach might change the color of your smoothie, but it really won’t alter the taste at all. This is an easy way to reap the benefits of dark, leafy greens without having to sit down and chew through a salad. Options include:

• Romaine
• Spinach
• Chard
• Celery

Boosters
There are many things you can add to your smoothie that won’t alter the taste, but will increase the nutritional value of the drink. Consider one or more of the following:

• Flaxseed: Flaxseeds contain rich healthy fatty acids (omega-3, omega-6, and omega-9) that are essential to the human body. They also provide soluble fiber and are high in lignans, which are hormone-like substances that are known to balance hormone levels in the body. Add freshly ground flaxseed or flaxseed oil to your smoothie for a dash of healthy, essential fat.
• Wheat Germ: Wheat germ is a good source of fiber and a concentrated source of several essential nutrients including vitamin E and folic acid. Just two tablespoons will provide 20 percent of the daily requirement of vitamin E and folic acid.
• Maca: Maca is a powdered supplement derived from the Peruvian maca root. It contains amino acids, B vitamins, and several minerals. It is considered an “adaptogen” and is excellent for balancing hormones. Maca does have a strong taste, so it is best used in smoothies with plenty of banana or other strong flavors.
• Hemp Protein: Hemp protein powder is derived from hemp seeds and has a 45 percent protein content. Hemp protein is high in omega-3 fatty acids. It has no saturated fats or cholesterol and is safe for diabetics and hypoglycemics.
• Raw Cacao Powder: Face it, sometimes you’re looking for something that tastes like a milkshake, but still provides a dose of nutrients. Raw cacao powder is high in magnesium and antioxidants—and it’s delicious. You can find it in most health food stores. It is unsweetened, so if you use it in a smoothie, you may want to include a sweetener such as agave nectar or honey.

A smoothie can be a quick, simple, nutrient-dense meal if you add the right ingredients. Get creative and find the blend that works for you. Below are a few delicious recipes. Cheers!

Green Dream:
Banana
2 kiwis
1 stalk of celery
Handful of spinach
Water

Ginger Warm-up:
Banana
Raspberries (fresh or frozen)
Handful of chard (or spinach or romaine)
Fresh ginger
Water

Almond-Chocolate Charge-Up:

• Almond milk
• Banana
• 1 tablespoon hemp protein
• 1 tablespoon raw cacao powder
• 1 tablespoon agave syrup
• 1 tablespoon maca powder
• 1 tablespoon ground flaxseeds

When Hollywood producer Laura Ziskin was diagnosed with breast cancer she did what comes naturally—she started solving the problem.

By Diana Price

Laura Ziskin is not a superhero. I don’t think. She does not leap tall buildings in a single bound; she does not live in a cave or drive a crazy, futuristic car. As far as I know, she has no metal body armor. And though I interviewed her by phone, I’m pretty confident that she was not wearing a shiny Lycra bodysuit when we spoke. Still, she may have more in common with one particular masked crusader than first meets the eye.

In the blockbuster 2002 film Spider-Man, the story’s hero, Peter Parker (aka Spider-Man), says, “Not everyone is meant to make a difference. But for me, the choice to lead an ordinary life is no longer an option.” Like Peter, Laura, who produced Spider-Man (and its sequel, Spider-Man 2), knows what it means to have your life unexpectedly turned upside down and your priorities reconfigured. And though in Laura’s case the catalyst was a cancer diagnosis—not a radioactive spider—there is no doubt that she too was meant to make a difference.

Living with Cancer
As a Hollywood producer with a long list of film and television credits—including Pretty Woman, As Good as It Gets, and the Academy Awards—Laura was diagnosed with advanced breast cancer in 2004.

She had undergone repeated mammograms over several years, and though the tests did not reveal any issues and her gynecologist continually assured her nothing was wrong, she had a consistent feeling that there was a problem. “I kept going in and being told that I was okay,” Laura says, “and because I wanted to be okay, I believed it.” But when she noticed an indentation on her breast, she insisted on further testing. The result: a series of biopsies confirming a 10-centimeter tumor. Further testing revealed 30 malignant lymph nodes.

Chemotherapy, an autologous stem-cell transplant, radiation, a mastectomy, and reconstruction followed her diagnosis. For three years her tumor markers were stable, until they slowly started to rise again. About a year ago, Laura was diagnosed with metastases to her liver. She chose to participate in a clinical trial, which again stayed the progression of the disease. In March of this year, the markers again started to rise, sending her on a search for a new treatment plan.

And yet what comes across most clearly when hearing Laura speak about her treatment and her current prognosis is not the challenge of the past six years but rather her single-minded determination to keep moving forward: she is living with cancer, not dying from cancer, and her attitude is at once pragmatic and hopeful. “My treatment is a part of my life,” Laura says. “When I’m feeling good physically, it’s much easier. When a treatment makes me feel bad, that’s much harder. I live with it, and I don’t like it, and it’s scary, but it’s a part of my life, and I’m okay.”

Open communication with her doctor, who has worked with her to maintain the best possible quality of life throughout, has been incredibly helpful. “I have an absolutely extraordinary doctor,” Laura says. “When I met my doctor, I told my husband, ‘Well, he’s my doctor because he looks at me like I’m going to live; and if he believes in me, I have more belief in myself.’” Bolstered by this productive relationship and by the love of her family and friends, Laura continues to focus on living well with cancer.

Making a Difference
Also an integral part of Laura’s life with cancer has been her commitment to advocacy. Following her diagnosis and initial treatment, Laura was galvanized by what she saw as a common misperception about the state of cancer research: “In 2006 I was in remission, and I wanted to do something about cancer—the state of cancer. Most of us, when we’re diagnosed, don’t know what a huge epidemic it is. And we think, Aren’t we doing much better than we were a decade ago? And it turns out that we’re not.” For Laura this state of affairs was unacceptable; and because it’s what she does best, she got busy solving the problem.

Her initial plan was to produce what she calls a “we better wake up” documentary. At the same time, it became clear that there were others involved in the entertainment industry with a similar desire to make a real impact in the fight against cancer. In 2007, the group, which includes Katie Couric and two representatives of the Entertainment Industry Foundation (EIF): CEO Lisa Paulsen and SVP Kathleen Lobb (EIF is the non-profit with whom Couric co-founded the National Colorectal Cancer Research Alliance); Sue Schwartz and Rusty Robertson, co-founders of the Robertson Schwartz Agency; Noreen Fraser, television producer and founder with her husband, Woody, of the Noreen Fraser Foundation; philanthropy executive Ellen Ziffren; and Sherry Lansing, former CEO of Paramount Pictures and founder of the Sherry Lansing Foundation, came together to create Stand Up to Cancer (SU2C), a grass roots movement aimed at accelerating cancer research and raising public awareness.

The powerhouse organization quickly proved its commitment to the cause—and its collective clout—by producing a groundbreaking “roadblock” telecast in September 2008, which aired on ABC, NBC, and CBS; reached viewers in 170 countries; and raised more than $100 million. But in planning the event, Laura says, the group had quickly realized that raising the money was not the end of the road. The real question was How will this money have the biggest impact?

The answer, they agreed, lay in funding translational research—research that quickly progressed from the bench (or laboratory) to the patient’s bedside. To make this model effective, the co-founders worked with a scientific advisory board to identify “Dream Teams,” or collaborative working groups, drawing from research talent across institutions and disciplines, that would focus on very specific problems in cancer. To ensure that the teams move at an accelerated pace, Laura says, they operate “under the mandate that the replenishment of their research funds is dependent on their meeting milestones and getting real therapies to patients in three years.”

Now, almost two years later, those Dream Teams are actively engaged in translational research, and SU2C has plans for another major event (see sidebar). In addition, the organization remains focused on another important aspect of its work: raising awareness about the impact of the disease and uniting survivors under the banner of cancer advocacy. “We need to be united,” Laura says. “And we have to be noisy, demanding, and mad as hell.”

Who Needs a Shiny Suit?
Those who know Laura are inspired by her relentless approach to advocacy and her personal strength in the face of her diagnosis. “Laura is the greatest female inspiration I have ever had in my life,” says Rusty Robertson, co-founder of SU2C and a friend of Laura’s. This intense personal connection combined with Laura’s ongoing battle with the disease continually drives home the relevancy of their shared mission and creates a labor of love: “She is fighting for her life,” Rusty says, “and I hope I am going to be able to be a big part of saving her life.” Between her own passion and her connection with Laura, Rusty finds no room for fear or doubt as they push ahead: “I have a personal inspiration to pick up the phone and call anyone , anywhere to convince them to be a part of our movement,” Rusty says. “Laura has made no mountain too high; I have no fear that we will not succeed.”

Sue Schwartz, co-founder with Laura of SU2C, says, “Laura motivates me, inspires me, and astounds me every day with her vision, her brilliance, and her can-do attitude.” As the “heart and soul of SU2C,” Sue says, “there has never been a time when Laura has said it can’t be done. Rather, she dreams big and attacks every challenge with intelligence, imagination, perseverance, energy, and a work ethic second to none.”

The work ethic and the energy that Sue describes have made it impossible for Laura to remain on the sidelines in her own—and the larger—fight for a cure. “For me it’s therapeutic because I’m a problem solver by nature; that’s my profession. If I were to sit here and wait for someone to fix me, I wouldn’t believe it’s going to happen. I have to take an active role in it.”

Laura’s active—and transformative—role in cancer advocacy and research efforts has changed the way we think about treatment and activism. And she’s not ready to slow down. She has a few more important items on her to-do list. First-up: “make everyone diagnosed with cancer a survivor.” And she’s not willing to settle for less. As she continues to recruit celebrities and friends, works to raise funds, and challenges the research community to step up, she has a simple message: “When I call people, I say, ‘We’re trying to cure cancer; and it’s not a joke. It’s for real.’”

Confronted with the challenge that cancer presented, it’s clear that, in Laura’s case, leading an ordinary life was no longer an option. So maybe when we talk about superheroes, we need to learn to think outside the box and adjust the criteria. Because who needs a shiny suit when you have a will of steel and a pocketful of can-do?

Tune in to Stand Up!
On September 5, 2008, the original SU2C telecast aired on ABC, NBC, and CBS, reaching viewers in 170 countries. The historic, star-studded event included more than 100 celebrities, survivors, caregivers, and leaders in cancer research, who joined forces to raise more than $100 million toward accelerated cancer research.

Now SU2C is ready to do it all again. On September 10, 2010, the organization will produce a second simultaneous telecast across major networks and cable channels. With an even broader reach than the 2008 event, organizers say the show will include increased celebrity participation and more music, building on the tremendous support garnered over the past two years. For anyone touched by cancer—and that’s all of us—this will once again be must-see TV.

By Mia James

Protecting your skin daily with sunscreen may sound simple enough, but when it comes to deciphering labels and choosing the most effective products available, you may start wishing you’d paid more attention in chemistry class. As you scan the tiny print of long, alien words, which ones do you want to find in the sunscreen you’re using, and what do the various ratings mean? Debra Wattenberg, MD, a New York City dermatologist whose specialties include prevention and early detection of skin cancer, explains what sun protection factor (SPF) numbers mean for consumers.

“There are three types of ultraviolet rays: UVA, UVB, and UVC. The SPF rating measures the protection a sunscreen offers against UVB rays, the ultraviolet radiation that causes sunburn,” Dr. Wattenberg says. The number—be it 15, 30, or 70—is a comparison of how long it takes unprotected skin to become red versus skin that is protected.
The Skin Cancer Foundation (www.skincancer.org) puts it this way: “If it takes 20 minutes for your unprotected skin to start turning red, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer—about five hours.” Practically speaking, to achieve the maximum benefit, sunscreen needs to be reapplied every two hours, and no sunscreen will block all UV rays. Also, judging your sun-safety by whether or not you turn red is not an accurate measurement, as the red hue of your skin is a reaction to only UVB rays and does not reflect the damage of UVA rays.

Given this background, what guidelines should we follow? Dr. Wattenberg says that while an SPF of 15 or higher is considered acceptable UVB protection, she recommends using a higher number, as most people do not apply enough sunscreen (or as much as testers in large-scale studies have applied). Currently, she says, there is no approved UVA measurement.

She also reminds us of the importance of using sun protection on a daily basis: “Sunscreens should be used by everyone, every day. They should be applied at least 30 minutes prior to going outside, and they should be reapplied after swimming or heavy sweating.”

It goes without saying that the best defense is, of course, to stay out of the sun if possible. “Sun protection shouldn’t stop with sunscreen,” Dr. Wattenberg says. It is important to physically block the sun from your skin.” Suiting up in long pants, long-sleeved shirts (ideally with collars that can be turned up to protect your neck), and accessories like wide-brimmed hats and UV-protective sunglasses will limit direct sun exposure while you enjoy your time outdoors.

Choose sunscreens that contain the following ingredients:

• UVA blockers
• UVB blockers
• A combination UVA and UVB sunscreens
• Mexoryl® (ecamsule)
• Avobenzene
• Oxybenzone
• Octocylene
• Physical blockers such as zinc oxide and titanium oxide

By Jen Miller

In 2007, Jen Singer was on a roll. Having taken a leap and quit her pharmaceutical advertising job, she was making a living as a freelance writer. Her funny, popular, award-winning Web site, www.mommasaid.net, was gaining an ever-widening audience; she was finishing work on a parenting book and had just signed a three-book contract to write a parenting series; she was serving as a spokesperson for Huggies® Pull-Ups®; and she had recently committed to contributing a column to Goodhousekeeping.com about parenting tweens, based on her experience raising her sons, now 13 and 11.

But she hadn’t been feeling well. Jen, who played soccer in college, was feeling rundown and had a constant cough. And, strangely, her shirts seemed to be getting tighter. What was going on? “Every symptom I had was poo-pooed as the ‘end-of-life change’ or as the whole menopause thing,” says Jen, now 43.

Then, six weeks after inking the book deal, doctors gave her an answer: Jen was diagnosed with aggressive Stage III B-cell non-Hodgkin’s lymphoma. A tumor the size of a softball was lodged in her lungs and had started to wrap around her heart.

Writing Through It
Jen started chemotherapy immediately, but she didn’t stop writing. “It was the only thing I could control,” she says, sipping tea in the living room of her Kinnelon, New Jersey, home on a steel-gray winter day. “Writing was a safe land I could go to, where everything was the same as before I got cancer.”

There were times when she fell asleep with the computer humming in her lap, but she was generally able to write pretty consistently. Jen’s brother had lent her his laptop so that she could finish You’re a Good Mom, and Your Kids Aren’t So Bad Either, the parenting book she had begun before her diagnosis; the book was published in 2008, while Jen was in the hospital.

Though the book didn’t include anything about cancer, Jen’s online work did. She’d pre-written a few Goodhousekeeping.com columns prior to her diagnosis, but she didn’t know how to continue writing about parenting tweens as she went through treatment without cluing her readers in. Luckily, her employer was flexible: “They gave me wide latitude,” she says. “It was about kids, cancer, and construction.”

Jan didn’t shy away from writing about cancer on www.mommasaid.net either. Her entries maintained the same kind of honesty she’d always shared with her readers since launching the site in 2003. “I wrote in real time, about what do you say to a mom who has cancer,” Jen says. And she maintained the site’s signature humor too: her wacky wig contest asked readers to pick—from choices that included a Mohawk—which wig she’d wear once she lost her hair.

Community Comes Through
The refuge that Jen’s writing life provided was a welcome distraction from a period that at times verged on bedlam. In addition to managing the challenges of diagnosis and treatment along with the standard chaos of her writing career and a young family’s busy home, the Singer family was in the middle of a house addition that included a new living room and an office space for Jen.

With the help of her extended family and their community, Jen and her husband, Pete, managed to hold it all together through her six rounds of chemotherapy (two that included hospital stays) and two months of radiation treatments. “People were cooking for us and taking the kids to swim meets,” Jen says. She rarely had to ask for help outside of her immediate family; it was presented to her. Casseroles were dropped off on the porch, friends helped with the kids, and support flowed in.

The Road Ahead
Jen was declared in remission on January 3, 2008, and she has had seven clear PET (positron emission tomography) scans since. She feels well, works with a personal trainer, and is back to doing things she loves, like skiing, though she doesn’t go quite as hard as she used to.

She’s nevertheless careful when she discusses her prognosis: “I don’t want to anger the cancer gods,” she says, acknowledging the ambiguity of her post-cancer life. “If I’m cured, why do I have to get PET scans, and why can’t I give blood?”

But clearly shining through Jen’s remaining anxiety is her sense of gratitude. To celebrate two years of clear PET scans, she threw a party and raised funds for the New Jersey chapter of the Leukemia & Lymphoma Society, which included performances from the Sugar Hill Gang, her cousins’ band the Flying Mueller Brothers, and a bongo performance by her mother. “It was a way of saying thank you to everyone who helped us, who cooked for us, and who drove our kids around. It was a very grand way of saying to my children that we’ve moved to a different stage of our lives,” she says.

This new stage continues to include a busy writing career. The two final books in Jen’s three-book series, which she finished while undergoing radiation, were published in 2009 and 2010, and she continues her work with www.mommasaid.net and Huggies Pull-Ups.

Despite the return to “normal life,” Jen acknowledges that her family will never be the same. Her kids grew up early by almost losing their mom, she says, and it’s not easy to look beyond the next PET scan. “The cancer was very hard on them,” she says of her sons. “Their mother, who was the center of their universe, almost died.”

In fact, her kids’ experience and her own as a parent with cancer has fueled her next project, a memoir tentatively titled If Cancer Is a Gift, Where Can I Return It?, which focuses on parenting during cancer and addresses a lot of questions she had while in treatment: How do you tell kids that a parent has cancer? How do you continue to be the parent you want to be? During her own journey, Jen couldn’t find anything to read that addressed those issues. Everything related to parenting and cancer was about having a child with cancer, she says, not the other way around.

This and her other projects keep Jen’s writing life busy as she looks ahead. But there has been one significant change: she is no longer stuck working in the corner of her basement. The office that the family added on while she underwent cancer treatment is complete, and she now “goes to work” in the new space, with a wide desk, floor-to-ceiling windows, and—her favorite feature—a door with a lock; and it all overlooks the backyard, where her sons can see her working while they play.

By Denise King Gillingham, MSW

So maybe life has thrown you a few challenges. Maybe you are facing a cancer diagnosis or that of a loved one. Maybe it’s a career challenge or a financial hurdle that has sent you reeling. Life may feel out of control. But here’s the good news: there is still time to live a great life. Though you didn’t choose to encounter this particular detour, you do have a choice in how you handle the emotions that result.

By training yourself to alter unhealthy mental and emotional attitudes—by taking control of your emotions and reactions—you can function better and improve your health. Ready to start training and regain some control in your life? Here is a three-step self-regulation exercise that may help.

Identify, Impact, and Reframe

Step 1: Identify
Identify the emotion or feeling you are experiencing. Name it! Sometimes it is very clear and pops right out. At other times this might take a bit more work. If you are having difficulty describing what you are experiencing, it might be helpful to jot down words that come to mind. Are you angry? Sad? Confused? Overwhelmed?

It may also be helpful to write about the situation. Journaling can help you better understand your feelings. Often when you express a feeling in an appropriate way, you feel better. All feelings, positive and negative, are legitimate and deserve to be expressed. The key to this process is to understand the feeling so that you can express it in a way that is beneficial to you.

Step 2: Impact
Consider the impact of the emotion you have just identified. Try to step back and look at the situation objectively. You may ask how your response benefits you or your relationship with others. Is this how you want to be in the world? What are some other ways you might have responded? What different outcomes would those responses have created?

To get a sense of the impact of your emotions, consider this hypothetical situation: You invite a new neighbor to lunch at your house. She does not eat anything. You can react in different ways. One reaction might be I worked so hard, and she is not eating. I am offended. Your reaction will come through and will most likely have a negative impact on your developing relationship. Another reaction might be I wonder if she is not eating because she is nervous or shy. In this example, you are reacting empathically, which will likely have a more positive impact on your relationship. Which impact do you choose to have? Remember, you have control of how you react!

Step 3: Reframe
Now reframe the emotion. This is where you try on different possibilities and perspectives about the event. If you were having a picture framed, you might go into a frame shop and see how the picture looks with several different frames around it. Do this with your situation. Ask yourself how another person might view the circumstances. How would a close friend or partner view what is happening? How might you react to the same situation in six months? Think of all the possibilities.

In a moment of heightened emotion, it may seem like there is only one way to see a situation. Like the facets of a diamond, every circumstance has many perspectives. One way to have a quick shift in perspective is to change your geography. If you are sitting and thinking about something, stand up and walk across the room. If you are inside, go outside. A physical shift can often trigger a shift in mental perspective. Our perspectives influence our reactions. A change in perspective—reframing your emotion—can help you react differently to a situation.

While many things in your life are beyond your control or choice, right now you do have control and power. This is a challenging time, but it is also filled with possibility. Your life will never be what it was before cancer. You may be angry and grieving for your old life. Go through the process—but also remember that this is your opportunity to reinvent yourself. Think about who you are, who you want to be, and the impact you want to have on the world. This is your time! Claim your power!

Denise King Gillingham, MSW, is a cancer survivor and a co-active coach who specializes in helping people navigate change and realizing their magnificence. Her international practice includes clients from all areas of life, including executives, cancer patients, artists, ex-patriots, and housewives. Denise received her MSW from Columbia University and has been a mental health professional for more than 15 years. She shifted her focus from therapy to coaching in 2006. Professional experience includes private practice in Prague, Czech Republic; crisis intervention with New York University; in-patient therapy at Payne Whitney Clinic in New York City; and substance abuse counseling at Bronx VA in New York City. Denise also served as a certified associate and an outplacement consultant with Lee Hecht Harrison, Inc. She conducts workshops on emotional intelligence in the United States and Europe.

By Carolyn Katzin, MS, CNS, MNT

Every day we are bombarded with messages about our food. With so many foods labeled “cholesterol free,” it can be easy to assume that cholesterol is a bad thing. But the truth is that although there is no dietary requirement for cholesterol, this complex fatty substance is vital to our health.

What Is Cholesterol?
Cholesterol is a soft, waxy substance found in the bloodstream and in each cell of your body. It is an important structural component of human and animal cells and serves as a building block for many hormones.

There are two general sources of cholesterol¬¬: your body and your food. The liver and other cells in the body produce about 75 percent of the cholesterol that circulates in the bloodstream. The remaining 25 percent is a result of the food you eat.

Cholesterol is essential to life, but, as with anything, too much of a good thing can be bad. Hypercholesterolemia is a medical term that refers to high levels of cholesterol in the blood. The condition is associated with a higher risk of cardiovascular disease and stroke. According to the Centers for Disease Control and Prevention, one in six Americans has high blood cholesterol.

Sometimes people refer to “good” cholesterol and “bad” cholesterol. Low-density lipoproteins, or LDLs, are the “bad” cholesterol that can build up and form plaque that blocks arteries and potentially leads to heart attack or stroke. High-density lipoproteins (HDLs), on the other hand, appear to protect against heart attacks by carrying cholesterol away from the arteries and back to the liver.

What Causes High Cholesterol?
Cholesterol levels are maintained by a number of regulated steps and to a large extent are genetically predetermined. Several lifestyle factors can affect cholesterol levels, however, including diet, obesity, and smoking.

Being overweight or obese can raise blood cholesterol levels, so losing as little as 10 percent of total weight, or 10 to 20 pounds, is often enough to lower the levels into a range that is associated with a reduced risk of heart disease. Tobacco and high blood pressure also raise blood cholesterol levels, so quitting smoking will make a big difference (for a number of health concerns). Type 2 diabetes is an additional risk factor.

When you put all of these risk factors together, the risk of heart disease is elevated six times.

Diet and Cholesterol
Foods that are naturally rich in cholesterol include egg yolks and organ meats. In the United States, most of the cholesterol in our diet comes from meat—especially processed meats, which include organ meats. For many people simply reducing the amount of meat, whole eggs, and dairy products in their diet is enough to bring cholesterol levels into a healthy range.

The National Cholesterol Education Program recommends consuming a diet that contains less than 200 milligrams of cholesterol per day. To put that number in perspective, a large egg yolk has 212 milligrams, so eating an egg each day would exceed this limit. We don’t need to assess day by day, however, but can take an average amount within our usual eating pattern. For example, using this method, eating a couple of eggs twice a week would be within the recommended limit. Of course, if you are eating other food sources of cholesterol, such as meat, you would need to be more careful of your intake of egg yolks. Egg whites have no cholesterol and are an excellent choice for extending eggs in omelets and other breakfast dishes.

Saturated fats, especially those that come from dairy and meat sources, also raise blood cholesterol levels. Saturated fats are described as “solid fat” in newer government guidelines because they are solid at room temperature. The recommended amount depend on a person’s activity level. A very active teenage boy might consume 3,200 calories, with 20 percent coming from extra discretionary calories, but a sedentary woman who burns 1,600 calories a day would have a smaller allowance of 8 percent of “extras.”

Making Healthy Choices
There are three major diet regulators of healthy blood cholesterol levels.

1. Avoid saturated fat. Eating a diet that is low in meat and saturated animal fats (processed meats like sausage and full-fat dairy products, for example) appears to regulate liver production of cholesterol and is more important in some people than in others. Interestingly, the liver is capable of making as much as 80 percent of your cholesterol requirements, so we don’t actually need to consume it in the diet. This is why vegans who don’t consume any cholesterol usually don’t suffer from cholesterol deficiency.

2. Consume dietary fiber. Foods such as vegetables, beans, and fruit contain indigestible carbohydrates called dietary fiber. Fiber helps modify the intestinal environment, providing support for beneficial microorganisms (probiotics), and it appears to benefit overall health. Nuts like almonds or pistachios, which are high in fiber, may be helpful in lowering cholesterol levels by providing dietary fiber as well as healthy oils.

3. Consume plant sterols. Plant sterols, or phytosterols, are the plant version of cholesterol. These compounds, which are found in beans, vegetables, and many other plant foods, appear to compete for cholesterol in the small intestine and thus reduce the overall blood levels.

Taking Care of Your Cholesterol Levels
Cholesterol is a complicated and active area of nutrition research. Diet appears to affect some people more than others. For most of us, eating a diet that is made up of predominantly plant rather than animal fats is healthy for our hearts and could reduce the risk of other chronic conditions, including many forms of cancer.

Questions to Ask Your Doctor

• What is my risk of heart disease?
• What is my blood pressure? What does it mean for me, and what do I need to do about it?
• What are my cholesterol numbers? [These include total cholesterol, LDL, HDL, and triglycerides—a type of fat found in the blood and in food.] What do they mean for me, and what do I need to do about them?
• What are my body mass index and waist measurement? Do they mean that I need to lose weight for my health?
• What is my blood sugar level, and does it mean that I’m at risk for diabetes? If so, what do I need to do about it?
• What other screening tests do I need to help protect my heart?
• What can you do to help me quit smoking?
• How much physical activity do I need to help protect my heart?
• What’s a heart-healthy eating plan for me? How can I tell if I’m having a heart attack? If I think I’m having one, what should I do?

Sources:

Your Guide to a Healthy Heart. National Heart, Lung, and Blood Institute Web site. Available at: http://www.nhlbi.nih.gov/health/public/heart/other/your_guide/healthyheart_fs.pdf. Accessed March 29, 2010.

Links and Further Reading

a Womans Health Cholesterol

Centers for Disease Control and Prevention

National Heart, Lung, and Blood Institute
The NHLBI provides information and publications about heart disease and heart health.

U.S. Department of Agriculture
The USDA Web site provides quick access to total calories, main food group (grains, vegetables, fruits, milk, or meat and beans), and “extras” (solid fats, alcohol, and added sugars, or SoFAAS). This site also provides comparisons between foods.

MyPyramid.gov
This is the USDA Web site linked to the dietary guidelines for Americans; it provides tools to personalize recommendations for you and your family.

By Paulette Lambert, RD, CDE
Director of Nutrition, California Health & Longevity Institute

The origins of our diet can be found through a study of human history. Looking back as far as our hunter-gatherer ancestors, people consumed very simple foods: plants, animals, and minerals. This diet of whole foods continued until the mid–twentieth century, when we moved from a largely farm-based food supply to a more commercialized system. As a result, our modern diet is a stark contrast to what humans have historically eaten. Today our complex, industrialized, and often highly toxic food system produces foodlike items that your grandmother would not recognize as food. Consumption of these foodlike items is sometimes referred to as the “Western diet.”

Science now tells us that consumption of a Western diet composed of highly processed food causes most of the diseases that are prevalent in our population today. Michael Pollan, author of In Defense of Food: An Eater’s Manifesto and a new book, Food Rules: An Eater’s Manual, for years has touted a mantra for healthy eating: “Eat food, not too much, mostly plants.” With obesity, chronic heart disease, diabetes, and cancer rates at all-time highs, it’s high time we evaluate the way we eat and change it through the practice of sustainable eating.

What Is Sustainable Eating?
Sustainable eating is defined as consuming food that is healthy for the body and the environment. In addition, it is humane for workers and respectful of animals, provides fair wages to farmers, and supports agricultural communities. In many ways it is the antithesis of the Western diet.

Sustainable eating is directly tied to our health. The main component of sustainable eating is consuming a plant-based diet, one in which plant material makes up the majority of the volume of food on the plate. With a high level of antioxidants, plants protect our bodies from oxidative stress, which damages cells, later causing diseases. A plant-based diet not only assists your body with its elaborate natural defense system aimed at minimizing damage from environmental toxins but also decreases your carbon footprint. In addition, eating food grown in a sustainable way reduces the potential consequences of pesticide contamination.

Eating foods that are grown locally is an important aspect of sustainable eating. Local produce varieties tend to be chosen for flavor and nutrition over shipping ability and are often in the market within 24 to 48 hours after harvest. In contrast, imported produce is picked before it is fully ripe and before nutrient content is completely developed. Therefore it can lose more of its nutrient value in the long travel time to your market. Finally, eating a sustainable, plant-based diet has a positive impact on biodiversity, climate change, and the water supply.

Reconnecting to food through sustainable eating can be a revolution against a broken, industrialized food system that has made us and the planet sick. Changing your eating behavior, even partially, will have a great impact on your health and the environment.

To help you begin this lifestyle journey, here are some easy, helpful strategies:

• Eat seven to 10 servings of fruits and vegetables per day (choose in-season, locally grown ones).
• Buy organic—especially meat, poultry, and dairy products.
• Shop at local growers’ markets.
• Use frozen fruit and vegetables to substitute for out-of-season produce.
• Eat less animal protein: 6 to 8 ounces per day for women and 8 to 10 ounces per day for men.
• Increase vegetarian food choices (more beans, lentils, nuts, and soy).
• Drink filtered tap water instead of bottled water.
• Join a community-supported agriculture (CSA) group for fresh, local produce delivered to your door.
• Use fewer processed grains: choose whole oats instead of packaged cereals, and eat whole grains like faro instead of processed and refined starches.
• Buy real, whole foods with less packaging.
• Eat sustainable, wild fish and seafood.

By Laurie Wertich

“Some people say that cancer is a tap on the shoulder. I call it a cosmic two-by-four whack on the head,” says Ruthann Saphier, who just finished treatment for uterine papillary serous carcinoma at M. D. Anderson Cancer Center in Houston, Texas. “It’s a big wake-up call.”

Ruthann echoes the sentiments of many cancer patients and survivors—that when that wake-up call comes, everything changes. It’s overwhelming, frightening, and lonely. When everything is turned upside down, where do you turn to find peace?

Find an Anchor
Cancer is hardly a peaceful experience. A diagnosis can knock even the most centered person off balance. Facing cancer also means facing uncertainty and our own fear of mortality, not to mention the physical challenges of treatment as well as the stress and the financial strain of the experience.

Cancer inevitably forces people to look around for an anchor to grab hold of. “Some people really do dig down and see this thing as a spiritual path, as a spiritual journey, not just a physical or medical thing,” explains the Reverend Tom Duncan, the clinical chaplain at the University of Wisconsin Cancer Center at Riverview.

Some people find comfort in traditional religion, whereas others seek solace in nature or nontraditional spiritual practices. The path you choose, or its attendant label, is irrelevant; what matters is finding a way to stay centered amid the swirling chaos of a cancer diagnosis.

Jackie Rittenhouse is an almost five-year survivor of breast cancer, a marriage and family therapist, and the wife of a pastor. She says that her psychology training and cognitive work were helpful in coping with her cancer diagnosis, but she also points out, “Psychology has limits. It has no answers for life and death.”

Jackie knows that her faith played a strong role in her journey with cancer. She said it was important to relinquish or surrender control that she didn’t have in the first place. “When I’d get to that point where I thought I couldn’t do it anymore, I’d say ‘Okay, God, that’s not my job. I’m doing my job. I’m going to give that to you,’” Jackie explains. And because of this, she saw “God’s fingerprints” throughout the experience. “Cancer is isolating,” she says. “No one else is in your body. No one else knows your fear. Only God gets that. I experienced God’s presence emotionally more than I ever have.”

Daily Practice
For many patients, treatment and all the related appointments and details create a singular focus—life starts to feel like it’s all cancer, all the time. Having some sort of daily practice can be one way to detach from the cancer experience and come back to center. For example, Ruthann meditated daily, and Jackie prayed and studied her Bible. Other people might find peace through music, art, yoga, or spending time in nature. The intention behind the practice is what matters—it’s a deliberate way to stop and carve out quiet time to keep stress and fear at bay.

“The morning was my hardest time,” Jackie says. “I’d wake up and realize I still have cancer. I’m still fighting this. I still have no hair. I still hurt all over. And so every day I would read my Bible and give it to the Lord again.” She believes that centering herself in the word of the Bible every morning is what helped her through each day.

Ruthann relied upon visualization, meditation, and positive thinking. “Some days I felt so crappy that I couldn’t even meditate, but as soon as I felt well, I would do it,” she says. “You have to remember every day to connect to Spirit.” In some of her darkest moments, she would coach herself either by verbally telling herself, “You’re strong; you’re going to make it through,” or by leaving herself sticky notes that said things like, “Go for a walk—you always feel better afterward.”

She also focused on gratitude and joy. “I counted my blessings daily, and I was always looking for joy,” Ruthann says. “I looked for joy every day, and I found it.” This joy was available to her in being with her grandchildren or taking a walk along a stretch where she knew there were the most beautiful flowers.

A Foundation of Support
All cancer patients describe the overwhelming loneliness of the disease and insist that finding support among friends and loved ones is critical in finding that sense of peace that can seem illusive. Reverend Duncan says that on the journey of life we sometimes end up on paths we had no intention of taking. He lost his first wife to cancer, and he knows what a lonely journey cancer can be. “The paths we take are always wide enough for friends to come along,” he says. “We don’t have to walk the road by ourselves.”

Jackie recounts what a difference her circle of friends made. She received cards, phone calls, meals, and even housecleaning help. All these things relieved her loneliness and suffering. Ruthann describes how helpful it was to be near her son and his family.

Think of Others
We all need the support of loved ones, but sometimes we benefit just as much by offering support in return. “It seems to me that patients who continue to look outside of themselves do better than those who close down and focus on their illness or their own situation,” Reverend Duncan says. “If one can continue to give out to other people, you just don’t think about yourself quite as much.”

Jackie recounts her experience with radiation, which lasted 15 minutes every day for six weeks. It was a vulnerable and lonely time for her, but she used that time to pray for her friends and their specific needs. “Radiation lasted about 15 minutes, and before I could blink it was over,” she said. “I used that to kind of get my eyes off myself and instead pray for them because you’re absolutely immobile and can’t do anything, so that was a really helpful thing for me.”

When she was having a particularly bad day, Ruthann received a special pillow from a stranger at the hospital. The woman told her to simply pass it on to someone else when she was ready. Ruthann describes the great joy she felt when she finished treatment and gave the pillow to another patient who needed it.

This Too Shall Pass
Cancer is an unplanned journey that can shake us to our core. It’s easy to succumb to the fear and the stress that come with a cancer diagnosis—but it takes discipline to stay centered and calm and remind ourselves that this too shall pass.

“We have to remember that it isn’t just the uncomfortable things that will pass,” Ruthann urges. “Wonderful things will pass, too, so we’d better appreciate them right now.”

Finding Center
There is no instruction manual for cancer or for life. A cancer diagnosis can be overwhelming and frightening. In her counseling sessions, medical counselor Bonnie Vestal, MD, focuses on three principles for helping patients find a sense of centeredness:

1. Be present.
2. Find a sense of purpose.
3. Have an awareness of your sense of place in the scheme of things.

Feeling overwhelmed? Try these tools for coming back to center:

• Meditate.
Go for a walk in nature.
• Pray.
• Pray for someone else.
• Attend a church service.
• Seek counsel with a minister, priest, or other spiritual adviser.
• Paint, sing, write, or find some creative expression that brings you joy.
• Spend time around children—their joy and laughter are contagious.
• Breathe deeply. Really—sit quietly and listen to the sound of your own breath.
• Count your blessings.
• Make a plan for the future. Create a list of things you want to do.
• Watch a sunrise or sunset. Get outside. Remember your connection to the larger world.
• Give. Giving gets us outside of ourselves.
• Spend time with loved ones.
• Seek solace in a spiritual text.
• Garden. Gardening is an act of hope.