vision cancer newsletter 2011 january

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VISION, JANUARY 2011

JANUARY 2011

Laughter - its fun and its free Johannesburg Support Groups members enjoyed a morning of funin December when laughter coach, Janine Grobler of Laugh SA tookover the meeting.

The session comprised a series of playful and energetic laughter exer-cises while moving around in a group,making good eye contact whilelaughing with each other never at each other patients, caregiversand buddies found themselves joining in with genuine laughter.

In fact, laughter seriously benefits our health and thousands ofscientific studies highlight the many benefits of laughter.

Laughter is natures stress buster.Considering that more than 80%of all illness today is stress-related, and that 80% of all prescriptionmedicines are for stress-related conditions, laughter quickly reducesour stress levels and keeps them down.

In 20 minutes of laughter we get thousands of Rands of natural andhealing organic pharmaceuticals with no bad side effects. Extended

hearty laughter causes our body to release a cocktail of drugs, hor-mones and neuropeptides into our blood that quickly reduce stress,make us feel good, boost our immune system and more.

It can help doctors, nurses and caregivers cope with the extreme stressof dealing with patients, families and the ongoing stress of their occu-pation. Taking home work stress can negatively impact on family lifeand marriage by reducing stress and providing tools for coping with

ongoing stress, laughter can make a real difference to caregivers lives.Regular laughter sessions also provide caregivers with better toolsfor dealing with patients and improve emotional intelligence. Evencaregivers approaching burnout can benefit from a fast energy re-charge and feel the stress levels drop after even one session.Laughter quickly reduces the harmful negative emotions includingfear, anger,distrust that lead to anxiety and depression. It increasespositive emotions that make life a wonderful experience for us andthose we come in contact with.


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not receive annual mammograms to screen for breast cancer, andnearly 40% of those ages 50 and older do not receive recommend-ed biannual mammograms, according to a study conducted forMedco Health Solutions, Reuters reports (Steenhuysen, Reuters,12/9).Debate over how many breast cancer screenings womenshould get and at what age has become more intense since 2009recommendations from the US Preventive ServicesTask Force,which said women should be screened once every two years start-ing at age 50,according to the Wall Street JournalsHealth Blog(Wilde Mathews,Health Blog,Wall Street Journal, 12/9). Leadresearcher Milayna Subar said in a statement,Our study suggeststhat even among an insured population, many women do not meetthat target, and a surprising number do not even have one mammo-gram in four years (Reuters, 12/9).The researchers studied a data-

base of 12 million health insurance claims from 2006 through 2009.They found that an average of 47% of women in their fortiesreceived an annual mammogram, as did 54% of women ages 50through 64. among women 40 and older, 77% had at least onemammogram in four years, and 60% had at least two in four years(Health Blog,Wall Street Journal, 12/9).

Source:Womens Health Policy Report, published by the NationalPartnership forWomen & Families

http://www.nationalpartnership.org/site/News2?news_iv_ctrl=-1&abbr=daily2_&page=NewsArticle&id=27060

At the recent SanAntonio Breast Cancer Symposium, researchersdiscussed how bone-loss drugs and hormone treatments mightaffect breast cancer.They also presented ndings showing thatinsured women might not receive recommended mammograms.

Bone-loss drugs:The bone-loss drug zoledronic acid does not appearto decrease recurrence of breast cancer in women in the earlystages of the disease, according to a study discussed at the sympo-sium last week, the New York Times reports.For the study,researchers examined 3,360 mainly British patients who had surgeryto remove breast tumours, followed by chemotherapy or othertreatments aimed at preventing recurrence.According to the study,women who received the bone-loss drug had roughly the samerecurrence rate after ve years as those who did not receive thedrug. the results did suggest a benet for women who were at leastve years past menopause.Researcher Robert Coleman, of theUniversity of Shefeld in England,said this nding suggests the drugcould help prevent recurrence in women who lack estrogen or otherhormones after menopause.This conclusion could explain resultsfound in a widely publicised trial two years ago that found thebone drug could help women avoid relapses of the cancer, theTimesreports. In that study, none of the1,800 participants had reachedmenopause, but they all had received treatments that shut downtheir ovaries and prevented estrogen production (Pollack, NewYorkTimes,12/9).

Drug Combos: Combining the drugs Herceptin and Tykerb to treatearly-stage breast cancer doubled the number of women whosecancer disappeared compared with women who took only one ofthe drugs, according to a study presented at the symposium, theAP/MSNBC reports.The study - conducted by Jose Baselga, associ-ate director of the Massachusetts General Hospital Cancer Centerinvolved 455 women who were also treated with the chemother-apy drug paclitaxel.The women were treated for about four monthsbefore having surgery to remove their tumours, followed by ninemonths of treatment.The researchers found that the cancer disap-peared in just over 50% of the women who received the drug com-bination, compared with 25% to 30% of women who only receivedone of the drugs. Baselga said,The possibility that we have here isto enhance the number of patients that are curedand prevent fur-

ther treatment that could be more costly (Marchione,AP/MSNBC,12/10).

Estrogen: Some postmenopausal women who have had hysterec-tomies and take estrogen might be shielded from breast cancer,researchers said at the symposium, the NewYork Times reports(Parker-Pope, NewYorkTimes, 12/9). For the study,University ofBritish Columbia oncologist Joseph Ragaz re-analysed data from theWomens Health Initiative, which found that women taking bothestrogen and progestin had their risk for breast cancer increase(Roan, Los AngelesTimes, 12/9).According to the new study, womenwho had had hysterectomies, took only estrogen and did not have afamily history of breast cancer had a statistically signicant lowerrisk of getting the disease (NewYork Times, 12/9). Ragaz recom-mended more research on whether endogenous estrogen producedby the body which is believed to incite cancer growth and out-side estrogen sources have different effects on womens risk of get-ting breast cancer (Los AngelesTimes,12/9).

Mammograms:About half of insured women ages 40 and older do

San Antonio BreastCancer Symposium

CONTRIBUTIONS FOR PUBLICATION INVISION NEWSLETTER

Articles and letters submitted for publicationin VISION are welcomed and can be sent to:

[email protected]

Want to be aLaughter Leader?

Janine Grobler of Laughter SA is running a training course for

laughter leaders and on completion of the course delegates arequalified to conduct laughter workshops, laughter classes, laugh-ter consultations and talks.The course is also excellent for selfdevelopment and growth.The course syllabus includes the dif-ferent techniques used when laughing with various groups suchas cancer patients, senior citizens, the corporate environmentand so on.

Saturday 29 and Sunday 30th January 2011 (both days from9H00 - 17H00).The venue will be confirmed but is most likelyin Bryanston. Closing date for registration and payment is Friday,21 January 2011.

This course is great fun and a positive life-changing experiencefor all who attend. It teaches us to put more joy into our livesand the lives of all the people we come into contact withthrough laughter. It takes only 90 seconds of unconditionallaughter to to change our state of mind from negative to posi-tive, thus increasing memory, communication skills, productivityand creativity, all of which are seriously compromised by stress.

Contact Janine on 082 516 7047 or email: [email protected] go to www.laughsa.com to find out more about Laughter SA.


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Dates to remember

15 January R4RVolunteers meeting 10h00

2 February R4R General meeting/Support 13h30

4 February World Cancer Day

5 February Bosom Buddies meeting

12 February Cancer Support Group, Parktown 0900

16 February Cape Town PLWC Gala Dinner at Zip Zap

Circus

26 February Bosom Buddies Valentines Bal

28 February Cape Town PLWC Support Group

1-4 March R4RVolunteerTraining

12 March Cancer Support Group, Parktown 0900

12 March R4R General meeting/Support 10h0026 March Bosom Buddies meeting

28 March Cape Town PLWC Support Group

9 April Cancer Support Group, Parktown 0900

13 April R4R General meeting/Support 13h30

18 April Cape Town PLWC Support Group

7 May Bosom Buddies meeting

14 May Cancer Support Group, Parktown 0900

21 May R4R General meeting/Support 10h00

28 May Bosom Buddies Pink Pyjama Party30 May Cape Town PLWC Support Group

11 June Cancer Support Group, Parktown 0900

11 June Bosom Buddies 6th birthday bash

27 June Cape Town PLWC Support Group

29 June R4R General meeting/Support 14h00

9 July Cancer Support Group, Parktown 0900

25 July Cape Town PLWC Support Group30 July Bosom Buddies meeting

CONTACT DETAILS :People LivingWith Cancer, Johannesburg: 073 975 1452,

[email protected] LivingWith Cancer,Cape Town: 076 775 6099,

[email protected], www.plwc.org.zaBosom Buddies: 0860 283 343, www.bosombuddies.org.zaCampaign for Cancer: www.campaign4cancer.co.zaCANSA Johannesburg Central: 011 648 2340, 19 St John Road,

Houghton, www.cansa.org.zaReach for Recovery (R4R) : Johannesburg, Antoinette Reis,

011 648 0990 or 072 849 2901Reach for Recovery: Harare, Zimbabwe contact 707659.Cancer Centre - Harare: 60 Livingstone Avenue, Harare

Tel: 707673 / 705522 / 707444 Fax: 732676 E-mail:[email protected] www.cancerhre.co.zw

News fromaround the world

Blood test to spot cancer . . . .A blood test that can detect cancer or determine whether a cancerhas begun spreading to other parts of the body has moved a littlecloser to your doctors office.

Health care giant Johnson & Johnson announced this month thattwo of its units will begin working with Boston researchers to bringthe test to market. Four major US cancer centres will also startstudies on the blood test this year.

The experimental test looks for cancer cells that have detachedfrom a tumour and mean that a cancer has either spread, or is likelyto. If left unchecked, these circulating cancer cells can grow intonew tumours.

Circulating tumour cells are found at very low levels in the blood-stream and are hard to detect.While there is one test on the marketthat can spot cancer cells in the blood - a test called CellSearch, alsomade by a J&J unit - it doesnt capture whole cells that doctors canthen analyse to monitor disease progression.

This newest test requires just a couple of teaspoons of blood, mean-ing patients might even be able to skip painful biopsies of cancertumours and the can be used to monitor treatment in already diag-

nosed patients.The test is so sensitive that doctors can administer a cancer therapyone day and sample the patients blood the next day to see if thecirculating tumour cells are gone.

. . . . but is it such a good idea?Dr. GilWelch, a professor of medicine at the Dartmouth Institute ofHealth Policy & Clinical Practice, reflects on the news about thistest in development in his CNN blog:

He writes:"The test could just as easily start a cancer epidemic.Most assume there are no downsides to looking for things to be

wrong. But the truth is that early diagnosis is a double-edged sword.While it has the potential to help some, it always has a hidden side-effect: overdiagnosis, the detection of abnormalities that are notdestined to ever bother people in their lifetime.

Becoming a patient unnecessarily has real human costs.There's theanxiety of being told you are somehow not healthy.There's theproblem that getting a diagnosis may affect your ability to gethealth insurance.There are the headaches of renewing prescriptions,scheduling appointments and keeping them. Finally, there are thephysical harms of treatments that cannot help (because there isnothing to fix): drug side-effects, surgical complications and evendeath. Not to mention it can bankrupt you.

I don't know whether this test will help some patients. It might, butit will take years to figure that out.But I do know that the test willlead more people to be told they have cancer (or that their cancerhas returned).That will lead more people to receive cancer treat-ment. Because these new patients are bound to be less severely ill(if they are ill at all), they will appear to do better. Many will assume


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that their doing better is because of the new test and early treat-ment. So the test will be performed more often.And a lot of moneywill be made along the way.

http://www.cnn.com/2011/OPINION/01/11/welch.overdiag-nosed.cancer/index.html?npt=NP1

An aspirin a day can reduce cancerdeath risk by 21%Yet another report on the benefits of daily aspirin claims that itreduces the risk of dying of cancer by 21% after ve years, and thebenets appear to increase with time, persisting for twenty years inmany cases. British researchers revealed this in an article publishedinThe Lancet, after gathering data from eight clinical studies - ameta-analysis - involving 25,570 participants who had been onaspirin therapy for at least four years. In all cases the trials com-pared aspirin to a placebo.

They also found that dying from any cause (not just cancer) was10% lower for those on 75mg of aspirin per day.

The doses of aspirin in the eight trials ranged from 75mg to 500mgper day.The trials studied were carried out originally for the preven-tion of vascular events. Investigators explained that their ndingsled them to believe that the benets of daily aspirin for those aged45 years or more far outweigh any side-effect risks. Long-termaspirins link to stomach and intestinal bleeding risk has historicallyput many doctors off prescribing it.

Long term daily aspirin was found to:

Reduce 20-year prostate cancer risk by 10%Reduce lung cancer risk by 30%

Reduce bowel cancer risk by 40%Reduce esophageal/throat cancer risk by 60%

Researchers think that the best time to start daily aspirin would be

when the risk of most cancers starts to rise signicantly; during apersons mid-40s.

Compassion fatigue - spare a thought forthe nursesIn an article entitledCompassion Fatigue in Nurses published onMedscape, MarilynW. Edmunds, PhD, CRNP gives an understandingof the emotional strain on oncology nursing staff.

Traumatic events leave indelible marks on those who are touchedby them.Those who care for or help individuals who are workingthrough a traumatic event can also experience stress.Compassionfatigue is the term used to describe the emotional effect of being

indirectly traumatised byhelping someone who hasexperienced primary trau-matic stress.To date, compas-sion fatigue has been studiedprimarily in non nursinggroups.

When watching a patient gothrough a devastating illnessor trauma, the nurse mayreact by turning off his or herown feelings, or by experienc-ing helplessness and anger.Many nurses nd themselvesrepeatedly on the margin of atraumatic event in the courseof patient care.

Compassion fatigue mayoccur in situations when anindividual cannot be rescuedor saved from harm, and mayresult in the nurse feelingguilt or distress. Hospicenurses;nurses caring for chil-dren with chronic illnesses;and personal triggers, such asover-involvement, unrealistic

PLWC Cape TownHave you, a friend or a family member been diagnosedwith cancer? Do you have any questions or concerns?

Do you feel the need to talk to others who have been inthe same position?

Or are you a survivor and would just like to meet andinteract with other survivors?

You are invited to join us at our Cancer Support Groupheld atVincent Pallotti Hospital in the GVI Oncology unit

Time: 18h00 19h30

See the calendar on page 4 for dates

or contact the PLWC helpline on 076 775 6099

We look forward to meeting you


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self-expectations, personal commitments, and personal crises, arelinked to compassion fatigue.

Although it is easy to say that nurses should be given the opportu-nity to recognise and talk about the stress that they experience, andto make plans for coping, these are challenging tasks.Traumaresearch indicates that people involved in traumatic events need tobe able to "tell their story" eight or nine times to defuse the physio-logic and psychological impact of what they have been through.Compassion fatigue is often linked to burnout, a related but differ-ent concept in which the nurse experiences slowly developing frus-tration, a loss of control, and generally low morale.

ViewpointCaring is one of the foundational tenets of nursing.When nursescannot care for patients at the therapeutic level, they will be inef-fective. However, caring too much is a major risk for nurses.

Compassionate nurses are an essential and dwindling resource intoday's healthcare system.The growing nursing shortage mandates

that the nurses who remain must also be supported and cared for.Nurses don't have a monopoly on compassion fatigue. Other studieshave demonstrated that psychiatrists, in particular, have high rates ofsuicide, severe depression, and general compassion fatigue.All health-care providers need to nd methods of mutual support for the anger,frustration, and helplessness that they experience at work.

http://www.medscape.com/medline/abstract/21035028

A good reason for optimismAccording to a Reuter report,optimists live longer, healthier livesthan pessimists.Researchers at University of Pittsburgh say that

their study may give pessimists another reason to grumble.In the study of more than 100,000 women ages 50 and over they foundthat women who were optimistic and expected good rather than badthings to happen - were 14 percent less likely to die from any causethan pessimists and 30 percent less likely to die from heart disease aftereight years of follow up in the study.The optimists were also less likelyto have high blood pressure,diabetes or smoke cigarettes.

http://www.edmontonjournal.com/news/partner/shell/Setting+injury+target+zero/3092493/Optimists+live+longer+healthier+lives+Study/1360893/story.html#ixzz1ASq6ScUL

Cancer campaigner gets MBEA well known British cancer campaigner was one of the deservingrecipients on the Queens New Year Honours List for his services tohealth.

Clive Stone said the award has made him more determined thanever.The 63-year-old,who was diagnosed with kidney cancer in2007, was put forward for the honour by Prime Minister DavidCameron. Since developing the disease,Mr Stone has since foughtsuccessfully to make the kidney cancer drug Sunitinib available onthe NHS and in July persuaded the Government to allocate 200mto an emergency drug fund for cancer patients.

Mr Stone is a member of the Kidney Cancer Support Network,KCSN,and three years ago he launched campaign group Justice forKidney Cancer patients.

This has made me more determined to keep fighting than ever. Ilook forward to the time when our five-year cancer survival ratesbecome the best in Europe, and very ill patients do not have to

spend their last days in fighting faceless NHS administrators foraccess to effective drugs which are freely available in other counties.

Greater happiness and elevated moodIt appears to be a myth that giving up smoking most likely makes you miserable. Brown University researchers found that those whowere in the process of quitting smoking were never happier.Theirstudy appears in an article in the journal Nicotine & TobaccoResearch.

Corresponding author, Christopher Kahler says smokers thinking ofquitting should be encouraged by the double benet - both physicaland mental. Giving up is far from being a psychological nightmaredone just for the sake of living a longer life, he added.

Kahler and team examined data on 236 male and female smokerswho wanted to give up.They were also heavy social drinkers.Theywere all provided with smoking cessation counseling and nicotinepatches and then set a date to give up smoking.A number of the

Meetings are held on the secondSaturday of each month at 9h00 at

18 Eton Road, Parktown(opposite Wits Donald GordonMedical Centre main entrance)

All patients and caregivers are welcomeNo charge is made

Enquiries:

073 975 1452

email: [email protected]: www.plwc.org.za

C a n S u r v i v e

CANCER SUPPORT GROUPThe Group is run by members of theJohannesburg Branch of People Living With

Cancer in association with the Wits DonaldGordon Medical Centre and is open to any patientor caregiver.

Medi-Clinic supports PLWCPeople Living With Cancer and the Cansurvive CancerSupport Group Committee wish to thank Medi-Clinic fortheir ongoing support, they have allowed us to use their

facilities and provided refreshments for the Group forthe past year and this is much appreciated.

We value the support and generosity of MediClinic andtheir commitment to improving services rendered tocancer patients and their families.


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participants were also given counseling on ways to cut down ontheir alcohol consumption.

They all underwent a standardised test for symptoms of depressionseven days before they stopped smoking. Further psychologicalevaluations for depression took place 2, 8, 16 and 28 weeks aftertheir quit date.

Of the 236 candidates:99 failed straight away (never abstained)44 were only found to be smoking free during their rst evalua-tion after the quit date33 abstained successfully right up to their 8-week check-up33 abstained throughout the whole period of the study29 exhibited none of the above-mentioned quitting behaviours

Among those who managed to quit for a while, the researchersfound that they were in very high spirits (happy) during the check-ups when their smoking cessation was being successfully carriedout. However, after failing their moods darkened signicantly, and in

many cases to lower depths than before the whole study began.Kahler said that enhanced mood and periods of abstinence wenthand-in-hand -the correlation was clear. The participants who failedstraight away were still followed up throughout the study and werefound to be the unhappiest of all the groups. The ones who man-aged to abstain throughout the study period had the highest levelsof happiness, the authors wrote.

The authors added that the link between happiness and smokingcessation was strong, regardless of whether the participant wasdrinking less or the same -the constant was successful smoking ces-sation.

The researchers believe that giving up smoking relieves symptomsof depression and that it is a myth to believe smoking eases anxiety.

Kahler said: "If they quit smoking their depressive symptoms godown and if they relapse, their mood goes back to where they were.An effective antidepressant should look like that."

Article URL:http://www.medicalnewstoday.com/articles/210375.php

Tobacco smoke causes immediate damageAccording to a report released recently by US Surgeon GeneralRegina M. Benjamin, exposure to tobacco smoke - even occasional

smoking or secondhand smoke - causes immediate damage to yourbody that can lead to serious illness or death.

The report, How Tobacco Smoke Causes Disease: The Biology andBehavioural Basis for Smoking-Attributable Disease, points out thatcellular damage and tissue inammation from tobacco smoke areimmediate, and that repeated exposure weakens the body's abilityto heal the damage.

"The chemicals in tobacco smoke reach your lungs quickly everytime you inhale causing damage immediately," Benjamin said in

No compassion, no water!Research by the NHS Confederation in the UK says things thatmatter to those in hospital such as pain control, privacy, keep-ing the noise down, and simply talking to them and being cheer-ful and upbeat are often ignored by staff. It appears that theyhave just discovered that a good bedside manner really does helppatients recover faster and feel happier!

Compassion for the sick is sometimes forgotten in the drive forsavings and efficiencies, they warn.

However, ensuring patients have a good experience can not onlyimprove the quality of care and success rates but also reducecosts, says their report.

The UK came bottom of the 2010 Commonwealth Fund apprais-al of healthcare services in seven countries for patient-centredcare while NHS surveys show 200,000 patients a year have anegative experience of hospital care

The report partly blames care scandals at NHS Trusts such ashappened in Maidstone and Tunbridge Wells and MidStaffordshire where patients were so thirsty they had to drinkthe water out of flower vases on inattentive staff!

Most NHS staff agree that patient experience could beimproved and that, on occasion, the NHS has badly let downpatients, says the report, and it adds that a big cultural shift atmany hospitals is needed.

releasing the report. "Inhaling even the smallest amount of tobaccosmoke can also damage your DNA, which can lead to cancer."

Fortunately, there are now more effective ways to help people quitsmoking than ever before. Nicotine replacement is available overthe counter and doctors can prescribe medications that improve thechances of successful quit attempts.

An easy-to-read guide, A Report of the Surgeon General: HowTobacco Smoke Causes Disease: What it Means to You is availableon-line from:www.surgeongeneral.gov/library/tobaccosmoke/index.html

The value of survivors Joining a new trend in the US, the very popular Health News Reviewblog recently made this announcement:We are pleased to welcome two breast cancer survivors as newsstory reviewers for HealthNewsReview.org.

This is the beginning of a new attempt to get more voices involvedin the review of stories on HealthNewsReview.org. In 2011 we willexplore ways to involve more "wisdom of the crowds" in our dailyreviews, so that we can better assess what people want and needfrom health care news stories - and better judge whether they'regetting what they want and need.

Hurray! Good to see that someone appreciates the input that can-cer survivors can add. Some of those medical conferences in SouthAfrica could do with a good dose of patient wisdom and reality.

DISCLAIMER:This newsletter is for information purposes only and

is not intended to replace the advice of a medical professional.Please consult your doctor for personal medical advice beforetaking any action that may impact on your health.The views expressed are not necessarily those of People Living WithCancer or those of the Editor.

He who studies medicine without books sails an unchartedsea, but he who studies medicine without patients doesnot go to sea at all. - Sir William Osler


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In response to an article in the Journal of Participatory Medicine, acomment posted by E. Michael D. Scott had this to say:Some people believe we need to replace the term patient theterm we use to describe a person seeking or needing the services ofa health care professional. Such people argue that, The wordpatient has negative connotations. They believe, with some justifi-cation, that the term patient carries implications of passivity. Theythink (or hope) that changing the term will change the waypatients are treated. They make note of its historic and etymologi-cal associations with the concepts of patience and suffering.I have argued for years quietly, and usually politely that replac-ing the word patient with another term will do little or nothing tochange the relationships between health care professionals andthose who seek or need their services.For interesting historical reasons, in the UK, surgeons are calledMister (or Ms.), not Doctor. It doesnt matter. Everyone under-stands they are still doctors. Calling surgeons Mister is just a termof art that is peculiar to the British medical system.Equally, patient is a term of art. The term itself is not inherentlyimportant. What are important are the implications of the term tothe nature of the relationships between each individual patient andthe health care professional whose services are being sought out orrequired.I am a patient, a patient advocate, a patient educator, and a profes-sional health care communications specialist. There are days when Iam all of these things at different times during a single 24-hour

period. There is no one term that encompasses all these differentfunctions. They are distinct. They may be interrelated, but they arenot the same thing at all.The thing that they have in common, when seen from my point ofview, is a perspective: every patient is an individual who is entitledto the respect and full attention of health care professionals.Whether the patient is active or passive, the health care profession-al should act first and foremost in the best interests of thatpatient. Sometimes that can be ethically, morally, and even person-

ally challenging, but the obligation on the health care professionalremains the same. From that point of view, the term patient isactually helpful. It assists the health care professional to remember

that obligation under all circumstances.Derived from Latin and Old French, the English noun patient,when used in its medical sense, is at least 628 years old, havingbeen used by Chaucer in 1382. If some individuals want to redefinethemselves as e-patients, em-patients, or clients, rather thanpatients, thats fine. However, the likelihood of successfully forcingsuch a wholesale change on even the 300-year-young US healthcare system is miniscule. What is necessary is a (gradual) shift inmindsets, not a sudden change in terminology. Here is a brief list ofmindsets commonly observed in health care settings that probablydrive most readers of this journal to distraction:

The physicians office receptionist who behaves as though his orher primary goal is to protect Doctor (yes, with a capital D)from actually having to see or talk to patients at almost allcosts.The patient in the emergency department who believes thateveryone needs to drop everything else because he or she needsattention now for his hang-nail, while there is a child with asevere gunshot wound in the next exam room.The autocratic nurse who walks you into an exam room, neverattempts to use your name, and simply says, Take off yourclothes and put this on. Doctor will see you soon, while tossing you one of those socially demeaning examination gowns.

The mindsets are the problem, not the terms patient, doctor, andnurse. The self-empowered patient has learned ways to deal withthe types of mindset exemplified above. The passive patient whoneeds help to become empowered will gain the first steps alongthat path when he or she is treated with respect and tact. The wisehealthcare professional has learned ways to deal with the patientwho thinks of no one but him or her self.

CHANGE MINDSETS, NOT TERMINOLOGYEffective participatory medicine requires mutual respect andacknowledgment of the rights of the various participants. It is notabout how smart or dumb the patient is. Its not about whetherthe doctor has a PhD as well as an MD after his name. Its not evenabout whether one is a wise user of Internet-based services. Its allabout how people interact with each other. If the doctor isnt listen-ing to me describe my symptoms, I will know. If I am not listeningto the doctor when he or she is telling me I need stop smoking, heor she will know. But if I am listening to the doctor as he or she tellsme I need to stop smoking, and I then say, I hear you, but I dontknow if I can manage to do that, then we have the beginnings ofan understanding.Participatory medicine is going to require a societal shift in how weinteract with each other if we are to achieve definable goals. Toachieve that shift, we shall need some other societal shifts too. Itsgoing to be a slow process. Medicine does not encourage suddenchange and for good reasons. This process may take 100 years toreach fruition.To read the article and responses, go to:http://www.jopm.org/opinion/commentary/2010/12/29/the-term- patient-may-describe-me-%E2%80%A6-but-it-does-not-define-me/print/

The term patient may describe me but it does not define me

Zimbabwe NewsA newsletter received from the Cancer Association of Zimbabweshows that the Harare Cancer Centre was very active during 2010.

A number of fundraising events were held as well as cancerawareness talks by Shinga Dakwa. Also a live TV presentation onbreast cancer by Shinga and a Think Pink Dinner Dance.Weekly events for patients included Meditation and Relaxationclasses together with Aromatherapy, Reflexology, Reiki and IndianHead Massage.They express their appreciation of the support received fromsponsors and volunteers and look forward to a full programme in

2011.Anyone wishing to support the Association with donations orgifts can contact the Cancer Centre at:P O Box 3358, Harare or Tel: 707673 / 705522/707444 and onemail: [email protected]

vision cancer newsletter 2011 january

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