So, you have cancer. No one wants this news. You have every right to cry, go numb, scream “Why me,” yell “Life sucks the big one!” All are perfectly normal and cathartic responses.

Once you’ve felt all the ranges of emotions, you’ll still have to deal with treatment of the dreaded C word. Depending on the type and stage of your diagnosis, you might need surgery, chemotherapy, and/or radiation. Every step is scary, but you don’t have to be helpless.

While cancer treatment is exhausting, there are sensible, easy steps you can take to help yourself endure it. You must first decide you want to make the best of the worst situation. No doctor can make cancer go away magically, but you can help achieve the best results by doing your part.

Get Healthy BEFORE Treatment

No matter the course of treatment, you can prepare by getting yourself in the best shape possible. This does not mean you should train for a marathon right before surgery, but it does mean following common health advices. You usually have one to two months from the diagnosis to the first treatment. This time is critical. Use it to shape up and to strengthen your mind to fight, fight, fight.

• Do not binge
• It’s common to reach for comfort foods in times of trouble. And no one will disagree with you that these are trying times. But before you devour a pint of ice cream, remind yourself that the more in-shape and health-conscious you are BEFORE surgery, the easier it will be for your body to recover.

• Don’t diet
• While some of us overeat, others go into shock and forget how to chew. You must eat sensible, balanced meals to upkeep your stamina. Or, if you were following some fad diet before diagnosis, stop. Just eat what you know is good for you: lots of leafy greens, salads, two servings of protein a day, moderate amount of fruit, nuts, cheese. Stay away from sugar and white flour products. We all know how and what to eat, we just don’t do it all the time. Now is the time.

• Keep exercising (or start walking)
• Whatever your exercise regiment before diagnosis, keep it up. This is asking a lot, especially with the cascade of doctor’s appointments and new information. But do it. Exercise will rejuvenate your spirits and prepare your body to endure the next six months (the average length of cancer treatment). If you have never exercised, it’s not too late to start. Actually, it’s crucial that you start. Don’t over do it. Simply walk with friends after work or appointments. You need to get lots of things off your chest, so you might as well be swinging your arms and quickening your pace as you rant against the world.

• Stop smoking
• Any surgeon will tell you smokers have the worst skin. Thin and brittle, it shreds like paper. This means it’s difficult to sew you up after surgery. So help yourself by helping the surgeon – stop smoking. Skin heals relatively fast. Start now and you’ll improve the layers of epidermis and dermis before surgery.

• Drink lots of water
• It keeps your organs (particularly skin) hydrated, thus easing the shock of surgery. Also, your system will heal more quickly and easily.

• Read
• Read everything you can about your particular type of cancer. The more informed you are, the more questions you can ask your doctors. Don’t be intimated by doctors. They are here to help you. Also, contact the experts:
• The National Cancer Institute’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6236)
• The American Cancer Society at 1-800-ACS-2345 (1-800-227-2345).
• Sleep
• Of course you’re stressed. But missing sleep will weaken the body you’re trying so hard to upkeep. If you’re getting less than six hours a night, consider asking your doctor for a sleeping medication like Ativan. Of course, if you’re exercising, this will help you sleep.

Surgery

Depending on the stage and size of your tumor, you might have surgery before or after chemotherapy and/or radiation. In any order, the best ways to prepare for surgery are the same.

• Do what the doctor suggests
• You’ve been reading everything. But that does not mean you now know more than the doctors. Listen to them. They will tell you when STOP eating and drinking the night before surgery. Do it, or you will have complications with anesthesia on the operating table. Trust me, it’s a bad thing. Also, expect a load of instructions on medications and exercises to continue at home after surgery.

• Stay in the hospital
• Don’t try to be a super hero/heroine. Stay in the hospital as long as prescribed. Usually, any surgery requiring more than four hours of total anesthesia requires at least two nights in the hospital. You’d be surprised how many patients try to leave because they’d feel better recovering in their own homes.

• Ask before doing
• Before surgery you might have been cycling, swimming, walking or jogging. Good for you. After surgery, ask before continuing your routine. The process of healing is complicated. You do not want to accidentally set yourself back. For example, if you’ve had a mastectomy, chances are you’ll have to wait at least a month before resuming swimming. Swimming strokes tend to aggravate pectoral muscles trying to heal after breast surgery.

• Visitors should call
• Family and friends are worried about you. They want to be there when you wake up or at least be there the morning after. Tell them before surgery to call the one person designated to be your chaperone. You might feel like telling everybody about life on morphine (the most common pain killer), or you might want to chill for a while.

• Going home
• It’s always best to come home to a clean and organized home. Before surgery, stock up on easily digestible, healthy foods that you like. Make soup and freeze it. Ask someone to clean the entire house. Put clean sheets on the bed. Buy reading materials. Arrange for extra help like someone to water the garden even after you’re home, or someone to help with the kids. The more you plan while you’re relatively lucid and pain-free, the better you’ll feel when you walk in the house.

Chemotherapy

Chemotherapy often scares patients much more than surgery. For one, there’s ubiquitous tales of hair loss. Two, there’s the enduring nausea. Know that both can happen, depending on the line of drugs used, but neither has be to catastrophic. You will best endure these symptoms if you plan ahead. You will have time because it’s customary to wait for two to four months after surgery to start chemotherapy, thus allowing your body to recover.

• Know what you’re getting
• There are more than 200 different types of cancer and more than 50 chemotherapy drugs which can be administered in numerous ways. Each can have its own side effects. So before you fret about hair loss, do your own research on the drugs you’ll get. You might not lose hair at all. Cancer is one of the most studied diseases. A monumental amount of data is available on everything from ingredients, reactions, dosage, toxicity.

• Know your terminologies
• At times it seems like everyone in the doctor’s office is speaking a secret language. Teach yourself common terms related to cancer care. Start a vocabulary list in a notebook and carry the notebook with you to appointments. The more you can keep up with the lingo, the more in control you’ll feel about your treatment. Some examples:
• Oncologist: doctor who prescribes and monitors the course of your chemotherapy.
• Adjuvant therapy: chemotherapy treatment that follows surgery or radiation therapy to prevent cancer reoccurrence.
• Antiemetic: medicine that controls nausea (ex: Zofran)
• Systemic therapy: describes how chemotherapy works. The drugs affect the whole body by flowing through the bloodstream. The purpose is to destroy cancer cells that may have spread from the original site.
• Metastasis: describes the condition where cancer cells have spread beyond the original site, such as from breast to liver. This occurrence may call for more strenuous drugs, larger doses and more rounds.
• Lymph node: rounded masses of lymphatic tissue through which cancer spreads throughout the body. A telling sign of metastasis is when one or more of the lymph nodes have enlarged.
• Expect weight gain
• Even as little as five years ago, chemo patients severely lost weight during treatment because of nausea. But with new anti-nausea medications, you will be able to eat. What’s more, your body will force you to eat because chemotherapy drugs are strong and demanding, making you ravenous all the time. The average weight gain is 20 to 30 pounds during the course of treatment. Don’t worry about the weight gain, you will lose it. That’s why it’s especially important to be in shape BEFORE treatment and to eat healthy foods throughout your entire regiment.
• Prepare as much as possible
• Once you know what to expect, visualize what life will be like during and after treatment. If you know you will lose hair, buy a great wig. Wear it to get used to your new look. Make your favorite healthy, nurturing foods and freeze them. Cancel unneeded trips and appointments.
• Try to keep busy
• Chemotherapy might last three months (one round every three weeks) or every week for a year. If you’re up to it, keep working and following your routine. The less time you have to fret about your reactions, the better. Of course, your level of activity is weighted against the severity and frequency of your treatment. Even if you’re weak, join yoga or tai chi or a class meant for soothing and nurturing. Many hospitals offer cancer patients these services for free.
• Bring a pal and a sucker
• Chemotherapy drugs can be given orally, by injection, through a catheter or port, or topically. Any way you get it, it’s unpleasant. So bring someone fun to sit with you through the course. If you must have to have a needle jabbed into the back of your hand for half an hour, it’s best to be laughing with a pal to pass time. Some drugs can leave a metallic taste, so bring suckers to block the unpleasantness.
• Be super clean
• Chemotherapy weakens the immune system because it destroys cancerous and beneficial cells. You must adamantly prevent from getting sick because a small infection can increase to a full-blown illness when your immune system is weak. It’s a Catch-22. Don’t get sick, at a time when you’re most likely to get sick. Remember these tips:
• You are most at risk seven to ten days after a treatment of chemotherapy, when your white blood cells will be at its lowest. Refrain from crowds, swimming pools, gyms, public transportation during these days. When at work, ask your co-workers with cold symptoms to stay at a distance.
• Wash your hands fastidiously. Use soap. Always wash your hands after toilet use and before preparing or consuming food. Also wash after shaking hands, touching doorknobs, handling common properties such as copy machines. Of course, do not bite your nails.
• Shower every day and do not share your towel, toothbrush, razor and other personal items with anyone.- Take extra care of your mouth. The mouth is the dirtiest part of your body. Use a soft toothbrush to prevent tearing of gums. Use antiseptic mouthwashes after meals and before bed.
• If you do get an infection, it easily can be treated with antibiotics if caught early. Monitor your temperature and call your doctor/hospital immediately if you are above 100.5°F (38°C)

• Drink plenty of water
• This cannot be emphasized enough. Water keeps your mouth moist and flushes wastes from your insides (kidneys and bladder). All this will prevent infections.

• Avoid risky foods
• When your immune system is low, do not eat foods that could be contaminated or filled with bacteria. These include:
• Salads – some retain dirt even when washed (instead eat cooked organic greens)
• Raw or lightly cooked eggs
• Shellfish
• Soft chesses
• Sushi and sashimi
• Look your best
• A change in your appearance does not mean you have to look frumpy. Be as outrageous or classy as you want. Organizations like Look Good, Feel Better are dedicated to helping you find the right wig, draw new eye brows, keep color in your cheeks.
• What happens after?
• Chemotherapy can treat most cancers effectively. But there’s no way to predict its effect on your tumor until you go through it. Medical tests will determine if chemotherapy is working. Possible results are:
• Absolute remission or response. Patient is monitored for reoccurrence.
• Partial remission or response. This means your tumor shrank but did not disappear. You doctors will most likely recommend more chemotherapy, possibly with different drugs.
• Stabilization. There’s been no increase or decrease in the size of your tumor. Other therapy possibilities will be offered.
• Progression. You tumor continues to grow. More aggressive therapy might be recommended.
• Secondary malignancy. This means cancer has spread to another area, which may require additional surgery, chemotherapy and/or radiation.

Radiotherapy

This treatment uses radiation to kill cancer cells and shrink tumors at a specific site. It is considered the least invasive of cancer treatment options. This is often the last step in your regiment, if it’s needed at all. If and when you should have radiotherapy depends on a myriad of factors. For example, in treating breast cancer, you and your doctors may have opted for a lumpectomy (removing the cancerous lump only) instead of a full mastectomy. Because the remaining breast tissue might have cancer cells, the treatment of radiotherapy would allow doctors to target that specific area of concern.

Radiotherapy is not known to cause nausea or to greatly weaken the immune system. But in cases where radiation is applied to the entire body, thereby soaking into the bone marrow, the counts of your white blood cell counts will decrease. You should be on high alert to prevent getting sick. Follow the same clean habits as during chemotherapy.

Recovery

Six months to a year after diagnosis, you will most likely be finished with treatments. It’s time to celebrate. Go on a trip, start a dream project: a garden, watercolor, kayaking. Your body will recover to its full speed and you will get your life back.

Two months after the last chemotherapy session, fuzz will appear, if you’ve lost hair at all. By now you should able to resume your exercise and work routines.Six months after the last treatment, you will be seeing your oncologist and other doctors only once or twice a year.

A year after treatment, you might be so engrossed into your “normal” life that you forget you had cancer. Well, not completely forget, but half of your day might be without a thought of illness.

Three years after treatment, you might only remember when you happen to look at your scar or breast reconstruction.

Five years after treatment, you might be declared cancer free. Congratulations!