NEWSLETTER

No. 28. October, 2004

Editor: John Conroy

1. REPORT OF THE MEETING HELD ON: Tuesday, 7 September.

a. Apologies were received from Robin Casson, Geoff Emanuel, Ron and Mary Jones, Jim Rogan, Ernie and Freda Treloar, and Wallis West.

We welcomed new members Paul and Helen Moore, and Geoff Shields.

b. It was a great pleasure to welcome this month's speaker, Christine Holbert, to talk to us on stress management and relaxation therapy in relation to Prostate Cancer. Christine is an experienced Yoga teacher and relaxation therapist, and has worked formerly at the Palliative Care Unit here at Mona Vale Hospital giving relaxation sessions to bereavement and terminally ill patient groups.

Christine introduced the session by emphasising the body-mind connexion. There is a complex interaction between them. Care of the body helps the mind and vice-versa. She described stress as any demand on a person which makes him or her feel unhappy, tense or distressed. Stress rises especially from loss: loss of a job, or one's country, one's health, one's independence, or the loss of someone through death. Stress can also arise from change, - from having to adapt; for example, moving house, getting married, or retiring. Often we speak of stress in the workplace: lack of job security, long hours; or through family trouble. In modern life we seem to be faced with chronic stress, such as from daily encounters with traffic or travel. Adding all up the line we seem to be in a constant state of anxiety.

The stress response of the body uses an ancient mechanism: the fight or flight syndrome, which goes back to the days when primitive humans were hunter-gatherers and frequently faced life-threatening situations. Our bodies were geared to this, and profound physical changes took place: the body was alert, the individual was ready to run. Breathing speeded up, heart rate increased, digestion shut down, as did the immune system (since neither was needed in the circumstances), the mind was alert and active, the liver pumped glucose into the blood. This physiological state was triggered by the brain acting on the hormone system. We are not hunter-gatherers any more, but we invoke this response in our bodies through our daily work and activities, - or through a diagnosis of cancer, - and so on. However, in modern society we don't usually follow up with the other natural physical response to release the situation in the way our primitive ancestors did. After the danger is passed, the body would return to its normal state of balance (homeostasis) and there would be the relaxation response: muscles relax,breathing and heart rate slow down, the digestive and immune systems pick up. Unmistakably in our modern lives, the tension remains there,: in the shoulders, or back, in rising blood pressure, or in digestive problems. With the stress that comes from cancer, the immune system becomes depressed, and with the mind alert you can feel anxiety, you can suffer from insomnia, and this can lead to mental depression.

In our modern lives of stress and anxiety, we need to evoke the relaxation response deliberately. Christine introduced us to sever tension/relaxation exercises while we were seated:

1. Breathe in and scrunch everything up (eyes, face, fists, toes, buttocks), hold, then breathe out and relax. Repeat this a few times.

2. Still sitting, stretch up with both arms as far as possible, then relax. Repeat this a few times.

3. Breathe in, turn the head to the left as far as possible, then let the breath out slowly and bring the head to the front. Repeat, this time turning the head to the right. Repeat this a few times. Loss of control can be recovered through exercises such as these.

How do we manage stress? The stress response creates lots of energy. Sometimes you can do something with this to achieve change,- change in job, or change in policy. But this is not always possible. We need to harness this excess energy; for example, by joining a group, talking, sharing, gathering information. Christine gave the example of Anna Wood's story, the account of the young Northern Beaches teenager who died from an overdose of the drug ecstasy. Her parents tackled the problem of the resulting stress in their lives with enormous energy, writing the book of the episode and immersing themselves in the anti-drugs campaign. People facing stressful situations can channel the excess energy through talking (with family, friends, or a counsellor) by writing, by playing a musical instrument, by exercise (walking, swimming, surfing) and so on. Another way to manage stress is to tune into your own body to see if you can detect how it is responding. Check into yourself; for example, for mood changes which can be the result of stress.

It is said that the normal human brain processes 60 to 90 thousand thoughts in a single day. Many of these thoughts are repeated, day after day, and many are negative. Thoughts create feelings and emotions which can affect our behaviour. Negative thoughts can make us feel bad. Women tend to be worriers but can change thoughts from negative into positive, but this is not easy. It takes time and practice, and you may need tools to do it.

Christine gave examples of negative thoughts:

1. What might happen in the future. While we spend a lot of time worrying what might happen in the future, 95% of it doesn't happen.

2. The past and regrets about it.

3. Overdramatising, using strong words like never..., always...,nobody ever.... These can make a situation appear worse than it is.

4. Expecting too much, using words like 'should' and 'ought', and laying expectations onto other people. This often reflects a situation where a person doesn't know how to cope.

5. Sometimes we look only for the black or the bad. 'Nothing is good about this disease'.

We need to look for the positive in the negative situation. We become disempowered because we think we don't know how, instead of saying: 'I can'.

We need to live more in the present moment instead of, as we so often do, planning for the future, or daydreaming about the past. Too rarely are we in the present - where we are at the moment. In the midst of treatment you know reality, - you know exactly where you are. In the flow of negative thinking, - breathe and relax. Turn the negative thoughts around by giving yourself a positive message, little by little. How can you change? By accepting the situation you're in. Acknowledge the feeling and know that you can cope. Thus, empowering comes back to awareness, - using information and turning it round.

Eating is one way to achieve change. The way you eat, what you eat and when you eat can affect the mind. Good food can nourish both the body and the mind. Coffee, tea, chocolate and cola contain caffeine and can add to stress, but they are OK in small doses. Minimise sugar intake; a sugar overload can make you more jittery. Good foods to eat include B vitamins (found in wholegrain and wholemeal breads), calcium, magnesium, potassium (which is important in the nervous system), dairy products, fish (especially tuna), fruit and vegetables, almonds and most other nuts and seeds. Vitamin C, found in capsicum, berries and oranges, is important for feeding the adrenalin gland, also for healing wounds, but it can be hard on the stomach, so be careful if you are feeling nauseous after radiation therapy. Some protein intake is important at all meals. It can be found in meat, fish, dairy products, legumes, nuts, tofu and other soy products. It also helps stabilise the blood sugar level. Fatty acids are important for the nervous system and can be found in olive oil, flax oil, and fish oils. Herbs can be good ways for nourishing the nervous system; for example, camomile and hops. They can be obtained through a naturopath, but always check with your doctor against other medications you are using. Herbs don't work like pills. They may take several days to have an effect. They are not addictive like other drugs.

To help you relax more deeply, you need to use tools to ease tension deliberately. This can be done by focusing the mind in some way; for example, concentrating in your mind on some scene which you find specially restful, or giving yourself mental focus by thinking consciously of your breathing. Christine concluded the session by giving us a fifteen minute relaxation practise incorporating these ideas. She has relaxation audio tapes available at $10.00 each.

2. INFORMATION UPDATE

a.) Bone Metastases Novartis Pharmaceuticals has brought out a brochure: Your Bones and Prostate Cancer. This gives a brief description of the nature of associated bone disease, bones which are commonly affected, diagnosis and management. A copy is available through the Lending Library.

b.) Prostate Cancer Awareness Week, 19-25 September, 2004

So far as I am aware, this has been a fairly low key affair. The Rural Health Education foundation ran a satellite broadcast on Prostate Cancer Treatment and Access in NSW on channel OTEN at 8.30 on Tuesday, 21 September. The Hills News in the Hills District ran an article on 'Beating prostate cancer'. The Cancer Council ran a 12-hour telephone Prostate Call-in on Thursday 23 September (picked up by The Manly Daily). Northern Beaches Radio was notified of this and, hopefully, gave us some air space. For information, could you please let us know by phone or e-mail if anything came your way? 9918 9358 or conroyjs@bigpond.com

c.) Our Website.

www.nbprostatesupport.com.au

If you have any comments or suggestions, please contact us by phone or e-mail, as above.

d.) Newsletter by e-mail

Our complete set of Newsletters is accessible on the website. If you would be happy to receive your regular copy of the Newsletter by e-mail (and so help cut the postage bill, currently covered by Hope Healthcare), please let me know by e-mail (as above) so that I can record your address.

e.) UK contact

Steve Dann, Chairman of the Torbay Prostate Support Association (TPSA) in South Devon, England, has responded to our letter, and has also sent a copy of their Newsletter: Checkmate. TPSA is a thriving and proactive group and Steve has offered to share ideas with us. A visit to the Association's comprehensive website, Beehive, is well recommend, at: www.tpsa.org.uk

f.) News of Members.

Ron Jones had a successful radical prostatectomy at the end of August, and is recovering well at home.

g.) PCFA

On 15 September John Conroy attended a telephone hook-up meeting of the Support and Advocacy Committee (SAC) of the NSW Chapter of the Prostate Cancer Foundation of Australia. This is a group looking at the range of issues relating to men throughout the state who have prostate problems. Some of the issues discussed were: a) governance of the SAC at national level; b) the update of a speakers kit in conjunction with the Cancer Council; and c) an exchange of information and Newsletters among members of Support Groups represented on the SAC. Minutes of the meeting are available for anyone who is interested.

h.) Carers

The Carers Group will meet again on Tuesday, 12 October at 6.30 pm in the Palliative Care Cottage. The speakers will be:

Srs Pam Johnston & Jenny McGowan: Cancer, Palliative Care and the Sydney Home Nursing Service

This will be a follow up to Dr Peter Moore's interesting talk on Palliative Care to the Men's Group in September. Pam and Jenny will be coming from the angle of the home nursing visitor, and they will give an interesting insight into their work with cancer patients.

3. REMINDER: - DATES OF NEXT MEETINGS:

(6.30 pm on the first Tuesday of each month in the Palliative Care Cottage, Mona Vale Hospital) All friends, partners, carers, and family members are welcome. Refreshments will be served.

5 October Sr Jane Matthews (St Vincent's Clinic): Rehabilitation afterTreatment for Prostate Cancer.

Jane is the clinical nurse working with Dr Phillip Stricker. She sees all his patients both before and after treatment with the intention that they are both well prepared and properly followed up. Jane will be talking about the procedures she follows. Whether your treatment is imminent, ongoing or already over, you will find the information about treatment readiness and recovery very valuable.

2 November David Smith (NSW Cancer Council): The Epidemiology of Prostate Cancer: Statistical Update

David spoke to our Group in March, 2003 and now returns to give us an update on the statistics of Prostate Cancer in NSW and Australia.

Please note: During meetings, all discussion and comment about our individual circumstances and experiences is confidential and should not be repeated outside the Cottage walls!

YOUR CONTACT NUMBERS

Program Co-ordinator Dr Peter Moore Northern Beaches Palliative Care 9997 3555	Group Leader John Conroy 9918 9358 conroyjs@bigpond.com
NSW Cancer Council Cancer Support Helpline 13 11 20	Prostate Cancer Foundation of Australia 1800 220 099