I’ve been diagnosed with cancer. How do I tell my children?

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With around one in 50 adults diagnosed with cancer each year, many people are faced with the difficult task of sharing the news of their diagnosis with their loved ones. Parents with cancer may be most worried about telling their children.

It’s best to give children factual and age-appropriate information, so children don’t create their own explanations or blame themselves. Over time, supportive family relationships and open communication help children adjust to their parent’s diagnosis and treatment.

It’s natural to feel you don’t have the skills or knowledge to talk with your children about cancer. But preparing for the conversation can improve your confidence.

Benjamin Manley/Unsplash

Preparing for the conversation

Choose a suitable time and location in a place where your children feel comfortable. Turn off distractions such as screens and phones.

For teenagers, who can find face-to-face conversations confronting, think about talking while you are going for a walk.

Consider if you will tell all children at once or separately. Will you be the only adult present, or will having another adult close to your child be helpful? Another adult might give your children a person they can talk to later, especially to answer questions they might be worried about asking you.

Two sisters
Choose the time and location when your children feel comfortable. Craig Adderley/Pexels

Finally, plan what to do after the conversation, like doing an activity with them that they enjoy. Older children and teenagers might want some time alone to digest the news, but you can suggest things you know they like to do to relax.

Also consider what you might need to support yourself.

Preparing the words

Parents might be worried about the best words or language to use to make sure the explanations are at a level their child understands. Make a plan for what you will say and take notes to stay on track.

The toughest part is likely to be saying to your children that you have cancer. It can help to practise saying those words out aloud.

Ask family and friends for their feedback on what you want to say. Make use of guides by the Cancer Council, which provide age-appropriate wording for explaining medical terms like “cancer”, “chemotherapy” and “tumour”.

Having the conversation

Being open, honest and factual is important. Consider the balance between being too vague, and providing too much information. The amount and type of information you give will be based on their age and previous experiences with illness.

Remember, if things don’t go as planned, you can always try again later.

Start by telling your children the news in a few short sentences, describing what you know about the diagnosis in language suitable for their age. Generally, this information will include the name of the cancer, the area of the body affected and what will be involved in treatment.

Let them know what to expect in the coming weeks and months. Balance hope with reality. For example:

The doctors will do everything they can to help me get well. But, it is going to be a long road and the treatments will make me quite sick.

Check what your child knows about cancer. Young children may not know much about cancer, while primary school-aged children are starting to understand that it is a serious illness. Young children may worry about becoming unwell themselves, or other loved ones becoming sick.

Child hiding in cushions
Young children might worry about other loved ones becoming sick. Pixabay/Pexels

Older children and teenagers may have experiences with cancer through other family members, friends at school or social media.

This process allows you to correct any misconceptions and provides opportunities for them to ask questions. Regardless of their level of knowledge, it is important to reassure them that the cancer is not their fault.

Ask them if there is anything they want to know or say. Talk to them about what will stay the same as well as what may change. For example:

You can still do gymnastics, but sometimes Kate’s mum will have to pick you up if I am having treatment.

If you can’t answer their questions, be OK with saying “I’m not sure”, or “I will try to find out”.

Finally, tell children you love them and offer them comfort.

How might they respond?

Be prepared for a range of different responses. Some might be distressed and cry, others might be angry, and some might not seem upset at all. This might be due to shock, or a sign they need time to process the news. It also might mean they are trying to be brave because they don’t want to upset you.

Children’s reactions will change over time as they come to terms with the news and process the information. They might seem like they are happy and coping well, then be teary and clingy, or angry and irritable.

Older children and teenagers may ask if they can tell their friends and family about what is happening. It may be useful to come together as a family to discuss how to inform friends and family.

What’s next?

Consider the conversation the first of many ongoing discussions. Let children know they can talk to you and ask questions.

Resources might also help; for example, The Cancer Council’s app for children and teenagers and Redkite’s library of free books for families affected by cancer.

If you or other adults involved in the children’s lives are concerned about how they are coping, speak to your GP or treating specialist about options for psychological support.

Cassy Dittman, Senior Lecturer/Head of Course (Undergraduate Psychology), Research Fellow, Manna Institute, CQUniversity Australia; Govind Krishnamoorthy, Senior Lecturer, School of Psychology and Wellbeing, Post Doctoral Fellow, Manna Institute, University of Southern Queensland, and Marg Rogers, Senior Lecturer, Early Childhood Education; Post Doctoral Fellow, Manna Institute, University of New England

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Eat to Your Heart’s Content – by Dr. Sat Bains

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    Making food heart-healthy and tasty is a challenge that vexes many, but it doesn’t have to be so difficult.

    Dr. Sat Bains, a professional chef with multiple Michelin stars to his name, is an expert on “tasty”, and after surviving a heart attack himself, he’s become an expert on “heart-healthy” since then.

    The book contains not only the recipes (of which there are 68, by the way), but also large sections of explanation of what makes various ingredients or methods heart-healthy or heart-unhealthy.

    There’s science in there too, and these sections were written under the guidance of Dr. Neil Williams, a lecturer in physiology and nutrition.

    You may be wondering as to why the author himself has a doctorate too; in fact he has three, none of which are relevant:

    1. Doctor of Arts
    2. Doctor of Laws
    3. Doctor of Hospitality (Honorary)

    …but we prefix “Dr.” when people are that and he is that. The expertise we’re getting here though is really his culinary skill and extracurricular heart-healthy learning, plus Dr. Williams’ actual professional health guidance.

    Bottom line: if you’d like heart-healthy recipes with restaurant-level glamour, this book is a fine choice.

    Click here to check out Eat To Your Heart’s Content, and look after yours!

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  • Alpha, beta, theta: what are brain states and brain waves? And can we control them?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    There’s no shortage of apps and technology that claim to shift the brain into a “theta” state – said to help with relaxation, inward focus and sleep.

    But what exactly does it mean to change one’s “mental state”? And is that even possible? For now, the evidence remains murky. But our understanding of the brain is growing exponentially as our methods of investigation improve.

    Brain-measuring tech is evolving

    Currently, no single approach to imaging or measuring brain activity gives us the whole picture. What we “see” in the brain depends on which tool we use to “look”. There are myriad ways to do this, but each one comes with trade-offs.

    We learnt a lot about brain activity in the 1980s thanks to the advent of magnetic resonance imaging (MRI).

    Eventually we invented “functional MRI”, which allows us to link brain activity with certain functions or behaviours in real time by measuring the brain’s use of oxygenated blood during a task.

    We can also measure electrical activity using EEG (electroencephalography). This can accurately measure the timing of brain waves as they occur, but isn’t very accurate at identifying which specific areas of the brain they occur in.

    Alternatively, we can measure the brain’s response to magnetic stimulation. This is very accurate in terms of area and timing, but only as long as it’s close to the surface.

    What are brain states?

    All of our simple and complex behaviours, as well as our cognition (thoughts) have a foundation in brain activity, or “neural activity”. Neurons – the brain’s nerve cells – communicate by a sequence of electrical impulses and chemical signals called “neurotransmitters”.

    Neurons are very greedy for fuel from the blood and require a lot of support from companion cells. Hence, a lot of measurement of the site, amount and timing of brain activity is done via measuring electrical activity, neurotransmitter levels or blood flow.

    We can consider this activity at three levels. The first is a single-cell level, wherein individual neurons communicate. But measurement at this level is difficult (laboratory-based) and provides a limited picture.

    As such, we rely more on measurements done on a network level, where a series of neurons or networks are activated. Or, we measure whole-of-brain activity patterns which can incorporate one or more so-called “brain states”.

    According to a recent definition, brain states are “recurring activity patterns distributed across the brain that emerge from physiological or cognitive processes”. These states are functionally relevant, which means they are related to behaviour.

    Brain states involve the synchronisation of different brain regions, something that’s been most readily observed in animal models, usually rodents. Only now are we starting to see some evidence in human studies.

    Various kinds of states

    The most commonly-studied brain states in both rodents and humans are states of “arousal” and “resting”. You can picture these as various levels of alertness.

    Studies show environmental factors and activity influence our brain states. Activities or environments with high cognitive demands drive “attentional” brain states (so-called task-induced brain states) with increased connectivity. Examples of task-induced brain states include complex behaviours such as reward anticipation, mood, hunger and so on.

    In contrast, a brain state such as “mind-wandering” seems to be divorced from one’s environment and tasks. Dropping into daydreaming is, by definition, without connection to the real world.

    We can’t currently disentangle multiple “states” that exist in the brain at any given time and place. As mentioned earlier, this is because of the trade-offs that come with recording spatial (brain region) versus temporal (timing) brain activity.

    Brain states vs brain waves

    Brain state work can be couched in terms such as alpha, delta and so forth. However, this is actually referring to brain waves which specifically come from measuring brain activity using EEG.

    EEG picks up on changing electrical activity in the brain, which can be sorted into different frequencies (based on wavelength). Classically, these frequencies have had specific associations:

    • gamma is linked with states or tasks that require more focused concentration
    • beta is linked with higher anxiety and more active states, with attention often directed externally
    • alpha is linked with being very relaxed, and passive attention (such as listening quietly but not engaging)
    • theta is linked with deep relaxation and inward focus
    • and delta is linked with deep sleep.

    Brain wave patterns are used a lot to monitor sleep stages. When we fall asleep we go from drowsy, light attention that’s easily roused (alpha), to being relaxed and no longer alert (theta), to being deeply asleep (delta).

    Can we control our brain states?

    The question on many people’s minds is: can we judiciously and intentionally influence our brain states?

    For now, it’s likely too simplistic to suggest we can do this, as the actual mechanisms that influence brain states remain hard to detangle. Nonetheless, researchers are investigating everything from the use of drugs, to environmental cues, to practising mindfulness, meditation and sensory manipulation.

    Controversially, brain wave patterns are used in something called “neurofeedback” therapy. In these treatments, people are given feedback (such as visual or auditory) based on their brain wave activity and are then tasked with trying to maintain or change it. To stay in a required state they may be encouraged to control their thoughts, relax, or breathe in certain ways.

    The applications of this work are predominantly around mental health, including for individuals who have experienced trauma, or who have difficulty self-regulating – which may manifest as poor attention or emotional turbulence.

    However, although these techniques have intuitive appeal, they don’t account for the issue of multiple brain states being present at any given time. Overall, clinical studies have been largely inconclusive, and proponents of neurofeedback therapy remain frustrated by a lack of orthodox support.

    Other forms of neurofeedback are delivered by MRI-generated data. Participants engaging in mental tasks are given signals based on their neural activity, which they use to try and “up-regulate” (activate) regions of the brain involved in positive emotions. This could, for instance, be useful for helping people with depression.

    Another potential method claimed to purportedly change brain states involves different sensory inputs. Binaural beats are perhaps the most popular example, wherein two different wavelengths of sound are played in each ear. But the evidence for such techniques is similarly mixed.

    Treatments such as neurofeedback therapy are often very costly, and their success likely relies as much on the therapeutic relationship than the actual therapy.

    On the bright side, there’s no evidence these treatment do any harm – other than potentially delaying treatments which have been proven to be beneficial.The Conversation

    Susan Hillier, Professor: Neuroscience and Rehabilitation, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • HRT Side Effects & Troubleshooting

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    This is Dr. Heather Hirsch. She’s a board-certified internist, and her clinical expertise focuses on women’s health, particularly in midlife and menopause, and its intersection with chronic diseases (ranging from things associated with sexual health, to things like osteoporosis and heart disease).

    So, what does she want us to know?

    HRT can be life-changingly positive, but it can be a shaky start

    Hormone Replacement Therapy (HRT), and in this context she’s talking specifically about the most common kind, Menopausal Hormone Therapy (MHT), involves taking hormones that our body isn’t producing enough of.

    If these are “bioidentical hormones” as used in most of the industrialized world and increasingly also in N. America, then this is by definition a supplement rather than a drug, for what it’s worth, whereas some non-bioidentical hormones (or hormone analogs, which by definition function similarly to hormones but aren’t the same thing) can function more like drugs.

    We wrote a little about his previously:

    Hormone Replacement Therapy: A Tale Of Two Approaches

    For most people most of the time, bioidentical hormones are very much the best way to go, as they are not only more effective, but also have fewer side effects.

    That said, even bioidentical hormones can have some undesired effects, so, how to deal with those?

    Don’t worry; bleed happy

    A reprise of (usually quite light) menstrual bleeding is the most common side effect of menopausal HRT.

    This happens because estrogen affects* the uterus, leading to a build-up and shedding of the uterine lining.

    *if you do not have a uterus, estrogen can effect uterine tissue. That’s not a typo—here we mean the verb “effect”, as in “cause to be”. It will not grow a new uterus, but it can cause some clumps of uterine tissue to appear; this means that it becomes possible to get endometriosis without having a uterus. This information should not be too shocking, as endometriosis is a matter of uterine tissue growing inconveniently, often in places where it shouldn’t, and sometimes quite far from the uterus (if present, or its usual location, if absent). However, the risk of this happening is far lower than if you actually have a uterus:

    What you need to know about endometriosis

    Back to “you have a uterus and it’s making you wish you didn’t”:

    This bleeding should, however, be light. It’ll probably be oriented around a 28-day cycle even if you are taking your hormones at the same dose every day of the month, and the bleeding will probably taper off after about 6 months of this.

    If the bleeding is heavier, all the time, or persists longer than 6 months, then speak to your gynecologist about it. Any of those three; it doesn’t have to be all three!

    Bleeding outside of one’s normal cycle can be caused by anything from fibroids to cancer; statistically speaking it’s probably nothing too dire,but when your safety is in question, don’t bet on “probably”, and do get it checked out:

    When A Period Is Very Late (i.e., Post-Menopause)

    Dr. Hirsch recommends, as possible remedies to try (preferably under your gynecologist’s supervision):

    • lowering your estrogen dose
    • increasing your progesterone dose
    • taking progesterone continuously instead of cyclically

    And if you’re not taking progesterone, here’s why you might want to consider taking this important hormone that works with estrogen to do good things, and against estrogen to rein in some of estrogen’s less convenient things:

    Progesterone Menopausal HRT: When, Why, And How To Benefit

    (the above link contains, as well as textual information, an explanatory video from Dr. Hirsch herself)

    Get the best of the breast

    Calm your tits. Soothe your boobs. Destress your breasts. Hakuna your tatas. Undo the calamity beleaguering your mammaries.

    Ok, more seriously…

    Breast tenderness is another very common symptom when starting to take estrogen. It can worry a lot of people (à la “aagh, what is this and is it cancer!?”), but is usually nothing to worry about. But just to be sure, do also check out:

    Keeping Abreast Of Your Cancer Risk: How To Triple Your Breast Cancer Survival Chances

    Estrogen can cause feelings of breast fullness, soreness, nipple irritation, and sometimes lactation, but this later will be minimal—we’re talking a drop or two now and again, not anything that would feed a baby.

    Basically, it happens when your body hasn’t been so accustomed to normal estrogen levels in a while, and suddenly wakes up with a jolt, saying to itself “Wait what are we doing puberty again now? I thought we did menopause? Are we pregnant? What’s going on? Ok, checking all systems!” and then may calm down not too long afterwards when it notes that everything is more or less as it should be already.

    If this persists or is more than a minor inconvenience though, Dr. Hirsch recommends looking at the likely remedies of:

    • Adjust estrogen (usually the cause)
    • Adjust progesterone (less common)
    • If it’s progesterone, changing the route of administration can ameliorate things

    What if it’s not working? Is it just me?

    Dr. Hirsch advises the most common reasons are simply:

    • wrong formulation (e.g. animal-derived estrogen or hormone analog, instead of bioidentical)
    • wrong dose (e.g. too low)
    • wrong route of administration (e.g. oral vs transdermal; usually transdermal estradiol is most effective but many people do fine on oral; progesterone meanwhile is usually best as a pessary/suppository, but many people do fine on oral)

    Writer’s example: in 2022 there was an estrogen shortage in my country, and while I had been on transdermal estradiol hemihydrate gel, I had to go onto oral estradiol valerate tablets for a few months, because that’s what was available. And the tablets simply did not work for me at all. I felt terrible and I have a good enough intuitive sense of my hormones to know when “something wrong is not right”, and a good enough knowledge of the pharmacology & physiology to know what’s probably happening (or not happening). And sure enough, when I got my blood test results, it was as though I’d been taking nothing. It was such a relief to get back on the gel once it became available again!

    So, if something doesn’t seem to be working for you, speak up and get it fixed if at all possible.

    See also: What You Should Have Been Told About Menopause Beforehand

    Want to know more from Dr. Hirsch?

    You might like this book of hers, which we haven’t reviewed yet, but present here for your interest:

    Unlock Your Menopause Type: A Personalized Guide to Managing Your Menopausal Symptoms and Enhancing Your Health – by Dr. Heather Hirsch

    Enjoy!

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  • Avoiding Razor Burn, Ingrown Hairs & Other Shaving Irritation

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    How Does The Video Help?

    Dr. Simi Adedeji’s incredibly friendly persona makes this video (below) on avoiding skin irritation, ingrown hairs, and razor burn after shaving a pleasure to watch.

    To keep things simple, she breaks down her guide into 10 simple tips.

    What Are The 10 Simple Tips?

    Tip 1: Prioritize Hydration. Shaving dry hair can lead to increased skin irritation, so Dr. Simi recommends moistening the hair by showering or using a warm, wet towel for 2-4 minutes before getting the razor out.

    Tip 2: Avoid Dry Shaving. Dry shaving not only removes hair but can also remove the protective upper layer of skin, which contributes to razor burn. To prevent this, simply use some shaving gel or cream.

    Tip 3: Keep Blades New and Sharp. This one’s simple: dull blades can cause skin irritation, whilst a sharp blade ensures a smoother and more comfortable shaving experience.

    Tip 4: Avoid Shaving the Same Area Repeatedly. Multiple passes over the same area can remove skin layers, leading to cuts and irritation. Aim to shave each area only once for safer results.

    Tip 5: Consider Hair Growth Direction. Shaving in the direction of hair growth results in less irritation, although it may not provide the closest shave.

    Tip 6: Apply Gentle Pressure While Shaving. Excessive pressure can lead to cuts and nicks. Use a gentle touch to reduce these risks.

    Tip 7: Incorporate Exfoliation into Your Routine. Exfoliating helps release trapped hairs and reduces the risk of ingrown hairs. For those with sensitive skin, it’s recommended to exfoliate either two days before or after shaving.

    Tip 8: Avoid Excessive Skin Stretching. Over-stretching the skin during shaving can cause hairs to become ingrown.

    Tip 9: Moisturize After Shaving. Shaving can compromise the skin barrier, leading to dryness. Using a moisturizer can be a simple fix.

    Tip 10: Regularly Rinse Your Blade. Make sure that, during the shaving process, you are rinsing your blade frequently to remove hair and skin debris. This keeps it sharp during your shave.

    If this summary doesn’t do it for you, then you can watch the full video here:

    How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

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  • Omega-3 Mushroom Spaghetti

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    The omega-3 is not the only healthy fat in here; we’re also going to have medium-chain triglycerides, as well as monounsaturates. Add in the ergothioneine from the mushrooms and a stack of polyphenols from, well, most of the ingredients, not to mention the fiber, and this comes together as a very healthy dish. There’s also about 64g protein in the entire recipe, so you do the math for how much that is per serving, depending on how big you want the servings to be.

    You will need

    • 1lb wholewheat spaghetti (or gluten-free equivalent, such as a legume-based pasta, if avoiding gluten/wheat)
    • 12oz mushrooms, sliced (any non-poisonous edible variety)
    • ½ cup coconut milk
    • ½ onion, finely chopped
    • ¼ cup chia seeds
    • ¼ bulb garlic, minced (or more, if you like)
    • 2 tbsp extra virgin olive oil
    • 1 tbsp black pepper, coarse ground
    • 1 tbsp lime juice

    Method

    (we suggest you read everything at least once before doing anything)

    1) Cook the spaghetti according to packet instructions, or your own good sense, aiming for al dente. When it’s done, drain it, and lastly rinse it (with cold water), and set it aside.

    2) Heat the olive oil in a skillet and add the onion, cooking for 5 minutes

    3) Add the garlic, mushrooms, and black pepper, cooking for another 8 minutes.

    4) Add the coconut milk, lime juice, and chia seeds, stirring well and cooking for a further two minutes

    5) Reheat the spaghetti by passing boiling water through it in a colander (the time it spent cold was good for it; it lowered the glycemic index)

    6) Serve, adding the mushroom sauce to the spaghetti:

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  • The Green Roasting Tin – by Rukmini Iyer

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    You may be wondering: “do I really need a book to tell me to put some vegetables in a roasting tin and roast them?” and maybe not, but the book offers a lot more than that.

    Indeed, the author notes “this book was slightly in danger of becoming the gratin and tart book, because I love both”, but don’t worry, most of the recipes are—as you might expect—very healthy.

    As for formatting: the 75 recipes are divided first into vegan or vegetarian, and then into quick/medium/slow, in terms of how long they take.

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    One of the greatest strengths of this book is that not only does it offer a wide selection of wholesome mains, but also, if you’re putting on a big spread, these can easily double up as high-class low-effort sides.

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