Cancer Immunotherapy

Immunotherapy is a cancer treatment that helps your immune system fight cancer. It is a type of biological therapy. Biological therapy uses substances that are made from living organisms, or versions of these substances that are made in a lab.

Doctors don't yet use immunotherapy as often as other cancer treatments, such as surgery, chemotherapy, and radiation therapy. But they do use immunotherapy for some types of cancer, and researchers are doing clinical trials to see whether it also works for other types.

When you have cancer, some of your cells begin to multiply without stopping. They spread into the surrounding tissues. One reason that the cancer cells can keep growing and spreading is that they are able to hide from your immune system. Some immunotherapies can "mark" your cancer cells. This makes it easier for your immune system to find and destroy the cells. It is a type of targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells. Other types of immunotherapies work by boosting your immune system to work better against cancer.

You could get immunotherapy intravenously (by IV), in pills or capsules, or in a cream for your skin. For bladder cancer, they might place it directly into your bladder. You may have treatment every day, week, or month. Some immunotherapies are given in cycles. It depends on your type of cancer, how advanced it is, the type of immunotherapy you get, and how well it is working.

You may have side effects. The most common side effects are skin reactions at the needle site, if you get it by IV. Other side effects may include flu-like symptoms, or rarely, severe reactions.

NIH: National Cancer Institute

Cancer--Living with Cancer

Learning to live with cancer

Cancer is a common disease. Almost 40 percent of Americans will be diagnosed with cancer during their lifetimes. Even though cancer may be life-threatening, many people have successful treatment. Others live with cancer for a very long time.

For most people with cancer, learning to live with the disease is one of the biggest challenges they've ever faced. That's because having cancer touches just about every part of your life and the lives of those around you.

Cancer and its treatment may change:

• Your daily routines and ability to work
• Your important relationships
• The way you look, feel, and think about yourself

You may feel more in control and prepared to cope with these changes if you learn about what to expect. Your health care provider can help you find information and support services that are right for you.

Coping with feelings about having cancer

Having cancer may cause a range of strong emotions, such as sadness, anger, fear, worry, or guilt. These feelings are normal, and they're likely to change over time. It's helpful to sort out your feelings in a way that's comfortable for you. You might try:

• Talking openly with someone you trust
• Writing about your feelings
• Using relaxation methods, such as meditation and other complementary and alternative medicine (CAM)
• Doing things you enjoy to give yourself a break from focusing on cancer

If your emotions seem to take over your life, tell your provider. You may need extra support if you have symptoms of depression, stress, anxiety, or panic disorder.

Communicating with your health care team

During cancer treatment, you usually have a team of providers. Along with doctors and nurses, you may be able to talk with social workers, pharmacists, dietitians, and other health professionals.

These professionals are prepared to help you deal with the issues that cancer brings up, including concerns about finances. But it's up to you to let your team know what's on your mind.

Good communication with your providers may help you feel more in control and satisfied with your care. Your communications may be better if you:

• Tell your providers how much you want to know about your cancer and its treatment. Do you want all the details or just the big picture?
• Write down your questions and concerns before your visits.
• Bring a family member or a friend to your visits. This person can help by listening, taking notes, and asking questions.

Talking openly with family and friends

Cancer changes the daily routines and roles of the people who love and support you. They may need to start doing the things you've always done for them. And you may need their help doing things you've always done for yourself. These changes can be difficult for everyone.

It may help to have an honest talk about changing roles and needs. If that sounds too difficult, ask a social worker or other member of your care team to help you talk with family and friends who are helping with your care. These caregivers may need some support, too.

Dealing with changes in your self-image

Cancer and its treatment may cause some big changes in how you look, feel, and think about yourself. For example, you may have:

• Less energy
• Temporary or permanent changes in your body, such as scars, or hair loss from chemotherapy
• Problems being sexually close or doubts about dating

Coping with these changes can be hard. But most people find ways to feel more positive over time. If you feel well enough, you might try:

• Exercise. Walking, yoga, or other movement may help you feel stronger and more in control of your body. But check with your provider first.
• Staying involved in life and helping others. Think about volunteering, hobbies, or other activities that might make you feel good about yourself.
• Counseling for sexual problems. Talking with a professional, either with a partner or on your own, may help.

Adjusting to life after treatment

After treatment, you'll have regular cancer follow-up care. Your provider will explain the schedule of checkups and tests you'll need. This is a good time to discuss the challenges you may face ahead. Knowing what to expect may help you make plans as you find a "new normal" with cancer as part of your life.

NIH: National Cancer Institute

Children's Health

Your child's health includes physical, mental and social well-being. Most parents know the basics of keeping children healthy, like offering them healthy foods, making sure they get enough sleep and exercise and insuring their safety.

It is also important for children to get regular checkups with their health care provider. These visits are a chance to check your child's development. They are also a good time to catch or prevent problems.

Other than checkups, school-age children should be seen for:

• Significant weight gain or loss
• Sleep problems or change in behavior
• Fever higher than 102
• Rashes or skin infections
• Frequent sore throats
• Breathing problems

Chronic Kidney Disease

You have two kidneys, each about the size of your fist. Their main job is to filter your blood. They remove wastes and extra water, which become urine. They also keep the body's chemicals balanced, help control blood pressure, and make hormones.

Chronic kidney disease (CKD) means that your kidneys are damaged and can't filter blood as they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health. Diabetes and high blood pressure are the most common causes of CKD.

The kidney damage occurs slowly over many years. Many people don't have any symptoms until their kidney disease is very advanced. Blood and urine tests are the only way to know if you have kidney disease.

Treatments cannot cure kidney disease, but they may slow kidney disease. They include medicines to lower blood pressure, control blood sugar, and lower cholesterol. CKD may still get worse over time. Sometimes it can lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplantation.

You can take steps to keep your kidneys healthier longer:

• Choose foods with less salt (sodium)
• Control your blood pressure; your health care provider can tell you what your blood pressure should be
• Keep your blood sugar in the target range, if you have diabetes
• Limit the amount of alcohol you drink
• Choose foods that are healthy for your heart: fruits, vegetables, whole grains, and low-fat dairy foods
• Lose weight if you are overweight
• Be physically active
• Don't smoke

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Cleaning, Disinfecting, and Sanitizing

Where are germs found?

Germs are a part of everyday life. Some of them are helpful, but others are harmful and cause disease. They can be found everywhere - in our air, soil, and water. They are on our skin and in our bodies. Germs are also on the surfaces and objects that we touch.

Sometimes those germs can spread to you and make you sick. For example, there could be germs on a tv remote. You could get infected with the germs if you touch the remote and then rub your eyes or nose or eat with your hands.

How can I avoid getting germs from surfaces and objects?

To avoid becoming infected by germs from surfaces and objects, it is important to wash your hands often. But you can't wash your hands every time you touch something. So it's also important to regularly clean and disinfect surfaces and objects.

What is the difference between cleaning, sanitizing, and disinfecting?

Some people think that disinfecting is same thing as cleaning or sanitizing. But they are actually different:

• Cleaning removes dirt, dust, crumbs, and germs from surfaces or objects. When you clean, you will likely use soap (or detergent) and water to physically clean off the surfaces and objects. This may not necessarily kill the germs. But since you removed some of them, there are fewer germs that could spread infection to you.
• Disinfecting uses chemicals (disinfectants) to kill germs on surfaces and objects. Some common disinfectants are bleach and alcohol solutions. You usually need to leave the disinfectant on the surfaces and objects for a certain period of time to kill the germs. Disinfecting does not necessarily clean dirty surfaces or remove germs.
• Sanitizing could be done by either cleaning, disinfecting, or both. Sanitizing means that you are lowering the number of germs to a safe level. What is considered a safe level depends on public health standards or requirements at a workplace, school, etc. For example, there are sanitizing procedures for restaurants and other facilities that prepare food. What you do to sanitize will vary, depending on your needs. You might be mopping a floor using a mop, a chemical, and water. You might use a dishwasher to sanitize the dishes. Or you could be using an antibacterial wipe on a tv remote.

If you both clean and disinfect a surface or object, you can further lower the risk of spreading infection. There are products that clean and disinfect at the same time.

Which surfaces and objects do I need to clean and disinfect?

To prevent the spread of infection, you should regularly clean and disinfect surfaces and objects that are touched often. For example, in your house, this would include countertops, doorknobs, faucet and toilet handles, light switches, remotes, and toys.

How can I safely clean and disinfect?

It's important to be safe when using cleaning and disinfecting products:

• Store them in the containers they came in. Always follow the instructions and pay attention to the warnings on the label.
• Do not mix cleaners and disinfectants unless the labels say that it is safe to do so. Combining certain products (such as chlorine bleach and ammonia cleaners) can cause serious injury or even death.
• Check the label to see whether you need to use gloves to protect your hands and/or eye protection when using the products
• If you swallow, inhale, or get them on your skin, follow the directions on the label or get medical help
• Store them out of the reach of children