nowhere hairThe title of this post is a quote attributed to Susan McHenry, from The Book of Awakening by Mark Nepo

“Cancer.” The first thought we may have when seeing someone without any hair or eyebrows.

Hair loss can be one of the greatest fears for a cancer patient. Many patients about to undergo chemotherapy shave their heads to avoid the experience of watching their hair thin and disappear. Why does this hair loss occur and why don’t all patients undergoing cancer treatment lose their hair? Medication administered to target and kill cancer cells is commonly referred to as “chemotherapy.” Many patients whose cancer treatment includes chemotherapy will lose their hair because of the mechanism of action of these medications. Some cancer patients undergo radiation treatment as well. Radiation may also result in hair loss.

Alopecia is the clinical term for loss of hair from the body. Alopecia can be in a specific area of the body, such as the scalp, or all over the body. Hair grows out of follicles and is characterized by a long growth phase, a transitional phase, and a brief resting phase, after which the hair falls out. One mechanism by which chemotherapy works is to kill off rapidly reproducing cells. Cancer cells and hair cells both divide constantly- and for this reason are targeted by many forms of chemotherapy. Chemotherapy speeds the progress of hair to the resting phase, resulting in a sudden onset of hair loss. Cancer patients receiving particular types of drugs, however, may not experience hair loss. Medications targeting specific cells or parts of cells or those that attack cancer by boosting a patient’s own immune pathways are unlikely to affect hair growth.

LEARN Cancer MEthodSince each medication has a slightly different onset of action and duration of effect, hair loss from chemotherapy may occur within a week or not until several weeks after treatment. Hair loss may be partial or total. Hair will usually return several weeks after treatment is completed. New hair growth may be a different color or texture from what it was prior to treatment, but the change is rarely permanent. Radiation therapy also destroys rapidly growing cells, so hair follicles in the area targeted by radiation may be destroyed. Hair loss in these areas can be permanent. If hair does return, any alteration in texture or color may be permanent because the goal of radiation is to alter and remove treated cells to prevent their regeneration. Radiation may target every cell in its path, while chemotherapy’s long-term effect is to permanently destroy only cancer cells.

Every cancer patient is different. Each person’s experience of hair loss is highly personal. One close friend might have a response you expect, another might surprise you. Be open and forthright and your friend or family member will appreciate your support. When one of my friends had hair loss during chemotherapy, she welcomed the hand-me-down hats from another friend whose sister had gone through chemo. A different person may not have wanted these hats. Sensitivity and empathy goes a long way. Years later, my friend and I still laugh about the wonderful experiences we had because she was bald and wearing a bold hat. It seemed we always got the best table in the restaurant and the most attentive service. Once, we got special attention from a rock star signing CDs after a concert. We’re convinced it was the crazy hat.

Websites for organizations such as the American Cancer SocietyJohns Hopkins Medicine and the National Cancer Institute offer useful information about coping with chemotherapy-induced hair loss. The comedian Jay London has said, “I was going to buy a book on hair loss, but the pages kept falling out.” Nonetheless, there are many helpful text references including Cancer Caregiving A to Z: An At-Home Guide for Patients and Families and Learn to Live Through Cancer: What You Need to Know and Do.

Cherise Tasker is an Instructor & Research Specialist at the Central Branch and has a background in health information. Most evenings, Cherise can be found reading a book, attending a book club meeting, or coordinating a book group.

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When you get a cancer diagnosis, it is natural to panic, get depressed, and feel angry. But, as Dr. Agus says in A Short Guide to a Long Life, take it not as a death sentence, but as a wake-up call and an opportunity to take control of the health of your own body by learning all you can, studying your options, and going forth with the best treatment that you and your doctor have decided on, all with the best positive attitude you can muster. But don’t become so micro-focused on this one area of your health that you let other areas of your life get pushed aside or forgotten, such as the simple joys of playing with an animal friend or eating a delicious meal.

You know your health is all wrapped up like a rubber band ball with your emotions, your lifestyle, and your attitude. More than anything, eating can be the most important and healthy thing that you can do to guarantee your body receives the raw materials to fight the growth of cancerous cells and to keep the rest of your body humming along in fine shape.

I am going to list a few of my favorite cookbooks from Howard County Library System for those who want to have some new recipes for themselves, a family member, or a friend who may be living with cancer and going through radiation and/or chemotherapy treatments. They may need some help with preparing a nourishing meal, especially if they have a decreased appetite and not much energy. Don‘t forget, drinking lots of fluids is super important, so check out the great drinks and smoothie recipes too–they are great for throwing in healthy ingredients!

The most beautifully illustrated book of clean, green, and fresh recipes is No. 4, but my favorite is No. 1 because it is written as if there is a helper there with you as you plan to make a tasty recipes with notes of interest on how certain ingredients are beneficial or may help with treatment side-effects. For instance, one note says that metal, as in silverware, can often have a bad taste or feel in your mouth when you are getting cancer treatments. So, the suggestion is to go get some pretty plastic ware so that your eating implements are not an impediment to having some yummy healing food.

My son, who underwent two radical craniotomies for brain cancer, said that it was the preparation of the food and often the smell of the cooking, and even sometimes the energy to do the chewing, that really didn’t make eating appealing. Things that could be prepared quickly were helpful. What he appreciated the most was cold things like yogurt, ice cream, fresh fruit shakes, and smoothies. Simple things like crackers and dips or hummus, omelets, cereal or even ramen noodles were preferred as well.

What helped my son the most? Someone who was there providing love and support as well as a full pantry and refrigerator with lots of good-for-you ingredients for wholesome recipe options, especially as he felt better and began to want to experiment with more foods and flavors as his health, energy, and well-being improved. You will find a treasure-trove of great recipes in these books to complement any lifestyle or condition, and remember healthy eating is for all of us always –and thanks for reading my story.

Susan Cooke has worked in Howard County Library System for 20 years. She loves golden retrievers, fresh veggies, and (of course) reading good books. She is proud to have her daughter Sarah Cooke working for HCLS alongside her!

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Prostate-specific antigen or “PSA” is a blood test that screens for the level of a protein in the blood that can indicate prostate cancer. For many years, it has been the only screening tool for prostate cancer. According to the Centers for Disease Control, approximately 30 million PSA screenings are done every year, and about 1.5 million of the screenings are found to be abnormal. Of the one million men who undergo a biopsy due to an abnormal PSA test, 250,000 are diagnosed with prostate cancer. This means that three out of four men with an increased PSA are found to be negative for cancer after having a biopsy.

The American Urology Association (AUA) released its new clinical guidelines on prostate cancer screening in 2013, creating a stir of questions by patients. The panel decided that, from a public health perspective, the current strategy of PSA-based screening that measures the level of enzyme in the prostate provided high rates of over-diagnosis, needless biopsies and over-treatment.

“We still believe the PSA test is the standard,” said Dr. Alan Partin, M.D., Ph.D., chairman, professor and urologist-in-chief of the Department of Urology and the James Buchanan Brady Urological Institute at The Johns Hopkins Hospital. “However, in the past, when an elevated PSA was found and the biopsy was negative, we would routinely biopsy again. Today, due in part to research Johns Hopkins participated in, we can offer two new tests: the Prostate Health Index (PHI) blood test and PCA3 urine test. As these tests become more widely available, urologists will be able to follow those 750,000 men each year and avoid performing some additional biopsies.”

Marc Applestein, M.D., a urologist on staff at HCGH, notes, “These new tests will offer men new options. PHI testing will be more widely available soon and, at present, neither the PHI nor the PCA3 tests are covered by insurance. There is still debate and a lack of consensus about recommendations for men about screening. Men should discuss their family history and when to start PSA testing as well as what new testing options are available with their urologist.”


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1CarePackageIt’s natural to want to show someone you care for and have been thinking about them, but it can sometimes be hard to come up with what to do or say. Do you send someone with cancer a get well soon card? Take them out to dinner? Send flowers? Just give them a hug? (Probably advisable, unless you’re sick -in which case stay away!) One good option is to give them a care package – it will show that you’re thinking about them and that you care how they’re doing, even when you can’t find the right words.

So, what do you put in a care package for someone who’s dealing with cancer (or other serious illness)? The following are just a few of the things I would pack for a friend going through treatment.

  • Something that’s cute or nice to look at; a little thing that will make them smile. I added  a small vase of flowers and a happy bumble bee knot-wrap containing a bath bomb and some sweet soap – just to help them relax in the bath and smile a little.
  • Soothing ginger and mint teas – to help an upset stomach or lessen nausea
  • Tea ball (a robot!)
  • Tea scoop
  • Travel mug
  • Lotion to soothe irritated and dry skin, the stronger and more intensive care, the better.
  • Lip balm
  • Hand sanitizer (unscented if possible)
  • Some treats, just for fun! A little bit of chocolate can make anyone feel a little bit better sometimes.
  • Streaming video service subscription – great for those days when you’re too exhausted and run down to go out for entertainment.
  • Easy to make chicken noodle soup
  • Home-made lap blanket
  • Travel water bottle – though a whole case of bottled water for the trunk of their car can be a big help after chemo sessions
  • The theme of my care package is "comfortable self-care." I thought about the things that would make me feel better and the things I would like to have on hand. The beauty of care packages is personalizing them. Some people need skull caps or soft hats when their hair starts to thin or magazines to flip through while sitting in a chemo chair. These are only a few of my ideas, what would you put into a care package?
  • Something that’s cute or nice to look at; a little thing that will make your care package recipient smile. I added a small vase of flowers and a happy bumble bee knot-wrap containing a bath bomb and some sweet soap – just to help them relax in the bath and smile a little.
  • Soothing ginger and mint teas – to help an upset stomach or lessen nausea. Tea ball (a robot!), tea scoop, and Travel mug.
  • Lotion to soothe irritated and dry skin, the stronger and more intensive care, the better. Think about lip balms and unscented hand sanitizer too.
  • Some treats, just for fun! A little bit of chocolate can make anyone feel a little bit better sometimes. If they don't eat them now, they'll still be there waiting. It can be nice to have a treat to look forward to.
  • Streaming video service subscription – great for those days when you’re too exhausted and run down to go out for entertainment. The library is a great resource for streaming and digital content, be it e-books, digital audio books, magazines, and even some movies. A home-made lap blanket (or any exceptionally soft blanket) along with some easy-to-make chicken noodle soup can bring real comfort.
  • Finally, something that your care package recipient will take with them everywhere: a travel water bottle. Though, a whole case of bottled water for the trunk of their car can be a big help after chemo sessions. Extra points if you have a cooler to spare.

Jessica Seipel is an Instructor & Research Specialist at the Savage Branch. She has worked for the Howard County Library System, in various positions, for a decade.

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calendar_2014smTuesday, August 12, 7:00 p.m. Movin’ Up to Middle School. Starting sixth grade? Meet new classmates, discuss the big move, and learn the secrets to success at the Elkridge Branch. Compete in a book bag relay and combination lock time-trial! Registration is required. Register online or by calling 410.313.5088. Also available August 18 at 7:00 p.m. at the Miller Branch.

Wednesday, August 13, 4:00 p.m. Kindergarten, Here We Come. The Glenwood Branch will have stories and activities to help mark that all important first day, including boarding a real school bus. For children entering Kindergarten this fall; 45- 60 min. Cosponsored by Friends of Howard County Library and Howard County Public School System. Registration is required. Register online or by calling 410.313.5579. Offered again at 7:00 p.m. and on Thursday, August 14, 10:00 a.m. and 11:30 a.m. at the Glenwood Branch, and August 14 at 10:30 a.m. at the Elkridge Branch. Also offered August 16 at 3:00 p.m. at the Central Branch.

Saturday, August 16, 11:00 a.m. Crop Swap. Do you have an abundance of vegetables from your garden? Let’s crop swap! Bring homegrown produce to trade for something new and delicious at the Miller Branch. Share growing tips and favorite varieties. Families welcome. Leftovers donated to the Howard County Food Bank. Set up from 11 – 11:30 am, swap from 11:30 am – 12 pm. Registration is required. Register online or by calling 410.313.1950.

Monday, August 18, 10:30 a.m. – 5:30 p.m. SAT Prep. The SAT is the most widely used college admission exam. Take advantage of our SAT Math Prep course specifically designed to help students excel on the math portion of the test. Students will take an official practice exam to simulate the experience, learn test-taking strategies, and solve problems related to algebra, geometry, and probability. Grades 9-12 only. Graphing calculators are recommended. HiTech is funded in part by a National Leadership Grant for Libraries from The Institute of Museum and Library Services. Registration is required. Register online or by calling 410.313.0760.

 Blood Pressure Screening at Glenwood Branch – a Well & Wise Event. Free, walk-in blood pressure screening and monitoring offered by Howard County General Hospital: a Member of Johns Hopkins Medicine. Also offered, Tuesday, August 12, 1:00 p.m. – 3:00 p.m. at Elkridge Branch. No registration required.


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fault in our starsI don’t want to say “You have to have been living under a rock not to have read/seen/heard of The Fault in Our Stars” because heaven knows I am frequently unaware of popular things, current fads, or even world-changing news at times (plus it is a little unkind to say that to someone anyway). But The Fault in Our Stars is colossally popular. It was even first mentioned on this blog two years ago by our wonderful JP. And, though I have yet to see the movie (sorry, Nerdfighteria, I promise as soon as it makes it to DVD, I’m there), I have read the book and laughed and cried through the amazing story of Hazel Grace and Augustus.

But what is the appeal? Why has a love story about two teenage cancer patients struck a chord in so many people? (It really is much more than a love story between two teenage cancer patients, but I can’t go into it without giving too much away.) I think (aside from the fact that the writing and the characters are humorous, honest, heartbreaking, smart, and realistic), the book’s popularity has a lot to do with how much cancer still looms in people’s lives. I’ve rarely met a person whose life hasn’t been touched by cancer in some way or another. Additionally, according to the CDC, cancer is still the second leading cause of death in the U.S., and, according to the WHO, lung cancers are the #4 killer in the world.

But why is this ancient beast (The American Cancer Society cites the first recorded description of cancer from Egypt at about 3000 BC) still plaguing us after so many years and so much research? Cancer certainly gets a lot of attention. For example, in FY2013, The National Cancer Institute’s budget was $4.8 billion. And there are numerous cancer research programs throughout the world. Even HCLS carries four periodicals devoted to cancer alone, and there are over 1,200 books in our collection dealing with this topic. But cancer continues. Is it really the result of a fault in our stars?

this star won't go outWell, maybe it’s a fault in our cellsThe National Cancer Institute states: “Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues.” Or maybe it’s a fault in our blood or lymph systems since it “can spread to other parts of the body through the blood and lymph systems.” Or maybe cancer is a fault in our genes as the American Cancer Foundation points out how certain risk factors that run in families and abnormal gene function can also play a role in cancer.

Maybe, however, we should stick with blaming our stars after all; The National Cancer Institute points out that cancer “is not just one disease but many diseases,” and with many possible causes. These causes and risk factors can include: chemical and environmental elements (including food content and radiation exposure), genetics, hormonal changes, infectious agents, exposure to the sun(!), tobacco use, weight, and physical activity levels, just to name a few without getting too in depth. We might as well blame the stars (not just the sun, but all of them) since some factors we can control, some we can’t, and Fortuna’s mood seems to come into play more than we’d like. No wonder cancer remains a provocative topic; it truly can come out of no where and change everything.

Alas, cancer is still very much a reality in the world, and I think we all hope for a day when it’s not. The Fault in Our Stars treats a frightening topic with care but without a sugar coating. Sometimes just a sense of mutual understanding can provide great comfort. And I feel this book has touched many hearts; it certainly did mine. If it touched your heart too, you may want to check out This Star Won’t Go Out: The Life and Words of Esther Grace Earl, a collection of works from the brave, young lady who was one of the inspirations for The Fault in Our Stars.

Joanne Sobieck-Lingg is glad to blog about her many, disparate interests (though expert in none, except maybe parenthetical asides). In past lives, she was a writer, proofreader, editor, project manager, teacher, and even co-coordinator of a certain health blog. She has been happily ensconced among the fiction and teen books at the Central Branch of HCLS since 2003.

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