Sometimes the biggest act of courage is a small one. 

                                                                         Lauren Raffo

FRIDAY, Dec. 23 (HealthDay News) -- The holiday season can be especially meaningful for cancer survivors, but they need to take steps to ensure they stay healthy through this often hectic and stressful time.

One in 20 U.S. adults is a cancer survivor and their ranks are growing. Many of these folks have long-term health needs due to the disease and its treatment, experts at the Fred Hutchinson Cancer Research Center pointed out in a center news release.

Karen Syrjala, co-director of the center's Survivorship Program, offers holiday health tips for cancer survivors, including the following:

• Be prepared for your holiday stress points. Take steps to deal with family conflicts or trying to do too much. For example, if you have to see a difficult relative, plan something fun afterward so you can look forward to doing something enjoyable.
• Take control of your time and eliminate holiday events or traditions you feel you can do without. Also, try to postpone non-holiday events until the new year.
• Make sure to schedule time with people who mean the most to you. Spending time with those closest to you has a beneficial effect on both the body and brain.
• Keep physically active during the holidays and all through the year. It's good for your overall health and may even reduce your cancer-related risks.
• Eat a healthy diet. Focus more on giving your body what it needs (such as fruits and vegetables) and less on trying not to eat certain foods. Eating healthy foods before going to a party will make it easier to resist sweets and other unhealthy foods. Consult a nutritionist if you're not sure what is healthy for you or if you have digestion problems.
• Avoid alcohol or drink in moderation. Alcohol has been linked with an increased risk of cancer.
• Find time to relax your body and mind, and tend to your body's needs. If you're having physical problems, make a list and schedule an appointment with your doctor in the new year. Knowing you have a plan for dealing with these problems can ease your mind during the holidays.

More information

The U.S. Centers for Disease Control and Prevention has more about cancer survivors.

MONDAY, Dec. 19 (HealthDay News) -- A new study finds that cancer survivors are at increased risk for cutaneous melanoma, one of the most aggressive forms of skin cancer. The highest risk is among those previously diagnosed with melanoma.

Cutaneous melanoma is the fifth most commonly diagnosed cancer in U.S. men and the seventh most commonly diagnosed cancer in U.S. women. Incidence of the cancer is increasing, and death rates from the disease have decreased little, despite survival gains for other types of cancer, according to background information in the study.

Ultraviolet radiation exposure is the greatest risk factor for cutaneous melanoma, but race and genetics also influence the risk.

In this study, researchers analyzed data from about 70,800 U.S. patients who were diagnosed with cutaneous melanoma as a first primary cancer (median age of 54 at time of diagnosis) and 6,353 patients who were diagnosed with cutaneous melanoma (average age of 70 at time of diagnosis) after surviving a previous cancer.

Patients with a previous melanoma diagnosis were more likely to develop cutaneous melanoma, said Geoffrey B. Yang, a medical student at Case Western Reserve School of Medicine, in Cleveland, and colleagues.

Among patients younger than 45 at first cancer diagnosis, 777 developed cutaneous melanoma. Those at significantly higher risk included those previously diagnosed with cutaneous melanoma or other skin cancers, Kaposi sarcoma, breast cancer or lymphoma.

Among patients who were 45 or older at first cancer diagnosis, the risk of developing cutaneous melanoma was much higher among those previously diagnosed with cutaneous melanoma or other skin cancers, ocular melanoma, breast cancer, prostate cancer, lymphoma and leukemia.

"Characteristics associated with better survival in both (groups) included female sex, age younger than 45 years at melanoma diagnosis, being married, being white vs. black, decreasing Breslow depth [how deeply tumor cells have invaded], lack of tumor ulceration, no nodal involvement, and absence of metastases [the spread of cancer from the primary tumor to other locations in the body]," the researchers wrote in a journal news release.

The results suggest the need for continued skin surveillance in melanoma survivors, they concluded.

The study appears in the December issue of the journal Archives of Dermatology.

Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City, said that people tend to think of melanoma "as 'lightening doesn't strike twice,' but unfortunately, there are both genetic and environmental reasons which make this a faulty comparison. A history of malignant melanoma makes you at an increased risk for a second primary melanoma and [you] definitely need constant monitoring.

"This risk remains elevated for over 15 years. This was a very important study which illustrated what I have seen in private practice over the past 20 years," she added.

More information

The U.S. National Cancer Institute has more about melanoma and other skin cancers.

MONDAY, Dec. 12 (HealthDay News) -- Acupuncture may help relieve nerve pain caused by some cancer drugs, according to a new study.

Cancer drugs called taxanes, vinca alkaloids and platinum compounds can damage peripheral nerves, especially in the calves and feet, resulting in severe nerve pain or difficulty walking.

Currently, there is no effective treatment for the condition, called chemotherapy induced peripheral neuropathy.

This small, preliminary study included six patients with peripheral neuropathy who underwent acupuncture and five patients with peripheral neuropathy who served as a comparison group. The acupuncture treatment involved insertion of 20 needles at specific points and depths, which were left in place for 20 minutes during each of the 10 sessions delivered by a doctor over a period of three months.

Tests of the signaling speed and intensity of two nerves in the same calf were conducted before acupuncture and again six months after chemotherapy. The same tests were carried out on patients who did not receive acupuncture.

The researchers found that both the speed and intensity of nerve signaling improved in five of the six patients who had acupuncture, and the five patients also said that their condition had improved.

Among patients in the comparison group, nerve speed stayed the same in three, improved in one and decreased in one. Nerve intensity improved in two, decreased in two, and stayed the same in one.

The study appears online in the journal Acupuncture in Medicine.

Previous research has suggested that acupuncture may increase blood flow in the legs, which may help repair nerve damage, the study authors noted.

They concluded that the findings of their pilot study are "encouraging" and warrant further investigation in a larger study.

More information

The U.S. National Cancer Institute has more about chemotherapy side effects.

WEDNESDAY, Dec. 7 (HealthDay News) -- Women can lower their risk of developing breast cancer by avoiding unnecessary medical radiation, forgoing menopausal hormone therapy and limiting alcohol use, but they don't need to worry about using hair dyes or cellphones, a broad new national report says.

Reviewing the body of research on environmental factors that may affect breast cancer risk, the nonprofit, independent Institute of Medicine (IOM) also said that the scientific jury is still out on whether exposure to some chemicals -- including bisphenol A (BPA), pesticides and ingredients in cosmetics and dietary supplements -- alter women's odds of the disease.

"There's been so much concern about the environment, and I think the report is a comprehensive look at what we really know, based on human evidence," said Dr. Robert Hiatt, a member of the 15-member IOM committee that compiled the 364-page analysis.

"It does a number of things: identifies elements of the environment we think are important in breast cancer causation, tells researchers and public health people what we can do to move forward on the issue, and provides opportunities for individual women to modify their lifestyle or behavior to diminish the impact," added Hiatt, also a professor and chair of epidemiology and biostatistics at the University of California, San Francisco.

The report, funded by Susan G. Komen for the Cure, was unveiled Wednesday at the San Antonio Breast Cancer Symposium.

The committee, interpreting "environment" to include all factors not inherited through DNA, noted that many breast cancer risk factors can't be modified, including age, family history, and age at first menstruation and menopause. Another barrier is that breast cancer research cannot center on the strongest types of studies -- randomized controlled clinical trials -- because of the ethical challenges of intentionally exposing women to potentially harmful substances.

Of the environmental factors reviewed, those with the most consistent evidence of a link to higher breast cancer risk are:

• Use of hormone therapy combining estrogen and progestin.
• Exposure to ionizing radiation, which occurs during diagnostic tests such as CT scans.
• Excess weight among postmenopausal women.
• Alcohol consumption.

"Obviously some risk factors are outside of our influence, but some are under our control," said Dr. Iuliana Shapira, director of the cancer genetics service at Monter Cancer Center in Lake Success, N.Y. "The more CT scans we have, the more likely we are to get cancer. This is a wake-up call."

The connection between smoking and breast cancer is more nebulous, the report said, because of mixed evidence. For several other factors -- including secondhand smoke exposure, nighttime shift work and exposure to the workplace chemicals benzene, ethylene oxide or 1,3-butadiene -- the evidence is less persuasive but suggests a possible link to higher risks.

A breast cancer association with bisphenol A (BPA), which is widely used in plastic containers and food packaging, is biologically plausible, the committee said, but research assessing the risk in humans is lacking. The same is true of pesticides and ingredients in cosmetics and dietary supplements, most of which aren't tested before going to market.

However, research doesn't support a link between the use of hair dyes and non-ionizing radiation -- which is emitted from electronic devices such as cellphones and microwaves -- and breast cancer, the study said.

"I'm impressed that they have taken certain positions that may have not actually been supported by public awareness or understanding, such as cigarette smoking or hair dyes," said Robert Schneider, co-director of the Breast Cancer Research Program and associate director of translational cancer research at NYU Langone Medical Center, in New York City. "In public, there's a widespread view that these are all related to breast cancer. I think the report did an excellent job demystifying what the risks are."

Advocating a "life-course approach," the report called for future research to focus on the many stages of breast development, which begins in utero and undergoes substantial changes through puberty, pregnancy, breast-feeding and menopause. Most research has concentrated on the several years before women develop breast cancer, but environmental exposures during their other life stages may have a profound influence on chances of developing the malignancy, which is diagnosed in about 230,000 American women each year.

"The most interesting thing the committee does a little differently, and is certainly useful, is explicitly recommending that we have to think about a life-course approach and the difficulties that come with that," said IOM committee member Dr. David Hunter, dean for academic affairs and a professor of cancer prevention at Harvard School of Public Health. "We're really calling for attention to developing methods that would give us information about exposures that would have happened in the distant past . . . and inevitably, that's going to take quite some time to develop and to come up with newer information. We don't really say we have the answers here, but we're calling on people to be more creative and look harder."

Along with the report, the committee released a brochure offering women information gleaned from the review in a simple question-and-answer format, which Dr. Stephanie Bernik said will help increase public understanding of the environmental issues surrounding breast cancer.

"They're putting it together in a way that's easy for women to access and understand," said Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. "I think a lot of women want to understand what they can do, and this is something physicians can easily give to their patients."

More information

The American Cancer Society has more on breast cancer risk factors  .