<

Some reactions reflect age differences

NEAL: Hello, and welcome to the American Cancer Society's Cancer Survivor Network, a service created by and for cancer survivors. I'm your discussion leader, Neal Sofian. On the phone with us are some special women who will help us talk about issues for Latino women. I'd also like to introduce our guest host today, Michael Samuelson. Michael is the chairman of the National Cancer Advisory Counsel at cancerfacts.com. Michael is also a cancer survivor. MICHAEL: Hi, Neal. Listen, I'm very excited about today's show. The whole issue about the way different cultures respond to cancer is very, very important. Let's go ahead and bring in our first guest, who is Marcella Gomez, from McAllen, Texas. Hi, Marcella. You,

like I, are a breast cancer survivor, and you spend a lot of your time working with Hispanic culture, particularly with Mexican-American culture. Why don't you tell us a little bit about the work that you're doing? MARCELLA: I'm a breast cancer survivor, and I am involved with the American Cancer Society, with their program Reach to Recovery. I do Reach to Recovery for women who have been newly diagnosed with breast cancer. And in the area that I'm from, I think that the population mix may be 80% Hispanic or Latino. Since I am bilingual, it has helped me to help a lot of the women who otherwise wouldn't have gotten any help before. I'm able to work with them as far as teaching them exercises, emphasizing to them to continue with the breast self-examinations. MICHAEL: In terms of working with the Hispanic culture and working with Mexican-Americans, have you noticed any specific differences with regard to the different cultures? MARCELLA: Well, I have noticed with the elderly women that it was very difficult for them to go and get a mammogram. And once they did have their mammograms, if they needed surgery it was just a little harder for them to do that versus the younger Latina women that are more educated, or are more in tune as to breast cancer. I've also found through the program that a lot of the women that were older felt that when they did have breast cancer, this was the time that their family really paid attention to them. They didn't want to let go of that, sometimes, and it was very hard. I especially remember one lady that I saw, a year and a half or two after she had survived cancer, which is wonderful, I think. She was still holding on to the belief that she had cancer and she was never going to get better. And that, I think, was very hard on me. Because I always felt that when I found out that I had cancer, we took care of it, and I kept moving forward. This particular lady did not want to move forward, and I didn't know how to reach her. I didn't know what to do to reach her and it's always kind of bothered me a little bit. MICHAEL: Marcella, do you find that there are any specific taboos particularly associated with the older Mexican-American women concerning their bodies? MARCELLA: Well, I'm basing my opinions not on any research that I have done but on women that I have worked with through the program. A lot of them did not feel comfortable touching their body, and especially touching their breasts. For them to do the breast self-examination... I had several of them tell me, "Well, we're not supposed to do that." You know, we weren't supposed to do those things when we were young, and trying to make them understand that what we're doing is medically necessarily for their health was hard. MICHAEL: So what has been the real message that you've then been able to give them that's gotten them over the hump to actually start doing the self-exam? MARCELLA: That it's okay. It's okay for us to touch our breasts, and if we do have a lump, for us to seek medical help right away, not to wait. That it's okay. If we've reached one out of five I'm glad that we've reached one out of five. MICHAEL: This whole issue of taboo in culture and hesitancy to do breast self-exams, does this also spill over to after the fact? To how they view their bodies, their self-image, after they've had a mastectomy, for example? MARCELLA: I've had mixed response to that. I haven't had too many older women that have told me that they feel bad about it. Now I've had younger Hispanic women really feel bad about losing their breast and saying, "What is my husband going to think of me? They're going to think of me as a freak." And I said, "No, no, they're going to look at you, you're still yourself." Losing a breast does not make you a different person. MICHAEL: And that of course, is an answer that would be given to any culture. Is there within the Mexican-American culture, particularly, a response from the men that would justify their concerns and their worries that their spouse would respond that way? MARCELLA: I have not been to many Reach to Recovery programs with the husband present. I've done a few, and every one that I have done with the husband there, the husband has been extremely supportive.

Educating and expressing yourself in your native language

MICHAEL: Well, I think this is a good time to bring in Ana Garcia, from Hawaii. Ana is not only a breast cancer survivor, but she also is a medical doctor. So she comes at this with multiple perspectives. Welcome, Ana. ANA: It's great to be here. MICHAEL: Ana, I understand that you recently attended a conference, and at this conference, there was a Latino group meeting for the first time. How was that organized, and what kind of insight did you come away with from the meeting? ANA: Well, the National Breast Cancer Coalition has this lobbying conference every May, and we have a certain number of agenda topics, and then we go to lobby on the Hill for things we're trying to get for breast cancer research, etc. And amongst the Latino women who were coming, we felt there were very few in number. I think there were only maybe 35 out of hundreds that were Hispanic there. And because of this, several of us got together and felt that this would be an opportune time for us to start talking together about our own specific issues. And so we did, and it was our first. Everybody was just really excited about having this group get together, and from all over, different states, and everybody put their input in, and what their issues were about. And there were a lot of different issues, just what you were talking about with Marcella about the cultural aspects. I think, you know, family is so important in every culture, but with Latinos it's a big family-type support. I mean, everybody gets involved. It's not just who's living in the household. But on the other extreme, oftentimes I see hesitancy, I think more with the older women, to even tell their family. Some women don't want to tell their family, thinking it's better to keep it from them. There's still some of that thinking going around, I think. MICHAEL: Ana, is that because of shame, embarrassment, fear? ANA: All of the above. I think it's telling of a lot of different issues. But I think a lot is shame, unfortunately...having to feel shame when you get cancer. I don't think it's as strong as it used to be. I was diagnosed in 1990, and everything has changed so much since then. Just with the education that all the organizations, like the American Cancer Society, are providing, all the different local chapters and coalitions, you know. They are just being bombarded with education, in Spanish as well as English, and I think that's been a significant difference. When unfortunately their friends or their family members are getting cancer, fortunately many are now getting mammograms, But still they're being held back a lot by the denial aspect. "I don't want to know, I won't do the test, I won't do the mammogram, I won't do the self-exam, and then I won't get it." That kind of attitude, I think, that's the fear component. MICHAEL: And that's changing for a lot of folks, and you were saying more and more there are Spanish materials out there. But I guess I'd like to go a step further. Is that enough? For a person who's Hispanic, what are the issues from a cultural perspective, what are the barriers that someone faces from the Latino community, that might be different? What do we need to be learning to do better, so that we can educate from the prevention side? And, from the treatment side, what do we need to be doing different to make our services better? ANA: Well, in areas where there's a higher population of Hispanics, a lot of the organizations are hiring or have people volunteering now that are bilingual. Having someone who speaks the language is so much better for them, because you get the emotion, the emotion comes out in the language itself. A lot of these older women still don't speak English that well. Here we are, having to learn new terms when we're diagnosed. We have to learn a whole new language all about cancer. So not only are they learning new words, but they're also new words in a different language, too. So it's so much easier for a lot of women who don't speak English well to be able to get the literature and have their contact people speak to them in Spanish. If that's their primary language, that's what they feel more comfortable talking with.

A personal respect for Western medicine and for traditional medicine

MICHAEL: The cultural differences go beyond simply the hesitancy on the part of the Latino woman to do the breast self- exam, but also to be assertive in the physician's office with regard to selecting her team and taking control of her health. ANA: Well, I think a lot of the younger population is learning the attitude that they do have more of a say with their doctors. It's not the attitude of a lot of the senior folks, who still think that whatever the doctor says, that's the way it is. They're afraid to ask questions, rather than taking an active part. And that's sometimes true with the younger diagnosis as well. A lot of it is the cultural aspect of respect for the doctor. There is still a lot of that, and respect is due when it should be. But I think, as an advocate, you have to oftentimes take things in your hands, just as you were saying. You have to do a lot of the investigation and the footwork on your own, and if you don't, sometimes things don't go the way they should. MICHAEL: So it's respect, but not just blind obedience. ANA: Right, and I think they tend to think oftentimes that whatever the doctor says, you don't question. MICHAEL: If you were diagnosed with cancer just now, as a Latina, where would you call, besides the American Cancer Society, of course? Where would you recommend other Hispanics make that call to look for support that's culturally sensitive? ANA: I think the 1-800-CANCER information line is a great resource. MICHAEL: Is it bilingual? ANA: I know a lot of people don't know about that one. I think calling their local hospitals or cancer centers is a place to get information. I think their oncologist oftentimes will give them some support, and some clinics do have some social workers that can help you in Spanish, about who to contact, who can give you support, financially or emotionally. That's another cultural aspect. There's so much, I believe, as far as your emotions, your psyche, your spirit, that has to do with healing. And we as Hispanics definitely have some belief in complementary medicine, using herbs and stuff, not Western-trained doctors. We call them curanderos. I think that a lot of Hispanics oftentimes are still connected with a curandero who will help them through. And some of the universities, they'll even allow the curandero to come and help them through the processing and help them do their own prayers. It's more with the older generation, and more with people who are raised closer to the border. Maybe where Marcella is, you're more in contact with curanderos that are available.

Building hope on a culturally spiritual foundation

MICHAEL: This is actually a question for both of you, as we've kind of talked about the issue a bit. But the whole aspect of the spiritual self, and the issue of hope and attitude. What role does this play in terms of recovery and facing cancer for the Hispanic? MARCELLA: I feel that that is very, very important. It goes back to what Ana was saying. We have to have a positive attitude, and in the Hispanics, a lot of that attitude also comes because of our religious beliefs, our very strong religious faith. MICHAEL: Sometimes the religious base for that can be one of resignation, or otherwise recognizing that perhaps this is God's will, as opposed to "I am part of the process and I can work with the higher being, in terms of either accepting or moving forward with this." When you counsel, or when you talk to patients, how do you approach this whole issue with them? MARCELLA: With the Reach to Recovery program we really do not talk religion. When I speak to a patient that has breast cancer and they ask me what my belief is, I tell them, "I had faith that God would help me through this. That with that faith behind me I could get through this." I did have some wonderful role models with two women that have been through cancer and survived, one of them being Ana. And so, with that faith that I had, I felt that I could overcome, or that I would make every effort that I could to help myself. ANA: I agree with Marcella. I depended so much on my faith when I had breast cancer diagnosed in 1990. And then I had a recurrence in my spine and then my ribs, which is metastatic disease. I was told, seven years ago, that there was nothing that could be done, that I wasn't going to survive. And I knew the statistics back then, that the survival rate for metastatic disease was less than one percent. It was really low in the literature that I was reading, and I just told myself that I was going to be that half percent, or whatever. But one of the most significant parts of my therapy was finding an oncologist who gave me my hope back. I think it's critical in this area of advocacy, and just working with patients, to give people back their hope and tell them not to lose their hope. Even if it's one percent, you can still hold on to that. And we all will know it when it's time to let go and prepare ourselves for the next level. But I think that no one, not physicians, not anyone, has the right to put a time on it. You know, some people, if the doctor says three to six months, well, they're going to die in three to six months, because that's what the doctor said. And so really a lot of it has to do with getting and keeping your own family supporting you, and hope is supporting you, and your prayer and faith. If someone isn't a Christian, I'll ask them if they believe in a higher power, and if they say yes... Most people do at least have a belief that there is a higher power, and I just tell them that I really feel prayer is significant. I truly believe in prayer and prayer chains. I tell people to get on as many prayer chains as you can, tell people to be praying for you. I really think that has a lot to do with healing. Plus it gives you some control back. You know, there's so much of our control taken away when you're a cancer patient, and by having that one thing, that nobody can take your faith away, nobody can take your hope away. Unfortunately, for a short period, I allowed somebody to take it away, but not for very long. I just think having that hope is really significant. For us, culturally, that's an aspect, this whole spiritual thing. As a culture, the spirit has always been very significant. And I think as a culture in general we believe in miracles more than most people do. So I think that is something to hold on to.

Cultural beliefs regarding touching

MARCELLA: I tell all the women that I talk to that touch helps us. Anytime we touch somebody, it helps. A lot of times when we go through the surgeries, and through the chemo, getting a massage as an alternative medicine really helps us. It makes us stop thinking about what's really wrong with us, and it makes us relax and let go of some of our stress. To me, it is very important. I try to tell as many women as will listen, and men, that it is important to have some kind of alternative treatment such as massage done. MICHAEL: Ana, how do you actually introduce these sorts of practices into your medical care practice so that it makes it more comfortable for folks? ANA: Well, living in Hawaii, unfortunately I don't get to see that many Hispanics. We do have a lot of Hispanics over here, more than we've had in the past. But I don't get to see them. When I was practicing in Texas, where I'm from originally, I practiced on the east side of Austin, and I served primarily Latinos and black indigent patients. Not only indigent patients. But it was a village by the town, and I wasn't dealing with cancer back then. But I would here in Hawaii. It's a very multicultural group of people, and with a lot of cultures that have very similar attitudes that the Hispanics have about touch and things like that. And it's opened them up to that possibility, explaining to them that anything that creates those good endorphins in our body or those good chemicals that make us feel good, will be boosters for our immune system. Anything that will make you happy, feel better, is going to make your immune system work more efficiently. So that's how I introduce it over here. And I just think that it's important. Just in our little community, alternative medicine is becoming an accepted part of it. It's easier now than it was seven years ago.

Involving my husband from the start

MICHAEL: So the advice is to keep an open mind in looking at some of these. I have a question for both of you. If I am a Latino man and my wife has breast cancer or some other cancer, what advice would you have for me as part of my support network? Knowing my culture, and knowing the way that I come into this. What advice would you have for me? MARCELLA: Well, I am married to a Latino. My husband is a surgeon, and I got support from him. It was hard for him, being a surgeon. That I was diagnosed with breast cancer, and that I had to go through the surger,y and so on and so forth. But I have found in dealing with the men that I have talked to, and from talking with their wives, they are very concerned about their wives. If they are happy in their marriages, they are very concerned about their spouse. They want their spouse to get better. They are willing to do whatever it takes to help her to get better. ANA: I agree with that. I think oftentimes it's harder for a lot of Latinos. Well, not just Latinos, but men oftentimes can't verbalize their emotions about these kinds of issues. I'm not saying for all issues, I'm saying for cancer. That kind of tough issue. And I think it's really important for a Latino woman to tell their spouse what they need from them. Sometimes the husband doesn't know what to do, and they don't have enough support, like support groups, to talk about it. They kind of pull away, they work more, just knowing that they are providing the support. But I really think that, as a culture, we are just learning now that we have to communicate more and to tell our spouses what we need them to do for us. And to talk about our fears. "Do you feel differently about me as a woman?" Or, "I feel like you feel differently about me." Oftentimes, we have so many thoughts that we think they are thinking, and they're not there at all. It's our own paranoia or our own fears that create that. MARCELLA: I think it goes back to communication. We have some husbands who are very, very caring, to the point of too much, and the wife says, "Please tell my husband I'm going to be okay." And then you have the other extreme, where the husband is, I think, scared. He doesn't know how to vocalize or demonstrate his feelings because of fear. MICHAEL: Ana, the issue of intimacy, with regard to the husband... We know there are women listening out there who perhaps feel ashamed or embarrassed. It may have been months, or it may have been years, and they continue to undress in the dark, and they are very concerned. And the husband doesn't know what to say, doesn't know what to do. So there's this kind of barrier of silence that actually ends up pulling them apart. ANA: I think if you get them to be involved with the dressing changes at the beginning, if the patient can get past that, and let them be a part of that, then you both get used to it at the same time. MICHAEL: So you want to get him involved right at the hospital. ANA: Right at the hospital. Because then it's not a shock. I mean, this is a new appearance, and we all have to get used to it. I think the younger women will probably elect to go more and more towards reconstruction, and then they have that comfort of knowing that their bodies will look more normal. What they consider back to normal. I think, for the women who don't have reconstruction, the men get very used to it. I have not found that it's been an issue for the men. In a good, strong, marriage relationship, it doesn't matter. MARCELLA: I have also heard the husband say, "Why do you even want the reconstruction? You're still yourself." A breast is a part of us that we feel is a very important part of our femininity, but it's just a breast. And I always tell whomever I speak with is that the most important thing is yourself. I am the most important person, and what's most important about me is that I'm still here. Whether I have a breast or not, I'm alive. And that is the most important thing. A lot of women do go through being embarrassed that they don't have two breasts. They don't want their husbands to see it. My advice has always been, like I was saying, get them started at the beginning to help you and to get used to it with you. Then after a while, it's just part of every day. ANA: With the sexual aspect of it, I just remembered, it was awkward at first for my husband to kind of place his hand on my chest and remembering that there was a breast there at one time. But it's not there anymore, and it's kind of an awkward feel, I think, for both of us. I was feeling it, I think, more than he was, but you just get used to it. And then it goes away. I think a lot of it is just going through the process and realizing that it all becomes normal with time. And it just takes time to heal on our own. MICHAEL: Did you talk about that? ANA: I had no problems with it. MICHAEL: I mean, did you get explicit about it? BOTH: If we don't communicate, we're in trouble.

Communicating with your children

MARCELLA: A step further is when I left the hospital and it was the first time that I really saw myself, and my husband was helping me do it. I also had my children then who at the time were, I think, 20 and 16. They were old enough to understand. But part of the thing was that I wanted them to see that I was still their mother, despite the fact that I had gone through this, and that everything was okay. MICHAEL: You bring up a really good point, Marcella, around children. How would you recommend you bring children into this process in terms of talking to them, and what works, culturally, most effectively? MARCELLA: Well, it depends on the age of the individual. For us, we have always been very open, we have always been very honest. We have always tried to communicate with each other and with our children. So to me, it was a very natural process. As soon as we found out the diagnosis, the most important people that needed to know were our children. And all four of us kept informed. The final decision was naturally mine, but we all four discussed what would be the best thing for me. ANA: I'm a pediatrician, that's my specialty. Where I practice I'm actually a general practitioner, but my specialty is pediatrics, and my son was 10 when we were going through this. When I had decided to go ahead and have reconstruction, I had my own personal fears. More the anesthesia than the reconstruction. It was more about the anesthesia, and I had decided that I wasn't going to tell him until I came back from what I had gone for. And I thought that that was better for him, because he was in school. I didn't want to disrupt his schedule. Soon after that, we had the parent-teacher meeting that was scheduled. The teacher said, "Well, I don't know what's been going on, but your son has just not been here for two weeks." And I just fell apart, because here I was, trying to protect him, but what I did by not sharing it with him, he knew something was going on. Their thoughts are so much worse, they create all this worry, and they think that things are much worse than they are. For all I know, he thought I was going to the hospital and would never come back, you know. Because I had gone away for treatments several times before, too. You don't want them to have to worry a lot, but I think sometimes by holding back information... I know some women won't ever tell their kids. In fact, there was a woman that I took care of here, who didn't tell her daughter. And until she was on her deathbed, she never understood that her mother had cancer. And it was such a traumatic time for this child. And so I think it's really important to let children know. Because there is literature out there to help you through it. Bernie Siegel tells this story in his book: One woman described it as, we're like a tree and we have to nurse the roots of the tree, and there's just one part, a branch, that needs to be taken off. The tree itself is still intact. I think that's a good way to present it to a child, you know? Don't keep them in the dark. I think too much information can be scary too, so you have to give them just enough. And you can usually tell, because typically, they'll cut you off when they can't absorb any more. MARCELLA: You have to think of their age. If you're talking about a 3-year-old or 4-year-old versus 10 or 12, and then on up, it makes a difference in their age. ANA: A lot of people, I think, feel that young ones don't understand, and I think they do. MICHAEL: Ana, I have a question for you. If I am a 55-year-old Hispanic woman and I have breast cancer, and I have a 14-year-old daughter, what do I say to my daughter, who I know now is at higher risk? ANA: Well, I think you need to teach her now the importance of diagnosing. The strongest thing we have right now is diagnosing early. By learning self-exams early on and making it a part of your routine life, you'll do self-exams. So the earlier she starts learning how to do self-exams, the better. But I think the most important thing is to tell her that it's very unusual to see it in young women, and that the majority, and this is critical, the majority of these cancers are not familial. It's not genetics. Eighty percent are sporadic, they just happen. So, it may not happen to her, but because it has occurred with the mother, she has to stay on top of eating well, doing exercises, and doing exams. I think actually in some programs that I've heard about at the Coalition, the teenagers are the ones learning it at school, and going home and telling their mothers to get the mammograms. So it works both ways. But I think it's really important for the mother to tell them. I've told my nieces, who have breast cancer on both sides, you have to stay on top of this. Don't be paranoid, but let your physician, your ob-gyn doctors, know early on that you need to be followed annually. Checked annually. MICHAEL: But again, from a cultural standpoint, reflecting on what both of you said earlier, if I am a 55- or 60-year-old woman and I have a teenager, I'm barely going to look at myself in the mirror. And I'm certainly not going to do my own breast self-exams. How am I going to be able to talk to my daughter about these issues that I've never been able to talk to her about before? ANA: Oh, I think oftentimes the 55-year-old has a pretty close relationship with the daughter, if they have a good relationship. And even if they don't, I think you have to go beyond what your own problems are with your body or your fears about that. You HAVE to share it with the daughter. You HAVE to get beyond that. I tell you, I have patients who come here and they know their grandmothers died of some kind of cancer, but they don't know what kind. And it's so crucial to know nowadays whether it was ovarian, or was it breast, or whatever it was. So it's really an injustice to our children by not telling them what the problem was or is. NEAL: It sounds like the one thing I'm hearing in terms of husbands, in terms of children, in terms of friends, is you need to talk. BOTH: That's the key. And educating yourself. ANA: Educating yourself. Being your own advocate. Educate yourself so you can talk about it, even if you have to look at a film that shows you how to talk to your family about it. There is so much information out now for people, and there are outreach people. If you can't do it by yourself, then get someone in to talk with you. Take your daughter with you to the doctor's appointment and let the doctor help explain if you can't do it yourself. But find a way. MARCELLA: That does happen. NEAL: So, bring people with you. If you're uncomfortable, take them by the hand and take them right into the doctors.

Final Comments: Sharing your experience with other Hispanic women

MICHAEL: I have one question for both of you. As a cancer survivor, it's a question that I like to ask. We all know that there are challenging and there are scary and there are trying moments associated with having cancer, but there are also some moments that transcend anything that can really be explained. For both of you, what has having cancer meant to you as a positive aspect of your life? ANA: Well, this has been a life-changing experience. I wish that I could have learned these lessons without having cancer, but it took cancer to get me to slow down and to start taking care of myself. I'm being a caregiver and I think, you know, we're all caregivers. But mothers, women, we just tend to nurture everyone else and forget about ourselves. We put ourselves low on the totem pole, and I think it's really critical. What I've learned is that I have to take care of myself so I can be around to take of others. I've just gotten so many rewards during this time, and unfortunately I had to live with a lot of fear. For about five years, I really felt like I had lost my soul and my spirit. With this new millenium, I've been doing lots of processing of things I felt I needed to change in me and in my life. And I just chose different ways to work with that. A lot of prayer, getting closer to God. I've just been on a path, because of this cancer. And this past year, when the millenium came, and I'm turning 50 in the year 2000, next month... I'm so glad to be here, because seven years ago they told me I wouldn't be. My goal was to see my son graduate, and he's a senior this year, and he's graduating. It has been such a reward to me to have had the personal spiritual growth that I have had through this experience. A lot of women when they get the cancer, and I did this the first time I had cancer-I got the cancer, I'd have my chemo on Friday, I'd go back to work on Monday, and it wasn't going to change my life. I was strong, I never got sick with it, I was just fine. But I didn't change anything, and so I really feel that that's the message I was getting from God, that I needed to make some changes in my life. And I've learned to process a lot of anger that I found out I had in me, for all kinds of different reasons. Even anger about getting cancer. But through that process, now, I knew that this millenium was going to bring the year of peace that I was looking for. The years of peace that I was looking for. And it's like a healing has occurred for me. It's just been amazing how different my life is now, through all the process work that I've chosen to do because of this cancer experience. MICHAEL: It certainly is a perspective experience, and it pulls you back. Marcella, how about you? What have you found to be positive about the experience? MARCELLA: Well, as Ana mentioned also, I think that she put into perspective who is most important. We as women, and more so because we are Hispanic, feel that we have to be caretakers. But in order for us to be able to take care of somebody, we've got to be well. And for me, it was getting myself well. And then once I was fine, then I could go back and take care of everybody, of my family, more than anything. It also taught us that life is very short, that God lends us our time down here, and when he's ready, he'll take us, and what little time we do have, to enjoy it. And for our family it's very important. So basically what I did was I set priorities, and the number one priority was our family, and if I had a choice between being at a social gathering or being with our children, we chose our children. And a lot of times in this fast-paced world we do forget our priorities, and it gave us a little perspective, a perspective on what is important. To us, our family is very important. ANA: And I think that for women who go through this, once they've been through it, in our culture, it's so important if they can share their story. That's what we did at this meeting of the Latinas that went to this last conference. There were elderly women there, and there were young women there, and we all had multiple issues. But to have our grandmothers get involved in advocacy work! They are doing this, and this is really important. You can make this a positive experience; you can help others, if you are willing to share your experience with others. You'll help your family, for one thing. But by sharing your story, or your experience in some way, just by telling it to one other person, you may save that person's life. I think if we can get over the thing, the cultural aspect of everything being private, and that we don't share those kinds of things, that we can do a lot for our culture. MICHAEL: So really, even in the midst of something this difficult, there really are some wonderful, positive things going on here. BOTH: Definitely. NEAL: I'd really like to thank you guys for being part of our show today, and I'd also like to thank Michael for being my cohost, helping us outline some of the issues, some of your personal experiences, and hopefully giving some ideas to others on next steps they can take in terms of dealing with their own cancer, or helping family and friends. Thank you very much. For the American Cancer Society's Cancer Survivors Network, I'm Neal Sofian. Note: All the content of this interviews has collected from American Cancer Society's Cancer Survivors Network.