It is important to question your physician about the prescriptions you are given. Most doctors will talk to you about the medication prescribed, but it is still important that you know what you're taking and ask appropriate questions.

• Know the name of the drug. This will enable you to look up information about the drug on your own. It will also enable you to discuss the drug with your doctor or another doctor for a second opinion.
• What is the purpose of the drug? This information will help you to know and understand what this drug is supposed to do and will let you know if the treatment is actually working.
• What are the side effects? It is helpful to be aware of the most common side effects. All drugs have some side effects. Information about side effects can be obtained by asking your doctor or pharmacist or consulting a reliable reference.

What to do with expired or unused medication?

The American Pharmacist Association (APhA) does not recommend flushing expired or unused medications down the toilet or pouring them down the drain, as they have the potential to contaminate water supplies. Instead, the association advises crushing or dissolving medications in liquid and mixing them with kitty litter or coffee grounds, and then placing in a sealed trash bag. Also remember to remove personal identification from any bottles.

In addition, check for community waste days where you may be able to bring your unused medications to be disposed.

Dr. Steven Sheaffer, Associate Professor of Clinical Pharmacy at University of the Sciences in Philadelphia, states that public medication disposal systems, where medications can be safely incinerated are 'the ideal scenario'. Until that becomes a reality, you can follow the above tips to safely dispose of unused medications and help keep our water supplies clean.

I've written twice before about a young woman named Diem Brown. I first wrote in August about her appearance as a contestant on MTV's Real World/Road Rules Challenge reality show. I wrote about how despite a recent diagnosis of ovarian cancer, she took herself to Australia to compete in physical and mental challenges with other spunky 20-something competitors. Brown, 25, fought for a cash prize of $250,000 -- while fighting cancer at the same time.

Brown did not win the grand prize, but she did win the admiration and respect of her castmates who on an MTV reunion show applauded her tireless and heroic efforts. In my second post, in September, I wrote about Brown's presence on the reunion show, about her strength, about the great mindset she acquired prior to returning home from Australia for treatment. I wrote about her foundation -- Live for the Challenge -- a wedding-type registry that allows patients to register for prescriptions, wigs, anything that helps them manage their illnesses. I did not write about the wig Brown wore on the show -- but it was apparent she had lost her long, blond hair and was masking the most visible side effect of chemotherapy.

Brown reluctantly yet powerfully unveiled her head on national television just a few nights ago during the beginning of another MTV Real World/Road Rules Challenge. During this installment -- The Duel -- Brown competes again, this time with the shortest of brown hair covering her scalp and with a fierceness that rivals anything she's offered on past shows.

Brown is back. She's in Brazil. And she is beating cancer.

The most recent season of MTV's Real World/Road Rules Challenge reality show has just ended. Customary after each season finale is a reunion show -- where a sampling of contestants recap their experiences, answer questions, confirm or dispel show rumors, and update viewers on the status of their post-television lives. The winners -- a twosome who took home $250,000 -- sit front and center at the reunion and get to bask in the glory of the physical and mental prowess that allowed them to win the big bucks. Two contestants clearly won -- they have the money to prove it. But another contestant -- who didn't take home a dime -- is the true winner in my book.

Diem Brown, 25, was cast on the MTV challenge show before she knew she had ovarian cancer. But prior to the start of the show, Brown did know of her diagnosis -- and she still decided after just a few treatments to head for Australia where she competed in physical stunts and tough competitions. The producers never knew of Brown's illness and she confided in only two castmates while she battled through fatigue and nausea to complete her own personal survival mission. She succeeded -- and she returned home victorious in her own right. And she has no regrets.

On the reunion show, Brown said the show made her more fierce, that she came out of the experience a stronger person, that she tried her hardest, put everything on the line, and didn't feel sorry for herself. And it put her mindset in a great place prior to returning home for continued treatment.

And now Brown is home. She is receiving treatment. And she is managing her foundation -- Live for the Challenge -- a wedding-type registry
where patients can register for wigs, prescriptions, anything critical to the management of their illness.

Ovarian cancer affects one in 50 women, mostly in a silent fashion -- with no overt symptoms until it's often too late. And there is currently no accurate screening for this life-threatening disease that can have tragic outcomes.

Brown seems to be managing just fine with the cancer she calls "the disease that whispers." She is strong, spunky, enthusiastic and positive about life, about her future. She is clearly a winner.

The Center for Caregiver Training is developing web based education courses for AIDS/HIV and cancer caregivers that offer practical skills to manage and cope with the responsibilities of being a caregiver. Caregiving 101 has three completed modules of lessons -- Learning About the Disease; Working with Your Medical Team; and Building a Personal Support Team.

To make the most of the time spent visiting with the doctor, one of the lessons in the Working with Your Medical Team module is How to Be Prepared for a Ten Minute Doctor's Visit.

Here are some of the tips included in the lesson:

• Always maintain an up-to-date medication list that includes all prescription and non-prescription items taken.
• Keep a journal of information that the doctor feels is important. This might be weight, temperature, blood pressure, blood sugar levels, and level of pain.
• Between visits, make a note of any unusual symptoms experienced in the journal. This might be night sweats, nausea, lack of appetite, insomnia, fatigue, confusion or anxiety.
• In the journal, jot down questions you might have for the doctor as you think of them.
• Bring the journal with you when you take your loved one to visit the doctor.
  

Other modules in development are Finding Help in the Community, Tools for Life as a Caregiver, Daily Care at Home, Managing Medications, Maintaining Nutrition, Managing Symptoms & Side Effects, Managing Pain and Coping With Mental Changes.

In USA Today, Prices soar for cancer drugs, are some disturbingly stunning and eye-opening facts regarding the current cost of cancer drugs and an examination of where the costs might be headed. For example, Avastin, a newer drug used to treat colorectal cancer, costs about $50,000 dollars a year in treatment. That price is expected to go to $100,000 dollars a year if Avastin is approved to treat breast and lung cancers. It would be an understatement to say cancer patients and insurance companies are concerned. It's an uneasy feeling.

Some cancer drugs can cost $10,000 dollars a month for a single drug. The average monthly cost for a prescription cancer drug is estimated at $1,600 dollars. Without insurance, few could afford to buy life saving drugs and the consumer has to be sitting precariously perched at the mercy of insurance companies to keep funding the medicine. I think it would be safe to say that any cancer patient among the 45 million uninsured Americans is going without much-needed  medications if they have to come up with the money to buy the drugs. At these prices it is not possible.

"These costs are out of control," says Fran Visco, president of the National Breast Cancer Coalition, which is planning a conference focused on drug costs in the fall. "We can't allow it to continue." Who is going to stop the drug companies from charging what they want?

"It's really exploiting the desperation of people with a life-threatening illness," says Marcia Angell, former editor of The New England Journal of Medicine.

I just posted about quacks who exploit the desperation of cancer patients. While I do not equate drug companies with that jailed quack specifically, there seem to be more bad guys than the obvious scoundrels who prey on vulnerability. I don't have the answers but I am pessimistic about how this turns out for the cancer patient. I have yet to see anything in our society fall in price. I don't begrudge a business of profit -- but this is starting to look like a free-for-all and forget who might be hurt along the way.  What do you think?

According to Atlanta's Centers for Disease Control and Prevention's Dr. Susan Sabatino -- based on a study -- there are an estimated 660,000 uninsured cancer survivors in the US.

Because of the lack of medical insurance, or financial ability, two-thirds of uninsured cancer survivors younger than 65 delay seeking medical attention or skip buying needed prescriptions. The reason the study focused on people younger than 65 is because they do not qualify for Medicare health coverage.

Sabatino and her team share that they found almost 43 percent of cancer survivors with no health coverage said they had failed to get necessary prescription medicines due to cost concerns. In what can seem a normal life, your whole world collapses when you get a diagnose of cancer -- I cannot fathom the additional inner terror that someone diagnosed with cancer must face if they do not have health insurance or realize they cannot financially afford treatment or long-term aftercare.