I was trained months ago to serve as a Reach to Recovery volunteer for the American Cancer Society (ACS). My purpose: to meet face-to-face with women facing breast cancer, to offer them some measure of comfort, to help them manage their overwhelming emotions, to provide them with information and resources, to impart hope during a time of fear and uncertainty.

For months, I had not been called upon to meet with anyone in my community. I'd like to think this is a good thing -- a sign of decreasing breast cancer cases perhaps -- but I tend to believe it stems from a hesitancy to ask for help or a lack of knowledge about this support program. Regardless, I got my first call last week. And I made my first visit. And these are my first impressions of my first encounter as a Reach to Recovery volunteer.

The Reach to Recovery program operates on the premise of matching like-cancer survivors. I was matched with a young woman -- she is 31; I am 37, although my diagnosis came at age 34 -- and each of us was diagnosed with early stage breast cancer. We both had surgery, both have young children, both feel a little sad that because of cancer, we likely won't have more children. We connected. We bonded. For a little more than one hour, we were in the same boat. Together, we tackled rough waters.

In 2003, 29 percent of the American population had only basic prose literacy skills and 14 percent had below-basic skills.

Prose literacy measures the skills needed to understand texts such as new stories, brochures, and instruction manuals. People with basic skills can perform simple, everyday literacy activities. Those with below-basic skills are proficient in only the most simple and concrete literacy.

How is it that these individuals, when they are diagnosed with a disease such as cancer, are able to understand the medical jargon thrown their way, the literature that piles up in front them, the complicated process we call the medical system?

They aren't. And this leads to increased chances that people will be hurt, even killed, in the course of their medical treatment.

There are many barriers that lead to miscommunication -- cultural differences, language problems, and overall poor literacy skills -- and experts in this area are recommending some changes. They urge more education and training for health care professionals who may not ever imagine someone might not understand their words. They suggest health teams use medical interpreters. And they seek to embrace a culture of easy-to-understand communication in all aspects of medical care.

Toni Cordell, a nationally-known health literacy advocate, says humiliation and shame washed over her three decades ago when her gynecologist told her she needed a simple repair and she woke from surgery to learn she'd had a hysterectomy. Struggling at the time with dyslexia and a poor education, Cordell never asked any questions of her doctor. She just accepted the course of action, without knowing anything about it.

"Ignorance is not bliss," she says. "It's not a good place to be."

Regular. Strenuous. Exercise. Memorize these three words. Live these three words. And abandon all thoughts of a fitness routine that is easy, moderate, or periodic.

Brisk walking, golf, and volleyball are considered moderate forms of exercise. Swimming laps, aerobics, and running are considered strenuous. And these are the activities we should be taking part in -- for the rest of our lives -- if we really truly wish to prevent breast cancer.

A new study, published in the February 26 issue of the Archives of Internal Medicine, shows women with a long-term history of engaging in strenuous exercise for more than five hours per week were 20 percent less likely to develop invasive breast cancer and 31 percent less likely to develop in situ breast cancer than those logging less than 30 minutes of strenuous exercise per week.

It seems strenuous exercise most affects estrogen-receptor negative breast cancer. But clearly, everyone can benefit from vigorous fitness training -- the American Cancer Society recommends moderate to strenuous exercise five days per week for at least 30 minutes each day -- and this is exactly why I am headed out for a run. Today!

As evidence mounts, it's becoming more and more clear that chemo brain, a mental fogginess that can result from chemotherapy, is a real concern and not just a convenient excuse cancer patients use to explain away their flighty and forgetful tendencies. It seems the brain really can suffer cognitive damage from the poisonous drugs that fight off deadly cancer cells. And sometimes, this damage is present years after treatment.

Add to chemo brain the normal aging process as well as brain conditions such as mild cognitive impairment and even schizophrenia and the brain might not stand a chance of ever remembering anything. Unless we buy into the new concept of mental training -- somewhat like physical fitness training -- in which case we may be able to bring back a level of sharpness to our lives.

Research suggests this type of training may delay mental decline. And Betty Hall, 85, who is taking a brain fitness class at her senior living complex in Illinois, says brain-enhancing activities are definitely helping her.

Hall is participating in an eight-week program where she spends one hour per day, five days per week using a computer to match words and listen for details in stories. She says it's helping her remember where she places her keys and her grocery lists -- and it's even helping her in her bridge club.

"I've won four times out of the last five at bridge club, and I think the players are going to shoot me because I keep remembering the cards people have," she said. "It's much easier for me to concentrate . . . and I brag about it everywhere I go."

One clinical professor of neurology says brain health programs will explode over the next few years because of the stunning findings on this front. One study shows relatively short training regimens, lasting just five or six weeks, improve functioning for as long as five years. And booster sessions help advance these gains. Study participants says their everyday tasks, like managing finances, are much easier after mental workouts. Another study of the computer software Hall uses shows the program shaves an average 10 years off the mental age of users.

Not all mental training is alike, and different cognitive difficulties may call for different training protocols. But the simple fact that I can work out my brain like I can work out my body gives me hope that I can possibly reverse the effects of chemotherapy on my own foggy brain, that I can one day not worry anymore that I might find my check book in the refrigerator and my cell phone in my sock drawer. Bring on the workouts!

Thanks to Bev, my brainy friend, for this story tip!

The build-up to 2006 was a bit uncertain for me. At the end of 2004, I was diagnosed with breast cancer and set my sights on short-term survival, moment by moment, day by day. I wasn't sure 2005 -- in its entirety -- was a guarantee so I tried not to look too far ahead. I focused on the completion of each of the year's cancer steps -- surgery, chemotherapy, radiation, the beginning of a year-long Herceptin therapy, and so much more -- and somehow, I survived the whole ordeal. And the whole year.

I made it through 2005, and I have almost made it through 2006 -- a year marked by a cancer slow-down, a more normal existence. Moment by moment, day by day, the burden of cancer loosened it's grip on me. And as I begin to reflect on the year that has all but passed before my eyes, I realize it turned out just fine. Here are seven reasons why.

• On May 19, 2006, my very first post published on The Cancer Blog. What a thrill it was -- and still is -- to find myself engaged in a useful pursuit as a result of my own cancer experience.
  

• On June 28, 2006, the last drops of Herceptin made their way through my body, marking the conclusion of 17 doses of this hopefully life-saving potion.

• On September 15, 2006, my port came out, signaling my acceptance of a life without drug treatment, my faith that I will never again need a foreign object sewn under my skin.

• On December 6, 2006, 18 months of counseling came to a close. Armed with skills to cope with all sorts of emotional issues, I am marching forward, free of the disabling anxiety and free-flowing tears that first landed me in the counseling chair.

• For much of 2006, I have been a student of fitness training, pushing myself physically in search of better health. It's not always easy, I'm not always motivated, and I am known to whine a bit -- but still, I am happier just knowing I am working toward sustained health.
  

• Throughout the entire year, I have walked away from every medical check-up and follow-up with a clean bill of health. I hear the longer someone survives cancer, the less likely the disease is to return. Happily, I have two years of survival under my belt.

• Ever since my diagnosis, I have been reaching for others with journeys similar to mine. First, I reached for support and guidance and reassurance. Then, I reached to offer my own version of support and guidance and reassurance. The year 2006 has been full of rich connections, found only because of cancer. Reaching makes me feel good.

Yes, the year 2006 turned out just fine.

It's not surprising marathon runners face an increased risk of skin cancer due to long-term sun exposure. What's surprising is that so many are not taking measures to protect themselves from the sun's damaging rays.

A team of Austrian researchers, all of them dermatologists, became interested in studying long-distance runners when they realized they had collectively treated eight ultra-marathon runners with malignant skin cancer over a period of 10 years. All researchers are themselves enthusiastic runners, and two of them participate in marathons. The topic was near and dear to their hearts.

Research was conducted on white runners, so it is unclear if the findings -- listed below -- apply to black runners.

• Only 56 percent of runners in the study reported wearing sunscreen. Most were unaware of the increased risk to their skin -- and even the running researchers report it is good to be reminded to wear the right gear and regularly use sunscreen

• Many runners race with a lot of skin exposed. And sometimes training clothing covers different areas than racing clothing. Shoulders that are covered during training may be exposed during the long hours of a marathon. During triathlons, most wear a bathing suit for the duration of the event, leaving most skin susceptible to burning. Runners can lower their risk by training during morning and evening hours and wearing water-resistant sunscreen. They can wear clothing made of new fabrics that screen harmful ultraviolet rays.

• It's possible that endurance athletes may have suppressed immune systems caused by repeated tissue damage, leaving them more vulnerable to skin cancer.

While some marathon runners take pride in a bronzed skin -- proof they are running in the elements -- researchers hope runners will consider the risk they face. In some races, volunteers offer to quickly apple sunscreen on athletes who don't want to lose precious seconds as they race for the finish line. It's a start.

It's kind of a blur how exactly I came to receive a phone call from a volunteer at the American Cancer Society just after my breast cancer diagnosis. I must have checked a box on one of many medical forms shuffled my way during this confusing time. Or I requested assistance from someone, somewhere, at some point in time. I'm not really sure. But I am sure of this -- one very nice woman, a young breast cancer survivor herself, called me one afternoon from the Reach to Recovery program. She asked me about my situation, told me of hers, and led me to resources -- other survivors, support groups, and the fitness group Team Survivor -- and she met me one afternoon with a goodie bag full of information and comforting gifts. She was my first link to the world of breast cancer survivors.

I've come to know this woman in different circles since she first called me. She was a physical therapist at the same center where I received therapy for post-surgery and radiation concerns. She has been present at every walk and fitness event and cancer function I have attended. And she leads the local Team Survivor group -- so I receive e-mails from her about all sorts of events and gatherings and opportunities for joining a spirited group of strong women. And just today, I received an e-mail invitation from her -- intended for all young survivors she knows who might be interested in becoming Reach for Recovery volunteers. I replied instantly. Yes, I want to do it. She happily replied. So in a short time, I will receive training for this very important job.

It's not a hard job -- it just requires some phone calls and a few personal visits. And the ability to share advice. And words of wisdom. And love and care and compassion for those who may not know how to manage during a personal brush with breast cancer. Whether facing a possible breast cancer diagnosis, a new diagnosis, or a troubling time with lymphedema or reconstruction, Reach to Recovery volunteers offer a hand to anyone grasping for assistance.

I must have been grasping during my own difficult time. I just don't remember much about that time. All I know is that someone helped me at a critical time. And now it's my turn to be that someone.

It may be possible to learn happiness -- like we might learn to cook or learn to dance -- by merely taking a class. Some refute this idea and believe you can't actually pursue happiness. You either have it or you don't. But some psychologists are embracing a whole new approach to psychology -- they call it positive psychology -- and they say it focuses on training the mind to focus on the past as very positive. It's completely different from traditional psychology where time is spent trying to determine why someone is so horribly sad. This movement, invented by University of Pennsylvania psychologist Martin Seligman in 1998 when he was president of the American Psychological Association, provides a scientific validated set of exercises -- known as interventions -- that lead happiness seekers to their ultimate destination.

Despite tensions between the United States and the Middle East, Laura Bush announced Monday a plan to raise breast cancer awareness in the Middle East -- first with partnerships with the United Arab Emirates and Saudi Arabia and later with Morocco and Jordan. Joining forces also with the Susan G. Komen Breast Cancer Foundation, the MD Anderson Cancer Center in Houston, and Johns Hopkins Medical Center, the First Lady outlined a plan that will allow governments, hospitals, researchers, and survivors to work globally to defeat breast cancer. Campaigns specific to each country will target research, training, and community-outreach programs. The reason for this partnership -- to raise awareness in countries where women are too embarrassed or too uninformed to seek treatment -- stems from compassion and human decency and a desire to form diplomatic friendships too. Laura Bush, whose own mother is a breast cancer survivor, shared that the tragedy of losing a loved one to breast cancer -- and the joy of watching a loved one survive this same disease -- is felt universally. Breast cancer affects all women in all countries. Borders make no difference in this matter. And helping save lives is the right thing to do.

I have tried to exercise most of my adult life -- at times because I felt obligated to participate in what I knew was good for me and at times to justify eating my favorite foods while maintaining an appropriate weight and at times because I wanted to actually have a toned, healthy body.

At this exact time in my life, I exercise with all of these motivations in mind -- plus a few more. I like to sweat and know I am accomplishing a physical feat. I like the mental release I get when I push my body to perform. I like the time to myself, the loud music I hear on my MP3 player, and the results I see from a little bit of hard work. And lately -- as a result of a new weight training program -- I know I am benefiting my body more than ever before.

The following are just seven of the many gifts that come from weight training. Gifts that will make me a happier, healthier cancer survivor.

Noticeable physical results -- Mostly, walking and occasional jogging have been my methods of exercise. And I've seen results from this type of workout -- leaner legs, more defined calf muscles, and the knowledge that I am increasing my cardiovascular health, as confirmed by the technician who performed an ultrasound on my heart in preparation for my Herceptin treatment for breast cancer. He told me he could tell I exercised regularly because of my low resting heart rate. But until I started weight training a few months ago, I never witnessed quick results. Yet after a few weeks of resistance exercise -- lifting 20-pound weights for my arms, shoulders, back, and chest -- I could see definition and tone that clearly would not have resulted from my purely cardio workouts.

Improved strength and endurance -- Lunges and squats and jumping with resistance bands have strengthened my legs. Lifting weights has strengthened my arms -- and I can now lift heavier weights than when I first started my new routine. I can do more push-ups now too -- not girl push-ups on my knees but real push-ups -- than I ever could have imagined doing when I could barely lower my own body weight and would crash to the floor on my stomach. My strength has improved. My endurance has improved. I feel more powerful.

Increased energy -- Fatigue (or maybe it's laziness) sometimes prevents me from happily jumping up to begin exercising. But when I push myself and exert myself and get lost in my exercise routine, my energy returns -- and not just during my workout but for some time afterwards too. Some say energy increases from strength training because it contributes to loss of fat which means we have less to lug around each day.

Burning of more calories -- Weight training raises basal metabolism which causes more calorie burning over a 24-hour period of time. Calories even burn during sleep as a result of weight training.  For every additional pound of muscle you gain, your body burns 50 extra calories every day -- 50 more calories than the few hundred that might burn from aerobic exercise. Research shows that regular resistance training can increase your Basal Metabolic Rate by 15%. So for someone who burns 2000 calories per day, that's upwards of 300 extra calories burned every single day. 

Decreased onset of illness -- Weight training can reduce the risk of adult onset diabetes and the risk for developing colon cancer and can improve the functioning of the immune system and the efficiency of the heart. It decreases the risk of low-back injuries, decreases resting blood pressure, increases good cholesterol (HDL), and improves posture. The list goes on -- and so does healthy living if weight training becomes a way of life. As a young person already having experienced a life-threatening illness, this comforts me.

Prevention of osteoporosis -- My recent bone density test revealed that I am not at this moment at risk for developing osteoporosis. I don't want this to change. Strength training can help me maintain this status because it can significantly increase bone mineral density -- which is important because we naturally lose bone density as we age. Strength training helps protect against osteoporosis. And age should not be a deterrent. Individuals who begin training late in life -- at age 65, for example -- can restore bone loss.

Improved outlook on life -- As a result of toning and shaping my body, burning calories, enjoying greater strength and energy, and working toward a disease-free future, weight training gives me an improved outlook on life. And weight training has recently been reported to significantly improve the quality of life of women recently treated for breast cancer. A May 2006 study indicates six months of twice weekly exercise was enough to improve the overall physical and emotional condition of patients.

Twice weekly is my weight training goal. I will continue to walk and run -- and bike on occasion too -- but strength training will be my priority. Because health is a priority.

When I was diagnosed with breast cancer I became dedicated to learning everything I could about breast cancer. What caused it. How to survive it. What the experts knew. What research had revealed.

In my studies, I came across information about weight gain and the risk it posed in managing long-term cancer survivorship. Basically, as I understood from what I was learning, I was at greater risk for recurrence if I gained too much weight.

When I sat in the oncologist's office waiting room, I noticed bowls of sugary candy liberally stationed in every corner of the waiting room. I remember wondering if this was a good practice.

One day I brought this up to the physician -- yes I was one of those patients who questioned authority if I had information that conflicted with what I was being told or what I noticed was the practice -- I was assured they were more worried about the weight loss of their cancer patients than weight gain.

Abramson Cancer Center of the University of Pennsylvania researchers report the results of a study to determine if progressive weight training increases the risk of developing lymphedema -- a buildup of lymphatic fluid under the skin that causes arm swelling for some breast cancer survivors after lymph node removal -- and found that weight-bearing exercise did not cause a higher incidence of this painful condition.

Because many women who undergo initial breast cancer diagnosis have lymph nodes removed to determine if the cancer has spread beyond the original tumor site, lymphedema is a real concern. Lymphedema can occur soon after lymph node removal, or years later. Breast cancer survivors are advised to alter some activities and to avoid undue physical strain when using the affected arm.

However, from the results of this small study, breast cancer survivors are assured that slow, light weight lifting is not a cause for concern. Personally, I use small five pound hand weights as part of my exercise routine, and like the researchers, would advise breast cancer survivors to avoid lifting weights heavier than five pounds until a study spanning several years is conducted.