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August 1, 2019Congratulations are in Order . . . Inova Fairfax Hospital was named #1 Best Hospital in Washington DC area by U.S. News and World Report and #13 in the Nation for Gynecology in caring for women.  Comments Off on Congratulations are in Order | Category In the News | Tags: August 1, 2019We are most grateful to our wonderful clients for so well representing Life with Cancer and to our staff who provides such incredible care.WTOP-Beyond Medicine  Comments Off on WTOP: Beyond Medicine | Category In the News | Tags: July 6, 2019Reprinted from Survivors’ TableBy Danielle PenickWe always hear about eating more produce and it’s a well known fact worth repeating, eating more fruits and vegetables helps with preventing chronic disease. But most of us are not eating enough, putting us more at risk for things like diabetes, high cholesterol, and even cancer. The Centers of Disease Control finds that only one in ten Americans are eating their recommended 5 servings a day. We know we should eat more, but many of us are overwhelmed with where to start. Do I have to change my entire way of eating? Or is eating this way is going to be expensive? What recipes do I use? What if I budget for extra produce and don’t like it? To what if it goes bad before I eat it? Some of us even get anxious starting if they have a spouse or family who doesn’t eat the same way. These are all reasonable concerns and I hear them from many of my patients and friends. But what if I told you it doesn’t have to be a huge uphill battle to eat better? The simplest place to start is by enhancing what you are already eating. For example  if you eat eggs at breakfast, just add veggies to an omelet or if you eat yogurt, cereal, or oatmeal, then add fruit to it. If you like to snack, try snacking on produce with hummus, cheese, or peanut butter etc. If getting your family on board with your new way of eating is a barrier, this is one way to make the change without drastically changing what your family is eating. They can even opt out of adding extra produce to their diets if they are extremely resistant to making changes. You can add veggies to your pizza, pasta, or casseroles, but your family can take them out or not add them to their plates (but who knows you might even inspire them to try it). You can also add fruit to ice cream, salads, pancakes, muffins, etc. Or try at meatless Monday and opt for veggies in place of meat. For example veggie tacos or veggie fajitas without the animal protein.Some people like another method of just trying one new produce item per week. Meaning if you’re at the store, grab something you have never tried or seen before and take it home. It may inspire you to try a new recipe or could be a good conversation piece at home. You may learn more about nutrition or another culture depending on the origin of the fruit or vegetable you choose.  Another consideration if you are worried about your produce going bad is to buy frozen produce or even canned produce (soaked in light syrup, water, or light salt in place of the heavy syrup or high salt options). Keep these on stock at home and use them at your convenience—this will ensure you don’t have to worry about them spoiling. Frozen is a great option for steaming veggies as well since you can toss them in the microwave or stove. Once you decide to make any changes it’s also important to look at your eating environment and what surrounds you. Just being around more produce in your home or at your work desk, increases the likelihood you will eat it. For example people who have a fruit bowl on their countertops or tables are more likely to eat fruit. If you have bags of sliced veggies in containers or baggies you are more likely to eat these as a snack than not. Or having dried fruit, apples, and bananas at your desk. Many people feel less overwhelmed to just start by eating just one extra serving of produce each day and once this becomes the norm, then you can add another serving. Over time the goal is to follow the American Institute of Cancer Research’s New American Plate method by filling 2/3 of your plate with plant based foods. Of note, this also includes beans, nuts, seeds, and whole grains. A good goal is to aim for 1/2 of your plate with fruits and veggies and the other 1/3 for grains. With time you will be able to do this without thinking much about it. One of the biggest barriers I hear about is perceived cost of produce. When you break it down you might be able to eat up to 3 servings of produce items for under $2 per day by looking at what’s on sale at the store or having frozen produce on hand. Check out conventional production methods as well since they are often cheaper than organic. If you opt for this choice just know that you will not be impacting your health or nutritional value by swapping for the cheaper option. I’ve written about this topic before, and the evidence has shown that neither production method is superior for health or nutritional value. If you have the time and resources growing your own supplemental garden may also be something you can look into. Eating in season can also help with reducing the cost of produce. Try a variety of all colors and eating cooked and raw fruits and veggies. Each color represents a different vitamin or mineral and eating cooked produce items can enhance the amount of some nutrients, while it can also decrease the amount of other nutrients. For example, a raw tomato is high in vitamin C, but much of it is lost when you cook the tomato. However, lycopene is enhanced when it’s cooked. So it’s best to eat a variety of all colors and cooking methods. If you’re looking for more meal planning ideas for fruits and veggies, I recommend checking out Eating Well for ideas. While it’s important to focus on a balanced diet, this way of eating may not be right for everyone while going through cancer treatment. If you are struggling to keep weight on or have swallowing issues, then this might be best reserved for a later time when weight loss is not of concern. Sometimes the goal is simply eating adequate calories and it may not include eating a lot of produce since they are low in calories if you can’t each much. This way of eating is good for helping to prevent cancer recurrence once treatment is completed or if you are well nourished. There’s no perfect way to eat more produce, but to succeed in your journey you just have to take that first step!For more updates, you can follow Survivors’ Table on Facebook. Thanks for joining me on this journey! – Danielle  Comments Off on How to Increase Your Consumption of Fruits and Vegetables (YES! you should) | Category Nutrition | Tags: Cancer,colorful foods,food,healthy diet,healthy eating,nutrition,survivorship July 6, 2019The AICR/WCRF Third Expert Report found strong evidence, for the first time, that eating 90 grams (about 3 ounces) of whole-grain foods daily reduces risk for colorectal cancer by 17 percent. Research also showed that eating greater amounts reduced risk even further.Click here to download the pdf version of the 2018 Revised Version of the report. Comments Off on Diet, Nutrition, Physical Activity and Colorectal Cancer | Category Nutrition | Tags: American Institute for Cancer Research,colorectal cancer,nutrition June 22, 2019 The word “qi” in Chinese means “energy.” According to traditional Chinese philosophy, qi is a form of fundamental life energy that is found throughout the universe and is responsible for health and vitality. “Gong,” meanwhile, means “skill.” Qigong (the skill of attracting energy) is an ancient system of healing that combines postures, exercises (also known as “movements”), breathing techniques and meditation to improve and enhance the body’s supply of qi, and to increase one’s sense of well-being.History of QigongNo one knows exactly who invented qigong, or when it originated. Some scholars estimate the practice of qigong to be upwards of 5,000 years old, and believe that it was first implemented by monks and other teachers.Although qigong has been practiced for thousands of years, it remained relatively unknown in the United States until the 1970s, when acupuncture was first publicized. As the public began to understand and appreciate the benefits acupuncture had to offer, the use of other forms of traditional Chinese medicine, such as qigong, increased. Today, hundreds of thousands of Americans practice qigong every day, an interest shared by more than 60 million Chinese.ConceptsQigong has been influenced by many parts of Chinese philosophy, most importantly the Taoist philosophy, which holds to the belief that the universe operates within certain laws of balance and harmony, and that people must live within natural rhythms. These beliefs are rampant throughout qigong.Traditional Chinese medicine shares many of the concepts of qigong, including the idea of energy patterns in the body. Qi is believed to flow through the body along certain channels, or meridians, with a meridian corresponding to each of 12 principal organs. With acupuncture, points on each meridian are stimulated to increase or decrease the flow of qi and promote healing. Similarly, qigong techniques are used to improve the balance and flow of qi throughout the meridians, and to increase the overall quantity and volume of qi.Qigong practitioners use the same points that practitioners of acupuncture and acupressure seek to stimulate.Another important concept in qigong is the relationship between mind and body. In qigong philosophy, mind and body are not separated; rather, the mind is present in all parts of the body, and can be used to move qi throughout the body.A third concept practiced in qigong is the relationship between yin and yang. Yin and yang are opposites, yet they interact with each other and influence the others actions. One of qigong‘s goals, in addition to improving the balance and flow of qi, is to balance yin and yang. Therefore, when qigong is practiced, complementary techniques are used to balance things out. For instance, a technique using the left hand may be followed by a technique involving the right hand; a strong technique may be balanced by a lighter technique, and so on.Qigong TechniquesThere are literally thousands of qigong exercises and exercise combinations. Specific techniques are used depending on the teacher giving the instruction; the school where one learns qigong; and the objective one is trying to attain.As mentioned previously, there are four major components of qigong. Postures may involve standing, sitting, lying down, or a combination of all three. Movements include long stretches, slow-motion exercises, thrusts, jumping, and bending. These postures and movements often occur together, and are used to strengthen and tone the body.Breathing techniques and meditation comprise the other components of qigong. Sometimes, patients may hold their breath; other times, they may take deep breaths from the chest or abdomen, or relaxed breathing. Meditations are used to stimulate the mind and move qi throughout the body. Many meditations are visualization-type exercises in which the subject visualizes moving energy from one part of the body to another (or from one organ to another).There are also two forms of qigong — internal and external. Internal qigong is performed by people who wish to increase their own energy and well-being. External qigong is usually performed by trained qigongmasters, who pass extra qi from themselves to patients to facilitate healing. While this may sound far-fetched in the West, external qigong is widely utilized in China. Entire medical qigong hospitals exist, in which practitioners combine external qigong, acupuncture, herbs and other forms of care to help subjects get well.How (and Where) to PracticeLike any form of exercise, qigong takes discipline and dedication. Exercises should be performed every morning and evening, for a minimum of 15 minutes per session (advanced qigong sessions may last an hour or more). Qigong should be performed in a clean, pleasant environment, preferably outdoors, which provides fresh air and allows people to move freely. Jewelry should be removed, and loose, comfortable clothing should be worn.Those interested in practicing qigong are advised to practice once or twice a week, and ease into more sessions gradually. In addition, beginners should learn from an experienced qigong practitioner so as not to perform the exercises or techniques incorrectly. Qigong should not be performed on a full (or empty) stomach, nor should it be performed in extremely hot or cold weather.Are There Any Side-Effects?While side-effects are rare, they do occur occasionally in people who are just learning qigong, or practice it incorrectly. Subjects may feel dizzy, fatigued, or suffer from headaches or shortness of breath. Other side-effects include insomnia, emotional instability, anxiety, or a loss in concentration. These side-effects usually clear up with rest and proper instruction from a qualified qigong practitioner.Regulation of QigongWhile qigong has been subject to much government in regulation in China, it is not regulated in the U.S. at this time. Different qigong schools may provide training for instructors, but as of yet, there are no generally accepted training standards. Qigong teachings themselves may also vary. To ensure quality training and instruction, contact a local or national qigong organization, such as the National Qigong Association or the Qigong Association of America, for a qigong practitioner in your area.Reprinted from Acupuncture Today Comments Off on What is QiGong | Category Mind-Body | Tags: mind-body,QGong,qi,QiGong Techniques June 22, 2019From The American Institute for Cancer ResearchMarch 26, 2019Wild Alaska Rockfish with Cauliflower Steaks, Turmeric and Curry ButterSponsored by Alaska Seafood Marketing Institute (ASMI)Enjoy this Wild Alaska Rockfish with Golden Cauliflower Steaks for a flavorful and creative presentation. The turmeric topping on the cauliflower contains curcuminoids which provide a warm, golden color. One of these compounds, curcumin, is studied for its role in cancer prevention. Cauliflower also boasts cancer-protective compounds called indoles and isothiocyanates. Mix up your healthy fish menu with this unique, delicious recipe.CauliflowerOlive oil spray1 large (at least 3 lbs.) or 2 small heads cauliflower1 Tbsp. extra virgin olive oilSalt and pepper, to taste1 1/4 tsp. ground turmeric1 tsp. coriander seeds, coarsely crushed with a rolling pin or mortar1 lemon, sliced into wedgesButter1 lemon for 1 tsp. zest and 1 Tbsp. juice4 Tbsp. unsalted butter, at room temperature1 Tbsp. chopped fresh ginger1 tsp. curry powder1/8 tsp. saltPinch of black pepperFish2 Tbsp. extra virgin olive oil, plus 1-2 tsps. for coating foil lining4 (6-ounce) Alaska rockfish fillets1/2 tsp. salt1/8 tsp. freshly ground black pepper2 scallions, finely sliced, including some of the green part (for garnish)2 Tbsp. chopped parsleyMakes 4 servings.Per serving: 390 calories, 23 g fat (9 g saturated fat), 13 g carbohydrate, 36 g protein, 5 g dietary fiber, 560 mg sodium.Prep Time: 20 minutesCook Time: 40 minutesPreheat oven to 450ºF. Spray or brush a rimmed baking sheet with olive oil.Slice cauliflower into steaks: Remove all outer leaves from cauliflower and stand it upright on a cutting board (trim the bottom of stem as needed to keep cauliflower stable). With a large knife, cut it into 3/4-inch thick slices. You will have some “scraps”—slices or florets of cauliflower – not attached to the core that fall apart, but you should get at least 4 slices that are intact.Roast cauliflower: Brush both side of steaks with oil, and toss “scraps” with a little oil. Arrange on the baking sheet, and sprinkle generously with salt and pepper, followed by turmeric and coriander. Squeeze lemon wedges over top. Roast 25 to 30 minutes, until golden and tender when knife tip is inserted into steak. Remove from the oven and set aside.Lower oven temperature to 400ºF.Make lemon-curry butter while cauliflower bakes: Zest lemon and squeeze juice. In food processor, process lemon zest and juice, butter, ginger, curry powder, salt and black pepper until combined. Scrape down the bowl once or twice as needed. Transfer to a bowl.Cook fish: Line baking sheet with foil and lightly brush with 1- 2 teaspoons olive oil. Set fillets on baking sheet. Brush with remaining olive oil and sprinkle generously with salt and pepper. Bake at 400ºF for 6 to 8 minutes, or until fish is cooked through and opaque. Remove from oven, cover loosely with foil, and let fish rest for 5 minutes.To serve: Cauliflower can be served warm or room temperature; return to oven for a few minutes to rewarm, if desired. Transfer cauliflower to large platter. Set fillets on top and dot each with curry butter. Sprinkle with chopped scallions and parsley and serve*All AICR Health-e-Recipes meet AICR recipe guidelines and are reviewed and analyzed by AICR Registered Dietitians. Comments Off on Wild Alaska Rockfish with Cauliflower Steaks | Category Recipes | Tags: Cancer,cauliflower steak,food,healthy eating,nutrition,recipes,wild alaska rockfish June 22, 2019From the Mayo ClinicGet the most from your workouts by knowing how to gauge your exercise intensity.By Mayo Clinic StaffWhen you exercise, are you working hard or hardly working? Exercising at the correct intensity can help you get the most out of your physical activity — making sure you’re not pushing too hard or too little. Here’s a look at what exercise intensity means, and how to maximize your workout.Choosing your exercise intensityHow hard should you be exercising? The Department of Health and Human Services recommends these exercise guidelines for most healthy adults:Aerobic activity. Get at least 150 minutes a week of moderate aerobic activity — such as brisk walking, swimming or mowing the lawn — or 75 minutes a week of vigorous aerobic activity — such as running or aerobic dancing. You can also do a combination of moderate and vigorous activity. It’s best to do this over the course of a week. You can achieve more health benefits if you ramp up your exercise to 300 minutes or more of moderate aerobic activity a week.Even small amounts of physical activity are helpful, and accumulated activity throughout the day adds up to provide health benefits.Strength training. Do strength training for all major muscle groups at least twice a week. Consider free weights, weight machines or activities that use your own body weight — such as rock climbing or heavy gardening. Or try squats, planks or lunges. Aim to do a single set of each exercise, using a weight or resistance level heavy enough to tire your muscles after about 12 to 15 repetitions.Your exercise intensity must generally be at a moderate or vigorous level for maximum benefit. For weight loss, the more intense or longer your activity, the more calories you burn.Balance is still important. Overdoing it can increase your risk of soreness, injury and burnout. Start at a light intensity if you’re new to exercising. Gradually build up to a moderate or vigorous intensity.Consider your reasons for exercising. Do you want to improve your fitness, lose weight, train for a competition or do a combination of these? Your answer will help determine the appropriate level of exercise intensity.Be realistic and don’t push yourself too hard, too fast. Fitness is a lifetime commitment, not a sprint to a finish line. Talk to your doctor if you have any medical conditions or you’re not sure how intense you should exercise.Understanding exercise intensityActivity trackerWhen you’re doing aerobic activity, such as walking or biking, exercise intensity correlates with how hard the activity feels to you. Exercise intensity is also shown in your breathing and heart rate, whether you’re sweating, and how tired your muscles feel.There are two basic ways to measure exercise intensity:How you feel. Exercise intensity is a subjective measure of how hard physical activity feels to you while you’re doing it — your perceived exertion. Your perceived exertion level may be different from what someone else feels doing the same exercise. For example, what feels to you like a hard run can feel like an easy workout to someone who’s more fit.Your heart rate. Your heart rate offers a more objective look at exercise intensity. In general, the higher your heart rate during physical activity, the higher the exercise intensity.Perceived exertion may not always be similar to your heart rate level, and it depends on the individual. But it can be a general guide to measure your exertion level. If you think you’re working hard, your heart rate is probably higher than usual.You can use either way of gauging exercise intensity. If you like technology, you can check your heart rate with an activity tracker that includes a heart rate monitor. If you feel you’re in tune with your body and your exertion level, you’ll likely do fine without a monitor.Gauging intensity by how you feelHere are some clues to help you judge your exercise intensity.Moderate exercise intensityModerate activity feels somewhat hard. Here are clues that your exercise intensity is at a moderate level:Your breathing quickens, but you’re not out of breath.You develop a light sweat after about 10 minutes of activity.You can carry on a conversation, but you can’t sing.Vigorous exercise intensityVigorous activity feels challenging. Here are clues that your exercise intensity is at a vigorous level:Your breathing is deep and rapid.You develop a sweat after only a few minutes of activity.You can’t say more than a few words without pausing for breath.Overexerting yourselfBeware of pushing yourself too hard too often. If you are short of breath, are in pain or can’t work out as long as you’d planned, your exercise intensity is probably higher than your fitness level allows. Back off a bit and build intensity gradually.Gauging intensity using your heart rateAnother way to gauge your exercise intensity is to see how hard your heart is beating during physical activity. To use this method, you first have to figure out your maximum heart rate — the upper limit of what your cardiovascular system can handle during physical activity.You can calculate your maximum heart rate by subtracting your age from 220. For example, if you’re 45 years old, subtract 45 from 220 to get a maximum heart rate of 175. This is the average maximum number of times your heart should beat per minute during exercise.Once you know your maximum heart rate, you can calculate your desired target heart rate zone — the level at which your heart is being exercised and conditioned but not overworked.The American Heart Association generally recommends a target heart rate of:Moderate exercise intensity: 50% to about 70% of your maximum heart rateVigorous exercise intensity: 70% to about 85% of your maximum heart rateIf you’re not fit or you’re just beginning an exercise program, aim for the lower end of your target heart rate zone. Then, gradually build up the intensity. If you’re healthy and want to exercise at a vigorous intensity, opt for the higher end of the zone.How to determine your target heart rate zoneUse an online calculator to determine your desired target heart rate zone. Or, here’s a simple way to do the math yourself. If you’re aiming for a target heart rate in the vigorous range of 70% to 85%, you can use the heart rate reserve (HRR) method to calculate it like this:Subtract your age from 220 to get your maximum heart rate.Calculate your resting heart rate by counting how many times your heart beats per minute when you are at rest, such as first thing in the morning. It’s usually somewhere between 60 and 100 beats per minute for the average adult.Calculate your heart rate reserve (HRR) by subtracting your resting heart rate from your maximum heart rate.Multiply your HRR by 0.7 (70%). Add your resting heart rate to this number.Multiply your HRR by 0.85 (85%). Add your resting heart rate to this number.These two numbers are your average target heart rate zone for vigorous exercise intensity when using the HRR to calculate your heart rate. Your heart rate during vigorous exercise should generally be between these two numbers.For example, say your age is 45 and you want to figure out your target heart rate zone for vigorous exercise using the HRRmethod. Follow these steps:First, subtract 45 from 220 to get 175 — this is your maximum heart rate.Next, check your resting heart rate first thing in the morning. Say it’s 80 beats per minute. Calculate your HRR by subtracting 80 from 175. Your HRR is 95.Multiply 95 by 0.7 (70%) to get 66.5, then add your resting heart rate of 80 to get 146.5.Now multiply 95 by 0.85 (85%) to get 80.75, then add your resting heart rate of 80 to get 160.75.Your target heart rate zone for vigorous exercise is 146.5 to 160.75 beats per minute.How to tell if you’re in the zoneSo how do you know if you’re in your target heart rate zone? You can use an activity tracker to check your heart rate regularly while you exercise.Or use these steps to check your heart rate during exercise:Stop briefly.Take your pulse for 15 seconds. To check your pulse over your carotid artery, place your index and third fingers on your neck to the side of your windpipe. To check your pulse at your wrist, place two fingers between the bone and the tendon over your radial artery — which is located on the thumb side of your wrist.Multiply this number by 4 to calculate your beats per minute.Here’s an example: You stop exercising and take your pulse for 15 seconds, getting 37 beats. Multiply 37 by 4, to get 148. If you’re 45 years old, this puts you in the target heart rate zone for vigorous exercise, since the target zone for that age is between 146.5 and 160.75 beats per minute using the HRR method. If you’re under or over your target heart rate zone, adjust your exercise intensity.Target heart rate tipsIt’s important to note that maximum heart rate is only a guide. You may have a higher or lower maximum heart rate, sometimes by as much as 15 to 20 beats per minute. If you want a more specific range, consider discussing your target heart rate zone with an exercise physiologist or a personal trainer.Generally only elite athletes are concerned about this level of precision. They may also use slightly different calculations that take into account sex differences in target heart rate zones. These differences are so small that most casual athletes don’t need separate calculations for men and women.Also note that several types of medications, including some medications to lower blood pressure, can lower your maximum heart rate, and then lower your target heart rate zone. Ask your doctor if you need to use a lower target heart rate zone because of any of your medications or medical conditions.Interestingly, research shows that interval training, which includes short bouts (around 15 to 60 seconds) of higher intensity exercise alternated with longer, less strenuous exercise throughout your workout, is well tolerated. It’s even safe for those with heart disease and type 2 diabetes. This type of training is also very effective at increasing your cardiovascular fitness and promoting weight loss.Reap the rewards of exercise intensityYou’ll get the most from your workouts if you’re exercising at the proper exercise intensity for your health and fitness goals. If you’re not feeling any exertion or your heart rate is too low, pick up the pace. If you’re worried that you’re pushing yourself too hard or your heart rate is too high, back off a bit.Before starting a vigorous exercise program, you may want to talk with your doctor. He or she may suggest that you have certain tests first. This may be the case for people who have diabetes or more than one risk factor for heart disease, and for men over age 45 and women over age 55.Reprinted from Mayo Clinic , May 15, 2019 Comments Off on Exercise Intensity: How to Measure It | Category Fitness | Tags: activity tracker,exercise,exercise intensity,movement,target heart rate