When the doctor says those three little words, your mind tends to black everything else out.  Am I going to live  Am I going to die?  How mutilating are my treatments going to be? 

Every person I’ve known who’s experienced cancer remembers that moment.  Everything changes after that. 

The good news is, your changes of surviving are much better today than they used to be.  Cancer treatments are much improved, even more than they were only ten years ago.  I’ve witnessed amazing advancements in surgeries, chemotherapy, and radiation, and the end result is that more people are living longer, and many enjoy the rest of their lives cancer free.

The problem is that with these improved treatments come unpleasant consequences.  I’m speaking mainly about the side effects.  Most people know that cancer treatments can cause nausea and hair loss, but I recently came across a survey in which more than 350 cancer survivors were asked to rain their most bothersome side effects.  Would you be surprised to learn that the top two reported were skin irritations and dry skin?

What we may not realize going into cancer treatments is that the side effects that alter our appearance and how we feel “in our own skin” can be the most difficult to manage.  Today’s more potent and often more effective chemotherapy agents are often very taxing to the body’s fast-growing cells, causing hair loss, dry skin, fragile nails, and even skin conditions like rashes, rosacea, and dermatitis.  Inf act, oncologists sometimes measure the success of  the treatment by the severity of the skin reaction!  More rosacea?  Great.  That means the treatment is working.

Good news if you’re trying to get rid of a tumor.

Not so good if you’re trying to enjoy the quality of your day-to-day life. 

What can you do?  How can you prepare yourself for these sorts of challenges?  In my work with cancer patients and survivors, I’ve discovered one thing- people are hungry for more information on how to deal with these cutaneous side effects.  That’s why I’m excited to be writing the forward for this book. What you need to get through this experience, to maintain your sense of control over your life, and to actually feel a little bit better and a little more comfortable, are tools.  You need information, instruction, and suggestions for what to do if your face breaks out in a rash, for example, or your skin becomes so dry and irritated that it stings and burns with the usual products you apply.  This book provides solutions for hair loss, missing eyebrows and eyelashes, thinning nails, dry skin, radiation dermatitis, and so much more.

If you’re new to this journey, you may be a little skeptical.  I’m fighting for my life, you may say.  Why would I care about missing eyelashes?  One thing that cancer survivors know is that the disease can wreak havoc on your appearance.  If you take all these effects together- hair loss, thinning eyebrows and eyelashes, dark and fragile nails, and dry, dull skin- what you have is an assault on your identity.  You look in the mirror and no longer see the same person.  That experience can be emotionally devastating to a lot of people.  You’re right- you’re fighting for your life.  But while you’re in the middle of that battle, you still have to function in your world.  Perhaps you have a job, a family, or people who rely on you.  If you start to look different, beaten down, and ill, it can negatively affect your confidence, which ultimately, can inhibit your ability to heal.

I started a program called “Brighter Days” about twelve years ago.  It’s a simple program that allows me and other dermatologists to reach out and help people living with cancer to feel just a little bit better.  Over the course of about one to two hours, I provide, free of charge, an in-person seminar where I a) explain the effects of chemotherapy and radiation on the hair, skin, and nails (TALK); b) personally attend to each member of the class, assess the condition of his or her skin and nails and offer personalized suggestions for better care (TOUCH); and c) invite all participants to share their stories (TELL).  Now, in my nearly forty years of practicing dermatology, I’ve participated in many programs that benefit the community, but never have I experienced the deep sense of joy and fulfillment that I get from interacting with these individuals who come to my lectures.  They are just so grateful and happy to have someone who cares enough to sit down and discuss their challenges with them, and then provide solutions they can use during the course of their treatment.

Not too long ago, I read an article in the Journal of American Academy of Dermatology  that was very informative about current chemotherapeutic medications and their effects on the skin.  I was disappointed, however, to find that it provided no therapeutic suggestions.  This points to why Brighter Days is such a valuable program.  At a session, you will find information on why certain side effects happen, and more importantly, what you can do to help alleviate the discomfort.

I have no doubt that tending to what may seem like the “little things” of your cancer treatments will have a huge effect on the success of those treatments, on the quality of life you enjoy while you’re going through them, and on how quickly and easily you recover afterwards.  In fact, one recent study showed that having a good quality of life and low levels of depression during treatment improved survival time.  You can’t keep your spirits up, however, if your skin is dry and covered with rashes, or you feel like you look “sick” when you go out of the house.

My daughter-in-law’s mother was a very tall, elegant, and intelligent schoolteacher named Kristine.  Everyone in the family admired her, and we were all stricken when she received her cancer diagnosis.  She fought a valiant fight for fifteen years, undergoing multiple surgeries, chemotherapy and radiation.  During her last few days here on Earth, I got a chance to talk to her.  I asked her then what she thought.  If I could have somehow developed a program that would have helped her care for her hair, skin and nails and thus, feel better about her appearance- even though I couldn’t have changed the course of her illness- did she think that would have been helpful?

She didn’t hesitate.  She told me that would be a wonderful idea, and encouraged me to do it, the sooner the better.

Her answer taught me one thing- no matter what happens with the disease, we need to think more seriously about quality of life during treatment.

We’ve been used to believing that a patient should just hang on by his fingernails in a sort of limbo between “okay” and “not okay” until that final day of chemotherapy or that final radiation appointment.  We’re missing something with that line of logic.  A patient continues to live, work, relate to loved ones, and experience life during treatment.  Enhancing those experiences is vitally important.  First, because it keeps hope alive and spirits strong, which has been shown in studies to boost the immune system and facilitate healing.  Second, none of us ever knows what’s going to happen tomorrow, so we must take full advantage of today.  If, by helping, you find a new way to fix your hair, moisturize your dry skin, tone down the redness of rosacea, or calm that rash, we can help you experience a better day, and that’s huge!

After that last talk with Kristine, I started Brighter Days.  Since then I have experienced firsthand the benefits of this sort of program can have on people living with cancer.  You can trust me when I saw that the tools you need are here, and that you’ll feel better as soon as you start reading about them and incorporating them into your life.

At the beginning of each of my seminars, I give out hats to the attendees.  Most of them have lost their hair, or have thinning hair, or are only months out of treatment with the hair just starting to grow back.  They all put on their hats, and it helps them to realize they’re all in the same boat.

These aren’t just any hats, however.  Imprinted on the brim are the words “Life is Good.”  They’re donated by the Life is Good Kids Foundation, and come in fun colors.  I hand these out as an icebreaker, but also as a reminder to each individual: Yes, you have cancer, but that doesn’t mean you can’t still experience good things in life.  It’s all about your point of view and how you approach the situation.  There are things that can make you feel better.  There are things that can make you look more like yourself, and boost your self-confidence.  There are ways to get through this experience with hope, optimism, and several good days to go along with the not-so-good ones.  If you can maintain your positive attitude and keep your spirits up during this period of time, I guarantee it will help you in so many ways. 

There are brighter days ahead.  You just need the tools to get there.

Dr. Donald F. Richey

Dermatologist and Founder of Brighter Days