Co Enzyme Q 10 (Co Q10) is also known as ubiquinone; it is formed in the mitochondria of each cell of our body, and is needed for energy production. Co Q10 is found in very high concentrations in cells that use a lot of energy, such as heart cells and skeletal muscle cells. It improves oxygen use by these cells, helping them to function. Co Enzyme Q 10 has many benefits for the heart, including:

•     It is necessary for the production of collagen and elastin, helping to keep the blood vessels healthy.

•     Acts as a strong antioxidant, protecting LDL “bad” cholesterol from oxidation.

•     Reduces the risk of blood clots and rupture of fatty plaques in arteries.

•     Needed for energy production by the heart and other cells.

Co Q 10 is considered one of the most important nutrients for a healthy heart, and yet statins deplete your body’s production of it. Many of the side effects of statin drags are probably caused by depletion of Co Q 10. Side effects of deficiency of this vital nutrient include:

•     Muscle wasting, causing weakness and muscle pain.

•     Heart failure (a deficiency weakens the heart muscle, making it less able to pump blood efficiently).

•     Neuropathy (damage to the nervous system).

•      Inflammation of the tendons and ligaments.

You are especially susceptible to suffer statin induced side effects if you are:

•      Elderly

•     Female

•     Diabetic

•     Postoperative

•      If you have a liver or kidney disease

•      If you take other medication, especially erythromycin, fibrates, itraconazole, or immunosuppressive drugs.

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certain criteria must be met. You (the person being cared for) must be receiving:

Disability Living Allowance care element at the middle or higher rate; or

Constant Attendance Allowance at least the normal maximum rate; or

Attendance Allowance at either rate. Additionally, the person caring for you must be:

aged 16 to 65 when they claim;

spending at least 35 hours a week caring for you;

earning no more than 50 pounds per week (after deducting allowable expenses);

not attending full-time education (more than 21 hours per week).

The person caring for you may be able to claim more money if they are looking after your children or additional money for your children.

Depending on your circumstances, you might be entitled to other benefits such as:

Income Support

Family Credit

Housing Benefit

Council Tax Benefit

as well as help with the cost of prescriptions, hospital travel and other health-related expenses.

Again, you can either check for yourself in the Benefits Agency booklets, or ask to speak to the social worker at your hospital if you think you might qualify – or if you would just like to check exactly what you are entitled to claim.

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There are many factors which will affect how you manage from day to day, and no two men will feel exactly the same even in very similar circumstances. Your symptoms and the effects of your treatment may not interfere too much with your daily life if your cancer was detected early. If it was more advanced and had already taken some toll on your body before treatment, convalescence could take longer and the impact on your daily life will be greater. Similarly, the physical effects of your cancer and treatment may hit you less hard if you are basically a strong and fit person than someone in less good general health. What is important is to take notice of what your body is telling you and not to fight it.

The day of my first consultation with an oncologist will be remembered as the Day of the Corridors! We had arrived at the general hospital and their once-weekly cancer clinic, and I was feeling weak and terrible. I am convinced that all hospitals have a cunning plan which ensures that all patients and their carers should walk all possible corridors before they arrive at their chosen destination. In a large, sprawling hospital such a trek really can feel like a marathon. The best way to counter this -which did not occur to us until we staggered out post-consultation and after another trek to the X-ray department, of course – is either to hijack the first spare wheelchair you come across (look in the lobbies around the entrance to any hospital or ask at reception), or if this is impractical insist on the help of a porter to help you navigate those long corridors. Do remember that you might have only a limited amount of energy and using it up in non-productive ways is not a constructive use of a scarce resource!

If you are the sort of person who would rather crawl into work with a burning temperature and a raging headache rather than admit that the ‘flu has got the better of you, then listening to your body and acting on it may take some effort. You might be tempted to understate your symptoms or side-effects, both to others in an attempt to prevent people treating you purely as a ‘cancer patient’ and to yourself so that you feel able to continue with your ‘normal’ life. A balancing act is needed here – of course it is helpful to lead as normal a life as possible rather than withdrawing completely and immersing yourself in your cancer. On the other hand, you need to be aware of your limitations and to modify your daily routines accordingly. This will require a good deal of trial and error, and you will misjudge your physical strength at times.

It will help too if you don’t test your body by pushing it to its physical limits. Especially coming home after a stay in hospital, it is easy to overstretch yourself even if you have been told to ‘take it easy’. Simple tasks around the house might take more energy and conscious effort than usual – you wouldn’t usually think twice about making a cup of tea, but this may leave you needing a rest afterwards. On some days you will feel stronger than others, and can take pleasure in tasks or hobbies which are too much for you on other days. The days when you have no energy can be intensely frustrating, but you won’t gain anything if you fight it! This does not mean you should never try to be active and just sit in a chair or retire to bed and do nothing. Don’t give up, but try to accept that for a while at least, you need to conserve your energy and use it carefully. Only you can judge your limits, and you mustn’t be too proud to impose them on yourself and others. It is crazy knowingly to exhaust yourself just to prove a point, for example, preparing your own lunch when someone has offered to do it for you. What exactly do you succeed in proving? And to whom?

If you have always worked and led an active life, it can be tough to accept that now there are times when you haven’t the physical strength to do so. Whatever the pace of your life up to now, be it frenetic and dictated by heavy pressures of work and family or more gentle, you will have to slow down. Admitting this is often the most difficult step to take, as if there is some shame associated with a loss of physical strength. Nobody will think any worse of you if you aren’t able to go to work every day, or indeed, if you need to take longer periods of sick leave. No one will laugh at you or condemn you or stop considering you a friend if you can’t play football at weekends or go to the pub or entertain until the small hours.

It is still natural to want to preserve as much normality as possible in your life. After the shock of a cancer diagnosis, you can gain reassurance from familiar routines, and they can provide some stability in a period of shock and stress. The people around you can probably make the greatest difference to how you feel, but you will need to feel that you are not entirely dependent on them and can also help yourself. Being assigned the status of a ‘patient’ can knock your self-confidence and it is important to feel that you can preserve some independence and the sense of self which you achieve from structuring your own life and deciding for yourself what you do and when.

Again, there will be times when you are treading a fine line. On some days you may be able to go to work or visit a friend or be active at home. There will be other times when it is a struggle to drag yourself out of bed and you feel exhausted after brushing your teeth in the morning. On your ‘tired’ days, you may want to do nothing but rest – even conversation may be too much. Accept this, even if you do feel wretched that you are so powerless. Use your ‘good’ days to best advantage, so that you can regain some sense of control in your life. For example, decide on something you would like to achieve that day. It doesn’t matter how small it is – writing a letter, making a phone call, walking down the garden – or if you are feeling good, going out for a short walk, visiting a friend or asking someone to drive you to a favourite place. Don’t set yourself tasks which you know you are unlikely to manage – there is no point in setting yourself up for a sense of failure. It is surprising how a small achievement can contribute to a more positive frame of mind. Don’t expect too much from yourself – treat yourself gently.

There will be times when practical help is very welcome. It may be hard to admit that you cannot be completely independent, but it is foolish to refuse help purely on the grounds of bloody-mindedness! If you are recovering from surgery, or feeling tired as a result of radiotherapy or at a low point in your chemotherapy cycle, you can feel physically very drained and weak. It makes sense to conserve your energy for yourself, and take up people’s offers to cook you a meal, drive you to the hospital, walk the dog, do some shopping, cut the grass – the list goes on. Help from family or friends with seemingly small tasks can make a big difference to the quality of your life, allowing you to use your energy to take pleasure in the company of friends or to carry out the tasks you want, rather than need, to.

When people ask, ‘Is there anything I can do?’, they mean their offer to be taken seriously. Even if you do not need help at that time, you can still say ‘I’m fine at the moment, but maybe I could ask you later when I’m not feeling so good.’ You could also check whether they would be prepared to help with specific tasks – ‘Would you mind driving me to the bank/supermarket/post office when you next go to town?’; or asking if they would be happy just to spend some time with you: ‘I know you’re busy now, but perhaps at the weekend you could come and visit for an hour?’ It is sometimes easier for everyone if some basic ‘guidelines’ for visitors are worked out and if your family and friends have some idea of the type of help you would welcome and what you would prefer to deal with yourself. This will also help you in maintaining a sense of control over your daily life, rather than allowing others to decide what is ‘best’ for you.

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We were initially unprepared for people’s reactions too -everyone wanted to jump in the car and come to visit, to support and help us, and just to be close. But when people ask on the phone, it’s hard to make your brain work at all, let alone figure out whether or not you want visitors. In time, we could anticipate people’s reactions – ‘Can I do anything?’ and ‘Can I come and see you?’ – and had thought out in advance our own reactions: ‘Could you just keep in touch by phone?’ ‘Could you phone tomorrow and perhaps visit then?’; ‘Could you collect a prescription while we’re at the hospital?’; ‘Could you pass on the news to X?’ It took time to reach the stage where we were thinking clearly and could be specific, but gradually we got there.

Your close family and friends are likely to react at first with shock and disbelief. Comments like, ‘You seemed so well last time we saw you’ or ‘But you always seemed so strong and healthy’ express how difficult serious illness is to accept. Although people are aware that many cancers are completely undiscriminating in whom they affect, they still find it hard to believe that someone close to them could be affected – cancer always happens to someone else. A common knee-jerk reaction is to deny your cancer: ‘That can’t be right’ or ‘I can’t believe it’. You should be prepared for anger too, once the initial shock has passed – those close to you will feel rage that this should happen to you. This anger may feel as if it is directed at you personally, and can be difficult to cope with. You can do nothing to make your cancer disappear (which is what we would all like, of course), and other people’s anger can feel very unkind and unjustified, as if they are accusing you of choosing to have cancer. Such outbursts can be very painful, but many people do need to express their anger as a form of emotional release.

In some ways more difficult are those who are completely unable to cope with the fact of your cancer, and who react as though nothing has happened. You are trying to convey a very serious piece of news, and it can be both disconcerting and upsetting if the sole reaction is, ‘Sorry to hear that, mate. I suppose you won’t be coming to the pub on Friday?’ Many men do find illness and the emotions it generates very hard to talk about, and therefore feel it is better to say nothing at all. This does not mean that the emotional reaction is any less powerful, but rather that the vocabulary and the confidence to express those emotions are suppressed. Reactions such as, ‘Nothing I say will get rid of the cancer, so why bother’ or ‘I wouldn’t know what to say – I leave that to my wife’ can seem uncaring but this is rarely the reality. It is more likely that your friend or relative simply has no idea what to say and is so embarrassed at the prospect of any emotional reaction that they try to continue as normal and treat you as if your cancer doesn’t exist.

People can also be uncertain about how to talk to you or mistakenly feel that you have enough to cope with and that it is better not to ‘bother’ you at all. This doesn’t mean that they don’t care or are not interested in what is happening, but rather that they don’t want to add to your problems: ‘He’s got enough on his plate without me visiting/phoning’ or ‘I’d call, but I just don’t know what to say’. What feels to you like a withdrawal of support or friendship is often no more than confusion about how to behave. It can be useful to make it clear to friends and family that you would welcome their phone calls or visits, but that they should not be offended if sometimes you are not feeling strong enough or simply in the right mood to chat or see people. They will understand, and will probably welcome any such guidance you can give them.

Although you are still the same person, it can be difficult to accept that some people will treat you in a different way after hearing of your cancer. Being considered a cancer patient first and ‘Neil’ second can be intensely frustrating, especially if you are making efforts to retain as much control over your situation as you can. People may treat you as though you are no longer capable of your usual activities and try to take control of tasks or situations which you are perfectly able to manage yourself. They will have the very best intentions, but may need to be reminded that while you appreciate their concern, it would be better if they waited until you really need their help.

Being treated as a different person can manifest itself in more subtle ways. Most of us have a perception of ourselves which is associated with strength in some form, be it

as a breadwinner;

in relation to our family;

as an achiever;

as someone who always copes;

as the person who always sorts out practical problems at home;

in a purely physical sense;

and this perception is often shared by those around you. In the same way that physical illness can undermine your own sense of strength, so others may see you in a new light. People may feel that they should no longer rely on you for your ‘strong’ qualities, not so much because they no longer exist but because you have something more important to concentrate on – your health and treatment. This can also be reflected in how they talk to you, and can be frustrating because you still need to be involved in the day-to-day problems and irritations of people’s lives. People might think, ‘We won’t bother to tell him about that, we’ll just sort it out ourselves.’

As a man, it can be confusing and distressing to realize that the expectations connected with your ‘strong’ qualities which were previously placed on you – both by yourself and others – have changed. On the one hand, people want to look after and ‘mother’ you, to take control on your behalf and ensure that you are not worried or bothered by the trivia of everyday life. On the other hand, you may also find that those close to you, in an effort to prevent you from becoming withdrawn, urge you to ‘pull yourself together’ or not to ‘let it get you down’. The very fact that people are reacting differently to you points to a change in their expectations which you may find difficult to deal with at first.

Although men are increasingly encouraged not to bottle up their emotions, there may still exist an unvoiced expectation that you will find the strength and reserves to cope simply because you are a man. This can feel deeply unfair because you just can’t win! You are urged to talk, to open up, to discuss your feelings but you may sense a slight discomfort in those around you that you need to, especially if this is uncharacteristic behaviour for you. If you keep your feelings to yourself, loved ones become concerned that you are trying to be too strong for them. Perhaps the best course is simply to trust to instinct and to talk to those you trust and feel comfortable with.

In the very early stages, you may not have the emotional energy to take as much interest in the trivia of everyday life as usual. Later, however, it can be very important to feel that you are not being sidelined because you are no longer capable of any useful input into other people’s problems. To be told after the event that ‘We didn’t think you’d be interested/didn’t want to upset you/thought you had enough to worry about’ can be very isolating. Although you need extra support, you don’t want to be constantly handled with kid gloves. It will take some time for you, together with your family and friends, to reach a good balance, but in the meantime you can assure them that staying in touch with the everyday details of other people’s lives is more helpful than troublesome for you.

Although I became very unwell very quickly, I still needed to feel involved in – and preferably in control over – the practical changes which we needed to make to our lives, and to a large extent, we managed this with the support of family and friends. What became extremely frustrating was to hear some people, with the best of intentions, asking Helen about my cancer and how I was rather than asking me – the classic scenario of talking about ‘the patient’ as if he isn’t there. These people were presumably trying to save me the effort and potential distress of going through my story yet again. Of course, there were times when I didn’t feel like talking, but on the whole, it feels better to be given the option! Similarly, while there were occasions when other people’s news felt pretty irrelevant, it was infinitely preferable to being excluded from all ‘normal’ conversation.

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Some cancers depend on a supply of hormones for their growth. The most common example of this in women is breast cancer and in men is prostate cancer, which needs testosterone in order to grow: without it, many tumours will shrink. Hormone therapy may therefore be recommended, which for prostate cancer takes the form of treatment either with hormones, or with drugs which interfere with the production or action of testosterone.

Hormone therapy is not used for the majority of cancers. As with all cancer treatments, any side-effects will depend upon the type of hormone therapy used, and if it is proposed for you, then your doctors will explain to you any side-effects which you might expect.

Biological therapy

There are hopes that various forms of biological therapy – and particularly those which help to stimulate the body’s own immune system – may produce effective new treatments in the future, but research is still at a relatively early stage in most cases. It is hoped that in the future, treatments based on substances produced by the body – such as certain antibodies and interferons (substances produced by the immune system which have the ability to inhibit viral growth) – may be developed to supplement and complement existing treatments. For example, research continues to work on ‘magic bullet’ techniques, in which certain antibodies (known as monoclonal antibodies) carry cell-poisoning drugs or radioactive isotopes directly to cancer cells while leaving normal cells alone.

cancer treatments

Alternative and complementary therapies

Forms of so-called ‘alternative’ therapy such as herbal, vitamin and dietary treatments, acupuncture and the use of homeopathic remedies are not yet proven as cancer treatments as they have not yet proven beneficial in the same lengthy and rigorous testing and trial processes as conventional cancer treatments. However, all doctors know that some drugs used today are based on traditional remedies or plant extracts – including some heart drugs and some anti-cancer drugs. A good doctor will be open-minded and, once tests prove an ‘alternative’ remedy to be effective, there is no reason why it should not enter ‘mainstream’ medicine.

Even before that, some alternative therapies may hold consider-able attraction given the nature of conventional cancer treatments, and there are increasing numbers of practitioners of non-conventional medicine. Some people find that they do derive some benefit from undergoing alternative therapies, and claims have been made

for the effectiveness of, for example, certain homeopathic remedies

in boosting the strength of the immune system. There is as yet no

concrete evidence (as recognized by the conventional medical

profession) that any alternative therapy will contribute to the success

of a conventional cancer treatment, but if it contributes to your overall well-being, then there may be a strong motivation to consider

it. It is very important to consult your oncologist before embarking

on any complementary treatment, and to appreciate that alternative therapies do not aim to replicate the effects of conventional

treatments.

On another level, you may find therapies such as massage, aromatherapy and relaxation techniques (which do not claim any specific healing properties) may still be beneficial to your overall well-being. Massage of areas of tension such as the shoulders can promote physical and mental relaxation. Learning breathing or visualization techniques which help your mind to slow down and let go of your worries for a short time can also be helpful. You may well find that classes are organized by your hospital, or that staff can provide you with information about useful contacts. Again, it is wise to check with your doctor before undergoing any physical therapies, in case they aggravate certain physical symptoms.

‘Prevention is better than cure’

Most of us are well aware of preventive measures which can help to reduce the risk of developing certain cancers. If you, as a reader, are already living with cancer then you might feel ‘This doesn’t apply to me – I’ve already got cancer’ and feel disinclined to be lectured about your lifestyle and behaviour, past or present. This is not a lecture, nor does it assume a right to tell people how to live their lives. It is simply a reminder that some of the main contributing ‘behavioural’ factors to certain types of cancer are smoking, excessive exposure to sunlight, alcohol and a low-fibre, high-fat diet. It is also unwise to dismiss the relevance of attendance at screening programmes, if appropriate.

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Symptoms you might notice include a painless but persistent swelling in your lymph nodes, usually in the neck, armpit or groin. In fact, enlarged lymph nodes often result from straightforward viral infections and are very common – but these clear up within a few weeks. Enlarged lymph nodes which are not accompanied by any infection, which do not disappear on their own and which are not tender to the touch, should be regarded seriously and checked by your doctor. Of course, there may be a perfectly innocent cause but the check-up can do you no harm. More general symptoms which tend to accompany lymphoma as it progresses are a general tiredness, loss of appetite and of weight and unusual sweating at night.

Lymphoma is usually diagnosed by means of a biopsy of the enlarged lymph node, which will help to determine the type of lymphoma in question: there are several dozen and the classification of lymphoma is a very complex area. Once the type of lymphoma is established, further tests will be carried out to establish how far it has spread and these may include a chest X-ray, lymphogram and scans. Both the type and spread of a lymphoma are important factors in determining the nature and extent of treatment you will undergo.

If your lymphoma is the slow-growing, low-grade type, then you may experience periods of time where no treatment at all is considered necessary. However, you are likely to undergo some chemotherapy at certain stages to keep the effects and symptoms of your cancer manageable – and this type of treatment may last for some years. In some cases, radiotherapy might be helpful to relieve problems if an enlarged lymph node is, for example, blocking another organ and causing trouble.

Treatment for the higher grades of lymphoma differs in that the cancer is faster and more steadily growing, and therefore cannot be left untreated for periods of time as the lower-grade lymphomas can. Chemotherapy is commonly used and it can lead to a cure. Radiotherapy may be used at the same time to treat localized areas of tumour.

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You might feel lonely, isolated and deprived of much-wanted physical and emotional attention. You might be frightened about sharing your problem even with your closest friends. Perhaps your partner has told you not to tell anyone—even your family doctor—about his erection difficulties. Perhaps the subject upsets him so much that he won’t even let you discuss your concerns with him.

You might begin to believe that your only choice is to ignore the problem. You might cling to the hope that if you bury your head in the sand everything will miraculously resolve itself.

But deep inside you know the problem will probably only continue—and might worsen.

These feelings are common. Many women whose partners have erection problems feel inadequate and sometimes blame themselves. And many women feel responsible for the solution. Some women cling to the romantic notion that love conquers all. But while love can be powerful, it can’t unclog blocked blood vessels, diagnose illnesses or remove all stress and pressure in life.

How can you help yourself and your partner? How can you cope with your own feelings while still being a support system for your husband?

There aren’t any simple solutions; what works for one woman might not work for you. But there are some basics to making the most of a tough situation. And there are ways to make it better.

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To begin, wear as little clothing as you are comfortable in. Or, if you choose, nothing at all. Sit on the floor or bed with a pillow between your crossed legs. Have your partner rest her head on the pillow. Then take a small amount of massage, coconut, or safflower oil in your hands and stroke it gently and rhythmically on your partner’s forehead. Using both hands, work your way smoothly across her closed eyes, her nose, and down across her cheeks. Feel the texture of the skin under your fingertips, and be aware of the planes and contours of the facial surface.

Never losing touch with her body, softly cup both of your hands around the back of her head and, with a steady motion, gently massage her scalp. Move down to the neck, massaging the underlying muscles which store tension. Then proceed to the shoulders, all the while manipulating your hands on her skin, absorbing the rising heat of her body. Think about how she is responding and how you feel. Does this intimate exercise stir a longing for more touching? If so, proceed to the next step.

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On another day, the test subjects were given twenty times the recommended vitamin doses—they took 800 international units (IU) of E and 1,000 mg of C—prior to eating the same fat-laden meal. This time, the dangerous adverse effects caused by triglyceride-heavy lipoproteins were avoided. The megadose of antioxidants allowed blood to flow smoothly. That smooth blood flow is crucial for good penile health. A simple way to get it—and keep it—is by taking vitamins E and C. Although this was a relatively small study, further research with larger groups may one day prove that it will be beneficial to take the C and E combo just before eating any fat-rich meal.

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For others, however, it had different implications. Its use brought up questions about vulnerability, self-esteem, and attractiveness. Sex before any notion of commitment was made possible by the pills. With the license to have “safe” intercourse (a very different term twenty years ago, meaning without the risk of pregnancy), a woman could enjoy at least in theory, uncomplicated sex. But, as we know, sex is never an uncomplicated matter.

I’m drawing a comparison between birth control pills and the oral intervention for ED for very specific reasons. Ironically, the problems that now afflict men with ED may soon have an unprecedented impact on their partners. Those very questions that haunt men concerning confidence, sex appeal, and worthiness could easily be transferred to women once the pill is a part of their lives. The inevitable question will arise: “Is it the pill that’s turning him on—or is it me?”

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