Dear Ann Landers,
y hus-band is a good man but he has one fault that bothers me terribly. When-ever we are out with friends he speaks in a very disparaging way about the man who owns the company he works for. He doesn't realize how bad it makes him look. Will you please say something to him, and to others who have this fault?

DEAR WIFE,
Elbert Hubbard, an old-fashioned philosopher and one of my long-time favorites, said it best. "If you work for a man, for heaven's sake work for him. Speak well of him and stand by the institu-tion he represents. "Remember, an ounce of loyalty is worth a pound of cleverness. If you must condemn and eternally find fault, resign your position and when you are on the outside, damn to your heart's content. But so long as you are a part of the company, do not condemn it. If you do, the first high wind that comes along will blow you away and you will never know why." 170 THE ANN LANDERS ENCYCLOPEDIA Cancer WHAT IS CANCER? Cancer, the most terrifying of all diseases, is surrounded by so much anxiety and fear that millions of people will not take the steps necessary to protect themselves against dying from it. Cancer is actually not a single disease. It is a group of diseases with one common characteristic-the uncontrolled growth and spread of abnormal cells. If the spread is not controlled, the results are fatal. But many cancers can be cured if detected early enough and treated properly. Today more than three million people in the United States are alive after having been treated for cancer. In the 1930s, science began to report impressive progress against cancer. One out of five patients treated with surgery at that time was saved. Within the next twenty years, the ratio of patients saved rose one in four. Today it is one in three. So much knowledge about early detection and proper treatment has been accumulated that if the patient and physician would take the neces-sary action based on that knowledge, one out of two patients could be saved today. HEALTH Ella Wheeler Wilcox wrote, "Laugh, and the world laughs with you; weep, and you weep alone." She also wrote this: Talk health. The dreary, never-ending tale Of Mortal maladies is more than stale: You cannot charm or interest or please By harping on that minor chord, disease. Say you are well, or all is well with you, And God shall hear your words and make them true. WHO GETS CANCER? Your chances of getting cancer are influenced by a wide range of factors- where you live, what you do for a living, your medical history, the medical history of your parents and grandparents, and your personal habits. Cancer is not caused by fluorides in the drinking water, cooking in aluminum pots and THE ANN LANDERS ENCYCLOPEDIA 171 pans, or taking smallpox, measles, mumps, or any other kind of immuni-zation. Mormons and Seventh-Day Adventists have less cancer than other people, possibly because they adhere to restrictions in lifestyle and diet. (Their religion prohibits the use of tobacco and alcohol.) One in four Americans can expect to develop cancer, most often between the ages of sixty-five and seventy-five. But cancer is also the leading cause of death-except for accidents and homicides-among Americans from one to thirty-five. Women generally get cancer at a younger age than men, but cancer ap-pears more frequently in men than in women, and men have higher cancer death rates. In the United States, poor people tend to have more cancers and more can-cer deaths than the financially well-off. Precisely why this is we do not know. Cancer death rates are higher in the Northeast and Middle Atlantic states, lowest in the Rocky Mountains, the Southwest, and the South (except the Gulf Coast states and the Mississippi Delta). Worldwide, between five and six million people get cancer each year. One third of everyone who is treated for cancer will be saved, and half of the remaining two thirds could be saved with early detection and proper treatment. For example, Charles Hoyt lost a vocal cord to cancer twenty-eight years ago. After treatment, he ran his own business, was an elected trustee of his suburban New York village, learned to fly a plane and was able to com-municate without difficulty over the aircraft radio. Now retired, Mr. Hoyt and his family travel extensively. Mrs. Charles Taylor was a homemaker and the busy mother of three young children in upstate New York, when she found she had cancer of the thyroid. She had surgery and follow-up radiation therapy. That was in 1954. Subse-quently, Kay Taylor had five more children. Today, a grandmother, she runs her own dress shop. Show business celebrities John Wayne, Beverly Sills, Richard Rodgers, Arthur Godfrey and Bill Gargan are just a few of the well-known person-alities who have been successfully treated for cancer-proof that having can-cer does not mean the end of a career-much less the end of life. WHAT CAN YOU DO TO PROTECT YOURSELF AGAINST CANCER? One simple step would prevent more than 30 percent of cancer deaths among U.S. men and women: STOP SMOKING! Avoid overexposure to the sun. If you must be out in the sun a great deal, use a sunscreen lotion. Women should practice breast self-examination monthly and have an annual "pap test." 172 THE ANN LANDERS ENCYCLOPEDIA Both men and women should have a "procto" exam of the rectum regularly (approximately every other year) especially after age forty. Be-cause the exam is somewhat uncomfortable, many people avoid this basic precaution which can uncover precancerous polyps in the colon, as well as cancer. These polyps can be removed by a simple office procedure. A very important test is the hemocolt slide in which a stool specimen is deposited on a thin white piece of paper after a three-day, meat-free diet. Check the causes of occupational cancers-discover whether your job has a cancer risk. If so, be sure your employer protects you and that you have frequent regular examinations. X rays are important for diagnosis. However, these should be done only when necessary and fluoroscopy in particular should be reduced to a minimum. VITAL TESTS TO DETECT EARLY CANCER: Breast self-examination is very important. The simplest safeguard against dying of breast cancer, and one that is available to every woman, is breast self-examination. This is an easy procedure by which a woman checks herself for lumps in the breast. Although any breast abnormality should be brought to the doctor's attention, women should be reassured by the knowl-edge that almost 80 percent of breast lumps turn out to be non-cancerous. Performed regularly, breast self-examination can provide an effective early warning. Your doctor can show you how to examine your breasts, or a pam-phlet is available from any office of the American Cancer Society. If you want a free pamphlet, write to your local unit of the American Cancer Soci-ety. (Check the phone book.) In recent years valuable new techniques have been developed to detect breast cancer at a very early stage. One is called mammography-a low radi-ation X ray of the breast which can reveal a tumor so small it cannot be felt. The American Cancer Society recommends this technique for women over fifty and for women who have a high risk for developing breast cancer. Microscopic examinations of sloughed-off cells from the cervix, lungs and bladder. X-ray examination of the colon by barium enema. Lighted instruments which can be inserted into parts of the body that are difficult or impossible to reach with standard equipment. Laboratory tests of blood in the urine or stool. Find out whether your community has an Early Warning System to screen for cancer. Programs such as CANSCREEN in New York, Philadelphia and Omaha; and in Chicago, the George and Anna Portes Cancer Prevention Center offer periodic examinations designed to uncover cancers. In between checkups, all adults should be on the alert for early cancer symptoms. Knowledge is protection. Arm yourself. Here are the signs: THE ANN LANDERS ENCYCLOPEDIA 173 Change in bowel or bladder habits. A sore that does not heal. t/nusual bleeding or discharge. Thickening or lump in the breast or elsewhere. .Indigestion or difficulty in swallowing. Obvious change in wart or mole. Nagging cough or persistent hoarseness. If you have any of the above symptoms see your doctor immediately. It is amazing how many people write to me and say, "I'm afraid to go to a doctor because he might give me bad news!" I respond immediately: "Go to your doctor at once. If there is no bad news, you'll feel like a million. If the news is bad, early treatment might save your life. Get going!" WHAT ARE THE MOST COMMON TYPES OF CANCER? The types of cancer that are the most common are in these organs of the body: breast, colon-rectum, prostate, stomach, pancreas, bladder, lung, skin and womb or uterus. BREAST: It goes without saying that if you detect anything irregular, any kind of discharge or lump, you should see your doctor at once. "High risk women" are those who have a personal history of cancer in one breast, lumps and thickenings in the breast, nipple discharge and other ab-normalities, a family history of breast cancer on the mother's side, or in sisters, late menopause, no childbirth, first child at age thirty or over, and early onset of menstruation. COLON-RECTUM: In addition to the warning sign of any change in bowel habits, an instrument has been developed to enable a doctor to find cancers of the rectum and colon in the very early stages. Called a proctoscope (procto for short), it is a hollow lighted tube through which a doctor can in-spect the lining of the colon and rectum. Medical authorities say the procto can help save more lives from cancer than any other procedure in a physical checkup. LUNG: Lung cancer is largely a preventable disease, since approximately 90 percent of all lung cancer is caused by cigarette smoking. Yet every year approximately ninety thousand Americans die from this form of the disease. About thirty million Americans have quit smoking cigarettes. However, thousands of young people are taking up the habit each day. According to a recent survey, 30 percent of all teenage boys and 27 percent of all teenage girls smoke cigarettes. So long as the smoker is portrayed by the advertising media as sexy, virile, sophisticated and "cool" we will see a continued in-crease in teenage smokers. I am in favor of an intensive nationwide campaign which presents smoking as a stinky, dirty, offensive, dangerous, expensive and a dumb thing to do. An annual chest X ray is of great value in detecting early lung cancer, par- 174 THE ANN LANDERS ENCYCLOPEDIA ticularly in heavy smokers. An early cancer may not show up on the X ray (but will be reflected in the sputum-or coughed-up phlegm-where cancer cells can be found). With improvement in early detection and treatment tech-niques, the cure rate for lung cancer, which is only 10 percent at present, will improve gradually. MOUTH: Since mouth cancer (including cancer of the tongue) may be painless or without symptoms in the early stages, regular and complete oral examinations are essential. This means scheduled periodic visits to the dentist so he can inspect the entire mouth. Sores that don't seem to heal should be seen immediately by a dentist or physician. Cigarette smoking and chewing tobacco are causes of mouth cancer. So is poor oral hygiene and lack of regu-lar dental care. Excessive exposure to the sun is a factor in lip cancer. SKIN: The most virulent form of skin cancer is melanoma. It usually ap-pears as a black or dark brown mole. All such moles should be checked the moment one is noticed, especially if they darken in color, enlarge or bleed and are located in friction areas: neck (collar), bra, belt, soles of feet. The risk of skin cancer is highest among farmers, sailors and others with outdoor occupations which require frequent sun exposure. This is particularly true for those with fair complexions. WOMB OR UTERUS: Death from uterine cancer is declining. The death rate has dropped 65 percent over the past forty years. Much of the credit for this dramatic decline is due to the Pap test, named after its discoverer, Dr. George N. Papanicolaou. The Pap test consists of an examination of cells shed from the uterus and taken directly from the cervix. It is a painless test, easily done in the doctor's office, and can detect cancer at an early stage when it is highly curable before a woman has any symptoms. The Pap test is almost 100 percent accurate in detecting cervical cancer and should be included in every regular health checkup. However, it is found to be only about 60 percent effective in revealing cancer of the upper part of the uterus. Additional procedures which can be done in a physician's office have been developed to help find this type of cancer in an early stage. Women who have made sex a part of their lives at a young age and have had several sex partners are more likely to develop cervical cancer. HOW IS CANCER TREATED? Surgery, radiotherapy (use of X rays and radium) and anticancer drugs and hormones are the principal methods used in treating cancer today. Ad-vances and improvements in these techniques have increased their effec-tiveness and safety and many more patients are being saved. The manage-ment of cancer by combining various methods of treatment has contributed greatly toward the saving of lives. SURGERY: A patient undergoing surgery can count not only on the skills THE ANN LANDERS ENCYCLOPEDIA 175 of the surgeon but also on a variety of supportive treatments and equipment. Improved means of controlling infection, more effective anesthetics, wider use of blood substitutes (materials which can replace blood temporarily if necessary) are just a few of the advances. Emphasis, too, is now placed on the recovery phase of surgery-intensive care units and sensitive equipment for monitoring the patient's postoperative condition. RADIOTHERAPY: In radiotherapy, too, remarkable strides have been made, thanks to the development of machines that produce beams of electron volt energy in the multimillion range. These megavoltage devices can now at-tack and destroy a cancer deep inside the body. CHEMOTHERAPY: Chemicals have proved capable of curing certain cancers and greatly extending the remission periods of others. About one third of all cancers are responding to chemotherapy. Unlike surgery or radiotherapy, which require precise location of a tumor, chemicals can spread throughout the patient's body and destroy cancer cells which the physician cannot locate. Cancers controlled by chemotherapy chemicals for five years and longer: Choriocarcinoma, a highly malignant, if rare, type of cancer in preg-nant women. Burkitt's lymphoma, a cancer found mostly in African children. Hodgkin's disease. Acute lymphatic leukemia. Wilms's tumor, which occurs in the fetus and may not be apparent for years. Superficial cancers of the skin. Some cancers of the testicles. Rhabdomyosarcoma, a cancer of the muscle fiber. Today hope is high that more drugs will be found to cure specific cancers. Combination therapy, the use of not one drug but several, in varying dos-ages, has proved highly successful in treating cancer. It has proved effective in treating Hodgkin's disease in 70 percent of patients. Chemotherapy is also combined with other forms of treatment such as surgery and X-ray therapy with good results in many other types of cancers such as lymphomas, ad-vanced breast cancer, Wilms's tumor, colon and ovarian cancers, and two types of bone cancer found primarily in children. WHAT HAS RESEARCH ACCOMPLISHED IN HELPING THE CANCER PATIENT? Research has already developed improved treatment, examples of which have been mentioned. Other aspects of research show continued promise. For instance, the Pap test is being applied to analysis of sputum (coughed-up phlegm) among persons having a high risk of developing lung cancer. This may lead to earlier diagnosis. New methods of X ray are being developed to examine the brain and other parts of the body more accurately than with 176 THE ANN LANDERS ENCYCLOPEDIA present conventional methods. Some bone cancer patients are being treated by removal of bone sections instead of amputation. Ultrasound uses high- frequency sound waves instead of X rays to locate tumors deep in the body. Immunotherapy holds out hope of harnessing the body's own disease- fighting immune system to combat cancer. The idea is to stimulate the body to reject cancer cells-the way it rejects other foreign substances. Although investigators have not yet found the best techniques to help the body resist cancer's invasion, research is being done with various cancers, usually com-bining immunotherapy with other modes of treatment. BCG, a vaccine against tuberculosis, is a chemical currently being tried somewhat successfully to bolster the body's defenses against cancer. Research into the relationship between viruses and cancer holds promise. We learned years ago that viruses can cause cancer in certain animals and the suspicion has grown that they may also cause cancer in some humans. If a particular virus should prove to be the cause of a certain type of cancer, the next step would be the development of a vaccine to protect people against that virus. Thousands of scientists throughout the world are working on leads to dis-cover causes and prevention of cancer. If your physician wants information on the most recent drug therapy for treatment of cancer, suggest that he write to the Chief of the Treatment Divi-sion of the National Cancer Institute (part of H.E.W.) in Bethesda, Mary-land. Don't worry about offending him. It will be to his advantage as well as yours. To assume that any doctor knows everything about medicine is a mis-take. Also be aware that there are nineteen comprehensive cancer centers in the United States which screen and treat cancer patients: University of Alabama 205 Mortimer Jordan Hall Birmingham, Alabama 35294 University of Southern California University of Southern California Cancer Center 1721 Griffin Avenue Los Angeles, California 90031 UCLA Comprehensive Cancer Center 924 Westwood Boulevard Suite 650 Los Angeles, California 90033 Colorado Regional Cancer Center 165 Cook Street Denver, Colorado 80206 THE ANN LANDERS ENCYCLOPEDIA Yale University 333 Cedar Street New Haven, Connecticut 06510 Howard University 1825 Connecticut Avenue, N.W. Suite 218 Washington, D.C. 20009 Comprehensive Cancer Center for the State of Florida University of Miami School of Medicine Jackson Memorial Medical Center 2 S.E. 13th Street Miami, Florida 33131 Blinois Cancer Council 36 South Wabash Avenue Chicago, Illinois 60603 Johns Hopkins Medical Institutions Johns Hopkins Cancer Center 550 North Broadway Baltimore, Maryland 21205 Sidney Farber Cancer Center 44 Binney Street Boston, Massachusetts 02115 Minnesota Cancer Council Mayo Clinic Rochester, Minnesota 55901 Roswell Park Memorial Institute Buffalo, New York 14203 Memorial Sloan-Kettering Cancer Center 1275 York Avenue New York, New York 10021 Duke University 200 Atlas Street Durham, North Carolina 27705 Ohio State University Comprehensive Cancer Center McCampbell Hall, Room 357 1580 Cannon Drive Columbus, Ohio 43210 178 THE ANN LANDERS ENCYCLOPEDIA Fox Chase & The University of Pennsylvania Cancer Center 7701 Burholme Avenue Fox Chase-Philadelphia, Pennsylvania 19111 University of Texas System Cancer Center Texas Medical Center Houston, Texas 77025 Fred Hutchinson Cancer Research Center University of Washington 1102 Columbia Street Seattle, Washington 98104 University of Wisconsin 1900 University Avenue Madison, Wisconsin 53705 Most Cancer Information Services have toll-free telephone numbers. If the number of the Cancer Information Service near you does not have such a listing, you may call the national toll-free operator at (800) 555-1212 and ask for the listing. Or write to the Office of Cancer Communications of the National Cancer Institute, Department of H.E.W., in Bethesda, Maryland. HOW DO YOU SPOT A CANCER QUACK? Here are eight characteristics of a cancer quack: He says there's only one way to treat all kinds of cancers-his way. (The fact is that no single form of therapy is effective against all cancers.) He avoids and is shunned by established medical facilities and reputa-ble physicians. He uses unorthodox methods of publicizing his discoveries. His cure appears in popular magazines but not in scientific journals. He claims that organized medicine or science is persecuting him, that the "establishment is out to get" him. He uses secret methods, doesn't name the compounds in his medicine and is reluctant to let legitimate practitioners try his procedures. Medical records are kept inadequately or not at all. Phony diagnostic tests (blood or urine tests or even a machine) take the place of biopsy and other recognized diagnostic techniques. He gets testimonials from patients and celebrities who have no way of scientifically evaluating his methods. He challenges all established theories and scientists-claims they don't really want to cure cancer. He compares himself to other scientific greats who were first persecuted then proved right. THE ANN LANDERS ENCYCLOPEDIA 179 A quack will not only take your last dollar, he will waste precious time that should be spent getting legitimate treatment. HOW TO RECOVER FROM CANCER Rehabilitation starts at the time of diagnosis and must continue physically and psychologically to help the patient return to normal. The American Can-cer Society's Reach to Recovery program, for example, helps women who have lost a breast to cope with emotional problems-which can be consid-erable. I have received hundreds of letters from women who fear their hus-bands or lovers will view them as "mutilated" or "disfigured" and it will put an end to their sex life. These women need reassurance to overcome the emo-tional trauma. Frequently the husband is less concerned about the distortion than he is about causing pain to his wife. WILL YOU BE ABLE TO PAY FOR CANCER TREATMENT? One way to insure yourself against the cost of cancer, or any major illness, is to check your insurance policy carefully. Here are four ways your insur-ance can give you better cancer protection: A policy should cover at least thirty days in the hospital. Be sure it includes outpatient coverage for such things as chemo-therapy and radiation therapy. Try to include home health benefits, such as visiting nurses and home health care services. Take a policy which has a high initial deductible-$500 or $1,000- and continues to cover you for catastrophic illness. You can usually handle that initial payment if long-term expenses will be paid. HOW TO HELP A PATIENT COPE WITH CANCER Reactions to cancer vary according to age, type of cancer, prognosis and type of treatment required. But a patient's hope can be kept alive regardless of the outlook. Learning to live with cancer is an art, not a science. Each must find his own way in his own style. The best advice for everyone is to live one day at a time. Once you can help a cancer patient do that, the battle is won. No matter how few or how many years he has left, they will be happy ones. HOW THE FAMILY CAN COPE WITH CANCER Until new treatment, cures and preventative measures are taken, cancer will eventually strike two out of three American families. The family plays a 180 THE ANN LANDERS ENCYCLOPEDIA vital role in the patient's adjustment. With cancer of a child, many problems arise. For example: Communication between family members, especially parents, often breaks down. The mother concentrates exclusively on the sick child. The father feels neglected. The other children are resentful. Sometimes parents feel guilty, believing the child became ill from being punished or due to some inherited problem. The parents refuse to accept the seriousness of the situation and do not get the best medical care available. The parents shop around for doctors, faith healers, quacks, any promise of a cure. One final word: Cancer research and educational material cost money. Urge your congressmen and senators to pass legislation that will enable us to continue cancer research on a large scale. We can conquer cancer in our life-time if we have the tools to do it. You Can Fight Cancer and Win, by Jane E. Brody of the New York Times and Arthur I. Holleb, M.D., of the American Cancer Society, is well worth reading. credit: My thanks to Theodore Adams, Editorial Consultant to the American Cancer Society, for his invaluable assistance in gathering information for this piece. Some statistical material reprinted from the New York Times, April 29, 1977. Checked for accuracy by Mrs. Albert D. Lasker. Final draft reworked and alterations made by William Cahan, M.D., Attending Physician, Memo-rial Sloan-Kettering Cancer Center, New York. I'M DYING, YOU'RE DYING