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Non Hodgkin's Lymphoma VAULT
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Coping is an endless process and I find myself costantly learning. Over time I developed this template to help me deal with living with a non curable cancer.  When I first started out in my battle little information was out there, web pages took forever to load and you needed a computer background to get around in DOS (computer operating system). Today that's all changed and computers are now user friendly, but its an information nightmare out there!

If your not organized you'll find yourself getting lost in knowledge.

The following headings came about from years of searching for relevant, time saving information sources that helped me to enjoy remission. I got tired of losing links and decided to get organized which resulted in my own cancer related web page, which evolved in a decades time from information oriented to a humanistic approach. I went from a gatherer of information, to a binder creater, to an author of a hard copy of organized information and thoughts, to a web editor and a web page. I had the luxury of a six year period to grow, before I became hungry for knowledge (major decision time). Now I use this template as a crutch for coping and when I find something new I have a place to keep me up todate and ahead of the game, which helps keep my sanity.

Definite Senior/Edgewalker characteristic, being prepared.

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COPING VAULT HEADINGS

Major Sites  -  Treatment Specific - Communication - Tools

Researching and Documenting Tips

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    Major Sites
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Today you really only need a few sites for general information because they are very information specific. Over time I've found out that cancer is a world wide issue and thus have also linked to several international sites. A fellow Senior/Edgewalker of  the STOP Non Hodgkin's Lymphoma message board, Shirls from Australia, who I consider a life long friend, once referred to my personal cancer related web page "NHL Playing In The Wrong League" as "her bible", that helped get her through another bout with cancer. Cancer knows no boundaries.

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Canadian
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National

Canadian Cancer Society

Overview: A national, community-based organization of volunteers, whose mission is the eradication of cancer and the enhancement of the quality of life of people living with cancer.

CCS web page is a well organized, easy to get around site, including a worksheet on "questions to ask your health team", which you can print out and review before your appointment. The Canadian Cancer Encyclopedia is a good general search tool. Also included is the Cancer Services and Programs search engine, two good sources to find relevant information about everything that is cancer.

National Cancer Institute of Canada

Overview: Funded by the Canadian Cancer Society and The Terry Fox Foundation, the National Cancer Institute of Canada is the country's premier research organization dedicated to supporting outstanding cancer research and advancing cancer control.

Good site for finding research news.

Canadian Cancer Society
Canadian Cancer Encylopedia

Overview: Quick link to informtion all gathered in one place in a search engine capacity.

Canadian Cancer Society
Canadian Cancer Services and Programs

Overview: Works well try typing in "Cancer" in the Search by name of service box and typing in your postal code.

Regional

Cancer Care Ontario

OverviewCancer Care Ontario is an umbrella organization that steers and coordinates Ontario’s cancer services and prevention efforts.

Great information site for everything from drug coverage to phone numbers and contacts  eg.Cancer Information Service at 1-888-939-3333

Wait Tmes In Ontario

OverviewThis web site contains the most currently available information about wait times in Ontario, including a breakdown by individual hospitals for five specific health services : Cancer surgery, Cardiac procedures (bypass surgery, angioplasty, angiography), Cataract surgery, Hip and Knee replacement, Diagnostic scans (MRI and CT scans).

Specific

Leukemia and Lymphoma Society of Canada

Overview:  The Leukemia & Lymphoma Society is the world's largest voluntary health organization dedicated to funding blood cancer research, education and patient services.

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International
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Heavyweights

American Cancer Society

Overview:  With chartered divisions throughout the country and over 3,400 local offices, the American Cancer Society (ACS) is committed to fighting cancer through balanced programs of research, education, patient service, advocacy, and rehabilitation.

The NexProfiler Treatment Option Tools, which can help you make an informed decision about your treatment looks interesting.

National Cancer Institute

Overview: The National Cancer Institute (NCI) is a component of the National Institutes of Health (NIH), one of eight agencies that compose the Public Health Service (PHS) in the Department of Health and Human Services (DHHS).

Good section on clinical trials and how to find one.

Wikipedia, the free encyclopedia

Overview: Wikipedia (pronounced We-key-pee-de-ah)  is a Web-based free-content multilingual encyclopedia project.

Hard to beat Wiki for information.

Specific

Lymphoma Research Foundation

Overview:The Lymphoma Research Foundation (LRF) is the nation’s largest lymphoma-focused voluntary health organization devoted exclusively to funding lymphoma research and providing patients and healthcare professionals with critical information on the disease. LRF’s mission is to eradicate lymphoma and serve those touched by this disease.

Lots of information and suggestions on how to get involved.

Individual

Lymphoma Information Network

Overview: These pages are for those seeking information on Hodgkin's and Non-Hodgkin's Lymphoma. Welcome! This site strives to do three things: put a bit of humanity and understanding to this disease, to gather lymphoma information and resources in one place, and to present information in an easy to understand and logical format.

This was one of the first sites I used regularily.

Stop Non Hodgkin's Lymphoma

Overview: Welcome to Stop Non-Hodgkin's Lymphoma (aka: Stop NHL), one of the oldest lymphoma support communities on the Internet. Although we've grown tremendously in size since our conception in 1997, and we have world-wide appeal with posters from the United States, Canada, Australia, England, Germany and other countries, we've managed to retain our small-town appeal. If you search hard enough you eventually find what you are looking for. I was looking for the reality that me beating cancer could be done. Here I found Bruce who I claimed as a blood brother, with the same type of NHL and a similar background. The rest is history and for nearly a decade we fought the beast together. His "Twin" through the battle Trudi, his wife is a truely inspirational caregiver to not only Bruce but also to numerous others across the world. The site is definetly worth a visit. On my last visit since she updated her webpage I got a very warm surprise.

Definite Senior/Edgewalker characteristic, communicator.

PatientCenters

Overview: Questions answered, experienced shared.

Has several interesting articles worth reading.

Professional

Professional Help

Overview:CancerConsultants.com Inc. is the leading developer of cancer program web sites, cancer related internet-based educational resources and marketing consulting services for cancer programs. CancerConsultants.com Inc. also manages www.cancerconsultants.com, the leading cancer information portal for patients and oncology professionals on the Internet. Educational content found on www.cancerconsultants.com is also distributed to over 200 leading providers of cancer care in the United States in both English and Spanish.

Betsy's story is inspirational.

Technology

NHL pdf file from Canadian Cancer Society

NHL pdf file from American Cancer Society

Overview:  Most larger organization are providing information in pdf format.
Adobe Reader provides a free download for pdf files.)

If you intend on becoming a true searcher on the internet better get use to working with pdf files.














































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    Treatment Specific

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My Treatment Summary - Chemotherapy - Radiation - Surgery - Immunotherapy/Clinical Trials

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My Treatments - Like most unique cancer patients I was given an individual treatment plan for each occurance of cancer that took into account my type of cancer, its characteristics, the stage of cancer and my personal health situation. For each fight with cancer I worked with my doctor to decide on a treatment plan, however the initial battle was all the doctor's doing. My treatments varied based on my medical history and this is a common occurance, because sometimes two people with the same cancer can be given very different treatments.

Each treatment has a GOAL, which you and your medical team hope to reach and I'll give examples of goals based on my medical history.

1st Remission (1990) - Because my cancer was not curable the GOAL of my treatment was to CONTROL the beast, and it was everywhere. The hope was to prevent the growth of cancer cells and to reduce the risk of my cancer recurring (at one time I hated that word).  Despite the primary treatment working and getting rid of my cancerous nodes I was given another dose of chemo (Leurkeran) Adjuvant Therapy, to destroy any remaining cancer cells and to reduce the risk of the cancer recurring (there's that word again).

2nd remission (1993) - In this recurrance the beast was only found locally or only in one spot and the chemo (Leurkeran) did what it was suppose to do, CONTROL. The chemo was the primary (main) treatment.

When I was first diagnosed the definition of Recurrent Non Hodgkin's Lymphoma was that the cancer came back in shorter
and shorter periods, until you were out of luck. My history of remissions was 3 years - 1 year - 1/2 a year (out of luck ? I think not!).

3rd remission (1997) - This is where all hell broke loose. In this battle I used a combination of treatments. The first stage of my Stem Cell Transplant was to receive Neoadjuvant Therapy, or chemo that was given before the primary treatment to reduce the size of the tumours, so that it was not only easier to treat with the chemo and radiation later, but also in my case to promote the primary treatment of harvesting of my stem cells. Before receiving my stem cells back I was given major chemo and major radiation and in this case the transplant was the primary treatment, not the chemo or radiation.

You can see why I once despised the word recurrent, but now that I and others like me have given new meaning to the
word in dealing with NHL (Non Hodgkin's Lymphoma), it doesn't have the effect on me that it once had.


It's interesting to note that my medical team used both Local and
Systemic treatments. Local radiation was used to relieve the pain from the node in my spine and I went from barely being able to move, to dancing in the streets virtually overnight. Systematic was used to get rid of all the other painless nodes that were still there and going no where fast. I like to think, although no one will tell me, that the treatment was given to CURE my cancer. February 18th (Stem Cell Transplant day and also my moms birthday) 1997 was the last time I physically had NHL.

4th remission (2004) - With this remission from a second type of cancer (Malignant Melonoma) my treatment team used Surgery as the primary treatment.

My system paid off because I had the tools in place this time to quickly gather information
and realize that because it was caught early it would be an easier battle, why over worry for nothing.

My General Practioner found the skin cancer as a result of treatment for a blood cloth in my lung, who's source was never determined. Thus my NHL medical team went into high gear to see if their was another type of sleeping beast elsewhere, namely had my NHL returned. I also found this time that because I was leading the charge and informed, new acquaintaince doctors were very receptive to discuss and clarify previous cancer involvment in the sway away from normal expedations. Today I'm more concerned with side effects from treatments, that my NHL coming back.

another Senior/Edgewalker characteristic: informed

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MY TREATMENT SUMMARY

Treatment Goals

Treatment decisions are based on: type, grade,   stage of disease and a person's age and well being.
Cancer treatment various with individual wants and needs and can change over time.


CONTROL
- stop cancer from growing and spreading or coming back.
CURE -
treatment is given as the main treatment to cure the cancer.
PREVENTION-
prevent the growth of cancer cells or to remove precancerous tissue that could turn into cancer.
PALLATIVE -
Treatment is given when cure is not possible.

Treatment Plans

Treatment plans are designed to meet the unique needs of each person with cancer.

 PRIMARY therapy is your main weapon in fighting the beast.
ADJUVANT therapy is used to destroy any remaining cancer cells and to reduce the risk of the cancer recurring.
NEOADJUVANT therapy is treatment that is given before the primary treatment, so that it is easier to treat with the primary treatment.
 
 Treatment Targets

LOCAL treatments are directed at a specific part of the body and are often used when cancer is limited to that area.
SYSTEMATIC treatments are given to travel through the bloodstream to reach cells throughout the body.







































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Chemotherapy

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. I have had  a single agent chemotherapy drug for treatment (Leukeran) and a chemotherapy combination. As part of Adjuvant treatment for my Stem Cell Transplant I received Cisplatin and Cytarabine and then received Etoposide (my personal non favorite chemo) and Melphalan before the stem cell infusion (CHOP is the most common chemotheraphy combination).

As you can see there are many types of chemo and unfortunately all have side effects. Leukeran (what I refer to as a light chemo) came in pill form and was the easiest to handle. I found if I kept something in my stomach I was all right . To get Cisplatin (middle of the road chemo) I was hospitilized to prevent dehydration, but remember limited side effects. The chemo Etopisode (heavyweight) I now really respect. It knocked me down bigtime and has lingering effects even today. If I had to take chemo again I would be really interested in looking at options, other than going through another Etopisode journey.

Drugs

Drug Information For Patients
Cancer Care Ontario

Overview:  This is a drug information site for patients that goes into how and why the medication is used and the precautions to look out for. Man I wish this site was around in my learning days.

The Internet Drug Index
RxList

Major Sites

Overview:  These are just a few of the many sites out there that have sections on chemotherapy.

Chemotherapy
Canadian Cancer Society

Chemotherapy Effects
American Cancer Society

Chemotherapy and You
National Cancer Institute

Chemocare.com

Overview:  Welcome to Chemocare.com, my new website designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. We are here to help by supplementing what you may already have learned from your healthcare professional.
-- Scott Hamilton





































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Radiation

Radiation therapy uses high-energy x-ray beams to destroy cancer cells. I have had both Local Radiation and Total Nodal Irradiation Radiation Therapy.

Local
(Pallative - reduce tumor bulk) Radiation was used to bring down the size of a cancerous node that was in my spine severing my nerves. I received 4 treatments with instant results. In fact I received the last treatment in an out patient bases, coming a long way from the bedridden sole a few days earlier. Local Radiation can also be used as the primary treatment, when the disease is localized.

Total Nodal Irradation
was used as part of a treatment plan for my Stem Cell Transplant. It's the heavyweight of Radiation therapy because
all Radiation fields are radiated at the same time. A Radation Field is the term used to describe the area being radiated. Combination therapy is where radiation is used as part of a treatment plan along with other treatments, such in my case chemotheraphy and the stem cell transplant. The dose and schedule for the radiation therapy is determined by the type of cancer, the extent of the disease, and whether the goal of treatment is to cure the disease or relieve symptoms. One particular side effect from Total Nodal Irradation is that the patient will become sterile, so if your planning on a family better save some swimmers.

On a NHL Message Board I once mentioned that I had the "pleasure" of receiving radiation. Some stated that they would never have
associated "radiation and pleasure" and then made reference to my glass is half full attitude or positive nature, which they said turned their day
around and noted that this attitude made my life easier to take and loved once around me lifes easier to take. How true!

another Senior/Edgewalker characteristic: positive most of the time

Don't get me wrong I respect radiation for I have seen its full force. Pallative radiation therapy can be used when chemotherapy is no longer effective to relieve symptoms.  My Dad for an example, went to radiation limits in his battle with prostate cancer and it wasn't pretty and that's why I know and appreciate my successful, pleasurable experiences with Radiation.

Overview: These are just a few of the many sites out there that have sections on radiation.

Major Sites

Radiation Therapy
Canadian Cancer Society

Radiation Therapy Effects
American Cancer Society

National Cancer Institute
Radiation Therapy and You:
































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Surgery

Up until doing a section on Surgery I never realized the role that surgery played in my recovery process.

Diagnostic surgery was the first type of surgery I had. It  is used to get a tissue sample to tell whether or not it is cancerous or to tell what type of cancer it is. When only a sample of tissue is removed, the procedure is called an incisional biopsy. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When a sample of tissue or fluid is removed with a needle, the procedure is called a needle biopsy, core biopsy, or fine-needle aspiration.

Next came Supportive surgery which  is used to help with other types of treatment. For example, a catheter port was surgically placed into a large vein in my chest and used to deliver chemotherapy treatments, replace stem cells and to draw blood for testing, reducing the number of needles needed.

Then I had Curative surgery which is the removal of a tumor when it appears to be confined to one area, or in my case the Malignant Melonoma. It was done as the primary treatment of the cancer. 

Preventive (prophylactic) surgery is done to remove body tissue that is not malignant (cancerous) but is likely to become malignant. For example, this type of surgery was used to remove precancerous condition polyps in my colon.

My Dad had Restorative (reconstructive) surgery which is used to restore a person’s appearance or the function of an organ or body part. In his case his arm needed to be reconstructed to recieve additional radiation.

Staging surgery helps determine the extent and the amount of disease. Lucily I never needed this type of surgery.

Major Sites

Surgery
American Cancer Society






































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Immunotherapy/Clinical Trials

Immunotherapy (biologic therapy) is a treatment that uses the immune system to fight cancer. It is the new tool in fighting cancer and can be used alone or with another type of therapy.

Immunotherapy Tyes include:

Monoclonal Antibody Theraphy (Passive - they use immune system components like antibodies created outside of the body to attack the disease).
Cancer Vaccines (Active - stimulate the body’s own immune system to fight the disease).
Nonspecific Immunotherapies and Adjuvants

Clinical Trial is the studies of promising new or experimental treatments in patients.

Phase I clinical trials: The purpose of a phase I study is to find the best way to give a new treatment and find out how much of it can be given safely.
 
Phase II clinical trials: These are designed to see if the drug works. Patients are given the highest dose that doesn’t cause severe side effects (determined from the phase I study) and closely observed for an effect on the cancer.

I was involved in a Phase III clinical trials with Monoclonal Antibody Theraphy: Phase III studies involve large numbers of patients. One group (the control group) receives the standard (most accepted) treatment. The other group receives the new treatment and all patients in phase III studies are closely watched.

Back in 1997 I was reluctant to move on to strong chemo so I researched my options and found out about Clinical Trials. My Onchologist Specialist recommended a Phase III Clinical trial at a research hospital and I quickly jumped at the chance to avoid chemo. The treatment was not beneficial to me but when my condition got worse I had an in with the same research hospital and had my Stem Cell Transplant done by some of the best NHL specialist doctors in the country.

Another Senior/Edgewalker characteristic: not scared to take a chance.

Major Sites

Overview: These are just a few of the many sites out there that have sections on clinical trials and immunotherapy.

Clinical Trials
Canadian Cancer Society

Ontario Cancer Trials

Ontario Cancer Research Network

Clinical Trials
American Cancer Society

Immunotherapy
American Cancer Society





































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    Communication Sources
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Communication sources are very supportive in nature because knowledge is divine. When I first started out in my cancer journey you didn't need Support Groups. In a support group you will find people with problems similar to yours. Group members will offer you emotional support, practical information and tips on how to cope with your unique situation. Support groups format centers around those led by professional facilitators such as a nurse, and those led by group members, which are often called peer or self-help groups and can be educational and structured. As more and more people survive cancer the need for a structured guide to coping is materializing and individuals like myself are putting together "Coping Workshops" to help others cope.

In addition to traditional in person support groups the Internet offers online support groups and communities.

Newsgroups are like virtual bulletin boards, with lists of messages on similar topics posted by users.You can read the messages called posts. You can post a message or simply browse the list.

Electronic mailing lists are different from newsgroups and operate by e-mail. To participate you join a mailing list and, as a member, you receive e-mails from other members. Each time anyone in the group sends an e-mail you also get a copy. If you send an e-mail then a copy goes to everyone.

Chat rooms operate on the same premise as newsgroups and electronic mailing lists. The difference is that they operate in real time, and there's no delay in the exchange of information. It's like being in a room talking to others who have a similar interest. But you're not talking out loud. You're talking through your keyboard.

Personal Web Pages/Blogs are usually a good source for all that is your cancer including personal stories.

Message Boards are like newsproups but done in a community setting.

Books are the traditional source for communicating messages.

Communication is vital to a health recovery. I learned this early.

Message Boards and Support Groups

For years the STOP NHL Message Board was my path to understanding what I was going through. A place to find out that I was not alone and that I could be down and had the right to feel down. A place to draw strength and guidance from. It  was and still is so real because you will always find fellow Non Hodgkin's Lymphoma'ers there in battle. This is a great site with friendly, caring and informative NHL patients and caregivers, who can be a wealth of support in times of need. The STOP NHL Message Board helped me and many others become and stay NHL PROUD.When you pay attention long enough special people emerge to the forefront. Dealing with NHL was no different and over the years special folks from around the world help me to cope, and even help today. There are larger lymphoma message boards on the Internet, but like large cities, they are fast-paced, cold, impersonal and easy to get lost in. In contrast, the Stop Non-Hodgkin's Lymphoma community is like a small town, where the pace is slower and almost everyone knows your name and cares about you. I may not post as much any more but I visit often to check on friends and to keep up with any news and even after what's closing in on a decade removed from active Non Hodgkin's Lymphoma, I am still considered a senior of the board.

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Workshops are becoming more common in dealing with all the cancer related information out there.

Lymphoma Education Session Schedule for People Living with Lymphoma

The workshop in Ottawa is being facilitated by one of my Stem Cell Transplant Doctors.

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Personal Web Pages, Stories and Blogs

I also like to read about other similar cancer battle stories.

There is something for everyone in the documentation of the cancer journey.

Recently diagnosed : Learn what others have experienced with your type of cancer and the types of cancer treatment they have undergone.

Experienced patients: Share your cancer experiences about cancer treatments and other concerns with the newly diagnosed and help others understand what it is like to have the cancer you have and what effects the treatment has on your body and lifestyle.

Friends and family: Deepen your understanding of the issues facing the patient. 


Lymphoma Information Network Inspirational Stories

STOP NHL Homepages

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Books have always been a source for information and today with the internet they are much easier to find.

NHL Cancer Books at Amazon.com

NHL Cancer Books at Ebay

A Cancer Survivors Bookstore
God Help Me

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Blogs are now the in thing for keeping track.

Lymphoma Invotations

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News is something that gives hope for a future.

Canada.com

Franklin Square Hospital Center

Lymphoma-net.org,

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    Tools
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Anything that helps to cope is valuable.  

Tech

Adobe Reader for pdf files

Overview: Upgrade today by downloading free Adobe Reader 7.0 software to view, print, and search Adobe PDF files. Whether you use it at home or in your business, on your computer or on a mobile device, upgrading to Adobe Reader 7.0 helps you work faster and better.

Cope With Cancer - CD Rom

Overview: Cope with Cancer is a new computer CD-ROM designed especially for newly diagnosed cancer patients.

Specialty

Disease Staging Manual

Overview: Standardized descriptions for staging various malignancies

Information

NCI Dictionary of Cancer Terms

Overview: Welcome to the NCI Dictionary of Cancer Terms, which contains more than 4,000 terms related to cancer and medicine. Type the word or phrase you are looking for in the Search box and click "Go". If you are not sure of the spelling, type in a few letters and click "Go". Or browse through the dictionary by clicking a letter in the alphabet.

Canadian Cancer Society
Cancer Checkup

Overview:Reducing your risk of cancer involves making healthy lifestyle choices and being proactive about screening and early detection. Answer the following questions and we’ll provide you with a personalized Checkup Checklist that you can take to your doctor. All it takes is a few minutes of your time. It’s completely anonymous and confidential.










































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Researching and Documentation Tips
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Over the years I've developed my own style for searching on the Internet and because cancer is such a "HOT" topic loads of information and information sources are available.

TIP #'er ONE
Stay focused and keep it topic specific.

What I've discovered in my internet journeys is that it is easy to get off topic. To avoid this I use a documentation process that allows me to keep track of everything I find. It is a simple approach that is based on the gathering and classification of information so that a more in depth analysis can be done later. I do this by using a browser (ex. Internet Explorer) and a source for documentation (ex web editor such as Netscape Composer - or a word processor such as Word -where you can hyperlink or Notepad where you will have to copy wep page addresses in). At this point I can go into the history of searching but because searching is becoming so user friendly I'll keep it basic.

First thing I do is a basic search on the topic on several search engines

Yahoo listing of search engines

My initial goal is to find a  reliable subject directory which is a service that offers a collection of links to Internet resources submitted by site creators or evaluators and organized into subject categories. Directory services use selection criteria for choosing links to include, though the selectivity varies among services and most directories are searchable. Using this site I begin the documentation process and begin to categorize based on their recomendations on the topic.

DOCUMENTATION CATEGORY TYPES

Major Sites - Must Reads - Catch All (A to Z) section

Major Sites are looked at quickly for additional avenues of research or classification and are added to the documentation page for analysis later. Must reads are not of the major sites classification but attracted my interest enough that they warrant a view later. The catch all section is just what it says and as I find related information on the topic, I put the link where it belongs (ex under B you might find a link to Books on the topic, under I you might find links to Inspiration Stories, under N you might find links to News, etc ...) You classify to your needs and wants and thus it is easier for you to remember where things are.

TIP #'er TWO
Document to your needs and wants.

An important part of the Internet search is keeping track where you search, especially if you plan on making a thorough search. To me a thorough search is examining the results of the search engine until the results are becoming off topic. However I have found several gem web pages by having the patience to find "needle in the hay stack" web pages that don't register as often with the search engines.

another Senior/Edgewalker characteristic: patience

Once I have done the basic search on my search engines I now refine my search by using the same topic, but enclose the topic in quotation marks. This usually will find more topic specific information.