As I reflect on the past year of our survivorship blog, it seems notable that many of you have mentioned the positive presence of people in your lives during this time.

These are the friends and family who know and understand how to love, support and simply be with you. This might also include people you've met along the way during your experience as a patient.

Now, it might also include those who are supporting each other through this blog. It's so amazing to see the love and strength that you're giving each other.

It's sometimes difficult for others to know how to be with someone who's experiencing cancer. Cancer is personal. It threatens our mortality, our lives, and the people around us in so many ways.

At times, friends and family pull away, not knowing what to do. However, this is the time when you may need them the most. I would love to hear from you about this. What has been your experience? What do you need the most from others?

Honest feedback may help others understand what kind of presence is the most helpful to a person experiencing cancer. I want to thank all of you for your presence on this blog in the past year.

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What is resilience? For you as a cancer survivor, it might be defined as the ability to recover, the strength to move forward, and the awareness of the needs of your own body.

Resilience is a strength that comes from within and is self-motivating. Research has shown that cancer survivors, when questioned, many times identify their own inner strength as one of the primary sources of strength as they experience and recover from a cancer diagnosis and treatment.

Many of you can identify with this concept, although it may be hard to put into words at first. Here are a few thoughts to consider as you reflect on your own resilience:

How do you bounce back from difficult situations? What are your coping mechanisms?How do you gain strength and courage to move forward? What motivates you?Are you able to ask for help when you need it? What is your support system?What inspires you and makes you feel whole as a person?

I have met so many survivors who have this amazing ability to survive and thrive despite the physical and emotional stress of cancer. Please share your thoughts on this topic. I would love to hear your opinion on what you feel is resilience and how this inner strength has helped you in your experience.

As a cancer survivor, you may be at risk for the occurrence of a second cancer. After treatment is completed it's great to have a break from all of the medical appointments. However, it's important to keep in mind prevention strategies and screening practices for the future.

As a cancer survivor, your risk for developing another cancer may be higher than the average person. This risk may be due to:

Chemotherapy drugs — Some may put you at risk for developing secondary leukemia. Radiation therapy may put you at risk for developing second cancers that are solid tumors. People at increased risk are those who have received high doses of radiation over a large area.Genetic mutations — Some people have inherited gene changes or mutations that increase the chances of getting a second cancer. If you feel that your family has a higher than average incidence of cancer, seek out a genetics specialist to review your family history and evaluate your risk.

What's important to keep in mind?

You may need more frequent or earlier screening than the recommended practice. Ask your health care provider what's recommended for you personally. Understand your risk for a second cancer. If you had treatment for cancer ask your cancer treatment team what your risk is for developing a second cancer. Be aware of changes in your body. Pay attention to new or unusual symptoms including: skin changes, swollen lymph nodes, unusual bleeding, pain, and excessive fatigue. Practice healthy habits for cancer prevention. Don't use tobacco, protect your skin from sun exposure, limit alcohol intake, incorporate exercise into your routine, and eat a healthy, low-fat diet (fruits, vegetables and whole grains).

Celebrate your life by remembering your risk and understanding what's best for your future. If you're not sure what you need, ask your cancer treatment team or primary care provider to help you plan for your future screening. Many of you have mentioned that you're dealing with a second cancer. Use this blog to share your experiences with each other.

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Mentor, navigator, advocate ... these are just a few of the people that you may have been touched by as a cancer survivor.

Most times, the people who fill these roles have faced cancer on a personal level as well. They've walked in your shoes and may have similar experiences to share. The art of caring, listening and supporting is so valuable.

Helping others make it through the experience of living with cancer is an incredible gift. They help you navigate your way through diagnosis, treatment and the time after treatment ends, which can be the hardest period.

People in these roles often want to give back by providing support and guidance to others who may be just at the beginning of their cancer experience. This is an empowering experience where the person helping oftentimes gets back as much as they give. For the person receiving the support, it's just so good to be with someone who knows exactly how they're feeling.

At Mayo Clinic Cancer Center, we are so fortunate to have American Cancer Society Navigators and volunteer survivors who work in the Cancer Education Center, Pink Ribbon Mentors who support breast cancer survivors, a strong group of men who organize the Prostate Cancer Support Group, as well as countless other advocates and community support.

Please share stories of how you've been touched by people in these supportive roles. Whether you were on the giving or receiving end, both are equally important!

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Last year, we had a blog discussion on "How cancer changes you" and so many of you wrote in to share your experiences. With this post, I want to delve deeper into the positive side. I realize it might be asking a lot to do this; however, while having cancer is a generally negative occurrence, some positive things may come from it.

I'll share a story of a woman I met who was diagnosed with breast cancer. After her initial treatment, she decided to reduce her work schedule and pursue her love for painting. She traveled to places she loved and created incredible watercolor paintings reflecting on the beauty of each place.

She stayed active in her work life, but was able to balance it with her dream of painting again. She told me she wouldn't have done this if it hadn't been for her cancer diagnosis. Previous to her diagnosis, she was extremely focused on her career and had put her love for painting on hold.

I'm sure this story isn't unique. Many of you have made positive changes in your life because of your cancer diagnosis. I've heard so many stories of love, courage and strength. At times, it's hard to be positive, as having cancer isn't exactly easy and the physical feelings of the body usually have a strong influence on the mind and outlook.

I would love to hear about your personal experiences. How did you transform the negative to positive? How did this experience change your life?

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The financial burden for cancer survivors is significant. In a recent study, more than 30 percent of people living with cancer said they had practical concerns regarding financial issues. On top of monthly or yearly insurance premiums, extra costs such as co-pays, medication (chemotherapy or treatment) expenses, travel costs and lost wages are all part of the equation as you deal with a cancer diagnosis, treatment and survivorship.

Some practical ideas that may help as you navigate your way through these issues include:

Talk with your health care team on an ongoing basis about treatment costs. If they recommend a new medication or prescription — ask about your out-of-pocket costs. Many times, your cancer treatment center's business office and pharmacy can give you an estimate of costs before hand.Meet with a social worker to review potential financial resources available to you. This might include charity care, prescription assistance programs, gas cards, low cost (or no cost lodging) and other resources.Call the American Cancer Society (1-800-227-2345) to connect with resources that are available to you as a cancer survivor. If you are unable to work because of your cancer diagnosis; talk with your employer to plan for medical leave, or call the Social Security office (1-800-772-1213) to discuss your options for disability benefits.

Feel free to share ideas, pearls of wisdom and any resources that you have found helpful.

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