In Indonesia, nasopharyngeal cancer is the most malignant tumors in ENT and is ranked the 5th largest for malignant tumors throughout the body with high mortality rates. The etiology of nasopharyngeal cancer is not known with certainty, allegedly associated with Ebstein Barr virus.
IN cases of nasopharyngeal cancer, the highest incidence found in ethnic Mongoloid. The disease can be of all age groups, the highest in decades 4 and 5. In endemic areas, 60% of patients aged less than 50 years. Comparison of male and female 2:1 to 4:1. At this age they are generally productive, so we need maximum effort to reduce this high mortality rate that is by doing nasopharyngeal cancer diagnosis as early as possible or at an early stage. Early diagnosis will determine the prognosis of the patient or the 5-year survival rate.
Diagnosis of nasopharyngeal cancer are often done too late. This is due dininya atypical symptoms and the hidden location of the nasopharynx. He was hidden behind the nasal cavity and located below the base of the head and associated with many important areas in the brain and neck. Patients are often only came for a treatment after the symptoms appear due to the spread of the tumor as a lump in the neck or neurological disorders. Given the location of the nasopharynx are not easily checked, the patient should consult an expert on them so the diagnosis can be established as early as possible.
Many factors are thought to relate to the incidence of malignant nasopharyngeal tumors, although the exact etiology is unknown. There are allegations of factors that play a role in it is the Epstein Bar virus infection, genetic susceptibility (Mongoloid race) and the environment, including living habits. Neighborhood factors and lifestyle habits, such as wood smoke used for cooking, often in contact with substances that can cause cancer or substances such karsiogenik bensophyrene, chemical gases, smoke, plant, insect repellent smoke, cigarette smoke, nitrosamines found in salted fish.
Symptoms Varies
Early symptoms of nasopharyngeal cancer is highly variable and are not typical symptoms of influenza as usual. Complaints that arise depending on the position and the extension of nasopharyngeal tumors, whether grown to estuary fallopian eustachius from ear or nose. Complaints that occur in the ear or nose was unilateral or one sided. Generally, ear disorders appear as early symptoms because tumors originated in the vicinity of the mouth of the fallopian eustachius called rossenmuller fossa tumor where the growth will clog the mouth of the tube. Disorders of the ear, can be a feeling of fullness in the ear, hearing loss, ear buzzing and pain in the ear.
Complaints of nasal obstruction in the form of settled on one side or both nostrils and recurrent bleeding (nosebleeds) or nasal mucus mixed with blood which caused the wall surface of tumor fragile, so easy to bleed in mild irritation. Another complaint form can not smell the smell and nose.
Symptoms that appear on the ears and nose is not a typical symptom of nasopharyngeal cancer, because it is also found in the form of infectious ENT diseases which are already widely known among other middle ear infections, chronic colds, sinusitis and others. Patients often regard this as something that is not dangerous because they do not immediately see a doctor. Instead the patient had gone to the doctor but the doctors diagnose as a chronic runny nose, runny nose usual. But if it is unilateral – occur repeatedly or settled without obvious cause, vigilance against the possibility of nasopharyngeal cancer should be improved especially with a lump in the upper neck.
In addition to symptoms of ear and nose, headache symptoms were also found in early cases. In nasopharyngeal cancer diagnosis needs to be done a series of examination and diagnosis must be confirmed by nasopharyngeal biopsy.
Examination
Examination of rinoskopi posterior nasopharynx using a mirror or with endoscopy. In many ways, endoscope 90% more profitable because it can see the nasopharynx at an early stage to assess the formation of a mild elevation of asymmetry. Because of its uses is to examine more thoroughly the nasopharynx and more detailed, the tool is very useful in early detection of mucosal layer in endemic areas and working in the early detection of a recurrence.
Nasopharyngeal biopsy can be performed with local anesthesia or general anesthesia. A biopsy should be done”avoe.”Furthermore, to ensure nasopharyngeal cancer biopsy tissue pathology examination by an anatomical pathologist.
Then, the current serological introduced as one way for early detection of nasopharyngeal cancer. With the entry of viruses into human cells, the body will form an immunological or immune reaction against antigens in the virus. The investigation of immunological reaction against Epstein Barr virus antigen has been successfully identified several specific antigens found in nasopharyngeal carcinoma.
1. Antibodies Ig G and Ig A against Viral Capsid Antigen (VCA). Until recently, the examination titer Ig A – VCA is considered the most specific and sensitive for early diagnosis of nasopharyngeal cancer. This test is also considered the method of choice for the state primary occolt namely the discovery of abnormal condition of the cervical gland enlargement or destruction of the skull base or brain nerve paralysis in the absence of tumor in the nasopharynx.
2. Ig G anti Farly Antigen (FA). For early detection of nasopharyngeal cancer, this test is less sensitive when compared with Ig A – VCA.
3. Antibody Dependent Cellular Cytotoxicty (ADCC). ADCC examination to determine the course of the disease and prognosis based on the high and low titer at the time of diagnosis.
As a means of early diagnosis, test A-VCA Ig is the most sensitive test for early detection of nasopharyngeal cancer, but it is advisable to do combinations with Ig G – EA to make it more specific and sensitive. For definite diagnosis of nasopharyngeal cancer, it remains to be done a biopsy and pathological-anatomical examination, whereas serologic as one of nasopharyngeal cancer early detection guidelines.

Primary bone cancer is cancer that starts in the (network) of bone. Primary bone cancer is rare. Much more common is cancer that starts in other organs, such as the lungs and later metastasis to bone.

There are 3 main types of primary bone cancer, namely:
• Osteosarkoma: developing cartilage
• Chondrosarkoma: begins in the cartilage of patients
• Ewing’s Sarcoma: begins in nerve tissue found in bone marrow.

Bone cancer is usually treated with surgery. In addition, other options include: amputation, chemotherapy and radiotherapy.

Osteosarcoma
Osteosarcoma usually attacks the boys aged between 10-25 years old and believed to be hereditary (genetic).

Osteosarcoma tend to grow at the lower end of the femur, or upper end of humerus or upper end of the shin.
The most common symptom is pain. In line with the growth of tumors, can also be a palpable swelling warm and slightly flushed.

Early signs of this disease may be a broken bone called pathological fractures.
This is because the tumor causes brittle bones.

Osteosarcoma usually be diagnosed by imaging tests such as CT Scan or X-ray bone. This type of bone cancer is usually treated with surgery. If there is a spread, chemotherapy can be done.

Chondrosarkoma
Chondrosarkoma usually cut in the cells of cartilage (cartilage) patients aged over 50 years.

This type of cancer usually grows slowly and often can be cured only by surgery. However, some of which are invasive and easy to spread.

In the case of chondrosarkoma, surgery performed to remove the entire tumor. Bone cancer is usually not react well to chemotherapy or radiotherapy. If the tumor is removed completely, more than 75% of patients survive. Amputation of arm / leg is usually rare.

Ewing Sarcoma
Ewing Sarcoma appear at puberty, when bones grow very fast. Rarely found in children aged less than 10 years.
Ewing sarcoma most often develops in long bones, pelvis, or chest.
Tumors of this type also are invasive, easily spread to organs such as the lungs.

Symptoms are most often complained of pain, fever and sometimes swelling of the bone. Usually, new patients are diagnosed when the cancer has spread.

Bone cancer treatment is often a combination of: surgery, chemotherapy and radiotherapy.

YOU certainly have heard a million benefit from a variety of colorful vegetables and good vegetable greens. Baby broccoli, for example, has been shown to protect the body from free radical attack. If you love vegetables, you’ve done the right thing, if not the invention of this Japanese researchers can be your motivation to consume vegetables, especially baby broccoli.

A study in Japan found that consuming 70 grams of baby broccoli every day for 2 months could protect the body against various stomach ailments commonly experienced, such as gastritis, stomach ulcers and even gastric cancer.

Baby broccoli shoots, bright researchers, is rich in sulforaphane, a natural chemical plant that serves trigger production of enzymes in the gut. These enzymes function against free radicals, the chemicals damage DNA and prevent inflammation.

In a study published in the journal Cancer Prevention Researchini, researchers found that consuming 70 grams of baby broccoli each day can help fight off some serious stomach problems.

“We found one food, which if consumed regularly, the potential for addressing the causes of the problem of gastric inflammation and can even help prevent stomach cancer,” says Jed Fahey, a nutritional biochemist from Lewis B. and Dorothy Cullman Cancer Center at the Chemoprotection
Johns Hopkins University School of Medicine.

Sulforaphane, he explained, has long been known as an effective antibiotic against Helicobacter pylori, a bacterium that causes gastritis, peptic ulcer and gastric cancer. However, this is the first experiment that shows the benefits of this substance in humans.

“Tunas broccoli contains sulforaphane levels much higher than mature broccoli,” said Fahey was quoted as saying by Reuters news agency.

In his study, the researchers involved 50 patients who infected Helicobacter pylori. The patients were divided into 2 groups. 25 patients were asked to consume as much as 70 grams of baby broccoli daily for 2 months.
While the other 25 patients were asked to consume alfalfa sprouts that do not contain sulforaphane.

“We know that 2 ounces pork broccoli a day is enough to raise levels of protective enzymes, explained he. In fact, continued Fahey, baby broccoli can reduce the rate of inflammation and peptic ulcer and
cancer.

World Health Organization (WHO) explained her, classified as a carcinogen Helicobacter pylori. Helicobacter this can damage the stomach lining.

“Helicobacter pylori can infect billions of people or say half
world population. This species has long been linked denagn stomach ulcers, which often can be cured with antibiotics, “he said.

A chemical expert, Bambang Kuswandi, PhD points out, the number of cancer cases in almost all strata of society, one of which caused a lot of food consumed containing formalin.
“Compared with the 1970’s, now it’s a case of cancer disease is mostly found in the community. It’s  because of a less healthy diet, either because they contain formaldehyde,” he said in Surabaya on Tuesday.
Graduated from “University of Manchester Institute of Science and Technology” (UMIST), UK chairman of Pharmaceutical Studies Program, State University of Jember (Unej), suggests that POM Hall commented on the findings of the Center for the noodles and tofu that contain formaldehyde.
Bambang argued, in addition to causing cancer, formalin also cause irritation effects on the body which passed. For example on the skin, respiratory tract or the stomach.
“If it lasts a long time, it can cause cancer. Formalin was` do not be digested so the body reacts. Reactions that could trigger the emergence of cancer, “said the man from Sumenep, Madura.
He argues, have long suspected the existence of formalin on wet noodle product, whereas formalin on instant noodle is a new thing, which was intended as a preservative.
“Even I also never heard of salted fish using formalin. Yet for salted fish was enough to use salt can kill the bacteria or if you can use sugar confectionery products,” he said.
According to him, in addition to formalin, a chemical element that is widely used for food products and usually consumed by children is a dye clothing or other chemicals used on tomatoes mixed with chili which is rotten.
He said, actually very easy to distinguish dyes used clothing to foods, ie the garment dye will stick to the bowl or plate.
“If the use of formalin, is usually a little chewy when eaten. If instant noodles can be eaten raw to start with,” he said.
To reduce the practical use of formaldehyde as well as preservatives and coloring it, then the government should immediately intervene to provide enough knowledge to society.
“All this is usually the government will intervene to take actions if there are cases. For my action agreed, especially for actors who belong to a lot of money and knowledge enough, but the need is awareness,” he said.
According to him, much use of formalin, dyes and other substances in the community, caused by two things, namely because of lack of knowledge and to stay alive amid the current economic crush.
“Public Health in the region must be proactive in providing information to the public. In Pharmacy Unej never entered into counseling about this, but then considered to provoke the public to not buy the merchandise PK-5,” he said.
He said such a negative excesses are difficult to avoid because it is the extent of unhealthy food peredaranan in society. Therefore, local governments need to find the right formula for small traders are not disadvantaged and the user community is also safe.
“It was never any idea of ​​returning to nature, for example to dye using pandan (green) and saffron for yellow. But it is less desirable because it is considered difficult and less interesting in terms of appearance than chemicals,” he said.
In addition, Bambang also asked Balai POM to be proactive to the community and not only do the action. POM must find alternatives to find a cheap material, but still hygienic for the same thing does not happen again.

Dogs are man’s best friend, but do you know if some types of dogs can even detect cancer and epileptic seizures in humans?
An experiment conducted by a team of doctors at Amersham Hospital, UK, proves this. They sent six dogs to sniff urine samples 144 people, 36 of them suffering from bladder cancer. The dogs were then successfully identified the urine samples of cancer patients as much as 41% of the experiments were conducted.
The researchers revealed that the cancer cells leave a particular odor that can smelt by dogs. If the doctor is able to detect chemical compounds in the urine smell out cancer cells, it can be developed a cancer-detection tests that may be easier and cheaper to do. Meanwhile, from another study conducted in Canada against 62 families who keep dogs and have children who suffer from epilepsy, it was revealed that 41% of dogs able to detect and warn the arrival of epileptic seizures.

Recently I attended a writing a trainer who told her story that inadvertently diagnosed with kidney cancer stage 3 and how the trip until he finally decided to do a surgical removal of the kidney. Remarkably, though one of his kidneys had stage 3 cancer, but cancer did not spread to other organs. A lot of interesting things that I got based on the story and based on the stories and writings that I have ever heard and I read.
What causes cancer? Until recently, the medical world still can not give an answer with certainty what causes cancer. It is said, the cancer arises because of a combination of several factors. These factors include: heredity, diet, environment, viruses, infections, behavior, emotions, and free radicals. What is interesting is to say that cancer is not a modern disease which only occurs in modern times, but has existed since time immemorial.
Several factors are quite popular among the public is heredity, and the influence of diet and unhealthy lifestyle. Typically, a child suffering from cancer similar to that suffered by their parents, or suffered by other family members, it is said that cancer is inherited in the family. True? Certain foods are also said to cause cancer. There is one term “carcinogenic”, ie a substance which is believed to trigger cancer. Among the substances preservatives, dyes, fried food. Really one of these?
Healing is also a wide range of cancers. Surgical removal of cancer cells or organs that have been exposed to cancer cells, not necessarily cure for cancer. Because of the possibility of the cancer cells can arise again. Some plants serve as an alternative, such as taro plants rats. But again, no one would dare claim can cure cancer in total.
On the way I learned the science of mind in recent times, I found some interesting things. It is said, someone with the qualities of mind are very strong and good, can create cancer cells in her body in a matter of minutes. With the same quality of mind, cancer cells can also be removed in minutes. However, in everyday life we ​​usually hear that cancer levels are formed or worse, in a matter of months, years even decades too. Why? Since the average human mind is not strong enough to create the cancer cells quickly. Thus, the term, the disease was payable little by little.
If it is true that the mind that created the cancer cells, the next question, what kind of mind that can create these cancer cells? In his book “Heal Your Body”, Louise Hay says that cancer is caused by feelings of sadness or hurt is very deep or treated unfairly because of feeling in a long time. I remember there were some cases handled by my friend, fellow hypnotherapist. One of them is a mother who had breast cancer. When treated, it is known that the mother was storing a deep sense of hurt as a child against his father, who always treated him arbitrarily. When feelings of negative emotion is released, without warning, her breast cancer disappeared by itself within 3 months. Whereas previously the physician has requested that this mother for surgery even though the mother was refused.
Is there anything else other than the negative emotions that cause cancer? In the world of meditation, it is said that cancer cells are normal cells that become wild. Wild Being here is because the normal cells obtain energy is called “wild”. Energy “wild” is said to be derived from our actions are “wild”, our minds are “wild” and also a lot of foods contain the energies “wild”, ie foods that contain lots of chemicals.
When I expressed my opinion this to a friend, I never argued with the given one example of the case. He mentions one of his sisters (in Catholicism) who had cancer and eventually died. The period of a simple life and well as a nun is said to harbor negative emotions, he said. I then remembered the story of my meditation teacher who never give meditation training to the Sisters. It is said by my teacher, that the nuns are turned out there who harbor negative emotions as well. Of course, these negative emotions will not be caught by our eyes or by saying that we can hear, because these emotions are all situated within the human subconscious. So, even if someone looks fine from the outside, but we never know what’s in the subconscious mind.
So, if it is true that negative emotions are the biggest influence in the formation of cancer cells, then we should always keep our emotions, by not harboring negative emotions from our past. If there is, immediately released. If unable to release themselves, ask for help therapists to help you. Of course, in addition to these emotions, it would be nice if we also lead a healthy life with a healthy diet and healthy thinking and behaving that well …

Benefits of Green Tea seems endless, Because it is so many uses of tea drunk without sugar is tasty. such as lowering blood pressure, as a powerful antioxidant to prevent cancer.

Green tea consumption is very healthy in every day, let’s peep some of the properties of green tea is …..

1. Maintaining healthy skin
Whether you are hand cut, burned or stung by a bee? Just brewed green tea, dip a cotton pad and apply on the wound area. Tea is a natural antiseptic to relieve itching and swelling. When acne grows or burning skin or eye bags, green tea as soon as possible to use dye to the solution. Not only that, In the laboratory, green tea helps block out the sunlight can trigger cancer, whether by way of drinking it or applying it directly to the skin. If applied directly to the skin, green tea can act as a sunscreen and moisturizer. Then, choose a moisturizer that contains green tea for the sake of beauty and skin care.

2. Reducing cancer risk
A number of polyphenols, a potent antioxidant found in green tea, it seems useful to prevent cancer cells proliferate in the body by inhibiting its growth and closing the occurrence of new blood vessels needed for growing up tumor. Study after study shows that people who drink green tea regularly have reduced risk of breast cancer, stomach, throat, colon or prostate.

3. Stabilize blood pressure
With blood vessels healthy awake, namely priced in the range of 120/80, is very precious to us. Mancri way how this level can be achieved is the ‘homework’ for us. Want a simple way? Try drinking a half cup of green tea per day seems to avoid high blood pressure by 50% than those who do not eat them. Thank you once again to the polyphenols (also known as ECGC). Compounds in tea helps keep blood vessels from contracting and increased risk of blood pressure.

4. Keeping the memory
Green tea also helps the brain to keep in mind, the alias is not easily confused. The parents who are diligent at least two cups of tea per day seems less so to have cognitive problems than those who do not like to drink tea. Sekal8i again this is attributed to the antioxidant content in tea to fight free radicals that damage the nerves of the brain as in the case of Alzheimer’s and Parkinson’s.

5. Ageless
Who does not want to stay young? The key is in the arteries. The younger and more healthy arteries, it will be more healthy and youthful body as well. So prevent the accumulation of plaque on artery walls that is the risk of heart attack and stroke for longer life. How much green tea is needed for this? Approximately 10 ounces per day, which is also useful to prevent the accumulation of body fat and cholesterol.

6.Turun weight
Well, this is probably the most expected. Drinking green tea regularly and as a bonus stay slim attractive body, because the tea act to accelerate the process of burning calories in the body.

As reported Kompas.com Monday (18/1/2010) Last BKKBN survey conducted in 2008 called 63 percent of adolescents in several major cities in Indonesia has been doing pre-marital sex. Two years earlier, Annie Foundation survey found that 42.3 percent of junior high and high school teens in Cianjur, West Java, had sex.

A survey carried out recently against a number of adolescent girls also prove that the sex between them done without coercion, and based upon consensual.

”They were not aware of the consequences of sex at a young age. As teens, the uterus is still very susceptible to various viruses and germs. So that the human papilloma virus (HPV) which is a precursor of cervical cancer can go in and attack them,”said Dr. Abidin SpOG Boy, the launch of the campaign I Know in Djakarta XXI Club Theatre, Monday (18/1/2010) ago.

Today these young women may not realize the consequences of sexual behavior. Which they fear may be simply that they are not pregnant. But more important note is that the HPV virus is likely to become cancerous the next 10-20 years. That is why cervical cancer can occur at a very young age.

”If they get pregnant, the consequences will be different. They may perform an abortion. But also there are consequences,”added the doctor who practices in RS Mitra Keluarga Kelapa Gading it.

Abortion is likened to a small tree that was removed from the land where grown. Can you imagine what happens when the tree is removed, such as what land in the vicinity. Dr Boy likens the womb it is ground.

“When the woman was married and wanted to get pregnant, will be very difficult, and it is not possible sterility,”said Dr. Boy. Rahim, he said, was strong enough to hold the baby at least 20 years of age.

Keeping the body healthy as possible and increase endurance is the best way to keep therisk of of breast cancer can be suppressed . Do not easily believe the myth that says that tight bras will cause cancer.
To date only one study evaluating the association between breast cancer and use a bra when sleeping. The result also mentioned the risk of breast cancer in women who slept with who do not use the bra was the same.
Maintain a healthy weight may help reduce the risk of breast cancer. due to overweight and obesity become one of the factors triggering breast cancer.
Women who are overweight usually have a large breast size and use a bra when sleeping. Meanwhile, thin woman who usually sleep without a bra. This difference is thought to nourish the myth of bra and breast cancer.

Beware what if you experience changes in bowel habits
WHAT IS LARGE INTESTINAL CANCER – anal?
Colon cancer – rectal (colonial-rectal) is a cancer that afflicts the large intestine to the anus. The growing slowly, any complaint arising slowly, so people often ignore or neglect of the symptoms of the disease.

WHY CAN SOMEONE colon cancer – rectal?
A person can be exposed to colon cancer – rectal if have risk factors as follows:
1. Genetic factors
Patients with a family history of colon polyps or colon polyps there who suffer
2. Ever suffered from inflammation of the intestine.
3. Ever suffered from colon cancer.
4. Ever had breast cancer or uterine cancer.
5. Eating habits are wrong, that is always eat meat and do not like vegetables, or foods that are processed by using preservatives or dyes. Can also eat food because it is often baked or roasted.

WHO CAN BE AFFECTED LARGE INTESTINAL CANCER – anal?
In Indonesia is likely to get cancer Colon / rectum between women and men equal. The most commonly occurs around the age of 30 years and about 60 years.

PART INTESTINAL CANCER WHICH CAN BE AFFECTED?
Cancer can attack the large intestine to the anus.

WHEN START of colon cancer – rectal?
Colon cancer may begin to arise since young adulthood to old age. But most often occurs is at the age of about 30 and about 60 years.

HOW TO PREVENT LARGE INTESTINAL CANCER – anal?
With good eating habits such as:
Many eating fibrous foods, such § vegetables, fruits, whole grains.
Eat less meat. §
Avoid eating foods that use § preservatives, dyes and food that is processed by means burnt or baked.

WHAT ARE THE SYMPTOMS OF INTESTINAL CANCER – anal?

Early Stage:
The presence of blood mixed with feces and § lenders (bloody stool).
Change in bowel habits, stool § sometimes watery sometimes hard, sometimes more frequent or difficult bowel movements.

Advanced stage:
Abdominal bloating, pain and tension. §
Sometimes it can be touched the masssa § or bulge in the abdomen.
Decreased appetite. §
Bleeding from the rectum. §
The signs are caused by narrowing and blockage of § large intestine – rectum, just as it is difficult defecation.

HOW TO DETECT EARLY LARGE INTESTINAL CANCER – anal?
In the early stages of symptoms and keluahan is often unclear and not heavy, so often people come to the doctor when the disease is advanced and difficult to treat.

1. For patients with no symptoms.
Digital rectal examination, as § part of routine health examinations.
Examination of Samara in the stool blood test in clinical laboratories § from the age of 50 years.
Examination with a tool inserted into the rectum § (Proktosigmoidoskopi) began at the age of 50 years. If in 2 times a routine health examination results are negative, can be performed every 3-5 years.

2. For patients with high risk.
§ Samara periodic inspection every year.
Whereas in the past have suffered from polyps § adenomatus, it is advisable to check with a tool inserted into the rectum through the colon (colonoscopy), 1 year after diagnosis, then every 3 years.
If previously there is a big § inflammatory bowel disease, it is advisable to perform periodic biopsy for detecting early changes in cells towards the malignancy (dysplasia pragmalignansi) and can be performed research (surveillance) annually by an expert.
When the history found there § keluraga family members who suffer a lot of polyps in the intestines (Familial polyposis), it is recommended to conduct the examination as stated in the ad. 1 (for patients with no symptoms) to a family member since the age of 14 years.
When previous large § colon cancer, it is advisable to do kolonoskpi 6 months to 12 months after diagnosis, then 24 months.

3. For patients with symptoms and blood in stool accompanied mucus.
Sometimes the symptoms are regarded as hemorrhoids (pile) or amoebic dysentery, so diagnosis is hampered. Therefore, the above symptoms should be regarded as a colon cancer until proven that it’s not cancer. Patients are encouraged to conduct such inspections at ad.2.

HOW LARGE INTESTINAL CANCER TREATMENT – anal?
Treatment of colon cancer – rectal are as follows:
1. Drugs killer cancer cells (sitostatica or chemotherapy).
2. Radiation (radio-therapy)
3. Surgery (operations), as long as possible.

For those who have undergone surgery or surgery on his colon and use the pouch on her abdomen (colostomy bag), it is advisable to follow a rehabilitation program