Health & Beauty Summer 2022

Health Beauty Pricele ess

summer 2022

HEALTH, HAPPINESS, AND PETS What men should know about prostate cancer Why women should care about their heart health Fitness, health and beauty tips Pass me on for a greener Bermuda

YOUR HEALTH

OUR PRIORITY » Prescriptions & Over-The-Counter Medications » Health & Beauty Aids » Vitamins & Supplements » Dental & Optical Care » Special Order Service For Medications » FREE Prescription Delivery » MDS Blister Packaging Service » Compounding Pharmacy Service » Over-The-Phone Prescription Refill Service » Healthy Lifestyle Advice » Medication Reviews & Usage Counselling » On Call Express Glucometer & Supplies 100% Covered By Argus » Seniors Save Wednesdays » Charge Card & Gift Card Service » Open Daily & Holidays » 8 Convenient Locations Island-wide

CONTACT DETAILS Dispensary

Address

Telephone

Facsimile

Email

The Phoenix Centre

3 Reid Street, Hamilton HM 11

295-0698

295-2636

phoenix_dispensary@psl.bm

Woodbourne Chemist

1 Gorham Road, Pembroke HM 08

295-1073

292-0230

woodbourne_dispensary@psl.bm

Clarendon Pharmacy

31 Victoria Street, Hamilton HM 10

295-9137

292-2265

clarendon_dispensary@psl.bm

King Street Pharmacy

38 King Street, Hamilton HM 11

279-5101

279-5102

kingstreet_dispensary@psl.bm

Collector’s Hill Apothecary

2 South Road, Smith’s FL 08

279-5512

236-9054

collectorshill_dispensary@psl.bm

Paget Pharmacy

Rural Hill Plaza, 130 South Road, Paget PG 06

295-5510

236-9057

paget_dispensary@psl.bm

Warwick Pharmacy

49 Middle Road, Warwick WK 05

279-5556

236-8625

warwick_dispensary@psl.bm

Dockyard Pharmacy

Royal Naval Dockyard Sandys MA 01

279-5515

279-5528

dockyard_dispensary@psl.bm

Visit The Phoenix Stores today. www.phoenixstores.bm

Delivering Deliveringthe theHighest HighestQuality Quality Delivering the Highest Quality Medical MedicalCare CarePossible Possible Medical Care Possible

Dr. Gerhard Dr. Gerhard Boonstra Boonstra Dr. Gerhard Boonstra

Dr. Basil Dr. Basil Wilson Wilson Dr. Basil Wilson

Dr. Roddy Dr. Roddy Moore Moore Dr. Roddy Moore

Dr. Samantha Dr. Samantha Price Price Dr. Samantha Price

Dr. Margot Dr. Margot K. Harvey K. Harvey Dr. Margot K. Harvey

Dr. Carlton Dr. Carlton C. Jones C. Jones Dr. Carlton C. Jones

Dr. Heather Dr. Heather Montgomery Montgomery Dr. Heather Montgomery

Dr. Diane Dr. Diane Kooiman Kooiman Dr. Diane Kooiman

Dr. Hayley Dr. Hayley Morton Morton Dr. Hayley Morton

Dr. Andrew Dr. Andrew WestWest Dr. Andrew West

Dr. Amne Dr. Amne Osseyran Osseyran Dr. Amne Osseyran

Dr. Joanne Dr. Joanne Lysack Lysack Dr. Joanne Lysack

Dr. Danielle Dr. Danielle Simons Simons Dr. Danielle Simons

Dr. Jasmin Dr. Jasmin Caines Caines Dr. Jasmin Caines

Dr. Andrew Dr. Andrew Jamieson Jamieson Dr. Andrew Jamieson

WHAT WHAT WE WE OFFER: OFFER: WHAT WE OFFER: • Family • Family Practice Practice • Family Practice • Functional • Functional Medicine Medicine • Functional Medicine • On-site • On-site Laboratory Laboratory • On-site Laboratory Open Open from from 7:30am 7:30am Open from 7:30am • Ultra • Ultra Sound Sound • Ultra Sound • Stress • Stress Testing Testing • Stress Testing

Paget Paget Location Location Paget Location 40 &4042& Point 42 Point Finger Finger Road, Road, Paget Paget DV04 DV04 40 & 42 Point Finger Road, Paget DV04 Monday Monday - Friday - Friday 8am8am - 7pm - 7pm Saturday Saturday 9am - 12pm - 12pm Monday -9am Friday 8am - 7pm Saturday 9am - 12pm CallCall 236-0084 236-0084 for Appointments for Appointments Call 236-0084 for Appointments

• 24hr.

• 24hr.

Blood Blood Pressure Pressure Monitoring Monitoring • 24hr. Blood Pressure Monitoring • TCD • TCD Examinations Examinations • TCD Examinations • Panel • Panel Physician Physician for for • Panel Physician for US US Immigration Immigration US Immigration • Scuba • Scuba Diving Diving Medical Medical • Scuba Diving Medical Examinations Examinations Examinations

Hamilton Hamilton Location Location Hamilton Location

14 Dundonald 14 Dundonald Street, Street, Hamilton Hamilton HM09 HM09 14 Dundonald Street, Hamilton HM09 Monday Monday - Thursday - Thursday 8am-5pm 8am-5pm Friday Friday 9am 9am - 4pm - 4pm Monday - Thursday 8am-5pm Friday 9am - 4pm CallCall 296-9733 296-9733 for Appointments for Appointments Call 296-9733 for Appointments

WWW.IHS.BM WWW.IHS.BM WWW.IHS.BM

• Home • Home Visits Visits • Home Visits • On-site • On-site Nurses Nurses • On-site Nurses • Vaccinations • Vaccinations • Vaccinations • Se • Se Habla Habla Español, Español, • Afrikaans, SeAfrikaans, Habla Español, Dutch Dutch Afrikaans, Dutch

St.St. George’s George’s Location Location St. George’s Location

13 Water 13 Water Street Street St. Georges, St. Georges, GE05 GE05 13 Water Street St. Georges, GE05 Monday Monday - Wednesday - Wednesday & Friday & Friday 8am8am - 5pm - 5pm Thursdays Thursdays 8am8am - 1pm - 1pm Monday - Wednesday & Friday 8am - 5pm Thursdays 8am - 1pm CallCall 297-0068 297-0068 for Appointments for Appointments Call 297-0068 for Appointments

CONTENTS

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16 5 7 9 10 11 12 15 16 18 19 22

Prescription medicines Preventing and treating cancer Herbal supplements Pioneering imaging Women’s heart health Prostate cancer Sun safe

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Health and pets Cancer care Alternative medicines Medical professionals guide

Publisher Ian Coles Director of Marketing Lissa Fisher Art Director Tim Parker Editorial Contributions Tim Smith, Annabel Cooper Editorial, Advertising & Distribution: PO Box HM 2032, Hamilton HM HX, Bermuda.

Tel: (441) 292-7279 Email: hello@bm.bm Website: http://www.bermudamedia.bm Health & Beauty 2022 is published biannually by Bermuda Media. © 2022 Bermuda Media.

All rights reserved. No part of this publication may be reprinted or reproduced without the written permission of the publisher.

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Associated media include Bermuda Business Visitor Your Future New Resident Guide Building Bermuda Going Green <RXU 2ƸFH Bermuda Property Matters Bermuda Channel House Garden Kitchen & Bath Health & Beauty Summer 2022

PRESCRIPTIONS

Take your medicine hen a patient accepts a doctor’s health recommendations and agrees to follow them, it is only half of the battle to a successful outcome. The other half is executing the doctor’s instructions, including taking prescribed medication according to the physician’s directions. Unfortunately, the percentage of patients complying with doctors’ orders is well below 100% for most prevalent medical conditions. Studies found that 76% of cardiovascular, 67% of diabetic and 58% of psychotic patients adhere to physician’s recommended treatments.

Poor adherence affects healthcare expenditures and worsens chronic disease complications.

Different methods are being employed to help patients take their medications as prescribed. Packaging medicines in punchcards or multidrug pouches with the name of the drug, instructions on how and when to take them and

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Health & Beauty Summer 2022

a description of their appearance are cost-effective and straightforward ways to help patients stay on top of their drug regimes. Numerous studies confirmed the beneficial impact of drug reminder packaging on blood pressure and blood sugar control, and other health outcomes. Helping patients to remind them to take the dose at the appropriate time was of utmost importance.

Blister packs and multidrug pouches were superior to pillboxes because pharmacists prepared them instead of patients or caregivers.

Caesar’s Pharmacy offers a state of the art Parata packaging system that seals medication in detachable, single-use, multidrug pouches. It provides patients maximum support in managing their medicines independently, improving their well-being and extending their autonomy. For many of our patients, it has proven to be the only measure allowing them to continue to take care of

their health needs unassisted.

Another way of improving the health outcomes of patients is the utilisation of health machines or kiosks. These are touch-screen terminals accessible to patients visiting pharmacies and other health establishments and can provide information and diagnostic services. They are easily accessible and can improve self-care and management of chronic conditions such as blood pressure and managed nutrition by checking weight and body tissue composition.

Caesar’s Pharmacy ‘Robodoc’ health kiosk provides measurements of blood pressure, height, weight, pulse, body tissues composition, blood oxygen level and temperature. It has already prompted some patients to visit their physicians and discover they suffer from hypertension. For many, it made them realise their weight and tissue composition are far from healthy and helped them monitor their progress towards more desirable ranges.

Caesar’s Pharmacy is pleased to offer services that can help improve the quality of life for their patients.

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Early Detection Saves Lives Cancer is most treatable in its earliest stages.

Routine screenings detect cancer so it can be treated before it has a chance to progress.

Cost should not be a deterrent to early detection or treatment. Bermuda Cancer and Health Centre provides mammography, breast and prostate biopsies, ultrasounds and radiation therapy treatment to all, regardless of their ability to pay.

Talk to your doctor about Bermuda’s recommended cancer screenings.

Bermuda Registered Charity #070

chc.bm

info@chc.bm

441-236-1001

CANCER

Getting ahead of cancer ver the past two decades, cancer death rates have decreased dramatically. The American Cancer Society reported a 32% drop in the cancer death rate between 1991 and 2019. In part, it attributes this declining death rate to cancer prevention and early detection.

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Prevention In fact, most of the decline comes from a decrease in lung cancer deaths. The primary reason is less smoking.

“This is a trend that takes decades to show results,” states Dr. Fosker, Medical Director and Radiation Oncologist at Bermuda Cancer and Health Centre. “The HƵHFWV RI VPRNLQJ DUH QRW LPPHGLDWH you don’t light a cigarette and develop lung cancer the next morning. Cigarette smoking has been on a steady decline since the 1960s and we are now seeing WKH HƵHFWV Ť The American Lung Association reports a decline from 42.4% of the adult population smoking in 1965 to only 13.7% in 2018 — a 68% decline.

In Bermuda, a 2011 Bermuda Health Council Health in Review Report found that only 8% of residents smoked daily.

“We can expect to see a further decline Health & Beauty Summer 2022

in lung cancer deaths as more people choose to take the preventive measure of not smoking,” continues Dr. Fosker. “This is an excellent example of the power of prevention.”

Another important preventive measure is reducing alcohol consumption. The American Cancer Society attributes 6% of cancer cases and 4% of cancer deaths to alcohol use.

“In Bermuda, breast cancer is the main FDQFHU DƵHFWLQJ ZRPHQ %UHDVW FDQFHU has been linked with consuming alcohol, even in small amounts,” explains Dr. Fosker.

Other cancers associated with alcohol consumption include cancers of the mouth, throat, larynx, oesophagus, colon, and rectum.

Exercise is another form of cancer prevention. Physical activity helps to control weight, reduce oestrogen and insulin levels, and strengthen the immune system.

A 2016 study by the American Cancer Society and National Cancer Institute linked exercise with reducing the risk of VSHFLƶF W\SHV RI FDQFHU Other prevention methods include maintaining a healthy diet, using sun protection, and getting vaccinated

against Hepatitis B, which is associated with liver cancer, and the Human Papillomavirus (HPV), which is the cause of nearly all cervical cancers.

Detection Early detection is also contributing to the declining cancer death rate. Treatment LV PRVW HƵHFWLYH ZKHQ FDQFHUV DUH LQ their early stages and routine screenings help to detect cancer when it is most treatable.

Women should begin regular screening for cervical cancer at age 25 and receive an annual mammogram beginning at age 40. Men should screen for prostate cancer annually at age 45 if they are %ODFN RU KDYH D IDPLO\ KLVWRU\ RWKHUZLVH their annual screens can start at age 50. Both men and women should begin screening for colorectal cancer at age 45.

Individuals who are at high risk for lung cancer should be screened annually.

Bermuda Cancer and Health Centre provides cancer screening and WUHDWPHQW WR DOO LWV (TXDO $FFHVV )XQG subsidises costs for the underinsured and uninsured. Learn more about cancer prevention and early detection at cancer.bm.

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HEALTH

Herbal Supplements: natural remedy or risk?

5LEVQEGMWX &RXSMRIXXI (ERRSRMIV I\TPEMRW [L] MXƶW MQTSVXERX XS YRHIVWXERH XLI FIRIǻXW ERH perils of taking herbal supplements erbal supplements are products derived from plants and/or their oils, URRWV VHHGV EHUULHV RU ƷRZHUV 7KH\ have been used for thousands of years and are believed to have healing properties.

Herbal supplements come in many GLƵHUHQW IRUPV DQG PD\ EH XVHG RUDOO\ RU topically. It is important to understand the SRWHQWLDO EHQHƶWV DQG VLGH HƵHFWV EHIRUH you buy. Even though they are labelled as ‘natural’, herbal supplements can pose risks and there is no guarantee that they will HYHQ EH HƵHFWLYH Herbal supplements can pose unexpected risks because many contain active ingredients that have strong HƵHFWV LQ WKH ERG\ )RU H[DPSOH WDNLQJ a combination of herbal supplements or using supplements together with prescription drugs could lead to harmful or even life-threatening results.

It is especially important to talk with your doctor about herbal supplements if you are taking prescription or over the counter (OTC) medications, if you have certain medical conditions, if you are undergoing surgery, or depending on your age. Some PD\ FDXVH VHULRXV VLGH HƵHFWV ZKHQ WDNHQ with aspirin, blood thinners and blood pressure medications. Taking supplements while pregnant or breastfeeding may be harmful to your unborn baby. Many KHUEDO VXSSOHPHQWV FDQ DƵHFW WKH outcome of surgery. They may decrease WKH HƵHFWLYHQHVV RI DQDHVWKHVLD RU cause dangerous complications, such as excessive bleeding. Older adults may PHWDEROLVH PHGLFDWLRQV GLƵHUHQWO\ Bermuda’s retail supply of herbal supplements is primarily received from the UK and US, so it also is important to note that the regulation of herbal supplements varies from jurisdiction to jurisdiction. In the UK, the laws governing foods sold in the UK also govern food supplements. There is no requirement for food supplements

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Health & Beauty Summer 2022

to be licensed or registered with any UK governmental agency. They must merely comply with the relevant food laws. Manufacturers of supplements must ensure that their products are free of contaminants, accurately labelled and that they do not make false or unsupported claims to sell their supplements. In the United States, herbal supplements are regulated by the US Food and Drug Administration (FDA) but not as strictly as prescription or OTC drugs.

Some helpful tips relating to supplements include: • For reliable information about a supplement, speak to your doctor or pharmacist. They can advise you and provide the latest medical guidance about a supplement’s uses and risks.

• When taking supplements, follow the directions. Don’t exceed the recommended dose or take for longer than recommended.

• Make a note of any supplements that you are taking and include them with your medication list of prescriptions and OTC drugs. Stop taking the supplement if it LVQšW HƵHFWLYH RU GRHVQšW PHHW \RXU JRDOV for taking it.

Mrs. Antoinette Cannonier is the Pharmacist Manager at Point Finger Road Pharmacy, conveniently located on the outskirts of town at 16 Point Finger Road. This full-service pharmacy accepts all prescription insurance plans and has plentiful free parking for easy drive in and out collections. Visit www.pharmacy.bm for more information.

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IMAGING

The imaging facility of choice that continues to pioneer for its patients Ultimate Imaging is HIP & Future Care approved and continues to lead the way in providing the standard of excellence in diagnostic imaging. Committed and SUHSDUHG WR PHHW \RXU QHHGV LW RƵHUV D

holistic, non-clinical approach, innovative WHFKQRORJ\ DQG TXDOLƶHG FDULQJ VWDƵ

Services include: GENERAL ULTRASOUND. Services include,

Abus 3D automated breast ultrasound uses sound waves to create 3D pictures of the breast tissue

but are not limited to abdominal, pelvic, kidneys and bladder, vascular, thyroid, MSK, carotid and testicular ultrasound.

OBSTETRICS. In collaboration with \RXU REVWHWULFLDQ 8OWLPDWH ,PDJLQJ RƵHUV the global standard of care in obstetrical ultrasound services such as 3D/4D technology, routine obstetrical ultrasound, OHYHO ,, XOWUDVRXQG ELRSK\VLFDO SURƶOH doppler study and nuchal translucency screening (1st trimester screening).

3D MAMMOGRAPHY. Ultimate Imaging LV WKH ƶUVW LPDJLQJ FHQWUH RQ LVODQG WR pioneer for the ‘status quo’ in breast care with integration of our 3D mammography (Senographe Pristina™) and computer aided detection software (CAD) and 3UR)RXQG $, DUWLƶFLDO ,QWHOOLJHQFH ABUS 3D automated breast ultrasound.

Unlike mammography, ABUS uses sound waves to create 3D pictures of the breast tissue. It may be ordered in combination with your regular mammogram screening.

PEDIATRIC ULTRASOUND. A hand KROGLQJ DSSURDFK Ş RƵHULQJ DSSRLQWPHQWV for our youngest of patients such as infant hip and cranial ultrasound.

Ultimate Imaging Ltd is in the International Centre, Suite 308, 26 Bermudiana Road, Hamilton Tel: 29SOUND. www.ultimateimaging.bm 10

Health & Beauty Summer 2022

HEART HEALTH

6 Reasons Women Should Care About Their Heart Health Females experience unique causes, symptoms, and outcomes. Here’s what to know. ardiovascular diseases are the leading cause of death globally, taking an estimated 17.9 million lives each year, according to the World Health Organisation.

Heart disease also strikes men, but women are more likely to have unique symptoms, be misdiagnosed, have worse outcomes, and die from their disease. What’s more, certain conditions appear to increase heart disease risk in women. These include preeclampsia and eclampsia, gestational diabetes, migraine headaches with aura, early onset menopause, and autoimmune diseases such as lupus and rheumatoid arthritis.

'HVSLWH WZR GHFDGHV RI QDWLRQDO HƵRUWV LQ WKH 8QLWHG 6WDWHV WR increase awareness that heart disease is the No. 1 cause of death for women, awareness has decreased — from 65% in 2009 to 44% in 2019. And awareness is the lowest among young women where prevention could make the greatest impact. A Women’s Heart Alliance survey of more than 1,000 women 25 to 60 years old, found that 45% didn’t know that heart disease is the leading cause of death for women in the United States.

Dr. Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute at NewYork-Presbyterian/ Weill Cornell Medical Center, and Dr. Jennifer Haythe, a cardiologist specialising in cardiac health during pregnancy at the Center for Advanced Cardiac Care at NewYork-Presbyterian/

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Cardiovascular diseases the leading cause of death globally

Columbia University Irving Medical Center, say women need to educate themselves to better protect their heart health. Here’s why: Women are less inclined to call 911 when they think they may be experiencing heart attack symptoms.

Cardiovascular disease complicates up to 4% of pregnancies, and that number has been increasing. Preeclampsia is an independent predictor of developing cardiovascular disease later in life. Women who have had preeclampsia should be mindful of having their blood pressure, fasting glucose, and cholesterol checked annually.

Women are less likely to be referred for cardiac rehabilitation after a heart attack. :RPHQšV KHDUW DWWDFN V\PSWRPV DUH RIWHQ GLƵHUHQW IURP men’s. Women may experience shortness of breath, nausea, palpitations, jaw discomfort, or overwhelming fatigue, according to the American Heart Association.

Women are less likely to receive bystander CPR in public than men (45% for men versus 39% for women). Learning handsonly CPR can help save a life. Visit HandsOnly.org to learn more.

After the age of 65, hypertension (high blood pressure) is more common in women. Go for an annual physical and have your doctor check your blood pressure and other cardiovascular disease risk factors. The American College of Cardiology recommends a blood pressure target of 120/80 or lower.

If you had COVID, it’s even more important to get your heart checked: a large study published in Nature Medicine in February found that having COVID before January 2021 VLJQLƶFDQWO\ LQFUHDVHG \RXU FDUGLRYDVFXODU GLVHDVH ULVN DQG burden at one year.

This article was adapted from NewYork-Presbyterian’s Health Matters.NewYork-Presbyterian’s Global Patient Services Program starts you on your journey to the very best medical care that you or your loved one deserve. For more information, contact: Simone Barton, CEO, Bermuda Heart Foundation & CORE Heart Health Center. Tel: 232-2673. E-mail: coreadmin@bdaheart.bm. NY Main 2ƸFH (PDLO JOREDOVHUYLFHV#Q\S RUJ

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Women are less likely to be referred for cardiac rehabilitation after a heart attack After the age of 65, hypertension is more common in women than men

Health & Beauty Summer 2022

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PROSTATE CANCER

What men should know about prostate cancer Prostate cancer is the most common cancer found in men, with many men showing no symptoms, often for many years

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ne in six men in Bermuda will be diagnosed with prostate cancer at some point in their lives – and they can’t say they haven’t been warned about it.

Awareness events such as Movember and Man on the Run are now established

ƶ[WXUHV RQ WKH %HUPXGD FDOHQGDU ZKLOH health professionals set up men’s health screening programmes and continually push prevention advice on social media.

Yet, with the island recording higher incidence rates of prostate cancer than the United States, Europe and the Caribbean, Dr. Michael Czerwinski

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doctors question whether the message is getting through.

Fear of the rectal examination, worry over the cost of treatment and plain testosterone are some of the possible explanations for men’s failure to get themselves checked regularly.

Given that 98 per cent of prostate cancer cases in Bermuda are diagnosed in men over 50 – the average age of diagnosis is about 65 – men are advised to get tested annually from the age of 40.

However, Dr. Michael Brooks, who recently held a session of free screenings at Dynamic Urology Services on Point Finger Road, notes: “Most of them were ƶUVW WLPH YLVLWRUV RU KDG QRW VHHQ D GRFWRU for years and years.

“They hadn’t had a general physical, and no sort of blood test.”

2QH LQ ƶYH YLVLWRUV WR WKH VHVVLRQV received abnormal results and were sent for further tests.

“It was concerning because it’s a relatively high pick-up rate,” Dr. Brooks says. ţ, ƶQG WKHUH DUH TXLWH D IHZ PHQ RXW there who still believe that once they feel 2. WKDW WKH\ DUH ƶQH 7KH\ RQO\ VHHN doctor’s advice when something happens, or they have some sort of symptom.

“With regard to prostate cancer, that is often the wrong approach, since in the early stages it is largely asymptomatic.

Oftentimes, when you do get symptoms, it’s at a very advanced stage.”

Dr. Brooks and other doctors have tried to improve awareness.

“I have been on radio shows, promotions on social media, but men in comparison to women are less likely to get their health sorted out and be proactive and stay well,” he says.

“My only guess is testosterone. We think GLƵHUHQWO\ :H DUH JHQHUDOO\ OHVV SURDFWLYH about going to the doctor to get things checked or have a wellness check.”

Dr. Brooks, who practiced in his home country Jamaica and the UK before arriving LQ %HUPXGD WKUHH \HDUV DJR LGHQWLƶHV an additional hurdle when it comes to prostate cancer.

“The problem comes in with rectal examination. I think still for some men it’s a huge issue. They don’t like to have the examination. ţ, GR ƶQG PRUH PHQ UHIXVH UHFWDO examination here than in the UK.” Dr. Michael Czerwinski, a urologist at Health & Beauty Summer 2022

PROSTATE CANCER Island Urology Services, advises a blood test can still provide doctors with the details they need.

“Even if people have hesitation about having a rectal examination, just say so. If \RX KDYH D 3URVWDWH 6SHFLƶF $QWLJHQ WHVW that gives us a lot of information.

“Don’t just shy away from the whole thing because of it.”

1HZ ƶJXUHV IURP WKH %HUPXGD &DQFHU and Health Centre (BCHC) show an average of 48 men per year were diagnosed with prostate cancer in the decade up to 2019.

Bermuda’s age-standardised incidence rate is about 90 per 100,000 people, compared with about 70 in the US, about 60 in Europe and about 75 in the Caribbean.

Dr. Chris Fosker, the medical director at the BCHC, says this could partly be down to Bermuda’s ageing population and high proportion of black people – both risk factors for prostate cancer – while higher reporting rates could also simply mean prostate cancer is less likely to be going undetected.

Dr. Fosker says feedback from doctors at the Dana-Farber Cancer Institute

Health & Beauty Summer 2022

Dr. Chris Fosker

in Massachusetts suggests further investigation is needed.

“Some of their prostate specialists have commented that they do see more

challenges here in Bermuda than they see in Boston. What we are trying to do is dig into the why. We are early days on that.”

He adds: “We are working on a national

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PROSTATE CANCER Dr. Michael Brooks

A survivor’s story Kevin Smith shares his experience with prostate cancer went to the doctor for my annual physical and he told me my PSA count was high. I really didn’t know too much about that but came to learn that PSA stands for prostateVSHFLƶF DQWLJHQ DQG LV D EORRG WHVW XVHG WR VFUHHQ IRU SURVWDWH FDQFHU So, my GP sent me to a specialist, Dr. Michael Czerwinski and he said we’re going to have to take a biopsy on your prostate, the result of which was positive for cancer.

Naturally, I was a little concerned, but since I do get regular check-ups, I knew that they must have found the cancer in the very early stages, and I decided to have a positive attitude from the very beginning and come what may.

The next step was a visit to Bermuda Cancer and Health Centre. The doctors there gave me some options. I could go overseas for treatment, or I could deal with it here, and I decided I’d like to deal with it here.

I started taking hormone tablets, and I got a hormone shot, and a couple weeks after that, I started my radiation treatment. I have to say it was a very good experience at Bermuda Cancer and Health Centre. All the ladies there were wonderful to me. They made the experience so pleasant. When you walk in, it’s so nice, and everyone is so warm and friendly. I know I’m in good hands and that I’m going to beat this.

So here I am today as a survivor and life goes on. I believe this was just a little bump in the road for me, and I plan on getting to my momma’s age — and she is 97.

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cancer control plan to try to strengthen how we can use our resources to improve cancer outcomes.”

'U )RVNHU DOVR VD\V ƶQDQFHV DSSHDU to cause hesitation. “Historically, men in Bermuda may have in their head that prostate cancer may get diagnosed but WKH\ FDQšW DƵRUG WKH WUHDWPHQW 6RPH PHQ didn’t want to spend their life savings on prostate cancer treatment. They would rather leave their family some money. I talk to people, they look nervous, and we say there’s no cost, and they look up and say, ‘Oh ok, yes, I’m on board.’”

Other potential factors include complacency because of a lack of symptoms, and fear of treatment.

Dr. Czerwinski says: “For men who do have symptoms for prostate cancer, they may have pain in their bones. It can start to cause blood in the urine. You don’t want to wait until those things are happening because that can be a lot more aggressive at that time.

“Cancer is a word that nobody really wants to hear. But it’s a very variable word.

I have this discussion with men all the time and see the responses of people. It can be crushing to hear.

“The majority of people with prostate cancer don’t die from it. Only about 3 to 6 per cent of men will die of it.

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Kevin Smith with his 97-year-old mother

“Another bad word is chemo. In general, chemotherapy is not part of prostate cancer treatment in the initial stages.”

Living a healthy lifestyle, of course, improves men’s chances of keeping prostate cancer at bay.

Dr. Fosker says: “You need to stay a healthy weight. Secondary to that is exercise. If you are a normal weight but VSHQG PRVW RI \RXU WLPH LQ \RXU RƸFH \RX

are still at risk. There’s stronger evidence for exercise than anything else in terms of OLIHVW\OH -XVW JR IRU D ZDON ƶYH WLPHV D ZHHN “Be aware of what’s happening in your family. If your genes are going to give you prostate cancer, you might as well know about it. You can start your checks at a younger age.”

Health & Beauty Summer 2022

SUN PROTECTION

Protecting your health during summer fun John Bentley, Pharmacist with The Phoenix Stores, provides some important tips to keep you safe in the sun ummertime in Bermuda is the perfect time for you and your family to enjoy the outdoor activities, sunshine and fresh air. Here’s some simple measures to help you stay healthy and safe while enjoying the great weather to the fullest.

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Sunburn Being out in the sun has many health EHQHƶWV EXW LI \RX ZHUH KDYLQJ WRR PXFK fun in the sun that you forgot to reapply your sunscreen, you risk sunburn.

Sunburn is skin damage caused by ultraviolet (UV) rays and usually causes the skin to become red, sore, warm, tender and occasionally itchy for about a week.

When burnt, the skin will normally start WR ƷDNH DQG SHHO DIWHU D IHZ GD\V DQG ZLOO usually fully heal within seven days. While sunburn is often mild and short-lived, it’s important to try to avoid being sunburnt, as it can increase your chances of developing serious health problems, such as skin cancer, in later life.

If the sunny weather has caught you out DQG \RXšUH VXƵHULQJ KHUH DUH VRPH ZD\V WR relieve and treat sunburn.

Find shade. Applying more sunscreen won’t reverse sunburn no matter how much you use. If you’re burnt, get out of the sun and seek shade as soon as possible.

Cover up. Wear cool, loose clothing that won’t rub or chafe your skin. It’s important to cover sunburnt skin from direct sunlight until the skin has fully healed.

Stay hydrated. In hot weather, staying hydrated is always vital, especially if \RXšUH VXQEXUQW VR GULQN SOHQW\ RI ƷXLGV Oral rehydration solutions such as Nuun hydration tablets or Diarolyte sachets containing essential electrolytes may help UHSODFH WKH ORVV RI ƷXLG DQG ERG\ VDOWV quickly.

Apply afterburn. Designed to cool, soothe and help sunburnt skin heal, Health & Beauty Summer 2022

afterburn treatments, often packed with cooling aloe vera, are particularly calming.

Try keeping it in the fridge for an extra FRROLQJ HƵHFW Take a cool bath. Relieve your skin with a cool shower, bath or damp towel to help ease the burning sensation — but don’t put ice or ice packs on sunburnt skin as it can cause further pain and damage.

Take pain relief. Pain killers such as acetaminophen and ibuprofen may help alleviate sunburn pain and reduce swelling and redness. If your sunburn is also itchy, you can try an over-the-counter steroid topical such as hydrocortisone cream.

Although mild sunburn can be treated at home and usually gets better on its own, you should consult your doctor if your skin has blistered or become swollen, your temperature is very high or you’re concerned you have heat stroke.

You should always contact your doctor for advice regarding a child or baby with sunburn.

Which sunscreen?

Prevention is always best when avoiding skin damage, so before heading to the beach, park, or out on the water, remember that a decent sunscreen is non-negotiable.

Which one is right for you with so many sunscreens to choose from these days?

There are a few things to consider when

picking a sunscreen and knowing how to use it correctly to ensure optimal results.

Choose the right SPF. SPF stands for sun protection factor and refers to the level of protection from UVB radiation linked to cancer. In Bermuda, it is advisable to wear an SPF factor higher than 30 to protect the skin.

0DNH LW ƶYH VWDUV &KRRVH D EURDG VSHFWUXP VXQVFUHHQ WKDW KDV D IRXU RU ƶYH star UVA rating. Broad-spectrum means the sunscreen protects against both UVA and UVB rays.

Apply. Apply. Apply. Research has shown that the best sunscreen protection is achieved by application 15 to 30 minutes before exposure, followed by a reapplication 15 to 30 minutes after exposure begins. Reapply at least every two hours and immediately after being in the water, even if your sunscreen is waterresistant. Application varies based on the indications and protection factor shown on the label — from as little as 80 minutes in water to a few hours, depending on the product selected. Don’t forget to apply sunscreen to your lips, ears, hands and the back of your neck.

Ditch old bottles. Before grabbing an old bottle from the back of the cupboard, remember that out-of-date sunscreen is QR ORQJHU HƵHFWLYH ,WšV EHVW SUDFWLFH WR WRVV sunscreen 12 months after opening.

Although sunscreens play an essential role in sunburn protection, they should never replace minimising sun exposure.

Spend time in the shade, particularly between 11am to 3pm when the sun is at its strongest. When out in the sun, make sure to cover up with suitable clothing, sunglasses and a wide-brimmed hat that shades the face, neck and ears.

Take extra care to protect babies and children as their skin is much more sensitive than adult skin.

For any queries or information please contact your local Phoenix pharmacist. We are always available to help, seven days a week.

15

PETS

Health, Happiness, and Pets Nothing compares to the joy of coming home to a loyal companion, and there are potential physical and mental LIEPXL FIRIǻXW XSS

16

dog isn’t referred to as ‘man’s best friend’ for nothing. It is believed that man and, back then, wolves, ƶUVW EHFDPH IULHQGV RYHU \HDUV ago. Since then, humans have welcomed all manner of living creatures into our homes, but why?

“The right pet can improve a person’s life tremendously,” says professional dog trainer, Eileen Thorne. “Interaction with animals lowers blood pressure and can provide an oxytocin rush.”

Oxytocin, also known as the ‘feelgood hormone’, is known to promote attachment, improve social skills and even induce sleep.

“The pet can also provide them with a way of interacting with society that WKH\ PD\ ƶQG XQFRPIRUWDEOH LQ RWKHU situations,” she continues. “I call animals conduits to human interaction for that reason. A pet can allow them to interact with people without the full social pressure on them.”

Some pets however, you don’t even QHHG WR LQWHUDFW ZLWK WR EHQHƶW IURP WKHLU presence.

There is a reason why doctor’s surgeries RU RWKHU FOLQLFDO DUHDV RIWHQ KDYH ƶVK tanks. “It’s because they have a very FDOPLQJ HƵHFW Ť DGGV .DWH 7HUFHLUD Executive Director of the Bermuda Society for the Prevention of Cruelty to Animals (SPCA).

Taking it a step further, animals can even provide a form of ‘therapy’ for people with certain medical or emotional needs.

Dr. Laura Henagulph owner of psychiatry and psychology practice, Seaglass Clinical Consulting, alongside Ms. Terceira and Ms. Thorne, runs TheraTails, an animal-assisted therapy programme at the SPCA. Some of Dr. Henagulph’s clients struggle with ‘traditional’ face-to-face therapy or simply won’t engage at all.

But if she suggests working with animals, “immediately there’s engagement!”

“They will attend therapy sessions, ZKLFK LV WKH ƶUVW DQG PRVW LPSRUWDQW thing. When they get into the session, the focus is not on them, it’s on the animal.

Many of the programme’s clients come through the department of child and family services, and are often struggling within the care system, which, says Dr. Henagulph, “is a great mirror for what goes on at the shelter.”

A

Health & Beauty Summer 2022

PETS Kate Terceira, Dr. Laura Henagulph and Eileen Thorne

TheraTails works with a wide variety of animals at the SPCA as well as a private barn which has a rescue horse.

“There’s something uniquely powerful about the horses,” says Dr. Henagulph.

“Because of their sensitivity and their relationship with humankind over the centuries.

“Working with all rescue animals really resonates with our client group, in particular Pit Bulls. Animals that have had a bit of a ‘reputation’, animals that are seen as being aggressive or badly behaved but in fact neglect or abuse have played a part in the way they behave.

Those kinds of presentations are very familiar to some of our adolescent clients who are in residential care.”

Sometimes however, they will ease someone in with smaller animals such as cats, guinea pigs or rabbits, which are less intrusive, giving the person space to observe and feel safe.

TheraTails also helps older people with Health & Beauty Summer 2022

age-related health issues. “One client who had early onset dementia came weekly to brush the horse,” explains Ms. Terceira, adding that it was the only time she was “enthused to do anything. It assisted with her strength and mobility, and the interest in doing so.”

“You have such a vast gambit of positives working with animals and how they provide unconditional, nonjudgemental love,” she continues. “It’s a massive sense of purpose as well because where you may not want to get out of bed in the morning, you have to because there’s an animal that is relying on you. It lowers blood pressure, but also, from the point of view of activity, it increases your heartrate because you are encouraged to exercise an animal as well.”

Horses and dogs, continues Ms. Terceira, “have distinct personalities.

They’re herd animals, so they like to be around people. They look at people as part of their herd.”

While horses and dogs may make great companions, not everyone is in a position WR WDNH FDUH RI WKHP +RZ GR \RX ƶQG WKH perfect pet for your needs and lifestyle?

Important things to consider, explains Ms. Thorne, are your living situation, mobility, available time, other people LQ \RXU KRPH DQG WKH ƶQDQFLDO FRVW RI GLƵHUHQW DQLPDOV 2QFH \RX KDYH determined the animal you want, she DGYLVHV ţƶQG D UHSXWDEOH EUHHGHU RU rescue that is looking at the temperament and health of the animals. If it is a breeder you want someone who focuses on appropriate early socialisation and handling. That is for any pet that you are going to want to handle – guinea pig, chicken, birds, cats.”

She also points out, however, how much she enjoys just watching lizards on her outdoor table during her ‘down time’.

“For people who are not in the position to have a pet right now, this kind of ‘backyard pet’ is a viable option.”

17

CANCER CARE

PALS nurses: L-R Reanna Stovell, Rosa Ward, Waynette Wilson, Kathy Fox, Merlyn Burgess

Improving the quality of life for cancer patients orty years ago, cancer was a word hardly spoken aloud in the community.

Patients were isolated for fear of contamination, and families were even afraid to use the same utensils. PALS began with a group of volunteer nurses to assist in getting patients home from the hospital with cancer. These patients needed a “pal,” someone to sit with them, read to them, or perhaps feed them. Robert Stigwood, a well-

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NQRZQ PXVLF HQWUHSUHQHXU ƶOP SURGXFHU and a Bermuda resident, provided funding for two years for a part-time nurse.

Today, Bermuda’s only home cancer care FKDULW\ KDV JURZQ WR LQFOXGH ƶYH IXOO WLPH specialised nurses, a palliative care physician, and a full-time medical social worker who all see approximately 180 patients a month.

PALS supports all patients with cancer at any stage of the disease. Some of its patients

complete their cancer treatment and no ORQJHU UHTXLUH LWV VSHFLDOLVHG VHUYLFHV others require palliative care for pain and symptoms experienced with end-of-lifecare.

PALS continues to support the patient and his or her family medically, emotionally, and ƶQDQFLDOO\ In addition to nursing support, PALS RƵHUV GXUDEOH PHGLFDO HTXLSPHQW WR LWV patients, including such items as hospital beds, commodes, shower benches, and wheelchairs, all free of charge. PALS will assist patients (on an individual basis once ƶQDQFLDOO\ VFUHHQHG WKDW UHTXLUH DVVLVWDQFH with purchasing food supplements, medications, and overseas medical travel for uninsured and underinsured patients.

PALS receives no government grants and relies solely on corporate and individual donations, various fundraising events and its thrift shop, to continue to support its programmes. PALS spends more than $5,000 a day on patient care, and its annual budget is approximately $2 million dollars.

PALS never charges a patient or his or her IDPLO\ IRU LWV VHUYLFHV $OO VXSSRUW ƶQDQFLDOO\ and through volunteering is greatly appreciated. www.pals.bm

Health & Beauty Summer 2022

PHARMACY

Don’t get distracted by the brand Melissa Butler, Pharmacist at Somerset Pharmacy, explains how many products are the same :KHQ , ZHQW RƵ WR FROOHJH , had a Bermuda cookbook of local family recipes. Many of the recipes required “Anchor” butter. I went from grocery store to grocery store looking for Anchor butter with no success. How was I supposed to make the hot cross buns, cookies, cassava pie? What I realised later was that those grandmothers were trying to say not to use margarine. When I realised this, I had many butter options available to me in the grocery store.

The same thing happens at the pharmacy. We often encounter clients coming in for a product from Asia which has D GLƵHUHQW QDPH KHUH RU ZKR LV looking for a branded product that has been strapped with supply chain issues. Going to every pharmacy on the island, in most cases will not solve the problem. When an alternative is RƵHUHG WKH\ UHIXVH )RU PDQ\ men, the refusal is out of fear of going home with the wrong product.

Flexibility is key. There are many alternatives at the pharmacy and these alternatives aren’t always generic products.

For instance, Tylenol Cold

Melissa Butler, PharmD, MPH, PhD.

Multisymptom Daytime has the same active ingredients as Dayquil Cold & Flu. Similarly, Tylenol 8hr Arthritis and Tylenol 8hr Muscle Aches & Pain are the exact same product. Lastly, for those concerned about their blood pressure, Coricidin HBP Max Strength Nighttime Cold & Flu is the same as Nyquil Cold & Flu. There are a slew of alternatives. Just ask your pharmacist.

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Choose Water ugar is a carbohydrate and occurs naturally in fruits, vegetables, and dairy products. Too many carbohydrates can lead to weight gain mainly due to extra calories in the diet. Sodas and other beverages are some of the main culprits of “added sugar”.

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Health & Beauty Summer 2022

There are profound health implications related to excess body fat. Being overweight increases your risk of high blood pressure, heart disease, stroke, and diabetes.

Drinking water is a healthier alternative to sodas. It allows you to hydrate without the sugars. Fruits like limes and

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19

HEALTH CARE

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lemons can be added to enhance the ƷDYRXU 6SDUNOLQJ ZDWHU LV D JUHDW RSWLRQ LI \RX PLVV WKH FDUERQDWLRQ RI VRGDV $OZD\V UHDG WKH ODEHOV RQ WKH ZDWHU \RX SXUFKDVH VLQFH DOO ZDWHUV DUH QRW FUHDWHG HTXDO

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DRINK MORE WATER. Drinking up to eight glasses of water a day will help you get clearer skin, feel more energized, lose weight and keep you hydrated. Start by simply bringing a refillable bottle to keep at work and a opt for water when dining out.

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Health & Beauty Summer 2022

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21

MEDICAL PROFESSIONALS GUIDE

Dr. Paul Risk

Dr. Patrick Murray

As a breast specialist radiologist, Dr. Risk is a medical doctor who specialises in diagnosis of breast disease, using mammography and ultrasound. For the Centre, having an onsite radiologist is about raising the level of patient FDUH RƵHUHG LQ WKH GLDJQRVWLF LPDJLQJ GHSDUWPHQW HVSHFLDOO\ IRU breast health.

Born and raised in Nova Scotia, Dr. Risk graduated from Dalhousie University Medical School in 1988. After working as a general practitioner for four years, he returned to school for postgraduate training in diagnostic radiology at McMaster University, Hamilton, Ontario. He completed his four-year residency program in 1997 before being admitted as a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCPC) with a 6SHFLDOLVW &HUWLƶFDWH LQ 'LDJQRVWLF 5DGLRORJ\ Dr. Risk worked as a general radiologist at St. Martha’s Hospital in Nova Scotia for 5 years before joining a large group of radiologists in Calgary, Alberta where he has worked since 2002. Within this very busy hospital and community clinic-based practice he helped foster and develop the small, dedicated breast imaging and intervention-focused group of radiologists with a subspecialty LQWHUHVW LQ WKLV ƶHOG RI GLDJQRVWLF LPDJLQJ 'XULQJ WKHVH SDVW years he has played an integral role as part of this group providing the vast majority of breast imaging and breast biopsies for the greater Calgary area and beyond.

Bermuda Cancer and Health Centre, 46 Point Finger Road, Paget, DV 04. Tel: 236-1001. Email: info@chc.bm. www.chc.bm

Patrick Murray hails from the UK and is a graduate of the University of Leeds, gaining membership of the Royal College of Surgeons of England. He obtained his research doctorate investigating immunological changes that happen within head and neck cancer, sparking his interest in the treatment of cancer.

In 2013, he was awarded a medical doctorate (MD research) from the University of Hull for successfully defending his thesis on immunomodulation in the head and neck cancer PLFURHQYLURQPHQW ƶHOG RI VWXG\ LPPXQR RQFRORJ\ +H completed his clinical fellowship at the Leeds Cancer Centre in the UK, the largest purpose-built cancer centre in Europe, before extending his training with a focus on high precision radiation techniques such as SBRT and SRS with a specialisation in head and neck cancer.

In 2017, Dr Murray was awarded the esteemed BJR Barclay Medal Award for his BJR paper on “A systematic review of outcomes following stereotactic ablative radiotherapy in the treatment of early-stage primary lung cancer”. He worked as a Consultant Clinical Oncologist at Leeds Teaching Hospitals NHS Trust before moving to Bermuda to join Bermuda Cancer and Health Centre’s radiation therapy department as a radiation oncologist.

Bermuda Cancer and Health Centre, 46 Point Finger Road, Paget, DV 04. Tel: 236-1001. Email: info@chc.bm. www.chc.bm

Dr. Chris Fosker

Dr. Alikhani, MBBS, MRCGP, MSc, Dip Palliative Care is the Medical Director and Palliative Care physician at PALS. She and the rest of the PALS team provide specialist palliative care and support to all those patients living with cancer in the community.

She trained in the UK as a GP and came to Bermuda with her \RXQJ IDPLO\ \HDUV DJR 6KH ƶUVW ZRUNHG DV D *3 EXW VRRQ discovered her love for looking after her patients who were at Agape House. This sparked educational interest and she completed postgraduate training in palliative care. She left general practice in 2008 to become a full-time palliative care physician at Agape House.

Dr. Alikhani was instrumental in developing the palliative care services at KEMH and in the community and in establishing the (QG RI /LIH %HQHƶW DV SDUW RI VWDQGDUG KRVSLWDO EHQHƶW 7KLV EHQHƶW DƵRUGV LQGLYLGXDOV WR EH FDUHG IRU LQ WKHLU KRPH VXUURXQGHG by their loved ones in their last few months of life. Her mission and message is always to be able to give people the choice of where and how they wish to be cared for aligned with their values. :KDW LV WKH GLƵHUHQFH EHWZHHQ SDOOLDWLYH FDUH DQG KRVSLFH FDUH" Both seek to improve the patient’s quality of life as much as SRVVLEOH KRZHYHU WKH GLƵHUHQFH LV LQ WKH VWDJH RI WKH LOOQHVV they treat. Palliative care involves active therapy that can last sometimes for many years. Hospice care is typically a solution for cancer patients whose life expectancy is six months or less.

PALS. Tel: 236-7257. info@pals.bm. www.pals.bm

Dr. Fosker MBChB, BSc, FRCP, FRCR is the medical director and radiation oncologist at the Bermuda Cancer and Health Centre, Director of Oncology at King Edward VII Memorial Hospital, and a consultant at Brigham and Women’s hospital in Boston. $V D &OLQLFDO 2QFRORJLVW 'U )RVNHU LV TXDOLƶHG WR WUHDW FDQFHU patients with radiation therapy, chemotherapy, molecular therapy and immunotherapy. Prior to moving to Bermuda, Dr. Fosker worked as a specialist at St James’s Institute of Oncology in Leeds, Europe’s largest purpose built cancer centre. Dr. Fosker has completed a Fellowship at Princess Margaret Hospital in Toronto and has published research in a number of clinical areas as well as in medical education, service development and health economics.

Aside from his clinical work he has held other positions of responsibility, including working for the Macmillan Cancer Charity as a policy adviser, and for NHS England as a clinical advisor. He is the recipient of a number of awards including the ‘RS Bush Award’ for academic excellence from Princess Margaret Hospital and the University of Toronto. Dr. Fosker received a Bachelor of Science in Genetics from the University of Leeds.

Bermuda Cancer and Health Centre, 46 Point Finger Road, Paget, DV 04. Tel: 236-1001. Email: info@chc.bm. www.chc.bm 22

Dr. Sharon Alikhani

Health & Beauty Summer 2022