VITAL VITTLES
Helping head and neck cancer patients stay nourished
THE BIG PICTURE
Your donation makes a difference to Alberta’s cancer statistics
TRAIN RIGHT Find the best exercise plan for you
SPRING 2019
THE
COMMUNICATION
ISSUE
TALKING TO YOUR FAMILY DOCTOR DR. MARGARET CHURCHER ENCOURAGES PATIENTS TO BE INFORMED AND CURIOUS
GO GREEN
‘TIS THE SEASON FOR FRESH VEGGIES
CALVES FOR CANCER RURAL ALBERTANS GIVE BACK IN A BIG WAY
LIVING WELL
THIS THREE-TIME CANCER SURVIVOR IS THRIVING
PM 40030911
UPCOMING EVENTS In support of the Alberta Cancer Foundation
May 26th
July 6
August 3-4
September 12
Scotiabank Calgary Marathon
Fort Saskatchewan Motorcycle Association Ride & Rally
Xtreme Raceways
Women in Seismic Engineering Golf Tournament
Calgary
June 8
Shannon Kimmitt Memorial Golf Tournament Fort Saskatchewan Golf and Curling Club
June 8-9
Namastey India The Meadows Community Recreation Centre, Edmonton
June 11
Kelly Lamrock Memorial Golf Tournament Leduc Golf Course
June 22
Wilde Bocce
Royal Canadian Legion #27, Fort Saskatchewan
July 6
Winky Rides/Greb Glides - Ride for Patty Fort McMurray to Ansac
July 12
Kelly Anderson Memorial Golf Tournament Edmonton
July 20
Motorcycles Ride Against Cancer Poker Run
Vegreville
Edmonton
July 1
July 27
Cooking for a Cure
9th Annual ADT Memorial 6 on 6 Soccer Tournament
Mink Lake
July 3
Sherlock Holmes Pubs Charity Golf Tournament Edmonton
Edmonton
August 3-4
Pigeon Lake Music Festival Pigeon Lake
Lacombe
August 17
Chase the Cure YEG Edmonton International Raceway
September 12
August 17
Boston Pizza Golf Classic
Down & Dirty 5KM Obstacle Course Sunridge Ski Area, Edmonton
August 17 -18
Enbridge Ride to Conquer Cancer
Blackhawk Golf Club, Spruce Grove
September 14
Legacy Walk 2019 Bow Valley Legacy Trail
September 15
Calgary and Area
Innisfail Trail Ride
August 24
Daines Ranch Rodeo Grounds, Innisfail
Laps for Life Eau Claire Market Plaza, Calgary
August 24
Cameron Daye Memorial Golf Invitational
September 27
Terwillegar Trail Run/Walk Riverbend Community Hall, Edmonton
September 29
Kananaskis Country Golf Course
Below the Waist Race
August 27
North Star Raceway, Strathmore
Alberta Cancer Foundation Golf Classic Country Hills Golf Club, Calgary
For more information about these events and to find out how you can get involved at the Alberta Cancer Foundation please visit albertacancer.ca/get-involved. *Please note event dates are subject to change.
Fox Hollow Golf Club, Calgary
CONTENTS
36 LIVING WELL After three cancer diagnoses, Frank Lightbound has a unique perspective on the concept of “survivorship.”
38 RESEARCH ROCKSTAR With a focus on collaboration, Dr. Corrine Doll is committed to finding new ways to treat patients with cervical cancer. 42 TRUE CALLING Michael Civitella, executive director of operations and facility development at the Calgary Cancer Centre, is passionate about patient experience.
FEATURES
22 THE COMMUNICATION ISSUE From understanding clinical trials to talking about end-of-life, we take a closer look at how patients, family members, doctors and care providers continue to find new and productive ways to communicate clearly and effectively. COLUMNS/DEPARTMENTS 20 EXPERT ADVICE Understanding how and when to use supplements, and a closer look at pain management.
Institute, the history of the Bell of Hope and more.
7 FRONT LINE Dr. Mokarram Hossain’s trailblazing immunotherapy research is yielding promising results, how rural Alberta is supporting the Cross Cancer
13 YOUR DONATION MATTERS From survival rates to incident rates, five ways your donation to the Alberta Cancer Foundation has made a positive impact on Alberta’s cancer statistics. 14 FOOD FOCUS A closer look at the top food trends of 2019, and how to make a living-lettuce salad.
17 WORKOUT Whether you’re inspired by a high-energy group class or a solo, long-distance run, our handy workout guide will help you find the exercise style that’s right for you.
34 CARING A dynamic team of four at the Cross Cancer Institute helps head and neck cancer patients stay nourished.
46 IMPACT Head and neck cancer survivor Ted Power shares his personal experience with the Mobili-T head and neck function retraining device. 47 WHY I DONATE For Joan Charbonneau, giving back is a family tradition. 49 MY LEAP By shaving their heads, medical students at the U of C helped raise $35,000 for cancer care and research. 50 GAME CHANGER How a 1970 Chevrolet El Camino helped raise more than $36,000 for the Cross Cancer Institute.
COVER PHOTO COOPER AND O’HARA
myleapmagazine.ca SPRING 2019 LEAP 3
MESSAGE
Creating Moments TRUSTEES
Leigh-Anne Palter (Chair) Rene Aldana Dr. Stanford Blade Dr. Heather Bryant Brenda Hubley Chris Kucharski Bob McGee Brian McLean Andrea McManus Dr. Matthew Parliament Gelaine Pearman Jamie Pytel (Vice Chair) Rory J. Tyler Mark Zimmerman
NEVER MISS AN ISSUITE!
We have spent the last few months working on a new strategic plan for the Alberta Cancer Foundation. We listened to our staff, external stakeholders and partners to help set the direction for the kind of organization we aspire to be. One of the things we spent much time on was our purpose statement. We wanted to make sure it reflected who we are, what we do, but most importantly, “our why.” And it does. Our purpose is to create more moments for Albertans facing cancer by inspiring our community to give to innovation in detection, treatment and care. Leap is a good illustration of how we try to live that purpose every single day. In this issue, for example, a pair of nine-year-old friends (p. 9) raised more than $10,000 for cancer research inspiring their school, their community and many of us around the province. You’ll also read about Dr. Mokarram Hossain, who is studying innovative ways to administer immunotherapies (p. 7). And when it comes to creating more moments, we can’t overlook the story of Ted Power (p. 46), who was able to enjoy his Christmas meal with his family after benefitting from technology that helped him relearn how to swallow after a head and neck cancer diagnosis. We also feature many Alberta Health Services staff who deliver that compassionate treatment and care right across the province. You’ll read about Michael Civitella (p. 42), who has spent the last two decades in leadership roles at the Tom Baker Cancer Centre and is now helping create the new state-of-the-art Calgary Cancer Centre, set to open its doors in 2023. We’re also so inspired by the team of women at the Cross Cancer Institute who help patients with head and neck cancer nourish their bodies as they relearn to swallow after treatment (p. 43). This issue’s theme centres around the importance of communication — including how doctors talk to their patients, how patients can connect with their peers and using new technology to engage with loved ones. We know how important communication is during this entire process and it is one reason why we love to share Leap magazine with you. As we learn more, so will you. Enjoy this issue.
VIS
a/leap/ albertacancer.c n tio ip cr bs su leap
4 LEAP SPRING 2019
ELLEN WRIGHT TERRILL,
LEIGH-ANNE PALTER,
INTERIM CEO ALBERTA CANCER FOUNDATION
CHAIR ALBERTA CANCER FOUNDATION
SPRING 2019
|
VOL. 5
|
NO. 12
ALBERTA CANCER FOUNDATION EDITORS
Phoebe Dey and Christiane Gauthier
MANAGING EDITOR Meredith Bailey ART DIRECTOR Kim Larson STAFF PHOTOGRAPHER Jared Sych CONTRIBUTORS Wes Bell, Colleen Biondi, Charles Burke, Elizabeth ChorneyBooth, Shannon Cleary, Cooper & O’Hara, Caitlin Crawshaw, Jennifer Dorozio, Jennifer Friesen, Glenn Harvey, Hannah Kost, Mae Kroeis, Victoria Lessard, Jenn Madole, Kaley Mckean, Karin Olafson, Aaron Pedersen, Pete Ryan, Paul Swanson, Julia Williams, Sean Young, Jim Zang PUBLISHED FOR
Alberta Cancer Foundation Calgary office Suite 300, 1620 29 St. N.W. Calgary, Alberta T2N 4L7
PROVINCIAL OFFICE
710, 10123 99 St. N.W. Edmonton, Alberta T5J 3H1 Tel: 780-643-4400 Toll free: 1-866-412-4222 acfonline@albertacancer.ca
PUBLISHED BY
Redpoint Media & Marketing Solutions 100, 1900 11 St. S.E. Calgary, Alberta T2G 3G2 Phone: 403-240-9055 Toll free: 1-877-963-9333 Fax: 403-240-9059 info@redpointmedia.ca PM 40030911 Return undeliverable Canadian addresses to the Edmonton address above.
PRESIDENT & CEO Pete Graves GROUP PUBLISHER Joyce Byrne EDITORIAL DIRECTOR Jill Foran CLIENT RELATIONS MANAGER Natalie Morrison PRODUCTION MANAGER Mike Matovich AUDIENCE DEVELOPMENT MANAGER Rob Kelly
It’s time to be bold. It’s time to save lives. Making life better for Albertans facing cancer. As the official fundraising partner for the Cross Cancer Institute, Tom Baker Cancer Centre, and the 15 other CancerControl Alberta centres across the province, the Alberta Cancer Foundation is making life better for Albertans facing cancer by investing in research and initiatives that reduce risk, detect cancer earlier, improve quality of life, and provide better treatment options.
myleapmagazine.ca SPRING 2019 LEAP 5
7TH
ANNUAL
DRAG CANCER THROUGH THE MUD ON AUGUST 17, 2019 Down & Dirty is an obstacle course event at the Sunridge Ski Area in Edmonton, benefiting the Alberta Cancer Foundation. Features include a variety of challenges for mud lovers - hills, lifting, climbing, an 80-foot slip and slide down the ski hill, and much, much more! Participants should prepare to get muddy, and have a great time doing it! *Bring your family to participate in the free ‘Kids Course’, with donation. Register Today at albertacancer.ca/downanddirty2019 BENEFITING
May has promised a gift of life. Her 52-year marriage cut short, May wants future generations to be free from cancer. A gift through her Will can honour her late husband and help save lives. This will be part of her legacy.
Thank you May!
LEGACY GIVING
Leave a legacy. Consider a gift of life in your Will. albertacancer.ca/legacy
6 LEAP SPRING 2019
FRONT B R I G H T M I N D S | T H E B E L L O F H O P E | C A LV E S F O R C A N C E R
BRIGHT MINDS
Mokarram Hossain hopes to optimize immunotherapy with his trailblazing research
W
hen Mokarram Hossain read a groundbreaking 2016 research paper by Drs. Jing Wang and Paul Kubes, it sparked an idea. The paper determined that immune cells exist not only in our blood, but also in the peritoneal cavity — the space housing our abdominal organs. Hossain asked himself: what if those same immune cells meant to protect us could be fooled into protecting cancer instead? The notion was so innovative that it led him to win the Alberta Cancer Foundation’s 2016 Fred Coles Cancer Research Fellowship at the University Calgary (U of C), where he currently conducts cancer research under Dr. Kubes. “I told Dr. Kubes that these immune cells may be very beneficial to injuries, but the same healing property of these cells can be very dangerous for diseases like cancer,” Hossain says. >
DR. HOSSAIN IS FINDING NEW AND MORE EFFECTIVE WAYS TO ADMINISTER IMMUNOTHERAPIES
PHOTOS JARED SYCH
myleapmagazine.ca SPRING 2019 LEAP 7
FRONT LINE
CURRENTLY, DR. HOSSAIN IS CONDUCTING RESEARCH AT THE U OF C
Dr. Kubes was intrigued by the idea and preliminary experiments Hossain had conducted that involved metastatic colorectal cancer cells that grow in the liver. The results suggested that immune cells could not distinguish tissue from tumour — offering the researchers a chance to solve a previously undetected problem and potentially optimize cancer treatment. Born in rural Bangladesh, Hossain learned to value academia from his father, a high school teacher. Math and science came effortlessly to Hossain from an early age, but he was uncertain how to apply his talents; meeting people, he says, introduced him to possibilities, and aspirations to teach and work in academia became his focus. Hossain obtained both a bachelor’s degree in pharmacy and a master’s in pharmaceutical sciences at Jahangirnagar University in Bangladesh in 2007. In 2010, 8 LEAP SPRING 2019
he moved to Canada to obtain his PhD from the University of Saskatchewan in pharmacology. The Fred C. Coles Cancer Research Fellowship brought him to the U of C in 2016, where he works to optimize immunotherapy with his research. (The fellowship ended in March 2019). When a tumour grows in an organ like the liver, Hossain says, it can rupture the membrane surrounding the organ, which is called a “capsule.” Those existing immune cells in the peritoneal cavity that Dr. Kubes helped discover are designed to heal injuries, fight disease and race to the rupture to assist healing. But they are unable to differentiate between healthy tissue and the tumour — leading the immune cells to sometimes protect the tumour. Also at work is a more sinister force: the tumour’s ability to release chemicals that can cause immune cells to express
immunoinhibitory molecules — also known as “checkpoint molecules.” These checkpoint molecules actually limit the effectiveness of immune cells, and help cancer to grow freely. In short? “Tumours,” Hossain says, “are very smart.” Current immunotherapies target these checkpoint molecules to keep them from impeding the immune cells, but are injected into the blood, where they often cannot reach the peritoneal cavity. Using pre-clinical models, Hossain is testing how the peritoneal immune cells can be targeted using immunotherapies. “We have found that if you inject immunotherapies directly into the peritoneal cavity you will get [a] much better effect of treatment than if you inject directly into the blood,” Hossain says. Based on this observation, Hossain anticipates that administrating immunotherapies this way will show better effectiveness for people with cancers growing in organs within the peritoneal cavity. So far, injecting drugs that remove immune cells from the peritoneal cavity first, then burning the tumour with radiofrequency ablation — the use of electrodes to generate heat and destroy abnormal tissue, and commonly used in clinics to treat unresectable liver metastases — has shown promising results. “I think all researchers actually dream of [doing] something that will be meaningful, that will be translatable, that can be taken to the clinic for the benefit of patients,” Hossain says. “I have the same ambition.” This ambition is not misguided: Hossain’s work has shown such promise that, in February 2019, he was awarded the Banting Postdoctoral Fellowship by the Canadian Institutes of Health Research to continue working under Dr. Kubes. It is considered the most prestigious postdoctoral fellowship in Canada. One can safely assume that through cancer research — and with continued aspirations to teach and to share his knowledge — Hossain has found where to apply his talents. “If we can make [even] a tiny bit of an impact to help cancer patients, that would be [incredible],” Hossain says. “That’s what we’re striving for.” LEAP — HANNAH KOST
BEST FRIENDS LEAH (LEFT) AND ALIDA (RIGHT) RAISED MORE THAN $10,000
Alida and Leah’s Cancer Quest Nine-year-old Alida Teghtmeyer remembers when she first told her best friend Leah Bentein, who is also nine, about her idea to raise funds for cancer research. “We were going to puzzle club and I looked at Leah and said, ‘I kinda want to shave my head for cancer,’ and she said, ‘Me too!’” From that simple exchange, “Alida and Leah’s Cancer Quest” at Prairie Waters Elementary School in Chestermere was born. Alida was inspired to shave her head when she learned that her grandmother had been diagnosed with stage 4 colon cancer. “I thought if I shaved my head, more people would pay attention and help fundraise,” says Alida. Leah was inspired to help, too. “I feel so bad for the kids and the people who have cancer and how much it hurts and how many people pass away,” she says. With the goal of raising $1,000 for the Alberta Cancer Foundation over three months, the friends put together posters advertising their campaign. With support from “the cancer club” (a group of 16 students who helped with the campaign) and teacher Janet Chapman, they held a bake sale in February and a loonie
drive in the first two weeks of March, but the highlight of the fundraising effort took place on March 19 during a school assembly. At the assembly, and in front of the school, Alida shaved her head along with Kristina Rentz, the school’s vice principal, and teacher Jeff Morey. (Leah had decided earlier on to dye her hair bright pink instead of shaving it off, because, in her words, “My hair is way too short already.”) Alida and Leah ended up raising more than $10,000. “I’m really proud of them,” says Nancy Teghtmeyer, Alida’s mom. “This was really their idea. They took full initiative.” Nancy says before the campaign began, the two girls sat down with the Alberta Cancer Foundation in a boardroom meeting. The pair asked a number of questions about cancer and fundraising, including how far their money would stretch, how many different types of cancers there are and if cancer could be caught. The girls decided to put their total fundraised money toward cancer research. “A little thing can make a difference,” says Leah. “Little things go a long way,” says Alida. LEAP
“I thought if I shaved my head, more people would pay attention and help fundraise.” — ALIDA TEGHTMEYER
— JENNIFER DOROZIO
ALIDA AND LEAH’S CANCER QUEST RESULTS
6
NUMBER OF PEOPLE WHO PARTICIPATED IN HAIR DYE/HEADSHAVE
$10,265 TOTAL AMOUNT RAISED
59
TOTAL DAYS SPENT FUNDRAISING
myleapmagazine.ca SPRING 2019 LEAP 9
FRONT LINE
Calves for Cancer
How rural Albertans helped raise $181,890 for the Cross Cancer Institute ON NOVEMBER 10, 2018, JOHN
Chomiak watched as his calf, Hooch, went up for auction at Farmfair International in Edmonton. This was no ordinary auction. Chomiak, a cancer survivor, had a personal stake in seeing the bids climb — Hooch was being sold to raise money for the 50th anniversary of Edmonton’s Cross Cancer Institute, where Chomiak received treatment. Hooch was also the first calf to kick off the auction for Calves for Cancer — a unique and relatively new fundraiser, spearheaded by 840 CFCW, that show-
cases the spirit of rural Albertans. In 2017, CFCW was approached by the Show the Love committee (the campaign established to raise money for the Cross in celebration of its 50th anniversary) to consider organizing a community event. The station came up with the idea to ask Alberta ranchers and farmers to donate 50 calves for charity. “When we launched CFCW’s Calves for Cancer last summer, we didn’t know exactly how we were going to do it when the calves went to market that fall,” says
PHOTOS PAUL SWANSON
BY THE NUMBERS 73 ranchers and farmers have participated 76 calves have been donated 12 auction marts have participated $9,500 the first calf to be donated, Hooch, raised the most money 50 the fiftieth calf to be donated was from country singer Brett Kissel $31,453 Vold, Jones & Vold Auction Co. Ltd. in Westlock raised the highest total of participating auctions
10 LEAP SPRING 2019
Jackie Rae Greening, CFCW’s program director. “The plan was I would pick the brains of the ranchers when they called in to donate, and that’s exactly what I did. [The campaign] was truly a collaborative effort.” The first person to donate a calf was Chomiak, a rancher and building engineering consultant. The former president and CEO of Hemisphere Engineering, he owns Chomiak Charolais farm in Mundare, Alta. Before the campaign began, Chomiak
received a phone call from Greening. The pair knew each other from numerous cattle-related events and she wanted his thoughts on the idea. “I supported it 100 per cent and said, ‘Jackie, I’ll throw in the first calf,’” says Chomiak. Chomiak’s enthusiastic support for the fundraiser stems from his own personal experience with the Cross. In 2015, he was diagnosed with prostate cancer. Over the next two years, he underwent 40 radiation treatments. During treatment at the Cross, he discovered an interesting link: >
RANCHER JOHN CHOMIAK, (LEFT) CHOMIAK WITH HOOCH
myleapmagazine.ca SPRING 2019 LEAP 11
FRONT LINE “Our engineering company, Hemisphere Engineering, did engineering renovation designs for the Cross Cancer,” he explains. “The machine I happened to be on for treatment was in the room that we designed and prepared for the latest machine.” Four years later, Chomiak, though still being monitored, is cancer-free. He hopes that Calves for Cancer will become an annual fundraiser within the community and would like to see 500 calves donated. So far, 73 Albertans have donated 76 calves. The livestock has been sold at 12 auction marts throughout northern and central Alberta, with the first five calves auctioned off at Farmfair International (including Chomiak’s Hooch). The auction is still ongoing — although the majority of sales happened last November — and the total amount raised so far is $181,890. With early spring calves typically bringing in between $900 to $1,100 at auction, this current tally shows the generosity of all involved — even the participating auction marts waived their typical commission fees on the calves. “I think the rural community throughout Alberta has been hit hard with cancer,” says Chomiak. “I’ve been involved in many fundraisers in my life, but on this one, the [73] farmers [and] ranchers that contributed each had a personal reason for doing it. They were open and candid about their ordeals.” The calf Chomiak donated has its own story of perseverance. After Hooch was left orphaned, Chomiak cared for him. “I bottle-fed Hooch from a little baby calf to what he is now. I can come up to him anytime. We [have] quite a good relationship.” On that exciting auction day in November 2018, fate kept the unlikely pair from being parted. Northlands bought Hooch initially and then sent him back into the ring to be sold again. “[There was] a voice in the background bidding,” says Chomiak. “[They] announced the name and it was my grandson who purchased it. He didn’t want [Hooch] to leave the farm.” Hooch sold for the highest amount among all the calves donated, raising $9,500. And today, Hooch has a place of honour at Chomiak Charolais farm — a symbol of rural Albertans taking a stand against cancer. LEAP — VICTORIA LESSARD
12 LEAP SPRING 2019
A Joyful Noise The Bell of Hope tradition is a meaningful milestone for cancer patients On any given day, the celebratory sound of a ringing bell can be heard throughout the basement radiology unit of the Cross Cancer Institute in Edmonton. The tradition is called the Bell of Hope. Patients are invited to ring a bell to celebrate a significant milestone in their cancer journey — the completion of treatment. “You see a change in patients [when they ring the bell]. Sometimes they’re a little bit timid when they pick it up ... but generally by that last ring, they mean it,” says Ashley Ayume, medical radiation therapist at the Cross. Ayume and her colleague Susan Mortensen, who also works as a medical radiation therapist at the Cross, brought the bell of hope initiative to the hospital about eight years ago. Ayume discovered the idea online while looking for inspiration from other cancer treatment centres. The pair wanted a way for patients, family and staff to publicly celebrate the milestone of finishing cancer treatment together. “We’re giving them this amazing care while we’re here, but we don’t want them to just feel lost when we’re done. We wanted to start something for them. Something positive. Then we found the bell, and it just fit,” says Ayume. The ritual first began at the MD Anderson Cancer Center in Houston, Texas, in 1996. Patients there ring a large bell that’s attached to a wall. Next to the bell is a poem on a plaque that was written by cancer survivor Irve Le Moyne, a U.S. Naval officer who was one of the first patients to ring the bell. Ayume and Mortensen have included Le Moyne’s poem on plaques throughout the unit at the Cross, as well. RINGING OUT Ring this bell Three times well Its toll to clearly say, My treatment’s done This course is run And I am on my way — Irve Le Moyne At the Cross, portable bells, rather than one large one, seemed more practical to accommodate the unit’s high number of patients. The mis-
matched bells that live on the radiation unit sit on tables lining the long waiting room hallway. Patients can choose to ring a bell from the collection or bring their own from home. Some celebrate publicly in the hallway with friends, family and staff, and are met with applause. Others choose a more private bell ceremony in their treatment rooms. Some patients even ring the bell when their treatment begins as a way to acknowledge the start of their cancer journey. Regardless of how it’s done, the bell brings courage for whatever step comes next. “It’s finishing a chapter and starting a new chapter of survival,” says Mortensen. “It brings a smile to your day when you’re working and you can hear the bell ringing. It’s a small and simple way for patients to say how happy they are to get through their journey.” Similar versions of the Bell of Hope ritual are practiced at cancer centres across the province, including the Tom Baker Cancer Centre. For patients, the ritual is especially important when the transition home can be fraught with anxiety over the unknowns ahead. “You’ve got to hold on to every win you get. Finishing that day, it doesn’t matter what’s coming after, you celebrate it if you can,” says Ayume. The sound of bells has an impact on those undergoing treatment, too. “When patients are having a rough day and need a light at the end of the tunnel, the bell can be it for them,” she says. “When they’re in the waiting room and see another patient ring the bell, they get to clap and be excited and know that their day is coming.” LEAP — MAE KROEIS
5 WAYS
Your donation to the Alberta Cancer Foundation has made on impact on cancer statistics in Alberta More than 20,000 Albertans are expected to be diagnosed with cancer in 2019. Thanks, in part, to the support of Alberta Cancer Foundation donors, researchers and health-care professionals are making advancements every day. Thanks to their efforts, more than 120,000 Albertans diagnosed with cancer are alive today. Improvements in early detection and treatment options also mean Albertans with cancer are living longer. Here a few ways your support has made a difference to the big picture.
THE RIGHT DIRECTION
EARLY DETECTION
Between 2001-2016, Alberta’s cancer incidence rates have declined by 0.5% annually.
Thanks to early detection initiatives, breast cancer is considered 95% curable if caught early.
SURVIVAL RATE The five-year survival rate for localized prostate cancer is close to 100%.
CLINICAL TRIALS
LIVING LONGER
Thanks to immunotherapy clinical trials, survival rates for late-stage melanoma have improved from 20% to 60%.
Mortality rates are decreasing in Alberta, falling on average by 1.8% annually since 2004.
Learn more about how you can support the Alberta Cancer Foundation at albertacancer.ca
Fifty years ago, only 25 per cent of people survived cancer. Today, that number is closer to 60 per cent — for some cancers it’s closer to 90 per cent. myleapmagazine.ca SPRING 2019 LEAP 13
FOOD FOCUS
Think Green When it comes to food and nutrition, trends often dominate the conversation. Whether it’s the ultra low-fat products of the ’90s or the ketogenic craze we’re seeing today, it can be hard to distinguish pointless fads from nutritionally sound advice. To help sort out which trends are worth paying attention to, Christine Fletcher, a dietitian with Alberta Health Services, weighs in on some of this year’s emerging themes. by ELIZABETH CHORNEY-BOOTH
FAT BOMBS
PLANT-BASED ALTERNATIVES Cutting down on animal products, or cutting them out altogether, has become an increasingly popular lifestyle change in recent years, with many people not only eating more fruits and veggies, but also looking for substitutions for meat and dairy. Products like the vegetarian Beyond Burger and other faux meat items are not all created equally, so Fletcher suggests carefully reading each item’s packaging to get a full nutritional picture. In general, however, she says that even though many packaged plant 14 LEAP SPRING 2019
protein alternatives do contain undesirable fats or high levels of sodium, they can be a better choice than their animal protein equivalents. “The new Canada’s Food Guide does recommend that Canadians choose more proteins that come from plants more often,” Fletcher says. “Something like the Beyond Burger does have less saturated fat than a standard beef burger, which is good because saturated fat has been associated with increases in LDL cholesterol and cardiovascular disease.”
The term “fat bomb” certainly doesn’t sound healthy, but these little nuggets are part of the ketogenic diet trend. The controversial low-carb diet requires users to eat a significant amount of fat to achieve ketosis, a metabolic state that is believed to result in weight loss. Fat bombs are a category
of high-fat snacks that let keto dieters increase their fat intake in just a few bites — they’re usually little balls or patties packed with ingredients like avocado, nut butters and/or coconut oil and can be sweetened with the sugar alternative stevia. Fletcher does not recommend keto diets unless taken on under the guidance of a health professional and says that fat bombs can contain more fat than a typical person needs to eat over the course of their entire day. She’d prefer to see those undergoing cancer treatment, or anyone else struggling to keep on weight, choose protein balls that contain a more even balance of carbs, fats and proteins. “I would recommend something that has some nut butter, some oats, some fruit or even honey,” she says. “That would be more appropriate for someone who wants a balanced snack in their diet.” >
R BUY YGOIUES VEG LLY! LOCA
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FOOD FOCUS
SEAWEED SNACKS Seaweed snacks — delicate sheets of roasted seaweed — are available in almost any grocery store these days, and Fletcher says they’re a trend she endorses. While they can be high in sodium compared to the other kinds of crunchy and savoury snacks that many of us crave, seaweed-based snacks are a much healthier alternative. “They are a green vegetable and have a good nutrient profile for things like vitamins, minerals and antioxidants,” she says. “Also, algae or seaweed is the only vegetarian source of omega-3 fatty acids DHA and EPA, which can be very hard to get for people who don’t eat a lot of fish.”
A BETTER PACKAGE Compostable take-out packaging has begun to replace the old unrecyclable Styrofoam in the food delivery business. With delivery services like DoorDash and cook-at-home kits like Chefs Plate and HelloFresh becoming so popular, keeping packaging out of the landfill is more important than ever. From a dietitian’s point of view, Fletcher says she doesn’t want people to use sustainable packaging as an excuse to eat more restaurant take-out. Cooking at home is almost always a
SEAWEED IS THE ONLY VEGETARIAN SOURCE OF OMEGA-3 FATTY ACIDS DHA AND EPA
Living Lettuce Salad
LOC GROWN ALELTLY HAS MO TUCE NUTRIENTRSE
Fresh fruit and vegetables are definitely on trend this year, as is eating local, and combining these two trends can result in a particularly nutritious meal. Even though Alberta’s climate doesn’t have the growing power of Mexico or California, there are locally-grown vegetable options that don’t just promote sustainability and support the local economy, but can also offer a nutritional boost. Inspired Greens grows its pesticide-free lettuces in greenhouses in Coaldale, Alta. The fresh, and local, greens are available at most major grocery stores. The lettuces are living, with the roots still attached, meaning that the plants’ nutrients are still intact, whereas non-living lettuces start to lose their nutrients as soon as they’re cut. The process also makes for a more flavourful product that can be served with little to no dressing to create a healthier salad. Play with different lettuce varieties and herbs to create salads that are packed with natural flavour.
16 LEAP SPRING 2019
healthier option, especially for those watching their salt and fat intake. But she does like the idea of cook-at-home meal kits, which encourage eating whole, fresh foods. “My patients are telling me that the kits give them great ideas for what they can cook at home,” Fletcher says. “They’re gaining skills in the kitchen. So for those who need ideas or can’t get out to the grocery store, I’d recommend those as a way to get into cooking.” LEAP
INGREDIENTS 4 cups living lettuce, washed and roughly torn (any variety will work — try combining a few different kinds of leaves) 1 cup mixed assorted fresh herbs, such as dill, tarragon, parsley, basil, mint or cilantro, roughly torn or chopped 1 yellow pepper, diced 1/2 cup halved cherry tomatoes 1/4 cup red onion, diced 2 tbsp hemp seeds juice of 1/2 lemon olive oil salt and pepper to taste
DIRECTIONS Toss together the lettuce, herbs, yellow pepper, cherry tomato, red onion and hemp seeds in a large bowl. Drizzle with lemon juice and olive oil to taste and season with salt and pepper. Give it another toss and serve immediately. SERVES 4.
WORKOUT
What’s Your Personal Workout Style? Get inspired to try a new workout or chase a goal based on how you approach exercise by KARIN OLAFSON THERE’S NO “RIGHT” WORKOUT — ONLY
what’s right for you. Getting in your 150 minutes of moderate exercise each week, a target amount recommended for adults by the World Health Organization, will feel fun if you love the activity that gets you moving. According to Dr. Margaret McNeely, the Edmonton-based lead of the Alberta Cancer
Exercise program (ACE), all exercise is valuable for health, although different kinds of exercise may offer different benefits for symptoms and daily life. “Aerobic exercises help to strengthen your heart and lungs, which will give you more energy, help you think more clearly, and may offset many chronic diseases,” says McNeely. “Resistance or weight training
will help strengthen your muscles so that you can, for example, more easily lift or carry objects and climb stairs. And programs such as yoga, Tai Chi and dance are excellent ways to maintain mobility and balance.” Not sure where to start? Choose your workout style and get motivated to get moving, try a new exercise or work toward a new goal. >
ILLUSTRATION KALEY MCKEAN
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WORKOUT
THE SOCIAL BUTTERFLY
1.
You’re committed to wellness, but it’s easier to get motivated and get your sweat on with a friend by your side — and you hold each other accountable. Maybe in the past you’ve enjoyed Zumba or spin classes. Your goal now is to exercise consistently, and without sacrificing social outings.
THE WORKOUT JOIN A BOXING STUDIO In an encouraging group setting, learn to jab, hook and cross while working on your cardiovascular fitness and strength. The upbeat soundtrack and flashy lighting that often accompany a boxing workout make the whole thing feel like a social evening out at a nightclub. Have friends join you at two high-intensity boxing sessions per week and add in one short recovery run to reach your 150 minutes of weekly exercise.
WHERE TO TRY IT Undrcard Boxing Studio in downtown Calgary offers group boxing sessions and boxing-yoga hybrid workouts. It’s designed to be social: a coffee shop is located right inside the studio so you can catch up with your workout pal over a smoothie after the session. CONSIDER THIS Many boxing studios are social places with an encouraging group dynamic. You might even form some new friendships there.
THE SELF-MOTIVATED KEENER
2.
When it comes to getting your weekly workouts in, you’re totally self-motivated. For you, endurance exercise is a kind of meditation, and working toward a big goal is satisfying. Perhaps you’ve already got some 5-kilometre running races under your belt and are looking for your next challenge. THE WORKOUT
REGISTER AND TRAIN FOR A RUNNING RACE You’re dedicated and consistent, so now increase your distance. Slowly build the distance you run each week and incorporate some weekly interval sessions to focus on speed. To enhance your training, download a running app. Use Runkeeper, to discover new training routes, get motivational cues and track your progress. Download Strava or Nike+ Run Club if you like to compete against other app users. WHERE TO RUN LONG In Calgary and Edmonton, the Bow River, Elbow River 18 LEAP SPRING 2019
and River Valley pathways are ideal for all-year training and you can easily increase your long-run distance by heading slightly further down the pathways each week. You’ll also get faster by incorporating stair running (try the Wolf Willow Ravine stairs in Edmonton) into your weekly workouts. CONSIDER THIS The Alberta Cancer Foundation is one of the Scotiabank Calgary Marathon’s official charities. Raise funds and complete your first 10K (or half marathon, marathon or 50K) on May 26.
THE ADVENTURE-SEEKER
3.
You’re not intimidated by muddy trails. You’re not scared of heights or disheartened by fitness challenges. You thrive in new environments and feel energized when you try something adventurous. Maybe you’ve already dabbled in obstacle course training and trail running and are now searching for a new thrilling activity.
THE WORKOUT INDOOR BOULDERING For something that’s always a little different, head to an indoor bouldering facility for a full-body workout. Bouldering walls are shorter than rock climbing walls — usually no higher than 15 feet — because there are no ropes or safety harnesses. The concept is the same as rock climbing, but there’s more risk: you select a “problem” that’s been set and try to make your way to the top using only the specified holds.
than 12,500-square-foot facility has a range of climbing routes, meaning it’s suitable for all levels. As you progress to climbing more difficult routes, you’ll also be strong enough to use the gym’s climbing-specific training apparatus to enhance your strength workout. CONSIDER THIS Know that most indoor facilities offer beginner courses and teach safety essentials like how to fall and how to progress in the sport.
3 Ways to Reach Your Weekly Fitness Goals
WHERE TO TRY IT Edmonton is home to Blocs, the biggest bouldering-specific gym in Alberta. The more
BY TIME
THE LIFELONG LEARNER
4.
You value your health, but maybe it’s been a little while since you’ve made fitness a priority. Perhaps you’re a little intimidated by some fitness classes and you’re not quite sure where a beginner should start. You know that fitness is for life and you’re looking to achieve a solid foundation so you can try new workouts in the years to come.
THE WORKOUT FIND A PERSONAL TRAINER When you work oneon-one with a qualified trainer at your local gym or YMCA, you’ll be guided through a training program that is specifically catered to your fitness level and goals. Aim to work through a tailored program twice a week and you’ll quickly see improvements in your cardiovascular fitness and strength. This will
give you the confidence to join in any group fitness class you’ve been eyeing.
a personal trainer out of the Brookfield Residential YMCA at Seton, the world’s biggest YMCA.
WHERE TO TRY IT SVPT Fitness and Athletics is a private gym in Edmonton that specializes in personal training. The 5,300-square-foot space has a range of fitness equipment that the trainers will teach you to use. For those in Calgary, consider working with
CONSIDER THIS Don’t want one-on-one time? Ask your gym if they offer semi-private personal training or join a group training session, where you exercise with a few other individuals with similar fitness goals.
Aim to reach 150 minutes of physical activity per week by doing five 30-minute workouts. Add a little more time to each workout as your endurance increases. BY WEIGHT
Start by lifting low and slow, then increase the weight load you’re lifting by five to 10 per cent every two weeks. WITH TECHNOLOGY
Use tracking apps, pedometers, or smart watches to measure everything from steps walked each week to calories burned and distance run.
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EXPERT ADVICE
optimally, and this can help support their immune system.
We go to the experts for advice on supplementing during cancer treatment and different techniques for pain management. by JENNIFER DOROZIO
Q: What are supplements? KATIE KELLER
USING SUPPLEMENTS SAFELY DURING CANCER TREATMENT The body is hard at work during and after cancer treatment and can sometimes use a boost, nutrition-wise, in the form of supplements. Katie Keller is a registered dietician at the Tom Baker Cancer Centre in Calgary and works to support the daily nutrition needs of cancer patients. Keller weighs in on the topic of supplementing for cancer patients.
Supplements can be a really big term for a dietician. [Simply put], macronutrients are the big guys — think nutrients we get from our diet like protein, carbohydrates and fats — and a supplement that would give us something like that would be a protein powder or some type of meal replacement. Micronutrients are our little guys and [provide] vitamins and minerals. Some examples would be a vitamin C supplement or a B complex. A herbal supplement is typically an alternative treatment. It could be a concentrated form of blueberry extract or curcumin, which is the active ingredient in turmeric.
Q: Can eating a wellbalanced diet eliminate the need for supplements? Food really is the best way for us to get our nutrients. Supplements can be important and beneficial, but they’re not always [needed]. It depends on the individual and the type of situation presented. If people — including cancer patients on- or off-treatment — are eating a variety of different foods regularly throughout the day, they are most likely getting all the nutrients their body needs to function
Q: In what scenarios could supplements be helpful? If someone is not able to get everything they need from their food — and this can be [in scenarios like] a pre-existing health condition, cancer side-effects/ symptoms or a personal choice, like they’re vegetarian or vegan — it might be a situation where supplementing does become really important to support overall health and well-being. Within these situations, the type of supplements that we would suggest depends on the individual and their situation.
Q: When a patient is undergoing cancer treatment would you recommend they visit a nutritionist? Yes, absolutely. Mostly we’re seeing patients because they’re not able to eat adequately — especially when they’re in treatment — and their nutrient needs can be elevated. If patients are losing weight, getting weaker, fatigued or maybe they’re having lots of food restrictions, then they would see us. Supplementing their diet might be an important part of their treatment. At the Tom Baker Cancer Centre, we see patients if they’re gearing up for surgery to do some nutrition optimization, but most commonly we see people who are actively on treatment. Always check with your health-care team before using supplements during treatment. ILLUSTRATION JENNIFER MADOLE
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DR. SHARON WATANABE
CANCER AND PAIN MANAGEMENT The pain felt during cancer treatment can be alleviated through a variety of techniques that include psychological, social, spiritual and interventional approaches to pain management. Here, Dr. Sharon Watanabe, the director of the department of symptom control and palliative care at the Cross Cancer Institute in Edmonton, shares some of the strategies she and her team use for pain management.
Q: What does the term pain management encompass? Pain is a common experience in people who are living with cancer. The goal of pain management is to make pain tolerable and, at the same time, keep any sideeffects related to treatment of the pain to a minimum. Pain management doesn’t necessarily mean eliminating pain, but rather trying to control it using various means, so that pain is not interfering with function and quality of life.
Institute is often referred to patients specifically because their pain is not adequately controlled by usual treatments. There can be a misunderstanding about the term palliative care; sometimes it is thought of as being synonymous with endof-life care, but what we now understand in oncology is that the palliative care approach means trying to optimize quality of life throughout the trajectory of cancer.
Q: So, a patient might be sent to the palliative care department to manage their pain? Yes, absolutely.
Q: How do you determine the root cause of pain in your patients? There are different sources of pain, and one of the key parts of trying to manage it is to have an understanding of where the pain is coming from. Sometimes, the cancer itself causes injury to the tissue, and that is perceived as pain. Sometimes, the treatment of cancer can cause pain. For example, some chemotherapy drugs are known to affect the nerves that give feeling to the hands and feet, and that can temporarily cause pain. The other type of pain, chronic pain – which is unrelated to cancer – is common in the general population. [Other factors to consider are] if someone is feeling emotionally distressed, more specifically if they’re feeling depressed or anxious, as that can sometimes heighten the sensation of pain.
Q: Why do patients get referred to your team?
Q: What are some common methods to manage pain?
The whole health-care team [of a patient] is involved in managing pain, and not all people who have cancer pain need to see a [symptom control] specialist. The palliative care department at the Cross Cancer
If the pain is coming from the cancer itself, cancer treatment can go a long way toward alleviating pain. There are [also] non-drug measures that can help pain. For example, pain that is aggravated
by certain positions or movements [is something] a physical or occupational therapist can help with. If there appears to be an emotional component to the pain, then counselling through psychology or spiritual care may also be helpful. There are some procedures like nerve blocks that can help certain types of pain. Then there are drugs. The type of drugs we use depends on how severe the pain is and how the type of pain or nerve pain may respond to specific medication.
Q: What about possibly addictive drugs — how do you decide when to prescribe them? One common concern raised is that opioids are addicting. It is true that opioids have the potential to lead to an addiction. When we see patients who are candidates for opioid management, we always assess for risk [of addiction]. Many patients will have a very low risk for this occurring, including if they’ve not had addictions to other substances in the past, or if they don’t have mental health issues. Other patients may have a high risk, and that doesn’t preclude the use of opioids, it just means we need to use them in a structured and monitored plan.
Q: What advice would you give family members to help support a loved one dealing with pain management? Family members can play an important role in pain management. They can help the person to carry out the plan, for example, to stay on track with medications, or record the pain ratings and extra doses in a diary. What they observe of the person’s daily experiences of the pain and its treatment can assist the team in knowing how well the plan is working. LEAP myleapmagazine.ca SPRING 2019 LEAP 21
The CO MMUNICAT ION ISSUE
From clear information on clinical trials and open discussion about mental health to new technologies that make conversations easier, we explore how patients, families and health-care professionals are finding new and productive ways to communicate clearly and effectively.
Let’s talk.
TAL KI N G T O PAT I E N T S
PRACTICING COMPASSION Mindfulness techniques can help doctors communicate more effectively with their patients by SEAN P. YOUNG
illustration PETE RYAN
ALTHOUGH HE SAYS he is blessed with a positive personality and optimistic nature, Dr. Rob Rutledge, a radiation oncologist and associate professor at Dalhousie University in Halifax, experienced burnout early in his 25-year career. “It felt like I was falling into depression, but I also remember the team members, the nurses being the ones who inspired me through their kindness,” Rutledge says. It was this personal challenge, coupled with reading alarming data showing that 50 per cent of working health professionals experience burnout during their careers, that led Rutledge to design a workshop called Taking Care of Us for health-care professionals. He has since delivered this session — which he first developed 15 years ago — around the globe in an effort to help health professionals help both themselves and the patients they care for. “The science is extremely strong: the higher the level of burnout, the worse the quality of care,” Rutledge says. Classic signs of occupational burnout include emotional exhaustion, cynicism and a reduced sense of personal accomplishment. Another sign, one that’s particularly dangerous in the world of medicine, is depersonalization, often described as compassion fatigue. > 22 LEAP SPRING 2019
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The CO MMUNICAT ION ISSUE
“All of [these habits] allow the frontal lobe to work better, which allows us to perform better, to be happier, and ultimately for our health to be better in the long-term,” Rutledge says. Communication with patients also improves when a physician is functioning from the frontal lobe. Doctors in tune with their innate compassion will continue to see each patient’s story as unique, even though they have likely seen many similar cases during their careers. “You have to always remember… to the patient, it’s a brand-new situation and they’re hanging on your every word,” Rutledge says. “They’re sometimes travelling for hours for a 10-minute appointment, and a single sentence can reverberate in their head for months.” Last spring, Rutledge shared his insights on neuroscience and his mindfulness tips with the health-care community in Alberta. He gave the Taking Care of Us talk at the Margery E. Yuill Cancer Centre in Medicine Hat, and it was also broadcast to 16 additional Alberta Health Services (AHS) facilities throughout the province. “The feedback we received was that it was excellent information,” says Mark Sloan, a community oncology social worker with AHS who helped facilitate the session. “[The audience] loved the idea of bringing neuroscience into the presentation, and it made those in attendance think about what they could do to be active participants in their personal care.” LEAP
“You start seeing [a patient] as a case, like breast cancer to bone for example, forgetting the person in front of you,” Rutledge says. Compassion fatigue can lead to a cold bedside manner or communication breakdown with the patient. “It’s so important to be in balance and have that natural compassion come through, because the stakes are so high in terms of how the patients are hearing what we’re actually trying to say,” Rutledge says. In his Taking Care of Us session, he advocates techniques that are backed by neuroscience (the scientific study of the nervous system, including the brain), which he says can help health-care workers avoid or overcome burnout. Modern neuroscience has greatly expanded our understanding of the brain with technological advancements like functional MRIs (which measure brain activity by detecting changes associated with blood flow) and electroencephalograms (or EEGs, which track and record the electrical activity of the brain). According to Rutledge, a litany of neuroscience studies show that humans fluctuate between two states of being: the irritable, stress brain and the compassionate, wise brain. Making doctors less likely to burn out requires they continuously react from their frontal lobes, where the wise, compassionate brain resides, Rutledge says. In the talks he delivers, he highlights scientifically proven habits doctors can use to train their brains to function more and more from their frontal lobes, including daily exercise, a low-glycemic diet, proper sleep, and regular relaxation or meditation practices. He also demonstrates several simple “in-the-moment” mindfulness techniques that can switch a person from their stress brain back to functioning from their frontal lobe. For example, he says, as few as four long, smooth breaths can be enough to send a signal to the brain via a nerve in the diaphragm, which shuts off the body’s fight-or-flight response.
For more information on Dr. Rutledge, visit healingandcancer.org.
THE FOUR LEVELS TO BUILDING RESILIENCE To help health-care workers live in a more compassionate, resilient state of being, Rutledge speaks about four mindfulness-based techniques: LEVEL 1 In-the-Moment Breathing Rutledge demonstrates mindfulness-type breathing techniques that can help a person return to their “best self” when they’re “in the midst of the chaos.”
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LEVEL 2 Setting Your Intention During his meditation practice every morning, Rutledge sets his intentions to be helpful to his patients. He will set his intention again when challenged, for instance when sharing bleak news with patients. “In that moment, I’m setting the intention to be compassionate," he says.
LEVEL 3 Viewing Stress As Enhancing Rutledge says with enough practice it is possible to view stress as helpful, which completely changes how a person deals with it. “I try to teach professionals the science behind how changes in perception can actually change brain function,” he says.
LEVEL4 Cognitive Reframing This technique, typically used by psychologists and therapists, “is basically reprogramming the thoughts that are causing us distress,” Rutledge says. With enough reframing, the individual can prevent their thoughts from manifesting into stressful reactions.
DR. MARGARET CHURCHER AT HER CALGARY CLINIC
TALK IN G T O YO U R D OC T O R
WHAT'S UP, DOC? Communication is an important (and sometimes overlooked) piece of the cancer treatment puzzle by JULIA WILLIAMS photography COOPER & O‘HARA
EVERYONE KNOWS CANCER
treatment is a physical and emotional process — but it’s also an ongoing exercise in communication. From the moment of diagnosis, the learning curve is steep, the options are varied and the dialogue is ongoing. To be your own best advocate (and to give your care team every opportunity to succeed), it helps to know how to navigate important conversations that arise during treatment.
DON'T BE AFRAID TO ASK QUESTIONS The shock of a cancer diagnosis tends to banish rational thought — at least temporarily. Dr. Margaret Churcher, a Calgary family physician, says that when people come in for test results and learn they have cancer, they usually forget every other part of the conversation. For that reason, it’s wise to enlist a family member or friend to accompany you as a back-up listener. If you need more information, your family doctor can provide follow-up appointments. After diagnosis, you’ll meet your oncology team within weeks (or even days) to start creating a care plan. However, Churcher advises patients to stay in regular contact with their family doctor throughout the treatment process, to manage their basic wellness, including diet, exercise and any existing conditions. “We encourage [patients] to continue looking after themselves as a whole person,” she says. Churcher encourages patients to make a habit of questioning their care team — not just because it’s the best way to learn, but because uncertainty increases stress. “The more you know, the less anxiety you’ll have,” she says. > myleapmagazine.ca SPRING 2019 LEAP 25
The CO MMUNICAT ION ISSUE
However, even the best-informed patients experience anxiety. Cancer treatment can be all-encompassing and fraught with unanticipated stressors, such as missing work or finding childcare. Churcher says family doctors and oncology teams monitor their patients for signs of anxiety and refer them to a range of psychosocial resources and wellness supports, both in the cancer centre and in the community. But there’s no obligation to wait for your doctor to give you a nudge — ask for more support if you need it. While Churcher wants patients to be informed and curious, she discourages people from researching their diagnosis on the Internet. “It’s often generic and worstcase scenario, and people have a hard time interpreting it,” she says. Instead, ask your care team, or ask your care team to recommend good learning resources.
GET INFORMED ON CLINICAL TRIALS Clinical trials give patients the chance to receive new medications or procedures as voluntary participants in a study. But, at any given time, there are many cancerrelated clinical trials taking place, so how do you know which ones you want to engage with — and whether or not you’re eligible to do so? The good news is that there’s plenty of information available about current opportunities. While the onus is on the care team, not the patient, to recruit participants (once you’re diagnosed, you’re identified as a potential subject), it’s always a good idea to do your own research. Alberta Cancer Clinical Trials provides information about current trials in print materials and on video screens in medical waiting rooms, and online trial databases help narrow your search. If you meet the broad eligibility criteria for a certain study, you’ll discuss the possibility with your oncologist. If you decide to proceed, you’ll enter a screening process that can involve blood work, lab work and other diagnostic imaging. Because this screening process is performed by your oncologist and an official clinical trial nurse, it’s a great opportunity to ask questions: What’s involved, medically and logistically, with participating? What benefits can you gain from the trial? What risks are involved? Is it possible to receive the treatment without being a trial subject? If your screening shows that you’re ineligible for a given trial, your care team will discuss this with you in person at your next appointment. However, if you can participate, expect to receive a thorough consent form — it can be 20 pages long and may take ample time to read and process — spelling out all the opportunities and risks. Can you change your mind after you sign? Sure. You can withdraw from the trial at any point. And, if any
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elements of the trial change once you’re in it, expect to be notified and offered an updated consent form. (With notes from Rosemarie Farrell, manager of clinical research unit, Tom Baker Cancer Centre).
SHARE YOUR EXPERIENCES Cancer research helps us understand how to treat cancer and improve the quality of life for people living with it. Who better to weigh in on this topic than people who have experienced (or are experiencing) cancer first-hand? Increasingly, cancer researchers like Dr. Colleen Cuthbert, a post-doctoral fellow in the Department of Oncology in the Cumming School of Medicine, are asking patients to help them decide where to direct their energy. Cuthbert studies to improve the health and well-being of colorectal cancer patients, and she makes research decisions with the help of priorities identified by patients through Priority Setting Partnerships (PSPs): Groups of patients, carers and clinicians who prioritize future areas of research. The PSP concept originated in the UK and was formalized in 2004 by a non-profit initiative called the James Lind Alliance. The movement has been gaining traction in Canada for about the last five years.
“Patients are the ones affected by their disease,” Cuthbert says. “Through PSPs, we engage with patients in a very meaningful and thoughtful way to ask them what they think is important for future research.”
PRIORITY SETTING PARTNERSHIPS: HOW TO GET INVOLVED Like clinical trials, you can find out about PSP opportunities through information at medical clinics, as well as through social media, community-based support organizations like Wellspring and advocacy groups like Colorectal Cancer Canada. Be sure to ask questions about who is running the study, the goal of the study and the time commitment involved. You’ll go through an informed consent process before participating. Some PSPs are broad, seeking to include any cancer survivors or patients, and others have a more narrow and specific
focus. And unlike clinical trials, participating in a PSP is often a zero-risk activity. You can get involved to the degree that you choose, but there are typically three steps to the process. The first step often entails an online survey, which identifies priorities for future areas of research. You can also choose to engage in the second part of the study, where you’ll help to rank the priorities identified by the first step, and/or in a third step, where you’ll meet with a group of patients and health-care providers to pare the list down. When the PSP is complete, researchers can take a final list of patient-identified priorities to research funders — and possibly change the way future care is delivered. LEAP Find clinical trial opportunities at alberta.cancerclinicaltrials.com. For opportunities and eligibility check out clinicaltrials.gov.
TALK IN G A B O U T T H E T R IC K Y S T U FF
THE POWER OF PEER SUPPORT by JENNIFER DOROZIO
TOGETHER IN A loose circle, in a quiet room, women dealing with breast cancer talk. Some of the women laugh and some cry — yet a positive energy floods the room. This is how Sandy Hammer describes the atmosphere of the Women’s Show and Tell Lounge, a welcoming space for women to pose their questions about breast reconstruction surgery and find support in others who have been there before them. The lounge runs as a part of BRA (breast reconstruction awareness) Day — a national one-day event that runs in select Canadian cities during October, supported by the Canadian Cancer Society and other local organizations like the Alberta Cancer Foundation. Calgary has held a BRA Day every year since 2013, and Edmonton’s most recent BRA
Day was in 2017. “[The feeling] amongst all those women [in the lounge] was empowerment,” recalls Hammer, a six-year volunteer of the event whose own double mastectomy and breast reconstruction surgery took place in 2012. “The funniest thing was that we all decided we would like to show off our new boobs — we wanted people to see them.” Safe spaces and conversations are vital in de-mystifying breast cancer-related surgeries and can take a lot of the fear of the unknown out of the picture, says Dr. Claire Temple-Oberle, a surgeon at the Tom Baker Cancer Centre who specializes in breast reconstruction. The inaugural BRA Day event was held in Toronto in 2012, and in 2013, TempleOberle brought BRA Day to
Calgary. She ran the event for five years — before passing the torch to Dr. Jennifer Matthew — in order to arm women with knowledge and support in an often-overwhelming time. “My main role is to ensure that a woman considering breast reconstruction knows all her options,” says Temple-Oberle. “There’s no pressure from the medical field for women to have reconstruction; it’s just an option with pros and cons.” During the 2015 BRA Day in Calgary, the first Partner’s Lounge opened. It’s a space where partners and caregivers are welcomed to join the conversation around breast cancer reconstruction and its outcomes (so long as they accompany a female or female-identifying partner). “[The lounge] lets people know that they’re not alone
and they can get through this,” says Brenda Smith, who underwent a double mastectomy and breast reconstruction in 2015, with the support of her husband, Jim. Today, Brenda and Jim volunteer together in the Partner’s Lounge in Calgary at the yearly event and field questions from nerve-wracked loved ones, and those facing surgery themselves. Not all people can attend BRA Day, which is why Temple-Oberle refers patients considering breast reconstruction to peer volunteers who have had the surgery, a role that both Sandy Hammer and Brenda Smith perform. “Often a friendship is actually built [between patients and peer volunteers],” TempleOberle says. “It’s really quite a beautiful thing.” LEAP
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TAL KI N G A B O U T D E AT H
FINDING THE WORDS Navigating a life-limiting cancer diagnosis by JENNIFER DOROZIO illustration GLENN HARVEY
KNOWING YOU'RE GOING to die means having a lot of conversations. At least, that’s been Calgarian Jeannie Finch’s experience as she grapples with the surreal knowledge that the glioblastoma (GBM), or tumour in her brain, will gradually steal her away within the next two years or so. She talks with her husband of 40 years, David Finch, about what she’s experiencing. She chats with her daughter — sometimes about dying, sometimes about eyeliner, because that’s easier by comparison. And she chats with her six-year-old grandson, gently mentioning she may not be able to attend his future birthday parties. “I’m trying to do things that have an eternal aspect to them, and I think relationships are that,” says Jeannie, who was handed her life-limiting cancer diagnosis in June 2018. 28 LEAP SPRING 2019
“Almost all of my bucket list stuff is people.” To that end, as a couple, Jeannie and David host a regular gathering at their local neighbourhood pub in Calgary’s northeast, where more talking happens, between friends, colleagues and family. “One woman called pub night a ‘love fest,’” says David. “We don’t talk about Jeannie’s death, it’s just a place for some people to come and see her.” Despite dealing with the unthinkable, both David and Jeannie have actions they take that help them cope, beyond conversation. These include smaller things, like keeping the house tidy, reading books on the dying process and reconciliation, and choosing to laugh together. And larger things, like leaning on their community of friends and family for support, and visiting their counsellor, Kathy Bach Paterson. “In 43 years of knowing each other, there’s been things that we can’t really agree on that [in the past] we’ve just swept under the rug,” says David. “We’ve been able to have those fights in the presence of Kathy and that’s been a gift.” Bach Paterson is a counsellor with Hospice Calgary. The organization runs two centres of care in Calgary: Rosedale Hospice, which is a 24-hour end-of-life care facility for adults with cancer, and Sage Centre, which offers
individual and family counselling services for people living with advanced illness and grief, like the Finches. The latter also provides grief counselling for children, teens and families after any cause of death. Its educational offerings and online resources are for anyone who would like to broaden their understanding of palliative care and grief. “My goal is to be of service and to be fully present with my clients,” says Bach Paterson, who brings several years of experience working as a nurse in palliative care to her role. “I can’t fix [their situation], but if my presence and my facilitation of conversation might help support [them] in some way, for me, it’s a privilege.” Conversations with loved ones are important, but they’re not everything, says Jeannie. Practical matters like palliative care options and end-of-life paperwork must also be considered.
In Jeannie’s case, David will help to communicate her wishes once her ability to speak is diminished. “At times, I really don’t want to be in this situation, but I’m not going to abandon her. I’m not going to run away,” says David. “Death is hard, but also beautiful and full of joy and grace.” LEAP
ADDITIONAL SUPPORT The Sage Centre’s Living with Cancer Program is another service of support. It is a weekly drop-in program for adults with advanced cancer and their caregivers. It runs 50 weeks of the year and features expert speakers on relevant topics, from cancer to end-of-life and everything in between. After a hot-cooked lunch is served, participants enjoy entertainment, such as music, belly dancing, comedy and pet therapy. The program offers peer connections and a strong sense of community.
TALK IN G T O FA M I LY A N D F R IE ND S
LETTING OTHERS IN by COLLEEN BIONDI
COMMUNICATING openly with friends and loved ones can be complicated at the best of times. After a cancer diagnosis, it can become even harder. But sharing information about your health can help the people close to you understand what you are experiencing, garner the support you need and reduce stress and isolation. Dr. Jennifer Pink, a post-doctoral fellow in the department of psychosocial oncology at Calgary’s Tom Baker Cancer Centre, helps patients, as well as their families and friends, to find ways to communicate about cancer that work for them through individual, couple and family counselling sessions and through facilitated support groups. “It is a privilege to be part
illustration CHARLES BURKE of families’ cancer experiences and to help them along,” Pink says. “When a person has cancer it can be a very challenging time, but it can also be a meaningful time and promote opportunities for change and growth.” According to Pink, it can be helpful for everyone affected by a cancer diagnosis to continue to communicate — research shows that people close to cancer patients often have “similar or higher levels of stress” than the patients themselves. One way to mitigate that stress is for patients and loved ones to talk openly and honestly. Let’s say, for example, that a person with cancer would ordinarily enjoy a weekly workout with friends. But if that person is going through treatment and feeling fatigued
or nauseated, they may not be interested or able to keep up that routine. If their friends know this, they will understand why the person is cancelling, and can suggest an alternate plan, like a quick visit over tea. But patients may be afraid to disclose such intimate information for fear of negative responses or a perceived lack of support. Indeed, well-meaning friends may say things that are intended to be helpful (“Just be positive,” or “Don’t worry”), but that actually come across as dismissive and hurtful because their simplicity does not begin to acknowledge the profound and complex nature of the disease. Alternatively, the friends may be so paralyzed by their own anxiety about the situation that they don’t say anything at all.
“We are not really taught about how to respond to people who are experiencing a serious illness,” says Pink. “That is not a course we take in school.” However, the benefits that people with cancer experience when talking with trusted loved ones about such things as their diagnosis, the sideeffects of treatment, changes in physical appearance or other challenges can far outweigh the risks. Letting others in brings greater support both to the patient and to their loved ones. Email, Pink says, can be a convenient framework for updates. A family member or friend can compose an email on behalf of the person with cancer, with their input, and send it out regularly. But, Pink advises, it’s important >
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to be cautious with social media platforms like Facebook and Twitter, where personal information may be viewed and forwarded broadly without permission. For more casual connections — a colleague or a new friend, for example — Pink advises patients to try writing out scripts, especially when feeling unprepared about discussing their diagnosis. That way, they’ll be ready when people ask, “How are you?” In these cases, Pink says it’s also okay to just mention one or two bits of information, such as, “I have cancer and am taking treatment.” Then, if people ask further questions you do not wish to answer, repeat the initial comment. “Feel free to be a broken record,” says Pink. “There is no one right way to talk about cancer. It’s [the patient’s] story to share.” LEAP
ENGAGING WITH FRIENDS WHO HAVE LOST A LOVED ONE TO CANCER • Acknowledge the loss with quick texts like: “Thinking of you.” “I know it is hard.” “Let me know if you need anything.” All convey caring and concern. • Don’t be offended if recipients don’t respond or decline invitations. Don’t badger them. • Issue an invitation to social events, but don’t worry if they cancel at the last minute. They are likely in self-preservation mode. • Do not pretend to know what is best for them. Comments like, “You just need to get out of the house,” or “Come over for a few beers and get it off your mind,” are hugely insulting to the very real suffering they are experiencing. • If they do attend an event and act out of character, be kind and forgiving. Grief is a messed-up journey. • Consider visits or outings that involve physical exercise. • Always act with empathy and compassion. Let your friends define their own social boundaries. Thank you to Todd Kemper, who lost his wife, Linnea, to breast cancer in 2014. He created this list.
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“ THERE IS NO ONE RIGHT WAY TO TALK ABOUT CANCER. IT’S [THE PATIENT’S] STORY TO SHARE.” – DR. JENNIFER PINK
PATIENT ADVISOR BRAD INKSTER
TALKIN G A B O U T A D V O C A C Y
SPEAK UP, SPEAK OUT Two committees at the Central Alberta Cancer Centre are focused on discovering how to improve patient care — by asking the patients by VICTORIA LESSARD photography COOPER & O‘HARA
ONCE A MONTH at the Central Alberta Cancer
Centre in Red Deer, a group of staff members including nurses, an occupational therapist, a dietitian, managers, and Darcie Flanders, the community oncology social worker, gather to discuss how they can improve patient care in the facility. Called Communities of Practice (CoP), the group looks at different ways in which patients can have better experiences. Launched as a provincial program in 2013 (with help of oncology social worker and provincial program lead Tricia
Hutchison) the CoP program has been operating in Red Deer since 2015. And it was in March 2018 when the Red Deer group first began searching for input on patient care from the patients themselves. One of those patients is Brad Inkster, who considers himself an advocate for his fellow patients in his role as a patient advisor with the CoP. Inkster hopes that by sharing his story, the patient’s perspective will be better understood by those who are on the other side of cancer care. He is adamant that patients need to speak up. “If you’re not your own personal advocate, you’re not going to get the help you need,” says Inkster. In 2008, Inkster underwent treatment for kidney cancer. During that time, his doctor noticed a spot on his lung. After a few months of monitoring, Inkster was informed the spot wasn’t growing, and no further steps were taken. But, in 2016, the spot had grown, and his doctor decided to do a biopsy. Days later, Inkster’s lung collapsed, and he was officially diagnosed with lung cancer. After it was discovered that the cancer had spread to the exterior of his lungs, Inkster was referred to an oncologist. He went two months without any word on when he would be able to see the doctor. > myleapmagazine.ca SPRING 2019 LEAP 31
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When he finally saw his oncologist, Inkster was told that his lung cancer was terminal. “I was rather shocked and mad that it went from, ‘We’ll just leave [the spot] alone and keep checking [it]’ to now ‘You’re done,’” says Inkster. After discussions with a medical oncologist and radiation oncologist, a different treatment plan for Inkster — who was 58 years old and otherwise in good health — was created, including chemo and radiation. He’s now in his third round of chemo. For Inkster, speaking up about his various concerns has been an important part of his journey. “It’s helped me push myself more,” he says. “The advocacy makes me want to fight harder.” Patient feedback like Inkster’s has helped the CoP confirm areas where they can change strategies, particularly when it comes to communication. In some cases, feedback has also confirmed the veracity of provincially mandated changes already in the works, including examining the referral process. But the CoP is looking at other changes to patient communication, too, including creating different ways of dispersing information, such as running informative slides on TV screens throughout the facility. The Central Alberta Cancer Centre has recently implemented another way in which patients can have an impact on the facility — the Patient Experience Committee. Organized by CancerControl Alberta, the committee is made up of patients and family members who have been treated there, as well as staff. The goal is to bring committee members on-site regularly so that staff members at the Central Alberta Cancer Centre can approach them to get feedback right away on proposed changes to the patient experience. Naomi Hanna is one of the four patient advisors sitting on the newly formed committee, and she’s looking forward to bringing her perspective. “I would like future patients to understand that they have [a] voice. And that people will listen to them,” says Hanna. LEAP 32 LEAP SPRING 2019
“ THE ADVOCACY MAKES ME WANT TO FIGHT HARDER.” – BRAD INKSTER
TALK IN G T H E TA L K
GLOSSARY OF COMMONLY-USED TERMS ACUTE A medical condition that comes on quickly and often involves severe, but brief, associated symptoms. BENIGN TUMOUR A non-cancerous, slowgrowing tumour that does not spread to the rest of the body. BIOPSY Removing specific cells or tissues in order to study them. A liquid biopsy studies fluids like blood or urine. CANCER A variety of diseases that happen when abnormal cells grow together and spread quickly. CHEMOTHERAPY Also called Systemic Therapy, a type of cancer treatment that involves special drugs, usually a combination of a few, that attack cancerous cells.
IMMUNOTHERAPY A treatment method that stimulates/suppresses a patient’s own immune system to aid the body in fighting cancerous cells. MALIGNANT TUMOUR A tumour made up of cancerous cells that can spread to surrounding tissue and beyond. METASTASIZE Cancerous cells spreading to one or more sites in the body, usually by way of the blood or lymphatic system. RADIATION THERAPY Cancer treatment that involves the use of highenergy radiation, including from X-rays or gamma rays and others, to kill cancerous cells and reduce tumour size. REMISSION When cancer symptoms disappear or are significantly reduced.
STAGES Staging systems classify a cancer based on where it is in the body, the size of the tumour(s) and how much of it has spread. Assigning a stage helps to plan treatment, predict prognosis and determine how well the treatment will work. It is also a way to create groups of people to study and compare in clinical trials. Depending on the type of cancer, different staging systems are used and can include numbers or Roman numerals. TNM STAGING SYSTEM In Canada, the TNM staging system is one of the most commonly used to categorize the level of cancer in the body. It stands for “tumour, lymph nodes and metastasis.” While each letter of TNM can be assigned a separate specific number, generally, doctors will assign an overall number to the cancer according to the following:
STAGE 0: the earliest stage where abnormal cells have not entered the surrounding tissue. STAGE 1: usually includes a small tumour that has not spread. STAGE 2: usually means that the tumour is larger than stage 1, but has not yet spread. STAGE 3: the tumour is larger than the previous stage and may have spread to surrounding muscle or lymph nodes. STAGE 4: usually means the cancer has spread to other parts of the body through blood or lymphatic system. TUMOUR A group of abnormal cells that grow together in a mass or lump. Can be “benign” or “malignant”.
5 COMMUNICATION TIPS FOR PATIENTS DO
Enlist a backup listener for important appointments. The My Care Conversation app, supported thanks to Alberta Cancer Foundation donors and available on iTunes, is a great way to record conversations with your cancer care team.
DON'T
DON'T
DO
DO
Keep your questions to yourself. Stay connected to your family doctor throughout your treatment.
Google-research your condition.
Embrace psychosocial and wellness supports.
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CARING
CARE COORDINATORS Working together to help head and neck cancer patients stay nourished by HANNAH KOST
MAINTAINING PROPER NUTRITION IS A VITAL COMPONENT OF CANCER
treatment. Research suggests malnutrition impacts up to 80 per cent of cancer patients, and some studies indicate the likelihood of survival is decreased if a patient experiences as little as a 5 per cent drop in weight. Eating well and regularly helps patients maintain the energy stores necessary to complete invasive procedures such as surgery, chemotherapy and radiation. Head and neck tumors, such as tumors of the tongue, tonsil and throat, can cause difficulty eating and swallowing. Swallowing difficulties can deprive patients of sharing meals with loved ones and increase risk of malnutrition — often resulting in social isolation, depression and weight loss. Weight loss can be detrimental, delaying procedures or even halting treatment entirely. At Edmonton’s Cross Cancer Institute, the complex challenge of helping patients with head and neck cancer return to normal eating is tackled by a group of four professionals — dietitian Patty Tachynski, speech-language pathologist (SLP) Anna Sytsanko, nurse practitioner Karmen
PATTY TACHYNSKI (MISSING FROM PHOTO: BEV MANGANO, REHABILITATION ASSISTANT)
KARMEN SCHMIDT
PHOTO AARON PEDERSEN
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Schmidt and rehabilitation assistant Bev Mangano. This team coordinates their disciplines to customize treatment and help alleviate symptoms for head and neck patients. “The patient doesn’t walk through treatment with one professional,” says dietitian Tachynski. “They actually often need several to get them through.” Tachynski’s job is to identify patients who are at risk for malnutrition and to help them maintain their nutritional status during treatment. One obstacle for Tachynski is that, for head and neck patients, the nerves and muscles that generate swallowing can be impacted by the cancer itself. Inefficient swallowing can be dangerous, causing patients
ANNA SYTSANKO
to choke on food or inhale liquids. It also disrupts caloric intake, heightening the threat of malnutrition. To stave off this dangerous symptom, Tachynski works closely with SLP Anna Sytsanko, who sees patients with concerns about swallowing and communication. The therapy Sytsanko provides is crucial, first assessing why the patient struggles to swallow before targeting and strengthening muscles with exercises that can enable them to eat. Relying on each other, Sytsanko says, is necessary to optimize care; it allows the team to understand patients — and their needs — comprehensively. “You need to see the person as a whole, and
treat swallowing difficulties in that framework,” Sytsanko says. When medical issues emerge that fall outside Sytsanko and Tachynski’s expertise, they are supported by nurse practitioner Karmen Schmidt, who manages complications such as pain, infections and feeding tube referrals, which head and neck cancer patients sometimes require. “I value the skillset that my colleagues have, and that I’m able to consult with them, discuss with them, learn from them, and collaboratively come up with a plan for our patients,” Schmidt says. Working mostly behind the scenes to assist the others is rehabilitation assistant Bev Mangano. She sometimes sees patients for swallow or speech practice, but primarily keeps days organized and appointments running smoothly for the team. She also helps patients avoid social isolation during and after treatment, connecting those living too far to commute to the Cross with Telehealth videoconferencing sessions and arranging group therapy for patients seeking support. Together, the team works within the larger operation of the Cross, coordinating with oncologists, nurses and many others. Within this spectrum of care, the team of four not only strives to provide the nourishment patients need during treatment, but also helps them take part in meals with family and friends again — feeding the body as well as the soul. “No one can do it alone; we work together every day,” Sytsanko says. “And our care revolves around the patient.” LEAP
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LIVING WELL
Surviving and Thriving After three cancer diagnoses, Frank Lightbound reflects on what “survivorship” means to him by JENNIFER FRIESEN
THERE IS NO DENYING THAT FRANK LIGHT-
bound is a survivor — that was clear long before he first heard “you have cancer” 32 years ago. As a park warden for six years and a forest ranger for 26, Lightbound, who lives in Lethbridge, travelled around Alberta by horseback, snowshoe and on foot. During that time, he found himself in many dangerous situations before retiring in 1985. “I was almost killed in a few situations in the field, so I must be a survivor,” he says. “I was in a lot of big fires in Northern Alberta — long hours under dangerous situations, but I came through with flying colours. I think that had a lot to do with me persevering through cancer now.” During a routine medical exam when he was 55, Lightbound’s doctor was concerned by an unusually high white blood cell count and sent him off for a series of tests. Soon after, his doctor told him the news: he had lymphocytic leukemia. “I remember thinking, ‘Wow, isn’t this well times,’” he says. “I just retired, and I get this news?” Surprisingly, that first cancer diagnosis wasn’t an isolated incident. Since then, Lightbound has been diagnosed with two other kinds of cancer. His second diagnosis occurred at the age of 62, when cancer was found again. “One day at a doctor’s appointment, he told me flat out that I had prostate cancer,” Lightbound says. “He gave me three choices and it was my decision what to do: surgery, radiology or nothing. But I didn’t
CANCER SURVIVOR FRANK LIGHTBOUND, AT HIS HOME IN LETHBRIDGE
have any trouble making the decision, I wanted that thing out.” Lightbound went into surgery in June 1994 and left the hospital prostate cancer-free nine days later. “I’m kind of an old hand at being told that I have cancer,” he says. “When the doctor said he thought I had skin cancer two years ago, honestly, I just thought, ‘Oh, here we go again.’” Currently, there are approximately one million Canadians who have survived cancer for more than 10 years, and the idea of “survivorship” has recently become more common among health-care professionals. The concept focuses on life after treatment, meaning that care is important not only during diagnosis and treatment, but in life afterwards, too. Continued care, during and after a can-
cer diagnosis, has become more of a focus in health care in recent years, and it’s something Lightbound, who received his cancer care at the Jack Ady Cancer Centre in Lethbridge, says he’s grateful for. “It makes all of the difference to have the support of the medical people around me,” he says. “It’s almost like they’re personal friends, and it’s comforting to be amongst those kinds of people.” Lightbound’s experience has inspired him to give back. He has included a gift to the Alberta Cancer Foundation in his will. Today, at 87 years old, Lightbound is still going strong. When asked how he’s feeling now — after a lifetime of battling the elements, wildfires and three different kinds of cancer — he says, “Old! But I got a lot further already than I ever thought I would. So, I must be a survivor.” LEAP PHOTO WES BELL
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August 27, 2019 Country Hills Golf Club, Calgary
Become a Sponsor Today! 3rd Annual Alberta Cancer Foundation Golf Classic We invite you to join us as a corporate partner on August 27, 2019 at the Country Hills Golf Club. Together, we have the power to change lives, one swing at a time. To learn more, please contact Michelle Body at michelle.body@albertacancer.ca or at 403.476.2421 albertacancer.ca/acfgc
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DR. CORINNE DOLL AND HER TEAM ARE COMMITTED TO THE BETTER UNDERSTANDING AND TREATMENT OF CERVICAL CANCER
ROCK S TA R RESEARCH
by JIM ZANG photography JARED SYCH
D
r. Corinne Doll, radiation oncologist and researcher at Calgary’s Tom Baker Cancer Centre, and the leader of a research team studying cervical cancer, knows that the stand against cervical cancer takes teamwork. “I realized long ago that to answer key questions, you have to have the right people on your team,” she says. >
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The goals of Doll’s research are to uncover molecular causes of radiation and chemoradiation resistance, and to explore new techniques for treating patients with cervical cancer. Her team is currently involved in image-guided brachytherapy for cervical cancer — a type of internal radiation that uses MR imaging and advanced treatment planning to deliver precision radiation therapy to malignant tumours via a radioactive isotope. This involves a specialized team including radiation oncologists, gynecologic oncologists, medical physicists, nurses and more. “Cervical cancer remains a significant worldwide health challenge,” Doll says, explaining that it makes up over onethird of HPV-associated cancer in women. “And, we know that other types of human papillomavirus (HPV)-associated cancers are rising in incidence. So, the knowledge we generate from this research may assist us in understanding and treating other types of cancers, since other HPV-related cancers are commonly treated with high dose radiation and chemotherapy.” According to AHS statistics, between 2006 and 2015 there was an annual average of 155 cases of cervical cancer diagnosed in Alberta. Although the majority of cervical cancers are diagnosed at an early stage thanks to early detection through screening programs, about one-third of patients present with more advanced disease, and innovative treatment options — like image-guided brachytherapy — are providing these women with more hope than ever before.
AN EARLY PASSION
Doll’s interests in medicine and patient well-being started early. She was born in Winnipeg, the middle of three sisters. Her dad was in property management and her mom was a nurse. “I loved hearing about my mom’s experiences with patients,” she says. “And I also liked science. I always knew I’d have a job that involved science and technology.” 40 LEAP SPRING 2019
When Doll was five, the family moved to North Vancouver, where the future Dr. Doll eventually attended the University of British Columbia, earning a BSc in microbiology. After working in clinical and testing laboratories, she became interested in the clinical context of her lab work and decided to pursue medicine. Doll attended medical school and completed a radiation oncology residency at UBC. She discovered radiation oncology after being awarded a summer research grant with Dr. Ivo Olivotto at the BC Cancer Agency in Vancouver.
“ [BRACHYTHERAPY] IS THE ULTIMATE IN PRECISION RADIOTHERAPY, ALLOWING CUSTOMIZED PLACEMENT AND DOSING TO MEET AN INDIVIDUAL PATIENT’S NEEDS.” — DR. CORINNE DOLL
“I was amazed at how the specialty combined so many of my interests — including physics, technical and procedural skills and biology. But I was most impressed with the time spent with patients, and how this type of treatment could save lives.” Medical school was followed by a CARO Fellowship Award and Clinical and Research Fellowship at Princess Margaret Cancer Centre in Toronto, where she honed her skills in brachytherapy and in clinical and translational research. Doll moved to Calgary in 2001, after hearing about the opportunities at the Tom Baker, including the potential for research support, from colleagues. “I applied for a radiation oncologist position, and began working in the gynecologic and gastrointestinal cancer tumour groups,” she says. Doll’s research at the Tom Baker has
included identification of biomarkers — such as tumour proteins, immune markers and genetic mutations — in cervical cancers that predict response to radiation or chemoradiation. Further research with Dr. Susan Lees-Miller at the University of Calgary showed that PIK3CA mutation, specifically, renders cell lines resistant to standard chemotherapy. “We determined that a PIK3CA mutation in a patient’s tumour [could potentially] increase the risk of death,” Doll says. This understanding of tumour biology and mechanisms for treatment resistance could open up new avenues of research, and potential clinical trials, for cervical cancer patients and also for those with other HPV-associated cancers.
A NEW APPROACH
Doll’s past work has helped lead her to today, where her team is preparing to launch an international study, supported by the Alberta Cancer Foundation, in image-guided chemoradiotherapy using adaptive brachytherapy. “Basically, this is a study where we aim to optimize and customize all aspects of cervical cancer patients’ treatment, with the overarching goals of improving outcomes and enhancing quality of life by reducing toxicity,” says Doll. This approach is centred around brachytherapy, which involves the temporary insertion of a tiny radioactive source called iridium. “[It’s] about the size of a grain of rice within catheters,” she says. “[It gets] as physically close to the malignant tumour as possible, targeting the affected area in a more customized way than traditional methods.” The intent, she explains, is better visualization, optimized catheter placement, and enhanced shaping of doses to be delivered to specific areas of tissue. “It’s the ultimate in precision radiotherapy, allowing customized placement and dosing to meet an individual patient’s needs.”
She is hoping that the clinical trial, which will include patients with locally advanced cervical cancer who could benefit from curative-intent chemoradiotherapy, will be open by the end of 2019. Overall, Doll’s research holds a lot of potential for tailoring treatment by using image-guidance techniques, personalizing therapy based on patient characteristics and/or tumour molecular features, and exploring methods to reduce the side effects of treatment, such as effects on the bladder and gastrointestinal tract, as well as aiming to improve quality of life. Another important aspect of Doll’s multidisciplinary collaboration is after-care support, offered through OASIS — the Oncology and Sexuality, Intimacy and Survivorship Program, initially funded thanks to the generosity of Alberta Cancer Foundation donors, and now a care program at the Tom Baker — a team that Doll is proud to be a part of. For Doll, who is also a mother of two, her work with cancer has become a lifetime commitment. She’s recently been named deputy medical director at the Tom Baker, and is incoming president of the Canadian Association of Radiation Oncology, starting October 2019. “I have been involved in cervical cancer research for almost 20 years,” she says. “I’m looking forward to continuing in my clinical care roles and exploring research opportunities to improve patient outcomes.” In the meantime, the best treatment for cervical cancer, she says, is prevention. “The majority of cervical cancers could be prevented through HPV vaccination in addition to regular screening (including Pap testing) and follow-up. Outcomes are becoming better and better with advanced treatments resulting from research. “However,” she says, “the reality is cervical cancer has not disappeared, and many Albertans are still dying from this disease. We need to do better. Teamwork is how we get there.” LEAP
7
QUESTIONS WITH DR. CORINNE DOLL
1. Describe what you do in 12 words or less.
3. Where do you get your best ideas?
2. What’s the biggest misperception about what you do?
4. If you weren’t at your current job, what would you be?
I am a radiation oncologist, treating patients with gynecologic and gastrointestinal cancers.
One of the misconceptions is that my job must be very sad, given that I work with patients with cancer, and another incorrect assumption is that radiation is only for palliation. On the contrary — there are many radical, curative intent treatments that we offer with radiotherapy, with very positive outcomes.
My best ideas come during either quiet reflective times or during lively discussions with my colleagues.
I can’t imagine doing anything else. I tell my kids that I have the best job in the world.
5. What is the hardest lesson you have learned along the way?
Sometimes treatments are not effective, and sometimes they cause long-term issues for patients. I think that creates passion and motivation to do better.
6. What motivates you?
The patients I meet in my clinics. And the excitement and enthusiasm of the research teams that I’ve had the pleasure of working with, especially when we identify new discoveries. 7. Why does your research matter?
The identification of tumour and patient factors which may predict response to conventional treatment, identify new types of treatment, or even de-escalate treatments to reduce toxicity, is meaningful because the end result is better outcomes and reduction in treatment-related toxicities. Our hope is that this will give the patient and their family better quality of life.
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TRUE CALLING
IMPROVING PATIENT EXPERIENCE Michael Civitella, executive director of operations and facility development for the new Calgary Cancer Centre, looks back on his distinguished career in health-care administration by SHANNON CLEARY
M
ichael Civitella began his path toward patient care at a hospital in his hometown of Montreal. In the summers between undergraduate semesters at McGill University, a young Civitella moved from one seemingly unrelated post at that hospital to another — a stint as an orderly, a job in the x-ray department, physiotherapy, the kitchen, maintenance and many others. >
PHOTOS JARED SYCH
42 LEAP SPRING 2019
MICHAEL CIVITELLA AT THE TOM BAKER CANCER CENTRE IN CALGARY
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“I had quite a general orientation by replacing people who were on vacation,” he says. This medley of roles was not random, but by design. Civitella recalls a particularly supportive human resources worker, perhaps one of his earliest professional mentors, who saw something in his curiosity and drive that was worth nurturing. “For some reason, she felt I was sincere,” he says. “She tried to help me by placing me in different departments so I could get a better understanding of the system.” Civitella was studying biochemistry at McGill, which he enjoyed, but he preferred tasks that brought him out of the lab. He liked working with people — he was good at it, in fact — and he liked discovering ways to make things better. When he researched a career in hospital administration, Civitella says he found his calling. “Trying to lead an organization in health care and have an impact on people, on a community,” he says. “’I thought, ‘Gee, that’s probably what I’m all about.’” Civitella’s parents immigrated to Canada from Italy in the 1950s — his father was a carpenter and his mother managed their three sons and family life at home. Neither had any formal schooling, but they encouraged and enabled their kids to pursue an education. After graduating from McGill with a bachelor of science, Civitella moved to Edmonton in 1979 to attend the University of Alberta (U of A). At the time, U of A was one of the few schools in North America that offered a graduate program in health services administration. Acceptance to the master’s program was a huge accomplishment for Civitella, one that rewarded him with stimulating curriculum, world-class professors, and peers who eventually became colleagues, fellow leaders in the field and friends. Among those friends and colleagues is Dave Bilan, a former VP in collaborative practice, nursing and health professions for Alberta Health Services. His 40-year friendship with Civitella began in grad school and has grown to encompass their families, as well. 44 LEAP SPRING 2019
CIVITELLA HELPED RAISE MORE THAN $100,000 FOR THE ENBRIDGE RIDE TO CONQUER CANCER
When it comes to caring for patients, Bilan finds Civitella’s sincerity palpable. “Patients and patient-care have always been at the forefront of everything he does,” says Bilan. “When you sit down and have a discussion with him [about work] … what comes up first is how to do better for the patient’s experience. He’s had a very long and successful career, for all the right reasons.” Civitella’s career in patient care spans four decades and is bookended by two of the province’s largest health facility projects. In his first job following his master’s program in 1981, Civitella landed the roles of financial planning manager and executive assistant to vice president planning and development of the $420 million Walter C. MacKenzie Health Sciences Centre in Edmonton. He credits the late J. Gordon Pincock, his boss at the time, for involving him directly in the planning, construction and commissioning process. For a newly graduated Civitella, it was a master class in capital health infrastructure. Following the MacKenzie project, he moved east in 1987, first to Winnipeg,
where he was business administrator in the Department of Surgery at the University of Manitoba and its Health Sciences Centre. There, Civitella implemented significant change to the Clinical Practice Group, moving the department from a deficit to a $1 million surplus. From 1990 to 1993, Civitella was the chief operating officer for the Thunder Bay Regional Cancer Centre, where he spearheaded the creation of a service plan as the cancer facility expanded. After three years at the TBRCC, he accepted the position of executive director of Wesway, an organization in Thunder Bay that offers short-term respite care to families whose loved ones live with disabilities or chronic health conditions. “During that time, Wesway was ahead of so many other similar agencies in the world,” says Civitella. He highlights his five years at Wesway as one of his most formative experiences. In 1995, he planned and hosted the first international conference on respite, now known as the International Short Break Association conference, as a way
to exchange and promote best practices in care. The conference has since become a biannual event, and has been held in Australia, Canada, the U.S. and throughout Europe. Civitella returned to Alberta in 1998 after Dr. Gavin Stuart, who was the director of the Tom Baker Cancer Centre in Calgary at the time, hired him to manage the final stages of the centre’s expansion. Civitella spent 10 years in leadership roles at the Tom Baker, eventually becoming executive director in 2009. For more than a decade, Dr. Peter Craighead, a radiation oncologist, worked in tandem with Civitella as the medical director of the Tom Baker. He valued Civitella’s talent as a “strategic thinker” as they improved the structure and function of the centre. “His understanding of health care is very vast,” Craighead says. “He truly understands what it means for a cancer centre to look after patients.” One of the many impacts of their partnership was starting the discussion and developing a plan for implementing a more formal tumor group model in patient care — a multidisciplinary group of care providers who meet regularly to discuss all care aspects of a patient’s plan. Made up of surgeons, radiation oncologists, medical oncologists, nurses, and psychosocial team members, this group, with the help of designated coordinators, works together to ensure patients with any care-related concerns are connected to the right person at the right time. “I’m a big believer in trying to individ-
ualize the care as much as possible,” says Civitella. “Rather than people fitting the programs, we can look at every individual and see how we can serve their individual needs.” Today, Civitella is the executive director of operations and facility development for the new $1.2 billion Calgary Cancer Centre (CCC) design-build project, a role he has had since the project’s inception in 2014. Expected to be fully operational by 2023, the massive, state-of-the-art health care facility and academic centre will consolidate and expand cancer care in southern Alberta. Civitella and his team are reaching the end of the design phase of the CCC, which began construction in 2017. He has worked with construction, government, administrative, medical and patient groups to identify the requirements for all programs, departments, and services in the new facility, and to make sure those requirements are reflected in the design. Over the next three and a half years, the team will begin the crucial operational planning phase, where they develop the centre’s overall operational plan, determining how staff and patients will experience their new environment. It’s a challenging undertaking but, as Civitella puts it, it’s fundamentally about working with people and finding ways to make things better. “In health care, you’re part of different teams. Some you lead, some you support. It doesn’t matter what my title is, I have to make sure that I’m part of a strong team,” he says. “I’ve been blessed in terms of being able to have some great people
to make a big difference for the cancer community here in Calgary.” The new Calgary Cancer Centre is estimated to take occupancy in 2023. Civitella imagines those first days: He sees a world-class building that accommodates research, education, and patient and family-centred care; staff who are supported and strengthened by their new space; and patients who “feel as though they’re being looked after even better than before” in their cancer care journey. The completion of the CCC will likely coincide with Civitella’s retirement, which he says he will use to do more of what he loves: spending time with his wife, children and two grandsons, and pursing hobbies such as sports, travel, pottery, wine-making, and cooking. In a moment of reflection, Civitella says, (albeit hesitantly) that he is proud of his role in improving patient experience in Alberta and Canada throughout his career. He is also quick to credits others — his mentors, his peers, his family and friends, the HR person who saw something in him when he was young and, especially, his parents. “I was so fortunate to have loving parents,” he says. “They did everything they could to encourage me.” For Civitella, it has never been a question of whether he, or any of us, can make things better. It’s just a matter how to get there. He says his late mother lived by this belief. “She had little to give, but gave a lot,” he says. “I think that would be the thing I remember about her. You can give in so many ways to make a difference.” LEAP
MAJOR CAREER HIGHLIGHTS 1993-1998
1999-2014
2012-2016
2012-2016
Executive director at Wesway, a respite care provider in Thunder Bay, Ont. Led a system-wide redesign process, earning the organization international recognition in delivering individualized services for families.
Various leadership roles at the Tom Baker Cancer Centre in Calgary, including managing the rapid growth that followed the centre’s expansion and working to develop its acclaimed academic program.
Participant in five Enbridge Ride to Conquer Cancer rides as a member and former team captain of the Tom Baker Cancer Conqueror team, raising more than $100,000 for the team.
Executive director of operations and facility development at the Calgary Cancer Centre, supporting the journey of the new facility in Calgary, which will enhance the patient and staff experience.
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IMPACT
CANCER SURVIVOR TED POWER PARTICIPATED IN THE MOBILI-T DEVICE CLINICAL TRIAL
A First-Head Experience with the Mobili-T Clinical Trial as told to JENNIFER DOROZIO
In 2017, Ted Power underwent a long surgery during which 25 per cent of his tongue was replaced with tissue from his arm in order to remove the stage 4 squamous cell carcinoma present in his tongue and lymph nodes. For Power — like many head and neck cancer patients who have received radiation therapy or have undergone surgery — eating, speaking and swallowing became a struggle. However, this past December, Power enjoyed
tucking into Christmas dinner with his family. He credits the ability to enjoy his meal to Mobile Technology (Mobili-T), a daily head and neck function re-training device. Mobili-T was developed by a team of clinicians, engineers and industrial designers under the guidance of Dr. Jana Rieger, a professor and clinician in the faculty of rehabilitation medicine at the University of Alberta. The technology was funded by the Alberta Cancer Foundation. The pocket-sized tech attaches to the chin and, through its corresponding app, prompts the wearer to perform swallowing exercises, as a targeted way to regain movement and strength. Power personally saw direct improvements thanks to the six-week clinical trial he participated in using Mobili-T, and he shares that experience here.
“I’m the president of a number of different companies [and] have to speak to customers and employees all the time. That’s what I do. It’s a critical part of my abilities overall. “[After surgery] I had to retrain my muscles how to swallow and how to speak again. Eating became a chore, it took hours to eat a meal. I was unaware of the Mobili-T device that Dr. Rieger had developed at the University of Alberta (U of A). “A friend of mine [told me to look into Mobili-T], so I met with the U of A and became a member of the [clinical trial]. It was a six-week program where you utilize the Mobili-T device on your chin, and it communicates with a cell phone. You do exercises to improve your swallowing and see the results on your cell phone as you’re doing it. “There is another device that works the same as the Mobili-T at the clinic at the Cross Cancer Institute, but it’s about the size of a refrigerator, so you can’t take it home with you. I was able to take Mobili-T to my office and literally do my exercises while I was sitting at my desk. It’s amazing. “After three weeks I started to get better. I was able to have Christmas dinner, I had turkey and mashed potatoes because of Mobili-T. It worked for me and I know it will work for other people. “I would hope that all of the people who have had head and neck cancer, and have the same problems I had, have an opportunity to use Mobili-T.” LEAP
MOBILI-T DEVICE FAST FACTS Mobili-T is 4 cm x 4 cm x 2 cm, about the size of a matchbook // Mobili-T was developed by researchers at the Institute for Reconstructive Sciences in Medicine at the University of Alberta // Mobili-T weighs 27 grams, equivalent to 5 quarters // The Alberta Cancer Foundation contributed $1.9 million in funding to Mobili-T PHOTO PAUL SWANSON
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WHY I DONATE
Lifelong Philanthropists by COLLEEN BIONDI
For the Charbonneau family, giving back is a tradition > PHOTOS PAUL SWANSON
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JOAN CHARBONNEAU, AT HER HOME IN ALBERTA BEACH, IS A COMMITTED DONOR TO THE ALBERTA CANCER FOUNDATION
AT 81, JOAN CHARBONNEAU HAS ENJOYED
wearing many hats during her lifetime. Formerly a nurse, Joan is a mother, grandmother and great-grandmother, an avid golfer, bridge player, traveller and a passionate advocate for persons with mental disabilities (her son, Dean, 53, was born with Down syndrome). For the last three decades, she has also been a committed donor to the Alberta Cancer Foundation. Like many donors, the rationale for this long-term relationship is a personal one. Joan’s granddaughter, Taylor, died of childhood leukemia in 1996. Two years later, her husband, Ken, died from complications related to prostate cancer. “Donating to the Alberta Cancer Foundation is very important to our family,” explains the resident of Alberta Beach. “Losing a granddaughter at the age of four is something you never get over. It is part of our legacy to her (and to Ken) to help others.” This mission started back in 1990, when Ken was undergoing treatment for cancer. His company, Metals West, began sponsoring the 18th hole during the Cross Cancer Institute’s annual golf tournament at the Derrick Golf and Winter Club in Edmonton. After Ken’s death, Joan continued the sponsorship. While she golfs during the event, her daughter, Tana, and one of her six grandchildren, oversees the hole, which is now called the Charbonneau Memorial Hole. The hole has a unique feature — golfers imbibe in an assortment of pre-made shooters (B-52s are popular) in memory of Ken, and cookies, chocolate chip or oatmeal, in memory of Taylor. “Ken believed there needed to be booze at his hole,” says Joan. “And the funny combination gives us the opportunity to talk about our story and cancer’s impact on a family.” Joan’s own story began on a farm outside Daysland, Alta. She and her family moved into town when she was five. She 48 LEAP SPRING 2019
took her nursing training at the Royal Alexandra Hospital and practised as an operating room nurse for a time before staying home to look after two daughters and Dean. “It was a challenge back then to find after-school care for children with disabilities,” she says. While parenting at home, she became president of Inclusion Alberta and vice president of the Canadian Association for Community Living. She was poised to become president when Ken became ill, and she turned down the opportunity to care for him. “I learned a lot during my terms and my involvement benefitted Dean as well.” Today, Dean — who lives with Joan’s youngest daughter, Michelle, and her teenage twins — is retired from the recreation facility at the University of Alberta, where he worked in the equipment room. He now spends his days working out, on a stationary bike and with weights, at his
local gym. Tana, 55, works as a vice principal and Michelle, 50, is an accountant with the City of Edmonton. In addition to the annual golf tournament sponsorship of $3,000, Joan gives $100 per month to the Foundation and makes donations in memory of friends and family members who die of cancer. She has also made a planned giving arrangement in her will. “I don’t believe in giving flowers,” she adds. “I think it is a much better use of dollars to donate to worthwhile charities. The Cross Cancer Institute and the Alberta Cancer Foundation are nearest and dearest to my heart.” Joan encourages others to donate to research, treatment and support initiatives related to cancer experiences. “Cancer affects every family, and it is such a complicated disease,” she says. “If we can find a cure, it would be a wonderful thing. Any help that we can offer is moving in the right direction.” LEAP
MY LEAP
U OF C STUDENTS SHAVE THEIR HEADS FOR CANCER
A Close Shave As the organizer of this year’s Medshave event, Daniel Bailey helped raise $35,000 for cancer care and research by CAITLIN CRAWSHAW
DANIEL BAILEY IS ONE OF THE LUCKY ONES. UNLIKE MANY ALBERTANS,
the 22-year-old, first-year medical student at the University of Calgary (U of C) hasn’t been impacted by cancer personally. But as part of his studies, Bailey has been shadowing doctors at the Foothills Medical Centre and says the number of patients being treated for cancer is shocking. “It affects a lot of lives there,” says Bailey, who was particularly affected by his experience following a hematologist (a doctor specializing in diseases of the blood, including cancers like leukemia and lymphoma) on her rounds. “The number of patients she saw every day with cancer — and the impact of it — just blew me away,” he says. One of these patients was a 19-year-old woman with a particularly aggressive form of lymphoma. Despite her good prognosis, the visit left him feeling unsettled: “It hit me hard because my sister is 19.” When Bailey was given the opportunity to organize Medshave, an annual fundraiser planned by the university’s first-year medical students, he eagerly volunteered. The head-shaving event has been organized by first-year U of C med students for the last 15 years or so in support of organizations involved in cancer care and research.
This year, the Alberta Cancer Foundation was chosen as the recipient. “When you think about it, there’s a two-way benefit for the medical community fundraising for a cancer foundation,” says Bailey. “A lot of us have been impacted by the disease personally, but when we fundraise for organizations like the [Foundation] we are ensuring we’ll have the best treatments and programs for our patients when we go into practice.” This year’s event was held on Valentine’s Day, in the atrium of the Health Research Innovation Centre at the U of C’s Foothills campus. A silent auction helped raise funds on the day of the head shave, but most of the $35,000 raised came from 11 individuals — mostly Bailey’s classmates — who committed themselves to shaving their hair and soliciting donations from family and friends. One volunteer, med student Helen TamTham, blessed with a luxurious mane of black hair, managed to raise a whopping $10,000. On top of donating his time to lead the planning of the event, Bailey raised $2,000 in donations for shaving his own head, and outside of feeling a little chilly afterwards, he says the experience was painless and fun. “[Afterwards] I went out for Valentine’s Day dinner and my date had to deal with my baldness,” he says. LEAP myleapmagazine.ca SPRING 2019 LEAP 49
GAME CHANGER DUSTIN AND KORINDA KOSTIW WITH THEIR SON, AUSTIN, AT THE AUCTION
A Living Legacy How a grandfather’s love and a 1970 Chevrolret El Camino helped raise more than $36,000 for clinical trials by JENNIFER FRIESEN
KORINDA KOSTIW WAS ONLY 29 YEARS OLD, AND IN THE FIRST
trimester of her pregnancy, when she noticed a lump on her breast. It wasn’t until 18 months later, when her son was 10 months old, that she was diagnosed with stage 4 breast cancer. “It was overwhelming for me and my family,” she says. “But it showed us how important it is to find every opportunity to discuss this disease that really doesn’t care how old or how healthy you are.” Almost four years later, Korinda is still living with the disease, and with the help of her family, she’s found ways to support other Albertans living with cancer, too. Korinda’s grandfather, Sid Braaksma, started the Edmontonbased modular structure manufacturing company Northgate Industries Ltd. 49 years ago. Family members from the next two generations joined the company, making it the family business it is today. Braaksma always had a penchant for giving, and he made it a priority for Northgate to donate to not-for-profits in the province. The need for more cancer research became apparent to the family after Korinda’s diagnosis, so Braaksma found a unique way to help. Last April, Northgate auctioned off Braaksma’s prized classic 1970 Chevrolet El Camino to the tune of $72,500 at the Ritchie Bros. Auctioneers annual auction in Edmonton. The El Camino was one of Braaksma’s many classic cars, as he’d been an avid car 50 LEAP SPRING 2019
collector for 50 years, and the mint-condition vehicle sold well above market value to an unknown buyer. All proceeds were donated equally to the Alberta Cancer Foundation and the Canadian Diabetes Association — another charity close to the family’s heart. The $36,250 gift to the Alberta Cancer Foundation was designated for clinical trials at the Cross Cancer Institute and made in honour of Dr. Michael Smylie and Dr. Karen King, Korinda’s oncologist. The Ritchie Bros. auction is one of Canada’s largest auctions, and the annual event is broadcast online across the world. Korinda says it’s rare to have a car auctioned off for charity at the auction, and it quickly garnered a lot of attention. As a result, the family had an opportunity to not only raise money, but also address the audience before the car was auctioned off. This helped to increase exposure, particularly about the need for more clinical trials. “Grandpa has always been very creative in the way he goes about contributing to different causes,” she says. “This was a unique way to bring attention to the cause, and I think other families and businesses can find creative ways like this to contribute as well.” Since her diagnosis, Korinda has undergone 45 rounds of chemotherapy, as well as surgery, hormone treatments and natural treatments. She’s currently considered to be in palliative care, but she and her family continue to push for clinical trials to find a solution. “Unfortunately, we know how these diseases can affect Albertans and Canadians,” says Korinda. “And research is critical. We really have to move forward with some other kinds of long-term treatment.” Dustin Kostiw, Korinda’s husband and an equipment sales manager at Northgate Industries, says they’re hopeful that breast cancer treatment options will continue to grow. “Because of everything we’ve been through, we’re looking for that next hope,” he says. “We know that one day something will be found, and we want to help move in that direction.” Sadly, the family received another blow this past January when Braaksma was diagnosed with cancer. He passed away a mere two weeks later, at 75 years old, but his family says they will continue to honour his giving spirit. “My grandpa was always trying to help people, and always trying to find creative solutions to problems,” says Korinda. “We plan to keep up the good work with his business and his legacy.” LEAP
REAL STORIES. REAL PEOPLE. BIG IMPACT. If you would like to share your personal cancer story, as a patient, survivor, caregiver, or loved one touched by cancer, we would love to hear from you. Your story has impact. You never know whose life you will change simply by talking about yours. Visit us at albertacancer.ca/shareyourstory to share your story. We all have a story and we want to hear yours.
CONGRATULATIONS TO BELLEROSE COMPOSITE HIGH SCHOOL ON THE SUCCESS OF YOUR 16TH ANNUAL BIKE-A-THON!
700 STUDENTS 48 HOURS
This past March, 700 students participating on 70 teams took part in a 48-hour Bike-A-Thon and raised $157,000 for clinical trials research at the Cross Cancer Institute. Thank you to everyone involved from the donors, to the volunteers, to the staff and teachers and especially to the students who took part! Thank you for your hard work and dedication to making life better for Albertans facing cancer. We are so very grateful. BENEFITING
Together we’re creating more moments for Albertans facing cancer
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