BALANCING ACT The Secret to Healthy Eating
QUESTIONING COSTS Cost-Effective Treatments on Trial
LIVING WELL
During Treatment and Beyond
SUMMER 2019
LEAP GETSN A L
PERSO
REAL TALK
CANCER SURVIVOR JYOTI MANGAT REVEALS WHAT CANCER TREATMENT FELT LIKE FOR HER
DOGS WITH A JOB
TULLY AND WOOLY OFFER COMFORT AND CUDDLES
BEHIND THE SCENES
WHAT CLINICAL EDUCATORS DO FOR YOU PM 40030911
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CONTENTS 42
34 CARING Advancements in radiation therapy make a difference for patients in treatment at the Cross Cancer Institute. 36 LIVING WELL These five things can help patients live well during cancer treatment. 38 RESEARCH ROCKSTAR Dr. Darren Brenner uses big data to answer important questions in cancer screening, prevention and treatment. 42 TRUE CALLING As CancerControl Alberta’s chief program officer, Brenda Hubley is excited to improve and enhance care in Alberta.
FEATURES
46 IMPACT Mike Proudfoot honours the memory of his extraordinary wife, Tegan Carmichael.
22 LEAP GETS PERSONAL With honesty, humour, hope and heart, these survivors and health-care providers share their deeply personal experiences with cancer. COLUMNS/DEPARTMENTS Plus, how two dogs make life a little brighter for cancer patients, why getting up and out of your pajamas improves outcomes and more.
7 FRONT LINE Dr. Michael Chu’s new trial explores cost-effective immunotherapy treatments. COVER: PHOTO AARON PEDERSEN THIS PAGE: PETE RYAN
13 YOUR DONATION MATTERS Five ways your donations to the Alberta Cancer Foundation help support state-of-the-art technology and equipment.
14 FOOD FOCUS We explore the concept of balance when it comes to healthy eating, and how to make a summer salad packed with plant-based protein.
17
17 WORKOUT Exercising during cancer treatment is an achievable way to manage some common side-effects, including muscle weakness, scar tissue and shortness of breath. 20 ASK THE EXPERTS Understanding the different stages of cancer, and a closer look at the role of clinical educators.
47 WHY I DONATE Larry and Joanne Pollock are inspired donors who give back in a big way. 49 MY LEAP Students are the driving force behind Holy Redeemer School’s annual March 4 A Cure fundraiser. 50 GAME CHANGER PCL Construction, a long-time supporter of the Alberta Cancer Foundation, is building and designing the new Calgary Cancer Centre as a welcoming space.
myleapmagazine.ca SUMMER 2019 LEAP 3
MESSAGE
Getting Personal TRUSTEES
Leigh-Anne Palter (Chair) Rene Aldana Dr. Stanford Blade Dr. Heather Bryant Brenda Hubley Chris Kucharski Bob McGee Brian McLean Dr. Matthew Parliament Gelaine Pearman Jamie Pytel (Vice Chair) Rory J. Tyler Mark Zimmerman
This issue’s theme of Leap magazine is “Getting Personal,” and we are so privileged that Albertans have opened up to share stories that are intimate, raw and vulnerable. Amber Lapshinoff, for instance, literally bares all as she talks about her new post-mastectomy breasts and what it was like to become reacquainted with her body (pg. 28). She notes how joining the Alberta Cancer Exercise program, funded by Alberta Cancer Foundation donors and Alberta Innovates, gave her a safe space to rebuild her strength and address mental fatigue. You’ll also read about personalized cancer care, including educating patients about the treatment planning process and precisely targeting radiation for each individual (pg. 26). Psychosocial supports can provide that same level of personalized care to ensure that what is offered will relate to each unique cancer experience, whether it be financial support, sexual health or caregiving responsibilities. We are also pleased to profile a visionary leader in CancerControl Alberta, the Alberta Health Services body that leads all cancer programming across the province. Brenda Hubley (pg. 42) took the helm as chief program officer several months ago, and we learn how her background as a radiation therapist keeps her connected to the caregivers and teams who interact with patients on a daily basis. We are honoured to be partners with CancerControl Alberta as our donors support the excellent treatment and care being delivered at all 17 cancer centres across the province. As we celebrate the summer months — and a busy event season for us, as so many Albertans participate in events benefitting the Alberta Cancer Foundation — we wish you many joyous moments with your families and loved ones.
NEVER MISS AN ISSUITE! VIS
a/leap/ albertacancer.c n tio ip cr bs su leap
4 LEAP SUMMER 2019
ELLEN WRIGHT TERRILL,
LEIGH-ANNE PALTER,
INTERIM CEO ALBERTA CANCER FOUNDATION
CHAIR ALBERTA CANCER FOUNDATION
SUMMER 2019
|
VOL. 9
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NO. 4
ALBERTA CANCER FOUNDATION EDITORS
Phoebe Dey and Christiane Gauthier
MANAGING EDITOR Meredith Bailey ART DIRECTOR Kim Larson STAFF PHOTOGRAPHER Jared Sych CONTRIBUTORS Andrew Benson, Colleen Biondi, Elizabeth Chorney-Booth, Emily Chu, Cooper & O’Hara, Jennifer Dorozio, Jennifer Friesen, Colin Galant, Kaitlyn Hanson, Stephanie Joe, Hannah Kost, Victoria Lessard, Jennifer Madole, Karin Olafson, Aaron Pedersen, Pete Ryan, Paul Swanson, Colin Way, Julia Williams, Sean Young PUBLISHED FOR
Alberta Cancer Foundation Calgary office Suite 300, 1620 29 St. N.W. Calgary, Alberta T2N 4L7
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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 SUMMER 2019 LEAP 5
UPCOMING EVENTS In support of the Alberta Cancer Foundation
August 3-4
August 24
September 12
Pigeon Lake Music Festival Mulhurst Bay
Cameron Daye Memorial Golf Invitational
August 17
Kananaskis Country Golf Course
Women in Seismic Engineering Golf Tournament
Chase the Cure YEG
August 27
Edmonton International Raceway
August 17
Down & Dirty 5KM Obstacle Course Sunridge Ski Area, Edmonton
August 17 -18
Enbridge Ride to Conquer Cancer
Alberta Cancer Foundation Golf Classic Country Hills Golf Club, Calgary
August 31 September 1
Xtreme Raceways Race To Victory IRONMAN Lacombe
Calgary and Area
August 24
Laps for Life YYC Eau Claire Market Plaza, Calgary
September 7
Val Thomas & Dave Simpson Memorial Golf Tournament J.R. Golf Course, Sturgeon County
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
September 12
Boston Pizza Charity Golf Classic Blackhawk Golf Club, Spruce Grove
September 14
Legacy Walk 2019 Bow Valley Legacy Trail
September 15
Innisfail Trail Ride Daines Ranch Rodeo Grounds, Innisfail
September 28
Terwillegar Trail Run/Walk Riverbend Community Hall, Edmonton
FRONT THERAPY DOGS | TERWILLEGAR TRAIL RUN/ WALK | #ENDPJPARALYSIS
BRIGHT MIND
Dr. Michael Chu’s newest trial will seek to create affordable cancer-killing modified cells at Alberta labs
D
r. Michael Chu is convinced immunotherapy is a game-changing treatment in the stand against cancer, and he sees the potential for this type of medicine as nearly limitless. “For decades we’ve been relying on surgery, chemo, and radiation, [but] immunotherapy has really changed how we look at oncology. We can now target the actual cancer cells directly through this treatment,” says Chu, a clinician and researcher at the University of Alberta’s (U of A) department of oncology. “It’s changed melanoma from an entirely palliative disease to something where about 50 to 60 per cent of patients are cured of it.” Chu, 34, is a born-and-raised Edmontonian who did his medical training at the U of A. Four years ago, his career focus shifted to immunotherapy after a combined clinical and research fellowship at Stanford University in California. Now a member of the Cancer Research Institute of Northern Alberta (CRINA), and currently practicing at the Cross Cancer Institute in Edmonton, Chu is leading the development of a clinical trial to manufacture CAR T-cells in Alberta to treat leukemia and lymphoma. >
DR. MICHAEL CHU, CLINICIAN AND RESEARCHER AT THE U OF A
PHOTOS PAUL SWANSON
myleapmagazine.ca SUMMER 2019 LEAP 7
FRONT LINE
DR. CHU IS LEADING THE DEVELOPMENT OF A CLINICAL TRIAL TO MANUFACTURE CAR T-CELLS IN ALBERTA
A breakthrough immunotherapy approach to treating cancer, CAR T-cell therapy is an adoptive cell transfer (ACT) approach that involves collecting and using the patient’s own immune cells to treat their cancer. T-cells, known as the workhorse of the immune system for their ability to find and kill cells infected with a pathogen, are genetically modified using a disarmed virus. “The virus introduces the gene that does the manipulation to the T-cell,” Chu says. “The virus is like the vehicle or the chaperone; the gene is what actually does the action.” These genetically modified cells develop receptors on their surface called chimeric antigen receptors, or CARs. The newly created CAR T-cells are then reproduced in a lab in 8 LEAP SUMMER 2019
the hundreds of millions and infused back into the patient. If successful, the CAR T-cells will naturally proliferate in the patient’s body. CAR T-cells are programmed by their newly-engineered receptors with a fresh battle plan: first, identify a unique protein, or antigen, that exists on the cancer cell’s surface, then kill it — and only it — leaving healthy cells intact. CAR T-cell therapy has shown to be incredibly effective in treating patients with relapsed leukemia, and lymphoma patients who would have exhausted all other options. While most researchers will shy away from the c-word, Chu calls it a “curative therapy” that has also shown early promise in treating solid mass cancers like breast and lung.
But, he says, as more common types of cancer start being sent into remission using ACT approaches, Canada could see a “crisis of access.” “The pharma version of this treatment is around half-amillion dollars [American] per patient, so as a society we’re going to have to decide, are we going to bankrupt ourselves in order to do this?” Enter the latest trial designed by Chu, which aims to begin within the next few months and will take between two and three years to complete. It will treat 57 adult and pediatric patients with relapsed leukemia and lymphoma using “point-of-care” CAR T-cell manufacturing. Rather than outsource the entire process to one of the three companies manufacturing CAR T-cell treatment, Chu will use two manufacturing sites in Edmonton and Calgary to create the “living treatment” for each patient in the study. The trial will also look to further prove the clinical merits of CAR T-cell treatment for relapsed leukemia and lymphoma patients. Chu says the bulk of the funding for this innovative study will be provided by the Alberta Cancer Foundation. Chu’s trial will still partner with a biologics company to license the virus that carries the gene that manipulates the T-cells. But even with the cost of the patented sequence, point-of-care manufacturing will reduce CAR T-cell treatment to approximately $54,000 per patient — or a 90 per cent drop in overall cost.
In addition to a more sustainable cost for the Canadian taxpayer, the point-of-care model will likely have numerous clinical benefits. Unlike the pharmaceutical model, point-of-care-made CAR T-cells do not need to be frozen because, as the name suggests, the freshly created treatment can literally be walked from the lab to the treatment sites and given to patients. “I think of it like buying groceries at the supermarket,” Chu says. “We think the fresh cells actually work better than the frozen, so that’s a major plus.” Chu says this system will also eventually cut down the lead time to create the synthetic cells from between 12 to 17 days to a goal of just under one week, which is critical when dealing with patients facing aggressive cancers that may have relapsed several times. While he is thankful Alberta is fertile ground for this type of initiative (having already built the lab infrastructure), he admits Canada is a few years behind several nations leading the charge in immunotherapy. He’s hoping this trial will help to catch us up, lead to new immunotherapy breakthroughs, and, most importantly, aid Canadians facing cancer for decades to come. “I’m hoping we’ll lay the groundwork to demonstrate how CAR T-cells can be introduced into the Canadian healthcare landscape,” he says. LEAP — SEAN YOUNG
THE PLTC RAISED OVER $28,000 IN 2018 AND HOPES TO RAISE $30,000 THIS YEAR
In Honour of Friendship and Sport Terwillegar Trail Run/Walk celebrates its 8th year DOUG MITCHELL AND HIS FRIENDS
share such a passion for athleticism that, over the years, they’ve run marathons together, pushed each other through gruelling Ironman triathlons and met for informal spin classes in Mitchell’s garage. Eventually, Mitchell says, they jokingly christened themselves the Pigeon Lake Tri Club (PLTC), named for the location of Mitchell’s cabin on Pigeon Lake in central Alberta. “This was the unofficial name for all of us when we used to get together and train at my cabin,” Mitchell says. “We would come out here, and we would ride [our bikes], and we’d go sit in the hot tub and have a beer and really enjoy life.” A core member of the PLTC was Ken Lane, a sharp athlete who competed with the group and kept them laughing with satirical newsletters he wrote about their lives. In 2009, after competing in an Ironman triathlon and finishing first in his age category, Lane was diagnosed with prostate cancer. This came as a tremendous shock to his close-knit group of friends — but they wouldn’t sit still for long. “What we wanted to do was something in the community,” Mitchell says. “And we didn’t know anything about running an event, but we sure knew how to participate in one.”
Lane’s diagnosis led his friends to formalize their nickname and create the PLTC Multisport Foundation, a non-profit organization that hosts the annual Terwillegar Trail Run/Walk in Edmonton to raise money for prostate cancer research. The inaugural event was held in 2012 and it heads into its eighth year this September with two signature athletic events that are designed to be inclusive — the 7.5-km walk is suitable for participants with dogs and strollers, while the formidable 10-km run honours the PLTC’s athletic roots with a trail that features steep descents, grinding climbs and, sometimes, mud. Barry Knight, a long-time PLTC member and one of the directors of the PLTC Multisport Foundation, says these challenges contribute to the event’s appeal. “Some of the fondest memories that I have of past events are those that featured some pretty inclement weather,” Knight says. “People will come back to the hall after the event covered with mud and with big smiles on their faces. And I think those are some of the happiest crowds I’ve seen come in after the race.” Mitchell and Knight hoped Lane would be able to attend the first Terwillegar Trail Run/Walk in 2012, but their friend’s illness was advancing, and he passed away shortly after the event. Nearly a
decade later, the event still begins with an acknowledgment of Lane, whose family participates alongside his old friends. “When I speak about Ken at the start of the event, it’s really about the celebration of family, and all the things that we like to do — to be friendly and have a good time,” Mitchell says. “It’s [an] informal and intimate event. Those are all things that we all love.” To date, the Terwillegar Trail Run/ Walk has raised more than $270,000 for the Alberta Cancer Foundation in support of prostate cancer research at the Cross Cancer Institute. This year, the PLTC’s goal is to raise $30,000 more. Knight and Mitchell say the race allows them to honour Lane’s memory, and they hope it makes an impact that will eventually transcend their involvement. “We’re trying to build some legacy into the event, and we’ve got some younger members now and they’re pretty enthusiastic about it — my fondest wish is that [it will] keep going for years and years,” Knight says. “[Lane’s death] was a tragic occasion, but if there’s some good to come of it, then we’re making our best effort to do that.” LEAP — HANNAH KOST
The 2019 Terwillegar Trail Run/Walk will be held on Sept. 28 in Edmonton’s Terwillegar Park. To register, visit terwillegartrailrun.com. myleapmagazine.ca SUMMER 2019 LEAP 9
JENNIFER JAMES WITH TULLY AND WOOLY
10 LEAP SUMMER 2019
FRONT LINE
A Day in the Life of a Therapy Dog Working with Calgary’s Pet Access League Society, Jennifer James and her Wheaten Terriers bring comfort to people living with cancer AS SOON AS JENNIFER JAMES
reaches for the blue bandanas dotted with white paw prints, her dogs, Tully and Wooly, know it’s time to go to work. Both of James’s Wheaten Terriers are therapy dogs, meaning they offer comfort in a variety of settings, including health-care facilities for individuals living with cancer. Pet therapy has proven therapeutic effects. “The Healing Power of the Human-Animal Connection,” a 2008 study published in the American Journal of Critical Care, found that pet therapy can lower blood pressure and have calming effects, reducing stress and anxiety. Therapy animals can help patients through the stress of cancer treatment, and the humananimal connection may even reduce pain, as petting an animal may trigger the release of endorphins. James has volunteered for the Calgarybased non-profit Pet Access League Society (PALS) since 2003. Six-year-old Tully has over four years of work experience as a PALS therapy animal, and nine-year-old Wooly has worked with PALS for five and a half years. On average, Tully and Wooly volunteer about twice a month. Whether Tully and Wooly are visiting cancer patients at the hospice at the Southwood Care Centre, at the Sage Centre, or elsewhere, their workday begins by getting ready to look the part. James brushes the dogs’ long beards and wheat-coloured coats before putting on their blue PALS bandanas and PALSspecific leashes. Shifts are short, but the dogs work PHOTOS JARED SYCH
hard. For roughly 60 minutes, Tully and Wooly visit with anyone who wants to see a therapy animal. Their work can sometimes look like play, and the comfort they offer varies. The dogs might give patients kisses and licks, they might stand next to an individual’s chair so the patient can reach down to pet them, or they may just let patients cuddle them, give belly rubs and talk to them. Yet the dogs can sense when a cancer patient needs something a little different, and one experience in particular sticks out for James. “Tully and I were visiting at Southwood Hospice and a patient wasn’t able to reach down from her bed to pet Tully. I asked if
I could put Tully on her bed, and the patient nodded her head, smiled and patted the space next to her,” says James. “Tully draped herself across the patient’s heart with her snout raised toward her face as though she needed to hear her heartbeat. The patient had one arm wrapped around Tully’s torso, and the other was stroking her head. I believe the patient was in her own little, happy world at that moment in time.” James adds that she experiences the positive change in people’s demeanours when she visits facilities. “I get there and see the smiles and the connections people make with the dogs,” she says. LEAP — KARIN OLAFSON
myleapmagazine.ca SUMMER 2019 LEAP 11
FRONT LINE
Four Things You Should Know About #EndPJParalysis Alberta Health Services is tackling the impact of relative immobility during hospital stays by encouraging patients to ditch their hospital gowns IN A HOSPITAL, THE SIGHT
of patients wearing hospital gowns is as common as medical professionals in their scrubs — but the #EndPJParalysis movement wants to change that. The initiative began in the U.K. in 2016 and evolved out of a tweet by U.K.-based professor and health-care professional Brian Dolan calling for an end to pajamas as a patient uniform. 12 LEAP SUMMER 2019
“Pajama paralysis” is when patients spend the majority of their stay in their hospital gowns and in bed, which can have a significant impact on their physical and mental health. The initiative aims to get patients up and out of bed and into their own clothes, ideally reducing hospital stays and improving outcomes. In Alberta, the Leduc Community Hospital introduced the
voluntary program in early 2018 and included a day where staff in two units wore their pajamas to work to better understand how patients feel when they’re encouraged to get up, get dressed and get moving. The experience was positive for both staff and patients, and since then, the #EndPJParalysis movement has continued to grow across the province. The initiative is now taking place in all five Alberta Health Services zones, including six hospitals with 15 units participating in Calgary — the Foothills Medical Centre and South Health Campus have also hosted their own staff pajama days. “It doesn’t have to be prescriptive, and that’s a rare thing in health care,” says Paul Wright, interim director of quality improvement and patient safety at AHS. “It’s really about encouraging patients to get up and dress. Each unit can do it a little differently as long as they’re focusing on [the] principles of respect and dignity and getting patients up and moving.” Pajama Paralysis Takes a Physical Toll If a patient spends up to a week in bed relatively immobile, total muscle mass loss can be up to 20 per cent, which increases the risk of falling. A week spent immobile in bed can also mean up to a 10 per cent loss of aerobic capacity, affecting a patient’s ability to breathe deeply. For seniors, the potential impact is even greater — for every 10 days patients over the age of 80 are immobile during a
hospital stay, their muscles age the equivalent of 10 years. Pajama Paralysis Also Has a Mental Impact The hospital gown can take on a symbolic meaning for those wearing it because it can be seen as institutionalizing patients. “Patients say [that] wearing a hospital gown, it’s hard for them to feel like they can question the medical team,” says Wright. “It can have psychological effects. When you do get dressed, you’re more likely to be successful and working on your care, your exercises, and your day-today plans while in hospital.” Get Up, Get Dressed Goals for the Day Before the initiative began, within the Calgary area, only 20 to 25 per cent of patients in participating units were up, dressed in their own clothing and active before 11 a.m. When the #EndPJParalysis initiative was introduced last year, AHS set a benchmark goal in the Calgary Zone to increase that number to 60 per cent. Now, that number has grown to 65 per cent. Family Support AHS is encouraging families to be partners in this patient-led initiative. Families can help support patients by bringing in loose, comfortable clothing, taking care of the laundry, bringing in walking aids such as a cane, and walking with the patient to different areas within the hospital during their stay. LEAP — VICTORIA LESSARD
5 WAYS
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POINT OF CARE ULTRASOUND
Used for advanced cancer patients, this portable imaging technology will allow patients to be seen at home rather than in a clinic or emergency setting, improving quality of life and care.
Improving radiation treatment by merging the imaging abilities of an MRI system with the treatment capabilities of a Linear Accelerator, this machine will allow doctors to see and treat cancer in real time.
VOLUMETRIC ARC THERAPY
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A recording app that enables patients to record appointments and conversations with their care teams to help them make more informed decisions and improve their cancer journey.
Your investment helps the Alberta Cancer Foundation provide support to all 17 cancer centres across the province. MY CARE CONVERSATIONS IMAGE Š ALBERTA HEALTH SERVICES USED WITH PERMISSION
myleapmagazine.ca SUMMER 2019 LEAP 13
FOOD FOCUS
Finding Balance When it comes to healthy eating, many of us strive for some sort of balance. From a cancer prevention point of view, eating an array of foods that contribute to overall health can be very beneficial, but sometimes it can be difficult to know when we’ve had enough fruit and vegetables for the day and when it’s okay to enjoy a treat that may be less nutritious. by ELIZABETH CHORNEY-BOOTH CANADA’S FOOD GUIDE In January of this year, Health Canada released an updated version of Canada’s Food Guide, a national document designed to inform Canadians’ eating habits. Gone is the familiar rainbow graphic, labeled with individual food categories and recommended serving sizes of each. The key message is that creating a healthy meal is easy when you use the Eat Well plate — a photo of a plate half filled with fruits and vegetables, a quarter with wholegrains and the final quarter with a mix of animal and plant-based proteins. The idea is that rather than counting servings throughout the day, all of us can eyeball our plates and assess how well the proportions mimic the graphic in the guide. Lindsay Lee, a dietitian at the Cross Cancer Institute in Edmonton, says she likes the effectiveness of the visual aid as well as the recommendation that we can all benefit from choosing “protein foods that come from plants more often.” The guide doesn’t just prescribe what we 14 LEAP SUMMER 2019
should eat, but also asks Canadians to be more mindful about their habits. “It’s not only looking at the types of foods, but also trying to increase awareness of how we’re eating,” Lee says. “It’s asking people to think about cooking more often at home, eating along with others, being mindful about our eating and being aware of things like food marketing that might influence our choices.”
TAKING A HOLISTIC VIEW OF HEALTHY EATING While Canada’s Food Guide also cautions Canadians about what foods and drinks to limit (namely, to stay away from sugary drinks and highly processed foods that add excess salt, sugar or saturated fat), eating can nevertheless be a great pleasure. We don’t need to always deny ourselves the joy that comes with beloved and culturally meaningful foods — even if they don’t fit into our typical eating plans. Many health-conscious eaters often view eating the occasional chocolate bar or hot dog as failure, or at the very least,
a “cheat,” which is a mindset that isn’t always a healthy approach. Vincci Tsui, a private registered dietitian in Calgary, says that whether someone is recovering from cancer or just trying to maintain a healthy diet, there’s no reason to feel guilty after savouring the occasional treat. While Tsui isn’t suggesting that people gorge themselves on processed foods or sweets, she does advocate “intuitive” eating, which involves following one’s body’s cues and looking at wellness from a holistic point of view. She advises that people consider the social and emotional benefits that come from celebrating with a piece of birthday cake or going out for dinner with friends, which can outweigh the effects of the extra sugar or calories. “People can lose sight of the fact that nutrition is really just a part of what makes up a person’s health,” Tsui says. “People can become very obsessive about restricting their eating and food choices. But that can end up damaging your mental health, as well as your social health and well-being.” >
HAVE PLENTY OF FRUITS AND VEGETABLES
EAT MOSTLY PLANT-BASED PROTEIN
CHOOSE WHOLEGRAIN FOODS
CANADA’S FOOD GUIDE FROM THE GOVERNMENT OF CANADA
myleapmagazine.ca SUMMER 2019 LEAP 15
FOOD FOCUS
FASTING Increasingly, people are turning to unconventional methods to balance out days when they may consume more calories than they’d like to. “Intermittent fasting,” as this is often called, involves limiting eating to a small daily window or going without food on alternate days throughout the week. It has become very trendy, primarily as a weight loss method. Lee says that while fasting can lead to immediate weight loss, like many other short-term weight loss approaches, it may not be sustainable. Fasting for religious reasons or prior to a medical treatment as per a doctor’s orders are appropriate. However, as a dietitian, Lee advises there isn’t research to support that fasting leads to better outcomes for weight management. There is also a trend toward
Curried Quinoa and Lentil Salad One of the key recommendations in the new Canada’s Food Guide is to regularly choose plant-based proteins over animal proteins. This salad from ATCO’s Blue Flame Kitchen is packed with quinoa, a terrific plant-based source of protein. INGREDIENTS 3 1/4 cup water 2 tsp curry powder 1/2 tsp salt 1 cup quinoa, thoroughly rinsed and drained 1/2 cup dried red lentils, rinsed and drained 1/4 cup white wine vinegar 2 tbsp tomato paste 2 tbsp water 2 tsp curry powder 1/2 tsp salt 1/8 tsp cayenne pepper 2 tbsp oil 1/4 cup thinly sliced green onion 4 cups torn young Swiss chard leaves or baby spinach
16 LEAP SUMMER 2019
DIRECTIONS Combine water, curry powder and salt in a large saucepan. Bring to a boil over medium heat. Stir in quinoa and lentils; return to a boil. Reduce heat; cover and simmer for 20 minutes. Remove from heat and let stand for 15 minutes. Transfer quinoa mixture to a bowl and fluff with a fork. Cool to room temperature. Meanwhile, to prepare dressing, whisk together next six ingredients (vinegar through cayenne pepper) until combined. Gradually whisk in oil until blended. Stir in green onion. Add dressing and Swiss chard to quinoa mixture and toss to combine. Serve immediately. SERVES 6
TER PLANT-RBIFAIC SOURCE OSED PROTEIN F
fasting during cancer treatment — patients sometimes will ask about fasting in order to reduce the toxicities that come with chemotherapy and may contribute to some of treatment’s more uncomfortable side-effects. “There just isn’t enough evidence for us to recommend fasting during cancer treatment,” Lee says. “There is interesting research going on right now, but until there’s a greater body of evidence, we can’t really recommend it for any of our patients.” Both Lee and Tsui want people to use common sense and weigh their bodies’ needs when making food choices. Balance looks different for everyone — maintaining health and happiness is about giving your body (and occasionally your mind) what it needs to stay strong and well-fuelled. LEAP
WORKOUT
How to Exercise with Cancer Incorporating gentle exercise into your week plays an important role in managing some common side-effects of cancer > by KARIN OLAFSON
ILLUSTRATION ANDREW BENSON
myleapmagazine.ca SUMMER 2019 LEAP 17
WORKOUT
MUSCLE WEAKNESS, SHORTNESS of breath, scar tissue — these are just a few of the side-effects you may encounter as you go through your cancer experience. One achievable way to manage these side-effects is through exercise, says Dr. Nicole Culos-Reed Culos-Reed is a professor in the faculty of kinesiology at the University of Calgary and co-lead of Alberta Cancer Exercise (ACE), a community exercise program for people living with cancer. She says it’s never too late to start exercising, and regardless of the type of cancer you’re living with or where you are in your cancer journey, exercise has proven physical, psychological and social benefits. Here, Culos-Reed offers some useful exercise tips and modifications for breast, head and neck, lung, and prostate cancer patients but recommends touching base with your doctor before beginning a new program or activity. And, keep in mind that when it comes to an exercise routine, there’s no one-size-fits-all regimen — while a tailored program can help mitigate specific side-effects of cancer, any activity that gets you moving is beneficial.
EXERCISING WITH BREAST CANCER
1.
Culos-Reed says that group circuit training can be a fun, social way to incorporate exercise into your week. If you’re undergoing breast cancer surgery, your circuit training routine might be modified to focus on exercises that rehabilitate and strengthen the pectoral and back muscles. Another common outcome of breast cancer surgery can be the buildup of scar tissue, so additional tailoring might involve more chest stretches to improve the arm’s range of motion. Culos-Reed says that range of motion is something to consult with a physiotherapist about to ensure the right exercises are being done. EXERCISES TO TRY Culos-Reed recommends that before you focus on building your general
fitness, modify your circuit program so you’re strengthening your upper body and your core. For example, bicep curls and modified push-ups strengthen muscles in the upper body, while exercises with balance boards, planks and sit-ups develop a strong, stable core. CAN I STILL EXERCISE WITH LYMPHEDEMA? The swelling of one hand, arm or breast, known as lymphedema, can be a common outcome of breast cancer surgery or radiation. “We know that general exercise does not increase lymphedema, but you should never feel tingling, heaviness or swelling in the hands,” says Culos-Reed. “If you do, you may need to wear a compression sleeve or cuff while exercising.”
“ If you love a certain exercise, it can be adapted so you can continue to do it in a safe way.” – Dr. Nicole Culos-Reed
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EXERCISING WITH HEAD AND NECK CANCER
2.
A weight-training program could be a great way to begin incorporating some movement into your week, as a common result of head and neck cancer treatment and surgery can be the loss of lean muscle mass. “There should be less focus on aerobic exercise and more focus on building muscle mass through resistance training,” says Culos-Reed. “You don’t want to burn more calories than you need to burn.” EXERCISES TO TRY Particularly after surgery, CulosReed says resistance training exercises will be rehab-focused to strengthen muscles impacted by the surgery. The trapezius — the
EXERCISING WITH LUNG CANCER
3.
triangle-shaped muscle behind your neck and upper back — is often the muscle that’s most impacted by surgery. Exercises like lateral pulldowns or upright rows require you to squeeze your shoulder blades together, strengthening various muscles in the upper back and neck. IS IT ONLY ABOUT THE WEIGHTS? While your workouts will likely focus on rehabilitation and resistance training, that doesn’t mean you should avoid aerobic exercise altogether. Culos-Reed recommends short walks and says that bursts of aerobic exercise with lots of recovery can help with the management of cancerrelated fatigue.
M WATERAKE DRINK YOOUR CHOICE F
Try to focus your weekly exercise regimen on slowly building up your aerobic capacity. Common side-effects of living and exercising with lung cancer include shortness of breath, particularly after surgery.
“Start really low and work up the time you spend doing cardio,” says Culos-Reed. “You might begin with five-minute increments of exercise. Work lots of rest and recovery into the aerobic activity as you build up your tolerance.”
WORKOUT SUGGESTIONS Because cardiovascular exercise increases your breathing rate, the amount of cardio exercise you do will increase incrementally. Whether you’re walking, jogging, spinning or swimming, you’re working your body and so your breathing rate will increase, but you should still feel in control.
IS IT SAFE TO DO MY FAVOURITE FORM OF CARDIO? In short, yes — but there might be a little modification required. “If you love a certain exercise, it can be adapted so you can continue to do it in a safe way,” says Culos-Reed. “An effective workout is about tailoring exercise based on what your body needs and on your exercise preferences.”
Less than 1/3 of cancer survivors self-report that they are meeting the minimum amount of physical activity suggested by the Canadian Physical Health Guidelines.
EXERCISING WITH PROSTATE CANCER
4.
Common side-effects of prostate cancer and its treatment include the weakening of the pelvic floor muscles and challenges with incontinence, so modify your exercise routine to incorporate movements that strengthen the core. With a personalized resistance training program and yoga, you’ll learn how to properly activate and release the pelvic floor muscles. WORKOUT SUGGESTIONS According to Mike Dew, project coordinator of the prostate cancer-specific program TrueNTH Lifestyle Management, resistancebased exercises like planks and one-leg balances can help to improve the strength of the pelvic floor muscles. Incorporating these exercises into a circuit program of
eight to 12 exercises will result in a full-body workout. Culos-Reed adds that choosing aerobic exercise where you have easy access to washrooms — walking on a treadmill at a fitness centre as opposed to long hikes in the wilderness, for example — might be a practical modification to consider. CAN I RIDE MY BIKE? According to Culos-Reed, there’s no evidence at all to suggest that biking is unsafe. “If it feels comfortable, it’s okay. Some men feel more comfortable on a recumbent bike versus an upright bike after surgery, but that modification is personal preference,” says Culos-Reed. “If you love biking, absolutely find a way to get back to it.” LEAP
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ASK THE EXPERTS
chemotherapy plus radiation, or immunotherapy options for certain cancers.
Q: What are the different grades of cancer?
We take a closer look at the stages and grades of cancer, and how clinical educators benefit both patients and doctors by HANNAH KOST
Q: What are the different stages of cancer? DR. SAFIYA KARIM
UNDERSTANDING THE STAGES AND GRADES OF CANCER A cancer diagnosis can be overwhelming, and its severity is often assessed through grades and stages that indicate how the cancer has progressed. Dr. Safiya Karim, a medical oncologist at the Tom Baker Cancer Centre in Calgary, explains the difference between the stages and grades of cancer, why they are important for doctors and patients to understand, and what to do to catch cancer earlier.
Stage one is the earliest stage, and stage four is the latest stage. Usually stages one and two mean that the cancer is localized, so it has not spread outside the location where it started. Stage three might have spread to nearby lymph nodes, areas beside where the tumour started. And then stage four is when the tumour has metastasized [spread], and is usually much further away from where the tumour started.
Q: Why is it important for doctors to discern the grades and stages of cancer? It guides a lot of our decisions in terms of treatment; it also helps us prognosticate the cancer and determine how aggressive we need to be in terms of our treatments. In some [instances], we use the grade in combination with other factors to determine what treatment might be needed in terms of chemotherapy [before or] after a surgery. Earlier stages tend to be treated with surgery or radiation, and the goal there is to cure the cancer. Later stages would generally be treated with chemotherapy, or
That depends on the particular cancer, but typically, it’s usually grade one to three. Grade one would be cells that essentially look like normal cells, and so they aren’t growing very quickly. Grade two is when they start looking like abnormal cells, and are growing at a faster rate than normal cells. Grade three is cells that look very abnormal, and are growing more aggressively.
Q: Why are stages and grades of cancer important for patients to understand? Both the stage and the grade are important because they provide prognosis information for the patient. For example, if something is early stage, then usually it’s correlated with a better survival rate and a lower risk of that cancer coming back; similar with a lower grade. With a more advanced cancer, the risk of the cancer coming back — or the survival, for example, with a stage four cancer — is worse than the stage one.
Q: How can patients attempt to detect cancer in its earlier stages? For certain cancers, screening has been shown to detect cancer at early stages. For example, with breast cancer, that includes getting mammograms at the suggested intervals. And with colon cancer getting colonoscopies on a regular basis after the age of 50 is important. Those are the two main cancers where screening has been shown to be beneficial in detecting cancer earlier and improving survival. ILLUSTRATION JENNIFER MADOLE
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KATIE PHILPOTT
promote professional accountability. If there’s any change of practice it would come to us, and then we would decide how to take that forward [to the medical staff].
Q: What is an example of how changes in practice are implemented?
MEET A CLINICAL EDUCATOR As medical technologies and cancer research evolves, so do best practices in oncology. Working behind the scenes at cancer centres across Alberta, clinical educators are registered nurses who are briefed regularly on changing procedures, and tasked with communicating developments effectively to medical staff. Katie Philpott, a clinical educator at Lethbridge’s Jack Ady Cancer Centre, speaks to helping the flow of education in cancer centres, the importance of ensuring standardized care province-wide, and how clinical educators benefit both patients and doctors.
Q: What does a clinical educator do? As clinical educators, we are involved in new staff orientation, annual nursing education and supporting staff with ongoing learning needs. We support staff with daily clinical questions and issues that arise. We participate in provincial initiatives, from planning to implementation and evaluation. We also support/encourage staff to have an evidence-based practice and
We have some medications that are only given by IV, but a year ago we started giving that medication also by [subcutaneous] injection. So that is something that would come to us, and then our group would figure out how we’re going to carry out educational resources for the nursing staff. [We’d also determine] how to get that information to the patients, because some of the patients who are already on that drug by IV can now have it by [subcutaneous] injection, which is much faster for them, so their time with us is lessened.
Q: How are clinical educators kept up-to-date about changes in the medical community? We are informed by leadership and our interdisciplinary health-care teams on new evidence-based policies and practices. We are also involved in different working groups and committees to stay informed on changes within health care. As educators, we are also able to attend conferences for updates on new treatments and practices.
Q: There are clinical educators throughout Alberta. Why is this important? As there are 17 cancer centres throughout Alberta, and all sites function differently, educators work together to standardize our practices across the province, knowing that each site has its differences. In order to give the same level of care to patients, no matter the site, staff require
the same level of support and education. We want to make sure that a patient who was treated in Lethbridge or a patient who is treated in Calgary is going to go through the same stream of education and treatment that they would at either site.
Q: How does your work behind the scenes benefit patients? Everything that we bring forward is all evidence-based, and everything that we strive for is patient-centered care. For instance, I’m part of a Patient Experience Committee where we actually have three patients who have gone through their [cancer] treatments. We now sit down with them once every two months, and we just discuss different things that they may have had issues with during their journey. We try to take those issues or concerns that they had during their treatment and make adjustments that will help future patients to have a more streamlined journey throughout their own oncology experience.
Q: How does your work benefit doctors? The majority of communication for our physicians comes from the medical director. [But] if the physicians have questions regarding [any] changes, [educators are] often who they will reach out to.
Q: What is the most rewarding part of your job? When you can roll something out and have everyone just be appreciative of it — because change is always scary in the health-care system. So, to have to bring about change, and have it go smoothly, and people understand and be open to it — that is rewarding. That means I have done well with the information I have presented and brought forward to them. LEAP myleapmagazine.ca SUMMER 2019 LEAP 21
Here, we ask patients, care providers and clinicians across Alberta to share their personal experiences with cancer, from diagnosis and treatment to remission and survivorship. We dive into the intimate details of what chemotherapy feels like, how doctors find hope through caring for courageous patients and why new tailored treatment plans give patients more options than ever before.
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” I F YOU CAN BE POSITIVE AND FIND A SILVER LINING, I THINK IT MAKES IT HARDER FOR THE CANCER TO GROW.” – AMBER LAPSHINOFF
myleapmagazine.ca SUMMER 2019 LEAP 23
FINDING SUPPORT
Jyoti Mangat’s year undergoing breast cancer treatment and recovery was physically challenging, emotionally draining and filled with moments of deep gratitude
W
HEN JYOTI MANGAT
found a lump in her breast in early 2016, she didn’t panic but decided to keep an eye on it before following up with her general practitioner. A few weeks went by without the lump going away, so Mangat texted her doctor, who told her to come into the clinic right away. A mammogram was scheduled along with an ultrasound-guided biopsy, and she was officially diagnosed with stage one triple negative breast cancer in June 2016. Mangat, who is the principal of Bellerose Composite High School in St. Albert, Alta., had a graduation celebration to emcee three days after she received her diagnosis. She persevered through the ceremony and, a month later, in July 2016, underwent a lumpectomy, followed by four rounds of chemotherapy and radiation at the Cross Cancer Institute in Edmonton. Today, the 51-year-old is cancer-free. She reflects back on the year she took off work so she could focus on treatment for her breast cancer and her recovery, and here she shares what that experience was like. “[On the day of diagnosis] I was
at school when I got the call [from my
I just dropped everything.
town and I would text him if I thought
“I remember my doctor saying to
of something I might be able to eat and
me, ‘I really wish you had brought your
he was great about running milkshakes
husband with you,’ and I just laughed
home to me. I could have something to
because it didn’t occur to me. I think I
eat and then he could go back to work.
was in such a rush to get it over with
“I think the thing I was unprepared for
that I just went [to my doctor] rather
was the fatigue. I remember parking for
than try and coordinate with him.
one of my radiation treatments at the
“A nurse navigator called me less
Cross and not being able to walk from
than 24 hours after my diagnosis to say,
my car without stopping along the way
‘I hear that you’ve been diagnosed and
to rest. I was unprepared for how bad the
I’m here to help you between now and
fatigue would feel. A friend described it to
the time that you are handed over to the
me and she said it felt like the lead blanket
Cross.’ That was really helpful to have
they put on you when you go to the
somebody [to answer my] questions and
dentist for x-rays — that’s what it felt like.
book all my appointments, so I didn’t
“I recall saying to my husband after
have to worry about any of that. It was
treatment ended, ‘I think I have PTSD.’
wonderful to have that support
After treatment was over, I was getting
“Up until I had my lumpectomy, I
physically stronger, then the emotional
never had a hospital bracelet on my
processing kicked in. I think partly what
wrist. I had never spent a night in the
happens with diagnosis is the ball gets
hospital. [I went] from being the type of
rolling so fast that you just hang on.
person who hadn’t taken anything stronger than an Advil to chemo. “The chemo was more difficult than
“I had a ton of support, but when you’re used to working every day and everyone you know is working every
I thought it would be. I broke my
day, you’re alone during the day.
ankle 48 hours after my first chemo
We can say all we want about technology
infusion and I think it was a result of all
and cell phones but it sure was handy
of this stuff in my system that I’m not
to be able to stay in touch with friends
accustomed to. I think my body just
and family.
rebelled and I fainted, and when I fainted I rolled my ankle and broke it. “[As for treatment], I wasn’t nauseous
“[Support] makes a huge difference. Every day you go into the Cross you think, ‘I’m really lucky to have access
doctor] and I remember looking at my
but I had thrush in my mouth and that
to this facility and these people and to
office manager and saying, ‘I have to go.’
meant I wasn’t able to eat. I survived on
know that I’ve got people around me
Booster Juice with a protein shot and
who care about me deeply.’
I haven’t had one since. This is just a
“[Today], whether it’s work, family
couple of years before the SkipThe-
or friends, I’ve got a ton of support.
Dishes phenomenon. My husband
The network I have around me is
worked downtown and we lived down-
something I’m proud of.” LEAP
by STEPHANIE JOE + photography AARON PEDERSEN
24 LEAP SUMMER 2019
“ A FTER TREATMENT WAS OVER, I WAS GETTING PHYSICALLY STRONGER, THEN THE EMOTIONAL PROCESSING KICKED IN.” – J Y O T I M A N G AT
myleapmagazine.ca SUMMER 2019 LEAP 25
Personalized cancer care plans help patients get through treatment on their own terms No two people experience cancer in quite the same way, and the differences aren’t just physical. How cancer affects you depends on many factors in your life, from your general health to your natural support systems, coping habits and even where you live. Any cancer treatment plan involves certain clinical protocols and timelines, but within that framework, care teams in Alberta find ways to accommodate individual needs, capabilities and preferences. EDUCATING PATIENTS IN BREAST CANCER CARE PLANNING Dr. Karen King is a medical oncologist at Edmonton’s Cross Cancer Institute. She treats patients with breast cancer, but, like all cancers, it’s a condition that defies easy categorization. “No two patients have the same disease,” King says. For that reason, King believes it’s a care team’s responsibility not just to deliver clinical treatments, but to make recommendations, educate patients and try to communicate as clearly as possible the benefits and risks of any therapy — from the earliest stages. That way,
26 LEAP SUMMER 2019
patients can make informed, confident decisions specific to their personal situations. “Patients need to understand what they’re getting into so they can consent to it. They need to understand their disease,” King says.
The education process begins after a positive biopsy result, which happens long before a patient meets King at the Cross Cancer Institute, for example. Following the positive biopsy, the patient enters the first phase of breast cancer care, a series of diagnostic tests that, in most cases, lead up to a lumpectomy or mastectomy. To navigate all these appointments, the patient is referred to Alberta Health Services’ Comprehensive Breast Care Program, a centralized network of services in Alberta that helps patients find the information they need to create a care plan. The purpose of the program is not to tell patients what they must do, but to help them understand the available services and options and support them through this phase. When this diagnostic/ surgical phase is complete, many patients require radiation, endocrine therapy and/or chemotherapy. At this point, they leave the Comprehensive Breast Care Program and
enter a new decision-making process, with the advice of a triage nurse, and the guidance of a multi-disciplinary team of practitioners (usually a medical oncologist like King, a radiation oncologist and a nurse practitioner, as well as input from the patient’s surgeon and pathologists). This team — called the Northern Alberta Breast Cancer Program at the Cross where King works (it’s southern counterpart is the Southern Alberta Breast Cancer Program) — considers all the factors that may affect outcomes for the individual, including age, general health, tumour pathology, family history, genetic profile and even cosmetic outcome (i.e., whether a patient wants a breast reconstruction or not). They also look for relevant clinical trial opportunities that might be a fit for the patient. Based on patient needs, the team may suggest modified treatment plans that accommodate personal challenges. For example, a patient who can’t access chemotherapy easily can be connected with a community cancer care program closer to home. King says the medical team never wants to compromise patient care, but they must consider the big picture: sometimes a patient’s health is best served not by insisting on a particular treatment, but by removing barriers that could prevent that patient from showing up for treatment. No matter what the experts determine, the patient is in control. A patient can opt out of any treatment at any time, even if doing so puts her health at risk. The important thing is that it’s an informed decision.
“We always tell patients, you’re the boss. You make the decisions,” King says. KEEPING THE BIG PICTURE IN MIND WHEN DELIVERING RADIATION THERAPY Radiation therapy targets cancer cells directly, while sparing healthy tissue. It is a hyper-localized treatment, but that doesn’t mean radiation therapy teams don’t consider a patient’s big picture. Fiona Lochray, associate manager of radiation therapy at Calgary’s Tom Baker Cancer Centre, says her team never forgets that patients are whole people. “Our focus is totally about the patient and what’s best for them," she says. Making sure radiation is targeted precisely is a highly individual process. After the type of tumour is confirmed, the patient’s next step is to go through a CT simulator, which determines the radiation plan for treatment. To ensure precision, each patient also receives a miniature CT scan (called a cone beam CT) before each treatment, and small adjustments are made to ensure the patient is correctly positioned for treatment. There are other factors to consider, too, which have to do with a patient’s ability to tolerate radiation therapy. Treatments take 15 minutes or more and may be delivered daily for up to six weeks. Can the patient stay completely still for as long as the procedure takes, or will they need to be immobilized? Can they show up for all their treatments? How’s their general health? Are they in pain? Are they mobile? Are they losing weight during the course of
by JULIA WILLIAMS + illustration ANDREW BENSON
treatment? Only after these questions are answered can the individualized treatment plan be created. Accessibility is also a factor, because each treatment must be performed in a designated clinic. Patients who have trouble getting to appointments may be referred to Wheels of Hope, a volunteer driver program for cancer patients. The Foothills Medical Centre Hostel in Calgary and Outpatient Residence near Edmonton’s Cross Cancer Institute offer temporary housing for patients undergoing cancer treatment, and radiation clinics in Calgary and Edmonton are open 7:30 a.m. to 6 p.m. so patients can come outside of their regular schedules.
Meanwhile, a project to improve access to radiation therapy province-wide is nearly complete. The Radiation Therapy Corridor, a northsouth network of radiation clinics in Alberta, will bring 92 per cent of residents within 100 kilometres of a radiation therapy clinic. Grande Prairie's new regional hospital and cancer care centre is scheduled to open in 2019, joining Lethbridge's Jack Ady Cancer Centre and Red Deer’s Central Alberta Cancer Centre to complete the corridor.
LETTING THE PATIENT LEAD WITH PSYCHOSOCIAL SUPPORTS Psychosocial services, which address the emotional, social, practical and spiritual impact of cancer on individuals and families, are an important part of a multi-disciplinary treatment plan. “A cancer diagnosis affects more than your physical health,” says Dr. Laura Labelle, a Calgary-based clinical psychologist and south supportive care lead with CancerControl Alberta. Diagnosis, treatment, recovery and survivorship affect mental, emotional, practical and spiritual well-being, and it’s different for every patient. Unlike medical treatments, which tend to be delivered on a schedule and in a specific order, psychosocial supports include a range of cancerspecific services and resoures from which patients can pick and choose. The network is made up of psychosocial support clinicians who specialize in cancer care, for example social workers, psychologists, psychiatrists and spiritual care providers. Depending on their needs and with the guidance of their medical providers, who may provide information, suggestions and referrals, patients can receive psychosocial services as an individual, couple, family or with other patients in a supportive group environment. “When patients are connected to psychosocial services, what they’re offered may relate to where they are in their cancer experience and tailored to their unique needs,” Labelle says. For example, a newly diagnosed
patient may be overwhelmed by practical concerns like finances, taking time off work and managing caregiving responsibilities, while a post-treatment survivor may experience complex feeings about their identity and fears about recurrence. Once they’re engaged with psychosocial supports, a patient will be involved in ongoing conversations about how they’re doing and what they may need to add or change to their support structure.
Labelle is working closely with Dr. Jill Turner, her counterpart in Edmonton, on a province-wide approach to psychosocial services that will ensure timely access to psychosocial care as close to home as possible, with the same quality of care for all Albertans living with cancer. With the support of the Alberta Cancer Foundation, they've introduced programs that address specific needs, including cancer patient navigators for adolescents and young adults, and sexual health services. “Emotional well-being and physical well-being are connected,” Labelle says. “Patients are often better able to manage their symptoms and side-effects if they’re taking care of their whole person.” LEAP
Personalized medicine goes gene deep In cancer treatment, “personalized medicine” has a deeper meaning: it describes an approach to the disease that takes into account a patient’s genetic makeup, as well as the genetic makeup of a specific tumour. Sometimes called precision medicine, this genetic approach to cancer care helps clinicians to plan treatments — particularly drug therapies — that are more precisely targeted than ever before. It can also help to predict who is most likely to develop cancer, while making early detection easier and preventing recurrence after treatment.
myleapmagazine.ca SUMMER 2019 LEAP 27
Gettin to Know Yourse by JENNIFER DOROZIO
HOW ONE WOMAN’S EXPERIENCE WITH CANCER CHANGED HER RELATIONSHIP WITH HER BODY
[LEFT] IN 2018, AMBER LAPSHINOFF UNDERWENT A MASTECTOMY ON HER LEFT BREAST [RIGHT] IN MAY 2019, SHE RECEIVED FOLLOW-UP RECONSTRUCTION ON BOTH BREASTS
28 LEAP SUMMER 2019
N
g + photography COLIN WAY
elf
N
OTHING PHYSICAL WOULD indicate that Amber Lapshinoff is living inside of an entirely different body, but mentally, that’s exactly how she feels. “It’s crazy. I don’t really know my body anymore to be completely honest,” says the 39-year-old. “It’s strange and sometimes frustrating.” Lapshinoff’s body feels so foreign to her because, in early 2018, she began treatment for a 5 x 5 centimetre cancerous mass (the clinical measurement) in her left breast. >
myleapmagazine.ca SUMMER 2019 LEAP 29
That February, during a self-examination, she noticed a change in her breast tissue. At the time she was working remotely as an environmental scientist. She came home to Airdrie and immediately saw her family doctor. Lapshinoff was diagnosed with stage 2A triple negative breast cancer, and a treatment plan was put in place. What followed included more than 600 pills for chemotherapy, numerous rounds of radiation, a mastectomy on her left breast, and, in May 2019, follow-up reconstruction on both breasts using tissue from her buttocks, called IGAP flap surgery — all of which primarily took place at the Tom Baker Cancer Centre in Calgary. Before cancer, Lapshinoff was a self-described “workaholic” who travelled constantly for her physically and mentally demanding job in the field. She hadn't taken a vacation in four years. “I knew my body very well before. I knew how hard I could push it, what foods it liked, how much sleep I needed and exercise that was required. Now I don’t know what to expect,” she says. As a result of her cancer treatment, Lapshinoff has experienced significant physical changes. After losing her hair from chemo, her formerly straight locks grew back curly; her left breast was removed and she now has reconstructed breasts that are entirely new; and, during treatment, a combination of the chemotherapy drugs, eating more to sustain her body and less overall activity led to a 30-pound weight gain. “Physically, the changes I observed were the hardest for me. I find I’m more self-conscious of the weight gain than having lost my breast,” says Lapshinoff. To tackle her weight gain and regain some vitality during treatment, Lapshinoff began attending a local gym but received stares due to her bald head and felt uncomfortable returning. She consulted her nutritionist at the Holy Cross Centre who recommended the Alberta Cancer Exercise (ACE) program. ACE is a collaborative provincial program and study designed by researchers at the University of Alberta and the
30 LEAP SUMMER 2019
University of Calgary. The U of A is the lead site for the ACE program, led by Dr. Margaret McNeely. It is a free, 12-week group fitness class specifically for those with, and recovering from, cancer and is funded by Alberta Innovates in partnership with the Alberta Cancer Foundation and others. Lapshinoff began the program with 13 others in September 2018 at the U of C’s Thrive Centre. After an initial fitness assessment, the group met bi-weekly for an hour to do strength, flexibility and aerobic training with equipment like weights and bands in a special sterilized gym — safe for people recovering from cancer. “It was amazing. I have more strength and more energy,” says Lapshinoff. “It helped with mental fatigue and joint pain. And no one ” W ITH TIME, MY BODY AND I WILL BECOME judged me...they were just REACQUAINTED, AND I'M HOPING THE happy I made it to class.” WORRY WILL EASE.” A scientist by trade, Lap– AMBER LAPSHINOFF shinoff enjoyed the chance to chat with the kinesiology gratitude, Lapshinoff does have a lingerresearchers running ACE and ask specific ing fear of cancer returning. questions about her new body, like what “With time, my body and I will become stretches were best for her left arm now reacquainted, and I’m hoping the worry that her lymph nodes had been removed? will ease,” she says. ACE wasn’t just about fitness; it was She plans to continue with the also an uplifting community space. ACE program’s follow-up maintenance “It’s like a safe zone,” says Lapshiclasses when her doctor gives her the noff. “I could go for coffee [with other all clear. Returning to work is also a participants] after the program, and you goal, but she says that this time she will support each other because everyone remember to take a vacation every year. can relate.” She’ll also continue to explore what the Now, after her successful reconstrucright diet and level of fitness is for her tion surgery, Lapshinoff’s immediate body today. focus isn’t on a goal weight but rather Mainly, Lapshinoff is excited to focus to take better care of herself, including on the positive aspects of her life. giving her body the nutrients it needs “If you can be positive and find a silver to heal. lining, I think it makes it harder for the “After all the stress, drugs and worry, cancer to grow,” she says. “My silver my body made it through chemotherapy, lining was that I got a butt lift and a radiation and surgery and I’m so very boob job for my [upcoming] 40th birththankful,” she says. day. How many people can say that?” LEAP Despite those deep feelings of
for his life. I was privileged to be a part of that in the several years that I got to know him. Q: Are there misconceptions about working as an oncologist? One is that it’s a depressing area of medicine. Fifty years ago, that was probably truer than it is [today]. Now we have a lot of different medications. We have non-chemotherapy drugs. We are curing more patients with advanced cancer. One of the biggest things we’ve changed is melanoma. Ten years ago, the chance of dying from metastatic melanoma was very high five years after diagnosis. Now, about half of the patients are being cured. That’s a huge advancement in this particular cancer, and we’re making advances in other cancers as well. It’s a very hopeful area of medicine.
Getting Personal with Dr. Xiaofu Zhu by VICTORIA
For Dr. Xiaofu Zhu, it wasn’t a big "a-ha" moment that brought him to the field of oncology — he describes his decision as little moments adding up that helped him realize how rewarding the work could be. Here, Zhu discusses his experiences practicing oncology and the patients who have made an impact.
ILLUSTRATION EMILY CHU
LESSARD
Q: Describe a moment that made oncology personal to you. Shortly after I started [at the Cross Cancer Institute], there was a gentleman who had incurable cancer. [What] stands out [is] the experience we [shared] in the clinic. He never really focused on his cancer, except for the rare times he had a lot of symptoms from his treatment. It
was more about his life outside of the clinic. He was a real car buff. He would talk about his time at the track and travelling the highways in his Mustang. We'd spend most of the time talking about his travels and his life. He was also an artist. He sometimes brought samples of his work from his home studio. [He] was a very memorable individual — not for his cancer but
Q: Is there a patient you’ve treated who gives you hope? There's quite a few. [One] is a patient who had metastatic cancer and [had] surgery for it. Unfortunately, over time, the cancer came back. For this particular patient, we took an outside-the-box approach. He was young and fit and working full-time, so we decided to make a referral to one of the few surgeons in the city who are very aggressive. It was a highrisk operation, but the patient, the surgeon and myself agreed that it was the best thing for the patient. He [went] through the treatment, a very unconventional surgery. Three years later his cancer has not come back, despite it being initially diagnosed [as] incurable. Helping him get to a point where he is essentially disease-free and may be cured, that's an incredibly uplifting experience. And that keeps us going — especially for patients who may not be curable right now but may get to that point later on in the future. LEAP
myleapmagazine.ca SUMMER 2019 LEAP 31
constantly for our areas and for our staff and for our patients.
Getting Personal with Cynthia Stulp by VICTORIA
Cynthia Stulp, manager of the radiation therapy department at Calgary’s Tom Baker Cancer Centre, always wanted to work in health care. For Stulp, radiation therapy is the perfect combination of working with innovative technology and caring for patients. A radiation therapist is an important part of a patient’s medical team — they deliver treatment via radiation machines, work on treatment plans and provide information to patients. Here, Stulp discusses the importance of caring for all aspects of a patient’s health.
32 LEAP SUMMER 2019
LESSARD
Q: Can you describe what you do in 10 words or less? Oversight of the operations of the radiation therapy department. That goes right from treatment planning all the way to finishing active radiation treatment. Q: What would you like people to know about your position? As a radiation therapist, the impact we have on patients is incredible. Because a patient comes every single day, for up to 35 treatments, we really form a relationship with the patient.
Q: Are there any misconceptions about what you do? There’s a misconception that management or operational leaders only care about the dollars and the number of patients that go through the system. Yes, we do care about that — we need to be fiscally responsible and to make sure that our staff is accountable. However, what guides us in doing all of that is what our patients need. What are our patients experiencing? How do we make it better for our patients? We don’t just stop at, ‘Okay, we’re good enough.’ We want to be the best all the time. We advocate
Q: What is the most important thing to you when considering a patient’s well-being? That their well-being goes beyond just the physical. It goes to their spiritual well-being, as well as their mental health. Knowledge is power for patients. Bring in their friends and family and get them involved in their care as well. That will go a long way. Q: What is your approach as a care provider? Appropriate compassion and empathy for patients. Most of them have come to terms with [their cancer] by the time they come in for their radiation treatment. That doesn’t mean they’re not still worried or scared or anxious. Having the appropriate amount of compassion and empathy for them is vital to their success. Take your cue from your patient. Let them steer where things are going to go. Then as a health-care provider, react appropriately to that. LEAP
ILLUSTRATION PETE RYAN
and get hit by a gravel truck — it’s just life. “And of course, not having breasts. I was [recently] at the [annual] Breast Reconstruction Awareness Day at the Foothills Medical Centre. [A plastic surgeon and I] had our own table, and it was really amazing because this one woman and her husband came over and she asked, ‘What made you choose to stay flat?’ I just told my story. I looked up at her husband as I was finishing and he was getting tears in his eyes. He said, ‘Listening to [you], it’s like [my wife] talking,’ and they both started tearing up. If I can help anyone’s journey be clearer — I just want to help other people. It’s so nice to be able to give something back, and I think part of that for me is the emotional healing [aspect of breast cancer].
Giving Back
Cheryl Goodwin’s journey through breast cancer and beyond by STEPHANIE
A
JOE
“I don’t think I’ve ever been angry about [my cancer diagnosis]. It was never, ‘Why me?’ It was, ‘Why not me?’ Because I’ve had such a good life, I take it as this is the way my journey is meant to be, and how do I make the most of it. “[Since my diagnosis] I have been slowly getting my life as simple as it pos-
FTER SKIING WITH A FRIEND
in March 2016, Cheryl Goodwin was driving to her cabin in Fairmont, B.C., for the weekend when she felt a lump on her right breast. She had a feeling that it might be breast cancer but didn’t know for sure, and Goodwin had to wait until Monday to talk to her general practitioner. Her doctor scheduled a mammogram the following Wednesday, and within a matter of days Goodwin was diagnosed. Having supported her mother through breast cancer a few years earlier, Goodwin knew exactly what she wanted to do — have both of her breasts removed. Goodwin opted out of breast reconstruction surgery. She also made the decision to not go through radiation or chemotherapy after she did further genetic testing, called Oncotype DX, to confirm that she was at low risk for cancer recurrence. April 15, 2019, marked her third year PHOTO JARED SYCH
cancer-free, but Goodwin hasn’t slowed down in her job as principal of a company called good nrg consulting or her hobby as a travel photographer. Along with exploring the globe with Beanie, a stuffed animal she travels with, and co-captaining the Women on Wheels team for the Enbridge Ride to Conquer Cancer, the nearing 50-year-old is passionate about sharing her journey with cancer. Here, she reflects on remission.
sibly can be. That’s another thing that has
new awareness about my body. My
who I am and you can love me or hate
joints are falling apart, because I’ve had
me. I want to be happy and healthy and
such a great life exploring the planet,
comfortable.
“[Now that I’m in remission] I have
but if some weird bump comes along on
happened since the cancer: I want to be able to experience life as it comes, with as simple a footprint as I can put down. “I think [the cancer] made me a better person and a better human being. The travel taught me how similar we are as humans, but the cancer has made me more authentic and more genuine. “Not that I used to be a false person before. The best part of this is I don’t ever have to wear a bra again in my life. I am
“I read about other women who’ve had
my body — I’m just hyper aware of that
cancer and are in remission and [some
type of thing, now. I can’t imagine going
say], ‘I’m going to eat everything that this
through [cancer] and not being that way
article and this diet says.’ My journey is,
with yourself. But maybe some people
‘I’m going to be as healthy as I possibly
aren’t — we all cope differently.
can, but I’m going to live every day as full
“For me, I’m not worried about it com-
as I can possibly make it.’ If I want to eat
ing back. I’m aware, of course, that it can,
a hamburger and drink a glass of wine,
but you can step out of your front door
then that’s what I’m going to do." LEAP
myleapmagazine.ca SUMMER 2019 LEAP 33
CARING
CHRIS BIRK, RADIATION THERAPY MANAGER AT THE CROSS, IN FRONT OF A LINAC MACHINE
PHOTO COURTESY BRIAN BRADY/CROSS CANCER INSTITUTE
34 LEAP SUMMER 2019
Precision Care
Advancements in radiation therapy at the Cross Cancer Institute by COLLEEN BIONDI
RADIATION THERAPY HAS BEEN USED TO
treat cancer for over a century. But the potentially harmful tools used in the therapy’s early days (such as basic X-rays and radium) have been replaced, thanks to advances in technology that have totally revamped the process. Today, radiation is more effective and has less deleterious side-effects, according to Chris Birk, radiation therapy manager at the Cross Cancer Institute. “With new machines, we get new abilities. Our field is ever-evolving,” Birk says. UNDERSTANDING RADIATION AND ITS EFFECTS
Radiation therapy is one of the four key treatment modalities for cancer (the others are surgery, chemotherapy and immunotherapy). In most cases it uses high-energy rays to kill the cancer cells of soft-mass tumours by damaging their DNA. It damages healthy cells, too, but they have the capacity to recover. Radiation may also be recommended before surgery to shrink and/or downstage a tumour (reducing the tumour’s clinical diagnosis from a higher-risk stage 4 to a stage 3, for example), thus allowing for a less-invasive procedure and a better outcome. After surgery, radiation can also eradicate microscopic cancer cells that might remain in the surrounding tissue. The most pronounced side-effect of radiation therapy is fatigue. This is often in combination with the stress-related fatigue from travelling and/or being away from family or work that many patients report experiencing. Skin may also be damaged by radiation therapy, especially in moist parts of the body, such as tumours of the mouth. Other effects — like swelling or nausea — are temporary and site-specific.
Currently, Alberta has four cancer centres that offer radiation — Edmonton, Calgary, Red Deer and Lethbridge. Radiation services at the Grande Prairie Cancer Centre are projected to open in 2019. EVOLVING TREATMENTS
Since 2011, the Cross has replaced five out of eight linear accelerator (Linac) machines used to deliver external radiation therapy to patients. New versions provide something called “rapid arc treatment.” It rotates around the patient and speedily emits pencil-beams of high-dose radiation directly at the tumour. “This was a big change for us,” says Birk. “When you get more focused radiation to the cancerous tissues, you can also spare some of that normal tissue.” The Cross also has three brachytherapy units that use radiation sources for additional personalized treatment options. Note: if you were treated with older machines, do not worry. “Treatment delivery and planning techniques have changed,” Birk explains. “But maximizing tumour dose and limiting the impact on normal tissue has always applied.” Today, all machines also have “on-board imaging,” which allows for more accurate patient positioning. Previously, imaging focused on where the tumour was relative to the nearest bone structure, like the rib or spinal column. With better imagining, therapists can provide these higher-dosage treatments (called stereotactic therapy) to the tumour and deliver fewer, more focused treatments. For example, brain cancer patients who are treated with gamma knife radiation stereotactic therapy may only need a single treatment session. The latest Linac-MR machine, which was being built and developed this past spring, will use more sophisticated magnetic resonance imaging to provide
BY THE NUMBERS
RADIATION THERAPY AT THE CROSS CANCER INSTITUTE
4,500
patients seen for treatment annually
63,793
sessions delivered annually
15 minutes (less than)
time frame of average treatment
20 to 25 sessions over
four to five weeks is the average number per patient
13
number of treatment machines in the program
85
number of radiation therapists in the program
$3.5 million cost of the latest Linac
sharper soft tissue contrast than the X-ray technology used in older models. The radiation therapy team has even examined the importance of aesthetics in improving the patient experience — now, when you are getting treatment, you can look at soothing images, like forests or skies, which are fixed, static images on the walls of the treatment vault. IMPROVING PATIENT QUALITY OF LIFE
Although there are no guarantees that radiation therapy will cure cancer, advances like these — resulting in lower-grade side-effects — ensure better quality of life for patients. They will be able to get back to their real lives faster and with more hopeful outlooks than ever before. LEAP myleapmagazine.ca SUMMER 2019 LEAP 35
LIVING WELL
5 WAYS TO LIVE WELL DURING TREATMENT 3.
GET ORGANIZED
2.
FIND SUPPORT
1. SHARE YOUR EXPERIENCE YOU ARE AN EXPERT in your own life, so don’t be afraid to be vocal with your care team about your experience, including issues around your mental health. The Putting Patients First symptom reporting form is a screening tool that allows patients to share their symptoms, including worries and fears, with their clinical team. It is used at all cancer care delivery sites under CancerControl Alberta. The tool offers an opportunity for patients to feel like their concerns, beyond physical symptoms, are a valid part of their cancer journey.
36 LEAP SUMMER 2019
CancerControl Alberta offers a variety of support services for patients living with cancer, as well as their families. Support services include psychosocial support, such as one-on-one counselling and pastoral care, as well as financial assistance and patient orientation services.
Clinical visits can often involve a lot of overwhelming information. To help you stay organized and informed, the My Care Conversations app allows you to take notes and record your consultations with your health-care providers for future reference. Developed by CancerControl Alberta and Alberta Health Services, and made possible thanks to the generosity of Alberta Cancer Foundation donors, the app can be downloaded from iTunes.
5.
STAY ACTIVE Fatigue is a common side-effect of cancer treatment, but if you can commit to regular exercise, those feelings of fatigue can decrease. Studies show that cancer patients who continue to exercise throughout their cancer journey recover sooner and more easily. Get started with the Alberta Cancer Exercise program (ACE). It’s a free, 12-week exercise program for cancer patients at different stages of their cancer journey. Learn more about ACE, as well as the type of exercise that may be right for you, on page 17. LEAP
4.
EAT WELL Eating well-balanced meals regularly can help you maintain your body weight in order to remain energized and strong during treatment. Good nutrition also plays an important role in healing and recovery when treatment is complete. Evidence suggests that cancer patients who maintain a healthy weight during treatment often have a better prognosis. Learn more about diet on page 14.
Thank you to Ringette Scores on Cancer! Your 10 years of continued support has raised over $785,000 to date for the Cross Cancer Institute.
Most recently, this past January, 16 teams and over 250 ringette players raised more than $64,000 for the Cross Cancer Institute over three days. These funds provide Albertans facing cancer with access to the best treatment and care. Thank you for powering progress down the ice AND in cancer research and care, right here at home! We are also very grateful to the University of Alberta Ringette team for their dedication to organizing this initiative.
August 27, 2019 Country Hills Golf Club, Calgary
Together, we have the power to change lives one swing at a time. Join us on August 27 th. To learn more, please contact Michelle Body at michelle.body@albertacancer.ca or at 403.476.2421 To support or participate in the tournament, visit albertacancer.ca/acfgc myleapmagazine.ca SUMMER 2019 LEAP 37
by COLIN GALLANT photography COLIN WAY
RESEARCH R O C K S TA R
A
WITH THE HELP OF DATA, DR. DARREN BRENNER IS INCREASING ACCESS TO CANCER SCREENING AND PREVENTION OPTIONS
t just 36 years old, Dr. Darren Brenner is at a relatively early stage in his career, but he’s already accomplished a lot. Not only does he work as a molecular cancer epidemiologist and an assistant professor with the departments of oncology and community health sciences at the University of Calgary, he is also co-principal investigator in a nationwide data compilation, analysis and translation project called ComPARe. Brenner believes that data holds the key to increased screening and prevention options — our best bet for significantly reducing cancer diagnoses in the future. >
38 LEAP SUMMER 2019
“ [ComPARE IS] AMONG THE MOST AMBITIOUS AND BROAD-REACHING CANCER PREVENTION RESEARCH PROJECTS EVER CONDUCTED IN CANADA.” — DR. DARREN BRENNER
myleapmagazine.ca SUMMER 2019 LEAP 39
As an epidemiologist, Brenner studies how often different diseases affect different groups of people and why. By determining which groups are affected, and how they are affected, scientists like Brenner are able to evaluate ways to treat — or prevent — diseases in patients. Brenner first became interested in epidemiology when he was an undergrad studying applied health sciences at Brock University in Ontario. “My mentor, Dr. Martin C. Tammemägi, was a cancer epidemiologist, and he was working on who should be screened for lung cancer — whether or not you should screen people for lung cancer and, if you should, who should be screened,” he says. “I found that to be such an interesting way to apply epidemiology, statistics and cancer biology all in one. And I thought this is something I could really find myself interested in and engaging in, career-wise.”
future burden of cancer in Canada and how those cancers could be prevented. ComPARe models the number of cancers in Canada that can be prevented through various individual initiatives (like being more active and improving diet) to population-level interventions (such as policy change). As the co-principal investigator, Brenner oversaw a team of five, along with Friedenreich, and was responsible for the collection, analysis and dissemination of research with a focus on lifestyle factors — the element of cancer prevention most actionable for members of the public. Presented in an accessible, interactive online environment filled with graphs, comparisons and predictions through to the year 2042, ComPARe is meant to equip government and health-care workers — as well as the general public — with the necessary information to make better decisions required to prevent cancer. In total, ComPARe looks at 20 modifiable
“ HE WORKS VERY HARD TO MAKE SURE THAT THE WORK HE DOES WILL HELP IMPACT [CANCER] SOMEDAY.” —D R. PAULA ROBSON, SCIENTIFIC DIRECTOR OF CANCER RESEARCH AND ANALYTICS AT CANCERCONTROL ALBERTA
Brenner’s next steps were to complete a MSc in epidemiology at Brock before spending a summer at the Johns Hopkins University’s Summer Institute of Epidemiology program and earning his PhD in the discipline at the University of Toronto. He was then chosen for a competitive spot as a post-doctoral fellow at the International Agency for Research on Cancer in Lyon, France. Next, Brenner made his way to Calgary in October 2013 for a second fellowship with Alberta Health Services (AHS) under the guidance of Dr. Christine Friedenreich, who would later become his co-principal investigator of the Canadian Population Attributable Risk of Cancer (ComPARe) project, which was launched to the public in May 2019. Brenner calls ComPARe “among the most ambitious and broad-reaching cancer prevention research projects ever conducted in Canada.” The project began in 2014, as a partnership between the Canadian Cancer Society and a nationwide team of experts to determine the current and 40 LEAP SUMMER 2019
risk factors related to 30 different types of cancer. According to the study, excess weight will be the second most preventable leading cause of cancer in Canada by 2042, and currently, the number one thing you can do to reduce your cancer risk is to not smoke tobacco. The study revealed that 4 in 10 of all cancers can be prevented through lifestyle changes and policy changes. Brenner’s hope for the project is that it provides a compelling, easy-to-understand map for individuals and legislators but also for medical professionals to help them make decisions that will help prevent cancer even earlier. For example, his research has shown that screening for colorectal cancer can be improved: the current way of evaluating who should be screened doesn’t necessarily consider all factors. “People who have a family history of colon cancer are carried differently through the screening process, while everyone else falls into what is classified as an average risk population,” he says. “But it is kind
of a misnomer, because there’s actually distribution of risk in the otherwise nonfamily history group,” he says. Essentially, Brenner wants to improve the cancer screening process for all Albertans. Dr. Paula Robson, the scientific director of cancer research and analytics at CancerControl Alberta and a colleague from Brenner’s days at AHS, notes the significance of Brenner’s work both as a researcher and connector. “It’s quite amazing, actually, for someone who’s relatively early in his research career, that he’s involved in and leading some really impactful projects,” Robson says. “I think that speaks to his passion, his energy, his drive, but also his fantastic ability to make relationships with scientists and other stakeholders right across Canada. He works very hard to make sure that the work he does will help impact [cancer] someday.” As for the future, Brenner is already starting on his next major research project, one he calls a follow-up to ComPARe. In collaboration with the Canadian Partnership Against Cancer, Brenner is working on a study that will estimate the cost savings related to cancer prevention in Canada, both in terms of reductions in direct patient treatment and indirect patient out-of-pocket costs. “This approach will give health decisionmakers a clear comparison between prevention and treatment in terms of impact and return on investment,” he says. “This is one of the largest projects to broadly examine this important financial aspect of cancer prevention in the world.” When Brenner isn’t working, you can usually find him with his wife, Melissa, and Nora, the couple’s beloved labradoodle. Whether that’s at an off-leash park or along the Bow River, where Brenner is an avid fly fisherman, depends on his schedule as an instructor at the U of C and part-time role as a spin instructor in Inglewood. We may never know how he finds the time for each of these pursuits, but a clue may be the inspiration he takes from his students. “It keeps me sharp,” he says. “I try to find the newest methods, the most upto-date research, so that it’s relevant and interesting for students. Because they’re so energetic, energized and engaged, it pushes things along.” LEAP
7
QUESTIONS WITH
DR. DARREN BRENNER 1. Describe what you do in 10 words or less. Cancer prevention and screening research. 2. What’s the biggest misperception about what you do? That all cancer researchers wear white lab coats and work at the bench. I am part of an emerging group of data scientists who use “big data” to address important questions in cancer prevention, screening and treatment. 3. Where do you get your best ideas? Walking my dog in one of the fantastic off-leash parks in Calgary. We are blessed with amazing green space in this city. These times help me to recharge and refocus our research plans on a daily basis. 4. What’s the hardest lesson you’ve learned? That changing complex behaviours and health systems is a serious challenge. We take the view that the only way to enable these changes is to provide the best data and answers to break down barriers. 5. What motivates you? Cancer touches all our lives. While not every research project will have an immediate impact on the cancer burden, we have come a long way in terms of understanding what drives cancer risk and how we can detect it earlier. If I can contribute to this knowledge in some tangible way so that the cancer future is brighter, it is extremely motivating to press on. 6. What do you do to recharge? Fly-fishing with my dog in mountain streams on the eastern slopes of the Rockies. 7. Why does your research matter? Despite incredible advances in treatment, prevention and screening remain our best options to significantly reduce the cancer burden in the future. Impactful research that will improve prevention and screening programs is essential to meet the cancer challenge in Alberta and beyond. This research can help Canadians in their lifelong cancer prevention journeys.
myleapmagazine.ca SUMMER 2019 LEAP 41
BRENDA HUBLEY SAYS THAT PATIENTS ARE AT THE HEART OF EVERY DECISION SHE MAKES
42 LEAP SUMMER 2019
TRUE CALLING
by KAITLYN HANSON photography COOPER & O’HARA
CANCER CARE VISIONARY CancerControl Alberta chief program officer BRENDA HUBLEY stays true to her clinical roots while improving cancer care for all Albertans
B
RENDA HUBLEY SAYS IT IS IRONIC THAT AS A CHILD GROWING UP IN NOVA
Scotia, she favoured independent pursuits, such as horseback riding, over group activities. “I was never a team sports girl,” she explains. “And then I moved into health care, which is such a team sport.” Today, Hubley is the chief program officer for CancerControl Alberta, taking on the operational leadership of all cancer programming provided by Alberta Health Services, which includes planning, delivery and evaluation of cancer services. Collaborative work is at the heart of every step of her career in health care, from supporting radiation therapy students at the University of Alberta to leading the teams behind the Radiation Therapy (RT) Corridor, a project that has increased Albertans’ access to radiation therapy clinics. As a direct result of this initiative, 92 per cent of people in Alberta now live within 100 kilometres of a radiation therapy clinic. >
myleapmagazine.ca SUMMER 2019 LEAP 43
“If I think about things that have made me really proud, [one] has been my ability to influence and support all practitioners to maximize their contributions regardless of their discipline or role,” she says. After completing her bachelor of science degree in psychology and biology from Dalhousie University in 1988, Hubley began her career working at a group home for adults with intellectual disabilities. When one of her clients was diagnosed with cancer, she was introduced to the Cancer Treatment and Research Foundation of Nova Scotia while supporting him through his treatment and care. Shortly after the experience of caring for her client, she saw an advertisement in a local paper that put her career on a new trajectory. “The Cancer Treatment and Research Foundation was looking for individuals interested in a career in radiation therapy,” she says, adding that the opportunity involved training in Toronto before eventually returning to Halifax to work. “It was a fully funded opportunity and I had just recently had this exposure to that world through my work, so I applied.” Hubley became a staff radiation therapist at the Queen Elizabeth II Health Sciences Centre in Halifax in 1992, after completing her diploma in radiation therapy, eventually progressing to the role of radiation therapy services manager. From 2000 until 2005, she was the School of Radiation Therapy’s clinical education director at the Queen Elizabeth II Health Sciences Centre. Hubley credits the early years of her career as a radiation therapist for keeping her connected to the caregivers who interact with patients on a daily basis. “Fundamentally, at the core of who I am, I’m a radiation therapist,” she says. “Very early in my career, it was really important to me to ensure that radiation therapists, as professionals, had as far and deep a reach into cancer services and providing patient care, and working to full scope of practice, that they possibly could.” 44 LEAP SUMMER 2019
After meeting her Alberta-based partner, Craig, a university administrator and professor, during his sabbatical in Halifax, the pair relocated, to Lethbridge, Alberta. Although she has called Alberta home since 2005, Hubley still makes the trip home to her beloved East Coast as often as she can. “As much as people here really love the mountains as being calm and very soothing, if you grow up around the water, you need water,” she says. After a short time working away from cancer services at the University of Lethbridge, Hubley received a call from Dr. Peter Craighead, a contact from her days in radiation therapy. He wondered if she would be interested in an opportunity to work with the Tom Baker Cancer Centre, and Hubley was quick to accept. From October 2005 to November 2007, Hubley was responsible for the development and management of an integrated clinical radiation therapy program within the Tom Baker Cancer Centre, splitting her time between her work in Calgary during the week and her home in Lethbridge on the weekends. Eventually, Hubley’s work in Calgary led to her appointment as lead for the RT Corridor project and administrator of the Jack Ady Cancer Centre in Lethbridge. In this role, Hubley not only provided day-to-day direction and leadership in the
administrative operations of the Jack Ady Cancer Centre, but also took on a key role in the project management, functional programming, and construction of radiation treatment centres and expanded cancer clinics in Red Deer and Grande Prairie. She was named CancerControl Alberta’s executive director of community oncology and provincial practices in 2012, providing leadership and operational management in support of all cancer treatment centres outside of Calgary and Edmonton. When a work opportunity presented itself to Hubley’s partner in 2013, the pair moved to Edmonton, where she continued in her role as executive director of community oncology. In the spring of 2018, Hubley became CancerControl Alberta’s senior program lead for the northern half of the province. And earlier this year, she moved into her current role as chief program officer, heading up all cancer operations within Alberta Health Services. “I still do pinch myself that I have the opportunity to take on this role, and what the future can hold,” she says. “It’s about enabling our system to respond to what patients and families need.” Hubley emphasizes that patients are at the heart of every decision she makes on the job. She aims to spend as much time
as possible meeting with patients and their families in cancer care centres across the province, and engages regularly with team leaders and staff to listen, provide support, and make plans for the future. “I really enjoy that strategic longer view,” she says. “Frankly, I probably frustrate some of the people I work with at times, but I am always encouraging us to look beyond a problem to the bigger picture, and to something a little bit further on.” Dr. J. Dean Ruether began working closely with Hubley in 2015 when he took on the role of medical director of community oncology, CancerControl Alberta. He says that her clinical background and training contributes to her comprehensive understanding of cancer care. “One of the things I appreciate the most about Brenda is that she has not forgotten her clinical roots,” he says. “She is always grounded in ‘what does this mean for patients?’ and she can speak with credibility because of her clinical background. She is an absolute joy to work with.” Hubley has remained an advocate for radiation therapists throughout her career, serving as vice-president of the Canadian Association of Medical Radiation Technologists from 2004 to 2008, and working with colleagues at the University of Alberta to enhance and improve radiation therapy education programs in the province. “When I first came to Alberta and through my early time here, I worked really hard to move our radiation therapy
education program from being hospitalbased to being a baccalaureate-qualified program within the University of Alberta,” she says. “I’m very proud of that.” Looking to the future, Hubley says she is excited about the opportunity to improve and enhance cancer care in Alberta even further. One important area of focus for Hubley and her team in the coming months and years is ensuring that cancer care services represent the full diversity of Alberta’s population. “We’ve started some important work on engaging with our patients, building a network of patient advisors, really bringing patients into our planning and how we deliver services in a material and important way,” she says. “Not just as a token, but really as a partner in care.” Her colleague, Marg Semel, senior program lead (south), CancerControl Alberta, says that Hubley’s ability to consider the voices of all stakeholders in the provincial cancer system is one of her strongest assets. “As a leader, she has a vision for the provincial cancer system,” says Semel. “As someone who has a deep understanding of the cancer system, she is open to hearing new ideas and moving these ideas forward. She listens respectfully, and she integrates what she has heard to take these ideas to an even stronger place.” Hubley says that her immediate focus is to support teams in enhancing their work with Indigenous and diverse populations including LGBTQ+ in the province,
ensuring that the patient-provider partnership is meeting the needs of all Albertans. “It really is about being very inclusive and respectful of the diversity of our patient population and the staff that we have in supporting our patients,” she says. Another key area of focus for CancerControl Alberta is using research generated in partnership with the Alberta Cancer Foundation to enhance patient care and patient outcomes, says Hubley. “The important element that we’re looking to in the future is really using that research to generate knowledge — not just information, but knowledge — and translating that into practice that changes and improves outcomes,” she says. Much of this work, she adds, is collaborative, which means that relationships and partnerships between care providers, patients and the wider community will continue to be nurtured in the years ahead. “Our program, and much of what we do, is around active therapy and treatments for patients with cancer,” says Hubley. “We are collaborating with partners in prevention and screening, as well as to support patients through their whole trajectory — putting mechanisms in place to ensure that patients get diagnosed quickly so they can move on to active treatment, and then supporting them post-treatment.” “It’s really about those partnerships,” she says. “Both across Alberta Health Services and with our community, so that we can improve the care across that continuum.” LEAP
BRENDA HUBLEY CAREER HIGHLIGHTS • Appointed chief
program officer for CancerControl Alberta in March 2019, taking on the operational leadership of cancer programming within Alberta Health Services.
•B rought cancer care closer to home for patients outside of Edmonton and Calgary through the Radiation Therapy Corridor, ensuring that 92 per cent of Albertans now live within 100 km of a radiation therapy clinic.
•S upported the
transition of the University of Alberta’s radiation therapist training program from a hospital-based program to a baccalaureate-qualified academic program.
•S erved as vice-pres-
ident (2004-2008) of the Canadian Association of Medical Radiation Technologists, which represents over 12,000 members as the national professional association and certifying body for medical radiation technologists and therapists.
•C ontinues to work
collaboratively with First Nations, Métis and LGBTQ+ stakeholders to enhance and improve personcentred cancer care that is reflective of the populations served by Alberta’s health-care system.
myleapmagazine.ca SUMMER 2019 LEAP 45
IMPACT
TEGAN CARMICHAEL AND MIKE PROUDFOOT AT THE 2016 ENBRIDGE RIDE TO CONQUER CANCER
Remembering Tegan as told to STEPHANIE JOE
In 2010, Alison Tegan Carmichael (known to family and friends as Tegan) began struggling with “intrusive thoughts.” Negative feelings or images would pop into her mind and overwhelm her, sometimes to the point of exhaustion. The staff at a hospital in Vancouver, where she was living with her husband at the time, initially misdiagnosed her symptoms as a psychotic episode, but Carmichael sensed that something else was wrong. That summer, she returned to her hometown of Edmonton and, unbeknownst to her family and friends, went to the University of Alberta Hospital, where she insisted they take an MRI of her brain. On June 9, 2010, Carmichael was diagnosed with an oligodendroglioma brain tumour in her left temporal lobe. She was 23. Following her diagnosis, Carmichael underwent seven brain surgeries, two spinal surgeries, two rounds of radiation and multiple rounds of chemotherapy. During treatment, she worked full-time, ran her first marathon and was heavily involved in the Enbridge Ride to Conquer Cancer, presented by Evraz, benefitting the Alberta Cancer Foundation, including serving as a team captain for seven years (most recently for the Accenture Brainiacs team.) Carmichael passed away on February 19, 2019, at the age of 32 with her family around her. This August, Carmichael’s husband, Mike Proudfoot, will be cycling in the 2019 Ride to honour her legacy. Here, Proudfoot shares his wife’s story and reflects on her inspiring life. 46 LEAP SUMMER 2019
“Tegan was always a very hard worker; she was very disciplined. She’s someone who never missed a workout and was in the gym every day. She ran most days and she was quite the athlete. I think that basically multiplied after she got her diagnosis. “She organized her life around, ‘What can I do to beat this thing?’ She was very determined to do so. I think, as happens with most people when they are faced with such a diagnosis, that they face their own mortality. Although she was very structured with her exercise regime and things like that, she also became much more spontaneous. For example, on her 25th birthday, she went skydiving, and for her 30th birthday, [I] bought her flying lessons. “I think when you get diagnosed with cancer, it’s such a complex disease and right away the odds are stacked somewhat against you. With something like the Ride [to Conquer Cancer], I think it’s a way for patients to gain control and having that agency provides an immense benefit to their state of mind. With Tegan that was pretty evident. Looking at it and saying, ‘There’s a lot of things I can’t control here, [but the Ride] is something I can control, and as a result I’m going to invest my efforts in that cause.’ “That’s the biggest benefit I think she gained from the Ride. You build your team and you’re all fundraising and you’re all working towards the same goal. You build lasting friendships. It also allowed her to share her story. “Since she has passed, I have received a ton of calls from people I’ve never met, [telling me] that Tegan continues to inspire them with how she responded to her illness and how she continued to fight in spite of everything is amazing. I think she gained a lot of pride for being able to share her story and inspire others with it as well. “This year, I am participating [in the Ride], and while I’m in Alberta or [elsewhere in] Canada, I don’t envision a situation where I wouldn’t participate. To me it’s a very worthwhile cause and it’s also a good way to honour Tegan’s legacy.” In her own words, this is what Tegan thought of the Ride to Conquer Cancer: “Since my original diagnosis, I’ve taken part in the Ride to Conquer Cancer [six] times, raising over $60,000 for the cause. In this time I’ve seen stats change. I’ve seen my life expectancy shift. This is 100 [per cent] because of the research made possible via fundraisers such as this Ride. These [funds] are making a difference and I’m seeing it first-hand. Trust me. Please, make a [donation]. I’m fighting against all odds and your donation is truly working to extend my life.” LEAP Learn more about the Tegan Carmichael Legacy Fund, in support of the Alberta Cancer Foundation, at payment.csfm. com/donations/calgaryfoundation/
WHY I DONATE
Offering Thanks by COLLEEN BIONDI
Larry and Joanne Pollock are giving back in a big way >
PHOTOS PAUL SWANSON
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FROM SPENDING WINTERS IN CALIFORNIA
and summers in the Okanagan to celebrating 50 years of marriage in the Mediterranean, travel has been a big part of Larry and Joanne Pollocks’ lives. “Travelling has given us such an appreciation for our way of life in Canada and exposed us to fantastic cuisine from different countries, as well as terrific scenery and historical sites,” says Larry. While travel has been important to the Pollocks since Larry retired from his role as CEO of Canadian Western Bank in 2013, it certainly hasn’t been their only focus. The couple, who live in Edmonton, have also continued to foster their long-time commitment to community involvement, both as volunteers and as donors. Over the years, they have funded kids’ camps and financial literacy programs. But when a dear neighbour died of cancer five years ago, the Pollocks decided they wanted to do something even more significant — with a personal twist. In 2015, they created the Pollock Family Foundation as a vehicle for their philanthropic donations. Following its creation, they continued to support various charities and planned a donation for cancer research — in memory of their neighbour. Then the unthinkable happened. In 2017, Joanne was diagnosed with endometrial cancer. She had surgery using the da Vinci Surgical System (which allows surgeons to perform minimally invasive surgeries with robotic technology,) at the Lois Hole Hospital for Women in Edmonton and is now, thankfully, cancer-free. Grateful for the exceptional care Joanne received, the couple began conversations with staff at both the Royal Alexandra Hospital Foundation and the Alberta Cancer Foundation about how they could contribute financially to the quest to conquer cancer. In 2018, they entered into a commitment with both funding groups, through which the Pollock Foundation 48 LEAP SUMMER 2019
JOANNE AND LARRY POLLOCK CREATED THE POLLOCK FAMILY FOUNDATION AS A VEHICLE FOR THEIR PHILANTHROPY
will dispense a certain amount of money per year to each foundation for five years. These moneys are not targeted. They will be spent at the discretion of the two foundations. “I wanted them to point the hose at the biggest fire,” Larry says. For the Alberta Cancer Foundation, one of the priorities the Pollocks are supporting is improving treatment for bone marrow patients at the Cross Cancer Institute. Specifically, the demand for malignant hematology stem cell transplantation is on the rise at the Cross. Between 2016 and 2017, there was an increase of 31 per cent in the number of referrals the facility received. Having a dedicated space, the latest technology and the right people in place will mean the Cross and its patients can be at the forefront of innovation. In addition, the Pollocks have engaged in a “matching donor” campaign with the Alberta Cancer Foundation, where they and another family will match donations that come in so each dollar goes three times as far. Today, the Pollocks have two grown
children and three grandchildren and are also part owners of the Play Estate Winery in Penticton. In his retirement, Larry continues to find other ways to give back, as well; he provides financial mentoring to a young technology guru and sits on two corporate boards. Donating money is one way to help the cancer community. But according to Larry, it’s not just the money you personally donate that is significant. “It is the effort you put in — whether it is by raising money, volunteering, mentoring or being on a board,” he says. He recommends making other people aware you have donated or served on a board as a way to steer friends and colleagues to worthy charities and causes. The Pollocks are pleased to enter into this kind of philanthropic framework. It is also their way of saying thanks to the cancer community who supported Joanne when she needed it most. “Dr. Valerie Capstick (an oncologist at the Cross) was absolutely terrific looking after Joanne,” says Larry. “It turned out well for us.” LEAP
MY LEAP
MICHAEL BACHINSKY AND VOLUNTEERS
Bright Lights The students at Holy Redeemer School are passionate volunteers by MEREDITH BAILEY
MARCH IS A BUSY MONTH AT HOLY REDEEMER JUNIOR/SENIOR HIGH
School (HRH) in Edson, Alta. On top of classes and extracurricular activities, students spend many of their lunch hours and evenings participating in a variety of events for the March 4 A Cure fundraiser in support of the Alberta Cancer Foundation. The calendar of weekly events includes bake sales (with a “cake war” competition), candy jar guessing games, a basketball shooting competition, hot lunches for sale and more. Founder and organizer Michael Bachinsky, who is the phys. ed and industrial arts teacher at HRH, was inspired to start the fundraiser 13 years ago for a deeply personal reason. “Over the course of a year or two, my Grandpa Bachinsky and my aunt both passed away from cancer,” he says. “March 4 A Cure actually started in my parents’ backyard as an auction with my family and friends. We wanted to support the Alberta Cancer Foundation because it makes an immediate difference close to home.” When Bachinsky began working at HRH in 2010, he introduced the fundraiser to the school. “When I held my first meeting nine years ago, 25 kids showed up, from Grade 7 to 12, and we just brainstormed. I let them run with it and they took full responsibility for the month of events.” Every year, HRH student volunteers set a target fundraising goal and decide on what events to run and how to run them, including everything from making posters to managing budgets. This year’s goal was to break the $100,000 mark for the total funds raised since the fundraiser began in 2010. “We have this core group of volunteers and I always joke, if you
talk about the youth of today, these kids are going to change the world,” Bachinsky says. “They’re super keen, super intelligent, want to make a difference and are willing to give their time.” Over the past nine years some of the fundraising initiatives have been more successful than others. For a few years, students and teachers participated in a headshave-for-donations event, which left Bachinsky — who let the students choose his shaved hairstyle — with a mohawk, tri-hawk and a “friar-tuck.” When that event lost steam, mainly because students didn’t want to cut their hair or already had, Bachinsky challenged the student volunteers to come up with other fun ways to raise money. “If the kids are no longer into it, you can’t force it,” he says. “So, there are few events we do consistently, but we also regularly come up with new events every year.” Bachinsky, who oversees March 4 A Cure, encourages the students to find a balance between raising awareness and raising funds. “One year, they had an idea to stick a kid to a wall with tape. So, you’d pay $5 and tape a kid to the wall in the gym and see how long they’d stick. But when I looked at the cost of duct tape I had to come back and say, ‘Guys, this is not cost-effective.’” One event that is consistently successful and a highlight of the fundraiser is the March 4 A Cure Silent and Live Auction. Held this year on March 15, it took place in the lobby of HRH in the evening and was open to the public. “Students canvas the community for donations the month before in April and the community really rallies around them,” Bachinsky says. “Even in a recession year we were able to get 140 items donated. We had a full concession and there was a dance recital in the gym at the same time, which got even more people through the door. It was really successful.” When the dust settled, this year’s March 4 A Cure raised a little over $7,000, which left the final tally of total funds raised at $98,000. Despite falling just short of the $100,000 goal, Bachinsky says he and his passionate student volunteers are not discouraged. “We’re excited to go bigger and better for the 10th anniversary of March 4 A Cure, and the kids and I have already started to brainstorm how we’re going to do that. We know we’ll meet our $100,000 goal next year and surpass it. It’s going to be a celebration of our students, too, and 10 years of amazing volunteer work.” LEAP myleapmagazine.ca SUMMER 2019 LEAP 49
GAME CHANGER
TEAM PCL ENERGY AT 2017 BUST A MOVE IN EDMONTON
Building Together PCL Construction Inc. has a long history of supporting the Alberta Cancer Foundation by JENNIFER FRIESEN
FOR MORE THAN 30 YEARS, CALGARY’S TOM BAKER CANCER CENTRE
has been providing excellent care for patients, but as the city grows, the centre has begun to run short on space to meet the needs of the growing population. Over those same three decades, PCL has supported the Alberta Cancer Foundation as donors, sponsors and participants in events — all in the hopes of helping Albertans facing cancer. Now, the company has been awarded the chance to use its expertise to design and build Calgary’s brand-new cancer centre. Plans for the development of the new Calgary Cancer Centre (CCC), which will be located at the Foothills Medical Centre, were announced in 2015. In 2017, after a rigorous competition process, PCL was awarded the contract for the facility. PCL is an employeeowned construction company that operates in Canada, the United States, the Caribbean, and Australia, and has offices in Calgary and Edmonton. “Our approach [to designing and building the CCC] has been to focus on creating a high-quality building,” says Toby Hendrie, senior construction manager of PCL in Calgary. “When people walk into the front door, we want them to feel like they’re in the right place and know they’re going to be treated with respect and given a fighting chance of getting through it.” Set to open in 2023, the CCC will be a first-rate cancer treatment 50 LEAP SUMMER 2019
centre, providing state-of-the-art care to those in need from across southern Alberta. The 127,000-square-metre facility will have approximately 160 inpatient beds, 100 exam rooms, 100 chemotherapy chairs, and more — a significant addition to cancer care services in the province. Hendrie has spent many years constructing health facilities while in his role with PCL — including helping in the creation of the $1-billion Victorian Comprehensive Cancer Centre in Melbourne, Australia, and renovations to the Cross Cancer Institute in Edmonton — but the cause became more personal last year, when he lost his brother to the disease. “It was tough,” he says. “I have a real personal interest in making sure that we’re doing a great job to build this right.” In designing the CCC, with input from staff, physicians, and patient and family advisors, the PCL team wanted the facility to evoke a sense of welcoming. From a bird’s-eye view, the building itself is meant to mimic the appearance of two people hugging, with two of its four branches enveloping the other two. “It’s a very pure vision of two people in an embrace,” says Hendrie. After being a part of building cancer centres around the world, Hendrie emphasizes that it’s important to think of the people on the ground. “I’ve gone to see patients and families on site after a cancer centre is complete, and I get to see their reaction,” he says. “Those moments stand out because I know that what we built will help thousands of people every year. [Cancer] is such a common disease, all of us have been impacted in some way.” As well as helping to improve the lives of cancer patients through the design and construction of the CCC, PCL’s offices in Calgary and Edmonton have provided sponsorships, donations and support to the Alberta Cancer Foundation for the Tom Baker Cancer Centre and the Cross Cancer Institute through various past events, including Edmonton’s Bust A Move and the Tom Baker Cancer Centre Golf Classic. This year, PCL will be sponsoring the Alberta Cancer Foundation Golf Classic and is part of team “Building Hope” in the Enbridge Ride to Conquer Cancer. “The odds of getting cancer in your life are now almost one in two,” Hendrie says. “It makes an impact wherever you live. Here in southern Alberta, we want to know that we’re doing our part to give back.” LEAP
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
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Together we’re creating more moments for Albertans facing cancer
albertacancer.ca