Leap Winter 2015

S OF CANCER THE HALLMARK

WINTER 2015

Leader of the

Pack

Dr. Michael Weinfeld’s rockstar team works towards improving cancer treatments

A POLE UP Nordic walking takes winter by storm

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HALLMARKS OF HAPPINESS Why oncologists need to take better care of themselves

PLUS: The health benefits of olive oil, take the stress out of eating, meet a ‘living library’ and more...

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benefiting

CONTENTS

WINTER 2015 • VOL 6 • No. 4

ON THE COVER: Dr. Michael Weinfeld

Photographed by Curtis Trent

WINTER SPOTLIGHT THE HALLMARKS OF CANCER

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DEPARTMENTS 4 OUR LEAP

A message from the Alberta Cancer Foundation

6 11 42

12 34

FOREFRONT How olive oil fights cancer, racing dragon boats for a cause, meeting a ‘living library’ and more

NEXT GEN A generous fellowship provides an opportunity to further glioblastoma research

BEYOND CANCER What you need to know about managing life once treatment ends and survivorship begins

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ASK THE EXPERT We polled the pros about getting geared up for winter running, mammograms and the potential link between processed meat and cancer

The Hallmarks of Happiness help oncologists lead healthy, happy lives.

24 FROM CELLS AND TISSUES TO HOPE Researchers work with the smallest pieces to solve cancer’s biggest problems

A University of Calgary researcher has set his sights on understanding the importance of compassion in cancer care

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34 BRIDGING THE CULTURAL GAP

38 WHY I DONATE

41

42 TOP JOB

Lori Kirkaldy helps aboriginal cancer patients navigate the system

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FEATURES 29 SOMEONE TO LEAN ON

28 PATIENT ENGAGEMENT

In complex workplaces, ensuring everyone has a voice leads to better experiences

24

A 15-year-old article meant to break down the complexity of cancer continues to help researchers

22 ONCOLOGIST, HEAL THYSELF

13 SMART EATS

Keep calm: eating smart shouldn’t make you feel under pressure

HALLMARK MOMENTS

CORPORATE GIVING Daytona Homes’ successful “suitcase party” sent donors on a meaningful weekend getaway

50 MY LEAP

Cancer survivor Kevin Coflin rides to conquer a family history of cancer

A POLE UP No skis, no problem. Nordic walking provides a full-body workout that’s easy on the joints

After a long cancer journey, Patricia Lamont’s loved ones donate in her name

Vivian Collacutt looks for ways to help cancer patients across the province

46 RESEARCH ROCKSTAR

Dr. Michael Weinfeld’s Alberta-based team works towards inventing new drugs that target cancer cells

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Message • alberta cancer foundation

Unfolding More Moments TRUSTEES Angela Boehm, Chair Calgary Gary Bugeaud Calgary Christopher Burrows Edmonton Steven Dyck Lethbridge Thomas Hodson Calgary Jordan Hokanson Edmonton Dr. Sandip Lalli Calgary Katie McLean Calgary John J. McDonald Edmonton Andrea McManus Calgary Brent Saik, Vice Chair Sherwood Park Sandy Slator Edmonton

It’s been 15 years since the seminal Hallmarks of Cancer paper was published, and since that time it has helped scientists navigate the complexity of cancer by identifying the six traits (or “hallmarks”) that all cancers share.

One of the hallmarks of the Alberta Cancer Foundation and our donors is to make life better for Albertans facing cancer. We recently unveiled our 2015 Report to Donors: “Unfolding More Moments,” which showed how our investments create more moments for Albertans facing cancer. In that report we tell the Alberta Cancer Foundation story. It’s the story about Albertans. And it’s a story about you.

Over the last year, you — our donors, our event participants, our partners — helped patients feel comfortable during chemotherapy. You provided financial assistance across the province. You helped ignite the imaginations of the brightest researchers so we can bring their discoveries to patients, faster.

In the last year, Albertans made almost 600,000 visits to cancer centres across this province. No matter where they lived, you were there for every step of the journey. From Fort McMurray to Medicine Hat, you stood alongside cancer patients. From the moment patients heard the words, “You have cancer,” you helped us offer three words in return: “We will help.”

In this issue of Leap, you will read about social worker Vivian Collacutt (page 42) and her incredible capacity to care for the unique needs of rural cancer patients. You will read about our investment in From the moment patients the provincial biobank and how these facilities give heard the words, “You have researchers access to high-quality samples that will cancer,” you helped us offer speed the pace of discovery, leading to more moments Albertans facing cancer. three words in return: forWe celebrate the years of research that have brought “We will help.” us to the point where more than 100,000 Albertans are alive today after a cancer diagnosis. And we know the work we do is still crucial to achieving the next advancements that will save even more lives. Just as the Hallmarks of Cancer have helped uncover the underlying principles of cancer, the Alberta Cancer Foundation has worked hard to change the medical landscape in this province. We have a sense of urgency, and are driven by a singular goal — to save lives by speeding up the pace of discovery and helping that innovation reach the health-care system.

Thank you for helping us unfold more moments for Albertans. See our story in our annual report here: http://albertacancerreport.ca/ Myka Osinchuk, CEO Alberta Cancer Foundation

Angela Boehm, Chair Alberta Cancer Foundation

Greg Tisdale Calgary

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myleapmagazine.ca

WINTER 2015 VOL 6 • No. 4

ALBERTA CANCER FOUNDATION EDITOR: PHOEBE DEY CALGARY OFFICE Suite 300, 1620 - 29 Street NW Calgary, Alberta T2N 4L7 PROVINCIAL OFFICE 710, 10123 - 99 Street NW Edmonton, Alberta T5J 3H1 Toll-free: 1-866-412-4222 Tel: 780-643-4400 acfonline@albertacancer.ca VENTURE PUBLISHING INC. PUBLISHER: RUTH KELLY MANAGING EDITOR: LYNDSIE BOURGON ART DIRECTOR: CHARLES BURKE GRAPHIC DESIGNER: ANDREW WEDMAN PRODUCTION MANAGER: BETTY FENIAK PRODUCTION TECHNICIANS: BRENT FELZIEN, BRANDON HOOVER WEB & SYSTEMS ARCHITECT: GUNNAR BLODGETT DISTRIBUTION: KAREN REILLY CONTRIBUTING WRITERS: Robin Brunet, Lisa Catterall, Julie-Anne Cleyn, Michelle Lindstrom, Jacqueline Louie, Trina Moyles, Shelley Newman, Shelley Williamson CONTRIBUTING PHOTOGRAPHERS AND ILLUSTRATORS: Brian Bookstrucker, Buffy Goodman, Cooper + O’Hara, Curtis Trent, Andrew Wedman ABOUT THE ALBERTA CANCER FOUNDATION The Alberta Cancer Foundation is Alberta’s own, established to advance cancer research, prevention and care and serve as the charitable foundation for the Cross Cancer Institute, Tom Baker Cancer Centre and Alberta’s 15 other cancer centres. At the Alberta Cancer Foundation, we act on the knowledge that a cancer-free future is achievable.

When we get there depends on the focus and energy we put to it today.

Leap is published for the Alberta Cancer Foundation by Venture Publishing Inc., 10259-105 Street, Edmonton, AB T5J 1E3 Tel: 780-990-0839, Fax: 780-425-4921, Toll-free: 1-866-227-4276 circulation@venturepublishing.ca

The information in this publication is not meant to be a substitute for professional medical advice. Always seek advice from your physician or other qualified health provider regarding any medical condition or treatment.

Printed in Canada by Mitchell Press Limited.

Leap is printed on Forest Stewardship Council ® certified paper Publications Agreement #40020055 ISSN #1923-6131 Content may not be reprinted or reproduced without permission from Alberta Cancer Foundation.

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Forefront • prevent, treat, cure

Oil is Well

Compound in olive oil found to kill cancer cells quickly Research published in the journal Molecular & Cellular Oncology, based on data from Rutgers University and Hunter College researchers, has shown a link between olive oil and eradicating cancer cells.

The team found that oleocanthal, a compound in extra virgin olive oil, destroyed cancer cells’ waste centres or lysosomes, which are larger than healthy cells, and they did so in less than an hour. Normally, unnecessary cells in the body experience apoptosis – cells dying – but it takes from 16 to 24 hours.

The findings are important because they suggest many possible uses for oleocanthal, which is just one of the phenols, or antioxidants, that exist in olive oil. The co-authors of the study, Onica LeGendre and David Foster of Hunter College, and Paul Breslin of Rutgers, have said they want to learn more about why the compound kills and shrinks cancer cells, and why cancerous cells are more susceptible to the effects of oleocanthal than non-cancerous ones.

While the discovery is a breakthrough, it will likely be years before oleocanthal makes it to clinical trial.

All Greek to Her Cancer survivor who inherited Ionian olive orchard brings her wares to Alberta Cochrane resident Rosie Lefler knows the value of a healthy diet in staying well, and for her, that includes olive oil. So when she had the opportunity to bottle her own oil from the fruit, she had no choice but to take it.

Lefler has a long history in the food industry, primarily in the Peace Region of B.C., where she and her husband Dimitri Pafiolis raised three children and ran as many restaurants, primarily offering Greek food. After Pafiolis died from cancer in 1995, around the same time she was diagnosed with cancer herself, she sold the restaurants. Then in 2005, she inherited her late husband’s family farm on the Peloponnese peninsula, and with that came 35,000 olive trees.

By 2007, she was pressing her own olives and producing and bottling oil. She admits the first few years were trial and error.

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“We had to learn how to make oil,” she says. In 2011, she began to bring her oil back to Canada, and moved to Cochrane where she set up shop. Now she has a co-op with 168 different farmers who believe in sustainable farming practises and also grow olives in her area in Greece.

Lefler can’t say enough about the merits of pure olive oil.

“Most of the oils here are blended, mixed and refined and cannot be used with heat,” she says.

“Real extra virgin olive oil is the only fat your body does not have to change in digestion, which is why it’s so healthy.

It aids in great digestion function and overall well-being.”

Parthena Extra Virgin Olive Oil is sold in many specialty shops throughout Alberta. For more information visit: parthena.ca

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Colourful Tribute WestJet flight attendant honoured with change in dress code WestJet has decided to honour one of its much-loved flight attendants with a slight change in its dress code.

Michelle “Red Lips” Malone, who died in August from cancer, was known in her off-time for her colourful style, including her bright lipstick – which went against the dress code or “grooming standards” of the airline.

Those who knew her said the 38-year-old’s exuberance would brighten the spirits of others and keep her going during tough cancer treatments. Malone underwent 25 rounds of radiation and six rounds of chemotherapy, all the while sporting her trademark crimson lipstick.

WestJet’s manager of public relations, Robert Palmer, says

the grooming standards, which had banned red lipstick and nail polish because it could look stark against some skin tones, was in need of an update, and the timing just coincided with the loss of Malone.

“What they decided to do was put out a note in Michelle’s honour, a company memo to cabin crews and airport staff, and the memo essentially says that we are allowing the wearing of red with respect to red lipstick and red nail polish – and to help people we hired a makeup consultant to help us create a new makeup palette. It was prompted by Michelle’s passing and it was deemed to be a fitting tribute to a beloved member of the WestJet family.”

Pink Paddling Movement Breast cancer survivors take to the river for awareness, dragon boat style What started as a trial to see the effects of dragon boating on a group of female breast cancer survivors has attracted a wave of interest that’s been going for nearly 20 years strong and now spans the globe.

Gillian Rutherford, a member of Edmonton’s Breast Friends Dragon Boat Team, says her team of 60 members originated when some medical personnel set out to study upper-body exercise on women, post-breast cancer treatment, back in 1998.

“At that time the best advice was if you’d had your lymph nodes removed, don’t carry a purse on that side or do any exercise, and avoid anything that could cause lymphedema (swelling of the arms),” explains Rutherford. “They did this study and chose dragon boating because it’s a repetitive upper body exercise and you can get 22 women in a boat, so it’s a nice group to study.” Dr. Don McKenzie led the research, which culminated in the team members paddling in the Dragon Boat Festival in Vancouver.

Not only did the study results show dragon boating was beneficial to breast cancer survivors, but the women who participated also wanted to continue with their activity, so they formed a team and started spreading the word about the “pink paddling movement,” says Rutherford.

Rutherford joined the team in 2008 after surviving her own breast cancer diagnosis in 2006 – and she hasn’t looked back.

In addition to annual races specifically for survivors, sometimes called the “C Cup,” the Breast Friends team also races in regular events during the dragon boat season, from May through September. “Our team’s motto is ‘awareness and hope in a dragon boat’ so what we do is demonstrate that by training together and racing together you can live an active, healthy life after you’ve

Alber ta Cancer Foundation

had a diagnosis of breast cancer,” she says.

As everyone on the team has had breast cancer, there have been sombre moments, too. “Since it was founded in the late 1990s we have lost a boat full of women to breast cancer,” says Rutherford.

Breast Friends trains together from February through September in the pool, gym and on the North Saskatchewan River.

The team now counts women of all physical abilities, ranging in age from their 30s to 70s among its recruits, but Rutherford notes that they are looking for new members, and recruit every January. There are also dragon boat teams in Calgary, Lethbridge and Medicine Hat. For more information about criteria to join, visit breastfriendsedmonton.org and sistershipcalgary.com

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Page Turners ‘Living Library’ participants share survival and cancer care stories

When Cancer Strikes Twice Survivors developing the disease more than once are on the rise in the U.S.

Mary Beth Eckersley (above) and Dr. Nigel Brockton are living proof that cancer can be survived. That’s why the pair was happy to team up with Cancer Control Alberta at Calgary’s Central Public Library branch to become “living books.” The well-attended event, held in September, saw Eckersley and Brockton (as well as 15 others touched by cancer, from researchers to survivors) speak about their journeys and treatment techniques.

Attendees could “borrow” a book, talking with the “living books” for 20 minutes at a time.

Brockton and Eckersley, who’ve both been featured in Leap previously, met at a cancer fundraising event a few years ago and have kept in touch ever since.

Brockton, who is a cancer researcher and avid fundraiser for the Alberta Cancer Foundation through his One Aim team and the Enbridge Ride to Conquer Cancer, is a cancer survivor himself. He was diagnosed with Ewing’s sarcoma in his jaw at 18, which prompted him to pursue a career in cancer research.

“A lot of people just wanted to talk about their own experiences and feelings about it,” says Brockton. “It was particularly poignant for me because I was diagnosed in 1989 and 1992 when there was no Internet, there were no layperson books about cancer or access to information, so I actually had to go to the library and read the heavy-duty journals to find that one bit of information. It was a very rare cancer and there’s very little information about it.” He said the event reminded him that things have changed immensely since his cancer. “Nobody even wanted to use the word,” he says. “So I think the fact that here we are 26 years later just being able to talk about it is progress in itself. And people are sharing that information with complete strangers.”

Eckersley agrees. “It was a great way to lessen their fears and increase their knowledge,” she says.

Eckersley has twice been diagnosed with cancer and blogs about it (iwillfightforme.blogspot.ca), as well as working as a volunteer aqua-fit instructor for cancer patients.

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New research found that almost one-in-five new cancer cases are occurring in people who’ve already had the disease.

In the 1970s, the incidence of second-or-more cancer cases was about nine per cent, but the new study shows that number has now risen to 19 per cent.

Experts are viewing the new rates as a bit of a success story: it shows people are living long enough to get cancer more than once. Causes of second cancers include gene mutations or risk factors such as smoking, which may have caused the first cancer. While treatments have improved significantly in recent years, in some cases radiation treatment, which likely saved a patient the first time, is to blame for a new cancer forming in their body later on.

Second cancers present challenges to medical teams and patients alike, including limited treatment options. For example, radiation is not usually given in the same part of the body more than once, and some drugs can only be administered so many times, to avoid permanent nerve damage.

The experts have some advice for cancer survivors, to mitigate risks and be prepared for the future: they include having a formal survivorship plan, including a record of treatments received, keeping up with screenings for other types of cancer and having any recommended tests, such as colonoscopies.

For those who face a second diagnosis, experts advise patients check all available resources, including social media, to keep abreast of new treatment options and developments.

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Nigella Lawson’s Cauliflower, Garlic and Turmeric Soup INGREDIENTS: • 1 head of garlic • 3 tbsp olive oil • 1 medium onion, chopped • 1 cauliflower, broken into florets • 1 tsp turmeric • 1 large potato, peeled and diced • 1 litre hot vegetable stock (bouillon powder is fine) • Parsley or coriander, to serve

Squeeze in the pulpy, sweet, baked garlic cloves (just squish the head straight into the saucepan), then add the stock.

Bring to the boil, lower the heat to a simmer, cover and cook for 15 minutes.

Purée in a food processor or blender or, if you like a soup with more texture, just stick a hand-held blender in the pan or

bash about with an old-fashioned potato masher.

Add freshly chopped parsley or coriander to the bowls as you eat. For extra protein, add a blob of crème fraîche or some grated cheese, or serve with cold meats on the side.

Source: The Royal Marsden Cancer Cookbook

DIRECTIONS: Preheat the oven to 200 C (or 400 F). Cut the top off the head of garlic so that you can just see the tops of the cloves. Sit the garlic on a square of foil (shiny side up) and drizzle a small amount of the olive oil on top. Pull up the edges of the foil to form a tightly wrapped but baggy parcel and put in the oven for 40 minutes. Remove and allow it to cool a little.

Pour the rest of the oil into a wide saucepan and fry the onion gently for about 10 minutes until softened but not browning.

Add the cauliflower and turn in the oily onion. Add the turmeric and keep stirring, then stir in the potato. Cover and cook over a low to medium heat for 10 minutes.

Sitting is the New Smoking Sedentary lifestyle linked to higher risk of cancer, diabetes, and heart disease Those who work at office jobs and spend the majority of the day sitting may want to rethink their position.

A study published in the Annals of Internal Medicine found that the amount of time spent sitting is linked to a person’s risk of heart disease, diabetes, cancer and death – even if he or she exercises.

The lead author on the study was PhD candidate Avi Biswas from the University Health Network and the Institute of Health Policy, Management and Evaluation at the University of Toronto, who worked with senior author Dr. David Alter, associate professor of medicine at the U of T. The researchers looked at 47 studies examining the relationship between sitting and mortality and found that people who sit for long periods were 24 per cent more likely to die

Alber ta Cancer Foundation

from health problems during the studies, which spanned from one to 16 years, as compared with people who sat less.

They also found that excessive sitting was associated with an 18 per cent increased risk of dying of cardiovascular disease and a 17 per cent increased risk of dying from cancer during the research periods. Sitting too long also carried a 91 per cent greater risk of developing Type 2 diabetes, and a 13 or 14 per cent increase in the risk of being diagnosed with cancer or heart problems during the studies.

People who also exercise were one-third less likely to die during the studies than those who did little or no exercise, according to 10 of the 47 studies.

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Top 5

Age-Old Cancer Myths Debunked

1.

CANCER IS A MODERN AND MAN-MADE DISEASE.

2.

CANCER CELLS LIKE SUGAR.

In reality, cancer has existed as long as humans have. Egyptian and Greek researchers wrote about it thousands of years ago, and researchers have since found signs of cancer in a 3,000-yearold skeleton. Michaela Binder, a PhD student at Durham University, found the hole-riddled skeleton, which dates back to around 1,200 BC, at the Amara West site in northern Sudan. Binder’s finding is of particular interest as it is 2,000 years older than the previously confirmed instance of the disease. The fact is, the biggest factor for contracting cancer is age – because more people are living longer, and we have eradicated many infectious diseases, the DNA in people’s cells gets damaged over time, leaving them more susceptible to getting cancer.

Some people believe that cancer feeds on sugar, and therefore it should be removed from all patients’ diets. In actuality, all cells, whether cancerous or not, use glucose for energy. The body does not choose which cells get fuel, but instead converts all the carbohydrates we eat to glucose, fructose and simple sugars. Tissues then use them for energy as needed. Researchers are currently working to discover the difference in energy use of cancerous versus healthy cells, and are trying to use the data to develop better cancer treatments.

Experts say that while limiting sugar is part of a healthy diet, it’s not accurate to say sugar in our food specifically feeds cancer cells.

3.

THEY HAVE FOUND A CANCER CURE.

While everything from coffee enemas to cannabis has been touted as a miracle cure, no such salve has been proven to eradicate cancer. Often, success stories are floated online but the stories are difficult to discern – not knowing the “patient’s” medical diagnosis, stage of disease or even outlook, if they have actually been cured or even had cancer

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to begin with. There is also no mention of the people who may have tried the “cures” and died. Researchers say this is the reason why peer-reviewed, rigorous lab research and clinical trials are necessary – to determine whether a prospective treatment is safe and effective, and that this is the standard to which all cancer treatments should be held.

some of them even die from it. To say that they are the ones behind a cure being revealed is a bit difficult to believe when viewed in this light.

5.

CANCER TREATMENT KILLS RATHER THAN CURES.

It’s true that the side-effects of chemotherapy, radiation or surgery are real and unpleasant, but it’s important to rememDRUG COMPANIES ARE KEEP- ber that they are designed to kill cancer cells. Unfortunately, that sometimes ING THE CURE A SECRET. Almost everyone has heard the claim that means affecting healthy cells too. The a cure for cancer has actually been found, later the stage a cancer has reached before attempting treatment, the less a but pharmaceutical companies are makchance that it will work. Surgery is still ing so much money off the disease, they considered the best treatment for canare suppressing it. But logic would say cer, but it needs to be diagnosed early that it would be in pharmaceutical companies’ best interest to reveal the cure or enough to be effective. Radiotherapy is drug, with huge sales of the antidote sure known to cure more people than cancer to follow. And one can’t discount the fact drugs, but drugs and chemo do play an that people who work for pharmaceutical important part in cancer treatment, companies and doctors are just that: peo- whether it’s to prolong a life or, in some cases, cure the disease. ple. They can and do get cancer, and

4.

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Next Gen • supporting young minds

BREAKING NEW GROUND A generous fellowship gives leading researchers an opportunity to further glioblastoma research

BY JACQUELINE LOUIE The diagnosis of brain cancer is often seen as a

death sentence. But the work being done by a young Calgary-based researcher aims to change that sentence, giving patients a better shot at long-term survival.

Dr. Wajid Sayeed, 31, is a neurologist who studies the diagnosis and treatment of nervous system diseases.

He is the first recipient of the Lynne Marshall and Wayne Foo Cancer Research Clinical Fellowship, an award intended to attract world-class physicians to the Tom Baker Cancer Centre and the University of Calgary.

The fellowship is a hugely significant award, both for Sayeed and for the discipline of neuro-oncology in Canada. “[It] means there will be a consistent stream of fellows who will be able to train in neuro-oncology and build up the discipline in Canada,” says Sayeed, who is a clinical fellow in neuro-oncology at the Tom Baker Cancer Centre in Calgary and is also doing post-doctoral research at the Arnie Charbonneau GROUND BREAKER: Dr. Wajid Sayeed is the inaugural Cancer Institute (formerly the Southern Alberta recipient of the Lynne Marshall and Wayne Foo Cancer Cancer Research Institute). Through the award, Research Clinical Fellowship.

“Calgary-trained neuro-oncologists will be available to provide patients with co-ordinated care tailored to their specific needs,” he says.

Sayeed conducts both clinical and laboratory brain tumour cells and is working to develop models to understand how these research. On the clinical side, he’s collaborating with tumours respond to chemotherapy. “What we are doing is unique, in that we have neurosurgeon Dr. John Kelly and medical oncologist shown a potential mechanism whereby these tumours form. This is a big question in Dr. Jay Easaw to determine whether cutting out larger the field, as we don’t have a good understanding of what makes a healthy brain cell volumes of brain tumours affects long-term survival. turn into a cancerous one… Our ultimate goal is to be able to predict how each “We’re looking at a large series of surgical cases here in tumour will respond to different treatments. That will help us develop treatments Alberta, examining imaging done on patients before that are tailored to each individual – and with that, we can make better treatment and after surgery,” says Sayeed, who hopes to eventual- decisions for patients.”

The fellowship was instated by Calgarian Wayne Foo, in memory of his wife, Lynne ly make this research a pan-Canadian project. “We correlate that with how well the patients did in terms of Marshall, who was diagnosed with glioblastoma – the most aggressive form of brain their general health. Our hypothesis is that larger cancer – in January 2013, and died in February 2014. “I personally, and my friends and family, felt a terrible loss with Lynne’s [removals] will be of greatpassing, especially given that her father er benefit to patients.”

“Our ultimate goal is to be able to predict The question is not a how each tumour will respond to different had the same disease,” Foo says. “It was her to do some good work in trying to trivial one. Many neurosurtreatments. That will help us develop treat- wish advance treatment of the disease.” geons believe that the ments that are tailored to each individual – The Lynne Marshall and Wayne Foo more tumour they remove, the longer the patient’s and with that, we can make better treatment Cancer Research Clinical Fellowship is a l i fe w i l l b e . H ow ev e r, decisions for patients,” says Wajid Sayeed. $1.5-million commitment that focuses on research into glioblastoma and related canSayeed explains, this is a contentious issue: other neurosurgeons prefer to take a cers of the brain at the Tom Baker Cancer Centre, where Marshall and her father more conservative approach, in the hopes of sparing were treated in 2013 and 1995, respectively. In parallel with funding the Lynne patients a potential disability that could result from Marshall and Wayne Foo Cancer Research Clinical Fellowship, Foo has committed surgery complications. to and completed additional fundraising, to close off the balance of Alberta’s In collaboration with Kelly, Dr. Michael Blough and committed portion of a national glioblastoma initiative, which supports research into Dr. Gregory Cairncross, Sayeed’s laboratory studies the disease.

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Beyond Cancer • stories of survivorship

Finding the Right Support As treatment ends and survivorship begins, it can be unclear what you need to know about managing life with cancer

BY JANINE GIESE-DAVIS

With so much focus on treating cancer, many researchers and clinicians have begun to try and anticipate the needs of survivors, undertaking work that tests whether self-management support interventions are helpful. This effort recognizes that there are skills that could help you take responsibility for the ongoing management of your cancer, as if it were a chronic illness.

A long tradition of self-management interventions have improved patients’ lives as they monitor, cope and live with the waxing and waning symptoms of other chronic illnesses like diabetes, arthritis and asthma.

Though cancer doesn’t traditionally fit into this category, theories on how to manage cancer survivorship have been changing because people are now surviving longer than ever before.

Successfully managing cancer survivorship means committing to learning about your cancer, monitoring changes, increasing your confidence, setting goals and developing problem-solving skills. You are not expected to accomplish all this alone. Your health-care providers must also teach you what you need to know, partner with you to monitor for changes, help to increase your confidence to take on these tasks independently, help you set realistic goals and teach you problem-solving skills. This may seem like a lot to take on, but there are some steps you can take to make it easier.

Forming partnerships with health-care providers: By considering cancer a chronic disease, the role of health-care providers becomes that of teacher and partner as well as professional supervisor. Survivors must be able to report accurately the trends and tempo of their disease and make informed choices about treatment.

Using available resources: Many providers alert survivors to community or educational resources but do not teach participants how to use them. Self-management support includes considering how to use resources and helping people seek these out in many ways (via the Internet, library, community agencies and local practitioners).

Problem-solving: In self-management support interventions, patients are taught basic problem-solving 12

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skills, including how to define a problem, generate possible solutions, implement solutions and evaluate results. What might that look like concretely? Let’s take lymphedema for instance: after breast cancer, some women experience ongoing lymphedema in their arms. That could lead to an inability to use their arms in daily life.

When generating possible solutions, patients might imagine changing the way that they approach tasks that involve the arm in question. Afterwards, they might evaluate whether this worked and if not, might try another approach or seek help.

Decision-making: Cancer survivors must make day-to-day decisions in response to changes in disease conditions. To do this, they must have the knowledge necessary to meet common changes. For example, back pain patients are taught to identify the serious symptoms or “red flags” that require medical attention, such as loss of bladder control. Likewise, survivors can be taught how to monitor symptoms that might mean a recurrence is likely and which provider to go to if they notice those symptoms.

Action planning/taking action: Taking action may seem more like a decision than a skill but, in fact, there are skills involved in learning how to change a behaviour (like increasing your exercise). In order to plan to act, and then actually follow through, you might need to make a short-term action plan and carry it out, focus on a short period of one or two weeks to try it out, make a plan that includes very specific behaviour (for instance, go to the gym on Tuesday at 9:00 a.m. every week), or focus on a realistic or “doable” action, (for instance, walk for 15 minutes).

While this column lays out some of these concepts to help you have a vision for these skills moving forward, the most important step you can take is talking with your health-care providers about moving forward together to manage your survivorship successfully.

myleapmagazine.ca

Smart Eats • food for life

Keep Calm and Eat Healthy

Eating right shouldn’t make you feel under pressure

BY JULIE ISAACS,

EDUCATION RESOURCES AND NUTRITION SERVICES

AT CALGARY’S SOUTH HEALTH CAMPUS

Often, healthy eating advice focuses on topics like vitamins, superfoods, calories and food portions.

Although these are all important, placing a consistent spotlight on them can lead many people to feelings of stress, guilt or apathy.

But we can think about food in a different way.

Healthy eating can be about turning delicious fresh foods into tasty meals and snacks, and it doesn’t have to be stressful. Here are some tips for making cooking more fun. After all, you are more likely to make lasting changes to your eating habits if you enjoy what you are eating.

Plan your meals: Most people don’t plan to eat unhealthy food – it just happens when they haven’t planned anything at all. So, plan meals and snacks in advance. Be sure to consider quick, easy meals for days when you’re tired or don’t have much time. Then, use your meal plan to make your grocery list. Using a list will help you avoid impulse buys. Also, try to follow the motto “Cook once, eat twice.” If you make enough for leftovers, you will have a meal for the next day or to put in the freezer for later. Luckily, there are many menu planning and grocery list apps available to make this easy.

Cook and eat with friends or family: The best way to feel motivated about cooking is to make a meal with – or for – someone else. For one, we are more likely to eat balanced meals when eating with others.

Cooking with a neighbour or friend also helps us learn new cooking skills. If you know people from different cultures, it’s a great way to try new foods. Ask a friend or family member to teach you how to make one of their favourite recipes. Take your time to enjoy your company and the food. Eat slowly.

Focus on the food: Turn off the TV and put away electronics. Chew slowly and really taste your food.

We often eat so fast we don’t even enjoy our favourite foods. Make a point of putting your fork or spoon down in between each bite. Focus on what you are eating to turn eating into a choice not a habit.

Alber ta Cancer Foundation

Choose fresh foods with minimal processing: Processed foods usually have more salt, fat and sugar, so whenever possible choose foods that are less processed.

Make your meals with fresh ingredients like vegetables, fruits, whole grains, fish, meat, eggs and milk. Some fresh foods like fruits and vegetables are only available certain times of year. If you buy from local growers, they often let you taste before you buy and they are usually happy to share their recipes.

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Ask the Expert • a resource for you

THE MORE YOU KNOW We polled the pros about getting geared up for winter running, mammograms and the potential link between processed meat and cancer

BY SHELLEY WILLIAMSON

I would like to keep up my running through the winter months. What do I need to add to my gear to be prepared?

As the old saying goes, there’s no such thing as bad weather – just bad clothing. “When gearing up for winter, its easiest to think from the inside out,” says Nolan Tudor, vice president of operations at Calgary’s Tech Shop running store. Here are his recommendations: Baselayer: “You should be looking for something thin with excellent moisture wicking properties,” he says. An insulated bottom layer to keep your legs warm might be a good idea depending on the temperature.

Mid-layer: The mid-layer really only applies to your top, and should be another insulated layer to keep your torso warm.

Outer-layer: On top you should be looking for something insulated but also wind and water resistant. “Having something that is wind resistant will really cut down on the cold you experience from windchill,” says Tudor. On the bottom your options are either tights or pants, and this is a personal preference.

Head: You should looking for something warm, but comfortable.

Some runners like Buffs, due to their versatility. Some prefer toques or just wear insulated headbands. “The key is to make sure that whatever you are putting on your head is moisture wicking. We accumulate a lot of sweat that can freeze on our head if not dealt with efficiently.”

Hands: You should look for a glove or mitt that is insulated and wind and water resistant. “Mitts are inherently warmer because your fingers stay in contact with one another while sharing body heat,” says Tudor.

Some companies even make convertible mitts that are a glove underneath with a stow-able mitt overtop.

Feet: Footwear is not to be overlooked during winter. With running surfaces often being icy, traction becomes very important. A lot of runners look to trail shoes as a solution. Trail shoes are meant for off pavement use and as such they have much better traction. The softer the outsole rubber the better it will grip on wet and icy surfaces. If slippery surfaces are keeping you from running (even with trail shoes) you can also look at a number of slip on traction devices available, which utilize some form of chains or studs to grip into ice.

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I have heard that the World Health Organization has confirmed there is a direct link between processed meats and cancer. Is this true, and should I cut them out of my diet?

Leap asked Dr. Nigel Brockton, research scientist in molecular cancer epidemiology, cancer epidemiology and prevention research for Cancer Control Alberta and Alberta Health Services.

“The very short answer (to the first part of the question) is ‘yes,’ but it is important that you understand the degree of risk associated with processed meats so that you can make a balanced decision about whether you should stop eating them or not,” Brockton says.

He adds that the recent announcement regarding the link between processed meats and cancer has resulted from IARC (International Agency for Research myleapmagazine.ca

on Cancer) reclassifying processed meat as a Group 1 carcinogen which he says “means, according to the weight of evidence, they are certain that it ‘causes cancer.’ This designation is an upgrading of these products from their previous category of Group 2 carcinogens, which meant that they ‘probably cause cancer.’ ” Brockton warns that this new information, while alarming, “needs to be put it into context. The change in category only reflects the degree of scientific certainty that consuming processed meats increases a person’s risk of cancer; it does not reflect by how much it increases a person’s risk of cancer.”

Just how much eating processed meats raises your risk of cancer (mainly colon cancer) is usually buried deeper in the various reports, but it is approximately 17 per cent, he says. “That sounds like a lot but it should be noted that the lifetime risk of someone developing colon cancer is about six per cent. If the risk of being diagnosed with colon cancer is – for someone eating the lowest amount of processed meat – about 5.5 per cent, then their risk will increase to around 6.5 per cent if they consume the highest amounts of processed meats.”

So, the consensus from more than 800 research studies is that frequent or excessive consumption of processed meat does increase your risk of cancer, Brockton confirms. “However, it is a relatively small increased risk for one particular type of cancer (although there is some evidence for increasing risk of other types). The key, as in most things, is moderation. Consuming processed meats infrequently will probably have a negligible impact on your overall health or cancer risk, especially if you have a balanced diet that includes plenty of fruits and vegetables.”

I am a woman in my 30s and have concerns about breast cancer, as I have a family history of it. What should I be doing to lessen my risk of contracting the disease? Do I need a mammogram?

“A family history of breast cancer can increase your risk of developing the disease,” says Dr. Huiming Yang, a medical director of screening for Alberta Health Services. Approximately five to ten per cent of breast cancer diagnoses can be attributed to mutations in certain genes (like BRACA1, BRCA2 or others).

“However, the majority of women diagnosed with breast cancer have no family history of the disease.” Yang says risk level depends on: • • • •

Which of your relatives have had breast cancer, How many relatives have breast cancer, At what age your relative(s) developed breast cancer, and BRCA1 or BRCA2 in the family

Your risk is higher if your relative is a first degree relative (like your mother, sisters or daughters), if you have more than one relative with breast cancer, or if your relative(s) developed breast cancer under the age of 50. For example, if your family history includes one grandmother who developed breast cancer after the age of 50, your risk is not much greater than a person with no family history.

Screening mammograms are not recommended for women younger than 40, unless they have a known BRCA1 or BRCA2 mutation, strong family history of breast cancer or personal medical history that significantly increases your risk. Yang also recommends using the risk assessment tool located at www.screeningforlife.ca to learn more about breast cancer risk factors and how they may affect you.

Ask our experts questions about general health, cancer prevention and treatment. Please submit them via email to letters@myleapmagazine.ca. Remember, this advice is never a substitute for talking directly to your family doctor.

Alber ta Cancer Foundation

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We would like to extend a huge thank you to our clients, vendors, Rangelanders, and the Alberta Cancer Foundation for supporting the Rangeland Engineering annual Cameron Daye Golf Invitational.

We raised over $50, 000 at the tournament and Rangeland matched it for a total of $100,812!

All proceeds will go to the Cameron Daye Sarcoma Fellowship, enabling full-time sarcoma cancer research at the Tom Baker Cancer Centre.

Thank you to the following companies that generously sponsored a hole this year!

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SPECIAL REPORT:

THE HALLMARKS OF CANCER

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orty years ago, a landmark paper explained to oncologists and medical professionals how cancer works. This issue of Leap explores how this seminal paper, The Hallmarks of Cancer, has affected how we live with, treat and survive cancer today.

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HALLMARK MOMENTS A 15-year-old article meant to break down the complexity of cancer continues to help researchers

ONCOLOGIST, HEAL THYSELF New research introduces the “Hallmarks of Happiness” – considering how both oncologists and patients can live healthy, happy lives

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FROM CELLS AND TISSUE TO HOPE Researchers work with the smallest pieces to solve cancer’s biggest problems

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Hallmarks of cancer

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A 15-year-old article meant to break down the complexity of cancer continues to help researchers

BY MICHELLE LINDSTROM

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t’s Mana Alshehri’s personal connection way The Hallmarks of Cancer is visualized on a wheel, to cancer that initially led him to research the and each of the hallmarks is considered an equal disease. Like many other scientists around the percentage of the wheel,” Robbins says. He feels each world, Alshehri is attempting to eradicate cancer cancer should have a different wheel, where the weighwhile improving treatment options for those afflicted ing of hallmarks differs for each type of cancer. by the disease. Alshehri is a PhD student in Dr. SteHe compares breast and pancreatic cancers: there is phen Robbins’ lab at the University of Calgary, study- roughly an 89 per cent five-year survival rate for breast ing glioblastoma multiform (GBM): “the most com- cancer patients, but there is less than a 10 per cent fivemon and aggressive malignant primary brain tumour year survival rate for pancreatic cancer patients. in adults,” he says.

Both types of cancers have all the same hallmarks, “My father was diagnosed with lung cancer that later but there are more successful drugs and treatments spread into different organs, and he passed away after for breast cancer, suggesting scientists have figured four years from the disease,” Alshehri says. “Two years out the priority of each of the 10 hallmarks for breast later, my grandmother was diagnosed with a brain cancer better than they have for pancreatic cancer. tumour and it was only four months later when she died from the cancer.”

“My father was diagnosed with lung cancer In the beginning of Alshehri’s cancer studies, that later spread into different organs, and Robbins introduced him to a paper called he passed away after four years from the The Hallmarks of Cancer. The highly regarded disease. Two years later, my grandmother scientific journal Cell published this paper, written by researchers Douglas Hanahan and was diagnosed with a brain tumour and it Robert Weinberg, in January 2000, and then a was only four months later when she died followup article in 2011 – Hallmarks of Cancer: from the cancer,” says Mana Alshehri.

The Next Generation. The first article helped reduce the complexity of cancer by determinThe Hallmarks of Cancer still has relevance in today’s reing six traits (or hallmarks) that all cancers share. The search, says Robbins. And while he continues to direct second version added four more.

Alshehri says the papers break down the molecular his grad students to review both papers, the Hallmarks processes that happen in a normal cell to transform it are a starting point to help students get a grasp on into a cancer cell. It also explains other traits that can- what cancer is and how to differentiate cancerous cells cer cells develop, like maintaining continuous growth, from regular cells. avoiding immune response, resisting treatment and “[Hanahan and Weinberg] synthesized the literature spreading into different organs. into this article in a very special way,” he says. “I’ve In Robbins’ lab, Alshehri is part of a team currently never heard any of the young minds say that they studying how cells move and invade tissues of the thought it was a bunch of baloney and they didn’t body, which ties into two of the hallmarks noted in the understand it.” With their newfound knowledge and articles: “sustaining proliferative signalling” (rapid understanding, Robbins asks students to find newer cell reproduction) and “activating invasion and me- articles that support or refute the hallmark traits. tastasis” (spreading into other organs).

Alshehri notes that understanding the hallmarks also While Robbins has his own lab at the University of helps explain why there are drugs that work really well Calgary, where Alshehri studies, he is also an asso- in the lab but don’t have a significant clinical impact on ciate professor at the University of Calgary and the patients that the researchers expected. “Targeting only Canadian scientific director at the Institute of Cancer one hallmark of cancer might activate the others,” he Research – meaning he oversees all cancer research says. For example, some studies show that when tarthat is funded nationally. Robbins says the research he geting the recruitment and the growth of new blood sees today is less about proving or disproving the Hall- vessels in a tumour (hallmark #5), this can actually lead marks papers, and more about determining the most to the spread of cancer cells into surrounding tissue beimportant hallmarks in each cancer. cause the cancer cells then search for a new energy sup“Where the model [becomes] a little simplistic is the ply (hallmark #6). Targeting a few specific hallmarks,

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Emerging Hallmarks

Deregulating cellular energetics

Avoiding immune destruction

Genome instability and mutation

Tumour-promoting inflammation

Enabling Characteristics

but by sharing knowledge with other labs around the world, each can build on where the others left off or were stumped.

“Genomic sequencing [determining the complete DNA sequence of all genetic material within a living being] became There’s also room for the Hallmarks of Cancer to influence so affordable to do that whole genomes for many cancers were intervention and prevention. sequenced,” Robbins says, “and the technologies allowed us to Dr. Darren Brenner, a research scientist in the Department of Cancer go forward and really understand the basic principles of those Epidemiology and Prevention Research for CancerControl Alberta cancer cells.” and Alberta Health Services in There are no restrictions to the findCalgary, says the hallmarks have “[Hanahan and Weinberg] synthesized the ings in his lab, Robbins adds. Other rerelevance in his epidemiology are given “open access” to his literature into this article in a very special searchers work. Epidemiology studies the lab’s results, and collaborative efforts are way. I’ve never heard any of the young patterns, causes and effects of increasingly becoming the global norm. health and cancer conditions for minds say that they thought it was a bunch This trend complements the work alAlbertans. Specifically, Brenner of baloney and they didn’t understand it,” ready done by Hanahan and Weinberg in studies the development of sevThe Hallmarks of Cancer. Yes, there are says Dr. Stephen Robbins. eral cancers – lung, breast and Hallmarks non-believers, and there is colon – and the connection with scientific criticism – mainly that the first chronic inflammation in the body due to lack of exercise. But he also five hallmarks are common in all tumours (benign or malignant), and studies the cancer prevention potential that lifestyle choices (like alco- only in the sixth trait does it introduce metastasis and tissue invasion, hol intake, diet and surrounding environment) can make for people. something benign tumours do not do.

“Several of the lifestyle factors that we research, like physical inactivRobbins says that it took about 30 years for Hanahan and Weinberg ity and excess body fat, are related to chronic inflammation, which can to gather and compile all of their research to create the first Hallmarks contribute to many hallmark capabilities in various ways,” he says. “As of Cancer article. It’s ironic, he says, as researchers first thought it Hanahan and Weinberg point out, some molecular epidemiology studies would just be a simple genetic defect that led to cancer. are showing that inflammation is evident at the earliest stages of cancer Now, the Hallmarks articles continue to stimulate conversation progression, which suggests the potential for intervention and cancer and study, helping change the daunting statistic that two-in-five prevention.”

Canadians will get cancer. Robbins says current research tends to take Research is much more collaborative now than when the first a more holistic approach, and looks at the bigger picture of cancer, Hallmark papers came out, Robbins adds. That’s mainly due to cost: not which is important as the disease has obviously proven to be much every lab can afford to have the scientists study everything they want to, more complicated than ever imagined. rather than just one, with combination drug therapy is something Robbins and Alshehri believe will be more prevalent in near-future clinical trials.

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New research introduces the “Hallmarks of Happiness”– considering how both oncologists and patients can live healthy, happy lives

BY LYNDSIE BOURGON

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or much of his career, Dr. Anil Abraham Joy has the ‘Hallmarks of Happiness’ that we feel should be of equal importance to watched patients and clinicians deal with cancer know, understand and practice for anyone involved in cancer care,” they diagnoses. “It’s amazing to see how people deal with all of write in the paper.

The list of key hallmarks are what Joy calls “common sense-type items. this,” he says, from his office at the Cross Cancer Institute.

Since the beginning of his training, Joy has been quietly considering There’s nothing that’s really magical or that stands out, but we believe that the life-altering implications of cancer diagnoses, and wondering people who consistently follow these essential elements had a better chance what sets apart those patients and clinicians who cope well with a to live a good, balanced and flourishing life.” diagnosis from those who don’t.

So he got to work with colleagues across the country and The paper outlines the elements, which are: taking the time to reflect; considered some of the elements that oncologists and their patients considering a deeper purpose in your work; striving for growth; prioritizing need to consider for a healthy life. “It’s not just from the cancer nutrition and exercise; remembering to rest; expressing gratitude; being perspective, but also from a life of service; striving to remain connected to “Looking after cancer patients others; and embracing uncertainty. perspective,” he says. “As I started to think about all this stuff, and reflecting “It is the constant demands of the job and is highly rewarding, but can on what I’ve seen time and time again, trying to do your best for your patients which become emotionally draining,” means that we often forget to look after I realized this is not just specific to oncologists or cancer patients, says Dr. Mark Clemons. ourselves,” says Clemons. it’s applicable to everybody.” The “That’s what struck me,” adds Joy. “I’m researchers expect to publish their findings this winter. trying to implement some of these things in my own life on a regular and Joy, along with Dr. Mark Clemons and Dr. Carmel Jacobs, set out consistent basis, and this has helped balance me out.” to consider a philosophical question: how can we live a healthy life?

In an oncologist’s busy life, and even for the rest of us, this can seem hard The idea came in the early part of 2015, with drafts of their paper being to achieve. “It’s not meant to be prescriptive,” says Joy. “But as we look at revised over a couple of months. It has turned, slowly, into a kind the various elements of well-being, I think somebody can find something in of op-ed for medical professionals. “Looking after cancer patients each of these areas to focus on. If we try to improve in these areas, we’ll have is highly rewarding, but can become emotionally draining,” says a better life.”

Clemons. “It was evident to Dr. Joy and me that, given the high rates of Clemons says that, busy schedules aside, oncologists should be aware physician burnout, we needed to warn doctors to look at themselves of these markers: “Sometimes, during a busy clinic visit, it is important and ensure that they are adopting healthy lifestyle choices. Failure to to remember this and spend a few moments not talking about the cancer do so is bad for the physician, their families and their patients.” and its treatment, but more ‘normal’ topics – like asking how a patient’s At first, the article set out to try and consider self-care from an children are.” oncologist’s perspective. Joy later intended their work to take two Joy is quick to add that we should all be experimenting with these aspects forms – a paper that addressed patients and another that looked of our lives – and if something doesn’t work, don’t sweat it. “This is not just specifically at oncologists. “The more we started digging into all about happiness, but really more about a sense of fulfillment and value of this, the more we realized it was applicable to all,” he says. The paper life,” he says. “I hope that people will make the time to think about these directed to oncologists is titled “Hallmarks of Happiness,” a nod to areas of their lives and see if they can optimize them. If they test it out and it the famous Hallmarks of Cancer papers and framework. “We propose works, keep on doing more of the same.”

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Hallmarks of cancer

From

Cells and Tissues to Hope

PEDAL POWER: Adam Sorenson, right, has sent part of his brain tumour to be held for biobanking.

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Researchers work with the smallest pieces to solve cancer’s biggest problems

BY SHELLEY NEWMAN / PHOTOS BY BRIAN BOOKSTRUCKER

A

dam Sorenson’s back-to-school eye exam changed his life forever. When the active, athletic 13-year-old went for the exam back in 2013, he and his family thought they were simply checking another thing off of the list before he started the eighth grade. Instead, Adam’s life was saved.

“My wife gets all the credit in the world for this, because she took the kids in for a routine exam, and that’s when the optometrist noticed swelling on Adam’s optic nerve,” says Brad Sorenson, Adam’s father. “When we got the results of the MRI back, we learned that there was a baseball-sized tumour on his brain, and he had surgery to remove it right away.”

The next couple of weeks were a blur for the family, as testing on Adam’s tumour determined it was grade four glioblastoma, the most aggressive type of brain tumour.

He had a second surgery to remove additional tissue two weeks after his first. “As part of the process, we signed consent forms for Adam’s tumour to be donated for biobanking,” Sorenson says. “The tumour from the first operation was the largest, so a portion of that tumour went into a biobank.”

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LOOKING AHEAD: Brad Sorenson, left, believes that biobanking Adam’s tumour will help other cancer patients in the long-term.

Adam is one of many Albertans who have donated samples for research.

These samples, representing over 40 different types of cancer, are used for research purposes in our province and around the world. “It makes me happy to know that I can contribute to cancer research,” Adam says. “My tumour is one piece that’s helping scientists find out what can defeat cancer, and that’s really important.”

The largest biobank in the province is the Alberta Cancer Research Biobank (ACRB), supported by the Alberta Cancer Foundation. When it comes to supporting cancer research, “The ACRB collects, stores and documents samples,” says Kathryn Graham, manager at ACRB. “Patients give permission for this through a process of informed consent.” The types of samples stored may be solid tissue samples that are not required for patient diagnosis and treatment, like Adam’s type of tumour placed in the biobank, or they may be blood fractions, which include serum, plasma and white blood cells.

Proper storage of samples is essential and, depending on the type, tissues may either be placed in liquid nitrogen and frozen, or placed in a solution for preservation.

“Researchers apply to the ACRB for access to the samples, providing their research plans are approved by an ethics board,” Graham says. “Investigators from Alberta, Canada and around the world use these samples to conduct research in their own laboratories.” The type of research being conducted is extremely broad, and Graham notes 26

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that, “Biobanking supports research across the continuum of cancer care, from prevention and earlier detection to treatment and outcome. Making these important samples readily available to local and distant cancer researchers facilitates progress in cancer research.”

The fact that investigators now work with tissue samples speaks to the tremendous advances in cancer research in recent decades. Tissues are created by many cells grouped together, which means they’re more complex than a single cell. It also means that studying tissues helps researchers learn more about the extremely complicated workings of cancer in the human body. This is one component of translational research, which Graham indicates is an important part of the research environment in Canada. “Translational research involves taking a basic scientific observation and moving it to a clinical application,” she says. “There is a large spectrum to the work in this area, as it may cover all aspects from initial observations to patient care.”

One investigator who understands the power of clinical samples is Dr. Corinne Doll, radiation oncologist at the Tom Baker Cancer Centre and associate professor at the University of Calgary. She is currently leading a research project encompassing this type of multidisciplinary team. The project, which has been ongoing since 2013, aims to determine why certain cancer cells and tumours are resistant to cancer treatment. “My research team is investigating mechanisms of chemotherapy and radiation resistance in two different tumour sites: cervical cancers and anal cancers,” Doll says. Both tumour types are associated with high-risk human papillomavirus (HPV) infections. Additionally, both types of cancers are treated with high-dose radiation therapy and chemotherapy for locally advanced disease. “This treatment is curative in many patients, but we do not know why some patients either do not have a complete response or have relapses of cancer,” she explains.

To help answer this question, Doll works with a diverse team including clinicians, translational researchers, basic scientists, pathologists, post-doctoral fellows and masters students. The team is using archived tissue samples of the tumours and an even smaller unit of biological research called cell lines to conduct their studies. They are looking to characterize tumours through genetic and protein testing, and evaluate cancer cell sensitivity to radiation, chemotherapy and novel drugs.

“Even though this type of research starts in a dish, patients are still at the core of what we’re doing,” Doll says.

“When you consider the impacts, we’re hoping to get a better understanding of resistance to treatments, which will improve patient outcomes.”

When Doll and her team use cancer cell lines as part of their research, they’re incorporating a vital element of cancer research that has been developed and refined over the last several decades. The first cell lines “were discovered over 50 years ago, and there has been a staggering advancement in research because of these cells,” she says. In Doll’s current research project, “We’ve worked in collaboration with Dr. Susan myleapmagazine.ca

Lees-Miller at the University of Calgary, and we have been able to actually alter these cervical cancer cell lines,” she says. “This has allowed us to determine their sensitivity to cancer therapies based on their expression of specific genes and proteins.”

Certain cancer cell lines are important in research terms because they are considered immortal. The vast majority of cells will grow and divide less than 10 times before they die, but cell lines can keep growing and dividing without limits, as long as they have space and nutrients. “An investigator may try for a couple of years to establish a successful cell line,” Graham says.

“There are now thousands of cell lines that have been derived from many types of cancer and non-malignant cells. Given the work it takes to get a single cell line, this speaks to the importance of these cells in research.”

Since cell lines can be grown in large quantities, they can also be provided to researchers around the globe, which means countless people undertaking countless projects that can advance scientific knowledge in everything from cellular biology to cancer research.

The first cell line was developed from cervical cancer tissue taken from a woman named Henrietta Lacks in 1951. This cell line, called HeLa cells, has been mass produced and used in research for decades. “Although cell lines such as HeLa have been a staple in the toolbox of researchers, there are limitations to these longestablished lines,” Graham says. “New methods allow the development of lines that better reflect the original tissue.”

And that’s not the only change since the time of Henrietta Lacks: when it comes to research, samples Alber ta Cancer Foundation

from patients can only be used with full consent. “Patients have the right to determine if their biological samples can be used for research,” Graham says, “and they also have the right to have their identity protected.” Laws protecting patient privacy and standards of informed consent are strictly followed, and various ethical bodies govern research in Canada, with the Health Research Ethics Board of Alberta being the primary governing body for cancer research.

With investigators looking into the vast scope of cancer research in so many ways, from cell lines to tissue samples to patient care, access to samples is critical – as is funding to complete the research. “Our work has been possible thanks to funding from the Alberta Cancer Foundation and Alberta Innovates Health Solutions,” says Doll. “Without that support, we simply wouldn’t have gone this far with the research and achieved our goals.”

As the parent of a cancer survivor, Brad Sorenson also places tremendous importance on funding research through the Alberta Cancer Foundation and the impact that donors have on programs. From his family’s perspective, biobanking Adam’s tumour will assist with long-term research, and it also helped Adam directly, which Sorenson notes is probably quite unique.

“When we were considering treatment options for him, we looked into a clinical trial and additional genetic testing was done on his biobanked tumour to see if Adam could enter the trial,” he says. Chemotherapy was an option they had been considering but, through the additional testing on his tumour, they learned that Adam was absent an important gene that was crucial in chemotherapy treatment.

“Based on these tests, we really felt chemo would hurt our son and not help him, so we started looking for plan B.” Through extensive research and connections with specialists, the family decided to proceed with a combination of radiation treatments, a ketogenic diet and hyperbaric oxygen therapy for Adam. Now, they’re two years past his initial diagnosis, and the healthy 15-year-old has had his sixth all-clear MRI. “What we learned through the testing on his tumour had a major impact on our decision, and it directed the course of his care,” says Sorenson. “I believe my son is alive because of this, and it wouldn’t have been possible without a biobank.”

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Engagement • giving patients a voice

Engagement Redux In complex workplaces, ensuring everyone has a voice leads to better experiences

BY JESSICA DOLLARD

The role I play in the health-care process can be hard to define. We call it “engagement,” but what does the word even mean? My role is to bring patients and families together in planning and improving treatment. But it’s a lot harder than it sounds.

Earlier this year, I proposed including patient or family advisors within a staff working group, as an important way to improve the cancer patient experience. As I shared my knowledge about engagement, one of them politely turned to me and asked: “Why would we bring a patient or family member into the group? We’ve had plenty of good ideas about how to improve for years; some of them are similar to what our patients and families suggest, but no one listens to us. Why would we do that to a patient or family member?”

Many others around the table agreed with the statement. A discussion of ethics ensued and I listened carefully: no one was trying to be oppositional, but they were sharing the truth of their experience.

It dawned on me: while I could bring patients and their families to the planning table, the work of “engagement” wouldn’t be successful unless staff felt they also had a voice. I saw that, without having staff feeling empowered or engaged, we could never bring about the changes we need. Without having all the pieces of the puzzle in the conversation, we could never see the whole picture. This was practice-changing for me. I changed my philosophy, from advocating for the importance of patient and family engagement to seeing engagement as a way of increasing everyone’s systems intelligence. This is a form of “systems thinking.”

Peter Senge defines systems thinking as “the whole being greater than the sum of its parts.” We live in a web of interdependence and everything we do, even if it’s a tiny change, has influence. In a system as complex as health-care, we cannot predict that impact. Systems intelligence means that we need collective intelligence: we need balanced perspectives and generative conversations between all of the smart people in the room. We don’t need just one smart person to tell us what to do. We have to be prepared to be wrong, to listen to opposing views, to create teams where it’s safe and there’s enough trust to disagree with each other and to be committed to trial and error.

That reflection brings me back a leadership concept that I find inspiring: if we define leadership as changing 28

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the world, it’ll be too big and beyond us – it’ll become an excuse to become a victim of the system. However, if we acknowledge that true leadership happens in the moments we create with each other, day to day, then we shift the paradigm. Suddenly we’re all accountable.

Now I approach the work of engagement with “systems smarts,” and I try to foster the same in our patient and family advisors, staff and leaders. It changes the conversation. Knowing that I am not right, that I only have one piece of the puzzle (and that’s true of everyone at the table, no matter what their title is) but also knowing that each person is infinitely able to make a difference at the same time is a powerful paradox to hold. Collectively, we can start to see what one individual cannot. This new interpretation of the word engagement (or engagement redux) renewed my sense of fulfilment in my work.

Jessica Dollard is the patient-centred experience advisor on the Calgary Cancer Project. As a consultant in engagement and patient experience, as well as an actor, film and theatre producer, programmer, medical skills trainer and executive certified coach, she brings a creative background to this work.

Watch Drew Dudley’s TED talk on Lollipop Leadership to be fully inspired by this concept. www.ted.com myleapmagazine.ca

to

Someone

Lean On

A University of Calgary researcher has set his sights on understanding the importance of compassion in cancer care

BY JULIE-ANNE CLEYN Alber ta Cancer Foundation

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hane Sinclair finds himself moved with emotion when he thinks about how some cancer patients describe their diagnosis. “We all know patients who have been affected by a ‘cold’ health-care provider whose actions, or inactions, seemed to compound their suffering,” he says. “It complicates and exacerbates it to a completely different level.

Almost like they had the pain of their diagnosis and then when they were down on their knees they got another shot to the kidney.”

Sinclair’s pain and compassion for his patients shows – it’s the reason he’s a natural at his program of research. “We talk about compassion, but do we really understand what it is?” he asks. Sinclair, an assistant professor in the Faculty of Nursing at the University of Calgary, has been working to define “compassion”: to date, the cancer patients he has interviewed comprehend it as largely unrelated to sympathy, sharing some qualities with empathy, but having additional and distinguishable features from it as well. “Compassion seems to come from a place of character and virtue,” Sinclair says. “It requires action. It’s not just simply listening to a person.”

For a health-care provider, this action can mean actively attending to a patient’s suffering. In addition to defining compassion, Sinclair is interested in delineating its elements and finding out if it can be measured, enhanced and developed in clinical care.

Sinclair chose to focus on compassion because he is primarily interested in addressing issues that matter most to patients. When he was working at the Tom Baker Cancer Centre and in palliative care, he remembers patients telling him “I love my nurse,” or “I have the best oncologist.” They told him they got the sense that the person genuinely cared for them, and Sinclair became compelled to find out whether a scientific lens could be put on compassion to make a long-term difference to patients.

“It’s a human element, so you can’t ultimately master it, necessarily, but you can understand, codify, measure, enhance and improve patient care.”

Sinclair’s research embodies two studies: the first took place from April 2013 to September 2014 and examined patients’ perspectives on compassion. Sinclair and his team asked 53 advanced cancer patients interview questions like: What does compassion look like in clinical practice? How is it different than empathy and sympathy? What makes a health-care provider compassionate? Does this make a difference in your life?

The questions allowed them to develop a conceptual model serving as a foundation for Sinclair’s program of research on compassion.

In September 2015, the team started a second study that, over the next two years, will survey health-care providers on their perspectives and understanding of compassion, including if they agree with patients’ descriptions of compassion and what informs compassionate care. The study interviewed health-care providers in hospitals, home care offices and hospices, and will take place not only in urban settings but in rural ones as well.

It’s a tough topic that can be difficult to obtain funding for, but Sinclair’s team has nonetheless been fortunate to obtain peer-reviewed funding from the Canadian Institutes of Health Research. In the same realm, the other challenge is studying compassion rigorously and scientifically while realizing it’s not “stats and rats,” as he says. “It’s a human element, so you can’t ultimately master it, necessarily, but you can understand, codify, measure, enhance and improve patient care.”

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Sinclair’s first study found that, when measuring compassion, patients believe going above and beyond sets some health-care providers apart – for example, a doctor calling them at home in the evening. Second, his work singled out compassion as the foremost characteristic of care – meaning it permeates and has an effect on all other areas of clinical care.

Sometimes, when prompted to give examples of compassion in care, patients gave examples of incidences when compassion was lacking. That dumbfounded Sinclair: “The fact that people would tell us – in many instances, months, years, or decades prior – and that they would carry that, residually, over all of those years, and raise it at a time when we didn’t actually ask them that question, I think is quite telling in terms of the importance of this topic.”

Now, Sinclair awaits the publication of two articles to come out of this study. Of the findings he has communicated to the Tom Baker Cancer Centre and as far as Copenhagen, researchers – and especially clinicians – have been very receptive. He also participates in an international group that is researching how to develop compassionate health-care systems. While his focus is on patient care, Sinclair’s work has proven popular far beyond the bedside.

To learn more about Sinclair, check out Leap’s profile of his switch from chaplain to researcher at: http://myleapmagazine.ca/2010/12/ spiritual-guide/

myleapmagazine.ca

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POLE Up No skis, no problem. Nordic walking provides a fullbody workout that’s easy on the joints

BY LISA CATTERALL

Alber ta Cancer Foundation

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n a bright winter morning, sunlight shines through a grove of poplar trees onto bare snow. The silence of the landscape is interrupted only briefly by a puffed-up chickadee trying to stay warm. Mandy Johnson picks up her walking poles and pushes forward down the path, the snow crunching under her feet. Never one to shy away from physical activity, her cheeks are rosy in the crisp morning air.

“I find that you’re burning more calories so you’re staying super warm. I’ve been out with my poles in minus thirty plus the wind chill,” says Johnson. As a master trainer and ambassador with Urban Poling, a national organization dedicated to Nordic walking, Johnson spends much of her time enjoying the fresh air, regardless of season. The use of Nordic walking poles provides increased stability and results in decreased sprains and strains from slipping on ice.

“Most people know how to walk. And this is really just the enhanced version of walking,” says Judy Boivin.

First identified as a training method for cross-country skiers in Finland, Nordic walking was popularized across Europe throughout the 1980s. But over the past decade it has been gaining popularity throughout North America – and that’s because it’s easy to pick-up. The basic principle of the sport is to increase stability and muscle engagement through the use of walking poles. The poles are used to push off with each step, and in doing so engage the upper body, abdominals and legs.

“Poling is good for everyone, especially for people that are sedentary and need to be more active,” says Johnson. “There’s really no better activity that they could do.”

Since 2008, Johnson has been working with Urban Poling to train Nordic walking instructors and introduce people to this low-impact, high-result activity. Over the last 32

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few years, she has seen increased interest across Alberta as more research is being done into the sport’s benefits.

“I have a degree in physical education, so once I put the poles in my hands, I was immediately taken with the benefits,” says Johnson. “In normal walking you use about 40 per cent of your body. When you add the poles and use the correct technique to engage your body, the number goes to upwards of 90 per cent. It’s just a super-effective exercise by taking very gentle steps.”

After having a total knee replacement in 2006, Johnson sought out a safe, engaging activity that would allow her to enjoy the outdoors. The use of Nordic walking poles created a total-body exercise and the safety and stability offered by the poles makes for an accessible, relatively easy activity for people looking to become more active without spending hours at a gym.

“It is so beneficial for people with various conditions.

For people who are less active, it’s hard to get them to get into a regular program of lifting weights or going to the gym. Nordic walking is just: go walking and use these poles. You get to use so many of your muscles, strengthen your core and burn more calories,” says Johnson. “But to me what’s really underrated is the benefit of being outside in the open air. Being out in such a pleasant atmosphere, seeing sunsets and sunrises and the smell of the air. It improves your peace of mind; you even sleep better.”

The use of poles transfers some of the body’s weight myleapmagazine.ca

into the upper body, relieving stress on lower joints. As a result, Nordic walking is an ideal activity for those suffering from arthritis, recovering from surgery or dealing with past injuries. Due to the increased muscle use, perfectly healthy individuals may also find benefits in Nordic walking.

“It changes the whole body,” says Johnson. “In a kilometre you will take between 1,200 and 1,300 steps. That means when you’re walking with a pole you will have contracted your abdominals 1,200 to 1,300 times. And your arms and shoulders over 500 times.”

“Most people know how to walk. And this is really just the enhanced version of walking,” says Judy Boivin, clinical lead for cancer rehabilitation at LifeMark Centric Health. Boivin is a major proponent of the benefits of Nordic walking, not just for healthy individuals but for cancer patients as well. As a physiotherapist and cancer survivor, Boivin has seen firsthand the remarkable improvements that Nordic walking poles can offer.

“There’s a lot to deal with following cancer,” says Boivin. “Individuals are told they need to do more exercise, but many cancer patients have difficulty achieving that exercise goal for a variety of reasons. A lot of them are exhausted from the treatment, but there are many other issues like balance impairment and neuropathy.”

Studies done in the past decade have shown that the use of Nordic walking poles can help with pain management and counteract fatigue for cancer patients. The poles also help to restore mobility and improve strength in the upper body for breast cancer patients.

“I find that you’re burning more calories so you’re staying super warm. I’ve been out with my poles in minus thirty plus the wind chill,” says Mandy Johnson.

“There are ways to improve cancer-specific side-effects like lymphedema, which produces swelling in the arm and is common following the treatment of breast cancer.

Nordic walking is an ideal exercise because of the pumping actions you do with your arms,” says Boivin.

Like with any exercise program, Boivin recommends cancer patients check with a licensed health professional before getting started. As Nordic walkers can adjust the intensity of their workout, a health professional will be able to develop a customizable program that meets the health history and requirements for each individual. The role of rehabilitation providers in cancer recovery is not only to protect patients from potentially strenuous activity, but also to encourage them to work at the right pace to get the optimal results.

“Ensuring that individuals have been screened for any potential safety concerns is important,” says Boivin, “but I would say the majority of cancer patients are fearful of doing anything that’s going to make them worse. As rehabilitation professionals, we hold their hands and encourage them to get going. Once they gain some confidence, they’re off.” LifeMark Centric Health has specially trained cancer rehabilitation therapists in 62 clinic locations across Canada, 11 of them in Alberta.

When compared with other sports, the costs for getting started with Nordic walking are quite minimal. Nordic walkers only require a comfortable, sturdy pair of walking shoes and a set of poles. As the only major investment, these poles are often priced around $100 and are available at many outdoor sporting goods stores. The poles differ from traditional ski poles in that they have been designed for use in an upright walking position. A removable rubber tip on the end of the pole allows for use on paved paths, while the sturdier metal tip underneath can provide stability on more rugged terrain, like hiking trails.

For those wanting to try the sport prior to buying the poles, many Nordic walking clubs offer rentals or have try-out sessions to learn more about the sport. Some of Alberta’s smaller communities, including Canmore, Chestermere, Okotoks and High River even have Nordic walking poles available for rent from public libraries.

“We want people to try it, and when they do, their eyes kind of open in amazement.

And they’re usually sold,” says Johnson. “It’s the kind of thing where once you’ve tried it, you’re hooked.

Alber ta Cancer Foundation

Pole Picking 101 When choosing the right walking pole, there are a few technical aspects to consider.

Do you want straps? Some experts argue that going strapless is better for form and strength.

Others say the strap helps walkers push off with better form. Luckily, some poles come with a detachable option.

Consider your height: Poles come in both adjustable and fixed versions, and to calculate the height you need, use this formula: (your height in centimetres) x (0.68). For fixed-length poles, round up or down to the nearest five centimetres to determine the length you need.

How light can you go: All Nordic walking poles are made from lightweight materials. While carbon is considered the best material, highend options include aluminum alloy poles that are lightweight while also strong as steel.

Handling it: Most handles are made out of plastic or foam, which are long-lasting, but cork handles are also beneficial because they are absorbent and easier to grip.

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Bridging the Cultural

GAP

Lori Kirkaldy helps aboriginal cancer patients navigate the system

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itting at her desk at the Cross Cancer Institute, Lori Kirkaldy defines the Cree word for cancer: munchoosuk. “It literally means, ‘a bug that eats you from the inside out,’ ” she says. “In other dialects, it translates to ‘a spider under the leaves.’ ” Kirkaldy’s job, as aboriginal cancer navigator at the Cross, sees her facing down the cultural and medical differences that arise when some aboriginal people are diagnosed with cancer. “It’s highly stigmatized,” she says of the disease. “Quite often, a person will know something is wrong with him or her, but not want to go for screening and hear that they have cancer.”

The rate of cancer incidence amongst aboriginal people has historically been lower than non-aboriginal people in Canada. Still, studies have shown a smaller percentage of aboriginal women receive mammograms

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and PAP smears every three years compared to non-aboriginal women in Canada. And recent research shows that due to social poverty and lack of access to education and health-care – and subsequently, higher rates of drinking, smoking and poor nutritional intake – the future cancer burden is expected to grow amongst aboriginal populations, particularly on First Nations reserves.

The disproportionate burden of poverty and disease – the “highs and lows” as Kirkaldy calls them – is what first motivated her to become an aboriginal cancer patient navigator.

“When I was in nursing school at the University of Alberta, we did a project on the high suicide rates amongst aboriginal youth. That’s when I first realized how poor our health is as a population, compared with non-aboriginals. Our life expectancy is lower, our mortality rate is higher. We have a higher incidence of heart disease, diabetes and hypertension. We have a lower income,” says Kirkaldy.

Kirkaldy was born and raised in Edmonton. Her mother was originally from Tsiigehtchic, a Gwich’in First Nations community located along the confluence of the Mackenzie River and the Arctic Red River in the Inuvik region of the Northwest Territories. Kirkaldy’s mother was a survivor of the residential schools myleapmagazine.ca

BY TRINA MOYLES / PHOTOS BY BUFFY GOODMAN system, a colonial project from 1870 to 1990 that forced over 150,000 indigenous children in Canada to leave behind their families and cultural ways to attend government-run boarding schools. In June 2015, the Truth and Reconciliation Committee urged the Canadian government to “acknowledge that the current state of aboriginal health in Canada is a direct result of previous Canadian government policies” and to implement the health rights of aboriginal people.

“Not everyone understands the history of aboriginal people and how the past has affected our health today,” says Kirkaldy. For 10 years, Kirkaldy worked as an oncology nurse at the Cross. During that time, she remembered saying to her husband: “I want to work with our people somehow. But I’m an oncology nurse – what could I do to help?” Shortly after, as though her prayers were answered, Kirkaldy stumbled across a job posting for an aboriginal cancer patient navigator position. “It was as though everything I’d gone through and experienced in my life led me to this job,” she says. She applied and was hired in July 2014.

The aboriginal navigator position, funded by Alberta Health Services’ Aboriginal Health Program, is a pioneering counselling service that offers special counselling support to aboriginal cancer patients through diagnosis, Alber ta Cancer Foundation

treatment and recovery at the Cross. “When I took this position, I thought I’d sit in my office and counsel my patients. But it’s so much bigger than that,” admits Kirkaldy. On any given day, she finds herself playing multiple roles: she explains medical procedures to patients, acts as a liaison between patients and oncologists, and helps them access housing and transportation resources.

“The aboriginal population typically shows up in the later stages of cancer, and our people tend not to finish their treatments. It’s for a variety of reasons – lack of resources, miscommunication or because they’re overwhelmed by the system. Through consultation, people said they needed someone who knew our life, our culture – they needed a friendly face to help them with the system. They asked for someone they could trust,” says Kirkaldy.

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Trust is key to Kirkaldy’s work. When she meets a patient for the first time, she takes time to get to know them. “How are you feeling? How was your trip?”

Kirkaldy asks them. Many of her patients are forced to travel from their homes on reserves and settlements for treatment. Patients living in northern Alberta face journeys of five to 10 hours on the road.

Many patients struggle to complete their treatment because of the long distance between their communities and the hospital. Patients receive treatment Monday through Friday at the Cross and are sent home on the weekends. For a patient living seven hours away, that schedule is a major barrier. She recalls a misunderstanding that occurred between a patient and oncologist: late on a Friday afternoon, the doctor wanted to put in a pick-line to help the patient, but the patient refused treatment and became “uncooperative.” Kirkaldy was called in to help mitigate the misunderstanding. The patient was from a remote community in northern Alberta and there was only one bus that departed at 4 p.m. With no pocket money or place to stay in the city – the patient had no other option to get home.

“I didn’t realize that before,” says Kirkaldy. “Patients can’t stay for the weekend; they have to go home. Some patients arrive home at 11 p.m. on Friday night and

by Sunday they’re travelling back for treatment on Monday. It’s exhausting for them.”

When patients reach the Cross, Kirkaldy knows they can feel exhausted, scared and vulnerable. She doesn’t rush her interactions with them. “I tell them, this is who I am, this is where I’m from – my mom was from up north. That sets the stage for a more trusting relationship.”

“It was as though everything I’d gone through and experienced in my life led me to this job.”

While relationship building is important in helping all cancer patients navigate through the medical system, Kirkaldy believes that it’s even more critical for health professionals to develop relationships with aboriginal cancer patients. “Often, patients tend to not communicate very well with health professionals. It’s sometimes about mistrust with the system, or they don’t want to confront people in power,” Kirkaldy explains.

In her position, she’s striving to bridge the cultural gap between patients and medical professionals. She believes that the medical system doesn’t always take into consideration the social and environmental challenges that patients are facing in their communities. “People don’t realize that social conditions on some First Nations reserves and Métis settlements are comparable to Third World countries,” says Kirkaldy. “There’s overcrowding in houses. Some reserves don’t even have running water to their houses. There are 46 reserves in Alberta and 41 still have to boil their water before drinking.”

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STRONG TIES: Kirkaldy visits patient Mary McCarty, originally from Cold Lake First Nation, at the Cross Cancer Institute.

Kirkaldy also facilitates educational workshops for health-care professionals to help them understand aboriginal cultural perceptions of cancer and Western medical treatment. Some traditional people believe that cancer is contracted as a form of “punishment” or bad karma for a negative action. Others believe it’s contagious. One of Kirkaldy’s former patients recovered from his treatment, which led his family to believe he never had cancer at all.

Female aboriginal cancer patients can face additional cultural challenges to receiving care and treatment. In many cultures it’s believed that women, as the bearers of life and creation, are very powerful. The womb is considered sacred.

Kirkaldy says that female patients are, at times, reluctant to allow oncologists to examine them.

“Many women are shy about being examined,” she says. “That can affect screening for cancer, as well. Some women don’t want anyone examining them unless it’s absolutely necessary. It could be part of the reason why women come for treatment at later stages.”

Despite the challenges her job entails, along with the larger socio-economic barriers her patients are facing on a daily basis, Kirkaldy is striving to work “one patient at a time” to help aboriginal patients access resources and navigate through a health-care system that’s created years of fear, mistrust and misunderstanding.

“We can’t fix aboriginal health overnight,” says Kirkaldy. “But we can try to help one person at a time.”

Although Kirkaldy’s position as aboriginal navigator is relatively new, she’s already made strides to support patients and oncologists, advocate provincially and federally for aboriginal health and document cases for statistical purposes. Kirkaldy feels grateful for the opportunity to work closely with her patients and learn from elders and knowledge keepers in aboriginal communities. “It’s definitely made me understand what my mother went through in residential schools. Growing up, there were things I didn’t understand. But now I’m seeing the long-term effects – and it’s making sense,” says Kirkaldy.

“My work has led me closer to my culture. I find myself thanking the Creator often.

I’m learning to find my spirit.”

myleapmagazine.ca

Why I Donate • stories of giving

CYCLE KING: This year marks the ninth annual Williams & Mudryk 100K for the Cross bike ride.

FOND MEMORIES: Clarke Lamont (right) has made a donation to Calgary’s Tom Baker Cancer Centre in recognition of the care his wife Patricia (left) received there.

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myleapmagazine.ca

Commitment to a Cause After a long cancer journey, Patricia Lamont’s loved ones donate in her name

BY JACQUELINE LOUIE

C

when Pat began to feel ill. “She wouldn’t come out walking with me. She was lethargic,” larke Lamont hopes for some good to come Clarke recalls. “In May, she started to cough and wake up in the middle of the night. It out of his wife’s tragic passing from lung cancer was really bad. I knew there was something wrong.” at the age of 72.

Clarke told Pat that she had to go to the doctor and get a chest X-ray. In early July, Last year, the Calgary businessman made a she was told the X-ray had found a large mass on her lung and she was booked in for an donation to the Alberta Cancer Foundation benefitting emergency CT scan. Around the end of July, Pat suffered a seizure. “It was just horrible,” the Tom Baker Cancer Centre in appreciation of the Clarke recalls. “I thought I would lose her then.” care that his wife Patricia received while a patient at the centre. The funds will be used to support a lung cancer They went to the emergency department at the Foothills Hospital. After medical staff screening program related to the work of respirologist checked the results of Pat’s CT scan, they found the lung cancer had spread to her brain.

Dr. Alain Tremblay, an associate professor of respiratory At the Tom Baker Cancer Centre, the Lamonts met with radiation oncologist Dr. Jon-Paul medicine at the University of Calgary, whose ultimate Voroney and his team, who started her treatment with radiation therapy on the three goal is to develop a provincially funded lung cancer tumours in Pat’s brain, before undertaking radiation therapy on her lung. The tumours screening program. shrank and Pat was put on chemotherapy. Several sessions were planned for her medical Pat Lamont was a non-smoker and went for annual care, but she only made it through one, ending up in hospital after the first session. checkups, “but they never “The chemotherapy almost finished did a chest X-ray, just a her – but maybe it helped,” Clarke says. Pat “Pat was a really special person. mammogram,” Clarke says. was determined to go home, and Clarke made We have two wonderful sons and two special arrangements for her to do so. Through When she was diagnosed with lung cancer, her wonderful grandsons. We had a very, the support of Alberta Health Services, they set physicians couldn’t pinpoint up a special bed in their bedroom, and Clarke very fantastic marriage,” a sure cause. There were no hired home care to help several times a week. He says Clarke Lamont. symptoms – typical of the took on the rest of her care himself. “She started illness – until very late. “Lung to walk again and started to get a little bit better. cancer is really hard to detect. When you get lung cancer I don’t know if it was the chemo or the radiation,” he says. and it moves, it’s terminal. It’s a bad thing,” Clarke adds.

That year, their family celebrated Christmas together, and in the new year, the The Lamonts, who met at university, were married for Lamonts went to Arizona with family members, Pat travelling in a wheelchair. nearly 49 years and dated for four years before getting Soon after, Pat’s care team found a new tumour, which started to shrink after she married. After graduating with a social work degree from underwent more radiation therapy. A checkup determined that the tumours had the University of Montana, Pat worked for the Alberta disappeared. Keeping up their commitment to travel, the Lamonts went to Edmonton, government as a social worker in Edmonton, High Prairie, Sylvan Lake and Banff, as well as to social functions with family and friends, out for Grande Prairie and Calgary. She also served as a volunteer dinner and shopping. For all of this time spent together, they and their family were for a variety of organizations, including as a member of extremely grateful. “I do think they gave Pat extra time – 14 months more than they the Junior League of Calgary, the University of Montana expected,” Clarke says. “We got to do a few things we never would have otherwise; we Alumni Association Board of Directors and the Alberta did all kinds of things.”

Appeals Secretariat.

In July 2014, however, Pat experienced another seizure, and the care team at the Tom “Pat was a really special person,” Clarke says. “We have Baker Cancer Centre discovered a new tumour in her brain. Voroney broke the news. two wonderful sons and two wonderful grandsons. We “He said, with tears in his eyes, ‘I can’t do any more,’” Clarke recalls. “They suggested had a very, very fantastic marriage.” she should maybe go to hospice.”

The Lamonts were in Arizona in the spring of 2013 It was devastating, but at least they had extra time after the initial diagnosis. “He had

Alber ta Cancer Foundation

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Why I Donate • stories of giving

FAMILY TIES: Clarke and Patricia Lamont with their grandchildren.

already given us 11 months after they told her she was terminal.” Pat ended up living at Southwood Hospice, where she stayed for two-and-a-half months before passing on September 29, 2014 – much later than the three to four weeks it was expected that she would live. “She passed away very peacefully,” says Clarke.

“Lung cancer is really hard to detect. When you get lung cancer and it moves, it’s terminal.

It’s a bad thing.”

He and his family are deeply appreciative of the care and compassion that Pat received all along, from physicians, nursing staff and other caregivers at the Tom Baker Cancer Centre, the Foothills Hospital emergency department – whose staff Clarke describes as “absolutely wonderful” – and Southwood Hospice, where “the care was just phenomenal.”

After her passing, the Lamont family asked that friends and family make a memorial donation to honour Pat, in lieu of flowers, to the Alberta Cancer Foundation, care of the Tom Baker Cancer Centre. Clarke himself made another donation this year on behalf of himself, Pat and their family, and he plans to make another contribution next year, continuing on a regular basis into the future.

He would like to see more money raised for the lung screening program and says it’s an important cause for those who would be interested in donating.

“We want to get more people pre-screened,” he says.

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Read more about Tremblay’s lung cancer screening program at www.myleapmagazine.ca

myleapmagazine.ca

Corporate Giving • working for a cause

GIVING TO GO

BY ROBIN BRUNET

Daytona Homes’ successful “suitcase party” sent donors on a meaningful weekend getaway Aerial acrobatics, a wine tasting and weekend vacation prizes: these are the elements that Ralph LOFTY GOAL: Daytona Homes and Hutchinson Acquisitions Corp.

Hutchinson recently summoned to help raise $150,000 fundraised $150,000 through their unique ‘suitcase party.’ for a new PET-MR scanner for the Cross Cancer Institute.

Those who don’t know Hutchinson may assume he’s a professional event organizer. But, as CEO of Daytona Homes and Hutchinson Acquisitions Corp., he has spent the past 20 years becoming one of Alberta and Saskatchewan’s largest family-owned homebuilders.

So how did a business leader get involved in his firstever Alberta Cancer Foundation fundraiser, and how did he manage to make the September 11, 2015, event so spectacular?

It began a year ago, when he read a magazine story about a “suitcase party” that had taken place in the United States. “It seemed like a wonderful idea, and it stuck with my wife, Janet, and me,” he says. “I chatted about it with my kids, who run Daytona and Hutchinson Acquisitions, and they agreed it was something we could stage.” A suitcase party is a fundraiser in which donors come with a fully-packed suitcase in the hopes of winning a prize vacation that begins immediately after the event.

Hutchinson knew what cause to support: he had friends undergoing treatment at the Cross Cancer Institute and was aware of the clinic’s effort to obtain a PET-MR scanner. The scanner’s soft tissue imaging has been called a game changer in the fight against cancer because it neighbour,” he says. “They weren’t wealthy by any means, but they contributed to a enables clinicians to detect early cellular changes before richness of spirit that made our community vibrant.

“When I became a success in business, I thought it made even more sense to help any anatomical changes can be observed.

“The scanner increases our understanding of how other people – and with something as devastating as cancer, any effort to improve lives is cancer works,” he says. “That, plus the fact that the Cross worthwhile,” he says.

In addition to Carter’s spectacular aerial display, Ricco Ferry, owner of Allegro West would be the first institute in Western Canada to get one, inspired our Daytona and Hutchinson staff as well as our End, provided an outstanding Italian menu, and Gurvinder Bhatia, owner of Vinomania, took guests through a tour of Italian wines that friends and business associates.”

“When I became a success in business, paired with the menu.

“We had about 80 people in that hangar, and To hear the CEO tell it, he merely recruited I thought it made even more sense to help it was tremendous fun,” says Hutchinson. Three other people – and with something as couples won the draw to enjoy a weekend of great volunteers, booked a food, golf and yachting in Sidney, B.C., and were hangar at Villeneuve devastating as cancer, any effort flown there by private jet.

Airport, enlisted his to improve lives is worthwhile,” says Although funding is still needed for the PET-MR friend Bill Carter of Bill scanner, Hutchinson has demonstrated that the Carter Aerobatics to Ralph Hutchinson. simple spirit of community involvement – and good provide a stunt-filled air business connections – can result in the procurement of groundbreaking technology. show and organized plenty of good food and drink.

And as far as he’s concerned, suitcase parties could be the ideal way to raise money.

That he downplays the time and effort it took to stage the event is understandable when one learns about his “The most memorable part of the event for me came toward the end, when a colleague childhood. “My parents viewed fundraising and other walked over and said, `This is the most fun I’ve ever had giving away money,’” he says. “I charitable acts as merely a normal part of being a good agree with him: in so many ways, it was money well spent.”

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Top Job

On the

ROAD Vivian Collacutt looks for ways to help cancer patients across the province

BY SHELLEY NEWMAN

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/ PHOTOGRAPHY BY COOPER & O’HARA

myleapmagazine.ca

I

n her role as a social worker, Vivian Collacutt calls all of Alberta her office. Taking a break between business trips to Toronto and Newfoundland, she shared what her days look like as the director of supportive care and patient experience with Cancer Control at Alberta Health Services. It’s a complex, busy role, and the scope of her work is broad – a typical day could involve everything from helping her social work staff support the needs of cancer patients in rural areas, to participating in collaborative initiatives at the national level.

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Top Job No matter where she is, though, Collacutt has an awe-inspiring capacity to care. That capacity, combined with an unimaginable work ethic – are the essential factors shaping both her professional and personal life.

From 1989 to 1993, for example, Collacutt and her husband Scott were living in Halifax, where they fostered 35 children, not counting those they took in for emergency respite situations.

“Most of our foster children were under the age of five, and most of them were boys,” she says. “We had some kids for many months, some off and on for years, and some for only a day or two.”

During this time, they adopted their first two sons. From 1993 to 1995, the family had several more changes, as they moved to Calgary and adopted four more children. “All four of our boys have the same biological mother, and our two girls are full biological sisters,” Collacutt says. With six children, and their four boys having a variety of special needs including ADHD, FASD and brain injury, the Collacutts did not foster children after moving to Alberta.

While raising their family, Collacutt decided to pursue her passion and make a career change: “In the mid-’90s, I decided to become a social worker,” she explains. “My intention was to work in adoptions, but I took an awesome health-care course and changed focus to a medical career.” Scott supported his wife’s decision, as he felt it was “a genuine fit for her,” but he still marvels at her ability to get everything done. “I was in the military at the time, and I was away on exercise and overseas a lot,” he says. “I think Viv is just so amazing. To look after six kids and put herself back through university – that’s just not what most people do.”

“I think Viv is just so amazing. To look after six kids and put herself back through university – that’s just not what most people do,” says Scott Collacutt.

Upon graduation in 1999, Collacutt began a full-time job as a social worker at Sturgeon Hospital in St. Albert. She was also a student again, earning her master of social work from Dalhousie University. Plus, she ran two marathons and over 15 half marathons during that time. “When I look back on it, I’m not sure how I did all that,” Collacutt says. “I think the running was a huge part of keeping my stress in check.”

Bernie Mallon, a longtime friend and master of social work schoolmate, observes other traits that help her friend succeed: “Vivian is really smart and organized, and she is able to make really good use of her time,” she says. “I’ve always admired how well she’s able to see the big picture. She can pull all of the pieces together nicely and, in her current role where her region is so broad, she has the ability to develop relationships and facilitate networking.”

Collacutt says her collaborative approach and background in social work applies to all facets of her job. “A lot my work is influential, so relationship building is at the foundation of everything that I do,” she says. “When we’re looking at helping patients from across the province, it’s important to bring all of the groups to the table so that we can understand what’s out there and how we can best work together to help people.”

Collacutt’s job is to assist patients in community oncology, with access to services and patient care being of critical importance.

While she doesn’t work directly with patients, she supervises and provides leadership to those who do. This includes managing a 44

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team of six social workers as they work with people at the four regional centres and 11 cancer care centres province-wide.

She says the social workers have become a true team, which is beneficial for patient care and for their professional connections. “It’s been so rewarding to see them grow and develop as a team,” she says.

“They have to work with some devastating situations, so to be able to bring the issues to the front and support each other is essential.”

This supportive approach is something Collacutt models to staff. “She’s a very compassionate and caring supervisor, for us as individuals and as a group,” says Tricia Hutchison, community oncology social worker with AHS. “Vivian emphasizes that we all have a role to play – we each have skills and we need to respect the skills of others to build a really strong team.”

A commitment to team building is evident in another aspect of Collacutt’s job, where she is responsible for the community oncology rehabilitation program. “We’re just starting to grow this program, and we have one physical therapist in Lethbridge and a physical therapist and an occupational therapist in Red Deer,” she says. “Cancer treatments can cause physical impairments, and it’s so important for people to have access to appropriate therapies and supports in the regional areas.”

Regional access to support is a pivotal point when it comes to the First Nations-Inuit-Métis (FNIM) work that’s another area of responsibility for Collacutt. “The focus in this area involves

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ONE FOR ALL: Vivian Collacutt credits ‘relationship building’ with being at the foundation of everything she does.

increasing access to cancer services for FNIM patients, improving In the end, Collacutt is all about relationships and connections. co-ordination of services across the cancer continuum and “Scott and I have always had a great partnership, with our children supporting the development and dissemination of culturally and now grandchildren being an incredible part of our lives,” she competent resources and care,” Collacutt says. To help make this says. “At work, I’m so fortunate to have a fantastic team, and I’ve never stopped learning and growing happen, Collacutt participates in nationally funded collaborative of the partnerships. I’m so No matter where she is, Vivian Collacutt because initiatives with AHS partners and grateful to have the opportunity to with FNIM leaders, communities has an awe-inspiring capacity to care. That do this rewarding work.” capacity, combined with an unimaginable and organizations.

“I really admire Vivian’s ability to When she considers the diversity advocate for patients and families, work ethic – are the essential factors in her current role, Collacutt is and the collaborative health-care shaping both her professional and thankful to “have a manager who team approach, in all of her day-topersonal life. supports me and encourages day responsibilities,” Hutchison says. me to pursue areas that are my But Collacutt’s husband Scott strengths,” she says. “I’ve been able to be part of many different thinks that it’s all her hard work that has led to this success: councils, projects and initiatives, including the CancerControl “She’s really put her heart into her work, and she’s helped to Alberta Supportive Care Council and the Communities of Practice effect changes in many ways, such as remote areas receiving more project, where I can represent community oncology and connect assistance,” he says. “Vivian is often the glue that keeps everything with people provincially and nationally.” together and makes it possible.”

Alber ta Cancer Foundation

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Research Rockstar

It’s all in the

DNA Dr. Michael Weinfeld’s Alberta-based team works towards inventing new drugs that target cancer cells and enhance current treatments

BY MICHELLE LINDSTROM

/

PHOTOS BY CURTIS TRENT

L

eadership comes in many shapes and forms – but not all are successful. Dr. Michael Weinfeld, University of Alberta professor in the department of oncology, insists that there is no “I” in “team.” In fact, he’d prefer that he be known as part of a “Research Rock Group,” rather than as a “Research Rockstar” himself, as his current work involves the efforts of at least 15 principal investigators within Alberta. He just happens to be leading and coordinating it.

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Alber ta Cancer Foundation

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Research Rockstar

“Michael is the best person for the job,” says Dr. Jack Tuszynski, Allard Chair and University of Alberta professor in the department of oncology. “Everybody likes Mike.”

Tuszynski is one of the investigators involved in a new study for which the Alberta Cancer Foundation has recently awarded $2.9 million over the next three years. The funding supports the unusually large and diverse team of scientists in its goal of creating new compounds (chemicals that have not been formed into drug-like structures yet) that will make cancer cells more sensitive to current treatments: radiation, chemotherapy and drugs.

“This is a very uncommon situation, where you bring together a spectrum of researchers and clinicians to solve the problem. In the past it’s been more of a sporadic, one group or two collaborating – 15 people is a big team,” Tuszynski says. “Mike understands all aspects of the project like nobody else.”

Weinfeld stresses that the key to this study is its multi-disciplinary design, including input and research from DNA repair specialists, computer specialists, chemists, imaging specialists and pharmacologists. The investigators are located across Alberta, employed by the University of Lethbridge, University of Calgary and University of Alberta with a bit of help from the Centre for Drug Research and Development in Vancouver.

“This is a very uncommon situation, where you bring together a spectrum of researchers and clinicians to solve the problem… Mike understands all aspects of the project like nobody else,” says Dr. Jack Tuszynski.

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In 1982, Weinfeld came to Canada from England to study at the Chalk River Laboratories in Ontario.

With his chemistry background, he worked with radiation biologists at the nuclear lab before moving west to Edmonton in 1985 to work at the Cross Cancer Institute as a post-doctoral fellow. “And I stayed,” he says, referring both to Canada and the Cross. “In 1989, one of the chemists here at the Cross left to go to the States and I inherited that lab.”

His lab, and 30 years worth of studies in it, focuses on DNA repair – providing a plethora of experience and base knowledge for study and research that began over the late summer and early fall of 2015. “Radiation and many chemo-therapeutic drugs kill cells by damaging their DNA,” Weinfeld says. “Often, we find that cancers are resistant to therapy, and part of the reason for that is their capacity to repair the damage.”

This concept is intriguing to cancer researchers, and Weinfeld’s team wants to do something about it.

DNA damage is a regular occurrence for all living beings and a detection and repair system, made up of proteins called enzymes, mends this damage. But problems arise if cancer cells repair themselves too well after chemotherapy or radiation treatment – some of these cancer cells will survive, causing patients to relapse. Weinfeld’s team is building on research his lab, and Tuszynski’s, has already completed about two enzymes – PNKP and ERCC1-XPF – that operate in key DNA repair pathways.

The team has set a multi-step approach within its myleapmagazine.ca

study – first, it will develop chemical compounds Even though Weinfeld and Tuszynski’s labs have already developed the first that inhibit the PNKP and ERCC1-XPF enzymes to compounds that inhibit enzymes PNKP and ERCC1-XPF in research – they’re not stop their ability to repair cancer cells. After, the goal drugs yet. “We’re a long way from a drug,” Weinfeld says. is to make these compounds work well in cells iniFor now, the Alberta Cancer Foundation’s investment will carry them for three years. In three to five years, Weinfeld says his team’s goal is to have two good tially grown in the lab. Subsequently, the team will formulate these compounds to one day be admincompounds that will target these enzymes and that will be what they report to the istrable to cancer patients as drugs and ensure the Alberta Cancer Foundation on. compounds target “I’m really happy to be a part of this team, and only cancer cells and I have to give [Michael] credit for bringing all of “Let’s say that you’re going in for radiation. these different people together. It wasn’t an easy not normal cells by Before your radiation, you’ll be injected packaging them in a process and was a competitive program,” Lavspecific way. with one of the compounds that we think asanifar says. “This is a unique situation and can “Let’s say that lead to bigger things with this team and different will work, and it should make the cells you’re going in for raareas of research.” more sensitive to the radiation,” “It’s worth noting that DNA repair got the Nobel diation,” Weinfeld says. says Dr. Michael Weinfeld.

Prize for Chemistry this year,” Weinfeld adds. “It’s a “Before your radiation, big area of research.” One he’s obviously very passionyou’ll be injected with one of the compounds that we think will work, and it should ate about, having studied it for so long already, with no signs of slowing down or make the cells more sensitive to the radiation.” changing course.

Ideally, the invented drug will inhibit key enzymes, making cancer cells more sensitive to radiation or chemotherapy by reducing the chance of cancer cells repairing themselves. Eliminating the chance of repair means all cancer cells should die, which in turn should also eliminate the chance of relapse.

Do you have a family?

“The target is, initially anyway, in colorectal canI have a wife and three grown children: two daughters and a son. cer,” Weinfeld says. “Although, we think this research will apply to many cancers.”

Are any of them into science and research?

EvErybody LikEs MikE

It makes sense to start with colorectal cancer because it’s one of the “big four” – lung, breast, prostate and colon – cancers that have the highest incidence rate. Also, breast cancer is found mainly in women, and prostate only in men, yet colon cancer occurs quite evenly between the sexes and provides a good variety of future clinical trial candidates.

Dr. Afsaneh Lavasanifar, University of Alberta professor in the Faculty of Pharmacy and Pharmaceutical Sciences, is one of the principal investigators on Weinfeld’s team. She has the difficult task of transforming the solid compounds the group’s chemists make into injectable solutions the body will accept.

Some compounds cannot be injected because they can’t be made soluble, Lavasanifar explains. And many of these drug candidates (or compounds) may cause toxicity within the patient. “One way to avoid this problem is to package [the compounds] into particles in the nanometre size range,” she says, adding that when you inject them into patients at that size, the drug won’t have to be metabolized before it reaches the cancer cells.

“These nanoparticles can dictate where the drug goes: not to the normal cells and tissues,” Lavasanifar says. “They can be designed to bring the drug only to cancer cells.”

It typically takes about a decade to develop a new drug that can enter into clinical trials and be used on cancer patients.

Alber ta Cancer Foundation

No, they were smart enough to stay away from it. My son is in university though, so maybe, but he’s more into the arts.

What are your hobbies?

I used to play soccer a lot. I do like scuba diving if I can do it and there’s time.

What was the best work-related place you’ve travelled to?

Back in the late-’90s, I went on a sabbatical to Clare Hall Laboratory in Hertfordshire, U.K., which is a cancer research lab with one of the guys who won the Nobel Prize in Chemistry this year. (The 2015 Nobel Prize in Chemistry was jointly awarded to Tomas Lindahl, Paul Modrich and Aziz Sancar for DNA repair studies.)

What was the best non-work-related place you’ve travelled to?

When the kids were younger, we’d go camping, especially on the May long weekend. My colleagues would ask, ‘Where are you going?’ and then they’d go in the opposite direction because they knew that we would always get the snow. It worked for them.

The national parks and provincial parks in Canada are a real treasure – more Canadians should value them because they’re just exceptional.

If you weren’t a researcher you would be...

Something that I like is politics. My wife was the campaign manager for Linda Duncan, the NDP Member of Parliament who retained her seat in Alberta. One thing I would like to see is more scientists and engineers in our parliament and legislatures. There are so few. That’s something I bore my friends with all the time: provincial politics.

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My Leap • inspiring individual FIGHT TO THE FINISH: Despite just finishing his own cancer treatment only months before, Kevin Coflin, right, led the Shell team in the 2015 Enbridge Ride to Conquer Cancer presented by EVRAZ, raising $80,000 for the Alberta Cancer Foundation in the process.

PHOTO COURTESY KEVIN COFLIN

C

M

Y

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The Wheel Deal

By Shelley Williamson

Cancer survivor Kevin Coflin rides to conquer a family history of cancer Like many Albertans, Kevin Coflin’s life has long been touched by cancer.

His father and brother died from the disease in their mid-50s, while two other brothers, and Coflin himself, are living with the disease. So it makes perfect sense that he became team captain for Shell in the 2015 Enbridge Ride to Conquer Cancer, benefiting the Alberta Cancer Foundation.

Coflin also saddled up to prove he could do it, he says. He had finished treatment for his second cancer, non-Hodgkin lymphoma, just months before last summer’s ride. “I would say it was quite selfish. Before I started my chemo last year I said, ‘I am going to need some kind of goal or physical activity so I can bring myself back,’ and so that’s literally my rationale [for doing the ride].”

When doctors found Coflin’s first cancer – in his prostate – back in 2003, he had the choice of being treated at Houston’s world-renowned MD Anderson Cancer Center or Calgary’s Tom Baker. He chose the latter and is thankful. That’s also part of the reason he started the Shell team: “Just the day-to-day mechanics of chemo and your family getting through it with you is a tough thing. But I saw how well [the Tom Baker] managed the side-effects and that was clearly from people being involved in clinical studies and the medical staff being there to be responsive,” he says. “That’s when I started to see it from the bigger picture of not just my personal goal of trying to do something physical, but the overall benefit of what impact this

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type of funding can have for cancer patients.”

While Coflin had his doubts about finishing Day 2 of the gruelling fundraising ride last August, he credits his fellow Shell riders with getting him through. “Still to this day, I don’t know how I finished the second day because I’d gone through six rounds of chemo and done a stem cell transplant in January. I went through all of that very well, but I didn’t fully appreciate how much the stem cell transplant and the high-dose radiation would kick the hell out of you. In January I could barely walk 50 metres, so I was not in shape enough to ride.”

The 2015 instalment of the Enbridge Ride to Conquer Cancer raised $7.8 million for the Alberta Cancer Foundation, with $80,000 of that coming from Coflin and his team’s 18 members. “I was very proud of the fact that we were able to do that,” he says, adding plans are in the works for Shell’s 2016 team.

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