P&T summer by lisa bucher

contents SUMMER 2012

On the Cover 18 Fashion for a Cure, interview with Farley Chatto, curator of the White Cashmere Collection 2012 13 Survivor’s Strength, Josephine Lee shares her story of battling Acute Myeloid leukemia as a young woman 32 Sara O’Neill, MFSc – certified exercise physiologist teaches upper-body resistance training for breast cancer survivors 26 Michelle Rosen shares her beauty-bag essentials for going chemical free and lets us in on the 12 ingredients to avoid 30 Dr. Gary Rodin explains the importance of talking about hair loss with your daughter

What’s New! 8 Katie Beattie laces up for the cure 9 Meet Nikki Bergen! Our NEW fitness expert 10 Sex After Cancer Workshop: We hosted with Dr. Jess, presented by We-Vibe 11 White Cashmere Collection: We went behind the scenes with our photographer, Magda 45 Dr. Martin Jugenburg tells us about the recent advances in breast reconstruction

Look Great

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21 It’s wedding season! Find out how to go strapless post-mastectomy 42 Stylish compression tights? These aren’t your granny’s stockings! 28 Sneak Peak - trendy eyewear launching for October

Eat Well 39 Who doesn’t love strawberries? Marlene MacPherson shares her Berry Good Salsa recipes – and her version uses locally grown Ontario strawberries

Embrace Life 23 Summer Fun in the Sun: How to stay safe with the right sun-care product 34 Move, Breathe and Be Happy: Mechanisms and benefits of yoga 16 The Pink Method exercise program for breast cancer survivors 46 So what is mindfulness? Theresa Jahn tells us 29 Financial support for survivors, Amie Heenan tells us how to save money on our lingerie

Media 47 Books to Film: Review of The Descendants 48 Film: Review of My Life Without Me 50 Resource Guide

PHOTO BY Magda

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Editorial and Creative Director Lisa Bucher Editorial Copy Editor Shauna Chase Art Arts Director Christopher Bates Graphic Designer Christopher Bates Photography Ashley Adams, Magdalena M, Shaemara Gottfried Nutrition Marlene MacPherson Contributing Writers Michelle Rosen-Mille, Theresa Jahn, Amie Heenan, Christopher Bates, Dr. S. Nicole Culos- Reed, Nikki Bergen, Sara O’Neill, Stefania Di Mascio, Aleyna Krantz, Marlene MacPherson, Liliana Mann, Cody Lee, Michael J Mackenzie, Dr. Martin Jugenburg, Jacqueline Bellmore- Kinney Cover Cover Design Christopher Bates Photographer Mario Miotti Model Angie Smith, producer and talent of Entertainment Tonight Canada Props 12|12 Décor Clothing Dress made of White Cashmere bathroom tissue, designed by BROSE by Marika Brose

Find Us! Publisher Bucher Media Inc.

Advertising Sales Strategic Solutions Media Sales Lesley Sanderson Phone 416 762 5407

Marketing and Communications Interns Megan Dussin & Cody Lee

Digital and Interactive Manager Web Creative Tim McArthur Web Designer & Developer Lucid Media

Lawyers Miller Thomson

Printer Transcontinental Inc. 100B Royal Group Crescent Vaughan L4H 1X9

Toronto Women’s Bookstore 73 Harbord Street, Toronto 416-922-8744 info@womensbookstore.com

Mastectomy Lingerie and More 549 Upper Wellington Street, Hamilton 289-689-5409 www.mlam.ca

Melmira Bra & Swimsuits 3319 Yonge Street, Toronto 416 485 0576 www.melmira.com

Purchase our magazine at these Well- spring locations! $2 from each copy sold goes to Wellspring

Wellspring Women’s College Hospital 76 Greenville Street, Toronto 416-323-6400 X 4240

Pink & Teal is published quarterly by Bucher Media Inc., no part of this magazine may be copied or reprinted without the written consent of the publisher. Please see website or contact us for annual subscription rates. (subscribe@pinkandteal. ca)

To subscribe visit us, www.pinkandteal.ca Mail to: Bucher Media Inc. 467 Woolwich Street Guelph, ON, N1H 3X6 ($22.60) © Bucher Media Inc. Vol. 1, Issue., 3, Summer, 2012 ISSN 1929-1825 Pink & Teal

All content in Pink & Teal magazine, including medical opinion and any other health-related information, is for information purposes only and not to be FRQVLGHUHG WR EH D VSHFLÀF GLDJQRVLV RU WUHDWPHQW SODQ IRU DQ\ LQGLYLGXDO situation. Use of this magazine and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own healthcare provider in connection with any questions or issues you may have regarding your own health or the health of others.

Wellspring Westerkirk House at Sunnybrook Hospital 2075 Bayview Avenue, Toronto 416-480-4440

Wellspring Chinguacousy 5 Inspiration Way, Brampton 1-877-907-6480

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Katie laces up for the Cure! BY CODY LEE

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ith an intense workout schedule, a lot of determination, and Luke Bryan’s Country Girl song pumping through her earbuds, Pink & Teal Magazine’s very own, Katie Beattie, is well on her way to preparing for the annual Canadian Breast Cancer Foundation CIBC Run for the Cure.

NetConneXion, a part-time jewelry maker, as well as a writer for Pink & Teal Magazine. Although she may lead a hectic work life, Beattie still manages to make time to train for this event every single day—especially since breast cancer is something that has personally affected her family.

The event is in September, and this 26-year-old Whitby, Ont. native wastes no time being a couch potato over the course of this summer.

“One of my great aunts had breast cancer, and another one had a scare, so it runs in my family.”

“Because the event is in September, I plan to keep up with my regular workout schedule for the time being, and increase my running a lot closer to the event… Lots of running but also cross-training including yoga, biking, gym, soccer, rollerblading, hiking,” said Beattie. Although this sounds like a gruelling workout plan, Beattie is more than happy to take on the challenge. “I would say I am a very sporty person. I love to run, I play soccer, and I go to the gym. I generally exercise every day.” To pump herself up during workout sessions, Beattie blasts her unique workout playlist on her iPod, which includes Tinie Tempah, Luke Bryan, M.I.A., The Arkells, and Dragonette. Beattie also plans to run the Scotiabank Half Marathon in October, which will make her summer training sessions doubly intensive. On top of her rigorous workout, Beattie works three different jobs. She is currently a project manager at 8 | Pink & Teal

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Beattie’s work with Pink & Teal Magazine as well as her passion for running has also influenced her decision to participate in the Run for the Cure this year. “Breast cancer is something that affects so many people around the world every day, and as a woman I feel very strongly that we all have to band together and fight.” This year will mark Beattie’s first time doing the Run for the Cure, and she’s very excited to be a part of it. She will be running alongside her sister, as well as her friends from the Running Room. “I want to help raise money for those suffering in the present, and as a way to combat it in the future.” Last year, the Run for the Cure raised over $30 million for breast cancer research. The Canadian Breast Cancer Foundation is grateful for this overwhelming support, and hopes that this year is no different. The Run for the Cure will take place on September 30th 2012. P&T For more information www.runforthecure.com

Meet Nikki Bergen Our NEW fitness writer

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Nikki Bergen was, appropriately, born in the year of the rooster. She almost worked in a cubicle after McGill business school, but a welltimed epiphany at the age of 21 led this life-long dancer to get a full-time gig donning sequins and stage makeup in Mexico. Nikki never looked back. This Stott Pilates instructor who loves the power of eye liner and nude pumps, grew up on Madonna’s Immaculate Collection, Fleetwood Mac and the Rolling Stones. She’s created a method of exercise for women called The Belle Method and believes women are the all powerful, all knowing beings that will eventually heal the world. Do you have exercise questions for Nikki? You can direct them to editor@pinkandteal.ca

feminine , fashionable , natural Let Linea Intima professionally fit you with beautiful Amoena intimate apparel and the latest in post-surgery breast forms. Visit lineaintima.com to find out more.

Tamara

Toronto 416-780-1726 Andrews at Hazelton Lanes 416-640-9225 Etobicoke 416-245-3633 Unionville 905-947-1744 London 519-850-3633 Oakville 289-291-3388

Sex After Cancer Workshop

We hosted with Dr. Jess, presented by We-Vibe

June 15, 2012 1. Dr. Jessica O’Reilly, Sexologist 2. Pennylane and friend, Pennylane Permanent Makeup 3. Melanie Abdilla of Cutie Pie Cupcakes 4. Body Bar team 5. We-Vibe Rep 6. Kim McDonald RN, CCPE, Toronto Cosmetic Surgery Institute 7. Carlyle Jansen, Good For Her 8. Studio 9 Lashes, Shellyza Kirmani

photography by Shaemara Estelle Rosemond

White Cashmere Collection

We went behind the scenes with our photographer, Magda

May 16, 2012 A breathtaking collection of bathroom tissue couture inspired by the courage and strength of women affected by breast cancer and a celebration of this countryâ&#x20AC;&#x2122;s top design talent.

photography by Magda

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editor’s note We launched

a blog on our web site! English & French Check it out!

www.pinkandteal.ca To read more about the magazine

PHOTO Magda

You realize how fragile life really is when facing cancer -- it forces you to step back and re-evaluate your priorities, and to appreciate the important things in life. This look at priorities is a theme in our summer issue. As a career woman, Marlene MacPherson struggled to find time for her daughter and husband; however, when faced with stage 3 breast cancer, Marlene pushed back from her desk to examine her priorities (page 39). In the book The Descendants, character Matthew King, father and husband, is forced to take the lead as a parent when his wife becomes ill and is lying in a coma (See Books to Film review on page 47). He’s a man who gets caught up in his career, and forgets to appreciate the important things in life. In the film My Life Without Me, Ann embarks upon a life she never would have been inspired to live before being diagnosed with cancer, inspiring you to make changes in your own life (Review on page 48). Rachel, who recently lost her battle with inflammatory breast cancer, inspired Nikki Bergen to create The Pink Method exercise program. After every session with Rachel, Nikki had left feeling different: somehow lighter, grateful and deeply humbled. After an hour with Rachel she would be a nicer, kinder, warmer version of herself (See page 16).

Another theme in this issue in mental health, which plays an important role in your cancer recovery process. Josephine Lee’s (page 14) advice for women undergoing treatment: Stay positive – mental health cannot be emphasized enough when facing a cancer diagnosis. Sara O’Neill (page 32) talks about lymphedema and upperbody weight training, and tells us of the many benefits of exercise including improvements to both physical and psychological health. Move, Breath & Be Happy (page 34): We learn that yoga can improve the overall mental health of women with cancer and those who’ve survived it. Theres Jahn explores the concept of mindfulness (page 46), and teaches us a simple exercise that can help to calm our minds and relax physical tension. I would like to finish by reminding our readers how much we love to hear from you. We can predict the stories that will inspire you, but to be on the mark we need your feedback and suggestions. We hope you enjoy our summer issue. Lisa Bucher - Editorial & Creative Director

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The

UNDEFEATABLE Josephine Lee SURVIVOR`S STRENGTH

osephine Lee, 29 this July, knows what it’s like to face her own mortality as a young adult.

Josephine in Bali, Indonesia last spring

BY SHAUNA CHASE

The optimistic, fun-loving Hong Kong native was diagnosed with Acute Myeloid leukemia in November, 2010. After the first round of chemo the cancer was in remission, but to be on the safe side her oncologist recommended a bone-marrow transplant. Fortunately for Lee, her brother was a perfect match, and donated his bone marrow. She went through a risky and intensive transplant in March of 2011. Naturally, this whole ordeal was hard, gruelling. “I think every part of the journey was difficult, but the most difficult thing is probably accepting the fact that I could actually die from cancer or even from the treatments that are supposed to get rid of the cancer,” says Lee. “I was very fortunate that I have an amazing support network of friends and family,” she says. “I was able to really Editorial and Creative Director concentrate on dealing with the treatments and focus on getting better after the treatment.” Lee underwent these remedies at the Princess Margaret Hospital, located in Toronto, where Lee now lives and works as a compensation analyst for Indigo Books and Music. At the hospital, a social worker gave her an information package containing a brochure for Wellspring, a cancer support centre, a place other cancer patients could not “stop raving about.” When she recovered, Lee applied to the centre as a volunteer.

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INSPIR IN WOMA G PROFIL N E

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INSPIRING WOMAN PROFILE: JOSEPHINE LEE Wellspring, a not-for-profit organization, offers free programs for cancer patients and caregivers alike. Ranging from yoga classes, to art therapy, to support groups for different demographics the programs provide the much-needed emotional, physical, and social support for those battling cancer. Lee began volunteering in the fall of 2011 at the help desk of the centre’s Odette House location. At the end of her stint, Eva, the director of operations and OD, approached Lee and asked her to volunteer as a Wellspring 20th anniversary ambassador. “From then on, I have been serving as their ambassador and spreading the word about this fantastic organization at fundraising events and other media outlets. I really enjoy my time and company whenever I’m at a Wellspring event; it’s such a great way to pay it forward, and give back to an organization that has been serving cancer patients and caregivers over Canada for 20 years.” Advice for women undergoing similar struggles? Lee says she’s learned that, when it comes to overcoming cancer, mental health and the support of others are paramount. “Stay positive – mental health is very important when facing a health crisis like dealing with a cancer diagnosis. And really just take one day at a time because throughout the whole journey, there isn’t a part of it one can rush; whether it’s managing side effects of your treatment, recovering from it physically and subsequently healing emotionally. And be sure to leverage your social support network and be willing to be helped; whether it’s your family, friends or an organization like Wellspring, there is no reason why anyone should go through this kind of situation alone.”

PHOTO Katie Shoemaker

Lee continues to nurture her relationship with herself and with others – right now this happens through bonding with her new puppy, sampling new restaurant fare with friends and family, plenty of reading, and volunteering at another cancer charity, The Brides’ Project, twice a month. Oh, and she’s one examination away from getting her black belt in TaeKwonDo… as if kicking cancer’s butt wasn’t enough! P&T Check out Wellspring at WWW.WELLSPRING.CA

Click Me!

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Joesephine volunteering for the Wellspring fundraising fashion show last February

INSPIRED BY RACHEL BY NIKKI BERGEN

I KNEW A WOMAN WHO LIT UP THE ROOM.

She was a young 33-year-old, stunningly beautiful, intelligent and an incredibly caring mom to two sweet and spunky little girls. This woman was named Rachel, and she lost her battle with inflammatory breast cancer after a long and courageous battle. This is a story of perspective checks, real courage and pure inspiration. I knew Rachel as her Pilates instructor. I would pull up to her driveway at whirlwind speed as I travel between clients all day, always watching the clock to ensure I’m “on schedule”. I would walk into her house and without fail, would literally stop in my tracks. Her courage, warmth, grace and beauty were palpable. She always had a smile, a joke and a kind word to say. She seemed to almost transcend the constant pain she felt. We would do our warm up, stretching tight muscles and scar tissue from her double mastectomy, working through lymphedema and sometimes, just focusing on breathing when the fluid in her lungs made other movements difficult. She never once complained. Not once.

This was the “Rachel-effect”, anyone blessed enough to know her would recognize the feeling. After an hour with Rachel I’d let people in my car lane, slow the heck down and hold the elevator for neighbours in my condo parking garage. I’d be a nicer, kinder, warmer version of myself. I’d be more like her. Rachel’s courage inspired me to explore more about exercise and breast cancer post-surgical rehab. I discovered the New Jersey based Pink Ribbon Program and flew down to take the course last May. Since then we have worked with many survivors in workshops across Toronto and continue to grow as The Pink Method: exercise for breast cancer recovery. P&T WWW.THEBELLEMETHOD.COM

Click Me!

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We would inevitably finish the session, say goodbye and I’d hop in my car to the next client on the schedule. But every time I’d leave different: somehow lighter, grateful and deeply humbled.

What is The Pink Method? The Pink Method is a Pilates based work-out for women in treatment for, and recovering from breast cancer. Pilates both during and after treatment can help to alleviate pain and restore energy, joint mobility, tissue integrity and overall strength. In particular for breast cancer survivors, Pilates breath-work can encourage proper lymphatic drainage. The benefits of Pilates go beyond the physical – many women report feeling emotionally recharged after class. Movement after invasive surgery is empowering and can help alleviate feelings of depression, getting you back to a feeling of normalcy. Exercise also releases endorphins or “happy hormones,” which elevate our moods.

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Fashion for a Cure

Behind the scenes of the White Cashmere Collection 2012 BY CHRISTOPHER BATES

The White Cashmere Collection is the world’s first and only fashion collection made from bathroom tissue (BT). The collection is inspired by the bravery and strength of women afflicted with breast cancer and is a celebration of Canada’s leading design talent. This year’s collection is curated by Canadian fashion designer and show producer Farley Chatto, who we interviewed to get the inside story on this innovative event. “I am very excited to be asked back to curate The White Cashmere Collection 2012! It’s a thrill to be asked again to play among the amazing Canadian design talent we have! Working with the team to create last year’s theme was fun, and coming up with one this year to top last year’s was a challenge,” he says. This year marks the 9th edition of the annual event that supports the Canadian Breast Cancer Foundation and its vision of creating a future without breast cancer. The collection launched in 2004 as a platform to show the creativity and talent of Canada’s established and emerging fashion designers and their dazzling designs made from plush cashmere fabric. Now a high-profile annual event, the international award-winning collection began using Cashmere BT as its fabric after the first two years. “The collection has been a proud supporter of the Canadian Breast Cancer Foundation since 2005, and in 2008 Pink Cashmere was introduced and 25 cents from the sale of every package throughout October, Breast Cancer Awareness Month, goes to the Canadian Breast Cancer Foundation,” Chatto explains.

“Children’s wear is also new this year and we approached veteran designer Izzy Camilleri to create this piece. A designer with years of experience, based on her work it was a natural fit,” says Chatto. “We also tasked her with an additional challenge: using Cashmere Envirocare to create her garment – a natural fit between children’s wear and hope for the next generation and a greener planet. Her dress is a symbol of hope, as is this campaign for the Canadian Breast Cancer Foundation: it’s about hope and the future, a future of a better world, a greener world and a world without breast cancer!” Designers for this year’s collection include: Anomal Couture by Sonia Leclair, David Jack, Izzy Camilleri, Adrian Wu, Ashtiani by Golnaz Ashtiani, SHKANK INC. by Rod Philpott, LABEL by Shawna Robinson and Natalie Sydoruk, LuShyne by Lucci Rojas, Laura Siegel, Al Shakour by SuhailaNiazi, Cara Cheung, DRON by Joël Bissonnette, MMCrystal by Michelle Merizzi, Jewelry by Karen McFarlane, and shoes designed by Yvonne Lin for Town Shoes. Designer Cara Cheung, who cites Elizabeth Taylor as a favourite glamour icon, comments on the dress she’s laboured over, saying, “I was asked to design an outfit from Cashmere Bathroom Tissue for this year’s White Cashmere Collection and I couldn’t pass up the amazing opportunity.” Working with bathroom tissues was challenging and required a lot of patience. Before even going through the natural steps of creating a dress, she had to turn the bathroom tissue into usable fabric,

PHOTO Magda

This year’s collection features a stellar cast of 15 leading-edge Canadian designers and their wonderful fashions creatively crafted from Cashmere BT. In addition to bridal, evening wear and jewellery, this is the first collection to feature footwear and children’s wear.

Town Shoes loved the idea and is teaming up with a new designer, Yvonne Lim, who was tasked with creating shoes to go with each of the designs this year – talk about a challenge! Limited work surface, smaller details and something that will face more stress than clothing! A challenge indeed, yet one that she and Town Shoes were excited about taking on!

WWW.PINKANDTEAL.CA which was a process in itself. Even after being fused tissue tears easily, so she had to be extra careful with it. Aside from the crystals, everything you see on the outside is bathroom tissue.

CONTEST

“I spent about two to three weeks working on it day ‘til night,” says Cheung. “On top of the actual construction of the garmment, a lot of hours went into the detail work. Every crystal was strategically placed and hand-sewn, and every flower petal was hand-cut, darted, glued, and then sewn individually. It was exhausting!” Cheung’s design was inspired by a classic femininity with a cinched waist and full skirt and then she put her own signature on it. Angie Smith, producer and talent of Entertainment Tonight Canada, is one of the models in the event, and will be donning Cheung’s creation. She has been supporting the WCC for five years now. She started out interviewing designers for ET Canada and transitioned into walking on the runway for the past three. “I became involved with the event specifically because it is a cause and a brand I support. When I see companies doing things for important causes I like to put my personal time and energy behind them,” she says. “Honestly, you never know when it could be your turn, or your mom’s, or your sister’s and I would like to know I’m being proactive.” Besides being an honour and a thrill modeling a tissue dress can be stressful, Smith says, “Truth be told (please don’t be mad Cara) I already split my dress at the photo shoot…like right up the butt. Unlike normal clothes there is no stretch or give to the material. Another issue is you cannot sweat from nerves or it might deteriorate” “Modelling for WCC is one challenge, but the entire crew behind the show is immense,” says Smith. “From the team at MAC cosmetics and Marc Anthony to the individual designers, it seriously blows my mind. For months, people are coming up with wild and new concepts and it truly is remarkable what we’re all capable of doing to help raise funds and awareness. I do hope people understand why and what goes in to this event.” This year included, the White Cashmere Collection has featured over 100 top Canadian designers.

PHOTO Magda

Dresses made out of Cashmere bathroom tissue may not necessarily be designed for real life, but they are certainly designed for wiping out breast cancer. Inspired by the bravery and strength of women afflicted with breast cancer, the White Cashmere Collection (WCC) is the world’s first and only fashion line that is actually made from bathroom tissue, and is a celebration of Canada’s leading design talent. This year marks the 9th edition of the annual affair that supports the Canadian Breast Cancer Foundation and its vision for creating a future without breast cancer. We would like to offer you two tickets to this exclusive fashion show. Our first toilet paper dress competition! You can win two tickets to the White Cashmere fashion show by designing your own toilet paper dress. The winning dress will be featured in our October issue, for Breast Cancer Awareness Month. What to do: Design and create the dress, then send us a high-resolution image of the full dress on yourself of someone else. How to submit: Submit your high-resolution image to editor@pinkandteal.ca along with your name, address, email address and phone number. Rules: -Open only to people living in Toronto and the GTA -Must use only Cashmere bathroom tissue -Must be an original design

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Fashion for a Cure: Interview with Farley Chatto, Curator of the White Cashmere Collection 2012 As expressed by Cheung, working with bathroom tissue is incredibly challenging for these designers. Chatto sheds some light on the production guidelines and process: “Besides the creative process of designing the garment, the second challenge is the R&D (Research & Development) of working with the bathroom tissue to get the shape and feeling you want from it. This is the most challenging part of the process – it’s all about experimentation and definitely trial and error! The most preferred way is fusing the tissue onto some sort of interfacing (a stiffening fabric) or backing it with a cotton broad cloth or a cotton muslin. Yet each year, it amazes me on how creative and talented the designers come up with new ways to mold, cut, shape, and fuse the BT in order to create their garments!” This year’s soiree features a runway show at the recently renovated Arcadian Court at the Hudson’s Bay Company Toronto flagship store on Wednes-

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day, September 19th, before an invitation-only audience. “With the theme being Hollywood Glamour, The White Cashmere Collection will evoke the silver-screen era’s elegance and style mixed with a swanky afternoon garden cocktail party! Here we will unveil the 15 stunning designs and fashion photography by amazing photographer Angus Rowe MacPherson. It’s one event NOT to miss!” he exclaims. Up next for Chatto and his line: “Well I am always involved in the industry. Being a newly appointed furrier and creative director for a fur accessory line, My Wild, we will be deep into the production of that collection in the summer. As for the line, it is always evolving and hopefully a new collection for the fall season will happen – in between the other amazing work lined up!” P&T The White Cashmere Collection is documented at www.cashmere.ca

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Tips for Buying Special Occasion Bras after Surgery BY LILIANA MANN bra-fitting expert and owner of Linea Intima lingerie stores

PHOTO ISTOCK © 4FR

Summer means special-occasion dressing, with weddings on the social calendar. Plus, revealing fashions are the look du jour during warmer weather.

This image is being used for illustrative purposes only and any person depicted in he Contet is a model

Women who’ve undergone a mastectomy or lumpectomy and endured the rigours of chemotherapy are in need of some glamour in their lives and may be eager to rekindle their femininity and feel pretty again. Strapless bras are at the top of shopping lists this time of year, to hold and shape under low-cut and strapless tops and dresses. Continued .. .

Tips for Buying Strapless & Special Occasion Bras after Breast Cancer Surgery Finding the perfect strapless bra is tricky. This is a fact common to anyone looking for a strapless bra, not just those who wear prosthesis. To get the best results, keep these tips in mind. For an optimal fit choose a smaller band size and larger cup size. A strapless bra is an investment so always buy the best quality you can afford. Higher quality brands are designed to provide serious support as well as shaping and will last longer. However, a strapless bra is not the best option for very large or heavy pendulous breasts and it is the one style of bra that is difficult for most women to wear after breast cancer surgery. Strapless and demi-cup bras by their very design and revealing shape can’t work with prosthesis because they are cut too low. But, the good news for mastectomy shoppers is, there are alternatives and other options depending on the situation!

Sexy options instead of strapless. Some regular convertible bras can be adapted to fit a prosthesis, which offers you the option to select fashionable colours, delicate lace fabrics and pretty feminine details. Wear this style of bra under retro-inspired halter necklines, glam low backs and red-carpet-worthy one-shoulder styles and cutout designs in bright colours and pretty prints. A strapless dress isn’t the only choice if you’re shopping for one that’s feminine, fashionably revealing and guaranteed to raise the temperature in the room! To flatter and support your figure comfortably, choose a convertible-style bra with a full cup that fits your prosthesis and has straps that change to work with the neckline of your dress.

Tips to help you shop for a special occasion bra. It’s important to understand and embrace your new body. After a mastectomy or lumpectomy, there is usually less tissue at the top of the breast, which is why a higher-cut style of bra, like a convertible, is needed. It will help to conceal the top of the prosthesis, which is worn to replace this lost tissue. Occasionally, after some lumpectomies, a strapless bra may be possible to wear with a regular breastenhancement accessory, such as a silicone “cookie,” which can be inserted into the bra to fill out the missing tissue and to help balance both sides. Another alternative is a “contact” prosthesis (such as Amoena Contact Light style #380), which adheres to the body with silicone. Although its shape is generally too large for a strapless bra to conceal, it just might be the answer in certain cases! Your best ally is a professional bra-fitter. Most women need bra-fitting solutions that are individual and customized to their specific shape. Two women who are both a C cup could need totally different bras because their breasts are shaped differently. The same holds true for mastectomy bra wearers. Each woman’s situation and post-surgery outcome is unique, requiring an expert evaluation and often some creativity to find the best solution. Someone who has had a radical mastectomy on one side and a lumpectomy on the other will need two different prostheses to attain the proper fit and balance. Diversity in the products and styles available now allows us to fine-tune and individually address each woman’s special requirements, helping them to choose a figure-flattering bra that makes them look and feel their best. P&T

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Summer Fun in the Sun: How to stay safe with the right sun-‐care product

PHOTO ISTOCK © Daniel Laflor

BY ALEYNA KRANTZ Learning & Development Specialist at Shoppers Drug Mart

This image is being used for illustrative purposes only and any person depicted in he Contet is a model

e all enjoy being out in the sun during the summer months or when on vacation, but how can we protect our skin?

There are many options to choose from when standing in front of the sun-care section at your local retailer; in fact, the selection can be daunting at first. SPF (Sun Protection Factor) ranges from 4 to 100, some products are for the face and different ones for the body, there are lotions, creams, or sprays; the choices are endless. Having an understanding of sunscreens and how they protect you enables you to make a more sound decision. Sunscreens help protect the skin from the sun’s ultraviolet (UV) rays. UVB rays are what cause the skin to burn and have a much greater risk of developing skin cancer, while UVA rays penetrate the skin at a deeper level causing age spots, wrinkles,

sagging, and photo aging. UVA rays are also being linked to some forms of skin cancer. UVA rays are not blocked by windows, so if your desk is directly beside one or if you are driving all day, you should wear a daily protection. Always make sure the label on your sun-protection product states it is broadspectrum, meaning it protects against both UVA and UVB rays. There are two types of sun protection – chemical and mineral. Chemical sunscreens, which include ingredients such as oxybenzone or avobenzone (Parsol 1789), penetrate into the epidermis (top layer of the skin) in order to protect and to be absorbed properly, and must be applied at least 30 minutes prior to sun exposure. Many sunscreens have a mix of active chemical ingredients to help protect from both UVA and UVB. Continued... SUMMER 2012 Pink & Teal | 23

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Summer Fun in the Sun

The types of rays and the most common ingredients used as protection: UVB – Octinoxate, Octisalate, Homosalate, PABA UVA – Avobenzone, Mexoryl SX

UVA and UVB – Titanium Dioxide, Zinc Oxide, Mexoryl XL, Tinosorb M

A mineral sunblock actually stays on top of the skin without penetrating and acts as a physical barrier from the sun’s harmful rays. The most common ingredients in a mineral sunblock are zinc oxide or titanium dioxide. Remember when you were a kid and your mom put zinc stick on your nose that stayed white all day long? Times have changed, but keep in mind that mineral protection tends to be white in colour and a lot thicker in texture than a chemical cream. A trick is to squeeze a small amount in the palm of the hand and rub together gently to warm it up, then massage on the skin for even coverage. A mineral sunblock is more photo-stable than a chemical sunscreen, which means it will not break down in the sunlight.

you calculate, reapply every two hours and immediately after swimming or excessive sweating. This is where most people make the mistake. We are all prepared to protect ourselves by purchasing the highest SPF we can find; we wear a hat, and stay in the shade if possible. But then we go swimming, towel off, and forget to reapply our sun protection. It has happened to all of us at one point or another and we end up feeling it for days. As if there weren’t enough options, a product’s texture also plays a part in your decision. There are creams, lotions, fluids, sprays, and sticks. Someone with an oily skin type should use a light-textured lotion, whereas someone with dry skin should usually go for a cream. For those pesky areas like the tops of the ears and for quick application on the nose, a stick is a simple solution. For children, parents can opt for sprays as they are super-easy to apply (note, however, a spray product still needs to be rubbed into the skin, applied liberally and reapplied at least every two hours).

UVA rays are not blocked by windows, so if your desk is directly beside one or if you are driving all day, you should wear a daily protection.

Before going to the store, ask yourself the following three questions:

It is recommended that those with skin sensitivities such as eczema or psoriasis use a broad-spectrum zinc-oxide sunblock. Zinc oxide is a mineral with antibacterial properties that can be cooling and soothing on the skin and does not exacerbate irritation.

What type of texture do you prefer?

There is much speculation around what number of SPF to use. The SPF number indicates how much longer you can stay in the sun with protection versus the time you can without protection. Easy math will help you find your number. Think of how many minutes it takes for your skin to turn red or feel hot if you are in the sun unprotected and multiply that number by the SPF on the bottle. Let’s say it is 10 minutes and you’re using SPF 45; 10 x 45 = 450 or 7.5 hours. Regardless of the time

Use these tips and information the next time you are searching for a new sun-protection product. The summer sun is fun, but it can be damaging to your skin.

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How long are you planning to be out in the sun? Are you interested in chemical or mineral sun protection?

Keep protected with the right product for you. And remember, if you have questions on sun protection while shopping, just ask one of the friendly and knowledgeable cosmetics team members to help you find the right product. P&T

Recommended Sunscreens Available at Shoppers Drugmart

Vichy Capital Soleil Ultra Light Lotion Sunscreen Fluid SPF 50 Mexoryl XL Broad

UVA/UVB Protection Sensitive Skin Anthelios XL with Mexoryl Ligh Weight Lotion. 100ML

Spectrum UVA/UVB Protection. 40ML

Life Sunthera3 Sports Continuos Spray SPF 30 Broad Spectrum UVA/UVB Protection Waterproof (177ML)

Eau Thermale Avene Mineral Cream SPF 50 UVA Broad UVB and UVA Protection for Intolerant sking Hypoallergenique and Water Resistant

Etival Ambient Light Face Cream SPF 50 Broad Spectrum UVA/UVB Protection Waterproof Hypoallergenic 60ML

La Roche Posay Anthelios XL SPF 60 Broad Spectrum

Lifethera3 Sports Sun protection SPF 60 Broad Spectrum UVA/UVB Waterresistant non-oily (180ML

Life Sunscreens (left) Clear Continuous Spray SPF 85 Broad Spectrum UVA/ UVB Protection Waterproof Scented (177ML) (right) Sports Sunscreen Continuos Spray SPG 60 Broad Spectrum UVA/UVB Protection Waterproof (177ML)

Etival Ambient Light Body Lotion SPF 50 Broad Spectrum UVA/UVB Protection Waterproof and Hydrofuge. 100 ML

Going Chemical Free! 12 Ingredients to avoid in your cosmetics BY MICHELLE ROSEN Makeup artist

This image is being used for illustrative purposes only and any person depicted in he Contet is a model PHOTO ISTOCK ÂŠ OLENA CHERNENKO

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like to live by the rule of everything in moderation. Eating clean, regular exercise, vitamins and supplements, I swear by, but I also like to drink cocktails, sometimes eat fries and treat myself to ice cream (of course!). When it came to making a decision to switch to natural beauty products and cosmetics, I really had to do my research. As a cancer survivor, I want everything I put on and in my body to be what’s best for me. I have become more concerned about the long-term effects of the chemicals used in cosmetics. While doing my research, I found it very interesting to learn that 60 percent of the products we use on our skin are absorbed and deposited into the circulatory system. For example, the average woman absorbs 30 pounds of the ingredients contained in moisturizers over sixty years. As a makeup artist, this concerns me even more – I need the products I use on both myself and my clients to do the best job they possibly can. There is a lot of marketing hype surrounding “natural” and “organic” these days.

Reading labels and recognizing problematic ingredients has become a necessary skill when choosing which products to buy. For my go-to list, I use “David Suzuki’s sustainable shoppers guide: 12 ingredients to avoid in your cosmetics.” You can find it on his website and even download the app to your phone. I always check at least the first few ingredients, as they are marked in order of volume. Trial and error can get expensive, so I thought I would share some of my favourite products. Apart from specialty shops, Whole Foods Market has a fantastic selection, but check out your local health-food store, because a lot of them do have a good beauty product department. I am a big fan of Dr. Hauschka, especially the hand cream and nail oil. Jurlique has a great eye cream. RMS is a natural cosmetic lines I love, with concealers are creamy and have really nice coverage. Her 100-percent coconut cleanser is to die for – you want to eat it, and actually can I suppose! I couldn’t give up a lot of my staples, but like I said, everything in moderation ... including moderation! P&T

PHOTO ISTOCK © Courtney Keating

DAVID SUZUKI: “THE DIRTY DOZEN” BHA and BHT Coal tar dyes DEA-related ingredients Dibutyl phthalate Formaldehyde-releasing preservatives Paraben, methylparaben, butylparaben, propylparaben Parfum PEGs (PEG-60) etrolatum Siloxanes Sodium laureth sulfate Triciosan SUMMER 2012 Pink & Teal | 27

Sneak Peak ClearlyContacts.ca is releasing a pink frames collection exclusively for breast cancer awareness month. The collection will be available online for the entire month of October, one dollar from every pink frame purchased will be donated to Rethink Breast Cancer.

David Cardigan 7003 Pink $98 Make a bold statement with these wayfarer style frames with the recognizable Derek Cardigan math symbols on the temples.

Kam Dhillon 3017 $98 These soft rectangular eyeglasses come in two shades of pink. The frames suit any face shape and any occasion.

Love L740 Black Pink $98 These retro style cat eye glasses have cute heart decal details on the wings of the frames that give it an added special touch.

Love L746 Black Pink $98 Geek out in these vintage style pink glasses. Perfect for those with a petite face shape.

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Financial Support for Survivors PHOTO SUBMITTED

BY AMIE HEENAN Amie Heenan is co-owner of Toronto lingerie boutique Melmira Bra & Swimsuits, seen on the Marilyn Denis Show, City Line and in Lou Lou Magazine

This image is being used for illustrative purposes only and any person depicted in he Contet is a model

hile many would agree that breast cancer is a health condition, women going through treatment soon discover that it is also an economic condition. Being diagnosed with breast cancer means taking time off work for treatment and recovery, and it places an enormous financial burden on women and men living with the disease as well as their families. Purchasing lingerie can be expensive at the best of times! After a lumpectomy or mastectomy, a womanâ&#x20AC;&#x2122;s lingerie collection may need some finetuning. Going for a bra consultation before surgery is a good idea, so that you can be made aware not only of the many lingerie options available to you right after surgery and during recovery, but also of the funding options that are at your fingertips. The government and most insurance providers offer some relief in terms of financing these necessary purchases. The Assistive Devices Program (ADP) is a Government of Ontario program set up to assist in the funding of prostheses for residents of Ontario with OHIP coverage. If you live in Ontario, you can receive a maximum of $195 for a full breast prosthesis or $105 for a partial breast prosthesis up to once every two years. Many women will have their prosthesis for two years or more before it fails (the prosthesis may split after wear and tear), but the option is there should you need it. If you have changed size or shape or had a change in your medical condition, however, you are entitled to one replacement within that two-year time

frame. After paying in full for your breast form, the application form (found on the ADP website at www.health.gov.on.ca or made available at the store where you purchased the form) must be sent to ADP in order to receive reimbursement (generally within 10 weeks). Another benefit available to breast cancer survivors is that as long as your bras and swimwear are deemed surgical, you are not required to pay sales tax. Should you purchase a beautiful matching panty or cover-up, though, you are not taxexempt! Before going for a bra fitting after surgery, check with your insurance provider about their coverage for surgical bras, surgical swimwear, support garments and breast prostheses. Your private insurance company will usually pay for the balance on the breast form that the ADP does not cover (less the deductible). They will often cover a certain number of surgical bras per year as well. While going for your first bra fitting can be overwhelming in many ways, awareness of these small-but-helpful advantages can help to lighten the financial burden of facing breast cancer. Now, what to do with that beautiful lingerie collection that you can no longer wear? If you drop off your clean, used bras, or gently used breast forms at Melmira Bra & Swimsuits at 3319 Yonge Street in Toronto, they will be donated to one of many womenâ&#x20AC;&#x2122;s shelters across the city! P&T SUMMER 2012 Pink & Teal | 29

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Talking Hair-Loss with your Daughter

ne of the most visible side effects of cancer treatment is hair loss. Although it is temporaray and one of the physically harmless things that happens, it can be a disturbing experience for women, and their children, particularly their daughters.

The reaction to hair loss for women undergoing treatment has a double meaning: “One meaning (is) to do with the cancer and all the fears and stigma connected to that, but it also connects to femininity. It is a double blow; all the fears of cancer plus this damage to their sense of femininity.” This image is being used for illustrative purposes only and any person depicted in he Contet is a model

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PHOTO ISTOCK © WAVEBREAKMEDIA

Dr. Gary Rodin, psychosocial oncology, says, “It kind of resonates back and forth. I think it is partially disturbing to the daughters because it is disturbing to the mothers.”

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Because the side effect is so visible it can be frightening for children, but isn’t just the hair loss itself that is scary. It is a mother’s emotions towards her hair loss that young girls picks up - the whole meaning of what is happening to their mother can indeed be scary. Dr. Rodin emphasizes the importance of talk openly about it, “Children usually know what is happening and when their parents are going through something. So often when parents try to protect them by saying nothing, it often just leaves children alone with their fears.” When talking openly, it is important to take into consideration the age and developmental stage of the child. For example, if the child is five or 10 or 15 there are different explainations that can suit those ages and stages. For a younger child, a toy might be just the thing! A growing social media movement called upon toymakers to create hairless dolls to emotionally comfort young girls and boys who suffer from, or have watched a family member suffer from, hair loss due to cancer treatments and other conditions. In response, MGA Canada has released a new hairless version of its Bratz dolls “Cloe,” “Yasmin,” and “Cameron.” Diane Goveia-Gordon, president of MGA Entertainment Canada, says, “Our dolls were inspired by the Facebook movement founded by Jane Bingham and Beckie Sypin in the United States. We watched this movement gain momentum online.”

We asked Dr. Rodin what he thought of this new hairless doll as a means to open communication with young girls watching their mothers suffer from hair loss. “Whether or not a child would actually want to play with it, that I am not sure,” he says. “However, I like the spirit of the doll, to detoxify and demystify what is happening. The idea that one can talk openly. I would say if it facilitates more open conversations then it might be a good thing.” A hairless doll’s symbolic value is its normalcy – it can tell a child that it okay to talk openly about hair loss, but more importantly that it is okay to discuss illness. The doll can be a helpful way to facilitate the initial cancer conversation between mother and daughter. As Dr. Rodin explains, sometimes facilitating conversations between daughters and mothers going through this can be very helpful. The silence around it, the fear of discussion, is more disturbing to a child than actually talking with them about it. The True Hope Bratz collection will be available at Toys “R” Us stores across Canada from mid-July. MGA Entertainment and Toys “R” Us will each donate. P&T Dr. Gary Rodin is the OCI Senior Scientist and Head of the Department of Psychosocial Oncology at Princess Margaret Hospital and recipient of the Canadian Association of Psychosocial Oncology life time achievement award for his exception and enduring contributions to Psychosocial Oncology

Both Bingham and Sypin have been affected by cancer and launched the Facebook page in an effort to help children and others become comfortable with baldness caused by illness. The site launched last December called “Beautiful and bald Barbie? Let’s see if we can get it made”now has over 150,000 “likes.”

SUMMER 2012 Pink & Teal | 31

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Lymphedema & Upper Body Resistance Training SARA Oâ&#x20AC;&#x2122;NEILL, MFSC, CSEP

n 2012, approximately 23,000 women will be diagnosed with breast cancer1. Thanks to various medical advances in the treatment and management of cancer, survival rates are improving and many patients will have a normal life expectancy2. As a result, it is increasingly important to better understand tools to manage disease and treatment related side effects.

and effective for women who have completed treatment for breast cancer to participate in resistance training programs that include upper body exercises. By performing progressive, weight-based exercises, twice per week, muscular strength improves and the frequency and severity of arm and hand symptoms as well as the incidence of lymphedema exacerbations are reduced4,6.

Upper limb lymphedema, affects 3558% of breast cancer survivors following treatment3. It is a chronic condition that results from an accumulation of lymph fluid in the affected arm, shoulder, neck or torso because of damage to or removal of lymphnodes. Lymphedema causes swelling and may limit range of motion in the affected limb4. It was previously thought that upper body exercises might aggravate or worsen lymphedema among patients. However, these guidelines were not supported by research and discouraged exercise without cause3.

These and other researchers have demonstrated that slow, progressive weight training in conjunction with the use of compression garments and close monitoring of lymphedema-symptoms is a safe and effective way of improving strength and function in breast cancer survivors. Weight lifting is particularly beneficial for breast cancer survivors as it effectively controls body fat and improves function as well as bone health, each of which are commonly reported as concerns by survivors3,6.

The benefits of exercise are numerous and include positive changes to both physical and psychological health. Exercise helps to control body weight and body composition as well as overall fitness and the ability to perform daily tasks5. It is therefore important to truly understand the impact of exercise and the risk for developing lymphedema prior to ruling it out of your daily routine. Researchers have demonstrated that it is safe

Starting with a supervised program will help to ensure that you are completing all exercises safely and correctly. The American College of Sports Medicine recommends starting with a minimum of 16 supervised sessions using very low resistance levels. This will allow you to become familiarized with the exercises in a safe environment. As you become more comfortable with the exercises, resistance can be increased in small increments3.

7KH EHQHĂ&#x20AC;WV of exercise are numerous and include positive changes to both physical and psychological health.

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Although researchers have demonstrated the safety and effectiveness of resistance training for breast cancer survivors, it is important to be aware of some safety considerations before and during exercise3. t*G ZPV IBWF IBE TVSHFSZ CF TVSF UP BMMPX BEequate time for healing prior to starting an exercise program3; t*G ZPV BSF DVSSFOUMZ FYQFSJFODJOH BOZ QBJO swelling or other lymphedema-related symptoms or if you experience a change in arm/ shoulder symptoms, consult your physician prior to starting or resuming any upper body exercises3; t4VSWJWPST XIP IBWF CFFO EJBHOPTFE XJUI lymphedema should wear a fitted compression garment during exercise to minimize injury risk3. Although exercise is well documented as an effective tool in the management of symptoms and side effects among breast cancer survivors, clearance for participation in a moderate or vigorous program should be obtained from either a physician or a qualified exercise professional prior to starting a program. Exercise prescription should be individualized based on the current level of fitness, other medical conditions that may exist, and any effects of treatment that may be present. As part of a well-balanced exercise regime, it is important to incorporate

aerobic and flexibility exercises in addition to resistance training. As a general guideline, individuals are encouraged to start with a volume and intensity of exercise that is comfortable (i.e., 20-30 minutes of low to moderate intensity exercise 3-5 times per week including aerobic and muscle strengthening exercises). As you continue to exercise, you should aim to accumulate 150 minutes or more of moderate intensity physical activity per week as outlined by the Canadian Society for Exercise Physiology (CSEP) in the Canadian Physical Activity Guidelines (www.csep.ca/guidelines). A qualified exercise professional (i.e., CSEP - certified exercise physiologist) can help design an exercise program that is individualized to one’s current fitness level and needs. A directory of qualified members across Canada is available at www.csepmembers.ca P&T References

Click Me!

1.Canadian Cancer Society’s Steering Committee on Cancer Statistics. (2012). Canadian Cancer Statistics 2012. Toronto, ON: Canadian Cancer Society. 2. McNeely, M.L., Campbell, K.L., Rowe, B.H., Klassen, T.P., Mackey, J.R., Courneya, K.S. (2006). Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ, 175(1), 34-41. 3. Schmitz, K.H., Courneya K.S., Matthews, C., Demark-Wahnefried, W., Galvao, D.A., Pinto, B.M., Irwin, M.L., Wolin, K.Y., Segal, R.J., Lucia, A., Schneider, C.M., von Gruenigen, V.E., Schwartz, A.L. (2010). American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors. Medicine & Science in Sports and Exercise. 4. Ahmed, R.L., Thomas, W., Yee, D., Schmitz, K.H. (2006). Randomized Control Trial of Weight Training and Lymphedema in Breast Cancer Survivors. Journal of Clinical Oncology. 5. Heyward, V. (2010). Advanced Fitness Assessment and Exercise Prescription. (6th ed.). Champaign (IL): Human Kinetics. 6. Schmitz, K.H., Ahmed, R.L., Troxel, A., Cheville, A., Smith, R., LewisGrant, L., Bryan, C.J., Williams-Smith, C.T., Greene, Q.P. (2009). Weight Lifting in Women with Breast-Cancer-Related Lymphedema. The New England Journal of Medicine.

PHOTO ISTOCK © MILOS JOKIC

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Move, Breathe & Be Happy: 0HFKDQLVPV %HQH´WV RI <RJD

This image is being used for illustrative purposes only and any person depicted in he Contet is a model

PHOTO ISTOCK © NATALIA MAXIMOVA

BY MICHAEL J. MACKENZIE, MSC & S. NICOLE CULOS-REED, PHD

For the past 10 years the University of Calgary has been home to one of North America’s largest community-based yoga programs for cancer survivors (See Yoga Thrive). The Yoga Thrive program was developed with the specific purpose of aiding participants in their cancer recovery via a gentle exercise program. Since 2002, and as part of several studies, participants have come to experience the benefits of yoga as a means of not only regaining strength and flexibility but also reducing stress and improving mood, fatigue, and overall quality of life (QOL). In this article, we would like to share an overview of exercise and cancer in general as well as lay out yoga’s’ role in cancer recovery. Exercise & Cancer Receiving a cancer diagnosis, undergoing treatment and the subsequent recovery takes a great toll on many cancer survivors. Distress stemming from the cancer experience is a significant problem for up to half of all cancer patients. Cancer survivors may exhibit lowered overall QOL and a host of more general mood, stress, sleep, and fatigue symptoms. In addition, there are often chronic and late-appearing effects of illness and/or treatment, and increased risk of cancer recurrence or other diseases. There is a growing interest in physical activity (PA) promotion and developing exercise programs specifically to improve cancer survivors’ overall QOL and mental health (See Physical Activity and Exercise: What’s the Difference?). Research indicates those with greater levels of PA report higher QOL and better mental health outcomes throughout the cancer experience as opposed to their sedentary, or inactive, counterparts. Regardless of intervention specifics, exercise has been shown to improve a variety of QOL, psychosocial and health outcomes in various cancer survivor groups both during and after cancer treatment. Exercise may also decrease the risk of cancer recurrence and extend survival. The American College of Sports Medicine (ACSM) roundtable on Exercise Guidelines for Cancer Survivors concludes exercise is safe both during and after cancer treatment. Current ACSM exercise recommendations for cancer survivors suggest 150 minutes of moderatevigorous exercise a week, two days of resistance training a week and flexibility/stretching regimen. These recommendations serve as a strong baseline prescription for cancer survivors to meet basic health needs. These guidelines further suggest exercise programs must be adapted for the individual on the basis of their health status, treatments, and anticipated disease trajectory.

In our experience as exercise professionals working with cancer survivors, even these basic recommendations can be challenging given the disease of cancer. In particular, cancers’ taxing treatment regimens and the combined sideeffects of both disease and treatment including fatigue, muscle weakness, cardiotoxic effects and cognitive impairments (i.e., “brain fog”) are barriers to PA. Thus, deciding on the best approach to tailor a program requires detailed knowledge of the individual’s current abilities, past exercise experience, specific cancer, treatment and recovery issues, and other health conditions. Given these challenges, and based on current research at the University of Calgary, we are seeking additional new ways to help facilitate this recovery process. The goal is to support cancer survivors in optimising their recovery and return to health. We serve this role in partnership with oncologists, nurses, family physicians, mental health and other allied health professionals in providing a total care package (now often referred to as integrative oncology) to those affected by cancer. Give Yoga a Try! Within the growing body of PA and cancer research, there have been calls to examine modes of exercise from the area of complementary medicine. In this regard, yoga is quickly emerging as an important complementary therapeutic approach in cancer care settings. We have found yoga to be a novel and important companion to cancer survivors’ ongoing recovery. Within the larger field of exercise and cancer, yoga is often considered a gentle form of mild-moderate intensity exercise. Contemporary yoga practice consists of postures, breath regulation and meditative techniques, modifiable based on desired outcomes as well as participant health status (See Yoga’s Roots and Modern Science). Studies comparing the effects of yoga and exercise indicate that in both healthy individuals and those with various health conditions (e.g., cancer) yoga may be as effective as more usual forms of exercise (e.g., walking, running or biking) at improving a variety of health-related outcomes. Within cancer settings, yoga groups compared to waitlist control groups or supportive therapy groups show greater improvements in overall QOL, psychological health, stress-related symptoms, sleep and fatigue. How Does Yoga Work? A commonly reported mechanism for yoga practice lies in the Autonomic Nervous System (ANS), which regulates many bodily functions, often without our conscious awareness. These include things like regulation of heart rate, respi-

WWW.PINKANDTEAL.CA ration, digestion and elimination, perspiration, salivation, and sexual function to name only a few. The ANS can be further broken down into two complementary subsystems: 1) the Parasympathetic Nervous System (PNS) which is predominant during resting functions (rest & digest) and, 2) the Sympathetic Nervous System (SNS) which comes into play in more stressful situations (fight or flight). These systems are at work when we navigate an icy Canadian road or deal with the ongoing stress of cancer diagnosis, treatment and recovery. While SNS predominance may be appropriate in the short-term initially, long-term SNS predominance can lead to a host of health problems (See Stress, the Autonomic Nervous System and “Allostatic Load”).

This image is being used for illustrative purposes only and any person depicted in he Contet is a model

This is one place where yoga can help. Yoga programs are reported to result in increased PNS activity (rest-digest). In other words, yoga helps to calm your body down! A proposed mechanism is that the conscious regulation of breathing practiced in yoga may regulate the balance of SNS and PNS activation, the latter increasing as the breath deepens and slows. Yoga practice also appears to result in increased control over autonomic responses such as heart rate. During active poses, ANS functions, including heart rate and respiration, may increase (SNS activation) consistent with mild-moderate exercise.

Then during and following restful postures, PNS activity consistent with relaxation and reduced physiological arousal is apparent. This final relaxed state has been coined the “Relaxation Response” by Dr. Herbert Benson, an eminent stress researcher. The Relaxation Response is a set of integrated physiological changes resulting in decreases in oxygen consumption, respiratory rate, and blood pressure, along with an increased sense of well-being implicated in an improved stress response and increased recovery. This strong mind-body interaction within contemporary yoga practice also adds a unique contemplative dimension to exercise, referred to as ‘mindfulness in motion’. Mindfulness is the systematic development of the ability to intentionally focus one’s attention in the present moment. Research indicates cancer survivors with higher mindfulness scores report less mood disturbance and symptoms of stress, and greater selfregulated emotion and behaviour, contributing to enhanced QOL. In addition, mindfulness in and of itself has been reported to lead to increased PNS modulation. In total, yoga practice takes participants through a gentle workout that shares many of the benefits of mild-moderate exercise in addition to yoga-specific control of the ANS. Survivor Perspectives Of great interest to our research team is our participants’ own experience of the Yoga Thrive program. Several participants have indicated the timing of participating in the yoga program has been important. Our program is one that will take participants regardless of where they are in the treatment continuum, from active treatment through to, in some cases, several years post treatment. These participants remark the Yoga Thrive program has always met them where they are at in this continuum, providing much needed respite during active treatment and growing with them as they return to life and work. Several have described how yoga has provided a bridge from lower intensity exercise back to more vigorous exercise as they continue to recover. As one participant put it, “The exercise classes were too hard for me so yoga seemed to be a good fit.” Many participants have touted the aforementioned calming and relaxation benefits of yoga. Several have suggested they initially attended the program for these relaxation benefits, often highlighted in popular culture. As one participant shared, “That really benefitted me with the yoga - It’s that relaxing time, that quiet time.” These benefits are achieved through strengthening the mind-body via individual yoga postures and sequences, with a focus on controlled breathing and restful supine and/or seated medi-

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tation at the conclusion of each class. One participant described it as such, “I think the yoga just kind of calms your whole body and mind.” Participants have often described being able to help themselves via yoga practice to regain a sense of self-control after cancer diagnosis. Participants also suggest coming to a yoga class comprised of other cancer survivors provides a sense of safety and a shared understanding of the cancer experience, regardless of diagnosis. Participants appreciate that instructors have received specific training in working with cancer survivors and that, while the class

Yoga Facts

Yoga Thrive is a research-based, therapeutic yoga program for cancer survivors and their support persons. This gentle, 12-week yoga program is based on contemporary yoga practices modified for cancer survivors. Dr. Nicole Culos-Reed has been researching the benefits of this program since 2002, and has translated this research and knowledge into continuing community-based programs, which have spanned across Canada. Results to date have found improvements in increased overall physical activity levels, improved strength, improved mood states, decreased levels of perceived stress, and improved quality of life. The Yoga Thrive program has had over 800 registrants in Calgary and trained over 50 yoga instructors across Canada, with instructor contacts located in Alberta, British Columbia, Saskatchewan, Ontario, Nova Scotia and a recently launched 6-week online yoga program. In addition, the original 7-week program was filmed and a cancer-specific yoga DVD was produced in 2008 (available at www.fitter1.com). Physical Activity and Exercise: What’s the Difference? – Physical activity can be defined as any movement of the body resulting in increased energy expenditure. Physical activity encompasses all bodily movements, from sports to activities of daily living. Exercise is a specific type of physical activity consisting of planned, structured bodily movement with the express goals of improving or maintaining physical fitness. Exercise programs are often categorized as to their effects (aerobic, strength or flexibility). Yoga’s Roots and Modern Science - Given yoga’s historical complexity and diversity, it has been suggested yoga practices have numerous applications, ranging from the lofty goal of enlightenment, as per the Patanjali Yoga Sutras (PYS), to ordinary physical and mental training, as is now popularly believed. Regardless of the applications of modern yoga, the root aim of yoga can be summarised in

is group-based, it is progressive and individual modifications of postures or sequences can be given to participants as needed. As one participant shared, “The expectation I had was that it would be progressive. That it would introduce us to yoga at a very basic level then progress us through, so you have a place to hang out in terms of whatever level you find you are at.” For many, ongoing participation in the program is a function of the perceived benefits they feel from tailored yoga practice, the therapeutic relationships they develop with instructors and the solidarity and support they feel with fellow class members.

the traditional definition (PYS) of yoga, as a path towards, “stilling the fluctuations of the mind.” Importantly, current neuroscientific research suggests subjective experiences of mental silence achieved during yoga practice are correlated to neurophysiological systems that mediate increased positive emotion regulation, internalised attention and ANS activity. Stress, the Autonomic Nervous System and “Allostatic Load” - From a stress physiology perspective, the cancer journey can be considered a series of “repeated hits,” effecting both individual psychology and physiology. As the body musters its resources to adapt to these newfound stressors, be they treatment-related or the inherent difficulties of adjusting to one’s newfound role as a “cancer survivor,” the body intuitively initiates a stress response via the sympathetic nervous system (SNS). Given the magnitude of cancer’s effect, this SNS stress response is often prolonged, mustering all the body’s resources as it seeks to find some balance in this newfound state. This push and pull between the illness and body’s reaction to it is not without a cost. This can be referred to “Allostatic Load,” a term coined by Neuroscientist Bruce McEwen to describe wear and tear on the body as a function of the stress response. Exercise-Mood Connection - A current area of clinical research interest is the study of positive affect, or feelings of pleasure, as an independent, adaptive pathway in the cancer experience. This emerging field of research suggests enhancement of positive affect is an important component of symptom management and cancer recovery. In general, exercise increases positive affect and reduces negative affect. Specifically, positive affect tends to increase pre- to post-exercise following exercise intensities that are not exhaustive as well as boosts low energy levels. Yoga fits this description nicely!

WWW.PINKANDTEAL.CA Getting Started We strongly recommend cancer survivors explore yoga programs in their own communities. Depending on where one is in their cancer experience, a gentle start is often best. If a program designed for cancer survivors, like Yoga Thrive, is not available in your community consider the following options:

ABOUT THE AUTHORS:

1.Look for yoga classes that include words like “gentle”, “restorative” and “therapeutic” in the class title or description.

Nicole Culos-Reed, PhD is an Associate Professor in Health and Exercise Psychology in the Faculty of Kinesiology, Adjunct Associate Professor in the Department of Oncology in the Faculty of Medicine, University of Calgary, and Researcher with the Department of Psychosocial Resources, Tom Baker Cancer Centre. Her work focuses on physical activity in cancer settings utilizing a multidisciplinary perspective to understand and improve the quality of life of cancer patients and survivors.

2.Contact the instructor prior to enrolling about your needs. Make sure they indicate a willingness and proficiency in adjusting or personalising elements of the class to meet your recovery needs. 3.Once you’ve found both the right class and right instructor, always go at your own pace. Classes can provide a challenge, but there’s no need to “push” yourself beyond your current abilities in a single session. Let the benefits accrue over time. In addition to taking classes in the community, we do recommend people practice, as they are able, at home. These practices can be anything from longer (20+ minutes) formal practices to start or end the day, to simpler, shorter (got 30 seconds?) informal practices throughout the day to take a break and rejuvenate. There are many books, DVDs and magazines to help in this respect. You may find your yoga teacher is also adept at making home practice recommendations. Again, remember less is more with yoga practice. Yoga should and can be something you enjoy and derive benefit from (See Exercise-Mood Connection). Therapies like yoga, directed toward addressing the functional links between mind and body, may be particularly effective in treating symptoms associated with chronic illnesses, such as cancer, as well as improving overall health. Our hope in offering comprehensive lifestyle management programs that include appropriately prescribed aerobic and resistance exercise, recovery-oriented exercise programs like yoga and allied dietary recommendations, is that we can work with the broader oncology treatment team to ensure successful cancer treatment and recovery. Yoga can be a potent aid in cancer recovery that can stretch and strengthen both mind and body. As one of our participants recently said, “This is a way of strengthening ourselves and getting back being more active in our lives.” P&T *All participant quotes come from the PhD research of Michael Mackenzie. 38 | Pink & Teal SUMMER 2012 pinkandteal.ca

Michael Mackenzie, MSc is a Doctoral Candidate in the Faculty of Kinesiology, University of Calgary. His research explores the relationships between yoga practice, affect and attention regulation, and health outcomes in cancer patients and survivors.

For further information or to contact the authors, please visit their website @: www.kin.ucalgary.ca/healthandwellnesslab/

BACKGROUND READING: Culos-Reed, SN., Mackenzie, MJ., Sohl, SJ., Jesse, MT., Ross, AN., Danhauer, SC. (In Press). Yoga & cancer interventions: A review of the clinical significance of patient reported outcomes for cancer survivors. Evidence-Based Complementary and Alternative Medicine. Ekkekakis P., Parfitt G., Petruzzello SJ. (2011). The Pleasure and Displeasure People Feel When they Exercise at Different Intensities: Decennial Update and Progress towards a Tripartite Rationale for Exercise Intensity Prescription. Sports Medicine 41(8), 641-671. Dusek, JA. & Benson, H. (2009). Mind-body medicine. A model of the comparative clinical impact of the acute stress and relaxation responses. Minnesota Medicine. 92(5), 47-50. McEwen, BS. (1998). Stress, Adaptation and disease: Allostasis and allostatic load. Annals New York Academy of Sciences. 33-43. Schmitz, KH., Courneya, KS., Matthews, C., Demark-Wahnefried, W., Galvao, DA., Pinto, BM., . . . American College of Sports Medicine. (2010). American college of sports medicine roundtable on exercise guidelines for cancer survivors. Medicine and Science in Sports and Exercise, 42(7), 1409-1426. Shennan, C., Payne, S., & Fenlon, D. (2011). What is the evidence for the use of mindfulness-based interventions in cancer care? A review. Psycho-Oncology, 20(7), 681-697.

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Marlene MacPherson’s Story

SUBMITTED

In 2008, you would have been more likely to find Marlene MacPherson behind her desk than in the kitchen. As a hurried banking vice president, she could barely find time to spend with her then three-year-old daughter Dakota and her husband Rick. In July of that year, however, Marlene was faced with news that forced her to push back from her desk and re-evaluate her priorities...that news was that she had stage 3 breast cancer. The cancer spread quickly, and by June of 2011 it had spread to her bones, liver and ovaries. Still in treatment, she continues to build her business. Marlene has become a recognized social entrepreneur and has shifted her focus from healthy eating and disease prevention through publishing her “Cook Once Produce Twice” cookbooks to her new show Marlene@Home. She hopes that through the show she can teach families to “Cook once and produce twice” – to prepare more wholesome meals for their families, reduce their time in the kitchen, and prevent disease. Every meal is made in her test kitchen in order to ensure that the recipes meet the needs of this

generation’s families. She believes that families have more control over disease prevention then they think. With a growing audience and an increasing demand for her recipes, she has published a second edition to her cookbook series called, Marlene’s Meal Makeover 2nd Edition: Cook Once, Produce Twice KIDS Cookbook. With a commitment to charity, Marlene contributes proceeds from the sale of each MMM cookbook to the maternal childcare program at Southlake Regional Health Centre in Newmarket, Ont., in support of their childhood cancer programs. She devotes her spare time to various initiatives to give back to the community that has given her so much. She is actively involved in speaking engagements, as she wants to spread the word about disease prevention and healthy eating to as many people as possible. It is evident to everyone that meets Marlene that she is passionate about making cancer history – and not just for her family, but for every family. P&T See Recipes from her cookbook on page 40 SUMMER 2012 Pink & Teal | 39

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recipes

Who doesn’t love strawberries? Salsa has traditionally been made with tomatoes as the main ingredient. However, Marlene’s version of salsa uses locally grown Ontario strawberries instead of tomatoes, which takes this dish to a new place on our summer patio. By making this trio you have a dressing for your lunch salad, a smoothie for your breakfast and even popsicles...what recipe could be more versatile and easy! COOK ONCE Strawberry Salsa Yield: makes 2½ cups Cook Once Preparation: Wash, hull, and slice 3 cups or approximately 25-30 large strawberries (reserve 1 cup for each recipe in the trio)

SUBMITTED

Ingredients: 1 mango, peeled, pit removed & cut into small cubes ½ medium red onion, thinly sliced 1 jalapeño pepper, minced ½ red bell pepper, stemmed, seeded & julienne ½ yellow bell pepper, stemmed, seeded & julienne ½ green bell pepper, stemmed, seeded & julienne ¼ cup fresh cilantro leaves, finely shredded 1 cup fresh strawberries, hulled & sliced from Cook Once Preparation ¼ cup fresh orange juice (no sugar added) 2 tbsps fresh lime juice 2 tbsps avocado oil sea salt & freshly ground black pepper, to taste

berry good salsa

Method: 1. Place mango, red onion, jalapeño pepper, red/yellow and green bell peppers, cilantro, strawberries, orange juice, lime juice, avocado oil, salt an pepper in a large mixing bowl and toss to combine. Cover and refrigerate at least 2 hours. Just before serving, remove the salsa from the refrigerator and bring to room temperature.

Cook Me!

PRODUCE 1 Strawberry Dressing Yield: makes 1 cup

PRODUCE 2 Strawberry Smoothie Yield: makes 2 servings

Ingredients: 1 cup strawberries, from Cook Once Preparation ½ cup avocado oil ¼ cup lemon 1 clove garlic 1 tsp honey

Ingredients: 1 cup strawberries, from Cook Once Preparation ½ cup soya or almond milk 1 ripe banana 1½ tsps agave nectar or honey

Method: 1. Blend all ingredients in a blender and use on top of your favorite salad. 2. Rinse blender and use for Produce 2.

40 | Pink & Teal SUMMER 2012 pinkandteal.ca

Method: 1.Blend all ingredients until perfectly smooth. Freeze the leftovers into popsicle trays for a quick kids snack.

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Quick and easy to make, strawberry salsa offers endless possibilities!

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Recent Advances in Breast Reconstruction

BY DR. MARTIN JUGENBURG

reast reconstruction after mastectomy is a continually evolving field and there are several exciting developments that have become available in recent years. Advances in both autologous (using your own tissue) and alloplastic (using breast implants) breast reconstructions now allow plastic surgeons to offer better, quicker, and safer reconstructive options. In autologous reconstruction, plastic surgeons use your own tissue to recreate breast shape and size, “flaps” (pieces of your own tissue) such as the DIEP (deep inferior epigastric artery perforator) flap allow for breast reconstruction that avoids some of the complications that are present with the most common flap known as the TRAM (transverse rectus abdominis myocutaneous) flap. A DIEP flap has a lower incidence of abdominal bulging and hernia formation, and the flap itself has superior blood flow. In alloplastic reconstruction, implants are used to recreate the size and shape of the breast. The use of ADM (acellular dermal matrix) and one-stage implants (Becker Implants) have allowed for quicker and simpler breast reconstruction. Traditionally, alloplastic breast reconstruction has required at least two steps. First, a tissue expander would be placed into the mastectomy area, and

then it would slowly be inflated over time to stretch out the pectoral muscle and skin. Several months later a second surgery would be performed to replace the tissue expander with the actual breast implant. The use of ADM allows this entire process to be completed in one step (if performed at the time of the mastectomy and if you have sufficient excess skin). Alternatively, the Becker Implant is a tissue expander and implant in one. This means that once the tissue expansion is complete, you don’t require another surgery to have the expander replaced for a permanent implant. You simply leave the expander (the Becker Implant) in place and the reconstructive process is complete. P&T Further information from Dr. Martin Jugenburg is available on referral at 647-436-6969. Dr. Jugenburg is certified by the Royal College of Physicians of Canada as a Plastic and Reconstructive Surgeon. He holds a medical degree from the University of Toronto and was one of the few applicants selected worldwide to train at the internationally renowned Memorial Sloan-Kettering Cancer Center in New York City, where he learned from the top plastic surgeons in the world.

SUMMER 2012 Pink & Teal | 45

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Mindfulness BY THEREA JAHN BSc, ND BY THERESA JAHN, BSc, ND

BY THERESA JAHN, BSc, ND

Life can be stressful and it can be challenging to remain calm through life’s unexpected situations. Facing an illness can be one of the greatest stressors, not just physically, but mentally. It raises thoughts and concerns that most people don’t consider in their day-to-day lives. It is not uncommon for people to experience anxiety as a result of these challenges. This stress can even bring on symptoms such as insomnia and depression. Dr. Mark Hyman MD recently wrote a thought provoking article for the Huffington Post entitled “Why Doing Nothing is the Key to Happiness” in which he stated “What matters most in life is the quality of our experience, the ability to be awake to what is real and true in our lives, for the difficult and the happy times, to be awake to each person we touch, to our own experience, to the moment we are in, to the simple, sweet, and alive gifts of a smile, a touch, a kind deed, the breeze on our skin, or a firefly flickering in the early summer night.” There has been a lot of media buzz surrounding mindfulness and meditation in recent years, and these terms/practices have gained significant attention at renowned research facilities around the world. In simple terms, mindfulness is the act of being present or attentive to the moment, and meditation can be a way to practise this. Making an effort to be present in one single moment at a time can be a valuable way to calm the mind in both the short and long term. 46 | Pink & Teal SUMMER 2012 pinkandteal.ca

Significant research has been conducted on the effects of meditation on well-being. It may help to improve mood, relieve insomnia, reduce anxiety, and even lower blood pressure. Daily breathing exercises can be a simple way to start incorporating mindfulness into your life. All you need is five minutes each day: -Sit or lie in a comfortable position, and place one hand over your belly button. -Breathe in through your nose and focus your attention to the hand on your abdomen. As you breath in, you should notice that your hand rises slightly as you inhale. -Exhale slowly though your nose, and try to focus your attention on your hand lowering on your abdomen as you exhale. You may notice that just doing this simple exercise can help to calm your mind and relax your physical tension. There are many ways to practise mindfulness. Community organizations and hospitals offer stress-reduction groups and classes. Check with your local hospitals or an organization such as Wellspring for more information. They can work with you one-on one or in a group setting to teach techniques to help create an environment of calm in your life.P&T

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Books to Film

The Descendants by Kaui Hart Hemmings REVIEWED BY STEPHANIE DI MASCIO & JACQUELINE BELLMORE-KINNEY

he Descendants, written by Kaui Hart Hemmings, is the emotional journey of Matthew King, a father and husband who is forced to take the lead as a parent when his wife becomes critically ill from a boating accident. While his wife lies in an irreversible coma, he not only has to reconnect with his two daughters, Alexandra, 18, and Scottie, 10, but is also forced to re-examine his relationship with his wife, after discovering she was having an affair. Joanie (who is called Elizabeth in the movie adaptation of the book) will never wake from her coma, so Matt has no choice but to disconnect her from life support in order to respect the terms of her will. He then has the responsibility of personally asking his family and friends to visit the hospital to say their final goodbyes. While preparing his children to bid their mother farewell, he finds out the details of his wife’s affair and makes the difficult decision to find her lover, so that he too can say goodbye. Hemmings does a beautiful job of exploring the emotional journey Matt has in reconnecting with his daughters. The reader can relate to each character. The novel’s humorous tone makes this bittersweet story easy to read and hard to put down.

The film, directed by Alexander Payne, was cast exceptionally well, with George Clooney as Matt King, Shailene Woodley as Alexandra, and Amara Miller as Scottie. It was nominated for five Academy Awards and won best picture and best actor at the Golden Globe Awards. Although the film feels a little slow at times, the actors do an amazing job at capturing the humour and emotion detailed by Hemmings in her novel. It was refreshing to see George Clooney in a new light – he isn’t the suave ladies’ man he usually portrays, but is a regular, imperfect guy facing the same challenges that many face in reality. He’s a man who gets caught up in his career, and forgets to appreciate the important things in life. Woodley and Miller (who play the children) do an exceptional job of carrying the story along and keeping the audience entertained and smiling. Overall, the movie is quite charming and we are very happy that we chose to read the book before seeing the movie. We recommend reading the book first to avoid missing the intricate character development so beautifully penned by Hemmings in the novel. P&T

SUMMER 2012 Pink & Teal | 47

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Film

My Life Without Me, directed by Isabel Coixet Authentic Acting Sheds New Light on Bleak Diagnosis REVIEWED BY SHAUNA CHASE

ost movies wherein cancer is a main theme are heart-rending, overly emotional parodies of real life (think A Walk to Remember…cute, but barely representative about what actual people go through when battling the big C).

see what it’s like. The film manages to portray what would normally be a sordid affair in a neutral way, possibly because at the same time Ann is attempting to find a new wife for her husband, someone he can love when she’s gone.

By stark contrast, this picture starring Canadian actress Sarah Polley has a filming style and script that could almost be improv, they hit so close to reality.

As she’s starting to live and to see life clearly for the first time, Ann confronts the harsh truth that she will very soon be gone. She walks down a busy commercial street, saying to herself: “You look at all the things you can’t buy, now you don’t even want to buy, all the things that will still be here when you’re gone.” She’s not self-pitying, she’s merely observing a fact. She lacks any sort of belief, saying to herself : “You pray -- you don’t even know what you’re praying to but you pray anyway.”

A brief synopsis: 23-year-old Ann is unexpectedly given a mere two months to live, as her ovarian cancer is too far along to be helped. She hides it from her husband and two young daughters, blaming anaemia for her low energy and frequent doctor visits. She can barely react to the situation since she is so young and has had no time to get to know herself as a person. She writes a “bucket list” of sorts, and sets out to live a life she never would have been inspired to live without its end being so near. Ann’s amazingly authentic interior monologue ties the plot together, as it would otherwise be a loose string of day-to-day events. She speaks to herself as an outside observer (thus the film’s title – my life without me). Themes of infidelity, anorexia, loss of youth, time, and real love accent what is essentially a coming-of-age story. Early on it’s revealed that Ann married her husband (played by sexy Torontonian Scott Speedman) and had children at a young age, completely skipping out on her own youth. One item on her to-do list is to make love to another man – and she does so – just to 48 | Pink & Teal SUMMER 2012 pinkandteal.ca

Polley’s character is so uncompromisingly genuine as she searches for ‘someone to fall in love with her’ (she succeeds, of course, with serious and cultured Lee, who is played by Mark Ruffalo). He truthfully says to her, “‘I love you, I’m in love with you, the world is less terrible because you exist’”. Polley loves him back, but can honestly reply after her short time of self-exploration: “Life is so much better than you think it is.” This is a cancer film which is not about cancer, and though it is romantic, the romantic scenes are far from cliché or overdone. Though the movie is obviously sad and painful, you won’t be left feeling down in the dumps after this raw and engaging -- and I think pioneering for its genre – drama. If anything, you might be inspired to make changes in your own life. P&T

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RESOURCE GUIDE International Association for Medical Assistance to Travelers Providing reliable and impartial travel health advice. Location: 67 Mowat Ave, Suite 036, Toronto, ON M6K 3E3 Phone: 416-Â652-Â0137 Website: www.iamat.org Location: 2162 Gordon St, Guelph, ON N1L 1G6 Phone: 519-Â836-Â0102 Fax: 519-Â836-Â3412 Macmillan Cancer Support Teaching and survivors of cancer how to build-Âup their diet Website: www.cancerbackup. org.uk Young Survival Coalition (global organization) Improving quality of life for women ages 40 and under, suffering from breast cancer. Website: www.youngsurvival.org National Cancer Institute Phone: 1-Â800-Â4-Âcancer Website: www.nci.nih.gov/ cancerinfo/takingtime American Cancer Society Phone: 1-Â800-Â227-Â2345 Website: www.cancer.org NATIONAL RESOURCES 5 to 10 a day for better health www.5to10aday.com breast cancer now what? An online community for young women with breast cancer sponsored by rethink breast cancer Website: www. reastcancernowwhat.ca Breast Cancer Society of Canada 1RW IRU SURĂ&#x20AC;W FKDULWDEOH organization that funds Canadian breast cancer research Location: 420 East St N Sarnia, ON, N7T 6Y5 Toll-Âfree: 1-Â800-Â567-Â8767 Phone: 519-Â336-Â0746 Fax: 519-Â336-Â5725 Email: bcsc@bcsc.ca Website: www.bcsc.ca

Canadian Association of Psychosocial Oncology An organization of professionals dedicated to the understanding, treatment an study of the social, psychological, emotional, spiritual aspects of cancer. Website: www.capo.ca Canadian Breast Cancer Network (CBCN) Focuses national attention on breast cancer, ensuring issues IDFHG E\ &DQDGLDQV LQĂ XHQFH healthcare decisions and policies. (French/English) Toll-Âfree: 1-Â800-Â6858820 Phone: 613-Â230-Â3044 Fax: 613-Â230-Â4424 Email: cbcn@cbcn.ca Website: www.cbcn.ca Canadian Cancer Society (CCS) 1DWLRQDO 2IĂ&#x20AC;FH

Dedicated to curing cancer and improving the quality of life of those suffering with cancer. Location: 55 St. Clair Ave. W, Suite 300, Toronto, ON, M4V 2Y7 Phone: 416-Â961-Â7223 Fax: 416-Â961-Â4189 Email: ccs@cancer.ca Website: www.cancer.ca Canadian Cancer Society 'LYLVLRQ 2IĂ&#x20AC;FHV British Columba and the Yukon (CCS) 565 West 10th Ave Vancouver, BC, V5Z 4J4 1-Â800-Â663-Â2524 604-Â872-Â4400 frontdesk@bc.cancer.ca Alberta/NWT (CCS) 325 Manning Rd, N, Suite 200 Calgary, AB, T2E 2P5 403-Â205-Â3966 info@cancer.ab.ca Saskatchewan (CCS) 1910 McIntyre St Regina, SK, S4P 2R3 ccssk@sk.cancer.ca Manitoba (CCS) 193 Sherbrook St Winnipeg, MB, R3C 2B7 204-Â774-Â7483 info@mb.cancer.ca

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Ontario (CCS) 55 St Clair Ave W, Suite 500 Toronto, ON, M4V 2Y7 416-Â488-Â5400 webmaster@ontario.cancer.ca Quebec (CCS) 5151 de lâ&#x20AC;&#x2122;Assomption Blvd. Montreal, QC, H1T 4A9 514-Â255-Â5151 webmestre@quebec.cancer.ca New Brunswick (CCS) PO Box 2089 133 Prince William St Saint John, NB, E2L 3T5 506-Â634-Â6272 ccsnb@nb.cancer.ca Nova Scotia (CCS) 5826 South St, Suite 1 Halifax, NS, B3H 1S6 902-Â423-Â6183 ccs.ns@ns.cancer.ca Prince Edward Island (CCS) 1 Rochford St, Suite 1 Charlottetown, PEI, C1A 9L2 902-Â566-Â4007 info@pei.cancer.ca Newfoundland and Labrador (CCS) PO Box 8921 Daffodil Place, 70 Ropewalk Lane St Johnâ&#x20AC;&#x2122;s, NL, A1B 3R9 709-Â753-Â6520 ccs@nl.cancer.ca Canadian Food Guide Health Canadaâ&#x20AC;&#x2122;s food guide www.hc-Âsc.gc.ca/fn-Âan/food-Â guide-Âaliment/index-Âeng.php Canadian Foundation for Womenâ&#x20AC;&#x2122;s Health Funding research that is improving womenâ&#x20AC;&#x2122;s sexual and reproductive health for Canadian women at every stage in their life. Location: 780 Echo Dr, Ottawa, ON, K1S 5R7 Phone: 613-Â730-Â4192 Fax: 613-Â730-Â4314 Email: info@cfwh.org Website: www.cfwh.org Canadian Lymphedema Foundation Supporting and advocating

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RESOURCE GUIDE for people who suffer with Lymphedema Email: info@lymphovenous-Â canada.ca Website: www.lymphovenous-Â canada.ca Canadian Womenâ&#x20AC;&#x2122;s Health Network Improving the health and lives of girls and women in Canada and the world (English/French) Location: Suite 203, 419 Graham Ave, Winnipeg, MB, R3C 0M3 Toll-Âfree: 1-Â888-Â818-Â9172 Phone: 204-Â942-Â5500 Fax: 204-Â989-Â2355 Email: cwhn@cwhn.ca Website: www.cwhn.ca Cancer Recovery Foundation of Canada Working to provide simple acts of kindness to those and their families who are affected by cancer. Location: 16 Esna Park Dr, Suite #107, Markham, ON L3R 5X1 Toll-Âfree: 1-Â866-Â753-Â0303 Phone: 905-Â477-Â7743 Fax: 905-Â477-Â4251 Email: info@cancerrecovery.ca Website: www.cancerrecovery.ca Cancer Research Society Funding and supporting cancer research nationwide Website: www.src-Âcrs.ca Ottawa Location: 200 Isabella St, Suite 305, PO Box 4613, Station E, Ottawa, ON K1S 1P7 Toll-Âfree Phone: 1-Â888-Â766-Â2262 Fax: 613-Â233-Â1030 Montreal Location: 625 President-Â Kennedy Ave, Suite 402, Montreal, QC, H3A 3S5 Toll Free Phone: 1-Â888-Â766-Â2262 Phone: 514-Â861-Â9227 Fax: 514-Â861-Â9220 Caring 4 Cancer www.caring4cancer.com/go/ cancer/nutrition/eating-Âwell-Â nutrition

Caring Voices Proving an online community for all cancer survivors. Website: www.caringvoices.ca Canadian Virtual Hospice Website: www.virtualhospice.ca Young Women with Breast Cancer Offering survivors the chance to connect with a peer matched to their unique circumstances. Toll-Âfree: 1-Â888-Â778-Â3100 Email: info@ywbc.ca Website: www.ywbc.ca Dietitians of Canada Finding a registered dietitian to suit your nutritional needs. Location: 480 University Ave., Suite 604, Toronto, ON, M5G 1V2 Toll-Âfree: 1-Â888-Â778-Â3100 Phone: 416-Â596-Â0857 Fax: 416-Â596-Â0603 Email: centralinfo@dietitians.ca Website: www.dietitians.ca Federation of Medical Women (Canada) Committed to the development of women physicians and the wellbeing of all women. (English/ French) Location: 780 Echo Dr., Ottawa, ON, K1S 5R7 Toll-Âfree: 1-Â877-Â771-Â3777 Phone: 613-Â569-Â5881 Fax: 613-Â569-Â4432 or 1-Â877-Â772-Â5777 Website: www.fmwc.ca Fertile Future Providing education, assistance and information regarding fertility preservation for cancer patients. Location: 19 Woodson St., Ottawa, ON K2G 6V7 Toll-Âfree: 1-Â877-ÂHOPE-Â066 Phone: 613-Â440-Â3302 Fax: 613-Â440-Â3329 Email: liz@fertilefuture.ca Website: www.fertilefuture.ca Food Safety Network www.foodsafetynetwork.ca Hats Off to Chemo Providing hats to anyone with hair loss due to cancer treatments. Location: 36 Regent St,

Shakespeare, ON N0B 2P0 Phone: 519-Â501-Â7518 Email: admin@hatsofftochemo.com Website: www.hatsofftochemo.com Infertility Awareness of Canada Raising public awareness about infertility and treatments. Location: 2100 Marlowe Ave., Suite 342, Montreal, QC H4A 3L5 Toll-Âfree: 1-Â800-Â263-Â2929 Phone: 514-Â484-Â2891 Fax: 514-Â484-Â0454 Email: info@iaac.ca Website: www.iaac.ca Mentor CANADA Providing breast reconstruction options Toll-Âfree: 1-Â800-Â668 6069 Fax: 905-Â725 7340 Website: www.mentorwwllc.com Website: www.plasticsurgeryinfo. ca Website: askmentorwwllc.com Nanny Angel Network Providing mothers with breast cancer with a little extra support in the form of childcare. 4841 Yonge St., Unit 2B., North York, ON, M2N 5X2 Toll-Âfree: 1-Â877-Â731-Â8866 Toronto: 416-Â730-Â0025 Vancouver: 604-Â484-Â4966 Calgary: 403-Â351-Â0179 Fax: 416-Â730-Â8963 Email: moms@ nannyangelnetwork.com Website: www. nannyangelnetwork.com Society of Obstetricians and Gynecologists of Canada (SOGC) Location: 780 Echo Dr., Ottawa, ON K1S 5R7 Toll-Âfree: 1-Â800-Â561-Â2416 Phone: 613-Â730-Â4192 Fax: 613-Â730-Â4314 Email: helpdesk@sogc.com Website: www.sogc.org 2IĂ&#x20AC;FH +RXUV 0RQGD\ WR )ULGD\ 7:30am to 5:00pm (EST) HPV Info Provides education and information regarding HPV. Website: www.hpvinfo.ca

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RESOURCE GUIDE Info VPH (French) Providing education and information regarding HPV in French. Website: www.infovph.ca Masexulite (French) Providing information and education regarding safe sex choices and sexual health in French Website: www.masexualite.ca Sexuality and U Providing information and education regarding safe sex choices and sexual health. Website: www.sexualityandu.ca The Dr. Jay Charitable Foundation Providing palliative care for children and families facing a terminal illness. Location: 85 Skymark Dr., Suite 2603, Toronto, ON M2H 3P2 Toll Free Phone: 1-866-687-9814 Phone: 416-586-4800 ext. 7406 Website: www.drjayfoundation. com The Dr Jay Children’s Grief Program Phone: 416-586-4800 ext. 6664 Email: max&bea@tlcpc.org Young Adult Cancer Canada Building a community of young adults diagnosed with cancer, that provides information, support, skills, and opportunity. Location: 18 Argyle Street, Suite 201, St. John’s, NL, A1A 1V3 Toll-free: 1-877-571-7325 Phone: 709-579-7325 Fax: 709-579-7326 Email: connect@youngadultcancer.ca Website: http://youngadultcancer.ca ALBERTA Alberta Cancer Foundation Promoting cancer education and funding research for those in Alberta Email: acfonline@ ertacancerfoundation.ca Website: http://albertacancer.ca

3URYLQFLDO 2IÀFH 710-10123-99 St NW Edmonton, AB, T5J 3H1 Toll Free Phone: 1-866-412-4222 Phone: 780-643-4400 Fax: 780-643-4398 Cross Cancer Institute 11560 University Ave Edmonton, AB, T6G 1Z2 Phone: 780-432-8500 Fax: 780-432-8357 Tom Baker Cancer Centre 1331 29 St NW Calgary, AB, T2N 4N2 Phone: 403-521-3433 Fax: 403-521-3224 Wellsprings Helping connect you with support groups and programs in your area. Website: www.wellspring.ca Wellspring Calgary Phone: 403-521-5192 Wellspring Edmonton Phone: 780-758-4433 BRITISH COLUMBIA BC Cancer Agency Providing nutritional care and information for cancer patients. Toll-free: 1-800-663-3333 Phone: 604-877-6000 Website: www.bccancer.bc.ca BC Cancer Foundation 600-686 W. Broadway, Surrey, BC, V5Z 1G1 Toll-free: 1-888-906-2873 (in BC) Phone: 604-877-6040 Fax: 604-877-6161 BC Women’s Hospital and Health Centre Foundation 5DLVLQJ VXIÀFLHQW IXQGV WR KHOS Women’s function as a leader in women’s health. Location: BC Women’s Hospital & Health Centre Foundation, Rm. D310 - 4500 Oak St., Vancouver, BC V6H 3N1 Toll-free: 1-888-823-9992 Phone: 604-875-2270 Fax: 604-875-2621 Email: info@ bcwomensfoundation.org

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Website: www.bcwomensfoundation.org ONTARIO The Board of Examiners in Sex Therapy & Counseling in Ontario Providing gynecologic cancer support and education. Wendy Trainor Location: 1201-372 Bay St., Toronto, ON, M5H 2W9 Phone: 416-204-0336 Website: www.bestco.info Community Care Access Centre (CCAC) Making in-home care accessible and convenient Location: 130 Bloor St. W., Suite 200, Toronto, ON., M5S 1N5 Phone: 310-CCAC (2222) Email: frontdeskservices@ccac- ont.ca Website: www.ccac-ont.ca Cottage Dreams Offering recent cancer survivors the opportunity to spend a week away at a private cottage with family and friends. Location: The Village Barn, 195 Highland St., P.O. Box 1300, Haliburton, ON K0M 1S0 Phone: 705-457-9100 Fax: 705-457-9188 Email: info@cottagedreams.org Website: http://cottagedreams.org HopeAir Providing non-emergency PHGLFDO ÁLJKWV IRU WKRVH LQ UXUDO RU UHPRWH DUHDV LQ ÀQDQFLDO QHHG 124 Merton St., Suite 207, Toronto, ON, M4S 2Z2 Toll-free: 1-877-346 HOPE (4673) Phone: 416-222-6335 Fax: 416-222-6930 Email: mail@hopeair.org Website: www.hopeair.org 0DUYHOOH .RIÁHU %UHDVW &HQWUH DW Mount Sinai Hospital www.mountsinai.on.ca/care/ mkbc Ontario Breast Cancer Information and Exchange A coalition of organizations

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RESOURCE GUIDE working together to improve access to information and support for women and their families affected by breast cancer Toll-free: 1-888-837-9071 Emails: info@obcep.ca kathythompson@obcep.ca Website: www.obcep.ca Ontario Breast Screening Program Location: 620 University Av., Toronto, ON, M5G 2L7 Toll-free: 1-800-668-9304 Phone: 416-971-9800 Fax: 416-971-6888 Email: breastscreen@ cancercare.on.ca Ontario Community Support Association For people who need help to function independently because of an illness or disability. Location: 104-970 Lawrence Ave. W., Toronto, ON, M6A 3B6 Toll-free: 1-800-267-6272 Phone: 416-256-3010 Fax: 416-256-3021 Website: http:// homeandcommunitysupport.ca Ontario Institute for Cancer Research Dedicated to research in prevention and early detection. Location: MaRS Centre, South Tower, 101 College Street, Suite 800, Toronto, ON, M5G 0A3 Toll-free: 1-866-678 6427 Phone: 416-977-7599 Website: www.oicr.on.ca Wellspring Helping connect you with support groups and programs in your area. Website: www.wellspring.ca Wellspring @ Women’s College Hospital www.womenscollege hospital.ca Phone: 416 -323-6400 ext. 4240 Wellspring Odette House & The Coach House (Toronto) Toll Free: 1-877-499-9904 Wellspring Sunnybrook

(Toronto) Toll-free: 1-877-499-9904

GREATER TORONTO AREA

Wellspring Halton-Peel (Oakville) Phone: 905-257-1988 Wellspring Chinguacousy (Brampton) Toll-free: 1-877-499-9904 Wellspring London & Region Phone: 519-438-7379 Wellspring Stratford Phone: 519-271-2232

Familial Breast & Ovarian Cancer Clinic Breast cancer and ovarian cancer at the Princess Margaret Hospital Location: 610 University Ave, Suite M-704, Toronto ON, M5G 2M9 Information line: 416-340-3388 Phone: 416-946-2270 Fax: 416-946 6528 Website: www.uhn.ca

Wellspring Niagara Toll-free: 1-888-707-1277 Wellspring Niagara Stevensville Satellite Phone: 905-382-6121 CANCER CENTRES IN SOUTHERN ONTARIO

Patient & Survivorship Education Program (GTA) Cancer patient and survivor support and education To view the schedule online: www.survivorship.ca/docs/ web_calendar.pdf Location: Princess Margaret Hospital, 610 University Avenue, Toronto, ON M5G 2M9 Phone: 416-946-4501 ext. 5383

Grand River Regional Cancer Centre (Kitchener) Phone: 519-749-4370 Cambridge Memorial Hospital (Cambridge) Phone: 519-621-2330 Freeport Health Centre (Kitchener) Phone: 519-742-3611 London Regional Cancer Centre Phone: 519-438-7379 Princess Margaret Hospital (Toronto) Phone: 416-946-2000 Mainline: 416-946-4501 Children’s Hospital Western Ontario (London) Phone: 519-685-8500 McMaster Children’s Hospital (Hamilton) Phone: 905-521-2100 Hospital for Sick Children (Toronto) Phone: 416-813-1500

ELLICSR: Health, Wellness & Cancer Survivorship Centre A support centre for cancer survivors Location: Toronto General Hospital, 585 University Ave (near College St), Basement Level, Room BCS-021 Phone: 416-581-8602 Website: www.ellicsr.ca Hours of Operation: Monday to Friday, 8:30am to 4:30 pm

Princess Margaret Hospital: Look Good… Feel Better Program Teaching women living with cancer how to use make-up and hair alternatives to deal with side effects of chemotherapy and radiation. Location: Princess Margaret Hospital, 3rd Floor, Rm. 642 Phone: 416-946-2075 Call to register Website: www.lgfb.ca/eu/ ab_welcome.html The Wig Salon & Accessories Boutique Hours: Monday to Friday, 9am to 4 pm Princess Margaret Hospital, 3rd Floor, Rm. 642 Information: 416-946-6596 Appointment: 416-946-4501

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RESOURCE GUIDE Youth in Time Youth in Time is a monthly program for young adults (from 18 to 29 years of age) with cancer. Providing a positive and motivating environment, creative workshops and freedom of expression. Location: Princess Margaret Hospital Information: Paulene 467-866-0245 Email: youthintime@gmail.com The Magic Castle Free childcare service for families of Princess Margaret Hospital patients, babies to age 12. Phone for reservations. Phone: 416-946-4501 ext 5157 Hours: 9am to 4pm Monday to Friday PYNK: Young Women’s Breast Cancer Program Supporting young women with breast cancer Location: Toronto’s Sunnybrook Hospital 2075 Bayview Ave., Toronto, ON, M4N 3M5 Phone: 416-480-5000 ext. 1059 Website: www.sunnybrook. ca/glossary/item. asp?i=275&page=2140 The Olive Branch of Hope Providing support to women diagnosed with breast cancer Location: Breast Cancer Support Services, 153 Bridgeland Avenue, Unit 3, Toronto, ON, M6A 2Y6 Phone: 416-256-3155 Fax: 1 416-256- 4069 Email: olivebranch@theolivebranch.ca Website: http://www.theolivebranch.ca

Phone: 905-389-5884 Community Site 501 Sanatorium Road, Hamilton, ON L9C 0C3 Phone: 905-667-8870 OTTAWA Breast Cancer Action Ottawa Support and resource centre for Ottawa Community. Workshops, Lymphedema information, peer VXSSRUW DQG ÀWQHVV Location: 301– 1390 Prince of Wales Drive, Ottawa ON K2C 3N6 Phone: 613-736-5921 Email: info@bcaott.ca Website: www.bcaott.ca Hours of Operation: Monday to Friday, 8:30am to 3:30pm, closed on Statutory Holidays. OSHAWA Hearth Place Cancer Support Centre Support Centre for cancer patients and their families Location: 86 Colborne Street West, Oshawa, ON L1G 1L7 Phone: 905-579-4833 Fax: 905-579-1204 Email: hearthplace@hearthplace.org Website: www.hearthplace.org Drop-in Hours of Operation: Monday - Thursday, 10a.m - 4p.m and Friday, 10a.m - 12p.m Administration Hours of Operation: Monday - Thursday, 9a.m - 5p.m and Friday, 9a.m - 1p.m LONDON

HAMILTON Wellwood Support centre for those who are affected by cancer Email: wellwood@hhsc.ca Website: http://www.wellwood. on.ca

Thameswood Lodge Accommodations for those receiving cancer treatments and live more than 40 km away from the facility Phone: 519-667-6727 Website: www.lhsc.on.ca

Hospital Site 711 Concession Street, Hamilton, ON L8V 1C3

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WATERLOO REGION AND WELLINGTON COUNTY Calvary Family Lodge Providing accommodation to those who are being treated for cancer at Grand River Regional Cancer Centre. Location: 340 Park St, Kitchener, ONN2G 1N1 Phone: 519-749-4300 ext. 5799 Cancer Prevention and Early Detection Network of Waterloo Region Raising early detection and prevention issues in Waterloo Region and Wellington County. Location: 150 Main Street Cambridge, ON N1R 6P9 Phone: 519-740-5793 ext. 3437 Fax: 519-883-2241 HopeSpring Cancer Support Centre Providing support to cancer patients Location: 43 Allen Street W, Waterloo, ON N2L 1C9 Phone: 519-742-HOPE (4673) Email: support@hopespring.ca Website: www.hopespring.ca Hours of Operation: Monday - Friday 9:00 am to 5:00 pm, Tuesday, Wednesday, Thursday 6:00 pm to 9:00 pm Saturday 9:00 am to 3:00 pm WINDSOR AND ESSEX COUNTY Windsor and Essex County Cancer Centre Foundation Gathering funds for the Cancer Centre at the Windsor Regional Hospital Location: 2220 Kildare Road, Windsor, ON N8W 2X3 Phone: 519-253-3191 ext. 58506# Fax: 519-255-8676 Website: www. windsorcancerfoundation.org

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RESOURCE GUIDE MANITOBA Cancer Care Manitoba Caring for cancer patients in Manitoba. Toll-free: 1-866-561-1026 Phone: 204-787-2197 Website: www.cancercare. mb.ca CancerCare Manitoba Contact Listing MacCharles Unit 675 McDermot Ave,, Winnipeg, MB, R3E 0V9 Phone: 204-787-2197

Manitoba Cervical Cancer Screening Program Toll-free:1-866-616-8805 Phone: 204-788-8626

CancerCare Manitoba Breast Cancer Centre of Hope 691 Wolseley Ave., Toronto, ON, Toll-free: 1-888-660-4866 Phone: 204-788-8080 CancerCare Manitoba Foundation Toll-free: 1-877-407-2223 Phone: 204-787-4143 Community Cancer Programs Network Toll-free: 1-866-561-1026 Phone: 204-787-5159

St. Boniface Unit, St. Boniface General Hospital “O” Block - 409 Taché Ave., Winnipeg, MB, R2H 2A6 Toll-free: 1-866-561-1026 Phone: 204-233-8563

Manitoba Breast Screening Program Toll-free: 1-800-903-9290 $GPLQLVWUDWLRQ 2IÀFH 204-788-8633 Appointment Inquiry 204-788-8000

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