Together Magazine 2014 by ChaiCancerCare

oge her 2014 issue 9

Reaching out – Chai’s expertise across the UK

When men get cancer

Our Annual Dinner and Spa Day

Latest research from front-line specialists The people we can’t do without – you

CHAI CANCER CARE

A Welcome Message I

t’s my pleasure to welcome you to the ninth edition of Chai’s ‘Together’ magazine. Each year sees development and innovation in the breadth of the specialised support and care we offer our clients. In this issue, you can learn how these services are making a positive impact on their everyday lives.

For many years it was unusual for men to come to Chai, but this is now changing. In our section focusing on men’s issues, three male clients talk about how Chai has supported them and their families. Following this theme, we also hear how our male therapists bring their individual expertise to the organisation. We now have eight Chai satellite centres across the UK and you can read how we are responding to the specific characteristics, personality and needs of each local community. With the welcome news that more people are living with and beyond their cancer, we spotlight our Lifestyle Group. This has

been developed to help clients maximise their quality of life after treatment. From the medical world, we are grateful to our specialists who report on targeted treatments and research in prostate, colon and ovarian cancers. Chai receives no statutory funding; the community is our lifeline and the effort and commitment of our wonderful supporters is never underestimated. Each fundraising event serves a dual purpose, enabling us to continue our work and also to raise awareness of Chai. This is vital in ensuring that whenever and wherever there is the need, people know they have somewhere to turn. Our deep appreciation and heartfelt thanks to everyone for their loyal and continued support.

Louise Hager Charirman

Chai Cancer Care requests the pleasure of your company at

THE 2014 NATALIE SHIPMAN MEMORIAL LECTURE JEWS AND CANCER – WHAT ARE THE LINKS? Keynote Speaker: Professor Daniel Hochhauser, Consultant in Medical Oncology UCLH Trust Monday 1st December 2014 Doors open: 7:00pm Lecture begins: 7:30pm

Chai Cancer Care, 142-146 Great North Way, London, NW4 1EH Admission free by ticket only. Please call 020 8202 2211 to reserve a place.

Cover Image: Cindy Lass and Karen Goodkind at the Chai Spa Day Photo: Chiko Photography

TOGETHER 2014

Contents Caring for Every Generation – Chief Executive, Lisa Steele

It’s Different For Men

An Overview of Prostate Cancer: Ian Donaldson, BMedSci BMBS MRCS

Meet the Team: focus on Chai’s male therapists

The Chai ‘Lifeline’ Dinner

Tailor-made to Every Community: our satellite services

The Chai Spa Day

Insights into Drug Treatment of Colon Cancer: Professor Daniel Hochhauser

‘It’s in the DNA’: Romie and Esther Tager in conversation

You’re Our Lifeline: our supporters amazing commitment

Service Spotlight: Lifestyle Group

Ovarian Cancer Update: Professor Jonathan Ledermann

Chai on Your Shopping List – the Chai Society Gift Sale

Service Spotlight: Image

The Chai Calendar

Would Like to Meet – Chai’s Young Committees

Sponsored Activities

‘Chai Challenges You’– our new initiative

PRESIDENT

TRUSTEES

MEDICAL PATRONS LIST

Prof Gordon Jayson

The Rt. Hon. Lord Young of Graffam

Louise Hager

Prof Michael Baum

Mr Amir Kaisary

Jonathan Hodes

Prof Michael Brada

Dr David Landau

Lady Kalms MBE

Dr Rachel Craig

Prof Jonathan Ledermann

Susan Shipman

Mr Michael Douek

Prof Gordon McVie

Dr Adrian Tookman

Prof Andrew Eder

Dr Jane Neerkin

Philip Weinstein

Prof Rosalind Eeles

Prof Gordon Rustin

Lord Young

Dr Ian Ellis

Prof Karol Sikora

Mr Daren Francis

Prof Albert Singer

Dr Jo Franks

Prof Stephen Spiro

Prof Anthony Goldstone CBE

Dr Adrian Tookman

FOUNDER PRESIDENTS Susan Shipman Frances Winegarten z”l CHAIRMAN Louise Hager CHIEF EXECUTIVE Lisa Steele

HONORARY PATRONS Lord Janner of Braunstone QC Maureen Lipman CBE Chief Rabbi Ephraim Mirvis

Prof Daniel Hochhauser Prof Ian Jacobs

This edition of ‘together’ is generously sponsored by The Dorset Foundation Editor: Deborah Wald

Design: Creative and Commercial

CHAI CANCER CARE

Caring for every generation Chief Executive Lisa Steele explains how the rise of cancer is affecting a younger age group and shaping the services we provide

hai never stands still. We constantly assess new trends in age, cancer types and trials, and what that will mean for our clients. Conversations with them and the expert input of Chai’s Medical Advisory Panel, give us a 360º understanding of how cancer, its treatments and its impact on patients is changing. Each step forward brings new challenges as we strive to widen the range of services that answer the multi-faceted needs of our clients. For at the very heart of our organisation is a clear philosophy – each person who contacts us is treated as an individual, with their own specific needs, and every aspect of care is personalised down to the finest detail. Despite cancer being primarily a disease of older people, the last three years has seen a marked increase in the number of young parents turning to us for support. For a person under 50, the ripple effect of a diagnosis is often much broader than for one who is older. Their circumstances bring new complexities, and we may see as many as four generations in one family, each with

“The number of clients aged under 20 rose by a startling 25% last year”

their own individual needs. In this respect, the most significant change we are seeing is in how our services are developing for family members aged 20 and under. There has been an increase of 25% of clients in this age bracket, starting as young as 3 years old. Our Children, Teenage and Family Service, which provides play therapy, art psychotherapy and music therapy – gives young people safe, creative routes through which to explore and express difficult feelings. Bearing these figures in mind, last year Chai launched its ‘Chai in Schools’ initiative – which gives teaching staff the strategies to support children going through a cancer diagnosis in their family. Chai acts as a central point of contact, liaising between the school and the family to co-ordinate all the support needs of the child. Overall client numbers across all centres increased by 21% last year. This has led to a national expansion of our team of counsellors, child therapists and complementary therapists. No single therapy or intervention is the answer – rather it is the range of therapies and support delivered by skilled practitioners, all working with one aim — the welfare of the Chai client. Families can struggle financially as household income decreases and we can advise on a

TOGETHER 2014

range of benefits, including non-means tested, that will help to ease this additional burden. The following case illustrates the broad spectrum of needs we are meeting with our services: Steven* came to Chai with his wife, Katie*. Two months ago, Steven was diagnosed with advanced pancreatic cancer and given a poor prognosis. He is 42 and Katie is 40. They have four children aged 15, 12, 9 and 6. Steven is on his third session of chemotherapy and is finding the side-effects physically and emotionally difficult to deal with. Katie’s parents live in Manchester and Steven’s family live in Israel. Katie’s sister and grandparents live in Essex. Steven and Katie met with one of our client service managers who will look after all their needs. She discussed a package of support with them including individual and joint counselling for Steven and Katie, music and play therapy for the children: a consultation with our palliative care consultant for Steven to discuss symptom control; and a consultation with the dietician. Steven is booked for physiotherapy and Katie for hot stone reflexology. In addition, Steven’s parents will be supported in Israel with Skype counselling from London. Katie’s sister will have counselling in Essex and her grandparents will have support therapies in their home in Manchester. One diagnosis, 11 clients supported, 16 appointments made and ongoing support for the whole family.

Coming to a Chai centre has intrinsic benefits that go beyond the specific treatment, but there are times when home visits may be the only option. Continuity of care is particularly crucial at this stage and whenever possible Chai ensures that the same therapist who has supported the client continues to facilitate the treatments they require as their needs change. As more patients are turning to Chai for longer periods, there is a greater demand for our Home Support Service. Home visits have increased by 7% from last year, making the total of home visits a staggering 3,600 from June 2013 to end of May 2014.

“The number of client appointments nationally has risen by 8.4%”

The World Health Organisation predicts that the number of cancer cases will rise from 1.4 million to 2.4 million a year by 2035, while Macmillan Cancer Care reports that at least 500,000 people in the UK face poor health or disability as a result of their cancer and treatments. With the population generally living longer, the NHS will feel the strain and faces ever-increasing financial and practical pressures. It is clear that Chai’s Medical Outpatient Rehabilitation Palliative Care Service will be called upon more and more. The 3 way collaboration with the Royal Free Hospital and Marie Curie Cancer Care was established 4 years ago, to provide a multidisciplinary, rehabilitative approach to care, combining conventional therapy with complementary therapies and counselling. Support from this service is not, as sometimes thought, solely about end of life care but can be beneficial anywhere during a client’s illness and recovery.

There is a growing number of cancer survivors. For them and those around them, once treatment is finished, it can take time to regain some sort of ‘normality’. Procedures, which are often invasive, may have challenging short and longterm consequences, some of which only emerge years later. Our new Lifestyle Group (see p27) supports clients after their treatment, with emotional, physical and dietary guidance and advice. The positive impact on their lives has already been quite remarkable. The benefits of this type of shared experience are very powerful and we are expanding the number and range of groups we offer to support clients as they move on from one-to-one care. Wherever you are, Chai is, too Witnessing on a daily basis the impact that a cancer diagnosis brings, we are committed more than ever to ensure that no one is without the specialised services that Chai provides, implementing best practice and optimal care. Over 1,800 clients nationally are currently benefitting from our expertise and support; 60% are cancer patients and 40% are family members. Clients living in Israel, Belgium, South Africa and the USA can also now access our services through Skype. It is a privilege to be part of this committed and dedicated team who all go above and beyond their duty of care. Chai’s staff, therapists, counsellors and volunteers, make up what I can only describe as a very special ‘family’ of which I am proud to be a part. ●

*Names have been changed to protect confidentiality

CHAI CANCER CARE

It’s different for men Coping with a cancer diagnosis raises particular issues for men, who are often reluctant to seek support. Three men talk about the pivotal role Chai has played for them STUART CAPLAN, 64 Stuart is a business consultant and lives in central London with his wife Susan

‘

There is an expression in prize fighting: “Everyone has a plan until they get hit.” Well, having cancer is being hit. And it’s up to you to get up. I was diagnosed with cancer of the tongue in May 2012 and had extensive treatment, involving chemotherapy, radiotherapy, the removal of two thirds of my tongue and the complete removal of the lymph nodes in my neck. It has taken a lot of hard work and determination to overcome the obstacles I was facing. I’ve had to learn to speak in a new way and sometimes people cannot understand me. Swallowing, eating and drinking are a challenge and I no longer have a sense of taste.

means the end of their career, and a loss of income and status. Maybe they may feel certain therapies are too ‘touchy-feely’ for them, or that they won’t help. But Chai is not a charity in the sense that it gives ‘hand-outs’. It is a key part of your support system when you have cancer, and an extension to your friends and family. This is not the time to be “macho” – it’s the time to do whatever is necessary to get well.’

To improve my quality of life, my surgeon recommended I try some therapies – and this is how I found my way to Chai. From the start, I felt complete confidence in their care, professionalism and understanding of patients’ needs. The removal of the lymph nodes in my neck means that part of my lymphatic drainage system doesn’t work at all, and my neck swells up. The Manual Lymphatic Drainage treatments I receive help enormously to counter this. I also have reflexology, which is very relaxing, and I do yoga, which alleviates some of the residual damage caused by surgery. Feeling helpless is a huge issue and men in particular don’t like the idea of turning to a charity, or of being dependent on others in some other way. They fear it

HOW CHAI CAN HELP

• Dealing with the side effects of treatment, including those relating specifically to male cancers

• Practical advice about employment law, the benefits system and easing the financial burden and implications of cancer

• Dietary advice, personalised to your treatment needs

• Strategies for coping with the changes that you are going through

TOGETHER 2014

ALEX SAMUELS, 24 Alex is a marketing assistant. He lives in Bushey Heath

‘

I was diagnosed with NonHodgkins Lymphoma just after my 22nd birthday, not an age you expect to have to think about whether you have a future or not. I’d gone through six months of tests, biopsies, operations, scans, steroid infusions, pills, creams and appointments and hadn’t been fazed by it at all.

Finally hearing the word ‘cancer’ brought out a different side of me. I couldn’t make eye contact with my parents or sister who’d come with me to the consultant. We all cried. It’s just not natural being told you’re going to die before your parents. I felt I’d let them down and it was even more heartbreaking telling my grandparents. I had to drop out of university to start treatment – my life was on hold, while my friends continued with theirs. It

NICK BLACK, 48 Nick works in his family’s concrete business in Glasgow. He is married to Abi and they have three children, Noah, 17, Aron, 15 & Ava, 12

‘

Cancer takes the wind out of you. Early on, when you don’t know what is happening, it’s hard to get your head round it…how it will affect your future, your work/life balance, all those things you take for granted. Cancer is for other people, you say to yourself. I was told I had myeloma, a cancer of the bone marrow, which affects the blood, in February 2014, just after my son Noah’s 17th birthday. It’s not hereditary, just random. All the healthy things I did – going to the gym, cycling, eating vegetables – wouldn’t have made a difference. Ten years ago, you might live for six months or three years or more. Now, because of improved treatments, though myeloma is not curable, you can go into remission and in July I started stem cell replacement therapy. Myeloma causes brittle bones and six cycles of treatment, involving Thalidomide, steroids and chemotherapy haven’t been a joy ride. I’ve had fatigue, high and low moods, headaches, numbness and hypersensitivity. The side effects hamper your ability to drive, wash up a few things, or simply watch your son play rugby for more than 20 minutes. That’s very isolating. At the start I thought, ‘I can handle this, we’ll get over it’. It took a few weeks for me to realise that this wasn’t something I could do on my own. Not only would this affect me, it would impact on

was petrifying, feeling sick and achy. Was I going to die? What would the treatment be like? What would I look like bald? My specialist also raised the issue of chemotherapy affecting my fertility and said I needed to plan ahead. That hadn’t even crossed my mind. As news got around, friends and relatives kept mentioning Chai. I never imagined my family or I needing help from a charity and wasn’t sure what to expect when I walked through the door, but the warmth and care was immediate. We all benefitted greatly from both family and individual counselling. I talked about my disease, the treatment and how it made me feel. There was only so much I could tell my parents about my fears and it was a relief to talk to someone external in whom I had complete trust. Massage and reflexology treatments helped me to sleep, and I also used the gym. Two years on, I have graduated and am working. Chai brought me out of a very dark place and made me feel human again when I had felt like a science experiment. It was there for my family. It gave me the confidence to go out when I had no hair or eyebrows and felt ugly. It taught me how to be positive and helped make my cancer experience easier to cope with.’

my family, too. Telling the children was the hardest thing I’ve ever had to do and Abi and I have been very open with them. They know my cancer is not fatal but that we have to adapt to get through this together. I was sceptical and nervous about seeing a counsellor at Chai. I didn’t want to reveal my feelings and the idea was challenging. But they help me rationalise and develop strategies for dealing with all that is happening and to recognise my feelings. Talking with someone external, rather than bringing these emotions to my family, who are coping with so much already, is so valuable. I have acupuncture and reiki, a non-invasive healing therapy, which is ideal for someone with my condition. The therapies help me relax and tolerate the side effects of all the treatment. I also receive advice from the Chai dietician as steroids make you crave sugar and I’ve bulked up. By understanding what they’re doing to me and now with a workable eating plan, I can get back a little control, which is good for one’s self esteem. Chai supports Abi as well. Parents and friends give invaluable and unquestioning support, but she needs Chai because she’s coping with so much too, including the fragility of the children. Men are notorious for not addressing their health issues, but cancer is a life-changing event for you and your family, and you can’t handle it all on your own. With Chai we don’t have to.’ ●

CHAI CANCER CARE

MEDICAL FOCUS

An overview of prostate cancer It is the most common male cancer and can often go unnoticed. But there’s good news about diagnosis and treatment, reports UCL clinical research fellow Ian Donaldson

he prostate is a gland that only men have. It sits between the bladder and urethra, and its main function is to produce seminal fluid. In young men it is about the size of a walnut but has a tendency to enlarge as men get older. This enlargement gives rise to symptoms that many men will be familiar with – difficulty passing urine, reduced flow and incomplete emptying of the bladder.

THE STATISTICS Ian Donaldson is a Clinical Research Fellow in the Division of Surgery and Interventional Science, UCL and Department of Urology, UCLH. He is in the final year of his PhD research programme evaluating new diagnostic strategies and minimally invasive treatment options for localised prostate cancer.

Prostate cancer is the most common male cancer. Around 40,000 men are diagnosed in the UK each year and it is the second most common cause of cancer related death after lung cancer. However, these alarming statistics do not tell the whole story. The 10-year survival rate after prostate cancer is very good, at 84%, and many men who are diagnosed will have low risk disease that does not need any treatment at all.

PRESENTATION & DIAGNOSIS Prostate cancer does not usually cause symptoms until the disease is quite advanced. It is normally detected with a PSA (Prostatic Specific Antigen) blood test and then a biopsy. The results of the biopsy and other investigations will determine which is the best treatment strategy. PSA is a chemical detected in the blood. It is produced by the prostate and elevated levels may indicate the presence of prostate cancer.

However, elevated levels do not mean that there is definitely prostate cancer. Levels can also be high due to enlargement, inflammation or infection of the prostate.

“Prostate cancer does not usually cause symptoms until the disease is quite advanced. It is normally detected with a blood test (PSA) and then a biopsy” To confirm the presence of prostate cancer a doctor may recommend a biopsy. This is where multiple small samples are taken from the prostate to look for the disease. Prostate biopsies can be taken either though the rectum or through the perineum (the skin between the base of the penis and the back passage). The trans-rectal method is performed with local anaesthetic and typically 10-14 biopsies are taken, spaced throughout the prostate. Some doctors argue that this technique can miss cancer as it is difficult to sample the prostate located away from the rectum and the biopsies tend not to be evenly spaced. The transperineal method is performed under a general anaesthetic. Biopsies are taken throughout the prostate using a grid to guide where to place the biopsy needle. The advantage is that it is easier to sample the whole

TOGETHER 2014

prostate gland and map where the biopsies have come from and therefore better locate the cancer. It also has a lower risk of infection as it avoids going through the rectum. In the past five years, a new diagnostic strategy has emerged. This is the use of MRI scanning to look for prostate cancer before a biopsy. The effectiveness of MRI is currently being investigated in a large clinical trial – PROMIS and several smaller institutional studies. Early reports are encouraging and if it does prove useful, may open up a new way to diagnose prostate cancer. It will also change the way in which we biopsy the prostate, targeting only the suspicious areas rather than the whole prostate, saving many men from having a biopsy and reducing the number that are needed to be taken.

PATHOLOGY AND GRADING The aggressiveness of prostate cancer is determined by how it looks under the microscope. Originally it was scored 1 to 5 based on the pattern of the cancer, 1 being the least aggressive and 5 the most aggressive. However, patterns 1 and 2 are no longer classified as cancer, so the scale now runs from 3–5. A total score out of 10 is given by combining the most common pattern and second most common pattern seen at biopsy. Prostate cancer is then stratified into Low, Intermediate or High Risk based not only on the pattern, but also the level of PSA, the number of positive biopsies and estimated size of the cancer.

TREATMENT OPTIONS The treatments for prostate cancer are wide ranging and are tailored to the risk of disease. At one end is active surveillance. This is where someone who has been diagnosed with low risk disease chooses to have no treatment at all. We know that in many men, small amounts of low-grade prostate cancer pose very little threat and can be safely watched over many years. Men on active surveillance have regular PSA monitoring, MRI scans and repeat biopsies. If at any point the disease appears to be changing then the man can elect to have treatment. For disease confined to a single area of the prostate, some men may be suitable for a new treatment option called focal therapy. This treatment destroys the cancer in the prostate without damaging normal tissue. By preserving normal tissue doctors attempt to reduce the side effects sometimes associated with treating the whole prostate. Focal therapy requires accurate localisation of the cancer and a way to deliver energy to the cancer to destroy it.

destroy the prostate cancer and cryotherapy, which freezes the prostate cancer. Other technologies under investigation are IRE (irreversible electroporation), PDT (photodynamic therapy) and radiofrequency ablation. These treatments are still in the evaluation stage and tend to be conducted within clinic trials. Conventional treatments for localised prostate cancer are radical surgery or radical radiotherapy. Radical surgery removes the whole prostate and is performed either through an incision in the skin or, in the last 10 years, with robotic assistance. This is an advanced type of keyhole surgery where surgeons remotely control a robot to assist with the removal of the prostate. The surgeon has very fine control of the robotic instruments and can more precisely remove the prostate whilst trying to avoid injury to important structures such as nerves, blood vessels and the muscles that control continence.

“With better diagnostic tests, advanced surgical techniques and new technologies doctors are getting better at recognising men who need treatment and delivering that treatment to them” For advanced cases of prostate cancer, where the disease has spread outside the prostate and could not be cured by surgery or radiation alone, treatment involves the use of medications to block the male hormone testosterone. Testosterone is a major driver for prostate cancer. By stopping its production doctors can dramatically slow the rate of the disease progression.

CONCLUSIONS Prostate cancer is a very common disease and it is highly likely you may know someone who has it, or has been affected by it. It is, however, for many men, a disease that they will die with and not die from. With better diagnostic tests, advanced surgical techniques and new technologies, doctors are getting better at recognising men who need treatment and delivering that treatment to them. ●

For more information about prostate cancer please visit www.prostatecanceruk.org or www.macmillan.org.uk.

Two emerging techniques are HIFU (high intensity focused ultrasound) which uses sound-waves to

CHAI CANCER CARE

Meet the team focus on Chai’s male therapists Jonathan Dove, Counsellor

‘It helps make sense of all they are experiencing’

Tim Anders, Art Therapist

‘Children understand the raw emotions they are feeling’

You might assume the therapists at Chai are all women, but in fact male therapists also provide expertise to our clients. Discover more about what they do... 10

Jake Gold, Acupuncturist

‘It allows people to switch off for a while’

TOGETHER 2014

Graham Silas, Physiotherapist

‘It’s a valuable way to manage pain’ Anton Shaw, Healer

‘I help the body become rebalanced’

Jonathan Richards, Podiatrist

‘It can give a person back their mobility’

Phil Evans, Music therapist

‘Making music helps a person feel heard without having to speak’

Johnny Lawton, Physiotherapist

‘Once a client experiences results, they are encouraged to continue’

Photographed in the Garden Room at Chai in North West London PHOTOGRAPHY: ADAM LAWRENCE

CHAI CANCER CARE

Tim, Art Therapist ‘I help a child make sense of the chaos they experience when they are affected by a cancer diagnosis, most often that of a parent. When they are unable to articulate their feelings with words, I can help them explore them using art materials. There’s sand, clay, glitter, paint, play-doh, paper for them to use…they might stab a piece of clay with a modelling tool or push sand everywhere. I reflect back to them what they are doing, helping to acknowledge the fear, anger or sadness they are expressing. Having taught art at primary schools for 12 years, I observed first-hand how beneficial art therapy is – being understood can effect change on a deep, personal level. Working at Chai allows me to support children through an extremely difficult period in their life.’

Jake, Acupuncturist ‘I see clients both during their cancer treatment or after it has finished. Acupuncture is very effective in easing some of the side effects such as nausea and fatigue, that arise from chemotherapy, radiotherapy or the medication a person may have to take. It allows people to switch off for a little while. The process stops the adrenal system releasing stress hormones into the body. Coming in for an hour to be cared for has clear physiological and psychological benefits. For example, a male client in his mid-60s with prostate cancer was experiencing severe night sweats and hot flushes, and was unable to sleep. Within a few minutes of his first session, he had fallen asleep. The following week he reported that he’d experienced ‘a miracle’. The flushes and sweats had become manageable and he was sleeping through the night.’

Jonathan, Podiatrist ’People don’t associate foot problems with cancer. But the side effects of chemotherapy can affect a patient’s feet, impacting severely on their mobility: swollen feet which can cause toenails to lift, neuropathy (numbness) and peeling of the skin. Proper nail-care, emollients and the removal of hard or rough skin helps alleviate this discomfort.

With cutbacks, foot care is not easily available on the NHS, so the service fills an important gap. Helping a person regain their mobility and self-confidence gives me a great sense of satisfaction. It’s an honour to work at Chai.’

Phil, Music Therapist ’We are surrounded by rhythm in everyday life – it’s something we respond to innately and it’s why music therapy is so valuable as a tool to help adults and children express emotions that are hard to verbalise. Everything we do is improvised and is led by the client – it’s not about being musically accomplished! Clients can play gongs, piano, guitar, African blowing instruments, drums, or use their voice. I work both one-to-one and in small groups, responding musically to what the client does, acknowledging the feelings being expressed. Being heard and responded to in a group setting can be incredibly powerful. Cancer can make you feel very isolated. Feelings are scattered and confused. When you hear yourself play or sing, the chaos becomes more ordered and manageable. Clients take those positive experiences and perceptions of themselves away with them.’

Anton, Healer ‘Explaining what I do is a challenge as healing is experiential in nature. I aim to restore balance to the body, mind and spirit of the recipient, using a handson approach (unless requested not to), as the power of touch resonates very powerfully. I channel healing energies to help the body adjust and repair itself at its own pace. Healing releases negative cellular memories and ‘stuck’ or unwanted energy, helping bolster immunity. In a session, clients feel peaceful and relaxed; they may enter an altered state between being awake and asleep. People have different reactions, they may laugh or cry quite spontaneously, as healing comes as a great relief. To those who are unsure of healing, I would say ‘try it’ and if it doesn’t suit you, Chai has many other therapies that most certainly will. I get a great sense of perspective and purpose working at Chai.’

“The range of expertise our therapists provide is comprehensive, meeting our clients’ different needs”

TOGETHER 2014

Johnny, Physiotherapist and fitness expert ’Surgery often limits a person’s range of movement and physiotherapy is an effective way to help restore mobility. For example, after breast removal, there is residual scar tissue, the chest muscles become tight and weak, and as a result a whole network of movements is affected. I work on joints and soft tissue to ease these problems. Exercise, at whatever level, also helps the process, building up energy levels as well as being mentally empowering. Once a client experiences positive results, they are more encouraged to continue. So many people I know have benefitted from Chai’s amazing support, and being able to make a positive difference to their lives is incredible.’

Steve, Reflexologist ‘This is a highly appropriate therapy for people who are being treated for, or have completed their cancer treatment - as it focuses on the feet, there is minimal invasion. Sensitivity to touch is a frequent side effect of treatment. Reflexology is similar to Chinese acupressure: it unblocks energy pathways in the body by following a ‘map’ on the feet that relates to the different organs. Where I find ‘crystalised’ areas on this ‘map’ I apply a particular type of pressure to ease them away, helping release the blockages and tensions in the corresponding part of the body. It is immensely calming and soothing for a client and when the body is relaxed, it is better able to heal itself both physically and mentally. I saw the benefit reflexology gave my father as he was dealing with the effects of cancer and if I can help someone feel more positive and not lose heart, that’s reward enough.‘

Graham, Physiotherapist ’Physiotherapy is suitable for people at any stage of their cancer journey, as long as their consultant is in agreement. Every client receives a tailored combination of movement and exercise, manual therapy, education and advice. This is a valuable way to manage the pain and physical impairment of cancer and its treatment, by preventing muscle tightness, weakness and postural imbalances. I also supervise the Open Gym sessions at Chai, in which up to four clients follow their own

programme. For some, the group dynamic is a great motivator. Exercising at home is also empowering for the client, giving them more control of their condition. Physiotherapy also benefits the carers of cancer patients, for example with appropriate lifting techniques and advice. It is rewarding both personally and professionally to be part of Chai, an organisation whose name is synonymous with quality care.’

Paul, Acupuncturist and Masseur ‘Chemotherapy and radiotherapy often cause peripheral neuropathy (tingling and nerve pain) as a side effect. Changes in blood flow to the extremities increases sensitivity, which can make walking painful, and gripping or fine motor control difficult. Acupuncture stimulates blood flow back into an area and is also valuable for relieving the symptoms of stress such as tight muscles, anxiety, and depression, which can accompany cancer and its treatment. In combination with massage, it is a positive step towards improving one’s quality of life. Chai’s forward-thinking approach provides care utterly centred on the client - It is a place that tends the soul.’

Jonathan, Counsellor ‘Counselling gives people the opportunity to discuss their anxieties with someone who is caring, objective, non-judgemental and professionally experienced. Using cognitive behavioural therapy (CBT) and solution-focused therapy, I encourage a more constructive attitude towards the challenges clients are facing, rather than delving into their history. In the past, men were more reluctant to speak about their feelings. Increasingly though they understand that laughter and tears are natural emotions, and far from being a sign of weakness, acknowledging them helps make sense of all they are experiencing. Working as a University Chaplain to Jewish students led me into psychotherapy and counselling. Supporting clients on their journey is a privilege and one can’t help but learn big lessons in life.’ ●

CHAI CANCER CARE

The Chai Cancer Care ‘Lifeline’ Dinner A

capacity-filled room at The London Lancaster Hotel was the venue for Chai’s annual dinner last December, hosted by long-time patrons, Benita and Gerald Fogel. At 90 years young, Gerald, the chairman of our patronage campaign, welcomed supporters old and new to an evening, which had as its theme, Chai as a ‘lifeline’ in the community. This was vividly brought to life in a film featuring twelve clients, aged three to 80, who spoke poignantly about their experience of cancer and the positive impact of Chai. The stories were a testament to the value of Chai in a year, Louise Hager described as one of ‘phenomenal development in response to relentless need, especially among people in their 20s, 30s and 40s.’ The inspirational and moving evening was rounded off with an uplifting performance by the cast of the Jersey Boys. ●

The Jersey Boys

Lisa Steele, Gerald & Benita Fogel, Louise Hager, Lady & Lord Young

Gillian & Irving Carter

Toni & David Spitz

Bob & Michelle Shemtob

Michael Segal, Joan & Steven Fogel, Frances Fogel, Gerald & Benita Fogel, Jo & David Fogel, Marsha Segal

TOGETHER 2014

Dr Huw Beynon, Andrew Fisch & Stuart Roden

Susan & Stephen James

Graham Edwards & Joan Lipkin Edwards

Madeliene & David Cope Thompson

Pat Rosenfeld, Carole Berman, Lindy Goldkorn.

Hannah & Anthony Loftus

Emma & Marc Samuels

Melanie & Edward Rom

Gabrielle & Steven Sharpe

Michael & Lesley Bennett

Naomi & Andy Fisch

Pinchas & Margaret Rothem

Linda & Gary Laurence

Gina & Vivian Imerman, Maxine & Nick Leslau, Mark & Liz Astaire

PHOTOGRAPHY: BLAKE EZRA

Sir Michael & Lady Heller

CHAI CANCER CARE

Tailor-made to every community Chai recognises that just as every person has their own characteristics and personality, every community does, too. Over the past seven years, we have opened eight satellite centres across the UK, reaching out with our expertise to support people in the most effective way. It’s the role of our client services managers to maintain Chai’s core ethos and respond to the specific needs of each community ‘WORD OF MOUTH HAS BUILT TRUST’

‘UNDERSTANDING THE RESERVATIONS’

Region: Manchester

Region: Hackney

Client Services Manager: Johanne Harrison Catchment area: North and South Manchester, Liverpool and Leeds

Counsellor: Toni Dzialowski Catchment area: Stamford Hill, Tottenham

‘

This is the fastest growing Chai centre outside London, providing support to more than 230 clients. Each month brings approximately 25 referrals. Based in Prestwich at the Heathlands Residential Home, clients come from far and wide, and encompass every shade of observance. Since opening five years ago, our presence has grown quickly, and services reflect the needs expressed by those we support. These include: counselling, relationship therapy, art psychotherapy, play therapy, physiotherapy, acupuncture, reflexology, massage, aromatherapy, hot stone massage and reiki. We also provide guidance for parents, helping them find ways to talk to their children about changes affecting the family. It’s a well-known characteristic of the north that people are open and friendly. Word of mouth has definitely helped Chai become embedded in the communities’ consciousness, building trust and reaching people in new areas. Leeds and Liverpool are recent additions to our catchment area. Many people like to be seen in their homes – it’s one less thing for them to worry about. And of our 20 therapists and counsellors, six are experienced in working with children. The commitment of our Chai team is amazing – we go the extra mile, literally – one of our therapists does a 90-mile round trip to support a client.’

‘

When I was appointed as a counsellor for Chai five years ago, I was impressed that the organisation’s team was drawn from across the religious spectrum. The Charedi community in Stamford Hill, where I am based, does not find it easy to address some of the issues around cancer. They are reserved and do not readily seek outside support. Chai appreciated that in order to gain their trust, its counsellors and therapists had to understand the mindset and background of this community. Word of mouth plays an important part in engaging people but once patients or family members have made contact, they realise the tremendous value of Chai and the range of support they can receive. Additionally, they can access these services at home if they wish. That trust was expressed by one client who said: “No one should have to know the despair of being given a cancer diagnosis. I did not know how to support myself, my husband or my children. Then Chai stepped in and gave me the tools to cope, a place to voice my fears and a haven where I could unload and find new strength to face each day. When one is so vulnerable, it’s one less barrier to have a counsellor who understands the community I live in.”’

TOGETHER 2014

‘DISCRETION IN A SMALL COMMUNITY’ Region: Glasgow Client Services Manager: Mandy Strang Catchment area: Glasgow, Edinburgh and surrounding areas

‘

Chai is based in Giffnock at the Walton Community Centre, a central point for the city’s small Jewish community. As such, it can sometimes feel like you’re living in a goldfish bowl, with everyone knowing your business. Although confidentiality is guaranteed, clients are often seen in their home – an extra reassurance at a fragile time. We are able to provide counsellors from within the community, which some clients prefer, as well as those who are not known, which other clients request. It’s vital people feel as comfortable as possible when they are expressing difficult emotions. Our service also encompasses physiotherapy, play therapy for children, aromatherapy, reiki, Indian head massage, reflexology and art therapy. Chai in Scotland launched in May 2010, and mainly sees clients in Glasgow and Edinburgh, though we go further afield as needed. Through The Jewish Telegraph (the local Jewish newspaper), shul bulletins and shul talks, we are becoming wellknown. We leave Chai Brochures and Together magazines in the Kosher Deli in Giffnock – we need to catch people where they are! And we have excellent working relationships with the Beatson Oncolgy Centre and the Prince and Princess of Wales Hospice.’

‘HERE IN TIMES OF CRISIS’ Region: South London Counsellor and Manager: Susan Archer Catchment area: South West and Central London and Surrey

‘

There’s a general perception in the capital that if you’re Jewish, everything happens in North London, so it often comes as surprise when people learn that Chai exists in South London, too. We are very different in some respects. Our clients are very spread out across South West and Central London, and Surrey. There is more inter-faith marriage in this region, and Chai is here for people in

those partnerships as well. I have seen how at times of crisis, the value of Chai really makes a difference. Even in very secular parts of the country, there is a need for us. Being flexible in how we deliver our services helps clients feel well supported. Our counselling is available face-to-face, over the telephone or via Skype. We also provide reiki, and dietary and advocacy advice. But if people can come to us, our base at Nightingale House in Clapham, is a well-known South London landmark.’

‘THE EXTRA DIMENSION OF SUPPORT’ Region: Essex Client Services Manager: Lesley Midda Catchment area: Redbridge, Chigwell, Loughton, Romford, Southend, Cambridgeshire

‘

We were Chai’s first satellite service seven years ago and now support more than 80 clients, whom we see at our consulting rooms in Lily House in South Woodford or in their own homes. We provide counselling for all ages, aromatherapy, reflexology, massage and physiotherapy. Dietary consultations, advocacy information about benefits and the NHS system are also available by phone and Skype. Clients hear about us through their GPs, hospital or consultant as well as through their shul or community centre. The first call is hard. There’s a “salt of the earth” skepticism in Essex. “Can counselling really make a difference?” I’ve been asked, and people are protective of their privacy. I stress the confidentiality of the process and that we do home visits; also that we provide both practical and emotional support services. Chai supported my mother eight years ago and I knew I wanted to give something back. Two years after she passed away, I began working for Chai. It’s very special to contribute and see Chai in Essex grow.’ ●

HOW TO GET IN TOUCH Call the Chai Freephone Helpline 0808 808 4567 Greater Manchester & Liverpool 0161 772 4760 Glasgow

0141 638 2483

Leeds

0113 266 7727

Hackney, South London and Essex 020 8202 2211 or email: info@chaicancercare.org

CHAI CANCER CARE

The Chai Spa Day Pampering, holistic treatments and even painting, added up to a very pleasurable way for supporters to raise £40,000 for Chai’s specialised services

Cindy Lass, Karen Goodkind, Vivien Kreegor, Louise Hager, Ruth Bray, Lisa Steele

T Rosemary Fisch

Marcelle Glanz, Lana Saffrin, Susan Heller

he weather was glorious, the guests were full of anticipation: it could only be Chai’s legendary Spa Day, back for the fourth time. Nearly 90 ladies attended the event held at a beautiful home in Hampstead Garden Suburb. Organisers Karen Goodkind and Ruth Bray excelled with a schedule of bliss-filled activities and treatments that included massage, reflexology, Reiki and Indian head massage, all of which are therapies available to Chai clients. Throughout the day, there were yoga sessions with instructors from the exclusive Yeotown spa in Devon, while acclaimed NLP

life coach, Robbie Steinhouse, was back by popular demand to share his life-enhancing tips. Stylists at a Nicky Clarke Blow Dry Bar worked their magic on guests’ hair, Kiehl’s brought lots of gorgeous products to try out, and there were make-up lessons, manicures and pedicures too. Guests sipped on refreshing bespoke fruit cocktails, courtesy of the mixologists at LiquidChefs and enjoyed mouth-watering, sophisticated dishes from Ben Tenenblat and Zeitlin & Co. The whole day was captured for posterity by Chiko Photography. In an emotional appeal, Karen Goodkind highlighted the important work of Chai. ‘My

TOGETHER 2014

darling mum, diagnosed with cancer 22 years ago, was told by her specialist that the best way to deal with it was not to tell anyone. We had no one to turn to,’ she said. ‘If only Chai had been there. It’s our insurance that if we, or our loved ones, have a cancer diagnosis, there is a place we can go for support.’ The highlight of the day was the unveiling of a painting of a cherry blossom tree in full bloom, given as a gift to Chai by artist Cindy Lass and titled ‘Blossom for Chai’. In 2010, Cindy presented a painting of a chestnut tree to the Anne Frank Museum after learning that Anne used to look longingly at one during her time in hiding from the Nazis. Well-known for her ‘pawtraits’ of high-profile pets (including the Queen’s corgies and the Beckham’s pooches), Cindy was then interviewed by Sky newsreader Vivien Creegor, and talked about her work, famed for its joyous colours and uplifting subjects. ‘I firmly believe that nature can bring comfort to people. I hope this painting brings much happiness to Chai.’ Guests were invited to paint their own blooms on a second painting and Chai clients who attend the Hendon art workshop are now completing it. Chai’s Chairman, Louise Hager, concluded saying, ‘It was a truly fabulous day and we

Jackie Lawson, Jacqueline Meller

We’ve blossomed for Chai, will you? We want to create a forest of trees! There are many reasons to ‘Blossom for Chai’. With every blossom symbolising hope, renewal and blessings, you can buy blossoms for:

Natalie Tahan, Varda Korczak

Mym Harding, Margaret Rothem, Louise Hager

were extremely touched by the generosity of everyone involved. The uplifting and warm atmosphere which epitomises Chai was felt by everyone.’ ●

• • • • • • •

Births Birthdays Bar and Bat Mitzvahs Weddings Anniversaries Festivals Before lighting your Shabbat candles • A meaningful gift for a dinner party • A ‘Thinking of you’ wish By buying blossoms you can celebrate the good times of life as well as commemorate loved ones, and at the same time help Chai support all those who are living with the effects of a cancer diagnosis.

• To donate £10 and add a blossom to the tree, text the word “Blossom” to 70660 • Go to the ‘Blossom for Chai’ website and buy a blossom, a branch or even a bouquet. • Watch the tree flourish as more blossoms are added and let your family and friends know too. Tracy Grabiner, Gillian Golembo, Estelle Cohen, Juliette Owide, Gloria Matz, Cara Minton

www.blossomforchai.com #BlossomForChai

PHOTOGRAPHY: CHIKO

It’s simple to take part and donate to the ‘Blossom for Chai’ campaign:

CHAI CANCER CARE

MEDICAL FOCUS

Insights into drug treatment of colon cancer This type of cancer presents some very specific challenges. Professor Daniel Hochhauser explains how research is leading to a personalised treatment approach

he major curative treatments for bowel (colorectal) cancer remain surgery and radiotherapy, but drug treatment adds significant benefit in many cases. However cancer treatment is rapidly evolving with personalised treatment whereby therapy is tailored to the tumour, rather than one treatment for all cancer types.

Daniel Hochhauser is Kathleen Ferrier Professor of Medical Oncology, UCL Cancer Institute and consultant medical oncologist, UCLH Trust. He is a member of the Chai Medical Advisory Panel.

Patients with colon cancer are often offered either chemotherapy or biological therapies, including the antibodies cetuximab (Erbitux) or bevacizumab (Avastin). Following surgery, chemotherapy is frequently recommended to prevent proliferation of unseen seedlings, which may be present; this is known as adjuvant treatment. In other cases, the cancer has spread at the time of diagnosis and the aim is to keep the cancer under control. Understandably, many patients with colon cancer wonder why there are seemingly fewer targeted treatments available, and why chemotherapy, seemingly an outdated approach, is used so frequently. I will try to answer these points rather than providing a comprehensive review.

DRIVERS AND PASSENGERS The development of personalised approaches to treating cancer has benefited patients whose tumours have particular genetic alterations (mutations) driving progression; these are termed

‘drivers’. Other mutations, occurring as cancer progresses, do not influence growth or aggressiveness of cancer and are termed ‘passengers’. This distinction is important as it can be difficult to identify drivers of particular cancers. The corollary is that little benefit is derived by using drugs which target ‘passengers’. This approach of targeting drivers with drugs, sparing normal cells, has been highly successful in lung cancer and melanoma, an aggressive skin cancer. For example, in a significant percentage of cases of melanoma, mutations in the BRAF gene are critical in development of the cancer. Drugs targeting BRAF, such as vemurafenib, induce remissions in a high proportion of patients. Unfortunately (at least at the time of writing), clearly identifiable drivers for colon cancer have not been identified. Even though some colon cancers also express mutations in the BRAF gene, drugs blocking this mutation have not been effective because of activation of resistance pathways.

“The development of personalised approaches to treating cancer depends on particular genetic alterations which drive the progression of cancer”

TOGETHER 2014

However, the antibodies cetuximab (Erbitux) and panitumumab (Vectibix) inhibit an important gene called EGFR (epidermal growth factor receptor), present in many colon cancers although not a specific ‘driver’. Many patients can derive benefit from these antibodies and analysis of DNA extracted from the cancer can identify patients who will not respond. However, we do not as yet have a clear way of identifying drivers in colon cancer. In some cancers single drivers may not exist, and there are several drivers, so that targeting any single one will be ineffective. If this is the situation with colon cancer, combinations of drugs will be needed for effective treatment. Another problem is that cancers contain a variety of cell populations with different genetic make-up, resulting in some cells responding to particular treatments while others, which are genetically different, do not. This is known as ‘genetic heterogeneity’ and implies that resistance to drug therapy can arise because of evolution of resistant cancer cells. With colon cancers, the situation is that drivers have not as yet been identified and, also, that resistance arises through heterogeneity. These problems should certainly become more soluble in the future with additional research.

CHEMOTHERAPY Chemotherapy may be prescribed before (neoadjuvant) or after (adjuvant) definitive treatment such as surgery, or to control more widespread cancer. There are a limited number of drugs used for colon cancer including irinotecan and oxaliplatin used with 5-fluorouracil (5-FU), or its oral form capecitabine (Xeloda). Clinical trials have shown that oxaliplatin and 5-FU reduce, but do not eliminate, the probability of recurrence of cancer.

“Chemotherapy drugs are ‘targeted’ in the sense they are more toxic to cancer cells than normal cells” There is a widespread belief that chemotherapy drugs are poisons indiscriminately killing normal and cancer cells. Certainly, these drugs have effects on normal cells, and this causes side effects including lowering of the white blood cell count (neutropenia) and impaired nerve sensitivity (neuropathy). Improved treatments for nausea, vomiting and other toxicities has made a tremendous difference with a significant proportion of patients able to continue daily activities while on treatment. However, in one sense, chemotherapy drugs are poisons. They poison mechanisms by which cancers grow and divide and, by damaging DNA and other

“With the development of molecular genetic testing, it should be possible to define a mutational ‘fingerprint’ which identifies patients with high or low risk of recurrence” components of cancer cells, block proliferation (increase in number) of cancer cells. Remarkably these drugs do show good targeting of cancer cells over normal cells. Research indicates that cancer cells are in fact considerably more sensitive than normal cells to chemotherapy and respond to drugs by triggering their own death. Whereas most normal cells in the body respond to damage caused by cancer cells by stopping division and repairing damage to DNA, cancer cells seem more sensitive to such damage, which they cannot repair. Thus chemotherapy drugs are ‘targeted’ in the sense of being more toxic to cancer cells than normal cells. Chemotherapy drugs play a major role in preventing recurrence of cancer, prolonging survival of patients in whom cancer has spread and reducing size of tumours in the liver to allow successful surgical removal. Thus chemotherapy remains a foundation of treatment of colon.

WHO BENEFITS? A critical challenge is therefore to determine who will benefit from these treatments. For patients whose cancers have been removed the question is the probability of the cancer recurring. Can we identify those in whom cancer is highly unlikely to recur and avoid overtreatment? Normally decisions on treatment are based on features which are well established such as presence of cancer in lymph nodes (Dukes C). Sometimes the decision is more difficult and other, less defined criteria, are used. With development of molecular genetic testing, it should be possible to define mutational ‘fingerprints’ identifying patients with high or low risk of recurrence. Such testing is used already in breast cancer but remains to be validated in colon cancer. For patients in whom the cancer is more advanced, the development of molecular ’biomarkers’ will allow appropriate treatments and prevent ineffective treatments from being administered. Thus there have been important advances in the treatment of colon cancer. The challenge of the future, apart from the vital tasks of screening, earlier detection and treatment is to use therapies rationally and tailored to the individual patient. Most of us working in the field are extremely optimistic that this will happen. ●

CHAI CANCER CARE

‘It’s in the DNA’ The personal stories of Romie and Esther Tager reveal why their support of Chai, and its new Teenage Resource Centre, is so heartfelt

n 1974, when Romie Tager’s mother, Minnie z’l, died from cancer, aged 54, the belief that she might survive surgery and radiotherapy, was slim. ‘It was assumed it would kill you,’ recalls Romie, 67, a leading commercial and property QC who with his wife, Esther, has supported the establishment of the new Teenage Resource Centre at Chai’s flagship centre in North West London. ‘Nowadays if you hear that someone has cancer, there’s more of an assumption they may survive.’ Esther’s mother, Gertrude z’l, also had surgery and chemotherapy for breast cancer. ‘She lived with it for 15 years, had a radical mastectomy and was one of the first women to go on Tamoxifen,’ explains Esther. In 1988, after ten years in remission, the cancer returned and she died a year later. At the time of their mothers’ illnesses, society’s response to a cancer diagnosis was very different. ‘There were so many horrors attached to it. Not only was the care and sensitivity not there, the word was not there,’ says Romie. ‘I don’t believe my mother or father ever said “cancer”.’ Esther’s mother took the line of silent endurance: ‘She felt it was a private matter and that the best way to recover was to get on with life. The talking cure was not for that generation. But I do remember her saying to my sister and me, ‘you won’t want to see me, because of the surgery.’ It was very poignant and not at all how we felt. Establishing the Teenage Resource Centre at Chai struck the Tagers as a particularly appropriate way to mark the 40th and 25th anniversaries of the passing of both mothers. Esther’s brother, David, and sister, Judy, were in their teens when their mother was diagnosed. ‘There were no resources for them. It didn’t occur to my parents

Esther and Romie Tager

to talk to their teachers about what was happening,’ she says. Today, the ‘Chai in Schools’ programme enables teachers across the country to support children affected by a cancer diagnosis in their family. Identifying the need to support teenagers impressed Romie. ‘It was a very imaginative concept and there was an obvious need.’ The Teenage Resource Centre officially opened in June 2014 and provides a multipurpose facility for one-to-one counselling, and for teenagers to meet and share their experiences. Experts trained in the educational, social and physiological pressures on this age group, enable clients to deal with the effects of changes in their families, helping them develop the skills they need to form and sustain healthy relationships as adults. With its leather

“Identifying the need to support teenagers impressed Romie. ‘It was a very imaginative concept and there was an obvious need.’”

TOGETHER 2014

armchairs, jukebox, pool table (in Chai purple!), stateof-the-art entertainment system and black and white photos, it is a relaxed, welcoming space. Practical care like this, which makes everyday life easier, resonates with Romie and Esther. ‘For every person that walks through Chai’s door, there are half a dozen more back home, all feeling the impact of the situation. When you support Chai, there is an immediate benefit for everyone affected.’ says Romie. ‘It’s a very Jewish response to say, “How can I help you in a practical way?”’ He saw this approach from his father, Osias z’l, and mother, Minnie, who were one of four families who established Ravenswood, the residential village that supports children and adults with learning difficulties. Romie’s older brother, Henry, who had severe learning difficulties lived there until he passed away in 2004; his younger sister, Sharon, who also has severe learning difficulties is still a resident. Growing up in the 1960s in Golders Green, Romie remembers, ‘my parents struggling on their own, with difficult domestic circumstances. There was as little outside help available to them as there was for cancer sufferers.’ Another sister, Helen Tager-Flusberg, is a professor of psychology and neuro-science at the University of Boston, and a leading authority on language disorders and autism.

“It is to Chai’s everlasting credit that it continues to bring the subject of cancer out into the open.” Times have indeed changed. As a consequence of the personal cancer experiences of Frances Winegarten z’l and Susan Shipman, Chai set out 24 years ago to create a new response to the disease, acknowledging and addressing the fears and anxieties of patients and families. ‘Chai is extraordinary,’ says Esther, who was introduced to the charity in its earliest days when her aunt, Hannah Goldberg and Frances were neighbours. ‘It encompasses the entire community, unaffiliated as well as orthodox. People turn to it and are strengthened by its support whether in a group situation, one-to-one setting or through complementary therapies. All in a place that’s not a hospital, which is the last place a cancer patient wants to go.’ The Tagers are involved in many charities and institutions: Romie as a trustee of Bar Ilan University (and Chairman of the British Friends of Bar Ilan) and Jewish Book Week, their joint patronage of The London Jewish Cultural Centre, The Prince’s Teaching Trust and various other charities. The couple met in 1970, at the wedding of Esther’s cousin and were married almost a year later. Esther’s father, Leo Sichel z’l, was the Minister of the Reading community, and they lived just 20 minutes from the Ravenswood village in Berkshire. Father and daughter would head there on Fridays to do Kabalat Shabbat, ‘so I actually

knew Henry before I knew Romie,’ Esther laughs. Twin sons Joseph and Simon arrived nine years later and Esther is frank about the possibility they may not have had children and that adoption was considered. They now have four grandchildren who are ‘an ever-increasing joy’, with two more on the way. Life is hectic and stimulating for both of them. Romie is head of Selborne Chambers and is described by Chambers and Partners, (a worldwide ranking of law firms), as a ‘phenomenally effective advocate’. ‘Law is an interesting and challenging career,’ he says, ‘I’m 67 and have no plans to retire. I wake up with the same positive feeling about going to work as I did 40 years ago.’ Esther sits on the School Appeals Panel in both Camden and Barnet. After studying history of art and women’s studies, she campaigned for and worked as a mediator on behalf of agunot (divorced women unable to re-marry because of their husband’s refusal to present a divorce document). She wrote her M.Phil on the subject and contributed to former Chief Rabbi, Lord Sacks’ Women in the Community review. She is soft-spoken but no less a powerful advocate for her interests than her husband. They tussle with respectful assertiveness when a difference of opinion arises. For instance, is it or isn’t it remarkable that two orthodox women founded Chai rather than two men or two less observant women? But they entirely agree it was a courageous step. ‘The problems the founders had to identify, tackle and create solutions for, reflected issues that were not unique to the Jewish community,’ says Romie. Now Chai’s expertise, experience and knowledge are reproduced in the wider community; it is involved in a pioneering Medical Outpatient Rehabilitation and Palliative Care Service with Marie Curie Cancer Care and the Royal Free Hospital. Adds Esther, ‘It is to Chai’s everlasting credit that they continue to bring the subject out into the open.’

The Tager Family

The Tagers have watched with pride at how far Chai has come since its inception. It has changed the lives of thousands of clients who have experienced its exceptional care and support. For Romie and Esther whose own cancer experiences were so markedly different, the connection to Chai could not be closer. As Romie expresses it so profoundly, ‘Chai is in my DNA.’ ●

CHAI CANCER CARE in a id o f

You’re our lifeline Some walk, some sing, some even jump out of aeroplanes for Chai! Each donation is valued and makes a difference, and every event ensures that more people know about us. As we receive no statutory funding, we simply couldn’t reach our £2.1m target without our wonderful supporters. Read their personal stories of why they choose Chai BRIDGING THE GAP

Wendy Hoffman, Angela White, Carol Ellman and Jackie Cohen

‘I never imagined a place could be so bright and beautiful. Chai was my ‘little haven’, where I could drop in anytime, wearing my headscarf and feel comfortable. After a treatment, I came away able to face the day.’ Though friends were more than happy to drive me to Chai, they were often reluctant to come inside. Were they nervous? Did they have visions of people crying and depressed, with no hair, looking ill? To show how far from the truth that was, in July 2012, I held an ‘End of Treatment’ lunch for family and friends at Chai. People were bowled over and it was then I decided to combine two things that were important to me – Chai and bridge. My friends and I have organised two very successful bridge lunches raising £7,671 and are looking forward to holding more.’ Carol Ellman

‘I want to get as many people through the doors to see how special Chai is’ 24

MAKING MUSIC IN MEMORY OF GRANDPA ‘We are four friends who like to sing and began performing at each other’s Bar Mitzvahs. In 2012, we decided to raise money for charities that are important to us. We pitched Dragon’s Den-style to each Asher, Gabriel, Rafi, George other and I argued the case for Chai (we also support Emunah and Water Aid). I chose Chai because my grandpa, who had a brain tumour, said that going to Chai was the highlight of his week. Sadly, my grandpa passed away but my mum and grandma also appreciated Chai’s support. As The 4 Sons, we’ve recorded a CD of Jewish songs and sold nearly 1,000 copies. It is truly special to make a difference to people’s simchas, and to hundreds of families affected by cancer. So far we’ve raised nearly £17,962 for our charities.’ Asher Levy, along with George Rosenfeld, Rafi Levy and Gabriel Bor

‘PAY BACK’ TIME ‘During my cancer treatment, between rounds of chemo, I would go swimming. Chai helped me through that challenging time, and when I was well again, it was my ‘pay back’ time. I did a swimathon and raised nearly £7000. Every time I got another sponsor, it gave me the biggest thrill to know it was for Chai.’ Judy Kanar

152 KILOMETRES, £14,000 AND COUNTING… ‘Mum used Chai’s services 14 years ago and for the past 11 years, we have taken part in the Chai Outlook 10k walk, raising £4,000. Two years ago, cancer came back into our lives and we have again turned to Chai. Last April, I took on the biggest physical challenge I have ever set myself – the London Marathon. My mum, cousins, aunts and I also organised a supper quiz, taking my total to over £10,000. I was truly overwhelmed by the support for a charity so close to my heart.’ Leonie Furman

Leonie (r) and her mother, Michelle

TOGETHER 2014

WHEN A LITTLE MEANS A LOT

CHAI CHANGED MY LIFE ‘I first had cancer when I was 37. How I would have benefited from Chai back then! Their inspirational work made me want to Elaine Barnett, Sally Needleman, Fran be involved – I am one Goldin, Susan Freedman, Janine Richman, of the original Outlook Janis Sher, Rikki Sher, Michele Lees-Smith committee members, which over 14 years, has raised more than £400,000 – and now I’m giving in another way, as a counsellor, which is very meaningful.’ Susan Freedman

Lea Pfeffer, Eden and Lulu Cohen

A HAIR-RAISING EXPERIENCE

FALLING FOR JO – AGAIN

‘Both my brother, and the mother of my school friend Adam, have had cancer and know first-hand the value of Chai. Adam and I wanted to do something eye-catching for Chai so, we had our hair dyed bright blonde! After the boys went Simon at HOB Salon in Temple Fortune did blonde the honours, and of course, we got huge amounts of stick at school. It paid off though: we raised £3,590.’ Rafi Kennard

‘Last June, on our first wedding anniversary, and 10 years after my wife was diagnosed with leukaemia, I wanted to do something that said Jo and Karl ‘thank you’ to Chai for all the care they gave to Jo and her family. My ‘gift’ was to skydive from 12,000 feet. It was an incredible experience – made even better because I raised £335 for Chai.’ Karl Ward

OUR ‘155TH’ CELEBRATION ‘Six years ago I had breast cancer and Chai was an amazing support to me. Many friends, too, have benefitted from this fantastic organisation. Five years ago, to mark my 60th birthday, my husband’s 65th and for our 30th wedding anniversary, we held a 155th party and asked our guests to make a donation to Chai instead of Linda and her giving gifts.’ husband, Ron Linda Cohen

A TRIATHLON FEAT ‘I went way out of my comfort zone (meshuganeh or what?!) to bring in as much money as possible because Chai relies solely on donations. I’m proud of myself, for finishing the gruelling triathlon and for raising £8000 for an important cause.’ Bradley Lazarus

THE FABULOUS BAKER BOY ‘Chai is a charity close to my grandpa’s heart [leading oncologist, Professor Michael Baum]. I get upset hearing about people who have cancer and wanted to support the work my grandpa cares Bar Mitzvah boy Zack Cohen with so deeply about. Leading up grandparents Professor Michael to my Bar mitzvah, I collected Baum and Judy Baum money for Chai by standing outside kosher bakeries in Golders Green and selling items on eBay. People would tell me how Chai had supported them, or a friend, or a family member. It made me feel proud to raise money for such a wonderful charity.’ Zack Cohen

IN HONOUR OF REED ‘The Sugar Rush ball in aid of Chai celebrated the life of Reed Fisher the husband of my close friend Lara, and dad to Samuel and Imogen. Reed was full of fun and cheekiness and he loved Haribo, (hence the name of the ball!). He lost his fight against a brain tumour but Lara, Caroline, Leon (Caroline’s throughout, he never let it affect his husband), Samuel and Imogen spirit. Chai in Redbridge was a great source of comfort to Reed and Lara at their most difficult times. The ball was a huge success raising over £21,000.’ Caroline Saunders u

“Many people told me how Chai has supported them. I felt so proud to raise this money.” Zack Cohen 25

CHAI CANCER CARE

THE MAGNIFICENT SEVEN

Diane Goldman, Pat Zermansky, Susan Da Costa, Loretta Leslie, Berit Denton, Sue Sherman

‘I was inspired to help spread the word about Chai in Leeds when I heard Louise Hager speak at their launch event. Our committee of seven organised an awareness evening with Louise, palliative care specialist Dr Adam Hurlow and teenage cancer spokesperson Charlotte Newman. More than 70 people attended, raising over £1000. We are so glad to help Chai become established in Leeds.’ Susan da Costa

HITTING THE RIGHT NOTE ‘“To Life!” is the CD I recorded especially to raise money for Chai. All 18 songs touch on themes of hope and healing. My wife had breast cancer three years ago and Chai in Manchester gave her an enormous amount of help, advice and therapy. I’ve always sung for fun, and this was my way of showing our appreciation. I’m delighted that sales here and in Israel have raised £8000.’ Ian Oster

A TOAST TO CHAI ‘It’s impossible not to be moved by the commitment of everyone involved in Chai, and I was honoured to join their advisory board. With a friend, Stephen Harrison, we held a whisky tasting event at the Village Shul in Hampstead. The global brand ambassador of the Balvenie Single Malt Whisky, ‘introduced’ us to a variety of blends – a great way to raise over £1000! It’s important to get the Chai message out there, and for our community to understand what an invaluable job they do.’ Robert Prevezer

OH WHAT A NIGHT! ‘We created a party in aid of Chai to appeal to young married couples. We wanted an exclusive atmosphere, great food and drink and fantastic music, to make it Nathalie Metta, Emma a night to remember. It was also Samuels and Claudia Salem important to raise awareness of Chai, and in fact we were overwhelmed by how many people said they knew of someone who could benefit from its services. More than 200 people partied the night away and thanks to their generous spirit, and our auction prizes, which included a safari to South Africa, we raised £27,000. ‘The best night for a great cause,’ was how one guest summed it up.’ Emma Samuels

Chai volunteers are another lifeline; here’s how they make a difference I’M GOOD AT TALKING!

ALLEVIATING STRESS

‘I can’t paint or draw but I’m a people person – so with fellow volunteers Sharon Pollins and Barbara Freedman, I arrange a fortnightly programme of events: games, talks, card afternoons. Two hours can make such a difference to someone. People are transformed as they laugh and debate and are able just to be themselves.’ Lynne Silver, volunteer, Wednesday afternoon club

‘I teach meditation at Chai. The relaxation response can generate great physiological changes and for some people, meditating is the only time they are out of pain. Just 20 minutes can leave the client more physically calm. I’m so happy to help people alleviate some of the stress they experience.’ Janis Sher, volunteer meditation teacher and reiki therapist

A MANCHESTER BAKE-OFF ‘My first husband had cancer before Chai arrived in Manchester. Appreciating how much people need its services and wanting to support this fantastic cause, a group of friends organised a Bakeoff. Jack Maurer, a retired master Ann Audin, Reba Tury, Fran Horwich, baker, and Cllr Sharon Briggs, the Stephanie Jacobs, Marcelle Kuhillow Mayor of Bury tasted more than 20 treats to pick the winners – a delicious way to raise £1000.’ Fran Horwich

GIVING IT OUR BEST SHOT ‘Having seen friends and family supported by Chai’s outstanding care and after learning that Chai relies solely on the generosity of the community, we formed the Club 18 Golf Committee nine years ago. Our annual Golf Day at Dyrham Park Country Club has so far Co-chairmen Michael raised £267,398 and we look forward with Lubliner and Ronnie Gottlieb pride to celebrating our 10th anniversary event on 3 June 2015. Come and join us!’ Ronnie Gottlieb OBE. ●

TOGETHER 2014

SERVICE SPOTLIGHT

‘My treatment’s over – what now?’ Chai’s new Lifestyle Group supports and empowers clients to regain their physical and mental wellbeing after their cancer treatment

nce a person finishes their cancer treatment, then what? ‘Getting on with life is not always simple – it can be hard to know how to move forward, ’ says Barbara Prager, the senior counsellor leading the Lifestyle Group at Chai’s Hendon centre. ‘There are, thankfully, a growing number of cancer survivors,’ she explains, ‘but often there is an expectation from patients and families, that life can go back to how it was. Both physically and emotionally, people have been through the mill, so this is not always realistic.’

The Lifestyle Group is for clients who have recently finished surgery and/or treatment (generally in the last 6–18 months). A forward-thinking programme made up of six sessions plus two follow-ups, helps people take back control of their life, empowering them through emotional awareness, dietary knowledge and exercise. In group discussions, clients explore themes such as self-confidence, body image, anxieties, and expectations. ‘There is an unspoken understanding between cancer patients, which helps them feel comfortable, supported and able to talk,’ says Barbara. ‘Over the weeks, this camaraderie increases clients’ self-confidence and motivation.’ Clients also learn about wellbeing through nutrition with Lana Pinshaw, Chai’s dietician: ‘As a result of treatment, people may experience weight-loss, changes in taste buds, altered bowel movements, mouth sores, nausea and difficulties in swallowing. Steroids meanwhile, may cause weight gain. Being on them long term can knock one’s self-esteem.’ Lana works with each client to produce a nutritional assessment, body proportion review, and a diet and medical history. She then tailors a nutritional plan addressing their needs, providing recipes, diet plans and advice on managing a balanced approach to food. The Lifestyle Group also addresses the physical changes caused by cancer. Activity helps survivors

cope with and recover more successfully, as Chai’s fitness expert and physiotherapist, Johnny Lawton, explains: ‘As clients gain in strength, their energy levels rise and they feel good about themselves.’ The type of treatment and surgery, and what the client did beforehand, dictates where Johnny starts his work. ‘I also look at medical history, injuries, medication, home life, a work and exercise pattern and we set some goals. A young man may want to start playing football again, an older client may want to walk to the shops. Every small increase in physical activity makes a difference to self-esteem and quality of life.’ Feedback from the first programme has been tremendous. One client says, ‘When I had cancer I felt my individuality and personality had been stripped away. Now I feel like a person again.’ The combination of expert advice and the interaction of the group have a powerful and transformative effect, helping people feel a greater sense of physical and emotional wellbeing and new levels of confidence. ●

FIND OUT MORE … The Lifestyle Group programme runs three times a year. For details, call Emma Gray on 020 8457 2074 or visit www.chaicancercare.org

CHAI CANCER CARE

MEDICAL FOCUS

Ovarian Cancer Update Parp inhibitor drugs are offering new therapeutic options for ovarian cancer patients – a welcome development, especially for Ashkenazi women THE BRCA GENE AND ITS LINK TO OVARIAN CANCER

Jonathan Ledermann is professor of medical oncology at UCL Cancer Institute and UCL Hospitals. He is the Director of the Cancer Research UK Cancer Trials Centre at UCL. He trained in London and Toronto and specialises in the treatment and research of ovarian cancer. His main area of interest is in clinical trials and he has led international research on the development of PARP inhibitors. He is a member of the Chai Medical Advisory Panel.

The cause of ovarian cancer in most women is unknown but in a minority there is a genetic inheritable connection with family members having had ovarian or breast cancer. The connection is the BRCA gene (breast cancer gene), a normal gene that in some individuals carries a mutation that is passed on through maternal or paternal lines. Many different mutations in the BRCA gene have been found in patients with genetic ovarian cancer, but in the Ashkenazi population there are specific ‘founder mutations’ and BRCA mutations are more common than in the general population. Consequently, a greater proportion of ovarian cancer cases are linked to a BRCA gene mutation in Jewish women. For many years, we knew little about the function of the gene and identification of a mutation was mainly helpful in screening unaffected family members, and, where appropriate, offering surveillance or risk-reducing surgery to lessen their chance of developing ovarian or breast cancer. The situation has now changed as specific treatments are becoming available for women who have ovarian cancer in association with a mutation in the BRCA gene. Chemotherapy is an important part of treatment and the most active drug, carboplatin works by causing damage to DNA (the molecules that contain the genetic code of all cells in our body) that needs to be repaired if a cell is to survive. Our DNA suffers spontaneous damage all the time, so the body has developed

complex repair mechanisms to ensure our normal cells survive. In high-grade (fast-growing) ovarian tumours, the most common type, a major DNA repair mechanism is defective. Because cells are so well adapted to repair DNA alternative repair pathways exist. One of these is known as the ‘PARP’ (Poly [ADP-ribose] polymerase) pathway. PARP is a normal enzyme that becomes activated in the presence of DNA damage, recognises breaks in the strands of DNA and plays a key role in its repair. Women who have ovarian cancer and a BRCA mutation have disruption of the major DNA repair pathway, and repair of DNA damage in their tumour depends on having an intact PARP pathway. We inherit one BRCA gene from our mother and the other from our father. In the tumour the good copy of the BRCA gene is lost, leaving only the BRCA mutated gene. In healthy tissues the unaffected copy of the BRCA gene is able to ‘override’ the defective (mutated) copy and repair takes place normally. Drugs that inhibit PARP have now been developed and this has led to clinical trials opening the way for a new treatment for women with BRCA mutated ovarian cancer.

“Specific treatments are becoming available for women who have ovarian cancer in association with a mutation in the BRCA gene”

TOGETHER 2014

‘PARP’ INHIBITORS BLOCK IMPORTANT PATHWAYS THAT REPAIR DNA DAMAGE PARP inhibitor drugs are tablets that are taken continuously to ‘switch off’ the PARP pathway and by so doing, prevent tumours repairing DNA damage. PARP inhibitors, unlike chemotherapy have mild side effects. These are most commonly fatigue, nausea and anaemia but most patients are able to take the [PARP inhibitor] tablets continuously for a long time without significant interference with daily life. Clinical trials have been running for just over five years and great progress has already been made. The widest experience to date comes from studies with a drug called olaparib. The first tests were in women with a BRCA mutation who had received many previous types of chemotherapy. These showed that many tumours became considerably smaller and in some patients further growth of tumours was stopped for an unexpectedly long time.

“Most patients are able to take the [PARP inhibitor] tablets continuously for a long time without significant interference with daily life” More recent clinical trials have investigated the effect of olaparib ‘maintenance’ therapy, which is giving the drug after the completion of a course of chemotherapy to hold back tumour growth. The first trial showed that there was a significant delay in further tumour growth, and in some cases women continued on the drug for a few years without further growth of their tumour. This trial also included women without a BRCA mutation as laboratory studies had indicated that tumours in about half of all patients with ovarian cancer have a defect in repairing DNA damage. This suggested that PARP inhibitors could have a benefit in non-genetically associated ovarian cancer, and might offer a new therapy to a larger proportion of patients. The study showed that the benefit of olaparib in these women was also significant, but less than in women with a BRCA mutation.

WHERE ARE WE NOW? In the UK, olaparib and other PARP inhibitors are all still undergoing clinical trials. The clinical trials need to be completed and analysed before the European Medicines Agency can be sure that the drugs are safe and effective. Patients are being referred for enrolment into clinical trials that are open in several centres throughout the UK. The olaparib programme (SOLO-1 and SOLO-2 trials) is being conducted only

“It is now recognised that around 15-17% of patients with high grade ovarian tumours carry a BRCA mutation. Amongst Ashkenazi patients, the frequency is higher” in patients who have a BRCA mutation. SOLO-1 is being done after first-line chemotherapy has been completed. SOLO-2 and the trials with niraparib or rucaparib are being conducted following treatment with platinum-based chemotherapy drugs for recurrent ovarian cancer. The NOVA (niraparib) and ARIEL3 (rucaparib) trials are accepting patients with or without a BRCA mutation. Entry to the trial is at the end of chemotherapy. Because the benefit has not been proven yet, some patients will receive a placebo tablet (one out of three patients entered) and the effect of treatment will be compared in the two groups. It is necessary to do these randomised placebo-controlled ‘blinded’ trials (neither the doctor or patient know the allocation, or can choose) to make sure that any differences observed are real, and unaffected by any bias. More information is available from CancerHelp UK (www.cancerresearchuk.org/cancer-help/) or the Target Ovarian Cancer charity (http://clinicaltrials. targetovariancancer.org.uk).

THE FUTURE It is now recognised that around 15-17% of patients with high grade ovarian tumours carry a BRCA mutation. Amongst Ashkenazi patients, the frequency is higher. Understanding a family history is helpful in identifying patients who are likely to carry the gene mutation but the absence of a family history does not exclude an inherited BRCA mutation. For example, the BRCA gene can be passed through the paternal line. Testing is done on a simple blood test after counselling patients. In patients with a BRCA mutation, information is given about approaching unaffected family members for testing. In Scotland and some parts of England, as well as in some other countries testing is now being offered to all patients irrespective of family history. Knowledge about a BRCA gene mutation is now becoming an important part of the care of women with ovarian cancer. It is likely that PARP inhibitors will, in the near future, become an additional therapeutic option for many patients with ovarian cancer, and provide better and longer control of the disease. ●

CHAI CANCER CARE

Chai on your shopping list The Chai Society annual Passover Gift Sale is now the A-list event for anyone with an eye for gorgeous presents and who wants to support Chai

ever mind the new shopping centres about town, the place for exclusive finds on 1st April this year was Chai’s flagship centre in Hendon, when more than 500 people thronged through the doors for the biggest ever Chai Society Passover Gift Sale. The 35 stalls displayed a fabulous selection of gifts including homeware, confectionery, accessories, babywear, bridge gifts, contemporary Judaica, beauty products, handmade cards and eyewear among many more. There was unique jewellery, lovingly made by members of the Chai Jewellery Workshop, and handdecorated ceramics by the Chai Ceramics Workshop.

Heartfelt thanks go to the Chai Society committee, and its Co-Chairs, Julia Abrams and Tania Levenfiche, who excelled themselves, raising an incredible £25,000 towards the £2.1 million Chai needs to fund its services this year. Jeremy Gee, director at Glentree Estates, which generously sponsored the sale said, ‘We had a very moving and thought-provoking tour of Chai’s flagship centre and we were very happy to be involved. We are keen to support it next year, too!’ A major contributor to the success of the sale each year is Maxwell Williams Homeware, which generously donates nearly 1000 items for the event. Michael Stein, Managing Director said, ‘I have seen the consequences of cancer: the trauma, treatment and aftermath. I am so impressed by the commitment of the staff and volunteers at Chai who try to ease the pain for the families affected.

Shirley Cohen, Jo Milehi, Val Barr, Emma Byre, Julia Abrams, Tania Levenfiche

As a member of the Jewish community, it is something of which I am extremely proud.’ Simon Barker, manager at HOB hair salon in Temple Fortune provided vouchers and goodie bags for shoppers. ‘Chai supports many of our clients. It’s good to do something for a charity that is thought of so highly in the community.’ Visitors enjoyed freshly-baked goods made by Sindy Caplan and Chai volunteers, and a raffle added to the excitement of the day with prizes including vouchers from Colletts Travel, Look New and Oliver Sweeny. For many people, the Gift Sale is their first visit to the centre, where they have the opportunity to experience its special atmosphere and appreciate the support Chai provides. ●

Jo Milehi, Julia Abrams, Lisa Steele, Jeremy Gee, Daniel Baum, Louise Hager, Emma Byre

Louise Hager and Orly Wolfson

Hold the date! Next year’s Gift Sale will be on 16th and 17th March 2015.

TOGETHER 2014

SERVICE SPOTLIGHT

Image Surgery and treatment for cancer can have a dramatic effect on a patient’s self-esteem. Chai’s new Image service helps build it back up again

rofound changes occur to the body during cancer treatment. Surgery and chemotherapy may result in scars, hair, eyebrow and eyelash loss, changes in skin texture and other side effects from drugs. In addition to the anxiety of the cancer itself, these physical changes can be deeply distressing.

Chai’s Image service provides a dedicated room where clients can address sensitive image issues with wig and underwear specialists, permanent make-up treatments, make-up lessons and nail care. The inviting, airy room has a fully equipped salon station to provide a comfortable and professional experience. Vaso Louca from the BBC3 salon in north London (bbc3hairstudios.com) helps clients select a synthetic or real hair wig, which can be cut, coloured and styled to suit. Macmillan trained and experienced in working with men and women with medical hair loss, she says, ‘A wig lets you carry on with your life without having to explain to everybody what is going on.’ Head coverings are another option for women experiencing hair loss. Shoshanna Berkley of Yona Designs (yonadesigns.wix.com) produces plain and embellished bandanas in soft jersey. The League of Jewish Women’s trained volunteers can also show clients creative ways to wear their scarves. Additionally, we provide underwear advisers should clients require this. To deal with the loss of eyebrows and lashes, the areola and nipple (following surgery) permanent make-up treatments are available. Practitioner

Hina Solanki, of Sol Cosmedics (solcosmedics.co.uk) explains: ‘The formulas, pigments and aim of permanent make-up differ completely from a tattoo. Our colours are blended to look as natural as possible, not to stand out.’ The work is performed under local anaesthetic either before or between rounds of chemotherapy. ‘How well the pigment takes is dependent on the white blood cell count, so the consultant’s consent is imperative,’ says another practitioner Laura Kay. She points out that permanent make up is suitable for men, who equally experience anxiety over their changed looks.

“We can help a client see themselves in a new and positive way” Volunteer, Taly Dahan who trained with Bobbi Brown, provides simple but invaluable make-up tips for clients. ‘Showing someone how great they can look even without eyebrows and lashes, is a privilege,’ she says. A therapeutic manicure can

lift one’s spirit, too. ‘Nails may discolour and become pitted from chemotherapy and the fingertips become sensitive,’ says volunteer Lesley Morris. ‘Massaging, shaping, buffing and painting the nails (with formaldehyde-free varnish) means a client can look at her hands and feel a bit better about herself,’ says Lesley. These image boosters play as valuable a part in supporting cancer patients as any other. As Chai’s Chief Executive, Lisa Steele, states: ‘When nothing else looks or feels right, we can help a client see themselves in a new and positive way.’ ●

The service is available at the North West London centre. For more information call Emma Gray on 020 8202 2974, or email: info@chaicancercare.org

CHAI CANCER CARE

The Chai Calendar Our year is filled with a host of events and expert lectures. Here’s a snapshot of the past 12 months SEPTEMBER 2013 Outlook Walk: The 11th Annual Chai Outlook Walk raised over £23,000 towards equipment for the Music Therapy Room. Gentleman’s Double Tennis Day at Chandos: Hosted by Jan Feldman and Sandra Levine, 20 players took part and raised nearly £500. Forest Friends Committee Supper Quiz: Over 100 guests tested their grey matter and raised £500 for Chai.

OCTOBER

Mitzvah Day: Chai in Hendon was buzzing with excitement when 42 children from the Nancy Reuben Primary School performed for clients and staff. Natalie Shipman Lecture: Over 80 people attended the Annual Natalie Shipman Memorial Lecture on the theme of ‘Genetics, Cancer and You’. The keynote speaker was Professor Rosalind Eeles from the Royal Marsden, NHS Foundation Trust and the evening was chaired by Professor Albert Singer.

All Out for Chai Bridge Lunch: Frances Berman, Madeleine Cope-Thompson and Gloria Smith held their annual Bridge Day. Over 50 people attended and raised £3,000. The next Bridge Lunch will be 12th November 2014.

NOVEMBER Think Pink: Brocha Lent from Chabad Nottingham held her annual ‘Think Pink’ event for the community and students during Breast Cancer Awareness Month. Launch of the Chai Leeds satellite service: We inaugurated this service with an expert lecture on ‘Cancer Survivorship in the 21st century’ by Dr Adam Hurlow, Consultant in Palliative Medicine at Leeds Teaching Hospitals, NHS Trust. It was held at the Marjorie and Arnold Ziff Community Centre and included a Q&A on the specialised support Chai would be providing.

Johanne Harris, Dr Adam Hurlow, Louise Hager, Lisa Steele

MAY Summer Separates Party: Hosted by Linda Cohen and Ruth Isaacs, the Summer Separates Party with stylish designer clothes from Paris and Italy, raised £200. Glasgow Lecture – Cancer Survivorship in the 21st Century Lecture: Over 50 people attended a lecture on ‘Cancer Survivorship in the 21st Century’ at the Maccabi Youth and Sports Centre in Giffnock, presented by Dr Richard Berman, Consultant in Palliative Medicine and Honorary Senior Lecturer at The Christie NHS Foundation Trust.

Dr Richard Berman, Larry Sellyn, President, Jewish Blind Society, Scotland Founder President Susan Shipman, Prof Rosalind Eeles, Prof Albert Singer,

DECEMBER Dinner at the Princess of Wales: Mark Silvert’s pub quiz in Primrose Hill raised £500.

FEBRUARY

JUNE Chandos Tennis Tournament: 28 enthusiastic and competitive tennis players took part in a tournament at Chandos Lawn Tennis Club in Golders Green. The event, hosted by Jan Feldman, raised £7,848.

JULY

Magical Afternoon Tea for Chai volunteers: Chai thanked their wonderful volunteers with an afternoon tea and spellbinding entertainment from magician, Magic Marco.

Dancing with Louise: ‘It’s Showtime’ brought together the best female talent in the community for this extravaganza. Organised by Louise Leach and Caroline Packter, and helped by Outlook Committee members, it raised £,5088.

MARCH

AUGUST

Swap Shop: Hosted by Caroline Tunkel, over 40 girls attended a Swap Shop clothes event at Chai’s Flagship Centre in Hendon, raising £700.

Dance For Life: ‘Dance for Life’ have been loyal supporters of Chai for over ten years and this year’s danceathon raised £3,250. ●

TOGETHER 2014

Would like to meet Have a great time, learn about Chai and support our valuable services. Our young committees can’t wait to welcome you to their next event WE ARE: CHAI FIVE How many years old? Five Come along if you’re: 23-35 What you’ll pay: £15–£20 per event / £40 for the dinner What we get up to: Eclectic events combine socialising with a twist: Friday night at a kosher Indian restaurant; a Come Dine With Me cookathon; a meet-the-authors champagne reception with the writers of The Jewish Princess Cookbook. Hosted at Chai in Hendon, young people came and heard from the people involved and could see why it is special for so many. Auction prizes at our young professionals dinner came from Tiffany and Travelex. Meet committee Chair, Liza Feiner, Assistant Head at a primary school: Five years ago, I didn’t know anything about Chai. I was on a leadership programme and looking for a place to hone my skills. A friend asked me to pick up some leaflets from Chai for an event she was organising, I was astounded by what it does and immediately wanted to get involved. Chai is at the forefront of my life.

WE ARE: YOUNG CHAI How many years old? Three Come along if you’re: 21-35 What you’ll pay: some events are free; others around £17 What we get up to: Appealing to a post-uni, professional crowd, Young Chai stimulates the mind with niche events, such as an artists showcase at the Jewish Museum, with cocktails and jazz to lubricate the conversation. We’ve hosted an evening with a motivational speaker,

a World Cup 5-a-side tournament and we hold an annual Halloween club night at the hippest venues. Meet co-chair, Talia Briski, secondary school teacher: Several close friends, who are mums, have needed Chai’s support and the positive impact cannot be described or quantified. There are so many charities and events that are out there, but this one is close to my heart and represents the essence of caring.

WE ARE: CHAI FLYERS

Party with Chai Flyers

How many years old? One Come along if you’re: 25-35 What you’ll pay: up to £50 What we get up to: We seek out cool settings for sophisticated events. Our Halloween party was at Bird of Smithfield, in Clerkenwell. Champagne, fancy dress, his n’ hers goodie bags and a top prize of a weekend away were the highlights. Many hadn’t heard of Chai before that evening, but you could hear a pin drop as client Katherine Lennard described the tremendous impact Chai has on her and her family. Meet committee co-chair, Sarah Shipton: We want to get people through the door, pass on what Chai is all about and make it a memorable evening. We all need to be better equipped to ‘be there’ for someone when cancer happens. I also volunteer for the jewellery class and see the transformations in people. ● For more information, contact Jo Milehi on 020 8457 3394 or jo@chaicancercare.org. Or visit our events pages at www.chaicancercare.org

Young Chai’s sporty event

Come DiNe With me iN aiD oF Chai CaNCeR CaRe Date: Friday Night 14th February 2014 Time: 6:30pm - 11:00pm Venue: Six exciting venues across hendon and then a grand Dessert Finale! Cost: £20:00 Limited places so book asap Please contact Jo Milehi on 020 8457 3394 or email jo@chaicancercare.org to book online, click here

Chai Five’s tasty invite Registered Charity No. 1078956

CHAI CANCER CARE

Thank You

HOW YOU CAN SUPPORT CHAI On special occasions

It is your generosity that enables us to make a difference to people’s lives. With more people turning to Chai each year, our continued and sincere appreciation goes to our Benefactors, Patrons, Friends and supporters, who are unfailingly loyal to Chai every year. And to our committees – Bridge Lunch, Club Golf 18, Chai Fashion, Chai Five,

Chai Flyers, Chai Society, Golf Fore Chai, Outlook, Spa Day and Young Chai – we are overwhelmed by the dedication, creativity and success of your events, which do such an important job of telling people we are here for them. We extend our heartfelt thanks to everyone.

The Fundraising Team

For Chai is our dedicated fundraising platform that lets supporters set up their own fundraising pages, load photos, messages and details about their activities. As we own this bespoke site, there are no additional fees and all the money raised goes directly towards providing our vital services.

Chai would like to acknowledge our wonderful supporters who have set up a fundraising page in aid of Chai. Simon Albert Gabriel Alfon Sarah Barnett Susan Bass Henny Bernstein Kim Blackman Gary Colet Colin Edelman Adam Ellis Ian Fishman Suzanne Freedman Danny Fresco Leonie Furman Lawrence Glass Avi Gordon Justine Gough Irina Gutin

Alan Hodari Ashleigh Jacobs Ellen Johnson Judy Kanar Mitchell Kalischer Rafi Kennard David Kirk Joey Kolirin Bradley Lazarus Melanie Leyens Jenny Lewin Sarah-Lou Lewis Raffi Maurer Suzzanne Mendell Amanda Mount Sharron Nachoom Julian Needleman

Amanda Newdall Ian Oster Justine Radiven Sarit Rich Michael Seitler Ella Sharron Lucy Shear Judith Spevock Tamara Sternberg Karl Ward Jake Wiseman Outlook Committee Community Fun Runners Think Pink 4 Sons

We greatly appreciate all those who nominate Chai to receive donations, in lieu of gifts, for their celebrations. For more information about how you can nominate Chai for your celebration, contact Sariet Pretz: sariet@chaicancercare.org or call 0208 457 2071

Leave a Legacy An important way you can contribute to Chai is to include a Legacy in your Will. Jewish Legacy Giving guides you through the simple process of ensuring your legacy is enshrined in your wishes. Should you choose to let us know of your intention, we would be honoured to recognise your generosity during your lifetime. Contact Lisa Steele: lisas@chaicancercare.org or call 020 8457 3392

Go Online You can donate to Chai online, and support a specific project. Donate through our main website: www.chaicancercare.org

Post It Send cheques or charity vouchers to the address below. Gift Aid declaration and Standing Order forms can be downloaded from our website. Chai Cancer Care 142-146 Great North Way London, NW4 1EH

Call Us We can take donations over the phone. Call Sariet Pretz on 020 8457 2071 or Janet Lloyd on 020 8457 2072 Charlotte & Jemima Gillis

Suzzanne Mendell

Justine Radiven

Gary Colet

Michael Seitler

Leonie Furman

Tammy Sternberg & Sara Barnett

Roni Nahum

TOGETHER 2014

OUR NEW INITIATIVE

‘Chai Challenges You’ Climb Kilimanjaro…trek the Sahara… If you have a spirit of adventure, Chai is giving you the chance to test your mettle – and raise valuable funds for us at the same time

hai Challenges You is a new initiative that lets you find out exactly what you’re made of, while supporting Chai. After last year’s intrepid climb by 23 Chai supporters to the summit of Kilimanjaro, which raised £330,000, climb organiser, Alex Maurice, had a thought: ‘So many people approached me saying they wanted to do something different to raise money for Chai, it seemed the Kilimanjaro trek could be the start of something much bigger. Soon the idea for ‘Chai Challenges You’ took shape.’ Alex’s own involvement with Chai began after her sister-in-law was diagnosed with breast cancer at the age of 43. ‘I could see the amazing support she and all the family received from Chai and knew I wanted to contribute in some way. The people who walk through Chai’s door on a daily basis all face such huge hurdles, it seemed appropriate that I should set myself a challenge – and encourage others to as well.’

something that takes them out of their comfort zone,’ explains owner/director of Charity Challenge, Simon Albert. ‘And I speak from personal experience. In June my brother-in-law, Joey Korilin and I did the London to Paris Bike Ride for Chai,’ he says, ‘and I’ve never done as much training as I did for this cycle ride – all for a very important reason. Chai helped my father-in-law immensely. I vividly remember him saying while he was was having his cancer treatment, that going to Chai for counselling and massage were the things he most looked forward to each week. I was inspired by seeing how Chai helped him.’ Simon’s company has more than 17 years’ experience organising challenges in all parts of the world. ‘Everyone signing up completes a medical questionnaire and gets a fitness programme to follow, including group training sessions, so you are well prepared,’ he assures.

The next ladies’ bespoke Chai event will take place in November 2015 – a trek of more than 100km in 5 days uncovering the epic views and fascinating communities of the Sahara Desert. Now, working in partnership with And there are more in the pipeline. Simon Albert, Joey Kolirin leading charity activity website, Charity Alex is keen to hear from you if you’d like Challenge, you will be able to fundraise for to take part or if you have your own ideas for Chai as you realise your own personal goal. You a challenge. ‘Whether it’s a 10k walk or a mountain can trek the Sahara, explore Ecuadorian volcanoes, bike trek in the Atlas Mountains, get in touch. We’ll kayak down the Zambezi or dog-sled through Lapland. help you do something personally fulfilling in aid of a In the UK, you can tackle the Three Peaks or Snowdon wonderful cause.’ ● challenges among others. ‘The idea is that people do

Ready to leave your comfort zone? Find out more about ‘Chai Challenges You’ at www.chaicancercare.org or contact Alexandra Maurice at: alexandramaurice@chaicancercare.org Alex Maurice, Ruth Bray

How does Chai care?

Advisory Services Advocacy, Advice and Information Financial and Legal Guidance Jewish Perspectives on Cancer Medical Connections Nutritional and Dietary Advice Resources and Information Counselling Counselling for Individuals, Couples and Families Counselling for Genetic Issues Relationship Counselling Telephone Counselling

Therapies Manual Lymphatic Drainage Physiotherapy

Thanks to the generosity of the community, Chai Cancer Care provides specialised support to thousands of people across the UK who have been affected by a cancer diagnosis. To find out more please call our Freephone Helpline on 0808 808 4567 or visit www.chaicancercare.org

Children, Teenage and Family Service Art Therapy Child and Play Therapy Music Therapy Teenage Service

Medical Outpatient Rehabilitation and Palliative Care Service Complementary Therapies Acupuncture Aromatherapy Eastern Facial Massage Foot Care Healing Hot Stones Indian Head Massage Manicures Post Prostate Surgery Advice Reflexology Reiki Therapeutic Massage Home Support Service Group Activities Art Workshop Ceramic Studio Computer Lessons Gentle Movement Jewellery Workshop Laughter Therapy Meditation Music Workshop Open/Supervised Gym Sessions Pilates Walking Group Wednesday Afternoons Yoga Support Groups BRCA Group Bereavement Groups Breast Buddies Groups for Cancer Patients/Carers

Services are available at: North West London South London Essex Hackney Southend Leeds Liverpool South Manchester North Manchester Glasgow Clientsâ€™ Homes Chai Lifeline Cancer Care Registered Charity No. 1078956 Editor: Deborah Wald Design: Creative & Commercial

Volunteer Services