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2015 issue 10

Special Anniversary Edition

Caring and committed the many faces of Chai

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Chai Cancer Care

A Welcome Message C

hai Cancer Care is 25 years old – a significant milestone for an organisation that began life in the minds and hearts of two inspirational women, Susan Shipman and my dear mother, Frances Winegarten z’l. Both had personal experience of what it meant to live with the effect of a cancer diagnosis at a time when clear information and support for the patient, let alone their family, were next to nil. For everyone connected with Chai, it is a moment to pause, reflect and recognise the momentous journey we have taken. Certainly no-one involved in 1990 could have envisaged how the scope of our early provision for cancer patients – a telephone helpline service and community lectures – would evolve. Many of those who have contributed to Chai’s development are featured in this issue of together leading medical experts, ground-breaking palliative care specialists, independent-minded trustees and lay advisers, highly qualified counsellors, therapists, dedicated client teams and volunteers… and, of course, our open-hearted donors, fundraisers and

President The Rt. Hon. Lord Young of Graffham CH DL Founder Presidents Susan Shipman Frances Winegarten z’l Chairman Louise Hager Chief Executive Lisa Steele

Trustees Louise Hager Jonathan Hodes Lady Kalms MBE Susan Shipman Dr Adrian Tookman Philip Weinstein Lord Young CH DL Honorary Patrons Maureen Lipman CBE Chief Rabbi Ephraim Mirvis

Medical Patrons Prof Michael Baum Prof Michael Brada Dr Rachel Craig Mr Michael Douek Prof Andrew Eder Prof Rosalind Eeles Dr Ian Ellis Mr Daren Francis Miss Joanna Franks Prof Anthony Goldstone CBE

supporters, whose unstinting generosity is our lifeline. Each person merits our deepest gratitude and thanks. We have come a long way and broken many taboos that once existed around cancer. The landscape of treatment and support is very different, and with ten Chai centres across the UK, we are now supporting just over 2,250 cancer patients and their families. But the need for Chai is greater than ever and will, sadly, only increase. To meet that challenge with no government funding, will take all our continued joint efforts and involvement. As we look to the future, the words that echo in our ears and which drive us forward are those of a client who said to us, ‘You cannot rest until Chai becomes the first port of call, and not the last resort.’ And in our co-founders, we have no better example of what can be achieved with determination, commitment and dedication.

Louise Hager Chairman

Prof Daniel Hochhauser Prof Gordon Jayson Mr Amir Kaisary Dr David Landau Prof Jonathan Ledermann Dr Jane Neerkin Prof Gordon Rustin Prof Karol Sikora Prof Albert Singer Prof Stephen Spiro Dr Adrian Tookman

Advisory Board Brian Brick Jo Coleman Alan Fell Jonathan Freedman Michael Glass Diane Kenwood Alexandra Maurice Robert Prevezer Marc Samuels Dr Adrian Tookman

Together Magazine 2015

Contents 4

Pioneers then and now

How experience and expertise made Chai and is shaping its future: Chief Executive, Lisa Steele

A paradigm shift in cancer treatment 25 years of advances, by our eminent Medical Advisory Panel

You don’t have to have cancer…

we are here for family, friends and the wider community too

The mindfulness group

Congratulations Chai! Tributes from our distinguished Trustees

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42 45

A sell-out sensation

A memorable night sets new records

What to eat when you have cancer

You’re amazing! Who ran, who skydived, who baked for Chai

Chai clients and volunteers took to the catwalk at our Spring/Summer fashion show

Chai calendar Highlights of the year

‘Life-enhancing Chai’

The Chai Cancer Care ‘Signature’ Dinner

Chai-king in Iceland!

Ten intrepid fundraisers trek Iceland’s stunning landscape

Lung cancer update… the good news:

How our creative workshops can give life meaning again

Congratulations Chai! Messages from our Honorary Patrons and Advisory Board

An unorthodox couple

Dr Sanjay Popat

The BRCA gene support group Helping clients explore some tough choices

Chai supporters Maxine and Nick Leslau do it their way

Survivorship – the next chapter: Dr Adrian Tookman and Dr Rachel Craig

The benefits of learning to live in the moment

Beyond the call of duty Professionalism and compassion are all part of the job for the Hendon client services team

A warm reception A new look for Chai’s flagship centre

Audrey Ardern-Jones OBE

The inspiration behind Chai Recognising key figures in our history

Genetic testing for BRCA1 and BRCA2 – what you need to know: Professor Ros Eeles and

Ways to give Inspired to get involved? Get in touch!

Top chefs’ recipes and Royal Marsden advice

2015 issue 10

Special Anniversary Edition

Chai Cancer Care Requests the pleasure of your company at

THE 2015 NATALIE SHIPMAN MEMORIAL LECTURE

Tuesday 13th October 2015 Doors open: 7:00pm Lecture begins: 7:30pm

Transforming the Prostate Cancer Pathway

Chai Cancer Care, 142-146 Great North Way, London, NW4 1EH

Keynote Speaker: Professor Mark Emberton, Professor of Interventional Oncology, Division of Surgery and Interventional Science, UCL

Admission free by ticket only. Please call 020 8202 2211 to reserve a place.

Caring and committed

ye ar s

the many faces of Chai

This edition of together is generously sponsored by The Emmes Foundation Editor: Deborah Wald Design: Creative & Commercial © Chai Cancer Care 2015 Cover: Chai team from across the UK, photographed by Adam Lawrence

Chai Cancer Care

Pioneers

then & now T

here is often a personal reason why we become part of the Chai ‘family’. My father passed away in 2000 from cancer and, already a practising counsellor, I felt I wanted to use my expertise in the field of cancer care and support. I began volunteering at Chai at a time when we worked from two rooms in an office block in Hendon, with two counsellors, four complementary therapists and a handful of volunteers.

It was clear we needed to have a more substantial presence to support the rising number of clients and be ready for the inevitable and increasing need” 4

As our reputation grew, and the need for cancer support services was becoming apparent, it was clear we needed to have a more substantial presence, not only to support the rising number of clients but to be ready for what we recognised would be an inevitable and increasing need. So in 2003, we took an enormous leap of faith and became property developers overnight! Chai moved into its Great North Way flagship centre, taking on a £1.8m mortgage, on a building and refurbishment that cost £3.1m in total. To finance the mortgage, we rented out part of the building. Soon, however, we were able – and needed – to take over the whole complex.

For 25 years Chai has been an innovator in cancer care support. Chief Executive Lisa Steele charts its achievements and explains how it is addressing the challenges of the future

REACHING FURTHER Through word of mouth, Chai was becoming known as a valuable resource beyond North West London. Taking calls from around the country, we responded by establishing our services within other communities. In 2007, we launched in Redbridge, the largest Jewish conurbation near London. Satellites in South London, North Manchester and Glasgow followed in 2008, 2009 and 2010 respectively and now we also operate in South Manchester, Leeds, Liverpool, Hackney and Southend. Chai’s Birmingham service launches this November. Just as every person has their own characteristics and personality, we recognise and are sensitive to the nuances of each community, shaping our provision accordingly. We currently support just over 2,250 clients. But these numbers don’t tell the full story. Chai’s impact ripples far wider: to the husband, child, wife, parents and friends of a client, who benefit knowing their loved ones are receiving Chai’s all-round expertise and support; to teachers, doctors, nurses, consultants and community leaders, whom we empower with information and insights about our services. Put this way, Chai supports many more thousands in indirect

Together Magazine 2015

and invaluable ways. Growing an organisation brings enormous challenges and much thought goes into how we transfer the very special ethos of care, empathy and expertise established at our flagship centre, to other sites. Our therapists and counsellors are chosen because they offer so much more than their CV qualifications; Louise and I travel regularly to all the satellites and maintain an open line of communication and support. Regular continual professional development takes place locally and nationally at our annual team-building day in London.

to our clients evolving needs. For instance, five years ago, awareness of BRCA gene issues was minimal. Now our support group helps clients address the implications surrounding a positive test. Input from our medical advisors, all at the forefront of research, treatment and palliative care, ensures we are informed of latest developments. With counsellors providing specialist support and the breadth of our complementary and therapeutic treatments, we are able to maximise tailored support. Truly, we are an all-encompassing resource.

CHAI IN THE FUTURE

My time at Chai has taken me from counsellor, then client services manager to Head of Operations and in 2013, Chief Executive – what an honour and privilege. Over the years, the organisation has expanded significantly. Our in-depth knowledge of the cancer world means we are ideally placed to introduce the services we know will bring real benefit, as well as to respond

Latest statistics show the number of people in the UK diagnosed with cancer is increasing by 3.2% every year. By 2030, that will translate into four million of us. At the same time, half of cancer patients now survive and live for longer after a diagnosis. Positive as this news is, managing the long-term impact of a cancer diagnosis and its treatments is an on-going struggle for health professionals.

TOTAL NUMBER OF APPOINTMENTS PROJECTED TO 2025 32,000

30,356

30,000

28,875

28,000 25,913

26,000 24,000

22,950

27,394

24,432

22,000 19,988

20,000 18,000

18,507

17,026

16,000

21,469

15,545

14,000

12,159

12,000 10,881

10,000

12,992

11,629

8,683

8,000

7,118

6,000 4,987

4,000

18 20 19 20 20 20 21 20 22 20 23 20 24 20 25

Chai has been a pioneer in tackling these challenges head on. The most striking evidence of this is our ground-breaking Medical Outpatient Rehabilitation and Palliative Care Service, a collaboration with the Royal Free Foundation NHS Trust and Marie Curie Cancer Care. As we prepare for the next decade, we know that a higher proportion of our clients will be young (under 40), and will bring with them multi-generational support requirements. We have already provided services for 15 members of one family (across several satellites), and understood the need for this type of support long before it was widely acknowledged. In fact, 40% of clients are the family members of cancer patients. Our graph predicting future appointments makes sobering reading. By 2017, demand for our services will rise by 47%; by 2025 it leaps to 153%. And this doesn’t include the thousands who will be using our group services. With no statutory funding, we rely on the community for support. You have been our generous partners for 25 years, enabling us to keep developing this essential – and remarkable – resource to meet the cancer support needs of the community. It is inspiring to see on a daily basis the positive impact Chai makes on people’s lives and to work within an organisation that is so forward thinking and innovative. Together we have achieved so much; together we can continue to make a difference.

20 15

20 14

20 13

20 12

20 11

20 10

20 08

20 07

20 09

2,589

2,000

A higher proportion of our clients will be under 40 years old and will bring with them multi-generational support requirements”

Chai Cancer Care

IN CANCER TREATMENT Each member of Chai’s Medical Advisory Panel brings a breadth of experience to Chai and we gratefully acknowledge their commitment and active guidance. We invite them to look back at a quarter of a century of developments in cancer treatment and care – and to see what the future holds…

Together Magazine 2015

LIFESTYLE FACTORS AND ORAL CANCER Professor Andrew Eder BDS MSc MRD FDS FHEA Pro-Vice-Provost and Professor/Hon. Consultant in Restorative Dentistry, UCL

The incidence of oral cancers has risen by a third over the past ten years and accounts for 2%, or one in 50, of cancer cases in the UK. Although oral cancers are more common in men than women and in adults over 50 years of age, recent rises have been seen in the younger population and in females.

recurring include addressing these risk factors, maintaining a healthy diet and going for regular dental check-ups as dentists can spot oral cancers at the very early stages. These cancers involve the mouth, tongue, lips and gums and less commonly the jawbones, salivary glands, tonsils or back of the throat. Symptoms include red or white patches on the soft tissues, ulcers or lumps.

Data suggests that 91% of oral cancers in the UK are linked to lifestyle factors, which include smoking, alcohol, infection with the human papilloma virus and exposure to the sun. Effective ways to prevent them from developing or

Treatment is usually less complicated and more effective if oral cancers are diagnosed early and will depend on the type and stage of the cancer and whether it has spread. Surgery alone will cure some cancers, others may respond better to

radiotherapy, or radiotherapy combined with chemotherapy or biological therapy. Advances in molecular biology are improving medical and surgical care, along with newer techniques such as internal radiotherapy and photodynamic therapy. Whilst some treatments can temporarily make the mouth dry, sensitive and increase the risk of infection, most of these side effects reduce or pass once treatment is complete. Longer-term challenges can include reduced chewing function due to missing teeth, difficulty in swallowing, speech problems and emotional disruption. Chai’s support throughout is invaluable.

SURGICAL CHOICES FOR BREAST SURGERY Joanna Franks, MBBS, BSc, MSc FRCS, Consultant Breast and Oncoplastic Surgeon

The lifetime risk of developing breast cancer for women in the UK is 1 in 8, and many of us know someone touched by this disease. Most of us also know that survival from breast cancer continues to improve and early diagnosis plays a big part in this. Surgery remains the mainstay of treatment. However, it has changed dramatically over two decades and effective cancer treatment can be combined with excellent cosmetic outcomes. Oncoplastic breast surgeons will never compromise breast cancer management but will

consider the aesthetics of the proposed breast surgery and personalise the surgical approach for each patient. Surgery can be divided broadly into breast-conserving procedures and mastectomy, the latter often being combined with reconstruction. Oncoplastic breast-conserving surgery aims to leave a discrete scar with minimal change to the breast volume, shape and nipple height. For those women who are not suitable for breast-conserving surgery, or who elect for a mastectomy, immediate reconstruction should be considered. There are many ways of approaching this and each patient should have the opportunity to discuss it with a reconstructive surgeon.

The improved prognosis for women with breast cancer has placed a new emphasis on survivorship. Patients live for decades with the results of their surgery and the side effects of treatment. Choosing the right treatments to achieve both good cancer management and maintain body image has therefore never been more important. Chai Cancer Care’s team of experts supports both the patient and their family and, as patients navigate their way through the different stages of their cancer management, Chai’s tailor-made services are invaluable. The advice I give my patients is to contact Chai – your only regret will be not doing it sooner.

Chai Cancer Care

AN EXPANDED APPROACH Daren Francis, Consultant General & Colorectal Surgeon

Although the management of some malignancies has not altered greatly in recent years, this is not true of rectal cancer. Advances in surgical technique, molecular biology, radiological imaging and both neoadjuvant and adjuvant (pre-and post-surgery) therapy have dramatically changed the way patients are treated. There has been the birth of multidisciplinary teams, composed of members of different healthcare professions with specialised skills and expertise. This allows for collaborative decision-making of treatment recommendations, which streamlines the patient journey by developing individual treatment plans.

Molecular biology has deepened our knowledge, helping identify those patients at increased risk and those more likely to respond to certain treatments. Highresolution CT scans and MRI have led to precise pre-operative staging of rectal cancer while the more widespread use of PET scanning has helped to more accurately identify occult (hidden) disease. These advances, coupled with innovations in industry, have enabled the use of new surgical techniques: trans-anal microsurgery (operating via the anus) and minimally invasive techniques (keyhole surgery) allow for radical curative surgery with quicker patient recovery times. Currently, robotic surgery is being studied. Surgical techniques for patients with liver and lung metastases (seedlings from the

Molecular biology is helping us identify patients at increased risk and those more likely to respond to treatment” rectal cancer) have improved, allowing their safe resection (removal) with both minimal morbidity and curative intent. The use of both chemotherapy and radiotherapy prior to and following surgery has led to a much lower rate of cancer recurrence. For patients with advanced disease, the developments in chemotherapy, radiotherapy and targeted therapies, as well as techniques such as cyberknife, offer doctors a comprehensive and effective armoury. Treatment of rectal cancer has come a long way in 25 years and scientists continue to look for ways to prevent it and raise awareness, but early intervention remains the most vital weapon against the disease.

‘TO KNOW IS NOT TO FEAR’ Albert Singer, Professor of Gynaecology (Emeritus) at University of London, and Chai’s first medical patron

Some 25 years ago Frances Winegarten z’l approached me asking about follow-up support services for patients like herself who’d had cancer. I told her that aside from BACUP and the Hospice movement, which was still in its infancy, little else was available. Frances had also linked up with Susan Shipman whose daughter Natalie was being treated for a brain tumour, and together we agreed a strategy directed at patient education based on the old

It is to their great credit that Chai’s vision of integrated support for the cancer patient and their family has been so successfully reaslised” adage ‘to know is not to fear’, which I believed was the most important message to give cancer patients.

At that time, before the Internet, there was nowhere to easily find out information about cancer. Chai’s pioneering idea was for cancer specialists to talk to a lay audience, help demystify the subject and relieve many of the anxieties people had. More than 400 people attended our first lecture at Norrice Lea Synagogue and 800 came to another about breast cancer in Stamford Hill. Top specialists spoke at Chai’s ‘Ask the Expert’ events, sharing news of the latest developments in treatment options – this was truly innovative.

Together Magazine 2015

Chai’s approach has always been anchored to listening to clients needs and offering practical support. In response Chai has expanded its range of complementary therapies, which initially drew adverse comments from some traditional oncology specialists. But it pushed ahead with this philosophy

and we now see how successful it is. With the acquisition of new premises in 2003, we have the most up-to-date and sophisticated methods of supporting the patient both physically and emotionally, as well as their families. Chai has developed enormously since its ‘humble’ beginnings over Frances’

kitchen table, and the centre is now recognised as a model for the NHS. It is a great credit to Louise and her team that the vision of Frances Winegarten z’l and Susan Shipman to create an integrated support system for the patient and their family, has been so successfully realised.

SHIFTING THE PARAMETERS OF TREATMENT Michael Baum MD, ChM, FRCR, Professor Emeritus of Surgery and Visiting Professor of Medical Humanities, UCL

The last 25 years has been one of the most remarkable epochs in the history of oncology. In the field of breast cancer we have witnessed a 50% reduction in mortality accompanied by an equally important improvement in quality of life, exemplified in the shift from mutilating radical surgery to a minimalist approach. These are a few key developments in that time: Loco-regional therapy (LRT): This is any combination of surgery and radiotherapy aimed at controlling local manifestations of the disease on the chest wall or axilla (arm pit). In about 1990, the last of the ‘dinosaurs’ advocating radical mastectomy, died off. For most cases in the last 25 years, breast-conserving surgery (BCS), axillary dissection and whole breast radiotherapy became the standard of care, with simple mastectomy reserved for tumours larger than approximately 4.5cms. Over this period, methods of reconstruction have been perfected so that most women are offered the services of plastic surgery after mastectomy.

Adjuvant systemic therapy (AST) is the delivery of medical treatments such as chemotherapy and hormone therapy for prolonged periods after LRT. This approach has delivered a 50% reduction in mortality as these systemic drugs mop up the latent microscopic disease that may be present throughout the body. These treatments have become more refined and less toxic as they are tailored to the biological characteristics of the tumour. Advanced disease: Although advanced breast cancer is still judged as incurable, there has been an accumulation of modest improvements that have contributed to making these stages of disease ‘chronic’ conditions, with women often living for ten years or more with good quality of life.

in the more advanced stages of disease. We need a more selective ‘risk management’ programme, an approach particularly pertinent to the identification of the Ashkenazi mutations on the BRCA1 and 2 genes. I have no doubt this will be a hot topic in the community over the next few years.

The last 25 years has been one of the most remarkable epochs in the history of oncology”

Screening: Unfortunately this has not lived up to its promise. I was one of the architects of the NHS breast-screening programme in 1987. The benefits from reducing deaths from breast cancer are half that expected and the harms that have emerged could not have been predicted: a 30% increase in the detection of ‘early breast cancer’ and no decline

Chai Cancer Care

THE ERA OF TARGETED TREATMENT AND TESTS Jonathan Ledermann, Clinical Director, UCL Cancer Institute, specialist in gynaecological cancers

When Chai began in 1990, chemotherapy was seen as the only way to improve the survival of women with advanced ovarian cancer. In the last 15 years the emphasis has shifted towards developing targeted therapies.

cell death. This is the most significant therapeutic development in the last two decades. These tablets can be taken over a prolonged period with very few and usually mild, side effects. They are particularly active in patients with a BRCA mutation as tumours already have defects in the repair of DNA damage.

The drug Bevacizumab (Avastin) targets blood vessel development, starving tumours of nutrients, and was the first targeted therapy used to treat ovarian cancer. PARP inhibitors, a new group of drugs, selectively inhibit the repair of DNA damage, which causes cancer

Inheritance of the defective BRCA gene predisposes women to ovarian and breast cancers. Found in about 1 in 400 people, it is ten times more common in the Ashkenazi population. Clinical trials show that PARP inhibitors make tumours smaller, or stop them from growing, often

DEVELOPMENTS IN DRUGS Professor Gordon Rustin, Professor of Cancer Therapy, Mount Vernon Cancer Centre

Twenty-five years ago the most commonly used method to determine whether a cancer was likely to respond to treatment was to see what it looked like under the microscope. Some cancers such as lymphomas and testis cancer were very sensitive to chemotherapy and frequently curable, but most cancers were less responsive. One of the few tests to predict response was measurement of oestrogen and progesterone receptors in women with breast cancer, to decide if they should receive anti-Âoestrogen therapy. In the 1990s the demonstration that patients whose tumours over-Â expressed a growth factor known as

HER2 benefited from trastuzumab (Herceptin), was the real start of what we call molecular targeting therapy. Since then there have been many discoveries of genes that are over expressed or mutated with drugs becoming available to specifically target these abnormal cells without harming normal cells. Possibly the most dramatic change has been in the management of melanoma which rarely responded to chemotherapy. About half of the patients with melanoma have a mutation in the BRAF gene and these patients have a high chance of responding to drugs such as vemurafenib and dabrafenib. Very recently two PARP inhibitor drugs have been licensed for tumours arising

for a long time. Olaparib (Lynparza) is the first PARP inhibitor to be licensed for the treatment of ovarian cancer with a BRCA mutation. About 18-20 % of advanced ovarian cancers contain a BRCA mutation and could be treated with PARP inhibitors. Routine testing for this gene therefore, could not only help women with ovarian cancer, but testing healthy family members for a BRCA mutation could prevent ovarian cancer through pre-emptive surgery. As a consequence of tumour prevention, there will be fewer women with ovarian cancer and less loss of life from this disease.

There have been many gene mutation discoveries and drugs are now targeting these abnormal cells without harming normal onesâ€? because of a mutated BRCA gene. It will become increasingly common that when a patient is diagnosed with cancer, their cancer cells will be examined to determine if they contain mutations or abnormal proteins that can be targeted by a specific drug. However, because cancers develop ways of overcoming damage from drugs that just target one pathway, there will be an increasing need for combinations of drugs to overcome resistance.

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BETTER TREATMENTS VS. BAD HABITS Professor Stephen Spiro, Honorary Consultant Physician and Professor of Respiratory Medicine, University College Hospital and the Royal Brompton Hospital, London

Lung cancer is responsible for more cancer deaths in the UK than any other cancer type. There has been a gratifying drop in annual cases amongst men due to them quitting smoking in large numbers between the 1970s and 90s. However, women aged 15-35 are increasing their habit and lung cancer incidence is rising, with 23% of adult women smoking, threatening to make this a female disease within the next 30 years. A 2011 US trial of more than 53,000 heavy smokers aged 50-70 were either screened annually for three years by computed tomography (CT) or a chest X-ray. CT scanning showed a 20% reduction in mortality. Trials in Europe are in progress, and although CT screening is likely to be considered too expensive, it may have a place for high-risk individuals and could be a breakthrough. Non-small cell lung cancers (85% of cases) have shown increasing responsiveness to chemotherapy. Also, identifying genes and receptors in tumour samples has led to targeted therapy for some patients, with drugs known as receptor antagonists being better than chemotherapy. Whilst surgery, and to a lesser extent, modern, focused radiotherapy will still provide the best chances of cure, 45% of patients diagnosed to have advanced disease today are alive at one year, compared to 10% 25 years ago. New research data on immunotherapy is exciting, too, in a selective group who have relevant genes, but this is at an early stage of clinical trials. Lung cancer remains a dreadful disease and patients need support, counselling and advice, especially in the 20% of cases, mainly females, who were never smokers, and find it hard to come to terms with having this illness.

PUTTING THE PATIENT FIRST Daniel Hochhauser, DPhil FRCP, Kathleen Ferrier Professor and Consultant Medical Oncologist, UCL Cancer Institute/UCLH Trust

The past 25 years have altered cancer care beyond recognition. Understanding the biology of cancer has enabled development of targeted therapies, radically changing management. For example, mutations identified in lung cancer in the EGFR (epidermal growth factor receptor) gene allows use of targeted drugs such as gefitinib instead of chemotherapy. In my field of gastrointestinal cancer, antibodies can significantly improve responses, either as single drugs or when added to chemotherapy. Immunotherapy drugs are already showing long-term survival for some patients with lung cancer and melanoma. This approach can justifiably be termed a ‘paradigm shift’ by reactivating the immune system, which may be inhibited by cancer, to attack the tumour. At the same time, multidisciplinary management has facilitated integrated care, allowing existing treatments to be used most effectively without delays. There has also been widespread recognition of the crucial importance of improving patient experiences physically, psychologically and emotionally. Advances in symptom control for pain and drug-related toxicities, such as new classes of anti-emetic drugs, have enhanced quality of life. The expanded palliative care specialty allows patients to live with comfort and dignity and has radically impacted care. Chai has been in the forefront of integrating these pathways. However, major challenges remain. Not all patients will be cured by new treatments and certain cancers remain difficult to manage effectively. It is clear that there are many ways in which cancer cells can develop resistance to treatments. Above all, treatment costs are escalating and in the context of an ageing population and pressure on healthcare Those of us budgets, it is unclear if in cancer comprehensive treatments are affordable. Despite research are these problems, those of us living through an working in cancer research and care are living through era of sweeping an era of sweeping change change, which is and one that is set to set to continue” continue.

Chai Cancer Care

The

inspiration behind Chai Aaron & Frances Winegarten z’l & Susan Shipman, Philip Shipman z’l

here are key people who have played a pivotal role in our 25 year history. First and foremost, we pay tribute to Chai’s co-founders, Susan Shipman and Frances Winegarten z’l, who had the vision, determination and passion to fill an unmet and unacknowledged need in the community.

Gerald Fogel z’l

They chose the word Chai (the Hebrew word for life) to symbolise both their experiences of living with the impact of a cancer diagnosis. In Frances’ case – her own, and, for Susan, finding a way to live after the loss of a loved one – her precious daughter Natalie z’l, who passed away just before her eighth birthday. Frances and Susan were fortunate in having sterling support from their husbands, Aaron z’l and Philip z’l, and together they were the first Trustees of the organisation.

Natalie Shipman z’l

Chairman of our Patronage Campaign in 2002 until his recent passing.

Their legacy to Chai of unwavering Chai has been blessed over the years to enthusiasm and belief in our purpose have had the support, commitment lives on. and generosity of some exceptional people, whom we remember with much gratitude and affection. In particular, Ernest Weinstein z’l who became a Trustee in 1995, his wife Stella z’l, who championed our home support service and Gerald Fogel z’l, who contributed so many Frances Winegarten z’l, Susan Shipman, Ben Shipman, Philip Shipman z’l, Mark Shipman, innovative ideas, Jane Shipman, Stella Weinstein z’l, Ernest Weinstein z’l and was Founder

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A warm reception Melissa Shooter & Mayor Cllr Mark Shooter, Maxine & Nick Leslau

n May, Chai celebrated its newly expanded reception area in Hendon with a ‘l’chaim’.

Lord & Lady Heller

The spacious, light-filled entrance with stained glass windows is an uplifting and welcoming environment for clients coming to Chai. Nick Leslau, who with his wife Maxine, were guests of honour, applauded the design and stressed the importance of physical aesthetics. ‘We continue to be inspired by Chai’s vision,’ he said.

Louise Hager highlighted Chai’s many developments over the past 25 years. A major illustration of this is its Medical Outpatient Rehabilitation and Palliative Care Service, based in the Heller Medical Suite at Hendon. During the event, Mayor of Barnet, Cllr Mark Shooter announced Chai as one of his chosen charities. Guests then had the opportunity to see the newly dedicated Irving Carter and family Image Resource Room and the Audrey and Leonard Sattin Assessment Room.

Irving & Gillian Carter Anita Zehavi, Sara Abrahams, Leora Sears-Zehavi, Ingrid Segal, Jonathan Shaw

Gabrielle & Steven Sharpe

Susan James, Louise Hager, Stephen James Photography: Graham’s Images To see more photos visit www.chaicancercare.org

Chai Cancer Care

Hendon’s Client Services Team (front row, l to r): Jodi Lazarus, Jo Awad, Debra Clifton, Client Services Managers. (back row, l to r) Caroline Tunkel, Client Services Administrator; Debbie Woolfson, Volunteer Services Co-ordinator

Beyond the call of duty Photography: Morris Wald

They are a client’s first point of contact – and are with them every step of the way. Chai’s Client Services Managers deliver support with absolute professionalism, infinite care, and immense sensitivity, as the Hendon team illustrates

Together Magazine 2015

stablishing trust is essential,’ says Jo Awad, one of the client services managers at the flagship centre in Hendon. ‘We may be the first person they have talked to about what is happening and it’s vital they know they can speak to us in absolute confidence. When a person picks up the phone to call Chai, it is a major step. They may be in shock, or be angry, having just received a diagnosis; perhaps they are worn down from the aftereffects of treatment; or overwhelmed at what their loved one is going through.’ Chai’s client services managers offer a combination of empathy and professional experience, which is totally client-focussed. The team co-ordinates services for clients within Chai and liaises, when appropriate and with clients’ permission, with the medical and social service sectors, hospices, schools and synagogues. In addition, the department organises the many volunteers who support clients with services such as transport and befriending. They also oversee the introduction of new services: BRCA gene support group and semi-permanent make-up for clients who have lost their lashes and eyebrows, are recent additions. ‘We aim to meet every new client within 24 hours,’ explains Jodi Lazarus, another of the services managers at Hendon. ‘If someone cannot come to us because they are too unwell, or don’t feel ready to come to the centre, we go to them. A host of emotions may surface, so we offer a lot of reassurance as we begin to understand their situation.’ The initial consultation establishes the client’s needs and how Chai can best support them. ‘It often comes as a surprise when we say that Chai is there not only for the cancer patient, but for family

members and friends, too,’ adds Debra Clifton, the third manager at Hendon. The manager then structures a programme of care tailored to the client’s individual needs. These can vary widely in scope. A single female client going through chemotherapy for breast cancer and experiencing side effects, may over a period of time access counselling, manual lymphatic drainage, healing, physio and acupuncture services. The mother of two young children, whose father is unwell and lives in another city, may receive support for herself and her children who are affected by the changes going on, while her father uses services at a Chai satellite.

DAY TO DAY AT CHAI… Debra: ‘I met with a father of four who was in hospital with lung cancer. His wife was stretched between caring for the children, hospital visits and her own emotional needs… it was a desperately sad situation. We supported her with counselling while the children had music and art therapy. Since the husband passed away, she has begun reflexology and, with the children, family therapy. His parents and siblings meanwhile, are having counselling.’ Jo: ‘Took a distressed call from a man whose aunt was in a care home, in great pain and deteriorating fast. I tried to get a palliative care team in to see her and was passed from one care authority to another until I found the right team. In the meantime I rang round to see if there was space in a hospice for her. Thankfully, there was, and she was able to spend her last days calm and in less pain. I’m so glad we could step in at that critical time, which we were told brought great comfort to the family.’

Day-to-day and strategically, Jo, Jodi and Debra keep track via feedback from the clients. As circumstances change, so will Chai’s support. For example, hearing that a client is starting to experience peripheral neuropathy (painful pins and needles) caused by chemotherapy, they will see the consultant in Chai’s Palliative Care Clinic. Achieving the right mix of support can significantly improve a person’s quality of life. Listening skills, foresight and lateral thinking are key qualities in the team. Recently, when a client came down to London from Liverpool, and needed an injection at a specific time, Jo had the brainwave of registering them temporarily with a London surgery to ensure it could be delivered. All too often the managers are witness to distressing situations and may have to broach sensitive subjects, such as funeral arrangements. ‘Many younger clients aren’t affiliated to a synagogue, and that has implications for burial. It isn’t easy to do but needs to be addressed as it can help reduce additional trauma later on,’ says Debra. Each call brings different scenarios and new challenges, ‘but as part of the team we understand the pressures and are able to give each other a great deal of support,’ says Jo. Additionally, the managers have regular team meetings, supervision and continual professional development. There are, of course, many uplifting moments, ‘like when a client told me recently he barely crawled through the door at Chai, but left us upright and transformed; or when a client calls to tell us they’ve been given the "all-clear",' says Jodi. ‘Knowing we are making a difference wherever we can to people’s lives is what it’s all about.’

Some details have been changed to protect client confidentiality

To contact the Hendon service, please call 0208 202 2211 or email info@chaicancercare.org

Chai Cancer Care

You don’t have to have cancer… I

When a person is diagnosed with cancer, it rarely affects just the patient. Which is why Chai’s support extends to parents, partners, children and friends who also feel the impact. One family shares their experience

n April 2011, Renee Baum, 55, underwent a radical hysterectomy for cervical cancer. At that time she was told no further treatment was needed, but the cancer returned in 2012 and this time involved nine weeks of chemotherapy and 28 radiotherapy sessions. While in remission in 2013, Renee needed surgery on her intestine as a result of treatment. Married to Daniel, 47, they have ten-year old twin girls, Brianna and Ellie, and live in London. Renee also has a 28-year old son in New York.

The Baum family in 2013 and, opposite, more recently

‘There was no time to think when I was diagnosed – it all happened so fast and I was in shock. It takes time to come to terms with the fact you are seriously ill. I told the girls, “mummy has bad cells”. They were only six, I couldn’t say the word “cancer” to them.’ Going back to work after surgery was impossible for Renee and it was her boss who mentioned Chai, after his own mother had used its services. ‘I had the wonderful support and love of family and friends but I’d lost so much confidence and energy. I felt disconnected from everything.’ At that point, only Renee had counselling, ‘but with the impact of the second diagnosis, we all needed Chai,’ she says. ‘I was scared of what we were facing – and so was the family. You wonder what will be when you have young children. To protect them, I think Daniel and I put up defences. But there was Chai, ready to embrace us, giving us all just what we needed.’ As well as family and individual counselling, Renee and Daniel had joint sessions. Says Daniel, ‘living with cancer or a close family member who has cancer, transforms your life overnight. It’s an abnormal existence and nothing relieves the stress and pressure. Family and friends mean well but unless they’ve been through it, they can’t fully understand. Counselling enabled us to talk and listen with skilled, caring people

Together Magazine 2015

explains what Chai means to her: ‘When I’ve had a bad day, I know that at Chai I have someone to talk to and I can express my emotions through speech and art. It has helped my sister and I so much, and mum, too.’

Chai gave us a way to move forward, as a family and individually” who do. I cannot speak highly enough of what Chai has done for us, especially Renee, in giving us a way to move forward, as a family and individually.’ Renee’s son Adam, who now lives in New York, also had the option of support. ‘It was very hard on him, too,’ says Renee. Chai’s support for the twins, Brianna and Ellie, included liaising with the teachers at their school, and setting up counselling and play therapy, which the girls continue to have. ‘The therapists are wonderful. Chai bent over backwards to get the right fit for the girls – nothing has ever been too much trouble,’ says Renee. Ellie

Alongside counselling, Renee has had massage and acupuncture, attended yoga and joined the art class. ‘It was so therapeutic, and helped improve my concentration and focus. I could talk freely to others who understood my situation. In your own small way, you discover you can comfort and encourage others. Doing something for someone else was very cathartic. I became less of a victim. And the atmosphere at Chai is so bright and uplifting – everything about it inspires you to be more positive.’ The setback of new surgery in 2013, however, presented further challenges. ‘Sometimes it feels like we’ve been hit by a hurricane that has wrecked our world. It has not been easy to stay strong but as a family unit we have a lot of strength (and I am very stubborn!). My parents and brother and his family are amazingly supportive as are our friends, so we are very fortunate. Chai has been there throughout as an incredible, on-going source of support for us. Their care and sensitivity, dedication and understanding of our individual needs cannot be overstated.’

CHAI IN THE WIDER COMMUNITY Raising awareness among teachers, community leaders and the medical profession is crucial for expanding the network of routes that encourage people to contact Chai. The Chai in Schools Initiative provides teachers with insights into pupil support when a family member is affected by a cancer diagnosis, as well as giving teachers a resource for when they need it, too. Recently Lisa Steele was invited to lead a workshop with final year trainee teachers at the London School of Jewish Studies on the issues associated with cancer in the family. Graduate Juliette Meller says, ‘We all learned so much and now feel more able to deal with these events in a child’s life.’ Regularly, communal groups, volunteer support networks, rabbis and rebbetzins from across the spectrum, are learning about Chai. Freda Caplan from Norrice Lea Synagogue visited the flagship in July. ‘Knowing about Chai’s phenomenal capabilities means we can give our members an informed and caring response and be the bridge to them finding help,’ she says. But perhaps building awareness of Chai is most essential in the medical world, so that nurses, doctors and oncologists can be fully confident of recommending a resource that fulfils many gaps in the NHS and private sectors. No better endorsement can be had than that from the keyworker of a client having treatment at The Royal Marsden, who called Chai ‘a centre of international excellence and a model of provision.’

Jonah, Sadie, Ori, Maxine, Nick and Jake Leslau

Gerald Ronson CBE & Dame Gail Ronson

the

Chai Cancer Care I

Peter & Sue Miller

t was the biggest, it was the most successful and its message – that everyone’s cancer experience is different – was powerfully delivered. Hosts Maxine and Nick Leslau welcomed a record 640 guests to Chai’s 2014 ‘Signature’ Dinner last December, at the London Lancaster Hotel. The spellbinding centrepiece of the evening was a film, ‘This is my Chai’, which told the individual stories of three clients: Larry, Charlotte and Gemma who spoke frankly, poignantly and with humour about how Chai has supported them on their cancer journeys. In his speech, Nick Leslau emphasised how Chai cares for all across the entire spectrum of the community providing

Dinner ‘a warm embrace and unrivalled professionalism’, while Chairman Louise Hager spoke passionately about Chai’s ethos of personalised care, ‘so that everyone can feel “This is my Chai”’. It was a sentiment supporters took to their hearts, donating an outstanding £1.1m. Guests were also dazzled and amazed by ‘mentalist’ entertainer extraordinaire, Lior Suchard.

Lord & Lady Young

Issy & Susan Zuckerbrod

The Hon Andrew Wolfson & Orly Wolfson

Angela & Stephen Rubin OBE

Together Magazine 2015

Ronnie & Loretta Harris

Emma & Marc Samuels

Naomi & Andrew Fisch

Sir Ralph & Lady Kohn

Bob & Michelle Shemtob, Joanna Franks, Adam Musikant

Tania & Olivier Levenfiche

Frances, Steven & Joan Fogel, Benita & Gerald Fogel zâ€™l

Karen & Jonathan Hodes

Michael & Lesley Bennett

Elli & Vicki Morris

Jo & Jonathan Benjamin

Georgina Black, Graham Edwards, Joan Lipkin-Edwards

Photography: Blake Ezra To see more photos, visit www.chaichaicancercare.org

Louise Hager, Lady Kalms, Lisa Steele

Medical Focus

Genetic testing for BRCA1 and BRCA2

- WHAT YOU NEED TO KNOW People with a mutated BRCA1 or BRCA2 gene, are at greater risk of developing cancer. Professor Ros Eeles and Audrey Ardern-Jones OBE from the Royal Marsden explain the implications for the carrier and their family

Professor Ros Eeles, FMedSci; PhD; FRCP; FRCR (above) is a specialist in BRCA-mutation carriers and prostate cancer and runs a laboratory at The Institute of Cancer Research (ICR) and a Cancer Genetics Clinic at ICR’s partner hospital, The Royal Marsden NHS Foundation Trust. Together with Audrey Ardern-Jones OBE; RGN; MSc (below) Associate Lecturer in Cancer Genetics Nursing at The Royal Marsden, they set up the now worldwide research project, The UK Genetic Prostate Cancer Study.

ur genetic code (DNA) is made up of 3 billion letters; genes are strings of code and every cell (building block) of our body has this code except for the eggs and sperm, which have half of the genetic component. When children are formed, half of their genetic code comes from each parent. We therefore have two copies of a gene in most of our cells. A human has about 25,000 genes of which BRCA1 and BRCA2 are two examples. There has recently been much publicity about BRCA1 as this gene was found to be (mutated) in the actress Angelina Jolie who had a family history of breast and ovarian cancer. It is known that certain inherited mutations in BRCA1 and BRCA2 markedly increase the lifetime risk of breast (80-85%) and ovarian (30-60%) cancers in women and some risk of breast (6%) and prostate (3-20%) cancers in men. These figures depend on many variables including family history, previous medical history and other treatments. Men and women in certain populations such as Ashkenazi Jewish families, and from some other populations (e.g. Icelanders) have an increased prevalence of mutations in the BRCA genes. In the Ashkenazim, two alterations in BRCA1 and one in BRCA2 are more commonly found and in a recent study in London, the incidence of these specific

mutations was found to be 1 in 40 in those whose grandparents were all Ashkenazi. This was irrespective of whether they had a family history of cancer or not. These genetic alterations are very old and have been passed down the generations since pre-Roman times.

HOW GENETIC TESTING WORKS Genetic testing is available to detect mutations in the BRCA1 and BRCA2 genes. A blood test reads (sequences) the genetic code of these genes to look for ‘spelling mistakes’ in the code. It is considered for patients with cancer where it has occurred at a younger age than is generally seen in the general population, where a person has had more than one cancer and/or there is a family history. (It is not recommended for children.) Generally it is better to test an affected person in a family first as the specific genetic mutation in the family can be identified; testing the affected person is called a Diagnostic Test.

These genetic alterations are very old and have been passed down the generations since pre-Roman times”

Together Magazine 2015

However in the Ashkenazim, unaffected individuals can be tested because of the founder (historic) mutations present in this population.

In a recent study in London, the incidence of BRCA1 and 2 mutations was found to be 1 in 40 in those whose grandparents were all Ashkenaziâ€? All people considering the test for cancer management need to know that if a mutation is found, then there are implications for other members of the family. The information may at times be very sensitive and difficult and it is very important that an individual understands all the implications before having the test. Furthermore it may alter cancer management, which may tailor treatment to manage the other cancer risks from the genetic mutation and, in some cases, guide the oncologist to use certain types of medicines. The time a genetic test takes varies depending on the type of test, but is generally several weeks to months and involves giving a blood sample. In some families it is appropriate to test more than BRCA1 and BRCA2 and several genes are analysed at once; there is currently a lot of research to investigate which of the variants we find are cancer-Âcausing and which are harmless. Tests are available via the Internet, which do not cover the whole BRCA code and include other genetic

variations in addition to founder mutations in BRCA in the Ashkenazim. The problem with Internet tests at present is that they do not include counselling and so the implications of the test specific to the person are not discussed. It is recommended that anyone wanting a BRCA test should discuss this with their GP who will advise if they should see a cancer geneticist. Predictive Testing: this identifies if a person carries a mutation, which is in their family to determine their personal risk. This may be done for several reasons: their own individual management i.e. more intensive screening or, in some cases, preventative medical options or surgery, or they may wish to know for their immediate family. Psychological implications: If a person is a mutation carrier in one of the BRCA genes, it is not possible to predict if they will develop cancer, what cancer they would develop, nor to completely remove the risk of cancer. Risk reduction is a complex process and what is a low risk for one individual is a high risk to another. The psychological impact on a person will vary according to their personality and experiences. Genetic counselling is recommended before and after any test and covers the psychological aspects and scenarios that are potentially concerning. Currently, there is a government moratorium on genetic testing in unaffected individuals until 2017. To find out more, visit the Association of British Insurers (www.abi.org.uk). Cancer genetics and genetic testing is a rapidly developing and changing area of medicine in which information is continually being updated as collaborative studies become available worldwide. If you want to discuss what is relevant for you and your family, your first stop should be your GP. The specialised services at Chai are there to support you in this process.

Chai runs a BRCA1 and 2 Gene Support Group. Read about it on p38

Service Spotlight Chai Cancer Care

THE

Mindfulness

GROUP

The impact of cancer can stir up a flood of thoughts, feelings and questions. In Chai’s Mindfulness group, clients learn techniques to help calm the racing mind

or a person newly diagnosed with cancer, having treatment or adjusting to life afterwards, the physical and emotional fallout can be overwhelming. There are huge issues to confront,’ says Diane Siskind, one of Chai’s counsellors and a facilitator of the mindfulness group at the Hendon centre.

‘Mindfulness enables us to focus our attention and awareness on the present moment while also calmly acknowledging and accepting feelings, thoughts and bodily sensations,’ explains Diane. Rather than tune out or withdraw from the world, mindfulness is about deepening one’s awareness in everyday life so that calm, clear thinking replaces habitual reactive, ‘autopilot’ patterns.

Rather than withdraw from the world, mindfulness is about deepening one’s awareness in everyday life” 22

Advocates say it has transformed their perspective on life. Clients meet in one of Chai’s bright, comfortable rooms and begin each session with a breathing exercise. ‘Concentrating on the breath and noticing its rhythm and sound is very calming and relaxing,’ says Diane. ‘It anchors the person in the present moment and enables us to “pause” the mind, which can easily wander in all directions.’ Clients are then guided through a series of mindfulness-based exercises, designed to quieten the mind. One such exercise, the body scan, involves directing one’s attention around the body to notice how it feels. ‘This can help a person whose mind is preoccupied by pain. The aim is not to avoid the pain but to notice it, allow it to be gently massaged by the breath and move on, always staying with the present moment.’ Another sensory exercise asks clients to listen for nearby, and then more distant sounds. ‘Here, too, we aim to notice, but not judge, label or get stuck,’ says Diane. But what difference can such apparently simple techniques really make? An increasing number of studies are showing the widening appeal of mindfulness. Companies such as Google, Apple and

KPMG are incorporating the practice into

their corporate philosophies and report benefits including employee wellbeing and reduced stress, anxiety and depression. At Chai, it is a popular service, providing valuable techniques for clients at any stage of their cancer journey. ‘People feed back to us its value in helping manage pain, fatigue, nausea and disrupted sleep,’ says Diane, ‘so even though something is happening to them regarding their health, these techniques provide a positive way to manage their situation.’ The combination of trained guidance in a group setting helps give a deeper understanding of the process. However, mindfulness is very much a technique ‘to go’ – and can be used anywhere – even a three-minute practice is effective. ‘It may help you notice that you are feeling tired, so you can choose to rest; if you recognise your neck is painful, you may consider adjusting your posture or go for a walk. A breathing practice can help deal with the anxiety that arises around appointment times for procedures and investigations. As a tool to bring about a relaxed, more calm approach to life, mindfulness is invaluable.’ For further details, call Jodi Lazarus on 0208 202 2211 or visit chaicancercare.org

Together Magazine 2015

Congratulations Chai! Our Trustees guide the development of Chai, ensuring it fulfils its promise to the community. We owe them much for their vision and dedication and invite them to share their thoughts on this landmark anniversary Lord Young of Graffham CH DL, President since 2006 Although I lost my brother through cancer and I had it myself, I had no idea that Chai even existed, let alone the great work it was doing. Once I discovered the scope of what it does, I was honoured to become its President in 2006 and have watched with admiration the way it has expanded, and its ambition for the future. Unfortunately the demand for our services will grow but I am confident that Chai will rise to every challenge as it has in the past.

Dr Adrian Tookman, Trustee since 2013 25 years ago I sat in my office with two formidable women, Susan and Frances z’l and we discussed their aspirations to develop a Jewish cancer support charity. I had expertise in the rehabilitation of people with cancer and was instantly drawn to their idea. An impressive programme grew to meet the complex needs of patients and their families. Now Chai is greatly respected in the medical community: it is innovative, responsive and it listens to professional advice to ensure its services evolve to serve the population. Please continue!

Susan Shipman, Founder President When Chai Lifeline began in March 1990, Frances Winegarten z’l and I were pioneers in the field of support, providing cancer information, a helpline, ‘buddy’ support and then complementary therapies. Despite criticism we persevered, and today there is no other organisation with Chai’s multifaceted approach. My late daughter Natalie, who passed away just before her eighth birthday, was our inspiration and I take comfort knowing she has been the catalyst for helping thousands of people. It was hard to leave my ‘Chai baby’ behind when I made aliyah but that I could was due to the confidence I had in Louise and her passion, sensitivity and vision. My sincere gratitude and congratulations to her, Lisa and the wonderful team of staff, therapists and volunteers – thank you for all the ‘Yiddishe nachas’!

Jonathan Hodes, Trustee since 2013 Like so many people, I often drove past Chai’s Hendon building, but had no idea what went on inside. Introduced to Louise when the Trustees were seeking further accountancy expertise, I was overwhelmed by the scale of its activities. It is a jewel: cross-communal, available to patients and families for as long as they need – and at no cost to them. I feel privileged to play a part in helping Chai continue to fulfil its vital role.

Lady Kalms MBE, Trustee since 2008 Cancer is frightening. It requires skilled medication but also a powerful antidote of the mind. Our ability to maintain our purpose can be inspirational and no better illustration of this exists than Chai’s art and jewellery workshops, where, under the guidance of committed teachers, clients take much pride and comfort from their handiwork. New ambitions are born and are a serious diversion from the daily stress cancer brings. In the field of human comfort Chai’s unique work raises the level of communal love for those who are moving through a dark cloud.

Philip Weinstein, Trustee since 1998 My family supported Chai’s pioneering work from its earliest days and I was honoured when Frances Winegarten z’l invited me to be a Trustee. A varied business background and involvement with charities and schools helps me enormously in contributing to strategic and day-to-day discussions at Chai. The organisation is a very important part of the AngloJewish voluntary sector and a bastion of chesed – unconditional kindness. I look forward to participating in its plans for the future.

Chai Cancer Care

An Behind the glitz of the smart fundraising events they attend, the personal stories of Chai supporters Maxine and Nick Leslau reveal the challenges that have motivated and strengthened them

ntrepreneurial spirit is something Nick Leslau knows about. As head of the Prestbury Group, he has for more than 30 years been an innovative personality in the commercial property world, taking risks, maximising opportunities and, in part, re-shaping the industry. His interests have ranged from a multi-billion pound property portfolio including Madame Tussaud’s, St Katharine Docks and Thorpe Park, to his passion, Saracens Rugby Club.

The impulses innate to an entrepreneur, he says, are not exclusive to the business world. ‘It’s about drive. You could be a musician, a mathematician – or run a charity. You just have different skills.’ Rising to a challenge is also characteristic of an entrepreneur and it was one of the qualities that drew him to Chai. But it wouldn’t have happened were it not for Maxine, his wife of 30 years.

‘I had assumed that Chai was a nice, small charity in an outpost in Hendon, offering a cup of tea to those in the frum community who had cancer,’ says Nick, 54. ‘It didn’t feature on our charity radar because it seemed, and I’m embarrassed to say it… a little too parochial for me.’ He admits

couple

he was wrong, ‘and that’s not something Maxine hears me say often!’ In 2010, the couple attended a Chai dinner, invited by friends already involved. Motivated to visit the Hendon centre soon after, a friend mentioned the charity was looking to expand its art facilities. Maxine, US-born and an avid art enthusiast, felt an immediate pull towards the idea. ‘I had recently lost my dad and wanted to do something meaningful in his memory. I also had an insight into how valuable art is in the healing process.’

ARTISTIC INSTINCT The ‘insight’ was Maxine’s own lifethreatening brain aneurism in 2010 when she was 46. It required major surgery and lengthy recuperation. Art was especially important to her at that time. ‘I recognised the need for a room where you can paint, express yourself, and be with others who have no expectations of you. Living with a serious illness can be very lonely. It’s exhausting and emotional and you wonder, “where is me in all this?”’ The light-filled studio offers painting, ceramic work and jewellery making. That all Chai’s services are open to the cancer patient and their family resonates hugely with the couple and their three sons,

Ori 26, Jake 23 and Jonah 17. ‘During Maxine’s illness, life changed for everyone, but as onlookers, you can feel so helpless. Everyone needs support and Chai excels at that,’ says Nick.

Maxine and Nick at the 2014 ‘Signature’ Dinner

Together Magazine 2015

CHARITY APPEAL It took just one visit to Chai for Nick to commit. ‘Far from being a shtetl in the sticks, I toured a beautiful modern facility with an unrivalled benchmark of compassion and professionalism, delivered with love. It was everything I expected it not to be.’ Understandably Nick and Maxine are approached by, and support, many charities but he says, ‘we are especially drawn to smaller operations where we can make a real impact.’ It took Nick a little longer to decide to take part in Channel 4’s The Secret Millionaire series in 2008, when he posed as a trainee social worker in Possilpark, a deprived area of Glasgow. ‘I wanted to find out about a community that would

“ It took just one visit for Maxine and Nick to commit”

otherwise be very difficult for me to meet.’ He mucked in and mucked out: delivering meals to a woman who hadn’t left her bedsit for two years, clearing her home of cat droppings, too. ‘We do put ourselves out there,’ he laughs. When Jonah was eight, the family went to Malawi to build an orphanage. A similar project took them to Peru. ‘We saw children so hungry they were eating mice. We try and teach our kids the more you have, the more you must give back,’ says Maxine.

THE NEXT GENERATION The couple are keen to encourage young Chai supporters. ‘Our children have seen us lose friends to cancer,’ says Nick, ‘and with more young people being diagnosed, it is equally relevant to their generation.’ The boys came to the annual dinner with friends. ‘It’s important, it’s up to them in the future,’ says Maxine. Attended by 640 people, the evening, hosted by the couple, was the most successful ever, raising £1.1m. The couple support secular and Jewish causes, though Nick had trouble finding his Jewish niche. His Polish-born mother converted to Catholicism to escape the Nazis and spent time in Russian labour camps. His parents divorced when he was nine and as a pupil at Mill Hill Boys School, he never felt he quite fitted in. He was conscious of his ‘have-not’ background, of ‘parents picking up their kids in fancy cars while I took the 113 bus home to Cricklewood.’ (Nick’s grandfather covered the fees.) He was Bar Mitzvah-ed at 26, before marrying Maxine. The couple, who met on a blind date, balance each

Far from being a shtetl in the sticks, it was a beautiful facility with an unrivalled benchmark of compassion” other well. Surprisingly Nick says Maxine is the more sociable: ‘she lights up a room and is very easy to love’ but in conversation they are equally forthcoming and visibly take great joy in each other’s company. Nick’s response to his childhood was energetic: a milk round, a market stall, managing a grocery store. He jumped ship from a German degree to study surveying and became the youngest CEO of a UK public company, at 24. ‘My ambition certainly comes from insecurity,’ he agrees. But while the acquisition of material things was pleasurable, Maxine’s illness shifted their focus. They downsized from a Mayfair mansion to a Primrose Hill penthouse with an arty ‘hippy-chic’ vibe, a rooftop garden and glorious views over London. After The Secret Millionaire, Nick reflected, ‘my life might be the same, but what I do might change.’ He sees wealth creation as fundamental to meeting the challenges facing the country and within that scenario, the pressures on Chai. ‘Whatever cancer throws at you, Chai is your refuge from the very first moment you enter the building. When I asked how much it costs for people to use this incredible facility and learned it is free to anyone in our community, I was blown away. That is Chai’s greatest achievement, and for both of us, what makes it so worthy of support.’

Medical Focus

Lung cancer…

the good news We are in the midst of a lung cancer treatment revolution. The past ten years has seen major advances in personalised drugs – and there’s more to come, says Dr Sanjay Popat, FRCP PhD

Dr Sanjay Popat is a Consultant Medical Oncologist at The Royal Marsden, and an internationally recognised expert in the treatment of lung cancer. He chairs the British Thoracic Oncology Group (BTOG), and the Advanced Diseases Sub-group of the UK NCRI Lung Cancer Clinical Studies Group and is active in many European and international researching and treating bodies.

The structure of DNA, above: genetic knowledge is helping refine and personalise treatment

ung cancer is not one disease: it is broadly split into small cell lung cancer (SCLC – because the cancer cells look ‘small’ under the microscope) and everything else, termed non-small cell lung cancer (NSCLC). This article focuses on advanced (metastatic) NSCLC, as this is where the greatest treatment advances have come. NSCLC is a mixture of different types of lung cancer classified by their characteristic appearance under the microscope. The two main classifications are adenocarcinoma and squamous cell carcinoma.

THE PERSONALISED REVOLUTION STARTS Data from mapping the human genome in 2001, armed scientists with knowledge of what a person’s normal genes are. The following decade’s research allowed a better understanding of gene abnormalities. We have discovered that lung adenocarcinomas have a number of abnormal genes, some of which are critical in driving cancer growth. If these genes are switched off with drugs, rapid cancer death can be

achieved. These discoveries came at a time in the 2000s when new classes of drugs were being developed (molecular targeted therapy). These medicines efficiently and precisely switch off cancer growth. Over the past 10 years, this has resulted in ‘personalised’ medicine. The term describes how we work out if particular genes within a cancer are abnormal (‘mutated’) in a patient and give appropriate drugs to switch off the effect of that gene, resulting in excellent tumour shrinkage.

Personalised medicine #1: the EGFR and ALK story Advances in cancer genetics have identified that lung tumours with an abnormal EGFR gene are exquisitely sensitive to tablet-based therapies that switch off the EGFR gene (e.g. the drugs gefitinib, erlotinib, or afatinib). This was

New medicines can efficiently and precisely switch off cancer growth”

Together Magazine 2015

identified in 2004 and in 2008 gefitinib was shown to be superior to chemotherapy for patients with mutated EGFR NSCLC. The same has been shown for erlotinib and afatinib, and now it is routine for advanced lung adenocarcinoma patients to have their tumour tested for EGFR mutation and to be treated with an EGFR inhibitor.

decision-making. Cancer Research UK funds the Stratified Medicine Programme, a national research programme whereby patients with NSCLC allow their cancers to undergo comprehensive molecular testing to gain more information about the

However, despite initial dramatic and rapid tumour shrinkage, cancers eventually relapse and re-grow. Again, science has identified that if the cause for relapse is over-growth of a specific EGFR abnormality, called T790M, then the cancer can potentially be treated using new drugs currently in clinical trials. Similarly, tumours that have an abnormal ALK gene are exquisitely sensitive to ALK-inhibitor tablets e.g. crizotinib. The ALK abnormality was first identified in 2004, and shortly afterwards, crizotinib was shown to be active in ALK-positive NSCLC and most recently, superior to standard chemotherapy. Although ALK positive cancers eventually relapse, newer ALK inhibitors are being used in clinical trials.

We used to treat all patients similarly, regardless of their cancer type. Now we can distinguish between them and decide on the optimal drugs to use”

Personalised medicine#2: advances in molecular testing Extensive genetic analysis of lung cancers has shown us that in adenocarcinomas, up to 60% of patients have a potentially ‘druggable’ abnormality (in the ROS1, RET, BRAF, and MET genes). Drugs for these types of abnormalities already exist and are approved for use in other cancer types, or are in development in clinical trials. Given all the genetic abnormalities identified, it is now standard for lung adenocarcinomas to undergo molecular analysis for EGFR and ALK abnormalities to guide drug therapy

abnormalities identified. Patients with a cancer genetic abnormality can then be enrolled into the National Lung Matrix trial to be matched with a suitable targeted drug. Immunotherapy is coming. Cancers become established since the immune system fails to recognise it as foreign. It is now known that a major ‘handshake’ (termed the ‘immune checkpoint’) between the immune cells and cancer does not work properly due to the abnormal functioning of two molecules called CTLA-4 and PD-1. CTLA-4 normally dampens down the body’s immune response (to protect our organs from attack from our own immune system) and PD-1 activates the immune system (as a second ‘are you sure you want to activate?’ signal).

In many cancers, it has been shown that CTLA-4 is over-braking the immune system when it shouldn’t, and drugs to stop this (ipilimumab and tremelimumab) have been developed. Similarly, PD-1 tends to be less active than it should and drugs to reactivate it have been developed (nivolumab, pembrolizumab, MPDL3280A, and MEDI4736). These drugs are called ‘immune checkpoint inhibitors’ and are still being tested in clinical trials, although initial results using nivolumab and pembrolizumab are very impressive.

WHERE NEXT? We have come a long way from treating all our patients similarly, regardless of their cancer type. Now we distinguish between adenocarcinoma and squamous carcinoma. For adenocarcinomas, knowing the EGFR and ALK gene status of the tumour allows us to decide on the optimal drugs to use. Where possible we also perform comprehensive molecular analysis on our patients’ tumour within clinical research studies, with a view to them receiving personalised molecular targeted therapy in clinical trials bespoke to their tumour profile. In parallel, the immunotherapy revolution is just beginning. Over the next three years I anticipate nivolumab and pembrolizumab becoming standard care for patients with relapsed lung cancer, and perhaps eventually as standard first-line treatment – potentially replacing chemotherapy for some. These are hugely exciting times for a lung cancer oncologist, and for cancer patients it’s a time of great hope, optimism and anticipation.

Chai Cancer Care

‘Life-enhancing Chai’ For many people, a painting or jewellery class is an entertaining hobby. For clients who come to Chai’s weekly workshops, it is so much more…

Elena Cancer has a traumatic impact but the art workshop has been an extraordinarily positive experience, giving me a new passion. Linda is the heart and soul of the group, and the volunteers are helpful, humorous and sensitive.

Deb

light uch de I feel s li abb ng when d r that lou with co m ill. Ia t e I forg

Katherine In 2009, I had to invent a new life that would have quality in it. Chai showed me how. I lose myself in the art class, it’s magical, and is a uniquely loving and sensitive environment.

Esther

In the jew ellery class I found com fort and su p p o rt, activity an d chatter a t my most diffic ult time.

Mish Through adversity, I have found painting, which gives me so much pleasure, peace and calm but above all has brought some truly beautiful people into my life.

Franie

When things are difficult – and also when they’re not – I know there’s a warm welcome in the art class. It is peaceful, there is laughter, and for two hours I forget my problems.

Together Magazine 2015

Tina

I was diagnosed – it felt like the I became very withdrawn and sad when i and brought me out of my end of my life. Good fortune led me to Cha class. llery depression. Now I feel lost if I miss a jewe

Alan S

Lynn

My dancing rabbis are based on a painting in Clore Manor, a few doors away from Chai, where my mother resides. They reflect my happiness and hope for the future: that is what Chai and Linda’s workshop gives me.

Being absorbed in learning something new enabled me to forg et for a while about the chemo; the empathy of th e class and encouragemen t from Linda are un ique. And the revelatio n that I actually had talen t– a wonderful surpris e! Chai art is life en hancing.

Beverley

An oasis of calm an d creativity in the midd le of a world of chaos!

I joined the class after an operation for bowel cancer, and haven’t looked back. The art sale was a highlight when all our paintings sold out! The camaraderie is incredible, so thank you Chai – I don’t know where I’d be without you.

ia Sylvother

ts All tmen nd n i o app e arou ad ay are m ednesd W lass. my ery c l l e jew

Nad

class is The art ly icine, on like med e th r: e tt much be a effect is e id s only . outlook positive

Ahuva

ve a safe space for creati The jewellery class is ers and a ch tea tic the pa em ortive, expression with supp rnings are dents. Wednesday mo fine circle of fellow stu journey. not to be missed on my most special to me –

Art and jewellery workshops are open to all Chai clients. Linda Sharpe is Art Co-ordinator and curated the recent art exhibition; Rebecca Silver and Belinda Shipton run the jewellery workshop and many clients’ pieces feature in our Chanukah and Chai Society and gift sales.

Photography: Morris Wald

Alan R

Chai Cancer Care

Joyce Misrahi

Tanya Rosenthal

a sell-out SENSATION

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Hayley Paradise

28/04/2015

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The second Chai Fashion show raised the roof, the spirits and valuable funds for the Image Resource Service

Together Magazine 2015

he best party on Election Day back in May, was the one at Finchley Synagogue when 350 Chai fashionistas gathered for a dazzling show of spring/ summer styles and a tantalising winter preview, courtesy of Averyl, Temple Fortune’s fashion emporium. Guests whooped as former Chai clients, Joyce Misrahi and Tanya Rosenthal, danced down the catwalk to a funky soundtrack, along with fellow Chai supporters and professional models. Joyce had treatment for breast cancer four years ago and had counselling and group support at Chai. ‘I experienced a post-traumatic stress reaction and it took me a while to find anywhere that offered what I needed. Chai absolutely understood what I was going through.’ Now as a volunteer, she is passionate about raising awareness of Chai. Tanya came to Chai when she was diagnosed with breast cancer 18 months ago. ‘I was very proud to model. Chai helped me in so many ways with counselling, physiotherapy and acupuncture, giving me confidence, comfort and reassurance.’

In a room bathed in pink light, decorated with stunning flower displays (all generously donated), hundreds of stylish looks were presented. Lunch, by Food Story, was a feast for the eyes and mouth. Guest of honour Dame Gail Ronson spoke movingly about her breast cancer experience seven years ago. ‘Only following my personal battle with cancer, did I fully appreciate how Chai with its vast experience, provides a lifeline to the patient and their whole family,’ she said. Supporters, some of whom came from Glasgow and Manchester, won prizes including tickets to an Elton John concert and bags by Laurel, Marella and Coccinellle, raised £85,000 for Chai’s Image Resource Service. Louise Hager told the story of Melissa, a 37-year old, diagnosed with Grade 3 breast cancer who knew her treatment might cause hair loss, ‘but didn’t imagine she would also lose her eyebrows and eyelashes, or that she couldn’t tolerate her favourite lipstick. She felt vulnerable, selfconscious and totally overwhelmed.’ The Image Resource Service provides a welcoming, private space where clients can seek advice on wigs and scarves,

specialist underwear and make-up. Nutritional advice, and counselling to deal with the emotional and physical changes is also available. Said Louise: ‘The inspiration behind our event came from a client who told us, “I couldn’t have imagined ever being able to bring back colour into my life. Chai has put the colour back”.’

Natalie Tahan, Claudia Salem, Varda Korczak, Stella Ashurov

Roz Laren, Nicola Loftus, Pat Davidson

Louise Coleman, Gabrielle Adlestone

Emma Samuels, Charlie Balcombe

Averyl Trupp, Lisa Steele.

Carole Sopher, Louise Hager, Daniela Pears

Natalie Chester, Orit Crocker, Pamela Crystal, Nicole Allalouf Photography: Jeremy Coleman See more photos at www.chaicancercare.org

Dame Gail Ronson

SPECIAL THANKS GO

TO…

Averyl, her team & supplie rs including Luisa Cerano, Max Mara, Riani, Paule Ka, Princess S, Airfield, Nice, Marina Rinaldi, Crea and D Exterior Food Story, Heathcote & Ivo ry, Jeremy Coleman, Muzika, Ok! Management , Sweet Creations Amber Rose, au Bouquet, Creations by Eddie, Fitzjohns, Funky Flowers, In Water, John Carter, Kristal, Miri, Paul Thomas, Rob Van Helden, Simon Lycett Chai models: Jackie Conw ay, Roz Laren, Joyce Misrahi, Hayley Paradi se, Tanya Rosenthal, Gaby Singer, Tanya Wynne

Chai Cancer Care

What to eat when you have cancer Cancer and its treatments can radically affect a patient’s diet, altering appetite, body weight and the digestion process. We explore the side effects of treatment, how to eat to maintain optimum health and, overleaf, suggest some comforting recipe ideas

ancer treatments can affect how the digestive system works, altering how much a person can eat, how quickly or slowly food travels through the system and how efficiently nutrients are absorbed into the body. Depending on the type of treatment (surgery, radiotherapy, chemotherapy, biological or hormone therapy), patients may experience symptoms such as nausea, loss of appetite, sickness, diarrhoea, vomiting, sore mouth and taste changes. For many people, the normally pleasurable experience of eating is diminished, and maintaining a healthy diet becomes harder. But there are strategies than can be put in place.

Diet has a strong bearing on a patient’s overall health and ability to withstand cancer treatment. Their nutrient intake can also affect how well the body responds to it. People who lose a lot of weight before or during cancer treatment (often a metabolic effect of the treatment) may find it more difficult to cope with the treatment, and the side effects harder to tolerate. Some chemotherapy and steroid treatments meanwhile, lead to increased appetite and body weight. There is however, no ‘special diet’ for people with cancer. What is essential is that each person’s diet helps them function as well as possible in order to maintain a healthy weight and allow the body to recover from the side effects of treatment. Eating enough food that tastes good and is packed with protein and nutrients is the key.

WHAT TO EAT • Protein-containing foods daily, such as chicken, fish, eggs, cheese, nuts, beans and pulses. They contain key nutrients such as fat, vitamins and minerals. Limit red meat to 500g per week. Keep processed meat to a minimum. • Plant foods with each meal including wholegrains, pulses, colourful fruit and veg to ensure a good variety of nutrients, and starchy foods like potatoes, sweet potatoes and yams. • Take care with fat, particularly saturated fat, but if weight gain is needed, it’s a useful way to increase energy intake. • Drink alcohol in moderation or avoid altogether.

Together Magazine 2015

CHALLENGES DURING TREATMENT Loss of appetite is a common side effect. Anxiety over investigations and the treatment itself can contribute to a person not wanting to eat. Mealtimes may become a chore and lead to a decrease in overall food intake and weight. Family and carers will try and encourage eating, and though well meant this can become a source of tension, making it even harder to eat when appetite is already low.

Tips for a poor appetite • Serve smaller portions of food on smaller plates. It will help family and carers to see how much you can eat. • Choose high-energy soups and drinks which offer both fluid and nourishment. • By eating small meals and snacks frequently, overall food and nutrient intake is likely to go up. • Choose foods you fancy – even if not nutritious, eat what you are able.

• When food tastes bitter or metallic (cited for meat, citrus fruit, chocolate, tea and coffee): choose alternative proteins such as eggs, yogurt and cheese; hot chocolate can replace coffee; try herbal teas or smoothies; eat foods that are cold or at room temperature; soak meat in a fruity marinade to counteract bitterness. A sore mouth or throat often occurs during chemotherapy because the tissues lining the mouth are particularly susceptible to damage. Radiotherapy treatment to the area or infection may also cause soreness. • Using a straw will help you continue to drink plenty of fluids; choose bland, soft, moist foods; fortify dishes with full-fat milk or cheese; avoid foods that take a lot of chewing, like muesli, bread and nuts; avoid citrus flavours and tomatoes. Dry mouth and difficulty swallowing may be caused by radiotherapy to the mouth or throat area and prescribed drugs.

Taste changes can be difficult to cope with and most people experience them, particularly if they are undergoing chemotherapy. Usually delicious foods taste bland, unusual or even unpleasant and overcoming this takes patience and a willingness to try new flavours or food combinations. Changes to smell perception may also alter during treatment contributing to feelings of nausea.

• Choose moist fish, eggs and cheese; well-cooked pulses or stews are good; make extra sauce or gravy and freeze in small portions; have nourishing drinks or desserts between meals to increase your intake.

Tips for taste changes

• Opt for bland foods; choose carbohydrate-based foods such as crackers, biscuits, bread and toast; combine protein with carbohydrates, for example cheese with baked potato; try cold desserts such as mousse; ginger is an old remedy for nausea – sip ginger beer or ginger tea.

• When food does not taste of anything: use herbs and spices; add a little more salt (after cooking); choose moist, hot or warm foods – flavours are easier to detect in warm foods; add a little sugar, honey or syrup; use soy sauce, balsamic vinegar and citrus flavours.

Nausea is a common side effect and getting the medication right can make a huge difference to alleviating symptoms and how much you can eat.

THE JEWISH ANGLE by Lana Pinshaw, Chai’s dietician Many people grow up hearing their parents or grandparents say ‘Es, mein Kind’ (‘Eat, my child’). Eating everything off your plate is a powerful childhood message and most Jewish festivals and occasions are celebrated with copious amounts of food. Deeply embedded ideas about food mean many people find the challenge of losing their appetite or being incredibly hungry due to cancer medication, difficult to handle. These aspects are beyond one’s control, yet in our culture, we feel we need to please family and friends, often invoking the ‘Jewish guilt’ associated with eating or not eating. At times of illness, community and family support can be incredible as people rally round. Yet lack of awareness about the psychological state of the patient and the effects of treatment on their appetite can lead to frustration and anxiety – on both sides. Feeding your loved one is often the only thing you feel you can do. But when that person can’t face eating what you’ve prepared, the disappointment and helplessness can be overwhelming. It’s important to take on board the patient’s food preferences. Appreciate that mealtimes may need to shift; if someone wants soup for breakfast and cereal for dinner, that’s ok. It’s a good idea to have small portions in the freezer and to seek advice from a nutritionist. Most importantly, realise that whatever the patient can manage is a plus – resist pressurising, just encourage. For individualised nutritional advice, contact us to make an appointment on 0808 808 4567

Chai Cancer Care

Recipes during treatment When eating is more difficult, these recipes are high in protein, vitamins and minerals

MINDY FOX’S WARM CHICKEN AND BARLEY SALAD Serves 4 A high-energy salad with protein, iron, zinc and beta carotene. Ingredients 1 tsp coarse sea salt 150g pearl barley ❉ 60ml plus 3½ tbsp extra virgin olive oil ❉

JAMES RAMSDEN’S COURGETTE MUFFINS Makes 12 muffins Ingredients 2 free-range eggs, beaten ❉ 200g caster sugar ❉ 100ml sunflower oil ❉ ½ tsp vanilla extract ❉ 250g plain flour ❉ 1 tsp bicarbonate of soda ❉ ½ tsp ground cinnamon ❉ Pinch ground nutmeg ❉ Pinch mixed spice ❉ Pinch salt ❉ 200g courgettes, grated Energy 230 kcal/965 kJ Protein 3.5g Fat 9.9g Sat. Fat 1.4g Carbohydrate 34g Fibre 1.1g

❉

❉ ❉

150g shiitake mushrooms, stems discarded, caps halved, if large 225g button mushrooms, stems trimmed, mushrooms halved or quartered 1 large garlic clove, finely chopped 225g large shreds roast chicken 2 tbsp finely chopped chives

4 tbsp finely chopped flat leaf parsley

2 tbsp finely chopped mint 115g rocket ❉ 1 tbsp red wine vinegar ❉ Salt and freshly ground black pepper ❉ ❉

Energy 519 kcal/2168 kJ Protein 23.6g Fat 31.5g Sat. Fat 4.9g Carbohydrate 37.6g Fibre 2.7g

Bring 2 litres water to the boil in a large saucepan with the coarse sea salt. Remove from the heat and add the barley, then return, reduce to a low boil and cook the barley for 40-45 minutes. About 20 minutes before the barley is ready, cook the mushrooms. Heat 60ml of oil in a large, heavy frying pan over a medium-high heat. Add one-third of the mushrooms, stir once or twice, then cook without stirring for 3 minutes until the mushrooms brown. Then add another third and continue in the same way until all the mushrooms are browned, about 10 minutes. Add the garlic and chicken and toss to combine. Season with salt and pepper. Drain the barley and transfer to a large bowl; add 2 tbsp of the remaining oil, the chives, parsley and mint. Add the mushrooms and combine. In a second bowl, toss the rocket with the remaining oil and the vinegar. Season to taste with salt and pepper and serve with the barley and mushrooms.

Preheat oven to 180°C/gas mark 4. Line a muffin tin with 12 paper cases. Whisk the eggs, sugar, oil and vanilla extract thoroughly together. Sift the flour into a separate bowl and add the bicarbonate, spices and salt, then fold the wet ingredients through. Finally fold in the grated courgettes. Divide between the muffin cases and bake for 20-25 minutes, until a skewer comes out clean. Turn out on to a cooling rack and store in an airtight tin. (They will last 3-4 days.)

TIP:

This s alad c an be fro zen or stored in the fridge if coo to just ked before the herbs are ad ded.

Together Magazine 2015

After-treatment recipes Aimed at those who are eating well, and are trying to lose or gain weight

MARY McCARTNEY’S QUINOA, KALE AND BEAN SOUP Serves 6 An excellent, filling soup. Low GI beans are absorbed slowly. The kale and carrots are packed with beta-carotene and vitamin E. Serve with wholemeal bread for extra B vitamins. Ingredients 2 tbsp olive oil ❉ 1 onion, finely chopped ❉ 3 shallots, finely chopped ❉ 2 large carrots, finely diced ❉ 2 celery sticks, finely diced ❉ 400g can cannellini or other white beans (240g drained weight) ❉

SAM & SAM CLARK’S BREAM WITH CHICKPEAS, CURRANTS, TURMERIC & DILL Serves 4

1 tsp dried mixed herbs 1 bay leaf ❉ 400g can chopped tomatoes ❉ 1.5 litres hot vegetable stock ❉ 50g kale, shredded ❉ 60g quinoa, well rinsed ❉ 25g basil leaves ❉ Salt and freshly ground black pepper ❉ ❉

Wild garlic is only available in the spring. Instead use ½ garlic clove or garlic chives. The dish is low in fat and saturated fat but packed with vitamins and minerals, including iron, B vitamins and beta-carotene. Ingredients ❉ 4 bream fillets ❉

❉

Zest and juice of 1 unwaxed orange Zest and juice of 2 unwaxed limes

1 tsp ground cumin ❉ 1 tsp turmeric ❉ ½ tsp ground cinnamon ❉ 200g Swiss chard, leaves only, finely shredded ❉

❉

Small bunch of dill, finely chopped Bunch of spring onions, sliced into thin rounds

❉ ❉

❉

❉ ❉

50g currants 120g canned chickpeas (drained weight) Small knob of unsalted butter 200ml fish or vegetable stock Salt and freshly ground black pepper

Energy 241 kcal/1018 kJ Protein 30.4g Fat 7.0g Sat. Fat 0.8g Carbohydrate 16.0g Fibre 2.2g

A few wild garlic leaves, finely chopped (optional)

Cut the bream into thin slices and put in a bowl with the citrus juices and zests, the cumin, turmeric and cinnamon. Season with salt and pepper and leave to marinate for 15 minutes. Put a large saucepan over a high heat. Pour in the fish and the marinade, followed by the remaining ingredients. Cover and cook for 2-3 minutes until the fish has cooked through and the chard has wilted. Check for seasoning and serve immediately.

P: Thi s very freezes w with ell, eve n the kale . Heat the oil in a large saucepan. Add the onion, shallots, carrots and celery, and sauté over a medium heat for 5 minutes. Add the beans and cook for a further 2 minutes. Add the herbs and tomatoes, then the stock. Season and simmer for 20 minutes. Finally, add the kale and quinoa, and cook a further 12-15 minutes until the quinoa is cooked through. Stir in the basil and serve immediately.

Extract and recipes from The Royal Marsden Cancer Cookbook (Kyle Books, £19.99)

Medical Focus

Survivorship – the next chapter

It’s an outcome that even a generation ago was rarely hoped for. Now as palliative care experts Dr Adrian Tookman and Dr Rachel Craig explain, surviving with and beyond cancer is a very realistic possibility

Dr Adrian Tookman (above) is lead Consultant Physician in Palliative Medicine at the Royal Free Hampstead NHS Trust and Medical Director of Marie Curie Hospice, Hampstead. With Dr Rachel Craig (below), Consultant in Palliative Medicine working between the Royal Free, Camden Community and Marie Curie Hospice Hampstead, they have developed Chai’s Medical Outpatient Rehabilitation and Palliative Care Services, a multidisciplinary rehabilitative approach integrating conventional medicine with complementary and talking therapies.

twenty-five year anniversary offers an opportunity to reflect on the significant changes we have seen in cancer treatments and cancer outcomes over that time. Chai has always adopted a responsive approach, doing its utmost to adapt to the changing needs of its clients. There are now many more people living ‘with and beyond’ their cancer, who need Chai’s support.

As has been seen in the press, there has been an increase in cancer survival rates, with more patients ultimately being cured. Only recently it was announced by Macmillan that over 50% of patients presenting with cancer are now cured. However, the reality is that people who are undergoing or have had treatment, have a need for support. In a recent Macmillan report (April 2014) it was stated that one in five of women diagnosed with breast cancer, and one in four men diagnosed with prostate cancer, will survive both long-term and in good health. The remaining longterm survivors will experience a range of other serious health conditions, and live with the worry that their

cancer may spread or come back. And there is more: we are living longer. The consequence of this is that many people suffer several serious medical conditions. A person with cancer may also suffer with other illnesses such as diabetes, heart problems, kidney disease etc. These are known as co-morbidities or multi-morbidities.

PRESSING NEEDS The challenge is how to manage and support people with these complex problems. The Macmillan report also stated that ‘many people with cancer

Chai has always adopted a responsive approach, doing its utmost to adapt to the changing needs of its clients”

Together Magazine 2015

now have other serious health conditions that make their cancer harder to treat and reduce their overall quality of life.’ At Chai, we recognise this. We also understand that cancer treatments are often arduous and can impact on people in many ways. The physical, psychosocial and financial impact of a diagnosis of cancer can be far reaching. To respond to this, Chai has developed services to support people and their families. Chai understands that in many cases ‘cancer survivors’ have disabilities as a legacy of their surgery, chemotherapy, radiotherapy, and the disease itself. Many are in need of physical and emotional support (Macmillan Cancer Support, 2008). Chai acknowledges that additional support is needed to address the complex problems that people have who are living with cancer. We aspire to develop innovative approaches to support people and their families. To do this requires an

A Palliative Care Specialist is skilled in the management of the symptoms with which cancer patients can suffer” understanding of current treatments and Chai is extremely lucky to have experts informing them about the most up-todate treatments for cancer. We have seen, in this issue of together, our Medical Advisory Panel members (all experts in their fields), inform and advise us on the advances in cancer that have taken place over the last 25 years.

AFTERCARE FOR THE FUTURE

Palliative Care Clinic Types of Cancer July 2014 to August 2015

35%

Breast

Lung

Pancreatic

17%

Other

Bladder

Ovarian

Bowel

Prostate

Melanoma

Lymphoma

Oesophageal

Myeloma

Thyroid

Chai also understands that people, during and following cancer treatment, can feel cheated of a healthy life, defeated by the burden of treatment and uncertainty about their future. There may be physical, psychosocial issues and financial pressures. People who have a life-threatening diagnosis can have spiritual angst, questioning the meaning of their life. They may have sexual dysfunction due to the treatments and drugs that they are taking. Their sense of ‘personhood’ may be disrupted, which can be distressing as they wrestle with retaining control in an

altered physical and emotional persona. Clinical services in our healthcare system struggle to assess and manage these problems and fail to use a holistic approach to care. In response to this, one of the highly innovative approaches Chai has undertaken is to introduce a medical clinic where patients can have another ‘layer of care’. A Palliative Care Specialist delivers this service; trained to assess patients holistically and skilled in the management of the wide range of symptoms that patients with cancer can suffer with. This service was developed in collaboration with Marie Curie and The Royal Free and set up five years ago and has been highly successful. One must always question whether the innovative services delivered by Chai are effective. A research trial in 2012 was published using the same approach that Chai has adopted. This robust piece of research was carried out in the Marie Curie Palliative Care unit, a partner organisation to Chai. The study showed that delivering a ‘complex rehabilitative intervention’ (which is precisely what Chai delivers) reduces the unmet need for support, particularly for psychological issues. This approach improves quality of life and reduces the demands that people make on health services. In other words: it works, it’s helpful and it’s cost effective. Chai’s services have grown and developed over the last 25 years to meet the changing needs of cancer patients. Its services are now supported by a medical clinic that facilitates the care of patients with complex symptoms. The future is difficult to predict, however we anticipate that the medical clinic will expand and, with the continuing support from experts in the field of cancer care, Chai will continue to grow and meet the ever-increasing needs of people living with and beyond cancer.

Service Spotlight Chai Cancer Care

The BRCA gene support group N

ewspapers have lately carried many stories about women opting for pre-emptive surgery as a way to reduce their risk of developing cancer. In particular Angelina Jolie who lost her mother, aunt and grandmother to cancer, has raised awareness of the genetic link, talking frankly about her double mastectomy and the removal of her ovaries and fallopian tubes after testing positive for the mutated BRCA 1 gene.

offered various options to reduce their risk, including the removal of the ovaries and fallopian tubes, breast removal or annual breast screening by MRI or mammography.

Chai has responded to the increasing number of people who know they are carriers by forming a BRCA support group. Barbara Prager is a senior counsellor and one of its co-facilitators. ‘The group lets clients explore their feelings and emotional responses to a positive test result and to hear from Mutations in the BRCA 1 and 2 genes are others,’ she explains. ‘Knowing you are not alone is so important because even strongly linked to an increased chance of breast cancer or ovarian cancer in women with a supportive family, the impact of a positive result can be very isolating. The and breast and prostate cancer in men. The Ashkenazi population has a high rate group offers comfort, taking you out of of carriers of BRCA mutations: about 1 in that lonely place. There is a lot to be gained from the commonalities that are 40 compared to 1 in 800 in the general shared.’ The group meets every three population. Though not everyone testing weeks and clients can come at any stage positive will get cancer, women are now of their BRCA journey.

Members of one family faced with the same risk, may make different choices and the decision is absolutely personal to each client”

‘When I discovered that I carry a mutated BRCA gene, I also discovered what a grey area this is,’ says Janine*. ‘There are so many choices and the paradox is that you’ve tested positive but you’re healthy. It’s hard to know what you feel.’ Clients talk about being on an emotional rollercoaster as they grapple with their dilemmas and fears: the impact on their marriage or relationship; how – or whether – to tell the children; other

people’s reactions; the ramifications if you’re single; whether to have children, or more children; feelings about possible surgery. ‘All these affect a person’s life plans and it is up to each individual to decide how to go forward,’ says Barbara. ‘Some may choose surgery while others will adopt a ‘watch and wait’ approach. Members of one family faced with the same risk, may make different choices and the decision is absolutely personal to each client. But with support from the group, they can feel more able to decide their response.’ Mandy* has had a preventative double mastectomy and reconstruction since attending the group. ‘Being able to discuss the choices and my emotions surrounding my decision definitely strengthened me,’ she says. Emma’s* experience also illustrates the group’s value. ‘Some friends react like you’re dying: “Oh you’re so brave”, others like you’re stupid: “What are you waiting for? Get everything removed now!” Meeting women at the group has eased the feelings of “why me?” Our sessions can be filled with laughter or tears but they always give us muchneeded support and compassion, and a platform to voice our feelings.’ Please call Jo Awad on 0208 202 2211 or visit chaicancercare.org for details of the BRCA support group. One-to-one counselling is also available.

The Chai BRCA Awareness Campaign is sponsored by the family and many friends of Debra Persey z’l.

*Names have been changed to protect client confidentiality

Discovering that you carry a mutated BRCA 1 or 2 gene and therefore a greater risk of developing cancer, has a huge emotional impact and potentially life- changing implications. In a supportive group, clients can discuss the issues

Together Magazine 2015

Congratulations Chai! We thank our Honorary Patrons for their continued and valued support

Maureen Lipman, CBE My heroine of the twentieth Century is Dame Cicely Saunders, who founded the Hospice Movement. I have also admired the work of the Bristol Cancer Centre founded by the late Penny Brohn and Patricia Pilkington. And I was led - too late, sadly - to Myeloma UK, when my husband of 30 years, Jack, was diagnosed with blood cancer. But no one endeavor has genuinely impressed me more than Louise Hager and the astonishing team at Chai Cancer Care. It has given wisdom, time, ingenuity and problem solving to our community and countless lives have been renewed and restored. Shoulders have been cried on but no-one has ever been shrugged off. Bespoke treatment, help and advice have made Chai a trusted friend to thousands of families. Dinners, lunches and fĂŞtes require a celebrity to turn up and cut the ribbon or say a few words, and I am always happy to be that be-hatted personality. But only those at the cliff face know how many sleepless nights spent with Post-it notes stuck on their pillows precede those seemingly seamless, occasions. This organisation works. It is a mitzvah, a blessing to us all and a model to the world in its accountability, inspiration and its heart. Long may it go on beating.

Chai Cancer Care

Congratulations Chai! Now meet the members of our Advisory Board, who bring expertise and perspectives from a broad range of backgrounds to guide, advise and ensure our future development Brian Brick I have supported Chai since its start and I am privileged to have given guidance on the pressures of growing the organisation, in particular Lisa Steele’s role as CEO. Led by Louise Hager, the work Chai does is incredible and her vision and belief that you never say ‘no’, has enabled Chai to grow. Well done!

Jo Coleman Chai has achieved so much in 25 years. Our task is to ensure that in 25 years time, it can still deliver the right services at the right time to those needing support. As a charity lawyer, I’ve been privileged to help Chai by ensuring it complies with the increasing burden of charity regulation and upholds high standards of charity governance – so it is fit for the future.

Alan Fell It’s hard to find anyone unaffected by cancer. For me, it was my dad. How can you not be committed to Chai? I hope I’ve helped by supporting the leadership and planning coherent ways forward. What an amazing success story of organisational development: from ‘kitchen table’ to respected, national organisation. We must help get it to 2025, because the need won’t go away.

Jonathan Freedman When Mum was dying of cancer, our family, especially my sister and I, were left to ‘get on with it’. Chai shows you don’t have to suffer, prepare for loss and grieve, alone and unsupported. I hope that my business experience applied in a caring and supportive manner helps Chai to maximise its reach. Onwards and upwards, Chai!

Michael Glass Having been involved for over 12 years with the development of Chai’s IT systems, sitting on the advisory board enables me to ensure IT continues to make Chai operate efficiently and meet its ever-changing needs. It is a credit to the management that after 25 years, Chai continues to remain at the forefront of cancer services for the community.

Diane Kenwood I’m committed to Chai because of the commitment they show their clients. The quality of care is remarkable. I’ve played a small part in many enterprises over the years. Our lay advisers’ meetings are both a responsibility and a privilege. There are no egos around the table – everyone is there because they want to help. Many congratulations on reaching this significant milestone.

Alexandra Maurice After seeing first hand the incredible support Chai Cancer Care provides to patients and families, I wanted to get involved. I’m honoured to be on the advisory board contributing fundraising, marketing and sponsorship knowledge. I hope also to expand the ‘Chai Challenges You’ initiative, raising funds through treks and challenges. What a legacy Chai has created in only 25 years!

Robert Prevezer I am very proud to be a lay adviser to Chai and to offer counsel, specifically marketing and business advice. This is a very special charity answering a real need in our community. Chai helps the whole family, not just the patient. It is a truly unique service and that is thanks to the very personal, caring team at Chai.

Marc Samuels I was invited 12 years ago to liaise between the trustees and architects, planners and contractors during the building of the amazing new centre for Chai in Hendon – what a project! With a background in property development, and with the building so well used, I now advise on the on-going needs of a large communal building. My wish? That one day it will not be needed.

Chai Challenges You

Chai-king in

ICELAND!

In July, Chai’s intrepid ‘Lava Ladies’ raised just over £100k on the 60-mile Landmannalaugaer trek across Iceland’s starkly beautiful landscape. They pitched the tents, we pitched the questions… Why did you do the challenge? Alex: I’m involved with the ‘Chai

Challenges You’ initiative. Taking on a physical challenge is a sign of solidarity with cancer patients who endure so much. Sarah: My sister-in-law recently had breast cancer and Chai was a great support. Sharon: I wanted to prove I could do something like this at 50. Sylvie: A friend is using Chai – and Iceland isn’t too far away! Jan: I’ve recently recovered from being unwell and wanted to take part. Amanda: To raise money for a wonderful charity and do something personally rewarding. What were the lows on the trek? Alex: The nights because there was

24-hour daylight and our bodies were completely confused. Jenny: Sounds ridiculous but dealing with my contact lenses! I could barely see by the end of each day.

Amanda: Being dropped off in the

middle of nowhere on the first night. The rain was lashing down, the wind was howling around us. Then we had to put our tents up.

made you reflect on what’s important in life and the amazing work of Chai. Sharon: The challenge was easy compared to what people with cancer have to go through.

…and the high points? Abi: The end of the second day, after

Which piece of kit was most important? Alex: The spare pairs of socks Jennifer

a ten-hour trek: the camaraderie and sense of achievement was so special. Jenny: Singing ‘Hevenu shalom aleichem’ with a group of Israeli trekkers we met. Naomi: Being in the wilderness, removed from everyday life. Sylvie: Climbing mountains – literally and emotionally.

and Jan lent me when mine were soaked through. Amanda: My walking poles, which I thought would stay in the wrapping, became my crutches.....literally! Emma: Boots, poles, Vaseline. Jenny: Bars of milk chocolate!

How did you remember the Chai clients? Amanda: The thought of why we were

here was never far away – we all know someone who has needed Chai. Jenny: We blogged every day about the trek and to keep awareness going. And we thanked people for their generosity. Sylvie: The long distances and landscape

What did you discover about yourself? Abi: If I set myself a goal, I can see

it through. It was right out of my comfort zone but I did it. Jenny: I learned I’m probably stronger and more capable than I thought. Emma: I found I could put up and take down a tent very quickly. Amanda: Sometimes stripping it all back and doing without everyday luxuries makes you realise how lucky you are. Alex: It reminded me no-one really understands a challenge until they’ve been there – Chai understands. For details of Chai’s challenges, visit: www.chaicancercare.org/getinvolved/chai-challenges-you/

The Chai-kers: Abi Reiss, Amanda Kessler, Alexandra Maurice, Sylvi e Berrebi, Sarah Burns, Jan Toledano, Jenny Silverman, Emma Byre, Sharon Goldstein, Naomi Gordon

The Chai Calendar SEPTEMBER Manchester Mad Hatter’s Tea Party

A Mad Hatter's Tea Party at Manchester Maccabi attracted a full house (and some lovely chapeaux), to raise £2,000 for Chai’s Manchester service.

Outlook Walk Our incredibly loyal supporters took to the green pastures of Hertfordshire for the 12th Annual Chai Outlook Walk, raising more than £7,600 for Chai’s Music Therapy Service.

OCTOBER Chai Art Exhibition More than 50 artworks by clients who attend Chai’s art workshop in Hendon, went on show in an exciting exhibition. Many artists were on hand to talk with the 140 guests, who included Tom Conti, and all the works were for sale. Hosted by Lady Kalms and organised by Chai Art

ce have Art, golf, dance and scien ar of ye sy bu ’s featured in Chai ere H ts. en ev fundraising and s are the highlight

Co-ordinator Linda Sharpe and volunteer Jane Jacobs, the event raised £4,500.

NOVEMBER

Auction. Hosted by committee members Aviva Braunold, Tarryn Chonin, Liza Feiner, Melissa Taylor and friends, the event raised £6,000.

Young Chai’s Chai-lloween

Bridge Lunch 116 keen bridge players attended a lunch at Chai’s flagship centre. The event, organised by Madeleine CopeThompson, Frances Berman and Gloria Smith, raised over £6,000.

Dressed to scare, there was plenty of party spirit when 200 Chai supporters at The Core Bar raised more than £4,000.

Junior Disco Two 13-year old budding entrepreneurs, Jack Glazer and Kobi Snow organised a disco for fellow Year 9 pupils from JFS and Yavneh College, at The Venue in Bushey, raising £900.

Mitzvah Day Girls from the Independent Jewish Day School Choir gave a joyful performance at Chai in Hendon for clients and staff in celebration of Mitzvah Day 2014.

Chai Five Young Professionals Dinner Linda Sharpe, Tom Conti, Lady Kalms MBE

Hendon Chai was transformed with bows and balloons for a Dinner and Chinese

DECEMBER Pre-Chanukah Party The Nearly Golden Oldies Committee hosted a Pre-Chanukah party and raffle at The Allum Hall, Elstree, raising £2,500.

The Natalie Shipman Memorial Lecture

Professor Singer, Professor Hochhauser, Louise Hager, Lisa Steele

‘Jews and cancer – what are the links?’ was the compelling theme of the 24th Natalie Shipman Memorial Lecture. The keynote speaker was Professor Daniel Hochhauser, Consultant in Medical Oncology at the UCLH Trust and the lecture was chaired by Professor Albert Singer, Professor of Gynaecology (Emeritus), University of London.

Together Magazine 2015

FEBRUARY Dance for Life Founded after a young Israeli dancer in London developed breast cancer, ‘Dance for Life’ has been a loyal supporter of Chai for over a decade. This year’s danceathon raised more than £6,000.

Chai Five Pre-Purim Dinner Spicy flavours were on the menu when the Chai Five committee welcomed 60 young professionals to a pre-Purim Friday night dinner at Indian restaurant Beit HaMadras in Hendon, raising £330.

Great bakers

Pennies from Heaven double

Londoners David Blitz, and sisters Maya and Tali Hurwitz served up treats at a charity Tali Hurwitz, David bake sale, which Blitz, Maya Hurwitz raised £150.

The Pennies From Heaven committee

MAY Chai 13’s Coffee Morning

It's been another busy year for the Pennies from Heaven Committee with a bridge function and screening of ‘The woman in gold’ at the Reel Cinema in Borehamwood, which raised £6,000.

Kids’ Pop-Up Charity Shop

APRIL Glasgow Girls Bridge Lunch The Chai 13 girls Nick Black, Lisa Steele

The Glasgow Girls committee with Lisa Steele, centre

70 bridge enthusiasts attended a lunch at Chai’s flagship centre. Hosted by the Glasgow Girls in London Committee, Linda Goldberg, Linda Reich, Louise Kramer, Louise Naftalin, Barbara Kay, Frances Bloom and Lynda Rapport, the event raised £3,000 for Chai’s Glasgow Service and the Glasgow Girls’ Charity.

Shoshana’s recipe for fundraising We’ve been inspired by 12-year old Shoshana Beach from Borehamwood who created Shoshie’s Bat Mitzvah Cookbook. Shoshana has been selling copies to family and friends and so far donated an incredible £1,225 to Chai.

Glasgow’s Chai 13 committee, Ava Black, Leila Black, Olivia Bishop, Katie Lewis, Hannah Rose and Maya Tenby, held a coffee morning in the Walton Community Centre, Giffnock, attended by more than 200 people and raised £2,535 for Chai’s Glasgow service.

Golf Fore Chai The biennial Golf Fore Chai Day drew 90 players and supporters to Hartsbourne Country Club and raised more than £55,000 for Chai. Hosted by committee members Jo Fogel, Mel Rom, Carolyn Joels, Janine Berg, Lesley Okin, Candy Landesberg, Alexandra Reid and Meryl Rosenberg, these fabulous events, which are so meticulously and elegantly planned, have raised an incredible £150,000 in just six years. Committee chairman Jo Fogel, inspired by her late father-in-

Fundraising superstars Freddie and Olivia Uprichard, 5 and 7, and Asher and Ruby Weissbart, 5 and 8, opened a pop-up shop in aid of Chai – in a Golders Green front garden, raising an impressive £64.61. law Gerald’s z’l deep commitment to Chai said: ‘The money raised from this event will support tailored services for men, who are often reluctant to seek support. With more male counsellors and therapists, Chai can ensure no one has to face the cancer journey alone.’

The Golf Fore Chai committee

Chai Cancer Care

10 years of the Club 18 Golf Tournament

members Paul Balcombe, Trevor Berkowitz, Jennifer Cohen, Jack Galaun, David Joffe and David Krok, has raised over £300,000 in ten years for Chai. Louise Hager congratulated their achievement, saying, ‘We are in awe of the energy and enthusiasm of the Club 18 Golf Committee and so grateful for their loyal support.’

‘Our most successful Chai Golf Day ever,’ agreed Club 18 Golf Tournament joint chairmen Michael Lubliner and Ronnie Gottlieb OBE, as 100 golfers celebrated the tenth anniversary of this popular event at Dyrham Park Country Club. ‘A full complement of players supported by sponsors and donors made for an amazing atmosphere,’ they added. The annual event, hosted by Ronnie, The Club 18 Golf Committee with Michael and fellow committee Rachael Martin, Louise Hager, Lisa Steele

The Chai Lights Committee Victory Supper at the Whitefield Golf Club in Manchester, celebrated the 70th anniversary of the end of World War II. Vintage themed entertainment made it a

night to remember and raised £2866 for Chai’s Manchester service.

JUNE Cookery demonstration

Michelle Mendoza, Lisa Roukin, Deanne Bloomfield, Ingrid Goodman

All eyes were on chef and author Lisa Roukin as she demonstrated delicious dishes to 60 guests at a lunch organised and hosted by Michelle Mendoza and Deanne Bloomfield, in memory of Deanne’s sister, Elaine Buchi z’l. The event raised over £3,500.

part in the Maccabi GB Community Fun Run at Allianz Park, raising more than £15,000.

Bridge Lunch Loyal supporter Carol Ellman and friends Wendy Hoffman, Jackie Cohen and Angela White held their annual bridge lunch, raising £5,500.

Gabby Niman Concert Singer and pianist Gabby Niman performed solo and with her choir, Shirei Ohr Ladies, in a concert at the Community Centre in Borehamwood, which raised £1,100.

JULY Exclusive Shopping in Leeds An afternoon of chic shopping and tasters of complementary therapies at The Zone Youth Centre raised awareness of Chai’s service in Leeds.

Jonah Marks

Evelyn Altbach

Simon Marks

Julian Anthony

Raffi Maurer

Ben Avital

Mindel Family

Jonathan Barr

Danielle Moses

Jonathan Benjamin

Jonathan & Francesca Moss

Emma Benson Besser Family Edwin Birstein Helene Blankstone Deanne Bloomfield Fiona Brandman Dylan Bull Peter Bush Amy & Alice Caplan Claudia Carr Yonatan Caspi Chai Lava Ladies Jerome Cohen

Stephen Nalkin Neuberger Family Gabby Niman Joanna Pater Jennifer Pearl Malcolm Persey Adrian Platt Gershon Portnoi Lucy Radstone Benjamin Rietti

Craig Family

Annabel Reis

Danielle Ellis

Reef Ronel

Hannah Forshaw

Claudia Rose

Frankfurt Family

Selina Rose

Gill & Andy Fraser

Paul Rosen

Eitan Freilich

Rosenthal Family

David Galaun

Alex Samuels & Francesca Saltman

Jonathan Goldberg Deborah Goldman Alon Hannuna Hannah Harris Melissa Harris Ian Hill Joel Hilton Sylvie Hodes Zsuzsanna Hudi Isabel Kennedy

Brian Levin James Levy Dawn Lisette Kanter Play therapist Pauline Martin with a young visitor

Andy Murray Adam Musikant

Jodie Richards

Micah Levi

Jamie Spier, Tamara Leslie

Amanda & Gabriella Mount

Gabriella Corpe & Hannah Nathan

Kramer Family

Community Fun Run

Allweis Family

Sarah Burns

Victory Supper

Community support was out in force when 260 runners, including some very young ones, took

Chai would like to acknowledge our wonderful supporters who have set up a fundraising page in aid of Chai.

Lyons Family

Andrew Selzer Ariel Shapiro Gayle Shein Simmons Family Elliot Smith Ed Spevock Michelle Spier St. Albans Synagogue Tapnack Family Ollie Tenzer Rachel Ucko Gary Weinstein Simon Wolmark Ruth Yale

Together Magazine 2015

You’re ! g n i z a m a

Everything that Chai does is made possibl e because of the incredible generosity and loyalty Benefactors, Patrons, Friends, supporters of our outstanding committees. To them and to and our the many who raise money by taking on brave and rre challenges, we give our heartfelt apprecibiza atio n, admiration and gratitude. All of you help ens ure that we can continue to provide specialised cancer care support across the community. The Fundraising Team Young triathletes fundraising triumph Friends and Year 4 Sacks Morasha Jewish Primary School pupils, Jonah Marks, Joshua Hamilton and Rafa Hannunah (and Rafa’s younger brother Gabriel), took part in their first ever triathlon in memory of David Goldschmidt z’l, the father of their classmate Ben, and his brother Jake.

Rafa Hannunah, Jonah Marks, Joshua Hamilton

Pounding the streets of Jerusalem for Chai Eitan Freilich ramped up the miles in the Jerusalem half marathon this year, running in memory of his late father’s 20th Yahrzeit anniversary. Jewish singer Eitan, 21, from North West London, completed the 13.1 miles in a fantastic two hours and 14 minutes and raised over £5,000. ‘Chai is an incredible charity and extremely close to my heart. The half marathon was tough as I didn’t do any training but it was an amazing and unforgettable experience!’

The boys said, ‘Ben and Jake sadly lost their dad nearly two years ago. We know it’s been a very tough time for them and that Chai has been helping them. So, we thought we would do something to say thank you to Chai for all the support they have given to our friends. We are blown away by how generous everyone has been and very glad to have raised so much money for Chai. We hope that other children don’t have to go through what Ben and Jake have been, but if they do, we are glad that Chai is there to help them.’ Jointly, the boys have raised an amazing £800.

Paul Rosen’s London-Paris bike ride

Eitan Freilich

For Chai is our dedicated fundraising platform where supporters can set up pages and load their photos and messages to keep everyone updated about their activities. You’ll also find details of our Chai Challenges You initiative, which offers a host of UK and overseas bespoke fundraising adventures so you can get involved.

When Paul Rosen was introduced to Chai three years ago, he was both impressed and inspired by the people he met who are supported by the charity. So much so, when he set himself the goal of losing weight and getting fit, he decided to take on the 512km London to Paris bike ride – and raised £3,500. Thank you Paul! If you’re tempted to take on a challenge, get in touch and we can help organise it, or visit our Chai Challenges You dedicated site.

Chai Cancer Care

Adam’s tribute to Rosie He’d hung up his long distance running shoes a long time ago, but Adam Musikant felt compelled to take on the Vitality 10k London race and run for Chai Adam Musikant in memory of his dear friend, 38-year old wife, and mother of two, Rosie Choueka z'l. Rosie passed away from cancer in June. ‘I wanted to raise money for a cause that I know Rosie supported and to ensure Chai’s services not only remain, but can develop,’ said Adam, who more than doubled his target, raising nearly £11,000.

Riding Chai Cyclists Jonathan Goldberg and David Galaun enjoyed trafficfree cycling Jonathan Goldberg during the Prudential Ride London- Surrey event in August. En route, Jonathan, who raised £2,215, found himself alongside BBC sports journalist Drew Savage, who tweeted from the saddle about Jonathan cycling for Chai. David, who raised £2,075, was motivated by his father’s cancer diagnosis this year: ‘Riding 100 miles with 25,000 other people was an awesome experience – and raising money for such an important charity made it even David Galaun more special.’

London Virgin Marathon Olive r Ten zer

oldman Deborah G

Mitc hell K alisc her

Franc e Donn sca -Mos s Grea t Manc heste r Run

Ariel is on song Grandparents are great, inspiring and teaching us, and loving us even when we misbehave! Last year Sara and Ariel Shapiro, lost three of their grandparents, something many people can sadly relate to. In honour of their memory, Ariel decided to raise money for Chai… but with a twist. The Ariel Shapiro amateur singer/songwriter, Ariel wrote, recorded and even filmed a video for a song entitled ‘Gone but never forgotten’. But to raise as much as he could, Ariel kept the song under wraps and dropped teasers as he reached key fundraising targets, only releasing it fully when he hit £1,500.

The Moss children: Samuel, 9; Sara, 4; Aryeh, 6; and Ora, 7 ‘spieling’ The Wizard of Oz at Purim

Michaela Winter and Gayle Shein Tough Mudder

r: Before and afte Sylvie Hodes’ sponsored snip

Simon Wolmark Hampton Court Half Marathon

Gabriella Corper & Hannah Nathan Leeds Jail Break

Alex Samue ls & Francesca Saltman Community Fun Run

Helene Blankstone Pretty Mudder

Together Magazine 2015

Ways to give Thank you. Those two words will never convey how much we value your support for Chai. No matter how small your donation, be assured you are making a difference and improving the services we offer and the support we give to everyone in the community. So ‘thank you’: for giving us the means to buy a toy that helps a child through a strange and frightening time; ‘thank you’ for funding a reflexology treatment to help relieve a client’s pain; ‘thank you’ for paying for a make-up lesson that helps a client feel able to face the world again. When you donate, you can even specify the service or project you wish to support. For instance… • £25 buys a set of paint supplies for our Children’s Play Therapy service • £50 pays for one manual lymphatic drainage session • £100 provides two family counselling sessions • £500 pays for 10 consultations with a nutritionist as clients manage weight gain/loss during and following cancer treatment OR to sponsor a service or room, please contact Louise Hager on louisehager@chaicancercare.org or call 020 8457 2075 £50 pays for a consultation in our Image Resource Room

MORE WAYS TO SUPPORT CHAI On special occasions Why not nominate Chai to mark an event or celebration, in lieu of gifts? Contact Sariet Pretz: sariet@chaicancercare.org or call 020 8457 2071

Leave a legacy A long-lasting and meaningful way to support Chai is by including a legacy in your Will. Visit Jewish Legacy Giving (jewishlegacygiving.org.uk) to find out more. If you wish to tell us 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

Donate online The simplest, quickest way to donate. Just click on the Make a Donation yellow tab on the top right hand side of our website.

Call us We can take donations over the phone Call Sariet Pretz on 020 8457 2071 Or Janet Lloyd on 020 8457 2072

By Post Send cheques or charity vouchers to the address below. Chai Cancer Care 142-146 Great North Way London NW4 1EH

Gift Aid makes more of your donation If you are a UK taxpayer, your donation is worth 25% more to Chai. Tell us when you make your donation, or download a Gift Aid Declaration form from our website.

How does Chai care? 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

Advisory Services Advocacy and Information Advice Bureau Financial and Legal Guidance Image Resource Service Jewish Perspectives on Cancer Medical Connections Nutritional and Dietary Advice Resources and Information Counselling Counselling for Individuals, Couples and Families Counselling for Genetic Issues Music Therapy Relationship Counselling Telephone & Skype Counselling Children, Teenage and Family Service Art Therapy Music Therapy Play Therapy Therapies Manual Lymphatic Drainage Physiotherapy

Medical Outpatient Rehabilitation and Palliative Care Service Complementary Therapies Acupuncture Aromatherapy Foot Care Service Healing Hot Stones Hypnotherapy Indian Head Massage Reflexology Reiki Therapeutic Massage Home Support Service Group Activities Art Workshop Computer Lessons Gentle Movement Jewellery Workshop Meditation Music Workshop Open/Supervised Gym Sessions Pilates Walking Group Yoga Support Groups BRCA Group Bereavement Groups Breast Buddies Groups for Cancer Patients/Carers Lifestyle Group Volunteer Service

Services are available at: North West London South London Essex Hackney Southend Leeds Liverpool South Manchester North Manchester Glasgow Birmingham (opening November 2015) Editor: Deborah Clientsâ€™ HomesWald Design: Creative & Commercial

Chai Lifeline Cancer Care Registered Charity No. 1078956

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