LEAP Magazine Winter 2020

NURTURING NATURE Palliative care and the outdoors

DISSECTING DOLLARS How your donation is used

MORE MOMENTS

Cancer patients are living longer

WINTER 2020

THE

INCLUSION ISSUE

PATIENT NAVIGATOR ARROW BIG SMOKE IS A PASSIONATE ADVOCATE FOR INDIGENOUS ALBERTANS

BRIDGING THE GAP

+

LEADING LIGHT

A THIRD-YEAR UNIVERSITY STUDENT DIVES INTO RESEARCH

WINTER WORKOUTS TIPS AND TRICKS FOR OUTDOOR EXERCISE

PM 40030911

CONTENTS

42

34 CARING Outdoor experiences can play a vital role in the health and well-being of cancer patients.

36 LIVING WITH CANCER Daina Kvisle Aldous shares her experience living with brain cancer.

38 RESEARCH ROCKSTAR Dr. Carrie Shemanko is working to understand the biology of breast cancer that spreads to the bone.

42 TRUE CALLING As the associate manager of the Blood and Marrow Transplant Program and Hematology at the Tom Baker Cancer Centre, Naree Ager leads with empathy.

46 IMPACT Don Wood is an advocate and champion for his wife, Sherry, who is living with cancer.

FEATURES

22 INCLUSIVE CANCER CARE From young adults to members of the LGBTQ2S+ community to people living in rural communities, we highlight the programs, services and care approaches that service all Albertans.

COLUMNS/DEPARTMENTS cancer research project at the U of A. Plus, exploring how to handle fatigue, the latest cancer survival rates and more.

7 FRONT LINE Meet Madison Wickenberg, a third-year science student who is part of an innovative

13 YOUR DONATION MATTERS Your donations to the Alberta Cancer Foundation are creating advancements in research and care for blood cancer patients.

COVER: PHOTO COLIN WAY THIS PAGE: ILLUSTRATION PETE RYAN

14 WORKOUT Discover what makes winter workouts so wonderful with our suggestions for the best outdoor exercises in the snow.

14

17 FOOD FOCUS Flavonoids, natural plant chemicals present in most fruits and vegetables, have powerful antioxidant properties for cancer prevention.

20 EXPERT ADVICE We explore how common ailments affect cancer patients, and share how your donation dollars to the Alberta Cancer Foundation are used.

47 WHY I DONATE Win4Skin honours both Owen Schlosser and Mary Johnston by raising money for a group of organizations that support kids’ access to sports, as well as the Mary Johnston Chair in Melanoma Research.

49 MY LEAP The annual Women in Seismic Golf Tournament is a not-so-serious event that raises serious funds.

50 GAME CHANGER The Boston Pizza Charity Golf Classic has raised over $2.2 million for the Alberta Cancer Foundation.

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MESSAGE

The Inclusion Issue TRUSTEES

Dr. Chris Eagle (Board Chair) Rene Aldana Cathy Allard-Roozen Dr. Stanford Blade Dr. Heather Bryant Dr. Greg Cairncross Brenda Hubley Dr. Mark Joffe Chris Kucharski Bob McGee Brian McLean Dr. Matthew Parliament Gelaine Pearman Jamie Pytel (Vice Chair) Rory J. Tyler Mark Zimmerman

GET YOUR FREE ISSUE!

As we enter a new decade, it’s worth celebrating how far we have come.

For instance, 10 years ago, we may have only been starting conversations about “inclusion” in cancer care and what those programs might look like in Alberta.

We are always proud to share Leap with you, but this issue is extra special as we take a look at how CancerControl Alberta and Alberta Health Services are addressing accessibility and inclusion to ensure all Albertans find the care they need.

You’ll see Arrow Big Smoke, a member of the Piikani Nation, gracing the cover of our magazine. As an Indigenous Patient Navigator, funded by Alberta Cancer Foundation donors, her role is to help lessen biases in health care and to connect patients across Alberta with the resources they need (pg. 22). From advocating for earlier screening to helping Indigenous Albertans feel safer within the cancer system, her role is an important one.

You will also read about much-needed non-medical support provided to communities in rural Alberta through Wellspring. Two pilot projects funded by our donors are looking at the best ways to offer rural and remote patients access to courses that could range from educational talks to exercise programs — all providing a safe space in the community to connect with others (pg. 27).

Conversations have also taken place around ensuring patient-centred care includes a welcome space for people who identify as LGBTQ2S+. Alberta Health Services has launched several services over the last few years that make it easier and more comfortable for patients to communicate their unique needs to health-care providers (pg. 30).

We’ve certainly come a long way in the last decade and we are proud of the role our donors have played in that progress. We hope you enjoy these stories and the other pieces about innovative research and care taking place in our backyard and the generous Albertans who support it.

Happy new year and happy new decade.

VISIT

a/leap/ albertacancer.c n tio ip cr bs su ap le

THERESA RADWELL, CEO (ACTING) ALBERTA CANCER FOUNDATION 4 LEAP WINTER 2020

DR. CHRIS EAGLE, BOARD CHAIR ALBERTA CANCER FOUNDATION

WINTER 2020

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VOL. 10

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NO. 2

ALBERTA CANCER FOUNDATION EDITORS

Phoebe Dey and Christiane Gauthier

MANAGING EDITOR Meredith Bailey ART DIRECTOR Kim Larson STAFF PHOTOGRAPHER Jared Sych CONTRIBUTORS Andrew Benson, Colleen Biondi, Charles Burke, Scott Carmichael, Elizabeth Chorney-Booth, Emily Chu, Jennifer Dorozio, Spencer Flock, Jennifer Friesen, Colin Gallant, Samantha Gryba, Glenn Harvey, Aiden James, Robbie Jeffrey, Stephanie Joe, Mae Kroeis, Nathan Kunz, Jennifer Madole, Fabian Mayer, Bryce Meyer, Karin Olafson, Aaron Pedersen, Pete Ryan, Paul Swanson, Colin Way, Julia Williams, Sean P. Young PUBLISHED FOR

Alberta Cancer Foundation Calgary office Suite 300, 1620 29 St. N.W. Calgary, Alberta T2N 4L7

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FRONT LINE M A N A G I N G FA T I G U E | M O R E M O M E N T S | P E D A L T H E PA T H

BRIGHT MIND

Madison Wickenberg is the youngest member of an innovative cancer research project

C

ountless researchers devote their lives to improving how we treat cancer, but few can say they started contributing to that goal even before getting their first degree.

It’s an opportunity University of Alberta student Madison Wickenberg has grabbed with both lab-gloved hands.

The third-year science student is part of a large new research project at the U of A that hopes to improve and broaden the use of immunotherapy to treat a variety of cancers.

Immunotherapy treatments harness the body’s immune system to attack tumours. A key step involves helping the body’s cancer-fighting T-cells recognize which cells are cancerous. Lead investigators Dr. Paul LaPointe, Dr. John Walker and Dr. Kristi Baker, and their students (including Wickenberg), are testing a new method of helping the body do just that.

“We’re using a drug that makes proteins in cancer cells degrade more quickly. That way [the proteins] present on the surface of the cell and our own immune system can recognize them and target them more easily,” says Wickenberg. >

UNIVERSITY OF ALBERTA STUDENT MADISON WICKENBERG

PHOTOS PAUL SWANSON

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FRONT LINE

WICKENBERG’S GOAL IS TO PURSUE A CAREER IN MEDICINE

Wickenberg got involved in the project after approaching LaPointe, with whom she had taken a class, about research opportunities last summer.

The timing was serendipitous — LaPointe had just received funding from the Alberta Cancer Foundation for a threeyear immunotherapy research project, including a locally designed clinical trial. The team started gathering data on a wide variety of fronts this past September. Wickenberg, specifically, is working on colon cancer, which typically doesn’t respond well to immunotherapy treatments.

“She’s been doing experi8 LEAP WINTER 2020

ments to extend some of the things we’ve seen with breast cancer and melanoma cancer cell lines to colon cancer,” says

of concepts and identifying various mechanisms within the cells. LaPointe says, within six to 12 months, they will have a

Immunotherapy treatments harness the body’s immune system to attack tumours. A key step involves helping the body’s cancer-fighting T-cells recognize which cells are cancerous.

LaPointe. “We want to try to use this approach to basically trick the cancer cells into showing themselves to the immune system.”

The project is still in the preliminary phase, with researchers establishing proof

massive amount of data with which to move forward into the clinical trial stage. He says for an undergraduate student to be able to contribute to a project with such real-world applications is pretty special.

“I think that makes it a

unique experience for any undergrad because normally you would never get close to a project like that,” says LaPointe. “She’s picked up really well on the techniques and has generated some results, which is exciting.”

It’s Wickenberg’s first time working in a lab, and she is making the most of the opportunity, learning lab procedures and techniques like growing and splitting human cancer cell lines. An Edmonton native, Wickenberg says she developed a passion for understanding the human body at an early age.

“My mom actually has an autoimmune disease, so I’ve always been interested in the immune system and how it works,” says Wickenberg. “I’ve also always been interested in pursuing a career in medicine — that’s my ultimate goal after my undergrad.”

Wickenberg’s newly acquired lab experience should serve her well in that pursuit, but she says it has also given her an increased appreciation of the research process.

“It’s definitely given me a new perspective on how research actually works,” says Wickenberg. “To get one concrete piece of data can take three weeks. It shows you why research and progress can seem so slow, but also why it’s so important to be involved.” LEAP — FABIAN MAYER

MORE MOMENTS Fifty years ago, only 25 per cent of people survived cancer. Today, thanks to risk reduction, early detection and improved treatment options, that number is closer to 60 per cent and, in some cases, as much as 90 per cent. Here, with information from Alberta Health Services’ 2019 Report on Cancer Statistics in Alberta, we take a closer look at the survival rates of the four most common types of cancer.

BREAST From 1996 to 2016, breast cancer mortality rates for women have decreased by 2.6% annually. Between 2012 and 2016, the five-year relative survival rate for breast cancer patients diagnosed at stage 1 was 100%.

94%

100%

COLORECTAL From 1996 to 2016, colorectal mortality rates for both men and women have decreased by 1.9% and 1.7% annually, respectively. For patients diagnosed between 2012 and 2016, the five-year relative survival rate was 94% for stage 1.

LUNG From 2008 to 2016, lung cancer mortality rates in women have decreased by 2.1% annually. From 2007 to 2016, lung cancer mortality rates in men have decreased by 3.2% annually. From 2012 to 2016, the lung cancer five-year survival rate was 61% for stage 1.

100%

61%

PROSTATE From 1996 to 2016, prostate cancer mortality rates for men have decreased by 2.4% annually. The five-year relative survival rate for prostate cancer in Alberta is 100% and 47% for stages 3 and 4, respectively.

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FRONT LINE

Running on Empty Understanding how recreational marathon runners deal with fatigue could help cancer patients better manage their own FOR OVER 25 YEARS, KARIN

Olson, a professor in the faculty of nursing at the University of Alberta, has researched cancer-related fatigue. It’s a common side-effect of cancer treatment that causes severe, prolonged periods of exhaustion that can affect day-to-day living and hinder a long-term treatment plan.

To get a better understanding of how to help cancer patients manage fatigue, Olson decided to study another group — recreational marathon runners.

In November 2018, Olson’s study, “Tiredness, Fatigue, and Exhaustion as Perceived

by Recreational Marathon Runners,” was published in the Qualitative Health Research journal. Beginning in 1999, Olson interviewed individuals with advanced cancer, major depressive disorder and chronic fatigue syndrome to hear how they described and experienced fatigue. In 2002, Olson and her team also began interviewing recreational marathon runners to find similarities and differences in how they experienced fatigue.

All runners experienced tiredness during their training and racing, and, in the interviews, explained its physical, cognitive, emotional and social effects. The runners described feeling socially engaged and clear-headed at the beginning of their run, but fatigued midway. They described the sensation of fatigue like hitting a wall. They reported blurry vision, feeling light-headed and having a pounding head. They also felt weepy and emotional and withdrew into themselves.

Olson discovered that it’s not just recreational marathon runners who experience fatigue in this way.

“It’s interesting that, regardless of whether I was talking to people with depression, chronic fatigue syndrome, cancer, runners or shift workers, some of the language that was used was the same,” says Olson. “I was really struck by the similarities.” For example, along with many of the other descriptors, cancer patients expressed that, when fatigued, they withdrew socially.

Olson’s study also found cancer patients experience a

more severe, longer-lasting tiredness than the runners.

Runners’ fatigue didn’t interfere with daily life, disrupt sleep patterns or last for months after a training cycle was over.

Interestingly, runners had specific coping strategies for managing fatigue. They reported using positive self-talk and visualization methods, as well as setting small goals throughout a run. They also cut back on running, but didn’t avoid exercise entirely, when feeling fatigued during training.

“What’s really important is that when the runners were in the recovery phase of their training, they didn’t stop exercising. They continued to be active, but at a less-intense rate,” says Olson. “Good fatigue management needs to include strategies for managing the cognitive components and the emotional changes that happen with fatigue.”

Olson’s main takeaway from the study is that there are several dimensions of fatigue — it’s not just physical. Seeing how recreational marathon runners handle a similar fatigue could

be beneficial for cancer patients to manage the exhaustion that sets in during treatment.

“Cancer treatment protocols include periods of time between treatment cycles to give the body a chance to rest and get ready for the next round of treatment,” says Olson. “During this rest period, individuals with cancer often feel very tired, and the ILLUSTRATION SCOTT CARMICHEAL

10 LEAP WINTER 2020

“ It’s interesting that, regardless of whether I was talking to people with depression, chronic fatigue syndrome, cancer, runners or shift workers, some of the language that was used was the same.” – Karin Olson

temptation is to not be active.”

Olson adds that treatments are sometimes delayed because cancer patients haven’t recovered from the side-effects, including fatigue, before beginning their next cycle. However, like the runners reducing their training volume, Olson says a carefully modified exercise program for individuals with cancer who are resting between

treatment cycles might improve their fatigue. This could minimize treatment delays or dose reductions, and therefore enhance the effectiveness of treatment.

But, as shown by the runners’ effective use of self-talk, exercise is only one component that could help cancer patients manage fatigue.

“I think health-care providers

could help individuals with cancer prepare a strategy that addresses all of the dimensions of fatigue at the beginning of treatment, and before fatigue develops,” says Olson. “It makes more sense to me to make strategies that focus on the social, cognitive and emotional dimensions of fatigue, too.” LEAP — KARIN OLAFSON

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FRONT LINE

BY THE NUMBERS

30

THE NUMBER OF PARTICIPANTS

2

BIKES PER TEAM

$5,000

THE EVENT’S PROJECTED GOAL

$17,793

THE ACTUAL TOTAL AMOUNT RAISED

355.86% THE PERCENTAGE OF FUNDS RAISED COMPARED TO THE GOAL

Sharing the Cancer Experience The Pedal the Path stationary bike marathon raises funds and awareness THE TEAM BEHIND THE FORT MCMURRAY

Community Cancer Centre’s first-ever fundraiser, Pedal the Path, in support of the Alberta Cancer Foundation, had more in mind than just money. Cancer patient navigator and event organizer, Janice Petruk RN, says they also wanted to raise awareness for the centre and the local patient experience.

“There are a lot of people that live here that don’t have a clue that we exist. So, it was really good to see a lot of chatter come out of it,” she says.

Held last October, Pedal the Path was a 12-hour stationary-bike marathon that took place in the lobby of the Northern Lights Regional Health Centre. Three teams of various sizes committed to fundraising and breaking a sweat for the duration, with rules stipulating that one member must cycle at all times. For some, this meant strategic timing to reserve energy, but Petruk says one team’s physical efforts stood out.

“Our Northern Lights Triathlon Club came in and they had six people registered 12 LEAP WINTER 2020

on their team. Some of the team members rode for six hours on their own,” she says.

As part of the event, participants were shown what it’s like to receive cancer care in several inventive ways. The cyclists wore oven mitts for part of the event to replicate the common side-effect of numbness in hands and feet following chemotherapy; riders were blindfolded

donated items was held.

Another team that stood out was Jodine’s Dickinsfield Flyers, led by Jodine Wells, an Albertan who has received treatment at the centre. She single-handedly raised $3,020 in pre-event donations and her team’s overall total was $5,320 — more than the event’s goal of $5,000.

The grand total raised was $17,793, more

The grand total raised was $17,793, more than three times the original goal. The funds will go towards enhancing patient care and providing comfort items at the centre. to simulate the shock and confusion that comes with a diagnosis; bike settings were cranked up to über-hard mode to replicate fatigue after treatment; and the protocol for negative reactions to chemo was demonstrated in part by placing participants on stretchers and in chemo chairs.

There were also moments of lightheartedness. Zumba and yoga offered some reprieve, participants dined on pizza and cake, and a silent auction for community-

than three times the original goal. The funds will go towards enhancing patient care and providing comfort items at the centre.

Beyond raising funds and awareness, the event had an unexpected outcome of creating community.

“One of the comments from the event was that teams came in not knowing anyone else, but they all left as friends,” says Petruk. LEAP — COLIN GALLANT

4 WAYS

Your donation to the Alberta Cancer Foundation is making life better for Albertans facing cancers of the blood Thanks to the generosity of Alberta Cancer Foundation donors, substantial advancements in blood cancer research and enhanced-care programs are expanding treatment options and easing the journey for patients across the province. Here are some examples: BONE MARROW TRANSPLANT PATIENT FINANCIAL ASSISTANCE PROGRAM

INTRODUCING PALLIATIVE CARE EARLIER

Until recently, Albertans undergoing bone marrow or blood stem cell transplants have had limited access to palliative care. A Calgary research group is examining the integration of early supportive palliative care in conjunction with administering life-prolonging treatments for patients with blood cancer.

The study’s goal is to lessen the burden placed on both patients and caregivers while increasing survival rates and improving outcomes.

Albertans requiring bone marrow transplants often need to travel for treatment. The Bone Marrow Transplant Patient Financial Assistance Program offers financial relief for patients by covering costs such as travel and accommodation.

CHEMOTHERAPY AT HOME

NATIONAL DATABASE FOR MULTIPLE MYELOMA

Learn more about how you can support the Alberta Cancer Foundation at albertacancer.ca

In Alberta, chemotherapy is typically delivered in a cancer centre. A Calgary-based study is looking at the feasibility of self-administered chemo- therapy for myeloma patients.

This will significantly reduce time spent at the hospital and allow Albertans to safely receive treatment at home.

A national database led by a team in Edmonton is furthering the study and treatment of multiple myeloma. Thanks to data collected from over 4,500 patients, researchers can use this information to guide treatment plans that will improve outcomes and quality of life.

According to Alberta Health Services, the five-year relative survival rate for leukemia patients in Alberta has increased from 53% for those diagnosed in 1992 to 1994 to 71% for those diagnosed between 2010 and 2012. myleapmagazine.ca WINTER 2020 LEAP 13

WORKOUT

Brave the Cold Embracing the winter weather for an outdoor workout is not just good for your health — it’s also a lot of fun. Here are five winter sports to try and some essentials to wear while you’re out.

by KARIN OLAFSON WHEN THE SNOW IS FLYING, and the temperatures are still below freezing, an outdoor workout might seem less than inviting.

But exercising outdoors, even at this time of year, has proven physical and mental benefits. A 2009 study published in Environmental Health and Preventative Medicine found that being in a natural environment lowers blood pressure, reduces stress and improves mood and self-esteem. A scientific review published in 2011 had similar findings: compared to exercising indoors, exercising outdoors increases energy and decreases feelings of depression.

Paul Chiddle, manager of the University of Calgary’s Outdoor Centre, says that an outdoor winter workout also provides a sense of adventure. Here, Chiddle shares his tips for a few winter activities that will have you working up a sweat in the chilly weather.

1.

FAT BIKING WHY IT’S WORTH IT Fat bikes are similar to mountain bikes, but have larger, thicker tires to help you navigate snowy trails or icy paths so you can enjoy riding throughout the winter. Because these bikes are heavier than mountain bikes, you

can expect to ride at a slower, more controlled pace.

Wider tires also mean it’s easier to balance.

WHERE TO TRY IT Head to Canmore Nordic Centre Provincial Park where there are designated single-track trails where fat biking is permitted. Try the Canmore Trail

or the Orchid Trail. These beginner routes are relatively flat and don’t require technical biking knowledge to complete.

PRO TIP “Don’t forget to read the terrain ahead of you, so your bike is in the right gear as you approach hills,” says Chiddle.

2.

CROSS-COUNTRY SKIING WHY IT’S WORTH IT This is a great low-impact alternative to winter running that improves aerobic fitness and endurance. It is also a full-body workout. And you don’t need to go far to enjoy it — many city parks groom trails after it snows specifically for it.

3.

ICE SKATING

WHERE TO TRY IT The Edmonton Nordic Ski Club developed and maintains the extensive cross-country ski trail system in Edmonton’s Goldbar and Goldstick parks.

Between these two parks, there are more than 10 kilometres of trails. Start with the Two-Way Lake trail in Goldbar Park, a flat, 1.1-km trail.

PRO TIP “Think about your pacing — you don’t need to ski fast for a good workout,” says Chiddle.

WHY IT’S WORTH IT Ice skating is a low-impact winter sport that works your balance and coordination. It’s something the entire family can enjoy together — new skaters can use a skate stabilizer to help with balance as they learn.

WHERE TO TRY IT Calgary’s Bowness Park Lagoon is a picturesque, familyfriendly outdoor rink. You can skate around the pond or adventure up the inlet. The U of C’s Outdoor Centre operates the Bowness Park Skate Shop, where you can rent skates on-site or have your own sharpened.

PRO TIP “Make sure your skates aren’t too tight and that they’re laced up properly to provide ankle support,” says Chiddle.

ILLUSTRATIONS ANDREW BENSON

14 LEAP WINTER 2020

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WORKOUT

4.

WINTER WALKING AND RUNNING WHY IT’S WORTH IT Heading to your favourite park, pathway or trail for a walk is a great way to begin embracing outdoor exercise in the wintertime. Start by setting small goals — your first winter walk or run might be 20 minutes — then increase the duration by a few minutes each week.

WHERE TO TRY IT The City of Lethbridge has more than 170 km of paved pathways for walking and running. Visit Henderson Lake Park and walk the 2.5-km loop around the man-made lake, or challenge yourself to the 4.3-km trail that goes around the perimeter of the park.

PRO TIP “Consider buying mico spikes or cleats that fit over any normal running shoe,” says Chiddle.

“These are useful on popular paths when snow gets packed down and slippery.”

5.

SNOWSHOEING WHY IT’S WORTH IT Snowshoeing is easy to master because it’s much like walking or hiking.

Plus, snowshoes allow you to explore snowy trails that are otherwise inaccessible in the winter. Use poles and you’ll also

16 LEAP WINTER 2020

incorporate your upper body into the workout.

WHERE TO TRY IT Kananaskis Country has numerous marked snowshoe trails, all of which offer scenic views. If you’re up for an adventure, try the Lower Kananaskis Lake Trail. It’s 3.9

km one way, passes through thick forest, and offers impressive views of Mount Indefatigable and the Opal Range.

PRO TIP “In the winter, consider using trekking or ski poles to help with your balance,” says Chiddle. LEAP

!

HOW TO DRESS FOR WINTER WORKOUTS Being prepared for an outdoor winter workout means wearing the right gear.

Paul Chiddle shares some useful tips.

PROTECT YOUR EXTREMITIES “Always wear a good toque and a set of gloves.”

LAYER YOUR CLOTHING “Layer synthetic clothing under a breathable jacket so you can take layers off as you heat up.”

DON’T FORGET SUNGLASSES “Even in the winter, it’s important to protect your eyes.”

FOOD FOCUS

“EAT THE RAINBOW” TO ADD MORE FLAVONOIDS TO YOUR DIET

Fabulous Flavonoids When it comes to reducing your cancer risk, prevention practices, such as exercise and eating well, play a vital role. Flavonoids, a group of phytonutrients with antioxidant and anti-inflammatory properties, are believed to be a potential factor in cancer prevention. >

by ELIZABETH CHORNEY-BOOTH

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FOOD FOCUS

While many of us may not quite understand what flavonoids are, the good news is we’re probably already incorporating them into our diets. FLAVONOIDS give fresh produce their bright colours — meaning, if you’re already “eating the rainbow” by seeking out varied hues of fruit and vegetables, you’re probably doing a good job of getting those flavonoids into your system. They can also be found in grains, barks, roots, stems, flowers, tea and wine.

MAXIMIZING FLAVONOIDS IN YOUR DIET WHAT EXACTLY IS A FLAVONOID? Simply, a flavonoid is a natural plant chemical present in most fruits and vegetables.

There are different subgroups of flavonoids that have varying antioxidant effects: the phytonutrients found in citrus fruit have different properties, for example, than those in brassica vegetables, such as broccoli and cabbage. This is why “eating the rainbow” is essential — different colours and families of fruit and vegetables will provide different flavonoids, so eating a little bit of everything can create a more well-rounded nutritional profile.

A FLAVONOID IS A NATURAL PLANT CHEMICAL PRESENT IN MOST FRUITS AND VEGETABLES

18 LEAP WINTER 2020

“Plants are full of natural chemicals that they use to defend themselves, including flavonoids,” says Kristyn Hall, a consulting dietitian and certified health and wellness coach with Energize Nutrition in Calgary. “So, when we eat that plant, we also ingest those superpowers from that plant.”

While Hall recommends sticking to a plant-forward diet full of many different colourful fruits and vegetables, rather than specifically seeking out flavonoids, she does note some plants are richer in flavonoids than others.

A bright colour isn’t necessarily an indicator of flavonoid richness — white vegetables like onions and garlic are good sources of flavonoids, as are more colourful foods like blueberries, oranges, parsley, and apples.

Hall does not recommend taking flavonoid supplements and says that you should be able to get what you need through a plant-forward diet.

Add some colour to your meals by throwing blue-

berries into your smoothie or granola, tossing a handful of pomegranate seeds onto a green salad, or adding purple cabbage to a coleslaw.

“The best thing to do is to ensure that you’re getting enough plantbased foods at all of your meals,” Hall says. “If you are eating too many processed foods that are high in added sugar, salt and fat and not enough vegetables, you probably are missing your flavonoids.”

Drinking tea is another excellent way to get flavonoids. Black and green tea, in particular, are powerful antioxidants high in flavonoids.

As for cooking, a variety of studies show that flavonoids can be lost during the cooking

process, though dry cooking (frying, roasting, grilling) can better retain flavonoids than boiling or steaming, where phytonutrients can transfer into the cooking water.

BLACK AND GREEN TEAS ARE A GOOD SOURCE OF DIETARY FLAVONOIDS

4 WAYS TO DRINK YOUR FLAVONOIDS

FLAVONOIDS AND CANCER PREVENTION Alberta Health Service’s Healthier Together website reports that 45 per cent of cancers are linked to habits that individuals can change, with healthy eating being a key factor. Canada’s Food Guide doesn’t single out flavonoids specifically, but it does recommend ensuring that half of our plates are filled with fruits and vegetables, which naturally contain flavonoids.

“Regular consumption of flavonoids is associated with a reduction of many chronic diseases, including cancer, cardiovascular disease and neurodegenerative diseases,” Hall says. “But there is a lot that we don’t know. We don’t know when it’s most important to have exposure to flavonoids or how they interact with other components in your food. This is why it’s important to eat whole foods and make sure that there are plenty of plant-based foods on our plates throughout the day, every day.”

Not only can you relax with a nice cuppa, but black and green tea can also be a good source of dietary flavonoids. Alberta is home to many tea importers and tea blenders, but there are also several growers in Alberta producing their own teas.

Since neither black nor green tea grows well in Alberta, most local tea producers specialize in herbal teas, sometimes blending their local herbal crops with imported black or green teas.

1.

VITALITEAS Founded by Fanta Camara, this Edmonton-based company sells a variety of teas, but its specialty is a spicy chai blend, made with locally grown herbs from Chickadee Farm Organic Herbs and ethically sourced black tea. vitaliteas.ca

2.

Citrus Spicy Chai Vinaigrette Recipe developed for Vitaliteas by Chef Najah Shtay of Rio Vida Gluten-Free Bakery, Edmonton INGREDIENTS 1 tsp Spicy Chai Mix with Organic Black Tea 1 fresh orange, lime or lemon, squeezed (optional) MAKE 2/3 cup olive oil A GREAST 2 tsp apple cider vinegar MARINAD 2 tsp tamari sauce CHICKEEN FOR 4 tsp Dijon mustard OR FISH 2 tsp honey 1 clove, mashed 2 tsp finely chopped onion or shallots

sea salt and pepper, to taste DIRECTIONS Mix ingredients together and enjoy over salad. Keep refrigerated and use within seven to 10 days. SERVES 6-8

ALBERTA RHODIOLA ROSEA GROWERS ORGANIZATION (AARGO) Rhodiola rosea, or golden root, is a locally grown plant known to contain flavonoids. AARGO not only supports rhodiola rosea growers, but also sells a tea blend made from the plant’s root via its website. arrgo.ca

3.

CHICKADEE FARM ORGANIC HERBS In addition to supplying providers like Vitaliteas with herbs, Chickadee also makes its own line of herbal teas made with herbs grown on the farm in Flatbush, Alta.

The teas are available at many health food stores throughout the province. chickadeefarmherbs.ca

4.

SENSES OF THE SOUL This Cochrane-based business is run by an herbalist who offers healing consultations, as well as a line of antioxidantrich herbal teas. LEAP sensesofthesoul.ca

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EXPERT ADVICE

neutroprenia or other complications.

Febrile neutroprenia is when your acute white blood cell count becomes dangerously low, and your body becomes unable to mount a response to an infection.

Q: How do these common ailments affect cancer treatment?

We explore how common illnesses affect cancer patients, and break down exactly how your donation dollars to the Alberta Cancer Foundation are used by MAE KROEIS

DR. MARGARET CHURCHER

sick, especially with the flu, they can develop serious complications (like sinus infections and pneumonia), which can put their lives at risk.

A cold is less serious because it doesn’t impact the immune system as much. Congestion from a cold can be unpleasant, but it doesn’t present the same danger as the flu.

People with head and neck cancers or leukemia and lymphoma face additional risks. Because of their types of cancer, they are more likely to get what are known as opportunistic infections such as tuberculosis, hepatitis and shingles.

CANCER AND COMMON AILMENTS

Q: How does cancer treatment affect patients’ immune systems?

Common ailments such as the cold or flu can be a nuisance to the average person with a healthy immune system.

But, for someone undergoing cancer treatment, a cold or flu bug can be a lot more serious. Dr. Margaret Churcher, a family physician in Calgary, explains why:

Treatment for cancer ideally would only attack the cancerous cells in the body, but it isn’t yet advanced enough to know which cells specifically to target, so it attacks all cells, including the immune system. This is why cancer patients have a compromised immune system when undergoing treatment.

Q: Why is a cold or flu virus a concern for cancer patients?

Q: What is the most dangerous common ailment for cancer patients?

A cold or flu compromises the body’s immune system. In a person undergoing treatment for cancer, the immune system is already compromised, so, if they get

If a cancer patient does get the flu, they need to be seen right away by their family doctor or in emergency care so doctors can check for fever and possible febrile

If your immune system has been compromised for any reason, and your white blood cell count is too low to undergo chemotherapy and radiation, you might have to wait until it bounces back up to continue your cancer treatment. Delaying treatment could be a problem for patients with aggressive forms of cancer.

Q: What can patients do to avoid getting ill?

Cancer patients don’t have to avoid being out in public, but they do have to be cautious. [I’d recommend they] wash their hands frequently and be aware of the signs and symptoms of influenza, which are fever and cough, sore throat, headache and aches and pains, so that, if they do become infected, they can seek treatment right away.

This is where the vaccine becomes especially important. Some cancer patients are worried that the flu vaccine will compromise their immune systems and affect their treatment, but the vaccine does not contain the live virus, so it does not harm you.

The flu vaccine is never dangerous, but there is a chance that it would not work as well if you’re undergoing treatment and your immune system is down because your body might be less able to mount a response to the vaccine.

If your oncologist recommends you not take the influenza vaccine, then it would be very important to have everyone around you vaccinated.

Q: What else can people close to patients do?

In addition to the vaccine, family members can help keep cancer patients well by following regular preventative measures like hand washing. It’s also wise to keep their distance if they are ill themselves.

ILLUSTRATIONS JENNIFER MADOLE

20 LEAP WINTER 2020

SHERYL BARLAGE

cost to raise a dollar and benchmark this against other-like charities in Alberta and always look for opportunities to be more efficient. Across revenue streams for the Foundation, the cost to raise a dollar is approximately 24 cents.

Q: Can I target my donation to a specific program or tumour group?

DONATING TO CHARITY Donating money to a philanthropic organization is a valuable way to support the people and communities you care about.

But, once you’ve donated, sometimes it’s hard to know exactly what happens to those funds. Sheryl Barlage is the vice president of fund development at the Alberta Cancer Foundation. Here, she explains how your donation dollars make an impact on cancer patients in Alberta.

Q: I’m interested in donating to the Alberta Cancer Foundation. How will my money be used?

We ensure donor dollars are put towards projects and programs that will have a direct impact on Albertans facing cancer. This includes the most innovative and advanced research opportunities, clinical trials, earlydetection initiatives, and programs that will improve patient and family care.

Q: Are there administrative fees taken from donations?

If so, how much?

As all charities do, the Foundation incurs administrative costs so we can make the largest impact possible for Albertans facing cancer. Different fundraising channels require different amounts of admin costs.

For instance, [admin costs for] the Enbridge Ride to Conquer Cancer are higher and individual giving or planned giving programs are much lower. We measure the

Donors have the opportunity to inquire about designating their gift to different research or care projects, cancer centre sites, or general tumour groups. Options are available for donors to consider where they believe their generosity will have the most impact, and we are happy to have conversations and share information to help donors make that decision. We work with donors to ensure their dollars make the biggest impact — sometimes, those investments can be more general (like clinical trials) and sometimes they are more specific (funding melanoma research, for instance).

Q: Are there programs that are more in need of assistance?

The “Area of Greatest Need” is always a priority for the Foundation [and has its own page on the website]. This fund

ensures that projects and programs with the most need are financially supported.

Currently, some of the areas that require the most support are the Patient Financial Assistance Program, the Patient Navigator Program and Clinical Studies.

No matter what, all donor dollars provide real-life returns for Albertans and their families facing cancer. You are making life better for patients and their families by providing enhanced treatments and improving quality of life.

Q: Is there a way to see the impact my donation has made?

Absolutely. We provide a variety of communications that celebrate the impact of your generosity. Our annual report, progress and impact reports, Leap magazine, videos and stories on the website, and invitations to events are some of the ways you can see your impact first-hand. We are always happy to hear from you so we can tell you more about the impact you have made for Albertans facing cancer. Your generosity is creating more moments for patients across the province, and we are so grateful for your support. LEAP Learn more about how you can donate to the Alberta Cancer Foundation at albertacancer.ca/donate

EXPANDING DONOR$ DOLLAR$ In some cases, the Foundation can leverage your fundraising dollars to generate more money for Albertans facing cancer.

For example, for every $1 raised by donors, the Foundation can attract an additional $2 from other funders. This means three times as many patients can benefit.

myleapmagazine.ca WINTER 2020 LEAP 21

THE INCLUSION ISSUE Nearly one in two Albertans — from every age, race, gender and cultural background — will be diagnosed with cancer in their lifetimes. It’s a disease that doesn’t discriminate.

But, for some patients, a lack of accessibility and inclusion can create a barrier to finding the care they need. To address this, patient-centred cancer research, treatment and care are continuing to evolve to foster inclusivity.

From young adults and Indigenous people to rural Albertans and members of the LGBTQ2S+ community, we explore some of the accessible and welcoming programs and services the province has to offer.

22 LEAP WINTER 2020

IN DIGEN OUS AL BERTAN S

BUILDING UNDERSTANDING AND TRUST The Indigenous Cancer Patient Navigator supports Indigenous Albertans impacted by cancer

by STEPHANIE JOE photography COLIN WAY

ARROW BIG SMOKE, a member of the Piikani Nation, has always been passionate about providing quality health care to Indigenous people.

Her role as southern Alberta’s new Indigenous Cancer Patient Navigator (ICPN) allows her to do just that.

Created by Alberta Health Services in April 2019, the ICPN role is funded thanks to Alberta Cancer Foundation donors. There are two positions in Alberta — one in the south and one in the north. As the southern Alberta ICPN, Big Smoke's scope of care includes patients south of Red Deer to the American border and everything in between. >

é “ I HAVE PERSONALLY SEEN AND EXPERIENCED BIASES IN HEALTH CARE, AND THAT’S PART OF WHAT FUELS MY PASSION TO DO BETTER.” — ARROW BIG SMOKE

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GETTING WISE Big Smoke has worked in the health-care field in Alberta for 10 years — she has experience as both a licensed practical nurse and a registered nurse. As an ICPN, she sees patients primarily out of the Holy Cross Centre in Calgary and sometimes provides services at the Tom Baker Cancer Centre. She works specifically with Indigenous patients and their families impacted by cancer. The position includes offering advocacy, support and connecting patients with resources. Often, during appointments, having another Indigenous person in the room can promote awareness and sensitivity.

“In a meeting with a patient and doctor, if I see that the client appears withdrawn or distant, I will ask if they’re okay and check in with them to see if their needs are being met or if they have further questions for the health-care provider,” she says.

Big Smoke draws from her own experience as an Indigenous woman to bridge understanding between an Indigenous client’s visualization of their care and the health-care community.

“I feel completely honoured to be able to work with our people in this way, and I want to take a sense of humility and modesty with me in doing this work,” she says.

Along with locating cancer programming within the city, Big Smoke helps clients find and connect with other services that are already in place in Calgary, such as through the Elbow River Healing Lodge, Aboriginal Friendship Centre and other Indigenous programming.

These facilitators often have cultural helpers, as well as Elders who have access to and understand protocols of certain cultural practices, such as smudging, singing, prayer and drumming.

Bridging the client’s own knowledge with that of medical professionals is an important part of Big Smoke’s role. More and more, health-care providers recognize the vital connection between physical and spiritual healing for Indigenous patients. It was once illegal in Canada for Indigenous people to practice their culture, so, in order for health-care providers to promote acceptance, they need to help create a safe space for the use of traditional medicines and cultural practices.

“Throughout my journey, I have worked with and have seen Indigenous clients in emergency and cancer care, and I continually find that there are still gaps in understandings,” she says. “I have personally seen and experienced biases in health care, and that’s part of what fuels my passion to do better.”

24 LEAP WINTER 2020

Created in 2001, the AHS Wisdom Council provides guidance and recommendations to AHS on the design, delivery and evaluation of innovative and culturally appropriate health programs and services for Indigenous peoples across Alberta.

The council includes 19 people who are First Nation, Métis and Inuit Elders, Traditional Knowledge Keepers, and Traditional Healers. Council members draw upon their traditional knowledge and cultural practices to offer recommendations for improving things such as health equity, health service quality, access and delivery. For example, the Wisdom Council has offered insight into how AHS supports and services can evolve to include traditional Indigenous healing practices.

It has addressed issues of racism by implementing education and training for culturally safe and patient-centred care approaches, and has created practices to encourage more Indigenous people to work in health care.

Learn more about the Wisdom Council at albertahealthservices.ca

Big Smoke also uses her own experience as an Indigenous woman through her understanding of intergenerational trauma — the idea that trauma is transferred from one generation to the next. For example, she didn’t attend residential school (a network of Canadian government-run schools that separated Indigenous children from their families and culture) herself, but she has family that did. Big Smoke can draw on that shared knowledge to provide quality care for her patients.

“I’m working closely with other providers to contribute to a system change,” she says. “But there’s still a lot of work that needs to be done to acknowledge bias and stereotypes within the health system. It deters people from wanting to come and see us.”

Another barrier to care is that, historically, Indigenous people don’t talk about cancer. This may be related to fear associated with cancer and the thought of burdening their friends and families with the negative stigma that is associated with a cancer diagnoses. This has made it difficult to find and connect with Indigenous cancer survivors. Through her role, Big Smoke has witnessed that Indigenous people can be diagnosed late, which means their prognosis is often not good.

“If no one’s talking about [cancer], then how do they get tested and screened and find out what’s going on in the early stages?” she says.

If there’s one thing Big Smoke would like to advocate for, it’s that people get screened earlier and receive earlier diagnosis. She hopes to help even one person feel safer accessing and navigating the cancer system.

“It’s about coming from a place of recognition, where understanding and trust can be built,” she says. LEAP

é “I FEEL COMPLETELY HONOURED TO BE ABLE TO WORK WITH OUR PEOPLE IN THIS WAY, AND I WANT TO TAKE A SENSE OF HUMILITY AND MODESTY WITH ME IN DOING THIS WORK.” — ARROW BIG SMOKE

myleapmagazine.ca WINTER 2020 LEAP 25

26 LEAP WINTER 2020

RURAL A L B E RTA N S

REACHING OUT Supporting all Albertans through the cancer experience

by FABIAN MAYER illustration PETE RYAN

IN ALBERTA’S biggest cities, facing a cancer

diagnosis can be an isolating experience. In the province’s smaller cities and towns, where care and support are more limited, that feeling is often even more acute.

Two new initiatives from Wellspring are hoping to change that.

For 13 years in Calgary and three in Edmonton, Wellspring has offered non-medical support for cancer patients, survivors and their families and caregivers.

Wellspring runs programs ranging from educational talks to exercise and art classes, while also providing a space for patients and their families to connect and experience community support.

In partnership with the Alberta Cancer Foundation, the organization is now looking to bring some of that support and programming to rural Alberta with two three-year pilot programs. Wellspring Edmonton’s Regional Cancer Support Initiative is targeting remote or underserved communities in northern Alberta and Wellspring Calgary is looking to connect with communities in southern Alberta to co-create sustainable cancer-support communities with its Southern Alberta Strategy Discovery Project.

WHY RURAL ALBERTA?

Both Wellspring Edmonton CEO Martin Dugas and Wellspring Calgary director of programming Sheena Clifford say they regularly get calls from communities throughout Alberta seeking to build supports for their community members living with cancer. Dugas says rural and remote patients have often heard about the programs offered by Wellspring and wonder how they might be able to access them.

“In regional and rural areas of Alberta, support is often absent. It is essential for communities to build their resilience, not only for cancer patients, but for

their immediate family, as well,” says Dugas. “If we don’t take that on, we’re leaving out an entire population.”

WHAT WILL IT OFFER?

Wellspring Calgary’s pilot launched this January, and the team is in the process of connecting with communities, specifically in southern Alberta outside of the city of Calgary, to learn what supports are needed. Clifford hopes her team will be able to offer a minimum of three pilot programs a year. The programs will be driven by what people living with cancer indicate they need, and won't duplicate what already exists.

“We are looking at offering programs over the phone and virtually, using technology so that people can access the type of programs we know are beneficial closer to home,” says Clifford.

Currently, Calgary offers Money Matters, Peer Support and Transitions Support Coach programs over the phone.

Wellspring Edmonton’s pilot program, which will launch in 2020, is still in its initial stages. The team there is also connecting with regional and rural communities in northern Alberta to understand exactly what supports to offer.

Dugas says the ultimate goal goes beyond providing outside programming, to actually building skills and knowledge and connecting resources within rural communities themselves.

“We cannot only attach communities directly to our programming to learn from our experts, but we have a chance to pilot classes and workshops where leadership is being run from the regional communities,” he says.

WHY DOES IT MATTER?

Even though the types of support provided by Wellspring are non-medical, Clifford says studies show that alleviating issues such as isolation can have positive medical effects for cancer patients, while also improving their quality of life.

“One of the huge benefits at Wellspring is to meet others who are going through a similar experience,” says Clifford.

“It’s an opportunity to connect, not feel so alone and learn from each other.”

Both initiatives will help bring some of those benefits to a broader swath of the province. Despite starting with just a few pilot communities, Dugas believes Edmonton’s Regional Cancer Support Initiative can grow initial connections and partnerships into a widespread regional and rural cancer support network.

“If we get the ecosystem right, we’ll be able to build on it and sustain it so it is constantly growing the supports,” says Dugas. “The end result is that we have a regional cancer support community that thrives.” LEAP myleapmagazine.ca WINTER 2020 LEAP 27

CARA BRADFIELD

28 LEAP WINTER 2020

YOUNG A D U LT S

THE BEST LAID PLANS After a cancer diagnosis, the AYA Patient Navigator program helped Cara Bradfield get back to her road map — and learn when to let someone else take the wheel

by ROBBIE JEFFREY photography AARON PEDERSEN

CARA BRADFIELD HAD a plan. As an elementary school teacher, planning was in her DNA. But this was more than a lesson plan — it was a road map for the next chapter of her life. She was 23 years old, had just begun her second year teaching third grade and had recently moved into a new house with her nowfiancé. Everything was going according to plan — until, suddenly, her plans derailed.

In fall 2017, Bradfield was experiencing severe pain. She saw several different doctors, including multiple visits to the emergency room, and received x-rays and ultrasounds until they found a mass. Through all of her appointments, Bradfield remained persistent and continued to fight for a diagnosis. She had a CT scan, then eventually an MRI that revealed the mass was likely some form of malignant and aggressive sarcoma. After a biopsy at the Cross Cancer Institute, she was finally diagnosed with Ewing’s Sarcoma, a rare and debilitating type of cancer that forms in the bone or soft tissue surrounding bones. Within two weeks, she started chemotherapy.

“I expected to move forward in my career and my relationship, and to make a life for myself,” she says. “But, suddenly, I couldn’t.”

Cancer changes anyone’s life, but especially an adolescent or young adult’s (AYA). The appointments and anxiety associated with a new diagnosis and the treatment that follows can be especially intense for someone just beginning their adult life.

This kind of pressure isn’t uncommon. It’s why Alberta Health Services began its AYA Patient Navigator program in early 2014. The first phase of the program took place in northern Alberta. Today, thanks to the generous support of Alberta Cancer Foundation donors, there are two AYA patient navigator roles in Alberta. The first of its kind in Western Canada, the program provides support to AYAs

facing cancer with challenges unique to their age group.

Take Bradfield. She didn’t have years of savings to draw from, like an older adult might, and Ewing’s is rare, so she didn’t have peers to talk to. She was worried about the long-term effects of taking time off from her teaching position and she had concerns about her fertility.

Adult cancer patients might have had children already, but Bradfield hadn’t yet, and motherhood was a key part of her plan.

Jodie Jespersen was the program’s first official AYA patient navigator. (She’s since taken a role with the Stollery Children’s Hospital Foundation.) Bradfield met Jespersen before she even began treatment. Jespersen would check in and sit with her during chemo sessions. If Bradfield needed information, Jespersen could find it.

For instance, she helped Bradfield deal with work challenges, like transitioning from teaching full-time to being on medical leave, among other things.

Jespersen says it’s essential to support AYA patients because this time in their lives is particularly important.

“What happens during these significant years of young adulthood can have a lasting impact on the rest of their life,” Jespersen says.

“Our young people have so much life left to live that it’s so vital that they feel valued, respected and listened to by their cancer team.”

“To her, I wasn’t a sick cancer patient,” Bradfield recalls. “I was a person. Jodie made me feel like I would get back into my real life again and beat this. She didn’t sugarcoat things, because you can’t sugarcoat cancer, but she made it a little easier. She gave me hope.”

Not only did Jespersen help Bradfield stick to her life plans, she also made it easier when life took a detour.

In March 2018, after six cycles of chemo, Bradfield had surgery in Edmonton at the Misericordia Community Hospital. In August, she travelled to the Massachusetts General Hospital in Boston for proton radiation, something Canada does not offer for Bradfield's diagnosis.

It was there, during a visit, that her boyfriend, Mitch, proposed.

Bradfield came back to Edmonton in October 2018 and is now in remission, but she is still experiencing the lingering mental and physical toll of the ordeal. Today, her plans are mostly intact, except for one thing — before starting treatment, her oncologist at the Cross Cancer Institute, Dr. Sarah McKillop, outlined the risk that, if she wanted to harvest her eggs, she’d have to delay chemo by a few weeks, and that could increase the chance of the cancer spreading because it was already in a lymph node. Ultimately, Bradfield decided it was a risk she couldn’t take.

“Cancer took my fertility,” she says. “But cancer gave me a different perspective, too. Now, I’m focused on living in the moment and appreciating the beauty in everything.”

Given the chance, Bradfield would tell another AYA cancer patient this: “Know you’re supported. Know you’re not alone.” Jespersen and the AYA Patient Navigator program, she says, can be a crucial part of this. A beacon of hope can be a lifeline. If you follow that beacon, you’ll end up somewhere worthwhile, even if you didn’t plan to. LEAP myleapmagazine.ca WINTER 2020 LEAP 29

LGB T Q 2 S+ CO M M U NIT IE S

YOU ARE SAFE HERE LGBTQ2S+ initiatives in health care can have life-saving results

by JENNIFER DOROZIO illustration PETE RYAN

IN VULNERABLE TIMES like

illness, feeling supported, understood and seen can be critical to those receiving care. That’s why the definition of patient-centred care is expanding to include much more than a patient’s diagnosis.

For people who identify as LGBTQ2S+ (lesbian, gay, bisexual, transgender, queer and/ or two-spirit), it is important that a health-care space be welcoming and safe, whether they need cancer treatment or anything else, says Amanda Bolderston, a faculty educator in the Radiation Therapy Program at the University of Alberta. A lack of inclusion can make a difference in regards to whether a person feels comfortable accessing care at all.

Bolderston studies approaches to LGBTQ2S+ community health care and is developing a website called Queering Cancer, which includes resources for LGBTQ2S+ people who have cancer.

“Treating everybody the same isn’t really the best care because we’re not the same, we all have unique needs,” says Bolderston.

“If you’re coming into an environment [as an LGBTQ2S+ person] you’re looking for clues that a) it’s friendly and b) they include people like you.”

Practical approaches, like adjusting signage and intake forms and furthering medical professionals’ education about members of the LGBTQ2S+ community can have life-saving effects in the long term, says Bolderston. These resources can help support someone to feel more comfortable expressing their unique needs to a health-care provider and, in turn, get the specific care they require.

For the past four years, Alberta Health Services has taken the initiative to offer more inclusive care to all Albertans, including through its CancerControl Alberta program.

Get acquainted with some of its services: 30 LEAP WINTER 2020

CONNECT CARE Connect Care combines health records into one single electronic file that is accessible across the province within AHS. What’s important is that, among other things, it provides a sensitive and respectful opportunity for an individual to identify themselves and, when appropriate, disclose their sex at birth, administrative gender and gender identity.

“That way we ensure that we accurately reflect a patient’s identity to help them have a safer, more inclusive health-care experience,” says Dr. Ted Braun, AHS vice president and medical director of central and southern Alberta.

The program also offers the

ability to select a third gender – the option of “X” – and a broader range of gender identities like transgender, two-spirit and non-binary.

“A lot of patients who are LGBTQ2S+ don’t come out to health-care professionals because there may be previous experiences that were negative in the health-care system. We don’t often give them a chance to come out,” says the U of A's Amanda Bolderston. “Forms are really important because they allow the patient an easy way to identify initially.”

The first wave of Connect Care rolled out in Edmonton in November 2019. Eventually, AHS plans to implement it across the province.

DIVERSITY AND INCLUSION COUNCIL Since its founding in 2016, the Diversity and Inclusion Council has created LGBTQ2S+ inclusive resources for staff and patients. It also plans Pride parties and organizes a presence in the Pride Parade.

The AHS LGBTQ2S+ / Sexual and Gender Diversity webpage offers tool kits for health-care teams. These include safe space posters, educational videos and

specific documents on things like how to use preferred pronouns when addressing patients.

On the patient side, there are tips on how to bring up sexuality, sexual orientation or gender identity with a health-care provider, resources on transgender health, and information on services that support diversity for all ages from youth to seniors.

SOGIE PAC SOGIE PAC (Sexual Orientation, Gender Identity and Expression) is a new Provincial Advisory Council formed by AHS in January of this year that engages with local communities to understand what’s needed to help LGBTQ2S+ patients feel more supported.

It exists, like many councils within AHS, to improve health services by engaging with the community and then incorporat-

ing relevant feedback to improve how AHS operates in all levels.

Though new, SOGIE PAC plans on eventually informing and enhancing program planning, development and evaluation with contributions and perspectives from the LGBTQ2S+ communities.

“The top priority in [its] work plan is actually creating educational materials for our staff and physicians,” says Braun. LEAP

PRONOUNS PRIMER Not everyone wishes to be referred to as either “he” or “she.” Foster inclusion by identifying the pronouns you prefer first. For example, “I’m Mary Smith, and I use she/ her/hers.”

Examples of personal pronouns She/Her/Hers He/Him/His They/Them/Theirs Ze/Zir/Zirs Per/Per/Pers

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NEW C A N A D I A N S

FEELING HEARD The AHS Interpretation and Translation Services Program helps health-care teams and new Canadians communicate

by SEAN P. YOUNG illustration EMILY CHU

CLEAR COMMUNICATION between patients and health-care workers is paramount when navigating the chaotic fog that can settle in during cancer treatment. It’s essential that patients feel they are heard by their medical team so they can trust the people responsible for their care. Patients must also feel informed and empowered to understand biopsy results, treatment options and a new lexicon of medical terminology from the outset.

For one in six Albertans born outside of Canada — whose first language is often not English — navigating the health-care system can feel nearly impossible. Preventing this potential communication fracture between health-care

1.

AMERICAN SIGN LANGUAGE (ASL) INTERPRETATION Behiel’s team will arrange to have a sign language interpreter physically present during appointments and also offers sign language interpreters via video stream in some AHS locations.

2.

TELEPHONE INTERPRETATION This service is what the program is primarily known for and is offered at all AHS facilities.

AHS employees dial a 1-800 number, key in an access code and, within 30 seconds (on average), a professional medical translator fluent in the patient’s first language is conferenced into the conversation.

Behiel says interpreters are specifically trained to convert complex medical terminology from English to one of 240 available languages, making the vendor’s translation accuracy exceptional. The program

provided more than 125,000 minutes of telephone translation in 85 languages in one month alone (Oct. 2019).

“Google Translate works great if you’re making a hotel reservation or setting up an appointment, but telling someone they have a certain type of cancer — you don’t trust that to A.I.,” Behiel says.

3.

DOCUMENT TRANSLATION Most of the requests for document translation come from physicians who need portions of medical records written in a foreign language translated to English. Behiel says doctors want to understand if the person has received any tests or treatments before coming to Canada. For those about to undergo cancer treatment, their Albertan care team must know their relevant medical history.

“The idea is that we can diminish costs and patient stress by knowing what was done and what the outcomes were,” Behiel says.

workers and new Canadians undergoing treatment is the mission of the AHS Interpretation and Translation Services Program.

“Professional interpreting and translation ensure that our staff have the best opportunity for clear and accurate communication with our patients,” says Louise Behiel, manager, AHS Interpretation and Translation Services. “The best health outcomes happen when the clinician and the patient speak the same language.”

Behiel has managed the program for the past 12 years. All AHS employees, including paramedics and public health inspectors, can use the program, which has been around for close to two decades.

There are four main services available to help bridge a potential communication gap with new Canadians.

4.

LANGUAGEPROFICIENCY TESTING This service is for AHS staff members and rounds out the program’s services. Behiel says managers at AHS facilities, including all those providing cancer care, need to know if their staff can accurately communicate with patients in languages other than English. Patients will often see a health-care worker that appears to be from their birth country and will start conversing with them in their first language. Wanting to help, the AHS staff member will often become the patient’s de facto interpreter, which is great if they are still fluent in the patient’s language. But often they are rarely using Mandarin or Hindi (for example) in their day-to-day lives.

“The risk is if you don’t use your first language regularly and consistently, you lose it,” Behiel says. “And if you don’t speak the language fluently and accurately, then you put our patients at risk.”

Behiel says approximately 20 per cent of staff tested fail the Language Proficiency

Testing. If that happens, they are told by management not to converse in that language with patients. Behiel says it’s nothing personal, and often staff are surprised to find out they are no longer fluent in their first language.

“This is all about making sure our managers know that their staff are appropriately communicating with our patients,” she says. “We also want our patients to be assured they’re getting good advice and good information no matter what language they speak.”

Behiel says demand for all of the program's services continues to grow as her team builds awareness internally through presentations and promotion. Behiel and her team host webinars, presentations and lunches for AHS staff and more.

The Interpretation and Translation Services Program is dedicated to equipping AHS staff with the communications resources they need to fully connect with patients, ensuring the best outcomes.

“This is all about patientcentred care. To reduce the risk to our patients, we have to assist our staff and make sure they’ve got the best resources,” says Behiel. LEAP

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CARING

Natural Benefits Quality of life improves for patients and care teams when provincial parks and health-care systems work together

by JULIA WILLIAMS

IT’S COMMON SENSE THAT A LITTLE FRESH

air does us good, but does going outside actually provide medical benefits? If so, should we make a greater effort to engage people, especially those with serious health conditions, in outdoor experiences?

Sonya Jakubec, a professor with the school of nursing and midwifery at Mount Royal University, believes so.

Jakubec spent her 20s as a community nurse and nursing teacher in West Africa, where most of her work took place outside. After moving to Calgary in 2003, she volunteered for an Alberta Parks group that helped to facilitate outdoor experiences for people with disabilities. These experiences taught her to think differently about what types of activities were possible indoors and outdoors, and even about who stood to benefit from being in nature.

“What we found was that volunteers and caregivers get as much out of those experiences as the official participants,” she says.

Over the past decade, Jakubec has studied the connection between natural spaces and well-being. Working with Mount Royal University, the University of Alberta and Alberta Parks, she led a province-wide survey in 2015 on the role of parks and outdoor spaces in palliative care, which includes pain management, end-of-life care and more. The survey found that over 90 per cent of participants wanted to include nature in their end-of-life experience Jakubec has been involved in other investigations that suggest outdoor experiences have a positive effect on well-being and quality of life for people in cancer recovery, people with disabilities and (as she observed as a volunteer) caregivers.

Outdoor experiences offer broad mental, emotional, spiritual and even physiological benefits. Jakubec’s research found that being in nature can help a person

calm anxiety, build social connections, spark happy memories and temporarily shed their “sick person” or “care partner” identity. It also connects people with the seasons and cycles of the natural world, which can help them reframe their circumstances in positive ways.

Jakubec says people with serious illnesses (and members of their care teams) tend to get caught in a cycle where life seems to revolve around appointments and recuperation and outdoor experiences aren’t a priority. At the same time, care facilities focus on treating and protecting

JAKUBEC’S RESEARCH FOUND THAT BEING IN NATURE CAN HELP A PERSON CALM ANXIETY, BUILD SOCIAL CONNECTIONS, SPARK HAPPY MEMORIES AND TEMPORARILY SHED THEIR “SICK PERSON” OR “CARE PARTNER” IDENTITY. patients, which is easiest to do in a controlled environment, and outdoor experiences can seem unfeasibly risky. Jakubec tells the story of a hospice resident who told her nurse she hadn’t seen the moon for an entire year. Another hospitalized patient longed to eat a meal outside.

The relationship of parks departments to health-care departments is evolving.

Jakubec says many people, from Alberta Parks leaders and palliative care workers to policy-makers, researchers and kinesiologists, have shown eagerness to shift the mindset on nature and health care.

They’re beginning to infiltrate each other’s worlds. Jakubec regularly presents at Alberta Parks conferences and sees Parks people exploring health-care contexts like palliative care conferences.

“There’s a growing inter-sector group of people keen on moving this kind of work forward,” she says.

Alberta Parks has already implemented innovative programs focused on well-being.

Push to Open Nature, for example, is an Alberta-based non-profit that increases access for people of all ability levels and stages of life through barrier-free trails, accessible facilities and offers reduced fees for caregivers. In 2017, Friends of Fish Creek Provincial Park Society in Calgary, along with Mount Royal University and Alberta Parks, launched Good Grief, a program that helps people process grief and loss by participating in eight weeks of group walks. The program has proven so popular that other organizations, including the Palliative Care Society of the Bow Valley, have expressed interest in implementing similar events.

What about the health-care world?

Should going outside be considered a medical intervention and prescribed as a treatment? Jakubec thinks not. “Do we view this as a health program and a prescription? That’s how health care works, and maybe it’s not the right relationship,” she says. Outdoor experiences are personal and based on individual histories, priorities and desires. As such, perhaps what’s needed is not a formal medical framework, but simply an openness to facilitating natural experiences in health care in some way, whether it’s a trip to a provincial park, a meal outside or even installing a bird feeder outside a hospice window.

“It’s a mindset. It’s an invitation to what’s already there,” Jakubec says. “The limitations are really of our own making.” LEAP PHOTO AIDEN JAMES

34 LEAP WINTER 2020

SONYA JAKUBEC AT GLENBOW PARK RANCH

myleapmagazine.ca WINTER 2020 LEAP 35

LIVING WITH CANCER

Meet

DAINA KVISLE ALDOUS

A passionate fundraiser, corporate lawyer and mom, Daina is also living with brain cancer

by MAE KROEIS

DAINA KVISLE ALDOUS WAS DIAGNOSED WITH

KVISLE ALDOUS IN HER FORMAL WEAR FOR THE UNMASKING GBM GALA

glioblastoma multiforme (GBM) brain cancer in May 2018. She completed the standard treatment of chemotherapy and radiation for her aggressive stage 4 diagnosis that August.

Unfortunately, it was unsuccessful.

Determined, Daina and her husband, Paul Aldous, investigated alternative treatments.

Currently, she is participating in an Avastin IV treatment, a type of cancer drug administered intravenously, at the Tom Baker Cancer Centre (TBCC). The drug restricts blood flow to the tumour, and monthly MRIs show no growth.

The genetic component to GBM, which scientists have only begun to investigate, is part of what drives Daina and Paul, parents to sons Beck and Jack, in their fundraising efforts.

Founded in 2018, the Kvisle Fund for GBM supports GBM cancer research initiatives at the TBCC. It has raised over half a million dollars to date in support of the Alberta Cancer Foundation, including from its annual Masquerade Gala called Unmasking GBM. Today, Daina works as a corporate lawyer and is optimistic about the future.

“Living with cancer is being able to roll with the punches, pivot every time something new with my health changes and being ready to respond to whatever those changes are.

“It’s a strategy that came from witnessing my mom live through her diagnosis with GBM. A lot of her treatment involved trying one thing after another to see what might work, but, with GBM being so aggressive, many treatments don’t work. It was the same with me.

“We’ve travelled abroad to access alternative treatments. The reason we started the Kvisle Fund for GBM was because we had the financial ability to travel and access treatments and we wanted there to be more options for people locally that may not have that option.

“With two young kids, I have to believe that I am still going to be here for them when they get their licences or graduate from high school.

But, instead of looking to the future, I enjoy all the moments as they come.” LEAP

PHOTO JARED SYCH

36 LEAP WINTER 2020

myleapmagazine.ca FALL 2019 LEAP 37

RESEAR C ROCKST H AR

by COLLEEN BIONDI + photography COLIN WAY

REASTT B Y F I T TO GE TO IDEN R G E N N I O K O R IS WO ETASTASIS S O K N A EMISK OF BONE MEY NEED > H S E I R AR TIENTS AT R REATMENT TH DR.CC PA AVING T S E CAN ER F I L HE THEM T

38 LEAP WINTER 2020

H

myleapmagazine.ca WINTER 2020 LEAP 39

AS A CHILD, DR. CARRIE Shemanko spent her afternoons and weekends exploring the forests and waterways surrounding her family’s grain farm near Rycroft, Alta.

“I ran wild in the outdoors and became fascinated by nature and biology,” she says.

It was the perfect training ground for her future career as a cancer researcher.

Shemanko first fuelled her fascination for nature and biology during her undergrad degree in genetics and her master’s degree in biochemistry at the University of Alberta. Next, she studied skin biology for her doctorate at the University of Dundee in Scotland. In the late 1990s, she did a post-doc fellowship at the Tumor Biology Center in Freiburg, Germany. It was there that she became interested in breast cancer, specifically understanding why many women who are treated for it also experience bone metastasis, the spreading of cancer into the skeletal system.

The statistics are troubling — 20 to 30 per cent of women who have been treated for breast cancer will experience metastasis, and 70 per cent of those women will experience bone metastasis, specifically. Shemanko’s research is focused on what happens once breast cancer cells reach the bone, and the damage they can cause once they’re there.

“It can take decades for the cancer cells that have spread to the bones to start to reproduce,” she says. “The cancer cells appear to spread to the bone early, but sit dormant for years.”

In 2002, Shemanko joined the faculty of science at the University of Calgary to lead a team of researchers dedicated to exploring the biology of breast-to-bone cancer in the lab.

“My main goal is to see if my research can be implemented clinically and change people’s lives,” she says.

Since 2008, Shemanko has also been a part of the Breast Cancer to Bone Metastases (B2B) Research Program — an initiative that established the tools and the patient resources that will help make her goal a reality. It was funded primarily from the Alberta Cancer Foundation’s former event, 40 LEAP WINTER 2020

the Weekend to End Women’s Cancers.

The B2B program was started by Dr. Nigel Brockton, who was formerly a cancer epidemiologist with Alberta Health Services and now works at the American Institute for Cancer Research in Arlington, Va. The program is compiling resource data (tumour tissue, blood samples and lifestyle information) on 500 Alberta women who have been diagnosed with breast cancer. These women will be tracked over the long term to determine who will develop bone metastasis.

Shemanko led one of four miniprojects under the B2B umbrella. Her

the bone cells, it means they are trying to digest the tooth. The only way we can see this is by brushing the cells away with a toothbrush, then staining the tooth with a dye to see if there are pits.”

Shemanko and her team learned the group of teeth with prolactin-laced breast cancer cells caused changes to the bone cells and, subsequently, damage to the tooth. The cells with no prolactin did not.

In addition to confirming the link between prolactin protein receptors and bone metastasis, the team also drilled down further to identify a signature bio-

“ MY MAIN GOAL IS TO SEE IF MY RESEARCH CAN BE IMPLEMENTED CLINICALLY AND CHANGE PEOPLE’S LIVES.” — DR. CARRIE SHEMANKO

project examined the role of the hormone prolactin, which has been associated with breast cancer for years in the literature, in developing bone metastasis.

The first phase of the project, which started in 2010 and was also supported by the Foundation, looked at breast cancer tissue from 140 women from the Prairies. Some of the women had already developed bone metastasis; others had not. Shemanko and her team measured levels of the prolactin receptor protein in each of the group samples.

They found that women with high levels of prolactin receptor had been diagnosed with bone metastasis, likely due to bone pain or a fracture. Samples with low levels of the protein were not associated with bone metastasis.

The second phase involved applying bone cells and breast cancer cells grown in the lab for research purposes — some laced with prolactin, some with none — to slices of hippopotamus teeth, which have similar structural components to human bone.

“We make little, flat slices of the hippo tooth, then add bone cells to the top with an eyedropper, then breast cancer cells with an eyedropper, then allow them to interact,” she says. “If there are changes in

marker (the specific components are currently proprietary) that can be detected in blood. “This whole project was unique from start to finish,” says Shemanko.

Circling back to the 500-strong B2B cohort, she will now test participants’ blood samples — over time — for this biomarker and track whether it is predictive of developing bone metastasis. If women can be identified as high risk for bone metastasis, the next goal would be to determine if early treatment with targeted medications improves their outcome, as once breast cancer has metastasized into the bone, treatment becomes palliative.

“That is what drives me forward,” she says. “To try to make that change.”

In addition, in 2018, Shemanko joined co-principal investigator Karen Kopciuk in leading the B2B program. (Kopciuk first took over when Brockton left in 2017.)

Other research projects are also percolating. With funding from the Cancer Research Society, she is testing existing drugs to see which ones might be ultimately viable for bone metastasis. “We are trying to find drugs that have a known safety profile and are approved for clinical use,” she explains. “If successful, this will

7

QUESTIONS WITH

DR. SHEMANKO 1. Describe what you do in 10 words or less.

Understand the biology of breast cancer spread to the bone.

2. What’s the biggest misperception about what you do?

Many people think scientists work in isolation, trying to solve a problem. Actually, we work with team members, often from different disciplines, to approach a problem from many vantage points.

3. Where do you get your best ideas?

Reading other scientific discoveries and also speaking with colleagues or students about what they have read or discovered is very helpful to stimulate new ideas.

4. If you weren’t a researcher, what would you be?

I love biology in general, so I’d probably do something in that area, but, if I could diverge, I might be a chef or baker.

5. What’s the hardest lesson you’ve learned?

Scientists very often experience rejection — rejection of a grant proposal that could fund their research and trainees or rejection of a scientific article that represents the lab results. I had to learn that these rejections aren’t the end, but can be overcome with additional work and perseverance.

6. What motivates you?

My love of learning and the knowledge that what I do could lead to improving patients’ lives.

result in a drug getting from the lab to the clinic faster than starting from scratch.”

When out of the lab, she shares her passion and knowledge by teaching cell biology to students at the U of C. Colleagues, including Brockton, are major fans of Shemanko and her work.

“Of course, she is a rockstar,” Brockton says. “Research progress demands tenacity and Carrie has worked tirelessly to reveal the secrets of how prolactin orchestrates both breast cancer cells and the bone

microenvironments where breast cancer cells can take up residence. Despite her tenacity, she is uniquely human, faultlessly modest, open-minded and cares deeply about the plight of breast cancer patients.”

Although research does not always go smoothly, there is no deterring this rockstar.

“I am an eternal optimist,” she says. “You have to work hard and believe that you are doing something of value to get you through those rough spots. I can always see the light at the end of the tunnel.” LEAP

7. What do you do to recharge?

I love being outside doing almost any activity — cycling, hiking or gardening.

myleapmagazine.ca WINTER 2020 LEAP 41

NAREE AGER AT THE TOM BAKER CANCER CENTRE

42 LEAP WINTER 2020

TRUE CALLING

by NATHAN KUNZ photography BRYCE MEYER

FOSTERING A COMMUNITY OF CARE NAREE AGER’S nurturing qualities have been central to her career in cancer care

N

AREE AGER’S CAREER IN CANCER CARE ALL STEMS BACK TO A DECISION

made in her final year of nursing school. Faced with choosing between critical care units for her practicum, while completing her nursing diploma at the Foothills School of Nursing in 1989, Ager says she was initially hesitant to venture into oncology.

“Cancer has a stigma attached to it, and I wasn’t sure I wanted to do that, but I chose it,” says Ager. “It was probably the best decision I ever made because I never veered from that path.”

In the three decades since, Ager has continued working with cancer patients, moving from her initial work as a front-line nurse into her current role as the associate manager of the Blood and Marrow Transplant Program (BMT) and Hematology at the Tom Baker Cancer Centre in Calgary. >

myleapmagazine.ca WINTER 2020 LEAP 43

Ager has spent 24 years working with the Tom Baker’s BMT program following six years on an inpatient unit at the Foothills Medical Centre. In her current role, she focuses on optimizing the delivery of care coordination for patients with malignant hematology diseases and solid tumours, such as lymphoma, through the BMT program. Most of Ager’s work happens behind the scenes, working on projects both within the Tom Baker and provincially, to help cancer patients navigate their treatment journeys with more ease.

On a day-to-day basis, Ager’s role means working closely with physicians, nurses, clerks, social workers and other highly skilled medical professionals, overseeing the operation of the clinic’s outpatient component through her team, while also working closely with the inpatient teams to ensure a seamless line of care.

NATURALLY NURTURING Partly inspired by her mother, who was also a nurse, Ager says she initially entered into the medical field looking for a way to offer her nurturing qualities on a larger scale.

“I’ve always had that innate trait of wanting to reach out and help make things better for people,” says Ager.

“Everybody finds meaning in it in terms of choosing their path in different ways, and for me, it was that patient connection. It was that partnership. It was that journey.”

It’s this profound connection that has kept her inspired throughout her work in health care.

Today, she recalls interactions with a terminal patient early on in her career that helped dissipate the stigma surrounding cancer. Still unsure of her choice to step into cancer care, Ager says she built a connection with the patient and that experience eliminated any hesitation she felt entering the workforce.

“He was the one that made it not as scary,” says Ager. “He was courageous, he was strong, but he was also honest and vulnerable. He had a profound impact on me as I started up my nursing career.”

44 LEAP WINTER 2020

The interaction stayed with Ager, lending to her central philosophy of gathering inspiration from those around her. Years later, witnessing the courage of patients continues to drive much of her work.

“As down as you can be because you’re sad for them, they actually bring you up.

They have that courage; they have that spirit; they have that bright light,” she says. “When they’re going through a time as tough as they are, their ability to hold us up is pretty amazing.”

As she moved from her initial designation in nursing into her current administrative role, Ager admits the transition led to worries regarding losing the patient

connection that attracted her to the field.

As a nurse, working with patients meant feedback came directly to her. In her managerial position, there was a buffer between her and the impact of her work.

Ultimately, it was another manager who told her to take a step back to understand the large-scale effect of her work. Ager recalls her reminder that “everything that you do each and every day trickles down to the patient in some shape or form.”

AN EXTENDED FAMILY Today, Ager says she’s found similar fulfillment from her nursing days through working with and supporting her team.

NAREE AGER CAREER HIGHLIGHTS • Celebrating 30

years of nursing and working with the incredible team that makes up the Blood and Marrow Transplant Program.

•C ompleting a

master of arts in Leadership, Health Specialization in 2014.

Beyond her team, the long-term nature •O pportunities to be part of the funcof BMT treatments tional planning for and complex followthe new Calgary ups often required has Cancer Centre. meant Ager has jour•O perationalizing neyed along with her the extended hours patients for years at a in the Tom Baker Cancer Centre BMT time as they stay with Treatment area the program. She says in 2017 – offering the fulfillment of partextended days and nering with patients weekends. and experiencing milestones with them, from finding new jobs to becoming grandparents, has long been a highlight of her work.

“They really are part of this bigger family,” says Ager. “To able to look after patients, to be allowed into their life — the whole dynamic is quite a privilege.”

Finding inspiration in the compassionate work of her colleagues has been a motivator throughout her leadership work at the Tom Baker.

“It’s hard work and it’s tough work.

Some of our outcomes are not so good, but people keep doing what they do,” she says. “There’s such diversity, yet such community when it comes to the work that we all do. We’re here because we want to be here. We’re here because we love this patient population.”

To better lead her team, Ager also completed a master of arts in leadership through Royal Roads University’s distance learning program in 2014.

CHAMPIONING PATIENT ADVOCACY With patients at the core of her work, Ager has pushed to optimize the BMT experience. Notably, in 2017, she led a project to extend the hours of the department to increase accessibility for patients.

The initiative increased the hours of daily operation during the workweek from eight to 12 hours. The clinic is now open from 7 a.m. to 7 p.m., Monday to Friday. It also extended operation into weekends.

Patients can now access the clinic from 8 a.m. to 4:30 p.m. on Saturdays and Sundays.

Beyond added availability, these extended hours mean patients can access chemotherapy options at the Tom Baker, which was previously unavailable as an outpatient treatment site due to the time restrictions.

“Just hearing that we’ve made a difference to make their journey a little bit more positive, that’s all you need,” says Ager.

Carol Baumgarten, director of Cancer Care Teams for the Tom Baker Cancer Centre, has worked with Ager in several capacities there, including alongside her in the clinic hour extension initiative.

She says Ager has consistently displayed an aptitude for embracing the constantly

evolving health-care field.

“I’ve always been amazed at how Naree has tackled change,” says Baumgarten.

“She has always been a driver for, ‘How can we do things differently? How can we think differently? And is the patient at the centre of our conversation?’”

There are promising developments in Calgary cancer care on the horizon, including the new Calgary Cancer Centre. Currently under construction, it is set to include an entire floor dedicated to outpatient BMT. Ager says she looks forward to offering cancer patients cutting-edge treatment as she continues to work to put new treatment options into practice.

In the meantime, innovations such as the emerging research around CAR T-cell treatment — a process in which patients “T” cells are genetically modified to fight pathogens — present further potential for the world of cancer care, offering yet another evolution of approach to treating the disease.

“It’s complicated because there’s always that vision of what you want to do.

And then it’s part of my role to operationalize that,” admits Ager of developing treatment options.

Despite the daunting task it presents, Ager adds the potential of innovative treatment is exciting, nonetheless. “It is definitely going to shift the way we treat patients in the future,” she says.

Beyond her career, Ager holds further stakes in the future of health care. Her two children are both currently pursuing post-secondary education in health-related fields, representing the third generation of the family in the health sector.

Ager hopes her legacy at the Tom Baker is one directly related to her philosophy of nurturing, patient-centred care.

In the constantly evolving field of cancer care, she hopes these values will continue to be a priority in the medical field. “[I’d like to be remembered for] being a patient advocate, being an advocate for my team and being an advocate for the program,” says Ager. “Really, helping to make the program the best it can be.” LEAP myleapmagazine.ca WINTER 2020 LEAP 45

IMPACT

DON WOOD IS A FAMILY ADVISOR AT THE TOM BAKER CANCER CENTRE

Family First as told to JENNIFER FRIESEN

Don Wood and his wife, Sherry, had their whole lives upended in April 2017 when, after a routine doctor’s visit, she was diagnosed with stage 4 cancer. That same year, Don left his job as the director of an environmental consulting company and started a consulting business of his own so he could care for Sherry through her treatments. Today, Don is a family advisor at the Tom Baker Cancer Centre and a member of the Patient and Family Advisory Council for the new Calgary Cancer Centre. He volunteers his time by offering insight on the health-care system, as well as business oversight on several working groups where patient and family advisors (caregivers) participate with AHS staff and other organizations like the Alberta Cancer Foundation. He and Sherry have joined the Foundation as ambassadors in sharing their story at conferences and speaking engagements, and Don has acted as a patient reviewer for some of the Foundation’s program investments. He shares his story here:

“Everyone has a different story and a different journey.

For me and my wife, Sherry, it started early in 2017.

“Sherry wasn’t feeling well. Her general practitioner was a good friend of hers — someone she could confide in. We didn’t think it would be anything big, but she was sent for an ultrasound right away. It was only 30 minutes later that they called and said, ‘Please come back to the doctor’s office.’

“They sent her for blood work and cancer screening right away, and a week later we sat down with the doctor at the Holy Cross, and she said the words, ‘You have cancer and it is stage 4.’

“Within a week, Sherry was in treatment. She was sent to an ovarian surgeon because, at that time, they believed it was ovarian cancer.

“They did surgery on what they thought was an ovarian cyst, but it turned out that there were cancerous cells elsewhere in her body. They did what they could, but it started a litany of other tests to determine what it was.

It went from a diagnosis of ovarian cancer to colorectal cancer, which meant multiple doses of chemo, with the goal of surgery along the way.

“We’ve had other hiccups. She had stage 4 metastatic colorectal cancer, and it spread to her liver and her lungs. We were lucky she was at the Tom Baker, and we had the best doctors and nursing teams.

“You have to shake the scary parts off. There are rough days, and then you start the next phase of the journey. It’s important to educate yourself. That’s where we are now. She’s been through 29 rounds of chemo and three major surgeries.

“I joined the Patient and Family Advisory Council in early 2019 as a way to give back and share my perspective from my business experience and from being involved in the health-care system.

“You get to a point where you can become an advocate for yourself and your partner. At times, I’ve been on approximately 10 different committee groups at the same time in the hopes of helping in whatever way I could. We had great oncologists and nurses doing amazing work, but by joining the committee, I learned how to navigate the system as a caregiver. And I figured that we’d learned so much from being on the other side of the table, we could help others.” LEAP PHOTO JARED SYCH

46 LEAP WINTER 2020

WHY I DONATE

RON JOHNSTON AND EVELYN CHICOINE

GREAT LOSS TO GREATER PURPOSE

by JENNIFER DOROZIO

Two incredible organizations have big reasons to give back >

PHOTOS PAUL SWANSON

myleapmagazine.ca WINTER 2020 LEAP 47

TO HER SON, MARY JOHNSTON WAS BOTH

a loving mom and a fierce hero.

“She was incredibly compassionate and kind, she always had a smile despite what was going on,” says Ron Johnston.

For 22 years of her life, Mary lived with cancer, specifically melanoma, as well as breast cancer. Ron says that didn’t stop her from being the first to volunteer her time for others, such as on school committees and as president of the Alberta Society of Melanoma, a support group for patients and their families.

He fondly remembers his mom, who lived in Edmonton, writing to the Edmonton Journal about the dangers of tanning beds and not wearing sunscreen — advocating for others to practice safe sun exposure before it was more common knowledge.

“She was very committed to that cause, knowing that it was an avoidable situation,” says Ron, who works as a forensic advisor in evidence recovery with the Edmonton RCMP. Mary passed away in June 2004, leaving behind four children and her husband, Dr. Bill Johnston, as well as numerous others who knew and loved her.

Her legacy is preserved, in part, by the founding of the Mary Johnston Chair in Melanoma Research at the Cross Cancer Institute, funded thanks to the generosity of Alberta Cancer Foundation donors in 2006.

The chair was established through the joint efforts of Mary’s family and Bill, who was formerly the director for the division of orthopedic surgery and chief of surgery at the University of Alberta Hospital and Grey Nuns Community Hospital. Bill passed away in 2018.

The first of its kind in Canada, the chair supports direct and continued research into prevention, detection and treatments specifically for malignant melanoma, helping to pair researchers and clinicians with the resources they need.

The story does not end there, however.

It was while still grieving the loss of his mother, in 2010, that Ron learned of a small, Edmonton-based fundraiser committed to donating a significant portion of its funds to his mother’s chair.

The fundraiser, Win4Skin, is dedicated to Owen Schlosser. Owen was one of six 48 LEAP WINTER 2020

children and was well-loved by many friends and family who knew him. In 2009, at 21 years old, he was diagnosed with malignant melanoma. He passed away that same year.

In his honour, family and friends created the Owen Schlosser Endowment Fund through the Edmonton Community Foundation, which gives money raised from Win4Skin to a group of organizations that support kids’ access to sports. Along with the fund, Win4Skin shares annual proceeds with the Mary Johnston Chair.

Held in 2010, the first Win4Skin event, a 3-on-3 hockey tournament, raised $32,000.

Knowing that the Mary Johnston Chair was created for melanoma research, the founders of Win4Skin thought it was a natural fit to receive event proceeds.

“Ron’s family was an immediate connection because they were raising funds to help with research and the care of patients with exactly what Owen had suffered,” says Evelyn Chicoine, Owen’s oldest sister and a Win4Skin committee member.

Ron had to know more, so he made a call to David Chapman, the founder of Win4Skin who also lives in Edmonton.

“When we talked on the phone that first half-hour, I described how much it meant to me,” says Ron. “These people that didn’t know my mom decided to raise money.”

It turned out that Ron and David, who is now a urology resident at the University of Alberta, had a lot in common, including that they had both experienced the loss of a loved one due to melanoma.

Hearing Owen’s story and his family’s commitment to supporting the Mary

Johnston Chair, Ron offered to help Win4Skin in any way he could. Over the next 10 years, with the work of a growing team — including Ron, his family, and Owen’s friends and family — the event grew.

In that time, Win4Skin has raised more than $950,000 for both organizations.

How Win4Skin fundraises has morphed over the years, but it always involves sports, in honour of Owen’s love of all things active, as well as a gala dinner.

“Owen was always a very happy, lighthearted guy; he was also very active,” says David, who first met Owen in high school.

The latest Win4Skin event, in June 2019, took place over a month, with a five-kilometre run, bowling event and soldout gala, raising more than $153,000.

“Each year, we seem to have new people coming in through the community that have been impacted by skin cancer, or have a passion about children accessing sports,” says Evelyn, who works in business development.

“Win4Skin reminds us of what amazing people both Owen and Mary were, but it’s also a forum for us to give back.”

Heading into its 11th year in 2020, Win4Skin inspires thankfulness in Ron, who is grateful for this community of former strangers who became friends.

“The biggest thing is trying to honour my mom’s legacy,” he says. “I’m humbled by the courage that she showed when facing melanoma by working tirelessly to try to prevent other people from going through the same thing.” LEAP Learn more at win4skin.com

MY LEAP

IN THE PAST 20 YEARS, THE WISE GOLF TOURNAMENT HAS DONATED MORE THAN $150,000 TO THE ALBERTA CANCER FOUNDATION

Teeing Off for Change For the past two decades, the Annual Women in Seismic Golf Tournament has contributed to the Alberta Cancer Foundation in a big way

by NATHAN KUNZ

EACH SEPTEMBER, THE WOMEN IN SEISMIC (WISE) COMMITTEE

hits the links at the Fox Hollow Golf Course in Calgary for an afternoon of networking and golf at the Annual Women in Seismic Golf Tournament.

But, for the participants involved, the afternoon is more than a chance to show off their putting skills — it’s golf fore a great cause.

Over the past 20 years, the tournament has raised and donated more than $150,000 to the Alberta Cancer Foundation in support of women’s cancer research.

According to former chair and current WiSe Golf Tournament committee member Joanne Poloway, knowing the event has had a positive impact for those facing cancer brings extra meaning to the annual tournament.

“Everybody knows somebody who has or has had cancer,” says Poloway, who has participated in the tournament since it began.

“Knowing that it potentially helped somebody that I know going through cancer, it’s just a nice feeling.”

The event first took shape in the mid-1990s after women involved in the oil and gas industry noticed a gap in female-centric golf tournament options.

Described as a “networking event disguised as a golf tournament,” the WiSe Golf Tournament emerged as a not-so-serious take on the often overly competitive alternatives. The event aims to give women in the field who work together on a daily basis — often exclusively by phone or over email — a chance to meet face-to-face and enjoy a fun-focused round of golf.

Originating as an 18-hole round, the WiSe Golf Tournament has since evolved to its current form as a 9-hole round of best ball at the central location of Fox Hollow in northeast Calgary.

While the event makes a serious impact through donations each year, Poloway says the tone is far from formal.

Mulligans are sold to golfers at rates of one for $5, three for $10, along with “grenades” that allow the golfer to pick up and throw the ball for a better lie.

Golfers can also pay for course pros to take a shot for them. Prize categories follow suit, with past awards for “Furthest from the Pin” and “Most Balls in the Sand.”

Recent years have also come with themes, from last year’s “Time Warp” to previous course attire based on “Superheroes” and “1980s.”

“It’s always been really, really fun and not very serious at all,” explains Poloway. “And that’s from day one.”

In addition to donations to the Alberta Cancer Foundation, a portion of funds raised from the tournament also support the Canadian Society of Exploration Geophysicists (CSEG).

“ We’re raising money for a good cause and we get to dress up. It’s just a lot of fun.” — JOANNE POLOWAY Participants of all skill levels and genders are welcome at the event, which will tee back up in September 2020 for another round. If you’re looking to take part, Poloway recommends overlooking any hesitation you may have related to the words “golf tournament.”

“You definitely don’t have to be a good golfer,” says Poloway. “We’re raising money for a good cause and we get to dress up. It’s just a lot of fun. It’s a golf tournament for non-golfers.” LEAP The 21st Annual WiSe Golf Tournament is scheduled to return to Fox Hollow Sept. 10, 2020. Golfers and sponsors can register at app.eventcaddy.com/events/ women-in-seismic myleapmagazine.ca WINTER 2020 LEAP 49

GAME CHANGER

FROM LEFT: DR. PAUL LAPOINTE AND DR. JOHN WALKER WITH FRANCHISEES BOB ADAMS, BARRY ARNDT, AND DALE SCHMIDT

Coming Together for the Cause Boston Pizza is committed to supporting cancer research

by JENNIFER FRIESEN

OVER THE PAST 27 YEARS, THE BOSTON PIZZA CHARITY GOLF CLASSIC

— hosted by the Northern Alberta Boston Pizza franchisees — has raised more than $3.1 million to support Albertan charities. For the first decade, it allocated the money to a variety of different charities every year, but all that changed in 2002.

In the early 2000s, Edmonton Boston Pizza franchisee and current Charity Golf Classic co-chair Bob Adams was supporting his wife, Elise, through treatment for breast cancer. Sadly, she passed away from the disease, and the heartbreaking experience transformed the charitable direction of the tournament toward cancer research.

From 2002 on, the Northern Alberta Boston Pizza franchisees, who represent 68 locations in northern Alberta, have donated approximately 90 per cent of proceeds from the Boston Pizza Golf Charity Classic tournament to the Alberta Cancer Foundation in support of the Cross Cancer Institute. (The remaining proceeds go to various other charities.)

“Through seeing the care that his wife received at the Cross Cancer Institute, Bob and the other franchisees came together and just knew they had to support the facility,” says Samantha Kelch, Northern Alberta Boston Pizza’s event planner.

The annual tournament, which takes place at the Blackhawk Golf Course in Spruce Grove on the second Thursday in September, has raised over $2.2 million exclusively for the Foundation. The franchisees focus on using those funds to support research projects that will have a tangible impact on people’s lives in Alberta.

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“We have a way of being intentional with our money so we can see that impact go further,” says Kelch. “We try to be a part of projects that have consistency, so it’s not just one-off donations — we’re right in the thick of it.”

Last year, the Northern Alberta Boston Pizza franchisees pledged $450,000 to an investigator-initiated trial in immunotherapy led by Dr. John Walker at the Cross Cancer Institute. The project focuses on repurposing drugs to boost immune response in cancers that were previously unresponsive to immunotherapy, including melanoma.

Kelch recalls an early presentation by Dr. Walker that showed a 10-per cent survival rate in people diagnosed with advanced skin cancer in 2010. Today, thanks to trials in immunotherapy, Dr. Walker shows long-term survival rates closer to 60 per cent.

“I remember thinking, oh my God, that’s it right there,” says Kelch. “Those dollars are working. This cause and the potential for it was there, and we’re so excited to be able to push it forward. I get goosebumps just thinking about it and how effective it will be.”

To reach their $450,000 pledge, the franchisees kicked off the funding with $175,000 from the pool of money raised at the 2019 Golf Charity Classic. The rest will be donated with funds from the tournament over the next two years, providing the event continues to be as successful as it has been.

Previously, the franchisees, and additional generous fundraising partners, helped fund Western Canada’s first PET-MR scanner with a total donation of more than $1.7 million. This unrivalled imaging technology combines magnetic resonance imaging (MRI) with positron emission tomography (PET), allowing researchers to detect cancer easier, and to understand, more than ever before, how it behaves in the body. The PET-MR technology became available at the Cross Cancer Institute in 2018, after years of support from the Northern Alberta Boston Pizza franchisees. Following that, the same group of fundraisers raised $1.2 million in support of the Linac MR – another revolutionary technology that will improve treatment options for patients.

Kelch says she’s continually humbled by the projects she’s seen flourish with the help of the Boston Pizza Charity Golf Classic.

“It goes to show that there’s strength in numbers,” she says. “Even if people can only donate a dollar or their time, it all makes a difference.” LEAP