Leap Spring 2020

POINT OF CARE A portable ultrasound benefits patients and caregivers

RIBBONS OF HOPE A new campaign inspires messages of love

3 MAJOR WAYS

Your donations benefit melanoma research and treatment

SPRING 2020

LIVING WITH CANCER FOR JULIE ROHR, GRATITUDE IS THE FUEL THAT KEEPS HER GOING

BEYOND BARRIERS

EXPLORING CANCER AND STIGMA

+DIG IN! PM 40030911

EVERYTHING YOU NEED TO KNOW ABOUT GROWING GARLIC

CONTENTS 38

34 CARING The Point-of-Care Ultrasound allows physicians to treat patients in their homes.

35 MY LEAP Motorcycles Ride Against Cancer supports patients in need.

36 LIVING WITH CANCER Julie Rohr shares how she’s living well with cancer.

38 RESEARCH ROCKSTAR Medical physicist Dr. Tyler Meyer is working to make brachytherapy treatments more convenient and accessible for patients.

FEATURES

22 B EYOND BARRIERS: EXPLORING CANCER AND STIGMA

From acknowledging cultural barriers and increasing access to screening programs to talking openly about diagnosis and sexual health, we explore how solutions for addressing stigma around cancer have evolved for the better.

COLUMNS/DEPARTMENTS Plus, the latest cancerrelated exercise guidelines, the Hope Ties Us Together campaign and more.

7 FRONT LINE Dr. Warren Chan uses nanotechnology to image, diagnose and treat disease.

COVER: PHOTO RYAN PARKER THIS PAGE: ANDREW BENSON

13 YOUR DONATION MATTERS Your donations to the Alberta Cancer Foundation are funding promising melanoma-based research, treatment and community initiatives.

14 WORKOUT Why group training classes can motivate you to train harder, and suggestions for where to sweat.

14

17 FOOD FOCUS Everything you need to know about allium vegetables — vegetables in the onion family — as well as tips and tricks for how to grow your own.

20 ASK THE EXPERTS Understanding the signs and symptoms of pancreatic cancer, and how to access EI sickness benefits.

42 TRUE CALLING Sandra Guzzwell, ambulatory and systemic therapy unit manager at the Grande Prairie Cancer Centre, has fostered a safe and welcoming environment.

46 IMPACT Nancy Barnes reflects on her journey to healing.

48 WHY I DONATE The Edmonton Civic Employees Charitable Assistance Fund supports the Alberta Cancer Foundation in a big way.

50 GAME CHANGER EFW Radiology’s team-focused culture means it gives back in a variety of ways.

myleapmagazine.ca SPRING 2020 LEAP 3

MESSAGE

TRUSTEES

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

GET YOUR FREE ISSUE! VISIT

a/leap/ albertacancer.c n leapsubscriptio

Exploring Cancer and Stigma A lot has changed between the time we first started working on this issue of Leap and the time it will arrive in your — digital and physical — mailboxes. When we began planning these stories over five months ago, we hadn’t yet heard about a “coronavirus” and wouldn’t have predicted how much of our world would change.

Just like the rest of you, the Alberta Cancer Foundation team adapted to COVID-19 and began working from home early after public health measures were announced. We kept a few essential workers in our Edmonton office who stayed to process the donations we’re still so grateful to receive and to maintain some of our financial operations. We also needed staff to process the growing claims to our Patient Financial Assistance Program.

We are all dealing with COVID-19 in some way, and for cancer patients and their families, this is no exception.

At this time, we have focused on key priorities that will deliver the biggest impact where it’s needed, when it’s needed. For us, that means supporting the 17 Alberta Health Services cancer centres, their patients, families and incredible staff right across the province as well as our Patient Financial Assistance Program that is now bursting at the seams.

Social workers say applications to this program have increased dramatically since the pandemic began. Patients and families in the middle of cancer treatment are struggling to make ends meet, and worry about the extra costs of travelling to cities. This includes finding safe accommodation so patients can isolate and lower their risk of getting sick. They need us now more than ever.

Every day, 53 Albertans continue to hear the words, “you have cancer.” They are still entering the cancer centres daily to receive treatment and

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

care. Research still needs to be done to find new discoveries and advancements. This important work doesn’t stop.

As an organization, we’ve adjusted. We’ve become adept at videoconferencing. We’ve discovered new ways to engage with you, our donors, as well as with patients and family members, staff at the cancer centres and each other. Sadly, we’ve had to cancel or postpone many of our events, including our big Enbridge Ride to Conquer Cancer in July. Aside from being such an inspirational event that sees cyclists ride more than 200 kilometres over two days, it is a significant source of annual revenue for us. It’s a loss in more ways than one. Despite these adjustments — some bigger than others — one thing that hasn’t changed is our purpose “to create more moments for Albertans facing cancer by inspiring our community to give.”

We know the financial situation has changed for many Albertans, but we also see so many generous donors stepping up and giving more because they want to continue to help.

We are hoping people will be back to work soon, and that many of the events we planned in the late summer or early fall to raise money for Albertans facing cancer will still be able to go ahead. In the meantime, we’ve created virtual events as a way for people to be active while social distancing and still raise money for the cancer centres across this province.

We are closely following public health guidelines as they evolve. Until then, we are so grateful to Albertans who continue to give when they can. They still need you. We still need you and are grateful for all of you.

We hope you find inspiration in this issue of Leap as you read about Albertans helping Albertans.

DR. CHRIS EAGLE, BOARD CHAIR ALBERTA CANCER FOUNDATION

SPRING 2020

|

VOL. 10

|

NO. 3

ALBERTA CANCER FOUNDATION EDITORS

Phoebe Dey and Christiane Gauthier

MANAGING EDITOR Meredith Bailey ART DIRECTOR Kim Larson STAFF PHOTOGRAPHER Jared Sych CONTRIBUTORS Catherine Anderson, Andrew Benson, Colleen Biondi, Charles Burke, Scott Carmichael, Robert Carter, Elizabeth Chorney-Booth, Mai Ly Degnan, Jennifer Dorozio, Spencer Flock, Jennifer Friesen, Jennifer Green, Samantha Gryba, Kyle Hack, Glenn Harvey, Aiden James, Stephanie Joe, Nathan Kunz, Jennifer Madole, Kailee Mandel, Bryce Meyer, Fabian Mayer, Karin Olafson, Ryan Parker, Paul Swanson, Keri Sweetman, Colin Way, Julia Williams, Sean Young

PUBLISHED FOR

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

PROVINCIAL OFFICE

710, 10123 99 St. N.W. Edmonton, Alberta T5J 3H1 Tel: 780-643-4400 Toll free: 1-866-412-4222 acfonline@albertacancer.ca

PUBLISHED BY

Redpoint Media & Marketing Solutions 100, 1900 11 St. S.E. Calgary, Alberta T2G 3G2 Phone: 403-240-9055 Toll free: 1-877-963-9333 Fax: 403-240-9059 info@redpointmedia.ca PM 40030911 Return undeliverable Canadian addresses to the Edmonton address above.

PRESIDENT & CEO Pete Graves EDITORIAL DIRECTOR Jill Foran PRODUCTION MANAGER Mike Matovich AUDIENCE DEVELOPMENT MANAGER Rob Kelly

myleapmagazine.ca SPRING 2020 LEAP 5

FRONTLINE FRONT PRESCRIBING EXERCISE

|

BIG BLUE SKY

|

RIBBONS OF HOPE

BRIGHT MIND

Dr. Warren Chan uses his knowledge and expertise to create more precise treatments and guide research proposals

F

or Dr. Warren Chan, working on a small scale can mean making a big difference.

Through his work as a professor and director of the Institute of Biomaterials and Biomedical Engineering at the University of Toronto (U of T), Chan is helping the progress of utilizing nanotechnology for medical use, creating more precise treatment through materials approximately 100,000 times smaller than the diameter of a human hair.

“We live in a world of technology where we should be able to be more precise in how we do these things,” he says of medical treatment. “What my lab works on is actually trying to deliver drugs specifically to target sites, and our target site is a tumour.”

Chan’s passion for advancing patient care goes beyond his own research, too.

In his time away from the lab, he acts as an academic reviewer for several funding bodies, including the Alberta Cancer Foundation. By taking a critical look at research proposals, Chan helps assess what work he believes is worth funding, weighing each for its potential to make an impact. >

DR. WARREN CHAN AT HIS LAB AT THE UNIVERSITY OF TORONTO

PHOTOS KAILEE MANDEL

myleapmagazine.ca SPRING 2020 LEAP 7

FRONT LINE

OUTSIDE OF THE LAB, CHAN WORKS AS AN ACADEMIC REVIEWER FOR THE ALBERTA CANCER FOUNDATION

“My role is to figure out what’s the best science with the highest potential to impact cancer in Alberta,” he says.

“I’m always happy to do it.

That’s part of the service as an academic.”

Chan’s expertise as an academic reviewer further shines in his ability to translate complex science into layman’s terms for review committees.

It’s a skill that’s particularly useful for patient advisor committee members who say Chan not only helps them understand the science behind the research, but also allows them to express their ideas in meaningful ways.

The Alberta Cancer Foundation is responsible for allocating donor dollars to the most cutting-edge technology and research that will have a direct impact on patients facing cancer. Having Chan’s knowledge on board is invaluable for 8 LEAP SPRING 2020

health-care professionals, and by extension, patients and families in Alberta and beyond.

“The impact [of Alberta Cancer Foundation funded research] in Alberta is immediate, but if it works, the technology can affect cancer patients all over the world,” he says.

In terms of his personal research, Chan’s interest in nanotechnology began in the late 1990s, when he worked on new strategies to label a cell for imaging during grad school at Indiana University. Noticing the shortcomings of using organic molecules, which were the norm at the time, he switched to the alternative of nanoparticles with metal components.

Using these new materials, he developed “quantum dots”— fluorescent nanocrystals that glow different colours, which made them ideal for labeling molecules on cells. Following this

success, he began to see the potential in medical application.

“We discovered, as time went on, that we may be able to use these as contrast agents for imaging tumours and cancer and all different types of diseases,” says Chan. “That’s when I began working in applying nanotechnology to medical detection or medical applications.”

The research has continued over the subsequent decades, with Chan and his team further developing the medical use of nanotechnology. Through meticulously designing carriers to transport drugs within the body, nanomaterials can be used to precisely locate and treat tumours.

Not only is this precision beneficial in treatment by increasing efficiency and limiting side-effects common in full-body therapeutics, it’s also effective in diagnosis and early

detection. While Chan notes nanotechnology in cancer care is still in its infancy, its potential is exciting.

“When you think about it, it’s pretty rad, right? You can design something that can target a specific cell type or specific molecule in the body,” he says.

In Toronto, Chan’s research is done through his Integrated Nanotechnology and Biomedical Sciences Laboratory at the U of T — known as the Chan Lab. Comprised of around 20 graduate students, postdocs and a research scientist, the Chan Lab takes on several facets of nanomaterial application and carries out groundbreaking work in the field.

Recently, the lab published a paper suggesting that nanomaterials enter through tumour cells, rather than between gaps in the tumour blood vessel.

According to Chan, this idea could challenge the way nanotechnology is applied in cancer application.

Today, Chan is hesitant to speak about his professional legacy just yet, insisting there’s still more he hopes to accomplish. When asked of his proudest achievement to this point, however, his answer requires nearly no pause.

“That’s easy. What I’m most proud of is my trainees,” he says. “It’s been incredible to watch them grow from understanding how to do basic experiments to the point that they can tackle the biggest problems in the world.” LEAP — NATHAN KUNZ

Ribbons of Hope A new campaign invites patients to write inspiring messages THE HOPE TIES US TOGETHER

campaign encourages Alberta Health Services staff, patients and visitors to write messages of hope on ribbons destined for the construction fence of the new Calgary Cancer Centre.

The campaign was born in August 2019 when PCL Construction provided a progress update on the new centre to the Patient & Family Advisory Council.

The conversation quickly turned to how a connection could be created between the healing work already happening in CancerControl Alberta and the new building.

“Encouraging people to write a message on a ribbon gives them a very unique and powerful opportunity to show what the new Cancer Centre means to them,” says Donna Oswell, a patient and family advisor. “Together this wonderful project will contribute to the development of a sense of community, which is vital for the new Calgary Cancer Centre.”

Toby Hendrie, project lead, PCL Construction Management, adds: “We were already proud to be ‘building hope’ at the new Calgary Cancer Centre, but the messages on the ribbons really reinforces the importance of the new facility to staff,

TO DATE, MORE THAN 400 RIBBONS HAVE BEEN COLLECTED

patients and their families. The construction team have also started adding their own personal and inspirational messages of hope, support, remembrance and survival.”

If you would like to write your own message of hope for Hope Ties Us Together, the project team has recently launched an online method to collect messages. Please visit together4health.albertahealthservices.ca/calgary-cancer-centre/ brainstormers/hope-ties-us-together and project staff will write on your behalf. LEAP

Messages of love and hope include: “Building strength together.” “ TBCC is a healing and caring place.” “ I miss you grandma and grandpa.” “ You’re always in my thoughts!” “ So grateful we will have this new facility which will benefit so many people from patients to workers to families, and a fantastic community to build it!”

— CATHERINE ANDERSON & JENNIFER GREEN

(Re-printed with permission from AHS) myleapmagazine.ca SPRING 2020 LEAP 9

FRONT LINE

Movement as Medicine Dr. Kerry Courneya played an instrumental role in the recently updated exercise guidelines for cancer survivors DR. KERRY COURNEYA, A PROFESSOR

in the faculty of kinesiology, sport and recreation at the University of Alberta, has been researching physical activity and its benefits for people diagnosed with cancer since 1994. In every aspect of his research, and through multiple ongoing studies, Courneya is working to address the same questions: Can an exercise program help manage cancer-related side-effects, increase treatment tolerance and response, slow progression, and even limit recur-

rence? And if it can, what kind of exercise program is most effective?

Because of the knowledge he’s gleaned in this field over the years, Courneya was one of many experts who worked on updating the exercise guidelines for cancer survivors, which were published in the journal Medicine & Science in Sport & Exercise in November 2019. The updated guidelines build on the first exercise guidelines for cancer survivors published in 2010, and are intended for exercise and

medical professionals.

In 2010, the number of exercise-related studies for cancer survivors was limited compared to the huge amount of new evidence now available. An international group of experts, led by Kristin Campbell from the University of British Columbia, analysed this new evidence, and the updated 2019 guidelines are the end-result.

Here, Courneya discusses what’s new in the exercise guidelines and what results he hopes his ongoing research will answer.

ILLUSTRATION KYLE HACK

10 LEAP SPRING 2020

Why focus your research on the effects of exercise after a cancer diagnosis?

This topic is important because many cancer patients want to know if there is anything they can do themselves to improve their chances and maintain quality of life.

Exercise may help cancer patients prepare for cancer treatments, tolerate and respond to cancer treatments, and manage treatment side-effects. Exercise could also help with recovery after treatments and improve long-term outcomes.

What role did you play in the creation of the updated exercise guidelines for cancer survivors?

I was a co-author for the entire guideline, and I was responsible for writing the sections on cancer treatment completion and response. My previous studies — like the analysis of the effects of aerobic and resistance exercise in breast cancer patients receiving chemotherapy, which was published in 2007 — are cited in the guidelines and helped influence them. My ongoing studies did not factor into these

updated guidelines because we do not know the results yet.

Can you explain what’s different in these guidelines from the first guidelines published in 2010?

The big difference is that we now provide exercise guidelines for specific treatment side-effects, such as fatigue, sleep quality, depression and bone health.

What are the key points cancer survivors should take away from these updated guidelines?

Exercise is safe and feasible for most cancer patients, even during intensive treatments. They will get benefits like improvements in aerobic fitness, muscular strength and body composition.

However, they will also get some unique benefits related to cancer-specific symptoms and side-effects. The big question is whether some patients may even improve their treatment tolerance, treatment response, risk of recurrence and overall survival. But this is an active area of research. LEAP — KARIN OLAFSON

PRESCRIBING EXERCISE According to the updated exercise guidelines, there’s strong evidence of consistent improvements to cancer-related side-effects with these three exercise prescriptions: SIDE-EFFECT

ANXIETY AND DEPRESSION Between 30 and 60 minutes of moderateintensity aerobic training, done three times per week for 12 weeks.

Combining 20 to 40 minutes of aerobic and resistance training twice a week for six to 12 weeks is also recommended.

SIDE-EFFECT

CANCER-RELATED FATIGUE During a 12-week training program, 30 minutes of moderate-intensity aerobic exercise done three days per week is recommended.

SIDE-EFFECT

LYMPHEDEMA A long-term resistance training program done two to three sessions per week under the supervision of a fitness professional. The program should begin with the participant lifting lighter weight before slowly progressing to heavier weights.

GET MOVING! Alberta Cancer Exercise (ACE) is a free, 12-week community exercise program and fiveyear study. It began in 2017, and is funded by multiple partners including the Alberta Cancer Foundation.

It is specifically for cancer survivors or patients currently undergoing treatment and is run out of community fitness facilities across the province. During the program, ACE instructors, with cancer-specific knowledge and training, lead participants through group classes two times a week.

Learn more at albertacancerexercise.com

myleapmagazine.ca SPRING 2020 LEAP 11

FRONT LINE

OLYMPIAN JAMIE SALÉ WILL BE HOSTING THE BIG BLUE SKY GALA

Celebrating the Best of Alberta The Alberta Cancer Foundation’s inaugural Big Blue Sky Gala highlights the best of the province while supporting Albertans facing cancer FROM NORTH TO SOUTH,

east to west, Albertans have one thing in common — a love for our province, our people and our communities. Known for our friendliness, diversity, resilience, generosity and good citizenship, Albertans have a lot to be proud of.

The Alberta Cancer Foundation’s inaugural Big Blue Sky Gala is an opportunity to celebrate all things Albertan — from music and art to sports and cuisine — while providing support to our friends, family and neighbours facing cancer through the Patient Financial Assistance Program (PFAP).

From its rich landscapes, golden grain fields and clear blue skies, Alberta is a beautiful place and the Foundation can’t wait to showcase all it has to offer and all we can accomplish, together.

“The Alberta Cancer Foundation represents the best of what’s available 12 LEAP SPRING 2020

in Alberta for treatment, research and care for cancer patients, and we want to celebrate that,” says Melanie Dekker, director of Community Relations at the Alberta Cancer Foundation. “Our goal is to bring the community together in an intimate setting to support Albertans facing cancer.”

THE DETAILS

Scheduled to be held in Edmonton on Nov. 5 at the JW Marriott, and in Calgary on Nov. 19 at the Big Four Roadhouse, the gala will feature Olympic gold medal-winning figure skater and Calgary-native Jamie Salé as the emcee. Guests can look forward to live entertainment, including a surprise Albertan musical celebrity. Besides a menu highlighting regional and seasonal ingredients, the event will also include both a silent and live auction showcasing Alberta-based experiences and locally made products.

PFAP BY THE NUMBERS

THE ALBERTA CANCER FOUNDATION INVESTED

$1.1 MILLION A WORTHY CAUSE

The Patient Financial Assistance Program offers financial relief for cancer patients in Alberta who are undergoing active treatment. Funded by donor dollars, PFAP covers costs like housing, food, childcare, transportation and accommodation for patients receiving treatment outside of their hometowns. Last year, over 1,000 eligible patients accessed it.

“PFAP is a provincial program that hits every tumour group, it hits every community, and it’s relatable because people understand when there’s financial need,” Dekker says. “We want people to focus on their healing, versus trying to pay their bills, and alleviate any stress that might come with that.” LEAP — SAM GRYBA

To learn more about these events, visit giving.albertacancer.ca/galayeg for Edmonton’s gala and giving.albertacancer. ca/galayyc for Calgary’s.

IN THE PATIENT FINANCIAL ASSISTANCE PROGRAM IN 2019 PFAP IS ACCESSED ANNUALLY BY MORE THAN

1,000

PATIENTS ACROSS ALBERTA

$200

CAN HELP A PATIENT WHO REQUIRES TREATMENT AWAY FROM HOME WITH EXPENSES FOR ONE TRIP TO A CANCER CENTRE

$500

CAN HELP A PATIENT WITHOUT INSURANCE COVERAGE PAY FOR THEIR MEDICAL PRESCRIPTIONS

$800

CAN SUPPORT THE FAMILY OF A PATIENT WITH THEIR DAY-TO-DAY EXPENSES DURING TREATMENT, SUCH AS CARE FOR THEIR CHILDREN WHILE RECEIVING TREATMENT, RENT OR MORTGAGE PAYMENT, GROCERIES AND BILLS

3 WAYS

Your donation to the Alberta Cancer Foundation is driving life-saving melanoma research and enhancing treatment options May is MELANOMA AWARENESS MONTH, and your donation to the Alberta Cancer Foundation is funding promising melanoma-based research, clinical trials and community initiatives.

Alberta’s rapid yet thoughtful translation of scientific insight to patient care supports patients throughout their melanoma diagnosis. Here are some examples of melanoma projects taking place throughout the province, thanks to the generosity of our donors:

THE MARY JOHNSTON CHAIR IN MELANOMA RESEARCH Based out of the Cross Cancer Institute, this research chair, named in honour of the late Mary Johnston, supports direct and continued research into the prevention, detection and treatment of malignant melanoma by helping to match researchers and clinicians with the resources they need.

IMMUNOTHERAPY CLINICAL TRIALS Since 2014, survival rates for late-stage melanoma patients have tripled from 20 per cent to 60 per cent thanks to groundbreaking immunotherapy-based clinical trials at the Cross Cancer Institute in Edmonton. More work is currently being done to make even further strides in this area.

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

ALBERTA-WIDE MELANOMA DATABASE A provincial melanoma database and registry will help to guide future research in advanced-stage melanoma.

The database aims to be a valuable tool by analyzing the role of genetic and environmental influences on treatment outcomes.

According to AHS, 82 out of 100 melanoma cases are preventable through sun-safe practices such as wearing a hat, using sunscreen with a minimum SPF of 30, and avoiding tanning beds.

myleapmagazine.ca SPRING 2020 LEAP 13

WORKOUT

Strength in Numbers When it comes to committing to an exercise routine, working out with others can be a powerful motivator by KARIN OLAFSON FINDING THE DRIVE, AND TIME,

to work out can be a challenge. But choosing a group training class might make working up a sweat easier.

Christina Collins is one of the owners of F45 Riverbend, as well as the soon-to-open Jasper Place and downtown studio, which offers a group fitness workout called F45. The 45-minute class focuses on high-intensity interval training and provides a full-body workout by incorporating a range of cardio and strength exercises.

While the workout is efficient and effective — a single F45 session can burn more than 750 calories — Collins also loves the supportive and social elements of the class.

A 2012 study found that working out with a partner increased participants’ motivation to exercise.

“We always end our classes with high-fives and team cheers,” says Collins.

She’s also seen how the F45’s group dynamic leads to greater accountability and improved athletic performance.

“When you’re working out next to someone, you want to do your best,” says Collins. “There’s a friendly competition and motivation to work hard in group fitness classes. And you’re more

likely to stick with the program. You’re more likely to turn up — and keep turning up — to workouts when the group expects you.”

The science supports Collins’ observations. A 2012 study found that working out with a partner increased participants’ motivation to exercise.

These results show individuals who trained on a stationary bike next to a partner spent double the amount of time working out as those who did so solo. Group training can also lead to exercising at an increased intensity — especially if you think you’re surround by better athletes. A study out of Kansas State University found that working out with a partner who you think is a stronger athlete leads to an increased effort and intensity during the session by as much as 200 per cent.

Group excercise classes might also benefit your training routine in the long run. An analysis published in the International Review of Sport and Exercise Psychology examined 44 individual studies, each of which looked at committing to an exercise routine.

It found strong evidence that people are more likely to stick to a workout program when it involved a group.

Collins says that an instructor-led group session also makes showing up easier because the workouts are diverse and expertly planned.

“With group workouts, it’s harder to get stuck in a fitness rut,” she says.

“Someone has already planned a great workout for you, and you just have to give 100 per cent.”

4 GROUP TRAINING CLASSES TO TRY

1.F45

HOW IT WORKS This 45-minute circuit and high-intensity interval training workout includes exercises like chin-ups, burpees, agility ladders and boxing exercises, which can be modified for different fitness levels. No two sessions are the same, and the supportive team spirit will keep you amped.

WHERE TO TRY IT F45 Riverbend Edmonton, f45training.com/Riverbend Edmonton

2.GROUP ROWING HOW IT WORKS This group workout is similar to a spin class, except instead of stationary bikes, participants use rowing machines.

After a gentle warm-up, fitness instructors lead the group through a full-body, low-impact session.

WHERE TO TRY IT Kinetic Indoor Cycling and Fitness, Lethbridge, kineticfitness.ca

ILLUSTRATION MAI LY DEGNAN

14 LEAP SPRING 2020

myleapmagazine.ca SPRING 2020 LEAP 15

WORKOUT

3.BUNGEE FITNESS HOW IT WORKS Bungee Fitness is part dance class and part acrobatics session.

Participants wear a harness clipped to a bungee cord, which is suspended from the ceiling.

As the group is led through a choreographed workout, the cord gives movements extra spring and height.

WHERE TO TRY IT Bungee Workout Canada, Calgary, bungeeworkoutcanada.com

4.POUND FIT

HOW IT WORKS As well as incorporating exercises designed to challenge your cardiovascular fitness and work on your muscular strength, each participant makes music using lightweight drumsticks called Ripstix. The class works together to create a rhythmic, acoustic beat while feeling the burn.

WHERE TO TRY IT GoodLife Fitness Huntington Hills, Calgary, goodlifefitness. com; poundfit.com LEAP Many gyms and fitness studios also offer virtual workouts via live streams.

Be sure to ask your local gym what options it might have!

JOIN A (VIRTUAL) GROUP WORKOUT IF YOU DON’T HAVE TIME TO MAKE IT TO A GROUP SESSION IN-PERSON, FIND SUPPORT THROUGH A DIGITAL COMMUNITY INSTEAD.

1.

NIKE TRAINING CLUB Connect with friends over this app and work toward achieving Nike Training Club’s various milestones and trophies. nike.com

2.

3.

This app is part video game and part workout tool.

On your screen, you’ll see your avatar running or biking whichever route you choose, even though you’re indoors. Zwift’s group events and races show others’ avatars working out alongside you. zwift.com

Peloton livestreams a variety of instructor-led workouts, and Peloton Challenges connects you with others using the platform so you can commit to goals together. onepeloton.com

ZWIFT

PELOTON

NOTE: This piece was written before COVID-19 when physical distancing measures were not yet enforced. We hope to see you all back exercising in groups soon.

16 LEAP SPRING 2020

FOOD FOCUS

Awesome Allium Vegetables Why foods like onions and leeks are so good for you, and tips to grow your own garlic by JENNIFER DOROZIO

myleapmagazine.ca SPRING 2020 LEAP 17

FOOD FOCUS

ALLIUM VEGETABLES — vegetables in the onion family — are part of a growing list of raw foods that are considered beneficial to cancer prevention. The good news is many of us already use ingredients from the allium family, like onions, shallots, leeks, chives and garlic, as a means of creating base flavours when preparing a meal.

Discover more about these powerful vegetables.

THE BREAKDOWN It can be tricky to link one food, or food group, to cancer prevention. Not only are there many factors that can contribute to a cancer diagnosis, but proving the connection between a certain food and cancer would be costly, time-consuming, and likely inconclusive, says registered dietitian Vincci Tsui. However, Tsui points out that there is observational data on the role of diet in cancer prevention, including promising cellular-level research into allium vegetables.

“There are theories that certain [sulphur containing] compounds in these [allium] vegetables might have anti-cancer properties,” she says.

Flavour-packed, non-starchy and often high in fibre, vegetables from the allium family can also be used as a healthier way to season a meal. “[Allium vegetables] are a healthy way to flavour food without necessarily adding sugar or salt,” says Tsui.

18 LEAP SPRING 2020

But you shouldn’t worry too much if you’re not naturally drawn to the intense flavours allium vegetables often have, and would prefer to limit them in your diet.

“Don’t stress too much about what is the best vegetable or what is the best food,” she says.

Generally, the more variety of vegetables you can mix into your meals, both cooked and raw, the better. Tsui says that according to epidemiology studies, eating more vegetables overall is associated with a lower risk of cancer.

“Choosing a varied and balanced diet and enjoying what you eat — that’s going to make a bigger difference in terms of cancer prevention.”

FLAVOUR-PACKED, NON-STARCHY AND OFTEN HIGH IN FIBRE, VEGETABLES FROM THE ALLIUM FAMILY ARE A HEALTHY WAY TO SEASON A MEAL

GARLIC FAMILIES There are over 600 varieties of garlic that fall into two categories: hard-neck, which are strains with a long flowering stem called a scape that are suitable for colder climes, and soft-neck, which are more delicate types that don’t develop a scape and are well-suited for long-term storage. Cheryl Greisinger, a garlic farmer and the owner of Forage & Farm in Millarville, Alta., highlights a handful of her favourite, locally grown hard-neck varieties.

ROCAMBOLE Kiwi-sized rocambole is mainly white with soft purple splashes. “[It has] really great flavour but doesn’t necessarily have a great shelf life,” says Greisinger. “It’s popular with chefs because it’s not bitter.”

Try crushing cloves in a vinegar and oil-based salad dressing so the subtle flavour can sing.

PORCELAIN This variety can be white or purple and anywhere from medium to large in size. It contains a high amount of the tumour-fighting active compound allicin. To get those benefits, Greisinger recommends eating it raw. She makes a smashed garlic-infused honey that can be added to hot drinks.

MARBLED PURPLE STRIPE Named for its dark purple and white zebra striped appearance, this variety has large cloves and bulbs.

“I call it the easy table garlic,” says Greisinger.

It also contains high levels of allicin, if eaten raw. Crush or chop and add it to salsa or hot sauce.

FORAGE & FARM’S TIPS FOR GROWING GARLIC IN ALBERTA 1.

Use hard-neck seeds. Many soft-neck types don’t do well in Alberta’s climate.

2.

Plant in the fall. You can plant during the spring, but fall is the ideal time.

3.

Put the clove in the ground and cover it with mulch to protect it during the freezethaw cycle.

4.

Pick a sunny spot. Planting where there is good drainage is also essential.

5.

Fertilize naturally. Find a comprehensive, natural fertilizer for a slow release of nutrients, and then feed the plant every couple of weeks.

6.

Harvest the scape. That green growth that comes out of the garlic can be eaten and should be cut, as it allows the bulb to grow.

7.

CRUSHING IT: HOW TO MAXIMIZE GARLIC’S AMAZING HEALTH BENEFITS

Replant the best-looking bulbs. Eat the ugly bulbs and plant the perfect ones — with no mould, bruises or nicks — for the best results.

In its bulbous form, garlic holds potent ingredients that are passive until crushed. Once crushed, these ingredients combine and create a powerful compound called allicin, which may lower cancer risk. Some studies suggest that allicin has antitumour qualities — specifically against gastric carcinoma, breast cancer, glioblastoma and cervical cancer — as it may slow cancer from multiplying and can even cause bad cells to die off. To receive its full benefits, consider crushing the garlic and letting it sit awhile before adding it to your recipe. LEAP

myleapmagazine.ca SPRING 2020 LEAP 19

EXPERT ADVICE

Q: What are the common signs and symptoms to look out for?

We ask the experts to weigh in on the signs and symptoms of pancreatic cancer, and the ins-andouts of EI sickness benefits by JENNIFER FRIESEN she explains the disease, as well as the signs and symptoms to look out for.

Q: What is pancreatic cancer?

DR. JENNIFER SPRATLIN

EXPERT ADVICE ON PANCREATIC CANCER Despite being rare, pancreatic cancer is one of the world’s deadliest cancers, with a typical life expectancy after diagnosis of less than a year. In 2019, an estimated 5,800 Canadians were diagnosed with the disease, 5,200 of whom died from it. However, Dr. Jennifer Spratlin, a medical oncologist specializing in gastrointestinal cancers at Edmonton’s Cross Cancer Institute, says she’s seen a large uptake in research and treatment since she began specializing in pancreatic cancer in 2008. Here,

It’s a tumour that starts in the pancreas, which is an organ behind the stomach.

The organ is responsible for several different functions, including regulating sugars and making proper enzymes for digestion and absorption of food nutrients. The cancer typically spreads early to other organs in the belly — particularly the liver, lymph nodes around the pancreas and inside the belly cavity. The thing about this cancer is people aren’t often aware of it until it has spread, and cure is not possible. People know where their breasts are and remember to look for lumps, for example, but if you ask somebody where their pancreas is and what it does, they don’t usually know.

Q: What are the different types?

Adenocarcinoma is the most common type (95 per cent of cases) and typically the one that has the shortest life span associated with it, but there are a few subtypes. There’s another type called neuroendocrine tumours of the pancreas that’s treated very differently.

Part of the problem with diagnosing pancreatic cancer is that patients typically will have symptoms going back months or years, but they are very vague. Commonly, it’s a general feeling of being tired or rundown. People often lose weight, and there might be some vague abdominal pain that can feel like indigestion or gas pains.

Sometimes there is back pain. There’s often changes with bowel function. People often use “sometimes” instead of “often” and end up getting diagnosed with diabetes within the months leading up to a pancreas cancer diagnosis — but diabetes is also common in the general population.

There’s a link between pancreas cancer and depression as well, but depression and mood changes are also very common in the general population. So, you can’t screen all people with these symptoms.

Q: What are the risk factors?

It’s generally a disease of the elderly over 65 years old. It’s also associated with excess alcohol use and smoking — particularly with the two used together, but not always. There are some genetic factors that come into play, but there aren’t genetic screening recommendations that we know of if there is a family history of pancreatic cancer.

Q: What advice do you have for people who experience these symptoms?

Generally, people know their own bodies.

And if anyone feels unwell and recognizes a grouping of these symptoms, then they should approach their family physician.

Awareness is key. This disease is so uncommon, and there’s no real test for screening, so people need to advocate for themselves and pay attention to their bodies.

ILLUSTRATION JENNIFER MADOLE

20 LEAP SPRING 2020

Q: How long can people access it, and how much do they receive?

They need their social insurance number, their mother’s maiden name, and they might need to include a pay stub if they have a variance in their salary.

At a later date, they will also need a medical certificate completed by their doctor and then a record of employment from an employer. From there, you complete the application online, which will take 45 minutes to an hour if you’re doing it for the first time.

For EI sickness benefits, you only get 15 weeks, and you receive 55 per cent of your best week on salary. For a lot of people, their illness is not resolved within those 15 weeks [and] after that time they’re unable to access anything else unless they qualify SARAH HOLLINGSWORTH for long-term disability benefits. You can’t qualify for any long-term disability benefits through Service Canada unless you have an illness that is severe and prolonged Q: What benefits can enough that it would last more than a year. family members of patients However, if someone has advanced cancer access? or faces complications, they can first apply There are compassionate care benefits HOW TO ACCESS for EI sickness benefits and then in the and caregiver benefits. The family caregivEI SICKNESS meantime apply for long-term disability if er benefit is for [caring for] an adult who BENEFITS WHEN the illness is expected to last longer than a is critically ill. It is also for 15 weeks.

FACING A CANCER year. Long-term disability takes more time to The compassionate care benefit lasts for DIAGNOSIS process, so this way, patients are covered as 26 weeks and applies to family or caregivthey move in-between benefits. ers of a person of any age who requires When confronted with a cancer diagnosis, end-of-life care. Family members can your day-to-day life is upended. Outside of share that time, but they need to apply focusing on getting better, finances often Q: What does the process separately. LEAP come into question as cancer patients of applying entail and what become unable to work. Service Canada documentation do people Learn more about employment has an employment insurance (EI) sickneed? insurance at canada.ca ness benefits program for those facing an unexpected illness, but paperwork can become complicated amid the chaos. Sarah Hollingsworth is a resource social worker in the department of psychosocial oncology at Calgary’s Tom Baker Cancer Centre, and here she explains how to access Thanks to the generosity of donors, the EI benefits.

ADDITIONAL FINANCIAL SUPPORT

Q: How does someone qualify for Government of Canada EI benefits?

A person would qualify for EI sickness benefits if they have put in 600 insurable hours of work within the last 52 weeks.

And then, of course, you would need a medical certificate proving that you have a sickness that would make you unable to work.

Alberta Cancer Foundation’s Patient Financial Assistance Program is another way Albertans can receive financial support while undergoing active cancer treatment.

Read more on page 12 or visit albertacancer.ca/investments/patientfinancial-assistance-program/

myleapmagazine.ca SPRING 2020 LEAP 21

BEYOND BARRIERS

EXPLORING CANCER AND STIGMA CULTURALLY AWARE SCREENING PROGRAMS, COMPASSIONATE HEALTHCARE PROVIDERS AND SUPPORTIVE LANGUAGE ALL CONTRIBUTE TO REDUCING STIGMA AROUND CANCER. FROM TALKING OPENLY ABOUT DIAGNOSIS TO UNDERSTANDING PALLIATIVE CARE, WE LOOK AT SOME OF THE WAYS PEOPLE AND PROGRAMS ARE HELPING SHIFT PERSPECTIVES AROUND CANCER FOR THE BETTER.

THE EVOLUTION OF PALLIATIVE CARE

BY COLLEEN BIONDI

L

ike many aspects of the cancer experience, the concept of palliative care may be unsettling. After all, there is a strong assumption it is associated with end of life. But this is inaccurate.

The truth is, palliative care is much broader and includes services such as pain and symptom management that can improve quality of life and, in some cases, actually extend lives.

Fortunately, people’s perception of palliative care is changing, says Reanne Booker, a nurse practitioner at the Tom Baker Cancer Centre.

Booker is also a PhD student in nursing with the faculty of human and social development at the University of Victoria, and a casual employee at Palliative and End-of-Life Care Services at Foothills Medical Centre in Calgary. Her thesis is exploring perceptions of palliative care and the benefits of early integration.

Booker tells us why the evolution of palliative care will make a positive difference for individuals living with life-limiting conditions, and shares her current research involving early integration of palliative care specifically for people living with blood cancers. >

ILLUSTRATION BY ROBERT CARTER

22 LEAP SPRING 2020

myleapmagazine.ca SPRING 2020 LEAP 23

Q: WHAT IS PALLIATIVE CARE? REANNE BOOKER: The definition I

use is from the Palliative Care Early and Systematic (PaCES) Project, a provincial initiative whose goal is to improve quality of life for Albertans with advanced cancer. Palliative care focuses on support of the patient’s and their family’s physical, emotional and psychosocial needs — including help with decision-making [from understanding a prognosis to exploring end-of-life choices] — while continuing with advanced, cancerfocused treatments. It provides an additional level of support, and it is now recommended alongside cancer treatment right at the beginning, not only for people at the end of their lives.

Q: HOW HAS IT EVOLVED OVER TIME? RB: Dr. Balfour Mount, a Canadian

physician, surgeon and academic, coined the term in the 1970s in an effort to replace negative connotations associated with the word “hospice.” Over time, palliative care began providing other services. Pain management explores the pros and cons of various medications [opioids or corticosteroids, for example] and routes of administration [orally, by needle, patch or under the skin]. It also looks at non-medicinal options like adjusting the elevation of a bed to assist with breathing. Symptom management offers medicinal and non-medicinal ways to relieve common side-effects like shortness of breath, constipation, nausea, vomiting and fatigue. Psychosocial support includes counselling, practical assistance with finances, legal issues and spiritual care support.

Of course, discussions about what happens to the body as life winds down and end-of-life options

24 LEAP SPRING 2020

[hospice, home care, Medical Assistance in Dying], should the patient request it, are still included.

Q: WHAT ARE THE BENEFITS OF EARLY INTEGRATION? RB: Early intervention palliative care

helps us to have respectful and sensitive discussions about difficult topics along the disease trajectory. It provides a continuum of care and has the capacity to shift gears quickly — from treatment-focused support to pain management to end-of-life questions and back again — to align with patient wishes and experiences.

In 2017, the American Society of Clinical Oncology published guidelines for integrating palliative care earlier in the cancer experience, indicating it was an essential component of care for patients with advanced cancer or significant symptom burden.

Q: WHAT STIGMA IS ATTACHED TO PALLIATIVE CARE? RB: The biggest stigma is the associ-

ation with imminent death. Although palliative care now offers much more diverse and comprehensive options, this myth remains

BOOKER’S RESEARCH From 2005 to 2015, Booker worked in the Alberta Blood and Marrow Transplant Program at the Foothills Medical Centre. In her experience there, Booker saw that this patient group often had serious symptoms, underwent intensive care and/or acute treatment, like chemotherapy, and, typically, had aggressive end-of-life experiences, such as more time spent in emergency rooms, in their final weeks.

Rarely was palliative care sought out.

Booker wanted to explore why this was happening and create an opportunity for early palliative care integration. Her research, which began in September 2018, will inform her PhD thesis. It is a collabora-

tion with Foothills Medical Centre and the Tom Baker Cancer Centre and is funded by the R.K. Dixon Family Award established through a generous gift to the Alberta Cancer Foundation from Mr. & Mrs. Dixon’s estate. Its three phases are as follows: Phase One was conducted from January to April 2019. Booker examined data (from anonymous health registries in Alberta) of 1,100 people who died of blood cancer from 2003 to 2010. She found 66 per cent had experienced aggressive end-of-life care and 25 per cent of people accessed palliative care support a week before dying.

Phase Two, which is expected to be complet-

entrenched in our society and creates a barrier for timely referrals and may prevent patients from investigating its benefits at all.

community workshops and present at conferences to get that message out to medical personnel and the public at large.

Q: HOW CAN WE OVERCOME THIS? RB: Although a name change might

Q: WHAT SHOULD THE FUTURE OF PALLIATIVE CARE LOOK LIKE? RB: It should be standard of care for

help — [for example] the University of Texas MD Anderson Cancer Center has switched to “supportive care”— we need a true philosophical shift. Once people understand that palliative care doesn’t mean you are dying right away, there is an acceptance of the concept. I provide

ed by summer 2020, involves interviewing 15 patients undergoing blood cell or bone marrow transplantation, 15 caregivers and 15 clinicians to determine what they would like from palliative care. Interviews are open-ended, allowing for detailed, descriptive responses.

Phase Three (in development) will integrate early palliative care into a group of these patients, while a separate control group will receive standard palliative care, as needed or upon request.

Outcomes from each group will then be studied and compared. Booker will run this intervention for a year starting in early 2021. Study results and data should be ready by the fall of 2022.

anyone with life-threatening illness, including those in rural and remote areas. There needs to be more education about palliative care in health-care curricula, so professionals have the skills to talk about the benefits of early integration. LEAP

ILLUSTRATION BY ROBERT CARTER

myleapmagazine.ca SPRING 2020 LEAP 25

LET’S TALK ABOUT SEX

BY JENNIFER DOROZIO

T

hough palliative care is her current topic of focus, Reanne Booker is well-versed in the stigma that surrounds another tricky topic: sexual health.

Booker finds it amusing how personal a clinician can be with a patient but can still feel uncomfortable bringing up sexual health.

“It’s funny, we ask a lot more invasive questions of our patients,” she says. “We’ll ask them about the size, consistency and colour of their

bowel movements, but there can be apprehension on behalf of both the patient and clinician to bring sexual health up.”

Early on in her career, Booker observed and participated in a lot of conversations with patients.

Often, health-care providers may consider sexual health as taboo or off-limits to bring up with patients.

Factors like culture, religion and various life experiences all play into an awkwardness around the topic.

But sexual health issues after cancer are very common and should be a normalized part of patient care. “[Sexual health] is not specifically linked to any particular type of cancer or treatment. It’s relatively ubiquitous,” Booker says.

Interestingly, this hesitancy to broach the topic of sexual health can often come from the clinician’s side. Once a health-care provider steps over that unseen barrier and

ILLUSTRATION BY ANDREW BENSON

26 LEAP SPRING 2020

FAQ ON SEX AND CANCER WITH REANNE BOOKER

addresses it, patients are usually more than willing to open up.

“If a clinician brings it up first, patients are very willing to talk about it,” Booker says. “The stigma and barrier really lie with us as health-care providers.”

Cancer, and illness in general, can greatly affect a person’s sex life in myriad ways, which is why it’s so important for clinicians to acknowledge it with patients. Side-effects of cancer treatment, like nausea and pain, can lower sex drive, and many chemotherapy approaches can have serious impacts on fertility for both men and women. Self-esteem and self-image can also take a hit as a person’s body changes from treatment, which can influence a desire to be intimate. Beyond distracting physical symptoms, cancer can put a strain on personal relationships as patients need to prioritize their energy and time for treatment and recovery. Plus, patients may not know how to bring up whether or not they can, or want to be, intimate with a partner, says Booker.

“If their treatment goes on for a year or more, that’s a huge imposition for a lot of people and can be very damaging to their relationships and quality of life,” she says.

To address these unique concerns about sexual health, Booker and several other health-care providers, from a variety of disciplines, secured funding to develop a sexual health

Q: CAN I GET/ CATCH/TRANSFER CANCER DURING SEX? A: For the most part, no. While there are some cancers that can be associated with infections passed on by sexual activity (HPV and hepatitis B and C), the vast majority of cancers are not associated with such infections.

Q: SHOULD I STOP ALL SEXUAL ACTIVITY DURING TREATMENT? A: You don’t need to stop all physical touch

and intimacy, but you could consider modifying sexual activity if it is too strenuous and should always consult your doctor beforehand.

Different approaches can be perfectly safe throughout treatment.

Q: WILL BEING SICK COMPLETELY WIPE OUT MY DESIRE TO HAVE SEX? A: There is a growing body of literature to suggest that many patients have desires, but some don’t. Even

program for cancer centres across Alberta in 2016. Now a permanent program, Oncology and Sexuality, Intimacy and Survivorship (OASIS) is offered out of the Tom Baker Cancer Centre, Cross Cancer Institute and Westmount Shopping Centre in Edmonton. The program seeks to better educate patients and health-care providers through specialized sexual health support and treatment.

Through OASIS, which partners with Alberta Health Services and CancerControl Alberta, (and at one time was funded through the Alberta Cancer Foundation) patients can attend workshops on vaginal changes post-diagnosis, access information about erectile dysfunction related to cancer treatment, and much more.

those who are really sick may still have a desire to be sexual.

Q: SHOULD I ABSTAIN FROM INITIATING INTIMACY WITH MY PARTNER WHEN THEY HAVE CANCER? A: Communicate openly with your partner, regardless of the outcome.

Often, after the initial shock of diagnosis, a desire to be intimate remains.

Help is available for these concerns from your doctor.

Program counsellors offer patient support and can also help direct them to information and resources about a specific area of concern. Online and print materials created by program experts are readily available in cancer centres for patients, too.

As for medical professionals, OASIS provides group training and direct one-on-one support to clinicians who have questions about sexual health after cancer. It also connects health-care providers to resources about cancer and sexuality, including tools for how to broach the topic and relevant research.

All these initiatives are important to dismantling the barriers to an open discussion about sexual health.

“Helping to normalize it is the first step,” Booker says. LEAP

myleapmagazine.ca SPRING 2020 LEAP 27

BEYOND BARRIERS

THE “C” WORD

Helping patients and their loved ones find connection and support after a cancer diagnosis BY ELIZABETH CHORNEY-BOOTH

W

hen Brian Palinka was diagnosed with melanoma in 2013, cancer became part of his life. But even when it spread to his lungs in 2017, he was determined not to be defined by his disease.

Only in his early 40s, Palinka wanted to continue to pursue his passion for running road races and his career as a tradesman in the oil and gas industry. His cancer was an issue that needed to be dealt with, but Palinka knew that he was still the same person he’d always been.

Unfortunately, not everyone in his life treated him that way. During his treatment, Palinka, who lives in St. Paul, Alta., regularly fielded texts from family members who only wanted to talk about his health status. He also found himself needlessly being assigned lighter tasks at his oil field job. Single and actively dating, Palinka felt like he should disclose his diagnosis to potential partners,

but also knew that the words “I have cancer” could drive them away.

“After my diagnosis I got a lot of support from people, but there were also a lot of friends that I just didn’t hear from,” he says. “They felt uncomfortable. I’ve had people tell me since that they wanted to call, but didn’t know what to say.”

Today, thanks to improved treatments and outcomes, and the fact that people are more open about changes in their health, the stigma surrounding cancer isn’t as strong as it was several years ago. But Palinka’s experiences illustrate that, while we’ve come a long way from the days when people talked about “the c-word” in hushed tones, there is still a certain stigma around a cancer diagnosis.

Dr. Jill Turner, a clinical psychologist and the supportive care lead for CancerControl Alberta North, based out of the Cross Cancer Institute in Edmonton, has observed this to be true. She supports patients

and their families through some of the psychological and emotional challenges that come with a cancer diagnosis and treatment. Turner says that many people still get very nervous when an acquaintance or loved one is diagnosed or treated for cancer and may not know how to support them. For some patients, a cancer diagnosis, and all it brings, can create feelings of isolation and loneliness, especially if friends and families struggle to understand the experience.

“There are still people who see cancer as a death sentence and are influenced by that,” Turner says. “So they get afraid or nervous and don’t know how to approach people who have cancer.”

This, coupled with a patient’s own preconceived ideas about cancer, can fuel depression, anxiety and other mental health issues, which can make patients feel further stigmatized. Turner says that it’s natural for patients to struggle emotionally,

PHOTO BY RYAN PARKER

28 LEAP SPRING 2020

HOW TO BE THERE No one wants to do or say the wrong thing when a friend or family member has cancer. Here are some tips on how to help ease challenges: ENGAGE IN ACTIVITIES YOU ENJOY. If you’ve always golfed or gone to the movies together, continue to do so when possible.

FOLLOW THEIR CUES. If they are tired of thinking about cancer, talk about other things. It’s OK to take a break from cancer talk.

LET THEM KNOW YOU’RE THERE FOR THEM. If they do want to talk about their cancer, be there to listen or help with practical things like picking up groceries or cooking a meal.

but that they shouldn’t feel self-conscious if they need to reach out for help in addressing their feelings, especially if they feel like they’re not getting sufficient support from friends and family.

“It’s normal to struggle with strong or difficult emotions with a cancer diagnosis but that doesn’t mean that it’s easy,” she says.

“There are professionals and resources that can help patients and their family members cope with the diagnosis, treatment and life after a diagnosis.”

Turner’s department treats both cancer patients and their families, and there are similar services at the Tom Baker Cancer Centre in Calgary, and regional cancer centres throughout Alberta, including new virtual counselling and support options. Over the course of her 20-year-long career, Turner has seen a definite increase in both patients and their loved ones seeking her services. Patients have the option of coming in for one-on-one counselling, couples counselling or utilizing various support groups, all of which are available without a referral from their doctor.

DR. JILL TURNER

“If patients are struggling with that sense of isolation and the sense that nobody understands them, a support group can be a really powerful place to lessen that sense of being alone,” Turner says.

As for Palinka, he’s found solace and belonging in running, having recently competed in a half marathon in Las Vegas as part of a cancer fundraiser. His cancer is now in remission and he’s made it his

personal mission to show people that his disease hasn’t changed him — it’s only made him stronger.

“Even when I was in treatment I was running races and people would look at me and say, ‘Aren’t you sick?’

They were surprised that I was running anyway,” Palinka says. “You can prove to people that you’re still the same person, which is what I’m trying to do.” LEAP

myleapmagazine.ca SPRING 2020 LEAP 29

BEYOND BARRIERS

THE BATTLE METAPHOR Why the most common way of talking about cancer treatment may not be the best way BY JULIA WILLIAMS

M

atthew Miller was 22 years old when he was diagnosed with stage 3 Hodgkin’s lymphoma and began a six-month course of chemotherapy. The entire experience — his body’s reaction to the treatment, his emotions, whether he would live or die — felt beyond his control, yet everyone kept praising him as a fighter and encouraging him to keep up the battle. They meant well, but their motivating words actually made Miller feel disempowered.

“When people said I was a fighter, I had to put on a brave face when I didn’t feel brave,” he says.

Later, after the death of a close friend whom he’d met in a cancer support group, Miller thought more about those words and what they implied. His treatment had worked, but his friend’s outcome was different.

Had he somehow earned his restored health? Had she somehow failed?

“Since I’m a survivor, I’m a ‘winner,’” Miller says. “But if the disease takes someone’s life, they’re a ‘loser.’

They didn’t ‘fight’ hard enough.”

Miller, who works for the Alberta Cancer Foundation as a development assistant, isn’t the only one who thinks applying war-related language

to cancer is inaccurate at best and damaging at worst. For decades, many people with cancer and their supporters, as well as medical professionals, psychologists and researchers, have discouraged these terms and metaphors, suggesting alternatives such as “journey with cancer,” or using neutral phrasing like “undergoing treatment” rather than “fighting cancer.” Nor is it just a matter of preference or opinion.

A 2019 Queen’s University study found that battle metaphors make people perceive cancer treatment as more difficult. They were also shown to have a disempowering effect by increasing fatalistic beliefs about prevention and making people less likely to pursue cancer screening.

Despite efforts to shift away from martial language when talking about cancer, it is still commonly used.

Jeopardy host Alex Trebek, who has pancreatic cancer, shares the latest on his “cancer fight” in the headlines. Obituaries memorialize people who have “lost their battle with cancer.” The language of war is sprinkled through copy for cancer charities, fundraising events and support organizations. Health and wellness publications describe new

drugs that “fight cancer.” Social media is peppered with hashtags like #cancerwarrior and #fightcancer.

Battle metaphors aren’t limited to cancer but pervade medicine. Hippocrates, the Greek physician who is considered the “father of medicine,” wrote about the “violence of disease” more than 2,000 years ago. We talk about the body’s “defense” mechanisms, suffer “attacks” of symptoms and order “batteries” of tests.

Dr. Elie Isenberg-Grzeda, a psychiatrist specializing in psychosocial oncology at Sunnybrook Health Sciences Centre in Toronto, says using war-related language in medicine is a very human response to our fear of disease and death. Metaphors allow us to simplify and comprehend complex diagnoses, and battle metaphors may give us a false sense of control over our fate: if we’re fighters, it follows that we can be victors.

Martial language also has a purpose of serving in the larger conversation about cancer. Isenberg-Grzeda says metaphors can help unite us around shared ideas and against common foes, which is why they’re so often used (to significant effect) in cancer awareness and fundraising efforts. The Canadian Cancer

ILLUSTRATION BY SPENCER FLOCK

30 LEAP SPRING 2020

FINDING THE WORDS If you’re reaching for a metaphor when talking about cancer, ask someone who has experienced it what works for them. Here are some possible alternatives (with commentary from Matthew Miller).

CANCER JOURNEY “That’s the one I use. It helps capture the entire experience.

Journeys can suck, and it doesn’t cover that up.”

MARATHON “I like that it ties into just how difficult and long [cancer treatment] is, but also about how you have to maintain the course and move forward one step at a time.”

DANCING WITH YOUR DISEASE “A friend of my mom’s who has cancer talks about it this way. She also describes [her illness] as a cloud or a storm in the distance. It’s always there, but it’s not necessarily raining right now.”

Society invites you to “Be a Cancer Fighter” by hosting a fundraising event. Survivors, friends and family participate in the annual Enbridge “Ride to Conquer Cancer,” a cycling event that benefits the Alberta Cancer Foundation. (The Foundation notes that the franchise event is an exception to its brand guidelines, and it works hard to avoid militaristic language and focus on more positive, collaborative words such as “facing cancer.”) Isenberg-Grzeda adds that U.S. President Richard Nixon officially declared “war on cancer” back in 1971, with a bill that substantially increased funding for

cancer research.

“The fact they chose that marketing strategy was not by accident,” Isenberg-Grzeda says. “People are happy to rally around this enemy.”

The battle metaphor becomes more problematic when it’s removed from the realm of fundraising and applied to the individual experience. Like Miller, Isenberg-Grzeda says battle metaphors are inherently judgmental, implying winning or losing, triumph or surrender. “It’s a pretty awful legacy to attach to somebody who died from cancer,” he says.

Moreover, cancer is a diverse and complex disease with a wildly varied

treatment process. In this context, reducing the disease to a simple, conquerable foe is misleading. “Not all cancers are curable by the time they are diagnosed,” says Isenberg-Grzeda.

“The most important inaccuracy [of the battle metaphor] is that people are left thinking that cancer is ‘beatable’ when often it’s not.”

So, what should a supportive friend or family member do? How do you know if your words are supportive or harmful? Isenberg-Grzeda says the best rule of thumb is to follow the patient’s lead: “Don’t use metaphors until the patient uses them first.” LEAP

myleapmagazine.ca SPRING 2020 LEAP 31

BEYOND BARRIERS

SCREENING AND STIGMA Addressing the barriers that may prevent patients from accessing potentially life-saving cancer screening

BY FABIAN MAYER

T

he earlier we can detect, diagnose and treat cancer, the higher the chance of survival.

The best way to identify some of the most common forms of cancer early is through regular screening to detect it before the patient has any symptoms. Today, thanks largely to screening, survival rates in patients diagnosed with early breast cancer, for example, are as high as 95 per cent.

Unfortunately, reaching the people who most benefit from screening is not always straightforward. In Alberta, which has provincial programs that screen for breast, cervical and colorectal cancer in eligible people, there may be cultural barriers and stigma attached to getting screened. Where a person lives or comes from might also mean they are sometimes less likely to access potentially life-saving screening services.

Thankfully, doctors, screening technologists and Alberta Health Services (AHS) are working together to dispel stigmas and bring equity to cancer screening to ensure all Albertans have access.

CULTURAL BARRIERS

When brain and breast cancer specialist Dr. Gloria Roldan Urgoiti first started practicing in Canada, she began to notice several patients who presented with very advanced breast cancer. This was somewhat unusual given the strides made in breast cancer screening over the past couple of decades, but there appeared to be a common theme among these cases: many were immigrants to Canada.

“I’m an immigrant, so I see myself reflected in every patient that comes

to Canada. You notice the inequity, and it hurts,” says Roldan Urgoiti, who works as an oncologist at the Tom Baker Cancer Centre. “I started trying to find reasons why patients that immigrate from other countries could present with such advanced cancers that could have been detected earlier.”

Roldan Urgoiti, who is originally from Uruguay, began thinking about what kind of barriers might keep people from different backgrounds from getting screened.

“It’s very multifactorial,” she says.

ILLUSTRATION BY ANDREW BENSON

32 LEAP SPRING 2020

“When somebody is new to the country, there are so many things that take priority — such as putting food on the table, finding a job and learning the language — that sometimes health is more secondary.”

But she also identified cultural barriers that went beyond the realities of starting life in a new country. These barriers may be harder to see but can be a big obstacle to getting screened and detecting cancer early.

Roldan Urgoiti says the concept of screening for something like breast cancer, even if a physican recommends it, might be unfamiliar to new Canadians, making them less likely to get screened. Stigma around the disease and the challenges of talking about breast health can also keep patients from disclosing an issue.

“When a doctor asks about breast health a patient might say everything is fine, even if it isn’t,” says Roldan Urgoiti. “It can be difficult to tell this to a male family doctor or even to a female family doctor.” She adds that acknowledging this difficulty, instead of assuming patients will easily disclose breast health issues, is important for health-care providers to recognize.

After witnessing the inequity in screening first-hand Roldan Urgoiti joined the advisory committee for the Creating Health Equity in Cancer Screening (CHECS) project. Led by AHS, this pilot program began in 2018 and includes a multidisciplinary team of experts exploring who faces barriers to screening and how those barriers might be overcome. Initial research by the project team has identified communities in Calgary with low screening rates, including in the east, upper northeast and lower northeast parts of the city, and, coincidentally, these

communities are very multicultural.

Next, the CHECS project will be conducting focus groups in areas with high numbers of new Canadians to identify and better understand barriers to screening with support from the Canadian Partnership Against Cancer through a community engagement grant. The project team is also interviewing health-care providers to get multiple perspectives on the issue. Information gathered from this engagement will be used to create a pilot program that will seek to increase awareness of, and ultimately participation in, cancer screening.

“We need to learn more about cultural differences that act as barriers to screening and detecting cancer early, especially in Canada because we receive patients from so many different countries,” says Roldan Urgoiti.

RURAL BARRIERS

While people living in Alberta’s largest cities can face substantial barriers to cancer screening, those barriers take on entirely new dimensions for patients in rural and remote communities. For example, while Edmonton and Calgary have dedicated breast cancer screening clinics, other areas of the province do not have dedicated screening clinics and instead rely on AHS mobile Screen Test clinics.

The two 53-foot trailers roam the province 48 weeks of the year, setting up in small towns and communities to provide breast cancer screening for rural Albertans. Occasionally making use of a community centre or arena parking lot, the mobile clinics can see up to 50 patients a day for screening mammograms, and usually stick

around each location for a few days or up to a week depending on demand.

The program now serves women in 120 communties across Alberta.

Harmony McRae is the health promotion facilitator for Alberta Health Services Screen Test, which is part of the Alberta Breast Cancer Screening Program. She says that many women in rural communities face unique barriers, such as a lack of transportation or being unable to leave work.

“Sometimes women may have cultural beliefs where they may believe that cancer is a result of something they’ve done, like they deserve to get it,” says McRae. “One of the ways we address that is through survivor stories of women who have come to our program, have been diagnosed and treated, and are back to regular life.”

Misconceptions around the screening process itself can also keep women from taking advantage of the service. McRae says that while mammograms can be a bit uncomfortable, the team shares client comments to show that it’s not as bad as most people think.

The program now serves 26 First Nation and Métis communities. McRae says establishing trust with Indigenous communities, which have not always been well-served by the healthcare system, is crucial to making progress on screening rates.

“In many Indigenous communities, there have been projects that continue for a short time only to leave,” says McRae. “Sometimes it takes several years for us to build trust with communities. The women start to realize we’re not just coming once, we regularly come back.” LEAP For schedules and more visit screeningforlife.ca

myleapmagazine.ca SPRING 2020 LEAP 33

CARING

Bringing results to the bedside How the Point-of-Care Ultrasound enables compassionate care for palliative patients

by HANNAH KOST

IT’S A DEVELOPMENT IN MEDICAL TECH-

nology that would be easy to consider unremarkable: an ultrasound made portable. But in the realm of palliative medicine, where physicians work to enhance the quality of life for patients through ensuring their comfort, dignity and privacy, the Point-of-Care Ultrasound (PoCUS) has been transformative.

The PoCUS is similar to the ultrasound provided by diagnostic imaging facilities.

However, it is designed to answer only one clinical question at a time at bedside and can be small enough to fit in a physician’s shoulder bag. It can be connected to a smartphone or tablet to deliver images that are read by a doctor immediately, and in the patient’s home. Clinicians can then communicate findings directly to specialists if those specialists are needed, which expedites wait-times for the patient if further treatment is required. To ensure the use of the technology is standardized, the Canadian Point of Care Ultrasound Society awards independent practitioner status to physicians who go through rigorous training and exams.

Made possible thanks to the generosity of Alberta Cancer Foundation donors in 2019, the PoCUS has proven to be a game-changer for doctors, patients and caregivers. Dr. Mehrnoush Mirhosseini, Palliative Care Physician Consultant for Alberta Health Services Edmonton Zone Palliative Care Program, says PoCUS could become as ubiquitous as the stethoscope in the future.

“The vision is that someday, each physician would have [one] in their pocket that they can use as part of their physical examination,” Mirhosseini says.

Since 2004, Mirhosseini has travelled across Edmonton as a palliative physician to meet her patients at hospices, community hospitals, long-term care facilities and their homes. She says that to treat palliative patients comprehensively, doctors must address their physical, psychological, social and spiritual needs; assessing them, she explains, in their “wholeness.”

“Palliative care is all about quality of life, dialogue and listening well,” Mirhosseini says. “We need to make sure that [patients] know what is happening, exactly what can be done, and the pros and cons of what is being offered.”

The PoCUS helps inform the dialogue between patient and physician by offering an immediate answer to a binary medical question, which can help manage symptoms and mitigate suffering.

“The findings trigger discussion at the bedside, and we can answer the questions that patients might have, which will help them to decide the future direction of their care,” she says.

That the PoCUS can provide those quick results in a patient’s home is also tremendously valuable, Mirhosseini says.

When a patient is experiencing symptoms that cause discomfort, the ability to determine if a hospital visit is necessary conserves precious time and energy.

“You want to provide the right diagnosis to inform the right treatment, and you need the technology, but the patient has no energy to leave their home,” Mirhosseini says. “So, imagine that you can bring this technology to their bedside.”

The PoCUS is useful for caregivers, too.

“For both of them to collect all their energy to go to [the hospital] is quite exhausting. So, for caregivers, it’s also very convenient,” Mirhosseini says.

The utilities of the PoCUS ultimately align so closely with the objectives of palliative medicine, that it is an example of a technology that proves greater than the sum of its parts — enabling care that is informed, efficient, convenient and empathetic.

“Our intention is to provide the best care possible, in a timely fashion, in the right space, and according to our patient’s wishes. This technology provides us the opportunity,” she says. LEAP ILLUSTRATION GLENN HARVEY

34 LEAP SPRING 2020

MY LEAP

On a Highway to Help Motorcycles Ride Against Cancer helps ease the financial burden for cancer patients

by COLIN GALLANT

IT WAS QUITE THE SIGHT TO SEE. SEVENTY MOTORCYCLES RODE

300 kilometres in formation between legion halls surrounding Edmonton for Motorcycles Ride Against Cancer (MRAC), a fundraising event for the Alberta Cancer Foundation’s Patient Financial Assistance Program (PFAP).

Event organizer Ray MacNeil had periodically organized fundraisers in support of cancer-related charities throughout the years but had his first two MRAC events in Alberta in 2009 and 2010, raising as much as $62,000. The fundraiser went on hiatus for a few years as his work schedule called for him to be out of town and available on short notice.

MRAC returned on July 20, 2019, and raised over $52,000 for PFAP, a program that provides financial support to patients in need who are undergoing active treatment. This program helps to cover costs such as food, housing, medication, childcare, and transportation so that patients can focus on healing rather than trying to make ends meet. Every year, the Foundation disperses more than $1 million to patients and families who need support across the province.

Throughout his childhood MacNeil, who is an electrician and welder and now works in construction management, recalls seeing both friends and family affected by the disease, so he chose the beneficiary with great care.

MRAC is an inclusive event. “Everybody is welcome to come on the ride, and it doesn’t matter what kind of motorcycle you have,” he says.

The event is what’s known as a poker run, which is a coordinated ride (by motorcycle, horses, boats etc.) between five different destinations where participants draw a playing card at each stop. They compete for the best hand, which is decided at the end of the day, with plaques awarded for first, second and third place. The participants of MRAC rode together between five legions in St. Albert, Devon, Mulhurst, Wetaskiwin and Leduc — some 300 km in all with 70 motorcycles carrying 81 riders from 16 different unions. In addition to advance fundraising primarily done by the unions, a donation jar was carried from stop to stop throughout the day.

Union involvement is an essential part of the fundraiser. It’s that bond between workers that helped make MRAC such a success. MacNeil, who has been a member of the International Brotherhood of Electrical Workers Local 424 since 1973, encouraged the 14 unions represented by the Building Trades of Alberta to get on board and help raise funds.

Individual unions already donate to multiple charitable partners, but, on top of that, they reached into their coffers to rally behind the Alberta Cancer Foundation.

Bikers in the fundraiser are serious about giving, but they also like to have fun. Beyond first, second and third place, a special consolation prize called, ahem, the “horse’s ass” is awarded to whomever has the worst luck during the day. For example, one biker forgot to use his kickstand and his bike toppled over, a serious “gaffe” in the motorcycle community. This tradition serves as a reminder that giving is much more important than winning a hand of poker.

COVID-19 will likely force the event to pause this summer, but MacNeil is hopeful the unions will be engaged in different ways. LEAP myleapmagazine.ca SPRING 2020 LEAP 35

IN OUR ONGOING PHOTO SERIES, WE CAPTURE THE BRAVERY, STRENGTH, HONESTY, HOPE AND RESILIENCE OF ALBERTANS LIVING WITH CANCER

PHOTO RYAN PARKER

36 LEAP SPRING 2020

LIVING WITH CANCER

Meet

JULIE ROHR

by JENNIFER FRIESEN

In November 2015, Julie Rohr’s life changed completely when she was diagnosed with retroperitoneal leiomyosarcoma, a rare form of cancer that affects soft muscle tissue.

With an extremely low survival rate, the Edmonton-native was told that her cancer was incurable. But, nearly five years later, the mom of two continues to live with appreciation for each day, saying, “Gratitude is the flow that keeps me going.”

IN HER OWN WORDS:

“If you asked me what it was like to live with cancer four years ago, I would have probably answered that it was fairly frightening and very confusing.

Honestly, the first weeks left me absolutely spinning. The bottom of my world seemed to have fallen out. I was 33 years old, and I had a six and a nineyear-old boy and a husband to tell.

“Over time, though, I’ve managed to change the way I look at the disease. People live with diabetes or heart disease, and they manage it. This diagnosis might seem more dangerous than other chronic diseases, but we’re all just learning to manage it in the best ways we can. I now think of it more like a chronic issue that isn’t an immediate panic. Every season comes with new highs and new lows to contend with.

“The lows are very low, as you’d expect, but there are very beautiful moments, too. I would like others to know that if you are looking for the beautiful instances within all the pain and trauma of living with metastatic disease – you’ll find them. That hospital roommate that makes you laugh. The support groups that become like family. The new doors that are opened for counselling others through their pain. All of these things have been beautiful outcomes I wouldn’t have expected. I think what surprised me the most was being able to reach inside and find an inner strength I perhaps hadn’t known was there. It surprises and delights me when I can reach that inner strength, get through the hardest moments and come out the other side feeling good.” LEAP

myleapmagazine.ca SPRING 2020 LEAP 37

R

38 LEAP SPRING 2020

by KERI SWEETMAN photography COLIN WAY

RESEARCH

OCKSTAR DR. TYLER MEYER IS WORKING TO OPTIMIZE BREAST BRACHYTHERAPY TREATMENTS, MAKING THEM MORE CONVENIENT AND ACCESSIBLE FOR PATIENTS

T

HE RURAL ALBERTA HIGH SCHOOL DR. TYLER MEYER ATTENDED WAS SO

small, it didn’t offer Physics 30 on-site every year. So, Meyer persuaded two of his friends to sign up with him in Grade 12, to guarantee that the class would be offered. Meyer liked physics so much, he later applied to study the subject at the University of Calgary (U of C), even though he had no idea what a physicist’s job might be.

In the third year of his undergraduate program, he discovered medical physics, and he’s never looked back.

“In a lot of physics work, it’s hard to pin down the benefit of what you are doing,” says Meyer. “Sometimes, it’s hard to see where it’s all headed. But in medical physics, there are patients in the waiting room every morning, and you know why you are going to work every single day.”

Meyer is now a medical physicist at the Tom Baker Cancer Centre in Calgary.

He is also an adjunct associate professor at the U of C in the department of oncology, with a secondary appointment in the department of physics and astronomy. The primary focus of his research and clinical practice is brachytherapy, a classification of radiotherapy where radioactive seeds or sources are placed in or near the target area. It’s commonly used in cancer treatment for prostate, cervical and other gynecological cancers. But Meyer is also doing groundbreaking research on breast brachytherapy. >

myleapmagazine.ca SPRING 2020 LEAP 39

RADIOTHERAPY IS indicated for about half of all cancers (while the other half benefit from different types of treatment). The most common radiation therapy is external beam radiation, where the radiation comes from a large machine, and the beam is directed at a target area in the body. This beam goes through the body and exposes a lot of tissue to radiation, so there can be sideeffects. The advantage of brachytherapy is that the radioactive source is placed in or near the target area (using a needle to insert the radioactive seeds), so the treatment area is much more concentrated.

Meyer admits it’s not easy to explain his job to most people. The Canadian Organization of Medical Physicists defines medical physicists as health-care professionals with specialized training in the medical application of physics. “It’s a small field and not very well known, so it definitely requires frequent explanation,” he says.

medical physicists like Meyer are in the operating room, helping with the technical aspects of the procedure.

For Meyer, the joy of being a medical physicist is tackling new puzzles and revisiting old ones. He had plenty of opportunities to problem-solve while growing up on a mixed grain and cattle farm near Castor in central Alberta and says the skills he learned on a tractor or wielding a shovel have helped him throughout his career.

His father still runs the family farm, and although Meyer occasionally thought about following in his footsteps, he pursued a career in medical science instead.

He chose the U of C because it was close to home and says he “got lucky because it has a great physics department.” After finishing his undergraduate degree, he spent a year working as a geophysical surveyor on the Montana plains. He then he returned to the U of C to start a master’s program in medical

“ THE FOUNDATION HAS HAD A HUGE HAND IN ALMOST ALL MY MAJOR RESEARCH PROJECTS. THEY’VE REALLY HELPED ME DO WORK THAT HAS MADE SIGNIFICANT IMPROVEMENTS TO THE CARE THAT WE CAN OFFER.” — DR. TYLER MEYER His research in prostate brachytherapy, which started at the end of his undergraduate program and continued during the five years he worked on his PhD at the U of C, can paint a clearer picture of exactly what his job entails. Using 3D ultrasound images, he worked on improving a newly developed brachytherapy delivery system for prostate cancer, enhancing the planning software, the dose calculations and the seed delivery mechanisms. Put simply, his role was to figure out “where the seeds should go and how to get them there.”

The treatment can involve High Dose Rate (HDR) brachytherapy, where the seeds are inserted temporarily, or Low Dose Rate (LDR) therapy, where the seeds remain in the body permanently. When the seeds are being inserted by the oncologist, 40 LEAP SPRING 2020

physics, soon transferring into the PhD program. Finishing his PhD in 2010, he began a two-year clinical residency in 2012 and took his national certification exam the following year. He joined the Tom Baker Cancer Centre as a certified medical physicist in 2013, and, not long after, became the team lead for the brachytherapy program.

In addition to continuing research and clinical work in prostate brachytherapy, Meyer and his team joined an existing pilot project in late 2013 to improve a new breast brachytherapy treatment developed

by Dr. Jean-Philippe Pignol at Sunnybrook Hospital in Toronto. The procedure is technically challenging, so Meyer’s team researched ways to make it more accurate, simpler and easier to deliver. With funding

from the Alberta Cancer Foundation, they were able to provide the treatment to 38 post-surgical women in Alberta.

Breast brachytherapy (also known as Permanent Breast Seed Implant or PBSI) offers a huge advantage over conventional radiation therapy. The standard treatment involves weeks of daily treatment, whereas brachytherapy is a single-day outpatient procedure. “The benefits to both the health-care system and the patients of only having to come in once are enormous, especially for rural patients,” says Meyer. “Where I grew up, I know of family members and others who struggled to get to the city for treatment every day for weeks on end.”

The 38 patients are still being tracked, and the study has found that the rates of recurrence and side-effects are similar to those observed in other techniques.

The next step, says Meyer, is to acquire funding for more PBSI research on a larger number of patients, preferably across Canada.

Dr. Michelle Hilts is a senior medical physicist for BC Cancer and an adjunct professor at the University of British Columbia. Based in Kelowna, Hilts has collaborated with Meyer on testing and improving PBSI treatment.

“He’s got ambitious, innovative ideas and he is clinically practical, so he is very interested in moving things forward that will benefit the clinic and patients as quickly as possible,” she says.

Among the innovations that Meyer has shared with the Kelowna team is a breast phantom – essentially a false breast – that allows staff to go through the PBSI treatment process on a “pretend patient” as a training and quality assurance exercise.

“It’s a tool that allows us to continually improve the treatment,” says Hilts. In B.C., PBSI has recently moved from being an experimental treatment for breast cancer to a standard of care, although the procedure is still only available in Kelowna.

Meyer, meanwhile, is effusive in expressing his gratitude to the Alberta

7

QUESTIONS WITH

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

Use physics topics and analysis methods to develop medical applications.

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

People often think physicists work behind the scenes or in a technical capacity on equipment or calculations. We are actively involved in patient treatments and therapy development or innovation.

3. Where do you get your best ideas?

Long drives. It’s rare to get three or four uninterrupted hours and having that time helps me think things through in detail.

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

I had a lot of great jobs. It was hard to leave a few of them to take a risk on a small and competitive field like this. I did some work for the town where I grew up, including public works and some time at the rink and golf course. That was a satisfying and healthy lifestyle I considered pursuing instead of university.

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

It has been hard for me to learn the difference between what I can do, what I should do, and what should be done.

Cancer Foundation for its support of his research over the years, starting with his graduate work on prostate brachytherapy, its funding of the PBSI pilot project and, more recently, a three-year, $515,000 investment into a major “uplifting” of the provincial brachytherapy program at the Tom Baker Cancer Centre. The investment includes two clinical trials, which began in 2019 and are currently recruiting patients, and three development projects in various stages. The new investment’s subtitle is “The Next Stage of Brachytherapy Practice in Calgary.” It runs from 2019 to 2022.

“The Foundation has had a huge hand

in almost all my major research projects.

They’ve really helped me do work that has made significant improvements to the care that we can offer,” Meyers says. “They do excellent work in funding these projects.

What’s important to them is how the research benefits patients and patient care.”

For Meyer, who divides his time between his clinical work, teaching and research, having the Foundation’s financial support has allowed him to pursue research projects that arise out of his clinical rotations. “Our research questions are clinically motivated, and everyone has direct patient benefit.” LEAP

6. What motivates you?

The clinical aspect of our jobs generates research questions, which aim to solve problems we encounter every day, giving us personal motivation to solve them and providing clear evidence of direct patient benefit.

7. What do you do to recharge?

Puzzles, but not contrived ones. A complex problem that I’m uniquely suited to solve with a solution that actually helps people brings me to work with a smile.

myleapmagazine.ca SPRING 2020 LEAP 41

SANDRA GUZZWELL IS THE AMBULATORY AND SYSTEMIC THERAPY UNIT MANAGER AT THE GPCC

42 LEAP SPRING 2020

TRUE CALLING

EMPHASIZING POSITIVE PATIENT CARE SANDRA GUZZWELL, ambulatory and systemic therapy unit manager at the Grande Prairie Cancer Centre, creates a home away from home for patients

by NATHAN KUNZ photography PAUL SWANSON

S

ANDRA GUZZWELL SAYS NEW PATIENTS ARE OFTEN CAUGHT OFF

guard by the laughter commonly overheard throughout the Grande Prairie Cancer Centre (GPCC) in the Queen Elizabeth II Hospital in Grande Prairie, Alta.

Faced with the uncertainty of entering their own cancer journey, the joyful environment Guzzwell has fostered at the GPCC can come as a surprise to newcomers, though the approach is at the core of what she brings to her role.

“Kindness is the philosophy that I walk in here with every day,” says Guzzwell. “If we can make part of [the patient] journey more comfortable, if we can put a smile on their face, if we can, for even a half-hour, take their mind off the worries that they have, we’re certainly going to do that.”

Guzzwell is the ambulatory and systemic therapy unit manager at the GPCC, where she’s overseen the outpatient cancer treatments for Grande Prairie and a wide range of surrounding communities for the past four years.

It’s a position that calls for diligence in heading new initiatives and ensuring the cancer centre continuously offers the best treatment options available. It also involves overseeing day-to-day treatments, which include chemotherapy and biotherapy, with an extensive team of medical professionals. >

myleapmagazine.ca SPRING 2020 LEAP 43

While paperwork and administrative tasks occupy a good portion of her time, Guzzwell also makes a point of doing twice-daily rounds of the GPCC, checking in with staff and patients to gather feedback and connect with everyone.

“I know the patients that are in the clinic,” says Guzzwell. “I’m trying to create an atmosphere that’s as positive and inviting as it can be, for both staff and patients.”

HISTORY IN HUMAN CONNECTION Guzzwell was prioritizing personal connections long before she arrived at the GPCC. Originally from Newfoundland, Guzzwell initially pursued a career in social work, although her education is diverse and varied. She received a bachelor of arts specializing in sociology and psychology, a bachelor of social work and a diploma in criminology from Memorial University of Newfoundland. She went on to obtain a masters of arts in social work from Rockville University in the U.S. She also holds a variety of diplomas and certifications, including qualifications in palliative care and supervisory management.

Guzzwell’s social work pursuits initially drew her to roles in community and institutional corrections — while living out east she organized individual and group counselling in prisons and federal halfway houses, developing connections in challenging environments.

Guzzwell’s interest in health care was first sparked in the early 2000s while she was living in Norman Wells, a small town in the Sahtu Region of the Northwest Territories. As manager of Child and Family Services for the region, she helped facilitate adoptions and provided a range of family violence, alcohol and drug counselling. Much of the job entailed working directly with health centres.

“I discovered that I really liked the health centre aspect and helping people get matched up with the services that they needed,” says Guzzwell.

In 2006, Guzzwell made the move to Alberta, where she worked in a variety of roles with the Peace Country Health 44 LEAP SPRING 2020

region including a job as an accreditation advisor in Grande Prairie in 2013. The accreditation position involved ensuring best practices throughout northern Alberta, travelling and assessing community health facilities in the region. This process gave her insight into the challenges rural health-care providers often face, and the ways facilities can overcome them.

In her own community of Grande Prairie, where she lives with her husband, Paul, and their two dogs, Parris and Lucky, Guzzwell clicked with the high level of care and services being provided at the GPCC, leading her to find her current manager position.

“I worked with the people here, I got to know the program and certainly believed in what they were doing,” she says. “I discovered that I had a passion for helping the staff here deliver services to patients.”

While the jump to health care represented a major transition in her life, Guzzwell says previous skills made the

move feel natural.

“The skills that I had, even in corrections with regards to listening, being accountable and intuitive, transferred over to my job in Norman Wells,” she says.

Those skills, combined with her understanding of best practices and experience helping people get medical services were immediately put to use in her current position at the GPCC. BEYOND THE STANDARD Guzzwell’s continued efforts ensure the GPCC is at the forefront of cancer care for both patients and staff.

“We make sure that the care we’re offering here in Grande Prairie matches the cancer care that you’re going to get anywhere else Alberta,” says Guzzwell.

Beyond typical treatment, this translates into services such as psychosocial therapy, an on-site dietician, a dedicated pharmacy and more. Following the completion of the new Grande Prairie

Regional Hospital, scheduled to open later this year, Guzzwell notes the programs and treatment offered through the new, larger cancer centre will further expand to include a full range of radiation oncology services, eliminating the need for certain patients to travel to Edmonton.

Guzzwell has also helped shape improved education initiatives at the centre, most notably the patient navigator program, an initiative largely made possible thanks to the generosity of Alberta Cancer Foundation donors. Through individual and group teaching sessions, the GPCC offers information and preparation for patients and families, with guidance from diagnosis and onwards through the cancer journey. Guzzwell says the program has been invaluable in alleviating patient and family stress, shining a light on what to expect and preparing patients to take on treatment with more confidence.

LEADING BY EXAMPLE Creating a more comfortable and welcoming environment is also a key part of Guzzwell’s leadership philosophy. During her rounds at the centre, she checks in with staff to ensure they have all the required resources in place to extend the best possible care to patients — a key element in the whole operation running smoothly. Beyond the operational aspects, the connections she’s developed with staff have allowed her to thrive in her role.

“I care about my staff. I can tell you their husbands’, wives’ and children’s

names,” says Guzzwell. “Staff are why we’re successful and able to do what we’re doing for patients.”

While the tight-knit community was part of what attracted Guzzwell to the GPCC, its location also comes with some challenges. Due to the surrounding rural landscape, the GPCC serves patients within a radius that stretches to the B.C. border to the west, the Northwest Territories border to the north, Grande Cache to the south and midway through the province in the east. The area served makes it the largest geographical patient base of any cancer centre in Alberta.

To reduce the need for patients to travel long distances, Guzzwell has helped usher in an emphasis on providing Telehealth options. From the GPCC, the resident radiation oncologist can connect with community doctors to organize virtual appointments and check-ups for patients close to their homes. The initiative has seen follow-up appointments, which previously warranted multi-hour drives, replaced with videoconference.

“The same thing would occur as if they were in the room except it’s safer for some patients not to travel,” says Guzzwell. “We try to minimize travel for them as much as possible.”

Carol Robertson, former CancerControl Alberta director of Cancer Care teams for Northern Alberta, worked with Guzzwell when she oversaw the GPCC. Robertson says finding solutions to challenges such as reducing unnecessary travel for

patients exemplifies the level of care Guzzwell and her team provide.

“It sounds mundane, but it can be very challenging for frail patients and their family or support to get to the cancer centre,” says Robertson. “Sandra and her team are attuned to those issues.”

Beyond her memories of Guzzwell’s care for patients, Robertson says the environment Guzzwell fosters for her staff stands out from her visits to Grande Prairie. Robertson notes Guzzwell is always quick to give credit to others and exhibits pride in her team, creating an infectious positivity within the walls of the GPCC. “It’s always fun going up to see them,” says Robertson. “It has that sense of family and a very close-knit environment.”

Recently, Guzzwell says a new patient came to the centre shortly after being diagnosed with cancer. Noticing the man’s natural hesitation ahead of his first treatment, she introduced herself, welcoming him into the family dynamic at the GPCC. While still hesitant, she says the patient began asking questions and making conversation, finding ease in the friendly environment fostered by Guzzwell and her staff. After the first six hours of treatment, she recalls the patient standing and hugging his nurse.

A few weeks later, as the same patient returned to the GPCC, Guzzwell says his greeting spoke volumes to the resonance of her and her team’s approach.

“At the front desk when he registered, he said, ‘Hi, I’m home.’” LEAP

SANDRA GUZZWELL’S CAREER HIGHLIGHTS • Worked in

Community and Institutional Correction (federal and provincial aspects) in Newfoundland.

• Past experience

in family violence awareness, addictions and mental health treatments, managing remote community health centres, adoptions, and child and family services.

• Worked in various

management roles in the Northwest Territories and Alberta.

• Played an instru-

mental role in developing educational initiatives at the GPCC including the patient navigator program.

• Has helped usher

in Telehealth options at the GPCC to reduce the need for patients to travel long distances.

myleapmagazine.ca SPRING 2020 LEAP 45

IMPACT

NANCY BARNES IS LIVING WELL WITH CANCER

PHOTO AIDEN JAMES

46 LEAP SPRING 2020

Finding Healing For Nancy Barnes, cancer is not who she is but a condition she lives with, and she is living every day to the fullest by NANCY BARNES Nancy Barnes is a loving mother of three sons and has been happily married to her life partner, Russell, for 30 years. Now retired, the 56-year-old was previously an oncology RN. She is also living with metastatic kidney cancer and receives treatment and care from Dr. Daniel Heng at the Tom Baker Cancer Centre in Calgary. With a strong drive to raise funds for cancer research, Barnes is a five-time participant on team RBC in The Enbridge Ride to Conquer Cancer benefiting the Alberta Cancer Foundation. The Ride is a family affair, and, over the years, her husband, sons, brother and sister have all joined in either as riders or volunteers. Here, Barnes reflects on her cancer journey.

I was initially diagnosed with kidney cancer in 2013, and I quickly underwent surgery to have my entire kidney removed. I was then told I was “good to go” with strict imaging surveillance as follow up. Unlike many other types of cancer, there are no current effective treatments to lower the chance of the kidney cancer returning.

Following surgery, I jumped back into my regular routine without giving much time or thought to dealing with the emotional impact of having cancer. Subsequently, I struggled with feelings of anxiety and depression for several years afterwards. I had lost trust in my body. My reaction was compounded by the fact I had been diagnosed with breast cancer in 2005, for which I had surgery and four rounds of preventive chemotherapy.

In 2017, four years after my initial kidney cancer diagnosis, a scan detected cancer in my lungs. My kidney cancer had spread. In a state of shock, fear and anxiety, I decided to step away from my job

as a homecare nurse. Now, being faced with an incurable illness, I realized I wanted to address my anxious, depressed state of mind. Obviously, my old coping mechanisms were not working for me, so I had to learn new ones. I gave myself compassion, love and time to process the emotional trauma I had been through. I deepened my yoga practice and began daily guided meditations. In conjunction with my medical treatment, I began to study Ayurveda, an ancient Indian healing system incorporating the mind, body and soul as a whole. I learned to focus on positivity; from the healthy food I put in my mouth to the healthy thoughts I put in my head. As a result, I began to discover internal peace and healing. To me, being told I have an incurable illness no longer means that I have an expiration date stamped on the bottom of my foot. I’ve made peace in living with the unknown and I’m carrying on living. Now, I take trips, enjoy golfing, cycling and being with loved ones more than ever.

Cancer is random, but I also think we do have some control over our susceptibility to becoming ill. When our body is rundown, stressed and unhealthy, I think we’re all ripe for an illness. If we can learn to slow down and take time to breathe and choose what we put in our bodies — good thoughts and good foods — then maybe we can recognize some early warning signs of any illness.

I used to find it difficult to talk about my cancer because I worried people would feel sorry for me.

As I began to heal, I recognized having cancer is not who I am, rather a condition I live with. I can’t predict the future, nor can anyone else, so, living and enjoying the present moment and the people around me is my best chance at true happiness. For me, this is a liberating feeling, and I am living every day to the fullest. LEAP Since this article was written, the 2020 Enbridge Ride to Conquer Cancer has been postponed due to the COVID-19 pandemic. The Alberta Cancer Foundation is so grateful for the support of all our Riders, sponsors and volunteers. myleapmagazine.ca SPRING 2020 LEAP 47

WHY I DONATE

A History of Support The Edmonton Civic Employees Charitable Assistance Fund operates with integrity, grace and dignity by COLLEEN BIONDI CREATED IN 1941, THE EDMONTON CIVIC

Employees Welfare Chest Fund raised money to support veterans and their families during World War II. Today, this funding machine — which was renamed the Edmonton Civic Employees Charitable Assistance Fund (ECECAF) in 1945 — consists of nine unions/associations and almost 14,000 employee members.

Managed by a board of directors, the non-profit collects over $1.2 million annually from member contributions (employee contributions represent one quarter of one per cent of salaries). Operating under two separate trust agreements — Educational and Financial Assistance Fund and Charitable Assistance Fund — the fund provides scholarships for members’ children and helps finance the work of registered charities in the capital region.

From 1996 to 2016, ECECAF donated over $1.3 million to the Alberta Cancer Foundation, a charitable organization close to the hearts of many members.

“Many of our members have travelled the hallways of the Cross Cancer Institute (CCI). They know it all too well,” says Reg Meinczinger, a training specialist with Capital Power who is secretary-treasurer on the ECECAF Board and a representative of Unifor 829.

According to Brenda Waluk, former ECECAF board chair and a project manager with the City of Edmonton, ECECAF’s funds have been directed toward two revolutionary pieces of technology for the CCI — a positron emission tomography (PET) MR scanner and a made-in-Alberta linear accelerator (Linac) MR machine. Waluk played an instrumental role in allocating funds to the CCI. “I was honoured to be part of this donation decision,” she says.

These investments have been gamechanging for patient experience at the Cross. The Linac MR, for example, merges 48 LEAP SPRING 2020

the imaging abilities of an MRI system with the treatment capabilities of a Linear Accelerator, meaning doctors can see and treat cancer with radiation using real-time MR imaging. Thanks to the ECECAF’s incredible generosity, the PET MR has been in use since 2018 and the Linac MR will be ready for clinical use later this year.

ECECAF has a proud history of supporting charities related to cancer. These include Kids with Cancer, Children’s Wish Foundation, Make-A-Wish Foundation and Rainbow Society. It has also donated to cancer-related

BRENDA WALUK, FORMER ECECAF BOARD CHAIR

research conducted through the department of surgery at the University of Alberta.

In addition, ECECAF provides assistance to other health charities, as well as to education, welfare and culture sectors.

It has touched the lives of thousands of people through donations to approximately 80 groups, from $1,300 to the Alberta Council on Aging in 1995 to $2 million to build a tower at NorQuest College in 2018.

Dollars donated to charities are targeted for specific projects (a recent renovation of the intensive care unit at the Stollery Children’s Hospital, for example). They cannot be used for wages or day-to-day operations.

This type of donation model represents 75 per cent of annual ECECAF distributions,

with the remaining 25 per cent of monies going to post-secondary scholarships for members’ children. Funds are distributed in accordance with the rules and regulations of the Canada Revenue Agency.

In return, charities provide impact statements back to the board to demonstrate how meaningful the donation has been.

This can be brief write-ups about projects, photographs and/or tours highlighting special events or services.

ECECAF accepts applications year-round from scholarship hopefuls and charities.

FROM 1996 TO 2016, ECECAF DONATED OVER $1.3 MILLION TO THE ALBERTA CANCER FOUNDATION, A CHARITABLE ORGANIZATION CLOSE TO THE HEARTS OF MANY MEMBERS.

The nine board/association representatives meet monthly (except during the summertime) to make decisions about recipients.

“Board members feel honoured being part of a well-run, organized group that operates with integrity, grace and dignity,” says Meinczinger. “And employees feel a proud sense of ownership.”

In a tough economy, this model works well and generates a secure, predictable amount of income. Meinczinger suggests other employee groups consider something similar to help their communities.

“You might find yourself needing these charities one day, so you want them to be well supported,” he says. “You are paying it forward.” LEAP

myleapmagazine.ca SPRING 2020 LEAP 49

GAME CHANGER EFW’S DIRECTOR OF MARKETING AND PHYSICIAN RELATIONS SCOTT SCHROEDER AT THE 2019 RIDE

Team Effort EFW Radiology is committed to supporting the cancer community

by STEPHANIE JOE

FOR MORE THAN 50 YEARS, EFW RADIOLOGY HAS PLAYED AN

essential role in the cancer care community. The company’s 450 staff and 80 physicians provide diagnostic and interventional imaging services to 13 community clinics in Calgary and area, including the Tom Baker Cancer Centre and Foothills Medical Centre. From x-rays and ultrasound to MRIs and CT Scans, EFW’s team performs more than 600,000 imaging services a year, helping colleagues from a variety of disciplines determine if there is illness or irregularities — including cancer — in their patients’ bodies.

“Sometimes [we’re referred to] as the physician’s doctor,” says Nairn Nerland, chief executive officer of EFW Radiology. “Say a cancer patient comes to us to do imaging with respect to their cancer — [imaging] would help identify the form of cancer, the aggressive nature of the cancer, or help identify remission.”

Besides accurately diagnosing cancer and monitoring for aspects of remission, EFW also uses its advanced technology to monitor cancer treatments during clinical trials “It’s a very important role,” says Nerland. “We do a lot of work in the Tom Baker Cancer Centre, because they conduct a lot of research trials on specific cancer treatments. They’ll come to us for imaging to see how the cancer is reacting to the treatment.” While these services are undoubtedly essential to cancer care and treatment, EFW’s commitment to the cancer care community extends far beyond the imaging support it provides on a daily basis.

“We are part of this community and we want to do everything we can to support it. The only way we can do that is to get involved socially, not just medically,” says Nerland.

Over the years, EFW has given back to the cancer community in several ways. In 2012, it made a major donation to the Alberta Cancer Foundation in support of breast cancer research at the Tom Baker Cancer Centre. “[The donation] was tied to the number of mammography examinations we performed,” says Nerland. “For each diagnostic mammography examination performed, we made an incremental donation, which [ultimately] totaled $50,000.”

That same year, EFW Radiology joined the Enbridge Ride to Conquer Cancer benefiting the Alberta Cancer Foundation through the Tom Baker Cancer Conquerors Ride Team, which is one of the Ride’s largest community teams with over 100 members. As well as financial support, many EFW employees joined the team — which includes nurses, doctors, patients and community members — to complete the two-day Ride.

“We bought the uniforms, and we had radiologists join the team,” says Nerland. “I’ve personally ridden on the team for five years.”

Today, EFW employees continue to ride as part of the Tom Baker Cancer Conqeurors. The team has raised over $2.5M for the Ride, and in 2019, EFW Radiology also sponsored the Anti-Gravity Booth at the event — a popular photo booth activation at camp.

“We want to have [and build] relationships in terms of fundraising, and also experience what goes on in the community to support cancer,” says Nerland. “That’s hugely important to EFW.” LEAP Since this article was written, the 2020 Enbridge Ride to Conquer Cancer has been postponed due to the COVID-19 pandemic. The Alberta Cancer Foundation is so grateful for the support of all our Riders, sponsors and volunteers.

PHOTO RON SOMBILON

50 LEAP SPRING 2020