Leap Fall 2016

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E ENHANCED CAR

FALL 2016

Cancer patients across the province take comfort in enhanced care

NO HOLDS BARRED Dance your way to improved fitness with a ballet-inspired workout

BETTER BY DESIGN The behind-the-scenes team at the Medical Physics Lab is pioneering new techniques

PLUS: Understanding research ethics, financial help for cancer patients, hiking tips and more


"Without your support, I wouldn’t be here THANK YOU." ~ Trevor Sauer ~

Tom Baker Cancer Centre

Cross Cancer Institute

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CONTENTS

Fall 2016 • VOL 7 • No. 2

ON THE COVER: Nancy Luyckfassel

Photographed by Bluefish Studios

FALL SPOTLIGHT ENHANCED CARE

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18 46

DEPARTMENTS 4 OUR LEAP

A message from the Alberta Cancer Foundation

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FOREFRONT A blogger’s cancer journey, tips for de-stressing, hiking basics, reopening of the Fort McMurray cancer clinic, RECHARGE study and a quinoa chicken parmesan recipe

NEXT GEN Dr. Sunil Verma connects with others to advance cancer research

BEYOND CANCER Survivors manage fears of cancer recurrence

13 SMART EATS

Put some pulses on your plate

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ASK THE EXPERT Inflammation and its link to cancer, increasing your calorie intake during cancer treatment and the dangers of prolonged sitting

27 PATIENT ENGAGEMENT

Sharing in the vision to build a centre of hope

36 CORPORATE GIVING

Jet Label’s charity run involvement hits close to home

50 MY LEAP

New Canadian Ahmed Al-Obeidi jumped at the chance to participate in the inaugural OneWalk to Conquer Cancer

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TREATMENT WITH A LARGE DOSE OF CARE Going beyond traditional treatment to enhance the life of patients and their families

22 CLOSE TO HOME

Barrhead’s cancer centre provides care in the community, improving patient experiences

24 SUPPORT WHEN IT’S NEEDED

Financial assistance program allows patients to focus on recovery

FEATURES 28 ETHICAL AGENDA

The important role of overseeing cancer research in Alberta

30 BETTER BY DESIGN

An inside look at the Medical Physics Design Lab at the Tom Baker Cancer Centre

33 BARRE BASICS

Ballet-inspired workout helps Albertans dance their way to better fitness

38 MAKING GREAT STRIDES

Breast cancer survivor Laurene Mitchell has been raising money at charity walks and other events for more than a decade

42 TOP JOB

Myrna Kelley has seen Red Deer’s cancer centre grow and its treatment options expand

46 RESEARCH ROCKSTAR

Dr. Wendy Smith does crucial behind-the-scenes work in developing new treatment techniques

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Message • alberta cancer foundation

Making Life Better for Albertans With Enhanced Care TRUSTEES Angela Boehm, Chair Calgary Gary Bugeaud Calgary Christopher Burrows Edmonton Steven Dyck Lethbridge Thomas Hodson Calgary Jordan Hokanson Edmonton Dr. Sandip Lalli Calgary Katie McLean Calgary John J. McDonald Edmonton Andrea McManus Calgary Matthew Parliament Edmonton (ex-officio) Brent Saik, Vice Chair Sherwood Park

When someone hears the words, “you have cancer,” it is life changing. But we know they are in good hands at any of the 17 Alberta Health Services cancer centres across the province. We hear often from grateful patients and family members – some of whom have sadly lost their loved ones in those centres – about the excellent treatment and care they receive under those roofs. Our job at the Alberta Cancer Foundation is to make life better for those Albertans by enhancing that care. As you’ll read in this issue of Leap, that might mean a blanket warming machine for the newly renovated Barrhead Community Cancer Centre where generous people in that community and others across Alberta – step up to organize events to support their local facilities (p. 22). It might mean providing financial assistance to a young couple from Fort McMurray who had to extend their Calgary stay after a bone marrow transplant because they weren’t allowed to go home because of the fire raging through their town (p. 24). It might also mean making a Christmas stay at the Cross Cancer Institute for a newly diagnosed mother that much more special (p. 18). Behind that excellent care comes excellent leadership, whether a longstanding nurse manager in Red Deer (p. 42) or a relative newcomer to the scene at the Tom Baker Cancer Centre who has brought his innovative ideas back to his Alberta roots (p. 11). We are privileged to work with these partners in CancerControl Alberta to ensure our patients and families are receiving the best possible treatment and care available. And we know they are. No matter whether you are facing a diagnosis or are already on the cancer journey, we want to be there to offer three words in return: We will help.

Myka Osinchuk, CEO Alberta Cancer Foundation

Angela Boehm, Chair Alberta Cancer Foundation

Sandy Slator Edmonton Greg Tisdale Calgary

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FALL 2016 VOL 7 • No. 2

ALBERTA CANCER FOUNDATION EDITOR: PHOEBE DEY CALGARY OFFICE Suite 300, 1620 - 29 Street NW Calgary, Alberta T2N 4L7 PROVINCIAL OFFICE 710, 10123 - 99 Street NW Edmonton, Alberta T5J 3H1 Toll-free: 1-866-412-4222 Tel: 780-643-4400 acfonline@albertacancer.ca VENTURE PUBLISHING INC. PUBLISHER: RUTH KELLY MANAGING EDITOR: KIM TANNAS ART DIRECTOR: CHARLES BURKE GRAPHIC DESIGNER: ANDREW WEDMAN PRODUCTION MANAGER: BETTY FENIAK PRODUCTION TECHNICIANS: BRENT FELZIEN, BRANDON HOOVER WEB & SYSTEMS ARCHITECT: GUNNAR BLODGETT DISTRIBUTION: KAREN REILLY CONTRIBUTING WRITERS: Jessica Barratt, Kelly Berg, Lyndsie Bourgon, Glenn Cook, Jessica Dollard, Chelsea Grainger, Doug Horner, Michelle Lindstrom, Melanie Rutten, Dawn Smith, Theresa Tayler CONTRIBUTING PHOTOGRAPHERS AND ILLUSTRATORS: Bluefish Studios, Bookstrucker, Jared Kelly, Don Molyneaux, Evan Montgomery, Darryl Propp

Making life better for Albertans facing cancer

For every Albertan who hears the words “you have cancer,” we offer three in return -

“we will help.” How We Make A Difference Diagnose cancer earlier Improve the effectiveness of cancer treatments

ABOUT THE ALBERTA CANCER FOUNDATION The Alberta Cancer Foundation makes life better for Albertans facing cancer by providing access to the best technologies, treatments and care. We are the official fundraising partner for all 17 Alberta Health Services cancer centres in Alberta, including the Tom Baker Cancer Centre in Calgary and the Cross Cancer Institute in Edmonton. Through this partnership, we are able to make the most significant impact for patients, right at the point of care.

Improve the care and quality of life for cancer patients and their families Reduce peoples’ risk of developing cancer

Get Involved Donate, fundraise, support patient care, volunteer, invest in research, make a tribute gift Find out what’s right for you!

Leap is published for the Alberta Cancer Foundation by Venture Publishing Inc., 10259-105 Street, Edmonton, AB T5J 1E3 Tel: 780-990-0839, Fax: 780-425-4921, Toll-free: 1-866-227-4276 circulation@venturepublishing.ca

The information in this publication is not meant to be a substitute for professional medical advice. Always seek advice from your physician or other qualified health provider regarding any medical condition or treatment. Printed in Canada by Transcontinental LGM Leap is printed on Forest Stewardship Council ® certified paper Publications Agreement #40020055 ISSN #1923-6131

The Alberta Cancer Foundation is the official fundraising partner of all 17 Alberta Health Services cancer centres. Make a difference today at 1.866.412.4222 or albertacancer.ca

Content may not be reprinted or reproduced without permission from Alberta Cancer Foundation.

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Forefront • prevent, treat, cure

Hiking 101 Hitting the trails is one of the easiest ways to get moving. Your reward? Great views and improved health. Here are some tips to get you started.

1. Find a friend to hike with Not only is it more fun to spend time with a good friend but it’s also safer. Depending on where you plan to hike, having someone with you to rely on if something goes awry is always better than trying to get yourself out of a tight spot (have you seen 127 Hours??) 2. Consider your path Make sure you check the trail you plan to hike before you hike it. Find out about things like natural views, accessibility and length of the hike based on your experience and abilities. The terrain can also make or break a hike. If it is a short hike but it’s too steep, it can be too challenging. 3. Pack lots of water You don’t want to run the risk of becoming dehydrated even if it’s just a short hike. Plan for one litre of water per person per hour of hiking. 4. Wear the right clothes It may seem like an obvious step in preparing for a hike but it can make all the difference in how much you enjoy the experience. Wear supportive, closed footwear and comfortable socks. Don’t try to break in a new pair of shoes on a hike. Wear comfortable clothes in layers that can be removed or added. Check the weather to see if you’ll need sunscreen, rain gear or both. 5. Pack smart Make sure you have basic first aid supplies and snacks like trail mix or granola bars.

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Positive Inking Micropigmentation can help those dealing with hair loss For cancer patients who have undergone chemo or radiation treatment, hair may not always regrow as it did before. There are multiple ways to deal with this, but one solution that isn’t mentioned very often is a hair tattoo or scalp micropigmentation (SMP). What is it? A certified technician like Maria Wu of Permanent Ink Clinic in Calgary implants ink into the dermal layer of the scalp to replicate the appearance of a hair strand – essentially, tattooing hair onto your head. Patients are recommended to see a specialist for consultation to determine if they are a good candidate for the procedure. Wu also highly recommends having a test area done before performing the full procedure. “This test area is very informative to both the patient and myself, as it helps him or her understand the SMP treatment and learn what to expect, during and after the tattoo session,” Wu says. “The test is also helpful for me to learn how the ink takes on his or her individual skin type so we get the best results.” Test areas usually take about 20 minutes with topical anesthetics.

The patient would wait three to four weeks to see results before booking the full scalp treatment. The results of SMP are virtually unnoticeable and create the look of actual hair. Micropigmentation is also used to recreate eyebrows or eyelashes and for scar camouflaging and areola repigmentation. Calgary and area patients who have been affected by cancer and other conditions may be eligible to receive compassionate pricing for some procedures, says the company. For more information, visit pinkclinic.ca.

Quinoa Chicken Parmesan Prep Time 15 minutes Cook Time 30 minutes

Yield 4 servings Total Time 45 minutes

With an amazingly crisp quinoa crust, you’ll never guess that this is actually so healthy and packed with tons of protein!

INGREDIENTS:

DIRECTIONS:

•1 cup quinoa •1 tbsp Italian seasoning •2 boneless, skinless chicken breasts, cut crosswise in half •Kosher salt and freshly ground black pepper, to taste •1/2 cup all-purpose flour •2 large eggs, beaten •1/2 cup shredded mozzarella cheese •1/4 cup grated Parmesan cheese •1 cup marinara sauce, homemade or store bought •1/4 cup basil leaves, chiffonade (thinly sliced)

• Preheat oven to 400 F. Lightly oil a baking sheet or coat with non-stick spray. • In a large saucepan of 1 1/2 cups water, cook quinoa according to package instructions. Stir in Italian seasoning. • Season chicken with salt and pepper, to taste. • Working in batches, dredge chicken in flour, dip into eggs, then dredge in quinoa mixture, pressing to coat. • Place chicken onto the prepared baking sheet. Place into oven and bake for 20-25 minutes, or until golden brown. Top with cheeses and marinara. Place into oven and bake until cheese has melted, about 5 more minutes. • Serve immediately, garnished with basil, if desired. Source: Damn Delicious

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Time to Recharge U of C study looks at how exercise can benefit caregivers Researchers at the University of Calgary are looking at the impact of a structured exercise program on family caregivers of cancer patients. It’s estimated that 8.1 million Canadians provide care to loved ones with health challenges. Often these caregivers put their own needs aside to care for loved ones and experience negative health implications. For instance, they may experience symptoms of depression, anxiety, relationship strain and diminished physical health. The 24-week study, called RECHARGE (which stands for Renewing Caregiver Health and Well-Being Through Exercise), will look at how exercise impacts both physical and emotional health in caregivers. “Results from RECHARGE will help to expand our current understanding of how exercise can benefit

family caregivers, as well as contribute to a greater scientific and social foundation for improving the experience of cancer for entire families,” says Colleen Cuthbert, a nurse practitioner in cancer care. Cuthbert developed the study along with University of Calgary co-supervisors Dr. Nicole Culos-Reed, a research associate at the Tom Baker Cancer Centre, and Dr. Dianne Tapp, dean of the faculty of nursing.

Fort McMurray Cancer Clinic Reopens Services return after wildfire evacuation The Northern Lights Regional Health Centre’s cancer clinic in Fort McMurray began a phased reopening on July 11 and residents now have access to most of the health-care services that were available before the fire. “We are thrilled to have all of our health services back up and running in the community,” said David Matear, senior operating director for Alberta Health Services, in a news release. The wildfire spread into the community in May and forced the evacuation of more than 80,000 people. It destroyed roughly 2,400 homes and other buildings, and residents were evacuated and unable to return for almost a month. Those receiving cancer treatment in Fort McMurray were transferred to other centres for treatment. For any questions or concerns, residents can call the Alberta Cancer Line at 1-888-432-8865.

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Sharing My Journey I’ve been journaling since I was a kid and blogging since 1999, so when I was diagnosed with stage four breast cancer last December it seemed only natural that I would talk about it online. Writing is how I process things and, for obvious reasons, receiving a terminal cancer diagnosis requires a lot of processing. There were so many questions and not a lot of answers. What did this mean for me? How long was I going to be here? What about my three young daughters or my husband? I was terrified. I still am. So I turned to writing about it and documenting what I was going through. I also started taking photos of myself with my daughters. I have so few photos of me and my mom because my family is the kind that runs away from the camera. They believe they never look good enough, they feel they need to lose weight, or their hair isn’t right. I decided when I got sick, before we even knew what was wrong with me, that I had to start putting myself in the picture before it was too late. The support I have received

Alber ta Cancer Foundation

By Melanie Masterson

for doing so has been amazing. I often have women contacting me to thank me for my openness. The metastatic breast cancer community is still largely overlooked. I certainly knew nothing about it before I was diagnosed. And so I write to process, and to help other women process what they are going through. I understand that not everyone wants to talk about their cancer; even the writer Nora Ephron – to whom almost nothing about her life was sacred – didn’t tell anyone about her cancer until the very end. However, I want my daughters to remember me when I’m gone. I want photos of us together smiling even though I felt, and often looked, awful. Because if I don’t do these things now, I may never get the opportunity. Melanie Masterson lives in Calgary and shares her story on her blog at www.meli-mello.com. You can also find her on Twitter @meli_mello and Instagram @meli_mello1.

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5 Ways to De-Stress: 1.

Sometimes life can seem a little too fast-paced and overwhelming. That’s when you need to get yourself in a better head space. Here are a few ways to help you de-stress right now.

GO FOR A WALK

Going for a walk not only boosts endorphins and gets blood flowing, but walking in a green space can also put your body in a state of relaxation thanks to something called “involuntary attention” during which something holds your attention but simultaneously allows for reflection.

2.

BREATHE SLOWLY AND DEEPLY

3.

Slow, deep breathing can reduce stress by giving you a boost of oxygen and slowing your heart rate. Think of the kind of breathing you do when you’re asleep, the most de-stressed part of your day.

PUT ON SOME TUNES

Classical music has the most soothing effect, but playing any music you enjoy can flood your system with stress-reducing hormones like dopamine.

4.

EAT A BANANA

Eating something sweet, like a banana, slows the production of the stress hormone glucocorticoid, and bananas contain potassium, which helps to regulate blood pressure.

5.

SPEND TIME WITH A FRIEND OR LOVED ONE

Being around a best friend or someone close to you can actually reduce your production of cortisol, otherwise known as the stress hormone.

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Next Gen • supporting young minds

MAKING CONNECTIONS Whether it’s on a local or global level, Dr. Sunil Verma is connecting with others to advance cancer research BY JESSICA BARRATT Cancer; the word no one wants to hear.

Yet, it’s the very word that keeps Dr. Sunil Verma, medical director at the Tom Baker Cancer Centre in Calgary, motivated in his work. “I am always struck by the complexities of the disease, and by how much suffering patients have to endure,” he says. “These elements have always spurred my need to understand and solve different puzzles in order to improve patient outcomes.” Born in Zambia, Verma moved to Calgary in 1988 when he was 13. “Calgary really laid the foundation,” he says, referring to his experiences at William Aberhart High School and later the University of Calgary. “This city is a very family-oriented, educationally focused area. I received great mentorship at every level.” From there, Verma went on to complete his oncology residency at the University of Alberta, and was later accepted into the Breast Cancer Fellowship program at University of Toronto. Quite the track record for someone who’s only just passed 40! ON TARGET: Dr. Sunil Verma is doing research on After completing his fellowship, Verma knew that “antibody-drug conjugates,” where antibodies attach returning to Calgary was an important step. “I needed to the chemo to better target the cancer cell. to give back to the city and province that made me who I am.” When he was asked by members of the Tom Baker Cancer Centre to apply for the position of medical director, Verma saw the offer as a tremenHowever, as Verma can attest, being a leader and innovator in the field isn’t dous opportunity. “When I came for a visit, I knew I’d always easy: “It’s a big challenge, to be able to shape the vision of how cancer care be joining a great team of wonderful people,” he says will be delivered and how research will be conducted,” he remarks. of his initial interview. “It made me want to help build Thankfully, he isn’t alone. Aside from the Tom Baker Cancer Centre’s existon the strength that was already there.” ing network of professionals, as well as the incredible support they receive That’s why, over the past eight months, Verma’s from Alberta Health Services, Verma insists that creating a global network is been busy mentoring more than 100 fellow innova- the key to making positive research advancements. “In order to be successful [in this field], you have to be able to tors at the Tom Baker Cancer Centre while simul- “It’s about giving and sharing. It’s providing collaborate and work with researchers on a global level. Part of the journey is taneously contributing to enough information to get people excited making those connections.” new developments in the about a certain concept or question, and field of breast cancer In fact, it’s his global perspective which then giving them enough room to fly,” research. “It’s about giving already has Verma looking to the future. and sharing,” he explains. “In my mind, there are three ways our says Dr. Sunil Verma. “It’s providing enough research is evolving. We’re looking to information to get people excited about a certain con- make advancements in targeted therapy, in order to offer patients more precise cept or question, and then giving them enough room treatment; in immune therapy, whereby a treatment utilizes a person’s immune to fly.” To be sure, it’s this kind of “giving and sharing” system in order to target cancerous cells; and finally, we want to increase patient that has spurred Verma’s research surrounding a involvement during their treatments.” treatment method called “antibody-drug conjugates,” Nevertheless, in the midst of these exciting developments, Verma remains whereby antibodies are attached to the chemo in humble and true to his passion. In his words, “to be able to instill the love for order to better target the cancer cell. “Patients have research in students, and then see these people succeed – it’s one of my greatest been benefiting – it’s remarkable,” he says. accomplishments.”

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Beyond Cancer • stories of survivorship

Fear Factor Managing fears of recurrence in survivorship BY JANINE GIESE-DAVIS Everyone who receives cancer treatment hopes that their cancer never returns and that they can gradually return to their “new normal� by re-engaging work, relationships and life goals. Cancer survivorship has come to describe many different paths posttreatment. In addition to beating the odds and living cancer-free, for an increasing number of people the path includes a second cancer diagnosis, a recurrence of the same cancer or a metastasis to another organ. People are living so much longer following treatment and they may go through repeated cancer diagnoses and treatments. Knowing these odds can mean that many survivors live with ongoing fears, act on misinformation or suffer unnecessarily living with a past cancer diagnosis. Fear of recurrence is one of the most common difficulties cancer survivors face as they end treatment, and for some survivors these fears continue long into survivorship. Recent research documents that it is in the top two difficulties for most survivors, but varies in how much it affects quality of life. A majority of survivors report ongoing unmet fear-of-recurrence needs because there are few interventions available to address these fears. For the 22 per cent to 87 per cent of survivors who report high levels of fear, research is showing that if survivors do not address these concerns, these fears can lead to increasing and long-term psychological distress and decreasing quality of life. Intervention research shows that a combination of actions can help to reduce the debilitating aspects of those fears of recurrence even if your actual risk of recurrence remains unchanged. Most importantly, many people assume that if they simply ignore, suppress or bottle up those fears by not talking about them, that they will gradually disappear. However, the most effective interventions to reduce these fears ask survivors to do just the opposite. It is difficult to confront those fears headon, to talk about them with others and to take a course of action to reduce them, but these are the 12

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most effective strategies to improve your quality of life. To confront your fears, researchers recommend a combination of strategies. The first strategy is to ask your oncology team to provide very specific details about signs and symptoms of a recurrence of your cancer and an action plan for you if you should begin to experience these. It is also important to understand what symptoms are safe to ignore. By taking control over your knowledge of your particular cancer and what symptoms matter, you learn how to relax and not monitor each and every physical change you experience. An additional strategy is to talk about these fears with your oncology team, your family physician, and your loved ones. Confronting these fears can take away their power. Just saying the words out loud has an almost immediate effect. We are social animals and programmed for sharing. Especially when confronting fear, this sharing can dramatically improve how you feel. It can also allow you to gain important information from your medical team and it can allow your family to join in supporting you. Family members often also share this fear of recurrence and will be relieved to be able to talk with you about it. Another strategy is to make use of guidance along your journey. Joining a support group, seeing a therapist and learning relaxation techniques can all shorten the road to improvement. Because licensed therapists are trained to facilitate the techniques shown to most quickly relieve these symptoms, you might consider accessing these services if you are experiencing a high level of fear. If you are experiencing fears of recurrence, but they are not intruding on your well-being, simply reaching out to friends, non-therapist-led support groups, loved ones and the peer support that other cancer patients can provide can help you gain tips and learn coping strategies. Lastly, reducing your stress levels through self-care can dramatically improve your well-being. Exercise reduces distress and improves feelings of control. Engaging with loved ones doing things you enjoy allows you to regain feelings of normalcy. Reading humorous books or seeing funny movies can allow you to relax and take a different perspective. In addition, making healthy choices to eat well, eliminate smoking and limit drinking and drug use will allow you to feel confident that you are doing all you can to survive cancer.

Where to Find help In Alberta, if seeking professional help, contact Psychosocial Oncology groups through the Tom Baker Cancer Centre in Calgary or Cross Cancer Institute in Edmonton for appointments or referrals. Many community-based organizations also provide peer support that can be helpful.

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Smart Eats • food for life

Pulse Points Packed with protein and low in fat, consider putting some pulses on your plate BY KELLY BERG NUTRITION SERVICES PROGRAM LEAD AT ALBERTA HEALTH SERVICES

It’s the International Year of Pulses, which means that pulses are in the spotlight. If you’re not familiar with the word pulses, they’re the edible seeds from legumes and include dry beans, peas, lentils and chickpeas. Most people can benefit from eating more pulses. They are low in fat and have protein, iron, B vitamins and are a great source of fibre. Eating the recommended amount of daily fibre can help you stay at a healthy body weight, which can help reduce your risk of cancer and Type 2 diabetes. Studies show that a high fibre intake may protect against colorectal cancer. Pulses also have plant substances and antioxidants that may contain anti-cancer properties. You can replace some of the red meat in your meals with pulses, which may help reduce your risk of cancer. At the grocery store, you’ll find pulses dried, canned and ground into flour. There are also many new food products made with pulses or with pulses added. Though some of these products are healthy, some are not. For example, cookies made with pulses are likely still high in sugar and calories.

Put Pulses On YOur Menu

Cooking dried pulses is simple. One cup (250 mL) of dry pulses yields about 2-3 cups (500–750 mL) of cooked pulses. First, sort pulses to remove any shrivelled beans or small pebbles, then rinse in a sieve with cold water. Next, add seasonings, pulses and 3 cups (750 mL) of water for each cup of pulses, to a pot. Cook on the stovetop until soft. The cooking time depends on the type of pulse: • Split red lentils cook in 10-15 minutes. • Split peas and whole lentils cook in 40-45 minutes. • Dried beans, chickpeas and whole peas cook in 45 minutes1 hours and need to be soaked ahead of time. • Pulses can also be cooked in the oven or in a slow cooker. Canned pulses, like beans or lentils, are quick and easy to use. Choose cans that are labelled “low sodium” or “no salt added,” or rinse and drain regular canned beans and lentils before eating. Rinsing regular beans will get rid of some of the unwanted salt. Tip: A 540 mL can of pulses equals about 2 cups (500 mL) of cooked pulses.

Pulses cost less than meat and taste great in salads, casseroles, soups and dips. Keep canned pulses in your cupboard or cook dried pulses ahead of time. Once cooked, pulses can be stored in the fridge for up to 3 days or the freezer for several months. Try adding pulses to your favourite dishes or make a meatless meal each week. Here are some tips for eating more pulses: • Add puréed white beans to mashed potatoes. • In recipes like meat sauce, stir-fry, curry, or stew, swap pulses for half of the meat. • Spread refried beans on a tortilla and top with grated cheese to make quesadillas. • Sprinkle cooked chickpeas on a salad. • Add cooked lentils or black beans to tacos or burritos. • Use red kidney beans in chili instead of ground beef. • Purée cooked black beans, and then add herbs and spices for an easy dip. • Stir split peas or lentils into soup. • Blend white beans into fruit smoothies.

Pulse flours like chickpea or black bean flour are available at many grocery or bulk food stores. They are higher in fibre and protein than most grain flours. For best results, use in recipes that ask for pulse flour.

For more information, visit the Global Pulse Federation: iyp2016.org.

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Ask the Expert • a resource for you

ANSWERING YOUR QUESTIONS We brought your questions to nutrition experts and research scientists about inflammation and its link to cancer, increasing your calorie intake during cancer treatment and the dangers of prolonged sitting. BY KIM TANNAS

I keep hearing about inflammation and how that relates to cancer. I’m assuming that means more than having swollen joints or limbs? What’s the relation? Dr. Nigel Brockton, a research scientist in molecular cancer epidemiology, says the link between cancer and inflammation goes way back to the 1800s when it was first proposed by Rudolf Virchow but it was largely ignored until the late 20th century! “We now know that cancer often arises at sites of chronic inflammation, and chronic inflammatory conditions dramatically increase a person’s risk of cancer,” he says, adding that, “Inflammation is a natural reaction to a wound, irritation or infection, but chronic inflammation can damage DNA, provide a powerful stimulus for cell growth, may increase the number of cells that can become cancerous and may help cancer spread from its primary site.” He explains that the most common cancers occur in epithelial cells that line organs such as the colon, lungs, prostate and breast. “These cells typically divide more quickly than other cell types, and chronic inflammation can damage the controls that normally limit their 14

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growth and division,” he says. “It is particularly inflammation that affects epithelial tissues that is associated with an increased cancer risk. However, lifestyle factors such as obesity, smoking and an unhealthy diet increase systemic (whole body) inflammation that can worsen local inflammation and increase a person’s risk of cancer.” Does that mean it’s worth controlling inflammation with medication to reduce the risk? Not necessarily, says Brockton. “Antiinflammatory drugs can reduce the risks of certain cancers but the potential risks associated with those medications are not currently justified by the reduced risk of cancer.” So can anything be done about inflammation? “Making healthy choices such as avoiding obesity, tobacco use and an unhealthy diet, all of which can increase systemic (whole body) inflammation, can reduce inflammation and a person's risk of cancer,” he says.

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I’ve been told I should increase my calorie and protein intake during cancer treatment. Do you have any tips on how I can do this? Katherine Younker, manager of Education Resources at Alberta Health Services, says that even a little more protein and calories every day can help you to maintain or gain weight and strength during treatment. She provides the following suggestions: • Try to eat every 2 to 3 hours, even when you don’t feel hungry. • When you feel well, make larger amounts and freeze meals in single portions. Or, try frozen TV dinners or meal services. • Most fluids, especially clear broth, coffee and tea are low in calories. Drink fluids between meals or at the end of your meal. • Limit foods and drinks that are labelled “light,” “low fat,” “fat-free,” “low calorie” or “sugar-free.” In addition, here are some foods she suggests that are higher in calories and protein: • Meat, fish, and poultry are good sources of protein. So are dried, cooked beans, peas, lentils, tofu, and eggs. Have these foods with your meals and snacks. • Choose higher fat milks like 3.25% (homogenized) or 2%, or flavoured milks like chocolate or strawberry. • Try adding skim milk powder or evaporated milk to soups, puddings, milkshakes, and casseroles. • Add Greek-style yogurt to fruit and vegetables, dressings, soups, or smoothies. • Choose egg dishes like soufflés, quiches, and omelettes. Add eggs to dishes like casseroles, hot cereal, fried rice, or stir-fries. • Snack on nuts, seeds, hemp hearts, or trail mix. “If you try these tips and are still worried about your appetite or your weight, ask your health-care provider to refer you to a registered dietitian,” says Younker.

Alber ta Cancer Foundation

Recently I’ve heard that sitting all day at work is bad for me even if I’m getting regular exercise. Is this true and what can I do about it? Dr. Christine Friedenreich, scientific leader of Cancer Epidemiology and Prevention Research and adjunct professor at the University of Calgary, confirms that there is now increasing scientific evidence that prolonged sitting is associated with an increased risk of developing several chronic diseases. These include different types of cancer, cardiovascular disease and diabetes. “Research has demonstrated that the average person has the opportunity to sit for 15.5 hours per day even if they are incorporating 30 minutes of exercise into their daily routine,” she says. As a result, several agencies including the American Institute for Cancer Research/World Cancer Research Fund now recommend that, in addition to aiming for 150 minutes per week of moderate or 75 minutes per week of vigorous intensity activity, prolonged sitting should be avoided to reduce the risk of developing these diseases. “Everyone should aim to avoid sitting all day whether at work, home or wherever they are,” says Friedenreich, who provides several options for breaking up sitting time that can be implemented in workplaces, homes and everyday life: “These include using a sit-stand desk at work, having standing or walking meetings, breaking up time while watching television or other screen-based activities, using stairs instead of elevators and trying to incorporate as much nonsitting time into everyday activities. Even a few minutes of standing to interrupt prolonged sitting is beneficial.” Ask our experts questions about general health, cancer prevention and treatment. Please submit them via email to letters@myleapmagazine.ca. Remember, this advice is never a substitute for talking directly to your family doctor.

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BUST A MOVE On March 19th, 2016 hundreds of participants gathered at the Alberta Cancer Foundation’s 5th annual Bust a Move for Breast Health event to leap, lunge and laugh their way through six hours of exercise bliss to make life better for breast cancer patients across the province. Thanks to the incredible support from participants, donors and volunteers a total of $330,2000 was raised in support of the clinical trials research unit at the Cross Cancer Institute. Thank you to all involved for making a difference for breast cancer patients across Alberta!


SPECIAL REPORT:

ENHANCED CARE

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hen you’re facing a life-changing cancer diagnosis, it’s often the little things that make a big difference. The Alberta Cancer Foundation aims to make life better for those affected by cancer by enhancing the care they receive at any of the 17 Alberta Health Services cancer centres across the province. In this issue of Leap, we take a look at some of these efforts to enhance care for patients and their families.

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TREATMENT WITH A LARGE DOSE OF CARE Going beyond traditional treatment to enhance the life of patients and their families

Alber ta Cancer Foundation

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CLOSE TO HOME Barrhead’s cancer centre provides care in the community, improving patient experiences

SUPPORT WHEN IT’S NEEDED Financial assistance program allows patients to focus on recovery

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Nancy Luyckfassel 18

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The Cross Cancer Institute goes beyond traditional treatment and enhances the life of its patients and their families

BY MICHELLE LINDSTROM

Alber ta Cancer Foundation

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PHOTOGRAPHY BY BLUEFISH STUDIOS

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f I couldn’t be at home, I wanted to be at the Cross,” says Nancy Luyckfassel, a former inpatient at Edmonton’s Cross Cancer Institute. Those are words Luyckfassel never expected to say, but in December 2015 everything changed for her and her family. She was an elementary school principal in Fort Saskatchewan, Alberta, with a very busy life. A mother of two teenagers, a wife and an avid runner, she began to feel more fatigued than usual from her day-to-day activities so she went in for testing. A shadow in an X-ray and various other tests determined she had precursor T-cell lymphoblastic lymphoma. She had a mass of lymph nodes in her chest measuring 25 by 18 by four centimetres that pressed on her lungs and wrapped around 70 per cent of her heart, while also going up the vein in her neck. All that pressure caused her lack of energy and breathlessness. “It’s an aggressive, rare non-Hodgkin’s lymphoma,” Luyckfassel explains. “It was Stage 3 and they wanted to start treating it right away.” She remembers the consultation day: “You sit and listen to what it’s all going to look like and the reality of that sinks in,” she says. “For me, the reality of it being inpatient treatment instead of outpatient was upsetting.” Due to the intensity of her treatment, she needed to stay at the Cross for monitoring, but as she would soon discover, it would be a place of great comfort to her. She was admitted to the Cross only a few days before Christmas last year. Treatment included six cycles of about five days of intensive chemotherapy. On a 24-hour basis, she either had the chemotherapy drugs, or drugs to help her get through the chemo, pumping through her system via an IV. She estimates she spent at least 40 full days at the Cross between December 2015 and May of this year. At the Cross, inpatients receive treatment on the third and fourth levels. Luyckfassel cannot say enough about the special lounge spaces – the Lion’s Den and Lighthouse on the third floor – that made such a difference for her and her family. Those rooms have recliners, TVs, books, movies, coffee tables and chairs. “For my family, that’s where we spent Christmas morning,” she says. “Often when I had guests, that’s where we would stay because it felt like being in your living room and not in a hospital space.” The sleeping chairs in the inpatient rooms turned into cots for family and friends to stay overnight. This was a great comfort to Luyckfassel when she said goodnight to her tone and may cause dark circles t0 appear under your eyes. husband on Christmas Eve and wondered what the next day would bring. He had to head “These ladies showed us how to do makeup for our new home to be with their 17-year-old son and 19-year-old daughter. On Christmas morning, situation.” Patients are allowed to try all the products and she awoke at 5:30 a.m. to see her daughter snuggled into the sleeping chair by her bed and also take a bag of free products with them. it warmed her heart. She also took comfort in the services available to help her deal with the hair loss that It’s all part of an enhanced care approach at the came along with her treatment. “A lot of people don’t think about anything other than the Cross brought to Albertans largely thanks to the support hair on your head and you forget simple things like eyelashes and eyebrows,” she says. “I of donations to the Alberta Cancer Foundation. “With lost all the hair on my body, and enhanced care, we’re understanding having no hair in the winter is that cancer treatments have gotten “They care more than any nursing staff I pretty cold.” and there is greater survivorship have ever come across in my life. The Cross … better A few kind gestures from staff and people are living longer with and volunteers helped ease her provided me with safety and familiarity with cancer; therefore patients’ needs discomfort with donated toques my treatment and there was that connection are going beyond what traditional and beanies as well as a homemade piece – they knew everything about me and it cancer treatments are all about,” says afghan on Christmas Eve for David Dyer, executive director of the was comforting to go back to the Cross.” all inpatients there overnight. Cross Cancer Institute. “A lot of our – Nancy Luyckfassel The heated blankets were also a enhanced care services help to support welcome treat. Wig Services at those other needs in addition to the the Cross allows patients to sign out wigs for free, and Luyckfassel took advantage of the traditional chemotherapy and radiation care.” opportunity to try a few new looks out. Dyer cites some additional programs that improve She also took part in the Look Good, Feel Better program, which the Canadian the quality of life of patients and their families. They Cosmetic, Toiletry and Fragrance Association (CCTFA) started in 1992 to empower include the Healing Arts Therapy program that helps women with cancer and help them manage the effects of treatment on their appearance. patients and their children adjust to the cancer diagnosis A free, two-hour workshop is offered across the country, and twice a month at the Cross. through art; Learning Through Love which provides “As you go through chemo, besides your hair falling out, your skin changes because the tours around the Cross for children of patients to help chemo kills good cells as well as bad,” Luyckfassel says, explaining that it affects your skin them gain a better understanding of what their parent

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CARE TEAM: Nancy Luyckfassel and some of the members of the team that provided care for her at the Cross Cancer Institute.

A Quiet Respite

will be experiencing; and Oncology and Sexuality, Intimacy & Survivorship (OASIS), a program for breast and prostate cancer patients and their partners to adjust to body and libido changes. The nursing staff also played a big part in her comfort and familiarity, Luyckfassel says, adding that she could name 15 nurses off the top of her head along with something about each of them. “They care more than any nursing staff I have ever come across in my life,” she says. “The Cross … provided me with safety and familiarity with my treatment and there was that connection piece – they knew everything about me and it was comforting to go back to the Cross.” Luyckfassel had the unusual experience of accepting a job offer with the Alberta Teachers Association (ATA) as an executive staff officer right before her diagnosis. “The ATA still accepted me and I was able to work it into my recovery plan that I would get treatment for a week, recover for a week and then go to the office for a week,” she says. It helped that the Cross offers free Wi-Fi, which allowed her to review anything workrelated while staying at the hospital. On May 2, Luyckfassel was discharged from the last round of her inpatient chemotherapy. On May 27, her family crammed into the consultation room to hear what the PET scan results were from her oncologist, Dr. Michael Chu. Thankfully, the scan showed that she was in complete remission and could move onto a maintenance treatment plan. “Because it’s a very aggressive lymphoma, the plan is that I will still get treated every month for the next two years,” Luyckfassel says. “I’ll go in once a month for IV chemo then I take two weeks of chemo pills and then take one chemo pill a week and then I repeat that every month.” This maintenance program allowed her to attend her son’s high school graduation on May 28. “There were a lot of happy tears that day,” she says. “Though I’m wearing a wig in his graduation pictures, I’m there with him and that’s all that matters.”

Alber ta Cancer Foundation

In 2014, the Philippine Bayanihan Association in Alberta (PBAA) learned that the Cross Cancer Institute was in need of donations to complete the renovations of a Family Quiet Room. The PBAA’s executives decided to donate $100,000 to the cause in November 2014 through the Alberta Cancer Foundation from money raised by its more-than 200 association members. Tony Briones, incumbent president of the PBAA says, “The CCI needed funding for [the Family Quiet Room] to provide a respite for those who are in the last journey of their lives and I think that it will give extra comfort for visitors and families of the patient.” The intent of the Family Quiet Room is to provide families of those patients who are acutely ill or palliative, a form of respite. Often there are numerous family members at the bedside who take shifts to be with the patient, allowing others the opportunity to rest. Renovations to the existing L-shaped Family Quiet Room began in March 2016, which was previously used as office space located on Station 40 at the institute. It will comfortably hold six to eight people with the capability of sleeping five. The space also has a table where families can gather to eat or play games and also has a 42inch TV. The room was scheduled to open again in August 2016.

Run for Fun Nancy Luyckfassel, along with family, friends and community members, will be celebrating her 46th birthday on September 10, 2016, in Fort Saskatchewan by taking part in a Fun Run (5, 10 or 15 kilometres) called Kickin’ it Nancy Style with all funds raised going to the Alberta Cancer Foundation.

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to Home A Barrhead’s cancer centre provides care in the community, improving patient experiences BY GLENN COOK

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PHOTOGRAPH BY JARED KELLY

cancer diagnosis can turn a patient’s world upside down. It can mean a lot of confusion and a lot of travel for treatments and appointments with specialists. Fortunately, for residents of Barrhead (about 120 kilometres northwest of Edmonton) and the surrounding area, things don’t have to be so frantic thanks to the Barrhead Community Cancer Centre. Located inside the Barrhead Healthcare Centre at 4815 51 Avenue, the Community Cancer Centre offers local patients the chance to undergo chemotherapy treatments much closer to home, saving them and their families the stress of having to find a way to get to

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opportunity to be able to be at home in their own beds at night, to be able to walk their dogs – to be able to do all of those things that we take for granted in our normal surroundings. When patients need to leave their homes to go to an alternate site to receive care, that normalcy is gone.” The Barrhead Community Cancer Centre is one of 11 community cancer centres across Alberta, and was one of the first to be established nearly 20 years ago. Most of these centres are located within other health-care facilities, with several dedicated chairs or recliners where patients can relax and have their chemotherapy treatments administered by specialized oncology nurses. Through Alberta Cancer Foundation patient navigator Linda Knapp, they can also access supportive care services that help with the psychological, physical, emotional, financial and practical concerns that arise throughout the course of cancer treatment. “These patients all do have to go to one of our tertiary or regional sites to start their treatments and get that first consultation with a medical oncologist, who establishes their treatment plans and, in collaboration with the patient, confirms that they’re appropriate to receive treatments closer to home in one of these smaller centres,” Hubley says. “Not all treatments can be delivered in the smaller centres.” Given that these cancer centres are serving local residents, they tend to be wellsupported by the local community. For example, Westlock Bowl – 30 minutes east of Barrhead along Highway 18 – has been holding a Bowl for Cancer fundraiser for the centre for the past five years, raising a total of $60,000 for the Alberta Cancer Foundation. “It’s extremely important” to hold fundraisers like this, says Susan Cloutier, coowner of Westlock Bowl with her husband Don, “because a lot of it directly affects our bowlers, whether it’s them or their families that are going through treatment.” The Cloutiers took over as owners of Westlock Bowl in 2015 from Carolyn and Garth Kohlsmith, and the first Bowl for Cancer fundraiser under their watch took place in January 2016, raising just over $15,000. “What we’re basically doing is raising awareness that there is a facility that close to us that a lot of people don’t know about,” Susan says. “It’s not necessarily about the amount of money you’re raising; it’s just that you’re raising awareness.”

“The ability to remain in their home communities, and to have as much normalcy in their lives [as possible] while they’re going through this difficult time is very important,” says Brenda Hubley. COMMUNITY CARE: Donna Nelson, Linda Knapp, Dr. A Tawfik and Hope Meier at the newly renovated Barrhead Community Cancer Centre.

Edmonton or another larger centre to obtain the lifesaving help they need. “We know, from cancer patients, they need support when they’re going through this time in their lives and through this cancer journey,” says Brenda Hubley, executive director of community oncology and provincial practices for Alberta Health Services. “The ability to remain in their home communities, to be surrounded by family, to be surrounded by friends and community supports, and to have as much normalcy in their lives [as possible] while they’re going through this difficult time is very important. “It assists them in their healing and creates that

Alber ta Cancer Foundation

Hubley says that having that kind of active support from a community is very important to the success of these cancer centres. “It speaks to the primacy and the role that we know this centre has within a local community,” she says. “It speaks to that community’s commitment to supporting members of their community through difficult times, and providing the financial support to ease them of burden – be that in travel or in creating an environment that is conducive to healing in their local area, which is very important. When we explore the opportunities in communities to provide care closer to home, an important part of that is having individuals – be they health-care professionals or other members of the community – that are really committed to and will support the success of a centre such as this.” With the support of Alberta Health Services and the Alberta Cancer Foundation, the Barrhead Community Cancer Centre recently completed a major redevelopment project, giving patients and caregivers a dedicated space for treatment and healing – including a courtyard – and more access to specialized equipment. “They now have access to a space that is for the purposes of providing cancer treatment. And whenever we have those spaces, it creates more opportunity as time goes on, as workload and patient demands or changes in treatments come along, for us to support that,” Hubley says. “So the focus and the work for the Barrhead cancer centre over the next number of years will be for it to grow and develop and respond to the local community needs as best as we can.”

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Financial assistance program allows cancer patients to focus on recovery BY THERESA TAYLER PHOTOGRAPHY BY EVAN MONTGOMERY

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Melissa Osmond and her fiancé Justin Freake Alber ta Cancer Foundation

elissa Osmond and her fiancé Justin Freake were taking Fort McMurray by storm in 2015. The young couple, both originally from Newfoundland, had migrated to the northern Alberta city – known as a mecca of financial opportunity for those eager to make a life and career in the remote but frequently booming oil town – to seek out a new prosperous journey into adulthood. When the two met, just over three years ago, love blossomed. Osmond and Freake were engaged to be wed right after her 25th birthday. That summer, they purchased and began setting up their first home together while simultaneously raising a happy little family – “Duke, the dog; Lily, the cat; and Thumper, a rabbit.” says Osmond, adding that life in ‘Fort Mac’ up until a year ago was pretty “carefree.” “No kids, just fur children. We were planning our wedding, planning for our future. We both had full-time jobs in the oilfields. Life in Fort McMurray after my cancer diagnosis changed. A lot.” The news – given by doctors at the Northern Lights Regional Health Centre on November 6, 2015 – that Osmond had acute myeloid leukemia came as “a complete shock to everyone, including myself,” she adds. Osmond and her fiancé had just returned from Newfoundland where they were visiting for her sister’s wedding. A few weeks after their plane touched back down in Fort McMurray, Osmond started feeling ill. What was at first diagnosed as a pesky bacterial infection in her throat soon evolved into bruising across her legs and stomach. “It happened so fast. I was sent for blood work. Later that evening I had multiple missed calls and voicemails from the doctor’s office,” she says. Finally, that evening she managed to connect with her GP over the phone. “They said that I needed to go straight to the hospital, right away. I was told ‘Don’t detour.’ All I could think of was ‘Gosh, maybe my iron is low?’ ” she says. “When we arrived … the doctor came in and said to me: ‘We believe you have leukemia, and we will be medevacking you to Edmonton as soon as the flight medics arrive.’ ” And then, Osmond’s world fell out from beneath her feet. “After the first week, I was able to get past the ‘Why me, out of all of the people in the world, why did this have to happen to me?’ Soon, I realized I still have a whole life ahead of me, and I need to beat this cancer,” she says. Osmond would spend the next month and a half in hospital in Edmonton. “My strongest rock since day one was my fiancé. Justin’s employers were beyond amazing through all of my treatments; they were very accommodating as he stayed by my side.” What would come down the pipe over the next year would include chemotherapy and eventually a stem cell transplant. The couple would need to relocate to Calgary for February through spring 2016. What they didn’t know then was that a massive wildfire would burn through their city in May, causing a mass evacuation and preventing them from returning home for several more months.

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“Finances were already rough and stressful. I needed a 24/7 caregiver. We had our mortgage, vehicle, utilities, insurance payments …” Osmond says. Osmond was referred to the Alberta Cancer Foundation’s Patient Financial Assistance Program, which assessed her need and quickly managed to find avenues of financial support. The PFAP helped the couple stay in an apartment for the months of treatment she would require during and after her stem cell transplant. That support was extended when the northern Alberta wildfires hit. “We can’t thank them enough. It reduces a significant burden so that you can use your strength to focus on recovering instead of stressing about money,” Osmond says. For patients who are in the midst of fighting not only the most emotional, physical, spiritual and psychological fight of their lives, the realization that their cancer diagnosis will also be one of the most financially challenging experiences of their existence can be a harrowing blow. The PFAP addresses one of the most common – and often ignored – aspects of a cancer diagnosis: finances. The program provides assistance to patients who need it most, for a variety of requirements. Although the chemotherapy that patients receive is most often covered by the government, medications that help patients with the side-effects of their treatment must be purchased, explains Melissa Wilde, a social worker with the Jack Ady Cancer Centre in Lethbridge. “If a patient does not have adequate drug coverage, these costs can be quite burdensome,” Wilde adds. “Many patients must travel from their home community for treatment. They may find that cost quite challenging because they could have multiple trips throughout the year, or they may have to stay in a location for several weeks or months for surgery, radiation or a stem cell transplant. Mileage, parking, meals, accommodations, the list goes on ... must all be paid for out of pocket. It can all add up the same time, we expect the number of people needquite quickly,” Wilde says. In addition to these costs, patients may need to stop working in order to receive their ing help will double by the end of the year,” Van Hyfte says. “And, we don’t want to ever treatment and heal, and they may have limited or have to turn anyone away.” no access to private insurance, employment in“We can’t thank them enough. It surance or disability programs. Van Hyfte says the program is dereduces a significant burden so that signed to help those in active treatLinda Beck shares in Osmond’s gratitude you can use your strength to focus on ment and symptom management. to the PFAP. When the then 59-year-old mother “By the time a social worker confirms and grandmother from Lloydminster was diag- recovering instead of stressing about a patient is eligible for the program, money,” says Melissa Osmond. nosed with acute myeloid leukemia with a 50 per all other funding, possibly governcent chance of survival in 2012, it was the last ment or medical, comes through.” thing she expected to hear. In 2015, the Alberta Cancer Foundation provided After several rounds of chemotherapy treatment in Edmonton, Beck was hoping can- more than $950,000 in support patients and families. cer would finally be gone from her body. But there was more bad news. She would need a “This year, we are aiming for $2 million. Sadly, cancer bone marrow transplant, which could only happen in Calgary. It was time to relocate for doesn’t take a break just because our economy does.” the next eight months to southern Alberta. Van Hyfte says. “I had the support of my son and his family. My granddaughter eventually became my Osmond was eagerly hoping to return home when caregiver. But I don’t know what I would have done financially without the Alberta Can- the fires raged through her northern Alberta commucer Foundation Patient Financial Assistance Program,” Beck says, adding that the orga- nity. “The wildfire was a huge slap in our face,” she says. nization made it possible for her to rent a condo across from the cancer centre during “Thankfully the Alberta Cancer Foundation was able to her transplant, which included daily trips back and forth for blood transfusions. let us stay in the Calgary apartment for another month “They also provide incredible service in the terms of emotional support. If there were until Fort McMurray could let residents back in.” issues with costs for my utilities and or groceries, my social worker put me in contact Today, Osmond is back at home doing well. The with other programs or arranged for financial help. They were a conduit to life. They al- couple was forced to cancel their wedding due to the lowed me to maintain my dignity and access help so that I could return to my new life in diagnosis and financial strain, and Osmond continues to Lloydminster and continue being a productive member of society after cancer.” travel back and forth to Edmonton every few weeks for Beck says she’s living a happy post-treatment life, enjoying her grandchildren and doctor’s appointments. her two dogs while looking forward to her granddaughter’s wedding this fall. “I’m lov“Eventually, those appointments will be spread out ing life again, and I can’t say enough about the help I received from the Alberta Cancer more and more. What’s next for us is just living our lives to Foundation,” she says. the fullest and getting used our new ‘normal’ life. We look Lynn Van Hyfte, vice president of fund development with the Alberta Cancer forward to hopefully having our wedding in the future,” Foundation, says the current economic downturn in Alberta has created massive ex- she says. “The Alberta Cancer Foundation helped us so tra need. “We have definitely seen the impact of the recession on fundraising yet at much and eased so much stress off of us financially.” 26

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Engagement • giving patients a voice Hallmarks of cancer

Engagement Call to Action Patient and family advisors share in the vision to build a centre of hope BY JESSICA DOLLARD

When asked, patient and family advisors, along with staff and health-care providers, offer powerful aspirations for the future of cancer care. When building a new cancer centre, they can easily describe the desired future state. It is my belief that the vision for the future is best defined through engagement, meaning: let’s ask our people and those we serve! Engagement on a large, complex project like a new cancer centre is always evolving and complicated. In Calgary, the focus for our project team building the new cancer centre at this early stage is on planning and design, but my mind is already jumping to the future. I want to talk about people and how we will deliver care at the new centre and, rightly so, our patient and family partners always provide feedback on the design and delivery of care at the same time. Our conversations always end up straddling things that we can address now and things that will have to wait for quite a few years before considering. The feedback we receive is always comprehensive because asking our patient and family partners to discuss portions of their health-care experience in isolation would be difficult. My job is to focus the conversation and help the patient and family advisors know the difference between feedback about design versus operations. I have to be honest – I am continually trying to figure out the difference myself! We are addressing design now; operations will come later. In the last few months, I created a poster-sized timeline to carry around with me to help us all (including myself!) understand the planning process. I use this by placing patient and family advisor feedback, such as “versatile chairs in chemotherapy,” onto a Post-it note. Then I take the Post-it note and put it onto the timeline somewhere in 2020 and this helps advisors know that we are not going to consider furniture options for at least four years. However, with the Post-it note with furniture details written on it, we will not lose that important idea or suggestion. At the same time, we receive input about the delivery of care or programs that will be offered. After all, when we’re talking about making a brand new building run, what we are talking about is people. Making a move from a cancer centre that is at capacity to a brand new, much larger facility will be a big change!

Alber ta Cancer Foundation

Luckily, engagement goes hand in hand with change management. In fact, when I first meet with potential new patient and family advisors, I try to be very clear that we are asking for them to share their stories for the purpose of change management. I acknowledge that it can be healing to share a story, but that is not something I can promise. The purpose of engagement (at least in this context) is changing practice, systems and design. Hearing from and working with patient and family advisors is all about engaging the hearts of our people in health care. Personal health-care stories remind us of our shared humanity and help us to see ourselves through the eyes of our patients and families. Engaging hearts and creating understanding is really the first step in a change management plan in support of building desire and awareness for change. You can see why my mind is always jumping to the future, to delivery of care and operational planning. By now, you might have figured out that I have a lot of hope for the new cancer centre and believe that engagement will be key in realizing an ideal future state. How could I not? Look at the company I keep: in the words of one of our brilliant patient partners, it will be a centre of hope, a healing environment where staff and teams have fulfilling careers as caregivers. Jessica Dollard is the patient-centred experience advisor on the Calgary Cancer Project. As a consultant in engagement and patient experience, as well as an actor, film and theatre producer, programmer, medical skills trainer and executive certified coach, she brings a creative background to this work.

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A provincial committee plays an important role in overseeing cancer research in Alberta

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undreds of clinical and research cancer studies and trials take place around the province every year, and the Health Research Ethics Board of Alberta Cancer Committee (HREBA-CC), housed at Alberta Innovates – Health Solutions, has a part to play in every single one of them. The ethics board, which provides scientific and ethical reviews of all cancer-related protocols in Alberta involving human participants, is made up of more than 30 volunteers, ranging from legal and privacy experts to psychologists and academic researchers to doctors, radiologists and statisticians. “It’s very important work,” says committee chair Dale Dewhurst. “In terms of research trials being conducted in Alberta, we conduct ethical reviews by exploring the methodology and analyzing the risks and benefits of the research and ensuring that informed consent for participants is more easily understood.” Dewhurst, who previously practised law and now teaches professional ethics at Athabasca University as an associate professor, first became a member of the board in 2005. He took over the role of chair almost two years ago. He says besides weighing the cost-benefit factors for patient participants and ensuring they are clear on what

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is required, HREBA-CC has the final say on whether a trial is approved or not. According to Dewhurst, the vast majority of the study applications the board receives are approved. Those that aren’t are most often missing information, need clarity or are awaiting funding. “We don’t see ourselves as a barrier for research,” says Dewhurst, noting there can also be privacy, legal and ethical reasons for refusing a study. Patients must also be aware of what the study is asking of them and, on a practical side, be well enough to take part. “Some of the participants, their illnesses are very serious, and some of the side-effects can be very severe ... they need to be exactly sure of what it is they are undertaking,” says Dewhurst. Many of the studies approved by the committee are international drug trials – often undertaken at the province’s two largest cancer treatment centres: Calgary’s Tom Baker Cancer Centre and Edmonton’s Cross Cancer Institute – but the board has also looked at research involving radio therapy, cancer treatment devices and even the effects of an exercise regime on cancer patients, says Dewhurst. The studies are initiated by pharmaceutical companies and researchers, including academics, doctors and other health-care professionals. Each potential study is reviewed by at least two members of the board, who summarize the project and recommend its approval or denial. Their findings are then taken to the full board during twice monthly meetings, held simultaneously in Edmonton and Calgary via video conferencing. In total, the HREBA-CC discusses about 130 study applications annually at the full board level. Many more studies considered minimal risk are reviewed outside the full board meetings. The committee, which is governed by Alberta’s Health Information Act, also monitors any adverse effects associated with approved studies and has the power to stop research and clinical trials. It was recently handed the

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responsibility of approving and monitoring pediatric cancer research. Dewhurst says being a member of the volunteer board is fulfilling. “You know the damage that cancer can do to individuals and families, and you know the importance of increased research and treatment,” says Dewhurst. “The satisfaction comes from having the role to promote positive and clear research for participants for improving cancer treatment in the long term.”

“As a researcher I want to further knowledge, ask questions, but on the flipside, people need to be protected. We have to have those checks and balances in place to ensure that,” says Dr. Naveen Basappa. Lauren Birks, who has her doctorate in public health and has studied maternal and baby care in Tanzania, took a role on the committee in February 2015. Like Dewhurst, she takes satisfaction in her role, saying it’s her way of contributing to a healthier community. “Research is a way of helping our caregivers and our society to move forward,” she says. “It’s an honour to participate in that process.” As a community member, Birks represents the layperson and says she views her assigned studies through a unique lens due to her background in qualitative research, research, advocacy and capacity building. “When I am reading protocols I [want] to make sure that, at the very minimum, no one is losing anything by participating, that it is indeed benefiting the community,” she says. Dr. Naveen Basappa is another board member. He is a clinical researcher at the Cross Cancer Institute and has sat on the board as a scientific member for about two years. In addition to his research, Basappa, who was born and raised in Edmonton, works on the front lines of cancer care as a medical oncologist and has a keen interest in ethics, which he says he came by honestly.

Alber ta Cancer Foundation

“To say things are black and white is hard ... there are a lot of greys these days. That’s why the ethics board is important,” he says, noting his father’s propensity for debate and asking tough questions got him interested in ethics. That early interest in the importance of looking at an issue from many sides, coupled with his desire to ensure patient participants of studies are protected, ultimately compelled Basappa to volunteer his time on the board. He is thrilled to be part of the collective that is the gatekeeper for cancer trials in Alberta, noting the makeup of the board, with its medical and law experts and laypeople, helps ensure the committee’s success. “Sometimes you get so focused on what you do that you don’t see it from the other side,” he says, explaining that as a researcher, he understands how compelling it can be to further scientific and medical knowledge. Basappa, a husband and father of two, says, for that reason, the board is a critical component of the tremendous research that is taking place in the province. “As a researcher I want to further knowledge, ask questions, but on the flipside ... people need to be protected. We have to have those checks and balances in place to ensure that,” he says, adding the recent death of several patients in a Phase 1 trial in France has reminded him of the importance of the ethics committee. “You can’t have clinical cancer research without the ethics board.”

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BETTER BY PROBLEM SOLVERS: (From left to right) Casey Bojechko, Christian Bagg, Will Gill and Adam Yarschenko are some of the team members working in the Medical Physics Design Lab.

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An inside look at the Medical Physics Design Lab at the Tom Baker Cancer Centre BY DOUG HORNER PHOTOGRAPH BY DON MOLYNEUX

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Design Alber ta Cancer Foundation

t’s a Tuesday afternoon in July and the Medical Physics Design Lab at the Tom Baker Cancer Centre is buzzing. “Fortunate Son” by Creedence Clearwater Revival plays through crackly speakers – just audible above an oscillating hum of clanking and whirring. “Let me grab a chunk of clay and then I can chat,” says Christian Bagg, a mechanical designer and the silver-hair-streaked veteran of this cauldron of invention. Matt Skarsgard, a 19-year-old Queen’s University student clad in a white lab coat and safety glasses, darts in and out of the room. He’s experimenting with different coatings to get a material to more closely resemble a tumour when viewed with ultrasound. Will Gill, a recent mechanical engineering graduate from the University of Calgary, strolls by carrying a face carved from blue Styrofoam. Adam Yarschenko, a design engineer and the lab’s other permanent staff member, plugs in a small robot that he built to mimic the movement of lungs during respiration. “No one comes in and says, ‘We need a bicycle,’ ” says Bagg, summing up the challenge and exhilaration that comes when collaborating with medical physicists on their quest to quell cancer with radiation. Bagg is at the lab’s main work bench, the focal point of the 1,500-square-foot room that includes welding equipment, 3D printers, saws and a variety of lathes, drill presses and mills, all of which are huge, heavy machines that can sculpt, carve and manipulate metal. The room is crowded with top-of-the-food-chain tools – the kinds of tools that make other tools. Bagg, however, is using his hands to sculpt the brown clay

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into the shape of a breast. The mould needs a specific geometry as outlined by Jose Eduardo Villarreal-Barajas, one of the Tom Baker’s 12 medical physicists. The Design Lab is in the basement of the Tom Baker Cancer Centre along with the rest of the physics department. Medical physicists are generally basement dwellers because one of their primary tools, the linear accelerator, requires several feet of concrete insulation in the surrounding floor, walls and ceiling to protect against errant radiation. The rooms that house these devices – floor-toceiling contraptions that accelerate electrons and then crash them into a heavy metal such as tungsten to produce precisely targeted, DNA-shredding photon beams – are called vaults. The Tom Baker has 10 such bunkers, although only eight are currently in operation. About half of cancer patients get treated with some form of radiation therapy and Wendy Smith, director of the Tom Baker’s department of medical physics, says her team helps treat about 3,600 patients a year. This brainy behindthe-scenes crew reviews every patient plan that includes radiation. They know the linear accelerators backwards and forwards and continuously test their accuracy. When they’re not helping to treat patients, medical physicists research new techniques and troubleshoot how to safely apply radiation in atypical cases. Treating cancer with something as powerful and dangerous as photon beams demands an unusual alliance between atomic physics and practical know-how.

“Without these guys, we couldn’t dream of doing the kind of testing that we’re doing,” says Jose Eduardo Villarreal-Barajas. “There’s a certain amount of fulfillment from understanding how the universe works,” says Smith. “But at the end of the day, what do you really accomplish?” The chance to apply high-level science to real-world problems is what motivated Smith to make the switch from theoretical astrophysics to medical biophysics. This hands-on dimension is also what makes the work of people like Bagg and his team indispensable for comprehensive cancer centres – at least in Canada. “Not having this workshop would be terrible for us,” says VillarrealBarajas. The senior medical physicist worked at the University of California San Francisco, which had no counterpart to the Design Lab, before coming to Calgary and the Tom Baker 10 years ago. Villarreal-Barajas explains that if he wanted to research a new radiation technique, he would be limited to online videos, attending conferences or, if he was lucky, one or two site visits to watch the procedure done at another hospital. Observation, says Villarreal-Barajas, is no substitute for first-hand experience. The clay mould Bagg was shaping on his work bench will form part of a model of a woman’s torso and breast. Medical physicists use these models, or phantoms, to research new treatment methods. Sometimes that can mean a completely novel approach for radiating cancer cells, but phantoms are also handy for training oncologists and radiation therapists (medical physicists do not actually deliver treatments) on techniques already in use at other centres. Phantoms are put through the entire rigmarole from CT scans to treatment plans, quality control checks and linear accelerator treatments. “We practise and practise until we master the process,” says Villarreal-Barajas, estimating that Tom Baker physicists introduce two or three new techniques every year. “Without these guys, we couldn’t dream of doing the kind of testing that we’re doing,” Villarreal-Barajas says of Bagg and his team. Tyler Myer, a Tom Baker medical physicist who grew up in Castor, Alberta, is also advancing his research with help from the Design Lab. Brachytherapy is another method of treating cancerous cells. Radioactive seeds are implanted 32

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with a needle and slowly release radiation to the surrounding tissue. The first-ever seed implant for breast cancer was done in 2004 at the Sunnybrook Health Sciences Centre in Toronto. Twelve years later it’s still a rare procedure performed by a handful of surgeons worldwide. “Not everyone is an F1 race car driver,” says Myer, explaining how the current technique demands extraordinary dexterity. Results of breast brachytherapy vary widely from centre to centre because it’s so physician dependent. Myer is working to standardize the procedure and reduce that element of surgical wizardry. “We want to make it safer and easier for more clinics to be able to offer this treatment,” says Myer, who consulted the Design Lab on ways to improve the technique. Bagg ended up creating the Stepper, a sleek L-shaped device that attaches to the patient’s bedside and has a series of knobs that allow the surgeon to precisely adjust the angle and placement of the needle. “He just went and built it,” says Myer, who began working at the Tom Baker a decade ago as a grad student. Myer remembers reviewing his CV at one point and realizing that every paper he has been involved in publishing has relied on one device or another that was developed at the Design Lab. “It’s better to do a functional decomposition of what they need rather than ask what they want,” says Yarschenko. It’s inevitably a trial-and-error process as the physicists and Design Lab staff whittle their way from abstract concepts to designs to tangible inventions. The small robot, called a sinusoidal wave form phantom, methodically rises and falls on the wooden table in front of Yarschenko. Its minutely calibrated movements are used to measure the amount of radiation absorbed at various heights. When we breathe, our chest expands away from our heart. The robot phantom helps plan linear accelerator treatments where radiation is released at the exact moment when it will do the least amount of damage to the heart. Yarschenko joined Bagg at the outset of 2016. He’s the first engineer to work at the lab, which had been the sole domain of machinists since its inception in 1963, when the Calgary Cancer Centre was located at the Holy Cross Hospital. Yarschenko is part of a new trajectory for the lab as it expands its capacity to support medical physicists as they push the frontiers of radiation therapy. “Pull the logo up,” says Bagg. Gill turns to a laptop on a desk behind the work bench. A symbol of an atom pops on screen. Instead of a nucleus, the three elliptical orbits, white arcs on a blue circular background, swoop around two gears with different sized metal teeth. It’s a succinct depiction of how medical scientists and metalworkers collaborate to provide individualized care and pioneer new treatments at the Tom Baker Cancer Centre.

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Barre Basics

This unique ballet-inspired workout is helping Albertans dance their way to better fitness

PHOTO: LAUREN DARY, L PHOTOGRAPHY

BY CHELSEA GRAINGER

Alber ta Cancer Foundation

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cross the country, fitness enthusiasts are transforming basic ballet moves into a heart-pumping, full-body workout. Barre classes – a fusion of Pilates, yoga and ballet – are part of a growing fitness trend that promises to give your body strength and definition as well as improve posture, endurance and flexibility. For Megan Clark and Elissa Jamieson, it was a no-brainer to open their studio, Barre Body Studio, in Edmonton three years ago. The duo was ahead of the curve when it came to bringing the workout style to Alberta’s capital city. Clark tried her first barre class while on vacation in Portland and was immediately hooked by the unique style. Soon afterwards, she began teaching barre at a local dance studio. “I thought it sounded interesting so I tried it and I absolutely loved it,” she says. Eventually, the wheels were put in motion and the first Barre Body Studio was opened in the city’s northwest. It has since expanded to three locations. “It’s kind of taken off,” says Clark, noting that boutique barre studios are popping up across the city. “People love it, and it’s growing.” A typical barre class consists of a combination of using the barre for standard ballet dance moves – such as pliés, pelvic tucks and fourth position – along with mat exercises and free-weight circuits. The Barre Body Studio’s workout method is a fusion of low-impact movements done in a high-energy environment that target common problem areas and focus on strength and flexibility, Clark explains. “The moves are really small and really controlled.” Barre is a great way to work out because it’s low impact and can actually help people relieve their back and joint pain, says Clark. “It’s easy on the joints, but it still gets deep into the muscles.” Barre Body Studio has a variety of different classes for barre enthusiasts to try. On top of the standard one-hour class, there is a Barre Body Blast class, which, in addition to the standard barre movements, includes two cardio components. Also offered is a Barre + Core + Stretch class, which combines typical barre movements with stretching and core-strengthening exercises. No matter what class, Clark says Barre is a complete full-body workout. “We really focus on working out everything and making sure we hit every muscle group,” says Clark. “We’re also doing it in a very safe and functional way.” Clark says barre is suitable for everybody, no matter their fitness level. “The movements are so small they’re really easy to follow and really easy to modify,” she says, noting each class offers modifications both for beginners and those who may be more advanced. “Listen to your body. If you need to take a break, take a break.” But don’t get the idea that the workout won’t challenge you. “There will be a burning in your body that you’ve never felt before,” says Clark. “People say they’ve seen changes in their body in just three classes,” she says. “Barre is going to help you live your life better.” At one Calgary studio, they are putting a new spin on barre classes. Barre Belle, a boutique fitness studio located in the city’s southwest, is transforming the barre craze into an ultra high-energy experience. Owners Jill Belland and Kristi Stuart opened their studio in February of 2016 and thought regular barre classes needed an overhaul. “We thought there was a missing component and that we could take the classes up a bit,” says Belland. At their studio, workouts are done to lively, loud music. For instance, the Cardio Dance class is described as a “dance party without the club but with the sweat.” “Barre Belle has kind of changed the landscape of barre, and Barre X is phenomenal,” says Belland, referring to a class that provides close to an hour of high-intensity

cardio. “You use the music to motivate you; it makes you seem as if you’re working as part of a team.” The pulse-pounding classes still incorporate all aspects of barre, with clients using the barre, mats and light hand weights. “You’ll be out of breath; we use lots of props,” says Belland. “But it’s fun. Sometimes it’s so fun, it doesn’t even feel like you’re working out.” The classes incorporate high-repetition exercises to help fatigue and stretch out the muscles, with some classes including a nine-minute arm circuit using light weights. “We tone all the muscles women want,” says Belland, who notes that barre classes are no walk in the park.

“We really focus on working out everything and making sure we hit every muscle group,” says Megan Clark.

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PHOTO: LAUREN DARY, L PHOTOGRAPHY

“You get a full-body workout and you will be challenged,” says Belland. “It’s some of the most challenging work you can do. You will leave sweaty.” Classes have always been well-received by clients, and some have been coming to the studio since it first opened its doors. “We’ve watched our clients’ bodies change before our eyes,” she says. A trained dancer-turned-runner, Belland instantly found her passion with barre. The workout style has allowed her to combine her two passions and help others achieve their fitness goals. She initially tried it on a whim and found that the unique workout style brought her back to her days as a ballet, tap and jazz dancer. “I loved barre; it totally changed my body,” she says. While all of the instructors at Barre Belle have strong dance backgrounds, no dance experience is necessary for those wanting to try barre. “I want everyone to try it,” she says. “People get intimidated because they think you have to be a dancer, but it’s really just getting through the front door for the first time.” That’s the case for Elaina Smith, who has no dancing background and tried barre

Alber ta Cancer Foundation

out of curiosity. Now she’s hooked and she has been going to classes steadily for the past year. “Barre seemed different than all the other classes I normally do, it’s more of a workout,” says Smith. The first class, although fun, had her muscles screaming. “It’s really tough,” she says, noting the dancer poses put emphasis on the legs. Smith, an athletic swimmer, says she’s most definitely noticed a change in her body thanks to pushing herself with barre. “The classes have gotten easier as I’ve gotten stronger,” she says. For more information, visit barrebodystudio.com and barrebelle.ca

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PHOTO: PIXELS BY CAPRI

Corporate Giving • working for a cause

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ABOVE AND BEYOND BY MARTIN DOVER

Jet Label’s charity run involvement hits close to home for many of its employees

Last year, Darrell Friesen reached new heights. For years, his company, Jet Label, had been a corporate sponsor of the Climb of Hope Run, which sees participants running and climbing stairs along the Edmonton river valley to a soundtrack of rock ’n’ roll music. But last year was special – during the event, Friesen’s father-in-law, who had survived a diagnosis of small b-cell lymphoma two years earlier, joined him. “Having him go through all of the chemo, the radiation, the treatments at the Cross Cancer Institute, and for him to come walk with me...” says Friesen. “It was a very rewarding part.” The Climb of Hope Run, presented by Jet Label, has been a part of Friesen’s life for eight years. “We always try to give back what we can, and this seemed like the right thing to do,” says Friesen of Jet Label’s involvement in the charity run. During their first year, Friesen was given an opportunity to speak with the Alberta Cancer Foundation about how their corporate donation was being used. “The coolest thing is that the expenses are all picked up corporately, so every nickel raised gets to the final source,” he says. “From that moment on, I was hooked.”

“This is something we can believe in and grow with. We feel very positive about giving,” says Darrell Friesen. Since then, Jet Label has continuously boosted its participation numbers in the races. Last year, 106 Jet Label employees participated on a corporate team, with Jet Label donating $100 on behalf of each of the employees participating in the event. Jet Label also provided team prizes during the event. “This is something we can believe in and grow with,” says Friesen. “We feel very positive about giving.” Part of that is due to first-hand experience with cancer. Friesen and his business partner, Rod Froment, have both seen close family members treated at the Cross Cancer Institute in Edmonton. “For both of us, we want to do everything we can because we have the ability to give back a bit,” says Friesen. “We’ve asked ourselves – what can we do to improve the chances or move the needle a bit?” But they also do it because they’ve seen the benefits of employee engagement in their company. “It motivates everyone. They look at how we support this with our cash and our time, and for them it’s meaningful,” says Friesen. “Most of our employees have, in some way or another, been touched by cancer, as most people have. So with that, our sponsorship hits close to home.” Friesen is a big believer in the power of giving: “It seems like, when we’re

Alber ta Cancer Foundation

generous, a lot of generosity is shown back to us,” he says. “We have had a very successful business in spite of some of the economic challenges. Sometimes you wonder about karma. I don’t know how much that has to do with it, but – holy smokes – we’ve been really blessed. I think we’ve been put on this earth to do something bigger than just kind of bump along. We can be good stewards and help improve the lives of other people.” Going forward, Friesen hopes that Jet Label can continue to top itself in employee engagement and donation amounts.

MOVE AND GROOVE Held on September 17 in Edmonton’s scenic Victoria Park, the Climb of Hope Run is an annual event – now in its eight and final year – in support of the Alberta Cancer Foundation, benefiting the Cross Cancer Institute in Edmonton. It combined a five-kilometre run or a 3.5-kilometre walk with stair climbing and rock ’n’ roll music. Participants were encouraged to dress up as rock stars (bring out the heavy eyeliner, big hair and skinny jeans) and had a chance to win prizes. Since its inception the event raised more than $840,000 towards the cause (not including the final year). In conjunction with the event, a live action cook-off between Edmonton’s top chefs was held on August 28, 2016, at the Workshop Eatery. Attendees enjoyed a five-course meal, including wine and craft beer, and took part in the live auction of the chefs’ table dinners. For more information, visit http://2016.climbofhoperun.ca.

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Why I Donate • stories of giving

PROUD MOMENT: Laurene Mitchell (bottom right) at the Weekend to End Breast Cancer in 2010.

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For more than a decade, breast cancer survivor Laurene Mitchell has been walking her way towards a cure BY KIM TANNAS

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aurene Mitchell has never been one to shy away from Over the years, Mitchell has built up an impressive track record as a a challenge. She’s just returned from a gruelling 75-kilometre top fundraiser at a number of events, raising a total of $118,000 for the hike along the West Coast Trail on Vancouver Island. “It was Alberta Cancer Foundation. Since 2005, Mitchell has walked more than pretty tough but it was awesome,” she says. 480 kilometres in eight Weekend to End Women’s Cancer events and The Calgarian trained for the week-long hike many months ahead, raised more than $8,500 during the six-hour fitness extravaganza Bust carrying a 40-pound backpack up and down stairways and over logs a Move, becoming one of the top fundraisers in each Alberta Cancer and boulders to build up her strength and balance. “You just try and do Foundation event. At OneWalk this year, she did it again, raising $9,000 as much as you can, but no matter what you do it’s not representative and exceeding her personal goal of $8,000. She plans to participate in of what you actually endure,” she says. the OneWalk again in 2017. Earlier this year, she was training for a different kind of challenge, “Very little – probably two per cent – has been donated through swapping her hiking boots for running shoes as she prepared for the organizations,” she says. “It’s pretty much been individuals that have inaugural OneWalk to Conquer Cancer, a fundraiser for the Alberta donated out of the goodness of their heart. I’m very grateful and very Cancer Foundation fortunate to have people donate very generously to my cause.” Held on June 25, the event started at Mitchell was diagnosed with breast Shaw Millennium Park in the pouring rain. cancer in 2003, when her youngest son Honorary chair Charlotte Kessler, who “I believe without the money going was two years old. She had a mastectomy was recently diagnosed with brain cancer, forward, I wouldn’t have lived as two weeks later and reconstructive spoke to cancer survivors, supporters and long. Who knows if I would’ve lived surgery in 2005. In 2010, she went volunteers about what the event meant for through genetic testing and found out she at all?” says Laurene Mitchell. her and her young family. was carrying the BRCA-2 gene (the same Almost 500 participants took part in the one made famous by Angelina Jolie). 25-kilometre walk through Calgary’s downtown core and neighbouring “In 2012, because of the direct link between ovarian and breast communities, raising more than $1 million for the Alberta Cancer cancer, I had a bilateral oophorectomy – the removal of the fallopian Foundation. Weather conditions improved throughout the day. “It’s to tubes and ovaries,” she says. That reduced her chances of getting benefit all cancers, and so I could choose where I wanted my funds to go, ovarian cancer to five per cent, the same as the rest of the female she says. “I chose breast cancer because I’m a survivor,” says Mitchell. population. In 2014, she decided to have a prophylactic mastectomy to remove the other breast to reduce her chances of having another People could walk and raise money as an individual or a team and many breast cancer. She’s had a number of modifications and small were decked out in colourful costumes as they made their way to the finish surgeries in between but has now been cancer-free for 13 years. She line. In true celebratory fashion, Mitchell danced across the finish line considers herself fortunate not to have needed any radiation or chemo with some friends. Hundreds of volunteers were set up along the route to in her treatment and says the whole experience was very positive. “I provide food, water and encouragement to the participants. This was a day was treated like gold and had really good care all the way through.” of camaraderie, with people coming together to make a difference.

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Why I Donate • stories of giving Her personal experience with cancer is her biggest motivation to raise money for the cause – “to raise money to hopefully put an end to it,” she says. “I have a granddaughter who’s six and because I carry the BRCA-2 gene, there’s a possibility that my three boys would carry the same gene.” There’s a 50-50 chance of her passing this gene onto her children and then, if they carry the gene, there’s a 50-50 chance of passing that gene onto their children. “If they do carry the gene, they have a definite chance of having prostate cancer or breast cancer themselves,” says Mitchell. She knows that the fundraising has made a difference in her own life and the life of others who have been diagnosed with cancer. “I very much appreciate the Alberta Cancer Foundation organizing these fundraising events. I believe without the money going forward, I wouldn’t have lived as long. Who knows if I would’ve lived at all?” she says. “There’s been such great improvements in treatments and longevity after cancer that there’s a lot of people that definitely would not have survived very long without the work that has been done so far by researchers and doctors. This has enabled us to survive and to have a happy, long, full life and I’m very appreciative.” It’s an appreciation she took with her on the West Coast Trail, where she experienced moments she’ll never forget. After a long vertical descent on Day 7 you reach Tsusiat Falls, a popular camping spot with a swimming hole and spectacular views along the coastline. “Just sitting there with my boyfriend and watching the whales offshore and watching two eagles come and pick a fish out of the water right in front of us, it was pretty cool,” she recalls. “It’s just a lovely place.”

Also unforgettable were the friendships that developed among fellow hikers they encountered along the way – at community fires where they met people from all around the world and the general spirit of camaraderie they experienced on the trail. In many ways, it sums up much of her motivation to continue with her extraordinary fundraising efforts – “People help each other,” she says.

WALK THIS WAY: Laurene Mitchell (far left) at the OneWalk to Conquer Cancer 2016.

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ONE DAY. ALL CANCERS. REGISTER TODAY! ONEWALK.CA 403.879.9802

OneWalk™ to Conquer Cancer benefiting Alberta Cancer Foundation is your opportunity to be part of an inspirational movement to conquer ALL cancers. Through OneWalk, Alberta Cancer Foundation supports breakthrough cancer research, clinical trials, enhanced care and the discovery of new cancer therapies at the Tom Baker Cancer Centre, Cross Cancer Institute and 15 other centres across the province. Walk as an individual or form a team of friends, family and colleagues and raise funds to conquer the cancer that matters most to you. Join us by registering for 2017! Together, we can make life better for Albertans facing cancer.

PURPLE TIE AFFAIR

Benefitting Pancreatic Cancer Research at the Cross Cancer Institute

November 5th | Art Gallery of Alberta

Ticket Price $125 Doors at 7 pm. Entertainment at 8 pm Duelling pianos, live painting, photo booth, silent auction, appetizers

Purchase tickets by emailing us at tickets@purplewithapurpose.ca or message us on our Facebook page, facebook.com/purplewithapurpose1


Top Job

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As the nurse manager at Red Deer’s Central Alberta Cancer Centre, Myrna Kelley has seen the facility grow and its treatment options expand

BY CHELSEA GRAINGER

Alber ta Cancer Foundation

/ PHOTOGRAPHY BY DARRYL PROPP

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or almost three decades, Myrna Kelley has spent her days caring for Albertans dealing with cancer. Kelley works as a nurse manager at the Central Alberta Cancer Centre, located next to the Regional Hospital in Red Deer, where she oversees daily operations of the facility that handles an estimated 15,000 cases a year. She has been there in her current role since 2000, connecting with her staff of 12 nurses and making sure all patients are comfortable and receiving the care they need. Kelley entered the world of cancer care in 1984 when she took on the role of a nurse at the centre. At the time, the centre was located in a tiny building with only enough room for two treatment beds. Three moves and 29 years later, it’s now a full-fledged facility with room for 27 patients. “The centre has really developed into a comprehensive cancer centre with lots of support to provide patients,” says Kelley, noting there now is a social worker, physiotherapist and a dietitian on hand. “It has really grown.” As a staple employee at the centre, Kelley has witnessed numerous changes in the field of cancer treatment and research. One of the biggest advancements the centre itself has made in recent years has been in bringing radiation treatment to central Alberta. The centre had two radiation vaults installed in 2013, the same year they moved into their most recent location, making it easier for patients in the area to get proper radiation treatment. “It’s been really fabulous for all patients in central Alberta,” says Kelley, noting before the radiation vaults were installed, patients needed to go to Edmonton or Calgary to receive their radiation treatments. Kelley has also seen cancer treatment options progress. “There are a lot more drugs available now,” says Kelley, noting drug advancement has allowed for more specialized care. “Prescriptions are becoming a trial,” she says. “As we continue to expand and get more confident in lot more targeted and specialized for each patient.” Doctors and nurses this new building and working with one another, I’m sure clinical trials have also learned how to better manage side-effects of cancer drugs. will continue to grow and be part of our operations here.” She’s also seen strides made on the chemotherapy front, noting as each year passes, more patients are able to receive their treatment Kelley’s foray into the field of nursing began when she was living through a chemotherapy pump in the comfort of their own home. in her home province of Prince Edward Island. She enrolled in the “There have been a lot of good things general studies program at the local happening,” she says. university to figure out what path “The centre has really developed into a Despite the progress, the censhe wanted to take with her life and comprehensive cancer centre with lots eventually nursing caught her eye. tre still faces numerous challenges. of support to provide patients,” She completed her registered Kelley says not all cancer patients says Myrna Kelley. nursing diploma and moved to Edcan be treated at the centre due to Red Deer’s small size. “It depends monton to get her feet wet in her on their diagnosis,” she says, noting that sarcoma patients and those newfound career. While working at a hospital in Edmonton as a genwith head and neck cancers are usually referred to larger centres. eral nurse, and completing her nursing degree at the University of AlIn addition, doctors at the centre deal with such a large number of berta, Kelley found herself fascinated by patients dealing with cancer. cancer patients that their services are more generalized than those in “While I was working on the medicine unit, I was always intrigued larger centres, who can specialize their care. “There’s good and bad to and attracted to the oncology patients and I’m not exactly sure as to that,” she notes. why. I just found it very interesting,” says Kelley. The centre has also not been able to partake in any clinical studies, She attributes her desire to delve into the cancer field to her curious but Kelley says that may change in the near future. “We’re in discus- nature. “There are so many different kinds of cancers,” she says. “Cansions, and soon we may have an initiative to start up our first clinical cer research is ever-changing; there are always new things coming out

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A REWARDING CAREER: Nurse manager Myrna Kelley has a natural curiosity and desire to make a difference.

to treat the patients and new ways to diagnose them as well. It’s an on- more than just a patient coming and going,” says going learning process and I think that’s what keeps it interesting.” Kelley. “You get attached to their patients and Shortly after making her decision to specialize in cancer, Kelley their families.” moved to Red Deer. She worked at the Red Deer Regional Hospital Kelley says although cancer is often a tough for three years before finding her current home at the Central Alberta journey, her job has not been a depressing one. Cancer Centre in 1984. “A lot of our patients look at life through a differFor the past three decades, Kelley has ent lens; they tend to dedicated herself to her patients, ensee the good things “I definitely think there are a lot suring they have everything they need of great things about nursing,” she in life,” she says. to make their journey through recovery “Our patients, the says. “It’s been a rewarding career majority of them, are comfortable. for me, always.” She said she wouldn’t change anything really appreciative of about her career. “I definitely think there us and come in to the are a lot of great things about nursing,” she says. “It’s been a rewarding centre quite upbeat.” career for me, always.” Above all, making a difference in each paAnd although she’s constantly learning about advancements in tient’s life has been what pushes Kelley to do her treatment, she’s also learned lessons from her many patients. “At best each day. the end of it all, I think the patients and what they bring to us is often “In nursing, you get a true sense that you are remore than what we give them,” she says. “They teach you to recognize ally helping out and making a difference in these the good things in life and not to take things for granted.” people’s lives,” says Kelley. “We get a lot of positive She has had the opportunity to build countless relationships with comments and feedback, on our work and the facilthe patients who have come under the centre’s care. “It becomes ity, but it’s not about that. It’s about the patients.”

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Research Rockstar

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Behind the Scenes Medical physicist Dr. Wendy Smith does crucial work in developing new treatment techniques in radiation therapy, improving outcomes for cancer patients BY DAWN SMITH

Alber ta Cancer Foundation

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PHOTOGRAPH BY DON MOLYNEUX

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r. Wendy Smith loves her job. The head of medical physics at Calgary’s Tom Baker Cancer Centre, Smith uses her scientific inclination to improve outcomes of cancer patients through both research and clinical work. “It’s the best job in the world for me,” says Smith of her role at the world-class facility, which serves more than 7,000 patients annually. “Medical physics is a chance to apply a real, pure science degree in a way that really changes people’s lives.” One of about 300 clinical medical physicists in Canada, Smith is an active researcher whose interest lies in the effect of motion on radiation therapy in the treatment of liver, lung and breast cancer. She is also keenly interested in the impact of timing inaccuracy in imaging systems. Smith, who is an associate professor at the University of Calgary, has published dozens of papers and given multiple presentations in her areas of research and has received funding for her work on using ultrasound to help guide radiosurgery of liver metastases. But her interest hasn’t always been focused on medical physics. She earned her first two degrees in physics at the University of Waterloo before developing an interest in medical biophysics, in which she earned her PhD at the University of Western Ontario in 2002. “When I started at university I wanted to do something intellectually stimulating,” says Smith, noting she studied black holes and wormholes while earning her master’s degree. It was shortly after earning her degree in astrophysics that she developed an interest in medical biophysics. “I enjoyed theoretical astrophysics – pushing the bounds of knowledge, but the idea of spending my life helping people and making their lives better, that was really intriguing to me,” says Smith. While completing her doctoral studies, she was part of a team working to develop three-dimensional ultrasounds when the technology was still in its infancy. In fact, she treasures an image taken of her eldest son taken while still in utero. After finishing her studies and completing a two-year residency at the London Regional Cancer Program, a world-class cancer treatment facility in southwestern Ontario, Smith took a job at the Tom Baker Cancer Centre. She hasn’t looked back.

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“I never wanted to leave,” says Smith of her 12-year tenure at the Tom Baker Cancer Centre. “It’s one of those rare places you can have a job that is both clinical and academic.” In fact, Smith says she has been able to apply most of her research to real-life scenarios, giving her the insight she needs to truly improve the outcome for cancer patients. Medical physicists at the Tom Baker Cancer Centre are responsible for ensuring the radiotherapy treatments prescribed by physicians get administered properly, explains Smith. They do this by making sure all the complicated imaging and radiology equipment is running properly, a very important job when mere millimetres can make a difference. A typical day might see Smith confirming that tiny radioactive seed implants are placed in precisely the correct position – using highly technical ultrasound equipment – during a prostate brachytherapy implant, working to help treat a tumour with stereotactic radio surgery or calculating the dose and time needed to treat cancer with a linear accelerator. “We design treatment techniques and develop processes with radiation therapists and oncologists. Medical physicists mainly do behind-the-scenes work,” says Smith, noting another key role for the highly educated professionals is to solve problems on the fly, often in intense situations. “You have to make really important life-or-death choices,” she says of her work. “It’s intellectually challenging, and you get fulfilment from that.” Aside from her clinical work, Smith is keenly interested in improving the quality of delivering radiation therapy. That topic is, in fact, where her research interests now lie.

“I enjoyed theoretical astrophysics – pushing the bounds of knowledge, but the idea of spending my life helping people and making their lives better, that was really intriguing to me,” says Dr. Wendy Smith. For instance, this work involves using infrared markers to ensure radiation treatment occurs in precisely the same location in breast cancer patients for every dose, thereby keeping the tissue near tumours as intact as possible. “We can carve that dose to be within less than two millimetres,” says Smith, noting ensuring cells near tumours stay healthy is not only cosmetically, but often medically, important. A uniform dose is also critical, and can be affected by something as small as the patient’s normal breathing patterns – especially when treating breast or other cancer close to the lungs. Smith says her team’s research in that area has led to changes at the clinical level. “Now our standard of care is having breast cancer patients take a deep breath to move the heart out of the field,” she says. Smith doesn’t work alone. She and the other 10 medical physicists at the Tom Baker Cancer Centre work with oncology and radiology physicians, students and radiation therapists. Every single team member plays a role in furthering research

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FAMILY TIME: Dr. Wendy Smith enjoys some active time with her four sons.

and treatment. “Our work is multidisciplinary,” she says. “That’s the way to create changes in patient care and outcomes.” That desire for improved care is why Smith and her colleagues actively publish. She hopes her work will spur more research in the area and keep other groups from “reinventing the wheel.” But most of all, she hopes for better outcomes for her patients. “A good-quality treatment should result in a better quality of life [for patients],” she says. The Tom Baker Cancer Centre, which Smith says treats about 3,600 cancer patients with radiation annually, has several specialty treatments not available anywhere else in the province, including stereotactic radiosurgery, breast brachytherapy and total body irradiation for bone marrow transplant preparation. In fact, Smith says her team recently implemented a novel arc delivery for total body irradiation that decreases treatment time, reduces staff injury and improves patient experience, with the first patient being treated with the method in January. Although it’s not the standard of care yet, Smith is hopeful it can be used to improve the experience of many more patients in the future. As for the future of cancer treatment, she says recently there have been “tremendous improvements” in the area of integrated imaging to verify locations of tumours in patients. “That’s really exciting,” she says. She is also thrilled with the new cancer treatment centre to be built at the Foothills Hospital site. The centre, for which the province has budgeted an estimated $830 million and has indicated will be completed in 2024, will help ease overcrowding at the Tom Baker Cancer Centre and offer a full slate of cancer treatments. She expects the new centre will help recruit world-class researchers and clinicians to southern Alberta and spur even more research. “Success breeds success,” she says.

Alber ta Cancer Foundation

GettinG to Know Dr. wenDy Smith What is something surprising about you? I am married to my high school sweetheart and we have four sons, ages six to 15. What do you do in your downtime? In my downtime, I mostly spend time with my family. We built a patio over the past few weeks, and the kids were right in there digging holes, carrying gravel and laying bricks. Do you have any hobbies? Recently, I have taken up cycling and have started biking from the park and ride to work. I also cycle on the weekends. Since I started in February, I have put on 1,250 kilometres. I also like to garden, colour and play video games with my husband and sons, but I’m not particularly good at any of those things. Where did you grow up? All over the United States and Europe. I lived in 10 different places before I graduated from high school! A typical Sunday morning looks like ... Either we go to church or have a family activity. Last weekend, for example, we went on a sixmile bike ride and assembled patio furniture. What was the last film you saw? Grosse Point Blank. We are working our way through ’80s classics with our teenager and preteen. The last film I saw in the movie theatre was The Secret Life of Pets. What was the last book you read? I’m currently reading Without Fail, which is a Jack Reacher novel by Lee Child. Prior to that, I was rereading a Terry Pratchett novel, Interesting Times. He’s definitely my favourite author. How do you balance work and home life? When I am at work, I’m entirely at work and totally focused on it and when I’m at home I tend to turn things off and be very present and there with my family. Also, my husband and I share the household duties.

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WALK THIS WAY: Ahmed Al-Obeidi joined hundreds of others to raise almost $1 million for the Alberta Cancer Foundation.

Stepping Up

By Jessica Barratt

A newcomer to Canada, Ahmed Al-Obeidi participated in the inaugural OneWalk after his sister’s struggle with cancer In 2014, when Ahmed Al-Obeidi’s younger sister Yasameen was diagnosed with mediastinal large B-cell lymphoma, it was up to Ahmed to stay strong for her while doctors in Dubai administered treatment that was both frightening and painful. “It was a disaster,” says Al-Obeidi. “We never knew if she would be there, alive, to open the door for us.” Thankfully, Yasameen made it through, and Al-Obeidi says it was the wonderful treatment his sister received from a Western hospital in Dubai that inspired him to cultivate a new life in Canada. Thus, by April 2015 – after applying for the Federal Skilled Worker Program – this civil engineer was on his way. “I toured all across Canada, but Calgary was calm and relaxed. My wife and I decided it would be a great place to raise our children.” Yet Al-Obeidi could not forget about his sister’s struggle and so began looking for ways to help others who were facing similar circumstances. That’s how he found out about OneWalk, the Alberta Cancer Foundation’s fundraising movement to conquer all cancers. Participants raised funds and joined in on a 25-kilometre walk through the streets and neighbourhoods of Calgary. “I knew it was something I had to do,” he says. Although nervous about fundraising, Al-Obeidi was pleasantly surprised to find that even his most cash-strapped friends were willing to donate. “Even my children wanted to help. They would take their savings and buy freezies to give to the foundation.” Motivated by the support he’d received, on June 25, Al-Obeidi, along with hundreds of others, helped the ACF raise almost $1 million toward the cause. “The feeling was unbelievable. There were all kinds of people with differing capabilities, 50

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and they gave me energy. I felt like I could have walked all the way to Edmonton,” he laughs. “I immediately signed up for next year’s event!” Al- Obeidi is sure that everyone has the ability to make a difference. Make your own at http://goo.gl/a5QRHk.

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PHOTOS: COURTESY OF AHMED AL-OBEIDI

My Leap • inspiring individual


The Cross Cancer Institute Golf Classic By 2017, nearly 2500 Albertans will be diagnosed with colorectal cancer. The Alberta Cancer Foundation’s, Cross Cancer Institute Golf Classic: Presented By

MTE have made a significant investment in a comprehensive colorectal research program that will make life better for Albertans facing this disease. Thank you to all our Golf Classic sponsors for making this investment possible, one swing at a time!

www.ccigolfclassic.com

2016 Golf Classic Committee: Sponsorship Committee Dave Smith Jordan Jeske John Kopeck Barry Lang Dean Heuman Don McNabb Harry Kipnes Ken Jurina Kyle Stowkowy Kris Mauthe Peter Inglis Peter Wilkes Ryan Christensen Sean Curran Simone Reese

Co-Chairs Darren Baumgardner Guy Mersereau Honorary Members Bob Bentley Cal Nichols Patrick LaForge

Photos by: Romy Young Photography

THANK YOU FOR 24 YEARS OF SUPPORT FOR THE TOM BAKER CANCER CENTRE! Twenty-four years ago, a golf tournament began spearheaded by Fred C. Coles called the Tom Baker Cancer Centre Golf Classic.

Over the years, this annual tournament has raised more than $6.9 million for cancer research and patient care.

TOM BAKER CANCER CENTRE

GOLF CLASSIC

In memory of Fred C. Coles

We would like to say a huge “Thank You” to all the committee members who were involved for their dedication and commitment. Your efforts have contributed to reducing the risk of developing cancer through earlier diagnosis, improving the effectiveness of cancer treatments and improving the quality of care for cancer patients. We would also like to thank all those who have been involved with the tournament, from the generous support of our sponsors, golfers, donors and volunteers. The tournament was a success due to the collective effort of all those involved and we are privileged to have had the opportunity to work with you!


Together we’re creating MORE MOMENTS for Albertans facing cancer

albertacancer.ca/moremoments


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