the pdf - Bladder Cancer Canada

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DECEMBER 2015
A RARE DISEASE
The story of a thyroid cancer
survivor. p04
INNOVATIVE TREATMENTS
Nuclear medicine’s role in the
fight against cancer. p06
BUILDING YOUR DEFENCE
Activating the immune system
to help beat cancer. p08
The Future of Cancer Care
CANCERCARENEWS.CA
Following the loss of both
parents to cancer, actress
Emmanuelle Chriqui vowed
to help educate Canadians,
sparking dialogue around the
importance of testing. p09
ONLINE AT CANCERCARENEWS.CA
Extended content from Emmanuelle Chriqui’s exclusive interview.
THANK YOU CANADA!
Together let’s continue to help end blood cancer.
DONATE TODAY
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IN THIS ISSUE
Comedian Brad Garret
Shares his experience with
cancer and palliative care.
p07
Restoring hope
Cutting edge treatments
improving outcomes for
liver cancer patients.
p10
Improving quality
of life
The future of breast
reconstruction surgery.
p12
Canadian Researchers Play a Leading
Role in Shaping the Future of Cancer Care
Canada faces a 40 percent increase in cancer cases over the next 15 years,
driven primarily by our aging demographics.
C
ancer is primarily
a disease that affects older people
and, by 2030, 1 in
4 Canadians will
be at least 65. Incidence rates of
cancer will remain relatively stable
and survival rates will continue to
climb across most types of cancers.
Prostate, lung, colorectal, and
breast cancer will continue to be the
most common. Some cancers, such as
prostate, are strongly associated with
older age, but others, including thyroid cancer and multiple myeloma,
will see an increase due to better diagnostic technologies and practices. A
rise in liver cancer cases will be fueled
by the high number of Canadians
with hepatitis, as well as obesity.
New areas of research
The need to invest in cancer research
has never been more urgent. Canadian researchers are playing a big
role in changing the future of treatment by embracing new areas of
research in cancer biology. For instance, a group of researchers in Ottawa are developing a new method that treats cancer with viruses. They engineer special oncolytic
viruses that target cancer cells selectively while leaving normal cells
unharmed, greatly reducing side effects. Dr. John Bell, a world leader in
this field, genetically tailors viruses
to thwart a cancer cell’s ability to defend itself against viruses. His work
is particularly promising for aggressive, hard-to-treat cancers such as
pancreatic. Dr. Jean-Simon Diallo
and Dr. Rebecca Auer, also in this
group, use viruses to make cancer
cells more responsive to treatment,
and to activate the immune system
to prevent cancer from spreading.
Targeted therapies
Dr. Katie Wright
Senior Manager, Research
Communications
Canadian Cancer Society,
Ontario Division
“Canada can play
a leading role in
shaping the future
of treatment.”
Biologics are another area of research
with great potential. Biologics are
a targeted type of therapy that uses
synthetic antibodies to mimic the
immune system’s own ability to attack proteins on the surface of cancer
cells. The new Toronto Recombinant
Antibody Centre was set up to enable
rapid development of these biologics.
Dr. Bradly Wouters, for example, is
designing biologics that hinder a
cancer cell’s ability to grow and divide by interfering with its metabolism. These new therapies have the
potential to be effective for patients
with different types of cancer, including aggressive forms, while being less
toxic to patients.
Focused therapies are the key
to both successful treatment and
greatly reduced side effects. The BC
Cancer Agency supports a clinical trial for the Personalized Oncogenomics Program of British Col-
umbia, which is interested in
treating cancer patients with “personalized” medicine. The investigators assess a patient’s individual
cancer using genome sequencing
to identify what genes are causing
the cancer to grow and thrive and, if
possible, match the patient to a biologically relevant targeted therapy.
While still a pilot project, investigators have shown this approach is
feasible and produces some promising patient outcomes.
Canada’s role
Canada can play a leading role in
shaping the future of treatment. We
have some of the world’s leading innovators in cancer research, including prevention, treatment, early detection, and palliative care. They
need and deserve support. I urge you
to get involved in the fight against
cancer by supporting charities that
fund cancer research in Canada.
Progress in Treatment of Blood Cancers
White blood cells protect us
from infection. However, these
cells can become cancerous,
leading to malignancies including leukemia, lymphoma,
and myeloma.
Just 50 years ago, a diagnosis of one
of these blood cancers was usually a
rapid death-sentence. We understood
very little about how these cancers
developed and there were essentially no effective treatments. Dramatic
scientific breakthroughs in the past
several years have significantly improved our understanding of these
diseases and have opened up new
treatment opportunities.
New advances in the genetic analysis of cancer cells allow physicians
Stay in Touch
and scientists to pinpoint the molecular defects in a patient’s blood
cancer cells. These molecular mutations let physicians better predict the likely response to treatment
and personalize the treatment approach. In addition, new drugs targeting these specific mutations in
blood cancer cells have been developed and are being tested in clinical
trials. Some of these drugs are producing dramatic responses in patients who are resistant to conventional chemotherapy.
We are also learning about the
origins of blood cancers such as leukemia — for example, why and how
some cancers relapse after initial treatment. This knowledge is also opening up new possibilities for
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treatments and how to monitor patients during and after therapy.
Immunology
Recent breakthroughs in immunology have revealed new opportunities
for the treatment of blood cancers.
Antibodies that preferentially target
blood cancer cells are currently used
to treat many patients both as standard of care and in clinical trials. We
are also learning how to harness the
patient’s own immune system to treat
cancers. In patients with solid tumors
such as lung cancer, new drugs can
prompt the patient’s immune cells
to recognize and destroy the cancer.
Clinical trials with these agents are
on-going in blood cancers. Finally, in
the last few years, we have been able to
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genetically modify a patient’s immune T cells so they can better recognize
the blood cancer within them. These
modified cells are then infused back
into the patient where they seek out
and attack the blood cancer. Dramatic results have been seen with this experimental therapy and studies evaluating the effectiveness and safety of
these cellular therapies are on-going.
Improved patient journey
Coupled with the advances in molecular biology and new drug therapy,
we are also improving our ability to
support patients through their journey with cancer. Interventions to
address the symptoms of cancer and
the side effects of treatment such as
pain, fatigue, depression, and propinterest.com/MediaplanetCA
blems with memory are being intensively studied. Improvements in
our support for patients and their families will be critical as it will allow
them to live better as well as longer.
Thus, we have seen remarkable progress in the last 50 years in the scientific understanding of how blood cancers develop and why they return in
some patients after initial treatment.
As a result, scientific progress is now
being translated into improved therapies for our patients.
By Aaron D. Schimmer,
Staff Physician and
Senior Scientist,
Princess Margaret
Cancer Centre, University
Health Network
Please recycle after reading
Publisher: Samantha Blandford Business Developer: Ian Solnick Managing Director: Martin Kocandrle Production Manager: Carlo Ammendolia Lead Designer: Matthew Senra Contributors: Dr. Katie Wright,
Aaron Schimmer, Stephen Wilson, Amy Elmaleh, Ishani Nath, Ben Chacon, Ken Donohue, Sandra MacGregor, Randi Druzin, Duff McCourt Cover Photo: Roberto Aguilar Photo credits: All images are from Getty Images unless
otherwise accredited. Send all inquiries to [email protected] This section was created by Mediaplanet and did not involve Toronto Star or its Editorial Departments.
MEDIAPLANET 3
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INSIGHT
The Hidden Cancer with a
Big Impact
F
or a cancer that most
people have never heard
of, it may surprise readers to discover that bladder cancer is the 5th most
common cancer in Canada — fourth among men
and twelfth among women. There are an estimated 80,000 bladder cancer patients in
Canada — about 8,300 more are diagnosed
every year and 2,300 will die of the disease.
Bladder cancer is the most expensive cancer to treat on a per patient basis because of
an 80 percent recurrence rate. Yet, ranking
20 out of the 24 most common cancers, research funding into this disease lags almost
all other cancers. Although the exact cause
of bladder cancer is not known, smoking is a
common risk factor, as is age and occupational exposure to specific chemicals.
The most common symptom of bladder
cancer is blood in the urine (called hematuria). Bloody urine may vary from pale
yellow-red to bright or rusty red. Blood in
the urine does not always indicate bladder
cancer — it can be caused by a number of
conditions — but seeing a doctor immediately to find out is critical. Early diagnosis
can increase the chances of effective treatment. Other symptoms may include bladder spasms, increased frequency and urgency of urination, and burning sensation
during urination.
“Bladder cancer is the
most expensive cancer to
treat on a per patient basis
because of an 80 percent
recurrence rate.”
In about 80 percent of cases, bladder cancer
tumours are contained within the bladder and
have not grown into the surrounding muscle
or beyond (nonmuscle-invasive disease). This
type of bladder cancer is initially treated with
surgery to remove the tumours from inside
the bladder and patients may require additional drugs placed into the bladder.
When the tumours have grown into the
muscle of the bladder or spread beyond into
other tissues, organs, or lymph nodes (muscle-invasive disease), treatment may include chemotherapy, surgery, radiation, or a
combination of these — depending on how
far the tumour has spread.
Surgery usually involves removal of the
entire bladder (radical cystectomy). When
the bladder is removed, a segment of bowel
is used to allow drainage of the urine. Select
patients may be treated with chemotherapy
or radiation, instead of surgery.
By Stephen Wilson,
Director & Communications Chair,
Bladder Cancer Canada
Susan Marshall and son share a warm embrace. Photo: Submitted
Putting Our Heads
Together To Fight
Brain Cancer
When Susan Marshall’s son, Brent,
was just four years old, she heard
the words no parent should ever
have to hear — “Your child has a
brain tumour.” Despite the devastating news, Brent underwent surgery,
radiation, and chemotherapy,
responding well to the treatments.
He led a full life into adulthood, went to
college, and worked in a computer lab,”
says Marshall, CEO of Brain Tumour Foundation of Canada. “But an aggressive form
of the cancer returned when Brent was 23.
He died less than a year later.”
Why brain cancer is difficult
to diagnose
Of the two types of brain tumours — benign
and malignant — benign is more common;
however, malignant tumours are largely
incurable with brain cancer being the
leading cause of cancer death in people
under 20.
Early detection is important, but this can
be challenging, because brain cancer is a
complex disease. “One of the difficulties is
that brain cancer is rarer than other forms
of cancer, and we don’t see a lot of cases,”
says Dr. Arjun Sahgal, a Radiation Oncologist at Sunnybrook Hospital. “The symptoms — headaches, numbness in the face,
vision impairment, seizures — can also mi-
mic other conditions and sometimes they
don’t get picked up early.”
Research is improving quality of life
While the treatment for brain tumours is
complex, there have been positive advances.
Traditionally, brain tumours were only treated with radiation, but research has shown
that combining radiation with chemotherapy has better outcomes. “Part of the reason
we can now better adapt treatment is that we
have a better understanding of the genetic
profile of the tumour,” says Dr. Sahgal. “Research is reshaping our understanding, and
we are rethinking how we treat brain cancer.
Even some people with malignant tumours
are living 10 and 20 years longer.”
While clinicians are still searching for the
next breakthrough, there is a new suite of
drugs being developed that will help to shut
tumours down, and researchers are looking
at how they can activate a patient’s immune
system to attack the cancer.
“Our hope is that brain cancer will become more of a chronic and managed disease,
and not a death sentence,” says Marshall.
“With continued research, we can get there. It’s that hope for other families that
keeps us going.”
By Ken Donohue
Every day across
Canada, 27 people
learn they have
a brain tumour.
But there
is Hope.
At Brain Tumour
Foundation of Canada,
volunteers and staff
work to provide
specialized community
programs to patients
and caregivers
impacted by
this disease.
We also fund
ground-breaking
research to find the
cause of and cure
for brain tumours.
Join the
movement
to end brain
tumours today.
Give, Advocate, Volunteer.
1-800-265-5106
www.braintumour.ca
Charitable Registration #BN118816339RR0001
4 CANCERCARENEWS.CA
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INSIGHT
A Survivor’s Story:
One Woman’s Battle
with Thyroid Cancer
Melissa Salvatore, board member at Thyroid Cancer Canada,
enjoys the outdoors with her husband. Photo: Submitted
By Sandra MacGregor
At the age of 29, Melissa Salvatore, thought she had it all. Grateful for a fulfilling job and a wonderful husband, she was looking
forward to the future and had even planned to speak to her doctor about family planning.
I
n March of 2013, Melissa was undergoing
her annual physical when her doctor
paused a long time
on her neck and then
asked, “How long has
your neck been so swollen?”
Things moved very quickly from
there. Within a few weeks, Melissa had an ultrasound and a CT.
The scans showed a nodule almost
eight centimetres large. A biopsy
revealed the mass was papillary
thyroid cancer. Though papillary
is generally considered the most
treatable form of thyroid cancer,
Melissa’s was more serious because
it had moved into her lymph nodes.
“At the time I knew nothing
about thyroid cancer. I knew I had
a thyroid but didn’t really know
what it did. We are told to check
our skin for moles or for lumps in
our breasts but no one ever talks
about checking your neck.”
Self-education is key
Melissa dealt with her shock and confusion by researching her condition.
“There was not much information
nodes and the entire thyroid gland.
The involvement of the lymph
nodes made the surgery more invasive and for a long time I had lin-
“One of the most important things
I did was educate myself. It helped
me feel more in control of a very
uncontrollable journey.”
out there but I did find Thyroid Cancer Canada,” she recalls. “Their website is great. I will always say that one
of the most important things I did
was educate myself. It helped me feel
more in control of a very uncontrollable journey.”
Melissa was scheduled for surgery in May. “My surgery was very
invasive. They took out forty lymph
gering pain.”
Yet already her cancer was beginning to teach her to look at life
differently. “I had my thirtieth
birthday a couple of weeks later.
I remember others complaining about how old they felt, and
feeling impatient with them. We
should be grateful for every year
we are able to celebrate.”
Radioactive iodine
and isolation
Unlike most cancers, thyroid cancer patients take radioactive iodine
to treat their disease. They are kept
in isolation for three days to ensure
that they don’t endanger others
with their body’s radioactivity. After surgery, Melissa’s radioactive
iodine treatment left her feeling
even more afraid and isolated. “Our
house was small and my husband
couldn’t even stay with me during
the treatment. He had to stay with
my parents for the three days to prevent harm from my radioactivity.”
Sadly, Melissa and her family had
more challenges to face. “I thought
things were as bad as they could be but
everything got a whole lot worse,” she
explains. “After the radioactive iodine
I went for a full body scan to see how
I was doing and I lit up like a Christmas tree. The scan showed the cancer
had metastasized to my lungs. Having
cancer at twenty-nine was one thing,
but then to learn I had metastatic cancer at thirty shook me to my core.”
A positive outcome
A few months later, Melissa did another round of radioactive iodine and
the results were much more positive:
the cancer in her lungs appeared to
be gone. “It completely exceeded my
physician’s expectations,” enthuses
Melissa. Though she will have to be
on hormone replacement medication for the rest of her life and under
a physician’s supervision, Melissa
has not required any additional treatment for the last two years and has
been feeling great.
“Having thyroid cancer really
changed my life. I feel more grounded
and have a perspective that I wouldn’t
have had otherwise. Having cancer as
a young woman was very hard but it’s
given me wisdom and maturity that I
wouldn’t have had otherwise. I see
life very differently now and try to
live each moment to the fullest.”
Thyroid Cancer: A Rare but Unwelcome Disease
At a time when the general
public is more well-informed
about cancer than ever before,
thyroid cancer remains an
unclear and misunderstood
disease. There is little known
about its causes or how to
prevent it.
It’s also unique in that treatment for the disease rarely involves
chemotherapy or radiation, but
rather requires surgery in which
the thyroid gland is partially or
completely removed, followed by
a dosing of radioactive iodine. Patients are required to ingest the
substance and then endure three
days of isolation in order to ensure
they don’t endanger others with
their body’s radioactivity.
Little awareness
“There is very little awareness about
thyroid cancer,” explains Rita Banach,
a thyroid cancer survivor and one of
the founders of Thyroid Cancer Canada. “I think that’s because it’s still a
relatively rare cancer and it’s also seen
as very curable.”
While it has traditionally been
more uncommon, the rate of thyroid cancer is increasing every year,
faster than any other cancer. Over
6,300 people will be diagnosed in
2015 — up from 3,400 a decade ago.
Over half of people living with thyroid cancer are between the ages of
15 and 49, and almost 80 percent of
them are women. Yet despite the
alarming incidence of the cancer
among young women it remains
very much under the radar.
When caught early, it can be very
treatable. But, the potential seriousness of thyroid cancer cannot be easily dismissed. “Although most people
have the curable form of thyroid
cancer, there’s a small percentage
that have a very dangerous type and
Hormone replacement
therapy
Participants at the thyroid cancer awareness run. Photo: Submitted
“It’s often detected almost by
accident. People may be having an
ultrasound for an unrelated condition
and a nodule in the neck is detected.”
they often don’t live longer than five
months,” says Banach.
Unique diagnosis and
treatment
What also makes thyroid cancer so
unique is the way it’s diagnosed, explains Dr. Alice Cheng, an endocrinologist at Credit Valley Hospital and St.
Michael’s Hospital, and a member of
the Medical Advisory Panel for Thyroid Cancer Canada. “It’s often detected almost by accident. People may
be having an ultrasound for an unrelated condition and a nodule in the
neck is detected. Or, a person feels a
bump when they apply face cream, or
you notice a lump in a friend’s neck.”
Afterwards, as the thyroid is an essential gland that regulates metabolism among other body functions, patients must receive hormone replacement therapy for the rest of their
lives. Unfortunately, there is no standard dosage and the amount needed
varies widely between individuals.
Until the correct amount is attained,
which can take months, patients can
experience the following symptoms:
fatigue, depression, weight gain, and
an overall sense of poor well-being.
High recurrence rate
Thyroid cancer survivors also have a
lifetime of medical monitoring ahead.
“Thyroid cancer has a very high recurrence rate — up to thirty percent,”
says Banach. “So unlike other cancers
where the patient may be followed
for a few years, we are monitored for
the rest of our lives. With thyroid cancer we don’t ever use the word remission; we just say there is presently no
evidence of the disease.” Patients are
often told by their doctors that they
have “the good cancer” — but that
does little to help with the fear, anxiety, and worry that so many people
experience when they receive a thyroid cancer diagnosis.
While raising awareness about
thyroid cancer is essential, Dr.
Cheng emphasizes that certain people may be at higher risk.
“People with a family history or
who have had exposure to severe
radiation (not like that from dental X-rays or a CT scan) should have
their thyroid checked. But in general, most nodules are benign.”
Like a chronic disease
But the rare nature and low fatality of
the disease does not mean that those
who are afflicted are immune from the
fears and stress that any cancer patient endures. “We need emotional
support,” insists Banach. “Having thyroid cancer is like living with a chronic
disease. Once you’ve been diagnosed
you have to take hormone replacement pills and be monitored for the
rest of your life. We are not just statistics; we are people, and having cancer,
no matter what kind, is scary.”
By Sandra MacGregor
A Commitment to Thyroid Cancer Patients
This section is made possible by support from Genzyme Canada
MEDIAPLANET 5
A sponsored feature by Mediaplanet
The thyroid gland is
a butterfly-shaped
organ at the base of
your neck.
It is a vital organ that
produces hormones that
help to regulate your
metabolism. It also works
to help the functions of your
brain, lungs and heart.
Thyroid Cancer: Know the Facts
The rate of thyroid
cancer is increasing
every year, faster
than any other cancer
In 2015, over 6,300
Canadians will
receive a thyroid
cancer diagnosis
Almost 80%
of those who
are diagnosed
are women
Half of those who
are diagnosed are
between the ages of
15 and 45 years old
Take Back Control
There are many things you can do to help you feel
more in control of how your cancer is managed
• Make a list of questions before you
go to your appointment.
• Ask family or a friend to come with
you to take notes for you.
• Track your symptoms and sideeffects. What does it keep you from
doing? What makes it better? Worse?
• Bring a calendar and note when
you can expect to be contacted for
referrals and appointments.
• Ask for copies of lab reports
• Ask when you will see your doctor
again, and how to reach him or her
if you have questions.
Thyroid Cancer Canada
supports patients and
their families as they make
important decisions about
their health.
Questions? We can help.
ThyroidCancerCanada.org
ThyroidCancerCanada
ThyroidCancerCa
6 CANCERCARENEWS.CA
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EXPERT OPINION
Nuclear
Medicine and
Cancer Care:
What You Need
to Know
Dr. Christopher O’Brien explains why you
should not be scared of nuclear medicine and
how it makes a big difference in cancer care.
W
hile some
may associate
nuclear
technology with
clean energy or weaponry, this
field has also been at the forefront
of molecular medicine or personalized medicine leading to significant clinical advances — specifically in the fight against cancer.
Nuclear medicine has become an
important tool for cancer detection
and treatment, as well as alleviating cancer-related pain in palliative care, explains Dr. Christopher
O’Brien, Chief of Nuclear Medicine
for the Brant Community Healthcare System. “In select populations,
this is a very powerful tool that
helps treat the patients more effectively and in a more balanced way.”
Catching cancer earlier
Before cancer can be treated, it
must be accurately detected. Medical imaging such as CT scans, MRIs and X-rays show what’s beyond
the skin’s surface, but nuclear
medicine adds a new perspective.
“MRI and CT scans look at the structure and anatomy of what an organ
actually looks like,” says Dr. O’Brien.
“What nuclear medicine is actually
looking at, is the cellular function.”
Nuclear imaging involves the patient swallowing, inhaling or being injected with a radiopharmaceutical — a drug comprised of a
pharmaceutical agent targeted at
a specific organ or tissue as well
as a material that gives off small
amounts of radiation. According to
the Canadian Cancer Society, areas
that contain tumours will “take up”
the pharmaceutical in an abnormal
way. The radiation acts as a marker,
bringing potentially cancerous tumours to the physicians’ attention.
“Nuclear medicine looks at cellular and tissue activity, allowing us
to detect disease entities earlier on,
before the organ actually changes
shape,” says Dr. O’Brien.
According to O’Brien, adding nuclear imaging to the arsenal of cancer-detecting tools can lead to a
more accurate picture of a patient’s
condition — allowing doctors to see
if a cancer has spread or assess if
treatment is working.
“You need the anatomic assessment
and you need the functioning assessment to be able to plan your best treatment more effectively,” he says.
“The radioactive iodine will be
picked up by the residual cancer
cells that may be there and that will
kill off those cells,” says Dr. O’Brien.
“The same thing occurs if the cancer has spread to the lungs or other
“In select populations,
nuclear medicine is a very
powerful tool that helps treat
patients more effectively.”
Treatment and pain relief
Once diagnosed, nuclear medicine can
also provide patients with additional
treatment for cancer, particularly for
those with thyroid cancer or specific types of adrenal gland, neuroendocrine or blood cell tumours.
Nuclear medicine uses radioactive
isotopes specifically targeted to an area of the body — such as radioactive
iodine used to combat thyroid cancer
— to destroy cancerous cells.
parts of the body or in the bone; the
cancer is still picking up the radioactive iodine and is able to be treated that way. This therapy complements surgery, for instance, and
together they minimize the chances
of the disease coming back.”
When cancer causes pain, such
as when it has migrated into a patient’s bones, nuclear medicine can
also be used to target and kill the
cancerous cells, thereby alleviating
some of the patient’s discomfort —
often with minimal side effects.
“As we’ve become more familiar
with the treatment options, we’ve
found that many more people can
access medical isotope treatment
without any complications and the
reason for that is that it’s targeted
therapy, it’s not affecting the whole
body,” says Dr. O’Brien.
The Canadian Cancer Society estimates that 196,900 new cases of
cancer will be diagnosed this year.
For some of these patients, nuclear medicine can make a difference
in how their disease is understood
and treated.
“[Nuclear medicine is] something
a patient should not be afraid of because of the name,” says Dr.
O’Brien. “It’s very important to
have a discussion with your doctor
to see if therapy with radiopharmaceuticals would be beneficial for
your type of cancer.”
By Ishani Nath
Radioiodine Ablation in
Differentiated Thyroid Cancer
One Mission.
Remission.
The standard of care—backed by
decades of clinical success1
>96% 10-year survival rate*2
85% of differentiated thyroid cancer patients receive
radioiodine ablation †3
“Re-sets” the risk of recurrence3
Patients classified as high-risk had the same recurrence
rate as low-risk patients after successful I-131 ablation2
Recurrence-free survival in high-risk and low-risk patients
(P=0.68)
1.0
Recurrence-free
Survival Rate
“Successful ablation
is a positive predictor
of a highly favorable
prognosis…support[ing]
the continuation of
adjuvant radioiodine.”2
.8
Risk Group
.2
Low-risk
High-risk
.0
0
5
10
15
20
Recurrence-free Survival (Years)
25
The administered ablation doses ranged from 1,100 MBq I-131 in patients with large thyroid
remnants to 7,400 MBq in patients with extensive locally invasive or metastatic disease2
*Standard treatment of total thyroidectomy followed by radioiodine ablation.
†
30
Based on Verburg et al, 2010.2
Based on the results of a large, multinational, patient/survivor-initiated survey
of 2398 participants.
www.draximage.com
References: 1. Siegal E. The beginnings of radioiodine therapy of metastatic thyroid carcinoma: a memoir of Samuel
M. Seidlin, MD (1895-1955) and his celebrated patient. Ca Biother & Radiopharm. 1999;14(2):71–79. 2. Verburg FA,
Stokkel MPM, Duren C, et al. No survival difference after successful 131I ablation between patients with initially low-risk
and high-risk differentiated thyroid cancer. Eur J Nucl Med Mol Imaging. 2010;37:276–283. 3. Banach R, Bartès B,
Farnell K, et al. Results of the Thyroid Cancer Alliance international patient/survivor survey: Psychosocial/ informational
support needs, treatment side effects and international differences in care. Hormones. 2013;12(3):428–438.
MEDIAPLANET 7
A sponsored feature by Mediaplanet
INSPIRATION
Leaving
with Love
The Difference
Palliative Care
Makes
Acting may be his profession, but
comedian Brad Garrett says his “calling”
is bettering cancer and end-of-life care —
issues that are close to his heart.
By Ishani Nath
“I lost my best friend — we were literally like brothers — and I lost my father
and my biological brother, all within a
three year period, to cancer,” says Garrett,
best known for his role as Ray Romano’s
brother on Everybody Loves Raymond.
According to the Canadian Cancer Society, cancer is the nation’s leading cause of death. Nearly half of all Canadians
will develop cancer in their lifetime and a
quarter will die from the disease.
Facing death is a universal fear, but
end-of-life care, also known as palliative care, is designed to make the most of a
patient’s final days.
“There was so much dignity,” says
Garrett, remembering his friend’s final
days at a Nevada hospice. “So much love and care that my friend was surrounded with.”
Surrounded by angels
Palliative care and hospice staff work
to ease patients and their loved ones through an unthinkably difficult time.
“They all just seem to have a real
strength,” says Garrett. “A strength that
makes the patient feel protected, so that
these poor people who are facing their
last days feel that someone has their
back beyond their family, beyond their
loved ones. You need that medical staff
that really makes you feel that you’re going to go out the best way you can.”
In Canada, hospice palliative care programs aim to give patients more control
over their remaining life, manage symptoms and pain, and provide support to
those they leave behind. “They’re really
like angels,” says Garrett.
A helping hand
When Garrett and his wife welcomed
new life into their family, it inspired him
to help the families of children with lifelimiting illnesses.
“When I was lucky enough to have two
healthy kids, I said to myself, I’ve got to
do something where I can help these families because there’s nothing more
frightening than losing a child or having
a child who is ill,” says Garrett. The actor started the Maximum Hope Foundation, a non-profit organization named after his children Max and Hope, that helps nearly 150 families per year with daily
necessities – everything from mortgage
payments to car repairs, to groceries.
When Garrett later experienced end-oflife care alongside his loved ones, he was
further inspired to help.
“Through the care that I’ve received
for my friends and family, I just felt that
going with dignity, without the pain,
the best way that the country will allow
their patients to go, was something that
I wanted to be involved in,” says the palliative care advocate.
After what he’s witnessed through his
foundation and with his loved ones, Garrett says that in the end, it comes down to
celebrating the life of each patient.
“It sounds corny, but you’ve really got to
celebrate the life, the memory, and what
they left when they were here,” he says.
Ottawa Mother’s Story Shows
Breast Screening Saves Lives
Geety MacLean’s first thought when she got the results of a breast
biopsy was, “What will happen to my two kids if I die?” The Ottawa
mother wondered if she had just been handed a death sentence.
Invasive cancer
In the following weeks, the news
went from bad to worse. Further tests
revealed that the cancer had spread
across one of her breasts and it had
to be removed. Following surgery, a
pathology report revealed the cancer
was invasive and had spread to her
lymph nodes.
MacLean, who was a senior product
manager with a high tech company,
endured four months of chemotherapy
and another month of radiation before
starting on medication that interferes
with the growth and spread of cancer
cells. The next year, her ovaries and
fallopian tubes were removed as a
precautionary measure. Today, almost
nine years later, she is healthy.
Screening saves lives
MacLean says she owes her life to breast
screening. If not for the mammogram that
raised a red flag, which she had requested
at the urging of a colleague, Maclean
wouldn’t have discovered she had cancer
until much later — and it might have been
too late. MacLean, who was 46 years old
at the time, was feeling fine and had no
inkling anything was wrong.
Many Canadian women have similar
stories, says radiologist Jean Seely, who
is an active member of the Canadian
Association of Radiologists (CAR) Breast
Imaging Working Group and the Head of
Breast Imaging at the Women’s Breast
Health Centre in Ottawa Hospital.
“Often, when I tell a woman she has
breast cancer, she is blown away. She
says, ‘I eat well and I exercise regularly.
There is no history of breast cancer in
my family. How could this happen?’ But
unfortunately, it does happen.”
Seely says that 75 percent of women
who are diagnosed with breast cancer
have no risk factors at all.
“75 percent of
women who are
diagnosed with
breast cancer have
no risk factors at all.”
Screening is key
She stands by the CAR guidelines and
recommends screening for women 40
years and older — breast cancer rates
are dramatically lower among younger
women — and dismisses claims that
screening with mammography doesn’t
reduce the number of women who die
from breast cancer.
Seely points to a Canadian study
published in the Journal of the National
Cancer Institute in October 2014 that
car-ad-BreastAdvice-e-2015-print-v1.pdf
1
2015-11-03
1:03 PM
OUR BRE
BREAST
BR
EAST AD
A
ADVICE
DVICE ON
AN IMPORT
IMPORTANT
RTANT
RT
TANT DISCUSSION
WITH YO
Y
UR PHYSICIA
Y
YSICIA
N
YOUR
PHYSICIAN
An important decision, such as when to undergo breast
cancer screening, is best made after an informed
discussion with your physician.
Starting at age 40, all women are urged to speak
with their physician about beginning regular breast
screening*.
determined breast cancer screening
reduces mortality rates by 40 percent in
all women, and by 44 percent in women
aged 40-49 years.
Seely also notes that it’s easier to get
screened than most people realize. A
woman doesn’t always need a physician’s
referral to get a mammogram. Once
she is in the Ontario Breast Screening
Program — which provides screening
to all women in the province between
the ages of 50 and 74 — she can selfrefer. Women 40-49 years old require a
referral from a family physician. Other
provincial screening programs have
similar processes in place, although
details vary among provinces.
You are your own advocate
In Ontario, women in the program get
screened every one to two years unless
they are considered high risk. In that
case they get a mammogram and breast
MRI annually. “Simply put, breast
screening saves lives,” says Seely.
No one is more convinced of that than
MacLean. “I urge every woman to be her
own advocate. Know what screening
tests are available to you and ask about
them,” she says. “Because anything can
happen to anyone.”
By Randi Druzin
A FEATURE BY
LUNG CANCER
PATIENTS AND
CAREGIVERS FACE
AN OVERPOWERING
AVALANCHE OF
INEQUITIES
Lung Cancer Canada’s Faces of Lung
Cancer: One Patient, One Diagnosis,
Countless Casualties is an in-depth look
at lung cancer in Canada and uses the
results of the 2015 patient and caregiver
survey to give voice to the human toll of this
disease. Providing new perspectives on the
country’s deadliest cancer, the report speaks
to a virtual avalanche that devastates and
impacts countless lives and systems in its
path. In a disease with low survival rates, we
are at risk of failing patients and caregivers
due to obstacles preventing access to lifeprolonging treatment, limited research
investment, inadequate availability of local
support services, as well as a concerning
lack of compassion for patients and
caregivers living with the disease.
The inequities start even before diagnosis.
Depending on where a patient lives, it can
impact how quickly they are diagnosed, the
support they can access, and how long it
will take to see a specialist and receive
treatment.
Caregivers are key soldiers in a patient’s
fight but this comes at a high cost. Fifty
nine percent of caregivers reduce the
number of hours they work, and a further
8 percent quit their jobs to look after a
loved one with lung cancer. Fifty percent
of caregivers reported a negative impact
on their household finances.
When asked what would make caregiving
easier to manage, caregivers most often
mention greater empathy towards lung
cancer in general and better access to
support services. However, the survey
showed that only 26 percent of caregivers
have ever received these services. Even
when they are offered, wait times and
access points can differ between provinces,
regions, and cities.
The deep-seated perception that lung
cancer is self-inflicted places an additional
burden on families. This negative stigma
prevails despite the fact that the majority
of Canadian lung cancer patients are exsmokers, and many never smoked at all.
Although lung cancer has the highest
mortality of all cancers in Canada, it
receives a disproportionate amount of
research investment compared with both
the scope of the cancer and with other
cancers. In fact, as of 2012, significantly
more funds were going into research for
breast cancer and prostate cancer. While it
is important that research continue in these
cancers, it is also important to acknowledge
the obvious need for more investment in
lung cancer research that, at the very least,
matches the significant burden of disease.
Indeed lung cancer kills more Canadians
a year than breast cancer, prostate cancer,
and colorectal cancers combined.
As outlined in the report, lung cancer
patients and their caregivers continue to
face a number of significant challenges.
Lung Cancer Canada urges all Canadians
to step-up and advocate for everyone who
suffers from lung cancer and help create the
necessary change.
For more information on lung cancer
and to view a copy of the Faces of Lung
Cancer report, please visit:
www.lungcancercanada.ca.
BREAST CANCER SCREENING
KNOW YOUR RISKS
Whether you are at average or high risk for breast cancer is determined
from a number of factors, such as:
• a personal or family history of breast and/or ovarian cancer;
• dense breasts;
• a woman's reproductive history;
• exposure to ionizing radiation;
• use of hormone replacement therapy;
• some lifestyle factors, such as obesity;
• and other potential factors as determined by your physician.
*The Canadian Association of Radiologists (CAR) has a series
of guidelines on breast imaging compiled in the CAR Practice
Guidelines and Technical Standards for Breast Imaging and
Intervention. The CAR is the national voice of radiologists. As
specialized physicians who are part of your healthcare team, our
commitment is to promote patient safety in medical imaging.
TALK ABOUT YOUR RISK FACTORS
WITH YOUR PHYSICIAN.
MAKE A DECISION THAT FEELS
RIGHT FOR YOU.
613 860-3111
[email protected]
www.car.ca
8 CANCERCARENEWS.CA
A sponsored feature by Mediaplanet
INSIGHT
Using the Body’s Natural Defence
System to Battle Cancer
In the fight against cancer, the leading cause of death in Canada, research indicates
that for some patients the human body may be its own greatest weapon.
I
By Ishani Nath
mmuno-oncology, also
known as immunotherapy or biological therapy, is a relatively new
treatment that uses the
body’s immune system
to fight cancerous cells.
“Cancer cells can manipulate the
immune system and make it ineffective,” explains Dr. Michael Smylie, professor of medical oncology at the University of Alberta. “All we’re doing [with
immuno-oncology] is reversing that
manipulation and activating the immune cells so the system will recognize
the disease as ‘foreign’ and get rid of it.”
In the past few years, this new
approach to cancer treatment has
been shown to dramatically improve the survival rates for certain
cancers including small-cell lung
cancer, melanoma, bladder cancer,
and colorectal cancer.
“It’s a revolution in cancer treatment,” Dr. Smylie says.
Comparing cancer
treatments
By using the body’s immune system
to find and destroy tumour cells, Dr.
Smylie explains that the disease can
be targeted more effectively than
with conventional cancer treatments like chemotherapy.
“When you give a patient chemotherapy, you hope that you’re lucky
and that the chemotherapy kills
enough cancer cells that the tumour
will shrink down enough to make the
patient feel better and hopefully improve their survival,” says Dr. Smylie.
“However, there is a lot of toxicity involved with chemotherapy.”
The side effects associated with
immuno-oncology depend on the
specific drug and dose administered, but this therapy may not be
as hard on patients as other forms
of cancer treatment.
In addition, immunotherapy allows the immune system to spot
cancerous cells that might otherwise be missed, thereby reducing
the risk of recurrence.
“Immune cells can find microscopic disease which imaging can’t detect and they can actually destroy the
microscopic metastasis before they
become apparent,” says Dr. Smylie,
who has seen this process first hand
with some of his melanoma patients.
Positive prognosis
Working in oncology can be tough,
but Dr. Smylie says that this new
“Immune cells can
find microscopic
disease which
imaging can’t
detect and they
can actually destroy
the microscopic
metastasis before
they become
apparent.”
form of treatment enables him to
give even patients with advanced
cancer some hope.
“[Immune cells] are there to
eradicate all cancer cells that
they encounter so this treatment
can potentially lead to longterm survivorship in Stage IV
cancer patients who would have
previously had a limited survival
rate,” he says. Several of the patients who he
diagnosed as terminally ill in 2007 —
estimating that they had between
six months to a year left — are still
alive today and living cancer-free
because of immunotherapy.
Forbes called immuno-oncology “one of the hottest fields in biopharma today,” with ongoing research and numerous new treatments in development for various
types of cancer.
“We’re getting close,” says Dr.
Smylie. “I think in the next five
years, we’re going to see tremendous
breakthroughs in cancer treatment.”
After more than two decades working in oncology, Dr. Smylie says that
the past few years have been the most
exciting time in his practice because
of immunotherapy. “It’s going to change the way we
practice cancer medicine,” he says.
THE HARD FACTS
ABOUT LUNG CANCER IN CANADA
#1
LUNG CANCER IS THE MOST COMMON CANCER, AND BY
FAR THE LEADING KILLER OF ALL CANCERS IN CANADA
EVERY
DAY
EVERY
HOUR
57
57 CANADIANS WILL DIE
FROM LUNG CANCER.
THE FIVE-YEAR
SURVIVAL RATE
FOR LUNG CANCER
IS ONLY
17%
VS. 95% PROSTATE
88% BREAST
64% COLORECTAL
2
CANADIANS WILL
BE LOST FOREVER
TO THEIR FAMILIES,
FRIENDS AND
LOVED ONES.
KILLS
20000+
CANADIANS EACH YEAR.
MORE THAN BREAST, PROSTATE,
AND COLON CANCER COMBINED.
LUNG CANCER
ACCOUNTS FOR
25%
OF ALL CANCER
DEATHS IN CANADA.
ADVANCEMENTS ARE
HANDICAPPED BY
LUNG
CANCER $
$ OTHER
CANCERS
VASTLY INADEQUATE
RESEARCH FUNDING.
THIS NEEDS TO CHANGE AND WE NEED YOUR HELP...
DONATE / VOLUNTEER / ADVOCATE
LEARN MORE AT LUNGCANCERCANADA.CA
About Lung Cancer Canada
Based in Toronto, Lung Cancer Canada (LCC) is Canada’s only national charitable organization that is solely focussed on lung cancer. Lung Cancer Canada serves as Canada’s leading resource for lung cancer
education, patient support, research, and advocacy. LCC’s mission is four-fold: 1) to increase public awareness of lung cancer, 2) to support and advocate for lung cancer patients and their families, 3) to provide
educational resources to patients, family members, healthcare professionals, and the general public, and 4) to raise funds in support of promising research opportunities.
MEDIAPLANET 9
A sponsored feature by Mediaplanet
INSPIRATION
GENRE
CATEGORY
Photo: Roberto Aguilar
Hair: Nick Irwin
Makeup: Jenny Morrell
Stylist: Marie Louise Von
Haselberg
Canadian Actress Emmanuelle Chriqui is
Committed to Educating Canadians about Colon Cancer
Canadian actress, Emmanuelle
Chriqui, sits down with Mediaplanet
to share her experience having lost
both parents to colon cancer.
Mediaplanet You’ve been a social
advocate for colon cancer awareness
for a number of years now. Can you tell
us how colon cancer has affected you
personally?
Emmanuelle Chriqui My mother had colon
cancer. It wasn’t her primary form of cancer, but
the colon cancer is the part that I remember the
most — only because she had a colostomy procedure. She lived with the pouch for five years. It was
such a rotten thing. Everything in your system
gets re-wired so to speak, and it’s not an easy adjustment. Obviously for the person who’s going
through it, but also for the people living around it.
So my mom was with the colostomy pouch
for five years and then she got sick again. It was
pretty awful to see. She was a fighter, but she
suffered a lot. I had a hard time grasping the
amount of suffering that was attached to her colon cancer. She passed away when I was 16, so
my mom was sick for most of my growing up.
And then much, much later, my father got colorectal cancer. He too had a colostomy and had
to live with a pouch for about three years. And
my poor dad, he just hated it. I don’t think he
ever got used to it. He passed away four years ago.
MP Did these experiences contribute
to your desire to raise awareness about
colon cancer?
EC Yes, absolutely. It was a very organic de-
cision for me, seeing as how both my parents
suffered from colon cancer. I’m from Can-
ada, but I haven’t lived in Canada for almost
16 years. So it was a very specific decision for
me to want to be part of a Canadian organization that works to raise awareness about colon cancer — in memory of my parents.
tory. And you know what? It’s super empowering
to take your health into your own hands. It’s empowering and it’s necessary. Cancer does not
equal death anymore. We can beat it now.
MP You’re right — colon cancer is
preventable in 90 percent of cases. How
do you convince people to take that
essential step of getting screened?
EC By removing the shame attached to colon
MP What kind of advice would you give
to people in general who, at this point
in their lives, are at risk for colorectal
cancer, but haven’t taken steps to get
screened?
EC My advice is to look at your family history
cancer and getting people to make their health
a priority. The biggest thing that I always say —
and this is probably because I’m somebody who’s
lived through both my parents dying from colon
cancer — is that people need to be more proactive
about taking their health into their own hands.
You need to have awareness about your own
health — especially if you have a dicey family his-
and take a proactive approach to your health.
Make healthy choices — healthy lifestyle
choices. We live in crazy times, but we also live
in really exciting times. It’s possible to live
healthily and to make conscious choices about
what you put in your body. I think that making
healthy lifestyle choices is really important, and
they become more important as you get older.
ss campaign urging Canadians to just “Get the
Test.” The test could be as simple as an at-home
procedure. For those with a family history of colon cancer or who are over 50, it might be more
appropriate to undergo a colonoscopy.
The WHO’s announcement has generated a
public conversation on colon cancer — not an
easy feat to accomplish — so let’s use the opportunity to encourage the choices that will really
save lives: getting tested. That’s what the meat
of the conversation should be.
Amy Elmaleh
Executive Director,
Co-Founder of Colon Cancer Canada
A Little “ick” Could Save Your Life
Y
ou’ve probably heard about the
WHO’s announcement that processed meats like hot dogs and
bacon are carcinogenic. This declaration resulted in a media outcry about having to give up our beloved prepared meats.
It’s the wrong conversation to have about
cancer, especially colon cancer. We should be
talking about screening and prevention — that’s
where we can make a difference.
The Canadian Cancer Society states colon cancer is the second leading cause of death from cancer in men and the third leading cause in women.
When detected early, colon cancer is 90 percent treatable, so that’s where our focus should
be — on increasing uptake on screening.
If we can encourage more Canadians to
overcome the “ick” factor associated with colon cancer testing, we could dramatically reduce the devastation of this disease.
Colon Cancer Canada launched an awarene-
Are you at risk
for Colorectal Cancer?
R
Early detection of colorectal cancer improves the chances of
recovery and survival. A simple blood test can help determine
your risk of colorectal cancer. Ask your healthcare provider
about Cologic today.
®
LifeLabs and the LifeLabs logo are registered trademarks of LifeLabs LP. © LifeLabs 2015.
Cologic® is a registered trademark of LifeLabs LP.
The Cologic® test is intended for use in risk assessment and monitoring; it is not a
standalone test, and is not a screening test for colorectal cancer. Speak to your healthcare
provider for more information.
LifeLabs.com I 1-877-849-3637 I CologicLabTest.com
@LifeLabs
10 CANCERCARENEWS.CA
A sponsored feature by Mediaplanet
INSPIRATION
Radioembolization can destroy the tumour over several weeks, and reduce the risk of systemic side effects compared to other therapies.
Cutting Edge Treatment Improves
Prospects for Liver Cancer Patients
I
By Randi Druzin
n October, iconic buildings throughout the
United Kingdom were
bathed in pink light.
NFL players wore pink
on their shoes during
games across the U.S.
and, in Canada, hundreds attended
high-profile galas — all to increase
awareness of breast cancer and
raise money to treat it.
While people across the Western
world are aware of this disease and a
handful of other cancers, liver cancer is not on their radar. But that
may soon change.
It is less prevalent here than in
countries where chronic hepatitis B
and C, leading causes of the disease,
are more widespread. However, according to the Canadian Cancer Society Statistics 2015, incidence as
well as mortality rates for liver cancer are on the rise.
Surgical resection and liver transplantation are the best treatment
options for liver cancer. However,
surgery is not always possible due
to the size of the cancer or it spreading to other parts of the body. Other
options include, embolization, ablation, chemotherapy (often a drug
called sorafenib), external bean
radiation, and internal radiation
therapy, which is also known as radioembolization.
In a treatment known as embolization, a substance is put into the artery carrying blood to the tumour.
This substance blocks the blood flow,
which makes it harder for the tumour to grow and sometimes causes all or part of it to die. Ablation consists of inserting a needle or probe into the tumour and destroying it by
delivering extreme heat, cold, or concentrated alcohol (ethanol).
that there is a radioembolzation
treatment manufactured in Ottawa
that has already been used in over
19,000 patients worldwide. Many
interventional radiologists have
endorsed this procedure, citing its
many benefits.
“The treatment targets the tumour and leaves surrounding tissue
unharmed. That means you can deliver radiation without killing the
“In radioembolization a catheter
is used to deliver small
radioactive beads directly to
the tumour in the liver.”
Healthcare providers started adding a chemotherapy drug to embolization in the 1970s (chemoembolization)
and, in the past decade, have been
combining embolization with radiation treatment (radioembolization).
In a radioembolization procedure,
a catheter is used to deliver microscopic radioactive beads directly to
the tumour in the liver. The beads,
which are glass, become lodged in
the tumour and, over the course of
several weeks, emit radiation that
can destroy it. Few people realize
liver, something that would be very
difficult to do otherwise,” says Dr.
Richard Owen, an Interventional
Radiologist and an Associate Professor in the Department of Radiology
and Diagnostic Imaging at the University of Alberta in Edmonton.
“In many instances patients have
been too unwell to tolerate established treatments,” adds Dr. Sean
Cleary, a surgeon at Toronto General Hospital, “so chemoembolization
and radioembolization techniques
have been considered because they
can be delivered with fewer side effects and risks.”
Radioembolization can be used
to shrink large tumours down to
the point where they can be surgically removed, and to treat tumours that are not responsive to
other treatments.
Dr. Rob Beecroft, an Interventional Radiologist at Princess Margaret Hospital in Toronto, says he
has used the procedure to treat patients who would not have tolerated
sorafenib because they were older
and more fragile — he reports that
it worked remarkably well. “In my
opinion, in certain patients with
advanced liver cancer, radioembolization can be more effective than
sorafenib,” he says, “and have fewer side effects.” Side effects include
fatigue, pain, and nausea. The majority of adverse effects are mild to
moderate in severity and are manageable or resolve over time.
Just as many healthcare providers have voiced their approval of this
new therapy, they have expressed
concern over its lack of availability.
New treatment not funded
for many Canadians
Although the treatment is costly,
it is less expensive than other liver cancer treatments and is publicly funded only in British Columbia
and Alberta. It’s available in just
six provinces — British Columbia,
Alberta, Saskatchewan, Ontario,
Nova Scotia, and Quebec. Many
Canadian patients seeking the
treatment have to go to the United
States to get it, which often costs
them tens of thousands of dollars.
Qualifying patients may also opt
for enrollment into radioembolization clinical trials available in Nova
Scotia, British Columbia, Alberta,
Quebec, and Ontario. More information on these trials can be found
at www.btgplc.com.
“For many patients radioembolization is clearly the best treatment,” says Owen. “However, for
the majority of Canadians it’s just
not available.”
Dr. Owen would like to see this
“made in Canada” treatment available in all major centres in conjunction with transplant programs. He
says treatment would have to be
overseen by a team of specialists
from various disciplines.
Without a doubt, more public
funding would help the growing
number of Canadians battling liver
cancer. With established treatments improving and new treatments being developed, physicians
will be able to target liver cancer
with even more precision and
greater success.
An Army of Glass: The Remarkable Liver Cancer
Treatment You Have Probably Never Heard Of
When Eleanor Cook’s cancer
spread to her liver, it was a sign
that something in her treatment regimen had to change.
Surgery and chemotherapy had already saved her life once since she was
first diagnosed with cancer in 2013,
but these new tumours would not be
beaten by the same familiar tools.
“I wasn’t a candidate for surgery
because I had too many tumours
on both sides of my liver,” Eleanor explains. “They couldn’t do a
resection.” Her search for a treatment that could help sent her ranging across North America from her
home in Fernie, British Columbia
all the way to New York City before
finally leading her to Dr. Richard
Owen in the Department of Radiology and Diagnostic Imaging at the
University of Alberta in Edmonton.
Millions of tiny glass soldiers
in the bloodstream
Dr. Owen suggested to Eleanor that
her cancer might respond well to a
liver-targeted microsphere therapy.
The treatment involves the injection
of millions of tiny glass beads (each
only a third the width of a human
“I have hope now
that I’m going to
have more years
to enjoy my family,
my grandchildren,
and doing the
things I enjoy
doing."
Eleanor Cook (second from right) spending valuable time with her family.
Photo: Submitted
hair) directly into the artery of the
liver, where the overdeveloped blood
vessels of the tumours suck them up.
Each bead contains a microscopic
payload of yttrium-90, a radioactive
isotope that can destroy the tumours
from the inside while leaving healthy
liver tissue largely unharmed.
Eleanor has now undergone two
separate treatments of microsphere
therapy, the first targeting one half
of her liver this past summer, and the
second targeting the other half in Oc-
tober. To her, one of the most miraculous aspects of the treatment was how
easy, non-invasive, and painless it
was. “It was nothing,” she says. “I was
[at the University of Alberta Hospital]
just for the day, spent one night in Edmonton, and was back home the next
day. The only side effect I experienced
was a little bit of fatigue. The care and
compassion at the hospital was just
incredible. From the time I arrived
until I was discharged, they treated
me extremely well.”
Canadians dying from lack of
access and awareness
Since its invention, this microsphere technology has been used
worldwide to provide hope to thousands of patients like Eleanor with
inoperable liver cancer. In Canada,
however, the treatment is arguably
underutilised, with a lack of awareness and funding preventing oncologists from recommending it to patients whose lives it could potentially save. Eleanor believes she would
never have even heard of the treatment if she had not been proactive
in reaching out to Dr. Owen of her
own accord.
It’s understandable, of course,
that it takes time for new therapies
to receive funding, and that doctors are slow to change the treatment plans that have been working for them. At the same time, Canadians living with cancer deserve to
have the best treatments available
to them, and they have a right to be
fully informed about their options.
For Eleanor, receiving this treatment has had a profound effect on
her outlook for the future. “I have
hope now that I’m going to have
more years to enjoy my family, my
grandchildren, and doing the
things I enjoy doing,” she says. “It’s
given me a lot of hope and I was extremely fortunate to be able to have
the procedure done.” Hopefully
soon all Canadians with this disease will have the opportunity to be
so fortunate.
By D.F. McCourt
MEDIAPLANET 11
Commercial Feature
FACTS
It is estimated that...
Liver cancer
will account
for 2.1% of
cancer deaths
in Canada
2 in 5 Canadians
will develop
cancer in their
lifetimes
275,200 new
cases of cancer
will be diagnosed
in 2015
2,200 Canadians
will be diagnosed
with liver cancer
in 2015
78,000 Canadians
will die of cancer
in 2015
1,100 Canadians
will die from
liver cancer in 2015
Source: Canadian Cancer Statistics 2015,
Canadian Cancer Society
Liver Cancer is on the Rise in Canada:
Access
Treatment
is Critical
Don’t to
let liver
cancer go unnoticed.
Undiagnosed liver disease can lead to liver cancer.
Livermay
cancer
can often be
treatedfor
— and
cured
— you
if caught
early. of.
There
be treatment
options
livereven
cancer
that
are unaware
Talk to
yourbeen
doctorshown
about liver
at youreffective
next appointment.
New targeted therapies
have
totests
be very
in treating liver tumours but
more information, call
our Help Line
at 1-800-563-5483,
emailthese
[email protected]
or visit liver.ca
may beForunder-utilized
in Canada.
Ask
your doctor about
therapeutic
options today.
Research | Education | Patient Support | Advocacy
Sponsored by
Don’t let liver cancer go unnoticed.
Undiagnosed liver disease can lead to liver cancer.
Liver cancer can often be treated — and even cured — if caught early.
Talk to your doctor about liver tests at your next appointment.
For more information, call our Help Line at 1-800-563-5483, email [email protected] or visit liver.ca
Research | Education | Patient Support | Advocacy
12 PERSONALHEALTHNEWS.CA
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NEWS
Knowing Your Options Post-Mastectomy
Raising awareness about breast reconstruction in Canada.
For most women, being
diagnosed with breast
cancer can trigger a complex
spectrum of physical and
emotional reactions that
go well beyond obvious
health concerns.
Breasts are not only part of the
female sexual identity but they
are often inextricably linked to a
woman’s very sense of self.
Thanks to an array of educational
campaigns and events over the past
decade, breast cancer awareness
continues to increase. Much less
well-known, unfortunately, are a
woman’s options regarding breast
reconstruction. This lack of awareness
affects not just breast cancer survivors
who have undergone mastectomies,
but also those who have elected to
have the procedure because they have
a family history or carry the genetic
marker for the disease.
Toronto plastic surgeon Doctor
Mitch Brown is all too aware of
cancer survivors’ lack of information
about their options. So passionate is
his belief in the issue, that in 2011
he founded Breast Reconstruction
Awareness (BRA) Day. “BRA is
based on the idea that women in
Canada and throughout the world
don’t have a full understanding
of the opportunity for breast
reconstruction,” says Dr. Brown.
Dr. Brown emphasizes that,
though breast reconstruction is an
individual choice and may not be
right for all women, it’s an important
issue because, “…for those who are
candidates for the procedure, it can
Doctor Mitchell Brown
Associate Professor,
Department of Surgery,
University of Toronto
have a significant positive impact on
their quality of life.”
Immediate breast
reconstruction
Of special interest for mastectomy
patients is the growing popularity
of immediate breast reconstruction.
“Immediate breast reconstruction is
when reconstruction is either started
or done completely at the same time as
a mastectomy,” explains Doctor Peter
Lennox, a Vancouver-based plastic
surgeon. This option is significant because it allows patients to spend less
time in surgery. “The goal is to reduce
the number of operative procedures a
person requires in an effort to help reduce the emotional or psychological
impact of having a mastectomy and
hopefully to give the patient a better
outcome,” says Dr. Lennox.
Dr. Lennox also notes that awareness and access to immediate breast
reconstruction surgery is dependent on where one lives in Canada.
Doctor Peter Lennox
Head, Division of
Plastic Surgery,
University of British Columbia
In Vancouver, mastectomy patients
are routinely informed about the
surgical option. He also points out
that the ideal candidate for immediate breast reconstruction likewise
varies; noting that some plastic surgeons believe the majority of mastectomy patients would be eligible
for the procedure. In Dr. Brown’s
opinion, however, the best candidates
for immediate breast reconstruction,
are “…women who’ve had preventative mastectomies…or those where
the cancer was detected at an early stage so there is a low likelihood
of chemotherapy or radiation after
the mastectomy.”
What isn’t dependent on where one
lives in Canada, however, is the cost of
breast reconstruction surgery. The
procedure is a medical service that is
completely covered under each
province’s health care plan.
More than
By Sandra MacGregor
A COMMERCIAL FEATURE BY LIFECELL™ AN ACELITY COMPANY
THE FUTURE OF BREAST RECONSTRUCTION
Innovative medical techniques and technology promise to revolutionize post-mastectomy breast reconstruction.
W
hile society’s understanding of breast
cancer continues to
develop, thanks to a
variety of educational campaigns,
there has been a growing increase
in the medical community’s awareness of the options and technologies designed to help women deal
with some of the physical after effects of the disease. Some of the
most significant progress — both
in awareness and in technology —
is in the area of breast reconstruction after a mastectomy.
“A field that has seen a great deal
of advancement,” explains Doctor
Peter Lennox, a Vancouver-based
plastic surgeon, “is immediate
breast reconstruction, which is
when breast reconstruction is either
started or done completely at the
same time as a mastectomy.”
Toronto plastic surgeon Doctor
Mitch Brown would agree, “There
have been improvements in tech-
Women gather at BRA Day events across the country to share their journeys and help raise
awareness about breast reconstruction. Photo: Willow Breast & Hereditary Cancer Support
nology available for plastic surgeons to provide good results in
immediate breast reconstruction.
Some of those advances have
been medical devices and breast
implant technology, as well as the
materials we use as internal tissue support structures known as
acellular dermal matrices (ADM).”
Dr. Lennox is equally as enthusiastic about developments in
ADMs. “Acellular dermal matrices
— of which AlloDerm® Regenerative Tissue Matrix falls into this category — can help promote good
outcomes in breast reconstruction
surgery… because it becomes incorporated into the patient’s own
tissue and acts as support where
soft tissue exists.” He also notes
that another advantage of ADMs
is that they allow direct-to-implant reconstruction, which hadn’t
been possible before. “Implant reconstruction used to involve two
stages. A tissue expander was used
to help shape the skin and then
you would go back to the operating room a few months later to add
a permanent implant. With dermal
matrices and the right candidate,
we can skip that step and, at the
same time as a mastectomy, go directly to putting in a breast implant.
Thanks to ADMs, everything can be
done in one operation.”
One ADM that sets itself apart
from others is AlloDerm® RTM.
Doctor John Harper, PhD, SVP Chief
Technology Officer at LifeCell, explains “AlloDerm® RTM works by
gradually integrating into the pa-
Only 3 out of 10 women are offered
breast reconstruction.*
At LifeCell, we believe that’s 7 women too few.
To learn more, visit www.lifecellcorp.ca
*Alderman, A. K. et al. Understanding the Impact of Breast Reconstruction on the Surgical Decision-Making Process for Breast Cancer. Cancer 2008
© 2015 LifeCell Corporation. All rights reserved. LifeCell™ is a trademark of LifeCell Corporation. MLC4698-CA/5125/10-2015
tient. As the body grows into AlloDerm® RTM, new tissue is regenerated that doesn’t have the disadvantages of scar tissue. To produce
AlloDerm® RTM, donor tissue cells
are removed from the human skin
through the LifeCell proprietary processing methods. This prevents it
from rejection by the normal transplantation reaction; instead allows it
to be accepted as though it were the
patient’s own tissue.”
Dr. Lennox also points out that
there have also been exciting advancements in fat grafting and
breast reconstruction. “You can inject a patient’s fat into different layers of tissue to build up a network
of fat cells in the tissue left behind.
This allows you to improve the thickness of the mastectomy flap or add
the fat tissue to the pectoral muscles to get more volume and improve breast contour and asymmetries. It can really improve the quality
of the reconstruction.”