going the
Keep a running routine
through the seasons
Five perspectives on
one woman’s diagnosis
How medical modelling
is giving cancer patients
a new outlook
a LiFe
Add fve years
with chocolate;
Better bedside
manners; Breast
and more...
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000Leap-RoadHockey-FP.indd 1 2/14/14 2:44:37 PM Leap_Spring14_p02-03.indd 2 2/20/14 8:22:27 AM
spring 2014 3
SPRING 2014 • VOL 5 • No. 1 CONTENTS
28 SEEdS oF HopE
New breast cancer surgery a first in Alberta
30 BEdSidE MAnnERS
How doctors deliver bad news with mastery
32 Top JoB
Neuroanesthesiologist Melinda Davis makes
an impression on her patients
35 WHy i donATE
Two-time cancer survivor lives and gives back
to the fullest
Chocolate can pack more than pounds
on your life – it can add years
Jana Rieger helps head and neck cancer
patients live better
47 GAininG TRAcTion
Running is no longer a fair-weather sport
4 oUR LEAp
A message from the Alberta Cancer Foundation
Trio of Fundraisers; Top 5 Medical Apps;
Tangy Beef Stew; Compassionate Leave Law;
New Organ Registry Rules; FIT Test
11 nExT GEn
Studentship teaches palliative caring
to students in health fields
12 Body Mind
Complementary therapies
High-protein foods carry weight
Can I get the flu from having the flu shot?
PLUS: Mammograms for the over-40 set;
nutritious eating on the run
16 BEyond cAncER
Treatment drugs and late-term side effects
40 coRpoRATE GivinG
Mobile mammography units get fuelled by Fas Gas
50 My LEAp
Doc’s photography turns a lens on nature
ON THE COVER: Jana Rieger
PHOTO: Amy Senecal
One woman’s story of diagnosis to determination
Keeping your foot out of your mouth when
talking cancer
24 i’M ALivE. WHAT noW?
Provincial program helps teach survival skills
Al ber ta Cancer Foundati on
000Leap-RoadHockey-FP.indd 1 2/14/14 2:44:37 PM Leap_Spring14_p02-03.indd 3 2/27/14 9:11:24 AM
4 spring 2014
alberta cancer foundation
message /
Angela Boehm, Chair
Gary Bugeaud
Heather Culbert
Steven Dyck
Paul Grundy
Edmonton (ex-offcio)
Don Lowry
Katie McLean
John J. McDonald
Andrea McManus
Brent Saik, Vice Chair
Sherwood Park
Sandy Slator
Greg Tisdale
Vern Yu, Vice Chair
myl eapmagazi ne. ca
You may have recently seen some news coverage around our campaign,
“43.” We launched it on World Cancer Day to raise awareness about
the startling statistic that every day, 43 Albertans hear the words, “you
have cancer.”
At the Alberta Cancer Foundation, we hear about this disease every
day. We know the statistics, the stories, the successes, the losses. But
over the last little while that one number – 43 – has stood out for us.
Every day we hear from donors who want to do something about can-
cer, make more progress, save more lives. We couldn’t agree more.
We know we can change these statistics. Alberta is rich with bright
minds, with a drive to innovate. We also have a role to shift philanthropy
towards strategic impact if we want to make a difference for Albertans.
How are we going to do that? The Alberta Cancer Foundation has a
plan to invest $120 million into cancer research, prevention and care by
2017. We’ve been busy since 2012 with this fve-year target and we are
well on our way. We know it’s a big number, but what’s even more impor-
tant is the impact it will make across the province.
We have also changed the way we invest in research, ensuring that
each decision we make is focused on improving patient outcomes. One
of the fi rst landmarks of thi s new research framework i s our
Transformative Programs, a competition that will accelerate discovery
and translate scientifc research into practice.
We originally received 56 calls for ideas and our expert review team
narrowed it down to a short list. Twelve research
teams then presented their ideas to a review team
made up of high-calibre researchers from across the
country as well as representatives from the business,
investment and donor communities. We heard from
researchers that this was one of the most rigorous
reviews they have faced for this type of opportunity.
Based on recommendations from the expert review team, we have
chosen to invest more than $7 million over fve years in Transformative
Program opportunities. Over the next few issues of Leap magazine, we
will profile the four research teams that will receive that funding. The
frst researcher you will read about is Dr. Jana Rieger, who is leading a
team to test a mobile app for head and neck cancer patients who have
trouble swallowing and eating. Using work already done at the Institute
for Reconstructive Sciences in Medicine, the goal is to have this device in
clinical trials within two years.
We look forward to hearing about the progress these teams make, the
milestones they achieve and ultimately, how this research will improve
the lives of Albertans facing cancer.
Myka Osinchuk, CEO Angela Boehm, Chair
Alberta Cancer Foundation Alberta Cancer Foundation
Transforming the Future
The Alberta Cancer Foundation
has a plan to invest $120 million
into cancer research, prevention
and care by 2017.
Leap_Spring14_p04-05.indd 4 2/20/14 8:24:27 AM
spring 2014 5
spring 2014 VOL 5 • No. 1
Al ber ta Cancer Foundati on
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
COnTriBUTing WriTErs: Colleen Biondi, Linda Carlson,
Janine Giese-Davis, Lucy Haines, Lindsay Holden, Michelle Lindstrom,
Nadia Moharib, Lisa Ricciotti, Cory Schachtel, Karol Sekulic
COnTriBUTing pHOTOgrApHErs AnD illUsTrATOrs:
Brian Buchsdruecker, Stockwell Colins, Aaron Pedersen, Amy Senecal
The Alberta Cancer Foundation is Alberta’s own, established to advance
cancer research, prevention and care and serve as the charitable
foundation for the Cross Cancer Institute, Tom Baker Cancer Centre
and Alberta’s 15 other cancer centres. At the Alberta Cancer Foundation,
we act on the knowledge that a cancer-free future is achievable.
When we get there depends on the focus and energy we put to it today.
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
The information in this publication is not meant to be a substitute for professional
medical advice. Always seek advice from your physician or other qualifed health
provider regarding any medical condition or treatment.
Printed in Canada by Transcontinental LGM.
Leap is printed on Forest Stewardship Council ® certifed paper
Publications Agreement #40020055
ISSN #1923-6131
Content may not be reprinted or reproduced without permission from Alberta Cancer Foundation.
Transforming the Future
Leap_Spring14_p04-05.indd 5 2/21/14 1:50:28 PM
myl eapmagazi ne. ca 6 spring 2014
Fundraising group
set to walk the walk
Breast cancer research and
clinical trials at the Cross
Cancer Institute are set to get
a big boost in donations
thanks to an extraordinary
group of women participating
in 2014’s Women in Action –
Steps of Hope event.
Taking place in early May,
this bi-annual walk will pit
these volunteers against the
harsh conditions of coastal
Nunavut. Beginning in Rankin
Inlet, and making a loop to
Whale Cove and back, they will
trek on foot through ice, snow,
wind and blazing sun, a jour-
ney of almost 200 kilometres.
Women in Action – Steps of
Hope was initiated by Edna
Elias, the current
Commissioner of Nunavut, as
a way to give back to the insti-
tution that helps so many peo-
ple in the North. In 2012, the
inaugural year, the walkers sur-
passed their $80,000 funding
goal and gave more than
$90,000 to the Cross Cancer
Speaking about the group’s
online fundraising efforts,
Amber Williams, events
development offcer for the
Alberta Cancer Foundation,
was enthusiastic when she
described the generosity of
donors. “I’ve spent some time
in these communities and
they’re truly amazing. This is
an exrtraordinary group of
women that is well-supported
by a wonderful community.”
– Allison Myggland
To contribute or to learn
more about the event
Annual high school fundraiser zooms
past the million-dollar mark
What high school student wouldn’t want to stage a
sleepover at his or her school at least once.
That’s exactly what a group of students, teachers and
alumni just did for the 11th straight year, as part of the
2014 Bellerose Composite High School annual
bikeathon in early March.
Of course, it wasn’t all sleeping bags and slumber.
The 48-hour event this time around not only saw
teams of eight to 10 alternate to cycle constantly for
two days straight, but the initiative – the largest high
school fundraiser in Western Canada – also raised
scores of money for cancer research that will stay right
here in Alberta.
Charissa Spencer of the Alberta Cancer Foundation
says, while there is a fundraising minimum for each team
of $1,250, it works out to a drop in the bucket of what
actually gets raised each year.
“The vast majority of teams always surpass their
fundraising goal,” says Spencer, noting several of the
of Hope
bikeathons, including this year’s event, have
drummed up in the neighbourhood of
$300,000 apiece.
This year’s sum has brought the amount
raised, which goes to support cancer research at
the Cross Cancer Institute, over the $1 million
mark. “Many of their own peers and a number of
their family members have been treated at the
Cross Cancer Institute so it’s very close to their
hearts,” Spencer says.
Teams of staff, current high school students
and alumni are all part in the two-day event.
“My favourite part of the event and what
makes it so special is the succession planning.
The Grade 12s really set a strong example for
the Grade 10s and they take it really seriously,”
Spencer says.
About 1,500 riders took part in this year’s event,
some even shaving their heads to show support.
Motorcyclists looking for a way to hit the open
road while raising money for a good cause can check
out George’s Ride this summer.
Named for organizer and two-time prostate cancer
survivor, George Hufnagel, the charity event will see
participants motor on two wheels from Lethbridge,
Alberta to Waterton Lake National Park and back on
July 26. Marking the third-annual ride, this year’s event
will raise money for patient resources at the Jack Ady
Cancer Centre – the third-largest facility in the province.
Rides in 2012 and 2013 drew about 50 riders, but
this year promises to boast an even bigger
turnout. “They are hoping to get 75 bikers this
year,” says Darren Neuberger, development
offcer with the Alberta Cancer Foundation.
“We have a lot of people that really enjoy doing
the ride; it’s very scenic going to Waterton and
back. And then the supper, dance and auction
are always a good time as well.” Also bigger
and better this year will be a fundraising goal of
$100,000, Neuberger says.
Riders can join the tour for $100, or $150
for tandem entries. Meanwhile for those who
prefer to just attend the dinner and dance
afterwards, tickets are $50.
“It’s unique. We don’t have a lot of
motorcycle rides through the Alberta Cancer
Foundation,” Neuberger says. “It’s bringing a
different [participant] to the event, people
who are enthusiastic about riding their
motorcycles. It’s electric; the buzz around
the Jack Ady for it is great.”
For more information about George’s
Ride, visit
George’s Ride

prevent, treat, cure
Leap_Spring14_p06-11.indd 6 2/21/14 1:51:21 PM
Al ber ta Cancer Foundati on spring 2014 7
Top 5 Cancer Apps
for the non-medical professional
Cancer.Net: Recently updated to include a Spanish as
well as an English version, Cancer.Net Mobile is a free
app for iOS (iPhone, iPad) and Android phone users and
features oncologist-approved cancer information for
patients. Users can access guides on 120 different types
of cancer, keep track of questions for their own health
care providers (and record voice answers), as well as save
their details about prescription medications, and track
their symptoms and side effects. Also included is a
section of videos, podcasts and feature articles. The app
comes with an optional passcode lock and iCloud backup
for medications, questions and symptoms sections.
CaringBridge: Intended to be used in conjunction with
the CaringBridge website, the app acts as a social
networking site for patients with cancer and chronic
medical conditions. It allows users to post personal
health information and updates for their family and
friends – to avoid having the same conversation with
every loved one after receiving test results, for example.
Patients can set how private they would like their settings
to be. It’s a free app, and available for both Android and
iOS-enabled devices.
iChemoDiary: Patients can keep track of everything
having to do with their chemotherapy treatments by
mobile device, thanks to this free app designed by drug
company, Merck. iPhone and iPad users can monitor not
only their chemo appointments, but also medication
schedules, and any side effects or symptoms they
experience as a result of their treatment or cancer.
Cancer Terms Pro: Doctors and other medical
professionals often use terms that can easily confuse the
layperson, a reality that can make a cancer diagnosis even
harder to face. This oncology-specifc app acts as a
glossary of terminology related to cancer treatment,
prevention, and diagnosis, to help decipher physician
speak in plain language, and is available for $1.99 for
iPhone users.
Breast Aware: While there are scores of apps to raise
awareness for breast cancer, this one, promoted by Breast
Cancer Ireland, is among the better options, in that it’s A)
free for iOS users and B) shows an actual woman doing a
step-by-step breast exam, rather than an animated fgure
or illustration. It features videos offering screening advice
and reminders to do breast exams regularly, as well as
tips for being more “breast aware” and advice on possible
prevention – such as maintaining a healthy weight and
eating a balanced diet – for breast cancer.
Albertans who want to donate their organs
will have an opportunity to do so, thanks to a
new bill proclaimed by the provincial
government last November.
Prior to the new Act, consent to donate organs
needed to be done in writing, and dated, signed
and witnessed to be legally binding. The new
legislation will allow Albertans renewing driver’s
licences or other identifcation to give verbal
consent to donate their organs, tissue, or body.
If they agree, the registry agent can then send
the information to the Alberta Organ and Tissue
Donation Agency, for which Albertans will
eventually be able to register online at A code or symbol will be
printed on their driver’s licence or ID to indicate
a person’s organ donor consent.
Alberta has the lowest organ donation rates in
the country, with less than 10 donors per one
million people. Ontario and B.C. had better
donor rates of 16.3 and 11.8 donors per million
of population respectively, as reported in 2011,
according to a release by the Government of
About 75 people die every year while waiting
for transplants in Alberta.
“The sad fact is that many Albertans on organ
donation wait lists die before a donor is found,”
says Nancy MacDonald, of the Alberta Donates
LIFE Coalition. “This Bill will make a big
difference in the lives of many Albertans waiting
for transplants.”
The new agency overseeing organ donation
should be up and running by 2015, including full
integration into the provincial government’s
computer system.
New Organ
Rolled Out
for Alberta
Fundraising group
set to walk the walk
Leap_Spring14_p06-11.indd 7 2/20/14 8:26:39 AM
Get inspired. Register now.
Changes to compassionate care standards by the provincial
government are making it easier for Albertans to take time off
work to care for seriously ill family members, without fear of
losing their jobs.
The legislation, the result of a private member’s bill by
Edmonton South West MLA, Matt Jeneroux, became
effective February 1, with an announcement at the
Cross Cancer Institute the same day.
The Compassionate Care Act states that
workers can take up to eight weeks off work
and return to the same job or a similar post.
The leave, which is unpaid, can be split up
into two sections over a 26-week period
without workers fearing for job recourse of
being off work to care for a loved one. Some
may also be eligible through the federal
government for Employment Insurance benefts
during the leave period.
Alberta is the last province in Canada to implement
compassionate care leave protection for its workers.
Thomas Lucaszuk, Minister of Jobs, Skills,
Training and Labour, said the law is about creating
fair workplaces. “No Albertan should have to
make the decision between going to work or
spending the last moments with their loved one at
a time when they are gravely ill,” Lucaszuk said at
the Cross, following the announcement.
Alberta’s Health Minister Fred Horne called
the move a “watershed moment in our
healthcare system.”
Anna Mann, executive director of the Alberta
Caregivers Association, said it was “an
acknowledgement that caregivers provide an
essential service – and that they’re disrupting
their lives to do it.”
To be eligible for the leave workers have to
have been employed with their employer for a
year straight.
More information about the Act is available on
the Alberta Government website.
Compassionate Leave
Alberta’s new compassionate care protection law offers job safety for caregivers
Leap_Spring14_p06-11.indd 8 2/20/14 8:27:48 AM
Al ber ta Cancer Foundati on spring 2014 9
Little Recipe Book on the Prairies
When authors of The Pure Prairie Eating Plan, nutrition
professors at the University of Alberta, Drs. Cathy Chan
and Rhonda Bell, set out to write their newly-released
cookbook, they came at it with a lot of the
right ingredients.
Based on nutritional meals using fresh, and whenever
possible, local ingredients, perhaps the best feature of the
184-page tome is the inclusion of a four-week menu plan,
complete with grocery lists.
Though it’s not just written for those with type 2 diabetes,
the book was developed with the nutritional needs of these
patients in mind, based on the concept that a “diabetes diet”
can be healthy for all Albertans, say the authors in a
press release.
With recipes loosely-based on the Mediterranean Diet, the authors say their
research gathered on made-in-Alberta ingredients (meat and dairy, eggs,
canola, barley, wheat, fruits and vegetables) reveals they have similar nutritional
qualities to those found in the Mediterranean.
Each recipe contains easy-to-follow directions and simple ingredients, as well
as nutritional information including calories, fat, carbohydrates, fbre and protein,
so those whipping up the wares suggested in the book know exactly what they are
consuming or offering their dinner guests. The colour photos throughout really
help make the snacks and meals – which serve up everything from applesauce
raisin cookies and egg-n-bacon sandwiches to savory beef and beans in wine
sauce – seem achievable and approachable, even for the novice chef.
Quick storage tips and options for enhancing
the recipes’ healthfulness are included on
nearly every page – a welcome bonus. Other
value-added, health-conscious features
include tips for using herbs and spices to lower
salt; “nutritional facts of the day” tables for
planning meals; and indices to search for
recipes by ingredients and meals. With more
than 100 recipes, PPEP offers something for
most tastes, with each daily menu averaging
2,000 kcal/day to 25 and 50 grams of fbre.
For more information or to get an e-version
of PPEP, visit
• 2 Tbsp (30 mL) all-purpose flour
• ¼ tsp (1 mL) salt
• 1/8 tsp (0.5 mL) pepper
• 1 lb (450 g) stewing beef, cut into
one inch (2.5-cm) cubes
• 1 ½ tsp (7 mL) canola oil
• ½ cup (125 mL) water
• ¼ cup (60 mL) ketchup
• 2 Tbsp (30 mL) brown sugar
• 2 Tbsp (30 mL) vinegar
• 1 ½ tsps (7 mL) Worcestershire
• ½ large onion, chopped
• ¼ green pepper, cut in strips
• 1 ½ carrots, slices
• 1 ½ potatoes, cubed
Tangy Beef Stew
1. Combine flour, salt and pepper in bowl. Coat
beef in flour mixture.
2. Heat canola oil and brown meat (on all sides) in
large skillet.
3. In another bowl, combine water, ketchup, brown
sugar, vinegar and Worcestershire sauce. Stir into
browned meat. Add onion; cover. Cook over low
heat for 45 minutes, stirring occasionally. Add
remaining vegetables. Cook until meat and
vegetables are tender – approximately 45 minutes.
Hot tip: Got leftovers? Freeze portions in freezer
bags, labelled and dated. Use within two months.
Serves: 5 Serving Size: Approximately 1 cup (250 mL)
Nutritional information: 293 kcal; 10 grams fat; 3 grams saturated fat; 23 grams
carbohydrates; 2 grams fibre; 29 grams protein. From the Pure Prairie Eating Plan, by
Dr. Catherine Chan and Dr. Rhonda Bell
PPEP was pilot-tested on 15 people over 12
weeks with type 2 diabetes, who reported
benefts of following the recipes as adding more
structure to their diet, increasing their awareness
of food choices, helping them buy healthier
foods, blood-sugar control and achieving better
“good” cholesterol.
Leap_Spring14_p06-11.indd 9 2/20/14 1:33:27 PM
At-Home Cancer Screening Tool
AUGUST 9-10, 2014
Space is limited, so be sure to secure your
space TODAY!
Register for The Enbridge
Ride to Conquer
benefiting the Alberta Cancer Foundation
and experience a 2-day cycling adventure like no
other! You will unite with thousands to fund the
things that matter most to Albertans: earlier
detection, better prevention strategies, improved
treatment and enhanced quality of life.
Colonoscopies could soon be a thing of the
past for some Albertans, with the advent of
a new home stool test to screen for
colorectal cancer.
The Fecal Immunochemical Test (FIT) is now
the primary screening test for Albertans aged 50
to 74, and could prevent the need for many
average-risk Albertans to have a colonoscopy, an
invasive examination of the lining of the colon
and rectum. Samples are acquired at home but
taken to a lab for testing.
Colorectal is the second-most deadly cancer,
behind lung cancer, and one of the most
commonly diagnosed cancers in Alberta. One in
13 men and one in 16 women will develop the
deadly form of cancer in their lifetime.
“Every year, nearly 16,400 Albertans are
diagnosed with cancer and more than 5,500
people die from this terrible disease,” Alberta
Health Minister Fred Horne said in January. “The
FIT tool will immediately improve our screening
for this deadly form of cancer and is another tool
in Alberta’s Cancer Plan, which is designed to ensure convenient access to
cancer detection and care.”
The province’s goal is to have at least 70 per cent of average-risk Albertans –
which represents about one million people from 50 to 74 – taking part in
regular screening by 2019, up from 40 per cent today.
But even at the current rates of screening, the new test is expected to detect
up to 200 cases a year.
FIT aligns with most provincial population-based colorectal screening
programs in Canada and is more accurate than its predecessor test, the guaiac
Fecal-Occult Blood Test (gFOBT).
The old test needed to be done over three days and had dietary restraints,
whereas the FIT test does not. The new test works by seeking microscopic
amounts of blood shed from a polyp or cancer. About 10 per cent of tests turn
out positive, but the presence of blood doesn’t always mean cancer is present.
It gives the cue that doctors should have a closer look, however.
Dr. Clarence Wong, medical lead of Alberta Health Services’ Alberta
Colorectal Health Screening Program, says FIT will not eliminate the need for
all colonoscopies. “Patients with positive FIT results are being prioritized and
considered urgent cases to have a follow-up colonoscopy,” he said.
Albertans aged 50 to 74 who are considered average risk of developing
colorectal cancer should speak to their family doctor or health care
professional about where the FIT kits are available.
Leap_Spring14_p06-11.indd 10 2/20/14 1:34:20 PM
Al ber ta Cancer Foundati on spring 2014 11
Dealing with patients in palliative care is one
of the hardest things an oncology team has to do, and
learning the skills to handle it well can mean stepping
outside of the classroom.
That’s the premise behind the Multidisciplinary
Summer Studentship, a six-week ongoing program
to which Shilo Lefresne was one of two inaugural stu-
dents. It was 2008 and she was 25, and between her
second and third years of medical school at the
University of Alberta. The course, which took place
at the Cross Cancer Institute, was an elective pro-
gram. But it was one that greatly infuenced her.
“I think it reaffrmed that the end-of-life process is an
incredibly important time in people’s lives,” says Lefresne,
who’s now 30 and finished med school. “It tends to be
something taboo in our culture and it highlighted that
this is important and – if discussed early in someone’s
disease trajectory with a team, with the family members
involved – it is something you can prepare for and try and
make as comfortable a transition as possible. It can be
something that isn’t necessarily a terrible process.”
Studentship participants, who must have completed
at least one prior clinical term, learn how to work as a
team with cancer patients and families. Summer was
chosen so students could focus on the studentship
without other course work. Participants shadow men-
tors on multi-disciplinary health teams, and are required
to write a paper refecting on the experience at the end.
Now in her fourth year of a residency at the B.C.
Cancer Agency (BCCA) and a student in oncology at the
University of British Columbia, Lefresne says she had
some interest in palliative care and oncology as an
undergrad, but the studentship firmed her goals. “I
worked with medical and radiation oncologists as well
as palliative care physicians, so the biggest learning
from that was appreciating how each different medical
specialty would interact with a patient with a cancer
diagnosis,” she says. “For me at that stage of my medi-
cal school training, it was important.”
Dr. Alysa Fairchild is a radiation oncologist at the Cross
Cancer Institute and associate professor in the University
of Alberta’s department of oncology, who oversees the
studentship, and was also responsible for helping create
it. “It’s important to show students how teams work, both
the advantages and the challenges, but also more impor-
tantly, we really tried to give students the opportunity to
see the cancer journey through a patient’s eyes – which
sometimes can get lost in our trying to master our disci-
pline-specifc knowledge,” says Fairchild.
Wayne Sartore donated $100,000 toward the studentship in honour of his wife,
Linda, who died of cancer in May 2009, after receiving what he calls “invaluable care”
from her medical team at the Cross Cancer Institute. “As we were getting to the later
stages with Linda, and our experience primarily with Dr. Andrew Scarfe, it became
clear we wanted to do something that we personally believed in – something that
would support the development of young medical professionals in the area of
bedside manner, doctor-patient relationship, the understanding of what families are
going through when they face cancer and certainly terminal diagnoses,” he says.
“We summarized it, saying ‘we’d like to clone a lot of people like Dr. Scarfe and
Dr. Fairchild.’ ”
Now future doctors, pharmacists, social workers, occupational, speech, and respi-
ratory therapists, nurses, and nutritionists will have a chance to weigh in on patients’
end-of-life care through the studentship. So far eight students have participated, two
at a time, but Fairchild still recalls the frst fondly. Fairchild says she was so impressed
by Lefresne, the pair has collaborated on two more papers since. “It’s really the start
of an ongoing professional collaboration, which I appreciate as well.”
The importance of the experience is not lost on Lefresne, who plans to do a fellow-
ship in the same feld as Fairchild, something she has set up in Australia for next year.
Afterwards, she hopes to return to Canada to continue her medical career in rapid
access palliative radiotherapy.
Studentship helps future health workers
glean insight into end-of-life care
Shilo Lefresne
supporting young minds
Next Gen

Leap_Spring14_p06-11.indd 11 2/21/14 1:52:26 PM
What are complementary therapies? Basically,
CTs are any product or therapy used to improve health
or treat symptoms outside of conventional medicine.
Specifc therapies that are considered complementary
versus conventional are constantly changing, as evi-
dence mounts to support their effcacy. For example,
25 years ago support groups for cancer patients were
thought to be a terrible idea – a bunch of sick people
getting together to talk about it would surely do more
harm than good!
Now, nearly every cancer centre offers such support
groups because there has been so much research and
evaluation supporting their helpfulness, and they are
just part of conventional care.
We often divide CTs into fve categories:
1) Natural health products: These are things you
ingest, including herbs, minerals, vitamins and
other botanicals.
2) Mind-body therapies: These are mental tech-
niques used to improve health, including ap-
proaches like meditation, imagery, hypnosis and
3) Manipulative therapies: These are things you
do to the body, like massage, chiropractic proce-
dures or osteopathy.
4) Energy therapies: These approaches all work on
the premise of balancing energy felds in the body,
such as Reiki, acupuncture and Tai Chi.
5) Whole-systems approaches (such as Traditional
Chinese Medicine, Ayurveda or Homeopathy): Each
of these approaches has its own philosophy about
health and healing and a number of treatments are
derived from that.
I did a survey in 2012 with psychology honours stu-
dent Ngaire King of nearly 500 people with cancer
and 100 health care providers at Calgary’s Tom Baker
Cancer Centre. We asked about patients’ knowledge,
communication and support-making decisions about
which CTs to use in cancer care.
While about half of the cancer patients had started tak-
ing some form of CTs since their diagnosis – the most
popular were natural health products and mind-body
therapies – and the other half were considering using
CTs, only 20 per cent of the patients said anyone at the
cancer centre had asked them about it. Only 15 per cent felt satisfed with the commu-
nication and decision support they had received. Participants also reported feeling they
lacked the knowledge to make their own decisions about what kinds of CTs to use.
For their part, the health-care providers also felt unknowledgeable about CTs,
with most reporting having received only minimal or no education about the
effcacy of CTs for cancer patients. They were interested in learning more, but that
kind of training is rarely provided in medical or nursing school curricula.
The good news is that we are addressing these omissions through our integra-
tive oncology education programs at the Tom Baker Cancer Centre. Beginning in
2012, I have provided a monthly educational seminar for all patients or support
people to attend; it’s usually on the third Wednesday of the month.
We are also in the process of adapting online training materials from the B.C.
Cancer Agency (BCCA) for health-care providers and plan to test their effcacy in
improving the confdence of professionals, as well as their knowledge about CTs
and their ability to counsel patients on which products to use and which to avoid.
Hopefully, if we redo the surveys in a few years, most patients will feel supported
and knowledgeable about which CTs may work for them, and health-care providers will
also be more comfortable talking to patients about their use and interest in CTs.
Dr. Linda Carlson ( is the Enbridge Chair in Psychosocial Oncology at
the University of Calgary and a clinical psychologist at the Tom Baker Cancer Centre.
myl eapmagazi ne. ca 12 spring 2014
from Convention
What do we really know about the effcacy of various
complementary therapies to treat symptoms or improve health?
making positive connections
Body Mind

Leap_Spring14_p12-13.indd 12 2/20/14 8:30:26 AM
Most foods contain a combination of protein, fat and carbohydrates. Foods that are
higher in protein come from the Meat and Alternatives and the Milk and Alternatives
food groups in Canada’s Food Guide. Foods in the Grain Products and Vegetables
and Fruit groups also have some protein, but in smaller amounts.
What does 30 grams of protein look like? This would be about 1
/2 cups
(350 millilitres) of lentils or three ounces (90 grams) of meat, fsh or poultry. Typi-
cally, people have less protein at breakfast and lunch and more at supper. Eating two
slices of whole wheat bread, two boiled eggs,
/4 cup (175 millilitres) of plain yogurt
and an orange is an example of a breakfast that contains 30 grams of protein.
What are the healthiest ways to get the right amount of protein?
• Choose lean sources of meat and meat alternatives. For example, choose skin-
less chicken or fsh in a 90-gram serving.
• Use meat alternatives like beans and legumes in recipes. For example, eat
baked beans for breakfast with whole wheat toast. Make a meatless chili or bean
dish at least once per week; try to increase the frequency if you can.
• Choose low-fat milk and alternatives. Have skim or one-per-cent milk on whole
grain cereal, or choose plain low-fat Greek yogurt on a baked potato.
• Shred lower fat cheeses (with less than 20 per cent MF on the label) and add to
a salad or soup, or melt on toast. Limit servings of red meat and if possible avoid
processed meats that are smoked, cured or salted. The World Cancer Research
Fund and the American Institute for Cancer Research recommend limiting red
meat and eating very little, if any, processed meat. Choose less than 500 grams
cooked weight per week. That would mean, for example, limiting your red meat to
one 180-gram trimmed steak, two 90-gram hamburger patties, and one 180-gram
serving of lean pork in a week.
So, do your muscles a favour and make sure you have enough lean protein at
each meal by spreading it equally throughout the day. Maintain or possibly build the
muscle you have with exercise and eating the right amount of protein each day.
Protein has been in the news a lot lately. We have
heard that higher protein diets help with weight man-
agement and have seen food marketers adding protein
to foods such as granola bars and bread.
What exactly is protein? Protein is a macronutrient –
a nutrient that provides calories. Protein is broken down
in the body into amino acids. These amino acids are
important for our body to function. Nearly everything
the body does needs protein. It is needed to build and
repair skin, muscles, bones, blood and organs, as well
as to make enzymes, hormones, and antibodies (for
immunity). Our bodies use protein throughout the day
to make and repair body cells.
The Canadian recommendations for protein are set
to help prevent deficiencies. The current guidelines
recommend 0.8 grams of protein for every kilogram
of body weight every day. For a 70-kilogram, gener-
ally healthy adult person, that would equal 56 grams
of protein each day, or about 20 grams at each meal.
Recent research has shown that we may need to eat a
bit more than the recommendations to build or main-
tain our muscle and help manage weight.
Some research suggests we should eat about 30
grams of protein at breakfast, lunch and supper. Since
there is a limit as to how much protein our body can
absorb at one time, eating more than 30 grams at
one time will not help to build more muscle. Unless
a person’s calorie needs are high, the extra protein will
eventually be stored as fat since our bodies cannot
store protein.
There are very few foods made solely of protein.
Karol Sekulic is a registered dietitian with Alberta Health Services who has expertise and interest
in the areas of weight management and nutrition communications.
Al ber ta Cancer Foundati on spring 2014 13
Lean and Clean
High-protein foods are being given more
weight as part of a proper, balanced diet
What do we really know about the effcacy of various
complementary therapies to treat symptoms or improve health?
food for life
Smart Eats

Leap_Spring14_p12-13.indd 13 2/20/14 8:31:01 AM
myl eapmagazi ne. ca 14 spring 2014
“Screening mammography is the best way to fnd
breast cancer early when treatment has the best
chance of working,” says Dr. Huiming Yang, Medical
Director, Screening Programs, for Alberta Health
Services. “Although the evidence supports routine
screening in women aged 50 to 74 it is less clear
that the benefits of mammograms outweigh the
risks for women who are 40 to 49 years old.”
As part of a personal breast health plan, women
40-49 are encouraged to consider certain actions,
suggests Yang:
• Know what looks and feels normal for you so you
can notice any unusual changes in your breasts.
Talk to your healthcare provider if you notice
unusual changes.
• Talk to your health care provider about your risk
for breast cancer, as well as the risks and benefts
of screening mammograms to help figure out
what is right for you.
“Most cases of breast cancer occur in women 50
years and older (about 77 per cent of all cases),”
says Yang. “Research has shown that screening
women in the 40-49 bracket isn’t as effective as it
is in older women (over age 50).”
If you chose to begin regular breast cancer
screening at any time in your 40s, you can access
screening mammography in Alberta with a referral
from your health care provider, adds Yang.
For more information about breast cancer and
s c r eeni ng mammogr ams , you c an v i s i t
I just turned 40. Should I start having
annual mammograms now?
You can eat healthy on the run – by planning ahead or by making the
healthiest choice available, says registered dietician Karol Sekulic, of Alberta
Health Services.
And that all starts with the frst meal of the day, she says. “If you eat breakfast
at work instead of at home, bring some plain instant oats and fruit. Add a plain
yogurt and you will have three of the four food groups covered; if you compare
that to a yogurt parfait from a coffee shop or fast-food restaurant, you will save
yourself added fat, sugar, salt and calories.”
But if you don’t have anything prepared at home, and you frequently grab
food on the go, here are some tips from Sekulic to keep that handy snack or
meal from doing more harm than good:
• For a healthy lunch or supper option, choose a salad with smaller serving of
chicken or fsh. Skip the white bread, pasta or rice options.
• Choose foods without breading, toppings or extra sauces. This will likely save
you extra fat, sugar and calories.
• Limit cheese, croutons, bacon, dried fruit or candied nuts as toppings.
• If you are choosing a sandwich, choose the smallest size available and look
for whole wheat or 100 per cent whole grain breads and have a vegetable as
a side.
• For snacks, choose plain vegetables, fruit or a few whole grain crackers with
hummus or a few plain nuts.
Can I eat on the run and
still eat healthy?
We put your questions to the health professionals
about eating healthy on the run, mammograms,
and the efficacy of flu shots
By shelley williamson
a resource for you
Ask the Expert

Leap_Spring14_p14-15.indd 14 2/20/14 8:31:54 AM
Al berta Cancer Foundati on spring 2014 15
Ask our experts questions about general health, cancer
prevention and treatment. Please submit them via email to Remember, this advice is never a
substitute for talking directly to your family doctor.
“That’s a great question and an important one during flu season,”
says Krista Rawson, nurse practitioner with Alberta Health Services, based in
Red Deer. “The infuenza (fu) vaccine (shot) does not cause the fu!”
Rawson says that though flu shots are made from viruses, they are strains
deemed “inactive or not infectious – so you cannot contract the flu from the
shot. You should know that every year scientists try to predict which fu will out-
break and make the shot based on their predictions,” she explains.
Of course flu outbreaks can and do happen, and it might not have been
the type of fu that is immunized for in the shot, she adds – likening that scenar-
io to buying farm crop insurance against a food, but instead having a drought
that year.
Rawson goes on to say it’s true that every year Canadians die from the flu.
“Older adults, those over 65 years, are at greatest risk of complications or death,
but so are those with underlying medical conditions such as cancer,” says
Rawson, who recommends annual administration of the inactivated infuenza
vaccine – the fu shot, not nasal spray – for all adult patients with cancer, and
especially those on active treatment or who were treated in the past year.
“Now there are two choices of fu vaccine on the market and it is important to
know this if you have a diagnosis of cancer,” Rawson says. “The shot (needle) is
the vaccine of choice for those who have had a cancer diagnosis. The nasal spray
is a live vaccine and is not recommended for those individuals with cancer.”
There are also a few other exceptions to the recommendation to get a flu
shot. People who have had or are about to undergo bone marrow transplants or
anyone on immune suppression medications should ask their health care pro-
vider prior to immunization. In terms of general words to live by, Rawson says:
“During flu season, get a flu shot if appropriate for you, wash your hands fre-
quently, stay home if you are sick and don’t hesitate to contact your health care
provider for advice.”
Do I need to get a flu shot? I am a little
apprehensive because I’ve heard you can
actually get the flu from the vaccine.
Don’t forget about what you drink on the go, advis-
es Sekulic, noting there can be added sugar and fat
in beverages, too. For this reason, she suggests
choose water to drink when possible. “If you choose
coffee or tea,” she says, “stick to the plain types and
add lower fat milk with two per cent milk fat or less
instead of whole milk cream, which can have 10 per
cent milk fat or higher.”
Leap_Spring14_p14-15.indd 15 2/21/14 1:53:26 PM
myl eapmagazi ne. ca 16 spring 2014
There are more than 50 cancer medications in
common use today. Some of these will have limited
side effects, while others have many. Like the effects
of radiation treatment, some of the effects of chemo-
therapy may occur months, even years, after your
treatment has ended. Whether or not you will have
these long-term effects depends on many things,
including your general health – weight, activity level
and smoking history – at the outset of treatment.
Other factors include your particular cancer type, the
drugs and dosage you received, the length of time on
the therapy, the way you took the drug (for example,
as a tablet or injection), the combination of other
drugs and/or radiation you were taking, and the way
your body reacted to those treatments.
Two people can have the same kind of cancer,
take the same chemotherapy and have different
long-term or late effects. For a useful source of
information about particular drugs or a list of side
effects of common cancer drugs, visit bccancer.bc.
ca and select “Drug Database” from under the
Health Professionals Info heading. You can search
drugs alphabetically.
Because chemotherapy fows through your body,
it can affect multiple organ systems. Chemotherapy
regimens have become more effective over time,
and your health-care providers try to give you the
least amount of chemotherapy that will still effec-
tively treat your tumour in order to minimize side
effects. Some symptoms might occur during chem-
otherapy and remain, but others might show up
months to years later so it is good to be aware of the
particular side effects that could potentially occur.
Chemotherapy targets cells that are rapidly divid-
ing, such as cancer cells. Unfortunately, many other
cells in your body also divide rapidly and so chemo-
therapy can affect areas of your body such as your
bone marrow, mouth, skin, hair, fingernails, and
stomach lining. Most of those short-term side
effects resolve as the tissues heal.
Many survivors will not experience late effects, or
if they experience them, will learn to adapt to them
so that they continue to thrive. If you begin to expe-
rience new symptoms, they might be a result of hav-
ing been on chemotherapy, as a result of aging, or
due to other medications you are taking.
Please make sure that your current medical team (i.e., family physician or oth-
ers involved in your care) knows you are having symptoms. Tests may be needed
to determine whether you should be concerned. Earlier detection of long-term or
late effects (see sidebar) can make a difference in ability to treat them.
The list of potential late effects is not complete and not every person experi-
ences these in the same way, if at all. Many of these health issues are also
strongly related to or impacted by your lifestyle. For example, if you develop a
heart problem, it could be a result of your family history or your lifestyle choices
(such as weight, diet, ftness level, and smoking history), not because of your
cancer treatment. There is no real way of knowing exactly what the reason is for
developing this problem, but it is very important you receive appropriate medi-
cal care to manage this health problem.
What can you do to cope? As always, we recommend talking with other cancer
survivors who can help you compare symptoms and talk about ways to adjust to
these changes. Also, discussing your situation with a professional counsellor
may be useful. Visit for updates on new information about
late and long-term effects.
Many of the available cancer medications have
limited side effects. The story is different for others
Not every cancer survivor experiences these potential late or long-term
effects in the same way, or at all. They are:
• Lung disease
• Osteoporosis
• Increased risk of
other cancers
To read other columns related to the late or long-term effects of cancer
treatment such as the risk of second cancers and the long-term effects of
radiation, visit and search “survivorship.”
Late effects
• Early menopause
• Heart disease
• Infertility
• Liver problems
stories of survivorship
Beyond Cancer

Leap_Spring14_p16-17.indd 16 2/20/14 8:33:31 AM
18 Game ChanGer
Cancer is a journey that affects more than
just the person who contracts it
ith the most recent statistics showing that one in every two
Albertans will develop cancer, it is a reality that touches just about everyone
at some point, if not multiple times, in their lifetime.
In this issue we examine one woman’s cancer journey from diagnosis to thriving, from
multiple points of view – her own, her loved ones, her medical team and her boss; delve
into how to talk about the tough subject with all those involved; and examine living life
to the fullest after cancer becomes a distant memory.
22 TouChy SubjeCT
Keeping your foot out of your mouth when
talking about cancer can be hard
24 I’m alIve. WhaT noW?
Provincial survi vorship programs help former
patients get back to their regular li ves
Al berta Cancer Foundati on spring 2014 17
Late effects
Leap_Spring14_p16-17.indd 17 2/20/14 8:34:08 AM
myl eapmagazi ne. ca 18 spring 2014
Cancer afects more than just the
person who contracts it. Here are a few
views on one patient’s diagnosis, from
those who helped her along the way
THE CANCER journey
Leap_Spring14_p18-21.indd 18 2/21/14 1:49:41 PM
Al berta Cancer Foundati on spring 2014 19
wo years ago, Kim Rideout of Red Deer had the perfect life.
She was married to her high school sweetheart. She had a good
job, two beloved daughters and friends everywhere. A trans-
plant from Upper Gullies, Newfoundland, she and her husband Clif
loved camping in the summertime and snowmobiling when the snow
few. In March 2012, that life came crashing down.
By Colleen BionDi / photography By aaRon peDeRsen
Leap_Spring14_p18-21.indd 19 2/20/14 8:35:58 AM
At an appointment with her new general practitioner, she’d asked for
antibiotics for a recurring infection in her right breast. The doctor exam-
ined her and recommended a mammogram. Kim explained that it wasn’t
necessary; she’d just had her annual mammogram in November. But the
doctor insisted. By the time she got home, there was a message on her
machine for a next-day screening appointment. “It all seemed so rou-
tine,” says Kim. “But really the stars
were just lining up.”
On March 14, the mammogram
technician took multiple pictures
of both breasts. Then there was an
ultrasound. When the radiologist
came to talk to her, Kim felt like she
was foating. Tears streamed down
her face. “Are you telling me I have breast cancer?” she asked. “Yes,” he
said, “in your left breast.”
Exiting the ofce that day, she remembers a few things – that fresh
springtime smell, the noise of trafc, wetness on the back of her neck –
but not how she got home. Some days it feels like it was yesterday, recalls
Kim. “The date is beginning to fade, but the experience will be with us for
a lifetime.”
The system kicked quickly into gear. There was a biopsy in nearby Dev-
on, surgery to remove two tumours (Kim had stage 2B cancer, meaning
the tumours were of a certain size and one tumour was in a lymph node),
scans to confrm the cancer had not metastasized, six sessions of chemo-
therapy in Red Deer and 16 sessions of radiation in Calgary (Red Deer did
not have the capacity for providing radiation treatment until recently).
Kim took eight months of work to deal with her treatments.
“I couldn’t believe this was happening to me. I didn’t want to hurt my
family. I was afraid I was going to die but wasn’t ready to be a memory.”
Chemotherapy was brutal. Kim experienced mouth ulcers, bone pain,
panic attacks and debilitating fatigue. Steroids added 35 pounds to her
petite frame. She lost her hair. “I was extremely uncomfortable.” To get
to radiation sessions at the Tom Baker Cancer Centre, she and Clif drove
through severe snowstorms. One day a semi jack-knifed right in front of
them. “We were defnitely white-knuckling it,” she says.
At a low point, she said to Clif, “I don’t think I’ll ever get healthy again.
I don’t know if I can do this.” He said, “You don’t have a choice.” That was
the last time she felt like giving up.
When the treatments were over, there were more issues to deal with.
There were mood swings, anti-depressants and a few sessions of counsel-
ling. Family members also admitted to feeling extreme stress and found
solace in their own private ways. “There was a whole lot of stuf going on
in my body that I didn’t have the faculties to deal with, but everyone was
sufering,” says Kim.
And once the medical monitoring fnishes, Kim recalls, “You feel like
you’ve been thrown of a ledge without a parachute. What if the cancer
comes back? How will I know? You should be feeling better but you are
not. The fatigue and mental aspect is still in play.”
It can take a year after treatments conclude to feel settled again. Kim
has now resumed regular activities and regained her sense of hope. She
has a new perspective. “I am thankful, grateful, blessed and loved. My
story is a good story.”
A large part of Kim’s recovery had to do with her supports. People
emailed and texted supportive messages, laughed and joked with her and
shared their lives with her. “I wanted people to treat me the same as they
normally would. It made me feel part of the human race.”
Based on her own experience, Kim says she has a few suggestions for
dealing with a loved one with cancer: Don’t ask too many questions, don’t
smother the patient, and take your lead from the patient. Replace pity
with compassion.
myl eapmagazi ne. ca 20 spring 2014
Kim kept people informed about her cancer experience with regular
group emails. She was often asked to create a blog or write a book. Last
May she published Taken to My Knees: My Journey After a Breast Cancer Di-
agnosis, (taken from a phrase Kim used to describe her low points) and
has subsequently mentored other women with breast cancer.
“Feel it, breathe through it, take it one day at a time or one hour at a
time,” she says to women with breast
cancer. “If you can’t put one foot in front
of the other, crawl. I was not too proud
to crawl.”
And things will get better, she adds.
“You’ll get there. You just need to have
faith in yourself.”
As Kim says, cancer impacts not only
the patient but their loved ones. Here are some of their stories:
Krista Rawson – The Nurse Practitioner
In her capacity as a nurse practitioner at the Central Alberta Cancer Cen-
tre, Krista sees and counsels dozens of people every day. But when she met
Kim in the spring of 2012, she knew she would never forget her. “People like
Kim stick in your mind,” she says.
Their frst meeting took place just before Kim’s second chemotherapy
session. Kim came with her husband, Clif, and a friend. Kim was very up-
set that day. She was 44, working full time and parenting two young adults.
She and Clif had been together since their teens and now she had cancer.
“We don’t anticipate facing our own mortality at that age,” explains Krista.
And Kim was doing just that.
But Kim faced the day – and each future session – with courage and
grace. She spent time at the information centre. With Krista she talked
about coming to terms with the diagnosis and side-efects she was expe-
riencing from treatment, such as mouth sores, bowel issues and extreme
fatigue. She was also concerned about maintaining intimacy with her hus-
band. It was a heavy-duty session; Kim was in shock, teary and afraid. But
her trademark sense of humour was intact, recalls Krista. “I remember we
laughed a lot.”
Krista saw Kim 10 times – before each chemotherapy session and, less
frequently, while Kim took radiation sessions in Calgary. She followed up
with a prescription for Tamoxifen (nurse practitioners can prescribe med-
ications) and a handful of phone calls.
There are many professionals who work with cancer patients on their
journeys; there might be a social worker, a psychologist, an oncologist or
general practitioner or a nurse navigator who co-ordinates sessions and
services. “We are woven together like a net to catch people in crisis. It is
such a privilege for me to work in the feld,” says Krista.
The cancer experience is profoundly stressful, destroying some rela-
tionships, particularly if they are already fragile. But with strong couples,
relationships may not only survive, they may thrive. That is what happened
with the Rideouts, notes Krista. “Kim and Clif are an extraordinarily
close couple. This [cancer] was not going to get in the way of that con-
nection.” Plus, she adds, Kim had a very supportive network with friends,
immediate and extended family and colleagues injecting practical and
emotional support.
Kim and Krista had an open and honest rapport, with no question
deemed insignifcant or inappropriate. “It is your health. It is you and your
family,” adds Krista. “What you bring to the table is a priority.”
Matt Olson –The Boss
Matt Olson is Farm Credit Canada’s district director for central Al-
berta and his ofce is in Red Deer. As such, he is the head honcho where
Kim works.
“I frst heard about Kim’s cancer from her direct supervisor, Spencer
THE CANCER journey
“I couldn’t believe this was happening
to me. I didn’t want to hurt my family.
I was afraid I was going to die but
wasn’t ready to be a memory.”
Leap_Spring14_p18-21.indd 20 2/27/14 9:13:31 AM
Al berta Cancer Foundati on spring 2014 21
Higginson. Our frst questions were:
What would be the impact for Kim and
how do we support her through this?”
Matt met with Kim before, during and
after treatments to plan work and support
strategies. His messages to Kim were clear
– we have your back, we’re going to do what we
can to help you out, we don’t want you to worry
about your job. That is the way every employee in
crisis should be treated, explains Matt. “She was worried
about her job; we were worried about her life.”
He explained disability benefts to Kim – short-term leave would
kick in for 15 weeks at 100 per cent salary followed by long-term disability
at 70 per cent. Kim was of work for approximately eight months, while get-
ting treatment, and wanted to come back full-boar in December. Spencer
suggested an integrated six-week plan, which started at 10 hours a week
and built back up to full time by the end of January 2013.
While on leave, staf invited Kim to cofee and lunches. Staying connect-
ed like this allowed both Kim and her co-workers to feel comforted and to
envision hope for Kim’s future. Staf supported a fundraising run in 2012
and 2013, by running with her or sponsor-
ing her fnancially (the company matched
employee donations). They also had ac-
cess to employee assistance program
(EAP) counselling services, to deal with
the emotional impact of having a beloved
colleague with cancer.
After Kim wrote her book, the company
sent her on tour to tell her story to other
company divisions and partners. “We have a business that needs to oper-
ate, but it is more than just dollars and cents. It is about people and doing
the right thing,” says Matt. Kim told Matt that on her last day of work she
got a hug from every employee and that meant the world to her. “We didn’t
think that was much, but she did. For us, it is just part of being human.”
Tammy Dodge – The Friend
Tammy, a nurse, found out that Kim had cancer from a mutual friend who
contacted people, at Kim’s request. “My wheels started turning,” she ex-
plains. The radiologist had said it was cancer even before the biopsy was
conducted. “I didn’t think it was going to be a false positive. This was going
to be a new reality for Kim.”
Kim didn’t want to talk to anyone that day, so Tammy sent a support-
ive text to her: “I love you. When you are ready to talk, I am here for you.”
Afterwards Tammy spent many afternoons and evenings at the Rideouts
talking to Kim and her family about technical things, like how the inci-
sion from surgery was healing or how Kim’s body was responding to the
anesthetic. She recommended Kim’s daughter attend a key appointment
and be the note-taker, so that details would not be forgotten. She joined
Clif at the hospital for Kim’s surgery and attended chemotherapy sessions
as well.
Tammy flled Kim in on what was going on with her and her own family.
And they laughed – a lot. “I was constantly trying to bring laughter into the
situation. Kim loves to laugh and the sound of her laugh is contagious.” She
listened a lot (no advice unless she was asked for it), gave lots of hugs and
tried to take Kim’s mind of things. One text gave Kim a hard time: “You
have earned the right to be sad. But not for long!” Because that was the way
Kim would want it.
Spending time with Kim during her struggles upped the intimacy factor
of their friendship. “There were no holds barred; no conversation was of
the table,” says Tammy. “We needed her as much as she needed us. She still
wanted to be a confdante.”
“I barely saw her cry. I would ask
her millions of times how she was.
She must’ve been sick of it. But she
said she was fine and I wanted
to believe it.”
Tammy has become a better person as a result of accompanying Kim on
this life event, she says. She donates more readily now, volunteers and readi-
ly sends caring messages to friends and colleagues. She feels grateful, doesn’t
stress as much about the little things anymore and is protective of her family.
“I don’t want my kids or husband to ever feel that fear the Rideouts felt.”
Tammy has advice for the friends and colleagues of people who are ill.
Don’t be afraid or intimidated to reach
out. “No one is going to turn down a kind
word or gesture.” And, if you’re a wom-
an, be vigilant about your own health
whether through self examination or
screening, she advises. At the age of 42, in
light of Kim’s diagnosis, Tammy had her
frst mammogram.
Cliff Rideout – The Husband
It started out as an ordinary day. Clif went to work and Kim went for what
they thought was a routine mammogram. But when Clif got home and
heard the news, he “went to pieces.” This was unusual for the shop super-
visor, who has cried maybe three times in his life – when his mother died of
ovarian cancer and when his daughters were born. “But your mind goes to
the worst,” he explains.
He accompanied Kim to the biopsy, the surgery and followup treat-
ments. “Take whatever time you need. Family is everything,” his supervi-
sor at Halliburton told him. He wasn’t docked any pay for time of and the
couple’s generous employee beneft plans covered 100 per cent of medica-
tion costs, totalling $17,000. “This took the pressure of,” adds Clif. “We
were fortunate not to have the fnancial stress.”
Clif’s sister and brother-in-law came out from Newfoundland to help
the family, as did Kim’s best friend. “It made things a lot easier,” Clif says.
Most of the time, Kim was comforting Clif and the girls. “I barely saw
her cry. I would ask her millions of times how she was. She must’ve been
sick of it. But she said she was fne and I wanted to believe it. She wanted the
treatments done and over with and to be back to normal.”
Clif appreciates his life now more than ever. He and Kim have begun to
travel, not waiting for the perfect time or until they are fush with money.
They went to their nephew’s wedding in Jamaica last October and have
a trip to the Dominican Republic planned for this spring. And the edges
are blurring a bit on exact times and dates, on fnely tuned details of the
cancer experience.
Writing the book and speaking to groups about her experience has been
Kim’s therapy and Clif fully supports her in that. But that is not his style.
He wants to move on. “I am kind of sick of cancer.” Clif doesn’t know how
he coped that year. “Kim’s attitude and personality actually made me feel
better. She is an amazing lady.”
And as far as what Clif contributed to Kim’s welfare? “I was just there.
That is everything. There is no magic.”
Leap_Spring14_p18-21.indd 21 2/20/14 8:38:48 AM
ancer is a touchy subject. Almost taboo for
some to bring up directly with a person they
know who was diagnosed with the disease.
Not knowing the right words to say, or avoid,
can make loved ones, friends and co-workers decide to
steer clear from talking about the subject altogether. But
it actually does the cancer patient a disservice if they don’t
talk about their disease, suggests Dr. Guy Pelletier, clinical
By MiChelle lindstroM
psychologist at Calgary’s Tom Baker Cancer Centre and ad-
junct assistant professor for the department of oncology.
“I have seen patients in the past try to keep the infor-
mation away from children and family,” Pelletier says.
“Then the situation goes from bad to worse.” Physical
evidence of surgery or long absences from work make
the secret impossible to keep and those close to you feel
hurt they weren’t told.
Keeping your foot out of your mouth when talking about
cancer can be hard. Here are some suggestions for how to
broach the topic with kids
myl eapmagazi ne. ca 22 spring 2014
THE CANCER journey
Leap_Spring14_p22-23.indd 22 2/20/14 8:39:40 AM
Some parents may initially feel they are protecting their
children by not telling them about Mom or Dad’s cancer di-
agnosis. “I’ve often told patients that a child’s imagination
is far more cruel than reality,” Pelletier says. “Whether it’s
the appearance, behaviour or time a person spends in bed,
children will notice all of that. If the parents do not discuss
the disease with the children, then the children will invent
their own ideas of what is really going on.”
Of course, he says, a conversation with a four-year-old
will difer than one with a 14-year-old – the simplicity of
the language will vary – but the two main messages parents
must express to their kids, regardless of age, are the same:
the cancer diagnosis is not the children’s fault and the chil-
dren are not responsible for getting Mom or Dad better.
“Parents should be as honest as they can be in terms
of talking to the children and telling them what is hap-
pening,” Pelletier says. “Older children may ask for more
detail about the nature of the disease and implications in
terms of how much treatment is needed. It’s a matter for
the parents to exercise a certain amount of judgment.”
He does advise that both parents make sure they are on
the same page of what they want to tell the children, if by
chance both aren’t available to sit down and answer ques-
tions together. Secrets, at a time like this, are not advisable.
It’s also a good idea for adults close to the child of a can-
cer patient – teachers and sports coaches, for example – to
be informed of the parent’s diagnosis. “When children
are distressed, it will show in environments like school
or sports,” Pelletier says. “So if the child mentions some-
thing or presents behaviour that might indicate distress,
the teacher or coach will know what that’s all about.”
Pelletier’s role as a psychologist is to help people who
are diagnosed with cancer throughout the treatment and
survivorship and he sees how the shock, fear and disbe-
lief afect the whole family. He extends the invitation to
family members of the patient to take part in group dis-
cussions about the disease and what options lie ahead.
He says it’s best for close family members to honour the
wishes of patients and let them decide who will be their
sounding board. Some patients choose to even keep the
health-related conversations amongst professionals to
avoid awkward responses or upsetting their loved ones.
In the workplace, if the news becomes publicly
known, it’s usually because the patient has purposely
told colleagues and is prepared to acknowledge he or
she has a disease. Many patients reiterate the phrase:
“You never know who your friends are until you are
diagnosed with cancer,” Pelletier says. An unexpected
fip-fop occurs with acquaintance-like colleagues step-
ping up and close ones distancing themselves.
For a co-worker who doesn’t know the diagnosed col-
league very well, Pelletier says, “Acknowledging the event
and giving the person an indication that you’re prepared
to be supportive is a good thing and probably sufcient.”
Pushing for details or ignoring evidence of discomfort
and hesitancy is not exercising good judgment, which is
crucial when discussing cancer, he adds.
A direct supervisor will likely be the frst to hear the
news in the workplace because many times a patient will
have to go on sick leave soon after a cancer diagnosis. Pelle-
tier says he’d hope a patient would hear supportive phrases
from his or her boss including: “We are terribly sorry to
hear that. How are you? Don’t worry about the job, worry
about getting better.” If not those exact words, the supervi-
sor should be able to explain how the employee can access
short-term disability quickly.
“Health, to a large extent, is a personal issue,” he says.
“When we talk about the dos and don’ts, it depends a lot
on where people’s level of comfort is. Judgment is al-
ways necessary.”
“Parents should be as honest as they can
be in terms of talking to the children and
telling them what is happening.”
Al ber ta Cancer Foundati on spring 2014 23
Leap_Spring14_p22-23.indd 23 2/21/14 1:54:27 PM
myl eapmagazi ne. ca 24 spring 2014
HIS STORY: Mike Lang has spent the years since his own
cancer diagnosis working with young cancer survivors.
THE CANCER journey
I’m Alive
Leap_Spring14_p24-27.indd 24 2/20/14 1:42:19 PM
Al ber ta Cancer Foundati on spring 2014 25
CancerBridges program brings former patients
back to their regular lives, with a focus on thriving
through survival
By Lucy Haines / photography By brian bucHsdreucker
on’t tell the thousands of survivors in Alberta that cancer is a death sentence.
In reality, advances in research and treatment have meant that many types of cancer have
extremely high survival rates, so much so that the medical community is starting to treat
some cancers as almost chronic in nature, akin to asthma or diabetes.
Today, about two in fve Canadians can expect to develop cancer in their lifetime – and more
than half of the new cases will be lung, breast, colorectal and prostate, according to Canadian
Cancer Society statistics. And though fve-year, relative survival rates for lung cancer are low at
about 17 per cent, the fve-year survival rates for colorectal cancer are at 65 per cent, while breast
and prostate survival rates are high, at 88 per cent and 96 per cent survival, respectively.
For cancers overall, that means that 63 per cent of Canadians with cancer are expected to
survive fve or more years after diagnosis. While the focus for cancer care across the country has
traditionally been on treatment, the large numbers of survivors – 120,000 in Alberta alone – has
meant a need to reassess where time and efort for care should be.
Enter Dr. Janine Giese-Davis and Mike Lang who, in co-operation with Alberta Health Services,
the University of Calgary and thanks to generous funding from a cancer survivor, came together
to create CancerBridges, a province-wide program with a focus on surviving cancer. Through
practical, educational presentations for survivors, families and medical professionals, as well
as an information-rich website with calendar listings for events across the province and links to
survivorship videos, CancerBridges ofers just that – a bridge from treatment back to regular life,
a link to a new normal.
I’m Alive
What Now?
Leap_Spring14_p24-27.indd 25 2/21/14 1:55:03 PM
myl eapmagazi ne. ca 26 spring 2014
and be heard, and to engage and be an active participant in his or her own life.
“We aim to normalize the experiences cancer survivors have – the depression
and anxiety – dealing with that guilt, fear and uncertainty about the future,” Lang
says. “At presentations, we allow space for the negative, but enhance the good stuf.
It’s empowering and inspiring for people to know they’re connected to a bigger
community – not alone – the
seminar is really an inter-
vention in itself.”
Nikki Battle calls Mike
Lang her cancer hero (along
with Terry Fox), as both
were fghters who became
part of her life and motivation about two-and-a-half years ago, when she was di-
agnosed with stage four metastatic breast cancer that had already spread to her
liver, lungs, bones and lymph nodes. Living with cancer, Battle had the same ques-
tions and concerns as most patients: How long will I live? How do I deal with others
who expect me to stay positive when I don’t feel like it? Am I now supposed to live
some sort of superhero life, making every moment count? How about handling the
return to work?
“When I was frst diagnosed, everyone cared. But when I didn’t die, some
workmates started feeling uncomfortable, as if asking ‘Are you still here?’ ” Battle
says. “CancerBridges is so important – the videos, the presentations, the tears and
“CancerBridges started by laying a research
foundation for program development, and the
program arm has become a hub of activity for
survivorship – a way of living with and beyond cancer,
and all the issues that come with it,” says Lang, himself
a fve-year survivor of Hodgkin’s
Lymphoma. “We’re all about
how to make the rest of your
life, the best of your life.”
Lang walks the talk – using
the years since his treatment to
work with young adult cancer
survivors and creating flms including Wrong Way to
Hope: An Inspiring Story of Young Adults and Cancer, Ebb
& Flow: Storytelling for Cancer Survivors, and Valleys.
The same is true for the Survive & Thrive Expeditions,
adventure trips Lang and his wife, Bonnie, co-ordinate
for cancer survivors and caregivers to refect, refocus
and rebuild their lives in a way that is meaningful to
them. Through the trips, flms and with his work as
survivorship program co-ordinator for CancerBridges,
Lang is tapping into the cancer survivor’s need to share
THE CANCER journey
“When I was frst diagnosed,” says survivor
Nikki Battle, “everyone cared. But when I
didn’t die, some workmates started feeling
uncomfortable, as if asking ‘Are you still here?’ ”
A TEAM: Mike Lang and Janine Giese-Davis
are helping cancer survivors how to make the
rest of their lives, the best of their lives.
Leap_Spring14_p24-27.indd 26 2/21/14 3:39:35 PM
the morbid humour – it’s patients helping other
patients who are going through the same things
that is so critical. I leave these sessions feeling
some hope.”
Battle says Lang’s Myths of Survivorship
videos were of particular help as she dealt with
the sense that she must have done something
wrong to get cancer – a common, blame-the-
victim assumption.
“People don’t do that
with any other illness – just
cancer. Or they ask, ‘How
long do you have?’ They
think you’re either cured
or you die; nothing in between. Since I entered
Cancer land, I feel I’m a cancer mascot – my job
is to educate others. I should write a book on
‘things not to say to people’,” Battle says.
The CancerBridges patient-centred website
and half-day seminars have benefitted more
than 1,500 survivors and families to date,
addressing the issues that matter to them –
coping with depression and “brain fog,” diet
and exercise, handling the return to work, and
maintaining healthy relationships.
While essential grassroots work has been
done for cancer survivorship in Alberta, the
challenge now becomes how to integrate patient education and outreach into
the cancer care delivery system. To that end, AHS (through Cancer Control), has
struck a provincial steering committee to identify current supports and services
that exist for survivors, and then create a framework – a priority action list – of how
to make tangible changes to the system.
“The aim is to build upon what CancerBridges has created, and find ways for all
areas of the health care system to communicate with each other, whether someone
is in treatment or just finished, or living well beyond cancer,” says Linda Watson,
leader of Interdisciplinary Practice
with Cancer Control Alberta. “If I’m
a patient in Peace River, for example,
I want the same access and support as
someone in Lethbridge.”
The steering committee includes
members from Cancer Control, CancerBridges and Wellspring Calgary, as well
as representatives from pediatric oncology survivor programs at the Stollery and
Alberta Children’s Hospitals. Members also come from the Cross Cancer Institute
and the Tom Baker Cancer Centre, plus those in primary care, medical oncology
and chronic disease management. Patients and families are part of the team, too.
“We’ve never collaborated across systems this way,” Watson says. “We don’t
know what needs survivors may have over time – physical or psychological – but we
have to build the system so it’s there when they do need it.”
Some 17 sites are flagged to deliver services to cancer patients from across
Alberta under the Cancer Control division of AHS, primarily the Cross Cancer
Institute and Tom Baker Cancer Centre, but also associate sites in Grande Prairie,
Medicine Hat and Lethbridge, and more than 10 smaller centres in local hospitals
around the province.
People are living longer – treatment is
effective. Now the cancer care world
has to move along the same path.

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Leap_Spring14_p24-27.indd 27 2/20/14 8:45:18 AM
A new breast surgery that
kills cancer cells from
within, with little impact to
surrounding tissue, is now
being ofered at the Tom
Baker Cancer Centre
Seeds of
By Lindsay HoLden
myl eapmagazi ne. ca 28 spring 2014
Leap_Spring14_p28-29.indd 28 2/20/14 8:46:46 AM
Seeds of
ews that cancerous cells have
been found in your breast can,
on its own, be difcult enough
for patients to bear. Add to that weeks
of draining and relentless, but life-
saving radiation therapy likely to follow
surgery, and it can be overwhelming.
But an innovative and efective new option called
breast brachytherapy now available at the Tom Baker
Cancer Centre in Calgary reduces radiation treatment
from up to seven weeks to a one-day followup surgery,
and promises to improve patient comfort with minimal
impact on their life.
Last summer, Calgarian Doreen Thomson under-
went a routine mammogram, which revealed abnor-
malities in her left breast. When a biopsy showed
something grim – carcino-
ma in her milk ducts – the
news blindsided the 59-
year-old and her family.
“It was tough on my
husband and kids,” says
Thomson, who had at-
tended the followup ap-
pointment solo to receive the outcome of the biopsy.
A self-described upbeat, high-energy lady, she breezed
into the clinic assuming medical staf would share rou-
tine and normal results.
But Thomson found herself emotionally broken
upon hearing the news and comprehending the next
steps. Although detected early, and among the most
treatable, surgery was urgent given that her cancer was
known to be a fast-spreading type if not contained. “If
it escaped out of the box, it would go like wildfre,” says
Thomson’s husband was on a business trip, and her
panicky phone call caused him to backtrack from Sas-
katoon down the highway without delay to comfort her.
“My daughter was hysterical. My husband dropped ev-
erything to come screaming back here,” says Thomson,
a mother of two adult children and celebrating 40 years
of marriage this year.
In less than a month after the diagnosis, Thomson
received a lumpectomy to remove the tumour, and she
steadied herself for followup radiation treatment that
would span up to seven weeks, and potentially leave her
with a host of side-efects.
“My doctor – who doesn’t mince words – told me to
brace for hell,” recalls Thomson. A fnance manager at
a Calgary dealership, she planned to arrange with her
employer to take time of for dozens of appointments.
But she was spared the ordeal when oncologists of-
fered Thomson a chance to take part in an innovative
surgery that was possible thanks to a group of committed
Alberta Cancer Foundation donors that rallied together to raise $252,000 in funds to
purchase the equipment.
Called breast brachytherapy, the treatment increases the quality of life for breast
cancer patients, with a single procedure that involves permanently inserting a set of
radioactive seeds into the void where lumps are removed via needles.
“The procedure will leave a needle mark like when you get blood taken, but heals
up quite nicely,” explains Rosie Moore, a radiation therapist for 31 years at the Tom
Baker Cancer Centre in Calgary.
Radiation oncologist Dr. Siraj Husain says breast brachytherapy ofers many pa-
tient benefts. “By not using radiation beams, skin reaction may be reduced, as will
the impact of radiation using other organs, including the lungs and heart,” says Hu-
sain. “The chance of the breast shrinking or changing shape is also diminished. It also
means patients can avoid daily trips to the hospital over the course of many weeks
for traditional radiation treatment.”
Made from the chemical element palladium, the seeds kill cancer cells from
within, with minimal impact to surrounding tissues. They remain in the breast but
lose radioactivity after about six weeks.
Traditional radiation treatment that follows a lumpectomy procedure would normally
see patients like Thomson receive a blast from an external
radiation beam fve days a week for nearly two months.
Thomson knew treatment would be necessary for sur-
vival, although a disruption to her life. But she was fright-
ened by the fact that scatter radiation from beam therapy
could cause burns to the entire surface of the breast, plus
adversely impact nearby organs such as the lungs and heart.
“After reading up on it, it kind of scared me. With the
scatter radiation you can be looking at hardening of the breast, a lot of shrinkage and
huge discoloration. Some people develop coughs,” she says.
Instead, she became Alberta’s frst breast brachytherapy patient last November.
“I had 22 needles, and 93 of those seeds put in on a Tuesday. I took of the rest of
the week and went back to work the following Monday,” says Thomson. Medical staf
juggled schedules to immediately begin honing their skills with the newly installed-
equipment to prepare for Thomson’s surgery. A similar method has been in practice
to treat prostate cancer.
Oncologists at the Tom Baker Cancer Centre will perform this innovative breast
cancer treatment on 20 low-risk patients as part of a study, says Moore. “The study
has been in place since eight years ago in Toronto, so we have a track record of what
is going on as a result. They have seen the same cure rates as external beam therapy
treating the whole breast,” she explains.
“It is efective, and with the installation of the new equipment, it could be a stan-
dard of care over time,” she says.
The procedure was pioneered at Sunnybrook Health Sciences Centre in Toronto
where the world’s frst permanent breast seed implant was performed in 2004. Only
patients with tumours smaller than three centimetres and who are considered low-
risk qualify for the procedure, and those who receive the treatment sign a consent
form to join the study.
“I am a little bit raw but for the most part I felt OK,” says Thomson, adding
within 10 days of the treatment she went with her husband on an 11-day road trip to
Yuma, Arizona.
Six months after the surgery, Thomson is expecting doctors to confrm she is free
from cancer, but in the interim, she has seen mild irritation from the active radioac-
tive seeds, as they begin to surface from the inside out.
For Thomson, the continuous followup prescribed over three years throughout
the study means she gets welcome attention to her wellness and an opportunity to
add to the treatment options and knowledge for other Canadians. “Compared to the
alternative, it’s a no-brainer,” says Thomson.
Al berta Cancer Foundati on spring 2014 29
“I had 22 needles, and 93 of those
seeds put in on a Tuesday. I took of the
rest of the week and went back to work
the following Monday.”
Leap_Spring14_p28-29.indd 29 2/20/14 2:07:38 PM
Delivering bad news is a skill
oncologists learn early. They
have mastered communicating
with cancer patients openly
and with respect
By Lindsay HoLden
myl eapmagazi ne. ca 30 spring 2014
he television dramedy House, won awards and had
viewers in the millions worldwide laughing at the folly of
its fctional main character, Dr. Gregory House, a medi-
cal genius known for his arrogant disdain for his patients’
emotional life. The show ran for eight years until 2012, with the central
character unwavering blunt in his disinterest of his patients’ feelings.
But in real life, such failure in bedside manner is no laughing matter,
especially when it comes to delivering bad news. Fortunately, for doctors
and patients alike, sensitivity can be learned and there are experts tasked
with training medical professionals in bedside manner.
“Part of what we learn is that some people are better communicators
than others, but all of us can improve. It is a skill that’s no diferent than
starting an IV – it is something that is on continuous improvement,” says
Diane Severin, associate clinical professor and acting director of oncol-
ogy at Edmonton’s Cross Cancer Institute. “Even if you are good, you can
always be better.”
Leap_Spring14_p30-31.indd 30 2/20/14 8:50:56 AM
Al berta Cancer Foundati on spring 2014 31
Through Severin’s career, she has trained to facilitate courses that help doctors learn
the steps and subtleties of communicating – ofered through the Institute for Health-
care Communication (IHC). The inclusion of courses on bedside manner for young
medical interns is seeing a heavier emphasis. It was once a commonly-held belief that
communication skills could not be taught: they were natural talents – inborn attributes
of the “good doctor” – and a young doctor was either endowed with them or not.
On the fipside, some new doctors who are naturally caring individuals feel inse-
cure about exploring both their own and their patients’ emotions because they are
concerned it could cloud their objectivity in critical situations. Severin says that even
veteran medical professionals can unknowingly use language about a patient’s disease
as though it is separate from the person.
“The important factor and premise of all communications courses is learning to
respect every person as an individual. They are not just a rectal cancer to be treated,
they are Julie Smith, and we teach techniques to show we’re thinking about how it is
afecting them,” Severin explains. “You might say the
right words, but if you are not seeing them as a person,
you are not travelling with them on that journey, they are
going to know.”
She points out that poor bedside manner does not just
lead to patients feeling hurt, but bad communication can
also create angst for families coping on limited resources,
or lead them to make treatment decisions based on poorly understood information.
For doctors, poor communication could lead to allegations of malpractice, and other-
wise good physicians can burn out.
In fact, in a 2007 Journal of the American Medical Association study, researchers at
McGill University in Montreal found the scores on a communication assessment in
medical school could predict a new doctor’s future patient complaints. Those who
were perceived as condescending or fippant had the highest number of patient com-
plaints about 10 years later.
Dr. Peter Venner, a doctor at the Cross Cancer Institute in Edmonton is not sur-
prised. “Sometimes when we fnd out patients are unhappy with their care, primarily it
is communication,” says Venner, who mentors younger doctors, and is praised among
patients and peers as having an especially kind approach in delivering grave facts.
“It is a tremendous responsibility and change in a young doctor’s life. They fnish
their life in training as residents, and the next day they’re responsible. Suddenly the
rubber is hitting the road and they are the ones responsible for having those discus-
sions. Hopefully we have taught them how to do that,” Venner says.
Communications courses sometimes include actors portraying patients in a
variety of scenarios and students participating in a role play, Severin says. The young
recruits learn from one another when they watch the recorded role play and receive
feedback – both good and bad. “Medical schools are doing a much better job teaching
communication these days,” she says.
Severin and Venner say a good doctor will take whatever time is necessary to ensure
an unhurried atmosphere for a patient appointment that’s going to include news of a
terminal diagnosis. Both have heard tales of doctors blundering through the exchange
with subtle actions like checking their watch, and standing over the patient or near the
door to send a signal that they are not ready to invest anything more into the patient.
If anything, a compassionate discussion is everything that the doctor can ofer,
says Venner. “When treatment stops working or doesn’t work at all, we have to tell
them their life will be shortened because of cancer,” he says. “Patients and their fam-
ily are very much involved in all the decision-making and must be in a position of
knowledge. They have to know in terms that they can understand what the situation is
and each step likely to follow.” Regardless of a patient’s religious beliefs, says Venner,
“peace” is a term that seems to be universally used to describe the moment when they
grasp the truth.
Venner emulates the bedside manner techniques pioneered by Dr. Robert Buckman,
a British-Canadian expert on doctor-patient communication. He was an oncologist at
Princess Margaret Hospital in Toronto until his death in 2011, and was a key infuence
behind medical schools’ curricula including courses on bedside manner.
Buckman authored 14 books, and was a popular keynote speaker at medical conferences
because of his ability to add humour to dry subject
matter. He produced more than 45 humour-driven med-
ical information videos with comedy actor John Cleese,
whom he frst met while performing comedy at Cam-
bridge University.
While patients will often resort to humour as a natu-
ral defense to break tension when hearing bad news, the
doctor shouldn’t initiate a light approach, says Venner.
However, he has often followed suit and shared a laugh
with patients and their family who have heard dark news
moments before, but cope by casting a one-liner to ease
the sombre mood.
Venner is careful to adopt an appropriate tone. He will
ask the patient how much detail they want in terms of
estimated life expectancy,
and expresses time left in
terms of the potential for
future events, such birth-
days or holidays on the
horizon. He also avoids
interrupting a patient, and
makes eye contact, while sitting on the same level. If
family members or friends are present, he addresses ev-
eryone, but primarily focusses on the patient.
Sometimes patients have become angry at hearing bad
news, and the doctor – as the messenger – will become the
target for hostility. But these are not among the worst-
case scenarios for doctors, say Venner and Severin.
Radical denial is the most challenging scenario, espe-
cially when the patient refuses traditional care that could
prolong life. Sometimes they refuse to deal with or dis-
cuss the prognosis because alternative practitioners have
advised positive thoughts will heal them, and negative
thoughts will cause cancer to become worse. Sometimes
patients can feel extraordinarily guilty and responsible
for causing their own disease, says Severin. Meanwhile,
family members can indefnitely delay dealing with the
loss of a loved one if they are forbidden to speak about it
while the patient is still alive, she adds.
In one instance in Venner’s experience, family mem-
bers of a terminally ill patient for whom English was a
second language attempted to shield their loved one
from the truth, and used misleading translations so the
individual thought his cancer was manageable. But their
eforts inadvertently thwarted his chance to make a fnal
visit to Asia to visit family.
Doctors may not meet everyone’s expectations, but
the skill and efort invested in their caring words have the
power to make an indelible impression on patients, their
families, and their friends. Executed badly, patients may
never forgive a doctor. Done well, they may never forget it.
During a Christmas shopping trip to the mall, Venner
was waiting in his parked car when he was startled by
a knock at his window. Venner assumed it was another
driver investigating the potential of snagging his spot.
Instead, it was a female family member of a patient who
had died years ago. Recognizing Venner, she approached
him to thank him for his kindness during the most dif-
fcult time of her life. “I was thankful I was able to make
that diference,” he says.
A good doctor will take whatever time
is necessary for a patient appointment
that’s going to include bad news.
Leap_Spring14_p30-31.indd 31 2/20/14 8:50:31 AM
myl eapmagazi ne. ca 32 spring 2014
SLEEP DOCTOR: Neuroanesthesiologist Melinda
Davis prides herself on the connections she makes with
patients pre-surgery.
myl eapmagazi ne. ca
Top Job
Leap_Spring14_p32-34.indd 32 2/20/14 8:51:57 AM
Al ber ta Cancer Foundati on spring 2014 33
By Michelle lindstroM / Photo By Brian Buchsdruecker
Dr. Melinda Davis holds a crucial role in the OR,
yet most patients forget she was even there
ost medical professionals are recognized for
their hard work, but there are exceptions to
the rule, especially when talking about neuro-
“Nobody really knows much about anesthesia in the real world,”
says Dr. Melinda Davis, a neuroanesthesiologist at the Foothills
Hospital in Calgary. “If we’re good at our jobs, nobody remembers
we were there.”
Davis took her frst year of medicine at the University of Newcastle,
in Australia, right out of high school at 17. She completed her medical
degree, a few internships and anesthesiology training before applying
for a fellowship in Calgary in 2004.
It was 10 years ago that Davis, 40, started at the Foothills Hospital
in a neurosurgery fellowship position led by Dr. David P. Archer – a
mentor of Davis’s who recently retired from practice at the hospital.
She said it was Archer – “a very smart man with a high profle in neuro-
anesthesiology” – and the Rocky Mountains that inspired her to travel
more than 13,000 kilometres for neuro-specifc anesthesiology train-
ing and research. Archer, and the Rockies, became key factors in why
Davis didn’t return home as planned when her year-long fellowship
“One of the reasons I chose anesthesiology was that I remembered
having my wisdom teeth out when I was 18,” Davis says. “I felt like I
was in a production line, like I was being treated by robots. Nobody
made a personal connection.”
Today, she makes a point of standing where patients can see her as
she administers drugs to put them to sleep for the surgery. “I appreci-
ate that they’re terrifed,” she says.
The low profle of anesthesiologists makes their job slightly
mysterious. It’s true they set up your IV, administer drugs to put you
to sleep and help you count backwards until you drift away for hours
in surgery. But the not-so-common duties of an anesthesiologist in-
clude taking a patient’s thorough medical history before surgery.
“It’s to make sure that they’re ready and there’s nothing that would
prevent them from safely going through the operative process,” Davis
says. For more elective surgeries, a patient’s history can be reviewed
weeks beforehand so further tests can be done, if required, and
adjustments made to medications, if needed. For cancer surgeries, or
non-elective surgeries, a shorter time frame is available to optimize
the patient’s overall health beforehand so Davis’s frst patient meet-
ing may then be the morning of a surgery.
Davis meets the patient in the preoperative area around 7:30 a.m.
to review medical history, explain what to expect before, during and
after surgery, before the patient is led into the operating room. She
hooks him or her up to various machines, including an EKG and blood
pressure monitor, before starting an IV. A “surgical time out” takes
place for the surgeon to summarize the case and ofer the patient and
medical team a chance to point out any concerns before the patient
is asleep and surgery begins. Once the patient is asleep, Davis puts a
breathing tube in and connects the patient to a ventilator. “Everything
we do in anesthesia afects the patient,” she says.
This means Davis remains in the operating room for the whole
procedure, monitoring carbon dioxide levels, for example, making
small adjustments to the IV and keeping a dialogue going with the
surgeon to alert him or her of any evident stress the patient may be
Dr. Yves Starreveld, a neurosurgeon at the Foothills, has worked
with Davis since he started there in 2006. “The problem with
Leap_Spring14_p32-34.indd 33 2/20/14 8:53:08 AM
Top Job
myl eapmagazi ne. ca 34 spring 2014
Mapping involves a patient
talking while the surgeon
electrically stimulates the
brain in search of “eloquent
areas” that afect things
such as speech.
neurosurgery is that the patient needs to wake up quickly
afterwards because you want to know if you’ve done some
damage to them,” he says, noting that Davis is able to do
this efectively and efciently.
Starreveld says Davis’s combination of “real com-
petence” to address any surgical issue, such as an air-
way blockage, and willingness to happily chat with an
awake craniotomy patient for hours, makes his job
easier. He’s able to focus on the surgery. “She manages
everything from airway to circulation, heart rate, to
blood pressure – fully keeping the patient alive when
I’m doing what I’m doing.”
Brain surgery on an awake patient still amazes Davis.
“We make them kind of sleepy to get them into position
and to get the skull open, then we let them fully wake up
while the surgeons map out the areas they don’t want to
resect,” she says.
Mapping involves a patient talking while the surgeon
electrically stimulates the brain in search of “eloquent
areas” that afect things such as speech. These areas
difer in patients due to their level of education and
number of languages spoken. When the areas are located,
a tumour can be safely removed without afecting speech
or motor areas in the brain.
After an hour or so of doing basic math out loud,
many people would go batty, so Davis semi-interviews
patients to get them talking about more interesting
things for however long it takes to map their brains.
“I feel like I should write a book: Awake Craniotomy
Patients I’ve Known,” she says.
The awake surgeries are the most exhausting and the
most rewarding for her. “Of all the cases I do in my an-
esthetic career, those are the patients I have the most
connection to because I’ve learned about the car they
just bought, where they go hiking and what their mother
does for a living.”
Davis admits life can get hectic as she wears a few hats
at the Foothills: three days a week she does clinical anes-
thesia, which includes neurosurgeries, general surgeries
or facilitator work as the anesthesia director of the Pre-
Admission Clinic. For the other two days of her full-time
schedule, she teaches at the University of Calgary Medi-
cal School (which is located in the Foothills Hospital) as
a master teacher.
The Master Teacher Program was an initiative set
in 2007 by the University of Calgary’s Ofce of Under-
graduate Medical Education. It addresses Alberta’s
rapidly increasing population
and physician shortage by al-
lowing clinician educators with
proven teaching track records
to teach within the undergradu-
ate curriculum.
It’s unrelated to neurosur-
gery, but in 2012, Davis decided
to take the year-long Master
Teacher training, prompted by
a colleague’s suggestion.
“I chose to do it because I felt that I had some skills
in seeing the forest for the trees and I think that is what
medical students need,” she says. “They are bombarded
with an incredible volume of new information and it can be overwhelming.”
She feels her strength is similar to most anesthesiologists’: having a knack to identify
the most important information thrown at them, locking that away and piecing new in-
formation together with previous learnings.
Davis can teach everything from endocrinology to cardiology in classrooms with
small groups or with simulator exercises. “It has been hugely rewarding,” she says. “I
suspect I have learned more than my students.”
But the many hats and surgeries can mean unpredictable
days – usually from 7:30 a.m. to 3:30 p.m. “If you embark upon
a case that unexpectedly takes longer than planned, which is
the nature of this job, you can’t just leave,” she says. An aver-
age craniotomy takes six to eight hours, but some go for 12.
When work needs more of her time, she’s thankful that her
four-year-old daughter’s nanny has the fexibility to start early
or stay late.
And, “thank God for hobbies,” Davis says. Having the moun-
tains only an hour away is a treat this avid runner takes advantage of as often as possible.
In fact, she’s currently training for Wyoming’s 50-kilometre ultra marathon in May. The
mountains are a pleasant reminder of what led Davis here – and kept her here unexpect-
edly – for the past decade.
myl eapmagazi ne. ca
MASTER TEACHER: Melinda Davis divides her
time between the OR and the classroom.
Leap_Spring14_p32-34.indd 34 2/20/14 8:54:06 AM
Two-time cancer survivor draws
her strength from family, horses
and giving back
By Cory SChaChtel
riding HigH
Al ber ta Cancer Foundati on spring 2014 35
ithin hours of meeting Wes, Jodi
knew he was her soulmate. Their frst
date was a blind one, at a drive-in movie
theatre with the couple who introduced
them. After their second, Jodi told her mom she’d one
day be Mrs. Mantey. They had two children, Trevor,
then Crystal. They had a home and careers.
Then, in 1996, with Trevor still in Grade 4, the Man-
teys’ world changed. “We were out camping with family
friends that June,” Jodi says. “We went for a walk and I
felt something rubbing against my left arm. The follow-
ing Monday I did a breast exam and found a lump. As a
young mother of two kids, I was terrifed.”
stories of giving
Why I Donate

Leap_Spring14_p35-37.indd 35 2/20/14 8:55:06 AM
“You’d think, because it’s cancer,
going to the Cross would be sad, but
it’s not. You laugh and make friends.”
myl eapmagazi ne. ca 36 spring 2014
With a biopsy scheduled for August, Jodi spent the summer waiting. She continued
her 18-year career with Telus and did her best to keep it together as a wife and mother,
while the Big C hung in the back of her mind. By August, the surgeon was optimistic.
When he removed her stitches, Jodi asked if she should bring Wes to hear the results,
and the doctor said no. Jodi was alone when she got the diagnosis: malignant.
“The frst person I told was my mother-
in-law because I wanted her to take the
kids so I could talk with my husband. We
had decisions to make,” she says.
A mastectomy and six months of che-
motherapy followed – a scary scenario
made more difcult by having to explain
to her children why their mother is sick, and going to get sicker, in order to get well.
“We got so much help from the Cross Cancer Institute, even outside of the actual treat-
ment,” Jodi says. “Before we broke it to our kids, we talked to people at the Cross, and
they gave us a book talking about how chemotherapy is like soldiers in a body, fghting
of bad guys. We used that analogy to help them understand.”
Two years after her diagnosis, Jodi and Wes sold their house and bought a farm on
Long Lake, a retirement dream they’d had since they married. “We went from a 1,900-
square-foot home in Edmonton to a 700-square-foot farm house in the bush,” Jodi says.
Telus gave her a severance package, and Wes found local contracting jobs – a drastic
change, but the right decision, she recalls. “At frst it was tough giving up the money, but
stories of giving
why I donate /
it was worth it to come home, sit on the deck, look out at
the lake and enjoy our family. We bought a couple two-
seater quads, and that became our passion. Every Sunday
morning, we’d jump on and go, for eight hours from our
backyard, without even going on someone’s private land.
We just enjoyed life together.”
In 2010, Jodi started having
stomach problems and had her
gall bladder removed. The issues
didn’t go away, however, and just
after Christmas, Jodi found out
she had stage four pancreatic can-
cer, unrelated to the breast cancer. It took time to fnd a
surgeon capable of the extremely risky procedure that
removed her pancreas, spleen, two-thirds of her stom-
ach and part of her bowel. After more chemo in Hinton,
Jodi had another CT scan at the Cross Cancer Institute.
What originally looked like scar tissue ended up being
her worst fear: the cancer had spread.
There were a few options. Jodi could opt for
treatment that would improve her quality of life
but would not extend it. Or, she could undergo an
Leap_Spring14_p35-37.indd 36 2/20/14 8:56:13 AM
Thirty per cent of the money goes to the Hinton Cancer Centre; the rest helps fund
special projects at the Cross Cancer Institute, including the revolutionary Linac-MR
machine. For Jodi, it’s the perfect way to appreciate nature and give back to the Insti-
tute. “Everyone at the Cross – the doctors, the nurses, the lab techs – is so warm. You’d
think, because it’s cancer, going to the Cross would be sad, but it’s not. You laugh and
make friends,” Jodi says. “And throughout all of my chemo, a week did not go by that I
was not on the back of that quad with my husband. Even when I was really sick, and I
could only go for a short trip up the trails, I would wrap my arms around him and ride.
You fnd things to pull strength from and make you feel at peace.”
Al ber ta Cancer Foundati on spring 2014 37
aggressive chemotherapy, that would make her sick.
“We had a week-long trip planned to Mexico, and the
doctor said I should go because it would probably be my
last vacation,” Jodi says. “We decided to take a month
and go away together, to make more decisions. It was
wonderful – we walked beaches, talked about our life
together and decided we would fght it with the most ag-
gressive chemo they had.”
At the time, Jodi didn’t want to know how long the
doctor expected her to live, so she left the room when he
told Wes she’d be lucky to see another Christmas. Three
Christmases later, Jodi is living three months at a time,
checking regularly for the cancer that, for now, is dor-
mant. But she’s not. In 2012, she helped organize the frst
annual Shining Bank Trail Ride for the Cure, a two-day
trail ride between Edson and Whitecourt and beneftting
the Alberta Cancer Foundation. “People bring their own
horses, and teamsters bring wagons to carry passengers.
We ride during the day and have a barbecue on the Satur-
day night, which a lot of locals come out for,” Jodi says. “In
2013, we tripled the participation and doubled the money
– just over $12,000 from 35 participants.”
SECOND CHANCE: After two bouts with cancer
Jodi Mantey lives life to the fullest. From left: Jodi
poses with her granddaughter, Kallie, at the 2013
Walk for the Cure in Edson; pits her muscle against
her son, Trevor, in an arm wrestle; and takes a
break from a quad ride with her daughter Krystal
and Krystal’s fance, Jason.
Leap_Spring14_p35-37.indd 37 2/20/14 8:56:30 AM
Chocolate is far more than a
guilty pleasure. Experts extol
the health benefits the dark
decadence offers the body
and mind and where the best
wares are found
By Nadia Moharib
“All you need is love.
But a little chocolate now
and then doesn’t hurt.”
– Charles M. sChulz
myl eapmagazi ne. ca 38 spring 2014
Leap_Spring14_p38-39.indd 38 2/20/14 8:57:48 AM
“All you need is love.
But a little chocolate now
and then doesn’t hurt.”
– Charles M. sChulz
Al berta Cancer Foundati on spring 2014 39
t is a sweet indulgence once reserved for royalty, a melt-in-your-mouth
treat many crave and some deem downright addictive. And if chocolate isn’t good
enough just being chocolate, there is increasing evidence the decadent culinary
creation seducing sweet-teeth everywhere ofers ample health benefts.
“I eat chocolate every single day,” chocolatier Brett Roy says from his Edmonton-
based Sweet Lollapalooza boutique. And with good reason.
Citing research, including some from Johns Hopkins University which credits choc-
olate with lowering blood pressure, boosting memory and possibly guarding against
brain injury after a stroke, he says it’s more than an extravagant pampering of the pal-
ate. “If you have 30 grams of chocolate on a daily basis, you can prolong your life by
fve years,” Roy claims. “Even though it’s good for you, moderation is the key – it’s still
high in calories. But a little bit goes a long way.”
Even snails, sluggish as they might be, are up to speed on some benefts of indulg-
ing. Hotchkiss Brain Institute researchers in Calgary found favonoid, a type of plant
antioxidant found in chocolate, substantially increased memory retention in snails.
Researchers put Lymnaea stagnalis, which breathes through its skin or via a breath-
ing tube, in oxygen-deprived water. The creatures were forced to use their breathing
tubes but each time one opened, a researcher would poke at it. Within about a half-
hour, to avoid an annoying tap on their tubes, the snails learned to keep them shut – a
memory held for two to three hours, researcher Ken Lukowiak says of fndings made
by then-student Lee Fruson. By adding favonoid to the water, training stuck for up to
48 hours, he says, lending credence to the belief that active ingredients in chocolate
likely act directly upon neurons in the brain.
It’s just one of many studies showing chocolate does the body good.
An Australian study found an individual investing $50 a year on chocolate would
save $50,000 in costs to treat cardiovascular problems. Findings in Finland showed
women who ate it while pregnant had babies who were happier and more active. And
research examining the Kuna Indians of Panama showed benefts derived from a daily
diet which included drinking favonol-rich cocoa included low heart disease rates.
“They looked at the same tribe living elsewhere but without chocolate in the regular
diet and found that wasn’t the case,” Lukowiak says.
Although it is not known exactly how active ingredients in chocolate beneft the
body, it is believed favonols – also found in green tea and red wine – help make new
blood vessels. “I joke that if you drank green tea in the
morning, had a little chocolate in the afternoon and
drank red wine in the evening, you are actually in pretty
good shape,” Lukowiak says. “It wouldn’t do most peo-
ple any harm, that’s for sure.”
Calgary naturopathic doctor Meaghan McCollum
prescribes dark chocolate to patients with blood sugar
fuctuation issues. Acknowledging its health benefts,
she also raves about its magic as a mood-enhancing
food – the sense of spoiling oneself tantalizing even before taste buds are exposed to a
sweet treat. “Chocolate makes everybody happy,” says McCollum, a woman apt to take
her own medicine. “I love the indulgence of it and buy ridiculously expensive bars.”
Brad Churchill also extols the many virtues of chocolate, but he isn’t convinced it’s
anything more than a decadent delight. “I can tell you defnitively, it’s not what all the
dietitians and health nuts are preaching about,” says Churchill, who owns Calgary’s
Choklat, where scrumptious creations are made in-house from scratch.
“Even dark chocolate is at least 35 to 40 per cent fat and 30 per cent sugar – how can
you, as an intelligent human being, say something that is 70 per cent fat and sugar is
healthy? The health pundits say it’s ‘good fat,’ but the reality is fat is fat – it’s going to
make you fat. You can have too much of a good thing. Take a block of cocoa butter and
starting eating it – it may not clog your arteries but it will clog your jeans.”
That said, Churchill – who purports to be the only chocolate maker (that’s from
bean to belly) in Alberta – won’t deny good chocolate is a delight. While his patrons
may be lured by his creations, from chocolate drinks to dark chocolate and made-
while-you-wait trufes, getting his recipe right was quite the grind. Several years
and many batches of bad chocolate later, he fnally forged the four ingredients –
cocoa beans, cocoa butter (fat from the beans), sugar
and Madagascan bourbon vanilla – into perfection.
Cocoa beans are picked from fruit trees in Brazil, Ven-
ezuela and Mexico and fermented and dried in the sun be-
fore arriving at Choklat, where they are roasted, crushed
and then, 50 pounds at a
time, put into refners to be
ground for two to four days.
No preservatives or artif-
cial ingredients are added,
but patrons can choose
from more than 200 fresh
favours, including pep-
permint plucked from an
on-site “grow-op,” to add to tailor-made trufes sold at a
premium people are more than willing to pay.
“It’s comfort food. It has a relaxing efect,” Churchill
says. “I get it from my mom’s lasagna; some get it from
mac and cheese.”
And those who fgure they are hooked on chocolate –
which at one time was included in U.S. soldiers’ rations
in lieu of wages, might be right.
“Certainly, it has addictive properties, given that
chocolate alters properties in areas of the brain associ-
ated with addiction, the same way alcohol can, the same
way running can,” Lukowiak says. “That is why they are
addictive; we get pleasure out of them. Mother Nature
is pretty good at designing the brain to say, ‘You should
do this.’ ”
Connoisseurs warn that not all chocolate is created
equal and that the best contains 70 to 80 per cent cocoa.
“I joke that if you drank green tea in
the morning, had a little chocolate
in the afternoon and drank red wine
in the evening, you are actually in
pretty good shape.”
Leap_Spring14_p38-39.indd 39 2/20/14 8:59:43 AM
myl eapmagazi ne. ca 40 spring 2014
An Alberta company’s generosity is fuelling
breast cancer screening in rural communities
Boost for Early
Parkland Fuel Corp. is a company whose roots are
frmly planted in rural Alberta. So its move to get involved
with the Alberta Cancer Foundation, donating fuel to
Screen Test, a program that brings remote screening to
women who might not otherwise get a mammogram,
just made sense.
“We started in small towns; our strength is in small
towns rather than the urban centres, so we looked at
the opportunities to give back and do charitable work in
rural communities,” says Peter Kilty, vice-president of
Retail Services for Parkland Fuel Corp., parent company
to Fas Gas. “This just seems like a perfect match to who
we are and what we value and stand for, and it was an
opportunity to help folks that are our customers.”
With its donation of $100,000 worth of diesel and
gasoline since 2011, Parkland has helped power two trailers
pulled by a semi-truck, housing digital mammography
equipment. In addition, the company has provided gas for
vehicles of staf manning the Screen Test.
“To women that don’t have access to a centre that
actually provides a mammography clinic, this ensures
that they have access to the same type and calibre of
service,” says Alberta Health Services’ Joan Hauber,
manager of Screen Test. “We know that with anything
like screening, it’s often done for well women. Women
who have screening have no issues with their breasts;
they just go in for just a regular test, like a dental checkup.
We know that sometimes, particularly in some of the
By Shelley WilliamSon
RURAL REACH: The mobile mammography
units cover 13,000 kilometres each year.
working for a cause
corporate Giving

Leap_Spring14_p40-41.indd 40 2/20/14 1:37:41 PM
Al berta Cancer Foundati on spring 2014 41
communities that are quite far from mammography
centres, it’s hard for people to fnd the time, or if they’re
not feeling unwell, they just put it of.”
As part of Screen Test, two 53-foot trailers have been
on the road 48 weeks a year for the past three years,
travelling to rural municipalities all over Alberta. The
trailer units cover serious ground, too; Haber estimates
that each averages 13,000 kilometres annually. “We do it
all winter. And it’s even more important in winter that we
keep our trailer running because if the power goes out,
our equipment on board is really sensitive to cold, so we
have to be really cautious,” Hauber explains. “We don’t
want to only go part of the year because we wouldn’t have
enough time to see all the clients.”
AHS employees who work on the initiative also
log their share of mileage – technologist teams travel
between their home base (either Calgary or Edmonton)
and the mobile communities they service.
The two south teams travel about 20,000 to 21,000
kilometres and the two north teams, about 30,000 to
31,000 kilometres annually. Communities served by the
mobile Screen Test have included municipalities as far-
fung as Cardston, Milk River, Grand Cache, Provost and
High Level, and many in between. Tens of thousands of
women have had access to mammograms as a result.
Though it was initially a three-year partnership
between Alberta Health Services and Parkland, “Our
intention would be to continue,” says Kilty of his
company’s participation in the life-saving initiative.
Hauber says the fuel that Fas Gas has donated is vital
to keeping Screen Test running. “We do a lot of travelling
and this enables us to provide these services so women
will get the mammograms done,” Hauber says. “With
their donations and their help, we don’t have to funnel
money from other places. Then it can be used for other
areas of AHS or even to enhance Screen Test.”
The Screen Test trailers are organized like a portable
clinic, with everything happening onboard. Each
contains a reception area, cervical screening room, ofce
area for technicians, dressing rooms, and, of course, the
mammogram, Hauber says.
She advises women in the province to take advantage
of Screen Test, which is designed to fnd cancer early.
“The importance of cancer screening, and the reason
we’re doing this, is to fnd breast cancer early,” Hauber
says. “When we fnd breast cancer early, the chance
of surviving is much better and there are many more
options for the type of treatments. Nobody wants to
hear that they have breast cancer – but it’s better to
fnd it early.”
A mammogram works by creating a special X-ray of the
breast, which can detect a lump months before it would
be found in a physical exam. The entire process, which
involves shooting four photographs digitally (two of each
breast), takes about 15 minutes. The newer machines are
also known for being less painful than their non-digital
Kilty can’t laud enough the qualifed staf working
on Screen Test. “I had a chance to see it in action in
Didsbury, and got to talk with some of the [women] who
were coming to use it,” Kilty says. “The folks that put it
together did an amazing job not only with the program,
but, more importantly, with the specialists who work
with the patients who are so passionate about it. There
are lots of things you can teach somebody, but passion
and caring for others is not one of them. They have the
absolute greatest people, who just make everybody
feel comfortable.”
About one in eight women in Alberta will be diagnosed
with breast cancer in her lifetime. Most of the cases (75
per cent) are found in women over 50, so that’s why
women in the 50 to 69 age range are encouraged to get
mammograms – and often. “You can’t just have it once.
This is a test that you have to have every two years, and
some women need it annually,” Hauber says.
The response has been positive to the mobile
mammography program, Hauber says, noting she hopes
the partnership with Parkland can continue past 2014.
“Fas Gas has been really great to work with. It’s been a
great relationship; I am very happy.”
“Nobody wants to hear that they have a breast
cancer – but it’s better to fnd it early.”
For more information about AHS’s Screen Test, or to fnd out when a
mobile mammography unit will be in a community, call 1-800-667-0604
or visit
ON BOARD: Louise Leduc, a mobile mammography
technologist with Screen Test, shows off the interior of
one of the trailers.
Leap_Spring14_p40-41.indd 41 2/21/14 1:56:39 PM
myl eapmagazi ne. ca 42 spring 2014
A speech pathologist who specializes
in reconstructive science is giving
patients with head and neck cancer a
better quality of life than mere survival
Research Rockstar
By Lisa Ricciotti /
photos By aMY sENEcaL
Leap_Spring14_p42-46.indd 42 2/20/14 9:05:21 AM
Al ber ta Cancer Foundati on spring 2014 43
Leap_Spring14_p42-46.indd 43 2/20/14 9:06:35 AM
myl eapmagazi ne. ca 44 spring 2014
Research Rockstar
r. Jana Rieger is having a Hamlet
moment. She stands, one arm outstretched,
cradling a model of a human skull in her
palm, unconsciously mimicking the pose
of the tragic Shakespearean Dane. At any moment you al-
most expect her to break into iambic pentameter starting
with: “Alas poor Yorick!”
But this isn’t a rehearsal hall and Rieger isn’t an actor,
she’s the director of research at the Institute for Recon-
structive Sciences in Medicine (iRSM) in Edmonton’s
Misericordia Hospital. So when she speaks, her words are
more surprising than Hamlet’s.
“Here in our Medical Modeling Research Labora-
tory, we can create a replica of a patient’s skull – and this
‘patient’ just happens to be me.” Rieger gestures toward
shelves where other eyeless skulls stare back, then points
to one ghostly white form near the end of a row of man-
nequin-style heads. “That one’s me too,” she says with a
slight smile. “I think everyone who works in this lab is
getting tired of me staring at them.”
There are more marvels on the shelves behind the
glass, notably computer-generated facial plastic “skin,”
remarkably realistic in its look and feel, and custom-made
templates that surgeons use as guides for reconstructing
jawbones. It’s all made possible by a combination of ad-
vanced imaging technology such as CT scans, computer
modelling and 3-D printing.
These innovations will make a world of diference to
patients who lose sections of their skull or face to head
and neck cancers. At iRSM, patients are also treated for
congenital abnormalities due to trauma, but Rieger says
that about 80 per cent require treatment due to cancer.
After life-saving treatment, many patients require re-
constructive surgery to restore their appearance and the
essential functions that most of us consider natural, like
the ability to speak well enough to be understood, to chew
well enough to eat more than mush and to do something
as refexive as swallowing. Patients who lose parts of their
mouth or tongue lose that ability; for some drinking a
glass of water comes with the fear of aspiration and pos-
sible pneumonia.
“The social impact of cancers that afect the head and
neck is huge,” says Rieger. “If there’s anything I hope
my research does, it’s to reduce the negative impact on
patients’ quality of life. When patients can’t eat or speak
normally, it’s so very traumatic. They lose their jobs,
families break apart; people become isolated and go rap-
idly downhill. We’ve been naïve in our treatment of these
patients; we really need to get better at getting them get
back to normal.”
When Rieger frst arrived at iRSM in 1999 as the program
director of head and neck functional outcomes, she admits
she wasn’t even knowledgeable enough to be called naïve.
Although she had a new PhD behind her name, earned at University of Alberta over fve
years for research in rehabilitation science, she had no idea what treatments worked best.
“I was a speech pathologist, but had no experience in head and neck cancers. Yet I abso-
lutely knew I wanted the position. The program was new and undeveloped.”
Rieger says it didn’t take her long to see there was a gap between what the literature
and post-surgery reports said and what she observed in head and neck cancer patients.
“I’d read how patients were doing great and had recovered speech. But what I heard was
far from normal speech, sometimes barely understandable. Why should that result be
considered as good enough?”
Head and neck cancers are ruthless, with a survival rate of barely 50 per cent. Conse-
quently many physicians defned success as survival. But Rieger saw and treated survival
daily as a clinician and researcher. If more could be done, the patients deserved more.
And if this was as good as they could be, post-surgery, maybe new surgeries with better
outcomes were needed.
Rieger knew that frst she needed to defne the problem. As all good researchers know,
you do that by looking at numbers, measuring and re-measuring, tracking and compar-
ing changes (or lack of changes) over time and analyzing the data. Yet as Hamlet himself
would say: “Ay, there’s the rub.” Objective numbers didn’t exist.
Because little thought had been given to gathering data, there were no standards or
benchmarks. Evaluations were subjective; one doctor’s “good” might be another’s
“fair.” And since many of the functions related to speech, chewing and swallowing are
not easily observed, there was no consensus on what should be measured or how. And
researchers couldn’t rely on most patients to accurately describe how they felt, because
“If there’s anything I hope my
research does, it’s to reduce the
negative impact on patients’
quality of life.”
Leap_Spring14_p42-46.indd 44 2/20/14 1:38:43 PM
Al ber ta Cancer Foundati on spring 2014 45
they simply didn’t know. Surgery left many numb, without nerve sensations or aware-
ness of what their muscles were doing.
Rieger opens the door of a small room to reveal her solution – a lab flled with large
machines. “This was a broom closet when I came here, but now we use machines like
this mobile swallow station to measure what’s really going on. We can actually see on a
screen what happens as patients swallow.” One machine measures air fow and pressure,
another measures sound.
Slowly but surely, patient by patient, Rieger built a database of objective measure-
ments. These data became the touchstones of her research, a scientifcally-valid refer-
ence point that provided feedback to surgeons. Working collaboratively, they began
testing creative new techniques, constantly revising, adjusting and getting better.
“Our surgeons have now developed a reconstruction technique that works perfectly
for the patients. And it was all made possible because we used measurements from these
machines to guide us,” Rieger says.
partment as a whole. One of the areas she’s most excited
about is the possibility of regenerative medicine using
stem cells from a patient’s own body. Instead of taking
skin from a patient’s arm or fbula bone to replace tissue
and bone lost to cancer, stem cells might be generated in
the lab from the patient’s own cells.
Just a few years ago, this idea sounded like a sci-f
dream, but it’s now one step closer to reality. The
machine Rieger’s group hopes will make it possible is a
highly advanced piece of technology called a 3-D Bioplot-
ter, iRSM’s quarter-million-dollar investment in the
future. One of only a few in Canada, it sits ensconced in
its own glassed-in environment in the Medical Modeling
Research Lab.
“Once a surgery of this type
is done, it can’t be undone.
The results are so much better
when measurements are done
in advance and the surgery
is preplanned.”
She holds up two skull models from the same patient to demonstrate how measure-
ments can afect a patient’s outcome. Both were created by the same skilled surgeon to
reconstruct a new lower jaw from the patient’s own fbula (a bone in the leg). For the
frst skull model, the surgeon worked freehand, relying on experience and what was
revealed during the surgery. On the second, a template was created before surgery using
the measurements and 3-D imaging from the patient’s
(soon-to-be removed) jaw.
Because all details are pre-planned when a template
is used, the surgery goes much faster, giving better
outcomes. But the real diference is what’s visible to the
naked eye. The frst skull model of the poor “patient” who
hypothetically received the freehand surgery reveals a
serious under bite. The jaws can’t possibly meet, and den-
tal implants would be impossible. The second jawbone,
created with the aid of the premeasured template shows
a beautiful, functional jaw.
“Once a surgery of this type is done, it can’t be undone,” Rieger notes. “The results are
so much better when measurements are done in advance and the surgery is preplanned.”
This method has become the new normal.
After a two-year leave, Rieger returned to iRSM in July 2013 as its research director.
Although she continues her own research projects, she now oversees work of the de-
Rieger is now in what she calls the second phase of her
research. Initially she needed to gather data; now she’s
looking at innovative ways to use technology for post-
operative treatment. She and her colleagues have tested
a plastic mold that gives patients immediate feedback
on how well they’re swal-
lowing or moving their
tongues via a computer
screen. Its appearance is
similar to a dental mold,
but the plastic form that
fts over the teeth, tongue
and mouth is implanted
with many sensors. These
relay data to a computer
screen as the patient per-
forms speech or swallowing exercises.
Results have been encouraging, but the downside of this
therapy is it’s time- and labour-intensive for both patient
and therapist. Generally, daily sessions are required over
several months, under supervision of a speech therapist.
Leap_Spring14_p42-46.indd 45 2/21/14 3:57:50 PM
Stereotypes persist about researchers – they’re
pale from spending too much time indoors in
labs, they never step away from their comput-
ers, they’re intense. What do you do off-hours
that might surprise people?
I box! I have a mannequin named Bob in the
basement, whom I like to punch. It’s something
I always wanted to try and I took a course about a
year ago. It’s a great work-out and now I want to
work with a personal coach.
I’ve also travelled extensively, both as part of
my job and on my holidays. I speak frequently
at conferences and I’m up to something like 60
events in more than 10 countries.
I got into scuba diving. I have my open water
certifcation and some of my favourite dives have
been in Belize, Cuba and Hawaii. I’ve even done
a night dive in Honduras, rolling out of a boat into
the black ocean with a fashlight.
You’re very open about your research
projects and share your results widely with an
international network. But I hear you have a
“secret project” that’s ready to go public?
I’ve been working on a novel for years. Up to
about Draft 252 now (just kidding!). I won awards
and was long-listed for its earlier drafts, so that’s
kept me going.
It’s a medical mystery thriller, set in Edmonton
and the main character is a medical researcher.
But she’s not me – she’s a feisty redhead. I’ve
drawn on my experiences for it, but it’s not directly
based on anyone from my real life. Well, except
my dog Max, a fve-year-old 60-pound standard
schnauzer. He’s in it, under a pseudonym. I’ve al-
ways felt like I should hide it because I don’t want
anyone I work with to think it’s about them. But it’s
just about ready to share. I won’t reveal the plot –
yes, there is a murder. It looks at the ethics of
medical research and what the pressures placed
on researchers can drive them to do.
As a writer, do you have any good reads to
Most recently I’ve really enjoyed The Burgess
Boys by Elizabeth Strout. I’m also halfway
through Dance, Gladys, Dance, a novel by Cassie
Stocks published by an Edmonton printing
house. She won the 2013 Leacock Award for it
and it’s very funny. I also enjoy local writers like
Todd Babiak and Hellgoing – Lynn Coady’s latest
book that won her the 2013 Giller Prize – is on
my must-read list.
Q and a with
dr. Jana rieger
myl eapmagazi ne. ca 46 spring 2014
Research Rockstar
Rieger has always looked to technology to overcome barriers and she’s about to
launch research into her new solution. It’s a portable unit that will communicate wire-
lessly with a mobile tablet device. As the patient engages in exercises – from any location
in Alberta – bars, graphs and visual images will appear onscreen to provide feedback.
A therapist can remotely access the device.
“We’ve found patients are very interested in these devices,” says Rieger. “They’re
portable and adaptable to lifestyle, but what they really love about the idea is the im-
mediate feedback presented in a visually engaging manner. The device takes on the role
of a personal coach, much like the FitBit device for ftness training.”
The Alberta Cancer Foundation is looking forward to seeing those results. Rieger’s
novel idea will be tested on patients, thanks to a $1.9 million investment, part of the
Foundation’s new Transformative Programs competition. This competition put
scientists through a rigorous process that included a review panel made up of national
researchers, informed patients and stakeholders from the business community. The
Foundation asked for bold ideas that would have a direct impact on Albertans facing
cancer and Rieger’s portable unit is one of those exciting initiatives that will improve
the quality of life for head and neck cancer patients.
When iRSM was established in 1993, some wondered whether its specialized services
were actually needed. Would there be enough patients to justify the space and dedi-
cated staf? Now, while Rieger talks about future research she’d like to pursue, the halls
ring with the sounds of hammers and pneumatic drills: iRSM is expanding, as a former
cafeteria is converted to fll the needs of patients across Alberta and Canada.
“I started the conversation about whether we’d really done enough for the survivors
of head and neck defects and the medical community has really embraced the new mis-
sion of doing more,” Rieger concludes. “Of course the frst focus will always be a cure.
But now we all understand that’s just the start. After their treatment, after they survive,
we must do our best to give patients back as much of their lives as possible.”
Leap_Spring14_p42-46.indd 46 2/21/14 2:23:28 PM
Al ber ta Cancer Foundati on spring 2014 47
t’s easy for your motivation to go into hibernation when
it comes to exercise in mid-winter. But there are many runners
who refuse to let the season slow them down. Well, it might
slow them down or slip them up, but it doesn’t deter them from
getting out and running.
For some dedicated year-round runners, the prospect of roughing
the brutal cold makes winter prime time to pound the pavement, ice-
covered or snow-packed though the trails may be. Steve Sweeney is
one of those runners. He slips out several mornings a week while his
No longer just a fair-weather frolic, serious runners pound
the pavement year-round
family sleeps and before the sun is up to hit the running in any season.
It’s easy for him to warm to the idea of running in the cold. “I like
the challenge of getting up, getting out – it feels like I have accom-
plished something before I even start,” the 45-year-old father of three
says of winter runs. “Some mornings are cold and dark; it’s hard to get
moving, but once you get warm, there is no better feeling. When you
come inside and have that hot shower, it’s a very simple pleasure but it
sets the day up. You feel energized, relaxed and ready for the day.”
It doesn’t hurt that most bike paths in Calgary are well-maintained
By NadIa MoharIB
Leap_Spring14_p47-49.indd 47 2/20/14 9:10:48 AM
myl eapmagazi ne. ca 48 spring 2014
and typically dry and bare year-round despite what Mother Nature doles out. And
thousands of kilometres later, Sweeney has yet to bore of the scenery ofered by the
great outdoors. “Anything along the river is just so beautiful,” he says.
Gord Hobbins, owner of Gord’s Running Store, says preparation is key for anyone
planning to step out for a winter run. Know your route well, especially as far as foot-
ing goes, and check out which way the wind is blowing – it’s best to run into the wind
on the way out and with the wind at your back on the homerun half.
To dress for success when running in the cold, think layers, layers, layers. Starting
at the top; pick a toque or a balaclava
or maybe, if you have a lot of hair and
it’s not too cold, put on a head band. A
tube neck warmer is versatile and can
be pulled up or pushed down as the
weather dictates.
When it’s -15°C or colder Hobbins
suggests putting a thin layer of Vase-
line on the face – even the earlobes – to
create a synthetic barrier against the cold. And if it dips down to -20°C, cover up
the nose and mouth. “I think the critical temperature is -21°C,” Hobbins says. “You
could run the risk of damaging the breathing tubes.”
Men should consider special underwear with a nylon panel meant for winter run-
ning to protect “the boys.”
“It could be worth its weight in gold,” he says.
There are similar products, so-called bum huggers for women, which keep the
tush toasty, he adds. Then pull on the next layer, a sweat-wicking, long-sleeved top
and tights. “In recent years there has been a massive upsurge in merino wool,” he
says. “It is warm and pulls moisture away but the biggest advantage is it doesn’t ab-
sorb body odour. A lot of guys like it for the low-maintenance factor. It doesn’t stink
and you can get away wearing it a few times.” The “crème de la crème,” brand is Ice-
Know your route well, especially as far as
footing goes, and check out which way the
wind is blowing – it’s best to run into the
wind on the way out and with the wind at
your back on the homerun half.
breaker from New Zealand but there are other compa-
nies that make merino wool clothing.
Expect to pay about $90 and up for tights and $80
and up for tops. Add a windproof jacket and pants and
if it’s cooler than -20°C, put a second layer between the
base layer and the jacket.
Hobbins says regular running socks should do (as
long as they cover up the Achilles tendons and ankles).
Thicker ones can make
it difcult to ft feet into
Typically, regular run-
ning shoes are adequate
but there are ones with
studded-type tread and
shoes with studs or studs
that can be screwed
into sneakers for those venturing out onto particu-
larly icy terrain or packed snow surfaces, adds Sean
Rickard, manager at Edmonton’s Fast Trax Run
& Ski Shop.
As for hands, Hobbins says mitts might be a better
option than gloves because the fngers can “keep each
other warm,” and he advises making sure the elastic
around the wrists is not too restrictive. Meanwhile,
refective arm-bands, fashers or light clips, which
can be attached to clothing or shoes and range from
$6 to $25, ensure runners are visible, and wearing just
one earbud means a runner can still hear hazards,
Leap_Spring14_p47-49.indd 48 2/20/14 9:13:07 AM
We’re back this March to leap, laugh & lunge our way towards
raising $1 million for breast health at the Cross Cancer Institute.
MARCH 22, 2014
Edmonton Expo Centre
Some tips on hitting the trails in the snow or ice, from Alan Cooper, sales
associate with Strides Running Store in Calgary:
• The fve-minute rule: If you are too hot after fve minutes of running you
have overdressed. If you are still cold after that time frame, it’s a sign that
you need to add more layers.
• Be aware of icy patches. You could also buy Yak Trax, (they strap on to
sneakers and have spikes and coils that increase traction).
JOIN THE CLUB: Running groups and sites: In Calgary and Edmonton:
• The Running Room ( Offers a variety of running clubs
and clinics year-round.
• The Tech Shop (
In Calgary:
• Gord’s Running Store (
• Strides Running Store ( Strides has its monthly
cookie run where participants bring cookies to share and, in exchange,
get a great group run and a cup of coffee when it’s done.
• Calgary Road Runners ( Memberships are $35
for an individual, or $50 for a family. Benefts include Club Night, which
features “generally an easy run followed by a social activity.”
In Edmonton:
• Fast Trax Ski Shop (
Run With it
be it an oncoming train or bell ringing cyclist.
For Hobbins, who organizes the annual Frozen Ass
Fifty (yes, that’s 50 kilometres in February), the cut-of
for an outdoor run is about -20°C, a temperature which
sends him searching for warmer climes. “The last re-
sort is the treadmill,” he says. “It’s the same place, the
same pace; you are looking at the same wall. There is
no variety to it.”
Outdoors, on the other hand, is the way to go when-
ever possible, he says. “It’s invigorating. I’m an outside
guy – whatever Mother Nature throws at you.
“Maybe, at some point, I will throw in the towel and
do the hamster-wheel type training, but I like the chal-
lenge of sticking it out outside. I just enjoy seeing the
variety – the diferent terrains, the diferent parks at
diferent times of year.”
He has seen outstanding sunrises, savoured sights of
coyotes and spotted deer on Nose Hill and on a Christ-
mas Day run through Calgary’s Confederation Park he
was even treated to the rare sight of 20 or 30 robins, who
had chosen to stick around for the winter season. “If I
was on a treadmill, I wouldn’t have seen that,” he says.
Edmonton’s Rickard says the very elements which
might deter some fair-weather runners are what
entice others. “The cold is one of the attractions,”
he says. “I just like being outside in the cold, still air.
It’s peaceful.”
Leap_Spring14_p47-49.indd 49 2/20/14 1:39:46 PM
myl eapmagazi ne. ca 50 spring 2014
Shooting for a Cure
Dr. Wayne Lynch is no stranger to hospitals. He began his career as an
emergency physician more than three decades ago, but after fve years, his wife
Aubrey Lang convinced him to follow his dream of becoming a wildlife photog-
rapher and science and nature writer. A decade later, she joined him and the pair
has worked together ever since.
But their dream life would be
interrupted in 2004, with a can-
cer diagnosis for Lang. “I was an
emergency doctor and she was a
nurse, so we’re aware of how vari-
able medical care can sometimes
be,” says Lynch. “We were so im-
pressed with the Tom Baker Cancer Centre and the treatment she got – and
she’s now 10 years post-cancer and she’s fne. Because of that, I wanted to give
back something.”
Since 2007 he has done just that by donating his Alberta landscape and wildlife
photography to the Alberta Cancer Foundation’s annual calendar. “For Aubrey
and I who are professional wildlife photographers and nature lovers, nature has
always been a source of comfort for us. And we know that for many people it’s a
source of comfort. I saw the calendar and I thought
if they spent less money buying photographs, then
maybe they’ll have more money for research.”
The calendar is a pillar of the Alberta Can-
cer Foundation’s mail-out
campai gns , says Sean
Capri of the Alberta Cancer
Foundati on. “The calen-
dar has reached superstar
status and helps to raise
significant funds for Alber-
ta’s cancer centres,” says
Capri. “Every year, our donors tell us how much
they love the photography and appreciate Dr.
Lynch’s contributions and this year is no differ-
ent. To date, the 2013 calendar has raised a net
of $144,000!”
For more information about Lynch’s photogra-
phy, visit –Shelley Williamson
Doctor-turned-photographer gives back by doing what he loves
“Nature can rescue you from despair.
Nature can soothe you in the most diffcult
of times and it certainly always has done that
for me and it can do that for many people
and that’s why I got involved.”
inspiring individual
My Leap
Sprint distance triathlon and duathlon
in support of the Cross Cancer Institute.
Register as a team or individual today!
000Leap-CCI_Triathlon-FP.indd 1 2/13/14 7:58:04 AM Leap_Spring14_p50-51.indd 50 2/20/14 9:14:56 AM
Sprint distance triathlon and duathlon
in support of the Cross Cancer Institute.
Register as a team or individual today!
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