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THE FIGHT AGAINST CANCERcancercarenews.ca
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Featuring
DO YOU HAVE A PLAN?
What you and your family can do to
ease suffering
MEN’S HEALTHHow we continue to fi ght prostate cancer
THE POWER OF CONVERSATIONTV host and health expert Dr. Oz speaks up about his scare with colorectal cancer for National Colorectal Cancer Awareness Month.
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$100 PREPAID VISA CARDS
CFL LEGEND LUI PASSAGLIA
Shares his experience with colon cancer
CHALLENGES
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Colorectal Cancer Aware-ness Month is upon us and once again our attention is immediately drawn to the importance of colorectal cancer screening, a simple way to avoid a most prevent-able disease through simple tests that bear acronyms such as FOBT and FIT, and ultimately the gold standard colonoscopy.
In addition to screening, there are other movements to increase aware-ness around prevention. Canadian associations are reaching the public to educate them in a fun and inter-active manner through events such as the Giant Colon Tour, where a 40 foot long colon displays the various pathologies that can be found inside the human Colorectum. E ach prov-ince may also run their own cam-paigns to promote their provincial population based screening pro-
grams. But what about those of us who already have cancer?
This year there will be over 24, 400 men and women in Canada diag-nosed with colorectal cancer. That’s 1 in 13 men and 1 in 16 women, if you’re into statistics. Many will be cured due to an early diagnosis be-cause of timely screening, but some of course will already have advanced stage disease and will require ex-tensive treatments. Many will sur-vive, but incredibly over 9,300 will die from the disease this year, even if they are lucky enough to receive all of the approved therapies. Gaining access to cancer drugs in Canada is a complicated process.
In Canada, once Health Canada has approved a drug for its safety, effi cacy and quality, each province then de-termines which cancer drugs are reimbursed if they receive a posi-tive funding recommendation from either the pan-Canadian Oncology Drug Review (“pCODR” ) for all prov-inces other than Quebec, or the Insti-tut national d’excellence en santé et en services sociaux (“INESSS”) for Quebec.
Most Canadians are not famil-iar with the drug approval process, but to cancer patients the health technology assessment (“HTA”) bodies that evaluate cancer drugs are of the utmost importance, since they determine what drugs patients will ultimately gain ac-cess to for their treatment.
The pCODR expert commit-tee considers research data and the cost of the proposed new can-cer drugs under review. They also provide the opportunity for ac-credited patient groups to pro-
vide input into the process. Patient groups can provide information on what patients and their caregiver’s value or see as a benefit both from existing treatments and from the new drug being assessed in order for the expert committee to better appreciate the quality of the pro-posed new drug.
The determination of what pa-tients value is essential to this pro-cess, but they are often ill defined, inadequately measured and may not be given sufficient weight in the final decision making process. Some amazing work has already been done by patient groups and they will increasingly have an im-pact on which cancer drugs are ap-proved and reimbursed in Canada.
Supporting patients to fi nd eff ect-ive treatments to improve outcomes is one of our hallmarks. While not as sexy as some of our other initiatives, in many ways it is more important, especially when it comes to drug ac-cess for those with advanced cancer.
Since patient values go to the heart of quality of care, the CCAC is embarking on a study to better de-fi ne, measure and weigh patient val-ues with the goal of increasing con-sistency and objectivity in patient group input to pCODR and INESSS, ensuring that Canadian cancer pa-tients get the eff ective cancer drugs they truly value.
Mediaplanet’s business is to create new customers for our advertisers by providing readers with high-quality editorial content that motivates them to act.
Play your part in the fi ght against stigmatized cancers
In Canada, the fi ght against cancer is in full swing. However, due to long-standing stigmas, people still fi nd it harder to speak out about colorectal, prostate and lung can-cer, and that is preventing Can-adians from getting screened or
seeking treatment. Well, it’s time to change all that; it’s time to start talk-ing about cancer.
Colorectal cancerColorectal cancer is stigmatized be-cause most of us have been socialized to be embarrassed when it comes to speaking about certain parts of our body and, as a result, we shut down when it comes to discussing things like our colon or rectum.
However, getting celebrated pub-lic fi gures onboard to speak freely and openly is making a huge impact in the way that people relate to colorectal cancer. “Having celebrities like Darryl Sittler tell you that it’s important to get involved or get tested really makes people sit up and take notice,” says Amy Elmaleh, Co-founder and Exec-utive Director of Colon Cancer Can-ada. “Having people who have been touched by colon cancer talk about it
THE FIGHT AGAINST CANCERFIRST EDITION, MARCH 2015
Publisher: Jacob WeingartenBusiness Developer: Ian Solnick
Managing Director: Martin KocandrleProduction Manager: Sonja Draskovic
Lead Designer: Matthew SenraDesigner: Mishelle Menzies
Contributors: Ian Bookman, Benjamin Chacon, Randi Druzin, Ted Kritsonis, Katherine O’Brien, Joe Rosengarten,
Michelle Sponagle, Barry Stein
Send all inquiries to [email protected]
Distributed within: The National Post, March 2015
This section was created by Mediaplanet and did not involve the National Post or its
Editorial Departments.
Photo credit: All images are from Getty Images unless otherwise accredited.
is making a diff erence.” Colorectal cancer is over 90 per-
cent preventable with screening, yet it’s still the second leading cause of cancer death in Canada. It’s simple: if more people start talking about colo-rectal cancer, more will get screened. And, with early detection, very often comes a full recovery.
Prostate cancerRaising awareness of prostate can-cer and making it a subject that is no longer a taboo is imperative if more men are to get informed about the true dangers of the disease. Across the country, awareness campaigns are working hard to get men talking. “Our focus is on raising social awareness for early detection because we know that survival rates are high if we can get to men early,” says Rocco Rossi, President and CEO of Prostate Cancer Canada. “Some companies are doing ‘lunches and learn’ with their work-force, which is a great way to give men more information about testing.”
Rossi also points out the import-ance of a network of 75 support groups situated across the coun-try, where men who have received
treatment provide peer-to-peer sup-port to the recently diagnosed and their spouses. As well as providing emotional support and reassurance, these support groups play an inte-gral role in educating men about their treatment options.
Lung cancerLung cancer is a fatal cancer and may be one of the most stigmatized. Take action, and
join the fight against colon cancer
PAGE7
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JOE ROSENGARTEN
Barry SteinPRESIDENT, COLORECTAL CANCER ASSOCIATION OF CANADA
“Start a con-versation to-day, with a col-league, a friend or a family member and play your part in breaking down the stigma.”
VISIT US ONLINE FOR EXCLUSIVE CONTENT AT:CANCERCARENEWS.CA
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COLORECTAL CANCER AWARENESS MONTH: ACCESS TO CANCER DRUGS IN CANADA
THE GIANT COLON TOURAn interactive exhibit is an engaging way to learn about the colon.PHOTO: COLORECTAL CANCER ASSOCIATION OF CANADA
There is a social tendency to blame the suff erer of the disease, a com-mon belief that they deserve to be affl icted by lung cancer. In fact, 15 percent of people who have lung cancer have never smoked, and an-other 35% are ex-smokers.
With the help of people like Anne Marie Cerato – a lung cancer sur-vivor and Lung Cancer Canada Board Member – organizations like Lung Cancer Canada are fi ghting to eradi-cate the stigma and dispel the mis-conceptions of the disease. “Lung cancer should not be just about whether you smoked or not,” Cerato says. “It’s about facing the reality of losing someone you love.”
These three cancers are stigma-tized for diff erent reasons, but that stigma causes the same problems: a lack of screening, awareness and prevention. So, start a conversation today, with a colleague, a friend or a family member and play your part in breaking down stigma. Together we can take the fi ght to cancer.
Special thanks to
PUBLIC AWARENESS IS KEYEducating the public removes stigma and is essential in the fight against cancer, as evident from the Movember Foundation’s impact on prostate cancer.PHOTO: MOVEMBER FOUNDATION CANADA
INSIGHT
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Mediaplanet caught up with Dr. Bookman, a Gastroenterologist at St. Joseph’s Health Centre and Med-ical Director at Kensington Screen-ing Clinic, who founded the ‘Bum Run’; a walk/run to raise awareness for colorectal cancer.
With catchy phrases out there like “love your bum”, what has changed in recent years in terms of public awareness for colorectal cancer?Education has made a big diff erence. Myths are starting to dissipate, such as “it’s an old person’s disease”, or “it mostly aff ects males”. The medic-al community has also become more proactive and organized in having discussions with our patients about screening and prevention.
Although awareness has im-proved, and colorectal can-cer is up to 90% preventable, why is it still the second lead-ing cause of cancer death?It is the silent killer that everyone thinks will be obvious. It is diffi cult to conceptualize that we would not feel anything while a tumor grows in our bowel. The truth is that by the time symptoms occur, the cancer has often spread and is no longer curable. Sadly, we still see this every day.
What do you think is integral to removing colorectal can-cer from the top killers list? We need to start a ‘blue wave’ of colo-rectal cancer awareness and screen-ing involvement, similar to how breast cancer awareness advocates creat-ed a ‘pink wave’ of knowledge and ac-tion. We need to invert the stigma of colorectal cancer screening and pre-vention, whereby it becomes normal to have discussions and participate in screening programs, and it becomes strange to avoid talking about it. I be-lieve the wave has already started; now we just have to keep spreading the word.
DR. IAN D. BOOKMAN BSc, MD, FRCPC
DON’T MISSProper bowel prep is critical for colonoscopy
TED KRITSONIS
Despite colon or colorectal cancer having long been considered among the most fatal diseases, screen-ing for it through a colon-
oscopy has been stigmatized because of how patients must prepare for it.
A colonoscopy tests for the cancer by fi nding irregularities and polyps in the colon and rectum, and accur-acy in discovering those largely de-pends on the quality of the bowel preparation. Patients must clean out their bowels by drinking a solution that is diluted with clear fl uids the day before the procedure.
However, doctors and nurses both acknowledge that these solutions can be diffi cult to drink, and patients will need to be in close proximity to a washroom during their bowel prepar-ation. These factors may make it diffi -cult to discuss the preparation openly, potentially leading to postponement of the procedure.
“It’s important that physicians have a good discussion about what patients can expect and what they will experience,” says Dr. David Mor-gan, a gastroenterologist at St. Jo-seph’s Healthcare in Hamilton, ON. “A lot of patients don’t ask questions that weigh on their minds, and often, if they have the answers they’re re-assured that things aren’t as scary as they otherwise might be.”
The drinking processPatients generally have three options in how they drink the solution. There is a four litre volume that is pre-mixed, a two litre that is pre-mixed and the smallest volume, which is two sachets of 150mL each. The low-est volume option requires about three to four litres of additional regu-lar everyday clear fl uids such as apple juice, ginger ale, Gatorade, white grape juice, white cranberry, tea or chicken broth, for example. Water alone and milk are to be avoided. Low volume options tend to be the most popular among patients.
“We have recently started doing split preparations where they drink half the night before and the other half the morning of the test,” says Usha Chahuan, a nurse and assistant professor at McMaster University’s nursing program. “We found that since we’ve been doing that, patients
have had fewer problems. For some, refrigerating the solution helps, whereas others may prefer little fl a-vouring packages to sweeten it.”
Chahuan adds that patients could benefi t from starting a low-fi bre diet earlier than the three-day period leading up to the test, and sticking to clear liquids over that time, too. Those with heart or kidney conditions will have to go with either of the larger pre-mixed options, regardless.
Proper prep ‘important’Gail Attara, president and CEO of the Gastrointestinal Society in Vancouver, B.C., says being strict with the process helps patients when it comes time to go through the procedure.
“During the colonoscopy, the phys-ician can insert water into the colon and fl ush it around a little bit to help clear away some debris, but that cre-ates a challenge because you’re irrig-ating the wrong way,” says Attara. “It’s
really important that you don’t stall on bowel preparation because you can detect the cancer early and stop it.”
Dr. Morgan adds that good prepar-ation tends to make the test easier to administer, as far as picking up polyps and identifying anything that might be cause for concern, particularly since any one of the solutions can do the job of fl ushing everything out.
Clean out your bowels by drinking a prep solution the day before your colonoscopy.
Drink 3-4 L of additional everyday clear fluids if you go with the lowest volume prep solution. Water alone and milk are to be avoided.
Get some rest and go into your procedure with proper preparation.
Dr. Ian D. Bookman BSc, MD, FRCPCGASTROENTEROLOGIST AND FOUNDER OF THE BALANSE BUM RUN
QUESTIONS TO ASK YOUR DOCTOR“Am I at
risk for colon cancer?”Want to help reduce your risk of colon cancer? Take action and bring this list to your doctor for the next steps in prevention.
☐ What are the signs and symptoms for colon cancer?
☐ When should I be screened?
☐ When should my family members get screened?
☐ How do I prevent colon cancer?
☐ What are the screening options I should consider?
Cut this out and take it to your doctor!
INSPIRATION
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Dr. Oz My advice is to be vigilant – with c o l o n o s c o p y, as well as any other diagnos-tics. If we can know some-thing and it is
going to help us avoid greater sickness or even
death, we should. So get a colonoscopy at the age of fifty and even earlier if you have symptoms or history. If colorectal cancer is in your family, then you need to have the test earlier than fifty and pay close attention to pos-sible symptoms, while eliminating as many lifestyle risks as possible. Speak with your primary care phys-ician in thorough detail and do as much reading on your own.
copy can detect what are known as pre-cancer polyps – small growths that, left undetected, can grow in-to cancer. Not only are these spot-ted during a colonoscopy, they’re removed as well. Still, tens of mil-lions of North Americans delay the procedure. So, if you’re still on the fence, consider this – it’s estimated that screening can prevent about 60% of colon cancer deaths by sim-ply detecting and removing pre-cancerous polyps.
MP What do you think is key in reducing the stigma around various cancers, including colorectal?Dr. Oz The key to reducing stigma is opening up a dialogue and tak-ing the taboo out of topics like cancer. These are topics that need to be dis-cussed – stigmas can be particularly detrimental to can-cer patients, especial-ly if they’re the reason for delayed screening. And I do think we’re making progress. Screening rates for colon can-cer have increased, and as result, the rate of colon cancer diagno-ses has decreased by 30%. But the numbers aren’t quite where we want them to be, yet. That’s why I share my story – in the hopes that others will take the same preventa-tive measures I did, and possibly save their lives in the process.
MP Do you have any words for those that are going through a similar journey as you and have been affected by colorectal cancer?
Advances in laboratory based testing could provide an additional tool to identify people at increased risk for colorectal cancer so the disease can be prevented and/or caught at an early stage.
Time to open upColorectal cancer is the third most common cancer and the second most common cause of death from cancer for both Canadian men and women. While colorectal cancer is highly treatable when detected early and is up to 90 percent pre-ventable with timely and thorough screening and testing, as it stands today, nearly half of those diag-nosed find out too late.
Population-based screening programs Early detection of cancer and pre-cancerous growth is key to improv-ing survival rates.
To this end, many provinces have put in place population-based colorectal cancer screening programs. Most provinces recom-mend that for people at average
New colorectal cancer screening tests are less invasive and more effective in picking up the disease
risk, they should get screened for colorectal cancer every two years, starting at the age of 50. Screen-ing tests involve a stool-based test such as ‘The Fecal Occult Blood Test’ (FOBT) or ‘Fecal Immuno-chemical Test’ (FIT) that the per-son can perform at home.
“The patient collects stool sam-ples putting a little bit of stool on a card (FOBT) or tube (FIT) provid-ed by their physician, and then mail it back to a lab,” explains Dr. Tim Feltis, the Deputy Ontario Medical Director for LifeLabs. “A chemical reaction test is then per-formed on that sample in order to detect small amounts of blood in the stool.” Where blood is detected in these tests, follow-up tests (typically a colonoscopy) are per-formed to determine if it is due to the existence of colorectal cancer.
A particular challenge that prov-inces are facing is getting people to participate in the screening rec-ommendations. For various rea-sons, colorectal cancer screen-ing rates are well below the lev-els needed to be as effective as possible at early detection. Some have suggested that people can’t
get over their discomfort with the stool-based samples.
Making breakthroughs In response to the general reluctance of patients to handle stool samples, scientists have developed a blood testing technique that can accurate-ly identify patients at increased risk of getting colorectal cancer.
“The development of Cologic blood testing for the identifica-tion of patients at increased risk for colorectal cancer is yet an-other tool that can help us im-prove the rate of early detection,” said Dr. Feltis. “This test has a low false negative rate and an accept-able false positive rate, meaning it is very accurate at detecting risk and therefore can facilitate ear-ly detection of premalignant/ma-lignant lesions resulting in better outcomes.”
By measuring the level of an an-ti-inflammatory long chain fatty acid, GTA-446, in the blood, the test determines whether or not a pa-tient is at risk for colorectal can-cer. “It’s a simple blood test, there’s no need to collect a stool sample,” says Dr. Feltis. “If your cologic
level comes back low, you are at risk. There was a large study done showing that 86 percent of people with cancers have low levels of GTA-446.”
This simple blood test can deter-mine a patient’s risk factor long before the cancer has even started to develop.
A new alternative The Cologic test is a new alterna-tive that can be used on its own or as a precursor to a stool-based screening program. Dr. Feltis be-lieves that the introduction of eas-ier, less invasive testing methods will lead more people to comply with regular testing, which is cur-rently a major barrier in the fight against colorectal cancer.
If you’re one of those people who have been avoiding getting tested, make today the day that you pick up the phone and book your ap-pointment. “The message is sim-ple,” says Dr. Feltis, “for those with a family history, change in bowel habit - at any age - or over 50 years of age, just get tested, it’s not as bad as you fear.”
through their daily lifestyle habits?Dr. Oz Lifestyle factors are incredibly important when it comes to reducing risk for certain cancers. In fact, re-search suggests that diet and lifestyle habits may actually contribute to one third of all cancers. And while some of these seem obvious (like smok-ing and lung cancer, and tanning and skin cancer), it turns out that some of the strongest links out there are be-tween diet, weight, activity levels and colon cancer risk. I discussed the im-portance of a healthy diet above, but of equal importance is maintaining a healthy weight and staying physical-ly active. Both obesity and physical in-activity put you at a higher risk of de-veloping colon cancer.
MP How did your lifestyle habits change once you received your diagnosis?Dr. Oz My lifestyle was not a risk factor, so I didn’t need to make chan-ges to my routine. The cause of my pre-cancerous polyp was genetic, so surveillance was the best prevention. Instead of every ten years, I will get more frequent colonoscopies, prob-ably every three to fi ve depending on the results. The great thing about a colonoscopy is that if done with proper frequency it’s both preventa-tive and curative.
MP What would you say to someone who is delaying their colonoscopy procedure?Dr. Oz Don’t delay. The best way to prevent colon cancer is through early detection – and when it comes to early detection, the colonoscopy is the gold standard. Why is it so important? A colonos-
Mediaplanet You had a routine colonoscopy when you turned 50. What were you feeling prior to the procedure?Dr. Oz Prior to the procedure I was joking at my 50th birthday party about the test, seeing it as routine and a way to show my audience how to “check the box” in their own lives to be smarter patients. Having no family history and no contributing lifestyle factors, it was the furthest thing from my mind that I would re-ceive an abnormal result.
MP When you went from doctor to patient and received a diagnosis of having a pre-cancerous polyp, what changed for you?Dr. Oz As a doctor, I have had thou-sands of diffi cult conversations with patients and families – many includ-ed grave news. Suddenly, I was on the receiving end of one of those serious conversations and it helped me as a doctor because all the empathy in the world can’t compare to the real ex-perience of being a patient.
MP What role does nutrition play in colorectal health? Are probiotics an essential part of a healthy lifestyle? Dr. Oz Nutrition plays a major role in colorectal health – research shows that your dietary choices can have a signifi cant impact on your risk for developing the disease. The top picks when it comes to lowering risk? Fruits, veggies, and whole grains. These fi ber-rich foods have been well-established when it comes to improv-ing digestive health, and studies show that they also may signifi cantly re-duce your risk of developing colon cancer, especially when compared to diets that are high in refi ned carbs and animal fats. Also gaining ground for its potential protective eff ects? Probiotics. Emerging research sug-gests that these good bacteria, found in foods like Greek yogurt and kefi r, can boost colorectal health.
MP How can individuals reduce their risk of cancers
Dr. Mehmet Oz talks about his experience with colon cancer, why you should regard screening as a top priority, and what you can do in your lifestyle to reduce your risk of cancer.
LET’S TALK ABOUT COLON CANCER
JOE ROSENGARTEN
“The key to reducing stigma is opening up a dialogue and taking the taboo out of topics like cancer.”
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Dr. Oz My advice is to be vigilant – with c o l o n o s c o p y, as well as any other diagnos-tics. If we can know some-thing and it is
going to help us avoid greater sickness or even
death, we should.
copy can detect what are known as pre-cancer polyps – small growths that, left undetected, can grow in-to cancer. Not only are these spot-ted during a colonoscopy, they’re removed as well. Still, tens of mil-lions of North Americans delay the procedure. So, if you’re still on the fence, consider this – it’s estimated that screening can prevent about 60% of colon cancer deaths by sim-ply detecting and removing pre-cancerous polyps.
MP What do you think is key in reducing the stigma around various cancers, including colorectal?Dr. Oz The key to reducing stigma is opening up a dialogue and tak-ing the taboo out of topics like cancer. These are topics that need to be dis-cussed – stigmas can be particularly detrimental to can-cer patients, especial-ly if they’re the reason for delayed screening. And I do think we’re making progress. Screening rates for colon can-cer have increased, and as result, the rate of colon cancer diagno-ses has decreased by 30%. But the numbers aren’t quite where we want them to be, yet. That’s why
through their daily lifestyle
Lifestyle factors are incredibly important when it comes to reducing risk for certain cancers. In fact, re-search suggests that diet and lifestyle habits may actually contribute to one third of all cancers. And while some of these seem obvious (like smok-ing and lung cancer, and tanning and skin cancer), it turns out that some of the strongest links out there are be-tween diet, weight, activity levels and colon cancer risk. I discussed the im-portance of a healthy diet above, but of equal importance is maintaining a healthy weight and staying physical-ly active. Both obesity and physical in-activity put you at a higher risk of de-
How did your lifestyle habits change once you received your diagnosis?
My lifestyle was not a risk factor, so I didn’t need to make chan-ges to my routine. The cause of my pre-cancerous polyp was genetic, so surveillance was the best prevention. Instead of every ten years, I will get more frequent colonoscopies, prob-ably every three to fi ve depending on the results. The great thing about a colonoscopy is that if done with proper frequency it’s both preventa-
Dr. Mehmet Oz talks about his experience with colon why you should regard screening as a top priority, and
what you can do in your lifestyle to reduce your risk of cancer.
LET’S TALK ABOUT COLON CANCER
“The key to reducing stigma is opening up a dialogue and taking the taboo out of topics like cancer.”
“If you’re one of those people who has been avoiding get-ting tested, make today the day that you pick up the phone and book your appoint-ment.”
MP You have been so passionate about various health issues and on multiple media platforms, what can we look forward to seeing from Dr. Oz in 2015?Dr. Oz My mission is to help view-ers show up in their own life. I want them to be the best they can be – not just in health but in happiness as well. Each of us should be striv-ing to reach 100% of our potential, feeling 100% healthy, and finding the happiness we deserve. Every episode of The Dr. Oz Show presents possible pathways to achieving that goal and that is the context for all our discussions.
Dr. Mehmet Oz is the three-time Em-my Award-winning host of THE DR. OZ SHOW, currently in its sixth season, air-ing weekdays at 2 p.m. ET/ 4 p.m. PT on CTV. For more information, visit CTV.ca.
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LifeLabs is pleased to offer a unique blood test option for patients to assess their risk for Colorectal Cancer
Available at all LifeLabs and CML Healthcare locations in Ontario. Your physician needs to order the test.
In other provinces please email us for a COLOGIC Kit at [email protected] or call 1-877-990-1575
For more information, please visit www.cologiclabtest.com
INSIGHT
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CFL legend battling to educate fans about colon cancer
vented me from pushing myself physically. I persevered and I’m now back to exercising as much as pos-sible. I think this allows me to heal both mentally, as well as physically. I feel like I’m in control of my body when I stay active.
MP How is your life different now than before you were diagnosed? LP I have learned to appreciate the important things in life more, es-pecially my friends and family who have been there for me during the rocky road. I don’t know what I would do without that support sys-tem, it helps to reassure me that I’m not fi ghting this battle alone.
Mediaplanet had a chance to catch up with Lui Pas-saglia, best known for his 25-year career with the BC Lions, who went public last year with his fight against co-lon cancer. He now dedicates time to helping increase awareness and encouraging people to talk to their doc-tors about this prevalent, yet highly preventable, disease.
Mediaplanet What motivated you to speak about your ex-perience with colon cancer?Lui Passaglia After the initial shock of being diagnosed with co-lon cancer wore off , I focused on arm-ing myself with as much informa-tion about the disease as possible. I soon realized that by simply starting the conversation, I might be able to help raise awareness and encourage people to talk to their doctor about the urgency of early screening.
This is a disease that I hadn’t given much thought to a few years ago. I fi g-ure many men and women share my previous mindset and we need to shift that way of thinking.
MP How did you find out that you had this disease?LP I was diagnosed with stage three colon cancer during a routine check-up with my doctor. Prior to my colon-oscopy, I showed some of the typical symptoms for the disease – consti-pation, abdominal discomfort, blood
in my stool, but I hadn’t done my re-search to know what I should be look-ing for.
There is a hereditary link to colon cancer, so this could have played a part. About ten years ago my dad was diagnosed with the early stages of co-lon cancer, in fact that was one reason I had my fi rst colonoscopy at age 54. Luckily my dad is also alive and well.
MP Do you think being an athlete gave you an edge when fighting the disease?LP As an athlete I developed the discipline to train and exercise even when I wasn’t feeling my best. Once diagnosed with colon cancer, there were times when the disease pre-
KATHERINE O’BRIEN
JOIN LUI TO HELP RAISE AWARENESSLui Passaglia and his team banded together to run/walk for colon cancer awareness, an essential step in the fight against colon cancer in Canada.PHOTO: COLON CANCER CANADA
In terms of physical side eff ects, I developed ongoing neuropathy in my hands and feet. Every three months I have a blood test to check my tumour marker. So far, I’m can-cer free. I can do everything I could do prior to my diagnosis.
What helps me every day is to focus on the positives and keep telling my-self that I’m going to beat this. We need to spread the word about the importance of early detection and screening. Colon cancer is 90 percent preventable if caught early. Everyone should speak to their doctor to ask when they should be screened. Lui Passaglia
CANADIAN FOOTBALL LEAGUE HALL OF FAME PLACEKICKER/PUNTER FOR THE BC LIONS
“What helps me every day is to focus on the positives and keep telling myself that I’m going to beat this.”
KATHERINE O’BRIEN
SCREENING AND EARLY DETECTION SAVES LIVESColorectal cancer is the third most common cancer and second most deadly cancer in Canada.
COLORECTAL CANCER IN CANADA
Source:http://www.phac-aspc.gc.ca/cd-mc/cancer/colorectal_cancer-cancer_colorectal-eng.php
• Colorectal cancer is the SECOND MOST DEADLY CANCER
• An estimated 9,300 CANADIANS WILL DIE from colorectal cancer this year
• Colorectal cancer is the THIRD MOST COMMONLY diagnosed type of cancer
• It is estimated that 24,000 CANADIANS will be diagnosed with colorectal cancer in 2014
#2
However, if caught early, colorectal cancer is highly treatable and is up to 90 percent pre-ventable through timely and thor-
ough testing and screening. “More than 9,000 Canadians a
year die from colorectal cancer, so it’s a big problem,” says Dr. Mal-colm Moore, Head of Medical Onc-ology and Hematology at Princess Margaret Cancer Centre in Toron-to. “The good news is that the death rate is falling by about two percent a year, so hopefully by 2020 colon cancer will no longer be the second leading cause of cancer deaths.”
It is important to speak with your family physician to fi nd out more about getting tested or screened. For many Canadians, the test could be as simple as an at-home stool sample test. For those with a family history of colon cancer, or who are over 50, it may be more appropriate to undergo a colonoscopy for screening.
“It’s not exactly popular conver-sation to talk about the colon, but I do think it’s changing,” says colo-rectal surgeon Dr. Zane Cohen, the Director of the Zane Cohen Cen-tre for Digestive Diseases at Toron-to’s Mount Sinai Hospital. “There’s been a heavy push on awareness, and I think it’s much less of a stig-ma now to talk about colorectal cancer, bowel movements and stool patterns.”
Higher-risk groupsAlthough no one cause leads to colorectal cancer, some people are at higher risk for developing the disease. If you fall into any one of the following groups, talk to your doctor about being screened as soon as possible:
■ You have a family history of co-lon cancer. (If you have a first-de-gree relative; parent, sibling, aunt,
uncle, grandparent, with a history of colon cancer, aim to get tested 10 years before their age of diagnosis)
■ You have been diagnosed with polyps or early stage colon cancer
■ You have inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
■ You have a family history of in-herited breast cancer, uterine or ovarian cancer
■ You are age 50+“There is no doubt that popula-
tion-based screening and early de-tection have cut the death rate,”
says Moore. “Everybody is at the same sort of risk for getting colon cancer, so we all need to be aware of it and we all need to be appropri-ately screened. If there’s one mes-sage, it is that once you reach 50, you need to be screened.”
Warning signsHere are the signs and symptoms of colorectal cancer to look out for:
■ Rectal bleeding or bright red or very dark blood in your stool
■ A persistent change in normal bowel habits such as diarrhea, con-
stipation or both ■ Frequent or constant cramps that
last for more than a few days ■ Stools that are ribbon-like or nar-
rower than usual ■ General stomach discomfort
(bloating, fullness and/or cramps) ■ Frequent gas pains ■ A strong need to move your
bowels, but with little stool ■ A feeling that your bowel does
not empty completely ■ Unexplained weight loss ■ Constant fatigueIt is important to note that symp-
toms often do not occur until the later stages of colorectal disease.
Talk openly with your doctor, know the signs and symptoms of colon cancer and your risk category. When it makes sense to go for screening, do so – there is no health advantage to inaction.
• 90% OF CASES are preventable if detected early
TOGETHER WE CAN BEAT COLON CANCER
“We continue to do this for all of our loved ones who no longer can and to hopefully change the outcome for those yet to be diagnosed.”– Sam Pollard, Tri-Cities Walk Lead
Sponsored by
Why We Push For Your Tush…
Ilost my mother, Maureen Lerman, to colon cancer at the age of 46. Within two years, and at the age of 39, my uncle
Howard Schwartz was diagnosed and died eight years later. The realization that this disease could take two lives at such a young age changed the course of my life forever. I was driven by a passion to help build aware-ness and raise funds and thus Colon Cancer Canada began.
Our beginningsColon Cancer Canada (CCC) started in my Aunt Bunnie’s (Howard’s wife) basement 18 years ago. My Aunt and I joined forces to help educate Canadians across the country about the disease. To date, and thanks to the support of generous people across the coun-try, we have raised over $12 million in sup-port of colon cancer education, awareness, research and patient support.
Over 90 per cent of colon cancer is prevent-able if caught through early screening. Despite this fact, colon cancer is the second leading cause of death from cancer in men and women combined. These are just two of the facts that
motivate us in our mission to talk about colon cancer, raise awareness and diminish the stig-ma surrounding the screening process. We need to continue the conversation around ear-ly screening and detection, because the more people talk, the more they’ll see the benefi ts of being proactive and lives will be saved.
Let’s walk to end colon cancerOur largest annual event is ‘Push for Your
Tush’, a Spring walk/run that began 18 years ago with a few friends and family. We now have the support of over 2,500 participants in 11 communities across Canada. This year, ‘Push For Your Tush’ will take place in com-munities across Ontario, Alberta, British Col-umbia and New Brunswick.
‘Push For Your Tush’ is a fun, high-energy event that draws out the colon cancer com-munity in a one-day walk/run to celebrate
the progress we’ve made and to raise funds in support of furthering our cause. This community provides an amazing support group for those fi ghting on a daily basis and to those touched by colon cancer.
Your support mattersWe couldn’t bring together these commun-ities and host ‘Push For Your Tush’ without the support of our sponsors including Dul-colex and Boehringer Ingelheim. Without their guidance, support and friendship we couldn’t bring our events to life.
We are constantly striving to grow our Colon Cancer Canada community and con-tinue to introduce new ‘Push For Your Tush’ locations across the country, as we ask Can-adians everywhere to show their support. If your community would like to organize your own event, we’d love to hear from you.
Amy ElmalehCo-founder & Executive DirectorColon Cancer Canada
For more information about Push For Your Tush, please visit pushforyourtush.ca
Join the growing community of people touched by colon cancer, and help beat this disease.
Don’t walk alone.
Go to pushforyourtush.ca/contest to take part in a walk in your local community. Register early and be entered into a
draw for your chance to...
WIN 1 OF 4 $100 PREPAID VISA CARDS
sponsored by Dulcolax
Colon Cancer Canada’s Annual 1K/5K Walk & 10K RunSpring 2015
CONTACT US1.888.571.8547 [email protected]
One of a thousand reasons to look for Astellas in oncology.
© 2015 Astellas Pharma Canada, Inc. All rights reserved.
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Excluding non-melanoma skin cancers, prostate cancer is the most com-mon cancer among men in Canada. It’s also the
third leading cause of death from cancer in men in the country. It’s strange to think, then, that there re-mains a stigma around this deadly disease, a stigma that prevents men from getting check ups, identifying symptoms and speaking about the health of their prostate.
Taking control of your health “As men, we are our own worst ene-
mies when it comes to health,” says Rocco Rossi, President and CEO of Prostate Cancer Canada. “We don’t want to talk about health and, when it’s health below the waist, if we aren’t bragging about it, we aren’t talking about it.”
Rossi also believes that the archaic societal perceptions of masculinity are still a prohibitive barrier stopping men from speaking freely about pros-tate cancer. “Men are taught from a young age to ‘man-up’; that you are not supposed to show pain,” says Ros-si. “Well, we want people to know that manning up is actually taking control of your health and getting tested, so that you stay healthy and are in a pos-ition to take care of not only yourself, but your family.”
Damaging misconceptionsWith metastatic prostate cancer – cases when the cancer has spread, usually to the lymph nodes and bones – there is a further damag-ing and tragic stigma; a stigma that costs men their lives. Because it’s the most advanced form of the dis-ease, people often believe, incorrect-ly, that once prostate cancer has me-tastasized all hope is lost. This com-monly held misconception, that metastatic prostate cancer is un-treatable, stops men from getting tested and needs to be eradicated.
There is also the sad fact that people are uncomfortable and reluc-tant to talk openly about a disease that could result in the loss of life, a reluctance that can have devastating consequences.
Rossi tells the story of a man who de-veloped prostate cancer and recovered, but felt unable to talk to his children about his experience. Tragically, the man’s son ended up developing meta-static prostate cancer and died. If doc-tors had known the family history of prostate cancer, the disease could have been picked up much earlier and the patient’s treatment options could have been much more favourable.
The common misconception that metastatic prostate cancer is com-pletely untreatable is further inhib-iting men from coming forward and getting tested or discussing symp-toms. This damaging belief is also un-true. Although, as Rossi explains, ear-ly detection is the best-case scenario, there are treatments available that can eff ectively prolong life and increase quality of life for men with the ad-vanced form of the disease. “The intro-duction of new treatments has been a real boon for patients with metastatic prostate cancer,” Rossi says.
Making change through social awareness Few awareness campaigns have had
the impact of Movember, a global men’s health charity and awareness campaign which encourages men to grow a moustache throughout the 30 days of November. “We want to open the door for men to have conversa-tions about their health and pros-tate cancer and, because of those moustaches, you see men gathered together, whether it’s at the work-place, at home or at a hockey game,” says Pete Bombaci, Country Director, Movember Canada. “The moustache is a conduit to a conversation about your health and whether you do it with 20 friends or just with your dad across the dinner table, it’s the start-ing point to some of those important conversations.”
The moustache is a true unifi er of men, a visible declaration of sup-port and understanding. Bombaci believes that social awareness cam-paigns, like growing a mo’, are inte-gral to eradicating stigma and help-ing men to speak openly and hon-estly. “Campaigns like ours help to bring the conversation to the fore-front,” Bombaci says. “Raising social awareness helps people to under-stand that they’re not alone when facing challenges on their journey with prostate cancer.”
Raising awareness is a vital and powerful tool in the fi ght against prostate cancer. Whether it’s edu-
PROSTATE CANCER: IT’S TIME TO END THE STIGMA Eradicating the stigma that still surrounds prostate cancer would play an integral role in
reducing the number of Canadian men who are killed by the disease.
JOE ROSENGARTEN
When he was diagnosed with advanced prostate can-cer in 2011, Denis Moher de-cided to take a proactive ap-proach to combating his dis-ease. He learned as much as possible about it, even travelling as far as Texas to meet with experts in the field, and he adopted a healthy lifestyle.
Moher, 62, also started taking a medication that blocks the pro-
New prostate cancer medications extend and improve patients’ lives duction of testosterone and other male hormones (called androgens), which stimulate the growth of prostate cancer cells. That kept the cancer in check until a month ago, when tests indicated the medica-tion was no longer working. He was diagnosed with metastatic castration-resistant prostate can-cer (mCRPC), which occurs when the patient’s cancer extends to other parts of his body and is able to spread despite initial hormonal therapy. His situation was dire.
Dr. Neil Fleshner, Chair of Urol-ogy at the University of Toronto and Chief of Urology at the Univer-sity Health Network, prescribed a different anti-androgen medica-tion — one that has been on the market for about two years. The re-sults have been excellent.
Transforming treatment “For the past 50 years we have been fighting a nuclear war with bows and arrows,” says Fleshner. “But we are now moving ahead by leaps and bounds. The pace of discovery is dramatic.” He attributes much of that success to what has been described as a molecular revolu-tion. Molecular testing is being
used to diagnose and treat diseases more accurately, and at an earlier stage, while pharmaceutical com-panies are using molecular tech-nologies to develop new drugs.
Not only do these new drugs ex-tend life but they have relative-ly few side effects compared to their predecessors. As a result, pa-tients taking this medication have a much better quality of life than anyone could have imagined just a few years ago.
Moher is a case in point. He has travelled abroad with his wife and friends and he does weight train-ing for 90 minutes a day, six days a week. It’s an intense workout that is similar in design to those followed by bodybuilders. Denis is much stronger now than he was before being diagnosed and has added considerable muscle mass — an exceptional feat given his testosterone deficiency.
Great expectations“Not only has weight training im-proved my physical health but it has also been good for my mental health,” says Moher. “I feel like I am doing something to improve my life. I don’t feel as helpless as I would otherwise.”
Moher now follows a diet that is almost entirely fat-free — “I’ve dis-covered kale chips,” he says with a laugh — and embraces every mo-ment of every day. “Having a dis-ease like this really changes your perspective. It makes you focus on what is important in life.”
Moher has nothing but praise for the health care providers he has encountered in this journey, from his family doctor to a urologist at St. Joseph’s Health Centre to the prostate cancer specialists with
cating men on new treatment op-tions, or highlighting the support structures that are available for men living with the disease, spreading the word and speaking openly about prostate cancer will save lives.
the University Health Network, whom he describes as leaders in their field.
His experience has given him confidence about the future. “I’m waiting for the next big break-through,” he says, “and I know there will be one.”
Rocco RossiPRESIDENT AND CEO, PROSTATE CANCER CANADA
Dr. Neil FleshnerMD, MPH, FRCSCHEAD, DIVISION OF UROLOGY, UNIVERSITY HEALTH NETWORK
“We want to open the door for men to have conversations about their health and prostate cancer.”THE POWER OF THE MO Mo Bro Michael Braiden cleans up for men’s health. PHOTO: ALAN PALMER
■ Prostate cancer is the most commonly diagnosed cancer among Canadian men – an estimated 24% of all new can-cer cases.
■ 1 in 8 Canadian men will get prostate cancer.
■ Each year, an estimated 23,600 Canadian men will be diagnosed with prostate cancer. 4,000 will die from the disease.
■ The death rate has been de-clining signifi cantly by almost 4% per year between 2001 & 2009 likely due to detecting prostate cancer earlier and bet-ter treatment options.
Source: Canadian Cancer Society, 2014
STATISTICS
“Having a disease like this really changes your perspective. It makes you focus on whatis important in life.”
RANDI DRUZIN
WE’RE IN THIS TOGETHER Denis Moher poses with his wife Martha. PHOTO: PROVIDED BY DENIS MOHER
INSPIRATION
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lung cancer is a paltry 17 per cent. After the learning of her disease, she had underwent chemotherapy, radiation and surgery. One year later, she was in remission, but
tions and just seven percent from government sources. Without ad-equate funds to conduct research, the battle against lung cancer is extremely challenging.
It started with a small lump on her collarbone. Toronto-based Anne-Marie Cerato, just 30 years old, had no other symptoms that hinted she would be among the Canadians diagnosed – more than 26,000 in 2014 – with lung cancer. The disease kills more people than the top three other cancers combined – prostate, colorectal and breast.
Overcoming the stigma When she told people about her cancer, she experienced firsthand the stigma attached to it – an as-sumption someone with it must smoke. That was the case with Cer-ato, too: “The reaction I got most wasn’t, “How are you?” or “I’m sorry.” It was, “Did you smoke?” In fact,15% of those diagnosed with lung cancer are lifelong non-smokers, while 35% more are ex-smokers, who in many cases quit years before their diagnosis.
The tie between smoking and lung cancer is well documented, but it’s only one element of a much bigger picture. Smoking is linked to many other types of cancer and chronic disease, yet those patients do not experience the same stigma. And it’s not the only cause of lung cancer. Passive (also called second-hand) smoke, exposure to asbestos and radon gas are also factors.
Lung cancer is the deadliest and most commonly diagnosed type of cancer (aside from non-melanoma skin cancer). In Canada, it receives only one percent of private dona-
Finding hopeThere is one bright spot and it’s why Cerato is alive six years after her diagnosis –incredible since the average five-year survival rate for
NEW TREATMENTS ARE AVAILABLEAnne-Marie Cerato, survivor and patient advocate for Lung Cancer Canada fights for access to effective treatment.PHOTO: LUNG CANCER CANADA
Reality check: about half of those with lung cancer do not smoke
the cancer had spread to her other lung and was ineligible for addi-tional surgery or radiation.
She had no symptoms, so doctors told her to wait before beginning treatment again. Waiting to get sick wasn’t acceptable to Cerato. As she tried to come to terms with having a much-shortened life, she was searching for hope. She found it. “I discovered the mention of a promising new drug being tested in trials,” she says. “My oncologist helped me to become part of one.”
New drug developmentA test of Cerato’s tumour showed that her cancer cells carried a rearrange-ment in the ALK (anaplastic lymph-oma kinase) gene – a trait that occurs in an estimated three to fi ve percent of lung cancer cases. The new drug she had stumbled upon was designed to target this type of lung cancer. She has continued to take the drug (two oral treatments daily) since 2011.
Today, Cerato is feeling healthy and strong, considering a return to work and preparing to get married. She’s also a board member with Lung Cancer Canada. She’s deter-mined to give others with her dis-ease hope by pushing for changes in attitude and for public educat-ing. “It’s a brave new world right now in terms of drug develop-ment,” she says. “All patients de-serve to have access to effective treatment and a chance of living a long, healthy life.”
MICHELE SPONAGLE
“She had no symptoms, so doctors told her to wait before beginning treatment again. Waiting to get sick wasn’t acceptable to Cerato.”
CHALLENGES
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A diagnosis of lung can-cer starts a fight – a fight for hope against a disease that too often takes a terrible toll. Lung cancer is the number one cause of cancer-relat-ed death in Canada, in both men and women. It takes the lives of more Canadians than breast, prostate and colo-rectal cancers combined.
Lung cancer stigmaWhile our Canadian health system prides itself on its equality and uni-versality, those concepts only go so far. For most Canadians with lung cancer, it also involves a fight against another enemy – disparity.
Unique among cancers, lung cancer
brings with it a heavy disparity of stig-ma – that people brought the disease on themselves by smoking. A 2010 na-tional poll showed more than 22% of Canadians said they feel less sympa-thy for people with lung cancer than those with other cancers because of its link to smoking.
Natalie Deschamps, whose hus-band is living with lung cancer says, “I still find that I have to justify my husband’s disease to others. He was healthy, athletic and never smoked. He was still running regularly when he went to the doctor for a spot at the back of his eye. It turned out to be a secondary tumor from his lung can-cer. That was three years ago, he was 40; our girls were 5 and 7.”
The need for care and supportLung Cancer Canada believes that pa-tients deserve the opportunities, care and public support afforded to other cancer patients. Reducing or even eliminating the stigma associated with lung cancer would be a major step forward in reducing the disparity.
In reality, one in 12 Canadian men and one in 14 Canadian women will be diag-nosed with lung cancer. Of those diag-nosed, 15% are lifelong non-smokers, while 35% more are ex-smokers, who in many cases quit years before their diag-nosis. For reasons that are unclear, non-smoking women are significantly more likely to be diagnosed with lung cancer than non-smoking men.
The lack of comprehensive screen-ing programs for at-risk populations also poses a barrier to detecting lung cancer earlier, and thus improving the chances of successful treatment.
Finding the cure for lung cancer in-volves large teams of researchers and importantly enough funding. Prog-ress in lung cancer is also challenged in this area. While lung cancer ac-counts for 27% of Canadian cancer deaths, the disease receives only 7% of cancer-specific government research funding and — even worse — less than 1% of private cancer donations.
Progress is hereDespite these challenges, excit-ing new progress is being made as
our understanding of the disease in-creases, and new tests and treatments are developed. We must continue to work to ensure research helps to bring about more choices for patients at all stages of diagnosis and treatment, and that those choices are readily avail-able to all patients who could benefit from them.
Importantly, we need to overcome the disparities present in the stigma, toll, diagnosis, treatment and research of lung cancer to ensure that in the fight against lung cancer in Canada we have all the tools we need to make hope a reality – and to win.
THE FACES OF LUNG CANCER: FIGHTING DISEASE, FIGHTING DISPARITY
LUNG CANCER CANADA
LUNG CANCER STIGMA AFFECTS FAMILIESNatalie Deschamps finds herself having to defend her husband, a “never-smoker”, to others.PHOTO: LUNG CANCER CANADA
FACT: Lung cancer
occurs at high rates in lifelong “never
smokers”
LUNG CANCER FACTS VS. MYTHS FACT:
Estimates from 2014 show that lung cancer
deaths are higher than prostate and breast
combined
MYTH:
More men and women die from
prostate and breast cancer than from
lung cancer
FACT: Estimates show
that there were 475 lung cancer deaths between the age of 20-49 years old in
2014
MYTH:
I am too young to get lung cancer
FACT: Estimates show
that 47% of new lung cancer cases in 2014 were males and females between the
age of 20-69
MYTH:
Only older men get lung
cancer
MYTH:Only smokers
get lung cancer
**Canadian Cancer Statistics 2014
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situations, that need may change from day to day.”
Advance care planningWhile most people would prefer to die at home, very few actually plan for it. A 2012 Ipsos-Reid national poll found that 86% of Canadians have not heard of the term advance care planning, and less than 50% have had a conver-sation with a family member or friend about their wishes should they not be able to communicate themselves.
“Death is a taboo in our society. We don’t like to talk about it,” says Louise Hanvey, Director of Advance Care Planning for the Canadian Hospice Palliative Care Associa-tion (CHPCA). “But evidence clear-ly shows that when people have these conversations, their families experience less stress and less anx-iety at end-of-life and following the death of their loved ones.”
For that reason, a big focus of ad-vance care planning has been to raise awareness of the importance of hav-ing an end-of-life plan.
“Advance care planning means re-fl ecting on and talking about our wishes for end-of-life care while we still can. And, very importantly, decid-ing who will speak for us if we can’t speak for ourselves,” says Hanvey.
“If I get to the point where I can’t speak for myself and make deci-sions about my health care, who’s
And with continued advancements in the fi eld of palliative care, patients can now receive nearly the same level of support at home as in a hospital—including visits from doctors, social workers and psychologists.
“Someone may have a person-al support worker who helps the client with getting ready for the day. That could include very basic things such as feeding or bathing or
Today, people are living long-er thanks in part to advances in medicine where the sick, the dying and often the elder-ly, can be kept alive long past nature’s end date. Instead of treating death as a natural part of life’s evolution, medi-cine and our modern society can prolong life at all costs.
While we may not yet be able to con-trol death, we can control how we choose to approach it.
Palliative care—also known as end-of-life care—is a type of health care that aims to relieve suff ering and improve the quality of life for people who are living with, or dying from, ad-vanced illness.
Usually an integrated approach involving medical care and pain management, palliative care also places a strong emphasis on sup-porting the loved ones of patients by acknowledging that the process of illness aff ects not only the patients, but also their families.
Taken as a whole, palliative care “addresses the psychological, so-cial, cultural, emotional and spiritual needs of the person and family,” says Anthony Milonas, Chief Operating Of-fi cer of CBI Health Group.
Home health servicesFor most people, dying in a home-like setting surrounded by family and friends can be a peaceful and comfort-ing experience.
“People are often more comfortable when they are in a familiar environ-ment surrounded by family and loved ones,” says Rosanna Dolinki, Nation-al Senior Manager of Clinical Practi-ces at We Care Home Health Servi-ces, part of CBI Health Group. “Hav-ing care provided at home can off er a more comfortable alternative for the person and family. Like the home it-self, the care provided there incorpor-ates all aspects of a person’s life and well-being” she says.
clothing,” says Ruth Wilcock, Exec-utive Director of the Ontario Brain Injury Association.
“Some people may be fi ne to get up and to dress and feed themselves, but they might have other needs. So they’ll have an occupational ther-apist who comes in or a physiother-apist or a nurse. What it comes down to is the level of need. In palliative
going to speak for me and make sure that my wishes are being met? All of these questions are critically important,” she says.
Moving forwardWhile work has been done recently in Canada by CHPCA and others to help increase awareness and promote the benefi ts of advance care planning, ad-dressing the taboo surrounding death remains one of the top priorities for palliative care providers.
The key to this is informing, edu-cating and engaging physicians, clients and families on the import-ance of this sensitive topic.
“Bringing awareness to the bene-fits of palliative care planning and educating the general public on how the system works is the first and foremost priority for health au-thorities,” says Milonas.
“These organizations play an ac-tive role in demystifying the topic of dying, so families, patients and the elderly population feel com-fortable to discuss subjects like ad-vanced care planning for example, as early as possible.”
BENJAMIN CHACON
“Evidence clearly shows that when people have candid planning conversations, their families experience less stress and less anxiety at end-of-life and following the death of their loved ones.”
Palliative care: do you have a plan?
PEACE AND COMFORTBeing surrounded by family and having home care improves end of life situations.