Leap Spring 2013

COMFORT FRIES
WHY WE TAKE SOLACE IN

STARCH BOILED IN OIL
THE TRAINED BRAIN
FINALLY! THE BENEFITS
OF BEING PLASTIC
PM#40020055
RESTORED
AND RENEWED
TOP JOB
CATCH A CULPRIT
It takes a virus researcher
and her team
TAKE TIME
How restoration
surgery and rehab
works
NEW FACES
Meet a team that
remakes patients
MYTHMAKER:
What are some common
cancer myths? p.7
Join our new & naughty scavenger quest or choose our iconic 10k Run/5k Walk to
fght cancers below the waist. Gather your friends and start your own team to run,
walk or hunt, or join the Alberta Cancer Foundations team!
Call to RegisteR
403.269.3337 780.423.2220 unCoveRtheCuRe.oRg
CalgaRy edmonton
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000Leap-Underwear-FP.indd 1 2/19/13 2:24:48 PM
Paul Grundy leads
cancer care from
experience
into Albertas cancer-free movement
SPRING 2013
Leap_Spring13_p52-01.indd 53 2/22/13 9:27:02 AM
NATI ONAL TI TLE SPONSOR
REGISTER TODAY!
CONQUERCANCER.CA
[
888
]
624-BIKE
THE RIDE IS BIGGER AND BETTER IN 2013!
The Enbridge
Ride to Conquer Cancer
benefiting
the Alberta Cancer Foundation has a new route,
campsite, and a whole new direction to ride in!
Space is limited, so be sure to secure your spot in
history today!
JUNE 22-23, 2013
000Leap-RideConquer-FP.indd 1 2/11/13 2:42:17 PM Leap_Spring13_p02-03.indd 2 2/21/13 4:08:43 PM
al ber tacancer f oundati on. ca spring 2013 3
SPRING 2013 VOL 3 No. 4 CONTENTS
FEATURES
16 RESEARCH ROCKSTAR
Maya Schmulevitz investigates viruses that can
catch a culprit
20 TOP JOB
Paul Grundy leads with vision and experience
24 THE TRAINED BRAIN
New studies into neuroplasticity shows that you
never stop learning
38 HEALTH RESEARCH
How our heal th system and spending are influencing
research, from the bench to the bedside
42 PLANNED GIVING
Alberta finance expert and
philanthropist Angus Watt
on planning ahead
44 WHY I DONATE
Mavis Clark celebrates her
husbands life by raising funds
for lung cancer research
DEPARTMENTS
4 OUR LEAP
A message from the Alberta Cancer Foundation
6 FOREFRONT
Steps to Stay Well; Tomorrow Project; Squash
Soup; Tumblr; Cancer Myths; Music For Hope;
Ringette Scores on Cancer; Desk Stretch; Top 10
Greens; Build your Weal th; Little Donor
12 BODYMIND
Find out about the si xth vital sign
13 SMART EATS
Eat, play, sleep
14 ASK THE EXPERTS
Why do french fries taste so good?
PLUS: Eye exercise, Aspirin and vitamin D
47 CORPORATE GIVING
EFW Radiology gi ves back to the cause it
holds close
49 BEYOND CANCER
Life after cancer brings new
challenges
50 MY LEAP
A cancer volunteer and
patient wins big
SPRING SPOTLIGHT
RESTORED AND RENEWED
16
42
34
ON THE COVER: Paul Grundy
PHOTO: Laughing Dog Photography
27 RENEWAL
Adjusting to the new you
28 ON THE PATH TO RESTORATION
Cancer survi val rates have improved, meaning more
patients adjust to more afterward
32 TAKE YOUR TIME
Undergoing jaw surgery and subsequent
rehabilitation requires effort and patience
34 A MODEL INSTITUTE
iRSM blends art and science to help patients look,
feel and function better after surgery
36 BECOME THE NEW YOU
Fortitude in adversity is easier for some people, but
its something most people can develop
24
NATI ONAL TI TLE SPONSOR
REGISTER TODAY!
CONQUERCANCER.CA
[
888
]
624-BIKE
THE RIDE IS BIGGER AND BETTER IN 2013!
The Enbridge
Ride to Conquer Cancer
benefiting
the Alberta Cancer Foundation has a new route,
campsite, and a whole new direction to ride in!
Space is limited, so be sure to secure your spot in
history today!
JUNE 22-23, 2013
000Leap-RideConquer-FP.indd 1 2/11/13 2:42:17 PM
20
27
Leap_Spring13_p02-03.indd 3 2/22/13 3:31:23 PM
myl eapmagazi ne. ca 4 spring 2013
alberta cancer foundation
message /
TRUSTEES
John Osler, Chair
Calgary
Angela Boehm
Calgary
Heather Culbert
Calgary
Steven Dyck
Lethbridge
Paul Grundy
Edmonton (ex-offcio)
Katie McLean
Calgary
John J. McDonald
Edmonton
Brent Saik, Vice Chair
Sherwood Park
Heather Watt
Edmonton
Vern Yu, Vice Chair
Calgary
There is tremendous value in partnerships. The Alberta Cancer
Foundation is built on these relationships within health-care delivery,
research and with our donor partners. We all play significant roles in
creating a cancer-free future for Albertans.
On our cover of this issue we feature Dr. Paul Grundy senior vice-pres-
ident of Alberta Health Services (AHS) - Cancer Care. The collaboration
between the Alberta Cancer Foundation and Alberta Health Services has
led to tremendous advancements in how donor funds are invested to sup-
port Albertans facing cancer, through research, screening, prevention and
enhanced care programs. We work closely with AHS - Cancer Care to
identify key opportunities that we can support with our fundraising.
The importance of our partnership with AHS - Cancer Care is especially
evident in the Tom Baker Cancer Centre in Calgary, the Cross Cancer
Institute in Edmonton and the 15 associate cancer clinics across the prov-
ince. Every day, our health partners in these facilities work tirelessly to
ensure that cancer patients receive the best care very often with a beam-
ing smile on their faces.
The Alberta Cancer Foundation is grateful to all of these clinicians and
care providers, because it is this kind of care that inspires you, and thou-
sands of donors like you, to give so generously to support continued
advancements in cancer research, prevention and care. The nurses, oncol-
ogists, radiologists, porters, receptionists, volunteers and so many others
at these centres remind us that the cancer journey is
often flled with moments of kindness and compassion
that inspire us all. In this issue of Leap magazine, you
will also learn about the work of a range of people
making an impact across the cancer spectrum, from a
rising star in immunology to a donor inspiring others to
learn more about lung cancer.
In equal stead are our donors. You are essential partners in a cancer-free
future. Just this past year alone, your donations have:
Purchased two cutting-edge PET/CT scanners at Edmontons Cross
Cancer Institute that provide high-resolution images, which are valuable
tools in cancer detection
Provided more than $750,000 in support to patients and families
through the Alberta Cancer Foundation Patient Financial Assistance
Program
Implemented the Nurse Navigator Program across the province to help
steer patients through the rough waters of cancer diagnosis, treatment
and into survivorship
Supported the Weekend to End Womens Cancers Breast Cancer Chair
with more than $47 million so that Dr. Christine Friedenreich can
continue her ground-breaking research into the impact of exercise in
preventing cancer
The spectrum of these partnerships is vast and represents the complex-
ity of the cancer journey. Leap is one of the ways that we can share the
advances we are making along that journey. Enjoy reading this latest issue
of Leap magazine.
Myka Osinchuk, CEO John Osler, Chair
Alberta Cancer Foundation Alberta Cancer Foundation
Partners Prosper
Take a moment and look what
we have done together. We all
have reason to feel proud.
Al ber ta s cancer- f ree movement spring 2013 5
w w w . a l b e r t a c a n c e r . c a
The Alberta Cancer Foundation
is more than a charityits a
movement for cancer-free lives,
today, tomorrow and forever.
Its a movement of those who know a cancer-free
future is possible and who wont settle for some day.
Its a movement of Albertans who stand with those
who have no choice but to stand up to cancer.
Its a movement of those who know something
can be done and are willing to do it.
For those facing cancer today, in honour of those
lost to cancer, and for generations to come,
we promise progress.
SPRING 2013 VOL 3 No. 4
ALBERTA CANCER FOUNDATION
ASSOCIATE EDITOR: PHOEBE DEY
EDITORIAL ADVISORY COMMITTEE
DR. PAUL GRUNDY,
Senior Vice-President and Senior Medical Director, Cancer Care
Alberta Health Services
DR. HEATHER BRYANT
Vice-President, Cancer Control
Canadian Partnership Against Cancer
DR. STEVE ROBBINS
Director, Southern Alberta Cancer Research Institute
Associate Director, Research, Alberta Health Services,
Cancer Care
CHRISTINE MCIVER
CEO, Kids Cancer Care Foundation of Alberta
VENTURE PUBLISHING INC.
PUBLISHER: RUTH KELLY
ASSOCIATE PUBLISHER: JOYCE BYRNE
EDITOR: MIFI PURVIS
ASSISTANT EDITOR: MICHELLE LINDSTROM
ART DIRECTOR: CHARLES BURKE
ASSISTANT ART DIRECTOR: COLIN SPENCE
ASSOCIATE ART DIRECTOR: ANDREA DEBOER
PRODUCTION MANAGER: BETTY-LOU SMITH
PRODUCTION TECHNICIAN: BRENT FELZIEN
DISTRIBUTION: JEN KING
CONTRIBUTING WRITERS: Colleen Biondi, Tom Cantine,
Linda Carlson, Alix Kemp, Jim Kerr, Craille Maguire-Gillies,
Bobbi-Sue Menard, Omar Mouallem, Janice Paskey, Lisa Ricciotti,
Robin Scroffel, Karol Sekulic, Jordan Wilkins
CONTRIBUTING PHOTOGRAPHERS AND ILLUSTRATORS:
Brian Buchsdruecker, Laughing Dog, Joey Podlubny, Pedersen,
Kelly Redinger, Raymond Reid, Heff OReilly, Eugene Uhuad
ABOUT THE ALBERTA CANCER FOUNDATION
The Alberta Cancer Foundation is Albertas 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 Albertas 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
circulation@venturepublishing.ca
The information in this publication is not meant to be a substitute for professional
medical advice. Always seek advice from your physician or other qualied health
provider regarding any medical condition or treatment.
Printed in Canada by Transcontinental LGM.
Leap is printed on Forest Stewardship Council certied paper
Publications Agreement #40020055
ISSN #1923-6131
Content may not be reprinted or reproduced without permission from Alberta Cancer Foundation.
forefront /
PREVENT, TREAT, CURE
If you have as little as two hours available,
you can volunteer in the Tomorrow Project,
the largest research study ever undertaken in
Alberta. Funded in part by the Alberta Cancer
Foundation, its primary goal is to discover more
about what causes cancer so that the disease
may be prevented in the future.
The research project hopes to have 50,000
volunteers whove never had cancer join the
long-term study. Sign up this spring to take part
in this landmark study. The Tomorrow Project
will follow Albertans ages 35 to 69 for the next
50 years, using a series of questionnaires and
surveys to gather information on lifestyle, plus
blood specimens and other samples.
There are centres in Calgary and Edmonton
that are designed to work with 350 volunteers
per week to conduct the study. You can choose
to participate in person or by mail only, although
youll be asked to consider attending a centre for
body measurements and saliva, blood and urine
sampling. The three requirements to volunteer:
youve never have been diagnosed with cancer
(except non-melanoma skin cancer); your
primary residence is in Alberta; and youre
between 35 and 69 years of age.
This is the largest long-term study of its kind
in Canada and it will provide invaluable data for
health researchers into the future. Fifty per cent
of Albertans will be diagnosed with cancer in
their lifetime and 25 per cent will die from it.
For more information and to register
online, go to in4tomorrow.ca.
50,000
STRONG
BY BOBBI MENARD, MICHELLE LINDSTROM,
MIFI PURVIS AND COLLEEN BIONDI
Dr. Guy Pelletier, a clinical psychologist at the Tom Baker Cancer
Centre in Calgary, has ve recommendations to help you stay psychologically
strong when you are dealing with the physical challenges that come with
cancer treatment:
1. Discuss possible physical repercussions with your health-care professional
before surgery or treatments such as radiation and chemotherapy. This is
when coping begins.
2. Do as much rehabilitation, with the assistance of related health
professionals such as speech pathologists, physical therapists or
occupational therapists, as possible. Consider seeking help from a
counsellor, too.
3. Understand that overcoming many of these issues will be hard and you might
feel anxious or depressed. There is little that prepares you for this,
Pelletier says. He works with many patients who are facing physical changes
from head-and-neck surgery. You have no training for when your salivary
glands cease to work.
4. Challenge erroneous ideas and beliefs that might prevent you from
rehabilitating fully. For example, if you are distressed that people might be
staring at you in a restaurant, think about how often you stare at other
people its not that often. You might need strategies to get you through a
meal. Go ahead and wipe your mouth, ask for more water or eat slower than
the others.
5. Accept your new reality, Pelletier says. No one is happy with cancer and
its aftermath, but many will arrive at the possibility of making peace with the
fact that their bodies have changed.
Steps to Stay Well
Visit CancerBridges!
The team is turning its attention to documenting
the back-to-work needs of cancer survivors. If
you have a story to tell that might help others
struggling with going back to work, please
contact cancerbridges.ca.
RESEARCH IN ACTION: A participant at the Tomorrow Project study
centre in Calgary will have an impact on future health care.
Al berta s cancer- f ree movement spring 2013 7
As the snow melts away, the greening landscape
pulls Albertans outside. Photography is a great way to
enjoy the season. With warmer days just around the
corner, its perfect timing to take a photography course
in the province. Use your lens to capture the changing
lighting of the sun, the landscape, wildlife and even the
joyful images of fellow Albertans bidding adieu to the
long days of winter. There are a few places to go looking
for the right class for you to expand your skills behind
the lens.
Local pro: Some local professionals oer
weekend workshops and photography tours. The
benets of this approach are usually a smaller class
size and a passionate pro who oers advice specic
to your situation.
Photography club: Many photography clubs around Alberta are open to new
members. Depending on the club, they might oer seminars, photo contests and
social gatherings. It is a great way to meet people who are enthusiastic amateurs with
experiences to share.
Adult learning: Call the extension program at your local community college or
continuing education venue to nd out about courses. This option allows you to learn
in an environment with clear goals described in the course outline. A course is often
the best choice for beginners or people who want to improve their technical skills.
Did You Hear That?
With something as serious and
life-altering as cancer, people want to
know more about the potential
causes, treatments and cures. And
nobody has a deeper sense of urgency
than cancer patients and their friends
and family. Sometimes the need to know
leads to questionable sources of infor-
mation. And thats how the cancer myths start.
One myth has it that theres a conspiracy on the part of pharmaceutical
companies to avoid nding a cure for cancer because they make so much
money by treating disease. Thats disconcerting if your life depends on it,
says Dr. Michael Speca, registered clinical psychologist in the department of
psychosocial oncology in Calgarys Tom Baker Cancer Centre. Cancer myths
have an allure because, he says, everyone wants to be the one to beat cancer.
Even though weve had improvements for treating many kinds of cancer, we
still dont have enough knowledge to make everyone feel safe and feel like
theyre going to survive, Speca says, so they naturally want to exhaust the
possibilities. Even if those possibilities are untested and far-fetched.
Dr. Nigel Brockton, research scientist for molecular cancer epidemiology,
population health research for Alberta Health Services, has heard similar
myths from patients he works with. Hes a co-researcher in a study to
determine why the disease spreads to the bones of some breast cancer
patients but not others. During the course of his study, interviewers ask
patients a set of questions and, so far, the 200-plus surveyed have almost
all said they believe stress is a reason they got cancer. Brockton has heard
or read accounts from patients that they believe aspartame, deodorant and
acidic diets can also cause cancer. These things are always seductive
because theres enough truth in there for people
not to completely discount them, Brockton says.
When Brockton was 21, he faced his own
second bout with cancer sarcoma. At the time,
the early 1990s, beta-carotene was the rumoured
solution to cancer, so his mother was sure to give
him a daily dose. Trials were still going on and it
was eventually determined that lung cancer
patients faced an increased reoccurrence of the
disease when taking beta-carotene. The truth is
an elusive thing and thats why were doing the
research. Brocktons research, and that of others,
is ongoing.
Brocktons objections to Facebook postings
and wild Internet rumours about the causes and
cures for disease stem from the fact, he says, that
they take away from the things that can actually
make a difference in a cancer patients life.
Speca suggests that people concerned about a
loved one do the legwork and research a
rumoured cancer cure, diet or treatment regimen
before overloading a patient with untested
advice. A cancer diagnosis is confusing enough,
he says, so hold back even if your intentions come
from a good place. Reliable sources of cancer
information, Speca says, include the National
Cancer Institute (NCI) of the United States, and
any larger, well-known cancer centres.
Get Outside, with
your CAMERA
600More than 600 Albertans survive cancer each year who
would not have survived had they developed cancer 25 years ago.
50More than 50 new cancer research projects ranging
from investigating cancer mechanisms at a molecular level to
increasing pain control for patients were launched last year, in
addition to the hundreds receiving ongoing funding from the
Alberta Cancer Foundation.
25,000rural Alberta women have access to digital mam-
mography screening through mobile units funded by the Alberta
Cancer Foundation.
2,700grants were given to patients and families in nancial
need during treatment.
2,000Albertans are participating in more than 200 clinical
trials across the province, spanning all cancer types.
50,000healthy Albertans will teach us more about
cancer by volunteering to participate in the Tomorrow Project
research study funded by the Alberta Cancer Foundation.
12endowed chairs have been established in Alberta ranging
from research on melanoma to palliative care.
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albertacancer.ca
Desk Stretch
You just arent that old. But you feel it.
Achy, hunched and cranky. Welcome to life in the
cubicle farm. Your spine takes a beating just by
you sitting around all day. Dont sit there and
accept the discomfort stretch past it. Heres a
new move to add to your o ce repertoire.
Get up and take a brisk walk of any length.
Sit down in your o ce chair and put both feet
at on the oor in front of you, knees and hips
at right angles.
Bring your hands to your knees.
As you inhale, spread your chest and arch your
back as you look upwards. Hold for ve
seconds.
Now, as you exhale, round your spine and drop
your head forward between your shoulders.
Hold for ve seconds.
Repeat three times, at 10:30, noon and 2:30.
Its a nice little lift-me-up.
Feed your brain with this tasty soup by chef Anne Desjardins, the owner
of the restaurant lEau la Bouche in Sainte-Adle, Quebec. This soup is one of
100 recipes available in Mindfull, an e-cookbook published by Baycrest, a
cognitive neuroscience research institute in Ontario.
INGREDIENTS
1 butternut squash (about 3 lb)
1 onion, peeled and halved
2 cloves garlic, unpeeled
2 Tbsp olive oil
2 cups low-sodium chicken broth
1/2 tsp salt
1/2 tsp apple cider vinegar
Dash hot pepper sauce
3 Tbsp yogurt
2 Tbsp pumpkin seed oil
2 Tbsp roasted pumpkin seeds
Roasted Squash Soup
with Roasted Pumpkin Seeds
DIRECTIONS
Preheat oven to 425F. Cut squash in half lengthwise;
scoop out seeds. Place squash on an aluminum foil-lined
baking sheet along with onion and garlic. Brush oil all
over vegetables.
Roast in centre of preheated oven, turning onion and garlic
a couple of times, until golden brown and softened, 40 to 50
minutes. Let cool slightly. Peel garlic.
Using a spoon, scoop out cooked squash; transfer to a
blender or food processor along with onion and garlic. Pour
in 1 cup broth. Pure until completely smooth. Return mix-
ture to pot, adding remaining broth. Whisk in salt, vinegar
and hot pepper sauce. If soup is too thick, whisk in a little
more stock or water. Heat over medium heat until steaming.
Pour 3/4 cup of soup into each of eight teacups. Top each
with 1 tsp yogurt. Drizzle with 1 tsp oil and then 1 tsp
pumpkin seeds.
TAKE THAT!
For his 12th birthday party, Alan Samycia asked for donations
beneting the Alberta Cancer Foundation in lieu of gifts. His birthday
is in December, but Alan knew that many families are busy that time
of year, so his parents rented a small hall and had the party in
September. Alan, whose grandmother Vicki had cancer, received 38
donations totalling $1,440 in his honour. Alan comes from a family of
fundraisers and plans to undertake similar efforts for the Alberta
Cancer Foundation in the future.
People from across Alberta support the
Alberta Cancer Foundation. One of the best
online ways to see whats happening in
Alberta communities is Tumblr. The Alberta
Cancer Foundation maintains pages on the
social media site showcasing Albertans who
are creatively engaged in the cancer-free
movement.
Tumblr is a social media site, rst designed
for artists to show off their portfolio of work. It
is an idea that melds beautifully with what
people in Alberta communities are doing. The
Alberta Cancer Foundation Tumblr features
images and highlights from a broad range of
fundraisers and events. The perspectives of
cancer researchers and other researchers are
also included.
Check it out: albertacancer.tumblr.com.
Tumble
Now
Top 10 Greens for Spring
Greens make your garden beautiful and provide tasty fare for
your table, too.
1. AMARANTH. A feature of Asian-inspired stir fries and soup, the greens
of this plant are high in protein.
2. SWISS CHARD. High in vitamins A, K and C, chard is an easy-to-grow
green that tastes great sauted in canola oil, garlic and a dash of
balsamic.
3. ARUGULA. With a peppery taste, arugula is awesome shredded into a
green salad or barely sauted, as a bed for sliced meat or a small let
of sh.
4. ICEBERG LETTUCE. Much maligned, this crunchy green is best
served fresh and offers a great architectural element to your salad,
according to Deb Perelman, author of The Smitten Kitchen cookbook
and website.
5. SPINACH. Fresh, frozen, cooked, canned. It gave Popeye super
strength.
6. RED LEAF LETTUCE. With a robust avour, but a tender bite, red leaf
lettuce offers a big vitamin K punch.
7. GREEN LEAF LETTUCE. Toss it in oil and vinegar, and lay it on a platter
as a tender-crunchy base for a whole-wheat pasta or barley salad.
8. DANDELION GREENS. Nicely bitter, dandelion greens are best boiled
for several minutes, then served with garlic butter or chilled and tossed
into a salad. Any large dandelion leaves will do just be sure you dont
harvest them from an area in which herbicides have been used often
or recently.
9. BELGIAN ENDIVE. Slice it lengthwise, brush it with canola oil and grill
for three minutes over medium-high heat. Salt, pepper, serve!
10. KALE. Dark green, curly and delicious, kale makes a great addition to
soups and stews. It also dries and freezes well.
BUILD YOUR WEALTH
Join nancial planner Girish Agrawal, founder of
Agrawal Associates and a senior executive
nancial consultant at Investors Group Financial
Services Inc., May 9, 2013, to learn how to build a
charitable giving plan. This free information
session includes a presentation by a nancial
planner, followed by an interactive planning
session. Contact Derek Michael at 780-643-4400
or derek.michael@albertacancerfoundation.ca
to register or to nd out more.
At the Ice Palace in West Edmonton Mall,
a special event Ringette Scores on Cancer IV
took place from January 25 to 27, 2013. The funds
from this event beneted the Cross Cancer
Institute in Edmonton to ensure that it remains a
world leader in cancer research, treatment and
patient care.
Every dollar raised stayed in Alberta. This
event was very important to everyone involved
players, coaches, parents and fans as they
worked to exceed last years total of more than
$64,700.
Ringette
Scores
on Cancer
3. ARUGULA. With a peppery taste, arugula is awesome shredded into a
green salad or barely sauted, as a bed for sliced meat or a small let
of sh.
My name is Isaac McNeill and I have set up a charity
benet gala in Fort Saskatchewan called Music for Hope with a
silent auction and live auction to benet the Alberta Cancer
Foundation. The event, in its second year, is planned for March 16,
2013. During our 2012 event, we were able to raise $13,237.81 for the
Alberta Cancer Foundation. I hope we can exceed that this year.
To that end, we are presenting an evening of entertainment with
country music star Bobby Wills and master of ceremonies chef John
Barry, plus a chance to dine with Edmonton Eskimo Nate Coehoorn.
My main reason to organize this event is to honour my mom. In
1999, she was diagnosed with chronic lymphocytic leukemia at the
young age of 45. In 2002, she went through a non-related bone
marrow transplant at the Tom Baker Centre in Calgary. We lived in
Fort Saskatchewan, and most of her treatments and appointments
were at the Cross Cancer Institute in Edmonton. My mom was very
ill and was taken to the emergency room more times than I care to
count. We were told on ve or six occasions that shed have only days
to live but shes still alive. I am very thankful for the doctors and
nurses at both the Cross and the Tom Baker for keeping my mom
healthy. Check us out at musicforhope.ca.
Music for Hope
MAKING POSITIVE CONNECTIONS
bodymind /
Its pretty hard to imagine being diagnosed with
cancer and not feeling some level of distress.
Distress is defined by the National Comprehensive
Cancer Network as a multifactorial unpleasant
emotional experience of a psychological (cognitive,
behavioural, emotional), social and/or spiritual nature
that may interfere with the ability to cope effectively
with cancer, its physical symptoms and its treatment.
Distress extends along a continuum, ranging from
common normal feelings of vulnerability, sadness
and fears to problems that can become disabling,
such as depression, anxiety, panic, social isolation,
and existential and spiritual crisis.
Cancer or not, I imagine weve all been there.
But cancer-related distress isnt just something
inevitable that you have to deal with on your own.
Cancer care professionals now recognize it as the
sixth vital sign in cancer care, following temperature,
pulse, blood pressure, breathing rate and pain. This
implies that its important to routinely assess distress
levels, and treat elevated levels when we detect them.
Professionals should assess distress at the point
of diagnosis and routinely throughout cancer care.
However, many care professionals arent that great
at identifying distress based on a short consultation.
Some care providers have developed specific
questionnaires to systematically assess many aspects
of a persons level of distress, including symptoms of
anxiety and depression, and common problems such
as pain, fatigue, sleep difculties, coping and practical
causes of distress such as financial concerns and a
lack of adequate drug coverage.
Based on recommendations that all patients be
routinely screened for distress, we designed a series
of large studies at the Tom Baker Cancer Centre
that screened newly diagnosed patients for distress.
We compared various screening tools and ways of
responding to results to determine the most effective
solution. Since 2006, weve assessed over 5,000 new
patients using touch screen computers and kiosks
(see www.6thvitalsign.ca for a demonstration)
and directed them to appropriate supportive care
services as necessary. We followed up with patients
for either three months or an entire year (depending
on the specic study) to see how their distress levels
changed over time, based on what type of screening
they had, compared to patients who
received no screening for distress at all.
We found that without systematic
screening for distress, patients levels
of anxiety, depression and distress
decreased naturally over a year after
diagnosis, but their fatigue and pain
levels did not. People who received
screening for distress showed decreases
over time on all symptoms. Those who
were highly distressed benefited the
most from having a staff member call to
discuss the concerns they identied on
the screening tool, and refer them to appropriate services such as counselling
or information sessions. Distress decreased the most for people who accessed
support right from the beginning. Benets were strongest for people with lung
compared to breast cancer, and for those who received personalized referrals
compared to computerized referrals. However, many patients did well with
computerized referrals directing them to appropriate resources, especially those
who had moderate (rather than high) distress to begin with.
Based on this work, Alberta Health Services, with help from the Alberta Cancer
Foundation has recently invested $1 million dollars in screening for distress
province-wide. Jurisdictions are phasing in screening at all centres across the
province over the next two years. Assess your sixth vital sign at a cancer centre
near you.
Dr. Linda Carlson (lindacarlson.ca) is the Enbridge Chair in Psychosocial Oncology at
the University of Calgary and a clinical psychologist at the Tom Baker Cancer Centre.
The Sixth Vital Sign
BY LINDA E. CARLSON
myl eapmagazi ne. ca
Many medical professionals now see distress as an
indicator that is predictive of health outcomes
Whats in the Checklist?
The Personal Well-being Checklist has two sections and takes about ve min-
utes to complete. When you get to the outpatient clinic or treatment area, staff
will ask you to do the Personal Well-being Checklist. After youre done, your
nurse or physician will talk to you about it and try to address your concerns.
The rst section looks at some
common symptoms:
Pain
Tiredness
Nausea
Depression
Anxiety
Drowsiness
Appetite
Well-being
Shortness of breath
The second section looks at
concerns patients may have had in
the last week:
Emotional concerns
Practical concerns
Information concerns
Spiritual concerns
Social/family concerns
Physical concerns
food for life
cookingsmart /
spinach, celery, cucumber,
eggplant, carrots, turnip
and brussels sprouts are
associated with decreased
risk. Try to include these
vegetables as part of lunch
and supper. For lunch, add
lettuce to your sandwich or
baby carrots on the side. At
supper, steam some turnip,
roast brussels sprouts or
make a salad with a dark
green lettuce or spinach.
3. Get fshy. Oily fsh, such
as sardines, anchovies,
salmon and rainbow trout,
have a fat that is healthy for
the heart. Some research
shows that oily fsh may also
reduce the risk of an eye disease called age-related macular degeneration. Canadas
Food Guide suggests two servings of fsh each week. Canned fsh is convenient and
affordable. Try a salmon sandwich with some vegetables, fruit and a glass of low fat
milk for a quick and healthy meal.
4. Eat the Mediterranean way. This is the style of eating from Southern Italy,
Greece and Spain. There is evidence supporting that eating this way reduces the
risk of heart disease and increases the chance of living to a healthy old age. The
Mediterranean diet emphasizes vegetables and fruit, whole grain bread, pasta and
brown rice and healthy fats, such as olive oil and nuts. Fish, eggs and chicken or
turkey are emphasized for protein and red meat is kept to just a few times a month.
Keep portions to sizes recommended in Canadas Food Guide. Remember, even
though a food is healthy, it doesnt mean you can have unlimited portions of it. For
example, even though leaner meats are emphasized, keep each of your two or
three daily servings to two-and-a-half ounces or 75 grams per serving.
5. Find the fibre. Add more soluble fibre to your diet. This can help lower your
cholesterol and protect against heart disease. Easy ways to do this would be to have
oatmeal for breakfast or choose barley as a side dish or as a breakfast cereal. You can
also buy breakfast cereals that have added psyllium which is a soluble fbre.
+ BONUS: Get enough sleep. Try to hit the hay and wake up at about the same
time every day.
Restore and recharge this spring by getting enough
sleep and eating right they go together. An adequate
amount of sleep, seven to nine hours a night, allows
us to feel refreshed and alert for the next day thats
no secret. But will getting more sleep help us live
longer? The research still isnt clear, but we do know
that lack of sleep can have surprising long-term
consequences. Although many factors affect weight,
people that dont get enough sleep tend to carry more
body fat and they may crave more snacks. A shorter
sleep affects the hormones that stimulate hunger
and appetite. And you cant make up for poor sleep
by chasing miracle diets.
Many news stories suggest there are superfoods
foods that can reduce the risk of heart attack or stroke or
prolong life. While some foods or eating habits are great
choices in a healthy lifestyle, one study doesnt always
tell the whole story. For example, a study showing
that broccoli protects mice against diabetes doesnt
necessarily apply to people.
Some foods and eating habits are supported by
research as beneficial to your health over the long
term. Some can help you maintain and promote good
health or, conversely, harm it. Here are fve easy ways
to incorporate healthy changes today.
1. Limit alcohol. The World Cancer Research Fund
Global Report says that alcohol consumption is
associated with increased risk of cancer. Even though
there may be a link between moderate alcohol
intake and reduced risk of heart disease, the report
recommends limiting alcohol. The recommendation
for alcohol is no more than two drinks a day for men
and one drink a day for women. One drink means: 12
ounces (341 mL) of regular beer, fve ounces (142 mL)
of wine or one and a half ounces (43 mL) of spirits.
2. Eat your veggies. Vegetables reduce cancer risk,
but only if you eat them, not let them rot in the fridge.
Non-starchy vegetables such as broccoli, lettuce, kale,
Karol Sekulic is a registered dietitian with Alberta Health Services who has expertise and
interest in the areas of weight management, nutrition and communications.
Some foods are great choices
in a healthy lifestyle, but one
study doesnt always tell the
whole story.
By KaroL sEKuLiC
The Sixth Vital Sign
Recharge your
Days and Nights
Its spring! Find time to review your habits and
renew your commitment to better health
COMFORT FOOD COMES CLEAN
We trolled the experts with queries about food,
eyesight and eye exercises, and asked about the roles
that vitamin D and Aspirin play in cancer prevention
Your vision has to do with the curvature and length of your eye,
says optometrist Dr. Brent Saik of Alberta Sports Vision in Sherwood
Park. Wearing or not wearing your glasses wont make your vision bet-
ter or worse. Saik, an Alberta Cancer Foundation trustee, says that your
eyes are working harder if you are not wearing your glasses and that
they relax when you put your glasses on. So if you wear your glasses
all day and take them off, your eyes are relaxed and it might seem like
you are not seeing as well.
Again, because your vision has to do with the structure of your eye
itself, exercises wont change or improve your prescription. But there
are other conditions that exercise can improve. If you have a lazy eye,
or you are seeing double, or your child gets a headache every time he
reads that could be a problem with the muscles of the eyes, Saik
says. And those muscles are like biceps and triceps in that they can
improve with exercise. He says its important to rule out other condi-
tions, but once he has, people with these problems can usually nd
some improvement with exercises under the supervision of an
optometrist.
One other group Saik sees is athletes who are seeking to improve
hand-eye co-ordination. Saik assesses the athletes vision and can
diagnose if, for example, her eye movements are slow and prescribe
remedial vision training exercises to increase speed, improving hand-
eye co-ordination.
Do your eyes get worse the more
you wear glasses? Are there
exercises for eyes?
asktheexpert /
A RESOURCE FOR YOU
Fries are an easy and quick source of energy, says
Charlotte Varem-Sanders, registered dietitian. Anything salty,
sweet or fat has helped humans survive through the ages. These
preferences are hardwired. And while commuting to the ofce
and foraging at the grocery store have little in common with the
hunting and gathering our ancestors carried out, modern humans
maintain pretty much the same physical makeup as our fore-
bears. Our current lifestyle of low levels of activity and constant
access to food that we just dont have to chase down, dig up or
even prepare ourselves has made those food preferences salty,
sweet and fat a health hazard rather than a boon to survival.
And to make matters worse, a delicious plate of fries holds
special allure if you have skipped breakfast or if you have not
been eating a balanced diet. And the idea of moderation is
terrific but, as Varem-Sanders says, most peoples idea of it
is not all that moderate.
She says that the key to avoid falling prey to your cravings is
to eat a healthy, balanced diet. One trick to beating the french-
fries cravings is to keep an even more convenient snack on
hand: nuts. They keep well and contain healthy fat and some
protein to satisfy carvings, she says. Plus, you can keep them
at the ofce, in the glove box or in your bag.
It doesnt get more convenient than that.
Why do french fries make
me feel so great when
Im eating them?
BY MIFI PURVIS
COMFORT FOOD COMES CLEAN
Dr. Peter Craighead, medical director of the Tom Baker Cancer
Centre, says that the case for taking vitamin D as a cancer pre-
venter is stronger than that of taking Aspirin for prevention. There
are few known associated benets to taking Aspirin for cancer and
there are risks, he says, citing the potential for stomach irritation,
including bleeding.
Craighead mentions a 2012 Oxford University study examining
several trials of long-term, low-dose Aspirin use. The study looked
at the use of the drug for stroke prevention. It indicated that Aspirin
may also reduce the risk of certain cancers, such as colorectal and
breast. Once again, these randomized trials were not aimed at
reducing cancer incidence, but Craighead describes this kind of
nding as an indicator that the Aspirin/cancer connection might be
a good topic for future trials.
Craighead cautioned that if people were to take daily Aspirin in
hopes that it might help prevent cancer, they should take only low-
dose (81-mg) tablets that have been treated with enteric coating to
offer some protection for the stomach.
Is Aspirin a cancer preventer?
Ask our experts questions about general health,
cancer prevention and treatment. Please submit
them via email to letters@myleapmagazine.ca.
Remember, this advice is never a substitute for
talking directly to your family doctor.
Vitamin D plays an essential role in the bodys absorption of
calcium and aids in the growth and repair of bones, says Dr. Peter
Craighead, medical director of the Tom Baker Cancer Centre and
academic head of the department of oncology at the University of
Calgary. It also has a role in immune function, and this might be at
the root of its reputation in cancer prevention; it has a role in cell
differentiation and growth of cells. Craighead says that the role of
supplementation with vitamin D to reduce cancer is unproven, in
that most randomized studies looked at its role in bone diseases
such as osteoporosis. Other studies were awed because of inap-
propriate dosing within the studies. Some population-based
researchers noted a decline in breast and colorectal cancer rates
among people taking vitamin D, but cancer prevention was not the
focus of those studies.
Craighead says that these anecdotal ndings have encouraged
other researchers to undertake randomized trials, testing the ef-
cacy of vitamin D as a tool for cancer prevention. Theres reason to
be cautiously optimistic, he says, and he looks forward to the
results of more studies.
For most adults with a family history of breast, prostate or colorec-
tal cancer, Craighead says a daily vitamin D dose of about 600iu
would not be harmful, noting that the body naturally produces vita-
min D in the presence of sunlight, with darker-skinned people pro-
ducing less. Given that most Canadian adults are advised to reduce
their risk of osteoporosis by taking vitamin D supplements, these
doses might also help reduce cancer incidence. While the absolute
benets are still unknown there are few known side effects and tox-
icity doesnt occur unless levels are very high, he says.
Higher doses have not been studied in children and he advises
that parents not give children vitamin D beyond what is in a standard
childrens multi-vitamin and fortied milk.
Should I be taking vitamin D
and giving it to my kids?
In what doses?
Research Rockstar
LAB LIFE: Shmulevitz nds a creative outlet
in her work with oncolytic viruses.
Maya Shmulevitz specializes
in oncolytic viruses - ones with
the ability to kill cancer cells
ou wouldnt expect them to be beautiful.
But under the microscope, they look like a eld
of interlocking ower petals, or thousands of
conjoined sapphires, sharp-edged but delicate.
These are mouse tumour cells, says Dr. Maya Shmulevitz.
Shes sitting in front of the microscope in her lab at the
University of Albertas Katz Group Centre. To her, the
cluster of cells looks more like a mosaic, or the kind of design
youd draw on the edge of your paper in school while your
teacher was talking. She can come up with a dozen ways to
describe them.
Shmulevitz and her research, like the cells under her
microscope, are not what youd expect. The 38-year-old
researcher is never more excited or enthusiastic than when
shes talking about her favourite subject: viruses.
Viruses are amazing because theyre so small, and theyve
got such little bits of information, and they can do so many
amazing things, she says. Shmulevitzs research is focused on
one group of viruses in particular: reovirus. Unlike the ones
most of us are familiar with, reovirus typically doesnt cause
illness. It belongs to a group called oncolytic viruses that
replicate inside cancer cells, killing them. These are the facts,
Y
Culprit
To Catch a
BY ALIX KEMP / PHOTOS BY AARON PEDERSON, 3TEN
Research Rockstar
Viruses are amazing because theyve
got such little bits of information,
Shmulevitz says. They can do so many
amazing things.
but Shmulevitz says she also tries to explain more
complicated scientic processes with metaphors.
Sometimes it works, sometimes not so much.
When Shmulevitz joined the University of Alberta as
an associate professor with the department of medical
microbiology and immunology in 2011, it was the latest
step in a lifelong love aair with science. Although
she also considered pursuing a career in journalism,
Shmulevitz displayed an a nity for the sciences early
on, dissecting the sh her mother would make for
dinner. It was hardly a surprise when she enrolled in the
University of Albertas biochemistry program, where she
became heavily involved in lab work and research even
as an undergraduate. She travelled to the Weizmann
Institute of Science in Israel and the Argonne National
Laboratory at the University of Chicago to work as a
research assistant on the Human Genome Project,
which, at that time, was sequencing the human genome
for the rst time. Shmulevitz enjoyed the work because
it was creative and demanding, but her true scientic
love was viruses, so she headed to Dalhousie University
in Halifax to pursue a PhD in molecular virology. It
was really the best time of my life, she says. My non-
science friends would make fun of me because I lived in
the lab. I would be there day and night, but I just loved it.
After a stint at the University of Saskatchewans
Vaccine and Infectious Disease Organization and taking
some time o to have a child, she returned to Dalhousie
for a postdoctoral fellowship working under Dr. Patrick
Lee, another University of Alberta alumnus. It was
Lee who rst discovered oncolytic properties of the
reovirus in 1995, and Shmulevitz describes her lab as a
continuation of his work. Where Lee was investigating
how and why reovirus replicated in cancer cells,
Shmulevitz and her students are trying to nd ways to
make the virus more eective. Thats especially relevant
now, since the Calgary-based company Oncolytics
Biotech is in the process of clinical trials to develop
reovirus as a human cancer therapeutic.
While Shmulevitz loves the science and is fascinated
by viruses, research isnt the only thing she enjoys.
When shes not in her o ce or at the lab, Shmulevitz
says her hobbies include playing with Lego with her
eight-year-old son, Ronin. I love being a parent because
theres even a science to it. I enjoy just watching him. If
you enjoy science, you cant not enjoy having a child,
because you see the truth, she says. And while shes not
sure if Ronin will take after her and become a scientist,
shes enchanted by his curiosity. Like her, he looks for
ways to experiment and to explain the world. Its not
uncommon for me to come home at night and go to brush
my teeth, and in the bathroom is this cup, frothing at the
top with toothpaste and theres rocks in there, and a little
note from him that says, Please dont touch. Im waiting
to see what happens.
Shes not pushing her son to go into science he is,
after all, only eight but Shmulevitz spends much of her
time at the Katz Group Centre trying to mould young
undergraduate students into talented researchers.
I think one of the keys is nding mentors who inspire
UP CLOSE: Shmulevitzs mouse tumour cells.
you, Shmulevitz says, who adds she was encouraged by both Lee and Dr. Roy Duncan,
another Dalhousie researcher. That certainly plays a part at Shmulevitzs lab, where she
embraces her role as an educator for the students she works with. She seems to have
passed on her own enthusiasm for science, because in mid-December, although the
lab is closed for exams, there are still students working at the benches. Shmulevitz is
eager to explain their projects and show o their work and encourages them to show
o for visitors. Dr. David Evans, chair of the department of medical microbiology and
immunology, describes Shmulevitz as researcher with a gift for teaching.
She has a good sense of the struggles that students face when they try to get their
minds around some of the research in the rst place, he says. Its not dead obvious
when they walk into our eld, and its often very di cult for students to make the leap
from textbook knowledge to actually applying it. She has a good understanding of those
di culties and is good at helping students overcome them.
Shmulevitz is also the ultimate optimist, and even nds pleasure in the paperwork
most scientists dread. Theres all kind of bureaucracy and things are changing
rapidly in the grant funding eld. There are lots of things that drive people crazy in our
business these days, and through it all, Maya continues to be an optimist and continues
to make progress, says Evans. In fact, Shmulevitz says she actually enjoys grant
applications because it gives her an outlet to write, something she once considered
doing professionally.
Its that optimism that denes Shmulevitz. Shes the kind of scientist who can wax
poetic about tumour cells and come up with novel ways to explain complex ideas until
she hits on the one that will do the trick.
5 QUESTIONS
As an undergraduate, you worked on
the Human Genome Project. What was
that like?
It was creative. It was trying to nd tools to
make something work. I liked the idea that
youd have to go home every day and think,
OK, this didnt work, so how can I change
it? It was very inventive.
You practically lived in the lab when you
were doing your PhD, but what did you
do for fun?
Every Wednesday, there was this professor
of philosophy at another college nearby.
He did philosophy for the people, so hed
advertise in the paper, Lets meet at this
cafe. Ill bring a topic and anyone can
come lets just talk about it. Sometimes
it got heated, depending on the topic, and
it was a fun way to think of things outside of
the lab.
Where did your sons name, Ronin,
come from?
Theres a movie called Ronin, and
somebody asked, Have you seen the
movie? I hadnt heard of it. I just liked
the name. I thought about some science
names. For a girl I thought Valence, like
valence electron, would be cool. I thought
Pipette would be cute but those ones
didnt go over well with Matt, my partner.
What does your son think about
your work?
He doesnt want to be a scientist, but hes
only eight. Right now he thinks it would be
really cool to work for Lego, so he wrote a
letter to Lego asking, What would it take
for somebody to work for Lego? They
wrote him back and said he might want
to consider an engineering degree, and
told him the things he would need to work
for Lego.
What do your students tease you about?
My students always make fun of me for my
use of metaphors. I try to use metaphors
quite often; its my favourite thing to
do to try to explain concepts because
sometimes it helps to imagine things. But
its hit and miss. Honestly, 50 per cent of
the time, everybody just stares at me and
the whole room goes silent. Its good for
a laugh.
TIME TO TEACH: Making an effort with students like Adil
Mohamed, recipient of the Alberta Cancer Foundation
graduate studentship, is of special interest to Shmulevitz.
Top Job
By Omar mOuallem / Photo By laughing dOg phOtOgraphy
He has traded the stethoscope for a suit
and an office, but Paul Grundy is dedicated
to excellence in cancer care across Alberta
p
aul grundy spent a chunk of the mid-1980s
working with three refrigerators that stored every
sample of Wilms tumour that the Cross Cancer
Institute had treated. The pediatric oncologist created the bank
for researchers who were trying to fgure out the nature of the
kidney disease and why it almost exclusively threatened children
so young theyd just begun to walk. But with only four or fve
Edmonton patients per year, it would take Grundys tumour
bank decades to become a reliable source for clinical trials that
usually depend on thousands of cases to make breakthrough
discoveries. Hes patient, but he knew this wouldnt work.
Thats when he had a breakthrough of his own.
Standards
of
Care
Top Job
22 spring 2013 myl eapmagazi ne. ca
Its not about administrative
e ciencies, says Grundy.
Its about combined power.
He reckoned that, since the Cross was collecting a few
samples a year, so would Calgarys Tom Baker Cancer
Centre, and so would every cancer institute in North
America. With the help of the National Wilms Tumor
Study (which is a slight misnomer, since the body in-
cludes experts from both Canada and the U.S.) he con-
vinced researchers in every state and province to com-
bine their Wilms samples and move the bank to a central
location, Columbus, Ohio. Its by far the biggest in the
world, he says.
As a result, researchers in Texas can now gain access
to the tumour bank as readily as scientists in British
Columbia. They use it for studies and to create clinical
trials that steadily improve the standard of care for the
disease.
These days, Grundys work environment is looking
very dierent. Theres still a refrigerator, but its a mini
one, better suited to storing his lunch than lifes work.
Across from that, theres a large
wooden desk, a bookshelf and
an enviable view of Edmontons
river valley.
Grundy sits comfortably in
a low leather chair, the bright
Alberta sun beaming through
the window. He admits hes still getting comfortable in
the role of senior vice-president of cancer care; its the
rst time someone has held this new Alberta Health Ser-
vices position.
My role is to help develop a more provincially-based
system, says Grundy, who also serves as senior medical
director at Alberta Health Services. Its like trying to
steer the Titanic.
Grundy is guiding the strategic plan of Alberta Health
Services cancer care, which runs from 2013 to 2030.
It aims to guarantee the same standard of care for all
Albertans no matter where they live in the province. Its
no easy task in a region where half the population lives
in a few cities and the rest is scattered across 660,000
square kilometres.
There are challenges for people who live outside of
Edmonton and Calgary. We have patients who have to
travel 11 hours for an appointment, says Grundy. We
are expanding our cancer treatment facilities in Grande
Prairie, Red Deer and Lethbridge so that 92 per cent of
Albertans will be able to get their complete cancer treat-
ment within 100 kilometres of where they live.
The plan is already in action. Alberta Health Services
recently brought two high-level oncologists to the Jack
Ady Cancer Centre in Lethbridge, while the newly re-
named Margery E. Yuill Cancer Centre in Medicine Hat
started oering clinical trials up to six per year which
allows some 30 new patients to try treatments previous-
ly unavailable outside of Edmonton and Calgary.
Technology, too, is expanding to the rest of the
province. Red Deers centre will get a state-of-the-art
radiation therapy facility this year, and so will Grande
Prairie in 2017. Although Alberta Health Services gives
the plan almost three decades to fully form, Grundy says
its never complete.
And hes not one to rush into things.
Grundy is the last person you want to be stuck
behind in a Starbucks queue. He likes to think the op-
tions through, weigh the choices. And, like the brew, any
request from subordinates, colleagues and even family
requires percolating, he says. My kids will tell you
that if you want to get something done, ask Mom.
His contemplative, patient personality may aggravate
people occasionally, but it has made him an eective
researcher. Though the qualities may seem contrary to
an executives role, theyre quite useful for carving out
a thoughtful long-term strategy. And, even though the
executives suit ts him as well as the lab coat did, hes
still not sure how he ended up wearing it.
Sometime during his fourth year of medical school,
hed become fascinated with the biology of cancer but
also recognized that he enjoyed working with children
most. I took a one-month elective on childrens cancer
and blood disease and really enjoyed it, and said, This is
what I want to do.
He married his high school
sweetheart, Lorie Grundy,
who followed a similar path
to become a pediatric nurse
practitioner. He interned at a
childrens hospital in New Zea-
land and specialized in pediatric cancer at the Childrens
Hospital of Philadelphia in 1984 before returning to his
hometown, Edmonton, and alma mater, the University
of Alberta. But soon he found himself practising less and
researching more.
Building on his work at the Wilms tumour bank,
Grundy chaired the National Wilms Tumor Study,
chaired the Kids With Cancer Society and co-founded
Canadas C17 Council, an umbrella organization com-
prising the 16 Canadian programs that research and
treat pediatric hematology, oncology and oer stem cell
transplants. We started this organization with a budget
of zero and one or two objectives. Now, 12 years later, it
has a budget of $3 million and six sta.
Along the way, he wove together the necessary skills
for his new post as surely as cloth for his suit, until he
found himself here, on the 15th oor of an o ce tower
in downtown Edmonton.
Hes also the impetus behind four new councils at
Alberta Health Services for radiation medicine, sup-
portive care, cancer surgery and systemic therapy. Each
sees a group of oncologists, pathologists and special-
ized nurses determining the most important needs in
their elds. That way, he says, only the most imperative
motions oat up to seniors such as Grundy. The whole
idea is to bring the right people together, he says, so
they have the right forum to identify the biggest needs.
Susan Fawcett, co-chair of the new radiation medi-
cine council and head of the Alberta School of Radia-
tion Therapy at Alberta Health Services, predicts these
councils will be a major leap for cancer care in Alberta.
His personal vision, and the one hes trying to engage
people with, is to make Alberta, once again, a power-
house for solutions on the full cancer-control spectrum,
says Dr. Peter Craighead, director of the Tom Baker
Cancer Centre. Thats prevention and screening, all the
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way through end-of-life care, and underpinning it with
research.
Craighead calls his colleague whos been training
people not to call him doctor for 30 years a modest
fellow, and its certainly true until you ask him if his
vision is just food for the monster we call Bureaucracy.
He shakes his head. Whats
evolved is a vision of what we
can accomplish with one in-
tegrated health-care system,
and its not just about admin-
istrative e ciencies. Its about
combined power, about having
a standard across the province. As evidence, he points
to how theyve shrunk waiting times for lung cancer
surgery in Alberta to two or three months.
Its also the thinking behind the Government of
Albertas decision to combine all its regional health
boards into whats become Canadas largest merger.
Now 100,000 employees (or three per cent of the popu-
lation) don lanyards with a single Alberta Health Servic-
es logo. Grundy says the chance to contribute positively
to this unbelievably big event was very appealing.
Grundy says hes not sure why hes become the
go-to guy for bringing medical professionals together.
The best he can come up with is, I guess Im geared
to try to improve things around me, creating some-
thing bigger.
Regardless, hes condent he can do more for cancer
treatment from up in the boardroom than down in the
lab or at the hospital. When people ask me, do I miss
the clinical work, he says, I tell them its been so new,
so dierent and challenging in a good way, that I havent
had time to miss anything.
But if theres one catalyst
that explains the turn of fate,
its the one captured in a black
and white photograph sitting on
his bookshelf. Its a picture of
his mentor, Dr. Giulio DAngio,
bespectacled and grey-haired,
holding the rst of Grundys four daughters.
Hes the grandfather of the medical specialty of chil-
drens cancer care, says Grundy. He was there before
there was a specialty in childhood cancer.
It was DAngio, who recently retired from the Univer-
sity of Pennsylvania at the age of 90, who rst nudged
the Albertan toward Wilms cancer and it was under his
leadership that Grundys rst research paper on the
disease was published in The Journal of Clinical Oncol-
ogy. Though theyve become career-long friends and
see each other yearly at industry conferences, DAngio
still remembers the young Grundys early start. He was
knowledgeable, meticulous, patients loved him and the
team took to him immediately, says DAngio. I really
think the world of him. Hes been able to do tremendous
good for children.
These days, his o ce
refrigerator holds his lunch,
not his lifes work
P
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k

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y

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!
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details and exclusive stories.
We think of people who are plastic as
shallow fakers. But when it comes to
the brain, plasticity is a positive and
natural trait
hen it came to aging, American writer Mark Twain ever the wise
man and wisecrack had a simple solution: Age is an issue of mind
over matter, he said. If you dont mind, it doesnt matter. While there
might still be philosophical truth to Twains dictum, modern science is increasingly
discovering just how strong the mind-body connection is. For instance, researchers
found that when people with Alzheimers disease lose their memories they also lose
their appetites. The reason: their sight deteriorates and they cant see whats on their
plates, so they eat less. Or consider the more widespread case of fading memory. First
we start forgetting names and where we left the car keys, and then we become worse at
multitasking. We might even have so-called senior moments, where getting back to
a task after someone interrupts us becomes more di cult.
As recently as a half century ago, people thought the human brain was xed
once you reached adulthood your neurons would short-circuit and die and your
brain would begin its inexorable deterioration. That changed in the 1970s, when
researchers discovered that our brains are much more malleable than many people
Twain included once thought. In The Brain That Changes Itself: Stories of Personal
Triumph from the Frontiers of Brain Science, Canadian psychiatrist Norman Doidge
detailed just how plastic the brain could be. Doidge shared remarkable stories of
recovery, such as the case of a blind man whose vision was restored through a sensor
on his tongue, and a surgeon paralyzed by a stroke who regained use of his body by
re-training his brain. Neuroscientists realized that there were also possibilities for
people with healthy minds who simply wanted to keep themselves as mentally agile
as possible as they aged.
Just thinking can change your brain, says neuroscientist Bryan Kolb, who studies
how experience physically alters the mind. If you have an idea today and youre able to
remember it tomorrow, your brain has been changed so the idea can form. Kolb, the
former president of the Canadian Society for Brain, Behaviour and Cognitive Science
and a professor of neuroscience at the University of Lethbridge, has been called the
founding father of behavioural neuroscience. (I didnt write that bio! he says.)
Kolb has worked with stroke patients and people with Alzheimers disease, and in the
area of pre-natal neuroscience the latter revealing how something as simple as tactile
stimulation can alter the brain of a fetus.
W
Trained
Brain
THE
BY CRAILLE MAGUIRE GILLIES
Cause and eect also extends to cancer with the
growing area of epigenetics, an old term that Kolb says
is acquiring new meaning. Epigenetics is essentially
a study of the changes in gene expressions that dont
involve a change to your DNA. Through various
experiences, you can turn certain genes on or o. Recent
research on cancer, for example, shows epigenetic
changes in areas of the body that are far from treatment.
For instance, when we irradiated the liver, says Kolb.
We saw changes in the brain, and then we noticed
subsequent behavioural dierences. Researchers are
studying how to use epigenetics to manipulate genes
aected by cancer, just one area where there is so much
more to learn about what goes on inside our heads.
But until they nd out the secrets of harnessing
the brains plasticity to train and retrain ourselves
to promote new skills and prevent cognitive decline,
what can we do to stay sharp? Here are ve methods to
promote mental tness.
1. Try Brain Bootcamp
The adage use it or lose it doesnt just apply to your
muscles. Giving your body a workout can keep your brain
t. The hippocampus, responsible for your memory,
makes fewer neurons as you age. Exercise is the biggest
thing you can do to grow these neurons, Kolb explains.
Its also a way to beef up your brain: a Scottish study
published in an October 2012 issue of Neurology, found
that seniors who exercised had bigger brains than their
less active peers.
University of Sydney neuroscientist Michael Valenzuela
points to a particular exercise that decreases the risk of
dementia: People who dance frequently are 70 per cent less
likely to develop dementia than people who never hit the
dance oor. Dancing is not only incredibly good physical
exercise, Valenzuela wrote in a book for Australias Future
Leaders think-tank, but is also mentally quite challenging
and great social stimulation.
2. Get a Life
Give up television for a week. That advice comes from
American psychologist Louis Cozolino of Pepperdine
University, who wrote about the impact of social
relationships on the brains neurochemistry in his book
The Healthy Aging Brain. Most researchers agree that the
more social connections you maintain, the healthier your
brain will be. Cozolino has called this process social
adaption.
In other words, keeping up with friends can boost
cognitive functioning. Kolb agrees. Youve got to keep
the frontal lobe active, he says. If you see six friends,
youve got to recall conversations with each of them.
Thats not happening if youre sitting at home alone
reading.
3. Eat Food for Thought
Vitamins and minerals might have a more dramatic
impact on our minds than you think. Kolb points to a
study by the University of Calgarys Bonnie Kaplan that
found a more than 50 per cent decrease in symptoms of
bipolar disorder when subjects took a broad-spectrum
supplement of vitamins and minerals. Though research specically about the aging
brain is limited, a number of studies (including ones reported in Posit Science and the
Journal of Alzheimers Disease) indicate that a range of foods from berries and walnuts to
oily sh such as salmon and sardines may help ward o cognitive decline. To that end,
Baycrest, a health sciences centre that partners with the University of Toronto, recently
published Mindfull, an e-cookbook by nutritionist Carol Greenwood with recipes from
Canadas top chefs. A taster: Roasted squash soup with roasted pumpkin seeds. See
page nine for the Mindfull recipe.

4. Avoid the Pressure Cooker
Keeping your blood pressure low isnt just good for your heart, its good for your head
too. Hypertension can cause small bleeds in the brain, which have been found in people
suering from dementia, says Kolb. Reduced blood ow to the brain is also responsible
for mild cognitive impairment resulting in memory di culties and strokes. The advice:
take your meds, even if you dont notice a physical dierence.
5. Play Brain Games
The idea that changing your mind can change your body is becoming mainstream
as companies, such as Lumosity, oer computer programs that purport to help you
counteract the cognitive eects of aging. Research is mixed. For example, a study in
Nature found that people who practiced, say, brain training games got better at the
games but those benets didnt translate to other cognitive skills. Kolb points to Posit
Sciences cognitive training exercises, developed by neuroscientist Michael Merzenich,
as one program that has shown positive clinical results. Posit exercises include tasks to
improve your memory (such as practicing listening to a set of instructions and recalling
it) and your visual processing speed (identifying the direction of a variety of visual
patterns to stimulate neurons in your brains visual cortex). Turns out that, when it
comes to staying mentally sharp, its all in your head.
28 ON THE PATH TO RESTORATION
More patients li ve longer, with greater change
idding the body of cancer is the primary goal of most cancer treatments,
but its only one part of the journey. From the point of diagnosis until a
patient is able to return to the new normal, theres another long-term
objective to work towards: restoration. And with increased survival rates, improving
post-cancer quality of life is becoming a major focus for professionals throughout the
eld, side-by-side with nding the cure.
32 TAKE YOUR TIME
Rehabilitation requires effort and patience
34 A MODEL INSTITUTE
iRSM blends art and science to help patients
36 BECOME THE NEW YOU
Recovery is tough, but, fortitude in adversity is
something most people can learn
R
SPECIAL REPORT:
RESTORED AND RENEWED
ADJUSTING TO THE NEW YOU
AFTER: Restored and Renewed
Some cancer survival rates
have tripled in the last decade,
meaning more patients need
treatments afterward
Restoration
and
Renewal
idding the body of cancer is the primary
goal of most cancer treatments, but its
only one part of the journey. From the
point of diagnosis until a patient is able to return
to his or her life and activities, theres another
long-term objective to work towards: restoration.
And with increased survival rates, improving post-
cancer quality of life is becoming a major focus for
professionals throughout the eld, side-by-side
with nding the cure.
R
BY ROBIN SCHROFFEL / ILLUSTRATION BY HEFF OREILLY
With people living longer, there needs to be a huge focus on the rehabili-
tation portion, says Linda Kempster, physical therapy co-ordinator for in-
patient surgery at the University of Alberta Hospital. A focus on restoration
means considering a patients outcome in terms of physical appearance and
their ability to move and function. From improved surgical techniques and
specialized physical therapy to advanced reconstruction, prosthetics and
new research into self-care options, theres a growing drive to get patients
back to a new normal from the very beginning.
Every cancer presents its own set of challenges, but some of the most dif-
cult to overcome in terms of restoration are the challenges of head and neck
cancer patients. The sixth most common type
of cancer worldwide, head and neck cancer
requires a multidisciplinary team and an ag-
gressive treatment that can drastically alter a
patients appearance and change his or her abil-
ity to eat, speak and hear. According to Dr. Hadi
Seikaly, professor in the departments of surgery
and oncology at the University of Alberta (and
divisional director and zone section head for
otolaryngology head and neck surgery for Alberta Health Services) the after-
eects of head and neck cancer can be nearly as di cult for a patient to cope
with as the cancer itself. We can cure these patients with surgery; we can
cure them with high-dose radiation and chemotherapy. However, all of these
treatments could potentially result in devastating decits, Seikaly explains.
If someone is missing half of their jaw and half of their tongue, yes, theyre
cured but, really, what kind of cure is that?
Its in optimizing restoration through the initial surgery that Seikaly and
his colleagues at the U of As ear, nose and throat program are making huge
advances. Seikaly was educated at the University of
Toronto and completed his residency at the U of A before
heading to Texas for advanced training in head and neck
cancer treatment and reconstruction. He brought his
skills back to Edmonton in 1996, and his arrival changed
the way head and neck cancer is treated at the U of A.
Now the magnitude and complexity of the surgeries in
Edmonton draws patients from across the country. It was
a paradigm shift from just xing them at all costs, Seikaly
explains of the approach. We now x them at all costs,
but we also want to bring
them back to real life.
Rather than simply re-
moving the cancer and
stitching the patient up,
Seikaly has initiated a
method that brings resto-
ration to the forefront of
surgical treatment. These
complex surgeries regularly run 16 hours or even longer,
and are done in shifts by two teams: one that resects the
cancer and another that rebuilds the patient. Depend-
ing on the location of the cancer, these advanced recon-
structive surgeries can include anything from building
a new ear, to harvesting bone and making a new jaw
complete with its own blood supply, to inserting bone-
integrated implants to accommodate future detachable
prosthetics, such as teeth.
Advances in physical therapy
and reconstruction have
helped patients get back to
their everyday lives.
In the Seikaly-Jha procedure (Seikaly pioneered
this treatment several years ago with Dr. Naresh Jha),
surgeons can move a patients submandibular saliva
gland(s) to another location in the mouth to keep them
out of the radiation eld, saving patients from the
lifelong dry mouth and tooth decay theyd experience
otherwise. And for patients who undergo laryngecto-
mies, surgeons can perform a trachea-esophageal punc-
ture to accommodate a voice prosthesis later on. These
surgeons are absolutely amazing. They literally almost
have to peel the whole face back to resect some of these
tumours, and they put the person back together like a
puzzle, says Kempster.
She should know. Kempster has been at the U of A
since 1995, and her team of physiotherapists represents
some of the rst people who see head and neck cancer
patients post-surgery. Early mobilization has led to
faster and better healing,
so Kempster does what she
can to get the patients ac-
tive from the rst day, run-
ning them through range of
motion and light strength-
ening exercises over the
course of their hospital stay.
Sometimes ICU physical
therapists even get patients
out of bed even while theyre still on ventilators. After
four to six weeks, many patients head to the Cross Can-
cer Institute to begin radiation therapy or a combina-
tion of radiation and chemotherapy. There, theyll start
new, more intensive physiotherapy regimens with the
physiotherapy team at the Cross in order to maintain or
improve mobility and function and prevent common is-
sues such as lockjaw, drooping shoulders and stiness.
Just as physical therapy advances have helped to opti-
mize restoration, advances in reconstruction have also
had a positive impact on getting patients back to their
everyday lives. Edmontons Institute for Reconstructive
Sciences in Medicine, based at the Misericordia Hospi-
tal, has become a leader in helping patients whose physi-
cality has been altered. A world-class facility, the insti-
tute oers clinical care in the form of case management,
treatment planning, rehabilitation and continuing care
services for patients, including those with head and neck
cancers. Surgeons like Seikaly work in close partnership
with iRSM to design better procedures, planning and
practicing complex surgeries step-by-step on computer
models as well as inserting implants during surgery to
make the transition to prosthetics as seamless as pos-
sible. When its not possible for a surgeon to reconstruct
using a patients own tissues, iRSM crafts missing fea-
tures with synthetic materials such as acrylic or silicone.
Technicians, some with training in art and engineering,
tailor these detachable prostheses to match a patients
anatomy and skin tone.
But even with these advances, many patients still
experience aftereects that last the rest of their lives.
For head and neck cancer patients, di culty opening
ones mouth or shoulder stiness and, for breast cancer patients, lymphedema or the
swelling of ones arms, can mean pain, social stigma, and di culty with the most basic
tasks, such as chewing or putting on clothes. Researchers, such as physical therapist
Dr. Margaret McNeely, are actively searching for ways to ease these problems and im-
prove restoration.
McNeely has a joint appointment in the U of As department of radiation oncology
and as a clinical researcher in the rehabilitation medicine department of the Cross
Cancer Institute. A former clinician, her research has resulted in immediate changes
in practice. A study she conducted on patients who sustained nerve damage to the
trapezius muscle during cancer surgery showed that early intervention drastically
minimizes shoulder stiness down the road. Since the studys publication in 2004,
physiotherapists have started to work the shoulder in these patients as a preventative
measure with much success.
In many cases, McNeelys research has focused on self-care techniques. Patients
like to be a partner in their recovery, and also to have hope that this is not how theyre
going to stay in the long-term, she says. In a feasibility study that wrapped up in Feb-
ruary, McNeely looked at various commercial nighttime compression garments avail-
able for breast cancer patients with lymph-
edema. These garments are an alternative to
nighttime compression bandages, which not
only require specialized skill to wrap prop-
erly but take approximately 20 to 30 min-
utes to apply. Next, she will gather evidence
about the eectiveness of such garments.
Without hard data, theyre not covered by
health insurance so theyre prohibitively ex-
pensive for many lymphedema suerers.
Similarly, McNeely is researching the eectiveness of commercial stretching de-
vices for the self-management of patients with jaw stiness from surgery or radia-
tion therapy. The devices, which can cost thousands of dollars, allow patients to take
a bigger role in their recovery by supplementing their physical therapy with home
stretching rather than relying solely on outpatient services which the health-care
system cant always support for the duration patients need it. But without evidence
proving they work, the devices arent covered by insurance and remain beyond the
reach of most patients.
McNeely is also looking at dierent methods of early detection for lymphedema in
breast cancer patients, including taking baseline measurements before treatment;
using a perometer, which assesses limb volume; and using a bioimpedance device,
which measures the uid volume in tissue. By monitoring those patients who are at
higher risk, its possible to treat them before lymphedema becomes a chronic condi-
tion and lifelong burden for a patient.
The path to restoration is being cleared by the initiatives of professionals like
McNeely, Kempster and Seikaly. According to Seikaly, the survival rate for head and
neck cancer patients has increased in the past decade from around 25 per cent to 70 or
80 per cent. And of those survivors, 80 per cent are now able to return to work, thanks
in no small part to the restoration-focused reconstructive and therapeutic advances.
And theres still much more work underway improving post-cancer quality of life.
New approaches, such as the use of robots for tumour removal, are proving more
eective and less invasive. Were still evolving. Were still trying to make things
better and better, Seikaly says. And for patients, that means looking forward to a
more eective restoration and a higher quality of life.
MEET JOES TEAM: A triathlon and a run/bike duathlon,
Joes Team raises money in support of head and neck cancer
research, beneting the Alberta Cancer Foundation.
This years event is in Calgary on Saturday, June 15, 2013.
Find out more at albertacancer.ca/joesteam
Just as physical therapy advances
have helped to optimize restoration,
advances in reconstruction have also
had a positive impact on getting
patients back to their everyday lives.
TAKE YOUR TIME
BY ROBIN SCHROFFEL
n a routine visit, your dentist
spots a lesion in your mouth.
Concerned, she refers you to an
ear, nose and throat specialist. The results
from the biopsy come back, and its cancer.
O
16 HOURS
You head into the hospital for surgery, where the advanced practitioner
briefs you on the journey. Surgeons at the University of Alberta Hospital
remove the tumour along with most of your lower jawbone. Five to eight
hours have passed.
A second team takes over. They
craft a new jawbone using part
of your bula the small bone
on your leg and connect it
to the blood supply from your
neck. It comes complete with
pegs to accommodate the
teeth youll receive once the
swelling goes down. When its
over, youve been on the table
for almost 16 hours.
1. Surgeons cut out the affected
piece of jawbone and scrape
away the tumour.
2. They put the affected bone back
into the jaw, just long enough to
make a wire mould. Then they
remove the affected section of
bone again, discarding it.
3. They take the bula, the thin
bone at side of the lower leg,
and form it to t the jaw, where
it takes the place of the missing
jawbone. They afx it to the wire
mould permanently.
At First 5 - 8 HOURS
A couple of days after surgery, you move from
ICU to the ward. You work with nurses, the
physical therapist, the dietician, the speech
language pathologist, the occupational
therapist, the respiratory therapist and a
social worker. For the next 10 to 14 days, your
interdisciplinary team helps with movement,
breathing, swallowing, nutrition and planning
your hospital discharge. They discharge you with
a home exercise regimen.
In four to six weeks, you begin a combination of radiation and
chemotherapy at the Cross Cancer Institute. The hospital refers you to
the physical therapy team there, and you begin a serious rehabilitation
program and attend the support group. Seven weeks later, your second
phase of treatment is wrapping up.
Youre back at work. You look different but,
thanks to the restoration work on your jaw
and your new teeth, the changes to your
appearance are much less pronounced than
they would have been a decade ago. You
continue to attend the support group at the
U of A for head and neck cancer survivors,
both for the support it gives you and to help
others on the journey.
3 - 14 DAYS
4 - 7 WEEKS LATER...
An institute in Edmonton is
dedicated to reconstructing
patients who have had life-
altering injury or illness
or all thats said about the heart, your head is where you
really live. Not only does it hold your brain, the seat of conscious-
ness and choice, but it also contains four of the ve big senses you
use to perceive the world: sight, hearing, taste and smell. And on
top of that, we humans rely enormously on our faces to communicate, identify
and relate to each other. So damage to the head, whether caused by trauma,
cancer, or congenital defect, is denitely a big deal.
The Institute for Reconstructive Sciences in Medicine (iRSM), based at
the Misericordia Hospital in Edmonton, was founded by Dr. Johan Wolfaardt
and Dr. Gordon Wilkes in 1993 to focus on research and treatment of skull and
facial problems. At that time the institute was known as COMPRU, for
Craniofacial, Osseointegration, and Maxillofacial Prosthetic Rehabilita-
tion Unit, and its international reputation has grown rapidly. Drawing on the
expertise of surgeons and engineers, and an artist, the institute is a world
leader in patient care and innovation. As well, the iRSM collaborates and
shares its knowledge with other prestigious institutions around the world, to
improve treatments for patients with serious skull and facial problems.
Skull surgery is nothing new; archaeologists have found skulls from as early
as 6500 BC showing signs of trepanning, a practice of boring holes into the cra-
nium. Patients often survived, evidenced by the fact that the unearthed skulls
showed signs of healing.
Although the techniques and equipment have improved dramatically over
the millennia, it wasnt until the invention of the X-ray that surgeons have been
able to get an idea of what to expect once they got inside. Even then, much of the
information surgeons needed to formulate a plan wasnt available until they had
opened the patients skull. Thats one of the reasons surgery can take so long.
So planning is everything, and the more data surgeons have to work with, the
better the preparation, and the sooner the patient can be sent to the recovery
room. At iRSM, the team uses modern advanced imaging technology, along
with sophisticated computer modelling techniques and 3-D printing, to prepare
F
BY TOM CANTINE / PHOTOS BY KELLY REDINGER
extremely detailed surgical plans long before the patient
hits the operating room.
Heather Logan is a surgical design simulationist at
iRSM. Before earning her M.Sc. in rehabilitative medicine,
she took a degree in industrial design. She helps to
provide the planning to ensure that a surgery is carried
out as e ciently as possible. One of the more challenging
projects in which shes recently been involved was helping
to plan for a complex surgery to reconstruct a patients
nose. Calling on her design skills, she worked from three-
dimensional scans of the patients face to create a plastic
template for the surgeon to use in shaping a section of
bone removed from the patients rib to form the new nose.
Jawbone reconstruction, in contrast, often uses a section
from the patients bula, the smaller bone that runs
alongside the shin bone.
Traditionally in this sort of reconstructive surgery, the
surgeon would need to work freehand, relying only on
experience and judgment to shape the bone. This takes
time, and since bone is living tissue, it cant be kept outside
of the body for very long. Preparing a precise template in
advance, using 3-D modelling on a computer, can improve
the precision of the nished piece and reduce the time a
patient spends in surgery.
One of the biggest things that weve been working on
lately, Logan says, is the dierence that surgical planning
makes on the outcome for the patient. While some
medical modelling has been applied for the past 12 years,
its only in the past couple of years that medical teams have
been able to do so much of the design and preparation
Sharing: FACE CANCER WITH STORIES AFTER: Restored and Renewed
ahead of time without intrusively involving the patient.
Since the kind of work that Logan does is so new, there
hasnt been enough hard data to give solid numbers on just
how much dierence it makes, but the team is recording
its successes.
Logan grew up seeing the challenges her brother, who
has a disability, faced daily. I really always wanted to work
with people who have a disability, she says. I worked as
a personal support worker for ve years. And I studied
industrial design to learn how to make tools that could
make life a little easier for people.
In addition to her work in surgical planning, Logan
draws on her design background to craft prostheses for
ears, noses and eyes, usually moulding them out of silicone.
While about 90 per cent of her medical modelling and
surgical planning is for cancer patients, Logan estimates
that her work on facial prostheses is about evenly split
between cancer patients, congenital defects, and trauma.
Pre-injury 3-D scans are not often available for accident
victims, so she must often work from photographs taken
of the patient before the accident.
One of the more surprising challenges is deceptively
simple: getting the colour right. If someones going to be
wearing an articial ear, it ought to match their natural
colour, after all. Lindsay McHutchion of the institute is re-
sponsible for colour-matching and materials testing. The
institute recently acquired a spectrophotometer, which
measures colour electronically, but it still has limitations,
in part because ones own natural colour changes from day
to day and hour to hour. Measure the colour of your ears
just after you come in from a brisk walk in a chilly breeze, and they will be unusually red.
Another project at the Institute is the osseointegrated implantation, where an implant is
actually anchored directly to the bone. This is useful for securing facial and dental prosthet-
ics to help a patient eat, speak and swallow. Particularly interesting, though, is its use with
bone-conduction hearing aids. Traditional hearing aids function as loudspeakers worn in
the outer ear, transmitting amplied sound waves through the air within the auditory canal
to the eardrum. In a bone-conduction device, the sound vibrations move through the solid
bone of the skull itself. There are bone-conduction headsets on the market, which are worn
externally and simply rely on pressure with the skull to transmit the vibrations, but osseo-
integrated implants go well beyond that; as the name suggests, they are integrated directly
into the bone. An external microphone is still used to pick up the sounds to begin with, but
the signal is then sent to the implant.
The work at the iRSM is novel and groundbreaking. It is also on the cutting edge in that
more often patients are living past cancer and in need of reconstruction. And it puts the
art in science.
FACE FORWARD: Heather Logan is on the
cutting edge of prosthetic design, creating a
new eld in medical modelling.
GENEROUS GIFT
Much of the work at the iRSM is supported by the Dr. Murray E.
Mickleborough Research Chair in Interfacial Biomechanics.
In 2009, Mickleborough, himself a maxillofacial surgeon, was diagnosed
with throat cancer, and became a patient at iRSM. He was impressed with
the work the institute carried out, and made a gift of $1 million to support
continued research. That, combined with money from Alberta Cancer
Foundation and the Caritas Hospitals Foundation, has led to the creation of
the new research position at the institute, named in honour of the doctor, who
died in 2011.
Fortitude in adversity is easier for some
people than others. But fortunately its
something most people can develop
BY COLLEEN BIONDI
Acceptance
and
Change
A
fter experiencing cancer, people often say they
have changed they appreciate the small things in
life and are more in the moment than before.
But many are also physically changed minus a
breast from a mastectomy, for example, or having neck scars
from thyroid cancer surgery. Obvious markers like these
can be psychologically devastating. Coping with them is a
testament to the human spirit and to the power of family,
friendships and community.
No one knows more about this than Tracy Coulter, a
36-year-old Calgarian who is recovering from oral cancer.
Coulter suspected the worst when she visited her physician
in the fall of 2010 with a mouth sore. Her fears were realized
and, the following February, she had surgery to remove 90
per cent of her tongue and to rebuild a new one with skin,
an artery and vein from her left leg. Doctors removed her
lower teeth and extracted some lymph nodes. Six weeks of
radiation followed and another surgery in January 2012 to
make the new tongue larger.
The recovery two years and counting is daunting. The
acute damage from surgery and radiation meant she couldnt
talk, swallow or eat at rst. Today, shes speaking, eating
pured foods (in addition to nutrients from a feeding tube)
and swallowing on her own.
I still have trouble with words like cat because I dont
have the muscles to make those k sounds anymore, explains
Coulter. And Im trying to speak more slowly so people
can understand me. But Im from Newfoundland and I have
never spoken slowly in my life. Coulter also talks to Daisy,
her beloved seven-year-old
English bulldog and cuddle
companion, practising the
sounds she struggles with.
And Coulter cant wait
for the day when she can
chew a steak. But there
are more surgeries one is
reconstructive and three involve dental implants scheduled
for this year. One day, Coulter says, I am going to get my
life back and I am glad to say that Ive never given up on doing
just that.
She admits feeling sad, mad and frustrated with the length
of her recovery. And shes self-conscious; her face looks
dierent, particularly from the lips down to the neck. For
a long time I didnt like to look at myself in the mirror, she
says. But I am OK now with the person looking back at me.
Dr. Guy Pelletier, a clinical psychologist with the
Tom Baker Cancer Centre in Calgary, is very familiar
with what Coulter is experiencing. He says the common
trauma of physical changes interferes with quality of life
and social interaction. Damage to salivary glands can dry up
saliva, making it hard to eat. Chewing can be di cult and
patients may be reluctant to eat in public for fear of choking
or looking messy.
Pelletier says coping begins early, when patients discuss
all possible physical repercussions with health-care
professionals before treatment. After surgery, he advises
patients to start rehab early and do as much as possible.
Anxiousness and depressed feelings are normal, he says,
but the goal should be to accept a new reality. No one is
happy with cancer and its aftermath, he says, but many
will arrive at the possibility of making peace with the fact
that their bodies have changed. Pelletier advises patients to
seek professional help at any time in the process, saying that
38 per cent of people impacted by cancer benet from the
services of a counsellor twice the rate of the general public.
Calgarian Brenda Reid, a 56-year-old yoga instructor and
childrens choir volunteer, chose not to pursue professional
help and also bypassed reconstructive surgery following a
mastectomy in December 2009. It never really entered my
mind, she says. I am not my breasts.
Nevertheless, when she showered in public facilities it was
di cult to look at the scar and, occasionally, the look of shock
on the faces of others upset her. But it didnt immobilize
her. I just smiled at them and answered questions if they
had them.
When subsequent chemotherapy took her hair, she went
bareheaded or wore a scarf. Again, it was concern for the
discomfort of others that bothered Reid more than concern
for herself. I want to impart that its not the end of the
world. For me, it was a blip. Reids surgeon made a comment
that was particularly supportive: Beauty is so much more
than what we see on the surface.
Reid has good examples in her life. Her son Jamie was born
with microtia, a condition manifested by an underdeveloped
ear. He is deaf on that side, but is successful, kind-hearted
and engaging. He also wears his hair short and around his
ears, she says. He is denitely my inspiration.
Reid, herself, is a great example
of the attitude it takes to reframe
the erroneous ideas and beliefs
that might prevent people from
rehabilitating fully. Pelletier says
that, for example, if a patient is
distressed that people might stare,
he or she should remember that
most people dont stare that often.
And remember that your friends and family will continue
to love and support you if you give them a chance to do so,
he says.
This was the case for Reid. I didnt need pity, she says. I
felt loved and supported by my friends and family.
In Calgary, Tracy Coulters circle of family and friends
has likewise helped her ride out the storms. She Skypes her
father in Newfoundland, who knows just what to say. When
Coulter was a girl, her father would hold her hair back when
she was ill and tell her everything would be OK. He is still
doing that, she says. Her husband, mother, mother-in-law
and best friend have all been at appointments and surgeries.
She knows it could be worse. The cancer, after all, has not
spread. And her own inner strength is like a muscle she has
developed; it keeps her from giving up.
One day, Coulter says, I am
going to get my life back and I am
glad to say that Ive never given
up on doing just that.
FIND OUT MORE: See page seven
for Dr. Guy Pelletiers tips on staying
psychologically strong after cancer.
Managing health-care costs includes
finding new ways to efficiently move
research from the lab to the patient
atients trickle in daily to Edmontons Cross Cancer Institute, on the
southwest side of the University of Alberta campus. Inside, they nd oncologists,
nurses, psychologists and speech pathologists, not to mention nutritionists and
spiritual care providers. The institute has a bone marrow and stem cell treat-
ment o ce, imaging departments and 40 day care units. When a patient has a blood test or
a mammogram, for example, the results are shared within the health-care team to avoid du-
plication. If patients from out of town need to stay overnight in Edmonton for treatment, a
volunteer team will shuttle them to their hotel or bed and breakfast. The institute aims to
treat the whole person, an important distinction in what can seem like a confusing and
fractured health-care system.
But theres another dimension to the Cross Cancer Institute that aects patients. The
facility, and others like it in the province, is a physical link between research labs and the
health-care consumer, because it collaborates with universities in Alberta on new tech-
niques and therapies. Roger Palmer, who recently retired as interim dean of the Univer-
sity of Albertas School of Public Health, estimates that 15 to 20 per cent of patients at the
Cross take part in clinical trials, meaning they get the best care, plus access to the latest
therapies and surgical procedures. Closing the gap between the latest research and pa-
tient care known as bench-to-bedside research can make all the dierence. If youre
looking for the intersection of high-level research and frontline care, youll likely nd it
in this squat brick building.
Bench-to-bedside research is often called translational research because it e ciently
translates basic science into practical treatments. In essence, most successful health
research eventually makes it to the bedside. Last year, however, Know, a publication of
the University of Texas at Austin, reported that it takes as much as 24 years for research
from the lab to reach your medicine cabinet. After scientists develop a new drug, for
example, it goes through several often lengthy clinical trials, is commercialized by a drug
company, winds its way through regulatory approvals and nally, eventually, reaches
the market. Translational research, on the other hand, aims to remove as many barriers
between disciplines as possible to bring innovative practical applications to patients
as quickly as possible.
P
System
Health
of a
BY CRAILLE MAGUIRE GILLIES / ILLUSTRATION BY RAYMOND REID
This approach has become a hot topic in health care. YouTube
is replete with short videos to help explain the concept. And its
not only on the mind of Canadian health-care policy-makers and
administrators. Last May, for example, a U.K. breast cancer tis-
sue bank opened, one similar to the Albertas cbcf tumour bank in
Edmonton, after an international survey found that researchers
could advance their work more quickly if they had access to more tis-
sue samples. In the United States, health centres such as Childrens
Hospital Boston and educational institutions such as the University
of California, San Diego, have established translational research
departments.
In London, Ontario, the Childrens Health Research Institute,
one of Canadas largest childrens research organizations, created
the Translational Research Centre with bench-to-bedside research
programs such as tissue sampling and a bio-specimens repository.
Like the U.K. tissue bank, the repository provides the infrastruc-
ture so researchers can easily access tissue samples an espec-
ially difcult challenge in pediatrics. In 2012, a new Alberta/Pfzer
Translational Research Fund was launched to support projects
with technology transfers and commercialization prospects. And
the department of medicine at the University of Alberta recently
created a $30,000 translational research fellowship.
The hype around a bench-to-bedside approach began around the time the Cana-
dian Institutes of Health Research (CIHR), a Government of Canada health research
outft, launched a strategy to improve patient-oriented care. The goals were to bet-
ter ensure the translation of innovative diagnostic and therapeutic approaches to the
point of care, as well as help the provinces and territories meet the challenge of de-
livering high-quality, cost-efective care. The result, the strategy claimed, would be
better health outcomes.
Its about the Money
Improving health care in Canada has been a decades-long discussion that goes
beyond quickly translating early innovations to the end user. The discussion typically
centres on money. Canada is made up of highly decentralized systems 10 provin-
cial, three territorial and one federal with many points of decision-making and infu-
ence inside them, the Canadian Institute for Health Information said in a 2011 report
on the drivers of health-care costs. Decisions in one system often infuence other
systems. The CIHI released its report around the time Canada topped $200 billion in
spending on health care a historic milestone and conversations around spending
and health outcomes became more heated.
Health care spending in Canada rose 7.5 per cent per year between 2000/2001 and
2009/2010, according to a study by the Fraser Institute. It predicts that, by 2028,
eight provinces will spend half of their provincial budgets on health care. (Alberta,
a big spender, is on track to reach this milestone by 2017.) In most cases, health-
care costs grow faster than provincial revenues, faster than population growth
plus infation and faster than economic output, Jefrey Simpson, a Globe and Mail
columnist, wrote. Simpson, whose new book is Chronic Condition: Why Canadas
Health Care System Needs to be Dragged into the 21st Century, continued: The Romanow
Commission a decade ago naively argued that heaps of new money would buy change.
Many in the health feld freely admit that resource allocation is key to transform-
ing the system. In a paper released last October, Herb Emery, the Svare professor of
health economics at the University of Calgary, explored what implications an aging
population would have on the fnancing of health care. The report, Can We Avoid a Sick
Fiscal Future, was co-authored by David Still and Tom Cottrell, and called for reform
in how services are delivered. Were basically pointing out that nothing about how
we do things now is sustainable. If we want to make it sustainable, Emery says, we
have to fgure out how to reduce the cost of care for Canadians 65 and over without
rationing care. In other words, prices of care have to come down. Emery believes that
if prices within the system were changed if fees were lowered for surgeries that were
once complicated and are now routine, such as many cataract surgeries, for example
money could be re-allocated to, say, new cancer drugs or long-term care. Discussions
of money and efcient access to care are the backdrop
to translational medicine.
People are Talking
Public discourse about cost and inefciency of health
care is what bolsters the case for optimized bench-to-
bedside care.
Not surprisingly, the shifting economic landscapes
impact innovation. In its 2011 study, the Cana-
dian Institutes of Health Research found that, in
a weak economic climate, Funders of basic bio-
medical research are anxious to see and to explain
to taxpayers and donors the public beneft of the
billions of dollars invested in scientifc research.
Streamlining the research process and aligning the
end-user more closely to the research process could of-
fer one solution. Patient-oriented research is not only
about doing things better, the CIHR study explained,
but also about being able to stop doing things that are
known to be inefective, unnecessary and often costly.
Breaking down the roadblocks to sustainable health
care is a systemic issue, but its not impossible. The
system has big challenges and theyre going to grow, but
theyre not going to become fundamentally diferent
from the challenges were managing now, says Steve
Buick, director of policy and communications at the
Institute of Health Economics, an Edmonton-based
non-proft that collaborates with government, aca-
demia and industry. Buicks message means that the
news is not grim. The system doesnt have to become
fundamentally diferent to manage those challenges.
When it comes to bench-to-bedside care specifcally,
the Canadian Institutes of Health Research identifed
two challenges, or death valleys. Valley one is a de-
creased capacity to commercialize health discoveries,
a problem that impacts the countrys clinical knowl-
edge base. Valley two is the ability to share and use re-
search results at both the clinical and decision-making
levels. These two valleys must be bridged if Canada is
you
translormational
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for becoming
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Progrcss Rcort
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to Donors
to bring evidence to bear to enhance health outcomes
and ensure a sustainable health-care system, the CIHR
reported.
But we have already come some of the way along the
research-to-practice continuum. In a 2009 internat-
ional ranking, Canada came in frst for patient-oriented
research, and was a leader, along with the U.K., Denmark
and the U.S., in the impact of
science on the health feld.
On a provincial level, mean-
while, Alberta has introduced
a new program that could im-
pact how research reaches pa-
tients. Alberta Health Services
launched six strategic clinical networks in late 2011 (a
further six are scheduled for March). The networks
bring together policy-makers, researchers, operations
and strategy specialists, community leaders, along with
patients and their families. The goal is to create a single,
cohesive health-care delivery system. (The networks
are part of a fve-year strategic plan that participants
hope will, among other things, reduce wait times for
cancer patients to meet radiation oncologists. Planners
expect that the wait times will drop from four weeks (in
2011/2012) to two weeks (in 2014/15).
Last October, Alberta Health Services appointed
scientifc directors for fve of the strategic clinical net-
works to bridge the gap between research and clinical
care. Its a golden window of opportunity to have prac-
tice-based evidence drive research and evidence drive practice, Linda Woodhouse,
one of the new scientifc directors told a health-sciences media rep at the University
of Alberta when the school announced the directorships in fall 2012.
For cancer care especially, drawing connections between research and leading tech-
nology might take the form of a clinical trial, a new way to deliver a service or a new
technology. Recently, the Cross Cancer Institute and Calgarys Tom Baker Cancer
Centre received two new linear particle accelerators, or LINACS. The new machines,
which deliver radiation therapy to cancer patients, are
faster and rotate 360-degrees around the patient, lead-
ing to a decrease in delivery time from seven minutes to
two minutes.
But pursuing efciency is tricky. Medicine is not
cookie cutter, Roger Palmer says. Groups of oncolo-
gists in Alberta spend a lot of time designing the best
ways to deal with particular tumour groups, he ofers by way of example, but when
it comes down to it, they might only use a technique in half the cases. That sounds
strange, until you realize human beings dont just have cancer, but may also have other
things going on diabetes, obesity, heart problems.
Despite such challenges, many in Canadian health care see bench-to-bedside re-
search as a key goal for the way research is completed.
Case in point: Dr. Gregory Cairncross, Alberta Cancer Foundation chair in brain
tumour research, is the mind behind international clinical translational research stud-
ies to fnd the best approach to treating glioblastoma, a particularly devastating type
of brain tumour. Cairncrosss research was the hallmark to doubling the lifespan of
glioblastoma patients and improving their quality of life. Cairncrosss studies showed
that glioblastoma patients did better with a drug called temozolomide in addition to
radiation therapy. This research moved relatively quickly from the lab and is now the
standard of care these patients.
Its a breakthrough that would translate into any language.
Improving health care in Canada
has been a decades-long
discussion that typically
centres around money.
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translormational
tLank
for becoming
a powerfuI part of
AIberta'e cancer-free
movement
Progrcss Rcort
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rcad tLc rcport onlinc at
to Donors
BY JIM KERR
Alberta nance expert and
philanthropist Angus Watt offers
a planners take on planned giving
IN THE KNOW: Angus Watt says
philanthropy is all in the planning.
planned giving /
WORKING FOR A CAUSE
WATT can
you do?
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f youve got a question about investing your
money, there arent many people more qualied
to provide an answer than Angus Watt, and the
same goes for investing in your community.
With more than 30 years working in Edmontons
financial sector and a history of philanthropy behind
him, it shouldnt come as much of a surprise to learn
that Watt is involved in planned giving through the
Alberta Cancer Foundation.
Watt, the managing director of the Angus Watt
Advisory Group, says planned giving is vital to the
l ongevi t y of char i t i es
because, whi le they all
need money today, they
also have to be able to
sustain themselves over
the long term.
Planned gi vi ng i s where you ve taken some
time, youve thought about setting priorities for your
charities that you want to support today and in the
future, Watt says. He says that you can participate in
making a charity well-funded by buying a life insur-
ance policy and naming the charity as a beneciary.
So when you move on because we all have death
and taxes theres an advantage to your estate, Watt
says, but, most importantly, theres an advantage to
your community.
Derek Michael, a gift planning specialist with the
Alberta Cancer Foundation, says that planned giving is
an opportunity for people to contribute much more to
a charity than they would otherwise be able to.
I think thats really the impetus or the catalyst
for people wanti ng to make thi s type of a gi ft,
says Michael. It is an opportunity to say I want to
make a si gni fi cant di fference and I know that,
when Im no longer here, I am still helping a cause in
a community.
The Alberta Cancer Foundation allows people to
get specic with their donations, directing their money
as they see t, to make it as meaningful an experience
as possible. It allows people to make a difference in
an area of cancer research and treatment that is
important to them, whether that means donating for
the research and care for a certain type of cancer or a
specic cancer centre.
While its an option available to many, Watt says its
generally planners who become involved.
Theyre people who plan they plan their vacation,
they plan for their retirement, they are conscientious
about their health, says Watt. Theyre people who
know that if you have a plan, things will get achieved,
and if you dont have a plan, then you hope.
Watt says money donated
t o t he Al ber t a Cancer
Foundation goes right back
into the community, and the
foundati on has a strong
focus on local research,
which attracts top doctors, allows for cutting-edge
medical equipment to be purchased and makes for a
better understanding of the disease.
Weve had a special focus on breast cancer and
weve participated in a number of activities and raised
a fair amount of money over the years for research and
development, Watt says. His wife, Alberta Cancer
Foundation trustee Heather Watt, is a former breast
cancer patient. Weve been very pleased in our con-
versations with the doctors and the researchers here
in Alberta.
Another thing that led Watt to take the planned giv-
ing route is the concept that if, as a nancial planning
expert, he doesnt participate, he wont know the expe-
rience his clients go through.
I was very pleased with the response I got from the
Alberta Cancer Foundation, says Watt. They were
professional about it and it was an easy process, and
thats one of the things that I wanted to experience for
myself to see whether it was a pleasant experience
or whether it was a bureaucratic experience, which I
would hate.
It turned out to be a very pleasant experience and
it was simple.
BY JIM KERR
HOW TO APPROACH PLANNED GIVING
Thinking about planned giving as an option? The Alberta Cancer Foundation is holding an event on
May 7, 2013 to help you make an informed decision.
Investors Group Financial Services senior executive nancial consultant Girish Agrawal will be speaking
about nancial planning concepts, how the planned giving process works and answering questions from
those in attendance.
Through this event, the plan is to help people understand how they can achieve or do what they want to
do in their life, Agrawal says. If we can help even a few more people donate more without compromising
their own nancial security, well just bring more benet to the community and, as such, to Canada.
Agrawal says everyone wants to do something for the community in one way or another, but people
dont always know exactly how to reach those goals. He says planned giving is a great way for you to leave a
lasting legacy and hes happy to show you how to do it.
The Alberta Cancer Foundation
has a strong focus on local research,
which attracts top doctors.
JOURNEY JOURNAL: Mavis Clark transformed
tragedy into a call to action.
STORIES OF GIVING
why I donate /
A Calgary woman celebrates her
husbands life by raising funds
for lung cancer research
D
By Janice Paskey / photos By brian bookstrucker
id he smoke? thats always the frst question.
No, never. Its not the answer they expect.
Like thousands of people each year, Paul Clark was diagnosed with lung
cancer. The Calgarian was part of a troubling statistic. Lung cancer strikes 2,000
Albertans a year, and is the leading cause of cancer death. And while smoking is the
key risk factor, as many as 20 per cent of people with the disease are non-smokers.
For unknown reasons, lung cancer is rising among non-smokers although tobacco is
still the leading cause. The complex puzzle of lung cancer, and the troubling lack of
funding, are garnering new attention because of Paul Clark and his wife Mavis.
Mavis clark opens the door to her comfortable brick walk-up home and
invites me in. Shes prepared, with a notebook detailing all her meetings pertaining to
lung cancer and extensive notes about each. She is a serious volunteer and it shows.
Mavis says her husband received his lung cancer diagnosis in 2007. He was 57. At the
time, the couple had lively and public lives. He was vice-president of communications
and public afairs with Canadian Pacifc Railway in Calgary and she was a teacher, and
later a superintendant, with the Calgary Board of Education. They had met as summer
students at an oil-and-gas company and spent decades together. They exercised,
volunteered in the community and travelled.
In March 2007, the couple was preparing for a holiday. Paul was coughing. He
thought he might have bronchitis, Mavis says. A visit to the family doctor and tests
brought a startling result: lung cancer.
Mavis said her husband initially felt total devastation. But, in typical form, he rose
to the occasion. Paul was determined to not be victimized, says Mavis. He was a very
independent person. He took on this disease and treatments as his job.
He made a very clear decision; he wasnt going to let this defne him. How he lived
was far bigger than cancer. Pauls approach refected his positive character. After all,
this was the man who had conceived the idea of the Canadian Pacifc holiday train,
STORIES OF GIVING
why I donate /
AT WORK: Medical oncologist and research scientist Dr. Don
Morris, expert in lung and other cancers, founded the Translational
Laboratories at the Tom Baker Cancer Center in 1999. And for more than
a decade, the Translational Laboratories has been promoting cutting
edge research in advanced diagnostics and novel therapeutics. Morris
and his team have an interest in creating and improving effective and
efcient strategies for the treatment of cancer patients. Check in to
watch the research grow at translab.ca.
MEMORIES: Mavis Clark in a rare
moment of relaxation.
didnt know Mavis until lung cancer brought them together. She does work tirelessly,
Longsta says of Mavis Clark. Shes dedicated, shes very eective, shes committed to
make sure something happens, Longsta says.
At Calgarys Tom Baker Cancer Centre, oncologist Don Morris treats patients
and runs a lab researching viruses that he hopes will ultimately attack tumours. Calling
this a cool and exciting era, he is heartened by the opportunity to make a dierence.
Like many, he credits the work of Mavis Clark. Whats uncommon is that shes a
doer; she gets right in the mix. Already, donations nanced new scientic equipment
allowing researchers to interrogate tumours more quickly and understand their
genetic makeup. Hes also hired scientic personnel.
The lungs are a challenge. They are very sensitive. They dont react well to surgery, or
needle biopsies; chemotherapy can be very tough on the lungs. Chemotherapy will be
used, but its is not the way of the future, says Morris. The work is important because
the toll is high.
What I say is that lung cancer, not breast cancer, is the womens cancer. It kills more
women than breast cancer.
For unknown reasons, lung cancer among non-smokers is rising. Thats a fact that
Mavis Clark knows well. As she photocopies documents for me, she says its not impor-
tant to her why someone has lung cancer. No one deserves to suer. Shes focused on
advancing research and care.
Sometimes you cant change your own personal circumstances, so you focus on
what you can change.
which travels nationwide each December to raise mil-
lions of dollars and collect tonnes of food for community
food banks. He remained optimistic.
They investigated treatment options. The Clarks trav-
elled to Seattle for a second opinion but were told equally
good treatment existed back in Calgary. While Paul under-
went treatments at the Tom Baker Cancer Centre in con-
sultation with Dr. Don Morris, the couple learned that lung
cancer received little funding. Dr. Morris talked about
improving outcomes, by individually targeting cancer
through viruses and new drugs. The Clarks took note.
Throughout it all, the couple was determined to enjoy
their lives. They socialized, travelled and were visible.
In June 2009, Paul received a call from Canadian Pacic
president Fred Green. Would he run the Olympic Torch
relay? It was an acknowledgment for his work in securing
Canadian Pacics Olympic sponsorship. Paul said, Ill
only run it if I can do the distance like everyone else,
Mavis recalls. And he did. The route was lined with Pauls
friends for the January 2010 relay. It was a proud moment
and a testament to his strength. The Clarks travelled to
Hawaii shortly after. But, in April 2010, Paul succumbed
to the cancer. Like most people with lung cancer, he
hadnt lived ve years past the diagnosis.
Could this change? About eight months after Pauls
death, Mavis Clark visited Dr. Morris. I asked him, If you
had a wish list, what would it look like? Morris cited pre-
vention, screening, awareness, research equipment and
funds, fellowships, and a chair in lung cancer research at
the University of Calgary. He talked of Calgary becoming
a leading centre for lung cancer research and treatment.
Mavis acted. First, she created the Paul Clark Fellow-
ship in Lung Cancer Research. She then joined forces
with Calgarians Bev Longsta and Peter Valentine to
help form the Lung Cancer Translational Research Ini-
tiative at the Tom Baker Cancer Centre and University
of Calgary. The goal is to fund research and improve
patient outcomes.
Mavis has gone on to become an integral member of
the Alberta Lung Cancer Research Initiative, a provincial
initiative facilitated by the Alberta Cancer Foundation
that seeks to leverage lung cancer research and discover-
ies and make a dierence for Albertans.
As her group found, the disease has an image problem.
Theres a feeling that, if you smoked, then you brought
this on yourself, says Mavis. Lack of advocates doesnt
help. When you look at breast and prostate you have
people out in the community talking about being survi-
vors. Lung cancer doesnt have that. So the initiative
powerfully states in its case: Each year more Canadians
die from lung cancer than breast, prostate and colorectal
cancers combined. Yet, despite this, there are no runs,
no ribbon campaigns. By chance, lung cancer awareness
month is November but its been claimed as Movember
by thousands of men who proudly grow mustaches for
prostate cancer research.
I think lung cancer is where prostate cancer was
15 years ago, says Mavis. Her colleague Bev Longsta
agrees theres work to be done. Many know Longsta
as a popular Calgary alderman and mayoral candidate.
She lost a friend, Peggy Valentine, to lung cancer. Long-
sta served on the United Way board with Paul Clark but
By Lisa Ricciotti
Professionals from a radiology
centre in Calgary opt to donate
to a cause designed to help the
breast cancer patients of today
and tomorrow
few years back, Dr. Houman Mahallati didnt climb
Mount Kilimanjaro just because it was there. I did it
because I wanted to make a diference, the Calgary
radiology subspecialist and managing partner of EFW
Radiology explains.
In 2005, Mahallati ascended Africas tallest peak with 21 other
philanthropically minded individuals. Their journey to the summit
raised more than $525,000 for cancer research. It was a personal
challenge and a chance to see some of Africa, he remembers. But
our primary motivation was the unique opportunity to support
advances in the treatment of cancer.
Fast forward seven years and Dr. Mahallati is again part of a team
that has contributed a signifcant gift toward breast cancer research,
but this time he did it with his feet on the ground. At the Calgary
Womens Show in late 2012, staf from EFW presented a cheque
for $50,000 to the Alberta Cancer Foundation on behalf of EFW
Radiology. The company has supported the foundation in the past,
but this occasion marked EFWs frst major gift to the foundation.
Dr. Sasha Lupichuk, chair of the Southern Alberta Breast Tumour
Group accepted the gift, which will help support the groups ongoing
research into new breast cancer treatments through clinical trials at
the Tom Baker Cancer Centre.
The desire to make an impact was Mahallatis personal motivation
for climbing Mount Kilimanjaro, and it is also the motivation behind
EFWs corporate donation. We want to make a diference in the
lives of our patients, he says. We do that frst by providing the best
subspecialty care possible at our 12 radiology clinics in southern
Alberta. But we also do it at the community level by supporting
not-for-proft organizations that work hard to improve the lives of
families where we live.
Mahallati says that EFW supports womens health and
organizations as a way to build stronger, healthier families. Dont
a
corporate giving /
working for a cause
Feet on the
Ground
EFW Radiology is keen to support
the local clinical trials, a research
area where new findings can quickly
make a difference in patients lives.
WHAT IS A RADIOLOGIST?
Radiologists are specialist doctors who use medical images to see inside
a patients body. They can diagnose and evaluate the progress of disease
and injury. Radiologists can also help treat illness such as cancer. They train
in the use and interpretation of test results produced by machines such
as ultrasound, X-ray, computed tomography (CT) and positron emission
tomography (PET), magnetic resonance imaging (MRI), mammography
and nuclear medicine. Some medical procedures are aided by the use of
radiologic imaging. These specialists work closely with a team of technicians
and technologists who often perform the test under the radiologists
direction. After the tests, the radiologist interprets the images and gives
results to a patient and/or the patients primary care physician.
get me wrong, he hastens to add, its not that we dont
care about men. But throughout history, women are
interwoven with health care for the family in all cultures.
We see more women in our clinics; they come as patients
and to support others. In other words, helping women-
focused organizations is EFWs way of helping everyone
in the family, male and female.
Since breast cancer is among the most commonly
diagnosed cancers in women, EFWs support for breast
cancer research is a natural t. Add theres a close
relationship between EFW and the Tom Baker Cancer
Centre, where many of EFWs breast imaging specialists,
such as Dr. Paul Burrowes, Dr. Andrew Lee and Dr.
Bobbie Docktor also participate in cancer research and
treatment. EFWs recent donation to the Southern
Alberta Breast Tumour Group made perfect sense.
EFW is especially keen to support the groups clinical
trials, and a research area where new ndings can quickly
make a dierence in patients lives. Alberta currently
leads the country in clinical trial participation, with 11
per cent of new patients signing on for trials compared
to the national average of seven per cent. Still, many
patients who would like to take part in a clinical trial in
Alberta nd themselves on a waiting list. Clinical trials
are expensive and, since their cost isnt covered as a
medical service by government funding, the number of
them is limited.
No one knows this better than oncologists and
researchers like Dr. Lupichuk, who wishes she could oer
a clinical trial spot to any patient it might benet. Shes
well aware that without support from companies like EFW
Radiology, many hospitals would be unable to participate
in important cooperative national group trials.
These academically driven clinical trials are where
the really signicant questions about new treatment
are being asked and tested, says Dr. Lupichuk. Its
research to nd the upcoming best standard of care,
the treatments of tomorrow its not abstract research
that will sit on a shelf. Real patients are involved and the
knowledge we gain can be put to use now. The support of
companies like EFW Radiology helps make clinical care
trials an option for more patients. The Alberta Cancer
Foundation recognizes the importance of clinical trials
and funds them at about $2.5 million per year.
Currently, the Breast Tumour Group has trials un-
derway to evaluate a new drug called Foretineb to treat
whats called triple negative breast cancer (where tis-
sue is negative for estrogen, progesterone and HER2
receptor) and the eectiveness of adding the drug Her-
ceptin to traditional chemotherapy and radiation treat-
ments. At press time, the details of the new clinical trial
that EFW Radiologys donation will support werent
conrmed, but one thing is certain: whatever the details,
it will make a dierence to the end users the patients.
corporate giving /
WORKING FOR A CAUSE
CHEQUE IT OUT: (l) Dr. Sasha Lupichuk
from the Tom Baker Cancer Centre, (r) Dr.
Bobbie Docktor, EFW Radiology, Breast
Imaging Radiologist.
STORIES OF SURVIVORSHIP
beyondcancer /
Receiving a cancer diagnosis when you are still of
working age is common; almost half of adult survivors
are under age 65. For many people, the after-effects
of surgery and treatments can alter their ability to
work and their prospects for employment. For people
who are able, work improves quality of life and self-
esteem. Its also important for society, because the
costs of disability will increase as the number of peo-
ple living with cancer increases. For many people,
going back to work is a personal benchmark for com-
pleting their initial cancer journey and recovery.
Fortunately, many cancer survivors are able to
return to work without disabilities. However, many
people struggle with cognitive, physical and treat-
ment-related changes, meaning it takes longer get-
ting back to work than they anticipated. Cancer survi-
vors are almost one and a half times more likely to be
unemployed than healthy people of working age.
Most survivors who were working at the time of diag-
nosis need to take a few months off during active
treatment. For most, their ability to work slowly
returns. In some studies, however, former cancer
patients report a 26 per cent deteriorated physical
work ability and a 19 per cent deteriorated mental
work ability between two and six years after diagnosis.
Some common problems keep survivors from
working. Many report difficulty remembering and
concentrating commonly referred to as chemo
brain or brain fog. For some people, treatments
lead to measurable cognitive changes, sometimes
due to anxiety and depression. Surgeries can impact
physical abilities related to job tasks, so that going
back to work may require survivors to retrain. Fatigue
can be overwhelming, and survivors can feel its
effects for years.
Employers would benet from education about the
needs of survivors. Some employers arent nancially
prepared or dont understand their employees need
for a slow re-entry to work. Organizations would ben-
et from creating plans and systems that prepare for
the interruption of work and the measured reintroduc-
tion of their employees to the workplace. One clear
message from the literature is that getting back to
work requires energy.
Survivors can facilitate their own return to work.
Staying fit and exercising within the limitations of
treatment, both during and after, can speed the return to work. However, the few
studies testing the effectiveness of return-to-work strategies indicate that pro-
grams are most effective when they are multidisciplinary and include physical,
psychological and vocational interventions. Survivors can set themselves up for
success by educating themselves, improving tness and talking to professionals,
other survivors and their employers about concerns. And they can benet from
engaging the health system or community programs for rehabilitation.
Moving beyond cancer includes steps to increase the readiness for work.
BY JANINE GIESE-DAVIS
BACK TO WORK
Getting past cancer includes taking steps to increase
your readiness to join the workplace again
WHAT CAN YOU DO?
First, start by learning. The Canadian
Partnership Against Cancer recently
published summaries of programs
that facilitate patients return to work
in North America, the U.K., and
Australia. These summaries are avail-
able at Cancerbridges.ca (see the
blog post for November 13, 2012).
You can also nd the information at
cancerview.ca.
Next, take advantage of programs
that offer support:
The B.C. Cancer Agency provides
a successful model for vocational counselling, and Wellspring has brain
fog and back to work programs in Calgary and elsewhere.
Dr. Nicole Culos-Reeds Thrive Centre in Calgary provides free workout
facilities and can provide a physiological assessment for tness program
for cancer survivors.
Better Choices, Better Health is a free program of Alberta Health
Services designed to support people living with ongoing chronic health
conditions, including cancer.
In Alberta you can receive nancial advice and help from cancer social
workers in psychosocial resources departments in Calgary and
Edmonton, and many rural locations.
Rehabilitation departments can also provide occupational, physical,
nutrition and speech therapy.
Psychological help (individual, group, family, and art therapy) for depres-
sion, anxiety, fatigue and sleep is also available free through Alberta
Health Services psychosocial resources and community-based
organizations.
Look at cancerbridges.ca for related programs on the live calendar.
Its easy!
The Silver Lining
The goal of the Alberta Cancer Foundations Cash & Cars Lottery & More is to
support cancer research and ultimately increase the quality of life of cancer
patients across the province. This years grand prize winner, Christine Zurburg,
knows all too well the challenges that come with living with cancer. She was
diagnosed with breast cancer last year and is currently undergoing treatment.
As tough as that process has been, Zurburg says she had no idea how hard bat-
tling the disease would be nancially. Having to take time off work for treatment
hasnt helped.
Zurburgs battle with cancer just got a little easier: she is the winner of a custom
dream home in Calgary valued at over $1.3 million. Since she lives in Edmonton
and isnt looking to relocate, she put the house on the market and it sold that same
day. I really cant believe that something like this happened to me, she says.
If I need to take time off work again I wont have to worry. I can just focus on
recovering and getting better.
The sole reason she purchased the ticket was to
support cancer research, she says, adding that the
possibility of actually winning anything, let alone
the grand prize, never entered her mind.
This is the rst time shes ever won a lottery like
this, but supporting cancer research is something
shes been doing for many years.
Ive been a very active volunteer for over 10 years
now and Ive always enjoyed meeting people who
are trying to make a difference, she says. Little did
I know that Id be raising funds to help myself. Its
all been very strange. Even this Ive been reading
Leap for a long time but I never thought thered be
an article about me. Jordan Wilkins
P
H
O
T
O
:

J
O
E
Y

P
O
D
L
U
B
N
Y
myleap /
INSPIRING INDIVIDUAL
THANK
YOU
TO THE
MOVERS
& SHAKERS
Thanks to your support, we jumped, jived, moved, and
grooved through six hours of exercise bliss while raising
funds for breast health in Calgary.
On March 23, were bringing the party to Edmonton and
its not too late to get in on the action!
REGISTER
for helping us
BUSTAMOVE.CA
Bust a
Move
000Leap-BustAMove-FP.indd 1 2/19/13 2:28:52 PM Leap_Spring13_p50-51.indd 51 2/21/13 4:48:14 PM
Join our new & naughty scavenger quest or choose our iconic 10k Run/5k Walk to
fght cancers below the waist. Gather your friends and start your own team to run,
walk or hunt, or join the Alberta Cancer Foundations team!
Call to RegisteR
403.269.3337 780.423.2220 unCoveRtheCuRe.oRg
CalgaRy edmonton
A
n
n
o
u
n
C
in
G
Th
e u
n
d
eRW
eA
R A
FFA
iRs
B
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y
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