Category Archives: cancer research

The Five W’s of Cancer

The moment I was diagnosed with cancer I entered a psychological realm where wanting to know everything about my disease alternated with fear and aversion. Once the initial shock wore off I realized that I would need accurate information in order to navigate my horrific, and sometimes terrifying, journey through ovarian cancer. Never in my life have I felt so simultaneously overwhelmed by an abundance of medial information and frustrated by a lack of it. This ambiguity of emotions is understandable in cancer patients, as they undergo treatment for some of the most complex and difficult to understand diseases within the field of medical science.

Simply explained, every cell in the body has a tightly regulated system that dictates when it needs to grow, mature and eventually die off. Cancer occurs when cells lose this control and divide and proliferate indiscriminately. Theories, treatments and possible explanations for cancer are abundant. They range from the factual or medically proven to the bizarre, absurd and downright dangerous. Regrettably there are a few contemptible individuals who knowingly try to profit from cancer patients or exploit our unique physical, emotional and psychological needs. I’m a journalism school graduate and I believe this has given me a better perspective than some patients when I’m confronted with information through online or traditional media.

newspaper

 

Whenever I read something pertaining to cancer I always keep in mind the Five W’s that I was taught when I was studying journalism.

Who?

Who carried out the research, and who funded them? If the Academy of American Poets or the League of Canadian Poets is telling you about a new study they funded showing that reading poetry is good for your health, it doesn’t mean that they’re wrong, but they have a vested interest. Knowing who is quoted in a story or who is commenting is also important. Stories often include comments from experts who weren’t involved in the study – these opinions have the power to help clarify how the results fit into the wider context, and whether they’re worth paying attention to. But still be aware of who’s commenting on the study.

What?

What did the researchers actually do? Was the study looking at cells in a dish, mice or patients? These are all crucial stages of testing a new cancer drug. New drugs can’t be tested in patients immediately – cell and animal studies are needed first to check if experimental treatments are safe, effective and worth further investigation. Keep in mind that in an ideal experiment only one thing will be changed at a time, so that you know any differences are because of that one change. In many cases it’s tricky, but not impossible, to try to pin down how much different variables affect cancer risk. Scientists can try to account for the things that cloud the picture, but there will always be gaps. And that’s why cancer research takes a long time, and needs to involve a lot of people.

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Where?

Oncologists and cancer experts aim to publish their results in journals, where their findings are scrutinized by others in their field – a kind of quality assurance called peer review. But oncologists share their work in other ways, particularly at conferences. Often these results are preliminary or don’t have as much information as would be in a published paper. In addition, much of the data is not yet peer reviewed. Unfortunately, these findings are often reported in the news with the same prominence, even though the results might be a long way from the finished article that is beng worked on.

When?

When was the study carried out, and how long did it run for? A week? A month? A year? The longer the better – long-term effects might be missed if you only look at a short timeframe. And if the study looks at people, are the data from the last few years, or from decades ago? An older study might have had more time to look at long-term consequences, but a more recent study could mean that the findings are more relevant to current lifestyle habits.

How Many?

How many subjects took part in the research? And who or what were those participants. Was it 10 mice? 100 patients? 1000? Generally, the more used, the more reliable the results are.

How much?

A recent headline, People who eat organic food are 25 per cent less likely to get cancer, sounds as though you had better eat organic if you want to significantly reduce your cancer risk. However, the headline uses what’s called a relative risk. The study of almost 70.000 volunteers found only a tiny 0.6% reduction in terms of absolute risk. It might also be important to keep in mind that people who buy organic tend to be richer, eat more fruit and vegetables, consume less meat and drink less alcohol.

 

In conclusion, I would like to emphasize that I don’t mean to condemn cancer research or the media where many crucial findings are reported. Most reporting will be accurate and responsible, and even when it isn’t it doesn’t mean that there’s malice behind any mistakes. Communicating science is extremely complicated, and it’s impossible for science journalists to be flawless all the time.

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Keep Your Eyes on the Prize

Now only thing I did was wrong
Staying in the wilderness too long
Keep your eyes on the prize, hold on

The only thing we did was right
Was the day we started to fight
Keep your eyes on the prize, hold on

Popular American Civil Rights Anthem

When the provincial government unveiled the design for the new Calgary Cancer Centre last month, it was arguably the most significant moment for southern Alberta’s cancer community in a generation. The new centre will reportedly have twice as much space available for clinical trials and for patient treatment as the aging Tom Baker Centre now has. Construction of the facility at the Foothills Medical Centre, which is already Alberta’s largest hospital complex, will start later this year.

PCL Construction Management Inc. was awarded a $1.1 billion design-build contract for the cancer centre. Stantec in conjunction with DIALOG, will ultimately be responsible for the architectural and interior design of the new cancer centre, as well as structural and electrical engineering. Stantec will also provide civil and transportation engineering expertise.

newcalgary-cancercentre

​The new facility will be located at the northeast corner of the Foothills campus. It will span more than one million square feet. The design includes a 1,650-stall underground parking garage and a 984-linear foot elevated walkway connecting it with other parts of the Foothills campus.

Services at the new cancer centre will include:

  • outpatient cancer clinics
  • more than 100 patient exam rooms
  • 160 inpatient unit beds
  • more than 100 chemotherapy chairs
  • clinical and operational support services
  • double the space for clinical trials
  • research laboratories
  • 12 radiation vaults
  • double the capacity to treat patients with the best technology

“What this building allows us to do is really integrate care across the cancer continuum and integrate cancer research and education within the cancer care delivery model,” said Dr. Sunil Verma, the medical lead for the new facility.

Verma said that with one in three Albertans expected to be diagnosed with cancer at some point in their lives and a five per cent growth rate each year, the existing Tom Baker Cancer Centre will soon be stretched beyond its capacity.

calgary-cancercentre

Premier Rachel Notley (L), Associate Minister of Health Brandy Payne, and cancer survivor Susan Cardinal examine a 3D model of the future Calgary Cancer Centre.

Personally, I’ll miss the iconic Tom Baker Centre, but I look forward to the opening of a desperately needed new building. Like the majority of patients undergoing treatment at the Baker Centre I have mixed feelings regarding my experience. I’m definitely impressed by the top-notch care I’ve received from the dedicated staff and volunteers. However, I’m alarmed by the all too obviously crowded quarters. On my visits I find it impossible not to notice how filled to capacity the building is—I’ve been subjected to the overflowing parking lot, the busy chemotherapy beds and the standing room only waiting areas.

The Tom Baker Cancer Centre has been serving men and women diagnosed with cancer for approximately a generation now; it opened its doors over 30 years ago in the early 1980s. At the time, Albertan’s marveled at the spacious and innovative new facility. There was incredible pride in the centre by those involved in its creation. The building had been meticulously designed to provide cancer care for Calgary’s population of 600,000 and the rest of southern Alberta. What is more, the new Baker Centre had cutting-edge technology, a first-rate young staff and space, an abundance of space.

I can imagine what it was like for those involved, because the sense of joy and anticipation among patients and their loved ones is once again palpable. It’s a sweet victory, we’ve waited over a decade and withstood the disappointment of several broken promises to build a new Calgary cancer centre. I can’t be certain what my future will bring or what role the new cancer will play in my life. But with construction scheduled to begin in just a few months, and completion planned by 2023, I definitely feel as though I have my eyes on the prize.

 

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Because it’s 2016: A New Era for Cancer Patients

One of the most stunning realizations that I’ve had since being diagnosed with cancer is how much cancer impacts the whole person—the disease can undermine almost every aspect of a person’s life. The field of oncology acknowledges this, at least more than it did four decades ago when my grandmother survived her breast cancer diagnosis. Today most cancer patients, including myself, have access to social workers, psychologists, dieticians and other skilled professionals. Treating the whole person and recognizing that each patient has unique issues and needs have become firmly entrenched and are part of the philosophy of cancer care.

At my cancer centre there are now two forms that patients are asked to fill out at every checkup. The first contains questions to gage a patient’s physical wellbeing as they go thorough treatment, but a second questionnaire was recently added. This latest form is used to gather information about the various psychosocial issues that are associated with cancer. Certain social, financial or mental health issues may need to be addressed. While I sometimes resent having to answer what I consider highly personal questions, I realize the importance of asking cancer patients about almost every aspect of their lives.

 

Research Breakthroughs

 

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Dr. Barbara Vanderhyden, one of Canada’s preeminent ovarian cancer researchers, recalls that when she began her work she was one of the only people in Canada researching the disease. Over a decade ago Vanderhyden started the Canadian Conference on Ovarian Cancer Research and now the community has grown from three people to more than 60 ovarian cancer researchers across the country. This flourishing research community has led to a number of recent discoveries. For instance, it is now known that ovarian cancer is not one disease but a spectrum of diseases with different responses to treatment.

I’m frequently amazed at the lightening speed at which new cancer treatments are being discovered and implemented. For example, immunotherapy is an emerging approach to treatment that boosts the immune response to cancer. It enables the body to target and destroy cancer cells. There are three main areas of immunotherapy that are showing promise.

  • Vaccines that enhance immune system response
  • Inhibitors that affect how the immune system regulates itself
  • Adoptive T-cell transfer, which removes a patient’s cancer-fighting T-cells and activates them before returning them to the bloodstream

Although gynecological cancers, such as mine, have seen only modest breakthroughs in immunotherapy, melanoma and lung cancer are areas that are witnessing great progress.

 

New Targeted Treatments

 

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According to many scientists a new era of cancer treatment is beginning in which patients get drugs matched specifically to their tumour. Patients experience longer survival and fewer toxic effects through this approach, which is being made possible by advances in genetic profiling of the tumour itself. Conventional chemotherapy and radiation treatments have both short-term and long-term side effects and can be absolutely brutal for patients to endure. These treatments kill a significant number of healthy cells in addition to the cancer cells. “At the moment it’s more like using a cannonball to kill an ant – and creating a whole lot of damage at the same time,” explains professor Roy Herbst, chief of medical oncology at Yale Cancer Centre.

Meanwhile a UK trial, called Optima, is being run by University College London and Cambridge University and funded by Cancer Research UK. Beginning this summer, it will recruit 4,500 women with breast cancer. The women’s tumours will be genetically tested as soon as they are diagnosed to establish which will respond to chemotherapy and which will not. Of the 50,000 or so women diagnosed with breast cancer in the UK each year, about 40 per cent, or 20,000, are currently given chemotherapy but only half of them do well as a result of it; in the other half, the benefit is unclear. The researchers hope to find out which of the latter group actually need chemotherapy. As one oncologist emphasized: “In some ways it is simple – it means that you can make sure you are giving the right drug to the right person at the right time. In others it is very complex, because there are so many pieces to the jigsaw. We need to put the puzzle together.”

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Relying on the Web: What Cancer Patients Should Know

When I was first diagnosed with cancer, I entered a psychological realm where wanting to know everything about the disease alternated with fear and aversion. Numb and in shock, I would often read over my three-page pathology report, using various websites to meticulously research the strange and frightening terminology it contained.

I’m not alone in feeling this way or in turning to the Internet for help. Nearly half of all Canadian adults are asking questions about cancer, and most turn first to the web for information. The problem is that this self-research is leaving many cancer patients confused, overwhelmed and stressed out. Although we tend to use the Internet as our first resource, most of us don’t have strong faith in the information that it provides.

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According to a new survey commissioned by the Canadian Cancer Society, when it comes to getting definitive cancer information, doctors and healthcare professionals are trusted by 94 per cent of Canadians. In spite of that only eight per cent of Canadians contacted their healthcare team first with questions. Similarly, cancer organizations and charities are trusted by 87 per cent of those seeking information, but less than five per cent of Canadians searching for cancer information reached out to them. People are more skeptical of online sources with only 69 per cent trusting the information. Despite their uncertainty, 85 per cent of people with cancer questions first turned to a search engine.

Why do Canadians so frequently consult the web for information about cancer if they place more confidence in their oncologist and organizations such as the Canadian Cancer Society? According to the survey, convenience is an issue. While the web is easily accessible, more than half of respondents said it is challenging to get time to speak with their healthcare team. But ease of use comes with unexpected side effects. Two-thirds of Internet users felt overwhelmed with information, and 62 per cent felt stressed out and worried, jumping to 70 per cent among Canadians 18 to 34.

There are several alternatives to randomly searching the web that I would strongly recommend.

Use Only Reliable Internet Sites

My cancer facility, the Tom Baker Cancer Centre in Calgary, provides patients with a list of recommend websites. Here are a few of the most essential ones.

American Cancer Society
Canadian Cancer Society
National Cancer Institute
CancerNet
Oncolink

Use The Canadian Cancer Society’s Cancer Information Service

IMG_0117Since 1996, the Canadian Cancer Society has answered 1,250,000 questions through its Cancer Information Service. The Society’s toll-free bilingual Cancer Information Service can be reached at 1-888-939-3333. Assistance is available to cancer patients, caregivers, the general public and healthcare professionals. An information specialist will take all the time you need to answer your questions and provide you with information on the following topics:

  • cancer treatment and side effects
  • clinical trials
  • coping with cancer
  • emotional support services
  • prevention
  • help in the community
  • complementary therapies

The Canadian Cancer Society’s phone line is available during business hours Monday to Friday. You should also note that when you contact the Cancer Information Service for help, your privacy is protected and you will not be asked for donations or put on a mailing list.

Access Support Organizations for Your Specific Cancer Type

Instead of randomly searching the Internet try connecting with an organization that specializes in providing support to individuals with your type of cancer. For example, staff in Ovarian Cancer Canada’s regional offices are available to answer your questions and to provide support via telephone or email. Ovarian Cancer Canada hosts webinars, workshops and events that are relevant to women living with the disease. You can also listen to various educational recordings on their YouTube channel.

Finally, Ovarian Cancer Canada offers a comprehensive guide to support and inform women who have been newly diagnosed with ovarian cancer. The publication is called By Your Side and printed copies of this resource are provided free of charge across Canada. You can Order By Your Side by filling out an online form or by calling 1-877-413-7970 (toll free).

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Time Heals: Today’s Cancer Patients Owe a Debt of Gratitude to Generations Past

Emperor-of-All-MaladiesOnly recently have I started to think a great deal about the history of cancer or the oncologists and patients that have come before me. I developed a fascination with these topics while watching the PBS miniseries Cancer: The Emperor of All Maladies. This three part series skillfully explores the medical and scientific aspects of cancer; even more impressive is the wonderful job that the producers have done of delving into its history and politics.

The creators of the groundbreaking television documentary based their project on a strong work of non-fiction by renowned oncologist and award winning journalist Siddhartha Mukherjee. Both the PBS documentary and Mukherjee’s Pulitzer Prize winning volume have one overriding theme. They bring to light that our current generation’s experience with cancer represents only a momentary chapter in an epic battle spanning thousands of years.

The Emergence of Modern Cancer Surgery

When I was diagnosed with fairly advanced cancer in my uterus and right ovary, the first, and most essential, part of my medical treatment involved surgery. I literally owe my life to the skill of my pelvic cancer surgeons and to the sophisticated surgical techniques available in the 21st century. Ovarian cancer is still the most serious of all women’s cancers, and the survival rates can be quite grim—the positive news is that the outlook has improved in recent decades, largely due to better surgical procedures.

For centuries surgery to remove cancerous tumours wasn’t a viable option, as the medical technology wasn’t yet available. In extremely rare cases a physician would attempt to cut out a cancerous growth. However, the circumstances would have been barbaric by today’s standards. There was no method to properly anesthetize patients and they were frequently operated on while conscious, in addition there was no use of modern antiseptics to keep the surgical wounds from becoming infected.

19th Century Surgery

The late 19th century witnessed the origins of present-day cancer surgery. Anesthetics such as either were discovered and this made lengthier, more complex operations possible. Procedures such as the radical mastectomy for breast cancer were successfully devised and implemented during this era. As a matter of fact, the medical community firmly believed that it was possible to cure cancer through surgery alone. The nature of how cancer spreads to distant sites in the body wasn’t yet well understood. Most experts mistakenly believed that its recurrence months or years after surgery was strictly due to not taking out enough tissue, reappearance of the disease was caused by the growth of fragments of the principle tumour that were left behind.

The Development of Chemotherapy

Sidney Farber

Dr. Sidney Farber

The nature of metastasis is much better understood today and a patient with gynecological cancer, such as myself, is routinely offered chemotherapy following surgery. Of course only in the past 40 or 50 years have powerful chemotherapy drugs been introduced to the arsenal in the war against cancer. Oncologist Sidney Farber (1903-1973) is considered by most historians to be the father of chemotherapy. Farber and his team in Boston began trials on children with leukemia in the late 1940s. At this time leukemia was still a death sentence for any child diagnosed with the disease.

Farber’s new therapy was almost miraculous in the sense that it led to remission in many of his young patients. Some of the children, including a patient named Robert Sandler, had their lives extended by months after the potent chemicals were administered to them. The leukemia would virtually disappear and they would momentarily resume an active childhood. Throughout the 1950s and 60s, Farber continued to make advances in cancer research, notably the 1955 discovery that the antibiotic actinomycin D and radiation therapy could produce remission in Wilms’ tumor, a pediatric cancer of the kidneys.

What the Future Holds

As I battle ovarian cancer I try to be realistic about how far treatment has come, I know there is still an extremely long way to go in the war against this insidious disease. Over the last two decades, the five-year survival rate for patients with ovarian cancer has improved significantly. Yet, according to the experts, no more than 30 per cent of long-term ovarian cancers are currently being cured. Oncologists admit that they are facing enormous challenges. While surgical advances and new treatment approvals, including Lynparza (olaparib) and Avastin (bevacizumab), have improved the outlook for ovarian cancer patients, late diagnosis and tumour resistance remain as the two most significant barriers in overcoming the disease.

Cancer Cells

Meanwhile, the medical community is continuously developing new treatments for cancer, one of the most promising is called immunotherapy. For decades oncologists have known that the immune system plays an important role in certain types of cancer. They noted that there were rare spontaneous remissions of cancer without treatment and they suspected that this was because the immune system was attacking the tumour. Immunotherapy is designed to boost the body’s natural defenses to fight the cancer. Medical specialists use materials either made by the body or in a laboratory to improve, target, or restore immune system function.

At the present time it isn’t entirely clear how immunotherapy works against cancer, it may function by stopping or slowing the growth of cancer cells, stopping cancer from spreading to other parts of the body, or helping the immune system increase its effectiveness at eliminating cancer cells. There are currently several types of immunotherapy in use, including monoclonal antibodies, non-specific immunotherapies, and cancer vaccines.

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