Implementation Of A Colorectal Cancer Screening Program
Â
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THE FIGHT AGAINST CANCER
cancercarenews.ca
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2. CHALLENGES
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST2 ¡ CANCERCARENEWS.CA
Colorectal Cancer Aware-
ness Month is upon us and
once again our attention is
immediately drawn to the
importance of colorectal
cancer screening, a simple
way to avoid a most prevent-
able disease through simple
tests that bear acronyms
such as FOBT and FIT, and
ultimately the gold standard
colonoscopy.
In addition to screening, there are
other movements to increase aware-
ness around prevention. Canadian
associations are reaching the public
to educate them in a fun and inter-
active manner through events such
as the Giant Colon Tour, where a 40
foot long colon displays the various
pathologies that can be found inside
the human Colorectum. Each prov-
ince may also run their own cam-
paigns to promote their provincial
population based screening pro-
grams. But what about those of us
who already have cancer?
This year there will be over 24,400
men and women in Canada diag-
nosed with colorectal cancer.Thatâs
1 in 13 men and 1 in 16 women, if
youâre into statistics. Many will be
cured due to an early diagnosis be-
cause of timely screening,but some
of coursewill alreadyhave advanced
stage disease and will require ex-
tensive treatments. Many will sur-
vive, but incredibly over 9,300 will
die from the disease thisyear,even if
they are lucky enough to receive all
of the approved therapies. Gaining
access to cancer drugs in Canada is a
complicated process.
InCanada,onceHealthCanadahas
approvedadrugforitssafety,eďŹcacy
and quality, each province then de-
termines which cancer drugs are
reimbursed if they receive a posi-
tive funding recommendation from
either the pan-Canadian Oncology
Drug Review (âpCODRâ ) for all prov-
inces other than Quebec,or the Insti-
tut national dâexcellence en santĂŠ et en
services sociaux (âINESSSâ) for Quebec.
Most Canadians are not famil-
iar with the drug approval process,
but to cancer patients the health
technology assessment (âHTAâ)
bodies that evaluate cancer drugs
are of the utmost importance,
since they determine what drugs
patients will ultimately gain ac-
cess to for their treatment.
The pCODR expert commit-
tee considers research data and
the cost of the proposed new can-
cer drugs under review. They also
provide the opportunity for ac-
credited patient groups to pro-
vide input into the process.Patient
groups can provide information on
what patients and their caregiverâs
value or see as a benefit both from
existing treatments and from the
new drug being assessed in order
for the expert committee to better
appreciate the quality of the pro-
posed new drug.
The determination of what pa-
tients value is essential to this pro-
cess, but they are often ill defined,
inadequately measured and may
not be given sufficient weight in
the final decision making process.
Some amazing work has already
been done by patient groups and
they will increasingly have an im-
pact on which cancer drugs are ap-
proved and reimbursed in Canada.
Supporting patients to find effect-
ive treatments to improve outcomes
is one of our hallmarks.While not as
sexyas some of our other initiatives,
in many ways it is more important,
especially when it comes to drug ac-
cess for those with advanced cancer.
Since patient values go to the
heart of quality of care, the CCAC is
embarking on a study to better de-
fine,measure and weigh patient val-
ues with the goal of increasing con-
sistency and objectivity in patient
group input to pCODR and INESSS,
ensuring that Canadian cancer pa-
tients get the effective cancer drugs
they trulyvalue.
Mediaplanetâs business is to create new
customers for our advertisers by providing
readers with high-quality editorial content that
motivates them to act.
Playyourpartinthefightagainst
stigmatizedcancers
I
n Canada,the fight against cancer
is in full swing. However, due to
long-standing stigmas,people still
find it harder to speak out about
colorectal, prostate and lung can-
cer, and that is preventing Can-
adians from getting screened or
seeking treatment. Well, itâs time to
change all that; itâs time to start talk-
ingaboutcancer.
Colorectal cancer
Colorectal cancer is stigmatized be-
cause most of us have been socialized
to be embarrassed when it comes to
speaking about certain parts of our
body and, as a result, we shut down
when it comes to discussing things
likeourcolonorrectum.
 However, getting celebrated pub-
lic figures onboard to speak freelyand
openlyismakingahugeimpactinthe
way that people relate to colorectal
cancer.âHaving celebrities like Darryl
Sittler tell you that itâs important to
getinvolvedorgettestedreallymakes
people sit up and take notice,â says
Amy Elmaleh, Co-founder and Exec-
utive Director of Colon Cancer Can-
ada. âHaving people who have been
touched by colon cancer talk about it
THE FIGHT AGAINST CANCER
FIRST EDITION, MARCH 2015
Publisher: Jacob Weingarten
Business Developer: Ian Solnick
Managing Director: Martin Kocandrle
Production Manager: Sonja Draskovic
Lead Designer: Matthew Senra
Designer: Mishelle Menzies
Contributors: Ian Bookman, Benjamin
Chacon, Randi Druzin, Ted Kritsonis,
Katherine OâBrien, Joe Rosengarten,
Michelle Sponagle, Barry Stein
Send all inquiries to
editorial@mediaplanet.com
Distributed within:
The National Post, March 2015
This section was created by Mediaplanet
and did not involve the National Post or its
Editorial Departments.
Photo credit: All images are from Getty
Images unless otherwise accredited.
ismakingadifference.â
 Colorectal cancer is over 90 per-
cent preventable with screening,yet
itâs still the second leading cause of
cancer death in Canada.Itâs simple: if
more people start talking about colo-
rectal cancer,more will get screened.
And,with early detection,very often
comesafullrecovery.
Prostate cancer
Raising awareness of prostate can-
cer and making it a subject that is no
longer a taboo is imperative if more
men are to get informed about the
true dangers of the disease.Across the
country, awareness campaigns are
workinghardtogetmentalking.âOur
focus is on raising social awareness
for early detection because we know
that survival rates are high if we can
get to men early,â says Rocco Rossi,
President and CEO of Prostate Cancer
Canada. âSome companies are doing
âlunches and learnâ with their work-
force,whichisagreatwaytogivemen
moreinformationabouttesting.â
Rossi also points out the import-
ance of a network of 75 support
groups situated across the coun-
try, where men who have received
treatment provide peer-to-peer sup-
port to the recently diagnosed and
their spouses. As well as providing
emotional support and reassurance,
these support groups play an inte-
gral role in educating men about
their treatment options.
Lung cancer
Lung cancer is a fatal cancer and
may be one of the most stigmatized. Take action, and
join the fight against
colon cancer
PAGE7
EDITORâS
PICK
â ASTELLAS.CA
â BUMRUN.COM
â CBI.CA
â COLONCANCERCANADA.CA
â DULCOLAX.CA
â FERRING.CA
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â NOVARTIS.CA
FOR MORE ON
TITLE FROM
OUR PARTNERS
JOE ROSENGARTEN
editorial@mediaplanet.com
Barry Stein
PRESIDENT, COLORECTAL CANCER
ASSOCIATION OF CANADA
âStartacon-
versationto-
day,withacol-
league,afriend
orafamily
memberand
playyourpartin
breakingdown
thestigma.â
VISIT US ONLINE FOR
EXCLUSIVE CONTENT AT:
CANCERCARENEWS.CA
MEDIAPLANETCA
COLORECTAL CANCER AWARENESS MONTH:
ACCESS TO CANCER DRUGS IN CANADA
THE GIANT COLON TOUR
An interactive exhibit is an engaging way to learn about the colon.
PHOTO: COLORECTAL CANCER ASSOCIATION OF CANADA
editorial@mediaplanet.com
There is a social tendency to blame
the sufferer of the disease, a com-
mon belief that they deserve to be
aďŹicted by lung cancer. In fact, 15
percent of people who have lung
cancer have never smoked,and an-
other 35% are ex-smokers.
With the help of people like Anne
Marie Cerato â a lung cancer sur-
vivor and Lung Cancer Canada Board
Member â organizations like Lung
Cancer Canada are fighting to eradi-
cate the stigma and dispel the mis-
conceptions of the disease. âLung
cancer should not be just about
whether you smoked or not,â Cerato
says.âItâs about facing the reality of
losingsomeoneyoulove.â
These three cancers are stigma-
tized for different reasons, but that
stigma causes the same problems:
a lack of screening, awareness and
prevention. So, start a conversation
today,with a colleague,a friend or a
family member and playyour part in
breaking down stigma.Together we
cantakethefighttocancer.
Special
thanks to
PUBLIC AWARENESS IS KEY
Educating the public removes
stigma and is essential in the fight
against cancer, as evident from the
Movember Foundationâs impact on
prostate cancer.
PHOTO: MOVEMBER FOUNDATION
CANADA
3. INSIGHT
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST CANCERCARENEWS.CA ¡ 3
Mediaplanet caught up with Dr.
Bookman, a Gastroenterologist at
St.Josephâs Health Centre and Med-
ical Director at Kensington Screen-
ing Clinic, who founded the âBum
Runâ; awalk/run to raise awareness
forcolorectalcancer.
With catchy phrases out there
like âlove your bumâ, what has
changed in recent years in
terms of public awareness for
colorectal cancer?
Education has made a big difference.Â
Myths are starting to dissipate,such
as âitâs an old personâs diseaseâ,or âit
mostly affects malesâ. The medic-
al community has also become more
proactive and organized in having
discussions with our patients about
screeningandprevention.Â
Although awareness has im-
proved, and colorectal can-
cer is up to 90% preventable,
why is it still the second lead-
ing cause of cancer death?
It is the silent killer that everyone
thinkswillbeobvious. ItisdiďŹcultto
conceptualize that we would not feel
anythingwhile a tumor grows in our
bowel. The truth is that by the time
symptomsoccur,thecancerhasoften
spreadandisnolongercurable. Sadly,
westillseethiseveryday. Â
What do you think is integral
to removing colorectal can-
cer from the top killers list?
We need to start a âbluewaveâ of colo-
rectal cancer awareness and screen-
inginvolvement,similartohowbreast
cancer awareness advocates creat-
edaâpinkwaveâofknowledgeandac-
tion. We need to invert the stigma of
colorectal cancer screening and pre-
vention,whereby it becomes normal
tohavediscussionsandparticipatein
screening programs,and it becomes
strangetoavoidtalkingaboutit. Ibe-
lieve the wave has already started;
now we just have to keep spreading
theword.
DR. IAN D. BOOKMANÂ BSc, MD, FRCPC
editorial@mediaplanet.com
DONâT MISS
Proper bowel prep is
critical for colonoscopy
TED KRITSONIS
editorial@mediaplanet.com
D
espite colon or colorectal
cancer having long been
considered among the
mostfataldiseases,screen-
ing for it through a colon-
oscopy has been stigmatized because
ofhowpatientsmustprepareforit.
A colonoscopy tests for the cancer
by finding irregularities and polyps
in the colon and rectum, and accur-
acy in discovering those largely de-
pends on the quality of the bowel
preparation.Patients must clean out
their bowels by drinking a solution
that is diluted with clear ďŹuids the
daybefore the procedure.
However, doctors and nurses both
acknowledge that these solutions
can be diďŹcult to drink,and patients
will need to be in close proximity to a
washroom during their bowel prepar-
ation. These factorsmaymakeitdiďŹ-
culttodiscussthepreparationopenly,
potentially leading to postponement
oftheprocedure.
âItâs important that physicians
have a good discussion about what
patients can expect and what they
will experience,â says Dr.David Mor-
gan, a gastroenterologist at St. Jo-
sephâs Healthcare in Hamilton, ON.
âA lot of patients donât ask questions
that weigh on their minds,and often,
if they have the answers theyâre re-
assured that things arenât as scary as
theyotherwisemightbe.â
The drinking process
Patients generally have three options
in how they drink the solution.There
is a four litre volume that is pre-
mixed, a two litre that is pre-mixed
and the smallest volume, which is
two sachets of 150mL each.The low-
est volume option requires about
three to four litres of additional regu-
lareverydayclearďŹuidssuchas apple
juice, ginger ale, Gatorade, white
grape juice, white cranberry, tea or
chicken broth, for example. Water
alone andmilkaretobeavoided. Low
volume options tend to be the most
popular among patients.
âWe have recently started doing
split preparations where they drink
half the night before and the other
half the morning of the test,â says
Usha Chahuan,a nurse and assistant
professor at McMaster Universityâs
nursing program. âWe found that
since weâve been doing that,patients
have had fewer problems. For some,
refrigerating the solution helps,
whereas others may prefer little ďŹa-
vouring packages to sweeten it.â
Chahuan adds that patients could
benefit from starting a low-fibre diet
earlier than the three-day period
leading up to the test,and sticking to
clearliquidsoverthattime,too.Those
with heart or kidney conditions will
have to go with either of the larger
pre-mixed options,regardless.
Proper prep âimportantâ
Gail Attara,president and CEO of the
GastrointestinalSocietyinVancouver,
B.C.,saysbeingstrictwiththeprocess
helps patients when it comes time to
gothroughtheprocedure.
âDuring the colonoscopy,the phys-
ician can insert water into the colon
and ďŹush it around a little bit to help
clear away some debris,but that cre-
ates a challenge because youâre irrig-
atingthewrongway,âsaysAttara.âItâs
really important that you donât stall
onbowelpreparationbecauseyoucan
detectthecancerearlyandstopit.â
Dr. Morgan adds that good prepar-
ation tends to make the test easier to
administer,asfaraspickinguppolyps
and identifying anything that might
be cause for concern, particularly
since any one of the solutions can do
thejobofďŹushingeverythingout.
Clean out your bowels by
drinking a prep solution the day
before your colonoscopy.
Drink 3-4 L of additional everyday clear fluids if
you go with the lowest volume prep solution. Water
alone and milk are to be avoided.
Get some rest and go into
your procedure with proper
preparation.
Dr. Ian D. Bookman BSc, MD, FRCPC
GASTROENTEROLOGIST
AND FOUNDER OF
THE BALANSE BUM RUN
QUESTIONSTOASK
YOUR DOCTORâAm I at
risk for
colon
cancer?â
Wanttohelpreduceyour
riskofcoloncancer?
Takeactionandbring
thislisttoyourdoctorfor
thenextstepsinprevention.
âWhatarethesigns
andsymptomsfor
coloncancer?
âWhenshouldIbe
screened?
âWhenshouldmy
familymembersget
screened?
âHowdoIprevent
coloncancer?
âWhatarethe
screeningoptionsI
shouldconsider?
Cutthisoutandtakeit
toyourdoctor!
4. INSPIRATION
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST4 ¡ CANCERCARENEWS.CA
Dr. Oz My
advice is to be
vigilant â with
colonoscopy,
as well as any
other diagnos-
tics. If we can
know some-
thing and it is
going to help us
avoid greater
sickness or even
death, we should.
So get a colonoscopy at the age of
fifty and even earlier if you have
symptoms or history. If colorectal
cancer is in your family, then you
need to have the test earlier than
fifty and pay close attention to pos-
sible symptoms,while eliminating
as many lifestyle risks as possible.
Speak with your primary care phys-
ician in thorough detail and do as
much reading on your own.
copy can detect what are known as
pre-cancer polyps â small growths
that, left undetected, can grow in-
to cancer. Not only are these spot-
ted during a colonoscopy, theyâre
removed as well. Still, tens of mil-
lions of North Americans delay the
procedure. So, if youâre still on the
fence,consider this â itâs estimated
that screening can prevent about
60% of colon cancer deaths by sim-
ply detecting and removing pre-
cancerous polyps.
MPÂ Â What do you think is
key in reducing the stigma
around various cancers,
including colorectal?
Dr. Oz The key to reducing stigma
is opening up a dialogue and tak-
ing the taboo out of topics like
cancer. These are topics
that need to be dis-
cussed â stigmas
can be particularly
detrimental to can-
cer patients, especial-
ly if theyâre the reason for
delayed screening. And I do
thinkweâre making progress.Â
Screening rates for colon can-
cer have increased,and as result,
the rate of colon cancer diagno-
ses has decreased by 30%.But the
numbers arenât quite where we
want them to be,yet.Thatâs why
I share my story â in the hopes that
others will take the same preventa-
tivemeasuresIdid,andpossiblysave
their lives in the process.
MP Do you have any words
for those that are going
through a similar journey
as you and have been
affected by colorectal
cancer?
Advances in laboratory
based testing could provide
an additional tool to
identify people at increased
risk for colorectal cancer
so the disease can be
prevented and/or caught at
an early stage.
Time to open up
Colorectal cancer is the third most
common cancer and the second
most common cause of death from
cancer for both Canadian men and
women. While colorectal cancer
is highly treatable when detected
early and is up to 90 percent pre-
ventable with timely and thorough
screening and testing, as it stands
today, nearly half of those diag-
nosed find out too late.
Population-based
screening programs
Early detection of cancer and pre-
cancerous growth is key to improv-
ing survival rates.
To this end, many provinces
have put in place population-
based colorectal cancer screening
programs. Most provinces recom-
mend that for people at average
New colorectal cancer screening tests are less
invasive and more effective in picking up the disease
risk, they should get screened for
colorectal cancer every two years,
starting at the age of 50. Screen-
ing tests involve a stool-based test
such as âThe Fecal Occult Blood
Testâ (FOBT) or âFecal Immuno-
chemical Testâ (FIT) that the per-
son can perform at home.
âThe patient collects stool sam-
ples putting a little bit of stool on
a card (FOBT) or tube (FIT) provid-
ed by their physician, and then
mail it back to a lab,â explains Dr.
Tim Feltis, the Deputy Ontario
Medical Director for LifeLabs. âA
chemical reaction test is then per-
formed on that sample in order to
detect small amounts of blood in
the stool.â Where blood is detected
in these tests, follow-up tests
(typically a colonoscopy) are per-
formed to determine if it is due to
the existence of colorectal cancer.
A particular challenge that prov-
inces are facing is getting people
to participate in the screening rec-
ommendations. For various rea-
sons, colorectal cancer screen-
ing rates are well below the lev-
els needed to be as effective as
possible at early detection. Some
have suggested that people canât
get over their discomfort with the
stool-based samples.
Making breakthroughs
Inresponsetothegeneralreluctance
of patients to handle stool samples,
scientists have developed a blood
testing technique that can accurate-
ly identify patients at increased risk
of getting colorectal cancer.
âThe development of Cologic
blood testing for the identifica-
tion of patients at increased risk
for colorectal cancer is yet an-
other tool that can help us im-
prove the rate of early detection,â
said Dr. Feltis. âThis test has a low
false negative rate and an accept-
able false positive rate,meaning it
is very accurate at detecting risk
and therefore can facilitate ear-
ly detection of premalignant/ma-
lignant lesions resulting in better
outcomes.â
By measuring the level of an an-
ti-inflammatory long chain fatty
acid,GTA-446,in the blood,the test
determines whether or not a pa-
tient is at risk for colorectal can-
cer.âItâs a simple blood test,thereâs
no need to collect a stool sample,â
says Dr. Feltis. âIf your cologic
level comes back low, you are at
risk. There was a large study done
showing that 86 percent of people
with cancers have low levels of
GTA-446.â
This simple blood test can deter-
mine a patientâs risk factor long
before the cancer has even started
to develop.
A new alternative
The Cologic test is a new alterna-
tive that can be used on its own
or as a precursor to a stool-based
screening program. Dr. Feltis be-
lieves that the introduction of eas-
ier, less invasive testing methods
will lead more people to comply
with regular testing,which is cur-
rently a major barrier in the fight
against colorectal cancer.
If youâre one of those people who
have been avoiding getting tested,
make today the day that you pick
up the phone and book your ap-
pointment. âThe message is sim-
ple,â says Dr.Feltis,âfor those with
a family history, change in bowel
habit - at any age - or over 50 years
of age, just get tested, itâs not as
bad as you fear.â
through their daily lifestyle
habits?
Dr. Oz Lifestylefactorsareincredibly
important when it comes to reducing
risk for certain cancers. In fact, re-
search suggests that diet and lifestyle
habits may actually contribute to one
third of all cancers.  And while some
of these seem obvious (like smok-
ing and lung cancer,and tanning and
skin cancer),it turns out that some of
the strongest links out there are be-
tween diet,weight,activity levels and
colon cancer risk.I discussed the im-
portance of a healthy diet above, but
of equal importance is maintaining a
healthy weight and staying physical-
lyactive. Both obesityand physical in-
activity put you at a higher risk of de-
velopingcoloncancer.
MPÂ How did your lifestyle
habits change once you
received your diagnosis?
Dr. Oz My lifestyle was not a risk
factor,so I didnât need to make chan-
ges to my routine. The cause of my
pre-cancerous polyp was genetic,so
surveillancewasthebestprevention.
Instead of every ten years, I will get
more frequent colonoscopies, prob-
ably every three to five depending
on the results.The great thing about
a colonoscopy is that if done with
proper frequency itâs both preventa-
tive and curative.
MPÂ What would you
say to someone who is
delaying their colonoscopy
procedure?
Dr. Oz Donât delay. The best way
to prevent colon cancer is through
early detection â and when it
comes to early detection, the
colonoscopy is the gold standard.
Why is it so important? A colonos-
Mediaplanet You had a
routine colonoscopy when
you turned 50. What were
you feeling prior to the
procedure?
Dr. Oz Prior to the procedure I was
joking at my 50th birthday party
about the test, seeing it as routine
and a way to show my audience how
to âcheck the boxâ in their own lives
to be smarter patients. Having no
family history and no contributing
lifestyle factors, it was the furthest
thing from my mind that I would re-
ceive an abnormal result.Â
MP When you went from
doctor to patient and
received a diagnosis of
having a pre-cancerous
polyp, what changed for
you?
Dr. Oz As a doctor,I have had thou-
sands of diďŹcult conversations with
patients and families â many includ-
ed grave news.Suddenly,Iwas on the
receiving end of one of those serious
conversations and it helped me as a
doctorbecausealltheempathyinthe
world canât compare to the real ex-
perience of being a patient.
MPÂ What role does nutrition
play in colorectal health?
Are probiotics an essential
part of a healthy lifestyle?
Dr. Oz Nutrition plays a major role
in colorectal health â research shows
that your dietary choices can have a
significant impact on your risk for
developing the disease.The top picks
when it comes to lowering risk?
Fruits, veggies, and whole grains.
These fiber-rich foods have beenwell-
establishedwhen it comes to improv-
ingdigestivehealth,andstudiesshow
that they also may significantly re-
duce your risk of developing colon
cancer,especially when compared to
diets that are high in refined carbs
and animal fats. Also gaining ground
for its potential protective effects?
Probiotics. Emerging research sug-
gests that these good bacteria,found
in foods like Greek yogurt and kefir,
canboostcolorectalhealth.
MPÂ How can individuals
reduce their risk of cancers
Dr. Mehmet Oz talks about his experience with colon
cancer,whyyoushouldregardscreeningasatoppriority,and
whatyoucandoinyourlifestyletoreduceyourriskofcancer.
LETâS TALK ABOUT
COLON CANCER
editorial@mediaplanet.com
JOE ROSENGARTEN
editorial@mediaplanet.com
âThe key to reducing stigma
is opening up a dialogue
and taking the taboo out of
topics like cancer.â
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST
Dr. Oz My
advice is to be
vigilant â with
colonoscopy,
as well as any
other diagnos-
tics. If we can
know some-
thing and it is
going to help us
avoid greater
sickness or even
death, we should.
copy can detect what are known as
pre-cancer polyps â small growths
that, left undetected, can grow in-
to cancer. Not only are these spot-
ted during a colonoscopy, theyâre
removed as well. Still, tens of mil-
lions of North Americans delay the
procedure. So, if youâre still on the
fence,consider this â itâs estimated
that screening can prevent about
60% of colon cancer deaths by sim-
ply detecting and removing pre-
cancerous polyps.
MPÂ Â What do you think is
key in reducing the stigma
around various cancers,
including colorectal?
Dr. Oz The key to reducing stigma
is opening up a dialogue and tak-
ing the taboo out of topics like
cancer. These are topics
that need to be dis-
cussed â stigmas
can be particularly
detrimental to can-
cer patients, especial-
ly if theyâre the reason for
delayed screening. And I do
thinkweâre making progress.Â
Screening rates for colon can-
cer have increased,and as result,
the rate of colon cancer diagno-
ses has decreased by 30%.But the
numbers arenât quite where we
want them to be,yet.Thatâs why
through their daily lifestyle
Lifestylefactorsareincredibly
important when it comes to reducing
risk for certain cancers. In fact, re-
search suggests that diet and lifestyle
habits may actually contribute to one
third of all cancers.  And while some
of these seem obvious (like smok-
ing and lung cancer,and tanning and
skin cancer),it turns out that some of
the strongest links out there are be-
tween diet,weight,activity levels and
colon cancer risk.I discussed the im-
portance of a healthy diet above, but
of equal importance is maintaining a
healthy weight and staying physical-
lyactive. Both obesityand physical in-
activity put you at a higher risk of de-
 How did your lifestyle
habits change once you
received your diagnosis?
My lifestyle was not a risk
factor,so I didnât need to make chan-
ges to my routine. The cause of my
pre-cancerous polyp was genetic,so
surveillancewasthebestprevention.
Instead of every ten years, I will get
more frequent colonoscopies, prob-
ably every three to five depending
on the results.The great thing about
a colonoscopy is that if done with
proper frequency itâs both preventa-
Dr. Mehmet Oz talks about his experience with colon
whyyoushouldregardscreeningasatoppriority,and
whatyoucandoinyourlifestyletoreduceyourriskofcancer.
LETâS TALK ABOUT
COLON CANCER
âThe key to reducing stigma
is opening up a dialogue
and taking the taboo out of
topics like cancer.â
âIfyouâreone
ofthosepeople
whohasbeen
avoidingget-
tingtested,
maketoday
thedaythat
youpickupthe
phoneandbook
yourappoint-
ment.â
MPÂ You have been so
passionate about various
health issues and on
multiple media platforms,
what can we look forward to
seeing from Dr. Oz in 2015?
Dr. Oz My mission is to help view-
ers show up in their own life.I want
them to be the best they can be â
not just in health but in happiness
as well. Each of us should be striv-
ing to reach 100% of our potential,
feeling 100% healthy, and finding
the happiness we deserve. Every
episode of The Dr. Oz Show presents
possible pathways to achieving
that goal and that is the context for
all our discussions.
Dr. Mehmet Oz is the three-time Em-
my Award-winning host of THE DR. OZ
SHOW, currently in its sixth season, air-
ing weekdays at 2 p.m. ET/ 4 p.m. PT on
CTV.For more information,visit CTV.ca.
5. LifeLabs is pleased to offer a unique
blood test option for patients to
assess their risk for Colorectal Cancer
Available at all LifeLabs and CML Healthcare
locations in Ontario. Your physician needs to
order the test.
In other provinces please email us for a COLOGIC Kit
at kits@lifelabs.com or call 1-877-990-1575
For more information, please visit
www.cologiclabtest.com
6. INSIGHT
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST6 ¡ CANCERCARENEWS.CA
CFL legend battling to educate
fans about colon cancer
vented me from pushing myself
physically.I persevered and Iâm now
back to exercising as much as pos-
sible. I think this allows me to heal
both mentally, as well as physically.
I feel like Iâm in control of my body
when I stayactive.
MP How is your life different
now than before you were
diagnosed?
LP I have learned to appreciate the
important things in life more, es-
pecially my friends and family who
have been there for me during the
rocky road. I donât know what I
would do without that support sys-
tem,it helps to reassure me that Iâm
not fighting this battle alone.
Mediaplanet had a chance
to catch up with Lui Pas-
saglia, best known for his
25-year career with the BC
Lions, who went public last
year with his fight against co-
lon cancer. He now dedicates
time to helping increase
awareness and encouraging
people to talk to their doc-
tors about this prevalent, yet
highly preventable, disease.
Mediaplanet What motivated
you to speak about your ex-
perience with colon cancer?
Lui Passaglia After the initial
shock of being diagnosed with co-
lon cancer wore off,I focused on arm-
ing myself with as much informa-
tion about the disease as possible. I
soon realized that by simply starting
the conversation, I might be able to
help raise awareness and encourage
peopletotalktotheirdoctoraboutthe
urgencyofearlyscreening.
This is a disease that I hadnât given
much thought to a fewyears ago.I fig-
ure many men and women share my
previousmindsetandweneedtoshift
thatwayofthinking.
MP How did you find out that
you had this disease?
LP I was diagnosed with stage three
colon cancer during a routine check-
up with my doctor.Prior to my colon-
oscopy, I showed some of the typical
symptoms for the disease â consti-
pation, abdominal discomfort, blood
in my stool,but I hadnât done my re-
search to knowwhat I should be look-
ingfor.
There is a hereditary link to colon
cancer, so this could have played a
part.About ten years ago my dad was
diagnosed with the early stages of co-
lon cancer,in fact thatwas one reason
I had my first colonoscopy at age 54.
Luckilymydadisalsoaliveandwell.
MP Do you think being an
athlete gave you an edge
when fighting the disease?
LP As an athlete I developed the
discipline to train and exercise even
when I wasnât feeling my best.Once
diagnosed with colon cancer, there
were times when the disease pre-
KATHERINE OâBRIEN
editorial@mediaplanet.com
JOIN LUI TO HELP RAISE AWARENESS
Lui Passaglia and his team banded
together to run/walk for colon cancer
awareness, an essential step in the fight
against colon cancer in Canada.
PHOTO: COLON CANCER CANADA
In terms of physical side effects,
I developed ongoing neuropathy
in my hands and feet. Every three
months I have a blood test to check
my tumour marker. So far, Iâm can-
cer free. I can do everything I could
do prior to my diagnosis.
What helps me everydayis to focus
on the positives and keep telling my-
self that Iâm going to beat this. We
need to spread the word about the
importance of early detection and
screening.Colon cancer is 90 percent
preventable if caught early.Everyone
should speak to their doctor to ask
whentheyshouldbescreened.
Lui Passaglia
CANADIAN FOOTBALL LEAGUE
HALL OF FAME PLACEKICKER/
PUNTER FOR THE BC LIONS
âWhat helps
me every day
is to focus on
the positives
and keep
telling myself
that Iâm going
to beat this.â
KATHERINE OâBRIEN
editorial@mediaplanet.com
SCREENING AND EARLY
DETECTION SAVES LIVES
Colorectal cancer is the third most common cancer and
secondmostdeadlycancerinCanada.
COLORECTAL CANCER IN CANADA
Source:
http://www.phac-aspc.gc.ca/cd-mc/cancer/colorectal_cancer-cancer_colorectal-eng.php
⢠Colorectal cancer is the SECOND
MOST DEADLY CANCER
⢠An estimated 9,300 CANADIANS WILL DIE
from colorectal cancer this year
⢠Colorectal cancer is the THIRD MOST
COMMONLY diagnosed type of cancer
⢠It is estimated that 24,000
CANADIANS will be diagnosed
with colorectal cancer in 2014
#2
H
owever, if caught
early, colorectal
cancer is highly
treatable and is up
to 90 percent pre-
ventable through
timely and thor-
ough testing and screening.
âMore than 9,000 Canadians a
year die from colorectal cancer, so
itâs a big problem,â says Dr. Mal-
colm Moore, Head of Medical Onc-
ology and Hematology at Princess
Margaret Cancer Centre in Toron-
to.âThe good news is that the death
rate is falling by about two percent
a year, so hopefully by 2020 colon
cancer will no longer be the second
leading cause of cancer deaths.â
It is important to speak with your
family physician to find out more
about getting tested or screened.For
manyCanadians,the test could be as
simple as an at-home stool sample
test.For those with a family history
of colon cancer,or who are over 50,it
maybe more appropriate to undergo
a colonoscopy for screening.Â
âItâs not exactly popular conver-
sation to talk about the colon,but I
do think itâs changing,â says colo-
rectal surgeon Dr. Zane Cohen, the
Director of the Zane Cohen Cen-
tre for Digestive Diseases at Toron-
toâs Mount Sinai Hospital.âThereâs
been a heavy push on awareness,
and I think itâs much less of a stig-
ma now to talk about colorectal
cancer, bowel movements and
stool patterns.â
Higher-risk groups
Although no one cause leads to
colorectal cancer, some people are
at higher risk for developing the
disease. If you fall into any one of
the following groups, talk to your
doctor about being screened as
soon as possible:
â You have a family history of co-
lon cancer. (If you have a first-de-
gree relative; parent, sibling, aunt,
uncle, grandparent, with a history
of colon cancer, aim to get tested 10
years before their age of diagnosis)
â You have been diagnosed with
polyps or early stage colon cancer
â You have inflammatory bowel
disease (ulcerative colitis or Crohnâs
disease)
â You have a family history of in-
herited breast cancer, uterine or
ovarian cancer
â You are age 50+
âThere is no doubt that popula-
tion-based screening and early de-
tection have cut the death rate,â
says Moore. âEverybody is at the
same sort of risk for getting colon
cancer, so we all need to be aware
of it and we all need to be appropri-
ately screened. If thereâs one mes-
sage, it is that once you reach 50,
you need to be screened.â
Warning signs
Here are the signs and symptoms of
colorectal cancer to look out for:
â Rectal bleeding or bright red or
very dark blood in your stool
â A persistent change in normal
bowel habits such as diarrhea, con-
stipation or both
â Frequent or constant cramps that
last for more than a few days
â Stools that are ribbon-like or nar-
rower than usual
â General stomach discomfort
(bloating, fullness and/or cramps)
â Frequent gas pains
â A strong need to move your
bowels, but with little stool
â A feeling that your bowel does
not empty completely
â Unexplained weight loss
â Constant fatigue
It is important to note that symp-
toms often do not occur until the later
stages of colorectal disease.
Talk openly with your doctor,
know the signs and symptoms of
colon cancer and your risk category.
When it makes sense to go for
screening,do so â there is no health
advantage to inaction.
⢠90% OF CASES are preventable if detected early
7. TOGETHER WE CAN
BEATCOLON CANCER
âWe continue to do this
for all of our loved ones
who no longer can and
to hopefully change the
outcome for those yet
to be diagnosed.â
âSamPollard,
Tri-Cities
WalkLead
Sponsored
by
Why We Push
For Your TushâŚ
I
lost my mother, Maureen Lerman, to
colon cancer at the age of 46. Within
two years, and at the age of 39, my uncle
Howard Schwartz was diagnosed and died
eight years later. The realization that this
disease could take two lives at such a young
age changed the course of my life forever. I
was driven by a passion to help build aware-
ness and raise funds and thus Colon Cancer
Canada began.
Our beginnings
Colon Cancer Canada (CCC) started in my
Aunt Bunnieâs (Howardâs wife) basement
18 years ago. My Aunt and I joined forces to
help educate Canadians across the country
about the disease. To date, and thanks to the
support of generous people across the coun-
try, we have raised over $12 million in sup-
port of colon cancer education, awareness,
research and patient support.
Over 90 per cent of colon cancer is prevent-
ableifcaughtthroughearlyscreening.Despite
this fact, colon cancer is the second leading
causeofdeathfromcancerinmenandwomen
combined. These are just two of the facts that
motivate us in our mission to talk about colon
cancer, raise awareness and diminish the stig-
ma surrounding the screening process. We
needtocontinuetheconversationaroundear-
ly screening and detection, because the more
people talk, the more theyâll see the beneďŹts of
being proactive and lives will be saved.
Letâs walk to end colon cancer
Our largest annual event is âPush for Your
Tushâ, a Spring walk/run that began 18 years
ago with a few friends and family. We now
have the support of over 2,500 participants
in 11 communities across Canada. This year,
âPush For Your Tushâ will take place in com-
munities across Ontario, Alberta, British Col-
umbia and New Brunswick.
âPush For Your Tushâ is a fun, high-energy
event that draws out the colon cancer com-
munity in a one-day walk/run to celebrate
the progress weâve made and to raise funds
in support of furthering our cause. This
community provides an amazing support
group for those ďŹghting on a daily basis and
to those touched by colon cancer.
Your support matters
We couldnât bring together these commun-
ities and host âPush For Your Tushâ without
the support of our sponsors including Dul-
colex and Boehringer Ingelheim. Without
their guidance, support and friendship we
couldnât bring our events to life.
We are constantly striving to grow our
Colon Cancer Canada community and con-
tinue to introduce new âPush For Your Tushâ
locations across the country, as we ask Can-
adians everywhere to show their support. If
your community would like to organize your
own event, weâd love to hear from you.
Amy Elmaleh
Co-founder & Executive Director
Colon Cancer Canada
For more information about
Push ForYour Tush, please visit
pushforyourtush.ca
Join the growing community of people touched by
colon cancer, and help beat this disease.
Donât walk alone.
Go to pushforyourtush.ca/contest to take part in a walk in
your local community. Register early and be entered into a
draw for your chance to...
WIN 1 OF 4
$100 PREPAID VISA CARDS
sponsored by Dulcolax
Colon Cancer Canadaâs Annual 1K/5K Walk & 10K Run
Spring 2015
CONTACT US
1.888.571.8547
info@coloncancercanada.ca
coloncancercanada.ca
8. One of a thousand reasons
to look for Astellas in oncology.
Š 2015 Astellas Pharma Canada, Inc. All rights reserved.
9. INSIGHT
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST CANCERCARENEWS.CA ¡ 9
E
xcluding non-melanoma
skin cancers, prostate
cancer is the most com-
mon cancer among men
in Canada. Itâs also the
third leading cause of death from
cancer in men in the country. Itâs
strange to think,then,that there re-
mains a stigma around this deadly
disease, a stigma that prevents men
from getting check ups, identifying
symptoms and speaking about the
health of their prostate.
Taking control of your health
âAs men, we are our own worst ene-
mies when it comes to health,â says
Rocco Rossi, President and CEO of
Prostate Cancer Canada. âWe donât
want to talk about health and,when
itâs health below the waist, if we
arenât bragging about it, we arenât
talking about it.âÂ
Rossi also believes that the archaic
societal perceptions of masculinity
arestillaprohibitivebarrierstopping
menfromspeakingfreelyaboutpros-
tate cancer. âMen are taught from a
young age to âman-upâ; that you are
notsupposedtoshowpain,âsaysRos-
si.âWell,wewantpeopletoknowthat
manningupisactuallytakingcontrol
of your health and getting tested, so
thatyoustayhealthyandareinapos-
ition to take care of not onlyyourself,
butyour family.â
Damaging misconceptions
With metastatic prostate cancer â
cases when the cancer has spread,
usually to the lymph nodes and
bones â there is a further damag-
ing and tragic stigma; a stigma that
costs men their lives. Because itâs
the most advanced form of the dis-
ease,people often believe,incorrect-
ly,that once prostate cancer has me-
tastasized all hope is lost.This com-
monly held misconception, that
metastatic prostate cancer is un-
treatable, stops men from getting
tested and needs to be eradicated.
There is also the sad fact that
people are uncomfortable and reluc-
tant to talk openly about a disease
that could result in the loss of life,a
reluctance that can have devastating
consequences.
Rossitellsthestoryofamanwhode-
velopedprostatecancerandrecovered,
but felt unable to talk to his children
about his experience. Tragically, the
manâs son ended up developing meta-
static prostate cancer and died.If doc-
tors had known the family history of
prostate cancer,the disease could have
been picked up much earlier and the
patientâstreatmentoptionscouldhave
beenmuchmorefavourable.
The common misconception that
metastatic prostate cancer is com-
pletely untreatable is further inhib-
iting men from coming forward and
getting tested or discussing symp-
toms.This damaging belief is also un-
true.Although,as Rossi explains,ear-
ly detection is the best-case scenario,
therearetreatmentsavailablethatcan
effectively prolong life and increase
quality of life for men with the ad-
vancedformofthedisease.âTheintro-
duction of new treatments has been a
real boon for patients with metastatic
prostatecancer,âRossisays.
Making change through
social awareness
Few awareness campaigns have had
the impact of Movember, a global
menâs health charity and awareness
campaign which encourages men to
grow a moustache throughout the 30
days of November.âWe want to open
the door for men to have conversa-
tions about their health and pros-
tate cancer and, because of those
moustaches, you see men gathered
together, whether itâs at the work-
place,at home or at a hockey game,â
says Pete Bombaci, Country Director,
Movember Canada. âThe moustache
is a conduit to a conversation about
your health and whether you do it
with 20 friends or just with your dad
across the dinner table,itâs the start-
ing point to some of those important
conversations.â
The moustache is a true unifier
of men,a visible declaration of sup-
port and understanding. Bombaci
believes that social awareness cam-
paigns,like growing a moâ,are inte-
gral to eradicating stigma and help-
ing men to speak openly and hon-
estly. âCampaigns like ours help to
bring the conversation to the fore-
front,â Bombaci says.âRaising social
awareness helps people to under-
stand that theyâre not alone when
facing challenges on their journey
with prostate cancer.â
Raising awareness is a vital and
powerful tool in the fight against
prostate cancer. Whether itâs edu-
PROSTATE CANCER: ITâS TIME TO END THE STIGMA
Eradicating the stigma that still surrounds prostate cancer would play an integral role in
reducing the number of Canadian men who are killed by the disease.
JOE ROSENGARTEN
editorial@mediaplanet.com
When he was diagnosed
with advanced prostate can-
cer in 2011, Denis Moher de-
cided to take a proactive ap-
proach to combating his dis-
ease. He learned as much
as possible about it, even
travelling as far as Texas
to meet with experts in
the field, and he adopted a
healthy lifestyle.
Moher, 62, also started taking a
medication that blocks the pro-
New prostate cancer medications extend and improve patientsâ lives
duction of testosterone and other
male hormones (called androgens),
which stimulate the growth of
prostate cancer cells.That kept the
cancer in check until a month ago,
when tests indicated the medica-
tion was no longer working. He
was diagnosed with metastatic
castration-resistant prostate can-
cer (mCRPC), which occurs when
the patientâs cancer extends to
other parts of his body and is able
to spread despite initial hormonal
therapy.His situation was dire.
Dr. Neil Fleshner, Chair of Urol-
ogy at the University of Toronto
and Chief of Urology at the Univer-
sity Health Network, prescribed a
different anti-androgen medica-
tion â one that has been on the
market for about two years.The re-
sults have been excellent.
Transforming treatment
âFor the past 50 years we have been
fighting a nuclear war with bows
and arrows,â says Fleshner. âBut
we are now moving ahead by leaps
and bounds. The pace of discovery
is dramatic.â He attributes much
of that success to what has been
described as a molecular revolu-
tion. Molecular testing is being
used to diagnose and treat diseases
more accurately, and at an earlier
stage, while pharmaceutical com-
panies are using molecular tech-
nologies to develop new drugs.
Not only do these new drugs ex-
tend life but they have relative-
ly few side effects compared to
their predecessors.As a result, pa-
tients taking this medication have
a much better quality of life than
anyone could have imagined just a
few years ago.
Moher is a case in point. He has
travelled abroad with his wife and
friends and he does weight train-
ing for 90 minutes a day, six days
a week. Itâs an intense workout
that is similar in design to those
followed by bodybuilders. Denis is
much stronger now than he was
before being diagnosed and has
added considerable muscle mass
â an exceptional feat given his
testosterone deficiency.
Great expectations
âNot only has weight training im-
proved my physical health but it has
also been good for mymental health,â
says Moher. âI feel like I am doing
something to improve my life.I donât
feelashelplessasIwouldotherwise.â
Moher now follows a diet that is
almost entirely fat-free â âIâve dis-
covered kale chips,â he says with a
laugh â and embraces every mo-
ment of every day. âHaving a dis-
ease like this really changes your
perspective. It makes you focus on
what is important in life.â
Moher has nothing but praise for
the health care providers he has
encountered in this journey, from
his family doctor to a urologist at
St. Josephâs Health Centre to the
prostate cancer specialists with
cating men on new treatment op-
tions, or highlighting the support
structures that are available for men
living with the disease, spreading
the word and speaking openly about
prostate cancer will save lives.
the University Health Network,
whom he describes as leaders in
their field.
His experience has given him
confidence about the future. âIâm
waiting for the next big break-
through,â he says, âand I know
there will be one.â
Rocco Rossi
PRESIDENT AND CEO,
PROSTATE CANCER CANADA
Dr. Neil Fleshner
MD, MPH, FRCSC
HEAD, DIVISION OF UROLOGY,
UNIVERSITY HEALTH NETWORK
âWe want to
open the door
for men to have
conversations
about their
health and
prostate cancer.â
THE POWER OF THE MO
Mo Bro Michael Braiden cleans up for menâs health.
PHOTO: ALAN PALMER
â Prostate cancer is the most
commonly diagnosed cancer
among Canadian men â an
estimated 24% of all new can-
cer cases.
â 1 in 8 Canadian men will get
prostate cancer.
â Each year, an estimated
23,600 Canadian men will be
diagnosed with prostate cancer.
4,000 will die from the disease.
â The death rate has been de-
clining signiďŹcantly by almost
4% per year between 2001 &
2009 likely due to detecting
prostate cancer earlier and bet-
ter treatment options.
Source: Canadian
Cancer Society, 2014
STATISTICS
âHaving a
disease like
this really
changes your
perspective.
It makes you
focus on what
is important
in life.â
RANDI DRUZIN
editorial@mediaplanet.com
WEâRE IN THIS TOGETHER
Denis Moher poses with his wife Martha.
PHOTO: PROVIDED BY DENIS MOHER
10. INSPIRATION
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST10 ¡ CANCERCARENEWS.CA
lung cancer is a paltry 17 per cent.
After the learning of her disease,
she had underwent chemotherapy,
radiation and surgery. One year
later, she was in remission, but
tions and just seven percent from
government sources. Without ad-
equate funds to conduct research,
the battle against lung cancer is
extremely challenging.
It started with a small
lump on her collarbone.
Toronto-based Anne-Marie
Cerato, just 30 years old,
had no other symptoms
that hinted she would be
among the Canadians
diagnosed â more than
26,000 in 2014 â with lung
cancer. The disease kills
more people than the
top three other cancers
combined â prostate,
colorectal and breast.
Overcoming the stigma
When she told people about her
cancer, she experienced firsthand
the stigma attached to it â an as-
sumption someone with it must
smoke.That was the case with Cer-
ato, too: âThe reaction I got most
wasnât, âHow are you?â or âIâm
sorry.â It was, âDid you smoke?â
In fact,15% of those diagnosed
with lung cancer are lifelong non-
smokers, while 35% more are ex-
smokers, who in many cases quit
years before their diagnosis.
The tie between smoking and
lung cancer is well documented,
but itâs only one element of a much
bigger picture. Smoking is linked
to many other types of cancer and
chronic disease, yet those patients
do not experience the same stigma.
And itâs not the only cause of lung
cancer. Passive (also called second-
hand) smoke, exposure to asbestos
and radon gas are also factors.
Lung cancer is the deadliest and
most commonly diagnosed type of
cancer (aside from non-melanoma
skin cancer).In Canada,it receives
only one percent of private dona-
Finding hope
There is one bright spot and itâs
why Cerato is alive six years after
her diagnosis âincredible since the
average five-year survival rate for
NEW TREATMENTS ARE AVAILABLE
Anne-Marie Cerato, survivor and patient advocate for Lung Cancer Canada
fights for access to effective treatment.
PHOTO: LUNG CANCER CANADA
Realitycheck:abouthalfofthose
withlungcancerdonotsmoke
the cancer had spread to her other
lung and was ineligible for addi-
tional surgery or radiation.
She had no symptoms,so doctors
told her to wait before beginning
treatment again. Waiting to get
sick wasnât acceptable to Cerato.
As she tried to come to terms with
having a much-shortened life, she
was searching for hope. She found
it. âI discovered the mention of a
promising new drug being tested
in trials,â she says. âMy oncologist
helped me to become part of one.â
New drug development
A test of Ceratoâs tumour showed that
her cancer cells carried a rearrange-
ment in the ALK (anaplastic lymph-
oma kinase) gene â a trait that occurs
in an estimated three to five percent
oflungcancercases.Thenewdrugshe
had stumbled upon was designed to
targetthistypeoflungcancer.Shehas
continued to take the drug (two oral
treatmentsdaily)since2011.
Today, Cerato is feeling healthy
and strong,considering a return to
work and preparing to get married.
Sheâs also a board member with
Lung Cancer Canada. Sheâs deter-
mined to give others with her dis-
ease hope by pushing for changes
in attitude and for public educat-
ing. âItâs a brave new world right
now in terms of drug develop-
ment,â she says. âAll patients de-
serve to have access to effective
treatment and a chance of living a
long,healthy life.â
MICHELE SPONAGLE
editorial@mediaplanet.com
âShe had no
symptoms, so
doctors told her
to wait before
beginning
treatment again.
Waiting to get
sick wasnât
acceptable to
Cerato.â
11. CHALLENGES
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST CANCERCARENEWS.CA ¡ 11
A diagnosis of lung can-
cer starts a fight â a fight for
hope against a disease that
too often takes a terrible toll.
Lung cancer is the number
one cause of cancer-relat-
ed death in Canada, in both
men and women. It takes the
lives of more Canadians than
breast, prostate and colo-
rectal cancers combined.
Lung cancer stigma
While our Canadian health system
prides itself on its equality and uni-
versality,thoseconceptsonlygosofar.
For most Canadians with lung cancer,
italsoinvolvesafightagainstanother
enemyâdisparity.
Unique among cancers,lung cancer
bringswithitaheavydisparityofstig-
ma â that people brought the disease
on themselves by smoking.A 2010 na-
tional poll showed more than 22% of
Canadians said they feel less sympa-
thy for people with lung cancer than
those with other cancers because of
itslinktosmoking.
Natalie Deschamps, whose hus-
band is living with lung cancer says,
âI still find that I have to justify my
husbandâs disease to others. He was
healthy, athletic and never smoked.
He was still running regularly when
he went to the doctor for a spot at the
back of his eye. It turned out to be a
secondary tumor from his lung can-
cer.That was three years ago, he was
40;ourgirlswere5and7.â
The need for care
and support
Lung Cancer Canada believes that pa-
tients deserve the opportunities,care
and public support afforded to other
cancer patients. Reducing or even
eliminating the stigma associated
with lung cancer would be a major
stepforwardinreducingthedisparity.
Inreality,onein12Canadianmenand
onein14Canadianwomenwillbediag-
nosed with lung cancer.Of those diag-
nosed, 15% are lifelong non-smokers,
while35%moreareex-smokers,whoin
manycasesquityearsbeforetheirdiag-
nosis.Forreasonsthatareunclear,non-
smokingwomenaresignificantlymore
likelyto be diagnosedwith lung cancer
thannon-smokingmen.
The lack of comprehensive screen-
ing programs for at-risk populations
also poses a barrier to detecting lung
cancerearlier,andthusimprovingthe
chancesofsuccessfultreatment.
Finding the cure for lung cancer in-
volves large teams of researchers and
importantly enough funding. Prog-
ress in lung cancer is also challenged
in this area. While lung cancer ac-
counts for 27% of Canadian cancer
deaths,the disease receives only 7% of
cancer-specific government research
fundingandâevenworseâlessthan
1%ofprivatecancerdonations.
Progress is here
Despite these challenges, excit-
ing new progress is being made as
our understanding of the disease in-
creases,andnewtestsandtreatments
are developed. We must continue to
worktoensureresearchhelpstobring
about more choices for patients at all
stagesofdiagnosisandtreatment,and
that those choices are readily avail-
able to all patients who could benefit
fromthem.
Importantly, we need to overcome
the disparities present in the stigma,
toll,diagnosis,treatmentandresearch
of lung cancer to ensure that in the
fight against lung cancer in Canada
we have all the tools we need to make
hopearealityâandtowin.
THE FACES OF LUNG CANCER:
FIGHTING DISEASE, FIGHTING DISPARITY
LUNG CANCER CANADA
editorial@mediaplanet.com
LUNG CANCER STIGMA
AFFECTS FAMILIES
Natalie Deschamps finds
herself having to defend her
husband, a ânever-smokerâ, to
others.
PHOTO: LUNG CANCER CANADA
FACT:
Lung cancer
occurs at high rates
in lifelong ânever
smokersâ
LUNG
CANCER
FACTS VS.
MYTHS FACT:
Estimates from 2014
show that lung cancer
deaths are higher than
prostate and breast
combined
MYTH:
More men and
women die from
prostate and breast
cancer than from
lung cancer
FACT:
Estimates show
that there were 475
lung cancer deaths
between the age of
20-49 years old in
2014
MYTH:
I am too
young to get
lung cancer
FACT:
Estimates show
that 47% of new
lung cancer cases in
2014 were males and
females between the
age of 20-69
MYTH:
Only older
men get lung
cancer
MYTH:
Only smokers
get lung cancer
**Canadian Cancer Statistics 2014
12. INSIGHT
AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET TO THE NATIONAL POST12 ¡ CANCERCARENEWS.CA
situations, that need may change
from dayto day.â
Advance care planning
Whilemostpeoplewouldprefertodie
at home,very few actually plan for it.
A 2012 Ipsos-Reid national poll found
that 86% of Canadians have not heard
of the term advance care planning,
and less than 50% have had a conver-
sationwithafamilymemberorfriend
about theirwishes should theynot be
abletocommunicatethemselves.
âDeath is a taboo in our society.
We donât like to talk about it,â says
Louise Hanvey,Director of Advance
Care Planning for the Canadian
Hospice Palliative Care Associa-
tion (CHPCA). âBut evidence clear-
ly shows that when people have
these conversations, their families
experience less stress and less anx-
iety at end-of-life and following the
death of their loved ones.â
For that reason, a big focus of ad-
vancecareplanninghasbeentoraise
awareness of the importance of hav-
ing an end-of-life plan.
âAdvance care planning means re-
ďŹecting on and talking about our
wishes for end-of-life care while we
still can.And,veryimportantly,decid-
ing who will speak for us if we canât
speakforourselves,âsaysHanvey.
âIf I get to the point where I canât
speak for myself and make deci-
sions about my health care, whoâs
Andwithcontinuedadvancements
in the field of palliative care,patients
cannowreceivenearlythesamelevel
of support at home as in a hospitalâ
including visits from doctors, social
workers and psychologists.
âSomeone may have a person-
al support worker who helps the
client with getting ready for the
day. That could include very basic
things such as feeding or bathing or
Today, people are living long-
er thanks in part to advances
in medicine where the sick,
the dying and often the elder-
ly, can be kept alive long past
natureâs end date. Instead of
treating death as a natural
part of lifeâs evolution, medi-
cine and our modern society
can prolong life at all costs.
While we may not yet be able to con-
trol death, we can control how we
choosetoapproachit.
Palliative careâalso known as end-
of-life careâis a type of health care
that aims to relieve suffering and
improve the quality of life for people
whoarelivingwith,ordyingfrom,ad-
vancedillness.
Usually an integrated approach
involving medical care and pain
management, palliative care also
places a strong emphasis on sup-
porting the loved ones of patients by
acknowledging that the process of
illness affects not only the patients,
but also their families.
Taken as a whole, palliative care
âaddresses the psychological, so-
cial,cultural,emotional and spiritual
needs of the person and family,â says
AnthonyMilonas,ChiefOperatingOf-
ficerofCBIHealthGroup.
Home health services
For most people, dying in a home-
like setting surrounded byfamilyand
friendscanbeapeacefulandcomfort-
ingexperience.
âPeople are often more comfortable
when they are in a familiar environ-
ment surrounded by family and loved
ones,â says Rosanna Dolinki,Nation-
al Senior Manager of Clinical Practi-
ces at We Care Home Health Servi-
ces, part of CBI Health Group. âHav-
ing care provided at home can offer a
more comfortable alternative for the
person and family. Like the home it-
self,the care provided there incorpor-
ates all aspects of a personâs life and
well-beingâshesays.
clothing,â says Ruth Wilcock,Exec-
utive Director of the Ontario Brain
InjuryAssociation.
âSome people may be fine to get
up and to dress and feed themselves,
but they might have other needs. So
theyâll have an occupational ther-
apist who comes in or a physiother-
apist or a nurse.What it comes down
to is the level of need. In palliative
going to speak for me and make
sure that my wishes are being met?
All of these questions are critically
important,â she says.
Moving forward
Whilework has been done recentlyin
Canada by CHPCA and others to help
increase awareness and promote the
benefits of advance care planning,ad-
dressingthetaboosurroundingdeath
remains one of the top priorities for
palliativecareproviders.
The key to this is informing,edu-
cating and engaging physicians,
clients and families on the import-
ance of this sensitive topic.
âBringing awareness to the bene-
fits of palliative care planning and
educating the general public on
how the system works is the first
and foremost priority for health au-
thorities,â says Milonas.
âThese organizations play an ac-
tive role in demystifying the topic
of dying, so families, patients and
the elderly population feel com-
fortable to discuss subjects like ad-
vanced care planning for example,
as early as possible.â
BENJAMIN CHACON
editorial@mediaplanet.com
âEvidence clearly shows that when
people have candid planning
conversations, their families
experience less stress and less
anxiety at end-of-life and following
the death of their loved ones.â
Palliative care: do you have a plan?
PEACE AND COMFORT
Being surrounded by family and having home care improves end of life situations.