Leap Winter 2014

RY ISSUE
30th ANNIVERSA
WINTER 2014
SBRT: Radiation therapy cuts treatment times by a third WHOLE PACKAGE: Healing the complete self
RESEARCH ROCKSTAR: Dr. Gregory Cairncross tackles brain cancer head on
LOFTY GOAL: Worlds Longest Hockey Game
PLUS: Give speed skating a whirl; integrative palliative care and more
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CONTENTS
COVER STORY: Celebrating 30 years of progress in cancer
treatment and research.
WINTER 2014 VOL 5 No. 4
WINTER SPOTLIGHT
30 YEARS OF CANCER RESEARCH
IN ALBERTA
38
20
18
DEPARTMENTS
4 OUR LEAP
A message from the Alberta Cancer Foundation
6
26
46
11
12
FOREFRONT
Firefighters join the Tomorrow Project; Brain
cancer treatment heads to clinical trial; Easy
stuffed chicken breast and more
NEXT GEN
Keith Brown meets the recipient of a studentship
created in his mothers name
BODY MIND
Growing support for the whole cancer patient
13 SMART EATS
Messages about fat have evolved through the ages
14
50
16
ASK THE EXPERT

What does the five year survival rate really mean?
PLUS: The right way to go vegan; Trip preparation
PATIENT ENGAGEMENT
Patient-centred care starts with a small gesture
44 CORPORATE GIVING
Pengrowths fundraising efforts ramp up
50 MY LEAP
Brent Saiks Worlds Longest Hockey Game
Alber ta Cancer Foundation
Scientific advancements have changed how

we diagnose and treat multiple myeloma
20 LEAPS AND BOUNDS
Cancer treatment in Alberta has improved drastically

over the last three decades
24 ACROSS THE DECADES
30 years have led to huge developments in cancer

research, treatment and survival
26 HEALING THE WHOLE SELF

Mental and spiritual health now plays
an important role in cancer treatment
FEATURES
30 GREAT EXPECTATIONS
SBRT shortens the number of treatments required

for lung cancer patients
32 BRIDGING THE GAP
Integrating a palliative care approach within

cancer care
35 SPINNING CIRCLES
Speed skating is a fun, heart-pumping way to

stay in shape
42 WHY I DONATE
An Edmonton chemist funds clinical trials

for the same type of cancer that she survived
A MATTER OF TIME
38
TOP JOB
Cross Cancer Institute nurse Karey McCann
gives one-of-a-kind care
46 RESEARCH ROCKSTAR
Dr. Gregory Cairncross credits his work with keeping

him strong in a trying field
winter 2014
Message alberta cancer foundation
Weve Come a Long Way
TRUSTEES
Angela Boehm, Chair
Calgary
Gary Bugeaud
Calgary
Steven Dyck
Lethbridge
Paul Grundy
Edmonton (ex-officio)
Jordan Hokanson
Edmonton
Don Lowry
Edmonton
Katie McLean
Calgary
John J. McDonald
Edmonton
Andrea McManus
Calgary
Brent Saik, Vice Chair
Sherwood Park
Sandy Slator
Edmonton
Greg Tisdale
Calgary
Cancer has been around since the dawn of history. Some of the earliest
evidence of the disease is found among fossilized bone tumours, human
mummies and ancient manuscripts. The first description of cancer
although it was not named that was in Egypt, dating back to about
3000 BC. An early textbook on trauma surgery describes eight tumours
or ulcers of the breast that were removed by cauterization with a tool
called the fire drill. The description said simply: There is no treatment. And the causes were a mystery, but ancient Egyptians blamed
cancers on the gods.
What a difference a few thousand years makes. Over the last few
centuries, scientists began to develop greater understanding of the
human body. The introduction of tools like the modern microscope
allowed the study of the disease at a cellular level. By the middle of the
20th century, the discovery of the chemical structure of DNA allowed
scientists to understand how genes work and how they could be
damaged by mutations.
Fast forward to the present. It has been well said that scientists have
learned more about cancer in the last two decades than has been
learned in all the centuries preceding. Scientists today are standing on
the shoulders of everyone that has come before them, and while we still
have much to learn, weve come a long way.
At the Alberta Cancer Foundation, we havent been
Now, more than ever, is the
around as long as early Egyptians, but with the celebratime to be bold and do
tion of our 30th anniversary, we have been instrumental
something about cancer.
to many improvements in cancer research, treatment
and care in Alberta. In this issue of Leap youll read
about some of those advancements and hear from patients who have
experienced first-hand how much their lives have improved because
of them.
The Alberta Cancer Foundation has played a role in improving
Albertas cancer survival rates significantly every year over the last few
decades and we will make sure those numbers continue to rise. While
we celebrate the years of research that have brought us to this point,
where more than 100,000 Albertans are alive today after a cancer
diagnosis, the work we do today is crucial to bringing us the next
advancements that will save even more lives.
We believe Albertas cancer program can be among the best in the
world and with our donors continued support, we can make that happen. We are investing in innovative solutions that are vital to translating
research into life-saving therapies. We are thinking outside of the box to
find those big, transformative ideas to make sure something good
comes out of our donors investments. We push discoveries forward
through strategic investments in cancer research that deliver clear
results to patients. Now, more than ever, is the time to be bold and
do something about cancer. So while we are celebrating our 30th anniversary, we know we are on the brink of bigger and better things that will
improve the lives of Albertans facing cancer. Stay tuned.
Myka Osinchuk, CEO
Alberta Cancer Foundation
winter 2014
Angela Boehm, Chair

Alberta Cancer Foundation
myleapmagazine.ca
WINTER 2014 VOL 5 No. 4
ALBERTA CANCER FOUNDATION

EDITOR: PHOEBE DEY
CALGARY OFFICE
Suite 300, 1620 - 29 Street NW
Calgary, Alberta T2N 4L7
PROVINCIAL OFFICE
710, 10123 - 99 Street NW
Edmonton, Alberta T5J 3H1
Toll-free: 1-866-412-4222
Tel: 780-643-4400
acfonline@albertacancer.ca
VENTURE PUBLISHING INC.
PUBLISHER: RUTH KELLY
DIRECTOR OF CUSTOM CONTENT: MIFI PURVIS
MANAGING EDITORS: LYNDSIE BOURGON, SHELLEY WILLIAMSON
ART DIRECTOR: CHARLES BURKE
ASSOCIATE ART DIRECTOR: ANDREA DEBOER
GRAPHIC DESIGNER: BEN RUDE
PRODUCTION MANAGER: BETTY FENIAK SMITH
PRODUCTION TECHNICIANS: BRENT FELZIEN, BRANDON HOOVER
WEB & SYSTEMS ARCHITECT: GUNNAR BLODGETT
DISTRIBUTION: KAREN REILLY
CONTRIBUTING WRITERS: Colleen Biondi, Linda E. Carlson,
Caitlin Crawshaw, Jessica Dollard, Lucy Haines, Jen Janzen,
Robbie Jeffrey, Sue LeBreton, Jacqueline Louie, Nadia Moharib,
Christy Nich, Samus Smyth, Karol Sekulic, Margaret Vernick
CONTRIBUTING PHOTOGRAPHERS AND ILLUSTRATORS:
Brian Brady, Ryan Girard, Bryce Meyer, Heff OReilley, Joey Podlubny,
Darryl Propp, Raymond Reid, Amy Senecal
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
TOGETHER
WERE CREATING
MORE MOMENTS
FOR ALBERTANS
FACING CANCER
The information in this publication is not meant to be a substitute for professional

medical advice. Always seek advice from your physician or other qualified health
provider regarding any medical condition or treatment.
Printed in Canada by Transcontinental LGM.
Leap is printed on Forest Stewardship Council certified paper
Publications Agreement #40020055
ISSN #1923-6131
Content may not be reprinted or reproduced without permission from Alberta Cancer Foundation.
Donate today at albertacancer.ca

winter 2014
Forefront prevent, treat, cure
Sparking Participation
The Calgary Fire Department throws its weight behind the Tomorrow Project
The Calgary Fire Department has issued a
challenge to the provinces emergency personnel

take part in the Tomorrow Project.
The Tomorrow Project, a large, long-term project
that aims to understand why some people get cancer and others dont, is supported by the Alberta
Cancer Foundation, Alberta Health Services and
other provincial organizations. Its been going on
since 2000, and currently has more than 47,000 participants in the province. James Whitworth, the projects study centre co-ordinator, says the goal is to
have 50,000 participants, and that the fire departments challenge is a big win in achieving that goal.
This could snowball for us, and were hopeful
that it does, he says. The Tomorrow Project did an
event with the fire department in October, which
drew more than 40 firefighters who signed up for the
study. It worked out and became a fantastic event,
Whitworth says. We saw a big uptake in enrolment
based on that alone.
The clinics that Whitworth helps arrange include
regular blood and urine sample tests and physical
measurements. Participants also fill out a health
information form, and they are informed that they
may be contacted in the future to do the process
again. Its important that we do what we can at this
point to make things better in the future, says
Whitworth. If I had my way, wed be in with every police department, fire

department and EMS in the provinces mid to large cities.
Whitworth says theyre also pleased to work with the fire department
because the majority of the participants so far have been female, and fire
departments (and other emergency professions) are a predominantly male
workplace. We just dont have enough [male participants], and we need the
biggest cross-section of individuals as possible.
All participants in the Tomorrow Project have never had cancer and are
between 35 and 69. The researchers will compare and track those participants
over years, or decades, and use that data to help understand more about
cancer causes.
Tackling Glioblastoma
A new brain cancer therapy heads to clinical trial
In October, we learned that researchers at
the University of Calgarys Hotchkiss Brain

Institute and the Southern Alberta Cancer
Research Institute had made a considerable
find that could prolong the lives of people living with glioblastoma, the most aggressive type
of brain cancer.
Samuel Weiss, a professor and director of the
Hotchkiss, and his team used tumour cells
derived from 100 different brain cancer patients
to test drugs that could target the disease.
Through this method, they discovered that
using the drug AZD8055, combined with
Temozolomide (TMZ) therapy (a drug already
used on many glioblastoma patients) could
extend lifespans by about 30 per cent.
6
winter 2014
Our research has identified a key process in brain tumour growth

that we are able to target with AZD8055, says research assistant Artee
Luchman. The research team at the University of Calgary is now working with other researchers and a drug manufacturer to plan a clinical
trial that would test a new drug similar to AZD8055 in combination
with TMZ.
Glioblastoma is the most common and deadly form of brain cancer
among adults. The tumours diseases progress quickly and are complex,
making them difficult to treat. The median survival rate is 15 months,
and only one to five per cent of patients survive beyond five years.
Discovering new pathways and therapies that can be tested in the
clinic provides the greatest hope for brain cancer patients and their
families, says Weiss. The study was funded by the Alberta Cancer
Foundation, Alberta Innovates Health Solutions and the Canadian
Stem Cell Research Network. Read more about glioblastoma and a
world-class scientist leading its way on page 46.
myleapmagazine.ca
Cool Runnings
From mushing to ice angling, theres lots to see
and do around Alberta this winter
TOUR LAKE LOUISE BY DOGSLED.

Not only will you participate in an hour-and-a-half dogsledding adventure along the
Continental Divide, you will also have time aplenty to enjoy the beauty of the famous lake.
This trip, operated by Kingmik Dog Sled Tours, takes guests to the Alberta-British Columbia
Great Divide a distance of about 16 kilometres. This adventure is for those really wanting
to experience the thrill of mushing, as guests are even encouraged to drive the team on the
home stretch, which includes an opportunity to snap a great shot of the north face of Mt.
Temple. The cost is $333.90 per sled or $165 per person, and tours, which run late
November through mid-April, are not operated on Thursdays. At the end, tours return to
Lake Louise, the perfect spot to sight see, skate on the lake or visit the Fairmont Chateau
Lake Louise. For more information or tickets, visit kingmikdogsledtours.com/tours.
BOARD A TRAIN FOR A HALF-DAY ROCKY MOUNTAIN TOUR.

Who says train travel is a thing of the past? Why not stay warm and enjoy the sights of
the Canadian Rockies during a half-day tour with Sundog tours. The route heads west on
VIA Rails Skeena line from Jasper, Alberta, to Harvey, B.C. Participants then derail and
make the return trip with a friendly driver via a comfy touring vehicle along the Yellowhead
Highway, with lots of chances to wildlife watch on the way back to Jasper. Tour durations are
five to six hours, with departures at noon Sundays, Wednesdays and Fridays. Adults pay just
$99 for the round trip and tickets for kids under 12 are $55. For more information or to book
a tour, visit sundogtours.com.
SLEEP WITH THE FISHES (AND HOPEFULLY CATCH SOME, TOO).

Halfway between Edmonton and Calgary, Gull Lake is a prime Alberta ice fishing
spot. Adventure Ice Fishing offers anglers the opportunity to even stay overnight to take
advantage of the best biting times. Adventure Ice Fishing is the only outfitter in the province that provides overnight huts with four bunk beds per hut, propane furnaces, propane
stove and light, kitchen counters and an outhouse. Fishing holes are pre-drilled, so all
participants have to do is watch for the northern pike to bite. Rods, gear, bait, an ice
scoop, tip-ups, a barbecue, dishes, utensils, pots and pans, and a table and chairs are all
provided in huts. The company offers daytime ice fishing adventures as well. The cost for
the overnight excursions starts at just $90 per person. For more information, visit
adventureicefishing.com.
CATCH THE WAVES AT WEST EDMONTON MALL.

The West Edmonton Mall World Waterpark offers surfing lessons for participants 10
and older. Lessons, which are 90 minutes, are offered once the waterpark closes to the general public on Thursday evenings, and Saturday mornings from 8 a.m. to 9:30 a.m. The cost,
which includes the use of a board, is $75 per person, and payment is required at the time
of booking. The Surf Club also offers drop-in lessons Monday and Wednesday, 30 minutes
after closing, at a cost of $30 per drop-in or $120 for a six-visit pass. Completion of a
private surf lesson is a requirement to join the Surf Club. For more information,
call 780-444-5313 or visit wem.ca.
DO SOME HORSING AROUND IN CALGARY.

Its always a good time for a romantic horse-drawn sleigh ride, so why not head to
Calgarys Fish Creek Provincial Park for a whisk around its winter wonderland. Horsin Around
offers seasonal horse-drawn sleigh rides every weekend starting at noon (weather permitting)
for $5 per person (kids under two years are free). Located in the southwest close to Fish Creek
Provincial Park, Horsin Arounds sleigh is an open deck with straw bales, and seats up to 20.
The 15-minute ride is a perfect opportunity to sing carols as a family or to just sip hot chocolate and catch up with your sweetheart. For more information, call 403-238-6665.
winter 2014
Raising Funds Through Fitness

Bust a Move is back for another year of heart-pumping fundraising
The worldwide phenomenon that is
Bust a Move for Breast Health is back

again this March, bringing together groups
of people all over the world to sweat it out
for charity. Started in Halifax in 2010, the
event takes place in cities across Canada
as well as in Brisbane, Australia. Bust a
Move is a community fundraiser that sees
teams or individual entrants raise $1,000
for cancer charities in their community.
On event day, everyone gathers in a
large space for what Alberta Cancer
Foundation development officer Breanne
Kraus calls a six-hour fitness extravaganza. The event brings in six instructors that
hold classes on everything from yoga to
Zumba. The instructors are raring to go
this year, says Kraus, of the March 21 event
in Edmonton. All funds raised for the
event will go to the Cross Cancer Institute.
Bust a Move has earned a strong following over the years, and participants often
arrive decked out in tutus, boas and other
crazy costumes. Every year, the team
arranges for a celebrity instructor to show
up and get the event off to a great start this year participants can expect a secret
local guest, according to Kraus. Registration is now open for Bust a Move for Breast
Health 2015. For more information, visit albertacancer.ca/BaMEdmonton2015.
SNOW SHOVELLING 101

1. Keep a wide stance.
When bending, put your weight
on the front foot, close to the
shovel, and use your front leg to
push the shovel straight ahead.
2. Once your shovel is full
of snow, shift your weight to the
rear foot and keep the shovel load
close to your body. Always lift
with your arms and legs, never
your back.
winter 2014
3. When throwing snow,

turn your feet in the direction
of your throw and pivot your
entire body. Avoid twisting
from the waist.
myleapmagazine.ca
Stuffed Chicken Breasts

Makes four servings.
Per serving: 200 calories, 6 grams total fat (1.8 grams saturated fat), 2 grams
carbohydrates, 32 grams protein, 1 gram dietary fibre, 209 milligrams sodium
INGREDIENTS:
DIRECTIONS:
Canola oil cooking spray

1 pound boneless, skinless chicken
breasts (four thick pieces)
3/4 cup low-fat shredded cheddar
cheese
2 Tbsp green onions, finely chopped,
including the stems
1 medium red bell pepper, 1/2 diced,
1/2 sliced
1 Tbsp plain Greek yogurt (canola
mayonnaise may be substituted)
2 tsp fresh lemon juice
1/2 tsp hot sauce (optional)
1 Tbsp olive oil
1/4 cup chopped fresh parsley or 1
Tbsp dried parsley
Salt and freshly ground pepper to taste
1. Preheat oven to 350 degrees. Spray a

7- by 11-inch pan with cooking spray.
2. Carefully cut about a one-inch wide
slit into the thick end of each chicken
breast. Insert knife to create a fairly deep
pocket.
3. Combine cheese, green onions, red
pepper, yogurt, lemon juice and hot
sauce in mixing bowl.
4. Divide mixture into four portions and
use a spoon to stuff breasts. Secure
openings with wooden toothpicks
inserted at an angle so meat lays flat.
Place in prepared pan.
5. Brush olive oil over top of chicken and
sprinkle with parsley, then pepper and
salt, if using.
6. Bake for 30-35 minutes or until chicken is cooked

through. Let stand about five minutes.
7. Garnish with red pepper slices and serve.
Source: American Institute of Cancer Research
Blocking Cancer in Its Tracks

A University of Alberta researcher studies cancer cell tentacles
Dr. John Lewis, a University of Alberta researcher, has led a study
that shows how cancer cells form tentacles to move from one part of the body
to another. The teams finding could open up new possibilities surrounding the
treatment of cancer.
Since the spread, or metastasis, of cancer is what makes it deadly, we have
been interested for some time in what genes and proteins are required for cells
to proceed through each step, says Lewis, who is also the Alberta Cancer
Foundations Frank and Carla Sojonky Chair in Prostate Cancer Research.
Almost immediately, we saw that the cancer cells moving through the bloodstream were forming long tentacles just before they escaped, so we decided to
take a closer look to see what they were.
Its an exciting find for the team. This means that cancer cell tentacles could
be a promising target for new anti-cancer or anti-metastasis drugs, says Lewis.
During the research, Lewis and his team watched as a cancer cell reached a tentacle slowly out of the bloodstream. Now that the team has identified the process, the researchers can focus on an effort to develop new drugs that could
block the tentacles and improve the lives of cancer patients in the future.
winter 2014
Just for Kicks

The organizers of the Worlds Longest Indoor Soccer Game reach success
Athletes from the Strathcona region have kept their
reputation for hours of competitive playing alive, by setting

another record for the Worlds Longest Indoor Soccer Game.
The organizers of the Alberta Cancer Foundations
WorleyParsonsCord Worlds Longest Indoor Soccer Game
have a good track record for organizing really long matches on
the pitch. In both 2008 and 2012, they held the worlds longest
games outdoors, clocking in at 33 and 38 hours respectively at
the Strathcona Athletic Park. Combined, those two events
raised around $140,000.
This year, their goal was to raise $48,000, and they held the
event indoors at Sherwood Parks Millennium Place. They
played a 48-hour game and managed to raise over $58,000.
For the first hour, everyone played together, and then they
took shifts so that people could take a nap or eat, says Kaitlin
Fox, a development officer at the Alberta Cancer Foundation.
They did that for about 46 hours, and then for the last hour
everyone jumped on the field together.
The participants had been recruited by organizers through a
combination of the two previous games and word of mouth,
Game organizer Michelle Chambers
with most of the players coming from Calgary or Edmonton.

The money raised will be going to the cellular imaging facility
at the Cross Cancer Institute. Its really translational research,
says Fox, of the technology that gives doctors the ability to see
a tumour react to different treatments in real time and how
they respond to different treatments. The discoveries made in
this facility will translate from lab bench to bedside and lead to
incredible advances in patient care and treatment.
Next Gen supporting young minds
HEAD OF THE CLASS

Keith Brown meets the recipient of a
studentship created in his mothers name
BY ROBBIE JEFFREY
Dr. Roseline Godbout leads us into a sparsely lit
research lab in the Cross Cancer Institute, where comPROUD SON: Keith Brown, shown here in an
puters occupy enough space to make it cramped for
undated photo with his late mother Betty Brown
our small group. Jiali Luan sits down in front of a comon a walk with the family dogs, has created a
studentship in her honour.
puter screen and explains what hes been working on
under Godbouts supervision; wrapping up his fourmonth studentship, he recently gave a presentation of
his research on the enzyme DDX1, a family of proteins
that participates in DNA repair. As the beneficiary of
the Alberta Cancer Foundations 2014 Betty K. Brown
Summer Studentship, Luan is conferred a special privilege today our groups most enthusiastic member,
Keith Brown, established the very studentship Luan
has been working under.
Jane Weller, development director at the Alberta
Cancer Foundation, gives our group a tour of the facility,
and Brown is quick to ask both Godbout and Luan
detailed questions about their findings. Its unfortunate you didnt go into research, Godbout tells Brown.
You think like a scientist. Naming the studentship
after his mother, whose first occurrence of breast cancer was in 1965, Brown stipulated only that the research
be pertinent to patients currently under treatment. I
wanted to give hope to patients that would otherwise
have none at all, he says. Brown established a different
studentship under his fathers name (Dr. Gordon Brown,
who was voted one of Albertas top 100 physicians in
2005) which has been offered since 1984, so he knew
the benefits. Today, however, he gets to see the effects
of the studentship he created in honour of his mother,
and hes overjoyed.
coming through, over and over the most impact you can make in cancer research
Over the summer, Godbout and Luan studied the is in the trainee awards, the graduate programs and the fellowships, she says. For
the future of the Alberta Cancer Foundations fundraiscorrelation between
ing, this is a priority. Students are the fuel for the research
overexpression of DDX1
I wanted to give hope to
and early relapse in
patients that would otherwise have engine. Godbout backs her up, praising the passion and
enthusiasm of the summer students, who need a GPA of
breast cancer patients.
none at all, says Keith Brown.
3.9 or 4.0 to even be eligible to receive the funding. As a
We want to understand
result, The calibre of students is incredible, she says.
what DDX1 does so we
can use different ways of targeting it and see if that can And a lot of them will be interested in medical school because they have the
be used as a method of treatment, Godbout says. If grades for it. These programs also kindle an interest in research, which increases
its just a matter of killing cancer cells, thats easy the the likelihood of important collaborations and discoveries down the road.
Not to put pressure on Luan, though he clearly thrives in the face of challenge.
key is that if you kill cancer cells, you kill normal cells
also. We need to become very clever at identifying tar- He was born in northeast China and came to Edmonton in 2000, and aspires to be
geted approaches. She and Luan both see the the first doctor in his family. Hes engaged in his work and recommends the experiresearch as having wide-ranging implications for treat- ence of being a summer student. Id do it again, he says. Its a great program.
As Godbout heaps compliments on Luans work ethic, its evident that Brown is
ment of all kinds of cancers.
As the tour ends, Weller describes how she and glad to have Luan as a beneficiary. Everyone involved in the studentship is excited
Brown consulted with doctors to create the Alberta to see the project continue and happy to be part of the Brown familys legacy.
Cancer Foundation studentship. The message keeps Today was a good day, says Brown, as he shakes Luans hand.
winter 2014
11
Body Mind making positive connections
30 Years and Counting

Support for the whole cancer patient has only
grown in the span of three decades
BY LINDA E. CARLSON
Since the theme of this edition of Leap is marking

the Alberta Cancer Foundations 30th anniversary, I
thought we could look back on cancer care 30 years
ago as compared to today, from the lens of whole person care and patient access to that care. Back in the
early 1980s, it would have been considered heresy to
put a group of patients together to talk about having
cancer. People thought it would be upsetting to patients to hear stories of what other people were going
through. This was before the dawn of psychosocial
oncology as we know it the study of the psychological, social and emotional impacts of cancer.
In the past three decades, many hundreds of studies have investigated the impact of support groups
for people with cancer and found a wide range of
benefits from decreases in levels of depression and
anxiety, to improved coping, social support and comfort with medical treatment. These days, you would
be hard-pressed to find a cancer centre that didnt
offer psychological support of some kind, and thats
a good thing. Not only do people benefit from group
support, but they also benefit from individual and
family counselling where they can find a safe place
to work through difficult emotions, from fear, sadness
and anger to grief and loss.
Psychosocial support is expanding to include not
just support groups and individual counselling, but
also more of the complementary mind-body therapies: meditation, yoga, hypnosis and imagery. At the
Tom Baker Cancer Centre in Calgary, we developed
a program in 1997 called Mindfulness-Based Cancer Recovery (sometimes referred to as Mindfulness-Based Stress Reduction). It teaches patients and
support people techniques of mindfulness, defined
as present-centred non-judgmental awareness, using
daily training in meditation and gentle yoga. The benefits are many, including stress reduction, decreases
in anger, depression and fatigue, and improved sleep
and quality of life. To date, thousands of patients in
Calgary have taken the eight-week group program.
With new technology advances in the last decade,
we decided to offer the program to Albertans across
the province who were not able to attend the program
in person. This may have been due to living far away,
12
winter 2014
an inability to travel, financial restraints, the burden of symptoms, low energy,

infection concerns, advanced stages of cancer or a host of other practical and
medical reasons.
We did a pilot study in 2012 and enrolled 63 Albertans, who did the eight-week
program online. We sent them web cameras, audio headsets and helped them
set up their computers so they could log in to the virtual classroom and see the
instructor (who was in California) as well as all the other participants around
Alberta. They attended weekly meetings similar to the in-person group and had
online discussions about mindfulness, meditation, stress reduction and yoga. They
learned how to meditate and practised at home daily between classes. Amazingly,
they reported all of the same benefits of those who participated in person! This
paper has been published in a scientific journal and we are now seeking funding
to make it a permanent clinical program offered to patients, survivors and support
people across the province.
This is just one example of how advances over the last 30 years in psychosocial
support services have allowed us to reach more people in need using novel and
innovative techniques. To read more, visit Tbccintegrative.com.
myleapmagazine.ca
Smart Eats food for life
Heart Health:
Then and Now
Messages about nutrition and the fat we eat

have evolved through the ages
BY KAROL SEKULIC
If you follow nutrition in the news, there are many

evolving messages about how to eat to prevent heart
disease. Nutrition research, like any research, changes
over time. This article will explain past thinking about
fat and its role in heart health and review current
recommended patterns of eating.
Questions about the fat we eat became popular in
the late 1950s, when a researcher found that certain
ways of eating affect heart disease. He discovered that
people with higher cholesterol levels had higher rates
of heart disease. Scientists then found that a higher
saturated fat intake was also linked to heart disease
risk; this started people thinking that if they reduced
fat and dietary cholesterol intake, it would reduce
their risk of heart disease.
Health organizations like the American Heart
Association developed dietary recommendations for
reducing fat intake in the late 1950s. By the 1960s
and 1970s, people were encouraged to replace
saturated fat with polyunsaturated fat, to help reduce
blood cholesterol levels. In the 1970s, they were also
advised to reduce foods rich in cholesterol, like egg
yolks and shrimp. However, further research found
that these fat recommendations did not have an
impact on reducing deaths from heart disease.
In the 1980s and 1990s, other foods in the diet
besides fat were scrutinized like vegetables, fruit, nuts
and fish. Researchers also studied the role of dietary
fibre. Research showed these foods had a bigger impact on heart disease risk than fat alone.
What is the current healthy eating guidance for
heart disease? Some health organizations still
recommend limiting dietary cholesterol for those who
have a high level of blood cholesterol, but research
is finding that dietary cholesterol has little impact
on blood cholesterol. The appropriate message is to
choose healthy fats, with a bigger emphasis on eating
foods that help protect against heart disease. Here
are some tips for heart-healthy eating:
Eat lots of vegetables and fruit. Aim for seven
to 10 servings each day. Include dark green and
orange vegetables like spinach and carrots.
Choose higher-fibre foods and whole grains,
including foods like amaranth, barley, buckwheat,
bulgur, cracked wheat, millet, oats, wild or brown rice.

Eat fish at least twice a week. Fish containing heart-healthy fats (omega-3 fats)
include salmon, sardines, herring, mackerel, trout and tuna.
Reduce consumption of added sugar by limiting sweet desserts, and drinks
with added sugar such as regular soft drinks, sweetened coffee and teas, juices
and fruit-flavoured drinks.
Choose and prepare foods with little or no added salt. Limit salty foods like
pickles, crackers, snack foods, deli meats, canned and dry soup.
Limit saturated fat by using lower-fat dairy products (skim or one per cent
milk), leaner meats or dried peas, beans and tofu.
Include small amounts of healthy fats (two to three tablespoons or 30-45
millilitres) every day such as:
- Olive, canola, peanut and sunflower oils
- Soft margarine with zero grams of trans fat
- Ground flax, chia or hemp seeds
- Nuts like walnuts, almonds, pecans or pistachios
Remember that fat is only part of the picture when choosing foods for heart
health. Include a variety of healthy foods and reduce foods that increase heart
disease risk.
Karol Sekulic is a registered dietitian with Alberta Health Services who has expertise and interest
in the areas of weight management and nutrition communications.
winter 2014
13
Ask the Expert a resource for you
KNOWLEDGE
IS POWER
We brought your questions to the

medical and nutrition experts on
travel vaccines, five-year cancer-free
anniversaries and vegan diets
BY LYNDSIE BOURGON
AND SHELLEY WILLIAMSON
Im planning to take a tropical

vacation this winter and want to
make sure I dont get sick. How far in
advance should I start considering my
travel health precautions?
Every winter, around two million Canadians

head south in the pursuit of beautiful beaches and
warm weather. But according to Silvina Mema, a
public health and preventive medicine resident with
Alberta Health Services, up to 75 per cent of those
travellers will develop a travel-related illness.
Infections, injuries and threats to personal safety are
common problems abroad, she says. Sick travellers can even bring infections back home when they
return to Canada, and expose family and friends in
their community to these health risks.
Mema says the key to staying healthy during your
trip is preparation. Ideally, you should start planning
your health precautions at least six weeks prior to
departure to give time for your immune system to
respond to vaccines, she says.
Start by discussing your travel plans with your
family physician, or by scheduling a visit with a travel
health clinic for an individualized pre-travel consultation. Your health provider will determine your
risks based on your health background and the
details of your trip, says Mema. They may recommend additional immunizations and other precautions to help you stay healthy and safe. Keep in
mind that, though its an added step in your pre-trip
plans, understanding health risks and choosing precautions are important moves to make before your
next trip.
Have a fun and safe vacation!
14
winter 2014
Id like to become a vegan but know that I

shouldnt dive right into a new meal plan. What
advice do you have for making a big diet change?
Deciding to become vegan, or follow a strict plant-based diet, is a

personal choice which may be made for any number of reasons. Before
beginning any new diet, its important to consider how much change will be
required, how committed you are to the change and the health consequences of making the change, says Shannon Mackenzie, from the College of
Dietitians of Alberta. A plant-based diet offers many healthy benefits, but
changing from a traditional diet to a strict vegan one is a big transition that
should be taken in mindful steps. A strict vegan diet can be limiting in entire
food groups and certain macro- and micronutrients, like protein, omega-3
fats, iron, zinc, calcium, vitamin D and B12. Therefore extra planning may be
required to do it well.
Mackenzie recommends seeking the input of a registered dietitian who can
help you make safe and manageable changes while maintaining a nutritionally
balanced diet. They have the science-based food, nutrition and health
background to help you make sound nutrition decisions and changes that fit your
unique health needs and lifestyle, she adds. To find a registered dietitian, visit
www.collegeofdietitians.ab.ca.
myleapmagazine.ca
I hear people talking about their five-year

anniversary of being cancer-free. Why is this
benchmark significant?
Peter Craighead, medical director at the Tom Baker Cancer Centre,

puts this cancer-versary in perspective. Celebrating after a five-year anniversary of your cancer being in remission is made after the risk of your cancer coming
back has been determined to be low. For most cancers the early years after
completion of treatment are associated with the highest risk of cancer recurrence, he says. After five years, it generally means that the risk of recurrence is
so low that we dont see the benefit to you continuing to see us on a regular
basis, he adds, noting, Although many patients are encouraged to move back
to their family doctors for followup, there are several reasons why we may not
allow you to be discharged away from our clinics after five years. For those with
aggressive cancers where statistical evidence cites a risk of the cancer returning,
Craighead suggests keeping an eye on the situation and still consulting your
oncologist or attending cancer clinics for a few more years.
There are a couple of other exceptions to cancer survivors getting a green
light. If you were on an experimental treatment and we needed your clinical
information to ensure the treatment didnt have bad side effects, then we
would keep you attending, he explains. And if you lived somewhere where
skilled health care supports were not available, we would keep you attending
our clinics.
While this milestone is worth acknowledging, it is never a guarantee the cancer will not return, he points out. Its obviously important to identify that even
after five years, when the risk has come down, that there is still a small chance
of the cancer coming back.
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.
winter 2014
15
Engagement giving patients a voice
ITS THE LITTLE THINGS

Patient-centred care starts with a small gesture,
a quiet place or an answered question
BY JESSICA DOLLARD
As an advisor in patient and family-centred care,
I have noticed sometimes there is a degree of fear surrounding bringing patients and families into the design, planning, delivery and evaluation of health care.
The fear seems to be that because patients and families do not understand the system or practice, they
will ask for things beyond our control as health-care
workers. While its true that sometimes we do collaborate on possibilities to dream big, patient and family
advisors understand clearly outlined limitations.
Recently, an advisor at the orientation for the
Patient and Family Advisory Council (PFAC) for the
Calgary Cancer Project asserted: We are experts in
our experience and ourselves but we acknowledge
your expertise too as doctors, clinicians, architects,
operational managers and engineers. For days afterwards, I shared that message with my team saying, Its
all about the synergy of expertise!
For our patients and their families, small and
thoughtful things can make a big difference a wellplaced private alcove, a place to have their questions
answered, someone holding the elevator door open
or wayfinding that helps them get to an appointment
on time. What I have noticed is that the adjustments
that are needed to the way we do things are not necessarily about changing the world or something big
and unmanageable.
Here is a beautiful patient story recently shared in
celebration of Patient and Family Centred Care Week
that I feel illustrates my point:
My name is Cheryl. In 2007, I was diagnosed with
small cell cancer in my right parotid gland. I was told many,
many times how rare this diagnosis was. I felt like a freak.
I want to share with you a brief and meaningful moment
that occurred while I was waiting for my radiation treatment
one day. I cant recall which day it was; somehow they all
blur together. Day 19? Day 23? I dont know and it doesnt
matter. What does matter is that I was sitting alone in the
waiting room on an uncomfortable chair and I was so tired.
It seemed like every cell in my body was exhausted. My
eyes wouldnt stay open and I was slouching, my head
hanging down.
I was waiting, patiently.
I was bracing myself for having my custom-made, claustrophobia-inducing mask placed over my face and neck, for
16
winter 2014
being clamped down onto the table, for the whirring sound of the equipment, and for the
disembodied, distant voice on the intercom telling me what was going to happen next. No
one else can be in the radiation therapy room with you in the few short minutes it takes for
the treatment to occur. No one can sit there beside you and hold your hand.
And as I sat in the waiting room, sinking deeper into my chair and deeper into my sadness, I felt a hand on my shoulder. A hand reached out and touched me. And that brief
touch told me that I was seen. That human contact told me that my suffering was visible and acknowledged. That warm palm and those five fingers on my shoulder said that
I was not alone and that there was some level of understanding between us, that what
I was experiencing was truly scary and difficult. That touch was encouragement, hope
and compassion.
I looked up to see my radiation therapist. I think, maybe, I managed to smile. I know that
she did.
It is important to be seen, to have our experiences witnessed by others, to know that we
do not suffer alone. Shared by Cheryl H., patient advisor, Calgary Cancer Project Patient and Family Advisory Council
I bet that radiation therapist touches and smiles at her patients every day.
It was not an extraordinary act. She may not even remember doing it. And she may
never fully know the impact of these small moments, or her impact on that patient.
I think all of us are change agents and, when we shift our perspective to acknowledge the power of the small, simple moments, we can create with each other, then
we really do have the power to change the world.
Jessica Dollard is the patient-centred experience advisor on the Calgary Cancer Project. As a
consultant in engagement and patient experience, as well as an actor, film and theatre producer,
programmer, medical skills trainer and executive certified coach, she brings a creative background
to this work.
myleapmagazine.ca
SPECIAL REPORT:
30 YEARS OF PROGRESS
hirty years ago, cancer was a topic that patients and their families
shied away from talking about, not to mention a disease that was far more often
than not a death sentence. Now, on the 30th anniversary of the Alberta Cancer
Foundation, Leap examines the strides that have been made in cancer research,
treatment, drugs and survival rates since 1984, and where we are headed in the future.
18
24
A MATTER OF TIME
Scientific advancements have changed how
ACROSS THE DECADES

A look at the numbers behind the gains made
in cancer research and survival rates
20
26
LEAPS AND BOUNDS

Cancer care in Alberta has improved drastically
over the last three decades
HEALING THE WHOLE SELF

Mental and spiritual health now plays an
important role in cancer treatment
winter 2014
17
30 YEARS of progress
Scientific advancements have drastically changed how

BY JEN JANZEN
hen Lorelei Dalrymple was diagnosed

with multiple myeloma, she was relieved.
It was 2009, and she had spent the last four
years living with fatigue, headaches and the
intermittent loss of feeling in her limbs. Various rounds of
tests had all come back with inconclusive results.
It wasnt until she repeated yet another round of
blood work that something suspicious showed up. After
a hematologist ordered a PET scan, it was confirmed:
Dalrymple had multiple myeloma, a cancer affecting the
18
winter 2014
plasma cells (a subset of white blood cells) in the bone

marrow (the precursor multiple comes from the fact
that there are many different types of myeloma). But the
diagnosis didnt scare her because it meant she knew
what she was up against. Theres nothing worse than
not knowing whats going on, she says. The next six
months were a whirlwind, as she underwent induction
therapy to try to reduce the load before a stem cell harvest and transplant that would lead to a three-and-a-half
year remission.
myleapmagazine.ca
of the disease and expanding options for treatment. One

of the treatments Venner is excited about is engineered
antibodies. Using the same approach as vaccines our
bodies create antibodies to fight the diseases were being
vaccinated for an engineered cancer-fighting antibody
would hone in on a specific marker in the cancer cell, targeting that cell and leaving healthy, non-cancerous cells
alone. This type of treatment already exists for lymphoma, but Venner says its taken a long time to develop a myeloma-specific form of it.
Our understanding of genetics is also leading to a greater understanding of myeloma. The Human Genome Project, which sequenced all the DNA in the human body, was
completed in 2003 after more than a decade of work.
Until recently, multiple myeloma prognoses

were grim. Even as little as five years ago,
the life expectancy from date of diagnosis
was just two to five years. Now, its up to
eight to 10 years, with many patients
living longer than that.
Until recently, multiple myeloma prognoses were

grim. Even as little as five years ago, the life expectancy
from date of diagnosis was just two to five years. Now,
its up to eight to 10 years, with many patients living
longer than that.
Dalrymple knew the cancer would come back: thats
just the way myeloma works. Her blood work had shown
slowly increasing myeloma protein levels, and she started to develop hip pain that got so severe that she couldnt
lift her leg. Her remission officially ended last fall, after an
MRI confirmed lesions in her pelvis. She went back into
a new course of treatment with radiation and new drugs
that she takes daily.
Dr. Christopher Venner, clinical lead for the Malignant Hematology Program at the Cross Cancer Institute
in Edmonton and assistant hematology professor at the
University of Alberta, says part of the difficulty in treating multiple myeloma is its ability to adapt to treatment.
Because its genetically unstable, it figures out ways of
evolving around our therapies, he says. Management
really revolves around the principle of trying to stay one
step ahead of it.
But advances are happening quickly in both knowledge
Now, says Venner, we can run a whole genome comprised of millions of genes in a week for under $1,000,
and we can even do some of that work in Alberta. DNA
mapping helps with myeloma because it paints a very detailed picture of what is going on in the cancer cells. You
can sequence all the DNA in a malignancy to see what
genes have changed, what genes are overactive or underactive, he says, noting that DNA changes are what causes
cancer in the first place.
The holy grail, says Venner, is to be able to pinpoint
the driver mutations, multiple DNA changes that can
cause myeloma, and to try to find a drug to turn that off.
He says thats the goal for all cancers, not just myeloma.
A province-wide clinical database, created with funding from the Alberta Cancer Foundation, is another important advancement. A database that tracks patient
treatment and outcomes is the only way you can see
whether what youre doing is working, says Venner. It is
also crucial to put the laboratory findings into perspective, making the discoveries relevant to the patients
sitting in front of us. Before the online database, a doctor would have to sift through paper copies of charts of
other patients to see if a particular drug or combination
had been attempted before. Its the first of its kind for
myeloma in Alberta and will complement other national
and international initiatives. While it may be ambitious,
the ultimate goal is to develop a comprehensive diseasespecific database used by all interested researchers and
clinicians across the country. Venner says that, Given
the interested and experienced core group of people in
Alberta, we are poised to be leaders here.
So far, everything looks good for Dalrymple. Her cancer is back in remission and shes taking oral chemotherapy every day. She knows her remission is temporary, but
shes confident that by the time the myeloma protein level starts to rise in her blood, there will be a new treatment
that will hold the cancer at bay or maybe even cure it .
winter 2014
19
SWEET MILESTONE: Thanks to great strides made in cancer diagnosis

and treatment, patient outcomes have improved vastly in the past 30 years
since the Alberta Cancer Foundation began, says Dr. Peter Venner, former
director of medical oncology at the Cross Cancer Institute, above.
20
winter 2014
myleapmagazine.ca
LEAPS
& Bounds
Cancer treatment in Alberta has improved
drastically over the last three decades
BY CAITLIN CRAWSHAW
PHOTOGRAPHY BY RYAN GIRARD
ets imagine you could turn the clock back to 1984 and peek into an oncologists
waiting room. Youd see patients with big hair and shoulder pads, looking
at magazines instead of smartphones. At the front of the room, youd see a
receptionist typing away on the latest and greatest computer technology: an Apple IIe. You
might hear Duran Duran playing on the radio. But you wouldnt hear anyone being scheduled
for an MRI, laparoscopic surgery or even a biopsy, and its unlikely youd see a patient smiling
after a test result. In fact, if you came back week after week, youd stop recognizing the
patients. Thats because, 30 years ago, practically everything to do with cancer treatment
from diagnosis to surgery to chemotherapy was on the verge of a revolution.
As a result of major improvements in diagnosis and treatment, patient outcomes have
drastically improved, says Dr. Peter Venner, former director of medical oncology at the Cross
Cancer Institute. When he began practising medicine in 1980, a man with prostate cancer (his
treatment specialty) would have been treated with hormone therapy and expected to live just
two years. Now, it is probably beyond five years because of new treatments, he says.
In fact, almost every cancer you can think of including breast, lung, colorectal
and gynecological cancers have much higher survival rates these days. Part of this relates to
better, earlier diagnosis, so theres better screening taking place, but theres also better
treatment, Venner says.
winter 2014
21
SLICE OF LIFE: Advancements in technology over
the past three decades have meant that survival rates
for certain cancers, such as Dr. Peter Venners treatment
specialty, prostate cancer, are much higher.
Diagnosis
location of a tumour and guide procedures like surgery, biopsy and radiation
In the early 1980s, a patient with cancer symptoms therapy. The device uses computing technology to analyze a series of X-ray
would have approached his family doctor with a health views of the body, taken at different angles, to create cross-sectional images. A
complaint, just like today but the similarities in few years after that, magnetic resonance imaging (MRI) a device that involves
treatment would have ended there. Instead of being magnetic fields and radio waves became ubiquitous, allowing doctors to get an
sent for an MRI or CT scan
even clearer view of a
to look for signs of cancer, a
patients internal organs,
You could almost count on your hand the
patient would have been sent
especially the brain and
number of drugs available to cancer patients spinal cord.
for an X-ray one of the only
imaging techniques available,
In the mid-1990s, positron
in the 70s and 80s. Now, there are probably
offering only a very basic view
emission
tomography (PET)
100, says Dr. Claire Temple-Oberle, a
of the inside of a persons body.
scanning became routine,
surgeon with the Tom Baker Cancer Centre. but it didnt come to Alberta
Ultrasound technology which
offers a clearer view of the bodys
until 2002. This screening
tissues without the radiation of an X-ray was still in its tool requires patients to swallow, inhale or be injected with a radioactive drug that
infancy and wasnt in common use for many more years. allows the device to capture information about chemical activity in the body. Its a
All the tools we take for absolute granted now were just useful tool for diagnosing some cancers.
not available, says Dr. Sandy McEwan, former director,
A big reason for the advancement in these technologies is computing power, which
oncologic imaging at the Cross Cancer Institute.
has improved immeasurably over the years, says Venner. As a result, doctors can get to
He explains that it wasnt until the middle of the bottom of a patients complaint much faster than ever before. We can diagnose
the 80s that computerized tomography (CT) cancer earlier and find metastatic spread earlier, he says. Imaging technologies also
scans began to be used consistently, offering help clinicians conduct a biopsy, in which a portion of tissue is removed and examined
doctors a tool to more accurately pinpoint the under a microscope for signs of cancer. All of this has improved patient outcomes.
22
winter 2014
myleapmagazine.ca
Much of Temple-Oberles work involves recreating breast tissue in women whove

Treatment
Thirty years after Venner started working at the Cross had mastectomies. Over the last decade, plastic surgery techniques have improved
Cancer Institute, the number of beds has dropped to the point where breasts created by a surgeon look real enough to pass the change
from about 100 to 56, even though the population of room test. Its even possible, sometimes, for a surgeon to save a womans original
the province has swelled. It isnt because of health care nipples and transplant them onto the new breasts. The number of surgeries needed
cutbacks or the opening of new facilities, but because to recreate breasts has also decreased (from two to just one) and its possible to do
most people who come to the clinic are now outpatients. the reconstruction at the same time as the mastectomy, although this still rarely
Over the years, the side effects of chemotherapy and happens. On average, only six per cent of Canadian women having mastectomies
radiation have lessened dramatically, and people are get reconstructive surgery at the same time; at the Tom Baker Centre, 25 per cent of
women have the reconstruction at the
well enough to return home
same time (one of the highest rates in
after their treatments. A lot of
All the tools we take for absolute
the country).
our medication used to cause
granted now were just not available,
nausea and vomiting, he says.
Now, we can be confident in says Dr. Sandy McEwan, former director, Patient wellness
telling patients that nausea
Better outcomes mean happier patients
oncologic imaging at the Cross
and vomiting is less common
but theres also more attention being
Cancer Institute.
and less severe than it used to
paid to the overall wellness of patients.
be. This is largely because of
In the last five to 10 years, more
pharmaceutical advances. You could almost count attention has been paid to how satisfied cancer patients are with the care they receive,
on your hand the number of drugs available to cancer says Temple-Oberle. In the breast cancer realm, two questionnaires the BRECON-31
patients in the 70s and 80s, he says. Now, there are and BREAST-Q have been developed to measure this.
probably 100.
There are also more resources to help a patient deal with the psychological impacts
Surgical treatment has seen some drastic of the disease, like support groups, counselling services and programs like Look Good
improvements, says Dr. Claire Temple-Oberle, a Feel Better (which helps women with cancer manage their physical appearance while
surgeon with the Tom Baker Cancer Centre in Calgary. theyre ill). Patients have better access to supportive therapies (like massage and
I think a general theme is Less is more, she says. nutrition counselling) to help them manage their symptoms, as well.
Over the last couple of decades, the surgical removal
And while many patients do recover, thanks to the improvements in treatment,
of cancerous tissue has become much more precise, theres more available to help those who wont. Thirty years ago, we didnt really have
resulting in smaller amounts of tissue being removed. a hospice in Edmonton, says Venner. We now have a large number of hospice beds.
A plastic surgeon specializing in breast reconstruction This frees up room in the hospital to care for other cancer patients and ensures that
and surgery for melanoma, Temple-Oberle explains palliative patients have the support they need to be comfortable and die with dignity.
that it used to be common practice for surgeons to We have specialists providing this care nurses, psychosocial support, pharmacists
excise melanoma with a large margin, to be sure all of in the community and in the hospice, and its now a specialty in medicine.
the cancer had been removed. Now, they take a very
different approach: Research shows taking less is easier
on patients and has better results.
The actual surgical techniques have also evolved.
When she started practising medicine in 2003, skin
grafting was crude and typically involved removing
Today, Albertans rally around cancer patients and research
layers of skin from the thigh and transplanting it where
Jane Weller remembers a time when cancer didnt come up in polite
the melanoma once was. Because the surgical areas were
conversation. Even when her school friends mother died of cancer,
fragile, a patient would be laid up in bed for three weeks.
it was never acknowledged. No one talked about Doriss mom, she
Now melanoma is removed with a keystone flap, a
says. Even if someone in your community had cancer, you didnt talk
surgical design that looks a bit like a keystone in an arch,
about it.
and doesnt require any skin grafting. Patients can walk
Almost three decades later, things have changed dramatically. Canafterwards and recover much faster.
cer patients and their families no longer stay silent about the disease.
Better surgical techniques also mean that patients
whose cancer has spread to their lymph nodes arent
People now stand up to cancer, says Weller, who has worked at the
automatically subjected to the removal of all of their
Alberta Cancer Foundation for 26 years. In 1988, Albertans donated
lymph nodes, which can result in painful swelling in the
$500,000 annually to our Foundation; that number has now sky rockarms and legs. Now, doctors can do a lymph biopsy to
eted to $48 million. Weve come together as a community to support
identify the cancerous nodes and then remove them.
Albertans throughout their cancer journey, she says.
Improvements in drugs also mean that patients
These fundraising dollars have made a huge impact on both patient
with late-stage melanoma dont always need surgery.
care and research. A $5-million donation from The Dianne and Irving
Before, the treatments were aggressive, she says. If a
Kipnes Foundation was instrumental in establishing the Edmonton
patient had melanoma spreading down the skin of their
PETCentre at the Cross Cancer Institute now one of the most adlegs or arms, they might need to have a limb amputated
vanced imaging centres in the country, helping both patients, clinior have a limb perfusion, a procedure involving injecting
cians and researchers. Its just one example of how donors are helping
a high dose of chemotherapy into a vein. A relatively new
Alberta maintain world-class cancer treatment facilities, says Weller.
drug called interleukin 2 (or IL-2) can spare a patient
from these treatments.
Something to talk about
winter 2014
23
Across the Decades

30 years have led to huge developments in
cancer research, treatment and survival
1984: Planning
starts for the Human
Genome Project,
the worlds largest
collaborative
biological project.
1986: Breast
cancer mortality
rates in Canada are
at their highest. They
have decreased by 42
per cent since then as
a result of increased
and better screening
technologies and
treatments.
1998: Results
from the National
Cancer Institutesponsored Breast
Cancer Prevention
Trial show that the
drug tamoxifen
reduces the incidence of breast
cancer among
women at increased
risk of the disease by
about 50 per cent.
1998: Research
done in Alberta leads

to the introduction
of Herceptin,
changing the way
we treat women
with breast cancer
around the world.
2003: The
Human Genome
Project is considered
complete, helping
scientists understand diseases at a
whole new level.
2008-2010:
2008: Alberta
offers the human
papilloma virus
(HPV) vaccine to
Grade 5 girls. The
HPV viruses can
cause cervical, head
and neck, anal and
penile cancers and
genital warts.
2008-2010:
The five-year relative

survival ratios for
women diagnosed
with breast, lung
and colorectal
cancer are 89, 19
and 66 per cent.
The five-year relative

survival ratios for
men diagnosed with
prostate, lung and
colorectal cancer
are 96, 12 and 66 per
cent respectively.
2010: Patient
navigators are introduced in Alberta,

serving all 15
community cancer
facilities and helping guide patients
through treatment
and followup care.
2010: Albertas
population grows
to 3.8 million, up 46
per cent since 1990.
1989: The hepa-
titis C virus (HCV) is

discovered. Chronic
infection with HCV
will later be found
to be a major cause
of liver cancer.
1990: Albertas
population reaches
2.6 million.
1994: The
tumour suppressor gene BRCA1 is

cloned. The protein
product of this gene
plays a role in DNA
damage repair, and
women who inherit a
harmful mutation of
it have increased risks
of breast, ovarian and
certain other cancers.
By the NumBers
A male born in Alberta is more
likely to develop prostate
cancer (with a rate of 1 in 6)
than lung cancer (1 in 12).
A woman born in Alberta is
more likely to develop breast
cancer (with a rate of 1 in 8)
than lung cancer (1 in 14).
About 1 in 2 Albertans will
develop cancer in his or her
lifetime and 1 in 4 people born
in Alberta will die from cancer.
24
winter 2014
In Alberta, more than 3,000

people die every year from
tobacco-related illnesses
and the annual health-care
costs related to tobacco use
have been estimated at nearly
$47 million.
For both sexes, cancer
mortality rates remain very
low until about age 40, when
they begin increasing rapidly.
The highest mortality rates
happen in the 80-plus range.
myleapmagazine.ca
A CAnCer Story
BY MARGARET VERNICK
2014: Alberta
expands its HPV
vaccines to boys in
Grades 5 and 9.
2013: Breast
brachytherapy is
performed for the
first time in Alberta.
2010: Breast,
prostate, lung and

colorectal cancers
are the most
diagnosed cancers
in Alberta, making
up 53 per cent of all
diagnosed cancers.
These four cancers
are attributed to 52
per cent of Alberta
cancer deaths.
2014: The Alberta

Cancer Foundation,
through the work of
Dr. Alain Tremblay
at the University of
Calgary, helps fund a
three-year pilot lung
cancer screening
program, with the
goal of eventually
reducing lung cancer
deaths in Alberta.
2015: 18,500 new

cancer cases are
projected, marking
a 138 per cent
increase from 1990.
About 3,600 males
and 3,100 females
are expected to
die from cancer in
Alberta this year.
2010: 15,232
people are
diagnosed with
cancer in Alberta;
5,526 Albertans die
from the disease.
Twenty-seven per
cent of all deaths in
Alberta in 2010 were
attributable to cancer.
2030: Albertas
population is
expected to reach
five million people.
When I was 35, I was diagnosed with

multi-focal stage two metastatic breast cancer
progressing so rapidly that even with surgery
and chemotherapy, the doctors were unsure if
I would be alive in five years. A modified, radical mastectomy and six months of chemotherapy was my suggested and implemented
treatment regime. My motivation? My late
husband Dr. John Vernick and my then fiveyear-old daughter Vanessa.
The cancer centre was an uninviting,
dimly-lit sterile hospital wing where we were
offered uncomfortable and crowded waiting
areas, with extremely outdated magazines to
distract us while waiting for our next shot of
debilitating, life-saving poison chemotherapy.
I survived the treatment and was completely
cancer-free until, 15 years later almost to the
date of my first diagnosis I was informed
I had an aggressive form of stage one metastatic breast carcinoma of my other breast.
It was a tumour unrelated to my previous
cancer and it would require surgery, chemo
and radiation.
Old fears and emotions again became a
reality, but this time, the experience was so
much different. This time, a panel of physicians carefully mapped out my treatment
regime, providing me with the optimal opportunity for success. Instead of six long months
of treatment, I was given six treatments over 12
weeks, then radiation.
This time, the cancer centre was a beautiful,
bright building, abuzz with friendly and capable people willing and able to help. Big overstuffed chairs, television screens and knitting
baskets helped to distract and keep the fears
at bay. Along with the treatment, it is the
human element that has made significant
changes in cancer care, by humanizing the
process and making the environment so much
more comfortable.
When I had my first encounter with cancer,
my survival rate was 20 per cent with an 80 per
cent chance of recurrence within the first five
years. Today those statistics are completely
reversed.
They say the first five years are the critical
years for recurrence. My daughter Vanessa,
now 27, was 20 when I was diagnosed the second time. I think my prognosis is pretty much
a slam-dunk for survival.
winter 2014
25
THE CANCER journey

WHOLE HEALTH: Patti Morris, executive director
of Wellspring Calgary, says the facility that offers
more than 20,000 hours of programming a year is
designed to speak to mind, body and spirit of
cancer patients and their families.
Healing the
Whole Self
Mental and spiritual health now plays an important

role in cancer treatment
BY COLLEEN BIONDI
26
winter 2014
PHOTOGRAPHY BY JOEY PODLUBNY
myleapmagazine.ca
hen Calgarian Linda Hack was a public

health nurse 30 years ago, she was skilled
at finding resources to help her patients. In
2010, Hack, then 54, would find that skill an invaluable
tool in her own life after being diagnosed with and
treated for invasive cervical cancer. When you are
diagnosed with cancer, you become part of the medical
system, and you are not in control of many things that
happen, she says. What I set out to do was self-manage my recovery and take back some of that control.
Hack knew that if she could become stronger both
mentally and physically she could deal with the diagnosis and better adjust to her new reality. She drank lots
of water, ate regularly and took walks during treatment.
She sought out specialized physiotherapists to help her
with pelvic floor exercises and to manage lymphedema.
She consulted the University of Calgarys Thrive Program for a specialized fitness assessment. She practised
yoga, spent time with her loving family and friends and
adopted a one day at a time attitude. Little things, like
a trip to Tim Hortons for a coffee or Friday lunch with
her daughter, became extra celebratory. You have no
control over the cancer itself, says Hack. But you do
have control over how you respond to it.
In addition, on the advice of a nurse from Calgarys
Tom Baker Cancer Centre, she did something that
changed her life. She visited a place called Wellspring
Calgary, and found a community of hope for cancer
patients and their families. At Wellspring, she became a
peer support volunteer and started a support group for
women with cervical cancer. Today, she and her husband
attend a program called A Gathering Time for Mortals,
which is targeted to people experiencing advanced-stage
cancer. I was feeling overwhelmed, says Hack. But
once I found Wellspring, I never looked back.
Wellspring, which gets some of its funding from the
Alberta Cancer Foundation, is a cancer support centre that
offers a speakers series, resources and evidence-informed
programs to help people at any point in their cancer journey (Wellspring does not offer
clinical or research services, but works very closely with colleagues in the community who
do.) Our diverse group of offerings speak to body, mind and spirit, says Patti Morris, who
has served as executive director of Wellspring since its inception in 2006. Wellspring is
also a community, a welcoming space, where people living with cancer can be with others
who get it. Programs dubbed Brain Fog, Exercise and Educate, and Creative Journaling
empower and build confidence so people diagnosed with cancer as well as their families
can make a positive difference in their lives.
It also offers a library, child-minding service, the previously mentioned peer support program and a stream of services specific to young adults who are living with
cancer. Services are free and do not require a referral. There are more than 2,700
members at Wellspring, which offers over 20,000 hours of programming every year.
Treating the whole person is vitally important for enhanced quality of life, Morris
says, adding that the need for this kind of approach is growing, as more people are
diagnosed with cancer and live longer with the disease. Not attending to symptoms
of distress can not only make a complicated cancer journey that much more difficult
for people, but can overtax an already-strained medical system if patients seek out
support in a reactive way.
No one knows this better than Dr. Barry Bultz, director of the Department of Psychosocial Resources at the Tom Baker Cancer Centre. He is a leader in psychosocial oncology and is passionate about the importance of tackling what is now referred to as the sixth
vital sign (behind blood pressure, temperature, heart rate, pulse and pain) distress.
Cancer is a challenging disease, he says, involving complexities of diagnosis, treatment, recurrence of disease, survivorship and palliative care. The primary goal of cancer
treatment is remission or, ideally, a cure, but if thats not to be, the goal becomes helping
the patient adjust to living with a life-threatening disease. How can they be comfortable,
cope with the stress associated with physical, psychosocial and practical manifestations
of the disease, decrease burden and suffering, resume a healthy quality of life and facilitate a good death through resolution of existential issues? In other words, it is about
reducing distress surrounding the overall cancer experience.
The Screening for Distress (SFD) tool, used in Alberta and eight other provinces,
tracks and treats distress associated with the cancer experience. Developed at the
Tom Baker Cancer Centre with funds from the Alberta Cancer Foundation, SFD is a
one-page questionnaire listing 10 questions and a well-being checklist, designed to
track a patients distress levels in a variety of areas repeatedly over the cancer journey.
It is used by the health-care team to identify and gauge what is bothering a patient, so
that clinical responses can be timely and tailored. If we dont measure these things,
we cant treat them, he says.
Linda Hack
winter 2014
27
THE CANCER journey
BIG PICTURE: Funded by the Alberta Cancer Foundation, both the

Screening for Distress program and Wellspring Calgary recognize the
importance of addressing the patient as a whole.
Here is a case example of SFD in action: A patient

with advanced-stage melanoma was referred to Psychosocial Resources with high-level anxiety. Using the
SFD tool, it was found that he had significant levels of
untreated pain (he hadnt mentioned that at the clinic as
he was a tough old Albertan and didnt want to rely on
drugs). He was then referred to the pain clinic where his
pain was managed. As a result, his anxiety was reduced.
Because SFD is used routinely with all cancer patients, and touches not only on issues like depression
and anxiety but on more physical areas like fatigue
and pain, it tends to destigmatize the discussion of the
distress experience, which is estimated to impact up to
45 per cent of patients. This is important because its
common for patients to under-report symptoms (pain,
fatigue, weight loss, lack of appetite, anxiety and depression) unless asked directly by the health-care team. As
well, health-care personnel have not always asked the
right questions. SFD takes the guesswork out of what
is going on and what we should do to help reduce the
burden of cancer, says Bultz. It creates efficiencies in
patient care.
A patient reporting difficulty eating on the SFD document, for example, might be referred to a dietitian.
Another who is feeling depressed due to being unable
to work might be sent to a financial resource counsellor.
Patients are also supported at Psychosocial Resources
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through group work or one-on-one therapy with

psychologists, psychiatrists or social workers.
Large-scale studies are using data from the
SFD tool to inform practice. For example, when
fatigue was discovered to be a critical problem
for cancer patients, a Calgary doctoral student
developed a program called I CAN Sleep, to help
patients sleep better using cognitive behavioural
techniques like not using caffeine past a certain
point in the day, avoiding daytime naps and setting a consistent time for sleep at night.
Bultz is not alone in calling for routine distress
monitoring and management as part of standard
cancer care. More than 75 international organizations, societies and accreditation bodies,
including the Union for International Cancer
Control (UICC), are on board. The emphasis is
on treating the whole person, he says. We need
to take a multi-dimensional approach to dealing
with our patients.
Thats how Hack continues to live her life fully and in an engaged way, until the day she cannot.
Its not always easy she has bad moments, and it
has taken time to accept her new reality. You are
on a new road, she says. There is no way you can
get back to exactly where you were.
But shes travelling that road with grace. She
continues to use the tools she has sought out to keep her moving in the right direction,
and is seeking out new ways to live as vibrantly and functionally as possible. And she
has advice for others: Life throws random curveballs. You really dont know what is
around the corner, she says. Dont take the present for granted. Try to be fully present and in the moment.
Screening for DiStreSS

SFD is a one-page survey that assesses the distress level of cancer patients and
helps identify areas where further assessment and interventions may be required.
The SFD intervention involves the routine use of the survey, a clinical conversation
to identify patients priority areas of concern and appropriate clinical responses to
those concerns.
The SFD tool is composed of two sections: the Edmonton Symptom Assessment
Scale (ESAS-r) and the Canadian Problem checklist.
Since the SFD intervention was implemented, patients have reported significantly
less symptom burden and fewer common problems, says Dr. Linda Watson, lead
for Person-Centred Care Integration.
Having patients fill out the tool is only a first step. If we dont review and respond
to the issues identified on the tool, we can do damage to the trust between us and
the patient, she says.
Next up is the development of an electronic system to access and evaluate
individual reporting, and help track response trends and inform practice. Also,
there will be ongoing support to ensure all centres integrate the SFD intervention
into their approach to care as effectively as possible.
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RADIOACTIVE: Stereotactic body radiation

therapy (SBRT), which was introduced at the
Cross Cancer Institute in 2010, cuts down
treatment duration for lung cancer patients
by a third, says Dr. Zsolt Gabos.
30
winter 2014
myleapmagazine.ca
Great
Expectations
BY SAMUS SMYTH / PHOTO BY BRIAN BRADY
Progress in radiation shortens the number of treatments required for

lung cancer patients, and could be used to treat other cancers
adical improvements in radiation therapy have drastically of the liver and spine. Clinical studies are starting to
look at treating these other sites with SBRT. With Alberta
shortened the number of sessions required for lung cancer patients.
Stereotactic body radiation therapy (SBRT) delivers a higher dose of Cancer Foundation donor support, they have committed
radiation over a more condensed period of time, cutting treatment to expanding to these sites that were previously not treatduration by a third. The high-dose radiation isolates tumours in the body over a shorter ed, says Gabos. It has been very successful in lungs and
course of treatment, with fewer side effects than currently experienced with conven- we are trying to move this success to other areas.
The therapys achievetional radiation treatment.
ments
have in part been due
Prior to the introduction of SBRT, therapy
With SBRT, more lung cancer patients are
to the assistance of a numfor lung cancer patients often took between
living longer and we are clearing more lung ber of donors across the
four to seven weeks, or upwards of 30 visits.
cancers compared to conventional therapy, province.
That has since dropped to between four and
Donors have been instrufive weeks and fewer visits.
says Dr. Zsolt Gabos.
mental in supporting enhanced
The procedure was introduced at the
Cross Cancer Institute in 2010, and SBRT has since become the standard treament for care grants to fund the necessary technologies that will
men and women with inoperable lung cancer since. Its used on patients with clinical help move us to be able to conduct this therapy in the
liver or spine, which require specialized equipment that
early-stage cancer, with tumours measuring as large as seven centimetres.
The treatment has been so successful that they are looking to make room for the we did not have available, says Gabos.
With great success comes great expectation. Gabos
procedure at the Central Alberta Cancer Centre and the Jack Ady Cancer Centre
cautions that not all cancer patients are a right fit to rein Lethbridge.
The process begins like a traditional consultation. A number of scans are taken to ceive SBRT. Treatments are part of an individualized
determine the exact location of the tumour and how much it moves with the individ- treatment plan, and there are many factors that go into
uals body. A four-dimensional scan is used for the lung and liver for an even higher these decisions, he says. [For] something like the livlevel of precision. A specialized robotic couch is then used to perfectly position a er, location matters, and it really is sort of personalized
treatment for the specific scenario. People wish to know
patient for pinpoint radiation treatment.
A main concern with traditional treatment is that patients with emphysema, or ad- if they are eligible, but cancer is so diverse. This has the
verse chronic obstructive pulmonary disease (COPD), are not eligible for lung cancer chance to treat many patients, but to be able to decide
treatment or surgery. Both health issues are common in patients with lung cancer. who is appropriate is a multi-step process.
Gabos says the success rate of controlling the localBut with this modern upgrading, patients with both conditions can now be treated
ized disease in lung cancer patients is 90 per cent. Aleffectively.
Side effects are significantly less with SBRT than with conventional therapy, says though he is hesitant to assume that the success rate
would transfer to other parts of the body, he remains
Dr. Zsolt Gabos of the Cross Cancer Institutes radiation oncology department.
Sterotactic radiation was originally invented for the treatment of tumours in the optimistic about the evolution of SBRT.
We are confident. We do not know if it can be as high,
brain. But in the past decade the treatment has evolved to attack tumours in the lungs,
but we are hoping to see considerably better results
thus adding the word body to the title.
Raja Mita, director of program investments at the Alberta Cancer Foundation, says than conventional radiation therapy, he says.
Long-term improvements will depend on the
one of the ultimate goals of provincial health care is to ensure that every Albertan has
access to the same aid. He commended the work of Gabos and his colleagues, noting success of the clinical trials, but hopefully similar to what
that advances in their work and research indicate that SBRT could be used to treat we have seen in the lungs. With SBRT, more lung cancer
patients are living longer and we are curing more lung
tumours across the body.
This work could cement and provide the evidence to begin implementing this cancers compared to conventional therapy, he continues.
Trials for new sites could begin as early as 2015, with
therapy province-wide, says Mita.
The treatment gives new promise to difficult-to-treat localized cancers like those liver patients among the first to try it.
winter 2014
31
32
winter 2014
myleapmagazine.ca
Bridging
THE GAP
Integrating a palliative care approach within cancer care
BY SUE LEBRETON
ILLUSTRATION BY HEFF OREILLEY
t times, it can seem that cancer is with cancer for several years, remembers the first time
surrounded by powerful words and strong she heard the term palliative in relation to her care, in
language. But one word thats hard to come to 2009. As I woke up from a surgical procedure, the nurse
terms with is palliative. For many, it implies co-ordinator told me I was being referred to the palliative
the end of life, surrender. Its a word that individuals living home-care team. I recall how frightening that was. No one
with cancer, their families and their health-care teams, had told me that I was dying. The palliative care team was
uniquely qualified to deal with a case as complex as Campstruggle to raise in conversation.
Yet its a word and a conversation that are essential to bells. I needed that specialized care but my goal was to
those whose cancer continues to advance and requires recover, she says. Recover she did. That word, palliative,
is loaded emotionally and
complex medical care, and
for those who are facing the Make sure that the patient has family, for most patients and famend of their life. According friends or a health-care support worker ilies, it indicates that their
one is dying, she says.
to the World Health Orgawith them when bad news is delivered loved
To her way of thinking,
nization, palliative care is
a dimension of care that so that the diagnosis can be processed the word palliative covers
intricate cancer care on a
improves the quality of life
together, says Alice Campbell.
spectrum, including people
of patients and their families facing the problems associated with life-threatening who will graduate from care and those who are terminally
illness, through the prevention and relief of suffering by ill and will progress toward the end of life with the support
means of early identification and impeccable assessment of a palliative team the entire way. When she was diagand treatment of pain and other problems, physical, psy- nosed with stage four non-Hodgkins lymphoma in 2009,
Campbells doctor told her there was no cure. Its a very
chosocial and spiritual.
While the definition of palliative care is supportive, in hard conversation when your doctor says, This cancers
reality few of us are ever prepared to hear that our life will not going away. You can count on it coming back but when
end, says Bert Enns, a spiritual care specialist and project it does hopefully we will have a new treatment. With the
lead at the Tom Baker Cancer Centre and Calgary Zone most recent reoccurrence, Campbell was told she could
Palliative Care Collaborative. Life is precious. As health- access palliative care again, if and when she needs it.
With years of nursing behind her, as well as her own
care providers, we face a dilemma. How can we explore
palliative and end-of-life care in a gentle and timely way cancer experiences, Campbell felt she had something to
to ensure that people have the necessary support through offer the Tom Baker Cancer Centre and the Calgary Zone
Palliative Care Collaborative. Ive learned a thing or two
one of lifes most challenging transitions?
Alice Campbell, a retired nurse who has been living after being around Tom Baker for so long and caring for
winter 2014
33
very sick adults and kids. Death is not the worst thing that
can happen to people, she says. She has some suggestions
for health-care professionals: Give bad news in small, digestible amounts where possible, so that there is time to
adjust. Make sure that the patient has family, friends or a
health-care support worker with them when bad news is
delivered so that the diagnosis can be processed together.
According to Enns, recent research has identified the
benefits of an early palliative approach. By working with
individuals and their families, health-care professionals
can help patients access a multitude of services for their
physical, emotional and spiritual well-being. With this
support, patients can make decisions that reflect their values and personal goals for living with cancer, including the
last stretch of life. For example, incorporating a palliative
approach into care can ensure that quality of life issues are
integrated into discussions regarding treatments at the
point of diagnosis. If treatments are not successful and
cancer advances, appropriate supports are added to ensure symptoms are well managed and decisions regarding
treatments continue to reflect an individuals priorities filled place for people with compromised immune systems, but its also an expensive way
and values. Patients need to be well informed about treat- to offer care that could be provided at home, especially if palliative care were involved.
ment options and services available at all points of their Once we had a palliative home-care nurse supporting us at home, we would never have
needed an ER visit, says Erlendson. We should have been in palliative care before
journey with cancer.
Enns is leading a two-year project, funded by the we were.
Although essential for Erlendson and his family, this care was not easy to access.
Alberta Cancer Foundation, to enhance the care for Tom
Baker Cancer Centre patients and their families in the There were many positives about Marjs experiences with the Tom Baker. The key meetings were well handled and we never felt rushed, he says.
Calgary Zone. The project
Despite Calgary having one of the
Erlendson even speaks positively about the chemo unit:
examines current services
best-resourced and utilized palliative We both really liked it. It was a happy and upbeat place.
and identifies gaps and opBut the transition from independence to dependence
portunities for best praccare programs in the country, there is
did not go as well. From the moment of Marjs diagnotices required to integrate
recognition that cancer patients and sis, the family knew her cancer was terminal. There was
an early palliative approach
their families are not always accessing something that should have kicked in so that palliative
to care. Despite Calgary
home care would have come to us. In retrospect we see
having one of the best-rethese services in a timely manner.
this, he says. Only because Erlendson had some prior
sourced and utilized palliative care programs in the country, there is recognition that knowledge of palliative home care gained from a neighbour, and through his communicacancer patients and their families are not always accessing tions work, did he realize that Marj required this service.
So he picked up the phone. Though he was told he could not self-refer, he stayed on the
these services in a timely manner.
In Phase 2 of the project, the committee will develop phone until he got a yes. Hes not optimistic that the average Albertan would have been so
pathways that guide patients, families and health-care lucky. Nobody referred us to palliative home care. We fell through the cracks.
Although they were a family who had fallen into a gap in the transition phase of care,
teams to ensure these conversations about care decisions
and resources are proactive and enhance the integration once they accessed palliative care, their experience transformed. There are no words
of palliative services. To better integrate early access to to describe the giftedness of that home-care nurse. She met my wife spirit-to-spirit,
palliative care, the committee will develop pilot opportu- Erlendson says. The nurse also interacted with Erlendson and his then-21-year-old son in
nities to address current gaps. It will also develop educa- different but equally amazing ways.
Palliative home care provided services that greatly reduced the burden of care on Ertional resources that support health-care professionals to
lendson and his family. For example, they connected the family with a pharmacy that dehave these difficult early conversations.
The Tom Baker Cancer Centre and Calgary Zone livered medications. This was a huge time and energy saver because Marjs medications
Palliative Care Collaborative will review services used could change every few days.
Erlendsons motivation for joining the project is a hope to be heard by policy-makers.
by more than 1,900 Calgarians who died from cancer
in 2012. By reviewing this data, the project committee People want to die at home, he says. They do not want to die in hospital. Marjs palliwill better understand how earlier conversations about ative home-care nurse was with her when she passed away. It may sound odd, but I refer
palliative care may impact overall support for patients in to Marjs last weeks and days as beautiful. It was beautiful caring from a gifted home-care
their last months of life including the need to use emer- nurse. Imagine if we had never accessed that gift? It would have been an awfully dark experience, says Erlendson.
gency or acute care services.
The challenge is clear. Whats the best way to introduce palliative care to ensure its enLike many families coping with advanced stages of cancer, Richard Erlendson, a communications professor at tire scope is provided? Is it a term that can become acceptable and supportive without diMount Royal University, and his wife Marjory, who was minishing a patients sense of hope?
We recognize we have work to do and are committed to finding better ways to intediagnosed with peritoneal cancer, visited the emergency
room on multiple occasions. Not only is this a risky, germ- grate an early palliative care approach into all aspects of our cancer care, says Enns.
34
winter 2014
myleapmagazine.ca
SPINNING
CIRCLES
Speed skating might sound daunting but its a fun,

heart-pumping way to stay in shape
BY LYNDSIE BOURGON
winter 2014
35
Safety on Ice
Heres the gear youll need to stay safe
on the track:
Speed skates often you can rent these
from the venue or association, until youre
comfortable enough to get your own
Helmet
Leather gloves, to protect your fingers
(Any sort of cut resistant gloves will do.)
More advanced skaters will need cut-resistant
Kevlar protection for their ankles
For short track skating, youll need:
Knee pads
Shin pads
Neck guard
Protective eyewear
36
winter 2014
myleapmagazine.ca
t looks like a dizzying, death-defying sport one that might knock

you and the rest of your track mates off course and flat on the ice. But Cecilia
Pacanins insists that speed skating is something you can pick up tomorrow, if
youre interested.
This is a sport that welcomes people from five to 85, says Pacanins, president
of the Calgary Speed Skating Association. Theres a skater who comes twice a week
who is 85 years old. Hes an example of how youd want to be when you get older,
his stamina and eagerness are amazing. The club operates out of the Olympic Oval
at the University of Calgary, a state-of-the-art facility that was built for the Winter
Olympic Games in 1988 and the first covered speed skating oval in North America.
It has since been converted into a public facility that hosts both first-time skaters
and professionals.
If you think you might be interested in strapping on the skates, Pacanins says approaching a local speed skating society is your best first step. With the CSSA, you
can drop-in for a quick evening skate to get a feel for what the sport is like. You get
used to what it is, to be on a long blade, says Pacanins. When you arrive, a coach will
teach you some basic skills, like how to place your body, how to push on the side of
the blade and how to breathe while youre skating. Then youre free to lap around the
ice. A lot of people, it only takes one time on the skates and they say the feeling is
amazing, she says.
There are a lot of great reasons to take up speed

skating. For adults, its a low-impact but whole-body
workout. You can choose to go your own pace, and you
can dictate in which ways you would like to advance.
From there, learners can enroll in a program like CSSAs Absolute Speed program
(ABS). There are two sessions that run for absolute beginners, one for kids and one
for teens and adults. They provide an opportunity to come to a practise and try it
out, she says. The sessions include a coach, and give you a shot on both the short and
long track. If you like it, you can decide to become a member and work more closely with a coach during weekly sessions. You work with a coach on your individual
goals, says Pacanins. Do you want to stay fit, get into beginner competitions or become a master skater?
The CSSA books ice time at the Oval, located on the U of C campus, and holds classes and coaching sessions there during evenings throughout the week. We are very
lucky to call the Oval home, because most of the clubs around Alberta have to haul
mats to the arena to practise, says Pacanins. For speed skating practise, 12-inch thick
mats are set up along the boards. At the Oval, they are set up all the time, unless there
is a competition or televised event going on.
We have our skaters, young and old, practising on incredible ice, she says. Its
well-maintained, and our skaters are exposed to training around international athletes. They see the motivation being around them is just amazing.
Beginners take to the ice during C time the time slots are divided into letters
that correspond to ability level. A time is for national competitors and B time is for
those in between club and competition level. You are guaranteed that everyone on the
ice with you will be on speed skates there is no open rink time, like at other venues.
There are a lot of great reasons to take up speed skating. For adults, its a low-impact
but whole-body workout. You can choose to go your own pace, and you can dictate in
which ways you would like to advance. Most groups have flexible practise schedules,
which mean you can fit it in with work and other responsibilities. Pacanins says a lot
of students participate as well and its good way to blow off some steam. If you have
a midterm, come the next day and let it all out, she says. The sessions are inexpensive and to practise one or two days a week at the recreational level costs about $470
for the season, which runs from September through March. For the ABS introductory
program only, the cost is $50.
And of course there is a social element. Speed skating isnt limited to the indoors,
and you can practise on outdoor rinks and ponds across the province. Members of the
CSSA who become active in speed skating often get together throughout the summer as well, to partake in dry
land training at the citys Edworthy Park. In fact, a lot of
athletes use speed skating as part of their cross-training
plan for participating in other sports. Its a sport thats
complete and healthy and peaceful, says Pacanins. Its
just you, the ice and the timer.
Provincial cool
Here are some venues in Alberta, where you
can take on speed skating:
CALGARY: The Calgary Speed Skating
Association uses the University of Calgarys
Olympic Oval. Email calspeed@ucalgary.ca
to reserve a drop-in spot.
CANMORE: The Banff/Canmore Speed
Skating Club train at the Canmore
Recreation Centre. For more information,
visit www.banffcanmorespeedskating.ca
EDMONTON: Soon, Edmonton will be
home to a new facility, the Aspen Overpass.
The recreation pavilion will be a new home for
the Edmonton Speed Skating Association.
RED DEER: The Red Deer Central Lions
Speed Skating Club is a community club that
practises on the Red Deer Outdoor Oval.
For the past four years, they have held a day
of outdoor competitions on the rink. More
information at: www.reddeerspeedskating.com
SYLVAN LAKE: The Sylvan Lake Ice
Marathon is held every year in February,
and is organized by the Foothills Speed
Skating Marathon Association. Email
contactus@sylvanlakeicemarathon.com
for more information.
winter 2014
37
Top Job
LIAISON: Karey McCann, in her role as nuclear medicine therapy

and neuroendocrine tumour clinic co-ordinator at the Cross Cancer
Institute, looks after all cancer patients and co-ordinates with five
doctors on the Edmonton team as well as liaising with the team at
the Tom Baker Cancer Centre in Calgary.
38
winter 2014
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Command
CENTRAL
The Cross Cancer Institutes Karey McCann has
been recognized for her dedication to patient
education and one-of-a-kind care
BY LUCY HAINES
/ PHOTOGRAPHY BY AMY SENECAL
winter 2014
39
Top Job
TEAM SPIRIT: (From left to right) Brent Schaitel,

Dr. Michael Sawyer, Karey McCann, Dr. Sandy McEwan,
Dr. Don Morrish and Dr. Viliam Makis are all part of the
Cross Cancer Institute team responsible for the care
of cancer patients from across the country.
s one of only two Canadian sites offering radioisotope ing, Monday through Friday schedule, but she says its a position with
therapy to those diagnosed with neuroendocrine tumours, challenges far beyond the everyday. Nursing school didnt prepare
the Cross Cancer Institute coordinates care for patients me for this the job can be both difficult and inspiring, but its always
from across the country. Providing treatment and help- gratifying, she says. I used to think Id become a teacher, and while
ing patients understand and deal with the unknown of a rare cancer that didnt happen, patient education is an important part of my
work so I think the job is a perdiagnosis is a job not many could keep
up with, but Karey McCann does so with
I think theres still a lot that I can build fect fit for me.
Patients ranging in age
dedication and strength.
into my role here, especially with patient
from newborn to age 90 from
For the past seven years of her
advocacy and education. By the time the across Western Canada come
13-year nursing career, McCann has
been the nuclear medicine therapy trial ends, maybe thats when Ill be ready to the Cross Cancer Instituteto receive one of two types of
and neuroendocrine tumour clinic coto retire, says Karey McCann.
radioisotope therapy lutetium
ordinator at the Cross Cancer Institute,
working with a team of five physicians and one other research nurse. and mIBG both forms of radiation treatment that target specifThe 43-year-old Slave Lake, Alberta native came to her position after ic cells, shutting them down so they cant multiply and divide, and
stints in pediatric oncology at the Stollery Childrens Hospital, as both unlike chemotherapy which attacks healthy and cancerous cells
well as time in several U.S. cities where she was introduced to radio- alike. Lutetium is imported in vials from Holland, where there and
across Europe and Australia the therapy has been regularly used for
isotope therapy.
Then I met Dr. Sandy McEwan, the guru of radioisotope thera- many years.
Still relatively new to North America, lutetium therapy is part of
py in Canada, and Ive been back and part of this amazing program
ever since, McCann says. This year, McCann, who is responsible for a long-term study at the Cross Cancer Institute. Co-ordinated by
co-ordinating and caring for all neuroendocrine patients at the Cross McCann and a colleague, the lutetium clinical trial started in April
Cancer Institute in a program thats a leader in its field across the 2014, aiming to prove the efficacy and safety of radioisotope theracountry, became a CANO Boehringer Ingelheim Oncology Nurse of py over a 15-year period. The trial currently has 97 participants, but
the Year Award nominee. On paper, McCann works a routine-sound- some 400 patients will be part of the program over the term.
40
winter 2014
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McCann might be seen as command central for those referred

to the Cross Cancer Institute for
neuroendocrine tumour treatment. She not only looks after
all the patients diagnosed with
the cancers, but also co-ordinates with the five doctors on
the Edmonton team experts in
endocrinology, medical oncology, nuclear medicine, radiation
oncology and surgery and liaises with the team at Calgarys
Tom Baker Cancer Centre.
Were lucky to have two teams in
Alberta other provinces dont,
McCann says. The physicians inspire me the whole team does.
The feeling is mutual among
McCanns colleagues. The tumour
team at the Tom Baker Centre in
Calgary works closely with the
Edmonton referral centre, but
Dr. Dean Ruether, leader of the
provincial endocrine tumour program and a medical oncologist,
says moving patients between
Edmonton and Calgary or to Edmonton from further afield is
McCann says that while, on average, patients live five years from
handled by dedicated nurses like McCann.
diagnosis, she has known patients to live much longer 10 years and
Wed not be able to do what we do without Karey, Ruether says. beyond. We just lost a fellow that was being treated for 14 years. Its
Her role is key, as she receives referrals, triages patients and assists tough because we build bonds with patients, McCann says. But I love
in the clinic for treatments. This is a great area to work in. With excit- my job, and I feel lucky to have it. Patients are often inspiring to me
ing treatment developments and patient advocacy finding its place, their attitudes and perspective and there are many Ill never forget.
it takes dedicated and passionate people like Karey and the entire
McCann remembers a 28-year-old pregnant woman from Quebec
team to make it work.
who came to the Cross Cancer Institute with an inoperable tumour
Neuroendocrine tumours only represent around two per cent of wrapped around her heart. The baby had to be delivered at 26 weeks,
all cancers, occurring mostly in patients with no risk factors and of- and today hes a healthy five-year-old and his mom is seeing him grow
ten starting in the lung or GI tract before metastasizing elsewhere. up. The womans courage and strength I still remember that,
Because these tumours can mimic other hormone-related problems, McCann says.
As a co-ordinator and educator, McCann has developed patient
the disease is often diagnosed quite late, when the cancer has already
progressed in stage, size and location. Though numbers are rela- education materials for use across the province, and started half-day
tively small the Cross Cancer Institute has treated more than 160 patient education sessions to answer questions and dispel myths
patients with approximately 550 lutetium therapies since August about the disease and radioisotope therapy.
Im always looking at different ways to help patients support each
2000 and, since 1987, 375 patients with thousands of mIBG therapies
patients can live many years with their disease, returning to the Cross other and advocate for themselves. We have tumour support groups
that are considered small because of the
every 10 weeks or so for radioof the cancer, but our attendance
isotope treatment.
We just lost a fellow that was being treated rarity
numbers are big, so theres definiteSurgery plays a big role in
for 14 years. Its tough because we build
ly a need, McCann says. People want
treatment, and sometimes
to know why their hair doesnt fall out,
external beam radiation and
bonds with patients.
or how to deal with family, friends or
chemotherapy drugs do as
well. But the highly specialized radioisotope therapies of lutetium co-workers that dont necessarily believe they even have cancer. Beand mIBG are seen as an effective treatment when the tumour is ing socially shunned, or living with the unknown these are difficult
too large to operate on, or has spread to other areas. Both therapies things for patients to cope with, and the lack of resources adds to the
are given intravenously, mIBG every 12 to 14 weeks, and lutetium patient burden.
As the lutetium trials continue, McCann says hundreds more
every 10 to 12 weeks.
McCann arranges an overnight stay for patients with each treat- will be referred to the Cross Cancer Institute to benefit from onment, so they can get scans and see where the targeted therapy went going treatments and maintenance. I think theres still a lot that
in the body. Showing pictures and explaining whats happening I can build into my role here, especially with patient advocacy
in their body is reassuring it gives a peace of mind to patient and and education. By the time the trial ends, maybe thats when Ill be
ready to retire.
family, she says.
winter 2014
41
Why I Donate stories of giving
WORTH A TRIAL
An Edmonton chemist and her husbands $300,000
donation will fund much needed clinical trials
BY JACQUELINE LOUIE / PHOTO BY DARRYL PROPP
42
winter 2014
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ill and Charlie Doiron have hope for a better, of $300,000, through the Alberta Cancer Foundation, dihealthier future for breast cancer patients today and rected to the Cross Cancer Institute to fund breast cancer
clinical trials.
in the future.
Youve got a talent pool of medical staff at the Cross
Thats why theyve recently made a major
donation to help fund clinical trials at the Cross Cancer Institute who work very hard, says Charlie. There
Cancer Institute in Edmonton. They want others are a lot of good things being done there using conventional
facing a cancer diagnosis to receive the benefits that Jill did sources of health care funding, which covers current stanfrom the facilitys world class specialists, facilities and dard treatments. Private donations help the Institute to go
beyond the basics to explore the newest treatments and parclinical trials.
In 2001, Jill, then 44, was diagnosed with stage 3C breast ticipate in world-wide clinical trials.
They could have chosen to leave a legacy donation, but
cancer and needed surgery, chemotherapy and radiation.
Statistically, her chances of surviving five years using con- instead opted to make their donation now, so they can see
ventional treatment were not much better than 50:50. the benefits of their commitment. When you donate while
These numbers concerned Jill and Charlie, who both have youre still alive, you get a chance to see your dollars at
science backgrounds. Her medical team helped them work, Jill notes.
Some of it is paying back in gratitude for the benefits
focus on what they could do to improve the odds, so that Jill
weve received from the Cross Cancer Institute but its
would be around see her three young children grow up.
They told me you never know which side of the statistics also a commitment to further the understanding of breast
youll be on, so dont give up, says Jill, who jumped at the cancer and its treatment. Its an investment in our future
opportunity her care team offered her, to participate in a and in our childrens collective futures perhaps a future
worldwide clinical trial studying three different chemother- without breast cancer.
The Doirons generous donation will help make a differapy combinations. Each of the three options was at least
ence in many lives. Its
as good as the best treatment
option available at the time
The Doirons feel its important to a phenomenal and very
donation that
and all had the possibility of begive back to the institution where welcome
will enable us to take the
ing better than the conventional
treatment. One of the drugs Jill benefited from top doctors doing ideas of cancer researchers in Edmonton and
being evaluated in the trial is
leading-edge research into better
bring them to patients
now the current best treatment
treatments for breast cancer.
for testing, says Dr. John
for the type of cancer Jill had,
Mackey, director of the
Charlie says.
For Jill, participating in the clinical trial through the Cross Cancer Institutes clinical trial unit. We know that
Cross Cancer Institute was an easy decision: it meant the patients who go on clinical trials have better outcomes, so
possibility of a better treatment, longer-term followup and I have no doubt these dollars are going to save lives. Clinical
the fact that her participation would help advance scientif- trials are incredibly important, because they bring tomoric knowledge and understanding of new treatments. It had rows cancer treatments to patients today.
Each year, clinical trials at the Cross Cancer Institute althe potential to improve the odds of survival over the stanlow more than 600 people to undergo new treatments that
dard treatment, recalls Jill.
Her journey back to health was not without a few bumps could become state-of-the-art in a few years time. Clinical
in the road, with local cancer recurrences near the surgical trials also allow the Cross Cancer Institute to access drugs
site in 2006 and again in 2011. Each time, she chose to par- that have not yet been approved for use in Canada, even
though we know they are working well, Mackey says. The
ticipate in another clinical trial.
The Doirons, who live in Sherwood Park, firmly believe clinical trials at the Cross Cancer Institute are really the
that access to these clinical trials and the excellent care Jill heart and soul of the institute because clinical trials are
received from the Cross Cancer Institute are factors con- the tool we use to improve our treatments.
Clinical trials are both complex and expensive, Mackey
tributing to why she is alive and thriving today. Im doing
great. We take one day at a time and you develop an attitude says, noting that the Cross Cancer Institutes clinical trial
of gratitude because we really are grateful for the care I re- program is the most active program of its kind in Canada:
more patients per capita participate in clinical trials in Edceived, Jill says.
For his part, Charlie believes that if Jill had not partic- monton than in any other jurisdiction in the country.
The Alberta Cancer Foundation and the money its donors
ipated in the clinical trials at the Cross Cancer Institute,
she might not be here today. They are especially thankful to provide go to support the Cross Cancer Institutes clinical
Dr. Anil Joy, and research nurses Diane Bodnar and Shelley trial program, which helps patients with many different
types of cancer. On top of this funding, the Cross Cancer
Sass, for their amazing advocacy, care and support.
The Doirons feel its important to give back to the Institutes clinical trial unit leverages its core funding from
institution where Jill benefited from top doctors doing the Alberta Cancer Foundation, at a rate of about six to
leading-edge research into better treatments for breast one, with additional dollars from companies and cancer recancer. To this end, theyve made a multi-year commitment searchers from around the world.
winter 2014
43
Corporate Giving working for a cause
FAST TRACK: Emrie Strohschein was among Pengrowths

33 team members in the Enbridge Ride to Conquer Cancer
which raised nearly $400,000.
THE WHEEL DEAL

BY CHRISTY NICH
Pengrowth Energy Corp.s fundraising efforts for

the Alberta Cancer Foundation are gaining speed
Pengrowth Energy Corporations team, Heels to
Wheels, raised the fourth-highest amount of all teams
in its inaugural ride in August 2014s Enbridge Ride to
Conquer Cancer and its members have big plans for
doing even better in 2015.
Under the leadership of Derek Evans, Pengrowths
president and CEO, the team of 33 members raised
$391,000 and has its sights set for $500,000 in 2015,
with a stretch goal of $600,000 and a team of 50 riders
entered. They already have 43 for the 2015 instalment,
thanks to the addition of some senior-level personnel
like Pengrowth COO Marlon McDougall.
According to Cloete Uys, manager of information
systems infrastructure and Evans ride co-captain
the event which benefits the Alberta Cancer Foundation,
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winter 2014
touches so many people personally.

One of those is, Emrie Strohschein, plant control
room operator who works out of Olds, Alberta. In
September of 2013, his wife was diagnosed with colon
and liver cancer and died less than four weeks later. A
day before she died, Strohscheins younger brother
was also diagnosed with colorectal cancer. I do it
in memory of my wife and in support of my brother,
Strohschein says in a video the company produced to
encourage participation, noting that his goal was to
merely finish the ride in good standing. He not only
did, but was also the first of the Pengrowth team to
cross the finish line. Emrie, our fastest [and oldest]
rider ... well done! says Uys.
And dont think that it was an easy ride. It was a
myleapmagazine.ca
two-day event that covered 220 kilometres, starting at

Calgarys Canadian Olympic Park (COP) and ending in
Okotoks about 110 kilometres away, with the option of
camping overnight. The next day, riders started from
Okotoks and rode all the way back to COP, covering
another 110 kilometres.
Each member of the 33-person-strong team had
to raise a minimum $2,500, but Pengrowth went well
beyond that benchmark, raising more than $12,000 per
team member.
Evans is the number one fundraiser, with a total
of $124,000.
In a humble way, he will admit that it did not take
much effort, says Uys, noting Evanss leadership went
far beyond riding. He was not only the top fundraiser for
the entire event, but he also personally matched each of
his employees donations dollar for dollar, making each
donation count three times.
We had 32 riders (as one had to pull out at the last
minute, but still managed to contribute), but many
more people were involved to make this possible and
successful, says Uys. Meanwhile, volunteers behind
the scenes help the team by co-ordinating fundraising
events and taking care of the logistics everything
from ordering team uniforms, to keeping everyone informed.
Already halfway there, Pengrowth would like to
bring its 2015 team participation to 100 members

(including both riders and volunteers), filling the
many non-rider opportunities available to volunteer
with the team. That is where the real strength of the
team comes from, says Uys.
Each member of the 33-person-strong

team had to raise a minimum $2,500,
but Pengrowth went well beyond that
benchmark, raising more than $12,000
per team member.
But the efforts were more than worth it for Pengrowth
to do the ride. It goes beyond the money and every
participant I have spoken to acknowledges some kind
of individual intrinsic reward, satisfaction or sense of
achievement that was experienced, apart from the aches
and pains, that came as part of the deal, Uys says.
Uys further adds: It goes beyond the individuals,
because as a team we accomplished something
worthwhile and wholesome ... and as a company we
confirmed and made a statement about our culture and
norms and values that we stand for. And so, as a society
we are standing together to conquer cancer.
Research Rockstar
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The
Brains
Behind the
Operation
Top neurological cancer researcher
credits his work with keeping him
strong in a trying field
BY NADIA MOHARIB
PHOTOS BY BRYCE MEYER
sk Dr. Gregory Cairncross what motto he lives by and he doesnt really have
an answer.
But chat with the passionate, world-renowned brain cancer researcher for a bit and
its apparent he has honed the fine art of appreciating the little things in life. After
toiling in a relatively dismal area of oncology for about four decades, his outlook is, no doubt,
good medicine for this doctor.
Ive dealt with many disappointments and failures, but I get satisfaction out of the little successes, in the minor victories, not in the big victories because they are so rare, says the director of
the Southern Alberta Cancer Research Institute and University of Calgary researcher.
It also helps that Cairncross divides his time between clinical practice and research, and
the 63-year-old firmly believes the latter is where hope lies in shedding light on the darker aspects
of the job.
How do I cope apart from dreaming about playing golf? What keeps me going is research. Its
the quest to discover something that makes a difference, he says.
winter 2014
47
Research Rockstar
For me, the research career has been an important
way to cope with the repeated disappointment in the
clinic. As Ive gotten older, Im less on the front lines with
patients and that keeps me sheltered a bit from the dayto-day reality. The status quo is the status quo; research is
the only way forward.
On that front, Cairncross is quarterbacking a
national team of researchers at four main laboratories
in Canada, with their headquarters located in Calgary.
Relying on tumour cells
from dozens of glioblastoma
patients, researchers found
a combination of drugs,
including AZD8055 and
Temozolomide already
taken by most glioblastoma patients extended the
life of lab mice by about
30 per cent.
If their laboratory findings hold true in patients, the
discovery could prolong the lives of people with the
aggressive and deadly type of brain cancer which is
diagnosed in about 150 Albertans each year. The findings are poised to go to clinical trial, but given that
most compounds aimed at targeting glioblastomas
fail, Cairncross has learned to curb his enthusiasm
with caution.
We are pleased research has led us to this observation and want to test it in people who have glioblastoma, but time will tell, he says. Its not that Im not
hopeful or excited to do the trial; its just tempered by
30, or 40 years in my case, of experience, where many are called and few are chosen.
True advances are infrequent, progress has been slow.
Over the decades, Cairncrosss commitment to finding breakthroughs in
understanding and treating brain cancer has been steadfast a pivotal point in his
career dates back to 1985 with the curious case of a patient named George.
Georges dramatic response to treatment prompted Cairncross to pursue what
would be his claim to fame the worldwide use of chemotherapy to treat those with
that particular type of cancer, oligodendroglioma. It
also led to the discovery of
molecular features in oligodendroglioma which are
used globally to diagnose and
tailor treatment for those
with the disease. It was a defining moment in my career,
Cairncross says. I spent
the next 30 years studying
Georges kind of cancer and am one of the worlds authorities on that type of cancer.
A few months earlier, his patient was a miserable man battling seizures, headaches
and weakness on one side of his body because of the cancer. But much to Cairncrosss
surprise, treatment melted the tumour away, giving George more time rather than an
imminent death sentence. Ive told that story hundreds of times to colleagues and
students and almost anyone who would listen, says Cairncross, still impressed by the
case. The response was so unexpected and dramatic ... it was so shocking he was better.
The magnitude of the discovery is not lost on Cairncross, either. It would have been
easy for that moment to slip by and not to have really noticed that this was extraordinary. I might have just kind of shrugged my shoulders. Some get a little better, some
dont and on we [usually] go to next patient, he adds. Nature was trying to reveal
itself, and say, This cancer that George has is highly sensitive to the chemotherapy you
are giving.
The average survival rate for a brain cancer

patient about 50 years ago was four to six
months, with less than one per cent of patients
living five years, while today the average life
expectancy is 12 to 15 months, with five to 10
per cent living five years.
BODY OF WORK: Dr. Gregory Cairncross has been a

leader in glioblastoma research for more than 30 years.
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Decades later, the opportunity to work with the

researcher behind that discovery was a big lure for
neuropathologist Dr. Jennifer Chan, who relocated
to Calgary from Boston to be on the Cairncross team.
When I was a baby neuropathologist, we all knew his
papers. He is essentially a household name, Chan says.
He is kind of like a rock star.
But his stardom of sorts comes without any diva-like
baggage. He is totally down-to-earth; there is nothing
snooty about him, she says. He is just sort of a quiet,
unassuming guy, but behind that he has visions. His
opinions are sought by others who are basically movers and shakers in the field.
That humble approach
might be why he complements his research with
front-line efforts. I still
see patients because, well, it kind of keeps me grounded
and in touch with whats important, he says. Patients
have been a source of inspiration for my research I get
ideas about how one might tackle the problem in
the laboratory.
He has been recognized outside the lab as well, having
been named Scientific Director, cancer research programs at the Universities of Alberta and Calgary, while
also engaging with key research funding partners at
the Alberta Cancer Foundation and Alberta Innovators
Health Solutions.
Over the years, radiation has become safer for treating
those with brain cancer and chemotherapy combined
with radiation can control many glioblastomas. Surgery
has improved, too. Any time the brain is operated on,
you might die, wake up speechless, paralysed or with
some trouble with vision, Cairncross says. These days
you wake up fine and most of the time with a lot of the tumour out.
The average survival rate for a brain cancer patient
about 50 years ago was four to six months, with less than
one per cent of patients living five years, while today the
average life expectancy is 12 to 15 months, with five to 10
per cent living five years.
That is a doubling of the average survival and five-fold
increase in long-term survival but the numbers are still
terrible, Cairncross says of slow progress on the treatment front. We still dont eliminate the disease except
once in a blue moon. Its not like some other cancers
where there is a significant cure rate ... where the treatment is noticeably better. In brain cancer the illness cant
be anticipated, he says, eschewing any notion of advantage gleaned from early diagnosis. By the time you have a
hint of it, its a fatal disease. Probably in my entire career,
Ive seen a patient or two who I thought really had a glioblastoma and it was cured. Whenever we see a long-surviving patient, we are immediately suspicious the diagnosis was wrong.
And so the work continues. Meanwhile, champions for
the work Cairncross does, both in the medical and academic realm, are many and rightly so. He is a passion-
ate believer that in order to get great health care we need great science behind it, says
Dr. Jon Meddings, dean of the University of Calgarys faculty of medicine. He practises
what he preaches ... he is a big-picture thinker, he adds.
For now, there is a bitter balance between hope and history for those working in the
field between what might ideally happen and what statistics have shown. The most
difficult thing is seeing a brand-new patient, who, of course, is incredibly hopeful their
illness can be eliminated, Cairncross says.
I dont ever want to take away that hope but of course where Im sitting, I have a different perspective on whats most likely to happen to them, he says. When Im with the patients, I am a glass-half-full person. I will describe how treatment has improved and continues to improve; some people have very good
results with treatment and there is no reason
why a patient shouldnt be one of them.
But he also knows the whole picture. Privately, I dont think anyone is satisfied with the
improvements made to date. My colleagues
want to do much better. The understanding of
the science [behind how the disease works] is
advancing rapidly. The treatment isnt.
Perhaps accepting current limitations of science, Cairncross takes comfort in smaller
victories. Most people who get brain cancers are just minding their own business. Ive
seen my share of sadness and heartbreak, but unfortunately it is a part of life, he says. I
dont take the treatment failure personally; its not my fault the tumour didnt respond.
The occasional patient does spectacularly well and thats a great joy.
Challenging as it might be, the scientist is quick to cite those with more taxing gigs.
Going off to Africa and getting into one of those space suits, looking after Ebola
patients and keeping your fingers crossed you dont get it when it seems like you can
get it fairly easily those doctors are on a much, much more difficult path than
Im on, he says.
When I was a baby neuropathologist,

we all knew his papers. He is
essentially a household name, says Dr.
Jennifer Chan. He is kind of like
a rock star.
Asked And Answered

We challenged Dr. Gregory Cairncross to finish these thoughts:
ON A DAY OFF, I LIKE TO take it easy.
TRAVELS: Im looking forward to going to Hong Kong in six months. Its
such a neat city but I hope its not in chaos when I get there. And one day
I want to go to Wimbledon and the Masters Golf Tournament. If I could
do those two things, I would feel like a pretty lucky guy.
I LISTEN TO country and western. I like the hurtin songs. Its good for my
soul.
WHEN DINING OUT, I ORDER a nice glass of wine. Im torn between
doing the right thing by eating fish and trying to pretend Im still young and
ordering a steak.
CANCER: a tough problem.
I STRUGGLE WITH my age. I dont know where the years went. One thing
I will not be doing is working in my 80s. I just want to do other stuff, even if
its nothing, even if its just looking at the sunset.
WHAT ARE YOU READING? Jonathan Kellerman. Im not sure I like it yet.
Its detective/mystery stuff.
MY JOB HAS TAUGHT ME that every day you are healthy is a very good day.
WHAT I MIGHT DO IF NOT MEDICINE: I hope Id be hitting golf balls, but
Id want to be good, like some of these young golfers.
ON MAKING A DIFFERENCE: Im sure Ive made a difference to the people Ive tried to help in some way with their journey. This doesnt make me
special I think a lot of health-care professionals do it day-in and day-out,
and I do it off and on.
winter 2014
49
My Leap inspiring individual
PHOTO BY RAYMOND REID
KEY PLAYERS: James Rosenau (left) will play in Brent Saiks

(right) fundraising hockey game, which strives to break a
Guinness World Record. But first the pair are helping construct
a new NHL-size arena and clubhouse for the February game
thats expected to last 10-plus days at Saiks Ardrossan home.
A Win in Overtime
The play-by-play for a hockey game where the
real goals happen off the ice
Maybe youre tired of writing cheques or signing petitions, and even a bucket of
ice seems tame. Lucky for you, Brent Saik hosts a fundraising hockey game accurately described as primal.
From an NHL-size rink on his acreage near Ardrossan, in 2003 Saik started his tradition of beating the Guinness World Record for the worlds longest hockey game,
which at the time was 82 hours long. In 2011, he and other participants played for
242 hours: more than 10 days non-stop. In 2008, the temperature plummeted to
-51 C and one participant actually lost a toe to frostbite. Its not all missing
appendages, however as the competition increased, so did the fundraising. In 2011,
Saik and the Alberta Cancer Foundation raised $1.3 million, and theyre hoping to
surpass the $2-million mark in February.
Everybody out there has a little bit of competitiveness in them, Saik says.
And who wouldnt, with a crowd of 50,000, including local media personalities in
attendance? For 10 days, legions of spectators will bring their motorhomes to Saiks
property to watch the event, and more than 800 volunteers, from referees to police
officers, will assist.
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winter 2014
By Robbie Jeffrey
The event doesnt only stem from Saiks passion

for hockey. My dad had died of cancer, and we were
trying to raise money for it, he says. I built a hockey
rink at my house and it grew from there. As we were
playing the first game, my wife was diagnosed with
cancer, and she subsequently passed away. From
this tragedy, Saik built the event into something he
will pass on to his daughter and son. Hopefully a
legacy is created, and this thing can just keep going
and going, he says.
The record to beat in 2015 is 252 hours, set by a
group in Calgary. So from February 6 to 16, 2015,
help Saik and the Alberta Cancer Foundation once
again break the record and keep the momentum going. You can donate at worldslongestgame.com or
through the Alberta Cancer Foundation website.
myleapmagazine.ca
THE ALBERTA CANCER FOUNDATIONS
TO EDMONTON ON
REGISTER TODAY
1.855.250.MOVE
BUSTAMOVE.CA
Join hundreds of women and men as they

sweat, laugh, squat and lunge it out through
six energizing fitness sessions while raising
valuable funds for the Cross Cancer Institute.
For thirty years, weve been at the foundation of everything from cancer care to cure.
Thank you for helping us make life better for Alberta cancer patients.
Learn more at albertacancer.ca

Leap Winter 2014

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Leap Winter 2014

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RY ISSUE

JOIN THE CONQUEST!

Register for The 2015 Enbridge Ride to Conquer Cancer

WINTER 2014 VOL 5 No. 4

A message from the Alberta Cancer Foundation

Messages about fat have evolved through the ages

ASK THE EXPERT

Pengrowths fundraising efforts ramp up

Brent Saiks Worlds Longest Hockey Game

Alber ta Cancer Foundation

Scientific advancements have changed how

20 LEAPS AND BOUNDS

Cancer treatment in Alberta has improved drastically

24 ACROSS THE DECADES

30 years have led to huge developments in cancer

26 HEALING THE WHOLE SELF

SBRT shortens the number of treatments required

32 BRIDGING THE GAP

Integrating a palliative care approach within

Speed skating is a fun, heart-pumping way to

An Edmonton chemist funds clinical trials

Dr. Gregory Cairncross credits his work with keeping

Message alberta cancer foundation

Weve Come a Long Way

Angela Boehm, Chair

WINTER 2014 VOL 5 No. 4

ALBERTA CANCER FOUNDATION

Leap is published for the Alberta Cancer Foundation by

The information in this publication is not meant to be a substitute for professional

Alber ta Cancer Foundation

Donate today at albertacancer.ca

Forefront prevent, treat, cure

challenge to the provinces emergency personnel

Whitworth. If I had my way, wed be in with every police department, fire

the University of Calgarys Hotchkiss Brain

Our research has identified a key process in brain tumour growth

TOUR LAKE LOUISE BY DOGSLED.

BOARD A TRAIN FOR A HALF-DAY ROCKY MOUNTAIN TOUR.

SLEEP WITH THE FISHES (AND HOPEFULLY CATCH SOME, TOO).

CATCH THE WAVES AT WEST EDMONTON MALL.

DO SOME HORSING AROUND IN CALGARY.

Alber ta Cancer Foundation

Raising Funds Through Fitness

Bust a Move for Breast Health is back

SNOW SHOVELLING 101

3. When throwing snow,

Stuffed Chicken Breasts

Canola oil cooking spray

1. Preheat oven to 350 degrees. Spray a

6. Bake for 30-35 minutes or until chicken is cooked

Blocking Cancer in Its Tracks

Alber ta Cancer Foundation

Just for Kicks

reputation for hours of competitive playing alive, by setting

Game organizer Michelle Chambers

with most of the players coming from Calgary or Edmonton.

Next Gen supporting young minds

HEAD OF THE CLASS

Body Mind making positive connections

30 Years and Counting

Since the theme of this edition of Leap is marking

an inability to travel, financial restraints, the burden of symptoms, low energy,

Smart Eats food for life

Messages about nutrition and the fat we eat