Cancer Society Wigs

♪♪♪ (patti cochrane)hello and welcome to "talk trillium:partnering for patients." i'm patti cochrane,senior vice president and chief innovation officerat "trillium health partners," which includesthe credit valley hospital, mississauga hospital,and the queensway health centre. i'm your host at "talk trillium"as we take a look at the work our hospital is doing to createa new kind of healthcare

for a healthier community. today we'll be talkingabout cancer, the programsand services that we offer across all three of our sites,and how we partner with our patients throughtheir cancer journey. i'd like to introduceour guests today, both experts in cancercare and treatment. dr. craig mcfadyen,he's got quite a title. he's the vice presidentof the cancer program

at trillium health partners. he's the chiefand medical director of the cancer program as well asthe regional vice president with cancer care ontario,so welcome, craig. (dr. craig mcfadyen)thank you, patti. (patti cochrane)and sarah etheridge,who is our regional director of the cancer program. (sarah etheridge)thank you, patti. (patti cochrane)so maybe over to you, craig,for our first question.

as the regional vice presidentwith cancer care ontario, can you talk a little bit more about the partnershipwith cancer care ontario and how it benefitsour patients? (dr. craig mcfadyen)so 2004, the province wassplit into 14 cancer programs. and they're governed,so to speak, by cancer care ontario, which isan arm's length relationship with the minister of healthand long-term care. each programis roughly attributed

to the size of the lhin. and each lhin or each programhas a regional cancer centre. (patti cochrane)so when we talk aboutthe lhin for our area, that would includemississauga, halton, and a small part of etobicokejust for our viewers. (dr. craig mcfadyen)right, so we arethe exception to the rule in the province of ontario, where our regional cancerprogram actually covers the central-west lhinand the mississauga-halton lhin.

(patti cochrane)so that includesbrampton then as well. (dr. craig mcfadyen)it does, yes. so the regional cancer program--the regional cancer centre is at the credit valley siteof trillium health partners. and our partnerships are withthe william osler health system, the halton health system, and headwaters hospitalin orangeville. (patti cochrane)so can you explain to ushow cancer care ontario helps patients throughtheir journey in cancer,

or sets standards,perhaps, in care? (dr. craig mcfadyen)so cancer care ontario hasspent a long time establishing an evidence-based programand disease pathway management with the goal that patients,no matter where they live in the province, and forour region where they live in the region,will have equitable, evidence-based,effective care. and one of cancer care'sother priorities is to make sure that everyone hasequitable access.

so access and quality of careare two primary motivators behind the cancer careontario theme. (patti cochrane)that's a wonderful--that's a wonderful program, i think, for our patientsin ontario. so can you tell me, how do weknow we're doing a good job in access and quality? you know, i'm familiar withgetting a report card in school, and it kind of tells me a littlebit about how well i'm doing. is there that kindof system for us?

(dr. craig mcfadyen)cancer care ontariois a highly metric or measurement driven system. and each regional cancerprogram on a quarterly basis is evaluatedon 14 different parameters as to how well they're doing and compared with allof the other programs within the province. so these measuresor these scores are related not only to access,but to quality.

so we look at wait timesfor surgery, radiation medical therapy, how well we're doingon screening, how well the data thatwe're actually submitting for measurement is,and so forth. the mississauga haltoncentral west regional cancer program,again of which trillium health partners isthe administrative epicentre, has fared very wellon that report card.

and in the final quarterof 2013/2014 actually finished secondout of the 14 programs in the province. (patti cochrane)that's wonderful. so it's great for our viewersto know that the services that they receive are beingmeasured and benchmarked, and we are actuallyperforming very, very well. that's great, thank you,that's great. so maybe switching to anothertopic that might be of interest

to our viewers, can you tell usa little bit more about the most common typesof cancer that we find? (dr. craig mcfadyen)so the most commontypes of cancer that we find in canada,and in fact in north america, are prostate cancer,breast cancer, lung cancer, uterine cancer,and colorectal cancer. those are the five majorcancers that we find within the--within canada. skin cancer, of course,is a very ubiquitous cancer,

and unfortunately gettingeven more common, especially melanoma,so it would also be included. we tend to talk aboutthe six leading cancers now. (patti cochrane)great. so, sarah, maybe you could talkto us a little bit more about supporting patientsacross their journey, their cancer journey. once a patient is diagnosed,what kind of supports do we providefor these patients?

(sarah etheridge)so we have many supports. we have a large healthcare teamthat looks after the patient throughout their journey. we have an opportunitywith respect to the diagnostic assessmentprograms for rapid diagnosisand support using nurse navigatorsthrough that part of the patient's journey. and then once the patients arereferred to the cancer program,

then we have primary care nurseswho will see the patient with their physicianon the first visit and who will bethe point of contact for those patients throughoutthat part of the journey. they're depending on the typeof cancer and the treatment that the patients need. there may be several handoffsbetween healthcare providers, but because we all workin the same system with respect tothe patient chart,

that access to that informationis always there for those patients. so whether it--whetherthe patient is coming to see the physician or whetherthey're going through for chemotherapy treatmentor radiation therapy treatment, we have a strong teamof professionals that are thereto support the patients. we also have a strongteam of support, allied health professionals,social workers, dieticians,

as well as spiritual careand psychology who can also providethat support to the patients. (patti cochrane)so it sounds likethe support is there even before diagnosisand definitely after diagnosis. so you mentionedsomething about the rapid assessment centres. can you just tell usa little bit more about them and how they were created? (sarah etheridge)so what the diagnosticassessment programs were,

a project initiative that camefrom cancer care ontario to provide that rapid access into the systemthrough diagnosis, and if necessary for the fulltreatment of cancers. specifically, they started with the breast diagnosticassessment program. so those patients come inwith a mammogram that may be suspiciousof a breast cancer diagnosis, they seea breast cancer surgeon.

they have access,as i mentioned, to the nurse navigator and any of the psycho-socialoncology support that they may need. and then if the suspicion isproven to be a cancer, they will then befollowed up with a surgeon, have the surgery, and thengo on to the cancer centre. (patti cochrane)so it sounds likeyou've removed some of those sleepless nightsof anxiety by fast tracking

that whole processthrough these types of centres. that's wonderful. you know, we've gone out toour community to ask questions, what they might have. and so why don't we takea look at what question they might have for us? (thomas walker)hi, i'm thomas walkerand i was actually wondering, would there be any wayfor me to reduce my risk of actually getting cancer?

(patti cochrane)wow, what a great question. i'm sure everybody'sinterested to know how to reduce their riskfor developing cancer. any thoughts, craig? (dr. craig mcfadyen)there are several waysthat an individual can reduce their riskof getting cancer. the first and probablymost commonly known is cessation of smoking. so, smoking is clearly the mostimportant cause of lung cancer,

which unfortunately is oneof the most common cancers in north americaand the most lethal cancer that we face nowadays. the cessation of smoking startsto reduce your risk of cancer within one year of stoppingof smoking. so smoking isa major carcinogen we find in our environment. it's not only relatedto lung cancer, but it's also relatedto oral cancer

or cancer within the mouth,esophageal cancer, and bladder cancerand kidney cancer. so there are many cancers that are specificallyrelated to smoking. the other thing is diet. colorectal cancer, which isa very common cancer in north americaand western europe, is not common in culturesin which the diet consists of higher fiberand lower saturated fats.

so there's clearly a linkbetween causation of colon cancer and the typeof diet we tend to eat in well-developed countries. the third one is weight. we know thatcancer unfortunately has a higher incidencewhen people are outside their ideal weight. the cutoff is generallythought to be about 20% outside your ideal weight,

but excessive weight gainis clearly associated with some cancers, includingunfortunately breast cancer. the final--not the comprehensive list, but the final important thingthat people can do is to pay attention to the sun. you know, melanoma is a very,very serious disease. and simply observingsome precautions: hats, shirts, good sunblocks can certainly reduce yourrisk of getting skin cancer.

it is believed that if you havetwo significant sunburns, especially inyour younger years, you double your risk ofgetting melanoma later in life. (patti cochrane)so craig, it sounds likegreat advice. a lot of it seems likecommon sense. so, unfortunately,you've mentioned staying out of the sun. you've mentionedsomething around diet, and i think ina previous show

we talked aboutalcohol and coffee, so we just addthe diet to the list. keeping ourweight in check, so that's always somethingthat we need to be mindful of. and i think the first onewas around smoking. and so i think that makesa whole lot of sense and i think most of our viewershave control of most of those factors. unfortunately, it's hardto do sometimes.

(dr. craig mcfadyen)the other thing that peoplewould be surprised to know, and there's fairlygood science on this, that people who arephysically fit, people are physically active,have a decreased risk of developing cancerlater in life. so just generally good lifestylehabits clearly reduce-- we feel fairly confident-- reduce your risk of gettingcancer later in life. now we just havea minute and a half

left in our show today, and i understand we havenew linear accelerators. can you tell us a little bitmore about that? (sarah etheridge)so yes, we-- in the last few months,we've actually had a couple of our radiation treatmentmachines replaced. they're calledlinear accelerators. and we are fortunate attrillium health partners to have the new generationof linear accelerator.

we have two of them currently,and we're expecting a third within the next nine months. we will be the only--firstcancer centre in the province to have three of thesetruebeam linear accelerators. the way that some ofthe features are within the linear acceleratorallows us to treat patients with cancer with a much moresharply focused beam with much rapid decrease of doseto the surrounding tissues.

so we're able to treatthe area of interest to a much higher dosewhile limiting the dose to the surrounding structures. (patti cochrane)so it sounds like that'sgot benefit for patients. can you describewhat the benefits are for patients a little bit? (sarah etheridge)certainly. at trillium health partners,we have started a new program of what we call high-precisionradiation therapy,

which includes what's knownas stereotactic radiotherapy, stereotactic radiosurgery. and it allows us to focusthe radiation treatment beam to a smaller area, providethat sharp edge definity to the lesion, and as wellbe able to vary that intensity across the treatment areaand limit the dose to the normal structures. so patients will havereduced side effects from the treatment, but alsowe hope a better outcome

at the end of that. (patti cochrane)that's great. so less injury to normal tissue,it sounds like, and the better ability to goafter those cancer cells. i want to thank you bothfor joining us for this segmentof "talk trillium" and we'll be backafter a short break for more informationon cancer programs. (patti cochrane)welcome back

i'm patti cochrane, your hostfrom trillium health partners, and today we've beentalking about cancer. we have been talkingto dr. craig mcfadyen, and now i'd liketo introduce his colleague, maria rugg. maria is the managerof supportive care and psychosocial oncology. that's quite a long title,maria. can you tell us what you do?

(maria rugg)so i think the cruxof it is really just trying to lookat what else can we do beyond the medical careand look at support and emotional,physical, emotional, psychological supportfor patients, and programs that willhelp the patient and their family members connectthroughout their cancer journey with things that can help themsee their way through. (patti cochrane)so it sounds likeyour role actually supports

the treatment of patientsholistically, as well-- not just the patientand their cancer, but them as an individualand their families. and so maybe i'll ask you,craig, or dr. mcfadyen, how you operate under thisvalues proposition. (dr. craig mcfadyen)as a surgeon,i'm frequently the first person to tell a patientor an individual that they have cancer. i've usually donean operation or a biopsy,

and so sometimes i'm the onebreaking the news. and i know that i'vetold them something that is goingto change their life. people get this diseasein a context of their life, of their family life,of their social life, of their religious life, of all of the peoplearound them. and what we want to make clearto people who come to us is that we're not only goingto treat your cancer,

we're not only goingto treat your tumor, but we're going to treat youas an individual. we're going to find a wayto tailor your treatment so it fulfills the goalsthat you want to get out of it. and we're going to payvery, very close attention to your emotional, faith-based,and psychological needs as we move youthrough this process. so, to us, we understandthat cancer is very personal. it frequently doesn't justhappen to a patient,

but it happens to the familyand their circle of friends. and we want people to knowthat in addition to just giving youthe therapies, we're going to payvery, very close attention in terms of supportingyou through this journey. (patti cochrane)that's very comfortingto know. so what are some of the socialand emotional challenges that an individual faces when they receivea cancer diagnosis?

(maria rugg)well, i think someof those things-- again, if you look at the life--anyone's life, financial issuescome about because, you know, employmentgets impacted. interaction withfamily members. you know, the cancertouches everyone, can touch anyoneat any stage of life. so issues aroundhow to talk to my children, how to talk to otherfamily members,

trying to look at one's self. and for many people,most people, that diagnosis beginsall sorts of thoughts about what does thismean to me, who i am as an individual,you know, where am i going to getthe help that i need, where am i going to find itin the community that i live? how am i going to talk to myneighbour or, you know, the people within their circle?

and so it impactsin all different levels, as a man,as a woman, as a young adult,as a middle adult, as an older adult. all through the lifecycle,there are different challenges,different issues. and so what i think we tryto do is try to ensure that what we arelooking at is really, as craig was saying,

those issues of it's personal,it's very personal. and therefore the whole patientand the whole family needs to be looked atas a whole. (dr. craig mcfadyen)when can i drive? when can i go back to work?can i travel? how do i tell my friends?how do i tell my partner? how do i deal withthat relationship? these are all thingsthat are really, really important to patients.

(patti cochrane)you know, i think ofour viewers would think that our hospitals do surgery, they know that we havean emergency department, they know that wehave hospital beds, but to think that we haveprograms and services to really offeremotional support and social supportis great news. can you describesome of the programs that you have in place

to support individualsand their families? (maria rugg)yeah, patti, i thinkwhat we try to do, again, we look at the whole journey. so we talk about some of thoseprograms that we look at are both self-directedand also supportive, so in a group,or one to one. so some of them we talkabout patient education, so we haveself-management classes, teaching people howto cope with anxiety.

anxiety is normal. it's something thatwe expect to happen. so we have things aroundbeing able to come and learn how to manage your anxiety,not just with a professional, but how to help yourselfmanage your anxiety. for certain diagnoses,breathing is an issue, so we have--versus just using medication, we try to bring in all sortsof things to help manage that. managing your diet.

diet is an important piece,not just of the cancer journey, but just, you know,taking good care of yourself. so we have programsthat are run by dieticians around how to manageyour nutrition, not just during treatment, but also to prepare yourself fortreatment and post-treatment. we also have programs thatlook at different things after. what happens aftertreatment's finished? where do i go?what do i do?

you know, what's next? this has changed meas an individual, changed my family. so we have a really robust whatwe call survivorship program, where we look at how do weconnect you with each other back into the community,but also, you know, there are thingsafter treatment's over. so we try to look at all aspectsof the cancer journey, all aspects of the personin the programs that we offer

so that they're therapeutic,meaning they offer therapy, but they also offer waysthat i can teach myself how to get myselfthrough this. so we have another questioncoming from our community. let's take a look and seewhat they have to ask us. (yvonne)hello, i'm yvonne. i have a question. like people always talkingabout the importance of, like, positive attitudeif you or your friends

are diagnosed with cancer. so what i wouldlike to know is, what exactly ispositive attitude, what we can do in orderto get this positive attitude. thank you. (patti cochrane)well, that'sa great question. positive attitude. i think that's truefor all of us. so can you speak a little bitmore about positive attitude?

(maria rugg)i think what i hearfrom patients and what i hear from theircaregivers and professionals, it's really about cominginto this with an idea that it's part of who i amand it's not just-- i'm not just the tumoror the treatment, but i'm me. and so, therefore,i as the individual am someone that canget through this, right? and so what we try to doin terms of promoting that idea ofa positive attitude,

as i said, for examplethe anxiety, anxiety is normal. we expect that. we know that's goingto be part of it, so what we try to dowith families and patients going through this diagnosisis say this is normal. how do we make it--normalize it and help youget through it? so that idea of a positiveattitude isn't just about not being able to cope,

but it's also about,you know what? this is going--i'm goingto get through this, and i have people to help me. (dr. craig mcfadyen)very strongly agree. this is very,very difficult to do. i'm not saying thisis easy to do, but we tryand encourage patients not to allow themselvesto be defined by their cancer. it's a word,it's not a sentence.

and i personally also tryto encourage my patients to be a little bitself-indulgent. be kind to yourself. eat well, sleep well,accept the help that your friendsare giving you and your supportstructures are giving you. this is a verydifficult time for you. you will feel that you wantto try and control everything, but unfortunatelythere are things

that you won't havecomplete control over, although we'll help youto the best of our abilities to get you throughwhat's about to happen to you. so i think that attitude goingin is extremely important. (patti cochrane)you talked a little bitabout self-indulgence. i know there's a program calledlook good, feel better. can you describe that programand what it offers patients? (maria rugg)it's a program--it's a collaborative program, so meaning that we work togetherwith our community partner,

the--it's an associationin the cosmetic industry. and they--what they go aboutis it's about the idea of the positive attitude. treatment can changethe physical appearance, and it's primarilydirected at women. and it really looks atthat idea of, you know, despite what may changephysically for me, i can still feel good. so they give skills,so it's an opportunity

to come together as a group. so they host sessionsevery two weeks right within the hospital. in the cancer program,we have a room called the look good,feel better room, where they have mannequins, they help people withhow to do their wigs and if they want to wear wigs, how to do scarves if theydon't want to wear a wig

but they want to wear scarves. they get access to fragrancesand cosmetics if-- you know, that's somethingthat they get an opportunity to have a demonstrationand be demonstrated upon. but it's more aboutthat opportunity to share each other's stories and know that i'mnot alone through this. and so we work withthe industry to help support a space for them and be ableto let patients know.

so we let patients know whenthe sessions are running, and they can sign upand kind of walk in whenever they decidethey want to. (patti cochrane)so it's great to know thatwithin the walls of a hospital, we're not, again,just doing major surgeries. we actually havesome soft spaces for patients to look good, feel better alongtheir cancer journey. now i know another wayof reducing anxiety

is by teaching patients. and i think you've gotsomething called a chemo class. can you describe thata little bit in one minute or less? (maria rugg)yes. so the chemo classis really about trying to understandthat treatment and how it impacts,not just on the physical self, but also on the emotional self.

so there arekind of two parts to it. and it's held--it's done byhealthcare professionals, pharmacy, nursing,social work, psychology. and they really talk abouthow the medications-- what medicationsyou will take, where they give an environmentalkind of tour. and then they also talk aboutthe emotional journey that you will go through, what it's liketo get the diagnosis

and kind of normal emotionsyou will feel all along the way. so they give youan opportunity to understand all the different aspects and really helps the patientwho's going through chemo to understandthat whole process. and they're reallymuch encouraged to dialogue with each other, as well as bringfamily members so they get a chanceto really understand

not just the pieces of what'sgoing to happen to me, but also howto navigate through. so dr. mcfadyen,we've got 30 seconds left. any last words of advicefor our viewers? (dr. craig mcfadyen)cancer is a very,very difficult thing to hear, but there are very-- there are many,many, many things that we at trilliumhealth partners will bring to bearupon your treatment

and your psychologicaland emotional health. there are many thingsthat we can do. so, although it'sa devastating word to hear, we have a lot of arrowsin our quiver. (patti cochrane)wonderful. thank you for joining usboth today. and stay tuned as wetake a short break. i'm your host, patty cochrane, and today we're talkingabout cancer care.

we've been speakingwith maria rugg, and right now i'd like tointroduce two more guests from our patient andfamily advisory council, ricci charette,and karen macneil. so maybe maria, you cantalk to us a little bit about why you were motivatedto start a patient and family advisory council. (maria rugg)so i think part of it isjust being in clinical care and having done clinical workwith patients and families,

the best person to talkabout their experience is the patient and families. so we really wanted to dothe work that we've seen at cancer care ontario,kind of our governing agency who have a provincial patientand family advisory council, and we wanted toget something that was regional for mississauga haltoncentral west. so the idea there is to havepatients and families helping right from the get-go, helpingshape and form their experience

within the cancer journey. and what better waybut to have a council that helps us look at care? (patti cochrane)so it sounds likewe're trying to hear the voices of patients asthey've been through the journey to help us improveand continuously improve, i guess, on that journey. (maria rugg)yeah, absolutely. and i think it's abouthearing their voices,

but even going beyond that,actually having their experience and helping themshape the experience for those who areto come as well. (patti cochrane)so who sits on the council,and how big is it? (maria rugg)so we have bothactive patients, patients who havefinished treatments, as well as family members. we also have staff memberssit on the council. there's about 20 to 25 people.

and the co-chairsof the council are actual patients themselves who have been treatedacross our region, which is mississauga haltoncentral west. so they may havebeen treated either at the credit valley siteor at the queensway site or at the mississauga siteor at william osler or in halton as well. so they bringdifferent experiences,

different site groups,diagnosis. some are at varying degreesof treatment or completed treatment. (patti cochrane)thank you. ricci, it's reallya pleasure to have you join us this morning. can you tell us a little bitabout why it's so important for you to sit on this council? (ricci charette)absolutely.

to me, it's an absolute honorto be able to have an opportunity to not onlyshare my own personal journey, but to also bea representative for the voice of the "we." and that's what i'm reallylooking forward to as we are learningand growing through this, getting this together,is realizing that what we do really doesimpact the outcome of what the care is,not just for myself,

but for othercancer patients as well. and i can tell you i've alreadyfelt my own care improve, which is just a small partof the motivation behind beinga participant on this. and of course, it'sabout the bigger picture, about making it betterfor everyone. (patti cochrane)so it soundslike you are on a cancer journeyyourself personally. (ricci charette)yes.

(patti cochrane)and how did youget involved, then, with the council? (ricci charette)well, by being veryopen with my doctors and communicating,advocating for myself that i believethat it's important to treat the entire patient and not justthe obvious disease. and i am a big advocatefor the mental health as well. so reaching outto my doctors

and asking for help with that. i mean, there was a few otherstepping stones in the way, but that definitely led meto maria and this board. and i couldn't bemore honored and more proudto be a part of it. (patti cochrane)so, karen, you mentioned-- or sorry, ricci, you mentionedthat you've already noticed a little bit of improvementthrough the services and by participatingin the council.

can you describethat a little bit? through--a lot of it is actuallythrough patient education. so the healthcare systemcan be very intimidating, and especially wheneveryou're first diagnosed because you're scaredout of your mind, you don't knowwhat's going to happen. the big c is there. it comes with all kindsof negative stereotypes. and when you open upthat door of communication

to your doctor, not only do youstart to break down that wall of fear,but that's actually how you can start gettingindividualized care, where you can--your doctor can mold to what you specifically need, because my cancer isdifferent than your cancer, is different from everybodyelse's cancer. so the only way to achieve thatindividualized care like that

is to break down thosebarriers of communication, figure out how to do that. so taking a couple of classes, like for instance,the coping clinic. it gives you so many skillson how to better communicate, not only with yourhealthcare team, but also with your family,your partners. you get guided really throughevery step at that point. and then you realizethat going through cancer

doesn't have to bean ugly, horrible thing. it can actually be beautiful,uplifting, life meaningful. and i'm sorry, i'm going to geta little emotional here. (patti cochrane)well, it's good to knowthat you've taken advantage of some of the servicesthat are offered. the coping clinicallows you to give you the skillsthat you need to be able to better voicewhat you need with your doctor. (ricci charette)yes, and mariawill tell you

that i volunteer for everything. and you don't even have to. even just--even justthe ones that are geared towards your interestare going to help you because it is for you. and they're designedin a broad spectrum, so then hopefully there'ssomething from each one that you're goingto benefit from. and the best analogyi could possibly give

is if you were walkingthrough a door and the door had the word"cancer" written over it. and as you're walking through,you go in as one person, and on the other sideof the door, you're completelyand totally someone else. and that's the--that's howyou can look at something that seems so horrible, but yet turn it into somethingincredibly beautiful. (patti cochrane)thank you, ricci,for sharing that.

now maybe we canask you, karen, about your personal reasonsfor joining the council. (karen macneil)i got the invitationto join the council, and i was very opento explaining my journey and how my--actually, my journey was quitea positive experience. and i wanted to be that voiceof positivity into the council because so many peoplejoin the councils or committees like this

and all they wantto do is complain. you know, we did this wrong,we did that wrong. i wanted to bethe voice of, "but look at all the thingsthat we're doing right." i thought that wasvery important to be that positive voice. (patti cochrane)so it sounds alsolike you've had a personal experiencewith cancer. (karen macneil)i have, yeah.

and i have more to come. (patti cochrane)okay, thank you. so we have a questionfrom our community. why don't we take a lookand see what they want to ask our viewers? (female)i have a loved onewho's diagnosed with cancer. what can i do to support them? (patti cochrane)so we've talked a lot about the support of patientsthrough this journey,

but what about the familymembers and their caregivers? maria, can you respondto that question? (maria rugg)sure. i think what we needto remember always and what we try to dowith our programs is help patientsand their family members, and supporting themreally means recognizing that while it maybe their mother, their father, or whomeveris going through cancer,

they are also going throughit from a different lens. so i think the best wayto support them is to be able to offerthings to them that they can help recognizetheir own experience, individualize their experience,because it may be very different than their loved onewho's actually going through it. so we give themthe opportunity. the best thing to do isgive them the opportunity to have a voiceand to be able

to describe their journey. you know, making surethat we're attentive and we ask them howthey're doing, how are they coping,how are they feeling, separate than howtheir loved one who's goingthrough it is feeling. i think that'sthe best way is, as ricci was talking about,opening up that communication and recognizing that it's

the whole familythat's involved. (patti cochrane)so, ricci or karen,any advice that you can give to family members who aresupporting loved ones through a cancer journey,what worked for you? (karen macneil)i would say the best thingthe family members can do would be to be--just be there, to ask themhow are they feeling. and the first time i had cancer,my children were fairly small, so they still expected meto be mommy.

and i couldn't always be mommy. there were times when theyneeded to cope on their own for a day or so, particularlyjust after having a treatment. so it was justto be understanding and to be there to dowhatever the patient needed. but as maria said,particularly for children it's very important that theirvoices are heard as well. (patti cochrane)and ricci? (ricci charette)i think exactlywhat she said.

the importance is you're there. first of all,just to be there, listen. but also don't be afraidto speak up for yourself when you need help. because you know,as a cancer patient, i can tell youi worry about whether or not my kidsare reaching out when they need help. i worry about whetheror not my husband

is seeking supportwhen he needs support. so don't be afraid to ask forsupport because in doing-- in taking care of yourself,you're also going to help take care of the patientyou're trying to support. so you have to learnhow to balance it. it's tough, but it's doable. (patti cochrane)and is there any adviceyou could give to anyone newly diagnosed with cancerthat you'd like to share? (ricci charette)don't be afraid.

and i know that sounds horriblebecause obviously everybody is going to be afraid at first,but you're more in the driver's seatthan you think. i think that's oneof the things that i would tell them. and you know, just take itone step at a time and ask as many questionsas possible. really, if you startwith asking questions, that communicationand everything else will come.

(karen macneil)i personally foundthat information was key. when i didn't knowwhat was coming, i was scared. when i first got diagnosedwith cancer, i went online, made sure i wentto a reputable website, didn't go to onethat was not based from the medical community,and i researched my cancer and found out a lot of thingsthat i didn't know. so i went to my oncologistwith a list of questions.

and i tooka family member with me. that's very important whenyou're in the early stages and you're scared and you don't knowwhat's coming. and you're reallynot listening to the answersto your questions. yes, you go with the questions,but you need somebody to be there to remind youwhat the answer was. (patti cochrane)so don't go it alone,ask lots of questions.

that's some really good advice. and to know that there'slots of programs and services available for youto help you develop some coping skillsand other types of skills as you gothrough this journey. i just wantto say thank you on behalf of rogersand trillium health partners for sharing a very personaljourney with our viewers, and hopefully supportingsome of them.

and thank you, maria,for all that you do. so we're just going totake a short break right now. we'll be back to talk aboutscreening, so stay tuned. i am patti cochrane, and today we're talkingabout cancer services. i'm really pleasedthat ray applebaum, ceo of peel senior link, has joined us as ourco-host today, so welcome. (ray applebaum)thanks, patti.

it's great to be here. i'd also like to introduceour two guests, who are going to talkabout cancer screening. first we have jane craik. she's the interim manager of the integratedcancer screening. and next to heris kayle mcmillen, health promotions coordinator. so jane, can you tell mea little bit about

why you're so passionateabout making sure everybody gets screenedfor cancer? (jane craik)oh, it's so importantto be screened for cancer. the purpose of screening forcancer is to find cancer early or to even find changesbefore they become cancer. so and we know that if we findcancer in the early stages that there aremore opportunities for treatment options, and it may evenimpact the outcome.

for example, if colorectalcancer is found early, it's 90% curable,so cancer screening is really importantfor all of our citizens. (patti cochrane)yes, my motheractually experienced that, and we were all advisedto get screened for colorectal cancer becauseit can be within the family. yeah, so it's reallyimportant to catch it early. so you might even considerthe prevention part is part of that cancer journey.

(jane craik)so, preventionis really important through healthy living,healthy eating, not smoking. but cancer screeningis also part of that preventative program and also early detection,very important. (ray applebaum)jane, what types of cancercan you screen for? (jane craik)so there are three organizedscreening programs in ontario. there's the ontario cancerscreening program, there is the cervical cancerscreening program,

and the colorectalscreening program. (ray applebaum)okay, thank you. (patti cochrane)so in termsof cervical cancer, have the guidelineschanged recently? (jane craik)yes, actually. the cervical screening programis for women that are 21 years of ageand have ever been or currently are ina sexually active relationship. and they used to be oncea year that a pap test

was recommended,but it's now every 3 years. the reason for that is thatwe know cervical cancer is a very slow growing cancer, and 3 years is an adequatescreening period in order to find cancerat its early stages. (ray applebaum)in terms of breast cancer,what about screening males for breast cancer? (jane craik)well, the ontario breastscreening program is for women, so men aren't included,but that doesn't mean

that men don't get cancer,but it's not very frequent. so if there's a family history or a family physician feelsthat a male should be screened, then that is absolutelyat their discretion, but it's not part of an organizedscreening program for men. (ray applebaum)and in termsof colorectal cancer, how would someone know if they're at a higher risk ofdeveloping colorectal cancer

or any cancer, per se? (kayle mcmillen)so with colorectal cancer, the majority of peopleare just at average risk and they have to be screenedwith average guidelines, so that would beall men and women. so it's the only screeningprogram available for men. and that would be betweenthe ages of 50 and 74 through a test calledthe fobt test, which is the fecaloccult blood test.

it's a really easytake-home test and you do a couplestool samples over a couple days,send it in an envelope, and they'll send the resultsback to you and to your doctor. for high risk, you candefinitely talk to your doctor about if you're at high riskfor colorectal cancer or any other type of cancer, whether it's throughlifestyle factors or family history,and see if you need to be

screened earlieror more often. (ray applebaum)you know, in the communitysector where i work every day, we see a lot of people who often would benefitfrom screening. and my question is, what aresome of the reasons people don't get screened for cancer? (kayle mcmillen)there are actuallya lot of reasons that people don't getscreened for cancer or that it might bemore difficult

for people to get screened. it can be a lack of educationand a lack of awareness. so even especially if someonehas a language barrier, that might make itmore difficult. things like beliefs or fearsor misconceptions, which couldeither be cultural or they could bepersonally based. for example, there'sa common misconception in some communitiesthat if you screen for--

if you breastfeed your children that you don't need to bescreened for breast cancer. and we know thatthat's inaccurate and that everyone--or allwomen need to be screened between the agesof 50 and 74. another barrier is actuallythe health system and accessingdifferent services. so, making sure that peoplehave services available in the languagesthat they speak,

as well as havethe access to a primary care provideror family doctor that can help guide themthrough the process. (patti cochrane)so kayle, you're a healthpromotions coordinator. and so how do you ensurethat everybody knows about the screening programs? how do you ensurethat it gets out there? (kayle mcmillen)we have a lot of programs that are out in the communityright now

that are really lookingat trying to address some of those barriersthat we just talked about, as well as reallytargeting different communities that we know have lowerscreening participation rates. so in our region, we know thatsouth asian new immigrant and low-income communities tend to have lowerscreening rates compared withthe general population. so we have a numberof different programs

that really outreachto those communities. we have one programthat we aligned with, the canadiancancer society with, their screeningsaves lives program. and we developeda complementary program called screen easy. and screen easy is reallytrying to take it past that next step of education and really helpto support individuals

in getting screenedfor cancer. so it's all--it's a navigationsupport system over the phone, where people can call inand we can answer any questions. if they don't havea family doctor, we can help them finda family doctor in their region. as well as we can help them actually bookscreening appointments, whether that's with an ontariobreast cancer screening site or with their primarycare provider.

some of the other programsthat we have are-- one is calledyour health matters, which is a workplacehealth program, where we gointo different workplaces and do presentationson cancer prevention and screeningfor the employees. and we also do a numberof different media campaigns. we just finished one upthat was advertisements and interviewson a south asian radio program.

and we're always out inthe community doing events to really reach outto those communities that we're trying to reach, either throughplaces of worship or ethnic grocery stores, settlement services,language instruction classes, and other community eventsthat are going on. (patti cochrane)so, some of our viewers that have just heardabout these programs,

how would they actuallyaccess these services? and is there a chargefor those services? (kayle mcmillen)so there's no chargefor any of the services, which is really, really great. the screen easy programthat i talked about, you can just callthe number 905-813-4220 and we'll havea navigator there that can talk you through,answer any of your questions. she speaks a numberof different languages

and we havetranslation services. as well, you can goonto our website, which is the regionalcancer program website, www.mhcwcancer.ca. and cancer care ontario'swebsite also has a number of different resources and informationthere for people. so you gave us somegood information there. and for the viewers thatwant more information,

they can also go to the trilliumhealthpartners.cawebsite and we'll haveall the information from these shows. so, thanks for sharingthat information. (ray applebaum)my question isjust to understand the referral process,that you do not require a referral thereforeto the program? (kayle mcmillen)for the screen easy program?

there are a numberof different ways that we actually get people in. so we're doing differentpublic education initiatives in the community. and either we can giveour phone number out and leave it up tothe individual to call us when they feel comfortable, or pass that informationon to a friend or family. as well, we havesome referral cards.

so if we can, we liketo get the information right from the individualon the spot and get their consentthat we can contact them, so it's just a quickfill out their name and number and a little bitof information, and then we'll have someonecontact you right away. (ray applebaum)that's really excellentbecause we know that access and information arereally key for people to take that first stepin the awareness side of it,

so that's really greatto hear that your program has no barriersfrom that perspective. (patti cochrane)here's a question for jane. i'm wondering ifone of the barriers is that people areafraid of the results that they might getwhen they go for screening. so can you giveany advice around anxieties, or how do we allay anxieties for people that areabout to go for screening?

(jane craik)so it is a frighteningconcept to think about, screening for cancer. i think one thing isto understand exactly what the screening is about, so exactlywhat's going to happen when you gofor the screening. for breast cancer,it's a mammogram, which is an x-ray of the breast. (patti cochrane)how often should individualsgo for a mammogram?

(jane craik)so for women betweenthe ages of 50 and 74, they should go twice a--every 2 years. and actually,that program you don't requirea referral from primary care, so a woman can walk inand receive that screening. for the cervical cancer,they examine some cells from the opening of the womb under a microscopeto look for any changes. that should be doneevery 2 years--

every 3 years. and for the colorectal program,a stool sample should be examinedevery 2 years as well. but so i think if youunderstand what it is that you're going to be doing, that helps to allaysome anxiety. but i think also to understandthat catching cancer early or before it even starts isa much better process than treating cancer later on.

so it's better to go in-- (ray applebaum)i know that i hadtwo experiences in my life many years ago, and they--fortunately,they were benign, but it was early detectionthat really was the thing that saved mein terms of getting in and getting that done. (jane craik)yes, yeah. (patti cochrane)any last piece of advicefor our viewers?

(jane craik)it's really, really importantto go for a screening for the threedifferent programs. please if you haveany questions, feel free to reach out to uson the screen easy hotline. we can guide you and helpyou find the services that you need,but it's really important. (patti cochrane)and kayle? (kayle mcmillen)yeah, i would echojane's comments as well. just it's betterto get screened

and get all of the information because when wecan detect it early, we can either preventit altogether or detect it early enough where there might bebetter treatment options. well, i want to thank you,ray, for coming to join metoday as co-host for this show. and i want to thank youboth for sharing your knowledge and expertise,

and certainly our previousguests on the show today. i think we've talkeda lot about cancer and the supports and services that are provided throughtrillium health partners and our community partnersas well. so thanks for joining our showtoday, and join us next time on "talk trillium:partnering for patients."