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Cancer: Getting Beyond is its own challenge

Cecilia Nasmith

By Cecilia Nasmith, Northumberland Today

CECILIA NASMITH Northumberland Today
Dr. Ralph George (second from right) enjoys meeting up again with Northumberland Hills Hospital's three surgeons — Dr. Andrew Stratford (left), Dr. Alison Tilley and Dr. Kaes Al-Ali — at this week's Beyond Breast Cancer event at the hospital. Dr. George participated in the training and education of all three surgeons.

CECILIA NASMITH Northumberland Today Dr. Ralph George (second from right) enjoys meeting up again with Northumberland Hills Hospital's three surgeons — Dr. Andrew Stratford (left), Dr. Alison Tilley and Dr. Kaes Al-Ali — at this week's Beyond Breast Cancer event at the hospital. Dr. George participated in the training and education of all three surgeons.

COBOURG -- As intricate a journey as fighting breast cancer may be, getting beyond that experience is increasingly being recognized as a condition in itself.

That was the message of Dr. Ralph George, an illustrious physician and scholar who participated in the training and education of all three surgeons at Northumberland Hills Hospital -- and who was one of two keynote speakers at the hospital for this week for the Beyond Breast Cancer event.

The presentation in the second-floor education centre was just part of the evening, with displays and representatives from more than a dozen other organizations -- the Survivor Thrivers, the Haliburton Kawartha Pine Ridge District Health Unit, the Central East Regional Cancer Centre and the Port Hope Northumberland Health Centre, for example -- as well as key departments within the hospital.

One of the event's key organizers, Dr. Kaes Al-Ali, introduced the man he referred to as a mentor and dear friend to a full room.

"I will be speaking in downtown Toronto tomorrow night, and we will be lucky if we get 40 people out," Dr. George remarked.

The doctor shared good news and bad news on the breast-cancer front, and the good news is extraordinary -- any woman presenting with breast cancer today has a 99% chance of being alive five years from now.

A combination of today's excellent diagnostic tools (which result in more early diagnoses) and evolving medical care (which permits personal targeted courses of treatment) have paid off. Today, an estimated 250,000 Canadian women are breast-cancer survivors.

"It's great they are alive, but we can't forget about them because the treatment of breast cancer causes women other problems," he said.

"I's something people can never completely 100% leave behind. We all have to remember that -- family members, spouses, physicians, the medical team.

"This is a new field -- the field of survivorship," Dr. George stated.

For one thing, it can be associated with extremely intense emotions that accompany the joy of survival -- concerns for other family members, fear over the small but very real chance of cancer rearing its head again, even survivor guilt.

Perhaps you sat beside a chemo patient who is no longer there, he said.

"Soldiers get that. Accident victims get that. Cancer patients experience that same thing."

And beyond emotions, there are very real physical risks that a course of cancer treatments may leave a patient more vulnerable to.

  • Sexual problems (such as loss of libido and hormonal mood swings) and reduced fertility can threaten the closest relationships in one's life.
  • Heart disease and bone-density problems are more likely for these people.
  • Other kinds of cancer are also more likely to occur.

"¢ Cognitive problems can develop (affecting how well you remember and how quickly you can select from among options), as can lymphedema (swelling and fibrosis).

These are the reasons a patient must never let up on whatever post-cancer regimen of treatments and check-ups has been prescribed. If any of these conditions is present, knowing about them as soon as possible can help a patient get on top of them.

"These aren't problems that happen to most people. But by looking for them, we can treat them effectively and help others live life completely," Dr. George said.

He also hopes these patients will do the right things to live their own lives in the healthiest manner possible, with good diet, plenty of exercise and no smoking.

"Smoking increases the risk of a second malignancy. Smoking sucks the calcium out of your bones," he warned.

Another need is the support of friends and family. For whatever reason, he said, it has been observed that a woman who has friends and family has a better survival rate than a woman alone.

"These people have very unique medical and social needs. They are very real, and require constant care," he said.

Dr. George was followed by St. Mary Secondary School teacher and breast-cancer survivor Marjolaine Trottier, who said her new heroes are her husband Mark and their children Jacob (age eight) and Mia (age six).

Trottier considered herself an independent, self-confident, self-sufficient woman, but this image was shaken in February 2016 when she found a lump in her right breast.

"It just didn't feel right," she recalled.

Trusting her instincts, she instantly consulted her family doctor. A week later, between her classes, she ducked out for a mammogram. After the radiologist read the scan, she was booked for an ultrasound within 30 minutes.

"I was starting to realize something was wrong," she said.

"The news came two weeks later. It was March break, I was at the cottage. I remember exactly where I was standing and exactly what I was looking at. I remember the doctor's exact words."

From that point on, Trottier felt numb. She chalks it up to survival mode, an attempt to separate her true self from her sick body.

She and her husband had a cry in the basement at the cottage. Then, that night, she made a list of everything she had to do to achieve her two ultimate goals -- to get rid of the cancer as soon as possible and to reduce the chances of any recurrence.

This included demanding both breasts be removed, a decision her husband supported. And as soon as she felt they were ready, she showed the scars to the children.

"Mama, it looks like when the sun goes to bed," Jacob remarked.

Mia looked stricken, almost like it was happening to her. Recently, however, she said, "You know that no-breast thing? It really makes you look a lot less chubbier."

She purchased the breast forms and the wig. They sit still unopened in her closet, as she found the courage (as she put it) to go natural.

Trottier threw a big party last November, when she completed her treatment. Though more than 100 attended, she said it was maybe one-tenth of the people who helped her in big ways and small ones.

And for the post-treatment period, she developed three strategies -- volunteer, find a new gym and see a psychologist.

Trottier is well aware each person's cancer journey is unique. Some breast-cancer diagnoses are far more severe than hers, some courses of treatment far more onerous. But for herself, she said, "already the struggle, the pain, the fear and the severity of what happened to me has started to evaporate, leaving space for the good things like love, compassion, kindness, true happiness. I feel privileged I am in the process of getting stronger.

"I can tell you I did not do this alone. There's a community out there ready to take on that role," she said.

"It was not natural for me to ask for help at first, but the first step is ours to make -- we need to tell them we are in need. When I reached out, it made me feel better 100% of the time."