What is cervical cancer?

The cervix connects the uterus (womb) to the vagina. Cervical cancer is almost always caused by human papillomavirus (HPV), which is passed from one person to another through sexual contact. There are over 100 strains of HPV, but only some can cause damage to the cervix that may lead to cancer.

Getting an HPV infection is very common. For most people, it will go away on its own without causing any harm. In some cases, however, a cancer-causing HPV virus can stay around for several years and cause more serious damage. This is why cervical cancer is very rare under the age of 25.

HPV vaccination is important because it can prevent many cases of cancer-causing HPV infections from developing. HPV vaccination does not prevent all cases, which is why screening is still important.

What will be changing around cervical cancer screening?

Ontario recently moved away from Pap tests as the first line of cervical cancer screening, to instead testing for the most common types of HPV viruses that can cause cervical cancer. HPV testing is better because it can identify those people who have a higher chance of already having or developing a cervical pre-cancer or cancer.

How is HPV testing done?

At this time, the most accurate way to detect an HPV infection with abnormal cervical cell changes is to take a sample directly from the cervix. Patients will still need to have a speculum exam at their doctor’s office, so the physical experience will feel the same as having a Pap. Patients will receive a copy of their results by mail. If positive for HPV, they will be advised of the necessary next steps. If negative, they will be told when they are next due for cervical screening.

A negative HPV test has been shown to be very good at correctly identifying people who do not have a cervical pre-cancer or cancer, and who will not develop a cervical cancer in the next five years.

If the presence of HPV is found, it doesn’t necessarily mean the patient will develop cervical cancer. Further tests will be done on positive HPV samples to look for pre-cancerous cells. Based on the HPV result and presence or type of pre-cancerous cells found, additional procedures such as colposcopy may be needed to look at the cervix more closely. For others, more frequent testing to make sure the HPV clears, or no new pre-cancer cells develop, may be all that is needed.

What is colposcopy?

Colposcopy is a procedure that closely examines the vagina, vulva and cervix using a special microscope. Sunnybrook is home to the largest colposcopy clinic in Ontario based on the number of patients seen. The multi-disciplinary team has specific training in detecting and managing genital cancers and pre-cancers.

At what age and how often should screening be done?

The other big change is around timing: screening will start at age 25. It’s recommended screening be done every five years because HPV infections need to be present for a long time before possibly developing into cancer. This change is based on science and people should feel safe. People who have a hard time fighting viruses due to a weakened immune system should be screened every three years.

Most people can stop screening between ages 65 to 69 if they have undergone regular cervical cancer screening during their lifetime. Your health-care provider can let you know what’s best for you.

Does it matter if I’ve ever been sexually active?

The HPV virus is spread through sexual contact with the genitals, which can include contact with the hands, mouth or genitals. This is why screening for HPV isn’t necessary unless a person has ever been sexually active.

Who specifically should be screened?

According to Ontario Health, get screened if you:

• are at least 25 years old
• are a woman, Two-Spirit person, transmasculine person or nonbinary person with a cervix
• have ever had sexual contact with another person
• do not have symptoms, like different bleeding or discharge (clear or yellow fluid) from the vagina

Ontario Health adds that you should still get screened if you:

• have had the HPV vaccine
• feel healthy
• have been through menopause
• have not had any family members with cervical cancer
• have had sexual contact with only one person
• have had the same sexual partner for a long time
• have not had sexual contact in a long time
• are in a same-sex relationship

How can I book screening?

There are a few ways. You can call your family doctor, nurse practitioner or midwife to book screening, or call Health811 to find a nearby screening clinic. Ontario Health also has a live chat option.

Where can I get more information?

To learn more about lowering your risk of cervical cancer, visit www.mycanceriq.ca.

Click here to read more about these new screening guidelines.

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Does sugar feed cancer?

No. Sugar is a carbohydrate and all cells in the body use carbohydrates for energy. If you avoid carbohydrates, that could actually lead to undesired weight loss which is associated with worse outcomes. While it’s always a good idea to focus on eating a variety of nutritious foods, there is no dietary change that can “starve” cancer cells.

Is it ok to eat soy (isoflavones)?

Yes, even for people with hormone-sensitive cancers like breast and prostate cancer. Furthermore, studies suggest that up to three servings of soy foods – like one cup of soy milk or one-third cup of tofu – per day may be protective against colorectal, prostate and breast cancer. It is not recommended to take soy supplements, since they have much higher levels of isoflavones.

Should I avoid eating red meat?

No, but remember moderation. Red meats like beef, pork and lamb provide protein and important vitamins and minerals that are part of a balanced diet. If you choose to eat red meat, limit it to three servings a week; higher amounts are linked to an increased risk of colorectal cancer. When it comes to processed meats like bacon and deli meats, try to avoid them or only eat small amounts.

Is it safe to eat dairy?

Yes. Dairy provides calories, protein, calcium and vitamin D, which are all important for a healthy diet. Canadian farmers are not allowed to use growth hormones in dairy cows, and all milk is tested to make sure it’s free of antibiotics.

Are there any benefits to opting for organic produce?

Eating fruits, vegetables and other plant-based foods, whether they are farmed organically or traditionally, is the best way to reduce your risk of cancer through food. It’s recommended that patients choose produce they enjoy the taste of and that fits their budget. That can include choosing fruits and vegetables that are canned, fresh or frozen.

Should I be taking vitamin/mineral supplements?

No, unless your health-care team recommends you to do so. The body uses vitamins and minerals best when a variety of vegetables, fruits, whole grains and protein foods are included in the diet.

Should all patients undergoing cancer treatment change their diet?

No, unless there are issues with weight loss or symptoms that make it difficult to eat. Following Canada’s Food Guide (food-guide.canada.ca) is a good starting point, and supports a balanced diet containing lots of vegetables, fruits, whole grains and adequate sources of protein. Talk to your health-care team if you have any questions. The Odette Cancer Centre also has nutrition resources for additional support. (Sunnybrook.ca/cancernutrition)

The post Dispelling the most common myths around nutrition and cancer appeared first on Your Health Matters.

Drinking enough fluids keeps you hydrated and prevents dehydration. Fluids help your body:

• Digest food and carry nutrients throughout your body
• Get rid of waste and flush out medications (including chemotherapy)
• Keep a normal blood pressure and body temperature
• Protect your organs and joints

Unless told otherwise by your doctor, people with and without cancer should aim for 9 to 12 cups of fluid each day.

It’s important to talk about what to drink because the type of fluids you choose can help you meet your protein and calorie needs. Fluids range in their nutrition content. Some fluids, like water, have no calories or protein, whereas others, like milk or soy milk, have lots. Choosing the right fluids can help you get the right amount of nutrition, depending on your needs.

When you have cancer, getting enough fluid, protein, and calories is an important part of your treatment and healing. If you have lost weight, have problems eating, or have questions about your nutrition, please speak with a registered dietitian. (Patients at the Odette Cancer Centre can stop by or call the Nutrition Resource centre to book an appointment.)

As a registered dietitian in the patient education program at Sunnybrook’s Odette Cancer Centre, I get many questions about what to drink. I answer some of the most common ones below.

As a person with cancer, why is what I drink especially important?

If you have cancer, choosing the right fluids is one of the easiest ways to add more protein and calories to your diet. Side effects from cancer and treatment can make it hard to eat enough. If you find swallowing painful or have a poor appetite, nutritious fluids like soups and smoothies pack a lot of nutrition into each sip and go down easier than a meal. This is important, because getting enough protein and calories can help you:

• Maintain your weight and muscle mass
• Keep your strength and energy
• Cope with treatment-related side effects
• Reduce your risk of infection
• Heal and recover faster

Swapping out low-nutrient fluids for high-nutrient alternatives can make a big difference. If you drink 1 cup of water in the morning but switch to 1 cup of milk, that’s an extra 9 grams of protein and 130 calories added to your day!

Are there any types of fluids I should drink lots of?

If you have lost weight, have problems eating, or need more protein in your diet, drink lots of fluids that are high in protein and calories. Choosing higher fat dairy products, like homogenized milk or cream, can also help you get more calories in each sip.

Examples of high protein and high calorie fluids include:

• Cow, soy, or pea milk
• Smoothies with added protein
• Soups made with cream, meat, fish, poultry, or legumes (dried beans, peas, or lentils)
• Yogurt drinks
• Nutrition supplement drinks like Boost, Ensure, Scandishake, or generic store brands

If your weight is stable, you have a good appetite, and you are eating enough protein, choose low-calorie fluids more often, like:

• Water
• Tea and coffee
• Broth

Are there any types of fluids that should be avoided?

If you have side effects from treatment, avoiding certain fluids might help. If you have diarrhea, for example, sugary drinks like juice or pop can make it worse. If you feel nauseous, high-fat fluids like cream soups might not be appealing. If you have pain when swallowing, avoid fluids with acidic or spicy ingredients, like lemon or cayenne pepper. Speak to a dietitian for more tips on how to manage side effects that are impacting your eating or drinking.

It’s also recommended to limit your caffeine intake to 400 mg each day, to prevent side effects like difficulty sleeping, headaches, and nervousness. That is equal to about 3 cups of coffee.

Finally, the World Cancer Research Fund and American Institute for Cancer Research recommends avoiding alcohol before and after a cancer diagnosis. If you do choose to drink alcohol, drink in moderation – that’s one drink per day for women and no more than two drinks per day for men. One drink is 12 oz. of beer, 5 oz. of wine, or 1.5 oz. of spirits. 

I’m having trouble eating…can what I drink help?

Absolutely! Some people, especially those with head and neck cancer, often only drink fluids throughout their treatment. It is possible to meet all of your nutrition needs this way, as long as you choose your fluids wisely. Smoothies and soups with added protein and nutrition supplement drinks can easily replace a meal or snack.

I’m having trouble even drinking – what should I do?

Most cancer centres have a registered dietitian who can help. Tell your care team about your difficulty with eating and drinking, and ask how to meet with the dietitian.

In the meantime, if you’re having trouble drinking because you don’t feel hungry, try taking small sips throughout the day and choose only high protein, high calorie fluids. Stir in protein or skim milk powder to add even more nutrition. Focus on fluids that you like, even if that means drinking milkshakes every day!

If fluids just don’t taste good, experiment with new flavours. Try soups with beans and lentils if meat tastes metallic. Add citrus, like lemon or orange, to smoothies to wake up your taste buds (unless you have mouth sores). If drinks taste too sweet, dilute with water or plain milk, or add a bit of salt.

If swallowing fluids is painful, avoid acidic and spicy flavours, drink fluids at room temperature, and puree and strain soups and smoothies to remove rough edges.

If the pain continues, speak to your doctor or a pharmacist. They may be able to prescribe a medication that can help.

The post Drink for your health: what should I drink when I have cancer? appeared first on Your Health Matters.

When you have cancer, there are a few reasons why you may not feel hungry. These include:

• cancer itself
• the side effects of cancer treatment
• feeling depressed or anxious
• being put off by the smells of cooking and food
• effects of medications
• digestive upset like constipation or diarrhea
• feelings of pain and fatigue

We are going to look at a few ways to help make sure that you are getting enough food and nutrition, and how to best manage cancer-related loss of appetite.

It is very important to make sure that you continue to eat and drink often to try to keep your weight the same. This will help keep you strong enough for cancer treatments. Since it can be difficult to eat when you aren’t hungry, here are three key ways to make sure you are getting enough food and nutrition into your body:

1. Getting enough protein
2. Getting enough calories
3. Making every bite and every sip count

Getting Enough Protein

Our bodies need protein to help with healing, especially when going through cancer treatments. To make sure you are getting enough protein, try to have some at each meal and snack.

Include foods like meat (chicken, beef, pork, etc), fish, eggs, tofu, nuts and seeds, dairy products, and legumes (beans, lentils, and peas).

Getting Enough Calories

One of the best ways to make sure you are getting enough nutrition is to add in extra calories. Eating small snacks or meals frequently, choosing fluids that are higher calorie and protein drink options, and choosing higher fat foods or adding fat to foods that you eat can help.

This can be done by drizzling oil over soup, putting butter or margarine on toast before adding another topping, choosing high fat dairy and adding it to congee, oatmeal, rice pudding, mashed potatoes, and making sure if having fruit or vegetables that they are dressed up with something (e.g. butter or gravy on steamed vegetables, dip fruit into high fat yogurt or nut butter).

Make Every Bite and Sip Count

With the cancer treatment, sometimes people find they are too tired to make foods and eating large meals can be challenging. Eating more frequent meals and having easy-to-eat snacks on hand are two ways to maximize how much you are eating throughout the day.

Some grab-and-go snack ideas are: prepackaged yogurts or puddings, cheese and crackers, hummus and vegetables or crackers, fruits, trail mix, nuts, mini cans of tuna or salmon.

If eating foods is difficult, another way to make sure you are getting all the calories and protein you need is to drink them. By having enough fluids, you are also keeping yourself hydrated. Remember that anything that melts into a fluid at room temperature counts too.

Some energy fluids are: milk, chocolate milk, soy milk, nutritional supplements, ice cream, popsicles, and cream-based soups.

If you have nutrition questions, speak to your nurse or oncologist who can connect you with more help. At Odette Cancer Centre, pop into the Nutrition Resource Centre to see the nutrition technician or book an appointment with a registered dietitian.

If you are experiencing other signs or symptoms, make sure to tell your nurse or doctor.

Written by Katie Brunke and Maxine Seider, dietetic interns in the Odette Cancer Centre Nutrition Program.

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In a recent Cancer Care Ontario survey on patient education Your Learning Matters, 76% of people with cancer from across the province reported changes in sexual function, with 73% reporting changes in relationship with their partner. Anecdotally, people said that they were not getting the information they needed; they were completely unprepared.

If there was material about sexual “health” and how to handle what might be coming in the information package I was handed that first day, I never saw it. I suspect it might be lumped in with a pile of side effects like mouth sores, nausea and fatigue — part of a list. But that kind of list is never that helpful. I had a large tumour in the wall of my vagina — yes that sex place the vagina. But no one was talking about that, least of all me.

Cancer changes everything. When its dust settles (only to be kicked up again, and again) for those of us lucky enough to have it settle at all, we, our loved ones and our potential future loved ones, are left with the shocking, burnt, shrunken, dry, scary, messy, numb, unresponsive, confusing remnants to gather and make something out of. Sex is one of them.

The icky details are different across the many forms of cancer and treatments. What might happen? What might it feel like? How long might it last? Is what I’m feeling normal? Whose job is it to tell us all that?

We’ve all waited hours and hours for appointments. How much longer might we wait if five or ten or 15-minute discussions about sex get tagged on? Surely our oncologists have a thousand other things and a thousand other people to worry about. But it needs to be flagged and we need to be pointed to something or someone that can tell us what’s going on. It’s often embarrassing and easier in the moment to be left unsaid, but normalizing the topic of sexuality is a great place to start. Please ask me how I’m doing down there.

Occasionally the topic of sex, sex-ish or sex bits did come up in a clinical setting. One radiation oncologist, in the way of describing how it would feel after radiating my vagina said Sometimes the ladies walk around with no underwear. Just short of clear. She might also have said the words painful mess, which is a little more illuminating.

When my doctor (kind but uncomfortably eager to pass the discussion of my vagina over to someone else) or nurse tells me about dilators: It’s kind of like when you get your ears pierced, if you don’t put something in it, it can close up. Start with the small ones then move to the larger ones. I’ve got to believe that they’re thinking we might one day want to put something other than a dilator up there.

A friend told me she tried using a vaginal dilator a couple of times then just stopped focusing on that area entirely. Just easier that way. “Maybe I should have asked more about it? Kept pushing the issue.” What she was saying was that maybe it was her fault for not pursuing the conversation. Our discussion brought it all back. “I think I’ll try the dilator again,” she said.

Another friend talked about having her libido disappear, like someone just switched it off. You can’t be in survival mode and want sex at the same time. Sex, she said, falls into the category of things I’ve lost, like the assumption that I’m healthy, that my body will work for me.

She was part of a small study on sex and sexuality in women with gynaecological cancers, that aimed to examine whether talking about it with others, helped. She said it was only looking back on the experience that she realized the value. It broke the isolation. It also made her feel grateful to be in a loving long-term relationship. The single women who were trying to imagine any kind of dating life, were struggling. How do you put yourself out there, what do you have to offer? Mostly the group provided a space for them to grieve the sexual people they had been, and begin to envision the new ones they would become. There are creative options to the old missionary position. Once the tremendous anxiety of cancer subsides somewhat, libido can find its way back. Best to be ready.

Issues related to sex and cancer are influenced by a range of complex factors including age, gender, sexuality, and type of cancer. No one pamphlet can cover it all. It would be way too heavy. Stand-alone topic-based resources would go a long way to meet the range of needs. The issues and concerns for young people, often tied to fertility, are going to be different. The issues for males and females and transgender people will all vary. And given the cancer stats for folks over 50, it doesn’t help that the media, Hollywood, and the advertising world (except of course for Viagra ads and the odd Bridges of Madison County) will have us believe that people that age aren’t having sex anymore anyway, so what’s to discuss?

Asking the question in a survey is a beginning. And like with many polls and surveys, the findings probably under-represent the problem. Expecting folks to just strike up the conversation over chemo is misguided. Let’s get over our collective squeamishness. Let’s make the space to do it. Let’s talk about sex.

Aviva’s advice

For clinicians/staff:

• Cancer is a weird world. Let patients know from the outset that no question or observation about anything they’re experiencing is too personal or awkward to be raised. There may not be an answer for everything, but acknowledging the experiences and letting people know they are not alone really helps.

• Normalize the discussion of sex, sexual dysfunction, intimate relationships and cancer.

• Raise the issue of sexual health regularly and as a matter of course. Don’t make the patient or their loved one bring it up first.

• Assume that sex and sexuality is important to all patients. Let them tell you they don’t need to discuss it.

• Be mindful that your patients may identify as lesbian, gay, bisexual or transgender. That can add an additional layer to an already difficult discussion. Don’t make assumptions.

• Know where to point your patients and their caregivers for more information.

For patients/caregivers:

• You are not alone.

• Being concerned about sex, sexual dysfunction and what the future holds is valid and normal.

• If your doctor can’t answer your questions, ask them who can. No questions are too weird or embarrassing. It’s your body. You need to know.

• It’s within your rights to get the information that meets your specific needs and circumstances.

Have a question related to sexual health and cancer? Please feel free to email patienteducation@sunnybrook.ca. We have information available on the following topics:

• Radiation therapy and sexual health for men
• Radiation therapy and sexual health for women
• Vaginal Dilators
• Erections and sexual functioning for men
• Sexual functioning for women
• Early menopause
• LGBT cancer information

No question is too embarrassing for us. Your email is confidential.

The post Let’s talk about sex — a cancer patient’s perspective appeared first on Your Health Matters.

To tell or not to tell

Parents may struggle with the idea of telling their children that mom or dad has cancer. It seems to go against our nature as parents to share upsetting news and usually parents feel reluctant to share the diagnosis because they feel protective about making their children sad and worried. Research and clinical experience tells us children benefit from honest, age-appropriate information about a parents’ cancer. When left without, children fill in the blanks, make assumptions and might not be able to ask questions.

Tips for telling

• Talk to a friend, family member or counsellor about telling your children. This helps you process your feelings about it before sharing the news with the children and helps you feel more in control.
• Set aside a time when things are quiet for the whole family to be together and when you are not feeling rushed.
• Share the diagnosis simply and honestly, using the word cancer.
• Let them know what to expect in the days or weeks to come and how it might affect them.
• Encourage them to ask any questions

Supporting them

• Let their school know and anyone of significance (e.g. coach). Let your child know who has been told so they can reach out when they need to. and so that those people can understand any emotional or behavioural changes they see in your child.
• Allow each child to process the information in their own way. Some children have many questions and require details while others may simply have one big question and need time alone to sort out the answer.
• Remember that you are the expert on your own child. Parents often report that although their child showed signs of the cancer impacting their lives, the child reacted in a way that was in keeping with their personality and coping style. If you see a sign that concerns you, reach out for help from professionals at the Odette Cancer Centre or a community support organization like Wellspring Cancer Support Foundation.
• Help them maintain their routine as much as possible and when this is not possible, try to give them a say in how things change, who will help etc. in order to help them feel more in control.

Supporting you so you can support them

• Remember, children do better when their parents are managing their own emotional needs.
• Parenting through cancer, though challenging, is possible and families can even look back with pride about their coping and support for one another.
• If you are a family coping with cancer, know that there is help and support. You don’t have to do it alone.

Resources available:

Patient and Family Support Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre. This is a free program for patients and their families with services to help you before, during and after your treatment. Visit our Patient & Family Support offices (T-Wing ground floor TG-230, Odette Cancer Centre) 8:00am to 5:00pm 416-480-4623

Wellspring Cancer Support Foundation has launched new programming specifically for parents with cancer and their children. The new Family Programming is being offered at Wellspring Westerkirk House, located on the grounds of Sunnybrook Hospital campus. Wellspring’s Family Programming is designed to support the entire family through this challenging and uncertain time. The program is comprised of three components: A Family Counsellor, Children’s and Parents’ Program and an online guide, When A Parent Has Cancer.

Wellspring is a network of community-based support centres offering programs and services that meet the emotional, social, practical and restorative needs of people living with cancer and those who care for them. Wellspring programs are offered free of charge. www.wellspring.ca

Wellspring Westerkirk House at Sunnybrook
105 Wellness Way
Toronto, ON
M4N 3M5
416-480-4440

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Fear, anger, loneliness are all common, and it may be difficult to talk about these feelings and keep communication open between family and loved ones. It might be difficult to open up and ask questions, but remember that your healthcare team is here to help you with all issues that are important to you, including sexual activity and intimacy.

For general information about sexual health and cancer, plenty of information is available online and at the Patient Education and Research Learning Centre (PEARL) located in the Odette Cancer Centre.

Asking questions about sex

Think about some specific sex-based questions that might be important to you. Men who have partners may be concerned that cancer can be passed on during sex, or that their partner could be harmed by the drugs they are taking or radiation therapy they are receiving. Your team can answer your questions or find the information you need so that you can continue with sexual activity and intimacy during your treatments. Your healthcare team can prepare you for any physical, mental or emotional changes  you may experience after treatment.

Maintaining sexual function

All men, including those with regular sex partners and those who don’t have a regular partner, may be concerned about their ability to have sex and be intimate in the future. It is very important to discuss these concerns with your healthcare team so you can maintain sexual function.

The “use it or lose it” saying is  true with sexual function. So having regular erections, whether you are sexually active or not, is important for the future ability to engage in penetrative intercourse. Self stimulation (masturbation) can be useful to maintain blood flow and penile health and this is often recommended after pelvic surgery. If sex becomes painful at any time after surgery or treatments, you can ask your healthcare team what to do.

Self-care strategies such as Kegel exercises can help to maintain pelvic muscle tone that is important for bladder control. Smoking and obesity are linked to erectile issues, so this may be a good time to think about quitting, starting an exercise regimen, or considering your diet. There is support available at the Odette Cancer Centre to help you with all of these strategies, so feel free to ask your healthcare team to connect you with the appropriate resource.

Intimacy: not just sexual

Intimacy is important to our health and it can include sexual activities. It can also involve any other activity that helps you to feel close to others and close to yourself. Holding hands; hugging; attending community, spiritual, and even sporting events with others can bring you close and make you feel connected to others.

Being able to carry on with those sexual and non-sexual activities that connect us to others and to ourselves can be very important to men with cancer. Write down your questions and start the conversations with your health care team; there is a world of resources out there to help you.

Resources

To read:

• Sexuality and Cancer, Canadian Cancer Society
• Sexual Health and Radiation Therapy: Guide for Men (can be found at the Odette Cancer Centre)

To watch:

• Managing cancer fatigue 

Peer support :

• Prostate Cancer Canada Network
• Wellspring – Exercise classes and support programs for cancer patients
• Wellspring Downtown Toronto has cancer support groups specifically for gay men

For more information please feel free to email us at patienteducation@sunnybrook.ca

The post Sexual health, intimacy & cancer: a guide for men appeared first on Your Health Matters.

There is an abundance of information out there about clinical trials. In the Patient Education and Resource Learning centre (PEARL) at the Odette Cancer Centre you can pick up a free copy of “Clinical Trials, A guide for people with cancer” written by the Canadian Cancer Society, which contains a lot of useful and relevant general information related to clinical trials.

The guide includes the following info:

What is a clinical trial?
A clinical trial is a type of research study. Clinical trials help find new methods for diagnosing, treating, managing and preventing cancer.

Why are clinical trials important?
Clinical trials show us what does and doesn’t work in medicine. They answer important scientific questions and lead to future research. Through past clinical trials, doctors have developed new methods of surgery that are easier on the patient, found new and more efficient drugs for specific types of cancer and found treatments that have fewer side effects.

Joining a clinical trial
You may be thinking about taking part in a clinical trial or your doctor may have asked you about participating in one. There are many reasons why you might choose to take part. Many people like the idea that they’re helping other with cancer, both now and in the future.

If you’re thinking of participating in a clinical trial, talk to your doctor or someone on your healthcare team. They can answer your questions and help find out whether you’re eligible to enter a specific trial. Before deciding whether a clinical trial is an option for you or someone you care about, it’s important to learn all you can about the trial

What you need to know
Each clinical trial has its own protocol, criteria for eligibility, benefits and risks. It is important that you understand each of these before you decide to enroll in a trial. Discuss the details of the clinical trial with your healthcare team.

Giving informed consent
You will be asked to give informed consent before taking part in a clinical trial. You will receive a printed informed consent form that outlines key facts about the study in plain language. The form should include details about the treatment, tests and any potential benefits, risks or side effects of the treatment. It should explain anything else that you may have to do. If you agree to take part in the study, you will be asked to sign the consent form and you will be given a copy of it.

• You understand that the trial is a scientific experiment, and there may be risks to your health.
• You have been told why the trial is being done, the drugs you might be given, the number of clinic visits and the kinds of lab tests required.
• You have all the information you need to decide whether to take part in the trial.

The informed consent process continues throughout the study. You will be told about new information that develops during your clinical trial, such as new risks. You may be asked to sign a new consent from as things develop during the study.

Even after you have given your consent, you can leave the trial at any time. You are in control and have the right to leave a clinical trial at any time. You do not need to give a reason.

Other links of interest about clinical trials
Clinical Trials at Sunnybrook:

https://sunnybrook.ca/research/content/?page=sri-ct-sunny

Ontario Cancer Trials: http://www.ontario.canadiancancertrials.ca/

Canadian Cancer Trials: www.canadiancancertrials.ca

National Cancer Institute: www.nci.nih.gov/clinicaltrials/

Cancer View: http://www.cancerview.ca

Clinical Trials Registry: https://clinicaltrials.gov/ct/gui

Odette Cancer Centre Clinical Research Programme Blog Working Group

The post Clinical Trials and your cancer appeared first on Your Health Matters.

How do you balance your own health and wellbeing with the needs of your loved ones with cancer?

Tracey Rapier, a Registered Dietitian at the Odette Cancer Centre, has put together a list of health tips for caregivers to keep energy levels up and eat a healthy diet.

Stay Hydrated

• Dehydration can cause a variety of problems from simple thirst to low blood pressure and increased heart rate. At extremes dehydration can affect your kidneys which can be dangerous.
• Water or other calorie free drinks like herbal tea are the best choices if you are trying stay hydrated throughout the day. The eight cups of water a day rule is great but the amount of fluids you must drink per day depends on many factors including how much you exercise. For more information on how much fluid you need to drink a day visit EatRight Ontario.

Eat enough fruits and vegetables

• Fruits and vegetables have been shown to boost immune function, which will help prevent you from getting sick so you can continue to provide the care your loved ones need
• Canada Food Guide recommends 7-10 servings of vegetables and fruit per day. A serving is the equivalent of a piece of fruit that fits the palm of your hand like a medium apple or banana or a cup of diced vegetables.

For ideas about the different types of fruits and vegetables you should eat, check out the Canada Food Guide.

Keep your energy levels up with quick and simple meals and snacks

Although it may seem obvious the most important part of good nutrition is eating a well balanced diet. There are lots of quick meals and snacks you can make in minutes or in advance that will pack a great nutritional punch.   Here are some ideas for keeping healthy:

• Breakfast: Smoothie with frozen pre-cut fruit, plain greek yogurt, a few tablespoons of ground flax seed and water, milk or soy milk as a base.
• Snack: Plain Yogurt, fruit and a few tablespoons of ground flax, chia seeds or hemp hearts
• Lunch: Hummus with whole wheat pita and raw pre-cut veggies for dipping
• Snack: A handful of almonds with fresh fruit
• Dinner: A few sliced boiled eggs (cooked ahead), whole grain toast and sliced tomato or a vegetarian chili     

Manage stress and avoid overeating

According to EatRight Ontario, “Studies have shown that stress can cause chemical reactions in the body that either increase or decrease appetite (the desire to eat).”

To avoid overeating due to an increased desire to eat:

• Keep healthy snacks handy like fruit, veggies, whole grain crackers or popcorn.
• Be active. Exercise can make you feel better and less stressed.
• Talk it out. Chat with a trusted person (eg. a friend or family member) and ask for help with tasks.
• Cut down on caffeine. Coffee, tea, chocolate, energy drinks and pop all have caffeine which can disturb sleep and make stress worse. Instead try water, herbal tea, milk, decaffeinated coffee or fruit juice.

Portion size matters

• Carry healthy meals and snacks with you when you are out and about and make sure to eat at regular times so you don’t eat too much too often
• Eat when you feel hunger begin and stop when you are full.  This will help your body get the energy it needs without overeating.
• If you are eating on the go choose wisely by avoiding high fat, fried or greasy foods and eat snacks that are low in sugar and fat.

Bottom Line

At the end of the day good nutrition is about staying hydrated and eating a balanced diet. This will help you as a caregiver stay healthy and energetic while providing the care your loved one needs and while keeping you healthy!

The post Nutrition for cancer caregivers appeared first on Your Health Matters.

Is anxiety normal?

Anxiety is a normal part of life. It is like an early warning system for life challenges. At certain points these feelings may get worse. Most people feel better after days or weeks and do not suffer from an anxiety disorder.

What can cause anxiety?

Anxiety or nervousness can be caused by things like:

• Waiting for test results
• Being told that you have cancer
• Having cancer treatments
• Having side effects from treatment
• Cancer treatments not working

Different people will experience anxiety differently. Anxiety can get better or worse at different times and can be a side effect of chemotherapy, hormonal therapies, steroids and pain medications.

What are the symptoms of anxiety?

• If you have anxiety you may feel tense, worried, irritable, uneasy or fearful and panicked
• You may have trouble sleeping or have lots of nightmares
• You may feel restless or agitated
• You may have upset stomach, diarrhea, increased sweating, nausea and vomiting, restlessness, muscle tension and headaches
• You may have obsessive thinking and/or ritualistic behaviors that take up significant amount of time (eg. hand washing or checking)

How do you know if you have acute anxiety or if you have an anxiety disorder?

An anxiety disorder is different from anxiety. An anxiety disorder is diagnosed when symptoms cause severe distress that lasts for weeks or more. People who have anxiety disorders may find it difficult to function on a day to day basis, make decisions, concentrate and be organized. They can also experience sudden feelings of fear and anxiety with physical symptoms like racing heart rate and shortness of breath which are known as panic attacks.

What can be done to help your anxiety?

There are many things you can do to help with your anxiety. Some of these include:

• Talk with someone you trust
• Write down your thoughts or talk with other people who are experiencing something similar
• Eat a healthy diet
• Sleep is essential, make sure your getting enough of it
• Exercise
• Try and steer clear of alcohol and caffeinated drinks
• Spend time with people who make you happy
• Try relaxation techniques or complementary therapies such as acupuncture, guided imagery, massage, meditation and yoga

What can be done to treat your anxiety?

There are numerous ways to treat your anxiety. The best thing to do is talk to a doctor who can tell you about the best treatment for you anxiety. Some of the different ways anxiety is treated include:

• Behavioral therapy
• Counseling (talking to someone about your concerns)
• Medications (such as sedatives and or anti-depressants)

Bottom Line

Anxiety is a normal experience that many people go through during cancer treatment. If your anxiety gets worse talk to your healthcare team. They can help you find someone to talk to or give you medicine that can help.

Compiled by Giovanni Poppenpoel for Patient and Family Education, Odette Cancer Centre. Additional resources on anxiety can be found at the Patient Education and Research Learning Centre (PEARL) in T wing, first floor, Odette Cancer Centre or by emailing patienteducation@sunnybrook.ca or calling 416-480-4534.

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