Tag Archives: cancer

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Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.  She is now recovering from thoracic surgery and undergoing chemotherapy.

 

For years, I have proudly worn my swim club team T-shirt. The slogan on the front reads:

You don’t stop swimming because you get old,

You get old because you stop swimming!

In early January, as I was pulling into the parking lot for swim practice, the radio announcer said, “For your morning commute, the time is 6:15, and the temperature is -27.”

I wasn’t alone in the pool that morning – there were 15 of us, and another twenty at the later practice. As usual, we moaned to our coach about a kick-set that is too long, and groaned about too many 100 IMs. But the brief bantering is part of the culture, part of the fun, and the coach takes it with a smile. Four mornings a week, for 22 years, I have been going to the National Capital Region Y Masters Swim Practice to start my day. Some of the swimmers who founded the club 34 years ago are still swimming; others devotees have joined more recently. One is an octogenarian. ...continue reading

Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.  She is now recovering from thoracic surgery.

 

Several years ago I was at a café on Bank Street in Ottawa with two friends - Sarah, my long-time neighbour, and Amy, a breast cancer survivor, a ‘Pink Friend’. Our conversation drifted to memories of New Year’s Eve at the Millennium. Sarah reminisced about her New Year’s wedding, at which I was a guest. She remembered glowing candles in the church, twinkling fairy lights, her husband’s tuxedo, and her ball gown. Amy paused for a moment, and then contributed, “I remember that night; that’s the night my hair fell out!” Amy stated the bare fact, leaving the emotional content for me to paint for myself.

The re-telling of this story always produces laughter, although I only tell it in sensitive circumstances. But I remember that conversation for many reasons. I am not a philosopher, and thousands before me have poured their energy into the question of random universal events. But I do wonder if the Universe has a Poker Dealer who randomly flips down cards for the day: today – joy for you, and despair for you! ...continue reading

Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.
 

I soon discovered that, "You have highly suspicious nodules”, also means, “You will have many appointments!”

"Don’t make any travel plans for the next 3 – 6 months," said my GP as he put my name into The System. The phone began to ring - MRI, PET scan, Nuclear Medicine, biopsy - to a total of ten schedules for scans, biopsies and doctors. My calendar became peppered with appointments.

One appointment was to see a Respiratory Specialist at the Cancer Assessment Centre at the General Campus of the Ottawa Hospital. I often walk or bike past the hospital, and have visited patients from time-to-time. But it has been nearly 22 years since I was a patient there, with a broken leg. Since then, I have grown to have confidence in my health. But, there I was, on the elevator, approaching the Cancer Assessment Centre.

I was trying to be very casual and nonchalant, pretending that I was going for a coffee at Bridgehead. After all, I didn’t really have cancer; I only had a ‘suspicion’, and Denial was a very comfortable place to be! But when I exited the elevator and saw the Big Lettering, CANCER ASSESSMENT CENTRE, some confidence slipped and my nonchalant attitude wobbled. ...continue reading

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Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.
 

In 1985, when I was diagnosed with breast cancer, the disease was private and hushed. Other than a campaign for SBE (Self Breast Exam) there was no publicity or awareness. Feeling ashamed and embarrassed, and thinking that I had somehow caused this, I kept my diagnosis secret and silent from all but a very few close friends. After my treatment, my fears and feelings were repressed and locked, and I got on with my life, my family, my career and my health.

Twelve years later, I was one of the founding members of the , and suddenly I was surrounded by other survivors and the steadily growing ‘Pink Ribbon Culture’! I found kindred sisters in these women, and my deeply secreted feelings found an outlet and an expression. My silence was broken, and relief came flooding in.

This year, when I finally accepted the ‘highly suspicious for Lung Cancer' report, I realized that I would not, and could not, be secret and silent about my disease. Learning from experience, I was concerned for my mental health as much as for my physical health ...continue reading

Guest blogger, Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.
 

So, the CT report found nodules that are ‘highly suspicious for lung cancer”. Now what am I supposed to do with that news? How am I supposed to react? How am I supposed to feel? There is no rehearsal for this, I thought. No class to take, no website to consult. I realized that I was alone in figuring out how to deal with this.

I needed several days to digest this information, to accept it, to find the courage to make it real by saying it out loud. Eventually, I was able to speak the dreaded words, to tell my two adult children. Because we are a very pragmatic family, and not given to drama, they were very calm, and declared their support. I also think, because they had been through Breast Cancer with me 29 years ago as children, there was a certain familiarity for them, and they had faith in a positive outcome.

I realized that I had to learn from them, and that the best way to handle this was to carry on with my normal life and my daily routine. In my daily life, I am a Swimmer. ...continue reading

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Guest blogger, Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete.
 

I enjoy a healthy, active life style and activities with my family and friends. In my fourteen years of retirement, I have climbed Kilimanjaro, hiked the Inca Trail and the West Coast Trail, cycled in many countries, and won medals at Provincial and National Masters’ swimming championships.

I have survived Breast Cancer, (age 41), a broken leg (age 49) and Melanoma (age 52).

On June 8, 2014, I celebrated my 70th birthday with a swim across Meech Lake in Gatineau Park, Quebec, with my daughter and friends. Five days later, June 13, I woke up with a sore throat and laryngitis. My third cancer story begins there. ...continue reading

Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

The was impressive. Thousands on the Ride to Conquer Cancer bike ride in Toronto reflects both the current popularity of cycling and people's willingness to support cancer charities. According to the photo caption, it had raised over $119 million; 20 million dollars this year alone. An immense achievement. Cycling has of course, been long linked with cancer fundraising through Lance Armstrong, long time champion for cancer sufferers who gave so many people hope and inspiration and raised millions for his cancer charity. Sadly, his doping admission destroyed his personal reputation and popularity, did untold damage to his cancer work, and disappointed millions of cancer patients.

Doping seems inextricably linked with cycling and will be once again in Canadian consciousness with the release on Friday June 13th of “”, a biographical film about . Its timely release will reprise the pressure on athletes to perform, the role of parents and coaches, and our own expectations of top athletes. The doping story in cycling doesn’t seem to have dimmed public interest however and, as the begins in a few weeks, cycling fans will look forward once again to watching the pain, suffering, and glory of the heroes and villains of the cycling world and still hoping to believe.

Cycling is more popular than ever, in spite of the seemingly relentless adverse publicity—even if we allow ourselves a quiet smile at the modern cycling phenomenon, the (middle-aged men in lycra). Doctors are not immune and, if coffee room chat is an accurate measure, may be particularly vulnerable to the MAMIL phenomenon. It is easy to forget the risks, however, when thinking of the considerable health benefits. To give this a medical context, do read this based on the crash injuring Sydney Medical School Professor when a 4x4 vehicle ploughed into their group of seven cyclists.

What can we do? We need to keep in perspective the public health benefits of physical activity and the wider benefits of this cycling movement. Serious road crashes are relatively rare, but they are preventable. There is no medical solution, its about the environment, the law, and society. Doctors may not have a direct part to play in changing government transport policy, the legal system, nor road design but they can give leadership, highlight the risk of injury and advocate for change.

Domhnall MacAuley is an associate editor on CMAJ, currently at the The Cancer and Primary Care Research International Network () conference in Winnipeg

Cancer is now a major primary care research area, which is reflected in the increasing importance and impact of the Ca-PRI conference. (UK) described it as a "boutique conference", but it won’t be for much longer. Cancer has long been the preserve of specialists focused mostly on treatment, and epidemiologists analysing data principally from registries. Sick patients and sad stories tend to attract greatest sympathy, research interest, and funding. Cancer diagnostic research in primary care is difficult, the symptoms are often completely undifferentiated and it’s hard to pick up the clues in a context where most patients don’t have cancer.

Late cancer diagnosis concerns physicians and patients alike but measuring delay in diagnosis is not easy. We need to use agreed definitions and (UK) in her systematic review of studies on ovarian and colorectal cancer, identified considerable variation within in the broad categories of patient interval, primary care interval and diagnostic interval, definitions used in the . For future research to be meaningful, we need to use agreed definitions.

(UK) pointed out a huge knowledge gap where delay in diagnosis is concerned: there are time lines for cellular growth, and there are time lines for symptom development but we don’t know how they are connected. These differ between cancers and cancer site and, as (Norway) reminded us, more aggressive cancers are easier to diagnose.

(UK) presented data showing improvements in speed of diagnosis of cancer in primary care in the UK in response to the National Awareness and Early Diagnosis Initiative. There were some small but significant improvements in practices that used at least one of the following: significant event analysis, practice audit, risk assessment and a practice plan. This against a background of considerable systems-change. Similarly, (Denmark) showed improvement with standardised cancer patient pathways. But, many patients don’t quite fit within the criteria relevant to the UK two week rule or the Danish pathway—many tend to have serious and vague symptoms that are not necessarily indicative of cancer. Greg Rubin (UK) suggested, in the subsequent discussion, that we may need to create diagnostic centres for those who don’t quite fit. And, as pointed out by a patients’ representative in the audience, it is also difficult for patients to know when to go to the doctor.

Looking at the wider aspect of preventive care, (Toronto), in her keynote address, told us about the , a cluster randomised factorial controlled trial that enrolled 800 patients across Canada in primary care. The trial was conducted in good practices but there was still room for improvement. The core intervention was that patients were given a preventive prescription, and it was unique in that it addressed chronic diseases with a facilitator already in the practices. It was effective and, interestingly, it was also effective in patients who had who had mental health problem—an often hard-to-reach group. While the economic evaluation identified costs, the practices also gained incentive payments. Now that trial has been the team are looking at dissemination and "adaption for adoption". The programme has already been taken up in the North West Territories.

A particularly successful conference innovation was a session including ten 3-minute presentations to the full conference audience. No introduction, no moderation, just a time keeper. Great presentations across the spectrum of cancer care from sophisticated diagnostic models in developing countries to hugely contrasting diagnostic challenges with extraordinary delay in the developing world. And some fascinating insights. There is major projected shortfall in oncologists in the US as a result of increasing cancer survivorship. And, in a systematic review of cancer mobile apps, one of the authors' major tasks was excluding those apps identified in the search strategy, that were created for astrology!

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