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Thursday, October 23, 2014

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Cancer survivors’ needs not being met: Dr. Marla

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MONTREAL — The psychological and social needs of Canadian cancer patients who have completed treatment are not being adequately addressed by the public health-care system, according to one of this country’s highest profile survivors of the disease, Dr. Marla Shapiro.

Dr. Marla Shapiro at Morris Goodman Cancer Research Centre forum.  [Howard Kay photo]

Shapiro, best known for her role as CTV’s medical consultant, returned to her native city and alma mater to speak May 16 at a public forum, sponsored by the Rosalind and Morris Goodman Cancer Research Centre of McGill University.

In 2004, Shapiro was diagnosed with an invasive form of breast cancer. Following chemotherapy, she opted to undergo a double mastectomy and hysterectomy.

Although she didn’t comment directly on her physical health today, she appeared to be vibrant. She juggles a busy life of family, TV work, writing, teaching, and maintaining a family medicine practice in Toronto.

“I was naïve. Although I had been a doctor for more than 25 years [at the time of her diagnosis] and had provided primary care to a large number of cancer patients, I had absolutely no idea what it was going to be like,” she told a capacity audience of 600 at the Mount Royal Centre.

She wasn’t only referring to the physical effects, but to “the feeling of abandonment” after the acute phase of her cancer was over.

The notion of “cancer survivorship” is still not well developed in Canada, she said, and the quality of life of former patients may suffer.

Forty per cent of Canadian women and 45 per cent of men will get cancer, and, in five years, cancer will be the leading cause of death, edging out cardiovascular disease, she said.

With this rising incidence and better treatment outcomes, the number of cancer survivors (or ‘thrivers,’ as she calls herself) is growing.

There are 11 million cancers survivors in North America, or 3.5 per cent of the population, Shapiro pointed out, and a third of them are under 65 years of age.

They also frequently have lasting or delayed physical effects, often a result of chemotherapy’s toxicity. One of them, which has just recently become recognized, is “brain fog.”

Shapiro has experienced memory loss. She can’t recall people’s names, for example, like she once did.

Cancer can also have long-term economic consequences; many ex-patients do not return to work, she added.

Cancer affects the sufferer’s relatives as well, and they become, in a sense, survivors, too, whose needs are also not being met, she continued.

“After my last chemo, I thought ‘what now?’ Who is going to watch over me, when I am suddenly out of the system?” Shapiro said.

She was fortunate to have been well supported by a husband, three children and a wide circle of friends and colleagues, but there was still a void.

Shapiro is a member of the Canadian Partnership Against Cancer, an independent organization established four years ago with federal government funding, that is working on a national cancer strategy from prevention to improving the quality of life of survivors.

Cancer has led Shapiro to reassess her priorities. Being a doctor was her first love and she had believed “what I do is who I am.” Today, she strives for more balance, including finding more time for family and herself.

Shapiro, a very attractive woman, was frank about what the loss of her hair meant to her and her family, especially her then preteen son, who was frightened by the change in her appearance.

“I could not believe what I was seeing in the mirror…I cried for hours,” she recalled. Now, she has no qualms about showing photos of herself hairless (a latex allergy meant should could not wear a traditional wig).

When she went on TV without a wig it was a breakthrough; she received many thanks from viewers.

Shapiro said she still sometimes “get overwhelmed by fear,” after all, she continues to treat cancer patients, and some of them die. The McGill Cancer Centre, established in 1978 through a bequest from Mortimer B. Davis and originally headed by Dr. Phil Gold, was renamed in 2008 in honour of its major benefactors, the Goodmans.

At a pre-reception for patrons, two other well-known cancer survivors, Montreal Alouettes quarterback Anthony Calvillo and his wife Alexia, presented themselves as two people who have benefited from the research and care McGill provides.

Alexia was diagnosed with non-Hodgkins lymphoma in 2007; a lesion was discovered on Anthony’s thyroid gland last December.

 

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