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Diagnosed at 39, B.C. breast cancer survivor pushes for lower screening age – North Island Gazette

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Sara Johnston likely had breast cancer for two to three years before it was diagnosed.

She discovered it herself on a winter day in 2021. Just home from a trip to the gym, Johnston was undressing to get in the shower when she caught a glimpse of herself in the mirror and noticed something different: a dimple on the side of her right breast. Probing the area with her hand, she felt a large, hard lump.

Just 39 years old at the time, the Lower Mainland mother had never had a mammogram. In B.C., the breast cancer screening exam isn’t offered to women until they’re at least 40. Health Canada doesn’t recommend the test until age 50.

Johnston had also never been taught how to do a self-exam, but she knew something was wrong. Without a family physician, she waited at a walk-in clinic to have a doctor refer her for a mammogram. Another six weeks passed before she was able to be seen for an exam.

“It was a long and very, very stressful, very, very dark time for me.”

In April 2021, she was diagnosed with Stage 3 breast cancer. Had she waited until her 40th birthday to get a routine mammogram, Johnston said it’s likely it would have been Stage 4 – the most advanced form of cancer with only 32 per cent of patients living for five more years, according to the Canadian Cancer Society.

“The reality of that is quite frightening to think about.”

Now two-and-a-half years later, Johnston has been through eight rounds of chemotherapy, a double mastectomy and 25 rounds of radiation. She said she can’t help but wonder how things would have been different if mammograms were offered to younger women and if her cancer had been caught earlier on.

If it were up to her, screenings would begin as early as in a person’s 20s. Her push to see the age lowered comes amid a national conversation on the issue.

Sara Johnston was 39 years old when she was diagnosed with breast cancer in April 2021. She discovered the cancer herself because in B.C. screening mammograms aren’t available to women until they are 40 or older. (Photo courtesy of Sara Johnston)

READ ALSO: B.C. woman who beat breast cancer twice advocates for body positivity on Instagram

Change to national guidelines under review

The Canadian Task Force on Preventative Health Care is set to update its breast cancer screening guidelines this fall and may change the recommended screening age from 50 to 40. The guidelines have long relied upon 50 as the starting age because that’s when the majority of breast cancer cases begin to occur.

According to the latest numbers from Statistics Canada, 86.2 per cent of the 26,175 women diagnosed with breast cancer in 2017 were aged 50 and older. The number of cases that occur in younger women is not insignificant, however. In that same year, 3,345 women aged 49 and younger were handed the same life-changing news.

Although less common, men can get breast cancer too. In 2017, 215 men were diagnosed with the disease across Canada.

In B.C., the number of younger women being diagnosed was enough to convince health officials that mammograms should be offered beginning at age 40. Even with that, dozens of women aged 39 and younger are told they have breast cancer in B.C. every year.

So why aren’t routine mammograms offered to all women regardless of age? Experts say it all comes down to a risk-benefit ratio.

Dr. Charlotte Yong-Hing, the medical director of breast screening at BC Cancer, said there are two main harms associated with screening in younger women.

First is the amount of radiation given off during a mammogram. This though, Yong-Hing said, is fairly minor given the radiation people encounter in their day-to-day lives. For instance, a person would be exposed to the same level of radiation during a round trip flight from Vancouver to Toronto as they would during a mammogram, Yong-Hing said. Still, radiation is known to be more harmful to younger people because their body tissues are still growing.

The second potential harm is the anxiety that screening can cause. A small percent of women who undergo a mammogram will be called back for further testing if the initial results aren’t clear, and Yong-Hing said having to wait to be sure of their outcome can be frightening. She added that further testing can be more common for younger women because their breast tissue tends to be denser, which makes screening more difficult.

Dr. Paula Gordon, a radiology professor at the University of British Columbia and breast cancer researcher, said the women she’s spoken with don’t always agree with the second risk, though.

“Women are horrified at how condescending and patronizing that is,” she said.

A third and highly uncommon risk is that women are treated for a cancer that wouldn’t ultimately have killed them.

For the health care system, testing younger women can also prove to be expensive. Studies show the price of a mammogram that catches breast cancer early on is far cheaper than treating things in an advanced stage, but if mammograms are simply giving people the all-clear, the costs can add up quickly.

Neither Gordon nor Yong-Hing said they think the screening age should be lowered below 40, but they said it’s important for younger women to discuss whether they may be at a higher risk of developing breast cancer with their primary care provider. Gordon said women should also be performing self-exams to get familiar with their breast texture, so they can tell if something changes. Doctors can order patients regular mammograms before they turn 40 if they agree there are concerns.

And while provinces have jurisdiction over health care, both Gordon and Yong-Hing said it would be an important move for Health Canada to lower the recommended screening age, as well. Having national guidelines that differ from provincial ones can cause confusion for family doctors and patients and dissuade women in their 40s from getting checked. As it is in B.C., Gordon said only about a quarter of women in their 40s get mammograms as recommended.

A September poll by Angus Reid and Breast Cancer Canada found 89 per cent of respondents believe the age should be dropped to 40 as well. A large majority also said Canada should be gathering race-based data on cancer screening rates.

For Johnston, screening at age 40 doesn’t go far enough. It wasn’t sufficient to catch her cancer and she knows it will inevitably delay diagnosis for others too.

She offers the same advice to women that a breast cancer patient gave her when she was first diagnosed: “Don’t take no for an answer and never let a doctor tell you that you are too young.”

READ ALSO: Revolutionizing breast cancer surgery: B.C. hospital adopts innovative technology

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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