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Cancer survivors face dilemma over banned breast implants linked to rare lymphoma – CBC.ca

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Dona Murphy was finally feeling relieved. Eight years after being diagnosed with breast cancer and having a mastectomy, her oncologist declared her cancer-free.

Then in November, she received a couriered letter from the hospital where she had her surgery, delivering some shocking news: The breast implant used during her reconstruction was now banned by Health Canada.

Last May, Health Canada pulled a type of textured breast implant off the market, following a joint investigation by CBC News, Radio-Canada, the Toronto Star and the Washington-based International Consortium of Investigative Journalists.

The product — specifically macro-textured Biocell implants, made by Allergan — has been linked to a rare form of lymphoma known as breast-implant-associated anaplastic large cell lymphoma, or BIA-ALCL.

Health Canada says it’s a “serious but rare type of lymphoma,” with the agency pegging the risk of BIA-ALCL at one in 3,565 (0.03%) for the Biocell implants. In Canada, more than 30 women have been diagnosed with BIA-ALCL.

Dona Murphy reads a letter from the hospital where she underwent a mastectomy after being diagnosed with breast cancer; it informed her that the implant used in the surgery has since been banned by Health Canada. (CBC)

Regulators in both Canada and the U.S. don’t recommend that women with the implants have them removed because the cancer is so rare. But they say women should check with their doctor if they have any symptoms, which include pain and swelling.

Paying for peace of mind?

While Murphy has no symptoms from her textured implant, she wants the device removed from her body. But the Ontario government has said that if the implant doesn’t affect her health, it’s up to her to pay to have it taken out.

“I can’t imagine why any woman would want to have it in them if there’s a potential — no matter how small — of causing cancer,” she said.

Patricia Mailman has two textured implants, put in after undergoing a double mastectomy in Halifax as part of her cancer treatment. When she found out about the ban, she too immediately wanted her implants replaced with non-textured ones.

She doesn’t have $10,000 needed to pay a plastic surgeon to have the explant done, she said, so she’s on a waiting list to have the Nova Scotia government pay, because the implants are causing her pain.

“We didn’t ask for the cancer in the first place, so we didn’t really ask for this either,” Mailman said.

Patricia Mailman had textured implants put in years ago after a double mastectomy. (CBC)

Textured breast implants were used in thousands of procedures in Canada beginning in 2006, with the pebble-like surface intended to act as a kind of Velcro, preventing the implant from sliding on the chest well.

The medical community started linking some breast implants to cancer in 2011.

BIA-ALCL is not breast cancer, but rather lymphoma that grows in the scar tissue surrounding the breast. It grows slowly and can usually be successfully treated by surgically removing the implants.

Risks involved with removal

Dr. Michael Weinberg, a plastic surgeon in Toronto, estimates he’s implanted about 100 pairs of textured implants. Now because of the ban, he says some of his former patients are scared, worried and asking for his advice.

“They are very emotional and I completely understand how they feel really badly,” he said.

Weinberg cautions that removing implants is a significant operation, both in terms of medical risks, as well as cosmetically.

The risks of implant removal include:

  • Infection.
  • Bleeding.
  • Scarring.

“You can’t guarantee when the implant is under the muscle that you’ll be able to take the whole capsule out,” said Weinberg, or the surrounding scar tissue that can stick to the ribs.

Still, for some women, the thought of possibly developing cancer is a worse risk.

Murphy is scheduled to have her implant removed in March, paying for it out of her own pocket. But, she points out, that’s something a lot of women can’t afford to do.

Cancer survivors are faced with difficult decisions months after textured implants were banned because of a rare cancer risk. The women must decide if the risks and costs of having implants removed outweigh the risk of leaving them in. 2:19

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Polio virus found in New York City wastewater, suggesting local transmission – CBC News

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Health officials identified the virus that causes polio in New York City’s wastewater, suggesting local transmission of the virus, state authorities said on Friday, urging unvaccinated New Yorkers to get vaccinated.

“The NYC Heath Department and the New York State Department of Health have identified poliovirus in sewage in NYC, 
suggesting local transmission of the virus,” the city’s health department said in a statement on Friday.

“Polio can lead to paralysis and even death. We urge unvaccinated New Yorkers to get vaccinated now.”

The identification comes weeks after a case of polio in an adult was made public on July 21 in Rockland County, marking the nation’s first confirmed case in nearly 10 years.

Earlier this month, health officials said the virus was found in wastewater in the New York City suburb a month before health officials there announced the Rockland County case.

The U.S. Centers for Disease Control and Prevention (CDC) said at the time that it was not clear whether the virus was actively spreading in New York or elsewhere in the United States.

Evidence of virus in London

There is no cure for polio, which can cause irreversible paralysis in some cases, but it can be prevented by a vaccine made available in 1955.

New York officials have said they are opening vaccine clinics to help unvaccinated residents get their shots. 

Inactivated polio vaccine (IPV) is the only polio vaccine that has been given in the United States since 2000, according to the CDC. It is given by shot in the leg or arm, depending on the patient’s age.

On Wednesday, British health authorities announced they will offer a polio booster dose to children aged one to nine in London, after finding evidence the virus has been spreading in multiple regions of the capital. Britain’s Health Security Agency said polio virus samples were found in sewage water from eight boroughs of London, but there were no confirmed infections.

Polio is often asymptomatic and people can transmit the virus even when they do not appear sick. But it can produce 
mild, flu-like symptoms that can take as long as 30 days to appear, officials said.

It can strike at any age but the majority of those affected are children aged three and younger. 

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Monkeypox: gov’t has no plans to call public health emergency – CTV News

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OTTAWA –

Canada’s chief public health officer Dr. Theresa Tam says there are no plans at the moment to declare monkeypox a public health emergency.

While the World Health Organization and the United States have both recently done so, Tam said there is little benefit to declaring a federal public health emergency in Canada, because of the structure of regional and provincial public health authorities.

She said a federal emergency declaration would involve the Emergencies Act — which hasn’t even been invoked to address the nearly two-and-a-half-year COVID-19 pandemic in Canada. Tam said thus far, Canada has already been able to mobilize vaccines, therapeutics, and funding to tackle monkeypox.

Tam also said local and provincial authorities have more flexibility, and have been able to respond to the rise in monkeypox cases. Local and provincial authorities could also decide to declare the virus a public health emergency at those levels, as many did with COVID-19.

“To date our discussions have focused on testing, working with community organizations to raise awareness on ways to limit spread the virus, and deployment of the Imvamune vaccine and therapeutics,” Tam said. “As the global monkeypox outbreak continues to be a serious concern, focusing efforts on the impacted communities in Canada and worldwide, including with vaccinations, we have an opportunity to contain the spread.”

To day, approximately 99,000 doses of Imvamune have been deployed to the provinces and territories, and more than 50,000 people have been vaccinated, Tam said.

Canada’s Deputy Chief Public Health Officer Dr. Howard Njoo said the approach continues to be vaccinating higher risk communities first, and there are currently enough doses to do so.

Tam says there have been approximately 31,000 cases of monkeypox reported globally, with 1,059 in Canada, mostly in Ontario.

While cases of the virus first started popping up in Quebec, Ontario has since surpassed it in its number of infections.

To date, there have been 28 hospitalizations — two in intensive care — from monkeypox in Canada, and no deaths. Tam said it’s too soon to tell whether the number of cases has plateaued in Canada.

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COVID-19 vaccine side-effects less likely in pregnant people, says study – CP24

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Pregnant people experienced lower rates of side-effects from the COVID-19 vaccine than their counterparts who weren’t pregnant, a new Canadian study suggests.

The Canadian National Vaccine Safety Network collected data from 191,360 vaccinated women aged 15 to 49 between December 2020 and November 2021. The researchers asked participants to report “significant health events” that were serious enough to make them miss school or work, seek medical attention or disrupt their routines.

Of 5,597 pregnant participants, four per cent reported a significant health event within seven days of receiving their first dose of an mRNA vaccine, and 7.3 per cent of 3,108 pregnant respondents said they had side-effects from their second shots.

Among those who weren’t pregnant, 6.3 per cent of 174,765 respondents reported a significant health event after dose one, and 11.3 per cent of 10,254 participants said they felt sick after dose two.

“One of the things that was really striking was that the rates of these events happening in pregnant people was lower than the rates happening in non-pregnant people at the same age,” said Manish Sadarangani, lead author of the paper published in the Lancet Infectious Diseases journal on Thursday. “It’s very reassuring around the safety of COVID vaccines and pregnancy.”

Studies on other vaccines have found that pregnant people experience side-effects at roughly the same rate as those who aren’t pregnant or even slightly higher, said Sadarangani, an investigator at BC Children’s Hospital.

More research is needed to understand why this might not be the case for mRNA COVID-19 vaccines, Sadarangani said, but he suspects the physical transformation of pregnancy could be a factor.

“There’s a lot of hormonal and immunological and physiological changes happening during pregnancy, and some of them we understand, some of them we don’t,” he said. “I’m presuming that some of these changes are leading to these lower rates.”

Thursday’s study found that rates of serious health events after getting a COVID-19 vaccine, such as hospitalization, were similarly rare across all groups.

There was no significant difference in the rates of miscarriage or stillbirth among participants who were vaccinated and those who weren’t.

Researchers are conducting a followup survey to see if participants experienced any side-effects six months after their COVID-19 shots, Sadarangani said.

Pregnant people are at increased risk of COVID-19 complications, he said, so it’s all the more important that researchers continue to study how vaccination affects them and their babies.

“All of the data we have really highlight the safety of all of these vaccines in pregnancy,” said Sadarangani. “Ultimately, this is the best way to protect this group of people in our population.”

This report by The Canadian Press was first published Aug. 12, 2022.

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