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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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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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