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Dr. Janice Giesbrecht: a 'driving force' behind cancer care in Niagara retires – Niagara Health News, Updates & Publications – niagarahealth.on.ca

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We are Niagara Health is a series of stories that celebrates the incredible people working and volunteering in our organization and how they make a difference in the lives of patients and coworkers every day.

There’s a good chance Dr. Janice Giesbrecht isn’t sure of her plans today.

The Niagara Health oncologist, who worked tirelessly to improve access to cancer treatment in the region, retired June 30 after 40 years of practising medicine. But ask her what she has planned for this next chapter and Dr. Giesbrecht will tell you, “I don’t know what to do yet.”

She did know what to do when it came to reducing wait times for cancer treatment in Niagara, including bringing radiation therapy to the region in March 2013 when the Walker Family Cancer Centre (WFCC) opened at the St. Catharines Site.

Until then, cancer patients could receive chemotherapy locally but had to leave Niagara for radiation treatment.

“It was wonderful to provide comprehensive cancer care in Niagara,” Dr. Giesbrecht says. “Having this treatment closer to home helps patients have a better quality of life. The community deserved this.”

Dr. Giesbrecht started her career with Hotel Dieu Hospital (now Hotel Dieu Shaver Health and Rehabilitation Centre), which provided cancer care in Niagara until 2005 when the program was transferred to Niagara Health. She was one of three oncologists serving the region at the time, working with Dr. Brian Findlay and the late Dr. Martin Samosh to expand services beyond chemotherapy.

Dr. Giesbrecht was part of a regional effort to bring enhanced cancer care, including critical radiation therapy, to Niagara. She advocated for her patients, underscoring not only the need for a cancer centre to provide enhanced treatment but a state-of-the-art facility that would serve as a beacon for more doctors, specialists and healthcare practitioners. When it opened, the WFCC became a regional cancer care centre, working closely with the Juravinski Cancer Centre in Hamilton and Cancer Care Ontario.

“The transition to Niagara Health brought lots of changes and good things,” Dr. Giesbrecht says. “The growth in care has been tremendous. The new hospital and now another new hospital (planned for South Niagara) – it’s pretty amazing to be part of all that. I didn’t think I’d be doing these things.”

In addition to advocating and planning, she continued looking after her patients in her trademark way of extraordinary caring, which always included open and honest communication about prescribed treatments.

“During patients’ first visits, it’s very eye-opening because we don’t always think about what words we say,” Dr. Giesbrecht says. “For good or for bad, what we say stays with them. It was one patient who said I told them, ‘I know you don’t want to be here but we’re going to do this, this, and this. That made all the difference.’ Who knew?”

A woman sits at her desk with a computer showing a incidence rate chart for cancer

Dr. Janice Giesbrecht, who retired June 30, plans to do rounds one day a week starting in the winter.

In 2010, Dr. Giesbrecht, who got interested in cancer medicine as a graduate student doing research at Princess Margaret Hospital in Toronto, was appointed Niagara Health’s Chief Oncologist. The new hospital, which would become home to the WFCC and a “nimble, state-of-the-art, very advanced” cancer care program, opened three years later.

An instant impact

WFCC physicians and staff provided compassionate care to 12,000 patients the year it opened. That number rose to 30,000 a few years later as patients shifted their care from elsewhere or started new treatments in Niagara.

Today the WFCC provides specialized inpatient and outpatient cancer care services that include chemotherapy and immunotherapy, radiation, supportive care, clinical trails, a lung diagnostic assessment program and prostate diagnostic assessment program, and palliative care.

“Dr. Janice Giesbrecht was the driving force behind establishing and developing cancer care in Niagara and played a key role in establishing the Walker Family Cancer Centre as it exists today,” says Dr. Johan Viljoen, Niagara Health Chief of Staff. “She will be missed by all of her colleagues at NH, but we will always remember the example of professionalism and caring she set for us to follow.”

Cancer care at Niagara Health continues to advance. The WFCC is home to a new CT simulator that will positively impact survival rates and quality of life with extraordinarily precise radiation treatment thanks to state-of-the-art detector technology and artificial intelligence (AI) that provides better-quality 3D and 4D imaging.

Dr. Giesbrecht has continued championing cancer care in the community and showcasing the incredible work being done by Niagara Health in the years since the WFCC opened. She’s also been actively involved in important fundraising events for cancer care at the hospital, including the Big Move Cancer Ride and the Rankin Cancer Run, working closely with the Niagara Health Foundation.

“It certainly feels good to be part of these things but it’s never alone,” Dr. Giesbrecht notes. “It’s the team here that has always made the difference. Everyone is a member of the team.”

Today, there are 20 oncologists in Niagara, including Dr. Michael Levesque, who trained in Niagara and was appointed Chief of Oncology at WFCC in October 2020.

As she wrapped up her full-time tenure at Niagara Health, Dr. Giesbrecht reflected on how some of her patients have been in her care for 35 years. They may still see her from time to time. She plans to do rounds one day a week starting in the winter.

Other patients she hasn’t seen in years have reached out to wish her well and let her know how they’re doing. They’ve thanked her for listening when they were patients, for her compassion for their story and her ability to put their treatment in a context that made it easier to bear.

“It’s been incredibly rewarding to be on this journey a long time and through different episodes,” Dr. Giesbrecht says. “Not everyone has that in their work. It’s pretty amazing.”

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Saskatchewan warns of elevated monkeypox risk through 'anonymous sexual contact' – Niagara Falls Review

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REGINA – Saskatchewan’s health-care delivery agency is warning there’s an elevated risk of acquiring monkeypox through anonymous sexual contact, and it’s expanding vaccine eligibility to adults 18 years and older who are close contacts or deemed higher risk for exposure.

The chief medical officer of health told reporters during a news conference Saturday that monkeypox cases in the province remain low — so far only three have been confirmed.

But Dr. Saqib Shahab says if people meet the risk criteria and have concerns, they should call the province’s 811 HealthLine for advice on testing, as well as on obtaining a pre-exposure vaccination.

The Saskatchewan Health Authority issued a news release saying the warning about catching monkeypox through anonymous sexual contact is due to recent known cases.

It adds information reported to public health, related to travel into and out of province, has prompted the alert.

Shahab says Saskatchewan wants to do everything it can to prevent a surge in cases.

“I think with travel interactions throughout Canada in the summer, I think this risk was bound to change for us in Saskatchewan and that’s why we are now really opening up the vaccine, not just for post-exposure prophylaxis, but for pre-exposure as well, for the very targeted group that we’ve identified,” Shahab said at the news conference.

“Obviously we don’t want over-testing happening, but in the right context, I think it’s important to seek testing, exactly for the reason that we don’t want to miss cases.”

So far, he said there have been no cases in Saskatchewan where a history of exposure hasn’t been identified. Additional vaccine doses have been ordered now that the province has expanded eligibility, he noted.

Monkeypox, which comes from the same family of viruses that cause smallpox, has been endemic in parts of central and west Africa for decades and was not known to trigger large outbreaks beyond the continent until May.

It causes fever, headache, swollen lymph nodes and lethargy, followed by the development of a rash over a person’s body. It spreads through close, personal, often skin-to-skin contact, touching bodily fluids or lesions of a person who is sick with the disease or exposure to contaminated objects such as bed linens or clothing.

The Public Health Agency of Canada says the majority of domestic cases are among men who reported intimate sexual contact with other men. Having multiple sexual partners may increase one’s overall risk, but the agency says the risk of exposure is not exclusive to any group or setting.

The number of Canadian monkeypox cases surpassed 1,000 just this week, though there are early signs the virus may now be spreading at a slower rate.

This report by The Canadian Press was first published Aug. 13, 2022.

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Sask Health alerts public of elevated risk of acquiring monkeypox – Global News

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The Saskatchewan Health Authority is alerting the public of an elevated risk of acquiring monkeypox through anonymous sexual contact.

Recent known cases have been associated with this form of transmission, and information reported to public health related to travel in and out of the province has prompted the alert.

Read more:

18+ eligible for 2nd COVID-19 vaccine booster in Saskatchewan on Monday

“We’ve have been following the global monkeypox outbreak very closely for the last five months now,” said Dr. Saqib Shahab, the Chief Medical Health Officer for Saskatchewan.

“We think now there is a higher risk that we may see ongoing transmission in Saskatchewan.”

There are three confirmed cases of monkeypox in the province. Shahab said the cases so far have been from people exposed outside of Saskatchewan, however there are now people who have been exposed inside the province.

“We have evidence of exposures happening in Saskatchewan,” Shahab said. “In many cases through anonymous sexual contacts. This is very similar to what has been seen in other provinces in Canada and internationally.”

Monkeypox is a rare viral illness that causes fever, headache, swollen lymph nodes and lethargy, followed by the development of a rash over a person’s body. Monkeypox does not spread easily from person to person. It is spread through:

  • Close, personal, often skin-to-skin contact.
  • Touching bodily fluids or lesions of a person who is sick with the disease.
  • Exposure to contaminated objects such as bed linens or clothing.

Anyone who believes they have been exposed to monkeypox can contact Healthline 811 to determine if they are considered at risk or eligible for a vaccine.

Read more:

Saskatchewan child care fees going down 70% starting Sept. 1

Eligibility for the monkeypox vaccine has been expanded to adults 18 years and older who are close contacts or deemed higher risk for exposure. Referrals are available through 811.

“With travel, with interactions in summer, this risk was bound to change,” Shahab said. “Now we are really opening up the vaccine for not just post-exposure… but for pre-exposure as well with the groups we have identified.”

The province has ordered additional vaccines to help with both pre-exposure and post-exposure, and plan to order even more if the demand increases.

Shahab hopes with the increase in vaccines and awareness of the symptoms, transmission can stay low in the province.

“We are really hopeful both in Saskatchewan and Canada that through all these measures of raising awareness so people are aware of symptoms and the can isolate, seek testing and now seek pre exposure vaccines, we really hope we can control this outbreak,” he said.

If you have recently been in contact with an individual suspected or confirmed with monkeypox and develop fever or other symptoms of illness, you should call HealthLine 811 or consult a health-care provider immediately.


Click to play video: 'About 50% of monkeypox vaccine supply used, Canada passes 1,000 cases: Tam'



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About 50% of monkeypox vaccine supply used, Canada passes 1,000 cases: Tam


About 50% of monkeypox vaccine supply used, Canada passes 1,000 cases: Tam

© 2022 Global News, a division of Corus Entertainment Inc.

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Worse Vascular Outcomes Found in Patients With Asthma – AJMC.com Managed Markets Network

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Patients with symptoms of asthma, regardless of physiological confirmation, experienced worse vascular outcomes and greater cardiovascular risk, which may be due to short-acting beta agonist (SABA) use, according to the results of a recent study.

Individuals with a clinical history of asthma had lower endothelial function than healthy controls, regardless of whether participants had physiological confirmation of the disease.

Study results, which were published in Respiratory Medicine, also showed that that participants with asthma who regularly used short-acting beta agonist (SABA) medications had increased arterial stiffness than those who did not use SABA.

Researchers aimed to compare markers of cardiovascular risk, specifically endothelial function, arterial stiffness, and systemic inflammation, among those with confirmed asthma, unconfirmed asthma, and healthy controls. Researchers also aimed to investigate the effect of SABA use on these vascular outcomes.

This cross-sectional study included 26 patients with confirmed asthma, 15 patients with unconfirmed asthma, and 26 healthy controls all recruited from the Edmonton, Canada metropolitan area. All participants in the study were aged between 18 to 45 years and current nonsmokers.

Participants completed a pulmonary function test and evaluation for asthma. Physiological evidence of asthma was defined as a clinical history of symptoms such as recurrent wheezing, cough, and/or chest tightness. Physiological evidence also includes a reversibility in forced expiratory volume in 1 second (FEV1) of ≥12% and 200mL, a ≥20% reduction in FEV1 after a methacholine challenge, or a ≥10% reduction in FEV1 after an exercise challenge.

Participants were labeled with confirmed asthma if they had a clinical history and physiological evidence of asthma. Those labelled with unconfirmed asthma had a clinical history but no physiological evidence of asthma. Healthy controls had no evidence of asthma. Researchers compared endothelial function, arterial stiffness, and systemic inflammation between these three groups of participants.

Researchers assessed participants’ endothelial function as flow-mediated dilation (FMD) after 5 minutes of supra-systolic forearm occlusion distal to the imaging site. A 1% decreased in FMD correlates with a 7% increase in cardiovascular risk.

Participants’ arterial stiffness was assessed using pulse wave velocity (PWV). PWV was measured between the carotid and radial artery. A 1 m/s increased in PWV corresponds to about a 16% increase in cardiovascular risk.

Systematic inflammation was assessed by C-reactive protein (CRP) levels in serum after venous blood was collected from the participants. CRP levels have been linked with cardiovascular risk, even for those without underlying cardiovascular morbidity.

Endothelial function was significantly lower in both confirmed and unconfirmed asthma groups than compared to healthy controls. There was no significant difference in FMD between the confirmed and unconfirmed asthma groups.

There was no significant difference found in arterial stiffness and systemic inflammation among both asthma groups and the controls.

Participants with bot confirmed and unconfirmed asthma were grouped together and then split based on SABA use. SABA was used by 19 participants and not used by 22 participants in the last year. There was no significant difference between in endothelial function and systemic inflammation between these two groups. However, SABA users had a significantly higher arterial stiffness by an average of 1.5 m/s than those not using SABA.

Limitations of this study include the small sample size and the inability to account for seasonal fluctuations in asthma symptoms due to the cross-sectional design. Also, this study did not adjust for other variables that can impact vascular outcomes.

Reduced vascular function was seen in participants with asthma regardless of physiological confirmation of asthma, suggesting that the link between asthma and cardiovascular risk may be due to factors other than asthma pathophysiology and perhaps due to asthma symptomatology, the researchers noted. The researchers also noted that this study highlights the need for proper asthma management to avoid inappropriate SABA use in patients with unconfirmed physiological asthma.

Reference

Henry SL, Moore LE, Brotto AR, Rowland S, Fuhr D, Stickland MK. Systemic vascular health is comprised in both confirmed and unconfirmed asthma. Respir Med. 2022;200. doi:10.1016/j.rmed.2022.106932

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