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Parksville mother’s cancer spread during chemotherapy wait

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A Parksville equestrian instructor whose cancer metastasized while she was waiting for chemotherapy worries late-stage patients like herself are being sidelined in an overwhelmed cancer-care system, especially on the Island.

Loni Atwood, 43, whose rare adrenal cancer was discovered during an emergency-room visit in April 2022, says that after surgery, she was twice advised to wait for preventive chemotherapy because of the supposed low risk of spread and high volume of cancer patients needing treatment.

“They rolled the dice with me,” said Atwood. “I think when you know you’ve got proven aggressive cancers, I don’t think that’s the right management strategy.”

In February of this year, while at the ER for a colonoscopy, Atwood learned the follow-up scan results on her file showed her lungs were littered with tumours, so much so that chemotherapy may be ineffective.

Atwood, a single self-employed mother of two teenage sons, Brandon, 19 and Garrett, 16, said she was heartbroken. “I thought: ‘There’s no way I’m leaving my kids, like this isn’t happening.’ It was too awful to be true.”

She said she trusted the system. “I felt like a number and that they were giving up on me.”

Atwood is one of a number of Island patients telling their stories in recent weeks of cancer-treatment waits that prompted them to head to the U.S. for treatment, or, in the case of one man, choose medical assistance in dying after an unbearable wait for chemotherapy for Stage 4 esophageal cancer.

Premier David Eby, at an unrelated news conference this week, called the stories “horrific”and said any wait times for cancer treatment are “unacceptable” for the patient, their families and for him.

Eby directed B.C. Heath Minister Adrian Dix and the B.C. Cancer agency to further address the problem.

Concern over radiation-therapy wait times spurred the province to offer eligible breast and prostate cancer patients waiting for radiation therapy the option of receiving treatment in Bellingham, Washington, all expenses paid.

“We want to reassure all B.C.ers we’re bringing every available resource to address their need to get this service within the clinical guidelines so that they can rest easy in what must be an incredibly difficult time,” said Eby.

Atwood’s adrenal cortical growth was removed on May 20, 2022 at Vancouver General Hospital. A pathology report came back in September, followed by a diagnosis of a rare type of adrenal gland cancer called adrenocortical carcinoma in November 2022.

Atwood says she was advised to delay IV chemotherapy until the results of the next scan. Those scan results, which she only received in February 2023 as a result of a visit to the hospital for a colonoscopy, showed the cancer had riddled her lungs and spread to her blood.

It was another two months, in April — a full year after she first went to the ER — that she met with a B.C. oncologist who said it was doubtful, based on the spread, that chemotherapy would yield the desired results. Nevertheless, she was started on chemo in May.

Dr. Kim Nguyen Chi, head of B.C. Cancer, said in a phone interview this week that human resources is the biggest challenge in the face of cases increasing at a rate of about three to five per cent a year. “We need to catch up,” he said.

The agency is also tracking whether there was an increase in late-stage cancers being diagnosed post-pandemic, he said.

While the goal is for everyone diagnosed with cancer to see an oncologist within four weeks of referral to B.C. Cancer, given the shortage of oncologists, patients “unfortunately” have to be prioritized by need at times, said Chi.

“People are prioritized and re-prioritized but it’s not something we want to do.”

A massive hiring effort is helping the system to meet the four-week benchmark, he said. About 27 radiation therapists and 61 oncologists — including radiation and medical oncologists as well as GPs trained in oncology and nurse practitioners who support oncology patients — have been hired, including about 10 oncologists on Vancouver Island, Chi said.

“Victoria has had a tremendous growth in oncologists,” said Chi, who says while it’s “phenomenal” that B.C. was able to recruit 61 oncologists so quickly, “more than that” are needed.

The impact of the new hires will become more apparent in the coming months, he said.

Chi said wait times for chemotherapy in Victoria are currently close to the benchmark, which is to have 90 per cent of people treated within two weeks of referral for chemotherapy. Wait times for chemotherapy are not public.

The large majority of people in Victoria are getting their chemotherapy within two weeks, said Chi. Because chemotherapy is often a final step in treatment — maybe following weeks and months of diagnostic tests, surgery and imaging — it can in some cases seem longer than benchmarks.

“The perception of the wait time may not necessarily be related to the actual getting the chemotherapy treatment, but it’s the totality of the wait time that they’re experiencing, which is an entire system problem, which of course needs to be fixed as well,” he said.

Chi said people with late-stage cancers deserve “the highest quality care as possible.”

“I am sorry that there is a perception that people are feeling sidelined because we certainly don’t want that to happen,” he said. “For the patients that are in the system, the vast majority are receiving their treatment on time, on schedule, as clinically needed and are getting great care.”

And while there are gaps in care, Chi said all parties involved are putting in tremendous effort to improve the system and are closing these gaps. “I think we will see change in this coming year,” he said

As for Atwood, her six sessions of chemotherapy ended in October, and she says the cancer has been contained and tumours have decreased.

She is privately paying for hyperthermia treatment, a method of heating body tissue to help kill cancer cells, via a naturopath and meanwhile continues to ride horses and teach.

“It’s really stressful because I’m supposed to be resting and balancing but I have to earn, I don’t know how else to do this,” she said.

Atwood will remain on the chemotherapy pill Mitotane, which includes side effects from nauseau to neuropathy, for the next 18 months in order to prolong her life. She’s been declined funding for an expensive drug via a phase 2 clinical trial.

“After that, there is no plan from B.C. Cancer — that’s it, that’s the end of the road for me,” said Atwood.

“There has to be something better than that. That’s why I’m not taking my foot off the gas.”

ceharnett@timescolonist.com

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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.

___

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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