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Well-oiled cancer care 'machine' gives Hamilton man quality of life – Hamilton Health Sciences

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Danny Prosic has undergone more treatments than most cancer patients due to his complex medical issues. He’s currently undergoing immunotherapy and doing very well.

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Danny Prosic repaired equipment for a tool-making company until a leg circulation disorder forced him to stop working.

But that wasn’t the only serious health issue to plague the Hamilton man, who went on to develop life-threatening conditions including liver cancer, a heart blockage requiring quadruple bypass surgery, and most recently a cancerous tumor on his spine.

Spotlight on Danny Prosic, liver cancer patient

“The human body is like a machine, but it’s far more intricate,” says Prosic, 63. “And machines don’t have feelings. It’s really hard living with such serious, ongoing health issues and I’m grateful for the way I’ve been treated by the doctors, nurses and staff at Hamilton Health Sciences (HHS). Everyone has been very kind and caring. I wouldn’t be here today if it wasn’t for them.”

Prosic receives cancer care at HHS’ Juravinski Hospital and Cancer Centre (JHCC). Earlier this year he had surgery to remove the tumor on his spine, at the base of his neck. This was followed by radiation therapy to kill or damage remaining cancer cells so they can’t reproduce. He’s considered palliative, meaning his cancer is too advanced to be cured. Instead, the goal is to continue knocking back the cancer with treatment so Prosic can live as long as possible with a good quality of life. He’s currently undergoing immunotherapy, which ramps up the immune system to keep the disease at bay.

“I have lots of patients, like Danny, who are surviving years rather than months.” — Dr. Brandon Meyers, medical oncologist

The neck tumor was a secondary cancer stemming from an earlier liver cancer diagnosis. Prosic wasn’t eligible for a transplant due to his history of poor circulation to his legs and heart. Instead, he received treatments including surgery, a specialized and intensive type of radiation therapy called stereotactic body radiosurgery (SBRT), and transarterial chemoembolization (TACE) – where blood supply to liver tumors is blocked and chemotherapy is administered directly to tumors.

“Danny’s had a lot of therapies compared to most cancer patients,” says his medical oncologist, Dr. Brandon Meyers. “He responded to these treatments extremely well.”

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Life-changing cancer care

JHCC is the only hospital in the region where patients can be treated for all forms of cancer, and is a designated leader in the provincial cancer system in a number of highly specialized cancers. Its staff and doctors support more than 26,000 patients with cancer each year.

Liver cancer falls under the category of hepato-pancreato-biliary (HPB) cancers, along with pancreas, gall bladder and bile duct cancer. HPB cancers are serious and complex with high mortality rates. They typically require a range of treatments.

At JHCC, doctors and staff are organized into disease-site teams based on areas Illuminight 2022: Donate today. ShineALightOnCancer.caof cancer care, with the gastrointestinal team covering HPB cancers. Each team includes medical oncologists, radiation oncologists, surgeons, nurses, radiation therapists, pharmacists, social workers, nutritionists, and psychiatrists.

Danny Prosic, outside Juravinski Cancer Centre

Danny Prosic, liver cancer patient

“That’s the beauty of working at a large centre like JHCC,” says Meyers. “We have a wide range of expertise all under one roof, and our collaborative team approach is helping our patients live longer with a better quality of life.”

On paper, liver cancer patients have a poor prognosis.

“If they’re seeing me for palliative treatment – which focusses on managing the disease because it’s no longer considered curable — the best case scenario statistically is a 12 month survival,” says Meyers. “But over half of my patients easily do better than that, thanks our team approach. I have lots of patients, like Danny, who are surviving years rather than months.”

Spotlight on Dr. Brandon Meyers, medical oncologist 

Black and white portrait of Dr. Brandor Meyers

Meyers joined HHS in 2006 as a resident doctor, then went on to complete a fellowship before joining the hospital system full time in 2012 as a medical oncologist. He works primarily with gastrointestinal (GI) cancer patients, with a focus on liver cancer.

“GI cancers are an area of care than I’m especially interested in, and it’s also an area of need,” says Meyers, referring to cancers of the digestive tract and liver.

Among the most satisfying aspects of his work is seeing patients like Prosic beat the odds. “Danny has already survived three times longer than his life expectancy, with a good quality of life.”

“It’s really hard living with such serious, ongoing health issues and I’m grateful for the way I’ve been treated by the doctors, nurses and staff at Hamilton Health Sciences.” — Danny Prosic, patient

Looking to the future, Meyers would like to see a nurse navigator join the team, but it would require funding. A nurse navigator works with patients who might otherwise fall through the cracks, helping them navigate the system so they understand their care plan and don’t miss appointments. Navigators could even help free up hospital beds, since their support could allow patients to recover at home after certain procedures instead of in hospital.

“Our liver cancer patients would especially benefit from a nurse navigator’s support, because their cases are so complex and they see so many different physicians for their care,” says Meyers. “It can often feel overwhelming, and it’s not unusual for some patients to lose track of appointments and miss them.”

Spotlight on Melanie Carrigan, medical radiation therapist

Black and white portrait of Melanie Carrigan

Medical radiation therapist Melanie Carrigan is also keenly aware of the difference that funding can make in providing the very best care. Donations from Hamilton Health Sciences Foundation support JHCC’s radiation therapy program for children, says Carrigan, who works with children and teens but also treats adult patients. She was Prosic’s radiation therapist for four of his five SBRT treatments for liver cancer.

“Cancer care isn’t all doom and gloom. It’s about working together to help people during the most difficult experiences of their lives.” — Melanie Carrigan, medical radiation therapist

With SBRT, highly concentrated doses of radiation are safely and precisely delivered over a much shorter period of time than with usual radiation therapy. “We can finish in a week what traditionally took months, with same or better benefits,” says Carrigan.

Carrigan is part of JHCC’s research, innovation and learning committee and she works closely with the radiation and medical oncology teams in running clinical trials.

“The future is happening now with the advent of new immunotherapies, and shorter, less toxic, and more effective combined therapies,” says Carrigan. “It’s very exciting to see the progress being made toward improved outcomes.”

But as much as she loves research and technology, the best part of her job is connecting with colleagues and patients.

“What it really comes down to is the people,” says Carrigan. “Cancer care isn’t all doom and gloom. It’s about working together to help people during the most difficult experiences of their lives, and giving them the confidence to know that our expert team is here to support them every step of the way.”

2022 Illuminight: Help shine a light on hepato-pancreato-biliary (HPB) cancer

Illuminight is an annual fundraising event that aims to shine a light on the nationally-leading, life-saving cancer care and research at JHCC. This year, we’re celebrating Illuminight with a five-part series of stories and videos from Sept. 22 to Oct. 11 featuring gynecologic, blood and hepato-pancreato-biliary (HPB) cancer care as well as cancer research and health equity.

Look for:
Tuesday, Oct. 4: Partnering for equitable, high-quality cancer care
Tuesday, Oct. 11: Lung cancer research and treatment working wonders

Since 2018, Illuminight has raised more than $500,000 to support the highest priority needs of the cancer program at Juravinski Hospital and Cancer Centre. Help us shine a light on cancer and donate today.

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Measles case reported locally turns out to be negative: health unit

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NEWS RELEASE
SIMCOE MUSKOKA DISTRICT HEALTH UNIT
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On March 26, the Simcoe Muskoka District Health Unit (SMDHU) was notified by Public Health Ontario’s (PHO) laboratory that due to laboratory error, the case of measles that had been lab-confirmed positive on March 12, based on symptoms and a positive urine measles laboratory result by PHO’s laboratory, is in fact negative for the measles virus.

“With this new information of the negative lab result, we believe that that individual was not infected with measles and that there has not been any public exposure to measles resulting from this individual’s illness,” said Dr. Charles Gardner, medical officer of health. “We recognize that notifying the public of what we believed to be a positive measles case in our area created worry, anxiety and disruption for some, and we regret this.

“We do know that, despite best efforts, on rare occasions laboratory errors can occur. We are working closely with the PHO’s laboratory to do all that we can to ensure that such an incident does not occur again.”

Measles is a highly contagious viral infection that spreads very easily through airborne transmission. The measles virus can live in the air or on surfaces for up to two hours.

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Symptoms of measles begin seven to 21 days after exposure and include fever, runny nose, cough, drowsiness, and red eyes. Small white spots appear on the inside of the mouth and throat but are not always present. Three to seven days after symptoms begin, a red, blotchy rash appears on the face and then progresses down the body.

The risk of transmission to those vaccinated with two doses is low, and when it does occur tends to show a reduction in the severity of these symptoms.

“Although we are relieved for the individual involved, and for all Simcoe-Muskoka residents, that this case has now been confirmed as negative, we know that measles is still active in Ontario at this time and the potential remains for new cases to arise, especially given the increase in Ontarians travelling to areas in the world that have higher numbers of measles cases,” said Dr. Gardner. “This is why we continue to advise individuals to keep up to date with their routine immunizations, including measles, mumps and rubella (MMR) vaccination.”

The risk of measles is low for people who have been fully immunized with two doses of measles vaccine or those born before 1970; however, many children have been delayed in receiving their routine childhood immunizations and people who have not had two doses of measles vaccine are at higher risk of contracting the disease.

People who do get sick usually recover without treatment, but measles can be more severe for infants, pregnant women, and those with compromised immune systems. Possible complications include middle-ear infections, pneumonia, diarrhea, or encephalitis (swelling of the brain) and occasionally death in the very young. Even individuals who are up to date with the measles vaccine should watch for symptoms of measles for 21 days after exposure.

For more information about measles, please visit smdhu.org or call Health Connection at 705-721-7520 or 1-877-721-7520, Monday to Friday between 8:30 a.m. and 4:30 p.m. to speak with a public health professional.

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Kate Middleton Not Alone. Cancer On Rise For People Under 50, Say Experts

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Kate Middleton revealed on Friday that her cancer was discovered after she received abdominal surgery

London:

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When Catherine, Princess of Wales, revealed she was being treated for cancer last week, part of the shock was that an otherwise healthy 42-year-old has a disease that mostly plagues older people.

However, researchers have been increasingly sounding the alarm that more and more people under 50 are getting cancer — and no one knows why.

Across the world, the rate of under-50s diagnosed with 29 common cancers surged by nearly 80 percent between 1990 and 2019, a large study in BMJ Oncology found last year.

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The researchers predicted the number of new cancer cases among younger adults will rise another 30 percent by the end of this decade, with wealthy countries particularly affected.

The increase in cases — and soaring global population — means that the number of deaths among under 50s from cancer has risen by nearly 28 percent over the last 30 years.

This occurred even as the odds of people of all ages surviving cancer have roughly doubled over the last half century.

Shivan Sivakumar, a cancer researcher at the UK’s University of Birmingham, called it an “epidemic” of young adult cancer.

Since Kate Middleton revealed on Friday that her cancer was discovered after she received abdominal surgery earlier this year, Sivakumar and other doctors have spoken out about the uptick in younger cancer patients they have been seeing at their clinics.

While breast cancer remains the most common for people under 50, the researchers expressed particular concern about the rise of gastrointestinal cancers — such as of the colon, pancreas, liver and oesophagus — in younger adults.

Colon cancer is now the leading cause of cancer deaths in men under 50 in the United States, according to the American Cancer Society. For women, it is number two — behind only breast cancer.

One high profile case of colorectal cancer was “Black Panther” actor Chadwick Boseman, who died at the age of 43 in 2020.

Why is this happening?

“We just don’t have the evidence yet” to say exactly what is causing this rise, Sivakumar told AFP, adding it was likely a combination of factors.

Helen Coleman, a cancer epidemiology professor at Queen’s University Belfast who has studied early onset cancer in Northern Ireland, told AFP there were two potential explanations.

One is that people in their 40s were exposed to factors known to cause cancer — such tobacco smoke, alcohol or being obese — at an earlier age than previous generations.

She pointed out that the “obesity epidemic” did not start until the 1980s.

Sivakumar felt that at least part of the puzzle could be explained by obesity.

However, there is “another wave” of under-50 patients who are neither obese nor genetically predisposed still getting cancer, he emphasised, adding that this could not be put down to “statistical chance”.

The other theory, Coleman said, is that “something different” has been going on with her generation.

Fingers have been pointed out a range of possible culprits — including chemicals, new drugs and microplastics — but none have been proven.

Some have suggested that so-called ultra-processed foods could be to blame. “But there’s very little data to back any of that up,” Coleman said.

Another theory is that the food we eat could be changing our gut microbiome.

While there is nothing conclusive yet, Coleman said her own research suggested that cancer causes changes to the microbiome, not the other way around.

Anti-vaxx conspiracy theorists have even tried to blame Covid-19 vaccines.

This is easily disproven, because the rise in young adult cancer has taken place over decades, but the vaccines have only been around for a few years.

What can be done?

To address the rise in younger colorectal cancer, in 2021 the US lowered the recommended age for screening to 45. Other countries have yet to follow suit.

But the researchers hoped that Catherine’s experience would remind people at home that they should consult their doctor if they sense anything is wrong.

“People know their bodies really well,” Sivakumar said.

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“If you really feel that something isn’t right, don’t delay — just get yourself checked out.”

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Almost 3,000 students suspended in Waterloo Region over immunization issues

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Close to 3,000 children attending elementary school across Waterloo Region were suspended from school on Wednesday morning for not having up-to-date immunization records.

The region says Waterloo Public Health suspended 2,969 students under the Immunization of School Pupils Act (ISPA).

For several months, the region has been campaigning for people to get their children’s vaccinations up to date, including sending letters home to parents on a couple of occasions, warning that students’ records needed to be up to date or they would be suspended.

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It announced in January that 32,000 students did not have up-to-date records: 22,000 elementary students and 10,000 high school students.


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“We have made remarkable progress from the original 27,567 immunization notices we sent to parents in November and December 2023,” Dr. Hsiu-Li Wang, medical officer of health, stated.

“Since that time, we have resolved more than 24,500 outdated vaccination records, providing students with valuable protection against these serious and preventable diseases.”

The high school students still have a few weeks to get their records up to date or else face suspension.

The ISPA requires students to have proof-of-vaccination records for diphtheria, polio, tetanus, pertussis, measles, mumps, rubella, varicella (chickenpox) and meningitis, which must be on file with public health.

Public health says caregivers whose children are suspended will need to book an appointment at regionofwaterloo.ca/vaccines for clinics, which will be held in Cambridge and Waterloo on weekdays.

“Given the high number of suspensions, it may take several days before you can be seen at an appointment and return your child to school,” a release from the region warns.

“Record submission and questions must be done in person to ensure immediate resolution.”

The last time suspensions over immunizations were issued was in 2019, when 1,032 students were suspended.

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