Breast Cancer Awareness

October is breast cancer awareness month.

Today’s column will be little different. Read the question and ask yourself how much you know about breast cancer. Then read the answer and see if there is something new to absorb.

Q. How many women will develop breast cancer in the U.S.A, Canada and Australia?
A. In U.S.A., one out of every eight women will develop breast cancer in her lifetime compared to one in nine in Canada and one in 11 in Australia (TIME Magazine).

Q. Breast cancer rate in Palliser Health Region is higher than the provincial rate – true or false?
A. False. The incidence and mortality rates for breast cancer observed in our region are similar to the provincial rates (Cancer in Alberta 2005).

Q. What is the survival rate for women with early-stage breast cancer?
A. Nearly 98 per cent of women with early-stage breast cancer will live five years or more thanks to regular mammograms and improved treatments.

Q. What is Tamoxifen?
A. Tamoxifen is a drug which can lower a woman’s risk of breast cancer by 35 to 50 per cent. It reduces the risk of breast cancer recurrence and the chance of a new breast cancer starting. It can stop the progression of breast cancer (breastcancer.org).

Q. What is Herceptin (trastuzumab)?
A. It is a drug approved for the treatment of women with advanced-staged breast cancer. It also helps women with early-staged breast cancer by reducing recurrence rate by 50 per cent (CMAJ, August 16, 2005).

Q. What is Femara (letrozole)?
A. It is used by post-menopausal women who have finished five years of tamoxifen therapy after breast cancer surgery. The drug significantly reduces both the recurrence of breast cancer and distant metastases (CMAJ, March 24, 2005).

Q. How can a woman reduce the risk of breast cancer?
A. Drink alcohol in moderation, avoid obesity (obese women are twice as likely to die from breast cancer), women at risk for breast cancer should avoid estrogen hormonal therapy, do regular breast self-examination, have regular mammograms, have your physician check your breast once a year at least.

Q. Is antibiotic use associated with an increased risk of breast cancer?
A. A study published in 2004 suggested that premenopausal women who used antibiotics for urinary tract infections had an elevated risk of breast cancer compared with women who did not use antibiotics. The authors concluded that additional studies are required before the implications for clinical practice are clear. So, the jury is still out (CMAJ, June 22, 2004).

Q. Is exercise effective in reducing the risk of breast cancer in postmenopausal women?
A. Several articles have been published showing an association between physical activity and breast cancer prevention in post-menopausal women. It also helps in the reduction of cardiovascular disease and diabetes (CMAJ March 2, 2004).

Q. How reliable is mammogram in detecting breast cancer?
A. Sensitivity of mammogram depends on several factors. Overall sensitivity of mammogram is 70 to 90 per cent. It is only about 50 per cent in women under the age of 40. Less than 0.5 per cent of women will be found to have breast cancer on screening mammogram. If mammogram picks up a suspicious lesion then the chances of it being cancer on biopsy will be 90 per cent (CMAJ, January 18, 2006).

Q. Why do 35 per cent of women with locally advanced breast cancer wait more than three months before seeking medical attention?
A. Fear, belief that symptoms might be benign, belief there was nothing to worry about because they did not have a family history of breast cancer and belief they were too young to get breast cancer were cited by one in three women who eventually came to the Toronto –based clinic (The Medical Post, January 10, 2006).

So, how did you do?

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Organ Donation

Photo of Audrey and Melinda Weimer
Photo shows on the left Audrey Weimer, 46-year-young patient with renal failure and her twin sister Melinda Fischer who received a kidney transplant in July.

Dear Dr. B: I love reading your column. On August 2, in the Medicine Hat News, there was a front page article on the taking of organs on Falun Gong prisoners in China, and our Canadian $50.00 bill in the photo. Can you please explain to your readers that purchasing organs is illegal in Canada, and what a tremendous gift of life organ donation means to people waiting for an organ. I am a pre-renal patient, and someday will also be on the transplant list. Thank you from the bottom of my heart. Yours sincerely, Audrey Weimer.

Fours years ago Audrey had chronic cough, lethargy and anemia. She was diagnosed to have kidney failure due to Wegner’s disease. The disease is also known as Wegner’s granulomatosis. It is a rare form of inflammation of the blood vessels that affects many organs. The lungs and kidneys are most commonly affected. Audrey new she would need a kidney transplant in the future. Her twin sister Melinda would be the best match as a donor.

Audrey asked Melinda to go get herself checked as a possible donor. But as fate would have it, Melinda was diagnosed to have Wegner’s disease as well. Melinda’s kidneys failed faster than Audrey’s and she went on dialysis. After waiting for three years, she received a kidney transplant in July from a deceased donor.

According to Health Canada website, in 2001, more than 3,700 Canadians were awaiting organ transplants for kidneys, hearts, lungs, or livers, and thousands of others were in need of replacements for tissues such as corneas, heart valves, bone grafts, and skin.

In year 2000 alone, 147 Canadians died while waiting for organs that never came because suitable donors were not found in time. Canada has one of the lowest organ donation rates among industrialized nations.

Organ transplant surgery has made significant progress in the last few years. We know that nearly 98 per cent of all kidney transplants, 90 per cent of liver transplants, and 85 per cent of heart transplants are successful. And the number of patients receiving solid organ transplant has increased by 22 per cent in the last decade.

Is this enough? No. Why should 147 or more Canadians die each year while waiting for a suitable donor? Something needs to be done to improve the situation. We need to raise the public’s awareness.

You can be a donor by signing an organ and tissue donor card (see on the other side of Alberta Personal Health Card) or by registering your consent through the provincial registry. You should also discuss with your loved ones your desire to be a donor. This is very important. Ninety-six percent of relatives agree to organ donation if they already know the wishes of the donor, while only 58 per cent agree when they have not been included in the process in advance, says Health Canada. Do it today. Talk to your family and sign the card. And yes, purchasing organs in Canada is illegal.

Signing an organ donor card does not mean you will not get appropriate care if you are seriously ill. The organ transplant team does not wait outside your hospital room ready to grab your organs as soon as you are pronounced dead. There is a strict protocol to follow before anybody can touch your body. The process is complex and requires a coordinated team approach.

In Alberta, the government has established the HOPE (Human Organ Procurement Exchange) program for the coordination of donation, recovery and distribution of organs for transplantation within Alberta. For southern Albertans the office is in Calgary. For more information phone 403-944-8700 or visit their website: www.calgaryhealthregion.ca/hope.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Bharwani to Share Experiences

Bharwani to share experiences (Medicine Hat News)
By Courtney Gillies

Photo of Noorali holding his book, A Doctor's Journey.

Dr. Noorali Bharwani wants to say thank you, celebrate the completion
of his first book and support a local charity all at the same time.

A Doctor’s Journey: An emotional and humourous look at life through the eyes of a doctor, is Bharwani’s first book and was released two weeks ago. On Thursday, Bharwani is hosting a book party at the Medicine Hat College courtyard from 6 p.m. to 9 p.m. The evening will include a book signing and refreshments.

Twenty-five per cent of the proceeds from the book sale that evening will be donated to the Medicine Hat News Santa Claus Fund.

“I want to say thank you to lots of friends who have helped me. The people of Medicine Hat have been wonderful and without their support for my column and for me in town here for 21 years nothing would have happened.”

Bharwani has been writing a medical column for The News for approximately nine years. The book includes several of Bharwani’s newspaper columns, however many of them have been updated or revised, he noted. The self-published book includes 28 chapters on various subjects, such as his childhood and writing for The News.

One of Bharwani’s favourite chapters is the one where he talks about his mother and father.

Bharwani said the response to his book since its release has been good.

“I get lots of comments. Those who haven’t bought it are thinking of buying it,” said Bharwani. “I think the momentum is building and I’m happy with the response I’ve had from people.”

Bharwani has plans to start on his second book after Christmas once he has finish promoting A Doctor’s Journey.

“I’ve got to sell this one first. I’ve got to make room in my office,” said Bharwani. “I have a couple of ideas, but I haven’t looked into a crystal ball and said which one would be the best one yet.”

A Doctor’s Journey is $18 and can be purchased at various locations around the city, including the Medicine Hat News office on Dunmore Road.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Writing a Book

Noorali and his mother, reading his book, A Doctor's Journey.

Noorali showing his book (A Doctor’s Journey) to his 87-year-old mother Sikina Bharwani in Calgary.

“Congratulations! You have done what many have talked about and never accomplished. I look forward to reading your book,” wrote my friend Kathy when I told her about my book, A Doctor’s Journey.

I am lucky to have accomplished this feat. Nine months ago, I was sitting in the intensive care unit of the Medicine Hat Regional Hospital worried about my health. But in the last couple of months I have been feeling pretty high and excited. That’s how life is. We all have our highs and lows. We just hope we have more highs than lows.

In August, I finished eight years as a columnist for the Medicine Hat News. In the next couple of weeks I will be writing my 300th “What’s up doc?” column. This would not have been possible without the help and encouragement from the present and former editors of the News and the readers of my column.

Writing a column on health, wellness and happiness has been a very healthy exercise and a source of joy. It also gave me enough confidence and material to write a book.

I believe that anything happening within and around our body directly or indirectly affects our feelings and hence our health. So the topics I choose for my columns vary a lot – from a purely medical to personal and family stories. It also depends on what sort of questions I get from the readers.

I love sharing my stories with the readers of my column. The stories are sometimes happy ones sometimes sad ones. But people relate to these stories as most people go through the same emotional ups and downs as I do.

I have written quite a bit about myself, my parents and other family members. Recently, I wrote about my nephew’s wedding. That story had many angles but it was also about happiness, choosing a good partner in life and dreaming about the future. All part of being healthy and well. People in happy relationships live longer and have better lifestyle.

My travel stories have similar message of happiness, friendship and how to stay healthy by taking time off from our stressful lives. This allows us time to spend with our friends and families. There is some thing to learn when we share our experience with others. That is part of being healthy and happy.

Writing A Doctor’s Journey was an exercise in patience and an exercise in happiness and satisfaction. I am thankful to so many people who helped me achieve my goal. They have been acknowledged in the book. The book costs $18 and is available at the Medicine Hat News, Shopper’s Drug Mart, Medicine Hat Regional Hospital Gift Shop, Damon Lanes Tea Room, Hair Palace, Alberta Massage and Spa, MacKenzie Eye Care Centre and my office.

On Thursday, September 28th, you are invited to come and celebrate with me the release of my first book at the Courtyard room, Medicine Hat College from 6 PM to 9 PM. There will be signing of the book and refreshment will be served. Part of the proceeds (25 per cent) from the sale of the books that evening will be donated to Medicine Hat News Santa Fund. I hope you can come.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!