How HSA members fight breast cancer, every day

The Report: November / December 2002 vol.23 num.5

very day, HSA members help breast cancer patients in their personal fight with cancer. We provide the diagnostic services that detect and pinpoint the disease. We perform crucial clinical roles during treatment. And with the rehabilitation services we provide, we help patients and their families adjust to their post-treatment lives.

HSA is a proud corporate level sponsor of the Run for the Cure, the Canadian Breast Cancer Foundations most important fundraising effort. Every year, HSA members participate in the run to help raise money to fight breast cancer. Its a fight HSA members are in every day.

At work, HSA members are running the race every day to help patients beat their cancer. One in nine Canadian women will develop breast cancer in their lives. And one in 27 will die. It takes passion, dedication and professionalism to do the jobs our members do when they work with patients with breast cancer ... the ones who triumph over it and the ones who leave families behind.

As a union predominantly representing women, dealing with breast cancer is often not only a professional challenge for HSA members ... its also a personal one.

In our words is a special feature highlighting six members in a range of professions, from all across BC. They talked to The Report about the challenges and triumphs they face on the job every day.

"Helping is a reward in itself"

was drawn to social work because I like being in the helping professions. Ive always enjoyed working with people and getting to know them better. I really like the feeling of helping somebody feel more in charge of their life.

Shelley Gordon
Registered Clinical Social Worker
BC Cancer Agency, Victoria
Patient and Family Counselling

There are lots of rewards because we develop a fairly close relationship with our patients, and were working with someone at a very difficult, challenging time in their life. Its really rewarding to develop a close relationship with somebody where Im in a position to try and facilitate their healing and their well-being.

When people are faced with any kind of illness, it really makes them look at their life and whats going on that isnt working for them, so I always help them to reframe the difficulty or the challenge into something positive that they can grow from; to help them look at the stress in a new way, so that they feel more in charge and more positive.

Patients are also dealing with the losses that they are experiencing, like the loss of their health. I can also help them to create more connection in their relationships so that they feel supported and connected to important people in their life. In the initial stages, I want to know how theyre facing the illness, and the impact its had on them, and what their community looks like; whether or not they have a supportive family and they have a supportive friends or community. I want to know how the diagnosis has impacted them, and help them cope better.

Its going to be different with each person. The approach doesnt depend on the gravity of the prognosis. Each persons situation is relevant to them, and its serious to them. So whether its a small lump or a graver situation, it really depends on the individual and how they are actually coping with breast cancer. Im looking at the individual rather than what the pathology is, and how that person is dealing with it, so they can develop better coping strategies. I help them to develop better support circles ... or to get to know themselves better as well so that they can live their life in a way that might help them realize how much strength they really have.

When I know that Ive had an impact in terms of somebody feeling better, either after one session or after a period of time of counselling, its incredibly rewarding because Ive connected to somebody in a meaningful way.

Its also rewarding in terms of working with somebody in a very devastating situation to feel more positive about it ... or just journeying with them in a difficult time.

I might be going with somebody through the different stages of cancer. This would be when they are initially diagnosed, to getting treatment, to post-treatment and then possibly towards their death.

And so there is a journey that that person is on and I feel quite honoured to be part of that journey with them, walk with them through the different stages that they go through. I think thats the main thing: knowing that Im in the helping profession and knowing that Im helping people, is rewarding in itself.

Caring through nutrition counselling

ve always had an interest in health, food and nutrition. In university when I was looking at courses, I felt that the dietetics program was a great fit for me. Having personally been touched by breast cancer, through family members, working at the BC Cancer Agency held a special interest for me.

Shelly Monkman
BC Cancer Agency, Fraser Valley
Breast Cancer Site Team

Unlike other cancer patients many women with breast cancer are well nourished and therefore the nutrition issues faced by these women are quite unique. Being diagnosed with cancer is often a life-altering experience and can leave people unsure about how to live their lives from that moment forward.

After a diagnosis of breast cancer, a lot of women are highly motivated and seek nutritional guidance in the hope of reducing their chance of recurrence or for some reducing the size of their tumour. It can also be a confusing time as patients are bombarded with information from friends, family, books and most recently the Internet. I see my role as a navigator, helping them make sense of these messages. Sometimes, simple reassurance that they are doing every thing right is all that is needed and other times I am helping them make changes to improve their diet.

During treatment, eating well can become challenging. One aspect of my job is assessing a patients nutritional status and providing tips to help them stay well nourished during their treatment. With radiation therapy for breast cancer, side effects rarely affect eating. But with chemotherapy, some of the side effects can make eating challenging. These can include loss of appetite, nausea, vomiting, mouth sores and taste changes. In addition to giving people information and ideas to help maximize intake, reassurance that these side effects are common and help with dealing with the side effects can often help allay fears that -something is wrong with me."

I find working with breast cancer patients rewarding and challenging. Challenging in that their thirst for knowledge often keeps them very well informed about the most recent nutrition issues related to breast cancer. This keeps me on my toes as I need to stay well informed.

I love my job because of the many patients and families I meet and help, as well as working with caring and skilled health care professionals.

Working here really makes me appreciate what I have; my health and ability to do a lot of things that I might otherwise take for granted. It makes me grateful for everything I have!

Seeing "the best of the human spirit"

t the BC Cancer Agency in Victoria we have a lot of involvement with patients, including breast cancer patients.

Carol Davis
BC Cancer Agency, Victoria
Breast Cancer Site Team

We have a pharmacist who sits on the Breast Cancer Site Team, which includes medical and radiation oncologists, nurses, a Clinical Trials nurse, dietician, pharmacist, and others.

Pharmacy, along with nursing, runs two group chemo-teach sessions each week, in which newly-diagnosed patients who will be receiving chemotherapy, are given information about how chemotherapy works, what to expect when they come for their first treatment, possible side effects they may encounter, and how to manage those side effects, and are encouraged to ask any questions they may have before starting their treatments.

Whenever a patient at the clinic is started on a new drug or drugs, we counsel the patient on the proper use of the medication. This is a time to reinforce information the physician has given the patient about how the drug works. We also review the patients Pharmanet profile to ensure theyre not on any other prescription medications that may interact with the medication thats being prescribed. We also ask them about any non-prescription medications, including alternative/herbal products they may be taking, and make sure that those dont conflict with treatments that they will be receiving here. During these counselling sessions the patients often have a lot of questions. Patients are encouraged to call us once they have started the drug if they have any unwanted side-effects or other concerns. We can sometimes offer suggestions on ways to manage those side effects, or suggest they speak to their physician if appropriate.

We get very good feedback from patients at the clinic. A lot of them remark on the excellent level of care they have received from us, and from every person theyve been in contact with at the centre. As pharmacists, we are just one of the many disciplines who are involved with them on their personal marathon of hope.

These patients have all had a huge reality check upon being diagnosed with cancer, and when they come to us,they give us a reality check too. And even though theyre going through something very difficult, they are so amazingly brave and so many of them approach their disease with such a positive attitude, that it cant help but rub off on you. I have had friends remark that it must be depressing working with cancer patients, but I find the opposite is true.

I find it uplifting, because I am amazed every day by the patients I see. This centre is an amazing environment in which to work. Yes, we are here for the patients, but they give us so much back. Just the fact that every day we get to see the very best of the human spirit ... thats their gift to us.

"I want to find the cancer"

m a Grade III mammography technologist, and Ive been at this now for about 20 years. I felt that by becoming a mammo tech, Id be helping my own gender ... self-preservation, in a way. Its very rewarding work, because you know that youre saving lives. It is so important to have your mammography screening done.

Laura Conzatti
Mammography Technologist
Vernon Jubilee Hospital

Breast cancer is a silent killer. There are about three different types of breast cancer. Some of them are estrogen positive lesions, which is a genetic type. Another type can travel throughout the ducts ... never forms a lump until its invasive, and then it goes into the lymph nodes.

Thats the kind my mother had, and I actually detected my own mothers breast cancer.

It was great that I found it, because I was able to save her life. It went undiagnosed when she had had several mammograms elsewhere ... and it wasnt until we detected it here in Vernon that I found it on mammography. She just came in for a simple screening and I found it.

I went through the whole thing with her. And it saved her life. Shes been four or five years free from cancer now.

At the time, I was taking my Canadian Breast Imaging ... my advanced certification. Im the only one at Vernon Jubilee and in the region who has a CBI, which is quite kind of neat.

What I like best about my work is the patient contact. When people come into the room, I dont treat them like a patient. I guess I treat everybody who comes into the department like I would treat myself.

Theyre coming into the room and they can be scared. Society now is so cold, and when you come into a clinical atmosphere it can be even worse, so if you can relax the person when theyre coming in, it makes for a much better exam - because they have to relax to get good images. So if you can get their confidence, then youre well ahead of the game for them to have a good result too.

Some are anxious, wondering what the outcome is going to be for them, especially the first-time patient. I tell them my name, let them know what the procedures all about, let them know it shouldnt hurt if its done correctly. I tell them its going to be done in five minutes, and that theyll find out the results in a couple of weeks. If we have to get them to come back for more images, therell not necessarily be anything wrong, and its just that we want to make sure that everything is good.

So yes, I love the contact with patients.

Were dealing with a lot of people coming from all over the place, like Salmon Arm, Nakusp, Vernon of course, Armstrong, Enderby ... its a busy place. We see a lot of clients here, and many of them keep coming back because they know our treatment is good for them. They get the best possible care we can provide. I take great pride in making sure that the standard is the highest possible, from processing and quality control to all aspects of patient care.

The other thing is this: I want to find the cancer. You get a keen eye, and you get so that you are able to do the extra views, position the patient in such a way that youre going to get optimum films to see the area thats in question. Im very proud of my job.

"I really love my job"

always wanted to work in health care so I looked at either being a nurse or in nutrition, and then I came across radiation therapy. It just sounded really interesting and really great, so I pursued it and thats how I got into it. I enjoy the hands-on aspect of this work, treating patients.

Gina Duckworth
Radiation Therapist
BC Cancer Agency, Southern Interior

I think what many people dont realize about this job is that the majority of our patients - not all of them, but a large percentage of them - are not acutely ill. Theyre walking around and they just look like you and me, and so they appear quite healthy. Everybody is not on stretches and in wheelchairs and dying. Its a smaller proportion of people that are acutely ill, in a lot of pain. But I think that thats what the general public thinks of the cancer patient as being.

We treat people who have cancer ... all different forms of cancer. What that entails is we plan their treatment, we take x-rays to plan the treatment, and then once they are ready for treatment we have a role in educating the patients about the treatment itself, the side effects, how to look after themselves while theyre on treatment, how to look after their skin and any acute side effects theyre going to experience. Some patients want to know exactly how the radiation should work, and how it will hopefully get rid of their cancer or alleviate the pain.

We have a role of assessing them on a daily basis: assessing them on how theyre managing and coping with daily treatments, because some of our treatments can go for seven weeks. I think some people have a feeling that we are just purely technical people and we just lie the patient down and turn on the radiation and irradiate people. But theres a whole lot more to our job than that.

I think the job can be very emotionally challenging when you have the patients who are in the end stage of the disease, and you know that theyre not going to live long term. It can be emotionally challenging to deal with those patients, but also inspiring as well, because so many of the patients we see have so much courage. It puts life in perspective.

I really love my job. I never have a morning where I wake up and I think, -oh, I dont want to go to work." I love coming to work! The Cancer Centre for the Southern Interior is a great place to work, and this job is a great job no matter where you work, in my opinion.

"As a therapist, it's wonderful to know I can help "

m a dual-qualified occupational therapist / physiotherapist. The thing that I find most satisfying in working with breast cancer patients is helping people who have had mastectomies deal with the immediate stage post-operatively. We see patients for fitting in their compression sleeves, or if they are having any problems with restriction and mobility in their shoulders.

Ann Craig
Physiotherapist / Occupational Therapist
Dawson Creek & District Hospital

There are things that they can do, and there are exercises they can perform to maintain the range of motion in their shoulder. Most patients are able to regain full motion, and its very rare that they dont.

Sometimes, the scarring is quite marked after the surgery, and so we talk about how we can make their scarring more comfortable and less noticeable over time.

After having surgery or having a mastectomy done, if any of the lymph nodes have been removed, then a woman may have problems with swelling in her arm or in her hand.

The lymph system never re-grows. These patients are faced with the reduction in the lymph system for the rest of their lives - but sometimes the swelling doesnt continue to be a problem, and is worst right after surgery.

We fit these patients with pressure garments, which help reduce the amount of swelling that might be present.

A pressure garment looks like an old fashioned stocking, elastic, and quite stretchy. They vary in compression. We use different compressions for different types of swelling. It can end up being a little bit difficult to get on! These are usually used just on the patients arm. If the patients hand is swelling, we might have to use a glove as well. But it would go up the full length of her arm ... up to the armpit.

These garments are required for the first year or so after the surgery, and sometimes they do have to wear them for long term. It depends on what the swelling is doing.

I think its really great that HSA is actively supporting the breast cancer campaign, because HSA is predominantly a union of women, and its really an issue for women. As a therapist, its satisfying to me when I know that I can help people deal with whats happened to them.

Canadian Breast Cancer Foundation Professional Achievement Award

This fall, the Canadian Breast Cancer Foundation honoured HSA with the Professional Achievement Award presented at the Foundations annual Awareness Luncheon attended by, among others, Premier Gordon Campbell and the Ministers of Health. The award is given to a group of professionals who go an extra mile in the fight against breast cancer.

HSA President Cindy Stewart accepted the award for the union.

"We're running for Brenda"

t is difficult for me to put into words how much this award means to me and to the health science professionals that I represent. In the current climate where HSA members contributions to health care are often seen to be undervalued and overlooked, this is truly appreciated. Our work with the Foundation is far more than just a volunteer activity.

The best way that I can explain this is to tell you about an HSA member named Brenda Munro. Brenda has been a screening mammographer for more than 15 years. She mounted a one-person crusade to ensure that women had access to regular breast cancer screening in her community of Port Alberni. On top of that she spearheaded the fund-raising campaign that ensured the appropriate screening equipment was purchased for the hospital.

As a mammographer, Brenda knows the importance of early detection and is unrelenting in her mission to ensure that this vital service is regularly available to women in her community. Of course, Brendas commitment and energy was nothing new to her colleagues at the hospital when she represented their interests with the same dedication as their union steward.

Whether her advocacy has been for breast health, or her co-workers, Brenda has an amazing capacity to give ... and many people have benefited from her generosity of spirit. By introducing you to Brenda, you have met HSA.

HSA has been a sponsor for ‘the Run for five years, and every year, I run in a different community with a different HSA team. This year, I ran in Nanaimo as a member of the St. Josephs Hospital Team from Comox.

Do you know the registration tag that we pin on to our shirts? This year, ours said, -Were running for Brenda." Because through a tragic twist of fate, Brenda is now fighting her own personal battle against breast cancer.

While she has participated in many of the Run for the Cure Events, she wasnt able to this year because she is now on the receiving end of the care provided by members of her extended HSA family ... who I know are giving her, as well as all the women they provide services to, the best of care.

I want to thank the Foundation for this recognition, and am honoured to accept this award on behalf of the 12,000 HSA members who provide critical diagnostic, clinical and rehab services in communities across BC, and who share the common vision that brought all of you here today ... that is, one day, we will live in a world free of breast cancer.