Alberta Cancer Foundation

Your health questions answered by the experts


Q: “Is SAD (seasonal affective disorder) a real thing? I feel like my mood is affected by the shorter days and cold weather. How do I know if I have it and what can I do?

SAD is most definitely a real disorder, says Linda E. Carlson, a clinical psychologist at the Tom Baker Centre, and Enbridge Chair in Psychosocial Oncology at the University of Calgary.

“It is recognized in the Diagnostic and Statistical Manual of Mental Disorders V (the handbook of all psychiatric conditions) as a subset of recurrent major depression with a seasonal pattern,” explains Carlson.

She goes on to say research shows the prevalence of the disorder in the U.S. ranges from 1.4 per cent in Florida to 9.7 per cent in New Hampshire. It is estimated to be higher in more northern climates, including Canada, where exposure to daylight decreases substantially in winter months.

Carlson says to look for the telling signs something more serious is wrong than just a blue mood. “Symptoms of SAD include difficulty waking up in the morning, tendency to oversleep and overeat, particularly sweet or starchy foods, accompanied by weight gain,” she notes. “Other symptoms include a lack of energy, difficulty concentrating on or completing tasks, withdrawal from friends, family and social activities, and decreased sex drive. This is often accompanied by feelings of depression, pessimism, hopelessness, and lack of pleasure in everyday life.”

Carlson suggests a visit to your general practitioner and/or a clinical psychologist or psychiatrist, any of whom should be able to assess for and diagnose the condition.

The remedy?

“Simple strategies such as spending more time outdoors, exercising and maximizing light exposure indoors by sitting near windows, leaving blinds open and trimming tree branches or other shade sources can help,” says Carlson. “And one of the most effective treatments is bright white light therapy. This is done with a home device called a light box, about the size of a small laptop computer. You sit about 30-60 centimetres from the box, with your eyes open but not staring at the light source for about 30-60 minutes per day, for up to a month or even longer.” Carlson says other treatments with some evidence for their efficacy include cognitive-behavioural therapy, antidepressant medications, ionized-air administration and melatonin supplementation. Plus, getting two and a half hours or more exercise per week benefits most depression.

More information on SAD and its treatment can be found online. One good source is from the Canadian Mental Health Association:

Q: “Is it true that some cancer treatments can lead to decreased bone density?”

Hormonal therapies that treat breast and prostate cancer can sometimes lead to decreased bone density, says Susan Bocchinfuso, a physical therapist whose practice, Oncology Rehab, specializes in treating people living with cancer.

“The goal of hormone therapy is to reduce estrogen levels in women and testosterone levels in men, since these hormones can stimulate the growth of breast and prostate cancers. These hormones also help maintain healthy bones, and reducing their levels can lead to bone loss,” Bocchinfuso explains. “Bone density levels can also be affected by treatments that can induce early menopause like chemotherapy or surgery to remove the ovaries.”

Although bone loss is not reversible, there are things you can do to build better bones and stop it from progressing, she notes. “Besides adequate calcium and vitamin D intake, exercise is key. Bone is living tissue, and just like muscle, needs to work against resistance to get stronger,” Bocchinfuso says. “Even if your bones are less dense, the right kind of physical activity can increase the quality of your bones, which in turn can influence their strength.”

Bocchinfuso, who also teaches yoga, says the most important elements of an exercise program to maintain optimal bone health include: postural exercises and core stability work to take undue stress off of weakened structures, balance activities to help increase co-ordination and reduce falls, vigorous weight-bearing activities like brisk walking and strengthening activities like lifting weights to promote the building of better quality bone.

“If in doubt, seek the help of a physical therapist who can design a program that will match the most appropriate activities for your level of fracture risk and ensure you are working efficiently and safely,” she urges.

Q: “Are there foods that reduce the risk of cancer?”

Though there are other lifestyle factors that affect cancer risk like physical activity, smoking and obesity, what you eat can also have an impact, says Karol Sekulic, a registered dietitian with Alberta Health Services.

The plants have it, she suggests. “Choose fruit, non-starchy vegetables, grains, beans and legumes in as close to their natural state as possible,” Sekulic says. Non-starchy vegetables include broccoli, eggplant, bok choy, carrots, rutabaga, turnips and green leafy vegetables, whereas examples of starchy vegetables that are not as protective against cancer are potato, yam, sweet potato and cassava. Other good foods to eat to reduce the risk of cancer are whole grains (brown rice, quinoa, oats and millet) versus refined grains, white flour and white pasta. And when it comes to proteins, limiting your red meat intake and avoiding processed meat (ham, bacon, pastrami, salami, sausages and frankfurters) altogether is best. “The report Food, Nutrition, Physical Activity and the Prevention of Cancer, a Global Perspective indicates there is evidence that red meat is a cause of colorectal cancer,” Sekulic says.

She also advises consuming higher-calorie food and drinks in moderation, as these can increase your risk of becoming overweight or obese when consumed regularly and in large portions. And those who imbibe will want to do so sparingly, drinking no more than two alcoholic beverages a day for men and one drink each day for women.Sekulic gives these suggestions to get started on a cancer-reducing diet:

  • Add 1/2 cup of beans to your day. Add chickpeas to your green leafy salad for a lunch entrée.
  • Making meat sauce? Replace half the red meat with lentils.
  • Snack on non-starchy vegetables like celery, broccoli, peppers or carrots.
  • Have a seasonal fruit for dessert. Try berries, citrus, apples, pears, plums or peaches.
  • Choose water to drink instead of sugar-sweetened pop or iced tea.
  • Substitute brown rice, quinoa or barley for white pasta or rice.
  • Choose plain oatmeal for breakfast instead of a sweetened cereal.

Ask our experts questions about general health, cancer prevention and treatment. Please submit them via email to Remember, this advice is never a substitute for talking directly to your family doctor.