They Ought to Know

Q: What are the top five steps I can take to avoid cancer?

“Different sources will provide different lists,” says Krista Rawson, nurse practitioner at the Central Alberta Cancer Centre. “If you are going to limit me to five, I’d say it’s the common sense ones.” The list looks familiar: don’t smoke, be sun aware, move your body, eat well and ask your doctor about the latest screening guidelines. Rawson says most of the benefits to following these tips are not limited to cancer avoidance, but also help as prevention measures against other diseases, such as heart disease and depression.

“But it’s not enough for us to tell people what to do,” Rawson says. “We have to look for tools that make it a little easier.” She says that people need to be supported in their health goals, from their family physician, as well as in the community.

Fortunately, Rawson says, as a society we are getting better about understanding how to make goals achievable. Your doctor, nurse practitioner or public health centre can help you find information about smoking cessation. Smokers typically make a number of attempts before they quit for good. “And the motivation has to be there. On a zero to 10 scale, put a number on your motivation. Then the challenge becomes moving that up a notch or two to improve the outcome.”

For example, if you want to quit smoking, start planning the trip you’ll take with the cash you’ll save.

And Rawson says that it’s likewise necessary to identify the obstacles to your goal and work around them. “Where in your day, for example, can you eke out the time to eat better or get more exercise?” If you are time-crunched, keep a bowl of apples handy or toss lunch-sized packaged peaches in your bag before work. It’s a good idea to examine what actually saves time. “It takes 10 minutes to chop up some food for the slow cooker, or 10 minutes to wait in line at the drive through. Are you really saving time by eating badly?” The same principle works for exercise. For example, you need to take your son to soccer practice. Can you spend 10 minutes doing the stairs? Or go for a brisk walk near the facility? Create small opportunities for good health in your day. – M.P.

Q: Is getting three, 15-minute exercise sessions done in a given day as beneficial as one 45-minute session?

According to Dr. Jane Shearer and Dr. Nicole Culos-Reed, two associate professors in the University of Calgary’s Faculty of Kinesiology, both approaches to exercise are beneficial.
If you are training for a long run, ride or swim, you’ll need to build the duration. But for beginners or those of us exercising for the health benefits, the multiple short durations of intense exercise approach is fine.

“The number one barrier to exercise for all of us is time,” Dr. Culos-Reed says, “So if it’s more achievable to get those shorter bouts in throughout the day, there’s nothing wrong with that.”

Dr. Shearer says that over the years, she’s become a bigger fan of short sessions. These can be more beneficial than one sustained workout, she says, as each session elevates your metabolism. But the 15 minutes of exercise must involve an activity that gets your heart rate up fast, such as a short jog, bike ride, ski or swim. “You want to be efficient with your time, get your heart rate up and sustain it for 15 minutes,” she says.

Dr. Culos-Reed researches physical activity for cancer survivors on and off treatment, and says that some people recovering from cancer treatment may find a 30- to 45-minute workout daunting. Achieving smaller bouts of exercise may be more realistic, and Culos-Reed says that some studies show that shorter durations of exercise for people receiving cancer treatment are more beneficial and achievable than a longer workout.

There is no one right exercise for anyone; it comes down to preference. Regardless of how you’re structuring your exercise, the benefits are many. “Both approaches are going to have benefits in terms of cardiovascular health, overall health and psychological benefits,” Dr. Shearer says. – C.K.

Q: My father’s radiation oncologist has recommended him for brachytherapy. What is it? What are the side effects?

The term brachytherapy stems from the Greek word brachys, meaning “short distance.” The practice of brachytherapy dates to the early 1900s when scientists discovered that radioactive material could be inserted into a tumour, causing it to shrink.

Brachytherapy is a form of radiation therapy where a radiation source, often called a seed (smaller than a grain of rice) is placed inside or near the tumour or other cancer site. “This method is used by itself or in combination with other treatments, depending on the diagnosis,” says brachytherapist Wendy Read. Read is a radiation therapist with more than 30 years’ experience at Edmonton’s Cross Cancer Institute, 10 of them as a brachytherapist.

The two main types of brachytherapy are interstitial and intracavity. In interstitial treatment, brachytherapists assist radiation oncologists to place the radiation seed directly into a target tissue. In intracavity brachytherapy, the team inserts an applicator that houses a radioactive source.

Brachytherapy can be a permanent technique where the seed remains in location forever, emitting a small amount of radiation over time, or it can be a temporary procedure using different doses. Depending on the treatment type, brachytherapy can be administered in a matter of minutes or could take several hours.

“In brachytherapy, the radiation dosage is localized, precise and tailored to the tumour volume, sparing the healthy tissue surrounding the tumour from unnecessary irradiation,” Read says. Unlike other treatment procedures, brachytherapy doesn’t result in obvious external scarring and can be done on either an out- or in-patient basis.

Patients react to treatments differently so the side effects will vary widely per individual and treatment type. Brachytherapy is another treatment tool available to the oncology team. – S.C.