Enjoying the sun safely

This week on Health Matters, Tarah Schwartz asks Dr. Greg Clark how the emergency rooms at the MUHC are coping with the latest wave of COVID-19. Financial planner Keith Donoghue shares how a charitable gift can not only benefit your favorite philanthropic cause, but also your wallet. Dr. Ivan Litvinov discusses the best kinds of sunscreen and the most common locations on the body to find skin cancer. And, Joanne Photiades details her ovarian cancer journey and her support of the DOvEE project. 

Cette semaine à Question de santé, Tarah Schwartz discute avec le Dr Greg Clark des salles d’urgence du CUSM, qui doivent faire face aux récentes vagues de COVID-19. Le planificateur financier Keith Donoghue expliquera ensuite comment un don peut non seulement encourager votre cause philanthropique préférée, mais aussi votre portefeuille. Le Dr Ivan Litvinov nous parlera également des meilleurs types d’écran solaire et des endroits du corps les plus courants où trouver un cancer de la peau. Enfin, Joanne Photiades nous racontera son parcours du cancer de l’ovaire et parlera du soutien qu’elle offre au projet DOvEE.

Transcript

Tarah Schwartz: 0:00

Hello there. Thank you for joining us. I'm Tarah Schwartz and this is Health Matters on CJAD 800. On today's show, she had no family history of cancer, but after experiencing unusual symptoms, she knew something was wrong. It was a doctor at the MUHC who finally diagnosed and treated her cancer. That experience inspired her to speak out and to act. And later in the show, a dermatologist shares the signs and symptoms of skin cancer that you need to look out for. But first, we are far from free and clear of COVID-19. There are still serious cases that are being treated at the MUHC, how are the emergency rooms coping with this latest wave? And are there different kinds of injuries and ailments that present themselves in the summertime? Dr. Greg Clark is the Research Director at the Department of Emergency Medicine at the MUHC, thank you so much for joining us, Dr. Clark.

Dr. Greg Clark: 0:58

Thanks for having me.

Tarah Schwartz: 0:59

So how are emergency rooms at the Glen coping with this latest wave of the pandemic?

Dr. Greg Clark: 1:07

Very challenging times. And I think we're seeing across Canada, healthcare systems and emergency departments are having lots of difficulties. Now, the interesting thing with this wave though, is that the patients with COVID are not coming in because of COVID. They're not an extreme because they're have a COVID infection. What we're finding is patients are coming with other medical problems like heart attacks, or appendicitis and they're incidentally testing positive. For me, this is an encouraging sign to a certain degree. It's trying to find a silver lining. COVID is here. It's going to be here for a while. But because of vaccinations and previous immunity from infections, people are not getting as sick from COVID. There's some people that are still at risk- the immunocompromised patients. But for the large part, the COVID patients who are coming in or having other problems than the COVID infection.

Tarah Schwartz: 2:00

And you and I were talking about this just before we jumped on to the interview, but that it's interesting that people are not aware that they have COVID. And that says something about how we're dealing with the virus, doesn't it?

Dr. Greg Clark: 2:12

It does. I think there's two aspects to that. It's good that people are not getting sick. But we also have to stay conscious of this because we all have family. Especially at the MUHC, we have immunocompromised patients or patients that can't mount a response to the infection with vaccines, and we have to protect them. Because they're the ones that remain vulnerable. And they're the ones that are getting very sick still.

Tarah Schwartz: 2:37

And Dr. Clark you mentioned that people are coming in with a variety of ailments. Is it possible that like heart attacks, you mentioned cardiac issues? Is it possible that COVID is making those situations worse than they would have been if COVID had not been an issue?

Dr. Greg Clark: 2:55

A challenging question and the research is still ongoing. What we do know is that patients did not consult as early as they would have before the pandemic. Let's say somebody was having chest pain, they would normally come immediately to the emergency department. There was a fear of contracting COVID here, and so they may have delayed. So that's one of the issues, people are having delayed presentations for things that they would have presented with earlier. What COVID is causing, we're seeing people with long-term problems with COVID. Some people are having respiratory issues. But I think the bigger issues because of the fear that was across the world, people did not come to emergency departments early on in the pandemic.

Tarah Schwartz: 3:37

We are speaking with Dr. Greg Clark, Research Director of Emergency Medicine at the MUHC we're talking about the ER and COVID-19. Dr. Clark, when we heard that was going to be yet another wave, how were staff at the ER preparing? It's already been such a difficult two plus years how are staff feeling and coping with what's going on now?

Dr. Greg Clark: 3:57

I'm going to use a hockey analogy because you know, we're in Montreal and you have to use hockey analogies. The emergency department is like the grinders, the fourth-line people. We're always ready. We're in the corners. We're digging for pucks. We're doing the dirty work, we're getting kicked at, spit at, and we're ready for it. And we're always there. We don't take days off. Well, in the ER, we take days off. But when we're here, we're always here. We're ready to take this on. And I think the gritty nature of the emergency team, the nurses, the coordinators, the PABs, the doctors- we're ready for this. We're disappointed that we're having to deal with it again. But the emergency department is always ready to take on the challenges. And so sometimes spirits are a bit low, but we stick together and we get the job done. And we protect our patient population and help them out especially in these difficult times.

Tarah Schwartz: 4:49

In light of that hockey analogy, which I liked very much so thank you. Thank you for that. Is there more, in a way a sense of calm because the virus is more familiar now? And while we don't know exactly where we're going, we know where we've been. Does that help?

Dr. Greg Clark: 5:04

Yeah, I think there's a confidence with what we know about the virus and what the virus does. I think we're coming back to a new normal where there's other issues at hand. There's press conferences this week about the state of emergency departments across Canada. And I think COVID is not the driver of these problems, but expose some of the issues that we will have with health care that our team at the MUHC is working to solve with research and other avenues. And we're all working towards this. But I think really, right now, we know what we're up against. We're ready to take on the challenge and we just need some help from different parts of the community to help us get through the difficult times that all emergency departments are facing across Canada.

Tarah Schwartz: 5:53

In light of the press conferences that are taking place with regards to emergency rooms across Canada, is that the message that you're trying to get out? That you need help from the community in order to get through this? And if so, what kind of help is that?

Dr. Greg Clark: 6:05

If we're talking specifically for research, we obviously need help. We need to improve the patient's experience We have to improve outcomes and find novel ways to improve our situation. Research is a good avenue for that where funding will help us get to the support that we need from methodologist and statisticians and help us get the work done that we need to help patients. But we also need governmental support. I think it's almost blasphemy to say that, but we don't necessarily need more help in the emergency department. We need money for research, but we don't need help otherwise. We need help in the whole healthcare system. We need better access to primary care physicians. We need more long-term care beds so that patients that don't need to stay in hospital after they're finished their treatments. They can leave the hospital and makes place for new patients that need the acute care that we can provide at our institution.

Tarah Schwartz: 7:03

And just to get back to the press conferences that are happening that people are talking about across Canada about emergency rooms. What is your advice or counsel to people who, may need to go to the emergency room, are not sure if they should? They've heard in emergency rooms are overcrowded that the COVID numbers are going up. What do people do? Because there's a lot of people that are very concerned about should I, shouldn't I? What is your advice to them?

Dr. Greg Clark: 7:29

It's an excellent question. We said earlier on in the interview that at the start of the pandemic, people were not willing to come. So my message is, if you're having symptoms of a heart attack, symptoms of a stroke, or a broken bone, come to see us. We're here and we want to help you and we've got the resources to help you and that's what our specialty is. Now if you're not sure, it's important to know what resources you have available to you. Some of the resources- if you have a primary care physician, a family physician, you can consult them and ask them what they recommend. Our community pharmacists are excellent at providing health advice and helping you navigate our system. And finally, we can't forget the excellent 811 system that we have. If you're not sure what to do, what the best approach is, you can call 8-1-1 and you'll speak to a nurse who will ask you questions and do an evaluation the best that they can over the phone and tell you what the best course of action is. So bottom line, if you've got a heart attack, or a stroke, or broken bone or uncontrollable pain come in to see us. If you're not sure, call your family doctor, the pharmacist or even 8-1-1.

Tarah Schwartz: 8:34

Excellent advice and I hope that message gets across. If you are seeing a lot of people coming in now, and that's why we're talking about ERs a lot these days, who are the patients that are coming in? Who is it that is in the emergency room a lot right now?

Dr. Greg Clark: 8:47

Right now, it's sort of business as usual in that context. We have a myriad of patients that are coming in. So at the MUHC we have our transplant and population with HIV and respiratory problems that are coming in and we're helping them out. We have the various things like chest pain and cardiac arrest, all those different things that we would normally see. We just have the added challenge of making sure that we assume that they have COVID until proven otherwise so we don't expose our more vulnerable patients to the virus.

Tarah Schwartz: 9:21

And I guess to not expose all the health care workers as well; despite all the precautions you're likely taking. Dr. Clark, you seem like someone who absolutely loves your job. What do you love most about it?

Dr. Greg Clark: 9:31

It's interesting, I was talking to my daughter's jujitsu coach yesterday. So it's important to stay active. And he was asking me do you still find excitement? I think one of the things that we have in emergency medicine is we have a finite period to make important decisions, to make a huge impact on people. In a space of five minutes, my decisions and my practices can mean the difference between life and death. And that may be a bit dramatic, but it's the reality. If somebody comes in with a heart attack, and if we missed the diagnosis, they can pass away. Whereas if we get the right information early on, we can start treatments and therapies and diagnostics that will make sure that this patient can have a good full life after they come to the emergency department.

Tarah Schwartz: 10:17

And that's your favorite part that excitement? In a way that drama? It's interesting.

Dr. Greg Clark: 10:24

Emergency physicians, if we're using sports analogy, we like the puck on our stick.

Tarah Schwartz: 10:31

Hockey again, I like it. I like it. Dr. Greg Clark, Research Director of Emergency Medicine at the MUHC. Thank you so much for taking the time to talk with us today. It's always very insightful.

Dr. Greg Clark: 10:43

Thank you very much. Have a good day.

Tarah Schwartz: 10:44

You as well. Next up on Health Matters, there

Keith Donoghue: 10:46

Thanks for having me.

Tarah Schwartz: 10:47

Some listeners may be thinking that they don't are many kinds of charitable gifts that you can make to your have the means for philanthropy. Or maybe they think that it favorite philanthropic organization. We speak with a financial planner about how making a donation can not only benefit the cause, but also your wallet. I'm Tarah Schwartz. won't have a big enough impact. What message do you have about Welcome back to Health Matters on CJAD 800. When you make a donation to the MUHC Foundation, you are not only helping our doctors, nurses and researchers find better ways to treat patients. But there are many benefits that you get, such as helping alleviate some tax burdens. Keith Donoghue is a financial planner at Assante Capital Management. Thank you so much for being here, Keith. the benefits of giving back?

Keith Donoghue: 11:39

First off, I would say that there's obviously lots of ways one can give back to their community. It doesn't always have to be financial, it could be that they're devoting their time or their expertise in a certain matter. But for those that are donating financially, every dollar helps. Especially these days, there's over 85,000 registered charities in Canada, so everyone's sort of competing for that same dollar from potential donors. Every little bit helps for sure. But there are definitely things you can do. Even if you think what you're contributing is not enough, maybe you can change up the strategy a little bit to make sure that you can make more of an impact later on. I always give an example. Let's say somebody's giving a regular contribution of $50 a month to the hospital or $100 a month to their church. And this is a regular ongoing donation so that is $600 to $1,000 of donations. That probably just helps the organization with their day-to-day activities, but maybe you want to make a bigger impact. One strategy we look at implementing for clients, if they do want that type of impact, is to ask your charity if they can forego that $50 or$100 a month that you regularly give. What you do instead is you take out, assuming you qualify health wise, you take out a life insurance policy for maybe$25,000 or $40,000. It depends on obviously your age and your health. But if you qualify, then you use that $50 a month or $100 a month to pay the premiums for that policy. Now, charity is the owner of the policy and the charity is the beneficiary of the policy, you just pay the premiums, but those premiums are tax deductible for you just like they were before.

Tarah Schwartz: 13:34

So both get tax deductions?

Keith Donoghue: 13:35

Exactly. So it's the same impact tax-wise for them. But eventually, when this person passes away, all of a sudden, it's a $25,000 donation or a $40,000 donation. Whatever it is. And that charity could really use that money significantly at that point. And you just have a bigger impact maybe later on without changing your cash flow.

Tarah Schwartz: 13:59

We're speaking with financial planner, Keith Donoghue, and we're talking about the benefits of giving a charitable gift. Keith, cost of living is going up, things are more expensive, talk going into recession. People may wonder about not only their ability, but what it can actually give to a charity. So tell us about some of the benefits that even if you're giving $20 or $25. Let's talk a little bit about the challenges of finances right now and why it's important to still give.

Keith Donoghue: 14:32

I firmly believe that it's always important to give back to the community. Even if it is $25 or $100 that you give to the charity, it all helps. Just so people understand tax-wise. Federally, for donations that are under $200 you get a 15% tax credit. And in Quebec it's an additional 20% for amounts under $200. For donations above $200 then the federal tax credit jumps to 29%. And in Quebec, it jumps to 24%. You could be getting a tax savings of depending on your income for the year, it could be 35-40%, maybe even 50%. Back. So even if you donated $500, for the year after taxes might only be costing you $250-$300.

Tarah Schwartz: 15:27

I didn't realize about the over or the under, but that's why we have people like you to explain the tax aspect of it. I also want to talk to Keith about the benefits of adding a charity as a beneficiary in your will. The more I learned about this, the more surprised I was that I kind of hadn't heard about it before as an option because it is interesting. Tell us about some of those benefits and how that works.

Keith Donoghue: 15:52

You can definitely leave money to charity through the will. Then it's your estate that would get the tax receipt for that donation, which could offset other income that the person had in their final years. One thing to consider, again, this is just a strategy. But we recently had a case where we had a couple that in their late 60s, early 70s. And they have $200,000 in RRSPs or RRIFs and they had two children. When looking at their estate plan, I saw that everything was going to the kids. But at the same time when looking at their tax return, I saw that they were leaving money regularly to a charity. And so I said, is this something you'd like to do at death, as well to leave money for charity? They said, Yeah, we'd like to do it but we want to help out the kids too. And I said, there's a way to do both. What we can do is, rather than naming the children as beneficiaries of the RRSP or RRIF, if they don't need the income from that RRSP or RRIF, what we'll do is we'll name the charity as beneficiary in the will. So now let's say that$200,000, instead of going to the kids; it will go to the charity, the hospital, the school, whatever it is. And the estate will get a tax return for that $200,000, thus erasing the$200,000 taxable income from the RRIF. There's no tax implication CRA or Revenue Quebec are not involved in your estate all of a sudden. Now, what about the money for the kids? While alive, if they don't need the income from that $200,000- you're supposed to be taking out like 5-6% of your RRIFs every year - and as you get older, you take out more. But if they don't need that $10,000-$12,000 of income, we'll use that to pay the premiums on a policy for$200,000 that will pay out upon the death of the second spouse. So now, when we look at it, the charity gets the $200,000 tax-free. There's no tax implication for the estate, and the children will get $200,000 tax-free from the life insurance company. All it costs is the annual premium. So assuming again, you qualify for the insurance, that's a great way to leave money to a charity to the will and leave money for the family. It may make some people uncomfortable to discuss things like this. But why should you have conversations with your family about giving back when estate planning? How do you suggest people have that conversation? It's not easy, and it's complicated. It's not easy, and it is complicated. But I do encourage families to get together to discuss these things. Usually a child is named as the liquidator or executor of the estate. And sometimes it's a surprise to them, about what the final wishes were in the will. Like money's going to a charity or money's going to somebody else and they weren't expecting that. It can cause fights or grievances amongst siblings. Everyone reacts a little different to money. So I really encourage a family meeting to go over these are my intentions, these are my wishes and do you do see issues with this? It's important that the liquidator or the executor and again, it's usually a child, in the case of the parents, that they're aware of it. Because a lot of times when people make a bequest through the will, it's based on the financial situation of the person or the couple at a time. Now that could have been five or 10 years ago and financial conditions for that person or couple could have changed in that five or 10 years. Maybe now there isn't enough money in the estate to honor that request that was originally thought of. It's important that they really get together, sit down, talk with each other, talk with the financial advisor, the estate planner, and make sure that everything is up to date. And it will just avoid a lot of fights and conflicts for sure.

Tarah Schwartz: 20:19

I'm running out of time, Keith, but I want to ask you just one final question. Everything that you're talking about is so interesting. But obviously, there's so much context and you have to learn so much. If someone is listening to this and thinking, I like this idea, I want to learn more and get started. What is the first person they go to? Is it a financial planner? Or is it a notary? How do they learn more about how to make these kinds of things happen and understand what their options are?

Keith Donoghue: 20:43

I would highly suggest talking to financial advisor, financial planners, such as myself. Some accountants obviously are well versed in the tax laws; you should see what the tax implications are. And, a notary can also provide guidance when it comes to leaving assets to a charity through the will. So all of the above I think are good, but usually the first point of contact should be a financial planner, if you have one. And if not, I would seek out the guidance of one because they're not only going to help you with the planning of it, but they can maybe also help with a lot of the implementation of it. So that's what I would recommend to do. Yeah. And one more quick thing...

Tarah Schwartz: 21:33

I wish I did, Keith, I'm like over time. But we'll bring you back on because there's so much to talk about. Keith Donoghue is a financial planner at Assante Capital Management. I want to thank you so much for your time today and the information it was really interesting.

Keith Donoghue: 21:45

You're very welcome. Thanks for having me.

Tarah Schwartz: 21:48

Next up on Health Matters, do you know the signs and symptoms of skin cancer? It has been a hot and humid summer so far, and if you are enjoying being outside in the sunshine, you should be doing it safely by protecting your skin. Are you regularly applying sunscreen with a high SPF? Cases of skin cancer in Canada have gone up significantly in the last three decades. And prevention is very important when it comes to this type of cancer. Dr. Ivan Litvinov is a dermatologist and scientist at the RI-MUHC. He joins me now to discuss what you should know when it comes to skin cancer. Thank you so much for being with us, Dr. Litvinov

Dr. Ivan Litvinov: 22:27

Thank you Tarah for having me. It's a pleasure to be on your program.

Tarah Schwartz: 22:30

We are almost through summer, I'm sad to report as I am definitely a summer person. Dr. Litvinov, how often do you repeat yourself about the importance of sunscreen during the summer?

Dr. Ivan Litvinov: 22:41

I repeat often. Of course, sunscreen is important for a body parts that cannot be covered by clothing such as the face. However, I think in addition to applying sunscreen regularly- every 2-3 hours and more often if you are in the water. It's important to make full use of those rash guards and supporting clothing that you see cyclers wearing etc. They breathe. They aerate well. They're very comfortable. And they are a very effective way of protecting from the sun; more so than sunscreen.

Tarah Schwartz: 23:13

It's funny that you should say that because I have very fair skin. My mother's a redhead. I'm a redhead. And for the first time ever, I bought a rash guard at the beginning of summer and I have to say I used it all the time every time I was in the water so that's great advice from Dr. Litvinov. Get yourself a rash guard because that that really did change things for me. Tell us Dr. Litvinov, why is there such a dramatic rise in skin cancer cases these last decades?

Dr. Ivan Litvinov: 23:37

Multiple reasons for that one, of course, is people living longer and they have more time to develop skin cancer. The other thing is we are exposing ourselves more and more to the sun. There was a culture shift. We're flying more to the south episodically where we get sunburned. We are less focusing on work and we're exposing ourselves to the sun outdoors. I mean, we want to enjoy outdoors. It's just there is a way to do it safely. The other thing, people have made studies and showed that climate change is an important contributor. It's getting warmer. The Ozone depletion in the atmosphere is contributing to dangerous rays reaching the earth. There multiple reasons-the bottom line is we are more at risk now than ever before. And it is very important to practice sun protection.

Tarah Schwartz: 24:25

Where are the most common locations on the body for skin cancer? And does it differ between men and women how we get skin cancer?

Dr. Ivan Litvinov: 24:33

Absolutely. The most common sites where you get skin cancer are the areas that are exposed to the sun. So for women, actually, it's the extremities it's the legs and arms that are more common. With many women having different hairstyles sometimes there's quite a bit of shade on the face, but nevertheless, it's usually legs that are the number one location where women get skin cancer; followed by the arms, followed by the face. This is true for melanoma. For non-melanoma skin cancers- it's still the face. For men It's usually the trunk, head and neck areas that are more prone to developing melanoma and other skin cancers. And then less likely, for the legs. Of course, those are usually covered by trousers. So if you think about typical sun exposure patterns, whatever the skin sees the sun is the part of the body that is most likely to develop skin cancer.

Tarah Schwartz: 25:21

I actually got a rash guard for my little boy this year, and I noticed that a lot more children were wearing these kinds of things than I've seen before. Maybe it's because I just got one, but I was happy to see that even children were now covering up more than they have been in the past.

Dr. Ivan Litvinov: 25:36

I congratulate you on that. In fact, I think we do need a culture shift in this country. We have done it before with seatbelts and smoking. And I think sun protection is important. Of course it starts with our children and the family. It's not per se an individual responsibility; it's a collective responsibility. So now you can see more favored rash guard, wears that go down to the knees or you know, all the way down to the ankles and the top protecting our children, protecting the mothers, protecting the entire family from the sun. I think that's the best way to go.

Tarah Schwartz: 26:08

Yeah, I really liked the way you phrase it like I think that makes sense that we need a culture shift. We are speaking with Dr. Ivan Litvinov and we are talking about skin cancer. Dr. Litvinov, I think most people would agree it can be difficult to get in to see a dermatologist. What is the best thing for people to do if they find a suspicious mole or mark on their body or on their face?

Dr. Ivan Litvinov: 26:29

I think the best thing to do is to connect immediately with your health care provider, which is usually a family doctor. The family doctor should carefully evaluate the lesion. It's true, right now, there's over 50,000 people waiting to see a dermatologist. But if a family doctor actually picks up the phone, calls the dermatologist that they're connected with, and says that I'm really worried about this, I think this could be a melanoma. Then a dermatologist will prioritize that case. Otherwise, there's of course walk-in clinics that you can go to, and be assessed. And then finally, more and more, there are private companies developing platforms online with dermatologist who are working privately, signing up to those platforms. One of them happened to be Derma-Go, where an image can be sent and assessed. But nonetheless, I think the best thing is really this personal connection with your dedicated health care provider. Connecting with your family doctor, seeing them looking at lesion together. And if necessary, not just sending a consult referral, but actually picking up the phone and calling dermatologist and saying we're actually very concerned about this lesion. Please see this patient this week.

Tarah Schwartz: 27:33

Okay, good advice to encourage your doctor to really go farther. I was interested to find out that you're noticing cases of skin cancer in younger people. Tell us a little bit about that.

Dr. Ivan Litvinov: 27:44

Yes, in younger people, we're seeing skin cancer and the pattern is a little bit different. We're seeing that there's more skin cancer in men. As we get older men really overtake women in terms of the numbers of skin cancers. What's interesting when we talk about melanomas particularly; we see it in younger people and more common in females. We're actually potentially attributing this to the artificial UV exposure practices in women, where they are much more likely to go sunbathe in artificial UV bed. So there are striking differences. And I think a lot of it, again, has to do with exposure, exposure exposure and your individual risk. So if you're redhead, if God forbid, one had a cancer like Hodgkin's lymphoma and received radiation, or use artificial tanning salons, those individuals are going to be at a very high risk of developing skin cancer younger and so those are important considerations.

Tarah Schwartz: 28:42

When you say younger Dr. Litvinov, what age group are you referring to where you're seeing this in younger people?

Dr. Ivan Litvinov: 28:49

Melanoma can develop in any age group. Even in children, for a variety of reasons and syndromes, etc. But in terms of sun exposure melanomas, or certain risk factors, like radiation. That cancer can appear as early as adolescence and in their 20s and 30s.

Tarah Schwartz: 29:07

I wonder if many of us don't think about how dangerous skin cancer can be and why is it taking us so long? Because I thought it was interesting. You mentioned the seatbelts, how we came to appreciate that as a culture. That if you're in a car, you wear a seatbelt. Why are we not getting it that the sun is dangerous? Why do you think that is?

Dr. Ivan Litvinov: 29:25

Because we're not in Australia, but we're catching up there. Australia and New Zealand are certainly leading the world in showing how we should treat skin cancer as an important matter, where people die at a very high level. Here in Canada, skin cancers a significant burden. It's one in five Canadians that are affected by skin cancers. And basically I think everybody can relate to this and knows a person who has skin cancer or had to skin cancer themselves. But the culture shift hasn't happened yet. I think based on what we're seeing in Australia, New Zealand, the United States, it's coming here to Canada. And of course, that's why we're talking about it. What we got to do is just keep talking about it, raising awareness, giving voices to our patients, so that other people can benefit from this information and prevent skin cancer from occurring in their body.

Tarah Schwartz: 30:15

When we choose a sunscreen, anything in particular, we should be looking for? Or as long as there is an SPF in there, we're good?

Dr. Ivan Litvinov: 30:20

I will give you an official answer- the best sunscreen is a sunscreen you will use. It has to be a Broad Spectrum SPF-50 and higher but then otherwise, it's really about the vehicle the texture, it has to be agreeable with you. People may have various concerns about sunscreens, it is a big divide between organic versus mineral sunscreens. The concerns about organic sunscreens is that if you actually apply it as you should significantly to your body, there is absorption in the bloodstream and that can actually change your endocrine system in the body. We also do not recommend to use organic or Dr. Ivan Litvinov, it is always such a pleasure to speak with chemical sunscreen in children for that very reason. Absorption causing abnormalities in an endocrine system. Finally, organic sunscreens are actually having a devastating impact on you and I always find I walk away having learned something coral life. They are bleaching coral. The result of that is in Palau, Hawaii and other jurisdictions, they are actually banned. Mineral sunscreens especially the nanoparticles, new. I'm going to go check out mineral sunscreen because now I they are not absorbed in the body. When you put it on, it stays like paint, it leaves a residue. It basically just reflects the sun from the skin surface. They're much safer from the standpoint that they are not absorbed into the bloodstream. want to understand how that feels on my skin. So thank you We actually recommend them for children six months and older. Before six months, people should be using clothing, and they actually do not have this adverse effect on coral reefs. I so much for taking the time to talk with us today. I'm sure actually have a bias and a preference for mineral sunscreens. But the official answer the best sunscreen is the one you will use. that many people are going to be impacted by your words. Thank Thank you very much for having me. you so much.

Tarah Schwartz: 32:09

I'm Tarah Schwartz, you're listening to Health Matters. Joanne Photiades had no family history of cancer or even risk factors when she started to notice unusual symptoms. She knew something was wrong and advocated for her health until she was finally diagnosed with ovarian cancer. She says that she is not only a cancer survivor, but a cancer thriver. She is also the co-chair of the DOvEE campaign, which we've talked about many times on this show. And it's a project I'm also so passionate about. Joanne, I want to thank you so much for taking the time to talk to us today.

Joanne Photiades: 32:41

Thank you for having me, Tarah.

Tarah Schwartz: 32:43

Let's go back a little bit. You started to experience symptoms and needed to be persistent to get a diagnosis. Tell us about that.

Joanne Photiades: 32:53

The symptoms started, we were trying to get pregnant actually. So I was really in tune with my body. And the symptoms were really mild at first, like heavier periods, and getting full quickly when I would eat, getting bloated, having to pee more often. But they're all symptoms that are mild, and you can easily dismiss. But since we're trying to get pregnant, like I said, I had some tests done. So I had some blood tests, but standard blood tests were not looking for any tumor markers. So they all came back clean. And then I went to do an ultrasound. And that's when they discovered that there was a mass growing on my left ovary at the time.

Tarah Schwartz: 33:37

Dr. Lucy Gilbert is an ovarian cancer specialist. She created the DOvEEgene trial, which we're going to talk about a little bit more in a moment. But when did you decide to consult Dr. Gilbert as a second opinion?

Joanne Photiades: 33:50

When I knew the mass drawing was 10 by 12 cms. They had told me it was a cyst and not to worry. But I did worry and I did ask for an MRI. At that time, I was told that I wasn't considered high risk and not to waste hospital resources. So I actually went to do it privately. I sent the results to my family doctor and my family doctor said I really don't like this. Go see my friend, Dr. Gilbert tomorrow morning.

Tarah Schwartz: 34:21

And what was that like when you were diagnosed? What was that moment like?

Joanne Photiades: 34:25

I honestly can't remember what was said. But I could remember how I felt. Obviously it was really scared I even hear the word cancer. I just know there was a lot of people going back and forth trying to get me on to the standby list for surgery; to have surgery as soon as possible. But I remember Dr. Gilbert making me feel safe. And I remember there was also a nurse with her there. I remember her name was Nurse Enza, and I will forever be grateful for them. They just reassured me. And like I said, it wasn't what they said; it was how they made me feel, and that we were going to get through this together that we were a team.

Tarah Schwartz: 35:07

They're a pretty extraordinary group of women. We are speaking with Joanne Photiades. We're talking about ovarian cancer and the DOvEE Project. Joanne, you are very active in fundraising for the DOvEE Project. And for context, this is a test in its final clinical trial before going to Health Canada for approval. And it detects ovarian and endometrial cancers before it's too late. These cancers are called the silent killers, because by the time you're diagnosed, it's often too late. And this test for the women out there, it's very similar to your annual Pap test, it just goes a little higher. So Joanne, you are also the co-chair of the DOvEE campaign. Why was it important for you to give back in this way?

Joanne Photiades: 35:47

Well, it's interesting that you mentioned the Pap test actually. Back in the day, now we think of Pap tests as standard care and that's really the goal of the DOvEE trial. To make this standard care because before the Pap test existed, cervical cancer was, if I'm not mistaken, the second leading cause a women's death. And now it's pushed down to 16. So we see what innovation can do... innovation and science. And what's really amazing is this is happening right here in our backyard and Montreal at the MUHC. It's going to change the outcome of ovarian cancer and endometrial cancers for all women around the world. So it's so exciting and the fact that it's my doctor that is working on this? It's just such an incredible opportunity to pay it forward. I'm just so grateful for it.

Tarah Schwartz: 36:41

Yeah, it really is. And she is an absolutely astounding woman. And you're right that it's happening in our backyard is really miraculous. She's going to change women's health globally and she's doing it here. And like you mentioned, it's your doctor. So it's clear why you're so passionate about the DOvEE Project, what does it mean to you, as a cancer survivor and thriver to know that this test is getting closer? We're still in the final clinical trial so we need women to participate. But what does it mean that it's getting closer to being available to all women? It's such an extraordinary thing to imagine.

Joanne Photiades: 37:16

Honestly, there is no word to describe it. It makes me so happy knowing that; if I wasn't listening to my body, at that time, I probably would have found it too late. I would have found it but even if it was a couple of months later, a couple months makes a big difference. Because it does tend to grow quickly. Mine grew from 10 by 12 centimeters to 18 by 20, in less than a month.

Tarah Schwartz: 37:39

Wow.

Joanne Photiades: 37:40

So that gives an indication of how fast they can go. Not always, it's not always as aggressive. But it does grow quickly and you don't usually notice it. So the outcome of ovarian cancer if you're diagnosed in phase three or four, the five-year prognosis is 10 to 30%. But if you catch it in phase one or two, it's 80 to 90%. So a huge difference. So we really need to get this test to market as soon as possible.

Tarah Schwartz: 38:06

I want to come back to something that you said because it really jumped out at me. I think it's an important thing to reiterate, listen to your body. Because as women, we don't listen to our bodies as much as we should. So I think that message coming from you is a good one. Listen to your body and act. If you feel something's wrong.

Joanne Photiades: 38:25

Yes, it's always better to hear, don't worry, it's nothing. Then, oh my goodness, you should have come in earlier.

Tarah Schwartz: 38:33

I was just I feel like we you and I could talk for much longer than this. But obviously we're restricted by time here. But I want to close by saying that I share your passion for this project so much. I have taken part in the DOvEE clinical trial, you just have to be between 45 and 75. And you can not only find out if you have these cancers or precursors for these cancers, you quite literally become a part of history in helping to get this test to women everywhere. So if you are a woman listening who wants to take part, here's the number you can call to take part in the DOvEEgene test. It's 1-866-716-3267. That's 1-866-716-3267. Joanne you have helped raise a significant amount of money for this DOvEE project. It takes money to advance science and to be innovative. Like you said, what message would you have for our listeners about getting involved in this project in any way they can. Whether it's to take the test or to give to the test? What would you say?

Joanne Photiades: 39:32

Thank you so much from the bottom of my heart because like we said it's going to change the outcome of ovarian and endometrial cancers for women around the world. And it really is my big dream that no woman's potential or life be lost. So thank you so much. No amount is ever too small because it always adds up to get that big amount that we do need to move it forward. So thank you so much.

Tarah Schwartz: 39:55

It does indeed. Thank you Joanne for joining us on Health Matters for all that you are and all that you do. Joanne Photiades is a cancer thriver and a spokesperson for the DOvEE Project. Thank you for being here Joanne, I always really enjoy speaking with you.

Joanne Photiades: 40:10

Thank you so much Tarah.