Tag Archives: Research

Balancing the benefits and harms of exercise for people living with and beyond cancer

Cancer On the Horizon – latest news Research

The benefits of exercise for people living with and beyond a cancer diagnosis are well established. A wide range of types and intensities of exercise have been shown to improve quality of life, reduce anxiety and depression, reduce cancer-related fatigue, improve treatment tolerance, and potentially lead to extended life.

The compelling evidence demonstrating the benefits of exercise for cancer survivors led to both the Exercise and Sports Science Australia (ESSA) and the Clinical Oncology Society of Australia (COSA) to call for exercise therapy to be embedded as standardised care for people with cancer.

“Exercise is widely accepted as safe, even for people living with or beyond cancer,” said Dr Rosa Spence, Research Fellow and senior member of ihop.

“However, every healthcare intervention brings risk of harm alongside potential for benefit. Unlike benefits, the harms of exercise have been poorly reported in exercise oncology trials to date, with the majority of studies failing to report or under-reporting harms.

“The problem with this is that widespread uptake of exercise into standard cancer care will require evidence of both benefit and low risk of harm across all cancer and treatment types and at the moment there is an evidence gap.

“There has been growing recognition across clinical trial disciplines of the need to provide balanced reporting of benefits and harms.

“This is why we designed the Exercise Harms Reporting Method or ExHarM protocol,” she said.

“This protocol is specifically designed for harms assessment within exercise oncology trials but can also be applicable in other behaviour change settings.”

Dr Spence says she defines the harms of exercise as ‘all undesirable, physical, psychological, economic or social consequences that are related to an individual’s participation in exercise’.

“It’s important for clinicians, patients and exercise professionals to understand the potential harms of exercise to ensure exercise is recommended to the right patients, prescribed in the right way and that individuals can make informed decisions about the potential positives and negatives of exercise participation ,” she said.

“The ExHarm protocol was developed, trialled and refined by the ihop research group to guide comprehensive and reliable harms assessment and reporting in both research and in practice.

“The protocol involves four core steps to capture, classify, analyse and report all adverse outcomes relating to exercise therapy,” she said.

  • Step 1 – Monitor and Identify – the participant reports or exercise professional observes adverse outcome.
  • Step 2 – Assess and record – record details of adverse outcome, severity, causality, impact on intervention and type of adverse outcome.
  •  Step 3 – Harms panel review – harms panel reviews and revises causality of adverse outcomes.
  • Step 4 – Analyse and report – all-cause adverse outcomes and exercise-related adverse outcomes are analysed and reported.

Dr Spence says the four-step process provides a simple framework for the collection, classification, analysis and reporting of adverse outcomes.

“ExHarm was developed with the goal of improving the quality of harms assessment and reporting within exercise oncology research and practice,” she said.

“It has been successfully implemented in multiple exercise oncology trials, involving samples with different cancer types (breast, brain and gynaecological), different stages of disease at diagnosis (stage I-IV), primary and recurrent diagnoses, and inclusion of samples with multiple comorbidities.

“Our hope is to continue to refine the protocol and continue to work to improve harms reporting across exercise research, with the goal of improving the quality of life for people living with and beyond cancer.”

To read the full manuscript on ExHaRM visit
ExHaRM Manuscript (BMJ Open)

For more information about the ihop research group, visit improvinghealth.com.au

Younger Women’s Wellness after Cancer Program improves quality of life for women in New Zealand

Cancer Interview Programs Research

Preliminary results from the culturally adapted Kōwhai Study in New Zealand are showing positive signs that the Younger Women’s Wellness after Cancer Program has the potential to improve the quality of life of women after cancer treatment.

We spoke to the Kōwhai Study Manager and long-time Women’s Wellness collaborator, Janine Porter-Steele, about the latest results from the study, as well as future plans for implementation across Australia, New Zealand and Hong Kong.

How are lifestyle intervention programs proving to improve the quality of life for women after a cancer diagnosis?

Younger women, under the age of 50, treated for breast cancer in Australia and New Zealand (NZ) are a large and growing population and while advances in diagnosis, treatment and management have significantly improved survival rates, the medium, long-term and late side effects reflect a significant burden to young women. Side effects include physical, psychosocial and psychosexual issues, like early menopause and associated risks, fatigue, obesity, sleep disturbances, higher incidence of diabetes, and cardiac and bone health concerns.  Social aspects might include disruption to family, relationships and work-life as well as fitting in with peers. Psychosexual side effects of treatment include sexual dysfunction, fertility and body image issues.

Studies have demonstrated that women believe they lack information and confidence in ways to not only reduce their risk of recurrence of cancer and other chronic disease but also to manage the long-term effects that cancer has on their lives.

There is also evidence that lifestyle interventions can mitigate chronic disease risk and many of the side effects associated as well as improve quality of life for this group of patients.

This is why we developed the The Women’s Wellness after Cancer Program (WWACP), which is a twelve-week Program designed to address common treatment after-effects in women after cancer. This program was subsequently adapted to focus on the different needs of younger women (Younger Women’s Wellness after Cancer (YWWACP). It has been trialled as a feasibility study in New Zealand (NZ) (The Kōwhai Study), in Australia (The Emerald Study), and in Hong- Kong. As part of the NZ study, a separate and discreet sub-study offering a culturally adapted program was undertaken with a cohort of Māori women.

Can you tell us a bit more about the Kōwhai Study, which was recently completed in New Zealand?

The Kōwhai Study recruited women aged 18- 50 years who had completed intensive treatment (surgery, chemotherapy / targeted therapies and radiotherapy) for breast cancer in the preceding 24 months.

The participants were randomised into a control (usual care) group or to an intervention group. The participants allocated to the control group received general information from their usual health care professionals during their routine clinic visits. The intervention group received a journal, fact sheets, access to a website and 3-5 consultations over the twelve-week duration of the program with an experienced cancer care nurse.

Apart from assessing the usability, acceptability and accessibility of the Kōwhai Study, improving quality of life was equally important, as our aim with the Younger Women’s Wellness after Cancer programs is to improve late and long term side effects and reduce distressing ongoing symptomology.  Secondary endpoints include comparison of waist circumference measurements from commencement to completion of the study and changes in menopausal symptoms, body image, sexual function, sleep, physical activity and nutrition.

Despite launching the Study during the Covid pandemic, we received a rapid intake of participants, which demonstrated an enormous desire for this type of lifestyle intervention in New Zealand.

What were some of the outcomes of the Study?

 While we are still collating and analysing some of the data from the Study, the Kōwhai Study is showing promising signs of improving late and long-term side effects of cancer treatment and improving quality of life for participants, from a physical, psychosocial and psychosexual perspective.

Participants are reporting reduced levels of distress, improved emotional status and a downward trend in waist circumference.

What’s next for the Younger Women’s Wellness after Cancer Program?

We have now completed feasibility studies in New Zealand (Kōwhai Study), Australia (Emerald Study) and Hong Kong (YWWACPHK), with all three studies receiving high interest and uptake from local participants and positive feedback. This proves to us that the program is feasible and accepted and that, if rolled out more widely, could be very successful and have a great influence on improving the quality of life for younger women after cancer.

We are now pooling the results from these three studies and will be looking to secure a larger partnership grant, in the near future, to conduct a larger study and roll the program out more widely.

For more information about the Kōwhai Study, click here.

For more information about the Emerald Study, click here.

For more information about the Younger Women’s Wellness after Cancer Program in Hong Kong, click here.

Women in Hong Kong pilot Younger Women’s Wellness after Cancer Program

Cancer Interview Programs Research

A team of researchers at the Chinese University of Hong Kong have recently completed the pilot study of a culturally-adapted Younger Women’s Wellness After Cancer Program for Women in Hong Kong (YWWACPHK).

We sat down with Assistant Professor Dorothy Chan from the Faculty of Medicine at the University to discuss the program pilot and plans to conduct a full-scale study in the coming months.

What was the driver for developing a culturally-appropriate program for younger women after cancer in Hong Kong?

Breast cancer is the most common cancer among Hong Kong Chinese women, and its incidence rate has continued to rise in recent years. In 2020, 4,956 new cases of breast cancer were reported in Hong Kong. Of these, 1,314 patients were aged below 50 years, representing 26.5% of the total breast cancer cases.

The number of breast cancer cases diagnosed at age 50 or below in Hong Kong is increasing. Around 70% of Chinese women in this age group are married and participate in the work force. Younger Chinese women with breast cancer are therefore expected to return to work after their cancer diagnoses and treatment. Current health promotion programmes for women with breast cancer in Hong Kong do not specifically target the younger age group. Most require the women to physically attend during office hours, and thus many working women may not be able to participate. The availability of a flexible and Internet-based programme that overcomes the problems of time constraint and geographical location can offer a new channel through which women can receive health information, advice and care from healthcare professionals. Nearly 99% of Hong Kong citizens use their smartphones to connect to the Internet, and approximately 71% use desktop computers. The Internet-based YWWACP, aimed at providing a whole-lifestyle intervention to help younger women managing their health, can therefore represent a suitable approach, which meets younger women’s needs and facilitates the delivery of information and support.

How has the program been adapted for Chinese women in Hong Kong?

The programme was culturally adapted, and modifications made where necessary. The text of the electronic original YWWACP programme book was translated into traditional Chinese. Then, to enhance the cultural relevance, some modifications were made, for example, in relation to the diet (types of food), the types of physical activities commonly performed by Hong Kong Chinese women and the places where relaxation activities took place. The body mass index was modified with reference to the recommendation made by World Health Organisation for Asian adults. Information about alcohol after cancer was removed as alcohol intake is not common among Hong Kong women. Furthermore, instead of presenting the content in the form of an electronic book, the contents were presented on the website and scheduled on a daily and weekly basis (over a 12-week period). In addition, some health information, such as local cancer statistics and screening measures, and the official websites of health departments providing information on healthy eating and physical activities, were added.

To illustrate the steps to perform stretching and muscle strengthening exercises, graphics of young Chinese women were used. A voice plugin function was added so that the participants could click and listen to the content. Consultations with a cancer nurse were conducted either using telephone or text messaging with a cancer nurse at Weeks 6 and 12 as per the preference of Hong Kong Chinese women made during the virtual consultation at the beginning of the programme. The discussion board was removed as suggested by previous WWACP studies as it was rarely used by participants.

What are you hoping to achieve from conducting a full-scale study later in the year?

In our pilot study which was conducted during the COVID-19 pandemic, at 12 weeks after intervention completion, the intervention group showed a significant increase in the pain subscale scores of sexual function, and more improvement in the level of physical activity than the control group. Nineteen intervention group participants reported that they were satisfied with the programme and suggestions for improvement were provided. We hope that in our future full-scale study, not only could we see the changes in their level of physical activity and sexual function, but also we hope to see changes in other aspects, such as sleep quality, dietary intake and quality of life.

What are your long-term ambitions for the YWWACPHK?

In the long term, we hope that this programme will be incorporated into the routine health services offered to breast cancer patients or have the website of the programme made available to all cancer patients who would like to search and obtain information.

For more information about the Younger Women’s Wellness after Cancer Program for Women in Hong Kong, you can visit ywwacp.nur.cuhk.edu.hk/

Tele-exercise to boost recovery for regional cancer patients

Cancer Programs Research

Women in rural and regional areas recovering from gynaecological cancer and treatment will now have access to a University of Queensland rehabilitation program through telehealth.

Professor Sandie McCarthy from UQ’s School of Nursing, Midwifery and Social Work, and co-lead of Mater Research’s Health Care Delivery and Innovation program, said additional  funding from Wesley Medical Research is expanding the ACUMEN program to help regional Queensland women access support previously unavailable to them.

“More than one third of women living with reproductive cancers in Queensland are from regional and rural areas and unfortunately, many can’t access the same post-operative support as their city peers,” Professor McCarthy said.

“The new funding from Wesley Medical Research expands the current ACUMEN program by providing this group of women with the support they need through telehealth.

“ACUMEN brings together a group of health providers to deliver key recovery tools that will enhance quality of life, and now we can do that through videoconferencing.”

Approximately 20,000 Australian women are living with treatment-induced chronic disease after their cancer diagnosis.

The project’s Chief Investigator Dr Janine Porter-Steele, from Wesley Medical Research, Wesley Choices Cancer Support and UQ’s School of Nursing, Midwifery and Social Work, said it was important to get regional and rural women involved in the program.

“Most women with reproductive cancers are insufficiently active and it comes down to the lack of support and education provided,” Dr Porter-Steele said.

“Despite the known benefits of exercise after treatment, only 30 per cent of women met physical activity guidelines.

“ACUMEN is addressing an unmet need for a large group of women who are at a heightened risk of chronic conditions including diabetes, fatigue, and psychological distress.”

Rural and regional participants will receive basic equipment, assessment tools and a Fitbit for activity tracking.

Supervised exercise sessions will be delivered via a videoconferencing platform.

The first phase of the ACUMEN program has delivered face-to-face sessions for almost 50 women in south-east Queensland over the past year.

Program participant Kerry Henry said self-confidence is replaced with fear and loss of control after a cancer diagnosis.

“The program gave me a chance to take control of my fitness, and with the support of great exercise physiologists it improved my strength and balance and I feel so much better within myself.”

Queensland women living in regional and rural areas can join the program by emailing the research team at acumen@uq.edu.au.

The University of Queensland, Wesley Medical Research and The Wesley Hospital, Mater Research and Metro North Health work together to deliver the ACUMEN program, with new funding from Wesley Medical Research enabling regional and rural women to access the program via telehealth.

This article first appeared in the UQ News.

Why women need to talk about type 2 diabetes

Diabetes Interview Programs Research

We recently spoke with Professor Jackie Sturt from Kings College London on the Women’s Wellness podcast about why women need to talk about type 2 diabetes and how the Women’s Wellness with Type 2 Diabetes program is helping women feel supported on their journey to wellness.

More than 200 million women across the globe are living with type 2 diabetes, which is a deficiency in insulin. Professor Sturt says the reason for the lack of insulin is often because the cells in our body have become resistant to the insulin circulating, which is necessary for glucose to get into our cells.

“Our body needs this glucose to function, but in type 2 diabetes there’s a problem between the lock and the key,” she says.

“The glucose is not getting from the circulating blood system into the cells that need it. So, there’s too much glucose circulating the body, which is what causes the problems.”

Professor Sturt says that type 2 diabetes now affects more than 60 million younger women, between the ages of 18 and 39, across the globe.

“There are genetic factors that affect your likelihood of developing type 2 diabetes, however, globally we’re living in this obesogenic environment, which is promoting sedentary behaviour and higher calory intake,” she says.

“These factors lead to weight gain and this can play a part in switching on those genes that trigger diabetes, so type 2 diabetes is certainly linked to lifestyle factors.”

Professor Sturt says women’s experiences of living with chronic health conditions differ from those of men so women need tailored support programs to suit their specific needs and concerns.

“Women have a reproductive stage of life, which can span between the age of 14 to 65, and this stage is very much impacted by living with a chronic condition like type 2 diabetes,” she says.

“Not only are women having to manage this complex metabolic condition, but they’re also having to manage their menstrual cycle, hormonal fluctuations, pregnancy and contraception and then the depletion of hormones and heading into menopause and the weight gain associated with this stage.

“All of these factors make it very difficult for women to focus on their diabetes, so they need extra support and special focus to help them feel like they’re in control and they’ve got some sense of management of these twin health experiences.”

Listen to the full episode on the Women’s Wellness podcast here or read more about the Women’s Wellness with Type 2 Diabetes program here.

 

Talanoa approach supports long-term change for Pasifika women with diabetes

Interview Programs Research

Type 2 Diabetes is a significant public health problem and Australian Pacific Islander women and their communities are experiencing a higher burden of morbidity and mortality from the disease. Despite the higher burden, there are few initiatives that are culturally tailored to improve prevention and management.

We spoke to Women’s Wellness Research Collaborative member Dr Heena Akbar from the University of Queensland about using talanoa, a community-based research methodology, to build capacity with Australian Pacific Islander women in Queensland to develop culturally relevant methods of information sharing and knowledge building to improve health outcomes for women with Type 2 Diabetes.

Can you tell us more about this project and how it came about?

The Pasifika Women’s Diabetes Wellness Program was borne out of wanting to look at diabetes in the Pasifika (Pacific) context because, as a person from Fiji, we are often faced with an increased risk of type 2 diabetes in our communities, both in the islands but also in Australia. Here in Australia, we don’t have recent data, which makes it challenging for our communities to address this important issue.

I started my PhD in 2013 after talking to our community elders and members about how we might address this problem in a culturally appropriate and strength-based way. My PhD looked at “Socio-Cultural Context of Managing Type 2 Diabetes in Australian Pacific Islander Women Living in Queensland” where through participatory action research and embedding the Talanoa Pacific methods – story telling – we aimed to understand how our women who already have type 2 diabetes were looking after themselves and managing their diabetes within their family and community context.

The focus of this research was about working together with our women in the Māori and Pasifika community to develop awareness around diabetes and to promote diabetes prevention and management for our Pasifika community. We worked closely with our Pasifika communities to host three diabetes health forums (during my PhD) that provided diabetes education, promoted awareness around chronic conditions and undertook health screening for our people within a culturally safe community space.

Community led initiatives have a far more powerful impact on change. This is partly because we frame our work through cultural safety principles and cultural values such as identity, respect, reciprocity, spirituality, family and community, which are pertinent to Māori and Pasifika communities and our ways of knowing, being and doing.

Can you tell us more about the community-academic partnership and the value of this to the project?

Community-academia partnership is really important, particularly when we want to build a culturally responsive research path for academia and community collaboration.

Strong partnerships are also very important if we want to make a positive contribution towards influencing long-term health behaviours.

Our work is largely a partnership with the Pasifika Women’s Alliance Inc. (PWA), a culturally diverse network of women from across Oceania that seeks to build and strengthen a Queensland sisterhood of Pacific Islander women and to raise awareness of members as to their rights and responsibilities as citizens and encourages their participation in all aspects of community life. A large part of this is ensuring that our women are aware of their health and includes promoting healthier and stronger families through projects like the Pasifika Women’s Diabetes Wellness Program.

What is the Talanoa Framework and how was it used in your approach?

‘Talanoa’ frames how we talk to each other. Talanoa – is a Pasifika way of having conversations and dialogues between people and relies heavily on building and maintaining relationships. Talanoa with elders and members of the Pasifika communities are critical in community engagement and in the development of diabetes research protocols to ensure long-term benefits and change in health inequities.

In the Pasifika Diabetes Wellness context, it is important for us to build personal connections with our women and communities – using our Pasifika way – ‘Talanoa’ – which means that our women own the process of collecting the information that is meaningful to them.

It is also about acknowledging our ancestors, our culture, where we come from and giving that respect to our people. Trust, reciprocity, spirituality, nurturing is all part of our collective Pacific culture. Embracing these in the research processes is imperative to working respectfully with Pacific peoples and is very important in our understanding of our health and wellbeing.

We have approached this research using talanoa as a cultural framework and taking this approach has certainly made the research and collecting information more meaningful for our women and community.

What have been some of the notable outcomes of this project to date – for the community and academia?

Our research and this project have built strong partnerships with key stakeholders, including Griffith University, Diabetes Queensland, The Good Start Program for Māori and Pacific Islander Communities, and many community groups who are represented by our PWA members. PWA have been pivotal in creating a safe space for our women to engage in this research process and also to ensuring that the research mutually benefited our Pacific communities.

Through these partnerships, we have led three very significant community summits – the Pacific women’s diabetes health forums, in 2013 and 2014, and community-led Pasifika diabetes health from in 2016.

We have also worked very closely with our Pasifika communities and PWA to provide a culturally-safe community space to run diabetes education sessions, undertake health screening for our people and conduct Talanoa discussions to collect information with our people. More than 90 Queensland University of Technology students have also conducted community placements in these health forums.

This framework has been used worldwide amongst Indigenous peoples and is notably a very successful model because it is driven by the people and for the people using their own cultural frameworks.

We have also been instrumental in building individual as well as organisational capacity for our women to address health in the community. We developed a teaching module which is currently being used by the Federal Government to train and educate health providers in how to work with culturally and linguistically diverse and Indigenous communities such as ours.

We have presented in several national and international Health conferences including NZ, Hawaii, Canada, Cairns and here in Brisbane and were awarded two grants to run the Diabetes health forums and carry out the research (through Diabetes Queensland and QUT Engagement and Innovation grant).

Future grants have allowed us to develop the Pasifika Women’s Diabetes Wellness Program and the most recent funding will allow us to trial this program.

For more information about the Pasifika Women’s Diabetes Program, visit www.dawncomplete.org.au.

Dr Heena Akbar is a Lecturer in Public Health within the Faculty of Medicine at the University of Queensland and an Adjunct Fellow at the Queensland University of Technology.

Life after cancer treatment – bridging the wellness gap

Cancer Interview

With the launch of the Women’s Wellness podcast, we spoke to Professor Sandie McCarthy from the University of Queensland about the Women’s Wellness after Cancer Program; its origins, its purpose and how lifestyle interventions can improve post-treatment experiences.

Why do we need a program for Women’s Wellness after Cancer?

The catalyst for the Women’s Wellness after Cancer program happened when I was working as a chemotherapy nurse many years ago. I would provide care for women over an intensive period of time and then never see them again and would often wonder what happened to these women after their cancer treatment. One day I ran into a lady I had helped treat and she looked really unwell. I asked how she was doing and she said that while the cancer was gone, she was left with heart failure. And this was many years before we fully understood the many side effects cancer treatments have.

So from that moment on, I started researching what happened to these women and was quite devastated as a clinician as to the after effects, and long term side effects, of the treatments that I had been administering. In those days these weren’t really well recognised – they are now.

Today we also understand that if we implement certain lifestyle changes, both during and after treatment, we can often prevent those side effects from happening or moderate their effects. And this was ultimately the impetus for the development of the Women’s Wellness after Cancer Program.

What sort of lifestyle modifications can women put in place if they are undergoing cancer treatment or completed treatment?

There’s a raft of different lifestyle changes and modifications women can make after cancer treatment but what ultimately underpins success for women’s wellness is good psycho-social support. We’ve got to wrap these women in a support blanket, because essentially when they’ve left cancer treatment, they’re left to recover on their own – they are considered well. Many women don’t know what lifestyle changes or strategies to use to change their treatment outcomes and post treatment experience.

What we’re really focused on with the Women’s Wellness after Cancer Program is quality of life and function for these women, and how lifestyle modifications can enhance that. This includes things like lots of movement, minimising alcohol wherever possible, eating a really healthy diet, getting enough sleep, minimising the effects of early onset menopause that is brought on by many breast and gynecological cancer treatments and minimising psycho-social distress.

So what can women expect from the Women’s Wellness after Cancer Program?

The Women’s Wellness after Cancer Program is a 12-week, very supportive, lifestyle management intervention program, where we give a lot of clinical and psycho-social support to women. Throughout the 12-weeks we guide them through the lifestyle changes that they need to make in a very evidence-based way. So things like, what’s the best way to get your body moving, particularly when you’ve got pain or neuropathy; what’s the best diet to have – women who have undergone breast cancer treatment, for example, often come out of the treatment weighing a lot more than when they went in due to the nature of the drugs, so we support women to lose weight in the best and safest way. We also help women work through how best to manage the hot flushes and the sleeplessness that is a result of treatment-induced menopause and how to manage lymphedema, which is the swelling of limbs that can occur after some surgeries.

These are just some of the ways we support women during the 12-week program and we’ve had a great deal of success with the program. Since then, we’ve moved onto younger women with the Younger Women’s Wellness after Cancer Program because they have very specific issues around sexual function, fertility, social support and how to bring up young children in the context of this condition, for example.

What’s next for Women’s Wellness?

We’ve expanded the Younger Women’s Wellness after Cancer Program into New Zealand and Hong Kong and next year we’ll be developing a whole new program with Canteen for younger women and young men between the ages of 15 and 24. We’re developing a lifestyle intervention for them, which will be totally delivered by telehealth and designed by the participants – they’ve even designed the logos for the program.

We’ll also be moving into addressing issues like body image in our Programs, because a lot of cancer surgeries, chemotherapy and radiotherapy result in a lot of bodily alteration that can be quite difficult to deal with, from the removal of breasts, lymphedema and stomas on the outside of your stomach rather than normal bowel function, for example. So we’re considering how to support women to develop a ‘normal’ lifestyle in the context of bodily alterations that come as a result of cancer treatments.

For more information about the Women’s Wellness after Cancer Program and other wellness programs, visit www.dawncomplete.org.au 

Janine Porter-Steele

Personal Stories Research Spotlight on....

Janine is The Clinical Nurse Manager of the Wesley Hospital Choices Cancer Support Centre in Brisbane.  The centre offers support, sharing and information for women, men and their families affected by a diagnosis of cancer. For many years Janine has also been actively involved with the Women’s Wellness Research Programs as manager,  delivering the programs, supporting the development of resources, and co-writing a number of the journals.

Janine undertook much of her training in the UK as a registered nurse, midwife, health visitor and family planning nurse. She completed a Bachelor of Nursing at QUT, a Masters in Nursing Leadership at ACU and she is also Breast Care and Women’s Health Nurse. Janine believes very strongly in providing interdisciplinary and comprehensive support for people affected by a diagnosis and treatment of cancer and has a particular interest in younger, midlife and older women’s health. Janine completed her PhD studies in the area of cancer and sexuality linked with the Women’s Wellness after Cancer Program (WWACP). Her particular focus is in managing menopause, sexuality, body image and depression issues for women.

Lately, Janine has been working with Auckland University and the University of Queensland to deliver a program as part of a research trial providing a Women’s Wellness Program for young women in New Zealand  (NZ) diagnosed with breast cancer. She and the Women’s Wellness team have also been recipients of a grant from Wesley Medical Research. They are using this to replicate the NZ feasibility trial with young women diagnosed with breast cancer in Australia.

In her spare time Janine likes spending time with family and friends. She enjoys walking the local bush tracks in the area. Her favourite relaxation is wandering along the beach in Northern New South Wales and kayaking the rivers down there.

Leonie Young

Cancer Personal Stories

We hear stories all the time about people diagnosed with cancer but when it becomes personal we’re never prepared.  Somehow, we seem to think we’re different and these things happen to other people.  Well I learned otherwise.  Cancer is what opened up another world and changed so much about who I thought I was.

Breast cancer was totally unexpected especially as I was only 32 years old.  I was busy enjoying being a mother to my two small daughters.  I certainly wasn’t ready to die, although like most people diagnosed with cancer, this is what I thought.

Just hearing the words You have cancer can be a devastating experience people usually remember for the rest of their lives long after they have forgotten all the details of medical treatment and tests that followed those words.

Often people are so frightened by the word “cancer” they hear nothing else.  Interestingly, hearing the diagnosis may actually be more traumatic for some, regardless of their diagnosis. That’s what having a cancer diagnosis is like – people aren’t necessarily brave or especially wonderful in what they do, they just do what they have to do to survive because there’s really no other choice.

My world soon changed to the previously unknown one of tests, surgery, and chemotherapy.  Cancer treatments aim to save lives but in doing so, they often bring life-changing side-effects.   I eventually found ways to make meaning of what I had been through  and found myself being involved with many aspects of cancer consumer advocacy, support, training, and mentoring.  I became interested in research because I believe evidence based practice is the only way we will see change and I have  been able to work along-side researchers  providing input from my personal experience as they develop their research projects.

Likewise, in my work at the Wesley Hospital Choices Cancer Support Centre (Choices) I help support people diagnosed with cancer from the perspective of someone who has “been there” and now with my work and through initiatives like the Women’s Wellness  Programs and the Younger Women’s Wellness After Cancer Program, this support is able to continue in a very rewarding way.

I’ve survived to see my daughters grow up, get married, and have children.  I have to confess I’m torn between wanting to stay young and knowing that growing older is a privilege many women still don’t have.  When I was that young woman back then I really wanted to be where I am today so I do try really hard to embrace the ever increasing grey hair and consequent extra trips to the hairdresser and wrinkles and all the other things that come with age.

Over time I learned to respect cancer, not fear it.  I discovered the power of the lived experience, the value of peer support, and about how I could make a difference.

I want breast cancer to go away so my daughters and grandchildren – and your children, grandchildren, sisters, mothers, friends can live without the fear of breast cancer.

Magnesium

Magnesium Deficiency

Nutrition Research

This information has been summarized from a discussion by George. D. Lundberg MD (in medscape.com May 2015)

Dr Lundberg says Magnesium is an essential mineral that has significance in multiple regulatory enzyme systems controlling, bone, muscle, nerve, protein, DNA, glucose and energy metabolism.  He discusses a report in 2009 by the World Health Organization that stated in America 75% of people did not consume enough magnesium in their diet. This may be due to the prevalence of fast or processed food intake. Interestingly consumption of alcohol even in moderate amounts can double or even quadruple the loss of magnesium from the body.

Deficiency in magnesium has been blamed for many illnesses including irregular heart beat, high blood pressure, anxiety, seizures, leg cramps, restless leg syndrome, fatigue, weakness, pre menstrual syndrome, osteoporosis and fibromyalgia. He points out that blood tests are not a reliable indicator of a person’s magnesium level but in people presenting with the issues described above, low magnesium should be considered

The recommended daily intake of magnesium varies according to whether you are male or female but Lundberg says 400mg is an average amount to include in your daily intake, preferably from your diet.

Magnesium is found in dark leafy greens, especially kale and spinach and broccoli, tree-nuts and peanuts; seeds; oily fish; lentils, legumes, whole-grains, avocado, yoghurt bananas, kiwi fruit, dried fruit, dark chocolate and molasses.

Check with your doctor whether or not it is ok to take a supplement if don’t think you are getting enough magnesium in your diet.  (I think I know what my supplement might be……!)