0:00

Hi there. Thank you for joining us. Tarah Schwartz is off this week. I'm

0:01

Kelly Albert. And this is Health

0:04

Matters on CJAD 800. On today's

0:04

show, the McGill University

0:09

Health Center is leading the

0:09

world on a new way to treat

0:11

throat cancer. Later in the

0:11

show, we speak with the

0:14

researcher who is pioneering

0:14

this new, less invasive

0:17

treatment. And, learn about a

0:17

new committee designed to help

0:20

patients and their families and

0:20

caregivers while receiving

0:23

treatment at the MUHC. To begin

0:23

today, February is Heart Health

0:26

Month, a time to bring awareness

0:26

to the importance of

0:29

cardiovascular health and what

0:29

we can do to reduce our risk of

0:32

cardiovascular disease. Heart

0:32

disease is the leading cause of

0:36

premature death in women. About

0:36

one in three Canadian women will

0:38

die from heart disease. The

0:38

Women's Healthy Heart

0:41

Initiative's mission is to

0:41

increase awareness, prevent and

0:44

treat heart disease. Wendy Wray

0:44

is a cardiac nurse and the

0:47

founder of the Women's Healthy

0:47

Heart Initiative at the MUHC.

0:50

Wendy, thank you so much for joining us.

0:53

Thank you for having me, Kelly.

0:54

So February is

0:54

Heart Health Month. But I feel

0:57

like there are still some

0:57

misconceptions that persist when

1:00

it comes to heart disease. Do

1:00

you feel that's true?

1:03

I feel that

1:03

very true, especially when it

1:06

comes to women. Unfortunately,

1:06

it still is believed that heart

1:11

disease is a man's disease.

1:11

Whereas, we know and have known

1:14

for a while now that it's not.

1:14

It's a women's disease as well.

1:19

Particularly,

1:19

because it is the leading cause

1:22

of death in women. We hear about

1:22

breast cancer. We think of the

1:26

different types of cancer that

1:26

affect women. But this is really

1:29

the one that we should be focused on.

1:32

Absolutely. I

1:32

don't think we hear enough about

1:35

women and heart disease. We know

1:35

that even in 2023, women are

1:40

under-aware of their heart

1:40

disease risk. They are

1:43

under-diagnosed, undertreated,

1:43

and under-researched. And I

1:47

think now is the time that this

1:47

should change. It needs to

1:51

change and that's why we need to

1:51

talk more about it.

1:55

In conversation

1:55

with Wendy Wray, a cardiac nurse

1:57

and the founder of the Women's

1:57

Healthy Heart Initiative at the

2:00

MUHC. Now we've spoken about the

2:00

Women's Healthy Heart Initiative

2:03

before on the show. But let's

2:03

remind our listeners for those

2:06

who may not know, what is the

2:06

WHHI.

2:11

The Women's Healthy Heart Initiative, we opened in 2009. And the reason

2:12

we developed this project was to

2:17

increase the awareness of

2:17

women's risk of heart disease;

2:20

as well as, empowering women to

2:20

improve their heart health.

2:24

Heart disease is 80%

2:24

preventable, usually through a

2:29

healthier lifestyle. And so as

2:29

you can imagine, if we get women

2:35

to be aware of their heart

2:35

disease risk, take better care

2:38

of themselves from a heart

2:38

health perspective, we can delay

2:45

heart disease down the road.

2:47

I think that's a

2:47

key number that you just

2:49

mentioned. 80% preventable. And

2:49

you mentioned lifestyle changes

2:55

and things like that. So if you

2:55

can prevent heart disease from

2:58

80%, how come we don't know more

2:58

about that? Like, why are we

3:03

screaming this from the

3:03

rooftops? I mean, you are but...

3:06

But I'm only

3:06

one voice. And that's why

3:11

speaking with you like this and

3:11

reaching your listeners. It's so

3:15

important, because that's a very

3:15

good question. I don't know why

3:20

we cannot get a light shone on

3:20

this issue that is so

3:25

preventable. As late as 2017 in

3:25

North America, we have seen an

3:32

uptick in heart disease in young

3:32

women. And this to me is

3:36

incredible that this could even

3:36

possibly be happening. Because

3:40

we are 'have' countries. We are

3:40

wealthy countries. And so why is

3:47

it that we're actually seeing an

3:47

uptick rather than a decrease in

3:50

heart disease in women? It makes

3:50

no sense to me.

3:53

In conversation

3:53

with Wendy Wray, a cardiac nurse

3:55

and the founder of the Women's

3:55

Healthy Heart Initiative, you

3:58

mentioned that we're seeing an

3:58

uptick. And you mentioned that

4:02

women are still

4:02

under-researched, under-treated

4:05

for heart disease. So what are

4:05

some things that anyone but

4:09

particularly women should know?

4:13

First of all,

4:13

heart disease should be on their

4:15

radar. Because certainly from a

4:15

woman's perspective, being a

4:18

woman myself, breast cancer,

4:18

uterine cancer, cervical cancer

4:23

is on my mind, but I'm more

4:23

likely to have heart disease. So

4:28

I think that we need to change

4:28

our priority list when it comes

4:31

to health. And if our health

4:31

care providers are not giving us

4:35

the information, or prioritizing

4:35

it for us, we need to advocate

4:40

for ourselves. We need to ask-

4:40

is my blood pressure okay? Is my

4:49

is my sugar okay? Am I going to

4:49

become diabetic? What is my

4:53

cholesterol? My body mass index,

4:53

am I too heavy? Am I doing

4:58

regular physical activity? These

4:58

things are all modifiable, these

5:02

things are all changeable. And

5:02

so as women, this is what we

5:06

need to do for ourselves.

5:09

And I think you bring up a good point too, that often we women don't think to

5:10

advocate for themselves. They

5:15

don't think to push a little bit

5:15

further if someone says; it's

5:18

fine. Or you say that yourself

5:18

about your symptoms, Oh, it's

5:21

nothing. I'm really tired. I am

5:21

very stressed right now. So what

5:26

are some things that we should

5:26

connect with if we're feeling

5:30

things in our body that are

5:30

different that we're trying to

5:33

I think the

5:33

first thing is number one to

5:33

dismiss? have heart disease on our radar.

5:35

The second thing is when it

5:40

comes to symptoms of having a

5:40

heart attack, or symptoms of

5:44

heart disease, if we have it on

5:44

our radar, we'll be more likely

5:48

to think about it. We're great

5:48

triagers as women because we're

5:52

often caregivers, nurturers and

5:52

so we're used to triaging for

5:57

our families, our colleagues,

5:57

our partners, etc. When it comes

6:01

to heart disease, you cannot

6:01

decide at home if you're having

6:05

a heart attack or not. Why?

6:05

Because we need three things

6:09

when you come to the hospital to

6:09

decide if you're having a heart

6:14

attack. Number one, we need to

6:14

hear the description of your

6:18

symptoms. Number two, we need a

6:18

blood test. And number three, we

6:22

need a cardiogram. So clearly

6:22

you can't do that at home. Women

6:27

have to feel comfortable coming

6:27

in with this discomfort in their

6:31

chest, they might be feeling. A

6:31

burning, heaviness, tightness,

6:36

pressure, or squeezing, a

6:36

general feeling of being unwell,

6:40

short of breath, a bit more

6:40

sweaty than normal. If it's not

6:44

a heart attack, and they do get

6:44

sent home, that's a good day.

6:48

But if they are one of the 15%,

6:48

who come into the emergency

6:52

room, having chest discomfort,

6:52

who are having a heart attack,

6:57

it could be the luckiest day of

6:57

their life. Because heart

7:01

attacks kill.

7:02

Absolutely. And I

7:02

think one of the things that I

7:05

love that you say all the time

7:05

is, no one is going to get mad

7:08

at you for going to the hospital

7:08

if you're think you're having a

7:10

heart attack. If you think

7:10

you're having a heart attack,

7:12

you've made the right decision,

7:12

you've gone to the right place.

7:15

So I think that's so important

7:15

to remember that if you think

7:18

you're having a heart attack, go

7:18

to the hospital, even if you're

7:21

not.

7:23

Absolutely,

7:23

because as you pointed out, you

7:29

can't decide at home anyway and

7:29

we understand that. So I think

7:34

it's very important. The other

7:34

thing is, tell them when you are

7:38

in the emergency room, tell them

7:38

why you're there. Say I'm

7:42

feeling unwell. I have this

7:42

chest discomfort. I'm afraid I'm

7:46

having a heart attack. Because a

7:46

lot of women tell me they won't

7:51

go to the emergency room because

7:51

they're afraid they're going to

7:53

sit there for 12 or 14 hours. If

7:53

you make clear why you were

7:58

there, you will get timely care.

7:58

But be sure to share with them

8:03

the reason that you're there. I

8:03

think that's really important as

8:06

well.

8:08

Wendy Wray is a

8:08

cardiac nurse and the founder of

8:10

the Women's Healthy Heart

8:10

Initiative. We have a few

8:12

moments left Wendy and I would

8:12

really love to talk about

8:15

February 13 and a special

8:15

presentation that you're doing

8:18

for Wear Red Day, can you tell me about it?

8:22

Actually we should be really proud because we started Wear Red Day here in

8:23

Montreal in 2010. And it's

8:28

exploded nationally through the

8:28

Canadian Women's Heart Health

8:32

Alliance. So yearly, on February

8:32

13, this year it is this coming

8:38

Monday. We encourage women to

8:38

wear red and men as well, to

8:43

support women and heart disease.

8:43

At the MUHC, at six o'clock in

8:49

the evening in the Research

8:49

Institute amphitheater. Dr.

8:53

George Thanassoulis, one of our

8:53

cardiologists, will be speaking

8:59

about prevention of heart

8:59

disease in women. It's not just

9:03

cholesterol. And I will speak a

9:03

little bit after about signs and

9:08

symptoms of heart disease or

9:08

having a heart attack. It's open

9:11

to the public. It's free and we

9:11

welcome everybody to attend.

9:15

It's an amazing

9:15

opportunity to take your health

9:19

into your own hands and to

9:19

advocate for yourself and to

9:22

know what you should look out

9:22

for. And Wendy, I'm so grateful

9:26

that you're doing this for our

9:26

listeners and for everyone who

9:30

wants to learn a little bit more

9:30

about their heart health. Thank

9:32

you so much for your time today.

9:34

Thank you very

9:34

much for having me, Kelly.

9:36

That's Wendy Wray,

9:36

a cardiac nurse and the founder

9:39

of the Women's Healthy Heart

9:39

Initiative at the MUHC. If you

9:42

would like to know more about

9:42

the WHHI, you can go to M

9:45

UHCFoundation.com Next up on

9:45

Health Matters, he knows

9:49

firsthand what it's like to live

9:49

with an irregular heartbeat, and

9:52

he's lending his voice to ensure

9:52

the experts of the MUHC have

9:55

what they need to fix it. Tarah

9:55

Schwartz is off this week. I'm

9:59

Kelly Albert. Welcome back to

9:59

Health Matters on CJAD 800. This

10:03

past holiday season, the MUHC

10:03

Foundation, fundraised to

10:06

purchase cutting-edge equipment

10:06

for the Electrophysiology lab at

10:09

the MUHC, this area of expertise

10:09

deals with the electrical system

10:14

of the heart. So if your heart

10:14

is beating too fast or too slow,

10:18

in both of these cases, it can

10:18

cause serious problems. And we

10:21

wanted to hear from a patient

10:21

who has experienced this and

10:24

knows exactly how helpful the EP

10:24

lab at the Glen site can be.

10:29

Hugo Perrin's life changed

10:29

completely on his 18th birthday

10:32

when his heart started racing

10:32

out of control. Hugo is a

10:35

cardiac patient who is being

10:35

treated at the MUHC and he joins

10:39

me now. Hi, Hugo, thank you so

10:39

much for being here.

10:42

Hey, thanks for the invite.

10:44

You have a very

10:44

incredible story. It was the

10:47

night of your 18th birthday. You

10:47

were out celebrating with

10:50

friends. And then all of a

10:50

sudden, your heart started

10:54

racing out of control. Can you

10:54

tell us a little bit about what

10:57

happened that night?

10:58

Yeah, what a night.

10:58

I was with friends partying,

11:05

like you mentioned. And I don't

11:05

remember, I think it was around

11:09

midnight, my heart started

11:09

racing like crazy. I was really,

11:12

really scared. But at first I

11:12

was like, maybe it's because for

11:15

the first time I was drinking

11:15

alcohol and that was a side

11:20

effect of it. After an hour, I

11:20

started feeling dizzy and

11:24

everything. So I asked my

11:24

girlfriend at time and she said,

11:32

Look, just lay there for a

11:32

couple of minutes, it's going to

11:35

go better. And 30 minutes later,

11:35

the ambulance came in. I had to

11:40

go to the emergency and they had

11:40

to stop my heart and restart it.

11:46

Just in order to make sure that

11:46

the arrhythmia stop, and I was

11:51

diagnosed with supraventricular

11:51

tachycardia. That's what

11:57

happened on my 18th birthday.

12:00

You sort of

12:00

described what it's like to have

12:02

a tachycardia that was the first

12:02

time you experienced it, but

12:05

what is it like to live with it?

12:05

It's been, I guess about 10

12:09

years since this happened to you?

12:11

Yeah.

12:12

So what is it like

12:12

to have attacks of tachycardia?

12:17

Basically, it's

12:17

just that your heart goes really

12:20

fast for a certain amount of

12:20

time. At the time, if I wouldn't

12:24

take my medication, it wouldn't

12:24

stop or it would take five

12:28

hours. It was kind of scary. And

12:28

when I was diagnosed with this

12:33

arrhythmia, I remember that when

12:33

I used to play hockey, I thought

12:37

that I was really performing and

12:37

I was giving a lot of energy on

12:41

the ice. But finally I realized

12:41

that it was tachycardia. So I

12:45

had a couple of examples in my

12:45

head of previous times it

12:51

happened to me. But it's really

12:51

your heart is going really fast.

12:55

Like if you're sprinting, but

12:55

you're looking at your computer

12:58

or your cell phone. So that's a

12:58

weird feeling.

13:01

Yeah, that is a weird feeling. Because you're sitting, you're resting, you're

13:03

not doing anything, and then all

13:05

of a sudden your heart starts to

13:05

race. That must be really

13:10

frightening when that happens.

13:11

Yeah. And I heard

13:11

that a couple of people, it's a

13:14

bit different than me. For me,

13:14

it's more when I bend over, or I

13:18

jump sometimes it can start like

13:18

that. And some people is just

13:21

there doing nothing and it

13:21

starts out of nowhere. So it

13:25

really depends on people. To me,

13:25

it's more positional.

13:29

We're speaking with Hugo Perrin, who is a cardiology patient at the MUHC.

13:31

You must have thought when this

13:37

was happening, that you're too

13:37

young to be having heart issues.

13:41

You were 18 when this happened,

13:41

you're still quite young. Like,

13:44

how difficult is it to wrap your

13:44

brain around that this is

13:48

happening to you?

13:50

Great question.

13:50

Honestly, with the support I had

13:53

with the older professionals at

13:53

the hospital, it was not a big

13:59

deal to me. Really, because my

13:59

cardiologist explaining

14:03

everything. He took the time to

14:03

really explain what the

14:07

condition was. And I realized

14:07

that first of all, it was not

14:11

life-threatening so that was

14:11

really comforting. And second of

14:14

all, he explained to me the kind

14:14

of the roadmap that we have to

14:17

follow to go through it. So what

14:17

was the medication, the

14:21

procedure that I would have to

14:21

go through eventually, and it

14:26

was really comforting. So of

14:26

course, I told myself that it

14:33

was kind of weird that that

14:33

18-years-old was a cardiac

14:37

patient at the MUHC. However,

14:37

with their support and

14:42

everything; I felt really okay

14:42

about it.

14:48

That's wonderful.

14:48

You mentioned your care team

14:51

that you're under Dr. Essebag.

14:51

Dr. Vidal Essebag who's a

14:54

wonderful electrophysiologist

14:54

and the head of the

14:57

electrophysiology department at

14:57

the MUHC. So what is it like to

15:00

be his patient you alluded to

15:00

feeling very comforted by him.

15:05

But what is he like as a doctor?

15:07

He's amazing. I

15:07

have to say. He was my first

15:10

doctor in all my life. Honestly,

15:10

this guy is just amazing. During

15:17

the surgery, you're wide awake

15:17

during a surgery; you're awake.

15:21

It's important because sometimes

15:21

after asking questions and stuff

15:25

like that. I remember the first

15:25

time; it was kind of scary my

15:29

first surgery. And we were

15:29

talking about hockey. Literally,

15:32

we're talking about the Montreal

15:32

Canadiens. And he was playing in

15:35

my heart, that was kind of

15:35

crazy. But you have to

15:38

understand the character. That's

15:38

Dr. Essebag, he is really

15:41

professional. He's thoughtful.

15:41

Like I told you, he took the

15:44

time with me to explain

15:44

everything. So the honestly, I

15:49

have nothing bad to say about

15:49

this guy. He's really amazing

15:53

guy.

15:54

He's a very warm

15:54

doctor. And I was very lucky

15:57

enough to see a procedure at the

15:57

MUHC. Sometimes, they let us

16:01

watch a procedure to see what

16:01

that's like. And it's sort of

16:05

fascinating how minimal it is.

16:05

There are just like a few little

16:09

holes in the body, not even very

16:09

big holes. And everything is

16:12

done with these tiny little arms

16:12

and scopes and things. And so it

16:17

must be so surreal to know that

16:17

there's something going on in

16:20

your body, but it's tiny.

16:24

And it's not even

16:24

just in your body in your heart,

16:26

right. He's taking control of

16:26

your heart. And you're talking

16:30

to the surgeon and everything.

16:30

Honestly, it was unreal the

16:34

first time. Because I had three

16:34

procedures and the first time I

16:39

did it; honestly, I couldn't

16:39

believe it.

16:41

In conversation

16:41

with Hugo Perrin, a cardiology

16:45

patient at the MUHC. So how is

16:45

your health now? Are you doing

16:49

okay? Are there things that you

16:49

always have to be mindful of now

16:52

as you go forward?

16:56

Right now it's

16:56

okay. After the first surgery,

17:00

it was I was really, really

17:00

lucky to be able to not have

17:05

arrhythmias anymore. It lasted I

17:05

think, two years. After that it

17:10

started to come back and

17:10

apparently that's normal. Dr.

17:15

Essebag told me that when the

17:15

heart grows and everything,

17:20

sometimes it happens that it can

17:20

come back. So I had to undergo

17:24

another procedure. So same thing

17:24

for two-three years, it was

17:29

okay. And then it came back and

17:29

I had another one the last time

17:32

and since then, I'm doing really

17:32

good. So it's always on and off

17:38

that's a problem. Sometimes,

17:38

like he told me, normally it

17:42

goes up for the first time. But

17:42

right now, for some reason, my

17:48

heart, I think it likes to have

17:48

arrhythmias. So once in a while,

17:52

it comes back. But it's not a

17:52

big deal. When it comes back, I

17:55

just take a pill and it's a lot

17:55

better. So it's not life

17:59

threatening, like I told you.

18:01

Good, you can keep

18:01

it under control. And one of the

18:03

things that I really admire

18:03

about you, Hugo is you've gone

18:07

through this experience, you've

18:07

lived with this condition for 10

18:10

or so years. And you are really

18:10

so grateful for the care that

18:16

you've received from Dr.

18:16

Essebag, that you're telling

18:18

your story, you're lending your

18:18

voice to the MUHC Foundation to

18:21

help fundraise for this EP lab.

18:21

Why is it important for you to

18:26

help other patients who might be

18:26

experiencing this get the same

18:29

care that you received?

18:32

Because I think

18:32

mostly, it's life-changing.

18:35

Having an arrhythmia can be

18:35

really scary. I have to be

18:40

honest. The first time you have

18:40

them, it's not a nice feeling.

18:45

And the surgery, the procedure

18:45

is, like you said really

18:50

minimalist. Since it's

18:50

noninvasive, I think it takes an

18:59

hour and a half, something like

18:59

that. And the next day, you're

19:02

out of the hospital. I wanted to

19:02

be able- since there's a

19:05

shortage of the EP labs right

19:05

now- I wanted to be able to help

19:11

others have the same access to

19:11

those EP labs that I had a

19:17

couple of years ago. So to me,

19:17

it's really important because it

19:20

basically changed your life. You

19:20

start from adding a problem to

19:24

not having one.

19:26

It's amazing. I'm

19:26

so glad to hear that you're

19:29

doing well. Hugo, thank you so

19:29

much for sharing your story with

19:31

us on Health Matters.

19:34

Thanks for the

19:34

opportunity. And anytime I'm

19:36

here for you guys.

19:37

That is Hugo Perrin. He is a cardiology patient at the MUHC. Coming up

19:39

on Health Matters how the MUHC

19:44

is leading the world in a

19:44

specialized way to treat throat

19:47

cancer. Tarah Schwartz is off

19:47

this week. I'm Kelly Albert and

19:51

this is Health Matters on CJAD

19:51

800. Last week, you heard us

19:55

speak about World Cancer Day and

19:55

six patient advocates that we

19:58

had sharing their stories as

19:58

ambassadors for the wonderful

20:02

care that they received at the

20:02

MUHC. Now we're still tallying

20:06

up the totals for what we

20:06

fundraise for World Cancer Day.

20:09

But until then, we wanted to

20:09

share with you the story of one

20:12

of the doctors who is supporting

20:12

two of our cancer patients with

20:16

throat cancer. Dr. Nader Sadeghi

20:16

is the Director of the McGill

20:20

Head and Neck Cancer Program and

20:20

the Chair of the department of

20:22

Head and Neck Surgery at the

20:22

MUHC. He joins me now because

20:26

the me he is actually pioneering

20:26

a new way of treating throat

20:30

cancer. Thank you so much for

20:30

joining me, Dr. Sadeghi.

20:33

You're welcome. Thank you.

20:34

So I said throat

20:34

cancer, I said head and neck

20:37

cancers, but what are some of

20:37

the cancers that you treat as a

20:40

head and neck surgeon?

20:42

We treated

20:42

all the cancers of the upper

20:44

aero-digestive tract that means

20:44

the oral cavity, the mouth, the

20:47

tongue, the tonsils, the voice

20:47

box, the back of the throat. And

20:53

in addition, we also treat

20:53

cancers of the salivary glands,

20:56

which are located in the head

20:56

neck region. And as well as

20:59

thyroid cancer and skin cancer

20:59

that developed from the skin on

21:04

the exposed parts of the neck

21:04

and the and in the face.

21:07

Those are a lot of

21:07

different areas that you take

21:09

care of. And, we spoke briefly

21:09

about head and neck cancers last

21:13

week on the show, but I think

21:13

it's worth bringing up again

21:16

that that you're actually

21:16

pioneering a new way of treating

21:20

these throat cancers. It's

21:20

called NECTORS-2; can you tell

21:25

me a little bit about what this means?

21:26

This is a

21:26

treatment for a HPV- Human

21:31

Papilloma Virus related cancers

21:31

of the throat, which is called

21:35

the otolaryngology. That's the

21:35

back of the throat, it's

21:37

essentially meaning the tonsils

21:37

and the back of the tongue, we

21:40

call that base of tongue. These

21:40

cancers in the last 20-25 years

21:44

has actually increased in

21:44

incidence. And it's also related

21:47

to the exposure to the human

21:47

papilloma virus and not

21:51

necessarily related to smoking,

21:51

or tobacco or alcohol. This is a

21:55

different kinds of cancer and

21:55

these cancers, patients do

21:58

better. So we're trying to

21:58

develop ways of treating them as

22:03

successfully as before, and if

22:03

not more successful. But also

22:07

minimize the side effects of the

22:07

treatments that sometimes

22:11

patients may have after that. So

22:11

in general, we use a combination

22:15

of surgery, chemotherapy and/ or

22:15

radiation therapy to treat these

22:19

cancers and often when they come

22:19

because tumors are relatively

22:23

advanced, we need to give two

22:23

types of treatments. Typical

22:27

treatment has been for many

22:27

years to give chemotherapy with

22:32

radiation. In the last 15 years,

22:32

it is changing now and we treat

22:36

these cancers with transoral

22:36

robotic surgery which we can go

22:40

through the mouth and through a

22:40

minimally-invasive approach

22:44

remove the cancer from the

22:44

throat. And separately from the

22:47

neck, we will remove the lymph

22:47

glands of the neck that are

22:49

involved by the cancer. So this

22:49

now has become a very common way

22:54

of treating these patients. But

22:54

when we do that, often patients

22:57

are required to have radiation

22:57

therapy afterwards. And this

23:01

combination, we believe that

23:01

whether we combine radiation

23:04

with surgery or radiation and

23:04

chemotherapy causes the chronic

23:08

effects of radiation- dry mouth,

23:08

scarring in the throat and

23:12

muscles of the throat, dental

23:12

health issues, and even

23:15

potentially some swallowing

23:15

issues to some degree. So what

23:18

do we have done, we actually

23:18

treat these patients first with

23:22

upfront chemotherapy because

23:22

that new adjuvant chemotherapy

23:25

that means we give chemotherapy

23:25

first. What it does is it

23:27

shrinks down the tumor both in

23:27

the throat as well as in the

23:30

lymph glands of the neck, we

23:30

call that downstaging of the

23:33

tumor, and then they go do

23:33

transoral robotic surgery. It

23:37

becomes much less invasive,

23:37

minimally-invasive to remove the

23:40

primary tumor. And then we also

23:40

do what we call a selective neck

23:44

dissection to remove the lymph

23:44

glands from the neck. Now what

23:47

it does, this allows us to

23:47

actually avoid adding radiation

23:50

therapy afterwards and that

23:50

prevents all the side effects

23:54

that comes from radiation

23:54

including the salivary glands

23:57

not working; therefore, the

23:57

mouth is dry. The dental health

24:00

can be significant affected. And

24:00

essentially there's no

24:03

collateral injury to the other

24:03

organs in the mouth and the

24:08

throat. And the purpose of that

24:08

is to really improve the quality

24:12

of life. So, patients can have a

24:12

normal diet, taste food, not

24:17

have a dry mouth and be able to

24:17

swallow whatever food they want

24:20

to eat. And also be able to

24:20

enjoy it and social setting

24:23

right so this is what we have

24:23

developed. Now this, again, is a

24:28

combination that is different

24:28

because internationally, this

24:32

combination is not used as a

24:32

treatment for throat cancer. So

24:35

this combination we believe

24:35

actually gives you better

24:37

results and other combinations

24:37

of treatment. So that's what

24:40

NECTORS-2 is. Neoadjuvant

24:40

Chemotherapy and Transoral

24:44

Robotic Surgery for Oropharyngeal Cancer 2. And this is how we treat the HPV Human

24:45

Papilloma Virus related cancers

24:49

of the throat.

24:50

We're in conversation with Dr. Nader Sadeghi the chair of the Head

24:52

and Neck Surgery Department at

24:55

the MUHC. I think that's really

24:55

an interesting fact that you

24:59

just pointed out that it

24:59

improves quality of life of

25:01

patients. Because the throat is

25:01

such a delicate area, you

25:05

mentioned that you swallow, you

25:05

eat, you speak. All of that area

25:09

can be impacted by any sort of

25:09

cancer treatment. So, the fact

25:13

that it's less invasive is

25:13

probably a really big advance

25:19

that has been made in the last

25:19

couple of years.

25:21

We believe it

25:21

is a big advance. And we also

25:21

I'm curious, Dr.

25:21

Sadeghi, how common is that HPV

25:23

have been very closely

25:23

monitoring our patients. In at

25:26

least the last seventy patients

25:26

that we have, patient reported

25:30

quality of life surveys that we

25:30

do on our patients, on a

25:33

sequential basis. From

25:33

pretreatment all the way up to

25:36

two years. We just looked at it

25:36

recently, on the 70 patients

25:40

that we gave these surveys to,

25:40

they gave us basically a measure

25:43

of various factors affecting

25:43

their quality of life. Of

25:47

course, initially during

25:47

treatment, the quality of life

25:50

does go down, that's expected

25:50

from the acute side effects of

25:53

treatment. But within three to

25:53

six months, patients are

25:57

actually going back to baseline

25:57

level, that means we are not

26:00

deteriorating their quality of

26:00

life from our treatment. And

26:04

that level actually stays like

26:04

that going forward up to two

26:07

years after we have been

26:07

following. This is actually a

26:10

significant change, because all

26:10

the other combination of

26:14

treatment actually does

26:14

deteriorate quality of life, and

26:17

it remains at a lower level than

26:17

what the patients came with.

26:21

What we want to do is maintain

26:21

what they came with and not

26:24

deteriorate from our treatment. positive throat cancer? Is that

26:32

something that's on the

26:34

increase? Is it something that

26:34

we should pay attention to in

26:37

our own health and life?

26:39

Yes, absolutely. It's very important. I thank you for asking that

26:40

question. Because very important, actually. In the last

26:42

30 years, the rise of throat

26:46

cancer has been steadily seen

26:46

across the industrialized world;

26:50

in Canada, North America,

26:50

Europe, everywhere. And this is

26:53

because of the human papilloma

26:53

virus in the population. So it

26:58

is rising, but hopefully over

26:58

the next 30-40 years, we can see

27:03

a drop in that. And that will

27:03

happen only through a mass

27:05

vaccination for HPV and that's

27:05

already happening, obviously. A

27:10

lot of youngsters in school

27:10

getting HPV vaccination. And

27:14

this would prevent not only this

27:14

disease, but also prevent

27:18

potentially cervical cancer in

27:18

women, and will also decrease

27:21

all kinds of other diseases that

27:21

caused by HPV. Therefore, the

27:28

hope that the disease will

27:28

decrease over the next 30-40

27:31

years, but that requires in

27:31

whole that the population is

27:35

vaccinated. Now the vaccination

27:35

is covered in the schools.

27:40

Penetration, fortunately, is

27:40

quite good. In Quebec

27:42

penetration of vaccination

27:42

schools, almost 90%.

27:45

That's incredible.

27:46

The rest of

27:46

the population is actually

27:50

trickling behind. And now,

27:50

there's just about a year ago,

27:53

there was a new indication for

27:53

vaccination was actually

27:57

prevention of head and neck

27:57

cancer- prevention of throat

27:59

cancer. So it's actually one of

27:59

the indications for vaccination.

28:02

And we recommend that adults as

28:02

well, based on what has been

28:06

studied, up to age 45 should

28:06

have the HPV vaccination. So any

28:09

adult that hasn't had

28:09

vaccination as a teenager or

28:13

youngster, and they should go

28:13

get also the HPV vaccination.

28:17

And is this

28:17

something that you can speak to

28:20

your family doctor about? If you

28:20

meet those criteria- if you're

28:23

under the age of 45, if you're

28:23

interested in learning about

28:26

this, can you can ask your

28:26

doctor about getting this

28:28

vaccine?

28:29

Absolutely speak with the family doctors and they will prescribe the

28:30

vaccine. The vaccine is used

28:34

either in the family physician's

28:34

offices or to the pharmacies.

28:39

Usually requires a two to three

28:39

vaccines and the qualification

28:44

so they will just go to the pharmacy and receive the vaccine.

28:47

Now, we don't have very much time left, we're in conversation with Dr. Nader

28:49

Sadeghi who is a head and neck

28:52

surgeon at the MUHC. We have

28:52

been fundraising at the MUHC

28:57

Foundation to support your

28:57

research. How important is it to

29:00

have philanthropic support for

29:00

the type of research that you

29:03

do?

29:04

It's extremely important. In fact, everything we have done on our

29:06

research on this HPV-related

29:09

throat cancer and the treatment

29:09

that we have developed now. And

29:12

now gradually, I would hope the

29:12

rest of the world adopts our

29:15

treatments. It could not have

29:15

happened without the

29:18

philanthropic support. In fact,

29:18

every part of this research in

29:21

the last six years that we are

29:21

conducting it at MUHC is

29:24

supported by the philanthropic

29:24

support. Without that we could

29:27

not do it. Not only that, but

29:27

philanthropic support also

29:30

allows us to build on the

29:30

research that we are doing and

29:35

be able to go get additional

29:35

support from the CIHR which is

29:39

the Canadian Institutes of

29:39

Health Research and other

29:41

resources for the fundamental

29:41

research that we carry out on

29:45

this disease. So it helps us in

29:45

many ways It allows us to

29:47

conduct research and all of us

29:47

to get actually get more support

29:51

from the governmental agency for

29:51

research.

29:53

I think that's

29:53

really important. I'm glad that

29:56

we can support researchers like

29:56

you if we're trying to pioneer

30:00

new and better treatments for

30:00

our patients. Dr. Nader Sadeghi,

30:03

thank you so much for joining us

30:03

on Health Matters.

30:06

Thank you. Thank you for the opportunity and thank you for the interview.

30:08

That is Dr. Nader

30:08

Sadeghi who is the Director of

30:11

the McGill Head and Neck Cancer

30:11

Program and the Chair of the

30:13

Department of Head and Neck

30:13

Surgery at the MUHC. Next on

30:16

Health Matters, the head of the

30:16

MUHC's patients' committee joins

30:19

us to share how they can help

30:19

you navigate the health care

30:22

system. Tarah is off this week.

30:22

I'm Kelly Albert and you're

30:25

listening to Health Matters on

30:25

CJAD 800. If you've been in the

30:29

hospital or supported a loved

30:29

one who is going through

30:32

treatments at the hospital, you

30:32

know how overwhelming it can be.

30:35

It can be stressful to get to

30:35

all of your appointments on

30:37

time, remember all the details

30:37

about you or your loved one's

30:40

condition and navigate the

30:40

health care system in general.

30:44

At the MUHC, there is a new

30:44

committee that is designed to

30:47

support patients, the families

30:47

and the caregivers. It is the

30:50

Users' Committee of the MUHC.

30:50

And Ingrid Kovitch has recently

30:54

been appointed the Chair of this

30:54

committee, she joins me now.

30:56

Good morning.

30:58

Good morning, Kelly. Thanks for having me.

30:59

Thank you so much

30:59

for joining us. So what is the

31:02

Users' Committee of the MUHC?

31:04

The Users'

31:04

Committee, which is probably

31:06

known to many of the Patients'

31:06

Committee is basically a group

31:09

of elected volunteers. And our

31:09

role from strictly a legal

31:14

perspective is to inform users

31:14

of their rights, and to defend

31:18

these rights in the broadest of

31:18

terms and in a wide range of

31:22

settings. And as you mentioned,

31:22

when we talk about users, we are

31:26

referring not only to patients

31:26

but also to their families and

31:29

to their caregivers.

31:31

I think that's

31:31

important because you could be

31:34

going to the MUHC every day, but

31:34

it's not necessarily you who's

31:37

being treated for it. So let's

31:37

get into the rights. What do you

31:42

mean by patient rights when you

31:42

say this?

31:44

Yeah, so

31:44

respecting health and social

31:47

services defines 12 patient

31:47

rights and these must be

31:51

respected at all times. It's

31:51

important to know, these aren't

31:54

just suggestions. These are

31:54

legally mandated requirements.

31:59

Now, some of them are pretty

31:59

intuitive. Most people probably

32:03

know about them, or could guess

32:03

them. For instance, of course,

32:05

all users have the right to

32:05

appropriate and high quality

32:09

care. We have the right to

32:09

receive this care and

32:11

compassionate and humane

32:11

fashion. We have the right to be

32:15

informed. We have the right to

32:15

consent and this means both to

32:19

receive treatment and to decline

32:19

them. But there's some other

32:22

rights that might not be as

32:22

well-known. And some of these

32:27

include things like having the

32:27

right to privacy and

32:30

confidentiality, we have the

32:30

right to access all the

32:35

information in our medical

32:35

files. And we have the right to

32:39

file a complaint. So that's

32:39

really the committee's legal

32:42

mandate- to inform and protect

32:42

these rights. But from a

32:45

practical perspective, our job

32:45

is twofold. First, we're here to

32:51

assist users and we do this in

32:51

really any manner that they

32:55

might require. And secondly,

32:55

we're here to promote

32:59

initiatives that ultimately will

32:59

improve the quality of services

33:03

and the quality of care that's

33:03

provided by the MUHC.

33:08

We're in conversation with Ingrid Kovitch, who has recently been

33:09

appointed the Chair of the

33:12

Users' Committee at the MUHC. So

33:12

I think we can maybe break it

33:17

down in a case example for our

33:17

listeners. So can we give an

33:22

example of what sort of thing

33:22

that you can particularly help a

33:26

patient or a user with?

33:28

Users come to us

33:28

for a number of things. There's

33:32

ways we can help individuals and

33:32

there's ways that we try to help

33:38

on a more generalized or

33:38

collective basis. So individuals

33:41

seem to often come to us with

33:41

various questions just about how

33:45

this great beast of the MUHC

33:45

works; how the system works.

33:50

They have trouble sometimes

33:50

finding or knowing about

33:54

hospital services or resources.

33:54

We can help inform them about

33:58

them. We can help them access

33:58

these things. We can hopefully

34:03

sometimes help them reach who

34:03

they need to reach. If they have

34:07

forms to fill out, we can help

34:07

them with this. And very

34:11

importantly, we can help them

34:11

navigate the complaints process.

34:16

And this might be as simple as

34:16

directing them to the office of

34:20

the hospital ombudsman, which

34:20

they may or may not even know

34:24

about. It can even extend as far

34:24

as helping them formulate the

34:30

complaint itself. There's also

34:30

things we could help with or at

34:34

least try to on a more

34:34

generalized collective basis.

34:38

And these are things like

34:38

addressing issues relating to

34:42

the physical environment of the

34:42

hospital or some of the sites.

34:46

We can help improve the living

34:46

conditions over long-term care

34:49

patients. The MUHC has under its

34:49

umbrella, a long-term care

34:55

facility. And also we really try

34:55

to help sensitize staff to the

35:01

needs of specific groups. So

35:01

they might be indigenous

35:04

populations, persons with

35:04

reduced mobility, persons who

35:08

aren't housed or struggle with

35:08

addiction, really any group of

35:12

patients and users that have

35:12

specific needs. Part of the way

35:18

which we do this is that we

35:18

actually represent the users on

35:21

a number of primary committees,

35:21

one of which is the Board of

35:24

Directors. But what enables us

35:24

to do that; in fact, the only

35:29

way we can do it, is by

35:29

listening to what users have to

35:34

say about their experience. We

35:34

want feedback. In fact, we need

35:39

feedback, and we want to hear it

35:39

all. We want to hear comments,

35:44

suggestions, compliments, and of

35:44

course, complaints. Because the

35:48

only way for us to truly

35:48

understand what's going on, and

35:51

to address shortcomings in the

35:51

system is to hear it directly

35:55

from users. Again, this means

35:55

patients, their families, and

35:59

their caregivers.

36:01

We're in conversation with Ingrid Kovitch, who is the chair of the

36:02

Users' Committee at the MUHC, I

36:06

think that is a lot that you do.

36:06

To put it in, in very easy

36:13

terms- you do a lot. So how do

36:13

you support all of the users?

36:18

Because the Glen site in general

36:18

is a vast site, there are so

36:23

many different areas of medicine

36:23

that are represented there.

36:26

There are so many possible users

36:26

who are there, patients loved

36:30

ones, caregivers. How do you

36:30

connect with all of the

36:35

different departments? And I

36:35

guess you work with a bunch of

36:40

advocacy groups as well?

36:43

We do not do

36:43

this alone. Absolutely not. And

36:46

just to clarify, the MUHC is far

36:46

beyond just the Glen site.

36:51

It's a great point.

36:52

There are other

36:52

sites and hospitals- the Neuro,

36:55

the General, the Allen, Lachine,

36:55

Pavillion Camille-Lefebvre- our

37:00

long-term care facility, the

37:00

Reproductive Center, the Eye

37:05

Center, I mean, I can go on and

37:05

on. So it's really important to

37:09

remember that we are the

37:09

spokespeople or the voice of

37:13

users at all these different

37:13

sites. For sure, we can't do

37:18

this by ourselves. Luckily,

37:18

there are already a number of

37:22

patient advocacy committees that

37:22

are already in operation. And we

37:27

hope to develop many more.

37:27

Particularly, those that will

37:32

represent groups that

37:32

historically have really

37:35

struggled to be heard. And so we

37:35

work collaboratively with and we

37:40

rely heavily upon all these

37:40

different communities, and

37:44

committees, and all with a

37:44

shared goal of improving care

37:49

for every single user within the

37:49

MUHC community.

37:53

We're in conversation with Ingrid Kovitch, who is the Chair of the

37:55

Users' Committee at the MUHC.

37:59

Unfortunately, we're short of

37:59

time, but I really want to get

38:02

our listeners to know how people

38:02

can get in touch with this

38:05

committee. How can patients or

38:05

caregivers get in touch with you

38:09

if they have a complaint or need

38:09

help or need direction and

38:12

navigating the system? How do

38:12

they contact you?

38:15

Yes, so the

38:15

committee is lucky enough to

38:18

have an administrative

38:18

assistant. And we do have a

38:21

physical office on the fourth

38:21

floor of the D Pavillion at the

38:25

Glen site. But really the best

38:25

thing to do and because all

38:28

information regarding the room

38:28

number, our phone extension, our

38:32

email, everything can be found

38:32

on the MUHC website, under

38:36

Patients' committee. That's

38:36

where they'll find everything.

38:40

That's great to

38:40

know. And like you said they can

38:42

contact you with any question or

38:42

concern and you'll make sure

38:45

that they get directed to the right person.

38:47

Correct. That's it.

38:48

That's wonderful.

38:48

So to find out more information

38:51

about the Users' Committee,

38:51

that's MUHC.com. And look for

38:54

patients' committee. Ingrid

38:54

Kovitch, thank you so much for

38:57

joining us on Health Matters and

38:57

talking about the wonderful work

39:00

you do.

39:01

Thanks. It's my pleasure and thanks for having me.

39:04

I'm Kelly Albert,

39:04

thank you for tuning in. What

39:06

would you like to hear about on

39:06

the show? You can write to me at

39:09

[email protected].

39:09

You can also follow the MUHC

39:14

Foundation on social media, sign

39:14

up to our newsletter, or hear

39:17

things you may have missed at

39:17

MUHCFoundation.com Tarah is back

39:21

next Sunday. Thank you for

39:21

listening to Health Matters and

39:24

stay healthy.