As the medical director at PALS Cancer Care, Dr Alikhani is tasked with visiting patients and families as they grapple with the devastating news that their cancer is terminal. 

“I sometimes go and see patients, and honestly I feel like I’ve done absolutely nothing,” she said. 

“I’ve gone and sat in their living room, and I’ve spoken to them for 20 minutes and oftentimes symptom-wise they’re OK, but they’re just quite anxious. 

“We end up talking about let’s say the colour of the sea – mundane things – and I leave thinking, I didn’t do anything, and I’ll sometimes apologise and say I’m sorry I didn’t have anything concrete this week. 

“And they say, ‘You have no idea what your visits mean.’ 

“That’s because it’s a lonely road sometimes, especially in Bermuda. You can feel very isolated, very alone and quite scared, and so when the nurses and I go and say, ‘Would you like a cup of tea?’ and you sit down and you take time to talk about just normal things, they say, ‘You have no idea the difference that made.’” 

Coming to terms with traumatic news is an immensely difficult part of the journey for terminal cancer patients and their families. One of the best ways of coping is contact with other people. 

“As human beings we live and thrive on connections,” Dr Alikhani said. 

“If you can keep a social connection, if you can make cancer not that taboo Big C, and find your people, find the people who give you joy. 

“I visited a lady yesterday – she is the most inspiring person I look after. She’s in her 80s. She said, ‘I have two or three friends that visit me every week, and they’re the only people I let visit me other than family because they are joyful and positive, and they fill my life with good things. Anybody who hasn’t got that hasn’t got room in my life.’ 

“It’s amazing. She has figured that out. She doesn’t need people who come and say, ‘I’m so sorry, it must be terrible.’ 

“We need to remind ourselves we are on this earth to hopefully lead a good life to enjoy. Despite having cancer, you can still do that, even if you’re limited.” 

All this might be easier said than done, however, for families of terminal cancer patients. How can they provide that vital support and positivity while, underneath, they are gripped with their own sudden wave of fear and anxiety? There is no easy answer to that question. 

Colleen English DeGrilla, executive director at PALS, said: “If it’s your loved one, you’re like, ‘What can I do? How can I help What do they need?’ There are so many questions for the patient and then for the loved one. 

“Oftentimes the family are thinking, ‘What can we do to fix this? Is there a cure? We want to try every treatment we can to keep our loved one alive.’” 

As well as critical health-related decisions, you might have financial worries, especially if the patient is the breadwinner or the treatment is costly, as well as the dilemma of breaking the news to family members and countless practical decisions. 

Unsurprisingly, one of the early coping mechanisms is denial. 

“We see this often, where people flip-flop from denial to complete reality and acceptance, back to denial, all within the space of maybe half an hour,” Dr Alikhani said. 

Yet generally, according to Ms DeGrilla, most families get there in the end. 

“You can’t argue with what’s happening in front of you,” she said. 

The good news for patients and families in Bermuda is that PALS is there to help. 

“We have six nurses, we have a doctor, we have a social worker, we have a whole team,” Ms DeGrilla said. 

“We also have connections in the community if someone needs therapy or anything else going forward. 

“We try to be there as early as possible. We can support whenever and however they need. Medically, psychologically, financially. Anything they need, we try to help with. And we don’t charge them for anything we do.” 

Dr Alikhani said: “If I was in a position where I had a cancer diagnosis, I would find it very scary and I would want a lot of people to help me through it, hopefully to my cure. 

“If my cure does not happen, which unfortunately does not happen for many people, then we are there with them, for however long with whatever needs they have. 

“If those needs evolve change, our input and how we are involved in that particular person’s life changes as well.” 

Coping strategies are individualised and seek to take advantage of Bermuda’s cultural and natural environment. 

Ms DeGrilla said: “In Bermuda, there’s a strong sense of religious belief. A lot of people get incredible security and comfort from those beliefs and will tap into their specific churches or ministers. Those communities can be incredibly helpful. 

“I don’t think you need to broadcast it to everybody, but if your nearest and dearest know what’s going on, it will help. Tell people what you need. 

“Bermuda is beautiful. If you can get out there in nature, we know that helps calm people. There are also lots of other strategies like mindfulness medication, music and art.” 

One of the hardest things is telling young children that they will lose a loved one. 

Ms DeGrilla said: “We use a lot of therapists in the community that help with kids, but we also try to encourage families to be honest. 

“The kids are going to see it, they are living in the house, they see what’s going on. Be as honest as you can according to their age.” 

For all its patients, PALS is in it for the long haul. 

“Once you’ve been referred to Pals,” Ms DeGrilla said, “you remain in our family forever. Our family just keeps growing and growing.” 

For more information, visit www.pals.bm 

The post In your darkest hour, PALS are here to help appeared first on RG Magazines.

Breast cancer is the most common cancer found in women in Bermuda, and this year there is an ambitious goal.

“We have a mammography machine that is coming to the end of its life,” explained Deborah Titterton Narraway, CHC’s chief marketing and fundraising officer.

“The breast cancer walk and everything we do in October will go towards that.”

October’s events usually raise around $200,000. The goal for this year however, is $400,000.

While a lot of fundraising happens during October, it is only one month in a busy year full of events. These include the Relay for Life, AXA XL Man on the Run 5K, MOvember Bermuda, St Baldrick’s and a host of other initiatives driven by organisations and individuals who have either been affected by cancer themselves, know someone affected, or simply care.

CHC has no government funding, but it receives insurance reimbursements. There is, however, no co-pay and no patient is turned away if they are uninsured or underinsured.

“No one should have to pay for their cancer care. They should be focused on wellness, not how to pay for something,” continued Ms Titterton Narraway. This is why their fundraising initiatives are so crucial.

Each year, the centre raises around $1.6 to $1.8 million, $1.1 million of which is restricted to the Equal Access fund. This fund covers care costs for those not adequately insured. Ideally, however, the annual sum raised needs to be $2.5 million.

“That would cover equal access, plus our education and wellness programmes, which are not fully funded at the moment. We run them anyway,” she explained.

“What that would leave us is any revenue we make off our clinical services, we could be investing in the future.”

Like the mammography machine, other valuable equipment needs to be replaced from time to time. There are also unexpected costs: for example, if a machine is not working, that patient has to go abroad for treatment instead.

“All we need is one hiccup with radiation therapy,” she said. “We have been very fortunate that our machine has stayed up and running.

“But, should a hurricane cause an issue, whether you can no longer physically access the building or we are without electricity for more than a certain period of time, we would be putting people on airplanes and sending them to Boston.

“For those who are not insured, we would cover all that. That would change our cash flow tremendously. We try and keep a healthy reserve for that.

“Every piece of equipment has a life span. Our radiation machine is coming towards the end of that life span. We will have to replace that equipment.”

They have also outgrown their building and need to acquire more space.

Most of the funds raised come from the community and this is why their events are so crucial.

“When you look at our events, that’s all peer to peer fundraising,” explained Ms Titterton Narraway. “We get people to register for the event. They’re the ones who go out and host fundraisers or send their URL to friends and family.”

The largest fundraiser by far is the Relay for Life, which takes place in May. This year, nearly 5,500 people helped to raise more than $800,000 and Ms Titterton Narraway puts its success down to the fact that it involves the whole community.

“Cancer doesn’t discriminate and cancer doesn’t sleep, which is why it’s an overnight event. It effects everybody, from families, community clubs, businesses.”

The guests of honour are the survivors, which makes it particularly poignant, especially as many have previously keep their cancer diagnosis to themselves. 

“Every year, we’re surprised at the number of people who come in and say they don’t know someone with cancer. We ask them why they’re there.

“It’s a community event and they keep coming back now, year after year, because they may have walked in the gate not knowing someone with cancer, but when they watch the people who walk the track and wear the survivor sashes, they’re usually surprised to see a colleague, a neighbour, who maybe hasn’t made it public outside of that event.”

Two more big events focus on cancers that affect men. The AXA XL Man on the Run 5k will take place on November 10 and MOvember, throughout the month of November. The latter is where men fundraise by growing a ‘MO-ustache or beard’ for 30 days. Last year, MOvember Bermuda raised more than $26,000 towards both the Equal Access fund and prostate cancer education and prevention.

2023’s AXA XL Man on the Run 5K raised over $36,000, which went towards free men’s health screening events, men’s health presentations and financial subsidisation for radiation therapy.

The CHC also works with the United States-based St Baldrick’s Foundation, which helps fund research into childhood cancer cures, and 10 per cent of the funds raised from Bermuda events stay on the island. Those funds go towards their SunSmart programme, which is primarily aimed at children.

While these large events make up the bulk of CHCs fundraising successes, there is a particular need for “unrestricted fundraising”, where funds can be used wherever needed, such as running costs or personal care products for patients. The Annual Appeal supports this. 

Whether it’s restricted or unrestricted funds, every little helps. Tiles can be bought for their Commemorative Tile Wall, women can host Girls Night In where the cost of a night out is donated, or you can simply organise your own fundraising initiative.

There are also very personal donations. Ms Titterton Narraway shared a story about a man who lost his brother to cancer: “They were avid golfers. He now donates $50 for every birdie he makes. 

“The donation doesn’t have to be big, but the continued support is what keeps us going.”

For more information visit cancer.bm 

The post Fundraising targets grow appeared first on RG Magazines.

Q: Does what you eat matter? 

A: Maintaining a healthy weight is a key player in reducing your overall risk of developing cancer. Diets that are higher in fast food, saturated fat or sugar significantly increase your risk of being overweight or obese, which in turn increases your risk of developing cancer. 

When reading about foods and cancer risk, consider who is writing the article, what their references are – are they based on large studies or good evidence? – and importantly, are they trying to sell anything? We’re looking at you, “superfoods”! 

Q: Do certain foods increase the risk of cancer? 

A: It is very difficult to determine a specific food that “causes” cancer as our diets are, for the most part, varied. There are some foods that research shows do have a higher risk associated with them. We know that components of red meats and the cooking methods we use can damage the cells of the bowel in a way that can increase cancer risks. 

Processed meats carry some of the same properties, and invariably are higher in fats and compounds from the preserving process, which is thought to be cancer causing. Try to limit red meats to once a week and processed meats to very special occasions. 

Alcohol consumption also comes with a risk. Regardless of the type of alcohol we choose, they all contain ethanol which is a cancer-causing compound. The benefits of alcohol that we often see touted in the news are misleading and, the higher the number of alcoholic drinks you consume, the higher the risk of cancer in the head, neck and oesophagus, stomach, liver, kidneys and the bowel: basically any part of the digestive system that has a role in the consumption and processing of the drink. 

Too much refined sugar in our diets can make it more difficult to maintain a healthy weight which, as above, can increase our risk of cancer. There is no scientific evidence to suggest a link between artificial sweeteners and cancer. 

Q: Do certain foods limit the risk of cancer? 

A: There is no magic bean to prevent the development of cancer, and no one food or diet will guarantee that you will not get cancer at all. 

There is evidence that diets rich in wholegrains, which are high in fibre, as well as dairy foods, can reduce the risk of bowel cancer. 

A healthy, balanced diet is one that is rich in wholegrains, including wholegrain pasta and multigrain bread, lean proteins such as plant-based like beans, pulses and lentils, or eggs, fish, chicken and turkey, as well as fruits and vegetables. Dairy is also a good source of protein and nutrients, especially if lower in fat and without added sugar. Dairy alternatives, especially soya, that are fortified will have some of the same nutrients but there is not enough research to suggest that they have the same risk-reducing effects. 

Q: Is it realistic to think a person can organise a diet around those foods? 

A: Absolutely! A Mediterranean-style diet is not only associated with reducing risks of cancer but is often cited as the healthiest dietary pattern going. 

Success won’t happen without some thought and planning. Start small, think about tweaks you can make to breakfasts or snacks, or choose one night per week to try a new recipe. 

The internet is bursting with inspiration. Find one or two simple recipes to try per week or use meal prep services or prepared meals based on a more plant-focused approach. Ideally, use seasonal products from farm stands or frozen bags of mixed vegetables. 

The post Choose your diet wisely appeared first on RG Magazines.

We human beings don’t have natural fur coats, scales that absorb UV rays, protective hides, or cooling feathers to keep us safe from the ravages of a mid-August Bermuda sun. 

We need to protect ourselves in more inventive ways, and the SunSmart Programme has consistently gone above and beyond to help Bermuda’s young people learn the habits that will shield them from the deleterious effects of over-exposure to the sun. 

Azuree Williams is the driving force behind the Bermuda Cancer and Health Centre’s SunSmart Programme, and she is always ready to remind students of the most important lesson. 

“The 5 S’s of course! SLIP on protective clothing, SLOP on mineral based sunscreen (SPF 30-35), SLIDE on sunglasses, and seek SHADE between 10am and 4pm – and a bonus ‘S’ is to STAY hydrated. 

“All of these simple protection measures give people informed, easy steps on how to protect the skin they’re in and reduce their skin cancer risk.” 

Reducing the risk of skin cancer is, of course, the primary focus of the SunSmart Programme. As with all forms of cancer, prevention is very much the best policy – so learning healthy habits early is essential. But is any single habit more important than the others when thinking about being sun smart? 

“Really, one should practice a combination of all five habits in order to be truly SunSmart because one over the others will never give you 100 per cent protection. 

“Sunscreen alone is not enough because it only provides around 96 per cent protection. Ultraviolet Protection Factor clothing is ideal. The higher the number of UPF protection on the clothing label, the better – and you don’t have to reapply like sunscreen.” 

Kids and adults are constantly reminded to practice the 5 S’s whenever the sun outside is oppressive, but has the SunSmart Programme really made much of an impact since its inception? 

“Absolutely! We do not have enough data to have followed around all the students who are now adults, who have experienced the SunSmart programme, but via the feedback from our radio interview segments for SunSmart, and our free presentations, the public seems to be listening and calling in to inquire about choosing the best sunscreen,” Mrs Williams said. 

“I’ve been running the programme for just over a decade and the calls and emails and concerns have been steadfast over the years, which alerts me that we are making a difference and people are tuned into their health and well-being.” 

Always keeping the focus on reaching young people with its vital message, the BCHC has recently recruited a popular local mascot to their noble cause. 

“At the moment we are reviewing, and in the process of revamping and reinvigorating the programme. Two years ago, we introduced Tiny the Tree Frog – special thanks to Elizabeth Mulderig, local author and creator of Tiny the Tree Frog, for giving us permission – as one of our new mascots joining our SunSmart girl, Piper Palmetto.” 

Although there is no official data to verify the SunSmart Programme’s impact on the general Bermuda public, it’s clear that we have become more aware of the dangers of over-exposure to the sun over the last decade or so. 

With all the excellent work this amazing programme has done, including free presentations from preschool to high school, free community Lunch and Learns, and free accreditation training for summer camps annually, it’s clear that the SunSmart Programme is doing its part to keep us safe in the sun. 

The post Sunsmart kids become sunsmart adults appeared first on RG Magazines.

Stoic, unflustered and routinely cool under pressure describes Arthur to a tee, so hearing that the brother I have known since our days patrolling the Eastern parishes together as constables on D Watch in the early 1990s has survived cancer – twice! – was not all that shocking. 

Of course Arthur survived cancer! Nothing can ruffle Arthur! 

Yet even a man who may well have an alter-ego from the planet Krypton has to pause and reflect when he hears the word “cancer” come out of his doctor’s mouth. Cancer, in any form, is the quintessential conflict of any narrative – and a certain turning point in every human story it has ever touched. For this man, that story began with a series of early morning nosebleeds in 2020. 

“This went on from February to March,” Arthur said. 

“I was having nosebleeds, almost daily, around 5.30 in the morning. One of my nostrils, pretty much every day, just blood coming out – and that’s not normal. That’s the body trying to tell you something. 

“I went to my GP and, eventually, I had to practically plead for a referral to a specialist, because he was trying to diagnose it himself. So, I got to go to an Ear Nose and Throat specialist, Dr Philip Bell, who was practising in Bermuda at the time. 

“From the scans they took, Dr Bell could see I had a blockage in my nostril that could be corrected with a routine surgery. By August, Dr Bell had removed about 80 per cent of the polyp that was blocking my nostril, but he had found something else as well. 

“When I went back to him for my check-up after the surgery, I noticed that he had this doom and gloom look on his face, like what he had to tell me would hurt him to say more than it would hurt me to hear. 

“That was when he sat me down and told me that the polyp they had found was not benign, but actually a rare form of skin cancer called squamous cell carcinoma.” 

This diagnosis led to a whirlwind of treatment, including several trips to Brigham and Women’s Hospital in Boston for more surgeries. The priority quickly became removing the remainder of the cancerous polyp before it had any chance to spread – the proximity to Arthur’s brain was a pressing concern. 

For Arthur, this was simply a call to do whatever he had to do to survive this disease – including 33 rounds of radiation at Bermuda Cancer and Health Centre after the experts in Boston cleared the malignant polyp out of his nostril. 

“That was the challenging part for me, because it involved being fitted with a mask that pressed down on my face – and I’m claustrophobic!” he said. 

“Every day from October to December, except weekends, I endured a half-hour radiation treatment session. I had to be bolted to a table: I couldn’t get up, I couldn’t even turn my head. But I got through it, because this was my life; and after the radiation treatment for 33 rounds, my scans came back clear.” 

Arthur’s most recent tests show that he is still clear of squamous cell carcinoma, and he said having a positive attitude and a small circle of staunch supporters were key factors that helped him through the entire ordeal. Cancer, however, was not finished with our hero yet. 

Fast-forward to 2022, and Arthur is shaken with another diagnosis. Scans during treatment for a bout of Covid-19 revealed a dark spot on Arthur’s diaphragm: a dark spot that would eventually be diagnosed as Non-Hodgkins Lymphoma. 

“So, it’s back to the whole thing of, ‘How am I going to deal with this?’ Emotionally, it really messed me up – like, I’m here saying, ‘Why Me?’ I’m thinking I’ve got one foot going in the right direction, I’m getting pulled back, right?” 

At this point, Arthur had an opportunity to do a training course at the FBI Academy in the United States, and this proved extra motivation to get through this second major setback. 

Perhaps the most fortunate aspect of those taxing years was that both cancers were detected at an early enough stage to treat them effectively. 

“Both cancer diagnoses, luckily, were in the early stages, which is good. Well, it’s not good to say that you have been diagnosed with cancer, but it’s good to catch it early so treatment can start.” 

Radiation treatment began on the Non-Hodgkins Lymphoma in late 2022. By April 2023, Arthur was able to attend his FBI training course. 

Of course, the doctors advised Arthur to go easy on physical activity, as radiation takes a heavy toll on the body – but he trod on. 

“I got through my FBI training course, physical activity and everything. I managed to get through it. Didn’t ask for any favours, did everything that was expected of me – so I graduated from the FBI Academy in June 2023, and here I am today.” 

Talking to him, you get the impression that Arthur is prouder of graduating from the FBI Academy last year than he is to be a two-time cancer survivor. That’s who he is though – a rock who has always made it a priority to serve Bermuda. He even said that he faced his first diagnosis more as “Arthur the police officer than as Arthur the human being”. 

This steadfast sense of duty and devotion to those closest to him served him well during his cancer journey, which still isn’t finished. He has been clear of squamous cell carcinoma for four years now, and the Non-Hodgkins Lymphoma has been dormant for over a year. Unfortunately, the Lymphoma tends to return – but he will be ready if it does come back. 

If you see Chief Inspector Arthur Glasford on the street, wish him well, and ask him to show you the S he wears under his white uniform shirt. 

The post Journey of Duty and Devotion appeared first on RG Magazines.

Dr Weldon was a young cancer researcher based in Britain when her grandmother was taken seriously ill back home, with very aggressive pancreatic cancer, in 2017. 

“I had been in Bermuda for Christmas, and she was fine,” Dr Weldon recalled. “I came to host my first international science conference in February and she was doing worse, but holding on. 

“Then a day after I got back to England, I got the call saying I’ve got to go back to Bermuda. It was really in a matter of weeks that it got bad. 

“I remember standing in the hospital room with my cousins, with my grandmother really sick, and my cousin looked at me and said, ‘Shouldn’t you know what to do? You’re a cancer researcher.’” 

Her grandmother sadly passed, but the cousin’s words had a transformative effect. 

“She didn’t mean it in a rude way, but it did resonate because I’m like, I’m Dr Weldon, I do cancer research, yet I can’t help her right now,” she explained. 

“I took that to heart. I shifted my thinking and questioned what I want to be doing with my life. 

“Doing really abstract cool science is nice, but I want to actually make an impact. That’s where it changed for me.” 

Through her groundbreaking research company CariGenetics, Dr Weldon is already on the road to making that impact. 

The company’s recent breast cancer study of 102 Bermudian women – the first of its kind to focus only on the Afro-Caribbean population – has unearthed new genetic information that can help shine a light on why this region suffers from higher rates of breast cancer. 

Ultimately, it could lead to more effective screening and treatment in a part of the world where cancer research has lagged behind Europe and North America for decades. 

A second study is underway focusing on prostate cancer in Bermuda and the Caribbean, where disproportionately high rates have been recorded. 

“We are doing the research. We are bringing together the clinicians and bringing together the scientists and getting it done,” Dr Weldon said. 

“There are a lot of things that get talked about, but we are focused on the execution. 

“I had a conversation earlier this week with a colleague at a company who said there is no other dataset that has 100 per cent African descent women for breast cancer. We knew we were doing a good thing but to hear that from another company is like, Woah! 

“We’re doing breast cancer, we’re doing prostate cancer, and we’re taking it on the road – we’re not just doing it in Bermuda, we’re expanding to five countries for prostate cancer.” 

So far, results have shown that two genes commonly linked to breast cancer – BRCA1 and BRCA2 – are much less prominent in Bermuda breast cancer than the rest of the world, including the Caribbean. 

“Each country is very different,” Dr Weldon said. “When we are talking about diagnosing and the risk of cancer, knowing ahead of time that we shouldn’t be just looking at BRCA1 and BRCA2, we should be looking at other genes, is a tangible, real outcome of what we’ve done.” 

The research also found mutations that cause breast cancer are much more likely to be genetic-based in Bermuda (nearly 20 per cent) compared with the US or Britain (5 to 10 per cent). This information can be used to make screening more effective so that treatment can start earlier. 

The prostate cancer study, which is currently in its early stages, will include Jamaica, St Lucia, Trinidad & Tobago and Antigua & Barbuda as well as Bermuda; 100 men have signed up to take part. 

This study will pave the way for scientists to develop a liquid biopsy for men in the Caribbean and Bermuda, so that cancer can be detected in blood samples, instead of an invasive biopsy. 

“Nobody has tested it in the field in the Caribbean context and we will be doing that once we get ethics approval,” Dr Weldon said. 

“That will be a game changer. If you can imagine you just need a blood sample and we can actually tell you whether you have cancer or not, as opposed to digging in, getting surgery, and all that. 

“That’s the impact.” 

Until now, funding for cancer research has been very limited in the Caribbean, compared with Europe and the US, although awareness is starting to improve. 

“It’s exciting because we’re now having these conversations with those funding organisations and they’re seeing the potential,” Dr Weldon said. 

“We are showing them what we can do, and they are saying let’s get going.” 

Bermuda’s status as an isolated island means that its gene pool differs from the Caribbean, so genetic research has great scope for game-changing findings. 

CariGenetics has recently launched CariGenetics Precision Diagnostics, a clinical lab registered with the Bermuda Health Council, which will perform clinical genetics cancer tests and report back to doctors while improving accessibility and turnaround times. 

With more studies in the pipeline, CariGenetics could end up making the difference Dr Weldon has craved since her grandmother’s battle with pancreatic cancer. 

“To me, I’m just a scientist who wants to get this done and bring everyone I can with me: Bermudians, young people, girls in science,” she said. 

“This is our time. Caribbean scientists. This is our time. We show out when it comes to athletics; Olympics we dominate. We can do science in a way that’s the same level as anywhere else and excel. That’s really my goal.” 

Dr Weldon is keen to help young people along a similar pathway and aims to create shadowing opportunities. 

“I’m really passionate about training the next generation,” she said. “When I was coming up, I didn’t have a black role model. I consciously decided I wanted to be that person for the next generation. 

“If anyone is interested should email me and we will do what we can to let you get ahead.” 

Contact Dr Weldon on [email protected] or visit www.carigenetics.com for more information. 

The post Groundbreaking Journey appeared first on RG Magazines.

“I said to myself I know I have to accept that it’s in my body,” said the 67-year-old, a manager customs broker for Fast Forward Freight.

“I was told and then when I went back to work – because I work in an office by myself – I just cried.

“I cried because it’s scary, but it’s something that I basically have to deal with.”

The months that followed saw Ms Rabain apply that same level-headed approach when she had to undergo a mastectomy and five sessions of radiation therapy.

“It’s not going to go away with a snap of the finger,” she said. “You just have to keep yourself calm.”

The athletic mother-of-three, who has represented Bermuda in six different sports, had no idea anything was amiss when she went for a routine mammogram at the Bermuda Cancer and Health Centre in August 2023.

“They spotted something in my left breast,” she said. “They called me back and they had to do another scan on it to verify it and then a little while after that I had to go in for a biopsy.”

Then came a daunting wait. “Sometimes I would think ‘well, nobody in my family has really had breast cancer’.

“It’s something that’s kind of stressful but not that bad because you can’t change the results. It’s something that you have to cope with and deal with.”

She went alone to the hospital to hear the outcome. After receiving the diagnosis, she set up a WhatsApp group with her three grown-up boys, the eldest of whom lives in the UK.

“I knew I had to be strong for my sons,” she said. “I wanted to let them know all at one time.”

Her children, Michael, Forrest Jr and Antione Williams, rallied round, with the eldest visiting the island so he could accompany her to some medical appointments.

“They are my strength, especially going through hard times back then,” she said.

“My sons, they definitely supported their momma. ‘Momma, you all right?’ They kept calling.”

Her twin sister, Marionette Zuill, a former nurse, was also a source of strength. She was by her side on the morning of October 26 last year when Ms Rabain went into hospital for outpatient surgery to remove her left breast and some lymph nodes.

Things didn’t go entirely as planned.

“I had an allergic reaction to the dye they gave me,” recalled Ms Rabain, who lives in Paget. “As soon as they gave it to me, I broke out in a little fine rash.

“When I went to the recovery room, that’s when they gave me an epi-pen. They had put it in my leg and it was more painful than the actual operation itself.”

The tears flowed again when Ms Rabain was wheeled down to her sister to be taken home.

“I really cried,” she said. “She brought me home and I just laid in bed. I had to take painkillers.”

The next day, Ms Rabain felt brighter and within a couple of weeks she went back to work, the surgery having been a success.

She returned to BCHC for five radiation treatments, which she found a “little stressful” as she is claustrophobic.

“You can’t move, the machine goes around you,” she explained. “But the nurses there were extremely supportive.”

She was full of praise for the caring attitude of the centre’s staff.

“They are boss, they are great,” she said. “They explained things to me and they were there for me. It made the treatment, and a lot of the stuff your body goes through, so much easier.”

At the end of her treatment, she got to ring the bell at BCHC, as is traditional for breast cancer patients.

“I wasn’t expecting that,” she said. “It just didn’t dawn on me. They let you ring that bell and state that you are cancer-free.”

Ms Rabain was given the all-clear on December 20 last year, after an MRI scan and bone density test showed the cancer was gone.

She must now take the hormone therapy drug Letrazole for five years and continue to have regular mammograms.

“I would advise women to make sure they get their mammogram done every year,” said Ms Rabain.

“Even if you can’t afford it, Bermuda Health and Cancer is still there to support you.

“You know, a lot of times people don’t like to ask for that type of help, but it’s for your health and safety and you need to get it done.”

She said the cancer had undoubtedly affected her, but it hasn’t stopped her enjoying the things she loves: playing cricket at White Hill Field in Sandys, having video calls with her two grandchildren in Leeds, England, and spending time with her close-knit family in Bermuda.

“I find my body is still not right,” she admitted. “It seems you can get a bit dehydrated after radiation. I have to make sure, even now, that I drink lots. You are not always 100 per cent.”

She added: “I’m not going to say I don’t think about the cancer. It’s something that stays in the back of your mind.

“I do worry sometimes, but I don’t let it control me.”

Ms Rabain believes life has made her resilient and she is able to find the positive even in the “life-changing” experience of having cancer.

“Sometimes it makes me think, ‘Do I have cancer anywhere else?’ But you have to train yourself to deal with things.

“You have to allow the hate and anger that you feel, because of the wrongness that’s been done to you, you have to let go.

“To be a survivor – a cancer survivor – it gives you strength.”

The post A Story of Resilience and Strength appeared first on RG Magazines.

Yet for all the success stories, each case of terminal cancer is a painful reminder that we still have so much further to go. 

Some aggressive cancers seemingly appear from nowhere in previously healthy people – and by the time the warning signs appear, it’s too late. 

For clinical oncologist Dr Chris Fosker, this is one of the harshest realities of cancer. 

“Globally, cancer care has improved dramatically over the last 50 years or so,” said Dr Fosker, the medical director at the Bermuda Cancer and Health Centre. 

“If you go back to the 1970s, about 50 per cent of cancers diagnosed were curable. Nowadays, it’s about 70 per cent. So, seven out of ten people diagnosed with cancer today will be cured. 

“Even if it’s one of the aggressive ones, if you catch it early, you can cure it. But that does still mean that three out of ten people diagnosed with cancer will pass away because of their cancer. 

“That is obviously the tougher part of treatment. It’s the tougher part of conversations.” 

Between 450 and 500 cancers are diagnosed in Bermuda every year; about 120 to 130 people die from cancer annually, which is a lower mortality rate than Europe, Britain or the Caribbean, according to recent statistics. 

“But if you or your family are just one of those people, then that doesn’t matter, the stats don’t matter. The individual person is what really counts in that sense,” Dr Fosker said. 

Aggressive cancers include melanoma, pancreatic and glioblastoma, but Dr Fosker pointed out they don’t always behave in the same way; sometimes traditionally aggressive cancers can be slow growing, while traditionally unaggressive cancers can misbehave. 

Every year, a handful of patients in Bermuda arrive at the doctor’s office with aggressive cancers that can only be treated with palliative care. 

“By the time we have got in a position to talk about the treatment, the treatment intent is to try to help quality of life rather than cure the cancer, and often just trying to make a short period of time as valuable as possible.” 

This means the patient and their family face incredibly tough choices. 

“There is nearly always some form of treatment,” Dr Fosker said. 

“I find myself often saying this isn’t a curable cancer, but it’s a treatable cancer. It’s not very often I find myself saying there is nothing we can do. 

“It’s remarkable how some simple things can make a difference. For people who are feeling really breathless from cancer, actually just putting a fan on reduces that breathlessness.” 

Dr Fosker’s job is to educate patients and their family about their options. 

“Their choice might be do nothing. Their choice might be to go for the aggressive treatment option because it may buy you two more weeks,” he said. 

“It’s not for me to say necessarily what’s right or wrong, it’s for me to help that person understand what those choices are and the impact they have. 

“It’s about trying to figure out, in that moment, each step of the way, what’s the best next step. Doctors have a huge body of literature about what we’re taught to think is right or wrong, but what I’ve really learnt over my career as an oncologist is that I can never put myself in someone else’s shoes.” 

Glioblastoma, a type of cancer that starts in the brain, for example, can be tackled with chemotherapy and radiation that might have significant side effects. 

“I’ve absolutely no idea what I would do if that was me or one of my loved ones, because you’ve got a good chance you will make them live longer, but you’ve also got the same chance that that length will be less good quality. 

“Who is it to say that three months of good quality is better than nine months of poor quality or vice versa? 

“Someone may be diagnosed with a really nasty cancer where everyone tells them, really sorry, your time’s really short, and then here they are a year later still going. 

“And then you have the other ones, who still are not curable but we’ve got a gentle chemotherapy with a 95 per cent chance of improving quality of life – and then they pass away two days later. 

“It’s the uncertainty that just makes the decision so hard.” 

PALS Cancer Care, which supports cancer patients and their families throughout the whole process, are “brilliant listeners and brilliant thinkers” in helping people make decisions that might seem impossible, Dr Fosker said. 

Looking to the future, the oncologist noted that treatment continues to improve, with advances in fields such as immunotherapy, DNA research and radiation technology. These advancements are providing new hope and options, but he warned there will never be a magic bullet that wipes out cancer. 

So what can people do to make sure their cancer gets spotted before it’s too late? 

Sadly some cancers, such as pancreatic or glioblastoma, are nearly always found at an incurable stage because they are silent until they have spread to such an extent they cannot be cured. 

But there are still things you can do to help yourself. 

“We know men in particular are terrible at going to see the doctor, and they will ignore symptoms until the 11th hour,” Dr Fosker said. 

“So you can live better, and you can also be more responsive to signs and symptoms that happen within the body. 

“If the doctor tells you told to come back in a month but if in two weeks time you feel awful, advocate for yourself and return to the doctor immediately. Don’t wait for the month. 

“Take control of what you can. All cancers are curable, if you can catch them at stage 1 or stage 2.” 

While cancer treatment has made significant strides, Dr Fosker said early detection and patient empowerment remain crucial. 

“Leading a healthier lifestyle and undergoing regular screenings can make a significant difference in outcomes,” he said. 

The post Tough Choices appeared first on RG Magazines.

Educating children about why salmon and broccoli is a better choice than fried chicken and French fries can help lay the foundation for a lifetime of wellness. Below, a few strategies for helping make diet and healthy eating a habit:

Lead by example

Children are always watching; it’s essential to model a balanced diet of fruits, vegetables, lean proteins, and whole grains. Show enthusiasm for trying new foods and flavours, and avoid negative comments about certain foods.

 Get your kids in the kitchen

Take your children grocery shopping and have them pick out fresh vegetables and fruits. Talk to them about your food choices; explain the nutritional benefits of different foods and why balance is key. In the kitchen, let them participate in age-appropriate cooking tasks: washing vegetables, stirring ingredients and making/assembling simple meals.

Turn off the devices

Serve meals at set times, regularly. When you can, eat as a family without distractions like television, electronic devices or books. When you eat without paying attention to your food, its texture, taste and aroma, there is a greater chance that you might overeat. You tend to continue eating and finish without realising your body and brain’s signal that you are full.

Teach portion control

Help children understand appropriate portion sizes by using visual aids and practical examples. Show them how to use their hands or everyday objects to estimate serving sizes. Encourage mindful eating by teaching children to listen to hunger and fullness cues; stop eating when they feel satisfied rather than finishing everything on their plate out of obligation. Avoid using food as a reward or punishment; celebrate achievements with non-food rewards or experiences.

 Promote variety and balance

Emphasise the importance of eating a variety of foods from all food groups. Teach children to “eat the rainbow” by consuming a colourful array of fruits and vegetables so they get a wide range of nutrients to help them stay healthy. Introduce them to new dishes gradually, one at a time. Put only a small amount of a new food on their plate so they are not overwhelmed; be mindful that it can take several attempts before they try it and even more before they begin to enjoy it.

Take them to the grocery store

Involve them in meal planning to encourage ownership of their food choices. At the supermarket, have them put their food choices into the shopping cart. Meanwhile, teach children to become savvy consumers by helping them decipher food labels and understand marketing tactics. Discuss the difference between whole foods and processed foods, and encourage them to question advertising claims. Empower them to make informed choices based on nutritional value rather than packaging or popularity.

Lead discussions, not lectures

Encourage questions about food and nutrition remembering not to be judgemental with your response. Talk about food choices, have them plan a balanced meal and make it. Avoid calling certain foods “good” and other foods “bad” – all foods have their place. Use age-appropriate language and tailor information to their level of understanding.

With such strategies in place, parents and caregivers can empower children to make healthy food choices that will ultimately support their overall wellbeing. Remember, the goal is to help them understand how a balanced diet can provide nourishment that sets them up for a healthy life.

The post Teaching children about diet appeared first on RG Magazines.

Q: What qualifies someone as obese?

A: Overweight and obesity are conditions where a person carries excess body weight in the form of body fat deposits. Obesity can be detected by making a simple calculation with your weight and height, this is known as your body mass index or BMI. A BMI greater than 25kg/m2 would indicate that you are overweight and a BMI higher than 30kg/m2 is classed as obesity.

Many of us are aware that the BMI calculation has its flaws, as the measure does not take body composition into account.

However, carrying excess body fat, particularly around our middle, is associated with an increased risk of type 2 diabetes, cardiovascular disease, stroke and certain cancers.

At Island Nutrition we utilise medical body composition scales, when appropriate, which calculate an individual’s muscle, bone, water and fat mass, along with visceral fat and a unique metabolic age assessment.

Q: How does Bermuda’s population look? 

A: In 2023, over 70 per cent of the population was reported to be overweight or obese, with similar levels seen in both the male and female population. Nearly 34 per cent of males and 36 per cent of females fall into the obese category. The Chief Medical Officer’s report gives further insight into those adults who are more at risk of obesity, highlighting people from a Black, mixed or other ethnic background and those whose income is between $75,000 and $150,000, although those with an income of over $150,000 are the most likely to be overweight.

Bermuda has the third highest rate of diabetes in the OECD. Over 50 per cent of the population are living with diabetes, heart or kidney disease, and one in three people have high blood pressure or high cholesterol, both of which can exacerbate the risk of heart disease, stroke and kidney disease. These conditions can be linked to things we cannot change, such as our age, ethnicity or genetics, but they are also associated with poor diet, low activity levels and excess body fat (which we can change).

There may be many reasons for seeing statistics like this in Bermuda. As the cost of living rises, those with lower incomes may need to work multiple jobs, which means less time to focus on exercise and home cooked meals. Likewise, the cost of fresh fruits and vegetables is significantly higher than most heavily processed convenience foods. Shipping considerations can influence the foods that are imported; for example processed, sugary and salty foods may have a longer shelf life than healthier alternatives.

Generally, physical activity in Bermuda can also be quite low. On a small island like this it isn’t required for us to commute very far at all on foot, and most people will park their vehicles very close to where they need to be. This means to meet the minimum activity recommendations (150 minutes of moderate intensity a week), we need to find time outside of our daily routines. The expense of a gym membership is unaffordable for many, and a lack of sidewalks on residential streets may also impact a person’s willingness to exercise.

There is a large role that could be played by implementing sufficient education around the impact that our lifestyles have on our health. But even with education programmes in place and with sufficient knowledge, the above can remain as huge barriers to making changes to our diet and lifestyle.

A lack of focus on physical activity, good nutrition and cooking skills in many schools, means many children are not learning how to incorporate these things into their lifestyles. But the community as a whole must bear the responsibility. Adults and community leaders need to set a good example and make sure health is prioritised in all that we do. Organisers and suppliers of community events and fundraisers should consider the health impact of the event, and encourage physical activity and healthy food choices.

Q: At what point do medical professionals get concerned?

Medical professionals need to be vigilant across the life span when it comes to weight.

A third of children screened in Bermuda’s schools had a BMI indicating they were overweight in 2022. Children that are overweight are more likely to track into adult overweight or obesity, so it is important to try to improve general health habits from a young age. Educating our children on the importance of a healthy lifestyle may help to establish these habits through to later life.

Another key time for medical professionals to encourage weight management is during pregnancy; extra weight gain is likely to lead to weight retention after giving birth. Increased body weight is also a risk factor for developing gestational diabetes. Although this usually resolves after childbirth, poor blood sugar control can lead to complications during labour, abnormally high birth weight, and the birthing-parent being at a higher risk of developing type 2 diabetes in later life.

Early referral to a registered dietitian to help people understand how food impacts on our health and our bodies is also beneficial, especially for those with modifiable health conditions.

Q: With adults, is a lifestyle change sustainable? 

With access to the internet and a wealth of conflicting fad diets promising to help “lose weight quick”, it can be challenging for individuals to tell facts from fiction.

The dietitians at Island Nutrition are experienced, qualified healthcare professionals whose medical nutrition services are covered by all local health insurance. We can:

• Help you know if dietary information is safe and based on evidence.
• Consider any medical conditions, medications and social circumstances.
• Discuss the best way to maintain a healthy weight by considering your diet and lifestyle as a whole.
• Support you to make healthier choices where possible and include variety and balance.
• Educate on helping people listen to their body’s hunger and fullness cues.
• Optimise your awareness of portion sizes and consider activity levels.
• Work with individuals, families and groups.

www.islandnutrition.bm

Instagram: IslandNutritionbda

The post How obese are we? appeared first on RG Magazines.