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What to ask your doctor about Angelina's cancer surgery.
When Angelina Jolie writes about her personal health struggles in the New York Times, it makes a splash. In 2013, Jolie set off a media storm by writing about her double mastectomy and genetic predisposition for cancer, then wrote about a second surgery, this time to remove her ovaries and fallopian tubes, in 2015.
High drama, yes, but it’s hard not to admire her candour. Jolie writes that she is now in full menopause and using bio-identical estrogen patches and an IUD to replace the hormones she’s lost. That’s no small reveal for anyone, let alone an actress known for her vitality and sex appeal.
Jolie also added a note of caution, knowing that the "Jolie effect" is now a recognized factor in doctor-patient conversations and that her preventative surgeries are an extreme course of action.
"I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this. A positive BRCA test does not mean a leap to surgery," she writes.
On this point, Canadian doctors and cancer experts agree. High drama may be a good way to start a conversation but calm heads makes the soundest decisions.
A cancer doctor weighs in
Dr. Marcus Bernardini a surgical oncologist at Toronto’s Princess Margaret Cancer Centre at University Health Network told us there are a few things Canadian women should know in the wake of Jolie’s announcement:
1. There is actually no effective general screening for high-grade serious ovarian cancer and screening is not recommended.
2. Preventative surgery is recommended for high-risk women (those who carry the BRCA1 or BRCA2 mutation).
3. Jolie mentions a scenario in which only the fallopian tubes are removed (called a salpingectomy) for women who still hope to get pregnant. Dr. Bernardini calls this "an intriguing strategy," but for now the removal of the ovaries and fallopian tubes (a salpingo-oophorectomy) is the recommended course of action.
4. There are four questions Dr. Bernardini suggests discussing with your doctor if you have concerns raised by Angelina Jolie’s story:
- Am I at risk for ovarian cancer?
- Is there a history of ovarian cancer in my family?
- How does one find out if they are eligible for testing?
- I know there are different types of ovarian cancer, are all preventable in this way?
Family history is the starting point
Responding to the Jolie news this week, Gillian Bromfield, the director of Cancer Control Policy at the Canadian Cancer Society also pointed out that it’s important that people try to learn their family health history.
The group also has information for women with a known strong family history of breast and ovarian cancer, including information on genetic testing, and preventive strategies that may be available to them, she says.
"The decision to have a preventive surgery is a very personal one that a woman would make in consultation with her healthcare provider based on her medical history and her personal preferences," she says.
Here’s hoping Jolie’s candour leads to more information being shared – not more panic.
Read on for more information on menopause and genetic testing.
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Many parents worry their divorce will negatively effect their children. However, one psychologist says divorce can have a positive impact on kids.
Your parents, a best friend, perhaps even yourself—most Canadians have had some experience with divorce. In 2008, Statistics Canada estimated that 41 percent of Canadian marriages would end in divorce before their 30th wedding anniversaries.
Despite this forecast, the actual number of divorces in Canada declined between 2007 and 2008—the most recent years studied by Statistics Canada—but the heartbreak that accompanies a divorce is still very real for many Canadian children. Thankfully, not all kids grow up to carry scars from their parents' split. Here are five positive life lessons children can learn following a divorce.
1. They become resilient and adaptable
For Gabrielle Domingues, a Toronto media specialist and married mother of two, her parents' divorce taught her how to roll with life's changes. "Divorce made me more adaptable to varying lifestyle situations," she says. "My dad lived in a different city for years, so I was more attuned to having more than one resting place with different people and things. That's a useful skill to have."
Dr. Lisa Ferrari, a Vancouver-based clinical psychologist, says Gabrielle's hunch is bang on. "A natural byproduct of going through divorce is that you are required to be more adaptive," she says. "You're in a situation where you have to develop coping strategies to deal with physical and psychological space transitions."
Often, children of divorce grow up having to develop coping strategies that their non-divorce counterparts wouldn't encounter until years later, if at all. "Having to overcome these obstacles and having to deal with change makes some children of divorce more resilient in life," says Dr. Ferrari.
2. They become more self-sufficient
Tara Richmond, a married mother to a six-year-old son and a marketing and media consultant in Collingwood, ON, found that her parents' divorce made her more confident in her own abilities. "Having a mother working full time after my parents' split taught me how to be more self-sufficient," she says. "I went home after school by myself and often started dinner. At age 11, I was doing laundry, and small grocery shops. I really relished my time alone at home. I got to know myself."
The new economic challenges that come with having a single-parent income often result in the child becoming more responsible for household chores. "It's logical that divorce offspring would view themselves as more self-sufficient, and see this strength as a positive outcome of their parents' divorce," says Dr. Ferrari.
3. They develop an increased sense of empathy toward others
A change in the family unit can make some children more sympathetic to the problems of others. "I think I am more accepting of people, their situations and circumstances," says Tara. "My parents were the first of my friends or family to get a divorce. It was 1980, so there was still a stigma."
Dr. Ferrari says that she sees this caring trait in the kids of divorce who frequent her practice. "When their peers have family problems, it's very relatable for them," she says. "I find that they can be quite empathetic."
4. The idea of marriage isn't taken for granted
"Coming from divorced parents, I have a heightened understanding to the stakes [in marriage], which hopefully makes me a more conscientious spouse," says Gabrielle. I feel a certain pride that my marriage is strong and happy when my parents' wasn't, like I'm succeeding where they didn't."
"I'm not surprised that's something Gabrielle's proud of," says Dr. Ferrari. "Even at a young age, kids want to create something different after they've experienced the hurt that comes from the separation of their parents. They say that they're going to do this better than their parents, or not do it at all. Gabrielle's doing it, and she's changing her history."
5. They learn more through quality time spent with each parent
Not all kids of divorce spend less time with their parents. "I got to know my parents on a different level by spending so much time with them individually," says Tara. "I think my relationship with each of them became closer and we learned a lot about each other."
Like Tara, the kids in Dr. Ferrari's practice often mention this plus. "The biggest positive I hear from the kids and see first hand is that they spend more time with dad, especially if their family structure was more traditional [pre-divorce]," she says. "When the parents move into a shared role, the kids find they get more time with their fathers."
While it's more common for a child, or adult, to recount negatives from their parents' divorce, Dr. Ferrari says that the legal community is adopting changes that suit the children's best interests. Hopefully, these adjustments will facilitate more positive outcomes. "We're moving towards alternate dispute resolution processes such as mediation, so parents can go through divorce without involving court," she says. "Engaging in co-parenting therapy lets mom and dad commit to parenting the kids the same way, despite no longer being married to one another. These changes are positive for kids."
If you're worried about introducing your children to your new partner, read our expert tips.
<p>Raina + Wilson</p>
As we usher in the fall season we also welcome changing foliage, pumpkin spice lattes and the coveted transitional coat—which depending on where you live in Canada can mean different degrees of warmth and protection. Here are 13 transitional toppers that will have you looking stylish and protected this fall, we picked one to go with every major city in Canada, related to their average fall forecast.
Rainfall isn't an issue in Calgary come fall, but temperature's sit right around 5c so keep cozy.
Oversized Suede-Like Jacket, $179.
Montreal get's a solid dose of precipitation (sometimes rain, sometimes snow) come the fall with averages hitting 4c.
TNA league jacket, $85.
Yellowknife's fall average sit at a brisk -10c with roughly 30 cm of snow projected, so it's time to break out the puffer—and snowboots!
The North Face Thermoball PrimaLoft Hooded Parka, $230, shop.nordstrom.com.
Halifax gets a hefty rain fall come the autumn, with its rainiest month being November. The average temp is 6c. Look for thin jacket or puffer with a water-resistant outer shell.
Alderwood shell, $425.
Whitehorse sits at a respectable -4 degrees come fall. Look for jackets made from natural materials such as cashmere, wool and alpaca to keep you cozy. It's a wee bit of a splurge, but if you buy a classic shape it will be a wear forever piece.
Charlotte Coat in Melton Wool, $528.
Saskatoon sits at 0 or below for 185 days a year, but come fall temps range from 18c to -7, so versatility is key—layering is also a smart idea. Try wearing a cape over a wool sweater to keep you toasty warm.
Twik Three-button cape, $70.
Iqaluit is in the Arctic, so it's average fall temperature is a chilly one: -15. A jean jacket won't cut it in these parts, look for a short parka or heavy duty puffer with a hood to protect you from the wind.
Anouk Paraka, $729.
Out east they get warmer fall's and St. Johns, Newfoundland is no exceptions, with temperatures sitting around 4c. Try layering a utility jacket over a hoodie.
Sherpa-lined utility jacket, $118.
Winnipeg has its nickname "Winterpeg" for a reason, the city's temperature fluctuates but the fall average sits at -1c. Look for an oversized stylish coat, perfect to layer over a puffer vest on cooler days or keep it open with a scarf draped around your neck for warmer days.
Cashmere-like open collar coat, $100.
Vancouver's wettest season is autumn, with an average of 450mm of rainfall and a temperature that hovers around 10c. Which means it's the perfect time to break out the rubber boots and find a slick coat to keep your warm and dry in the downpours.
Michael michael kors hooded trench coat, $149.
Toronto average forecast is sitting pretty around 12c, which means it's the perfect jean and moto jacket weather.
Cropped Suede Moto, $458.
October is Charlottetown's rainiest month, with and average of 110 mm of rainfall and temperatures at -1c.
Rains trench coat, $119.
Fredericton enjoys a sunny climate, averaging about 2,000 hours of sunshine a year however its temperatures are on the chillier side come fall, sitting around 4c.
Wane Lux Wool Waterfall Collar Jacket, $750.
We love the nostalgic, yet refreshing comeback that macrame has made in the world of DIY. Whether you are looking to up your wall game or suspend some blooms, we have a project just for you.
We love this colourful spin on the classic plant hanger.
Perched over a bed or in a child's room, this wall hanging will makes a simple statement.
Shed some light in a dark corner of your home with this woven masterpiece.
Showcase blooms in this simple hanging vase.
Make your next party an affair to remember with these colourful garlands.
Hang this basket in your bathroom to keep essentials stylishly close at hand.