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The Oncologist, the Patient and CKN — Sharing Knowledge

Multidisciplinary Canadian consensus recommendations for the management and treatment of hepatocellular carcinoma

by M. Sherman, K. Burak, J. Maroun, P. Metrakos, J. J. Knox, R. P. Myers, M. Guindi, G. Porter, J. R. Kachura, P. Rasuli, S. Gill, P. Ghali, P. Chaudhury, J. Siddiqui, D. Valenti, A. Weiss, R. Wong


Globally, hepatocellular carcinoma (hcc) is the third most common cause of death from cancer, after lung and stomach cancer. The incidence of hcc in Canada is increasing and is expected to continue to increase over the next decade. Given the high mortality rate associated with hcc, steps are required to mitigate the impact of the disease. To address this challenging situation, a panel of 17 hcc experts, representing gastroenterologists, hepatologists, hepatobiliary surgeons, medical oncologists, pathologists, and radiologists from across Canada, convened to provide a framework that, using an evidence-based approach, will assist clinicians in optimizing the management and treatment of hcc. The recommendations, summarized here, were developed based on a rigorous methodology in a pre-specified process that was overseen by the steering committee. Specific topics were identified by the steering committee and delegated to a group of content experts within the expert panel, who then systematically reviewed the literature on that topic and drafted the related content and recommendations. The set of recommendations for each topic were reviewed and assigned a level of evidence and grade according to the levels of evidence set out by the Centre for Evidence-based Medicine, Oxford, United Kingdom. Agreement on the level of evidence for each recommendation was achieved by consensus. Consensus was defined as agreement by a two-thirds majority of the 17 members of the expert panel. Recommendations were subject to iterative review and modification by the expert panel until consensus could be achieved?

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Health care strategies to promote earlier presentation of symptomatic breast cancer: perspectives of women and family physicians

by M. Sherman, K. Burak, J. Maroun, P. Metrakos, J. J. Knox, R. P. Myers, M. Guindi, G. Porter, J. R. Kachura, P. Rasuli, S. Gill, P. Ghali, P. Chaudhury, J. Siddiqui, D. Valenti, A. Weiss, R. Wong


Many women with symptoms suggestive of a breast cancer diagnosis delay presentation to their family physician. Although factors associated with delay have been well described, there is a paucity of data on strategies to mitigate delay.

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Using a positive self-talk intervention to enhance coping skills in breast cancer survivors: lessons from a community based group delivery model

by R. Hamilton, MSES, B. Miedema, PhD, L. MacIntyre, BA, J. Easley, MA


Cancer survivorship is a distinct phase of the cancer continuum, and it can have myriad associated stresses and challenges. The purpose of the present study was to evaluate the effectiveness of a positive self-talk (PST) intervention in enhancing the coping skills and improving the psychological well-being of breast cancer survivors.

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Introducing the First Fertility Registry for Cancer Survivors

Long term follow-up of the reproductive outcome of cancer survivors is very important. The larger the data base feeding the follow-up studies, the more informative and accurate the conclusions will be. This will allow for better consultation to patients and their families. We do encourage you to complete this survey.  

Dr. Hananel Holzer, attending physician, McGill Reproductive Centre


By Kate Waimey Timmerman, PH.D.

One out of 48 women will develop invasive cancer before age 40. Many young women will survive their cancer treatment and live long lives that include decisions on building a family.   Currently, there is a lack of data on the long-term reproductive outcomes in young women after cancer treatment. Investigators at the Oncofertility Consortium recently launched the first long-term study to investigate the reproductive impact of cancer treatments on women. The Fertility Information Research Study (FIRST) is a registry project that will collect this information from and for female cancer survivors.

We are happy to announce that women who want to participate in science and help the next generation of cancer patients can now be a part of this study. Any woman between 18 and 44 who is less than three years from a cancer diagnosis or treatment can sign up for the study. Interested women can call the FERTLINE (866-708-FERT [3378]) or contact the study team by email ( to learn more about the study.

Participants will be asked to complete an online questionnaire yearly that will assess a variety of women’s health outcomes, from fertility to abnormal periods to premature menopause. This information will help researchers learn the scope of reproductive problems after cancer with just a few minutes of effort each year.

If you are a young woman who has had cancer or cancer treatment, or know women who are, please think about signing up for the FIRST Registry by calling the FERTLINE at 866-708-FERT (3378) or contacting the study team at  With your help, we can help guide counseling and treatment of future young women.


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