The Canadian Task Force’s anti-screening bias

That’s dangerous for Canadians!

Natalie Kwadrans, X, May 8, 2024

For those of you following my blog, you know that I have been a vocal and passionate advocate for cancer screening and cancer research. So when I read a blog post on OncoDaily Medical Journal‘s website where I was labelled a “cancer activist”, I was beaming with pride!

On the theme of advocacy, I just released my second episode of my Getting it Off my Chest series. This the first of five episodes in which I explain my concerns as they relate brief they posted on the House of Commons Standing Committee on Women’s Health.

Task Force members, who volunteer their time and expertise, are vetted to ensure neutrality in assessing evidence and developing recommendations

Canadian Task Force on Preventative Health Care 1

This episode is dedicated to debunking that claim by concretely showing the Chair of the CTFPHC, Dr. Guylène Thériault, has a clear and known anti-screening bias. This means she is not a neutral party; her mind is already made up. She should not be on this Task Force, let alone be chairing it.

  1. Canadian Task Force on Preventive Health Care. (2024, February 14). House of Commons Standing Committee on Health  Study on Women’s Health . HESA – Home – House of Commons of Canada. ↩︎

5 years ago today

5 years ago today,

I found a lump in my right breast.

5 days after my 46th birthday.

And 5 years ago today,

lived Janice, Marloes, Libby, Yvette 

and Natalie.

Fast forward 5 years to present day.

4 of the women in peace may they rest,

and 1 “living while dying,” as they say.

5 years from then marks today the day,

when statistically only one would be left to be.

I hate knowing the last one left is me.

While I am clearly not a poet, I hope you can feel my pain and frustration. These women were my friends. All five of us were diagnosed under the age of 50. For the five of us, there are thousands of others in our situation. Our current Canadian Breast Cancer Screening guidelines are failing us, our families and our friends. I will continue to use my story to advocate for better screening guidelines in Canada. I will fight until I can no longer.
Getting It Off My Chest, episode 0001 – My Breast Cancer Screening Story

Did my story move you? If so, feel free to buy me a coffee or contribute to my medical bills.

My immunotherapies work together like Tre’Davious White & Jordan Poyer

Today marks my 75th Herceptin and Perjeta infusions, which means I’ve been getting these for 225 weeks, or, if you prefer, 4.25 years. I thought it would be interesting to explain, in layman’s terms, how these two drugs work together to sustain my life.

These two drugs are considered targeted therapies, both of which target my HER2 protein receptors in the triple positive subtype of breast cancer I have. Think of HER2 receptors as being little antennas poking off a cell. The two immunotherapy drugs Herceptin and Perjeta bind to these antennas, interfering with their growth and reproduction signals. However, they do so by attaching to different parts of the HER2 protein “antennae”. As a result, they are more effective at doing their job because they are hitting it at different spots. 

My boyfriend is one of Buffalo Bills’ biggest fans, so I’m going to use a football analogy. It’s as if Tre’Davious White and Jordan Poyer simultaneously their opponents’ receiver, with Tre tackling the upper body and Jordan tackling his legs. While either one of these two defensive players would possibly stop the opposing offensive player from getting a touchdown, the two of them tacking together would significantly reduce how many yards the opposing team advanced much more effectively. 

NB: While my boyfriend is a HUGE Buffalo Bills fan, the first game I watched with him was in the 2020 season. I didn’t know a thing about football, although I remember seeing players dancing after a touchdown when I saw the occasional game playing on TV in a sports bar back in the late 1990 and early 2000s. I was disappointed to learn about the  “excessive celebration” rule because I thought it made the game more interesting as a spectator. It was only a few minutes later that Stefon Diggs caught the ball, ran like crazy and managed to zig zag perfectly to avoid getting tackled. He scored a touchdown and did a small victory dance. I loved it and since then, Stefon Diggs has become “my” player. It’s also fitting that he wears #14, which is the day I was born. 

This was a long ‘nota bene” to say that I couldn’t find a way to fit Stefon into my football analogy, so I decided to diverge and write the second part of my post about how he has become “my” NFL player. I’m sad their season is over, but hope to be well enough to go to Seattle next season to see the Bills play there! 

Did you like this post? If so, feel free to buy me a coffee or contribute towards some of my uninsured medical expenses.

Photo credit

Photo 43766579 © Michal Bednarek |

The moving goalposts

As I reflect on my year the term “moving goalposts” came up regularly in my life. However, the best time it was used, and which makes me smile every time I think of this DM exchange with a friend, was below. My friend noticed that I had changed my kids’ Terry Fox School Run target because they had hit their target so early, we didn’t want donations to stop coming in. He noticed because he gave a significant donation that brought them over their BHAG (Big Hairy Audacious Goal). 

What I realized in this reflection is that we are generally taught to move our goalposts to achieve a better result. You often hear people say “raising the bar”, which is a similar concept. However, nobody ever talks about moving in “the other direction.” Yet, as I continue my palliative treatments, I’ve had to do that regularly and I have beaten myself up over it every single time. There are times I didn’t move my goalposts and I failed to achieve what I had set out to do, not for lack of trying; I am no longer able to perform at the same level I used to. Let me tell you – it’s hugely demoralising, and I’ve cried over it so many times this year. When I say I’m not able to perform at a level, I’m not talking about racing on my snowboard, beating a hiking time on a certain trail, or anything of the sort. I’m referring to the day-to-day things, like cleaning my house, doing my laundry, making meals, etc. I hit my wall sooner than I did in the early years of my cancer treatments. I still think I can be SuperMom who is able to shop, make dinner and clean my house before taking my kids to their extracurricular activities. 

2023 was the year I finally figured it out. It’s OK to move your personal goalposts whenever and wherever you want to move them, work being the exception as it would likely be seen as sandbagging. The reality is that you know what you are physically, mentally and/ or emotionally capable of. If it means that you move the goalposts and things you planned to do don’t get done, that’s OK. The world won’t end, I promise!

The goalposts

There are obviously times when the goalposts can’t move. You can’t leave a 4-year-old waiting at a bus stop alone or have them cook their own dinner, for example. Child Services would be visiting very quickly. While I have often asked others to help, I have always felt guilty that I was a burden to them. Thankfully, I have an incredibly wise boyfriend and a persistent therapist who continually remind me that those around me wouldn’t help if didn’t didn’t want to do so. It’s taken me a few years, but as I was driving through the mountains a few days ago, it all started to make sense.

The field full of teammates

For the times when the goalposts truly can’t move, not because of a self-imposed constraint, but because there are real consequences to moving them, I have teammates! I needed to reframe how I saw those who have been cheering me on and helping me along the way. They don’t see me ad their “pitiful” [insert appropriate noun: sister, daughter, girlfriend, mom, friend, acquaintance, patient, customer…]. These individuals choose to help because I contribute to their lives in some fashion, even if it isn’t often obvious to me.

Going into 2024, I will remember I have every right to move goalposts where I need to and when it’s permissible. For the times it isn’t possible, I have the most compassionate and amazing teammates along side me and waiting for me to simply pass the ball to them.

To A.A.B, I am dedicating the title of this blog to you. To all those my team, please accept my heartfelt thank you. I’m ready to head into 2024 with a different outlook on adjusting my goalposts.

Like my blog? Feel free to buy me a coffee or help with medical expenses!

#1 Terry Fox School Run Fundraisers in 2023!

Kids running at the Terry Fox School Run in 2023

There are so many things for me to be proud of when it comes to my kids. I think I have the best kids in the world! OK, so does every other mom, so this isn’t a unique perspective. Having said that, I can unbiasedly say that my kids are the best Terry Fox fundraisers in 2023! Imagine the pride I had when I received the following email this morning.

#1 Terry Fox School Run fundraisers for 2023
#1 Terry Fox School Run fundraisers for 2023

This year marks the 5th year my kids have been running as part of their school’s Terry Fox School Run, and every year, they have grown their fundraising efforts. The don’t simply rely on “mom” to spread the word via social media; they work hard at raising funds. They ask their friends’ parents at their extracurricular activities and they knock on doors for donations. In fact, they door knocked twice this year, hitting up hundreds of homes. Their efforts were noticed in the community. They had a visit from our Ward’s City Councillor to talk about their story, which he shared on his social media. They were also interviewed by CBC’s reporter Tom Ross, and their story aired on CBC News Calgary on September 22, 2023. Click here to listen to the segment.1

It’s hard to believe that in the month after the segment aired, the kids’ donations went from $10,000 to a whopping $21,100. I’m floored at how much they have collected this year.

I’m so grateful to still be here to watch my kids grow up. In 2018, Victoria asked her grand-parents to donate. In 2019, I remember how fearful Victoria was the first time we knocked on someone’s door. But she was enthusiastic; she did the knocking and I did the talking. Things started to change in 2020. Victoria did the knocking and some of the talking, with Nicolas and I standing by her side at the door. In 2021 with Nicolas started helping his big sister. He did the knocking and she did the talking. I was told to stay on the sidewalk and only to come if someone needed a tax receipt. Last year, Nicolas did the knocking and some of the talking, while Victoria ran off to the next house to do her “spiel”. 2023 was the year the kids partially split up, increasing on the numbers of doors they knocked on. They both did the knocking, they both did the talking, but at different houses. Still a little shy, Nicolas would sometimes give his big sister the stage and act as the “QR code provider.” I stayed back and only helped with income tax receipts.

As I sit here writing this post, I find myself smiling ear-to-ear. I’m lucky to be a “stage 4 breast cancer unicorn” (meaning I have outlived my life expectancy) as I am able to witness my kids, who are only 9 and 7, raise over $35,000 for cancer research so far. The magnitude of what they have done this year is beyond incredible. As Victoria so eloquently put it, “I hope that it goes smoothly like this every year.”2

  1. Ross, T. (2023, September 22). Two Calgary kids have hit a huge milestone raising money for the Terry Fox Run this year [Radio broadcast]. CBC Calgary News ↩︎
  2. Victoria Kwadrans, age 9, interviewed by Tom Ross, in a CBC Calgary News segment on September 22, 2023 ↩︎

Are you proud of my kids and my fundraising efforts for cancer research? If so, feel free to buy me a coffee or contribute towards some of my uninsured medical expenses.

Survival guilt : living among the dying

I know it sounds strange that I would claim I have survival guilt, which is typically reserved to victims of a unplanned traumatic event such a car crash, a property fire, large-scale tragedies or crisis. Yet, I believe that’s what I am feeling.

I met a woman at a local breast cancer group for young women in Calgary on July 4, 2019 for group coffee meetup. Like me, she also was a young mom. Her daughter was 11 months old when I met her. She had felt a lump in 2017, but busy with life, and soon after a pregnancy and then an infant, she didn’t have time to follow up until she found it again around 7 months after she had her daughter. That is when our paths converged through the breast cancer “club”. She told me it was stage 2b.

Ten days ago, my friend died. It boggles my mind. Statistically speaking, she should have lived much longer than me. With what they consider a locally advanced stage breast cancer, with emphasis on “locally”, she should have had a 95.6% chance of surviving the next 5 years. Unfortunately, mine was stage 4 de novo, meaning it was terminal from the time of diagnosis. My chances were only 22% for that same period. This is my second friend in 3 years who were supposed to outlive me.

Aside from the stage of our disease, she and I had the same diagnosis: triple positive, with low HER2 expression. We had same treatments and compared notes almost weekly throughout our treatments, post-surgery and radiation. We were being treated by the same doctor and she was initially three weeks behind me. Eventually, she finished her treatments first because I had an anaphylactic reaction to the second type of chemo we received, so I had to pause for 6 weeks, which allowed me to get approval to get onto a different version of the drug, one made with a bio-synthetic base as opposed to Castor Oil, which was the ingredient I was actually allergic to. That’s when she caught up, and then finished her treatments and had her surgery 3 weeks ahead of me.

I understand that we each make our treatment choices. My friend had an underlying medical issue that required her, if she couldn’t live with the symptoms of that disease, to go back on her old medication, knowing they were contraindicated given their immune-suppressing nature. She started those treatments a few months after finishing her radiation treatments. She debated whether to restart the drugs knowing they were immunosuppressants and that it opened a door up for the cancer to grow again. Unfortunately, it came back for her. She immediately moved to her second and then last line of treatment. We shared the same bone mets radiation and orthopedic oncologists. We truly were “Bobbsey twins” when it came to our cancer diagnosis and treatment. Unfortunately, between her underlying medical issue and need for immunosuppressants while in treatment, and other treatment decisions she made, her cancer continued to spread while mine didn’t. Logically, these explain why she and I have had such different outcomes, I still feel guilty.

  • I think back to so many conversations we had. Did I do enough to try to convince her to listen to her doctor?
  • Why couldn’t I help her more?
  • Why do my kids get more time?
  • I can’t sleep, other times I wake up in the middle of the night, sometimes lying still in bed and sometimes crying quietly, because I have outlived two of my local friends who were in earlier stages than me and didn’t make it.
  • Why am I a unicorn? What makes me different? What do I have in me that they didn’t?

Today is her funeral. I can’t make it today because I have my kids with me and I don’t want to upset them with the knowledge that another friend of mine just died. But I don’t know that I would have gone even if my children were with their dad and I was available. I don’t know that I could look into her husband or daughter’s eye and not want to vomit on them because it makes me sick to my stomach that I am here and she is not.

Selfish? Perhaps. I think saying it’s self-preservation is more accurate.

My friend L, I’m sorry I can’t be there for your family, in particular your daughter. Know that I am thinking of you. I hope you are in a better place where there are no demons haunting you as they did here. <3

Are my blog posts helpful to you or someone you know? If so, feel free to buy me a coffee or contribute towards some of my uninsured medical expenses.