Transcript: Your Health Season 3 Episode 26 | Apr 02, 2002

A slate reads "The advice given in the following program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances."

(music plays)

Against a gray background, an animated blue, green and gray grid shows clips of doctors and patients as the white letters of the title of the show fly forward: "Your Health."

Maureen says THIS WEEK…

Jo-Anne Cooke is in her forties, with short straight brown hair. She wears a fluffy purple sweater.

She says SYMPTOMS WERE VAGUE,
I... EVEN BACK TWO YEARS
EARLIER I HAD SOME STOMACH
PAINS THAT WOULD COME AND
GO.
NOTHING THAT PERSISTED FOR
ME.

Barry Rosen is in his forties, clean-shaven and with short curly graying hair. He wears glasses, a white shirt, printed tie and a white coat.

Barry says IT'S CALLED THE SILENT
KILLER BECAUSE IT DOESN'T
PRESENT WITH ANY SYMPTOMS.

Maureen says FIGHTING THE
ODDS AFTER A DIAGNOSIS OF
OVARIAN CANCER.

Doctor Hamilton Hall is in his fifties, clean-shaven and with short gray hair neatly combed back. He wears glasses, a gray suit, pale gray shirt and printed tie.

Hamilton says I HAVE A WONDERFUL
CARTOON OF THIS SURGEON
HANDING THE YOUNG SURGEON
THE KNIFE SAYING WE'VE ALL
GOT TO START SOMEWHERE, WHY
DON'T YOU DO THIS ONE.

Maureen says THE LEARNING CURVE FOR
NEW SURGEONS.

Maureen says AND ON MEDICINE
101.

Paul Caldwell is in his late fifties, with a beard and receding white hair. He wears a yellow shirt and a printed tie.

THE COLON IS NOT A VERY
EXITING ORGAN.

Maureen says THE COLON,
BORING BUT NECESSARY

The animated grid appears showing clips of a woman holding a baby, pills, a surgery, a needle and a man doing exercise.

The title of the program reads "Your Health." The "R" in "Your" ends with an "X."

Maureen Taylor stands next to a screen in a studio. She is in her late thirties with shoulder-length light brown hair. She wears a soft yellow dress under a soft yellow blazer.

Maureen says HELLO, I'M
MAUREEN TAYLOR.
THERE'S BEEN A LOT OF
DEBATE REGARDING THE
EFFECTIVENESS OF MAMMOGRAPHY
AS A SCREENING TOOL FOR
BREAST CANCER.
BUT AT LEAST THERE IS A
SCREENING TOOL.
NOT SO WITH OVARIAN CANCER.
THERE IS A BLOOD TEST BUT IT
MISSES THE CANCER 50 percent OF THE
TIME.
WOMEN ARE OFTEN DIAGNOSED
WHEN IT IS ALREADY TOO LATE.
JOANNE COOKE WAS ONLY 42
YEARS OLD, THREE YEARS LATER
SHE HOPES SHE WAS TREATED
IN TIME.

A slate appears with the caption "Silent Cancer. Produced by: Janet Aronoff."

A clip shows Jo-Anne Cooke jogging.

Jo-Anne says I WAS HAPPY, I WAS DOING
WHAT I WANTED TO DO.
I FELT GREAT, I WAS RUNNING
WITH MY FRIENDS.
TOOK A TRIP TO NEW YORK THAT
YEAR.
WE HAD A SKI TRIP, IT WAS
1999 WAS REALLY A GREAT YEAR.
UP UNTIL NOVEMBER OF '99
WHEN THINGS CHANGED FOR US.
SEPTEMBER OF '99 I WAS
FEELING A LITTLE OFF BUT
NOTHING... NOTHING UNUSUAL.
MY STOMACH WAS A LITTLE OFF
AND I WENT TO SEE MY FAMILY
DOCTOR AND HE SAID WELL,
JOANNE WAIT AND SEE, JUST
CHART HOW YOU FEEL.
SO I DID MY PHYSICAL IN
OCTOBER AND AT THAT POINT
THE DOCTOR THOUGHT THAT
MAYBE I HAD SOME FIBROIDS.
SO HE SAID NOT TO WORRY,
JUST GO DO THIS ULTRASOUND.
SO I PUT THE PAPER IN MY
PURSE AND YOU KNOW PUT IT
OFF.

A doctor doing an ultra sound says TAKE A BIG BREATH.
AND HOLD.

Jo-Anne says IN NOVEMBER OF '99 I WENT
FOR THE ULTRASOUND AND AT
THAT POINT I KNEW SOMETHING
WAS SERIOUSLY WRONG.

A picture of a blond woman appears.

The caption changes to "Andrew Callum."

Andrew is in his late thirties, clean-shaven and with short straight blond hair. He wears a striped shirt.

Andrew says IT WAS CHRISTMAS JUST
BEFORE SHE WAS DIAGNOSED AND
SHE JUST WASN'T FEELING
WELL.
SHE KIND OF FELT RUNDOWN AND
TIRED.
DIDN'T HAVE AS MUCH ENERGY
AS SHE NORMALLY WOULD AND
SHE KIND OF WROTE THAT OFF
TO A BUSY CHRISTMAS.
ABOUT TWO OR THREE WEEKS
AFTER CHRISTMAS SHE WENT TO
OUR FAMILY DOCTOR AND
COMPLAINED OF PAIN IN HER
SHOULDER, WHICH FELT LIKE A
MUSCLE PAIN BUT SHE HADN'T
DONE ANYTHING TO, YOU KNOW,
TO INDICATE SHE SHOULD HAVE
HURT HERSELF.
DURING THAT TIME SHE HAD A
PROBLEM WHERE HER CLOTHES
WEREN'T FITTING ANY MORE.
SHE WENT BACK TO THE DOCTOR
AND THE DOCTOR SENT HER TO
AN ULTRASOUND.
THEY CAME BACK WITH SOME
VERY FUNNY RESULTS AND THEN
WE GOT THE CALL TO SAY THAT
THEY HAD MADE AN APPOINTMENT
WITH AN ONCOLOGIST.
AND IT WAS AT THAT POINT
THAT WE REALIZED THERE COULD
BE SOMETHING WRONG.

The caption changes to "Doctor Barry Rosen. GYN Oncologist. Princess Margaret Hospital."

He says to a patient THE PROBLEM THAT YOU HAVE
IS THAT YOU HAVE WHAT WE
CALL A PELVIC MASS.

Barry says EVERY YEAR THERE ARE 2500
NEW OVARIAN CANCERS
DIAGNOSED IN CANADA.
THERE ARE 1500 DEATHS FROM
OVARIAN CANCER IN CANADA A
YEAR.
AND THAT NUMBER IS ACTUALLY
INCREASING BY ABOUT THREE TO
FOUR percent A YEAR.
MOSTLY BECAUSE OF THE AGE OF
OUR POPULATION.

Jo-Anne says I CAN REMEMBER WAKE UP
AND THE FIRST THING THAT I
SAID TO MY HUSBAND AFTER THE
SURJERY WAS, WAS IT?
AND HE SAID OH, YES, IT WAS
OVARIAN CANCER.
IT WAS CLASSIFIED AS, AT
THAT POINT EARLY STAGE THREE.

Andrew says I REMEMBER IT ALL STARTED
TO SINK IN WHEN SHE CAME
BACK FROM THE OPERATING ROOM
AND I WAS WAITING IN HER
ROOM AS SHE HAD IVs AND YOU
KNOW, STOMACH PUMPS AND ALL
KINDS OF STUFF.
AND YOU REALLY START TO
REALIZE, OH MY GOD.
SHE WAS CERTAINLY LEVEL
THREE.
I THINK THEY WOULD HAVE
ALMOST CALLED IT AN ADVANCED
LEVEL THREE.
SHE HAD TUMOURS THROUGHOUT
HER ABDOMEN, SHE HAD CANCER
IN HER LYMPH NODES.

A clip shows cancerous cells under a microscope.

Barry says USUALLY WE CONSIDER STAGE
ONE OR TWO AS EARLY STAGE
OVARIAN CANCER AND THOSE ARE
THE STAGES WHERE THE CANCER
IS CONFINED TO THE OVARY AND
THE PELVIS.
STAGE THREE OR FOUR IS WHEN
IT HAS SPREAD BEYOND THE
PELVIS INTO THE ABDOMEN OR
POSSIBLY CREATING FLUID ON
THE LUNG.
SO IN EARLY STAGE OVARIAN
CANCER THE SURVIVAL, THE
CURE RATE IS, IN FACT, VERY
GOOD.
IT'S FOR STAGE ONE IT IS AS
HIGH AS 9O percent.
FOR STAGE 2 IT IS AS HIGH AS
70 TO 75 percent.

Barry says to a patient OKAY, I'M JUST GOING TO
EXAMINE YOUR ABDOMEN.

Barry says IN STAGE THREE AND FOUR
THE ADVANCED STAGE, THE CURE
RATE IS AS LOW AS 15 percent, AND
AS HIGH MAYBE AS 20 TO 25 percent.
AND THAT IS A REAL PROBLEM.
BECAUSE MOST PEOPLE PRESENT
WITH ADVANCED STAGE OF
OVARIAN CANCER SO THE CURE
RATE IS LOW AT 15 TO 25 percent.

Jo-Anne says IT IS THE DISEASE THAT
WHISPERS, IT HAS A HIGH
MORTALITY RATE.
DEPENDING ON WHAT STAGE THEY
CATCH IT.
A LOT OF WHAT I WAS READING
WAS NEGATIVE.
SO FROM THAT PERSPECTIVE I
JUST FELT SICK.
I WAS KICKING THE TEETH IS
REALLY WHAT IT WAS.

Andre says IT WAS SHOCKING.
YOU KNOW WE WERE, YOU KNOW,
AT THAT AGE, YOU KNOW, 30
YOU THINK ARE YOU INVINCIBLE,
YOU THINK YOU ARE IMMORTAL.
AND YOU KNOW, WE THOUGHT WE
HAD EVERYTHING IN THE WORLD
GOING.
IT WAS... NO, IT WAS A SHOCK.

Barry says WHEN SOMEONE IS DIAGNOSED
WITH OVARIAN CANCER
TREATMENT IS COMPOSED OF
SURGERY, FOLLOWED BY
CHEMOTHERAPY.
SO THE ROLE OF SURGERY IS TO
FIRST MAKE THE DIAGNOSIS
BECAUSE WE REALLY DON'T GET
A FIRM DIAGNOSIS UNTIL WE
HAVE SOME TISSUE REMOVED.
THE SECOND ROLE OF SURGERY
IS TO REMOVE AS MUCH OF THE
TUMOR AS POSSIBLE.
THE SECOND STEP OF TREATMENT
IS CHEMOTHERAPY.
AND WE USE TWO DRUGS
PRIMARILY INITIALLY.
WE USE TAXOL AND CARBOPLATIN.

Andrew says IT WAS HARD.
IT WAS ARGUABLY HARDER THAN
SURGERY AND THESE ARE THE
DRUGS THAT MAKE YOU FEEL
LIKE A CANCER PATIENT.
THESE ARE THE ONES WHERE YOU
ARE GOING TO LOSE YOUR HAIR
AND YOU GET SICK AND THESE
ARE THE ONES WHERE YOU LOSE
WEIGHT AND YOU CAN'T EAT.

Jo-Anne says I THINK IN THE WHOLE
THING WITH THE CHEMO, THE
BIGGEST WORRY WAS MY HAIR.
I LOVED MY HAIR.
I HAD LONG HAIR AND I WAS
ALWAYS CUTTING IT AND
PLAYING WITH IT.
AND JUST LOVED MY HAIR.
AND I KEPT THINKING THAT I
WOULDN'T LOSE MY HAIR.
BUT SURE ENOUGH, 21 DAYS
AFTER THE FIRST CHEMO IT
JUST COMES ALL OUT, ALMOST
IN THE COURSE OF TWO DAYS.
I HAD SIX TREATMENTS OF
CHEMO WHICH WERE OVER FIVE
AND A HALF MONTHS.
I HAD 25 DAILY TREATMENTS OF
RADIATION, WHICH RAN THE
SUMMER.
AND THAT FOR ME WAS HARDER
THAN THE ACTUAL CHEMOTHERAPY.

Andrew says IT WAS PRETTY SCARY
NUMBERS.
WE WERE, YOU KNOW, WE WERE
BANGING AGAINST THEM AND WE
FOUND ALL KINDS OF REASONS
IN OUR HEART AND IN OUR
HEADS WHY WE WERE GOING TO
BEAT THE ODDS.
YOU COULDN'T HAVE GONE
THROUGH IT THINKING IT
WASN'T GOING TO DO YOU ANY
GOOD.

A clip shows Jo-Anne dining with her family.

Jo-Anne says THAT WAS AUGUST OF 2000.
SO THAT WAS A YEAR AND A
HALF AGO.
I DO FEEL ENERGIZED, HAPPY
TO BE HERE.
HAPPY THAT I WAS ABLE TO GET
THROUGH IT AS WELL AS I DID.

Barry says WE'RE NOT CURING MORE
PEOPLE BUT IN FACT WOMEN ARE
LIVING LONGER IN WHAT WE
CONSIDER A DISEASE-FREE
STATE SO A REMISSION WHICH
IS A HUGE BENEFIT TO THESE
WOMEN.
THEY HAVE NO SYMPTOMS, THEIR
LIVES GET BACK TO NORMAL AND
THEY ARE LIVING LONGER.
AS A RESULT OF THESE NEW
DRUGS.

Andrew says WHEN THEY GAVE US A CLEAN
BILL OF HEALTH IN THE BACKS
OF OUR MINDS WE KNEW ENOUGH
TO KNOW IT WASN'T GOING TO
LAST FOREVER.
EVERYTHING YOU READ AND
LEARNED ABOUT THERE CANCER
WAS THAT IT WAS SOMEWHAT
RELENTLESS AND THAT IT CAME
BACK AND IT CAME BACK, AND
THE REAL SUCCESS WAS BEING
HAD, AT CONTINUING TO FIGHT
OFF THE RECURRENCES.

Barry says INITIALLY THESE WOMEN'S
CANCERS WERE RESPOND TO THE
CHEMOTHERAPY.
AND THEY WILL GO INTO A
TEMPORARY REMISSION.
BUT AT SOME POINT THESE
CANCERS DEVELOP RESISTANCE
TO THESE DRUGS.

Family pictures of Andrew’s wife and kid appear.

Andrew says EARLY '99 SHE FELT FINE
AND THEN AROUND EASTER SHE
HAD ANOTHER PAIN IN HER
SHOULDER.
SHE KNEW RIGHT AWAY
SOMETHING WAS WRONG.
WE WERE PROBABLY BACK IN PMH
FOR FOUR DAYS STRAIGHT OF
STRAIGHT TESTING.
AND THEN AGAIN, THEY BRING
US IN AT THE END OF THE DAY,
FRIDAY AND THEY TELL US THAT
NO, THE CANCER IS BACK.
THEY LOOKED AT ALL KINDS OF
DIFFERENT TREATMENTS,
DIFFERENT CHEMOTHERAPY
TREATMENTS, RADIATION
TREATMENTS, AND A WHOLE LOT
OF MORE EXPERIMENTAL PHASE
ONE AND PHASE TWO DRUGS AND
WHAT THAT CLEARLY POINTED
OUT, AFTER A DAY OR TWO, BOY,
THEY DON'T KNOW THE ANSWER.
I THINK WE WERE STARTING TO
REALIZE THAT SHE MAY NOT GET
BETTER.
I DON'T THINK WE WERE... I
DON'T THINK WE REALIZED SHE
WAS GOING TO DIE.
AND THEN IT WAS THE FIRST
WEEK OF JANUARY SHE PASSED
AWAY IN 2000.

Barry says RESEARCH IN OVARIAN
CANCER IS VERY CHALLENGING.
THERE ARE NO SEGREGATED
FUNDS IN THIS COUNTRY FOR
RESEARCH IN OVARIAN CANCER
AS THERE ARE IN BREAST
CANCER AND PROSTATE CANCER.
IT IS SOMETHING THAT I FEEL
IS ABSOLUTELY NECESSARY.

Andrew says THERE IS JUST NO
AWARENESS ABOUT THIS
DISEASE.
AND PART OF IT IS THERE ARE
NO SPOKESPEOPLE.
I MEAN IT TAKES A PERSONAL
STORY TO MAKE A DIFFERENCE
AND TYPICALLY WOMEN WHO ARE
DIAGNOSED WITH OVARIAN
CANCER DON'T HAVE A LOT OF
ENERGY AND DON'T HAVE A LOT
OF TIME.

Jo-Anne says OH, SURE YOU WORRY ALL
THE TIME.
AND IT IS A SCARY THING.
AND YOU JUST PRAY AND HOPE
THAT YOU ARE ABLE TO BEAT IT.

The logo of the show appears.

The health quiz appears on screen.

Maureen says HERE IS OUR WEEKLY HEALTH
QUIZ, WHICH OF THE FOLLOWING
OILS ARE HIGH IN SATURATED
FATS AND BAD FOR YOUR
CHOLESTEROL COUNT?
PALM OIL.
PEANUT OIL, OR OLIVE OIL.
WE'LL HAVE THE ANSWER LATER
ON "YOUR HEALTH."

Maureen says EVERY ONE FROM
WAYNE GRETZKY TO YO-YO MAH
WILL TELL YOU THAT NATURAL
TALENT ONLY GETS YOU SO FAR.
TO BE GOOD AT SOMETHING YOU
HAVE TO PRACTICE.
BUT IF THAT SOMETHING IS
SURGERY, THE PRACTICE IS ON
HUMANS, AND THAT PATIENT MAY
BE YOU.
SO HOW STEEP IS THE LEARNING
CURVE FOR SURGEONS?
WE TURNED TO ORTHOPAEDIC
SURGEON AND SURGICAL TEACHER
DOCTOR HAMILTON HALL FOR SOME
ANSWERS.

A clip shows Maureen interviewing Doctor Hall in a surgical theatre.
A dummy lies on the operation able.

Maureen says DOCTOR HALL WELCOME.

Hamilton says THANK YOU.

Maureen says ACTUALLY I'M IN
YOUR TERRITORY.

Hamilton says WELCOME TO YOU.

Maureen says WELL, WHO IS HE
AND WHERE ARE WE.

Hamilton says WELL, WE ARE IN A CENTRE
DEVELOPED FOR TEACHING
STUDENTS HOW TO WORK IN THE
OPERATING ROOM.
THIS ISN'T ACTUAL SURGERY,
THIS IS MORE THE IDEA OF
WHAT GOES ON IN HERE, THE
TECHNIQUES, THE PROCEDURES,
THE ACTUAL SURGICAL
TECHNIQUE IS NOT PRACTICED
IN THIS ROOM.

Maureen says WHERE DO THEY
PRACTICE SURGERY.

Hamilton says THEY PRACTICE IN THE
OPERATING ROOM.

Maureen says ON REAL
PATIENTS.

Hamilton says WELL, THAT'S... YES, ON
REAL PATIENTS.
NOT UNSUPERVISED AND NOT, I
HAVE A WONDERFUL CARTOON THE
SURGEON HANDING THE YOUNG
SURGEON THE KNIFE SAYING
WE'VE ALL GOT TO START
SOMEWHERE, WHY DON'T YOU DO
THIS ONE.
AND IT IS NOT QUITE LIKE
THAT.
I MEAN THERE IS A GREAT DEAL
OF SUPERVISION, THEY
GRADUATE INTO IT.
THEY SPEND A LOT OF TIME IN
REAL OPERATING ROOMS DOING
NOTHING MORE THAN LOOKING OR
HOLDING A RETRACTER, JUST A
HOOK TO KEEP THE TISSUE OUT
OF THE WAY AND THEY GRADUATE
FROM THAT OVER THE COURSE OF
YEARS INTO ACTUALLY BEING
ABLE TO TIE A KNOT, TO CUT
WITH SCISSORS TO EVENTUALLY
TAKE THE SCALPEL.
SO THIS IS NOT A SUDDEN
TRANSITION.

Maureen says TELL ME ABOUT
THE EARLIEST DAYS WHEN YOU
WERE A RESIDENT AND YOU
WATCHED SURGERY BEING DONE.
DO YOU REMEMBER THAT.

Hamilton says OH, VERY WELL, VERY
VIVIDLY.

Maureen says WHAT DID YOU
SEE?

Hamilton says FIRST OF ALL IT IS VERY
FRIGHTENING.
WHEN YOU DON'T UNDERSTAND
WHAT YOU ARE SEEING IT IS
TERRIFYING.
YOU ARE WATCHING THINGS THAT
BLEED.
YOU ARE WATCHING PEOPLE PUT
THEIR HANDS INSIDE OTHER
PEOPLE, AND IT, IN THE
BEGINNING YOU LACK AT THIS
AND LIKE ANYONE YOUR EYES
ARE AS BIG AS SAUCERS AND
THE WHOLE THING IS JUST
MAGIC.
YOU WATCH THEM DO THINGS
THAT TO YOU LOOK VERY
DANGEROUS, VERY FRIGHTENING.
I REMEMBER VERY MUCH
WATCHING A SURGEON OPERATING
ON SOMEONE, HITTING A BLOOD
VESSEL, HAVING THE BLOOD
SPURT UP, YOU KNOW, PROBABLY
SIX OR EIGHT INCHES AND HE
SIMPLY JUST PUT HIS FINGER
IN THE HOLE AND SAID OOPS,
AND KEPT ON WORKING.
NOW AT THE TIME I THOUGHT
YOU KNOW, THIS IS A TRAGEDY.
THE INDIVIDUAL LOST YOU KNOW,
A SYRINGE FULL OF BLOOD IN
THE TIME IT TOOK HIM TO STOP
IT.
ONCE HE HAD HIS FINGER ON IT
WAS CONTROLLED, ELY GATED
THE VESSEL AND WENT ON WITH
THE SURGERY, NOTHING WRONG.
AND IN THE YEARS SINCE MANY
TIMES I WILL HIT A BLEEDER
AND PEOPLE WILL LOOK AT YOU
AND YOU GO IT IS NO PROBLEM
AND DO EXACTLY THE SAME
THING.

The caption changes to "Doctor Hamilton Hall. Orthopaedic Surgeon."

Maureen says WHEN DID IT
START TO FEEL, IF NOT EASY
THEN, AT LEAST COMFORTABLE
AS A SURGEON CUTTING INTO
SOMEONE, OPENING THEM UP?

Hamilton says YOU KNOW, IT IS DONE IN
SUCH A GRADUAL WAY THAT IT
IS ALMOST COMFORTABLE FROM
THE BEGINNING.
NOW YOU ARE NOT TECHNICALLY
AS GOOD AS YOU WILL BECOME
IN THE FIRST TIME THAT YOU
ARE ACTUALLY GIVEN THE
SCALPEL AND TOLD TO CUT THE
SKIN YOU ARE VERY NERVOUS.
MUCH LIKE THE PILOT TAKING
HIS FIRST SOLO FLIGHT.
BUT LIKE THE PILOT ON HIS
FIRST FLIGHT HE'S READY,
HE'S PREPARED.
HE HAS PRACTICED WITH
SUPERVISION.
HE HAS HAD PEOPLE PRACTICE
WITH HIM.
HE HAS PRACTICED TYING KNOTS,
HE HAS TAKEN THE SCALPEL AND
CUT INTO ORANGES, ALL OF
THIS HAS BEEN DONE.
SO THE TIME COMES, YOU DO
IT.
YOU ARE NERVOUS BUT YOU DO
IT.
NOW OBVIOUSLY AS TIME PASS,
AND YOU'VE DONE IT TEN TIMES,
50, 100, 1,000, YOU ARE NO
LONGER HAVE THAT SAME
FEELING.

Maureen says NOW I WANT TO
KNOW, LET'S LOOK AT IT FROM
THE PATIENTS POINT OF VIEW.
DO YOU TELL YOUR PATIENTS IF
YOU ARE GOING TO HAVE A
RESIDENT ACTUALLY DOING THE
SURGERY.

Hamilton says WELL, FIRST OF ALL, THIS
IS VERY DIFFERENT, DIFFERENT
SURGEONS.
AS A TEACHING SURGEON I AM
IN THE ROOM FOR ALL MY
CASES.
I MAKE IT A POINT OF NEVER
SORT OF WALKING OUT AND
LEAVING MY RESIDENT TO DO MY
CASE.
NOW IF THE PATIENT AND THE
RESIDENT, IF THIS IS AN
AGREED UNDERSTANDING THAT
THE FELLOW, IT IS USUALLY A
FELLOW WHICH IS A SLIGHTLY
HIGHER LEVEL OF TRAINING IS
TO DO THE CASE THE PATIENT
IS INFORMED THAT
DOCTOR SO-AND-SO WILL BE THE
SURGEON AND I WILL BE THERE
TO HELP.
OTHERWISE, IT IS MY CASE.
AND THEREFORE I WILL BE
THERE.
SO THAT IN THE COURSE OF
THAT PROCEDURE, IF I FEEL
THAT THERE IS SOMETHING THAT
THE FELLOW IS CAPABLE OF
DOING.
I WILL CERTAINLY LET HIM DO
IT.
I AM VERY CAREFUL TO WATCH
WHAT HE DOES, BUT HE WILL
LEARN BY DOING WITH MY
ASSISTANCE AND THAT IS HOW
HE IN TURN WILL DEVELOP HIS
SKILLS AND HIS CONFIDENCE TO
GO FORWARD.

Maureen says HAVE THEY EVER SCREWED UP
AND YOU ARE RIGHT THERE MAY
BE TO TAKE OVER, HAS THAT
HAPPENED.

Hamilton says YES, YES AND IT TEACHES
YOU TO BE A VERY GOOD
SURGEON GETTING OUT OF THE
TROUBLE THAT SOMEBODY ELSE
GOT YOU INTO.
YES, IT DOES HAPPEN.
NOW THERE ARE THINGS THAT
YOU ANTICIPATE, THERE ARE
THINGS YOU KNOW ARE
DANGEROUS.
DEPENDING ON THE QUALITY OF
YOUR FELLOW, YOUR RESIDENT
THEY WON'T BE DOING THAT,
YOU WILL BE DOING THAT.
AT A POINT HOWEVER WHEN THEY
ARE FINISHED AND HAVE THEIR
ORGANIZATIONS, WHEN THEY
LITERALLY ARE FULLY
QUALIFIED AND PUTTING IN
THEIR LAST FEW MONTHS
WORKING WITH YOU, THEY ARE
LEGALLY AND MORALLY AND
ETHICALLY AS PROPER A
SURGEON AS YOU ARE.
AND AS LONG AS THE PATIENT
IS AWARE, THEN THAT IS
PERFECTLY REASONABLE.

Maureen says I WONDER THOUGH
IF IT WERE YOU COMING IN AND
IT WAS YOUR FIRST BORN WOULD
YOU LET A RESIDENT DELIVER
YOUR BABY, WOULD YOU LET A
RESIDENT OPERATE ON SOMEBODY
YOU LOVE.

Hamilton says DEPENDS ENTIRELY ON THE
RESIDENT OR THE FELLOW,
DEPENDS ON THE
CIRCUMSTANCES.

Maureen says BUT MOST OF US
DON'T GET TO KNOW, KEEP THAT
IN MIND.

Hamilton says NO, THAT IS RIGHT.
AND I THINK WHEN PATIENTS
COME TO ME, THAT IS ONE OF
THE REASONS WHY I STAY IN
THE ROOM.
WHEN PEOPLE COME AND EXPECT
ME TO BE THEIR SURGEON.
AND I GET ASKED THIS ALL THE
TIME, WILL YOU DO THE
SURGERY AN MY ANSWER IS YES,
I WILL DO THE SURGERY.
AND I WILL HAVE
DOCTOR SO-AND-SO AND
DOCTOR SO-AND-SO WHO WILL BE
WITH ME AND PARTS OF THIS I
WILL DO BUT YES, I WILL DO
THE SURGERY.
I'M RESPONSIBLE, IT IS MY
OPERATION, YOU ARE MY
PATIENT AND THAT IS THE WAY
IT WILL ALWAYS BE.

Maureen says YOU GUYS THOUGH
IN THE BUSINESS MUST KNOW
WHO'S THE BEST AT THIS, YOU
KNOW, THE BEST HEART SURGEON,
THE BEST BACK SURGEON, AND
YOU KNOW, WOULD YOU GO AFTER
THE BEST PERSONALLY IF YOU
NEEDED SOMETHING DONE.

Hamilton says OH, CERTAINLY.
AND YES, INSIDE THE BUSINESS
WE DO HAVE OUR PERCEPTIONS.
NOW WE MAY NOT BE RIGHT.
BEING IN THE BUSINESS
DOESN'T GUARANTEE THAT YOUR
PERCEPTIONS ARE ACCURATE.
WE CERTAINLY KNOW WHO WE
THINK ARE BEST.
AND THE NURSES KNOW.
AND IT IS ONE OF THOSE
COMPLIMENTS WHEN NURSES IN
THE HOSPITAL WILL COME TO
YOU AND ASK YOU TO DO THEIR
SURGERY BECAUSE THEY SPEND A
LOT OF TIME, ESPECIALLY THE
OPERATING ROOM NURSES
WATCHING SURGEONS WORK.

Maureen says WHAT CAN THE
AVERAGE PATIENT THEN DO WHO
NEEDS SOME SURGERY AND WHO
DOESN'T HAVE WHAT KIND OF
EXPERTISE.

Hamilton says THE THINK THE MOST
IMPORTANT THING FOR THE
PATIENT IS TO UNDERSTAND
THAT SURGERY IS A VERY
MECHANICAL, VERY PHYSICAL
THING.
SURGERY IS NOT VAGUE.
YOU KNOW, YOU PUT YOUR KNIFE
IN ONLY ONE PLACE.
SO THAT THE SURGEON WHO
OPERATES SHOULD BE ABLE TO
EXPLAIN TO YOU IN VERY CLEAR
TERMS WHAT IT IS HE INTENDS
TO DO AND HOW HE INTENDS TO
DO IT.
AND WHAT THE COMPLICATIONS
MAY BE OF WHERE HE IS GOING
TO GO.
SO THAT IF WE ARE TALKING
ABOUT YOUR FOOT, THEN YOU
UNDERSTAND THAT THE BONE
WILL BE BROKEN, THAT IT WILL
BE MOVED OVER, THAT THE SIDE
OF THE JOINT WILL BE
TIGHTENED, ALL OF THIS CAN
BE DESCRIBED, PICTURES CAN
BE DRAWN.
I THINK IF YOU COME OUT OF
THERE UNDERSTANDING WHAT THE
SURGEON INTENDS TO DO, I
THINK THAT IS A VERY GOOD
FIRST STEP.
NOW OBVIOUSLY WORD OF MOUTH
WORKS.
PEOPLE THAT HAVE HAD GOOD
RESULTS TELL YOU ABOUT THEIR
SURGEON.
AND THAT IS FINE.
BUT EVEN GOOD SURGEONS CAN
HAVE BAD RESULTS.
AND OCCASIONALLY NOT SO GOOD
SURGEONS CAN HAVE WONDERFUL
RESULTS.
SO I THINK THERE HAS TO BE A
RECORD SORT OF A LIFETIME
ACHIEVEMENT OF GOOD SURGERY
AND THE SURGEONS WHO DO THAT,
TEND TO BE WELL REGARDED.
THEY TEND TO BE PEOPLE WHO
EXPLAIN WHAT THEY DO WELL.
AND WHO MAKE GOOD DECISIONS.

Maureen says ON THE WHOLE HOW
WOULD YOU RATE THE CALIBRE
OF SURGEONS IN CANADA.

Hamilton says FIRST OF ALL I THINK THE
CANADIAN SURGEONS ARE GOOD
COMPARED TO ANY OTHER
COUNTRY IN THE WORLD.
WE HAVE VERY HIGH STANDARDS.
THEY LOVE TO GET US IN OTHER
COUNTRIES.
I MEAN, YOU KNOW, THE BRAIN
DRAIN, THE SURGICAL DRAIN,
THEY LOVE CANADIAN SURGEONS.
I MEAN WE ARE IN DEMAND
EVERYWHERE IN THE WORLD.
IF THEY CAN GET A CANADIAN
SURGEON, THEY KNOW WE ARE
WELL TRAINED.
THEY KNOW WE HAVE THIS LEVEL
OF QUALITY THEY WILL TAKE US
IN A MINUTE.
WHICH IS KIND OF HURTFUL
WHEN AT HOME YOU ARE BEING
PICKED ON AND PEOPLE OUT
THERE SAYING WELL, THEN,
COME WORK WITH US.
WE ARE CONSTANTLY BEING
ASKED TO RE-QUALIFY, THERE IS
NOW A POLICY WITH THE
COLLEGE OF PHYSICIANS AND
SURGEONS THAT WE MUST
RECERTIFY OURSELVES EVERY
FIVE YEARS.
WE'RE REQUIRED TO COLLECT
CERTAIN AMOUNTS OF POINTS IN
EDUCATION AND POSTGRADUATE,
POST, POST, POSTGRADUATE SO
THAT WE MUST ALL STAY
CURRENT.
YOU CANNOT SIMPLY GO OFF IN
A CORNER AND DO WHAT YOU
HAVE ALWAYS DONE AND NOT BE
EXPECTED TO IMPROVE.

Maureen says WELL, YOU MADE
ME FEEL BETTER, THANKS FOR
YOUR CANDOUR.

Hamilton says A PLEASURE.

Maureen says COMING UP.

Paul says IT'S BORING AND
PREDICTABLE BUT EVEN THE
COLON HAS ITS EXCITING SIDE.

Maureen says DISPELLING OR IS
THAT EXPELLING SOME MYTHS
ABOUT THE COLON.

The opening sequence rolls again.

Now, Maureen stands next to a screen that reads "Health Digest."

The caption changes to "Impotence."

Maureen says THIS WEEK IN OUR
HEALTH DIGEST MEN WHO SEEK
HELP FOR IMPOTENCE SHOULD BE
SCREENED FOR DIABETES WITH A
BLOOD SUGAR TEST.
ACCORDING TO RESEARCHERS IN
BRITAIN.
THEY LOOKED AT 129 MEN WHO
WERE UNABLE TO SUSTAIN AN
ERECTION.
22 OF THEM HAD ALREADY BEEN
DIAGNOSED WITH DIABETES AND
OF THOSE REMAINING, NEARLY
FIVE PERCENT HAD THE DISEASE
AND DIDN'T KNOW IT.
ANOTHER 12 percent HAD GLUCOSE
LEVELS THAT COULD LEAD TO
DIE PIECE EAT... DIABETES IF
NOT MANAGED WITH DIET AND
EXERCISE.
DIABETES CAN AFFECT BLOOD
VESSELS, NERVE AND SMOOTH
MUSCLE AND IS AN UNDERLYING
CAUSE OF ERECTILE
DYSFUNCTION.

The caption on the screen changes to "Diabetes."

Maureen says THE OTHER CONDITIONS
DIABETICS ARE AT INCREASED
RISK FOR ARE HEART DISEASE
AND STROKE BUT FEW ARE AWARE
OF THAT ACCORDING TO A NEW
SURVEY.
HEART DISEASE IS LINKED TO
TYPE II DIABETES PARTLY
BECAUSE OBESITY AND HIGH
CHOLESTEROL MAY BE FACTORS
IN THE ONSET.
BUT IN A SURVEY OF MORE THAN
2000 DIABETICS 68 percent SAID THEY
DIDN'T CONSIDER HEART
DISEASE TO BE A SERIOUS
COMPLICATION OF DIABETES
EVEN THOUGH TWO-THIRDS OF
THEM WILL DIE BECAUSE OF
HEART DISEASE.

The caption on the screen changes to "Obesity."

Maureen says IN BRITAIN PATIENTS CAN ONLY
GET THE OBESITY DRUG ZEN HE
CALL IF THEY SHED 5.5 POUNDS
IN THE MONTH BEFORE STARTING
THERAPY AND ONCE THEY START
THE DRUG THEY MUST ALSO LOSE
FIVE PERCENT OF THEIR WEIGHT
WITHIN THREE MONTHS IF THEY
WANT TO CONTINUE TAKING IT.
BUT THE LATEST RESEARCH
SHOWS MOST PATIENTS FAIL TO
MEET THOSE STRICT
CONDITIONS.
ONE RESEARCHER SAID THAT
SINCE MOST OF THESE OBESE
PATIENTS START OFF WEIGHING
ALMOST 300 POUNDS, IT IS
DIFFICULT TO LOSE THE FIVE
PERCENT QUICKLY.
IN BRITAIN THE NATIONAL
HEALTH SERVICE PAYS FOR
PRESCRIPTION DRUGS WHICH IS
WHY THE GUIDELINES FOR
ZENECAL WERE IMPOSED.

The quiz appears again.

Maureen says READY FOR THE ANSWER TO OUR
QUIZ?
IF YOU ARE WATCHING YOUR
CHOLESTEROL YOU SHOULD AVOID
PALM OIL T CONTAINS HIGH
LEVELS OF SATURATED FAT
WHILE PEANUT OIL IS
ACCEPTABLE AND OLIVE OIL
CONTAINS THE LEAST.

Maureen says YOU HAVE
PROBABLY HEARD THAT A HIGH
FIBRE DIET IS EFFECTIVE IN
PREVENTING CONCERN TYPES OF
CANCER.
DO YOU KNOW WHY?
IT HAS TO DO WITH THE HEALTH
OF YOUR COLON.
HERE IS DOCTOR PAUL CALDWELL TO
EXPLAIN.

Paul sits at a table with a stethoscope and a couple of cauliflower florets on it.

A caption reads "Doctor Paul Caldwell. Family Physician."

Paul says EVEN FOR THOSE OF US WHO
ARE UNABASHEDLY ENTHUSIASTIC
ABOUT THE HUMAN BODY, THE
COLON IS NOT A VERY EXCITING
ORGAN.
THINK ABOUT IT.
THE COLON, OR LARGE BOWEL IS
A TUBE, IT IS ABOUT SIX TO
EIGHT FEET LONG, TWO TO SIX
INCHES IN DIAMETER, IT IS
THE LAST PART OF THE GUT.
ALL IT DOES IS ABSORB FLUID
AS PART OF THE DIGESTIVE
PROCESS AND THEN, WELL, IT
EXPELS ANY LEFT OVERS AS
WASTE.
IT IS BORING AND PREDICTABLE
BUT EVEN THE COLON HAS ITS
EXCITING SIDE, ESPECIALLY
WITH REGARD TO CANCER AND
ITS PREVENTION.
IN THE COLON ALMOST ALL
CANCERS BEGIN AS POLYPS.
A POLYP IS A SMALL GROWTH
THAT STICKS OUT OF THE MUCOUS
MEMBRANE ON THE LINING OF
THE BOWEL.
THIS PIECE OF CAULIFLOWER
RESEMBLES A POLYP AND A
POLYP IN A COLON OFTEN LOOKS
JUST LIKE THIS.
OFTEN THESE POLYPS ARE
NOTHING TO WORRY ABOUT BUT A
SMALL PERCENTAGE OF THEM
DEVELOP CANCEROUS CELLS.
IT USUALLY STARTS IN THE
CELLS FURTHEST FROM THE
STALK.
AND IF UNDETECTED IT SPREADS
DOWN INTO THE STALK, THEN
INTO THE WALL OF THE COLON
AND FROM THERE THE CANCER
HEADS ON TO THE LYMPH NODES,
THE LIVER AND LUNGS.
UNFORTUNATELY, IT IS HARD TO
TELL IF YOU HAVE POLYPS.
THEY USUALLY DON'T PRODUCE
ANY SYMPTOMS.
AND YOU ONLY SEE SIGNS OF A
CANCER IF THE TUMOUR REACHES
A LARGE SIZE.
IF WE COULD ONLY FIGURE OUT
WHO HAS THESE POLYPS, AND
THEN REMOVE THEM THROUGH THE
COLONOSCOPY THAT IS A FAIRLY
EASY PROCEDURE IF THEY ARE
SMALL, THEN WE WOULD BE ABLE
TO PREVENT CANCER OF THE
COLON ALL TOGETHER.
BUT HOW CAN WE FIGURE OUT
WHOSE GOT THESE POLYPS.
THERE ARE TWO COMMON
METHODS.
FIRST, WE CAN TEST FOR
OCCULT BLOOD, WHICH MEANS
HIDDEN, WE KNOW THAT POLYPS
BLEED MICROSCOPIC AMOUNTS OF
BLOOD IN THE STOOL SO BY
TESTING THE STOOL FOR THE
PRESENCE OF THIS HIDDEN
BLOOD, WE CAN IDENTIFY THOSE
PEOPLE WHO MIGHT HAVE
POLYPS.
THE SECOND WAY IS A COLON
OP... COLONOSCOPY INSERTING
A SMALL FLEXIBLE TUBE WITH A
LIGHT ON THE END TO VIEW ALL
OF THE MUCOUS LINING ALL
EIGHT FEET OF IT.
OBVIOUSLY THIS IDENTIFIES
ANY POLYPS THAT MAY BE
PRESENT AND IT ALSO ALLOWS
THE SURGEON TO REMOVE THE
POLYPS IF THEY ARE SMALL
ENOUGH.
SO WHY DOESN'T EVERYONE HAVE
A COLONOSCOPY.
WELL, IF YOU HAVE A
FAMILY HISTORY OF CANCER OF
THE COLON YOU CERTAINLY
SHOULD.
SO SHOULD ANYONE WHO HAS
SYMPTOMS SUCH AS A CHANGE IN
BOWEL HABIT, ABDOMINAL PAIN
OR BLEEDING IN THE BOWEL.
SOME DOCTORS FEEL THAT
EVERYONE SHOULD HAVE A
COLONOSCOPY AFTER AGE 50 BUT
IT IS NOT A PLEASANT
PROCEDURE AND IT IS SURGERY,
AND THERE CAN BE COMPLICATIONS.
AT ANY RATE UNDERSTANDING
HOW CANCER IS PRODUCED IN
THE COLON AND IDENTIFYING IT
BEFORE IT STARTS, IS THE BOTTOM
LINE IN THIS RATHER UNINSPIRING
CORNER.

Maureen says THANKS DOCTOR CALDWELL.
WE HAVE TRANSCRIPTS OF HIS MANY
MEDICAL GEMS ON OUR WEBSITE.
GO TO: WWW.TVO.ORG/YOURHEALTH
THAT'S OUR PROGRAM FOR THIS
WEEK.
I'M MAUREEN TAYLOR
THANKS FOR WATCHING.

A final slate reads "Your Health. Email: yourhealth@tvo.org. Fax: 416-484-4519. Mail: Box 200, Station Q, Toronto, ON, M4T 2T1."

(music plays)

The end credits roll.

Executive Producer, Patricia Ellingson.

Host and Producer, Maureen Taylor.

Producer, Cathy Perry.

Director, Michael Smith.

Logo: CEP Local 72m.

A production of TVOntario. Copyright 2002, The Ontario Educational Communications Authority.

Watch: Your Health Season 3 Episode 26