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Tori Puras was diagnosed with breast cancer not once, but twice, before her 31st birthday. The first time, she was 25 years old. She’d experienced lumpy breasts and dozens of cysts and benign tumours since high school and was put in a monitoring program because of a history of breast cancer on her mother’s side.
When Puras felt a dull ache in her right breast ahead of her yearly check-in, she fought to move up her ultrasound, despite doctors brushing it off. “I knew something wasn’t normal,” says the 32-year old Toronto-based content creator and owner of Trendfluence Creative Agency. “That lump ended up being my first diagnosis.” She had stage zero non-invasive ductal carcinoma in her right breast.
Five years later, the cancer came back, this time, stage 1 invasive ductal carcinoma in the same breast. Within 15 minutes of finding out, she was booked in for a mastectomy. Puras was able to identify the potential signs of breast cancer because of her family history. Thanks to her perseverance, she pushed to get diagnosed and treated. Now, her bravery in taking her story public on social media is helping to change the narrative about the face of cancer in Canada. “There’s this huge, outdated approach that breast cancer only happens in middle age,” she tells FASHION. “The more we talk about it, the more people will hear us. Maybe they’ll check themselves, advocate for themselves, and catch something early. Maybe we can even save a few lives.”
Photo: Wade Hudson
Merck Canada is highlighting Puras’ story to spark these exact sorts of conversations and raise awareness of critical health issues that affect women. While research continues, cancer isn’t going anywhere, anytime soon. Two in five Canadians will be diagnosed in our lifetime and certain cancers, such as cervical, breast, and endometrial, are on the rise for women in their 30s and 40s. In 2023, 115,000 women were diagnosed with cancer; the most common types were breast, lung, colorectal and uterine, according to the Canadian Cancer Society.
If we don’t talk about the disease, we can’t learn how to prevent it. Crucially, “prevention of any cancer is better than any treatment of any cancer,” says Dr. Shannon Salvador, a gynecologic oncologist at the Jewish General Hospital in Montreal, associate professor at McGill University and president of The Society of Gynecologic Oncology of Canada. “We want to keep you from ever needing to see someone like me.”
Most of us are well-versed in how not smoking, consuming minimal alcohol, limiting sun exposure and being more active can decrease the risk of cancer. Also key is knowing which testing and tools are available to you—something many of us are never taught. “Preventative measures, genetic testing and pre-screening programs, these are resources that as a younger woman, I was never told about,” recalls Puras. “Resources that my friends were never told about.”
Here’s what women are entitled to and should ask their doctors for, says Dr. Salvador:
- Pap tests every three years starting at 25; during these, the doctor collects cells from your cervix.
- HPV screenings beginning at 30 every five years to detect the presence of human papillomavirus, which can lead to cervical, vulva, vaginal, anal, and mouth and throat cancers.
- Mammograms—the recommendation is at least every two years between the ages of 50-74, however many provinces are now offering mammograms for women 40 to 50 if they have a family history or wish to be screened.
- A fecal immunochemical test (FIT) for early colon cancer detection at least every two years after 50, or a colonoscopy if you’re having any sort of symptoms.
- And don’t forget thyroid and glucose checks, every five years after the age of 40.
“Beyond that, any hormone testing is based on symptoms,” says Dr. Salvador. “So, for example, if someone is experiencing premenopausal symptoms in their early 40s it could be useful to check their follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol levels to see if they are already in perimenopause.”
The good news? Access to all of these screenings to support early detection are widely available in your province via your provincial healthcare website, even if you don’t have a GP.
Regular self-exams are also imperative, especially if you fall outside these screening ages, she says. There is a disturbing trend in early onset cancers, akin to what Puras experienced, and if you don’t necessarily fit in those above eligible groups, or you have a family history of a certain type of cancer, it’s important to advocate for yourself.
Photo: Wade Hudson
That’s sometimes easier said than done, we know. “There’s no polite way to advocate for your health,” says Puras. “When in doubt, ask for more and ask for it loudly. The doctor is not inside your body. I am not inside your body. If something feels off, push for it, kick and scream.”
In some instances, namely with cervical cancer, we know nearly all cases are linked to HPV, so immunization along with other prevention methods are often your best bet. The vaccine is available for women and men up to the age of 45, but if you are older than that and at risk of exposure, you can still ask your doctor for it, notes Dr. Salvador.
“The biggest thing we’re trying to get across is that it’s a vaccination to prevent cancer, not a vaccination to prevent a sexually transmitted infection,” she adds. “At any point in time that you have your first sexual debut, you can get introduced to an HPV virus, whether it is in your teens or in your 20s or in your 30s. Receiving the vaccine will prevent that.”
That, of course, is a work in progress. “Canada had initially made a strong effort towards encouraging and providing vaccination for prevention of cancers caused by the HPV virus,” she says. “However we must reinvest in our vaccination efforts and education to reach our goal of elimination of cervical cancer in our population.”
Reducing cancer rates will take continued collaboration between all parties—and most importantly, open conversation between doctor and patient.
Hearing and believing their patients should be a doctor’s priority. “The thing that I’m always listening for is someone who says, ‘Something is different,’” says Dr. Salvador. “My ears perk up. If something was different enough to get their attention, it gets my attention.”
Styling: Ashley Galang. Hair and makeup: Steph George, P1M.
