It’s a decision no woman wants to face: should I have my breasts removed to prevent breast cancer? Thankfully, Kelly Metcalfe has a way to help women navigate their way to an answer.

As a nurse and researcher focused on breast cancer prevention, Metcalfe counsels women after they have been identified as having a BRCA1 or BRCA2 mutation. A woman identified as having a mutation in one of these genes is at about an 87 per cent risk of developing breast cancer. The challenge then becomes how to help these women decrease or eliminate that chance of getting breast cancer.

“Suddenly, these women are told they have a very high risk of developing breast cancer, however, there are options to prevent it, such as removing their breasts,” she says. But not every woman around the world has that option to talk to someone like Metcalfe about making these tough and emotional decisions — they are often left to make them alone. That got Metcalfe thinking about developing a tool to help women — wherever they might be in the world.

Together with her team, Metcalfe created a decision aid to help at-risk women make cancer prevention decisions. A written guide, it helps women not only navigate their prevention options, but face some of the psychological effects of a particular option. “It’s more than telling women about how much an option is going to reduce their risk. There’s also those other things that go along with it, like ‘what am I going to feel in terms of body image and how is this going to affect my sexual functioning?’”

Ultimately, Metcalfe is hoping women using the decision aid will feel more knowledgeable and less distressed when making decisions about breast cancer prevention. “We want to know if we are influencing what a woman does, and if so, hopefully we are able to prevent them from getting breast cancer.” – Anjali Baichwal

 

 

How does water move? This is the question that motivates geography professor Brian Branfireun at the University of Toronto Mississauga — but not just for its own sake. He’s interested in the transport and transformation of mercury in the environment.

Mercury is a natural element that exists in forms that aren’t particularly toxic. It’s only when it goes through a series of chemical transformations that it becomes what’s called methyl mercury, which is the kind that bioaccumulates in fish and acts as a central nervous system toxin in humans.

The question is how — and where — this transformation happens.

“We have to figure out how and where water is moving first,” he says. “But we also know that mercury doesn’t move as water moves. It is conveyed by water but it can also be delayed through a whole range of biological and chemical interactions.”

Branfireun is deeply committed to the public health outcomes of his scientific work, and hopes to influence public policy. The lives of humans and animals depend on it, he says.

“We can choose to fish. If people go to the cottage and fish for pickerel, they can choose to eat that fish. But an otter has to eat a fish. A loon has to eat a fish. Similarly, people who live in the Canadian north don’t really have a choice. They have traditional access to food that is aquatic.

“I try to place my work in the context of vulnerable communities, both animal and human. I’m motivated by both ecosystem integrity and human exposure.”– Jenny Hall