Calgary cancer doctor wins award for work helping patients recover faster after surgery

At age 75, Linda Shaikh is not slowing down.

The Calgary philanthropist has been deep into research and writing her PhD, but in the spring of 2023 she was feeling a bit rundown and concerned she might have a blood clot so she went to the emergency room.

“He (the emergency room doctor) said it could be a blood clot that still hasn’t shown itself  ‘or cancer’ he whispered.  Then they took an ultrasound and found that my whole stomach was riddled with it.  The cancer had exploded,” Shaikh recalled about the ovarian cancer diagnosis.

“It was a surprise because I had just been to my doctor a week before, and he gave me a clean bill of health and congratulated me on taking care of myself,” Shaikh said.

Shaikh was told she would first need chemotherapy, to be followed by a hysterectomy and more chemo.

“I followed instructions to a T, which can be challenging at times. I went through chemo. I went through six sessions and during every single one of them, you have a few days where you think you just won’t make it, but they encouraged me to move. Even in all my terribleness, it was just wonderful,”  Shaikh said.

On doctor’s orders, she nourished herself before surgery and moved as much as she could after surgery.

“I was up and about in no time. A really fast recovery,” Shaikh said.

Her cancer surgeon was Dr. Gregg Nelson, physician lead for Enhanced Recovery After Surgery (ERAS) Alberta as well as a professor and chief of gynecologic oncology at the University of Calgary.

ERAS is evidence-based surgical practices that get patients back on their feet sooner.

They include keeping patients well-nourished, avoiding use of long-acting sedatives, using non-opioid pain medications and encouraging patients to move as soon as possible after surgery.

Nelson won an international award this year for work examining the barriers patients are encountering when it comes to getting ERAS benefits.

He says despite best efforts, many of the recommendations remain poorly adhered to.

“It comes back to what people are used to doing. In some cases, it might be easier or that’s what they’ve been doing for a long time,” Nelson said.

Historically, opioids have been used as one of the main ways to address pain, but now doctors are using alternatives for managing pain.

“In the past, people would be hooked up to an opioid pain pump and left on the ward for several days. Why was it that people weren’t able to eat and they had nausea or they weren’t able to get up and walk around? It was because of the opioids,” Nelson said.

“By providing people with evidence that there are other ways to manage pain after surgery, in many of these cases patients are requiring very little opioids and we are seeing the benefits of that,” Nelson said.

He says the solution to getting wider use of ERAS is educating health-care professionals about the benefits.

“It can take upwards of 12 to 15 years in order for change to occur. Resistance to change is a significant barrier in healthcare in general,” Nelson said.

Nelson said the ERAS  movement started in the early 2000s by a group of European surgeons who were questioning some of the historical surgical dogma of the day — things like nothing to eat or drink after midnight.

“What they were finding was the outcomes they were seeing in these patients were not what they thought were optimal so the movement of ERAS was based on challenging those historical surgical practices with evidence-based care,” Nelson said.

“Now, doing things like allowing people to eat and drink up to a certain time prior to surgery, making sure they’re coming into surgery in a nutritional state, feeding people sooner after surgery, taking catheters out and avoiding opioids. As it turns out when you do this, it is associated with significant outcome improvements not only for the healthcare system because there’s decreased length of stay, but importantly, patients have improved satisfaction with ERAS,” Nelson said.

Now several months since her last round of chemotherapy and surgery, Linda Shaikh is thankful for changes to post-surgery care that benefited her.

“The doctors’ positive attitude was amazing to me and it made me relax right away and thought ‘my goodness I’m in competent hands'” Shaikh said. “These doctors are so well-trained, they’re quiet and they work so hard,”

She believes that following medical advice was key to her speedy recovery and she feels fortunate to have received the care she had.

“I don’t have a lot of compromising illnesses so I’m very fortunate but it sure helps to sit back and listen,” Shaikh said.