Doctors and researchers at Sunnybrook Health Sciences Centre are conducting world-class research and designing new therapies to save and extend the lives of cancer patients.
Because no patient is the same and no cancer is the same, Sunnybrook’s Odette Cancer Centre specialists collaborate to find the best treatment plan for each patient.
“Our goal is to find treatments that will have the maximum impact on the cancer while minimizing the impact on a patient’s life and the lives of their families,” says Dr. Andy Smith, chief of the Odette Cancer Program. “Our leading expertise right now is with minimally-invasive therapies and targeted, personalized treatments.”
Here are some of the innovative ways Sunnybrook is saving lives.
Delaney Janhunen of Kitchener, Ont., was 42 when her aggressive form of the disease, HER2-positive breast cancer, returned after treatment six years before.
In 2010, she entered a global clinical trial for women with advanced HER2-positive breast cancer that had progressed after initial chemotherapy treatment. She received T-DM1, a new drug that kills cancer cells precisely without harming normal cells. Now, Delaney has no detectable cancer. “It’s a miracle drug. I’m very blessed to be maintaining close to a normal life. I haven’t experienced any nausea or hair loss and there’s been no effect on my immune system,” says Janhunen.
Dr. Sunil Verma, medical oncologist at Sunnybrook and lead author of the international study, says “this targeted approach creates the framework for a new direction for the treatment of cancers. Our research was the first to show that an antibody-drug conjugate, a drug where a chemotherapy drug is combined with a targeted antibody, was effective for solid tumours. Those who received T-DM1 lived much longer, had fewer side effects and enjoyed a better quality of life compared to those who received standard chemotherapy.” About 20 per cent of breast cancers are HER2-positive.
Minimally invasive surgery
Dr. Shady Ashamalla uses his training in minimally invasive surgery and surgical oncology to remove colon and colorectal cancer from patients, leaving the smallest surgical footprint possible while ensuring that no tumour cells are left behind.
“By sneaking in like a thief in the night, our job is to go in and not let the rest of the body know we were there, doing everything we can to cure the patient’s cancer,” says Dr. Ashamalla.
Mary Abbott went home just two days after Dr. Ashamalla removed her tumour and resected her colon in one minimally invasive operation using a laparoscope. He made only a few tiny incisions, rather than the usual large abdominal incision used in open surgery. Three weeks later, Mary was enjoying a hiking vacation. “I’ve had C-sections for both of my children. This recovery was far easier,” says Mary, a Toronto resident in her early 40s.
Dr. Ashamalla is now exploring new ways to use minimally invasive surgery for colorectal cancers that require multiple organ removal..
Odette researchers in collaboration with Sunnybrook’s Centre for Research in Image-Guided Therapeutics (CeRIGT) are spearheading the first study in patients to treat brain cancer with a combination of high-intensity focused ultrasound (HiFU) and magnetic resonance (MR)-guided imaging.
Together, MR imaging and focused ultrasound allow tumours to be ablated or ‘cooked’, without cutting or harming healthy tissue. For the patient, no general anesthesia is required and side effects are minimal.
“The addition of magnetic resonance imaging allows us to deliver ultrasound to a fine level of detail, within one millimetre of accuracy, and to do so non-invasively, in real-time, because the technology is integrated into one unit,” says Dr. Gregory Czarnota, program research director, Odette Cancer Centre.
Sunnybrook is only one of a few centres in the world with the expertise to develop this advanced technology. Researchers are investigating how MR-guided HiFU could be used to treat prostate cancer, head and neck cancers, and cancer spread or metastases.
Leading-edge genetic research
Currently, about 30 per cent of men diagnosed with prostate cancer are over-treated, meaning that they would have lived a long, healthy life without addressing the cancer. On the other hand, some who have prostate cancer are not diagnosed in time and die from the disease.
“The holy grail question with prostate cancer is to find out who does and who doesn’t need treatment. We wanted to find a way to answer the question with innovation at the genetic level,” says Dr. Robert Nam, head of Genitourinary Cancer Care at Sunnybrook.
Dr. Nam and his team have assembled a large tumour bank to analyze the genetic makeup of prostate cancer tumours. “MicroRNAs are genetic modifiers that can mutate and develop into cancer. What we found is that there are several mutations that are very concentrated for prostate cancer, so by adding this new tool to our risk calculator, we hope to more accurately predict who needs treatment,” says Dr. Nam.