Rare is a word used to describe Bryde Fresque on many levels. He has a zest for life that sets him apart. In fact, his physician Dr. Carolyn Nessim, a surgical oncologist and clinician investigator at The Ottawa Hospital saw this firsthand when Bryde faced a diagnosis that would have him battle for his life, with one rare condition after the other. Ultimately, it would take a skilled team to come up with a diagnosis and treatment for Bryde – a pheochromocytoma – an uncommon tumour that left Bryde’s future uncertain.

Bryde’s journey to his diagnosis of a rare cancerous tumour began on Boxing Day of 2012. He was travelling home from Napanee when he started to have pain in his left side. He stopped at a pharmacy just outside Ottawa and by the time he got to the counter he was doubled over in pain. The pharmacist told Bryde to get to the closest hospital — a community hospital was not far away.

Not long after arriving in their emergency room, Bryde was sent by ambulance to The Ottawa Hospital where he could receive care that is more specialized. He was in a tremendous amount of pain. Upon arrival, Bryde was suffering from a spontaneous hemorrhagic rupture of the left adrenal gland and he was bleeding significantly. Thankfully, he was in good hands as our interventional radiologists performed an emergency embolization procedure. This is a procedure where a guide wire was placed in a vessel in his leg and that allowed physicians to get all the way to the bleeding vessel by the adrenal gland, at which point they injected a product that plugged the vessel and stopped the bleeding. He was hospitalized for ten days before he was able to go home.

Unusual symptoms continue to develop

Bryde continued to feel off. A young, active man, Bryde recalls unusual symptoms that he couldn’t shake. “I remember feeling really sweaty, I couldn’t cool down properly. I would stand under the gym’s cold water shower for 15 minutes post bike ride and it didn’t make a difference,” recalls Bryde.

By the summer of 2013, he was going through a battery of tests and questions at our Cancer Centre to try to pinpoint the diagnosis.

“He had such rare conditions – one right after the other.”

— Dr. Carolyn Nessim
Bryde Fresque, who was treated for a rare pheochromocytoma at The Ottawa Hospital, pictured kayaking in Iceland with his wifte, Natalie.
Bryde and Natalie kayaking in Iceland.

Though, at only 32 years old, cancer was the furthest thing from Bryde’s mind. “I was young, healthy, a non-smoker, non-drug user, and active. That active part of my life was actually the only time I initially showed symptoms. That’s when I would overheat on even the coolest days and couldn’t cool down afterwards.”

The spontaneous rupture of Bryde’s adrenal gland six months earlier contributed to the challenge of pinpointing a diagnosis. It was believed he suffered from a large hematoma – a large residual clot after the bleed. “He had such rare conditions – one right after the other. A spontaneous rupture of an adrenal gland happens very rarely. I would say the challenge is that because the blood clot is so significant, it hides the underlying tumour and so it’s difficult to identify on imaging,” says Dr. Nessim.

Pinpointing the cause

Bryde Fresque was treated for a rare cancer (pheochromocytoma) at The Ottawa Hospital
Bryde Fresque was treated for a rare cancer at The Ottawa Hospital.

As time progressed, Bryde developed issues breathing, he couldn’t bend in certain directions, and then he noticed a distention on his left side. Signs that had been pointing to a hematoma didn’t add up because a hematoma should have healed within a few months, according to Dr. Nessim. That’s when she started looking at the fact this could be a tumour.

Bryde’s case ultimately landed with The Ottawa Hospital Sarcoma Tumour Board. “We meet every Friday to discuss complex cases like Bryde’s. Everyone is in the room including medical oncology, radiation oncology, pathology, radiology, and surgery. We take each individual case and we discuss it as a group to determine the best course of action for a patient,” explains Dr. Nessim.

This panel of experts decided that surgery was the best course of action to not only diagnose Bryde’s condition but to treat him at the same time and remove this tumour that had significantly affected his quality of life. Given the large size of the tumour and the extent of organs it seemed to be invading on imaging, this would be a long and extensive operation with many potential risks and complications that would be best mitigated by a specialized team. The sarcoma team is well equipped and knowledgeable in how to do these complex operations. Our hospital is one of the three Cancer Care Ontario designated Sarcoma Centers in the province. Although Bryde did not have a form of sarcoma, the surgical approach for a pheochromocytoma is the same.

Most unusual pre-op visit

By the fall of 2013, the mass located on Bryde’s left side was now the size of a cinder block. Staying true to his rare and unique personality, Bryde, who loves Halloween, showed up for his pre-op appointment on October 31, 2013, wearing his homemade Iron Man costume!

On November 15, a huge team of more than 20 medical professionals assembled in the operating room. As Bryde lay on the operating table awaiting surgery, he recalls Dr. Nessim telling the team about the Halloween pre-op appointment, “Then she looked down at me and said, ‘Take a deep breath, Iron Man’ as I was intubated.”

Bryde had to put his full trust in Dr. Nessim and her team during the complex, 12-hour surgery. The procedure can carry several risks because although Bryde seemed to have a non-functional pheochromocytoma, with the stress of surgery there is always the risk of stimulating the tumour causing it to release adrenaline, which can lead to a serious increase in blood pressure during surgery. Bryde was given some special medications during the operation to help ensure that didn’t happen.

“I feel privileged every time I’ve been able to help a patient.”

— Dr. Carolyn Nessim
Dr. Carolyn Nessim, a surgical oncologist at The Ottawa Hospital
Dr. Carolyn Nessim, Bryde’s surgical oncologist

Just prior to going into the operating room for this intricate surgery, Dr. Nessim reviewed the scans one last time and then visualized each step, planning the order they would follow to remove the tumour successfully. The highly skilled group alongside Dr. Nessim included a urologist, a thoracic surgeon, and a Hepato-Biliary and pancreatic surgeon, along with two anesthesiologists. “It was a big case,” says Dr. Nessim.

Bryde had his left kidney removed, as well as his left adrenal gland, and a third of his pancreas. They performed a colon, bowel, and diaphragm resection and reconstruction for each, removed his spleen as well as an accessory spleen, which can be found in many patients, 10 lymph nodes, and the hematoma. Thankfully, Dr. Nessim was also able to remove the entire tumour. The surgery was a success.

Finding the answers

Bryde spent a total of 40 days in hospital recovering, and it was during that time that he finally received an explanation for his symptoms. He was diagnosed with pheochromocytoma, which is a rare form of tumour that can be cancerous. They usually form on one of the body’s two adrenal glands, which are located above the kidneys, and approximately 10% of pheochromocytomas spread to other parts of the body. Pheochromocytomas can be dangerous because they may produce an excessive amount of the hormone adrenaline, which makes people sick, primarily by increasing their blood pressure. In Bryde’s case, what made a diagnosis challenging before surgery was that his pheochromocytoma was considered non-functional, and his urinary tests for adrenaline markers were negative. But it’s possible it was releasing low levels of adrenalin all along.

“The Ottawa Hospital is very well positioned in the study and treatment of this rare but dangerous tumour.”

— Dr. Neal Rowe

“It potentially explains all his sweating and feeling very flushed and hot as maybe he had a subclinical release of adrenaline,” confirms Dr. Nessim. Bryde also learned the tumour was cancerous.

Expertise in pheochromocytomas

Bryde with his wife and child
Bryde Fresque, his wife Natalie, and their son Edmond.

Much of the research, around the globe and here at our hospital, focuses on timely detection and treatment of pheochromocytoma. Dr. Neal Rowe is a clinical urologist at The Ottawa Hospital researching this type of tumour. “There are several known genes that increase the risk of a patient developing a pheochromocytoma. By identifying these genes in people, we can test family members, achieve early detection, and better understand the biology behind why these tumors form.” Dr. Rowe says this type of tumour affects between one to two cases per 100,000.

“Thanks to Dr. Nessim and the team at The Ottawa Hospital, I got better – I get to enjoy my life to the fullest. I got to marry the girl of my dreams and I got to become a father.”

— Bryde Fresque

“The Ottawa Hospital is very well positioned in the study and treatment of this rare but dangerous tumour. We have a collaborative group of experts in endocrinology and medical genetics in addition to a dedicated team of anesthesiologists and surgeons. With our research and development of various national initiatives, I think we’re front and centre,” says Dr. Rowe.

Moving forward, upwards, and giving back

Today, Bryde is seven years post surgery, and cancer free, with no signs of recurrence. While his recovery took time, he’s back to living his active life and truly grateful for the care he received. In fact, to raise funds and awareness for rare neuro endocrine cancers, Bryde and his wife, Natalie, climbed Mount Kilimanjaro in Tanzania, as well as the highest pass in the world, located in Annapurna range of the Himalayas in Nepal – all while still being considered a cancer patient.

Bryde and Natalie at Uhuru Peak on Mount Kilimanjaro.
Bryde and Natalie on Mount Kilimanjaro.

“Being a cancer patient or being sick is a life-changing event. Thanks to Dr. Nessim and the team at The Ottawa Hospital, I got better – I get to enjoy my life to the fullest. I got to marry the girl of my dreams and I got to become a father.” He adds, “I honestly think if I had been anywhere else, if I had been under anyone else’s care, I probably wouldn’t be here today. I really wouldn’t.”

That’s why Bryde also holds an annual Halloween fundraising party, known as Spadinaween, to support our hospital. To date, he’s raised over $10,000 and Dr. Nessim even drops by to show her support.

The special bond between this patient and physician continues, as Bryde even enrolled to help Dr. Nessim with a global research project on sarcomas. For Bryde, it’s an honour to help other patients. “Me giving back to The Ottawa Hospital has come full circle as I was invited to partake in an international study on sarcomas with Dr. Nessim and other doctors from the UK, Italy, the States, Netherlands, and Australia – to help improve the patient experience. If I can turn a negative into a positive. I’m in!”

Seeing Bryde thrive today is what makes those long, grueling days in the operating room and the constant search for answers worthwhile. “It’s why I do my job. It’s the biggest joy and most rewarding,” says Dr. Nessim. “I feel privileged every time I’ve been able to help a patient.”

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.


Trusting his instincts led to a rare cancer diagnosis

At the first sign that something might be wrong, Kevin thought he would just wait to see what happens — maybe his one-time symptom would go away. But in the middle of the night, he felt compelled to call to his doctor and leave a message. Tests revealed Kevin had mucosal melanoma — a rare form of skin cancer found inside the body. Today, he encourages others to take action when it comes to their own health.

Kevin got this tattoo, of two Montreal Expos tickets, in memory of his godfather who died of liver failure. They bonded over watching the team when Kevin was young. “He didn’t take his health seriously soon enough,” says Kevin, who hopes he can inspire others — especially men — to avoid the same mistake.

Click here to watch a video Kevin made announcing his diagnosis to his friends and family.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.


A message to other cancer patients: “You are not alone”

In 2019, Jennifer received an unexpected breast cancer diagnosis. It was overwhelming at the time, but she and her family were in it together. Her journey would include chemotherapy treatment, and surgery. While she knows nobody wants to join this club, Jennifer wants others facing a cancer diagnosis to know, they’re not alone.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.


A top-notch attitude and big dreams

A young man with a young family and big dreams. But at twenty-nine-years old, Matt received the news no one wants to hear — a diagnosis of medullary thyroid cancer. With his wife and newborn by his side, Matt has kept a “top notch attitude” through the ups and downs of his cancer journey.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.


Breast cancer diagnosis shocks pregnant, young mom

At the age of 22, Alyssa Tremblay lost her 53-year-old mom to breast cancer — 13 years after her mother’s initial diagnosis.

For Alyssa, pro-active screening began when she was 26 after she discovered a lump in her breast that was a fibroid. But after that experience and the arrival of her own daughter, Gabrielle, she decided to do the genetic testing to find out if she was at high risk of developing breast cancer.

The young mother would soon learn she had the BRCA2 gene. For the 31-year-old, it brought mixed emotions. “It just felt like a shock but a relief at the same time because I knew I had the gene and that meant I could start taking precautions to hopefully eliminate a cancer diagnosis,” says Alyssa.

With the BRCA2 gene confirmed, Alyssa knew she wanted to take the necessary steps to help remove any possibility of her getting breast cancer, but she and her husband wanted another baby too, so she decided to wait.

Then, just one year later, she faced another curveball— a breast cancer diagnosis. First, an ultrasound and mammogram in November 2020 revealed a tumour in her right breast. “I just started getting anxious, and I started thinking ‘What if I’m not here anymore for my daughter and my husband?’ Everything started racing in my head.”

Then, at the end of the month, a biopsy indicated the tumour was cancerous. Incredibly, just three days earlier, Alyssa and her husband, Mathieu, discovered they were going to have another baby. “I was scared every day for my baby,” explains Alyssa.

In January, Alyssa had a mastectomy. That surgery revealed the cancer cells had spread to her lymph nodes, and they were removed. Alyssa then met medical oncologist Dr. Mark Clemons because she would need chemotherapy treatment, something she just couldn’t imagine for her unborn baby. But Dr. Clemons offered her hope. “He was so reassuring telling me ‘We’re saving everybody, you and the baby,’” says Alyssa.

Those words stayed with Alyssa through each treatment and each month as her baby grew inside her. On July 29, 2021, baby Audrée was born via C-section — strong and healthy — and Gabrielle became a big sister.

The next day, Alyssa and her husband held their breath waiting for the results of a CT scan, which had been delayed until after the baby was born. Then some more good news — all clear — the cancer hadn’t metastasized. Once Alyssa recovered from her C-section, she underwent 15 rounds of radiation treatments, and was induced into menopause — all to help ensure she’s able to watch her daughters grow up.

“With the advancements in medicine and the precautions my care team is taking at The Ottawa Hospital, my husband and I are hopeful I’ll watch our daughters graduate from school, get married, and have their own children someday. We’re planning for the future.”

Alyssa Tremblay

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.


A cancer diagnosis later in life didn’t stop this athlete from competing

Update: It is with sadness we share that Samuel Lawrence passed away in February 2022 shortly after we published his story. Samuel inspired us with his determination to compete and achieve his goals despite undergoing cancer treatment. We hope that by sharing his story of resilience he will inspire others like he did us, and we offer our sincere condolences to his family.

At age 78, Samuel Lawrence’s athletic ability continued to dominate his life, even after a diagnosis he didn’t see coming.

In October 2018, a regular check-up with his family physician discovered Samuel’s red blood cell count was very low. The news came as a surprise to him and his family. “I didn’t have any physical signs of being sick. I was feeling OK in my day to day life,” says Samuel.

Referred to The Ottawa Hospital for a bone biopsy to try to pinpoint the cause of the low hemoglobin levels, Samuel was shocked by the results. He was diagnosed with a myelodysplastic syndrome, or MDS, and learned this is what happens when a person’s bone marrow does not produce enough functioning blood cells. 

Treatment began soon after. Samuel continued to visit our hospital’s Medical Day Care Unit (MDCU) every six weeks for treatment that includes two injections. “The regular injections took a toll on me. It took me about a week to recover from each treatment and to get my energy back. The drug was to help maintain my counts, but it’s not a cure.”

In the summer of 2021, his hemoglobin levels dropped again, and his doctors were trying to determine why. Samuel learned his condition is complicated and unpredictable.

Samuel credits the caring team for helping him through each session. “The Ottawa Hospital has been the best. The MDCU is incredible. The nurses who took care of me every six weeks — they were my guardian angels. They were wonderful people and they treated me very well.”

That exceptional care helped Samuel achieve a significant goal in the summer of 2021 when he competed in javelin and high jump at the Ontario Master Championships in Toronto. Samuel recalled sheepishly asking his hematologist, Dr. Grace Christou, if it would be ok to participate. “She bounced out of her chair and became an instant cheerleader, and she told me to go for it!”

He trained through the summer months at the Terry Fox Athletic Facility and competed in mid-August 2021. His doctors altered his treatment in order for him to be able to compete. Samuel medaled in both his javelin and high jump competitions.

Today, the injections have stopped — they became too much for Samuel and he made the decision to end treatment. While his condition continues to decline, he is comfortable and in good spirits. He and his family are grateful for the care he received. “I couldn’t t ask for any better group to treat me and I’m also blessed to be in Canada receiving this care.” He’s also grateful to those hidden heroes — those who generously donate blood on a regular basis to help patients like him.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.


Look forward. Move ahead. Cycle through cancer

Look forward. Move ahead. That’s the motto Robert Hurst lives by — no matter what challenges life throws his way.

Forced into early retirement from the Canadian Navy after he suffered significant injuries in a cycling accident, Robert moved to Ottawa in 2007 and started a new career in the technology sector. It wasn’t until 2015 when he would overcome his mental fear of cycling — in fact, cycling played a critical role helping him through a new healthcare hurdle he would soon face.

In late 2017, Robert was diagnosed with a cancerous tumour inside his mouth on his right cheek. Within three months, he had surgery to remove the tumour that had tripled in size. “It went from the size of a marble to a robin’s egg,” explains Robert.

The recovery from the surgery took a greater toll on Robert than anticipated. Once he was ready, he began radiation treatment. It was a difficult and sometimes painful time for Robert, but he credits our Cancer Centre for guiding him through each treatment. “The dietitians, physiotherapists, and the psychologists, I talked to them all. It was like having a small family group in the hospital — they really helped me get through the major parts of radiation. There was a period of time when I couldn’t eat anything solid — it was like swallowing razorblades.”

After 30 rounds of radiation, which took place five days a week for about 90 minutes, Robert had completed treatment, but his journey was far from over. The side effects from radiation resulted in bone death in his right lower and upper jaw. He had surgery in May 2021 to remove three dead teeth, but the bone wouldn’t heal so Robert started regular treatment from the Hyperbaric Unit to help heal the gums. He’s had 116 treatments in total — 30 of which happened at our hospital — to stop a bone infection in his jaw. To this day, he still has exposed bone on his rear molar on his lower jaw that he’s receiving care for by a dental surgeon at our hospital. “But that’s where the cycling comes into play,” Robert quickly adds.

Despite everything Robert’s body has been through, he turned to his love of cycling to help build his muscle back up. “Before radiation, I was in really good shape, but within two months of treatment I had no muscle.” That’s when Robert decided to take back control of his body. “I bought an indoor trainer, set a goal, and by August 2019, I completed a 190 km bike ride.”

Since then, he’s logged hundreds of kilometres for different events, including THE RIDE, a past cycling fundraiser for The Ottawa Hospital.

Today, at age 50, Robert is cancer-free. However, there’s a precursor to cancer called lichen planus, which he now has in his mouth and is being monitored closely by his team at the Cancer Centre every three months.

He hopes his motto will catch on with other patients who face this disease. “Look forward. Move forward. What’s done is done. Listen to your doctors at the Cancer Centre. They will help you move forward. You cannot heal if you don’t set positive goals for yourself that is the biggest key to it all.”

He continues to set those goals for himself. “Next summer I have big plans. I’ll be travelling to Kansas for the world-famous 200-mile Unbound Gravel Bike race in June. Then in August, I have been cleared to cycle from Vancouver to Halifax.” For Robert, it’s all about looking forward.

“The dietitians, physiotherapists, and the psychologists, I talked to them all. It was like having a small family group in the hospital — they really helped me get through the major parts of radiation.”

Robert Hurst

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.


Diagnosed with two forms of non-Hodgkin’s lymphoma within five years

Janet Pigott’s cancer journey began in Paris, France in late 2010 — the 51-year-old was enjoying a vacation with her husband when she noticed some enlarged lymph nodes. With no previous health problems, Janet didn’t worry much but followed up with her family doctor when she returned home.

By early 2011, Janet faced a diagnosis of non-Hodgkin’s lymphoma — a form known as Follicular lymphoma. This type of lymphoma typically develops slowly, but by late fall of 2011 the cancer got to a point where hematologist Dr. Isabelle Bence-Bruckler put a treatment plan in place.

Given the chance to participate in a clinical trial, Janet jumped at the opportunity. It included immunotherapy treatment in combination with chemotherapy. “It felt great to be part of something that could lead to cancer treatments that are less toxic, more tolerable, and less painful down the road,” says Janet.

By March 2014, Janet’s treatment was finished, and she celebrated — she was in remission. Not long after, she decided to retire from her role at the Canada Council for The Arts in early 2015 — she was ready to spend more time with her family, including her elderly mother and her three grown children. But, by that summer, she would face a new health challenge when she started noticing lesions on her skin.

Referred to dermatologist Dr. Melanie Pratt, Janet underwent a multitude of tests — all of which came back negative, but the symptoms persisted.

Ultimately, it took three years before biopsies revealed a positive result and confirmed a diagnosis. Janet credits Dr. Pratt for being persistent in diagnosing these mysterious lesions, which turned out to be another form of non-Hodgkins lymphoma known as Cutaneous T-Cell Lymphoma.

A prescribed medication would help eliminate a majority of the lesions on Janet’s body, but one lesion progressed to the point where radiation was required. She had five rounds of radiation, and her treatment was deemed a success by January 2021. “I’m told I’ll always have this type of cancer, but it’s treated like a chronic condition.”

Janet’s first lymphoma recently relapsed. In the coming weeks, her oncology team will determine the best form of treatment and timing. While the news wasn’t entirely a surprise, it was still a bit of shock. “I had practically forgotten about the cancer, but I know I’ll be well taken care of by the hospital,” says Janet.

With over a decade of visits to the hospital, Janet is grateful for the exceptional care and attention she received for both cancers. She witnessed the extra steps staff take to make sure each patient is treated with kindness. In fact, there was one moment on a cold winter day, she won’t soon forget. “I had an early morning appointment in January, and I was tired because I was undergoing chemo. I was on a waiting room bench and I put my head down, when a hospital team member came over with a heated blanket and put it over me. That was pretty special,” says Janet.

“It felt great to be part of something that could lead to cancer treatments that are less toxic, more tolerable, and less painful down the road.”

Janet Pigott

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.