The study that is changing breast cancer treatment around the world

There is such deep love in Gina Mertikas-Lavictoire’s eyes when she looks at her three young children. But there is something else, too: fear. Fear that one or even both of her daughters will develop the same aggressive breast cancer she’s had. So, when an opportunity arose to participate in a clinical trial through The Ottawa Hospital’s REthinking Clinical Trials (REaCT) program, she readily agreed.

Gina Mertikas, centre, and her family
Gina and family

“I’m really big on clinical trials,” says Gina, “so I had no hesitation helping…and I trusted Dr. Clemons.”

Dr. Mark Clemons, scientist and oncologist at The Ottawa Hospital, was Gina’s medical oncologist and also the one who launched REaCT in 2014, together with Dr. Dean Fergusson, senior scientist and Director of The Ottawa Hospital’s Clinical Epidemiology Program, and others. The purpose of REaCT was to make enrollment in clinical trials easier for cancer patients. The more patients who enroll, the more that can be learned, which leads to better treatments and practices.

“When you think the most common killer is now cancer,” says Dr. Clemons, “and only 3% of patients are involved in trials, it’s quite shocking. Patients are desperate to help, not just for themselves but for their children. They want their children to have better treatments if this happens to them.”

Study focused on safer care, less cost, fewer hospital visits

Gina participated in a study focused on a drug called filgrastim, which boosts the production of infection-fighting white blood cells. People with early-stage breast cancer often receive daily injections of the drug at the start of every cycle of chemotherapy, anywhere from five doses to seven to 10. Many cancer patients struggle with both the cost of the drugs, at more than $200 per injection, and the side effects.

“This is an incredibly expensive drug,” says Dr. Clemons, “but often patients feel horrible with it. It makes you feel miserable.”

Up to this point, there had been conflicting debate on how many injections worked best. So, after reviewing all the evidence and surveying doctors and patients, Dr. Clemons and his colleagues launched a clinical trial to find out, enrolling 466 patients from seven Canadian cancer centres.

Gina was among those patients, giving herself a daily shot of filgrastim 10 days in a row after each of her three rounds of chemotherapy.

Gina presenting a cheque to Dr. Clemons in support of the REaCT program at The Ottawa Hospital

“I’m so thankful I was part of this trial”

Gina says she had no hesitation volunteering to be part of this trial, “because I’m able to help future breast cancer patients,” adding, “We are helping the future generation with every trial we do, so I’m happy they asked me.”

She’s happy, too, with the results of the study, published in Annals of Oncology, which have helped change care globally. Researchers discovered that five doses of filgrastim are just as good as seven to 10 doses in terms of preventing infections. And when they looked at treatment-related hospitalizations, they found that five doses are better: patients who received five doses had a 3.3 percent chance of hospitalization for side-effects compared to 10.9 percent for people who had seven to 10 doses, a difference of more than three-fold.

“I believe this is how we will find the cure for cancer.”

– Gina Mertikas-Lavictoire

Results change global standard of care

Drs Mark Clemons and Dean Fergusson developed the Rethinking Clinical Trials or REaCT program
Drs. Mark Clemons and Dean Fergusson developed the Rethinking Clinical Trials or REaCT program

“This study is already changing practice around the world,” says Dr. Clemons. “It is making our patients healthier and giving them more time with loved ones by reducing unnecessary hospital visits. It is also saving our healthcare system millions of dollars every year.”

“This study is already changing practice around the world. It is making our patients healthier and giving them more time with loved ones.”

– Dr. Mark Clemons

The REaCT team wants to take this research one step further to find out whether even fewer doses can be prescribed. They have just applied for funding to start that study and are focused on several other clinical trials as well. With more than 2,700 patients participating in 17 trials in 15 centres across Canada, REaCT is now the largest cancer clinical trials program of its kind in the country.

“By thinking differently and using innovative approaches, we are efficiently answering some of the most important questions for patients and for our healthcare system,” says Dr. Fergusson. “The Ottawa Hospital is a leader in this kind of innovative research and our patients are among the first to benefit.”

Gina knows that well. She’s participated in two other clinical trials through REaCT and has become an ardent fundraiser, securing more than $25,000 for cancer research at The Ottawa Hospital.

“I believe this is how we will find the cure for cancer,” she says, “so we really need to continue to support this avenue, to support the next generation of cancer patients.”

“The Ottawa Hospital is a leader in this kind of innovative research and our patients are among the first to benefit.”

— Dr. Dean Fergusson

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

REthinking Clinical Trials (REaCT) is a unique research program aimed at improving the lives of people with cancer through patient-centred, pragmatic clinical trials.

Based at The Ottawa Hospital, the REaCT program engages patients and their loved ones in research every step of the way, from generating ideas to setting priorities to designing studies and sharing results.

Unlike most cancer clinical trials, which are focused on evaluating experimental treatments in a very narrow patient population, REaCT trials compare standard approved treatments in a real-world setting with a broad range of patients. In this way, REaCT trials can efficiently answer some of the most important questions for cancer patients and the health care system.

REaCT is the largest pragmatic cancer clinical trials program in Canada, with more than 2,700 patients participating in 17 clinical trials at 15 centres in Canada.

Gina Mertikas-Lavictoire grateful for her care at The Ottawa Hospital

“We are helping the future generation with every trial we do. I’m so thankful I was part of this trial.”

— Gina Mertikas-Lavictoire, REaCT trial participant

“Being diagnosed is pretty lifechanging. You feel for other women who are going through this, and so I wanted to give back for the care I was receiving to help other women. I was open to any treatment that was new and innovative. The REaCT trial procedures were straightforward and easy to understand.”

— Connie Chartrand, breast cancer patient, participated in three REaCT clinical trials

Surgeon-scientist Dr. Rebecca Auer is leading a world-first clinical trial that she hopes will protect cancer patients from COVID-19 and other respiratory infections by boosting their immune systems during treatment. The trial was funded in part thanks to donor support to the COVID-19 Emergency Response Fund.

“A cancer diagnosis is scary at the best of times, but the pandemic has made it even worse,” said Dr. Auer, surgical oncologist and Director of Cancer Research at The Ottawa Hospital and associate professor at the University of Ottawa. “Cancer patients have weakened immune systems, which makes them more likely to get severely ill from COVID-19.”

At best, a severe infection could delay a patient’s cancer treatment. At worst, it could kill them.

Patients receiving cancer treatments are the most at risk because the treatments further weaken their immune system. This at-risk population is quite large – over 90,000 people received radiotherapy or chemotherapy treatments in Ontario alone in 2019.

“While there are many specific vaccines for COVID-19 in the works, they won’t be available for at least a year. Cancer patients need protection now.” – Dr. Rebecca Auer

Boosting the immune system during treatment

Dr. Auer and her team at The Ottawa Hospital came up with the idea of testing whether boosting cancer patients’ immune systems during their treatment could help prevent COVID-19 and other respiratory infections. In collaboration with scientists at the Ontario Institute of Cancer Research, they explored an immune-stimulator called IMM-101. Then she worked with Canadian Cancer Trials Group at Queen’s University to design and run the clinical trial at nine cancer centres across Canada.

The researchers will recruit 1,500 patients currently receiving cancer treatment to this clinical trial. Patients will be randomly assigned to receive either regular care, or regular care plus IMM-101. This preparation of harmless heat-killed bacteria had been developed as an anti-cancer therapy because it stimulates the immune system. It has already been safely given to 300 advanced cancer patients in earlier trials.

Training the innate immune system

Dr. Rebecca Auer speaks with a colleague
Dr. Rebecca Auer speaks with a colleague (Photo taken before COVID-19)

This trial takes advantage of a lesser-known aspect of the immune system — innate immunity. This first-response arm of the immune system plays a key role in detecting viruses.

Innate immune cells recognize features that are common to many viruses, allowing them to attack viruses the body has never seen before. This is different from the adaptive immune system, which only recognizes viruses the body has already encountered through prior infection or through a vaccine.

The research team hopes that because the IMM-101 treatment can train the patient’s innate immune system, it will help to fight off the COVID-19 virus, in addition to other viruses that cause respiratory infections.

“There is good data to suggest that the reason some people have no symptoms from COVID-19 while others get very sick is their innate immune system’s ability to respond early and quickly to the virus. This made us consider whether we could use an innate immune booster to prevent COVID-19 infections.” – Dr. Rebecca Auer

Based on data from other immune stimulators, it’s likely that this immune-boost would be temporary. But researchers hope it will last long enough to get a patient through their cancer treatments. Once the treatments have ended, the patient’s immune system would return to its regular strength and be strong enough to fight off viruses on its own.

Protection from more than COVID-19

The advantage of this immune-boosting approach is that it could help cancer patients fight off all sorts of viruses while they are undergoing cancer treatments and are at their most vulnerable.

“The treatment we’re using trains the immune system to do a better job fighting the next viral infection,” said Dr. Auer. “It’s not specific to COVID-19, but actually applies to any viral respiratory illness.”

If successful, IMM-101 could also offer benefits to people with other chronic illnesses or compromised immune systems who are similarly at a heightened risk of serious outcomes from COVID-19. It could also help protect people with cancer from other respiratory infections like the seasonal flu.

Preparing for future pandemics

“In 20 years, we’ve had three coronavirus epidemics or pandemics –SARS, MERS and COVID-19—so it’s likely that we’ll see another,” said Dr. Auer.

“We think harnessing innate immunity could be one of our best weapons for fighting COVID-19 and could be easily adapted to tackle future pandemics.” – Dr. Rebecca Auer

Donate today to support promising research and clinical trials like this one.

Cancer patients undergoing active treatment who are interested in participating in this trial should speak with their cancer specialist.

The Ottawa Hospital Foundation provided seed funding for this project through the COVID-19 Emergency Response Fund, funded by generous donors in the community. Read about other projects that have received funding thanks to donor support and are making a difference in the fight against COVID-19.

Additional funding and in-kind support for this trial have been provided by the Canadian Cancer Society, BioCanRx, the Ontario Institute for Cancer Research, The Ottawa Hospital Academic Medical Organization, ATGen NK Max Canada, and Immodulon Therapeutics, the manufacturer of IMM-101.


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

Exceptional care makes young mother want to give back

When Gina Mertikas-Lavictoire received the good news that she had gone from breast cancer patient to cancer survivor, she knew she wasn’t done with The Ottawa Hospital.

Eternally grateful for the care she received, Gina knew she wanted to give back — she felt that she needed to.

“After my treatment was done, I asked my oncologist, Dr. Mark Clemons — who’s one of the best doctors in the world — ‘how can I give back?’ I need to do something to give back.” – Gina Mertikas-Lavictoire

Gina was 34 years old with three young children at home, the youngest just 12 months old, when she felt something was wrong — there was an unusual firmness in one of her breasts. A breast cancer diagnosis followed and rocked her family’s world. She immediately went into survival mode. “The first thing I asked my doctor was when can I have a mastectomy and when can I start my treatment. I never looked back,” Gina says.

Despite the alarming health news, she faced the disease with sheer determination. “I received excellent care at The Breast Health Centre at The Ottawa Hospital. I went through chemotherapy and radiation. I’ve had four surgeries including a hysterectomy and a double mastectomy.”

An unimaginable experience for a young mother, but the gratitude Gina has for The Ottawa Hospital is undeniable in her desire to give back.

Paying it forward

Gina Mertikas and Katerina Mertikas
Gina and her mother, Katerina Mertikas, a renowned local artist

“When I received the news that I would be able to watch my children grow up, that’s when I put the wheels in motion to help others,” recalls Gina. She came up with the idea of selling a calendar to support cancer research at The Ottawa Hospital.

Today, she’s feeling great and is solely focused on her fundraising efforts, which have exceeded her wildest expectations.

“From the get go, the calendars kept selling out. They were just flying off the shelves. What I’m surprised by is the amount of support that I had, not only friends and family but from all of Ottawa and across the country. People are supportive. We’ve even shipped calendars into the United States,” says Gina.

Gina hasn’t done any of this alone. Right alongside her during her diagnosis, treatment, and now the furious fundraising efforts is her family, including her mother Katerina Mertikas. Katerina is a local artist, who is renowned across the country for her beautiful paintings. It’s Katerina’s art, which is featured each month in the calendar.

Research is transforming care

For Katerina, it was extraordinarily difficult to watch her daughter go through the treatment and surgeries. “There are no words,” says Katerina.

However, the mother of two knows cancer research played a role in helping her youngest daughter recover. “My own daughter has benefitted from research through the treatment she received, which was Herceptin — a chemotherapy drug. It was originally used in a clinical trial before becoming a standard of care for patients,” acknowledges Katerina. It’s for that reason this mother-daughter duo is working together to help others facing the disease.

With calendars from 2019 and 2020 under her belt, and $25,000 raised for cancer research, Gina wants to see this continue for years to come with the help of her own children. Her eldest daughter, Katerina, has been introduced to philanthropy and what it means to give back. For Gina, she’d love to one day hand off the calendar project to the next generation. “I’m hoping someday my kids will take over this calendar and it will continue on,” says the proud mother.

Excellence in care

For this family, there is undeniable gratitude toward the care team at The Ottawa Hospital, which helped Gina when her life depended on it. The impact has been profound on the family and for Katerina, especially from one doctor in particular — Dr. Mark Clemons, medical oncologist and associate scientist at The Ottawa Hospital Cancer Centre.

Dr. Clemons first joined The Ottawa Hospital in 2009 and has made a remarkable name for himself since, both among patients and colleagues alike. At the time, he was unsatisfied with the way breast cancer was being monitored and treated in Canada, so this quickly became his primary area of specialty for clinical trials.

In fact, in 2014, along with Dr. Dean Fergusson, Director of the Clinical Epidemiology Program, Dr. Clemons developed the Rethinking Clinical Trials or REaCT program as a way to make the process of enrolling in clinical trials easier and more efficient for cancer patients. As of June 2020, this groundbreaking program had enrolled over 2,600 patients, making it the largest pragmatic cancer trials program in Canada. In recognition of their success, the REaCT team recently earned a 2020 Research Excellence Team Award from The Ottawa Hospital. Dr. Clemons was also the recipient of the Chrétien Researcher of the Year Award in 2013.

For Gina, she is grateful to have been cared for by such an accomplished researcher who also happens to be a compassionate physician. Dr. Clemons offered guidance, encouragement and hope when she needed it most, and this inspired her to give back.

“Dr. Mark Clemons is a very special doctor,” says Katerina. “He made us feel so comfortable. He helped a lot with his attitude. He gave it his all — so how could we not give back? I wish we could give more.” – Gina Mertikas-Lavictoire

Listen to Pulse Podcast, and hear Gina’s story, including a special guest appearance by Dr. Mark Clemons.

A race against the clock

Karen Lawrence is no stranger to helping those in need. After all, she’s a Clinical Manager of Oncology at The Ottawa Hospital. Her position, largely characterized as providing specialized treatment and care to some of the hospital’s most ailing, has taught her the value of advocating for those in need and raising money for critical research.

Now, sitting with the knowledge that her own body will soon start to deteriorate, she reflects on her life – and the future of her three boys.

An uncertain future

On January 27, 2014, Karen received the results of a genetic test, confirming one of her biggest fears. She is a carrier of a gene that causes amyotrophic lateral sclerosis (ALS) – a rare disease that gradually paralyses people because their motor neurons, which send signals from the brain to the muscles, break down and die.

As she sits staring at an oversized clock mounted on her living room wall, it seems to take on more significance – each second that passes moves Karen toward her inevitable fate. Like so many family members before her, Karen will too develop the disease. It’s just a matter of time.

“My family has been stricken with the familial form of ALS,” she explains with a pained expression. “I have lost 14 members of my family to this devastating disease, including my father.”

Watching ALS render her father helpless, while keeping his mind intact, was a cruel reminder that today there is no fighting this disease. “There is little hope yet. Today, there is only pain and suffering. Facing an uncertain future, a cure can’t come soon enough,” says Karen.

Karen Lawrence sitting at the kitchen table in her home.
Results of a genetic test showed Karen Lawrence carries a gene that causes ALS.

Family ties

No one in Karen’s family realized it at the time. Several members of her extended family were diagnosed with ALS and passed before they connected the dots. It was only once her grandfather, uncle and father were diagnosed that the family started to talk about the fact that it was likely genetic. The women in her family, her aunt and cousins, were diagnosed in their 40’s. The men were diagnosed when they were a little older, but under the age of 60. Once diagnosed, most only survived 12-18 months.

With a 50/50 chance of having the gene, it was never far from Karen’s mind. “It’s like walking around with a target on your back. You’re just kind of waiting,” she said. And she was tired of it – the waiting. That’s when she got tested.

“It’s like walking around with a target on your back.” – Karen Lawrence

“When they told me I had the gene, I was very composed and held it together until I thought of my kids and then I started to cry. That’s when it really hit me. I potentially gave a terminal illness to my children. So that’s very difficult to live with.”

The race is on

When Karen found out that she had the gene, something as simple as dropping a pen, or a small stumble, would have her mind racing to the future.

Karen is aware that it’s just a matter of time before her brain will no longer be able to talk to her muscles. Eventually, she’ll have trouble with her balance, then she won’t be able to walk, then talk and then eat. But her mind will be intact, trapped within her body, while she waits for ALS to take her ability to breathe. Karen has a pretty clear idea of what this will look and feel like, having watched her father go through it just a few years ago.

So, how does she grapple with the thought of such a grim future? She runs – literally. And she raises a substantial amount of money in support of neuromuscular research and care while she’s at it.

Her first ever marathon was in Copenhagen and her second in New York City. More recently, she has participated in The Ottawa Hospital’s Run for a Reason, where alongside her team, she raised funds towards a brand-new Neuromuscular Centre right here in Ottawa.

“The race is on to fund research to find a cure, or to prevent onset before my three beautiful boys are faced with the same agonizing decision of whether to get tested.” – Karen Lawrence

A new Neuromuscular Centre

Thousands of people in eastern Ontario are affected by neuromuscular diseases. Until recently, patients had to travel to Montreal or Toronto to participate in clinical trials to help further research in these diseases. However, Dr. Jodi Warman Chardon noted that The Ottawa Hospital had more than 50 researchers and clinicians working on behalf of people like Karen. Each is working on various aspects of neuromuscular disease – from clinical care to lab research. There was no reason why the most promising clinical trials couldn’t be offered here in Ottawa.

Dr. Warman teamed up with Senior Scientist Dr. Robin Parks, who is conducting lab-based research on neuromuscular diseases. Their dream to have a centre that would bring these experts together in one place caught traction, and in May 2018, The Ottawa Hospital Neuromuscular Centre opened its doors to patients. “What’s exciting is it’s more than just a clinic. It’s a clinical research centre,” said Dr. Robin Parks. “So the idea is to do research and get results that will then feed back to the patient to provide insight into new therapies for them.”

Today, Ottawa is at the global epicenter of neuromuscular research. Equipped with the strongest neuroscience research team in the world, we are well positioned to discover new treatment options and cures, which will change patient outcomes worldwide.

“When a cure is found for this disease [ALS], the chances are it will be found in Ottawa,” said Duncan Stewart, Executive Vice President, Research, The Ottawa Hospital.

Zest for life

Karen does not yet have ALS, so she is not undergoing any treatment. But she remains hopeful that when she develops the disease, she will participate in the Neuromuscular Centre’s clinical trials and benefit from treatment developed at The Ottawa Hospital.

Until then, she tries to not dwell on what lies ahead and instead focuses on her hope for a healthy future for her boys.

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

Hope despite aggressive skin cancer diagnosis

Diagnosed with a stage 4 melanoma at the age of 62, Dan Collins feared for his life when he learned about the aggressive form of cancer. However, immunotherapy treatment gave him a reason to hold out hope. Dan had hope because of scientists who never gave up; who were determined to turn the tables on cancer and to create a better chance of survival, for patients like him. Hope that a cure is coming.

Discovery of a mass

Four years ago, Dan had been travelling for work, when he started noticing some pain when he’d lean his head back to rest on the plane. He recalls turning to his family doctor to get answers. An ultrasound revealed there was something inside the back of his head that looked like a cyst.

After an initial biopsy, Dan was referred to a surgeon at The Ottawa Hospital Cancer Centre. Another biopsy revealed the cyst was actually a mass. It was melanoma. “I was scared. Cancer had stripped my family of so much. I lost both of my two older brothers and my father to cancer. I feared for my life,” recalls Dan.

Unfortunately, the mass starting growing – and it was growing fast. By the end of July, just two months later, the mass went from being not visible on the back of his head, to the size of a golf ball.

His surgical oncologist, Dr. Stephanie Obaseki-Johnson, initially wanted to shrink the tumour before surgery to remove it. However, the mass was growing too quickly.

Oncologist Dr. Michael Ong of The Ottawa Hospital in a patient room.
Dan Collins with Oncologist Dr. Michael Ong.

Time to act

On August 11, 2015, Dan had surgery that lasted most of the day. When it was over, he had 25 staples and 38 stitches in the back of his head. As he recovered, Dan was reminded of a saying that helped him through recovery, “Never be ashamed of your scars. It just means you were stronger than whatever tried to hurt you.”

He would need that strength with the news that awaited him. Only two weeks later, the mass was back. His doctors also discovered a mass in his right lung and shadows in the lining of his belly. He had stage 4 cancer – it had metastasized. This was an aggressive cancer that left Dan thinking about the family he had already lost and what would happen to him.

The next generation of treatment

Soon, he was introduced to The Ottawa Hospital’s Dr. Michael Ong and was told about immunotherapy – the next generation of treatment, with the hope of one day eliminating traditional and sometimes harsh treatment like chemotherapy. Dr. Ong prescribed four high doses of immunotherapy. At the same time, radiation treatment began for Dan – 22 in all. His immunotherapy treatments were three weeks apart at the Cancer Centre and between each, he would have an x-ray to monitor the tumours.

“Each x-ray showed the tumours were getting smaller. That’s when the fear started shifting to hope.” – Dan Collins, patient

By December 2015, Dan finished immunotherapy treatment and the next step was to wait. “This transformational treatment was designed to train my own immune system to attack the cancer. We would have to be patient to see if my system would do just that,” says Dan.

While the shadows in Dan’s stomach lining had shrunk, the mass in his lung had not. That’s when Dr. Ong prescribed another immunotherapy drug that would require 24 treatments.

Dan learned from his oncologist that melanoma has gone from being an extremely lethal cancer, with few treatment options, to having many different effective therapies available.

“When I started as an oncologist a decade ago, melanoma was essentially untreatable. Only 25 percent would survive a year. Yet now, we can expect over three quarters of patients to be alive at one year. Many patients are cured of their metastatic cancer and come off treatment. We are now able to prevent 50 percent of high-risk melanoma from returning because of advances in immunotherapy,” says Dr. Ong.

Dan completed his last immunotherapy treatments in September 2017.

Oncologist Dr. Michael Ong posing with armed crossed at The Ottawa Hospital.
Oncologist Dr. Michael Ong of The Ottawa Hospital.

Today, there is no sign of cancer

When Dan thinks back to the day of his diagnosis, he remembers wondering if he was going to die. “I believe I’m here today because of research and because of those who have donated to research before me.”

He thinks back to when his older brother Rick died of cancer in 2007. “At the time he was treated, his doctor asked if he would participate in a research study. The doctor told him directly, this would not help him, but it would help somebody in the future.” Dan pauses to reflect and then continues, “I like to think, that maybe, he had a hand in helping me out today. Maybe he helped me survive. One thing I do know is that research was a game changer for me.”

The Ottawa Hospital has been a leader in bringing immunotherapy to patients. Research and life-changing treatments available at The Ottawa Hospital altered Dan’s outcome and he hopes that advancements will continue to have an impact on many more patients, not only here at home but right around the world.

Making world-first discoveries and pushing the boundaries of breast cancer care and research right here at The Ottawa Hospital

In front of a buzzing crowd of more than 200 generous contributors and tireless allies, the new Rose Ages Breast Health Centre at The Ottawa Hospital officially opened its doors on September 20, 2018. The event marked a thrilling close to an ambitious $14 million fundraising campaign.

Built and equipped through the unfailing generosity of our community, the Centre now houses an impressive suite of technologies that are among the latest and most comprehensive in Canada. Many of them enable more accurate and much less invasive diagnoses and treatments.

But more than just technology, the new Centre was designed as an inviting space to enhance wellness and connection to friends and family. It also allows patients to be closer to the specialists involved in their care, from before diagnosis to after treatment, and beyond. This means, thanks to donor support, more patients can be treated with therapies that are tailored to their unique circumstance.

A comprehensive breast health program to address growing need

The Ottawa Hospital offers a comprehensive breast centre, providing expertise in breast imaging, diagnosis, risk assessment, surgical planning, and psychosocial support.

The consolidation of four breast health centres spread out across the city down to two (the Rose Ages Breast Health Centre and Hampton Park), allow for more centralized services, less travel time, improved patient care and operational efficiencies.

This year alone, another 1,000 women in our region will be diagnosed with breast cancer. Thanks to the generous donor community in the Ottawa region, The Ottawa Hospital is already tackling this growing challenge and working hard to improve every aspect of breast cancer care with innovative research and the very best treatments and techniques.

“Your generosity has improved the largest breast centre in Canada,” said Dr. Seely. “We are now poised to lead the way for excellence in breast health care.”

The creation of REaCT

The Ottawa Hospital’s commitment to innovation and research is revolutionizing clinical trials, improving patient outcomes every day. Though clinical trials offer improved treatment options, less than three percent of cancer patients in Canada are enrolled in clinical trials. Part of the reason for low enrollment is the daunting prospect of lengthy paperwork each patient must fill out before becoming involved in a trial. As well, regulatory hurdles often make opening a new trial too expensive and time consuming. In response to these challenges, in 2014, Dr. Marc Clemons, medical oncologist and scientist, in collaboration with Dr. Dean Fergusson, Director of the Clinical Epidemiology Program, and their colleagues at The Ottawa Hospital, developed the Rethinking Clinical Trials or REaCT program as a way to make the process of enrollment in clinical trials easier and more efficient for cancer patients.

This ground-breaking program conducts practical patient-focused research to ensure patients receive optimal, safe and cost-effective treatments. Since REaCT isn’t investigating a new drug or a new therapy, but rather looks at the effectiveness of an existing therapy, regulatory hurdles are not an issue and patients can consent verbally to begin treatment immediately. By the end of 2017, this program enrolled more breast cancer patients in clinical trials than all other trials in Canada combined. Currently, there are more than 2,300 participants involved in various REaCT trials.

Drs Mark Clemons and Dean Fergusson developed the Rethinking Clinical Trials or REaCT program
Drs Mark Clemons and Dean Fergusson developed the Rethinking Clinical Trials or REaCT program

The Rose Ages Breast Health Centre 2018-2019 stats and facts

  • 49,288 diagnostic breast examinations and procedures
  • 2,397 breast biopsies
  • 5,129 breast clinic patient visits
  • 1,929 referrals to the Breast Clinic
  • 889 diagnosed breast cancer patients

Specialized patient care

Tanya O’Brien

Tanya O'Brien, cancer free for more than five years.

Five years ago, Tanya O’Brien received the news she had been afraid of all her life. Like her six family members before her, she was diagnosed with breast cancer.

Today, Tanya is cancer-free. When she thinks back to the 16 months of treatment she received at the Rose Ages Breast Health Center at The Ottawa Hospital, Tanya credits her dedicated and skilled care team for guiding her through and out of the darkest time in her life.

“We have come so far as a community in changing the narrative of breast cancer. We have given women like me, like us, so much hope,” said Tanya.

Rita Nattkemper

When a routine mammogram identified a small tumour, Rita Nattkemper was given an innovative option to mark its location for the surgery.

When a routine mammogram identified a small tumour, Rita Nattkemper was given an innovative option to mark its location for the surgery. A radioactive seed, the size of a pinhead, was injected directly into the tumour in her breast.

For years, an uncomfortable wire was inserted into a woman’s breast before surgery to pinpoint the cancer tumour. Today, a tiny radioactive seed is implanted instead, making it easier for surgeons to find and fully remove the cancer, and more comfortable for patients like Rita.

“It’s a painless procedure to get this radioactive seed in, and it helps the doctor with accuracy,” said Rita.

Marilyn Erdely

At the age of 29, Marilyn had a lumpectomy after receiving a stage zero breast cancer diagnosis.

At the age of 29, Marilyn had a lumpectomy after receiving a stage zero breast cancer diagnosis. She was confident she would be fine. But five years later, her cancer metastasized.

“Scans would reveal the cancer was throughout my body. I had significant cancer in the bones, in my femur, in my back, in my ovaries, and in my liver. I was head-to-toe cancer,” said Marilyn.

Oncologist Dr. Stan Gertler gave her hope for recovery. Within six months of her stage four diagnosis, Marilyn required several surgeries. But then things changed. She started feeling better, stronger.

Today, she is down to just a couple of one-centimeter tumours on her liver. Everything else is resolved. The cancer is dormant.


Breast Health Centre Update 2018-2019


More inspiring stories

Annette Gibbons

Annette Gibbons after speaking at The President's Breakfast.

‘I walked through my darkest fears and came out the other side.’

It would be a routine mammogram, which would turn Annette Gibbons’ world upside down. The public servant would soon begin her breast cancer journey, but she put her complete trust in her medical team at The Ottawa Hospital.

Vesna Zic-Côté

Vesna Coté imaged at her home.

The gift of time with family

Mom of three, Vesna, is living with terminal metastatic breast cancer. She is hoping clinical trials will continue to extend her life so she has more time with those she loves.

International research to find breast cancer sooner

The Ottawa Hospital is one of six sites in Canada participating in the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), a randomized breast cancer screening trial that will help researchers determine the best ways to find breast cancer in women who have no symptoms, and whether a newer 3D imaging technique decreases the rate of advanced breast cancers.

The trial compares standard digital mammography (2D) with a newer technology called tomosynthesis mammography (3D). Conventional 2D mammography creates a flat image from pictures taken from two sides of the breast. With 3D mammography a 3D image is created from images taken at different angles around the breast.

Worldwide the study is expected to enroll around 165,000 patients over five years. With the new, increased mammography capacity at the Rose Ages Breast Health Centre we expect to enroll at least 1500 patients from our region.

Your impact

The Rose Ages Breast Health Centre at The Ottawa Hospital is committed to providing an exceptional level of care for patients, approaching each case with medical excellence, practice, and compassion. The Centre’s reputation for world-leading research and patient care attracts to Ottawa some of the brightest and most capable health-care professionals in the world who help deliver extraordinary care to patients in our community.

You continue to be a critical part of our success as we strive to redraw the boundaries of breast health care. On behalf of the thousands of patients and families who need The Ottawa Hospital, we thank you for your tremendous support and for your continued involvement.

A melanoma diagnosis

The Ottawa Hospital, The Ottawa Hospital Foundation, Ian McDonell
Ian McDonell received immunotherapy in 2017, which erased any trace of his melanoma.

Several years ago, Ian McDonell, a Staff Sergeant with the Ottawa Police and father of three had just lost his father to cancer and his brother was dying of melanoma. Ian’s wife insisted he see his physician to check out a mole on his back. It turned out to be an ulcerated nodular malignant melanoma – an aggressive form of skin cancer.

Ian had surgery to remove it along with a lymph node from his left groin. Several weeks later, he had a lymph node removed from his armpit. Following these surgeries, he had no signs of cancer, but due to his family’s history, Ian was at high risk for relapse.

Sobering news

Ian was feeling well, but during a standard monitoring visit in June 2017, his CT and MRI scans showed sobering news. He had half a dozen tumours in his groin and abdomen, and three more tumours metastasized to his brain. Ian’s cancer was stage 4.

Given the severity of the findings, Dr. Michel Ong at The Ottawa Hospital suggested an aggressive approach – a recently approved immunotherapy treatment.

Unmasking cancer

Scientists have tried for decades to stimulate the immune system to attack cancer cells. But the game-changer was the discovery that cancer cells make key molecules, called immune checkpoint proteins, that suppress immune cells and prevent them from attacking the cancer. These immune checkpoint proteins cloak the cancer from the immune system. New drugs called immune checkpoint inhibitors remove this cloak and allow immune cells called T-cells to naturally attack and destroy the cancer.

“The idea of chemotherapy is to kill off cancer directly,” said Dr. Ong. “There are potential side effects, because chemotherapy tries to poison the cancer.

“Immunotherapy does not directly affect the cancer itself. Instead, immunotherapy unmasks the cancer to your immune system by flipping some switches on T-cells, and the body’s own immune system does the rest.” – Dr. Michael Ong

Ian McDonell with his wife Michelle (left), and their daughters Kendra, Macy, and Ainsley, hiking in the Adirondack Mountains in 2019.
Ian McDonell with his wife Michelle (left), and their daughters, hiking in the Adirondack Mountains in 2019.

CyberKnife treatment

Ian started on a combination of two immunotherapies given intravenously in the chemotherapy unit at The Ottawa Hospital’s Cancer Centre. He also underwent CyberKnife radiotherapy treatment where high doses of radiation were directed at his brain tumours. He bravely continued with the second round of immunotherapy, but was so sick, he had to be taken off the treatment and started on steroid medications to slow down the immune system. Ian felt better, but his immunotherapy was on hold.

Shrinking tumours

When Ian began to develop weakness in his face, he worried his cancer was getting worse. It wasn’t. Scans showed one tumour had shrunk from 25 to 10 mm, and another had shrunk from eight to four mm.

Dr. Ong recommended trying a single immunotherapy rather than two, and while the treatment made Ian very sick, it did the trick.

Two months later, the results of a PET scan, MRI, and a CT scan showed that he was tumour-free. All trace of his cancer was gone.

Oncologist Dr. Michael Ong said recent immunotherapies are hugely successful for treating melanoma.
Oncologist Dr. Michael Ong said recent immunotherapies are hugely successful for treating melanoma.

Advances in immunotherapy

When Dr. Ong first met Ian in 2013, options for immunotherapy or targeted chemotherapy weren’t available. Thanks to incredible advances in immunotherapy, there is now hope.

“In the last few years, we’ve gone from having very poor options to having many effective options for melanoma. That’s because cancer therapy continues to develop at a very rapid pace,” said Dr. Ong. “We, at The Ottawa Hospital, are constantly participating in practice-changing clinical trials. The standard of care is constantly changing, as it should. We are continually trying to push the limits of cancer treatment.”

The Ottawa Hospital is a leader in cancer immunotherapy research, both in terms of developing new therapies and in offering experimental treatments to patients. Currently, there are approximately 70 active cancer immunotherapy clinical trials being conducted at the hospital involving nearly 700 patients. The hospital also hosts a national network for immunotherapy research and has developed a number of unique immunotherapies made directly of cells and viruses.

Hope for the future

Because of successful immunotherapy treatments, patients like Ian are now planning a future of living cancer-free.

“When the provincial exams for police services came up, I said, ‘I’m gonna write it, because I’ve got a bit of hope now.’” said Ian.

More importantly, in addition to his career plans, immunotherapy has allowed Ian to plan for the future with his family and a chance to watch his daughters grow up.

Hear more about oncologist Dr. Michael Ong’s work with immunotherapy.

An unexpected breast cancer diagnosis leads patient down an uncertain path

Annette ringing the bell of hope following her final cancer treatment.
Annette ringing the bell of hope following her final cancer treatment.

In July 2016, Annette Gibbons had a routine mammogram. She didn’t expect that day would become a pivotal moment in her life and lead to a breast cancer diagnosis. This unexpected news sent her on a journey of treatment, surgery, and uncertainty that required she place her complete trust in her medical team at The Ottawa Hospital for both her physical and emotional well-being.

Following the mammogram, Annette was told that she had dense tissue, which made it difficult to read the results. She wasn’t worried at all when she received a call to schedule another mammogram and ultrasound. But that all changed when her radiologist, Dr. Susan Peddle, gently told her that she thought it was cancer.

Annette, visibly emotional, recalls that fateful day. “Just like that, my life changed and I began my journey.”

The challenges of chemotherapy set in

Annette began chemotherapy treatment under the watchful eye of medical oncologist and scientist Dr. Mark Clemons. “He specializes in the type of cancer I had and is very active in clinical trials and research on leading-edge treatments and practices,” said Annette.

During these early days, she focused solely on getting through the wear and tear of chemotherapy. She recalls that “it’s not anything you can truly prepare for, or understand, until you’re the patient…There was the depressing hair loss, the constant nausea, the searing bone pain and the mind-numbing fatigue. Despite all that, I still tried to keep my spirits up with exercise, a support group, and lots of old movies.”

Research making a difference

During her treatment, Annette participated in several clinical trials led by Dr. Clemons through his innovative REthinking Clinical Trials (REaCT) program. This program engages patients and their loved ones in research every step of the way, from generating ideas to setting priorities to designing studies and sharing results.

One of the studies that Annette participated in has now produced important results that are helping breast cancer patients not only in Ottawa, but around the world.

Trusting her medical team

She also put her complete trust in her medical team and was determined to stay positive. “I knew the stats for survivability were fairly good and I looked forward to resuming my ‘normal life’.”

Little did she know that the next steps – mastectomy and radiation – would be tougher than chemotherapy. The surgery itself and healing had gone well. She credits her amazing surgeon, Dr. Erin Cordeiro, for her compassion and skill.

“She held my hand as I lay in the operating room preparing for the operation to begin.” – Annette Gibbons

“In the end,” Annette says with a little smile on her face, “she gave me, dare I say, the nicest, straightest surgery scar I have ever seen on anyone.”

Sobering news

Annette wouldn’t have the full picture of her cancer prognosis until pathology results came back on her tumour. Several weeks later she received alarming results from Dr. Cordeiro. It was devastating news. “She told me that my tumour was much bigger than first thought. They had found cancer in many of the lymph nodes they removed. I was not expecting that, it was a huge blow.”

As she tried to absorb this news, she sat down with Dr. Clemons a few days later and was dealt another blow. “He gave it to me straight: because of the tumour size and number of lymph nodes affected, my risk of recurrence was high.”

Compassionate care during a dark time

That’s when Annette’s world came crumbling down. She recalls spiralling down into a dark place. “It was very hard to crawl out of this place. But my medical team saw the signs and knew how to help me. My dedicated radiation oncologist, Dr. Jean-Michel Caudrelier, spotted my despair and referred me to the psychosocial oncology program. With the amazing help of Dr. Mamta Gautam, I walked through my deepest fears and came out the other side.”

Annette completed her radiation treatment and then slowly reclaimed her life. But as all cancer patients know, the fear of recurrence can be a constant companion. “I don’t know if that will ever change. But I decided to make it my friend who reminds me to think, not about dying, but about the importance of living while I am alive,” said Annette.

She’s grateful to know the best medical professionals were right here in her hometown when she was diagnosed. As a self-proclaimed “frequent flyer at the hospital”, Annette is proud to say she’s reclaimed her life — including her return to work. “I am myself again, and life is strangely somehow better than it was before.”

“Jillian was a true champion of The Ottawa Hospital. She not only shared her story to encourage and inspire others, but she reminded us that every day is a gift to be cherished. Jillian’s enthusiasm for life and positivity in the face of adversity was evident as she poured herself into her family and continued to move forward with hope. We are deeply saddened by her loss and offer our most heartfelt condolences to her husband, her three children, extended family, and friends. All of us at the Foundation remain profoundly moved by her determination, strength, and bravery.”

Tim Kluke, President and CEO of The Ottawa Hospital Foundation

The following story was written in early 2019, before Jillian passed away.

Jillian O’Connor stands in her living room laughing. A small boy hugs her leg, then takes off and disappears down the stairs to play with his older brother and sister. That was Declan. He turned four on February 1, 2019. The fact that his mother saw him blow out the candles on his birthday cake is extraordinary.

When Jillian was 18 weeks pregnant with Declan, she was diagnosed with metastatic breast cancer. She wasn’t expected to celebrate his second birthday. Two and a half years later, Jillian celebrated his fourth birthday with him—and still living life to its fullest.

Insatiable enthusiasm for life

The first thing that strikes you about Jillian is her smile. Next, it’s her insatiable enthusiasm for life. Then comes her contagious positivity. Hard not to think the latter alone is why she has made it so far against daunting odds. It may be anecdotal but Jillian definitely thinks, or rather knows, it’s the key.

“I am totally full of cancer, pretty much from my head to my toes,” said Jillian. “Every day I get is a blessing, ‘Oh, I woke up. Perfect!’ You just want to go at it as hard as you can, for as long as you can. Just being optimistic, I think helps. I really believe it helps.”

Jillian’s petite frame belies her light-up-the-room personality. She is gregarious with an enthusiasm that bubbles infectiously out of her. She talks about her cancer matter-of-factly. It is part of her life, but doesn’t rule her. She has other things to focus on—her precious family. The 35-year-old laughs and chats so easily about her life and her journey with cancer that it takes a second to realize how extraordinary her journey has been.

Diagnosis during pregnancy

In 2014, Jillian was still nursing Landon, her second child, when she went to see her physician about a blocked milk duct. It turned out to be breast cancer. Doctors wanted to do CT scans to determine the extent of her cancer, but Jillian couldn’t. She was 18 weeks pregnant. Without treatment, she was told she wouldn’t survive to give birth. It was unfathomable. She had a three-year-old daughter and a one-year-old son at home. It was a devastating diagnosis but Jillian met it head on with her own special brand of optimism and determination.

Terminating the pregnancy was not an option for Jillian and her husband David. Her oncologist, Dr. Mark Clemons, told her she didn’t have to. He could provide a chemotherapy cocktail that would keep her cancer at bay without harming her unborn child. Jillian had a mastectomy and a dozen chemo treatments tailored to her special case. On February 1, 2015, she gave birth to a healthy baby Declan.

“I received chemotherapy right up until I delivered him. He was healthy—a wonderful birth weight. He was absolutely perfect,” said Jillian.

Every day is a gift

After Declan was born, Jillian had scans to see where the cancer was. It had spread, and had metastasized to her bones, liver, and lymphatic system. That was when she was given less than two years.

“Basically, they said, ‘We can’t give you a long timeframe. It’s stage IV, so every day you wake up is going to be a gift,’” said Jillian, who stopped working as a nurse at the Queensway Carleton Hospital and became a patient there, receiving treatment at The Ottawa Hospital’s satellite cancer centre, the Irving Greenberg Family Cancer Centre. “Two years passed, then three, and then I passed four years this past summer. I’m hoping I’ll have another 40 plus years. I got a pretty doom and gloom diagnosis, but I continue to pull life off.”

Jillian has pulled life off in a big way. After all, when she brought Declan home from the hospital, she had three children under the age of three to look after. She poured herself into motherhood, enjoying every moment with them. Between weekly trips to the cancer centre for treatment, she was busy changing diapers, making meals, caring for, playing with, and loving her little ones.

Declan and Jillian O'Connor
Four-year-old Declan sits on his mom’s knee.

Celebrating milestones

Declan is back and clambers onto his mother’s knee—for about 30 seconds—before scrambling off onto the couch beside her. He is a typical four-year-old. His big sister Myla, who is seven, and brother Landon, who is five, appear, and the three play on the floor near their mom. Jillian chatters happily with them.

Jillian has celebrated all her children’s early-year milestones: learning to walk, talk, run, play, read, and become independent little people. Both Myla and Landon are now in school. Declan will be joining them in September. In mid-January, Jillian and David registered him for junior kindergarten. Nowadays, while the two older ones are in school, she and Declan have fun hanging out. They fill their days with activities that include volunteering at the school, as well as the more mundane household chores.

“I got a pretty doom and gloom diagnosis, but I continue to pull life off.”

Jillian is exuberant about life. She lives each day as it comes.

“She has, with all the help that modern radiotherapy and medical oncology can offer in Ottawa, in addition to her tremendous personality and drive, done amazingly well in a tragic situation for any young mom,” said Dr. Clemons. “At the same time, she has been involved in practice-changing research that is going to improve the care of patients—she continues to give.”

ReACT program

Jillian has participated in several clinical trials led by Dr. Clemons through his innovative REthinking Clinical Trials (REaCT) program. This program engages patients and their loved ones in research every step of the way, from generating ideas to setting priorities to designing studies and sharing results. The results are helping people with cancer not only in Ottawa, but around the world.

Over the past four years, Jillian has participated in clinical cancer trials with new therapies that have kept her cancer in check. When it spread to her brain a couple of years ago, she had whole-brain and CyberKnife radiation. Then she was put on new medication that can cross the blood brain barrier, which her regular chemotherapy couldn’t do. The medication halted new tumour growths in her brain. Her cancer is not getting better, but it’s not getting worse, either.

“I’m happy to stay status quo, because there is nothing I want to do that I can’t do right now,” said Jillian.“Status quo—I’m good with that. I feel great. I don’t have aches or pains or anything. I don’t have time to think about how I feel.”

An inspiration

Jillian sits on the floor laughing and playing with her three children. She looks at the little doll her daughter Myla shows her, and hands a ball to Landon. “I really think it’s the kids. They have so much to do with it, because they are so great. They are so fun. They keep me really busy and that’s half the fun. By the time I go to bed at night, I don’t think about cancer. I don’t think about tests coming up. I don’t think about that stuff because I’m too tired. So I think that is helpful.”

Dr. Clemons agrees.

“She is a gem, and her attitude of living life with true meaning is a humbling lesson for all of us,” said Dr. Clemons. “Too many people in society spend too much time moaning about the trivial, as well as things they can’t do anything about. Life is for living, and Jillian encourages people to do that—live!”