Published: May 2024

Emmy Cogan was extremely tiny when she arrived in this world, but the impact of her birth was big. Born at 23 weeks gestation, she weighed only 515 grams — that’s just over one pound. Emmy was one of nine babies enrolled in a world-first cell therapy trial to heal the lungs of preemies and was the first in North America to receive the therapy. Now, that promising trial is ready for its next phase.  

Her early arrival happened not long after first-time parents Alicia Racine and Mike Cogan returned from a trip to Hawaii. Alicia was back at work as a 911 operator for the Ottawa Police when her water broke.   

“My sister works with me, and she brought me to The Ottawa Hospital’s General Campus. I was in a lot of pain, and I wasn’t too sure what was going on. And then we found out that it was contractions, and I started dilating,” explains Alicia. 

Born at 23 weeks gestation, Emmy Cogan weighed just 515 grams.

The baby would hold on for another six days before being born on February 20, 2023. Those few extra days in the womb were critical to give Emmy a chance at life. “It changed the game entirely for us and her. She was able to be intubated, and she just started fighting from that moment on,” explains Mike.

Health challenges lie ahead

Initially, Emmy was cared for in The Ottawa Hospital’s Neonatal Intensive Care Unit (NICU), followed by 10 days at CHEO before returning to our hospital. 

Emmy’s first month of life faced many challenges, including a duct between her heart and lungs that wouldn’t close, gastro-intestinal issues causing her to become septic, and concerns of a blood infection. Once Emmy got through those life-threatening issues, she was extubated and put on a high-flow oxygen. “We got to hold her for the first time at that point and my parents were able to be there for that, which was really nice,” says Mike. 

Emmy also developed bronchopulmonary dysplasia (BPD). This is a condition known to affect many preemies. Because these infants are born so prematurely, their tiny lungs are underdeveloped and require extra oxygen to help them breathe properly. But giving this oxygen — critical for survival — can damage their tiny lungs. It’s like starting life with emphysema. 

The devastating impact of BPD

In Canada, 1,000 babies are diagnosed with BPD every year. That number jumps to approximately 150,000 worldwide. Often, babies with BPD develop other chronic lung diseases, such as asthma, and may require prolonged oxygen and ventilation.  

Additionally, they have a high rate of hospital readmissions in the first two years of life. Babies with BPD often have problems in other organs as well, such as the brain or eyes. There is currently no cure, but this world-first clinical trial led by Dr. Bernard Thébaud, a senior scientist and neonatologist, hopes to change that. 

Two decades ago, Dr. Thébaud’s team discovered that stem cells from the umbilical cord — known as mesenchymal stromal cells (MSCs) — could heal lung injury and prevent BPD in newborn rodents. Since then, the team has worked tirelessly, here at home and collaborating with other scientists around the world, to bring this novel therapy to babies and their families through clinical trials. While other trials have tested MSCs for treatment of BPD in premature babies, no other group has used MSCs taken from the whole umbilical cord and processed them the way that Dr. Thébaud’s team has.  

What is bronchopulmonary dysplasia?

Bronchopulmonary dysplasia — or BPD — is a chronic lung disease that most often occurs in premature or low-weight babies who have received supplemental oxygen or received mechanical ventilation for long periods.

“In our rodent research, we’ve used stem cells isolated from the umbilical cords of healthy newborns to prevent lung injury or even to some degree regenerate the damaged lung,” says Dr. Thébaud. “We foresee that these stem cells, given during a certain time during the hospital stay of these babies, could prevent the progression of the disease.”

Shortly after Emmy’s birth, her parents met Chantal Horth, a clinical trial coordinator, and were introduced to Dr. Thébaud. “Chantal came to us and said Emmy qualified for the trial,” remembers Mike. “It sounded like a great opportunity.”

"Being a preemie, she’s going to have some health issues, and anything that could help her, we wanted to give her that extra shot."

— Alicia Racine

Saying ‘yes’ to a world-first clinical trial

The couple met with Dr. Thébaud, and he answered a long list of questions they had about the trial. “He’s a very personable guy, and it was very easy to talk to him. We trusted him. Being a preemie, she’s going to have some health issues, and anything that could help her, we wanted to give her that extra shot,” says Alicia. 

To qualify for the trial, the premature babies — born at 23- or 24-weeks’ gestation at The Ottawa Hospital — had to be seven to 21 days old and treated in the NICU. They also had to require 35% oxygen. This level of oxygen puts them at 60-70% risk of developing BPD. Sunnybrook Health Sciences Centre recruited one baby, becoming the second site involved.  

On March 3, 2023, at 11 days old, Emmy received an IV infusion of umbilical cord tissue grown from the donated cords of healthy newborns. It was a special moment for everyone involved. She was the first baby in North America to receive this kind of therapy. 

"This is the first trial of its kind in the world, and what could be more rewarding than helping preemies?"

– Dr. Bernard Thébaud

“Dr. Thébaud administered the stem cells, and everyone clapped,” says Mike. “She will have follow-up appointments at different stages for two years, and then she’s going to be followed up by phone for 10 years.”  

For Dr. Thébaud, it was a moment he and his team had dreamed about. “It was an exciting and huge milestone when that day arrived — after 20 years of work we were able to test this therapy for the first time in a patient. This is the first trial of its kind in the world and what could be more rewarding than helping preemies?”

The next step for this stem cell trial

Thanks to those nine tiny patients, including Emmy, recruitment for the Phase 1 trial is now complete. The purpose of this trial is to test the feasibility and safety of the stem cell therapy. The next phase will test safety as well as how effective it is.

"All the stars lined up to have her be a part of that little piece of history — something that could impact babies like her in the future.”

– Alicia Racine
Emmy with her parents.

“Now we can determine if this therapy will make a difference in patients,” explains Dr. Thébaud. “There will be two groups in the next phase — one that will receive cells and one that will receive the placebo — it’s a randomized controlled trial. We’ll need 168 patients to determine if these stem cells make a difference.”

While babies for the first phase were recruited from NICUs at The Ottawa Hospital and Sunnybrook Health Sciences Centre, the next phase will be a multi-centre trial across the country. Dr. Thébaud hopes it will begin by the end of 2024 and it will take two years.

“Working with babies is, I think, the most beautiful job on Earth. Because they’re born, and they have all their life and all their potential in front of them. Our task is to give them a great jumpstart,” says Dr. Thébaud.

As for Emmy, she left the hospital five months after she was born, and while Mike and Alicia don’t know if the stem cells impacted her health, Emmy is doing well. “We don’t know what she would be like without it, but she’s awesome right now,” says Mike. “We felt very fortunate to be in the right place at the right time for our little girl.”

It’s something Alicia feels makes Emmy all the more unique. “All the stars lined up to have her be a part of that little piece of history — something that could impact babies like her in the future,” explains Alicia.

That’s certainly what Dr. Thébaud is hoping for. “It would change the way we care for premature babies. It’s my hope that these tiny patients have a chance to thrive, grow up, and have an impact on the world around them.”

Emmy doesn’t know she’s made history, but that’s ok. For now, she’s keeping her parents busy. She’s pulling herself up and will be walking in no time. She’s also been off oxygen since November 2023, giving her even more mobility. “It was really fun to have her free. We had a cordless baby for the first time! That was a big step when she didn’t need to rely on the oxygen anymore,” smiles Mike.

This Phase 1 trial is funded by the Stem Cell Network with in-kind matching funds from MDTB Cells GmbH. Dr. Thébaud’s research is also possible because of funding from the Ontario Institute for Regenerative Medicine, the Canadian Institutes of Health Research, The Ottawa Hospital Foundation, and the CHEO Foundation. 


Randy McElligott’s unusual reaction to his cancer diagnosis

Published: February 2024

When Randy McElligott heard the words “you have cancer”, he didn’t have the average reaction to this type of news. “I was happy. Most people don’t take that attitude, but I saw it as an opportunity to change my life,” explains Randy.

That’s exactly what he did. Randy decided to train for a marathon. He wanted to try something challenging, and he’s been moving ever since.

“I had what’s known as smoldering multiple myeloma. It sits there and doesn’t do anything. It’s like a volcano just waiting to erupt.”

— Randy McElligott

It was July 13, 2005, and Randy was 49 when he received the news — it was a surprise find. His family doctor had ticked off an extra box on the requisition form for his blood test. That mark resulted in the discovery of cancer — or what would become cancer. “I had what’s known as smoldering multiple myeloma. It sits there and doesn’t do anything. It’s like a volcano just waiting to erupt,” explains Randy.

Multiple myeloma is a cancer that starts in a type of white blood cell that’s known as a plasma cell. These cells help the body fight infection, and they can be found in the bone marrow, as well as other tissues and organs.

For nine years, he waited for the “eruption” but maintained his positive attitude. And over those years, he kept busy doing the things he loves, like hosting his jazz radio show, In Transition, on CHUO-FM — a program he’s been doing since 1988. But his greatest distraction has been running. Since his diagnosis, he has completed 12 marathons and about 80 half-marathons. “That kept me sane and kept me focused. By doing marathons, I was building up my mental ability to handle what was ahead for me regarding cancer.”

Becoming symptomatic for multiple myeloma

In 2014, Randy and his wife, Nicole, were in Barbados on vacation, and he became symptomatic. “I was in excruciating pain. I returned home and was hospitalized right away. The cancer had spread to my spine, chest, and sternum.”

Randy makes bi-weekly visits to the General Campus for his treatment.

Once Randy was stabilized, he was discharged, and chemotherapy treatment began at the cancer outpatient at the General Campus of The Ottawa Hospital. He also forged on with his running.

The next big hurdle Randy faced was a bone marrow transplant in October 2015. But true to his character, seven weeks later he did a 10k run and then another marathon. “It’s all because of the cancer. I must prove, even if I have cancer, I don’t have to stop. I wanted to show other cancer patients they can keep going. Look at Sindy Hooper — she is incredible and one of the inspirations in my life to keep going and do these races,” explains Randy.

“I have a great cancer team. If any medical trials are coming up, they know I want to help.”

— Randy McElligott

This cancer journey has been a rollercoaster ride for Randy — he has been in and out of remission several times since his diagnosis almost 20 years ago. But his positive attitude is the one thing that never wavers.

He also credits the specialized team — which includes four hematologists — for always being ready when a new challenge presents itself. “I have a great cancer team. If any medical trials are coming up, they know I want to help.”

Access to clinical trials at The Ottawa Hospital

Access to clinical trials is key for patients like Randy, and thankfully, The Ottawa Hospital has one of the largest and strongest clinical trials programs in Canada. This gives patients access to even more novel therapies. And in addition to helping establish best practices for patient care around the world, clinical trials also provide new hope.

Through his own journey, Randy is doing what he can to help our scientists learn more. “I told my hematologist, Dr. Arleigh McCurdy, she can do anything. I’m your guinea pig. I’m on my second drug trial now. It’s a highly experimental drug and so far, it’s going well. The first trial, three or four years ago, was for another drug, and that worked for a while, but then I relapsed,” says Randy.

“It means the world to have access to this type of care. And if I can help other patients, what could be better?”

Randy is an avid runner.

Maintaining a positive attitude

In the last few years, Randy faced new health challenges. In 2021, within only a few weeks, he lost 30 pounds. It was a bit of a mystery as to what was happening. “It was looking like this was the end of the road for me. I thought my time was running out, but I just said, ‘Cool.’ Hospice care was being planned, but then I started gaining weight again, and I completely rebounded,” explains Randy.

“I never get discouraged. I’m always joking around. It’s been an incredible journey.”

— Randy McElligott

Unfortunately, Randy then had new obstacles to overcome. The following year, he was on a trip to Montreal with his wife when he fell and broke a leg, wrist, and two ribs. Then in February of 2023, he broke the same leg, again. After surgery on that leg, he contracted a potentially life-threatening bacterial infection. He was treated in hospital for a month, and he had to learn to walk again.

These incidents may have taken the biggest toll on him, as they’ve prevented him from running. “I never get discouraged. I’m always joking around. It’s been an incredible journey.”

Today, thanks to the clinical trial he’s currently on, Randy is once again in remission. He hopes to start back on his spin bike to regain his strength so one day he might get back to running — his true love.

Randy makes bi-weekly visits to the General Campus for his treatment.

For now, he makes bi-weekly visits to the General Campus for his treatment. “It was initially every week, but now it’s every two weeks, and it only takes seconds to administer by needle. I think my team is surprised I’ve lasted this long after relapsing several times. But as of today, there’s no trace of the myeloma,” Randy smiles.

While fatigue is preventing him from being active, he continues to entertain radio listeners with his jazz favourites and looks forward to lacing up his running shoes once again.

“It’s really an incredible life.”

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

Published: December 2023

The way Katie Skidmore sees it, she was living a normal life for a 36-year-old. She had a full-time job in Information Management/Information Technology, and for four years, she worked for a mining company in Vancouver before moving back home to Ottawa last year to work from home. In April 2023, Katie ran a half-marathon, then only a couple of weeks later was diagnosed with a rare autoimmune disease. The diagnosis would change the course of her life and push her to advocate for advancements in kidney research. 

Shortly after her race, while in Calgary on a work trip, Katie started feeling a bit off. “I was feverish and feeling rundown. It was a crazy busy time at work and so that’s what I attributed it to, but then I noticed my urine looked pink,” she recalls. “I didn’t think it was a urinary tract infection (UTI) and my friend suggested I might have a kidney infection.”  

She went to a Calgary hospital where some initial tests were done, and they suspected a UTI and prescribed Katie some antibiotics. If symptoms changed, she was to consult her doctor when she returned home. “By the time I got back to my hotel room, I felt even worse and so I booked an earlier flight to Ottawa. Once I was home, I had kidney pain and my urine changed to dark red, so when I landed, I went straight to the hospital. 

Katie Skidmore

Tests revealed a slight decrease in kidney function, so she was monitored overnight. In the morning, her stats improved, and she went home with medication. But when she woke up from a nap, her symptoms had progressed. “I got up to go to the washroom and I couldn’t walk. I also started vomiting. 

Katie in Calgary (late April 2023) at the acute care clinic before coming home to learn she was critically ill.

Alarm bells would soon sound

The next day Katie made another trip to her local hospital. Doctors advised her to continue her antibiotics. Five days later she returned to the hospital because she had stopped urinating altogether. At this point, she wasn’t alarmed — she believed she was healthy and there would be a solution soon. 

But alarm bells would soon ring. Her creatinine levels — which monitor kidney function — had gone from 125 to 1,750 in the span of one week. “I didn’t know what that meant, but I thought, ‘This can’t be good.’ The next thing I knew, I had a catheter inserted and then I was put in an ambulance to be transported to the General Campus of The Ottawa Hospital,” says Katie.  

What she didn’t know at the time — but her healthcare team suspected — was that her kidneys were failing because of an autoimmune disease.  

“It was a Saturday night. I had many injections, there was a line put in my chest, and they did a biopsy of my kidneys,” remembers Katie. “I wouldn’t be able to start dialysis until Monday, but I was like ‘Rock on – get me better and out of here. I have a trip to France planned that I’ve got to get to.’ I was clueless of the severity of what I faced.” 

Faced with a rare autoimmune disease

Within a couple of days, Katie was diagnosed with anti-glomerular basement membrane (antiGBM) disease. She had never heard of it and admits she had a very delayed reaction to the news and what it meant for her future.  

“It hit especially hard when I realized my kidney function likely wouldn’t come back. It was horrific news to try and digest. My life is changed forever. I see it as the girl who flew to Calgary and never came back.”

– Katie Skidmore

What is anti-GBM disease?

Anti-glomerular basement membrane (anti-GBM) disease is an extremely rare autoimmune disorder in which antibodies from the immune system attack and destroy healthy lung and/or kidney tissue.

Previously called Goodpasture disease, anti-GBM disease occurs in fewer than one in a million people. The exact cause of anti-GBM disease is unknown, but it can be triggered by viral respiratory infections or exposure to chemicals, such as through breathing in hydrocarbon solvents or smoking cigarettes.

Symptoms usually, but don’t always, develop quickly. Treatment involves stopping the production of antibodies, removing the antibodies from the blood, and reducing inflammation. The fast development of the disease means it can cause severe kidney damage before it’s diagnosed. In these cases, dialysis is often required.

The following months were beyond difficult for Katie. Mentally and physically, she felt like a completely different person. “I didn’t recognize the person I saw in the mirror.”

According to Katie, doctors call anti-GBM the worst of the worst for kidney disease. “It comes in out of nowhere and it kills your kidneys in days or weeks,” she explains. “It will leave your body in a few weeks or up to two years and never come back but does its damage. It leaves when there’s nothing else to kill.”

Katie’s been told the disease will likely be gone from her body in six to 12 months — it’s trending down but still active now.

After a week in the hospital, Katie went home with her parents and started to put the pieces together about what her new life would look like — dialysis three days a week and no cure for the kidney disease. That’s what led her to want to create more awareness for this illness and kidney research.

“I depend on medical intervention to stay alive, so I need to get the word out that kidney disease is prevalent,” says Katie. “Once you’re on dialysis, it’s for life. I want the world to know, I’m never cured. I’m not in remission. I’m a kidney disease patient for life.”

What kind of kidney research is happening at The Ottawa Hospital?

It’s for that reason, Katie hopes to see research advancements in kidney disease. While there is no cure, there is significant research happening at our hospital to better understand it and hopefully find a cure.

Dr. Manish Sood is a senior scientist, nephrologist, and former Jindal Research Chair for Prevention of Kidney Disease at The Ottawa Hospital. He recently published a study of more than eight million adults in Ontario that suggested even a modest loss of kidney function is associated with increased health risks. This could result in better ways to prevent chronic kidney disease and related conditions, especially for younger adults. 

“The dogma is that healthy, young adults don’t need to worry about kidney function unless it drops to around 50% of the normal level,” explains Dr. Sood. “But our research suggests that even a more modest 20-30% drop may have consequences, and we may want to have earlier conversations about prevention and monitoring.”

When it comes to prevention, researchers are attempting to engage the community. Dr. Sood and his colleagues have developed an online calculator that can estimate a person’s risk of developing chronic kidney disease. Early-stage chronic kidney disease has no symptoms, and its onset can often be reduced with lifestyle modifications such as diet, exercise, and quitting smoking. This calculator may improve awareness and help people reduce their risk.

“Our goal is to improve awareness of chronic kidney disease and to empower and personalize care for patients. Our calculator is a simple tool that can be completed by anyone without prior medical knowledge or blood work.”

–Dr. Manish Sood

Care for dialysis patients across eastern Ontario and beyond

Katie began her in-centre hemodialysis treatments at the General Campus and then in June, moved over to the Riverside Campus. She quickly learned what a drastic change this was going to be for someone who was always on the move — now she would be a frequent flier at the hospital. 

The nephrology program at our hospital provides care to residents of Ottawa and most of eastern Ontario who suffer from kidney disease. It also serves as a referral centre for the Renfrew and Sudbury area. The Ottawa Hospital’s nephrology program is one of the largest in Canada and offers a broad range of services to those affected by this illness. 

Katie Skidmore with her home hemodialysis equipment.

With the expertise of her care team, Katie felt she was in good hands. “There are really supportive people at dialysis — the care team is amazing.” But she admits, as a young patient, she didn’t see many people her age. “For example, I sat next to a 75-year-old gentleman who was great, but he said ‘I’ve lived my life. I can accept this, but I wouldn’t if I were you.’” 

It’s conversations like that one, the support of the dialysis team, and Katie’s desire to be more independent, that led her to explore home hemodialysis. She started with a chest catheter implanted to start, and then training began. Her weeks were busy in preparation. “It’s 12 hours of therapy and then 12 to 13 hours of training for home hemodialysis — that started in mid-September. You learn everything from how to set up your machine, connect yourself, troubleshoot if there are issues, do your blood work, change your dressing, and disconnect,” explains Katie. 

It takes a lot for a patient to prepare for, but the hospital provides all the support required so that patients can live more independently, which is exactly what Katie has hoped for. 

“I feel mentally prepared for it now. I feel physically capable. My blood pressure is under control. I can look at the line in my chest without crying.”

– Katie Skidmore

With everything set up in her home, Katie completed her first home hemodialysis in mid-October. She continues to be cared for by Dr. Deborah Zimmerman and Dr. David Massicotte-Azarniouch — one focused on her kidneys and the other focused on the antiGBM 

Katie baking at home

Awaiting a kidney transplant

It’s expected she will be ready for a kidney transplant this summer she just needs a kidney first. Katie is on a kidney transplant list, and she has people stepping forward to see if they could be a living donor 

As she adjusts to her new life, she is determined to plan for her future. “I have more life to live. I want to travel more, especially internationally. I’ve investigated Dialysis at Sea — cruise ships that offer nephrology care. I want to live my life as much as I can.” 

But Katie is also here to remind people that she is still not better — her life is completely different today compared to six months ago.  

“When people saw me acutely sick, and they see me now going to the gym and travelling across the country, they say it’s so amazing to see you healthy. But I’m not healthy. I’m on dialysis three days a week,” she says.

"I want to project that I’m healthy, I don’t want anyone to forget that I’m part human, part machine. For 15 hours a week I require a machine to keep me alive.”

– Katie Skidmore

And so, she moves forward, as an advocate for kidney disease and a desire to push the boundaries of kidney research for her and others like her.

Published: November 2023

Tanya Di Raddo was 15 years old when she started having severe headaches — she was diagnosed with migraines. As time progressed, the headaches continued. Decades later, she turned to The Ottawa Hospital and was diagnosed with not one, but two illnesses — a brain tumour and multiple sclerosis (MS). 

By her late 20s and early 30s Tanya was married and had two children, and the headaches remained a constant part of her life. As her kids grew, she faced a difficult time when her son began suffering from mental health challenges. He was later diagnosed with first-episode psychosis, so she pushed her health issues to the side and persevered.  

As time progressed, the headaches worsened — there were times when Tanya couldn’t lift her head off the pillow because the pain was so debilitating. It was still considered a migraine, but she also started to notice something wrong with her right hand. “I don’t know if I’d describe it as tremors, but my right hand would form a claw,” remembers Tanya.  

Shocking discovery of a brain tumour plus an MS diagnosis

By the spring of 2021, Tanya started to experience pain in her left eye — soon her vision deteriorated significantly. You know when you see dark clouds in the sky? It was like that in front of my eye. I could kind of see peripherally, but at night, I couldn’t see car lights out of that eye at all, not even colour,” explains Tanya. 

Tanya and her cat, Zeus.

“I knew something big was wrong for a long time, so in some ways, the MS diagnosis made sense, but the discovery of a tumour as well was a shock.”

— Tanya Di Raddo

After an extensive examination by her eye doctor, she was referred to the University of Ottawa Eye Institute of The Ottawa Hospital. She met with a neuro-ophthalmologist and was diagnosed with optic neuritis, an inflammation that damages the optic nerve. However, Tanya also needed further testing to better understand the root of her headaches and vision loss. She never imagined what that test would reveal. 

Read our Q&A with Dr. Fahad Alkherayf

MRI results showed both MS lesions and a brain tumour. “I knew something big was wrong for a long time, so in some ways, the MS diagnosis made sense, but the discovery of a tumour as well was a shock,” explains Tanya. 

She was immediately referred to Dr. Fahad Alkherayf, a leading skull base neurosurgeon at our hospital. The MRI from mid-summer 2021 showed a large tumour at the back of her brain. “It was a three-and-a-half by five-centimeter mass — the size of a small orange. It was a meningioma, which is a benign tumour that is slow growing, but it was putting pressure on her brainstem and affecting her neurological function,” explains Dr. Alkherayf. 

Due to the size of the tumour and the impact it was having on Tanya’s life, Dr. Alkherayf believed surgery was needed within a few months.  

In the meantime, she turned to The Ottawa Hospital’s MS Clinic where she met Dr. Mark Freedman, a world leader in MS treatment and research. “She was referred to us after having her vision affected back in mid-2021. We proceeded to confirm a diagnosis of relapsing-remitting MS and then got her onto effective therapy as soon as possible,” explains Dr. Freedman. 

A plan for specialized brain surgery

As her MS treatment got underway, surgery to remove the tumour was scheduled for early November. According to Dr. Alkherayf, the surgery carried significant risk.  

The tumor was pressing at the back of the brain — which we call the cerebellum — as well as on the brainstem.” he says. “The brainstem is the main structure which controls a person’s ability to breathe, walk, and state of consciousness.” 

“It’s thanks to having a specialized team who work closely with our neuro-anesthesiologists to operate this equipment that we’re able to provide this technique.”

— Dr. Fahad Alkherayf

Neural monitoring, with what’s known as interoperative neuromonitoring, is an important part of this type of specialized surgery. It allows neurosurgeons to watch the patient’s brain and brainstem functions while attempting to remove the tumour. This is where The Ottawa Hospital excels.  

“We’re lucky in that we have good support from the hospital where we can do two or three surgeries at the same time with the ability to monitor the patient,” says Dr. Alkherayf. “It’s thanks to having a specialized team who work closely with our neuro-anesthesiologists to operate this equipment that we’re able to provide this technique.”

The Ottawa Hospital has invested to support this expertise, as it can be challenging to have the right people to operate specialized equipment and interpret the information. 

During Tanya’s operation, the surgical team sent a signal through the brain to stimulate her muscles to ensure they were responding during the operation. “Even though she was asleep, we’re still able to look at the function of the brain and brainstem, as if she’s awake,” says Dr. Alkherayf. 

Additionally, the system also helps the surgical team monitor the cranial nerve, which controls swallowing, for example. This prevents any possibility of damage during the surgery. If the nerves become irritated during the operation, the surgical team gets a signal.  

“When that happens, we stop immediately and change our course of action during the surgery,” says Dr. Alkherayf.

“If you don’t have that technology, then there is the risk of causing damage and you wouldn’t notice it until the patient wakes up.”

— Dr. Fahad Alkherayf
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During an almost eight-hour surgery, the large tumour pressing on Tanya’s brainstem was completely removed.

Not just saving a life, but also maintaining quality of life

For Dr. Alkherayf, it’s not only about saving a life, but also about maintaining quality of life. He acknowledges it puts more stress on the team knowing they are caring for a young person, who has many years ahead of them.  

“A good analogy is a bomb squad. They want to disable and remove the danger without causing any problems or damage,” he says. “That’s what we’re doing when we remove a tumour like this. We want to remove it without causing any other damage that could impact the patient’s life.” 

The good news for Tanya is the whole tumour was removed during the almost eight-hour surgery. This provided her relief from the excruciating headaches she suffered, and her vision has improved, but colour is not crisp yet. “It’s like an older TV. It’s not 20/20, but it’s better than it was,” explains Tanya. 

Looking forward

It’s been two years since that complex surgery with no signs of recurrence to date, and she’ll be closely monitored by Dr. Alkherayf for up to 10 years. 

Tanya also continues to be in the care of Dr. Freedman for her MS. She has some challenges with her mobility and regularly uses support to get around, and MS flare-ups continue to impact her day-to-day living.  

“I’m doing better today, but cognitively it impacts my life,” she says. “It’s the little things we take for granted that I notice, like leaning forward to make a meal or cutting something. The numbness in my fingers makes it difficult, and sometimes my leg will give out.” 

The reality of facing two serious illnesses at the same time is not a uniqueness Tanya was aspiring for or ever thought she’d face, but she’s grateful to have access to the best treatment options available, from complex surgery to ongoing, compassionate care.

Tanya Di Raddo with her husband and daughter.

Published: October 2023

These days, when Amy Volume swings her leg over her motorcycle, it’s still a bit of a surprise. After a lifetime of pain, the announcer best known for entertaining listeners on CHEZ 106 radio had hip replacement surgery in May 2023 by the skilled orthopaedic team at The Ottawa Hospital.

Discomfort and pain plagued Amy her entire life. As a baby, she was always crying, well beyond just a colicky infant, so her parents sought out answers. “I was officially diagnosed with juvenile rheumatoid arthritis — an autoimmune disease — at the age of 18 months. My entire life I have grown differently,” explains Amy.

As a result, she spent much of her life in and out of the hospital. Her care started at SickKids in Toronto, but when CHEO opened its rheumatology clinic, Amy was able to be cared for in her hometown. By 16, she became a patient of The Ottawa Hospital and she’s been cared for here ever since.

“I have surgeons working at both the General and Civic Campuses. I have seen from an early age that the orthopaedic team is very invested in their patients' care.”

– Amy Volume

“I have surgeons working at both the General and Civic Campuses,” she says. “I have seen from an early age that the orthopaedic team is very invested in their patients’ care.”

Amy Volume in the CHEZ 106 studio.

What is rheumatoid arthritis?

Rheumatoid arthritis causes your immune system to attack healthy cells in your body and results in painful swelling, usually in joints. Long-term, this can damage the joint tissue causing chronic pain, lack of balance, and deformity. While it can develop at any age, it’s most common in adults in their sixties. “People do think that what I have happens to older people. This has been my life story,” explains Amy.

It’s certainly taken a toll on Amy’s body. As a result of the medications Amy takes, her body can’t fight infection. When she was a little girl, Amy got chickenpox and was hospitalized for three weeks. It also affected how her bones grew when she was young.

“It doesn’t just destroy your joints, which then leads to you having bone on bone contact, which creates terrible problems. It also attacks soft tissues, your organs, and your blood,” explains Amy. “You can tell when I’m having a rough day because I sound extra rough on the radio, but that’s my paycheck.”

Much of the pain Amy has experienced is because of her hips. They never formed properly when she was young, and she has hip dysplasia on both sides — a known risk factor for early hip arthritis.

“It’s all just bone on bone. And when that happens, as you can imagine, it’s just extreme pain, which interferes with your daily life. It makes normal activities near impossible, which also has an impact on your mental health.”

Radio host Amy Volume has been an orthopedics patient at The Ottawa Hospital since she was a teenager.

Hip replacement surgery by a specialized team

Amy was only 17 when she had her first bone surgery at the Civic Campus. She had her left toe joint removed because it didn’t grow properly, and it was replaced with a steel bar.  

“The prospect of not getting relief from this pain or losing my ability to walk — of having the hope of meaningful medical intervention and recovery slip away really spooked me.”

– Amy Volume

While the orthopaedic team at The Ottawa Hospital has been caring for her for twenty years now, most recently, her hips started to give her a great deal of pain — impacting her life, including keeping up with her two children, riding her motorcycle, and her overall mobility.

By 2022, the pain became unbearable. “The prospect of not getting relief from this pain or losing my ability to walk — of having the hope of meaningful medical intervention and recovery slip away really spooked me,” she recalls. ‘I can’t give up hope,’” Amy wrote in her blog.

The chronic pain that Amy has lived with is where Dr. Paul Beaulé, Professor of Surgery and an orthopaedic surgeon at The Ottawa Hospital, comes into the picture.

“Amy suffered from hip pain and a lack of function for over a decade. She had an underlying malformation of a joint that was probably present when she finished growing,” explains Dr. Beaulé. “At some point, the hip starts manifesting itself to the point where it’s not functioning properly because of the malformation.”

Amy’s right hip joint was too damaged to save, but because of research and technology advancements, there was a good plan to get her quality of life back, thanks to a specialized surgery,” explains Dr. Beaulé. “Using a total hip arthroplasty anterior approach, she could go home the same day. Because of this approach, her muscles aren’t damaged. That means when she’s done healing from the surgery, she can resume her activity more rapidly and have a good quality of life.”

Thanks to these advancements, Dr. Beaulé says Amy can expect a good 20 years of function with no major issues. “Amy truly is a poster child for the best possible outcome.”

An x-ray showing Amy’s new hip joint.

Research aims to improve hip surgery

Dr. Beaulé knows the impact that preserving and replacing hips can have on patients — especially young patients like Amy.

“Research helps us better understand what we’re doing in the operating room and asks the question, ‘Is this the best we can do?’”

– Dr. Paul Beaulé

One area of research that is of particular interest is surgery that can improve pain, stop damage, and prevent a hip replacement in people with pre-arthritic hip disease — that includes preventing and treating hip problems in young athletes.

Another key focus for Dr. Beaulé is studying the results of The Ottawa Hospital’s same-day joint replacement program, which focuses on getting patients home as safely and early as possible. “Research helps us better understand what we’re doing in the operating room and asks the question, ‘Is this the best we can do?’” says Dr. Beaulé.

Amy is a big proponent of research and the possibilities it could create for her and other patients — especially knowing she will face more orthopaedic surgeries in the future. That’s why she’s also open to participating in research studies so more can be learned about her illness.

“We’re always learning, and there is no one-size-fits-all treatment. I’m always raising my hand and saying yes to the next thing, because we are blazing a trail, and I might make it easier for the next kid that comes along with this weird disease because something worked for me — it might give hope to others.” 

She’s grateful for the work of the orthopaedic team at The Ottawa Hospital, including the Research Chair in Regenerative Orthopaedic Surgery, and what their research could mean for patients in the future as well.  

Read our Q&A with Dr. Beaulé

"You're a part of the scientific frontier that is going to improve the quality of life for all Ontarians, Canadians, and perhaps even globally. It’s the big picture.”

– Amy Volume

“I think that the more people that you can encourage to get on the research train the better. You’re a part of the scientific frontier that is going to improve the quality of life for all Ontarians, Canadians, and perhaps even globally. It’s the big picture.” 

Getting her life back

Following her surgery, Amy was amazed to be up and walking in no time with the assistance of crutches. While there was some initial post-op pain, she was back on the air within 11 days.

Now, several months later, she’s started to see the impact this specialized surgery will have on her long term. “I’m getting into the zone where I’m healthier than I’ve ever been. It’s because The Ottawa Hospital and the surgical teams put their best foot forward in making sure that I have a fulfilling life — that I can keep up with my kids. They’re very fast,” Amy laughs.

Amy Volume enjoying one of her passions, riding her motorcycle.

“I say thank you profusely to the surgeons, but I know to them it’s their 9 to 5 job, that’s what they’re doing constantly, day-in and day-out. They are rock stars – they are who I idolize.”

– Amy Volume

She’s also truly grateful and in awe of the work of her surgical team. “I say thank you profusely to the surgeons, but I know to them it’s their 9 to 5 job, that’s what they’re doing constantly, day in and day out. They are rock stars – they are who I idolize.”

For now, Amy enjoys being able to ride again and is grateful for the quality of life she’s been given. While she knows there will be more surgeries down the road on her other hip and right toe, she has complete confidence in what her care team has planned for her.

“I saw my surgeons in my follow-up care, and I know they’re invested in my continued success, which is really nice. And it makes me feel good about the future, because I know I will be seeing them again. It’s nice to know you have that team of experts on your side.”

Update: October 2023

Over the past few months, we’ve had the distinct privilege of working closely with Alison Hughes to share her story. Only 37 years old when she was diagnosed with breast cancer, she wanted to raise awareness, especially among other young woman like her.

We are heartbroken to learn that Alison passed away on Wednesday, October 11, 2023. We offer our deepest condolences to all those who knew and loved her, and we remain profoundly inspired by her.

Originally published: September 2023

This is Alison’s story told in her own words.

I wanted to share my story now, because I want more young women to have a story they can relate to. Sadly, breast cancer doesn’t just affect women over 50. By sharing my story, I hope I can help younger women better understand what this journey is all about, because I didn’t really have that when I was first diagnosed ten years ago. 

At that time in my life, I owned a consignment store specializing in women’s fashion. I love fashion, so it was a great fit for me. I also had two young children — life was busy.  

But then I got the shock of a lifetime. It started when I found a lump on my right breast, and I remember telling my husband at the time that it hurt. He told me not to freak out, but I just had this feeling something was wrong, so I called my doctor.  

Little did I know, that was the beginning of my breast cancer journey. I was sent for a mammogram, just to be safe. It was a Friday, and I remember walking into the office and looking around and seeing older women — I was young and hip — no one else looked like me. It wasn’t long after the mammogram that I knew something was wrong. The busy office went quiet, it was like I’d stepped into a movie. Other experts came in and examined my results. It turned out I had stage 3 breast cancer.  

My way of coping with a breast cancer diagnosis

I remember someone talking to me, but I honestly don’t remember what they said. Then a lovely nurse sat next to me, and that’s when I felt a tear drop out of my eye, and then I slowly started to cry.

“I can’t do this…I have no room in my life for this right now – this can’t be happening!’

— Alison Hughes

I drove back to my store and remember thinking ‘I can’t do this. I have a two-year-old and a three-and-a-half-year-old. I have no room in my life for this right now – this can’t be happening!’ 

But it was happening, and within two weeks, I had a PICC line inserted, and chemotherapy soon followed. The news of my diagnosis was particularly difficult for my parents because my dad’s mom died from breast cancer in her mid-thirties. So, I said ‘We have one day to cry and then after that, for the outside world, there’s nothing happening.’ We hid my diagnosis from almost everyone — that was my coping mechanism. Everyone has their own way of coping – this was mine. 

Soon, I met Dr. Mark Clemons. I refer to him as my first oncologist and now my forever oncologist. We clicked. He was well informed, supportive, and had time for all the questions we had for him. He gave me confidence to know that the choices he was making were not from just a singular perspective, he was looking at my total healthcare options.  

Alison Hughes with her two children, Rosie, and Raffi.
Alison is living with stage 4 breast cancer.

The specialized team ready to handle my care

But he wasn’t alone. There was an entire team at The Ottawa Hospital ready to help me have more time to watch my children grow.  

From September to December 2013, I underwent chemotherapy, but by the fifth and sixth treatment, I was hit hard. My beautiful hair fell out, my skin turned gray, and I was in bed all the time. Then in February of 2014, just as I gained back most of my strength, I had a mastectomy. During that operation, a bunch of lymph nodes from under my right arm were removed and sent for testing. We’d later learn that more than half of them were cancerous. That’s when radiation treatment started. 

The care was amazing, and so were the resources made available to me afterwards, because that is a difficult operation to undergo. I had access to psychosocial oncology, as well as a dietitian.  

By that summer, I started feeling better, and that’s when I started telling people what I had gone through. Sometimes they’d turn white as a sheet when they heard the news — I really believe it’s because there’s not a lot of women my age that relate to this kind of a diagnosis.  

Then after five years, I was doing well and released from the cancer program. I had successfully recovered from breast cancer — or so I thought.  

Devastation when cancer metastasized

In 2021, in the middle of the pandemic, I experienced a ton of pain in my back and my hips. I started physio and got relief for a few days but then it came back. One day at work, I tripped on a mat, fell, and couldn’t get back up at first. I kept getting this insane spasm. Later that night my parents found me on the floor, unable get up. They helped me into bed, and I stayed there for four days. 

Then one day my daughter noticed my leg looked like I’d been burned by a big rod. I looked at my kids and I said, ‘I think I should go to the hospital.’ Little did I know my world would be turned upside down, again. 

“I went from seeing a physiotherapist because of my back pain to stage 4 cancer with possibly only months to live. It was almost too late.”

– Alison Hughes
Soon, I discovered my breast cancer had metastasized. I had compression tumors on my spine and a lesion in my lung. I had a tumour on my liver, and there was cancer in my stomach and in my bones. I also had multiple moving blood clots, which caused that mark on my leg. It was kind of like the house was lit on fire and it was going up in flames. Suddenly, I went from seeing a physiotherapist because of my back pain to stage 4 cancer with possibly only months to live. It was almost too late.   

My body was riddled with cancer

The next thing I knew, I dove back into treatment. I had a radiation team, an oncology team, and a palliative team. I had a home nurse as well as psychological support. The resources are unbelievable.  

I moved back in with my parents, along with my kids who were then 10 and 12, because I was at a point where I couldn’t climb a set of stairs, and I couldn’t really function on my own. In addition to the blood clots, I had multiple broken bones from the cancer and crooked shoulders from all the broken bones in my back. I was either in a wheelchair or walked with a cane, and my stomach was really bloated because of the disease. There was just so much going on — my body was in emergency mode.  

While my extensive team at the hospital mobilized, my parents took care of me and the kids, and our incredible network of neighbours rallied alongside us. That meant I could be in treatment, and the kids could still have some normalcy — they could go outside and play.  

Alison with her parents and children.

Finally, there was some good news

From June 2021 through until February 2022, I had radiation led by Dr. Laval Grimard to help with the cancer in my bones, followed by chemotherapy. After a clinical trial was not successful, Dr. Clemons tried me on a new chemo option that finally brought some hope. In June 2022, I started to feel better.

By that summer, my spine started straightening, I could move better. And my health continuously improved. All my bones healed, the tumors shrunk, and I could walk unassisted most of the time. I was back working part time as a background actor in movies — maybe you’ve seen me in a Hallmark movie — I also do some modelling.

By the spring of 2023, I had a clear scan, and I went overseas to spend some time in Oxford and London — it was spectacular. But when I returned home in early June, I could feel my body grinding to a halt. I could barely walk. The next thing I knew, I was in a wheelchair — I couldn’t walk. It happened fast.

Alison on set.

Little did we know what would come next

Once again, I was thrust into emergency mode to determine what was happening. I had x-rays and scans, and I don’t think any one of us expected to see what we saw on those scans. I was pretty sure this was it for me.

There were new lesions on my lower spin and this time they also found a tumour on my brain. Immediately, my care team acted. My new plan included five radiation treatments on my back and one on my brain. Then I started a new type of chemo treatment in August. This chemo is at the forefront of treatment options, and I can’t thank Dr. Clemons enough. I call it the Cadillac of treatment — I feel really lucky. And the way I see it is, if I can be an early user of this drug and they can learn from me, that’s a good thing.

“My philosophy is, if you can test me or use my blood or do something with me that's going to make things better for someone else, sign me up.”

– Alison Hughes
In fact, when it comes to clinical trials, I’m in total favour of getting involved. I told them, ‘You can poke me, learn from me, use me as a case study. Let students practice on me.’ I’m already sick, so my philosophy is, if you can test me or use my blood or do something with me that’s going to make things better for someone else, sign me up. I just feel so fortunate to have this level of care and access to clinical trials — even if the one I tried didn’t work, it gave me time. And the medical team learned because of me.
Alison with her two children, Rosie, and Raffi.
Every day I’m so thankful to have this precious time. Dr. Clemons has even given me the nickname “Puss in Boots” because it’s like I have nine lives. He has such a unique and special way with patients. He asks, ‘What life are we on?’  

In fact, I often find myself thinking, ‘Who gets this many chances?’ And that’s why I’m sharing my story. I’m fortunate for the care, the support, and the learning because life doesn’t always gets perfectly tied with a bow — not everyone gets a bow.

I don’t know what the future holds.

I just want the chance to be here for my kids and my family. I do my best to make every day a good day with them and hope that science continues to improve. Today, Rosie is 13 and Raffi is 11. I’m learning to become a mom of teens. I like to think about their high school graduation and university life. I just hope I’ll be able to keep watching them grow, even when they don’t need me as much.  
Download episode #86 of Pulse Podcast to hear Alison’s story and why she wants to help other young women who face a breast cancer diagnosis.

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Published: June 2023

When someone suffers a stroke, the results can be devastating, from severe debilitation to death. An intracerebral hemorrhage (ICH) stroke, more commonly known as a bleeding stroke, is the most serious form of this disease. However, after decades with little in the way of treatment advancements, a global research trial being led in Canada by The Ottawa Hospital could mean an effective treatment is finally on the horizon.

The Ottawa Hospital is recognized worldwide for its expertise in neuroscience, and we’ve made significant strides in addressing today’s most pressing challenges in this area of medicine — including our international, groundbreaking work in stroke. In fact, we are leading the way in how stroke care is delivered in Canada.

“The ICH stroke makes up roughly a quarter of strokes. It’s more common as people's ages go up. In Canada, we have an aging population, so we're seeing more and more cerebral hemorrhage.”

— Dr. Dar Dowlatshahi

Dr. Dar Dowlatshahi is a stroke neurologist and senior scientist in the neuroscience program at our hospital. He is leading the Canadian site of the research trial and hopes it will change the way we treat the deadliest and least treatable form of stroke. “The ICH stroke makes up roughly a quarter of strokes. It’s more common as people age. In Canada, we have an aging population, so we’re seeing more and more cerebral hemorrhage,” explains Dr. Dowlatshahi.

All about stroke

Stroke is a disease that occurs within the arteries — also called blood vessels — that are connected to and within the brain. These arteries carry vital nutrients and oxygen to the brain. A stroke occurs when one of these arteries is either blocked by a clot or bursts, preventing the oxygen and nutrients from reaching the brain and causing the artery and brain cells to die.

When a stroke code is called

The first thing to happen when someone experiences a stroke is they lose an ability ─ and it happens fast. This is the case whether it’s an ischemic stroke (blood clot) or a bleeding stroke. “For example, they’ll suddenly not be able to move an arm or leg, you’ll see their face droop, or they’ll lose the ability to speak. They may lose vision, or they may also collapse to the floor,” explains Dr. Dowlatshahi.

“For any type of stroke, we use the acronym FAST. If you suddenly see a person’s face get droopy, that’s the F. Ask them to lift their arm, and if they can’t, that’s the A, if their speech changes, that’s the S, and the T in FAST is for time. If you see these symptoms, you need to call 911 immediately.”

How can you check if someone is having a stroke?

If you suspect someone is having a stroke, experts recommend using the F.A.S.T. method.

In the Champlain region, which includes Renfrew County, Ottawa, North Lanark, North Grenville, Stormont, Dundas, and Glengarry, as well as Prescott-Russell, the rapid response stroke system is excellent, according to Dr. Dowlatshahi. “When you call 911, they can identify the correct stroke hospital to take the patient to, and they call ahead. In the Champlain region, that hospital would be the Civic Campus of The Ottawa Hospital. Our stroke team knows they’re coming, and we’re ready to receive the individual.”

When it’s a stroke where a blood clot has formed in the vessel, there have been significant advancements in care when the patient arrives at the Emergency Department. Those treatments include new clot-busting medications or pulling the clots out with new technology.  

However, when the vessel bursts and bleeds into the brain, it’s a more devastating stroke — one that occurs every five minutes in Canada. About 80% of people who have this type of stroke are permanently disabled, while about 40% don’t survive past the first month.  

“And nothing’s been successful in the past 20 years as far as treatment, except for bringing down the blood pressure a little bit. That helps, but not in a major way,” explains Dr. Dowlatshahi. “So, we’ve been working very hard over the last decade here, and with our international colleagues, to come up with an approach to treat this type of stroke. 

Global intracerebral hemorrhage stroke research trial may lead to better outcomes

Now, a global research trial being led in Canada by our hospital could result in the first drug treatment for ICH stroke patients.  

The trial is called FASTEST, referring to the importance of treating a patient who has a bleeding stroke as fast as possible — in under two hours. “It’s a very aggressive, fast trial, and we give the patient a compound that helps stop the bleeding. This compound is called factor VII,” says Dr. Dowlatshahi. 

“When a vessel bursts in the brain, it starts squishing that brain and damaging it, and you must get to it as fast as possible to stop the bleeding.”

— Dr. Dar Dowlatshahi
Dr. Dar Dowlatshahi is a neurologist and researcher at The Ottawa Hospital.

Factor VII is one of many clotting factors naturally produced by our bodies. As Dr. Dowlatshahi explains, the drug in the trial is a synthesized version of factor VII, and time is crucial. “The reason we want to act fast is, if you can imagine you have a pipe that bursts and you’re getting water everywhere, what you’re trying to do is seal the pipe before all the water comes out and damages everything around it,” he says. “That analogy holds all too true for the brain because it’s a closed compartment. It’s got a skull around it. When a vessel bursts in the brain, it starts squishing that brain and damaging it, and you must get to it as fast as possible to stop the bleeding.” 

When a patient with an ICH stroke arrives at The Ottawa Hospital, the trial protocol allows the stroke team to access this new therapy. It’s randomized testing, so neither patients nor the care team know whether the actual drug or the placebo was administered.  

In 2021, the trial launched. The Ottawa Hospital was the first centre in Canada and enrolled the first two patients worldwide. “Typically, you would think the U.S. would get the first patient because they’re bigger, they have more centres, but it was actually us — it was here in Canada,” says Dr. Dowlatshahi. To date, six countries are participating in this trial including Canada, the United States, the United Kingdom, Spain, Germany, and Japan. 

What are the early indicators?

While the testing is randomized, there are early indicators that give reason to be optimistic about what the results of this trial could mean for stroke patients in the future.  

In fact, Dr. Dowlatshahi cites the first patient enrolled was an 80-year-old woman who arrived at the hospital in 2021 suffering from a life-threatening stroke. She was enrolled in the study, and less than a week later, she walked out of the hospital. That’s not something this stroke specialist typically witnesses in this type of patient. “She did amazing to the point that she returned completely back to normal,” he explains. “We also got the second patient in the world — both did spectacularly. We’re now up to six patients in Ottawa.” 

“If you are in Ottawa and suffer this type of stroke, you have a 50% chance of getting something that nobody else can get — something that may very well be the future standard of care.”

– Dr. Dar Dowlatshahi

Globally, 172 people have been enrolled in the trial with an eventual target of 860. While this is a randomized, blinded trial with final results still to come, Dr. Dowlatshahi believes this treatment could be a game changer for stroke patients after decades of little in the way of options. And for those living in the Ottawa region, they get access to something few Canadians have at this stage. “If you’re somewhere where this trial is not available, you would go to the emergency department, get your blood pressure lowered, and receive the best of the standard care available,” explains Dr. Dowlatshahi. “However, if you are in Ottawa and suffer this type of stroke, you have a 50% chance of getting something nobody else can get — something that may very well be the future standard of care.”

“This research means a type of stroke that affects one out of four, that is currently the most lethal and the most disabling type of stroke, could become completely treatable.”

– Dr. Dar Dowlatshahi

And while the research teams continue to recruit more patients into the trial, not only here at The Ottawa Hospital, but also at all the other sites around the world, there is optimism that this could be the long-awaited breakthrough for patients who suffer from ICH stroke. “This research means a type of stroke that affects one out of four, that is currently the most lethal and the most disabling type of stroke, could become completely treatable.” 

Listen to episode 85 of Pulse Podcast for our conversation with Dr. Dar Dowlatshahi.

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Published: May 2023

Sometimes you meet someone and wonder what drew you together. That’s what happened when Holly Wagg met Lynne Strickland in Patagonia, Chile. Both women lived in Ottawa, but it was a serendipitous meeting almost 10,000 kms from home where they ended up as bunk mates while on an expedition. Soon, they would discover a special bond between them — they both had loved ones who faced leukemia, and while their journeys were different, their stories connected in an unexpected way.

The story begins in the fall of 2015 when Holly’s wife, Julia Wagg, started to feel inexplicably tired. At the time, the Director of Talent Management at Hydro Ottawa was also teaching a course at Carleton’s Sprott School of Business, and juggling life with three children — she had a lot on her plate. But then one day she noticed blood in her mouth and decided she’d better make a dental appointment. By early December, symptoms escalated. “Julia woke up at 2 or 3 a.m. one night and said, ‘I need to go to the hospital.’ She could hardly breathe because she had crushing chest pain,” remembers Holly.

That first visit to the hospital didn’t determine any clear signs of what might be wrong, but Julia’s fatigue persisted into the new year. The family had big plans to travel to Africa, and Julia was determined to go. Holly was leaving early to climb Mount Kilimanjaro, then Julia and their youngest daughter, Addison, would follow two weeks later.

Leukemia diagnosis heard around the world

Holly Wagg has committed to leaving a gift in her will to further advance research.

As Holly summitted the mountain, back home Julia received devastating news. “While I had been up there, she had taken herself to the hospital one morning, and they told her she wasn’t leaving — she had leukemia,” says Holly. “Julia waited four days to tell me so I could finish my climb. When I found out, I raced back as soon as I could.”

The life Holly returned to was much different than the one she had left. Julia was immediately put on a chemotherapy cocktail — 24/7. She remained hospitalized for three to four weeks and when Holly was finally able to visit her in the hospital, she says the reunion was heartbreaking and devastating. “Julia was going through this fight of her life and was having so many complications from chemo. I was researching and I knew what we were facing.”

The couple learned Julia had the acute myeloid leukemia mutation known as FLT3. It was aggressive. “This is like driving your car and slamming your foot down on a gas pedal — that’s how fast the cancer was reproducing. Most people have a 10% chance of surviving five years,” explains Holly. “So, my mission became to make whatever time we had left the best possible time.”

By the second round of chemo and after 12 weeks as an in-patient, Julia was in remission and was eligible for a stem cell transplant. Her sister was a match, and three weeks later, in May 2016, Julia received the transplant of her sister’s stem cells — and the hope for more time with her family.

However, Julia faced one complication after another and spent the better part of eight months in the hospital. “Her whole team of doctors and nurses up on 5 West and the Bone Marrow Transplant team at The Ottawa Hospital were amazing,” remembers Holly. “She left hospital in December with limited mobility, but started strength training and eventually we had her skiing. We learned how to cross-country ski.”

Making the most of their precious time left together

The family had what Holly describes as the perfect three months of a cancer-free life. During Julia’s cancer care, she never made promises to her children, but there was one exception. She told Addison she would be there to celebrate her sixth birthday — things were going well. A big birthday party was planned with a fairy theme and all their friends came together to celebrate. “It was beautiful and joyous,” remembers Holly.

But after the party, Julia collapsed on the floor in agony from extreme bone pain. By the next day, the same thing happened, and she went to the hospital. The blood work looked normal, so they did a bone marrow biopsy. When Holly and Julia returned to the hospital for the results, Julia couldn’t walk.

Julia’s cancer was back. The couple knew if a patient relapsed within 12 months following a stem-cell transplant, there’s no chance of a second transplant. It had only been 11 months.

Julia passed away in the ICU of The Ottawa Hospital a week-and-a-half later. “She had all the people who loved her around the bed that night. I brought Addi into the room, and I grabbed Harry Potter because that was the story we were reading at the time. As I was reading, Julia’s heartbeat started to decelerate. I wanted to stop, but I knew she needed to hear me. She needed to know we’re all okay,” recalls Holly. “Jules was surrounded by love, and she chose to let go during this beloved bedtime ritual.”

Holly Wagg and her daughter Addison holding a photo of Julia.

Meeting a ‘spitfire’ young researcher

Before Julia passed away at the age of 36, she and Holly had some difficult but honest conversations. During her lengthy time in hospital, Julia witnessed many things as a patient. As a patient at a teaching hospital, she met many rotations of residents, in both the physician and nursing programs. Julia often said yes to the residents who were taking blood for the first time, and she said yes to two doctors who performed their first bone marrow biopsies. She wanted to help.

“One of the physicians who cared for her was Dr. Natasha Kekre. She was a spitfire — she was young, and she was brilliant. She was looking to start a clinical trial at The Ottawa Hospital to offer breakthroughs in leukemia treatment using CAR T-cell therapies. Julia wanted to elevate that research.”

– Holly Wagg

Because of the aggressiveness of her cancer, she also interacted with many physicians who were also researchers. “Julia was very curious and asking them about their projects. One of the physicians who cared for her was Dr. Natasha Kekre. She was a spitfire — she was young, and she was brilliant. She was looking to start clinical trial at The Ottawa Hospital to offer breakthroughs in leukemia treatment using CAR T‑cell therapies. Julia wanted to elevate that research,” explains Holly.

Julia and Holly had read about CAR‑T and knew what the possibilities would mean for patients like Julia in the future. It was the first big game changer to leukemia treatment in more than 20 years. They had seen what was happening in the United States and believed patients in Canada should have access to it. “Being a part of research to improve that path for people going forward was very important to both of us, which is why, for us, that legacy was about making sure other families didn’t have to experience what we did. We wanted to be a part of that change,” says Holly.

Dr. Natasha Kekre,hematologist for The Ottawa Hospital's Blood and Marrow Transplant Program.

Read our Q&A with Dr. Natasha Kekre

What is CAR-T therapy?

CAR T-cell therapy involves removing the patient’s T-cells and genetically engineering them with a disarmed virus to produce synthetic molecules called “chimeric antigen receptors” (CAR). These new CAR T-cells are then injected back into the patient so they can target and attack the cancer.

Julia’s legacy and her commitment to research

With that in mind, Julia decided to leave a gift in her will to support research at The Ottawa Hospital. Her legacy would live on. Holly has also committed to leaving a gift in her will to build on Julia’s wishes and to further fund research that was so important to both of them.

By 2019, The Ottawa Hospital became one of three centres in the province administering the Ontario CAR T‑cell Therapy program for adults — just the type of progress Julia would have wanted. The program meant the T‑cells could be collected from the patient here, then sent to the U.S. to be genetically engineered into CAR T‑cells. Those cells are returned to the hospital and injected back into the patient so they can target and attack the cancer. The challenge is that it’s only available for patients with a specific type of lymphoma and leukemia. Commercial CAR‑T therapy is also very expensive and time-consuming. The commercial cell manufacturing, testing, and shipping process can take up to eight weeks– time that many of the sickest patients don’t have.

What is a legacy gift or an estate gift?

Both terms refer to a donation to a charity made through your will or estate plans. These donations can take several forms, such as cash, securities, or even property.

That wasn’t good enough for people like Dr. Kekre – she wanted to develop a made-in-Canada solution. Today, she’s helping to lead a Canadian-first CAR T‑cell therapy clinical trial at our hospital. This opens the door to faster, less expensive, and more equitable CAR‑T treatment across Canada. It also provides a platform for the development of even better cellular immunotherapies that may work for more kinds of cancer. World-class research facilities at The Ottawa Hospital, such as the Biotherapeutics Manufacturing Centre, have played a key role in the development of this platform.

“It was amazing to get updates on the project because we found out that it was going to clinical trial and there were very positive early results,” says Holly. “And then I saw the first face of a trial participant — a man named Owen. Then I read Camille’s story. And that was an amazing one for me.”

A Canadian-first clinical trial gives lymphoma patient a third chance
CAR-T clinical trial provides ‘one last shot’ for leukemia patient

Making the connection

The impact of Julia’s forward thinking became even more personal when Holly had that chance meeting with a stranger in another hemisphere in February 2020. She and Lynne were both seeking adventure in Patagonia. For Holly, it was a big step — the first time she had travelled since Julia’s death. The two women bonded when they realized they had a special connection — Lynne’s daughter, Nicole Strickland, had been diagnosed with acute lymphoblastic leukemia in 2018 and treated at The Ottawa Hospital. 

“We had that common kind of understanding of seeing a loved one go through leukemia, the challenges, and a stem cell transplant,” explains Lynne. “But then when Nikki relapsed, I remembered Holly had mentioned Julia’s legacy had gone to funding research into CAR‑T.” 

Holly and Lynne in Patagonia.

Nicole was just 19 years old and in military college when she was diagnosed. At the time, she was stationed at CFB Petawawa for job experience with the helicopter squadron. She underwent chemotherapy treatment, but because her cancer was aggressive, her care team at The Ottawa Hospital recommended a stem cell transplant. Nicole’s sister was a 100% match. The stem cell transplant took place in September 2018, and then Nicole went into remission.

By the summer of 2021, Nicole was posted with a new unit in Halifax and getting routine blood work. That’s when she learned her cancer was back. But this time, she was introduced to immunotherapy, which she received in Halifax, followed by CAR‑T therapy — which meant returning to The Ottawa Hospital.

“There was a world of difference between CAR T‑cell therapy and the stem cell transplant,” explains Nicole. “I lost 40 pounds during the stem cell transplant. I couldn’t eat. I almost had to get a feeding tube at one point, which scared me. It took me about eight months to fully recover and then another year to get back into the gym. It was also mentally difficult. But with CAR‑T, I had energy, and my spirits were good. There were just a few days of feeling off and then I was back on my feet.”

How CAR T-cell therapy gave Nicole new hope

Nicole qualified for the Ontario CAR T‑cell Therapy program, which saw her T‑cells shipped to the U.S. to be genetically modified into CAR T‑cells. Once they were shipped back to The Ottawa Hospital, they were then infused into Nicole’s body.

“Unless you’ve been through what my family and I have been through, it’s hard to understand the depth that donating to a cause like that means. CAR-T gave me my life back — I’m just so grateful.”

– Nicole Strickland

Today, 18 months after her CAR‑T treatment, Nicole is now an operations officer and continuing her military career in Halifax and feeling stronger each day. She’s deeply grateful to people like Julia who had the forethought to invest in cancer research. “Unless you’ve been through what my family and I have been through, it’s hard to understand the depth that donating to a cause like that means. CAR‑T gave me my life back — I’m just so grateful.”

It’s those who support research that pave the way for patients like Nicole to have better outcomes. For Lynne, it’s also the work that’s came before breakthroughs like CAR-T that is just as important. “For Nikki’s care during the stem cell treatment, they had a plan, and that plan was because of the research and the investment made by others before CAR‑T was an option. It’s about bringing forth solutions that save not just one person’s life, but their whole family,” says Lynne.

Nicole Strickland was diagnosed with acute lymphoblastic leukemia in 2018.

“It’s about bringing forth solutions that save not just one person's life, but their whole family.”

– Lynne Strickland

For Holly to make that personal connection with Lynne and to see someone as young as Nicole have success is not something she ever expected. “As a donor, somebody who invests in research, I never expected to see any transformation in my lifetime. I’m willing to wait and be patient. But I never expected to see actual change to medical practice in my lifetime. And never mind did I expect to see it just a few short years after my wife’s death.”

And so, Julia’s legacy continues today, not only through her three children Robin, Brandin, and Addison, but also through the research she helped fund — research that is changing the course of cancer care. The more faces Holly connects back to the research and the more stories of survival she learns about, the more she witnesses Julia live on. “When you think about a legacy and about what you leave for others and how you shape a world — how much more powerful can that be knowing that in some way you’ve given other people an extra shot at life?”

Download episode #84 of Pulse Podcast to hear Holly Wagg talk about Julia's life and legacy.

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Published: March 2023

The search for the silver bullet for sepsis has been decades in the making. However, The Ottawa Hospital is taking a big step forward in the next phase of a world-first clinical trial using stem cells in patients with septic shock — not so much a silver bullet, but a seed that could lead to future innovative treatment options and impact millions of patients. The hope is to not only save more lives but also improve the quality of life of those who do survive this devastating illness.

Sepsis is caused by our own body’s response to infection. When that infection spreads through the blood stream and over-activates the immune and coagulation systems, it can cause the heart and other organs to fail. Sepsis is associated with a death rate from 20% to 40% and upwards from that, depending on the patient. Survivors of this devastating condition often have their quality of life impacted and often for the long term. Sepsis knows no borders and impacts people globally.

What is Sepsis?

Sepsis occurs when the body has an extreme, life-threatening response to an infection. The infection includes bacteria that enter the blood stream, triggering a chain reaction during which the patient’s immune system response damages its own tissues, potentially leading to organ failure and death.

Dr. Lauralyn McIntyre is an intensive care unit (ICU) physician and senior scientist at The Ottawa Hospital, and it’s her care of critically ill patients that has motivated her research into sepsis. Over the years, she’s witnessed the debilitating impact it can have on patients and their families. “It’s why I’m doing this research. As researchers, we love science. We love posing questions and the thinking that goes with these questions, and we love the answering those scientific questions. But the main reason we’re doing research is to help patients,” says Dr. McIntyre. “If there’s some way we can just move that needle to help these patients and their families, that just means so much.”

The global impact of sepsis

Sepsis is recognized as a global health priority. It’s estimated there are 48.9 million cases of sepsis annually and 11 million sepsis-related deaths — those account for almost 20% of global deaths. It is also the leading cause of death among COVID-19 patients.

To put that in perspective, a study published in 2021 led by researchers at The Ottawa Hospital and ICES (Institute for Clinical Evaluative Sciences) showed that severe sepsis is linked with higher mortality, increased hospital readmission, and higher healthcare costs. In Ontario alone, sepsis related costs are estimated at $1 billion per year.

“It’s the complexity of the infection and the challenge that drew me to the research, but also knowing the potential to really help patients and see if we can make them better.”

– Dr. Lauralyn McIntyre

According to Dr. McIntyre, sepsis is the most common reason why patients are admitted to ICUs. “They account for about 20% of the cases in the ICU at our hospital. From a provincial glance, over a four-year period, there were 270,000 cases of patients that were admitted to hospitals in Ontario for infection — about 30% had the more severe form of sepsis, with infection plus organ failure which amounts to about 67,500 patients a year in Ontario alone – it’s staggering,” explains Dr. McIntyre.

These data are a key motivator to learn more about sepsis and how to treat it. “It’s the complexity of the infection and the challenge that drew me to the research, but also knowing the potential to help patients and see if we can make them better,” says Dr. McIntyre.

Putting a face to the impact of the infection

Ten years ago, sepsis changed the life of Christine Caron — a single, working mother with four children who, at the time, ranged in age from 15 to 24. Throughout the winter and spring of 2013, she hadn’t been feeling well. Then in late May, while playing tug-of-war with her four dogs, her left hand was accidentally nipped. “It wasn’t a serious bite, just a break in the skin. I had no redness or pain, so I washed it out and disinfected the area,” recalls Christine.

Four days later when Christine was at work, she realized she hadn’t gone to the bathroom all day — eventually she learned this was because her kidneys were shutting down. The following day, she set out for a morning run. “I was winded and had to walk home but felt better after a shower. Later that day, I had terrible stomach pain — like someone had punched me in the stomach — and felt disoriented. I went home and slept. My son woke me up at one point to say I was breathing funny, but I assured him I was fine and fell back to sleep. I was shocked when I woke up and realized how long I had been asleep,” says Christine.

Christine Caron is a survivor of sepsis.

She remembers feeling agitated and more symptoms developed, including sweating despite feeling cold and becoming very thirsty. She went to a local urgent care centre, but it was closed. “I had no idea how sick I was, and the thought of sitting in an emergency department was overwhelming. I decided if I wasn’t feeling better in the morning that I would go to the hospital then.” 

Later that night, while her children slept, she became very sick — flu-like symptoms as she describes it. “I lay on the bathroom floor, probably ‘till three in the morning. I thought about calling an ambulance, but I didn’t want to wake up my family,” says Christine. “I wasn’t thinking clearly. I now know this was delirium.”

The next morning, a friend took Christine to a local hospital. “I was dizzy, I could barely breathe. I handed my health card to the attending nurse and then I collapsed,” explains Christine.

Christine wouldn’t regain consciousness for a month. On June 13, she woke up at the Civic Campus of The Ottawa Hospital to learn the devastating news of what sepsis had done to her body. This was when she heard about septic shock for the first time. “I had bronchitis that progressed to walking pneumonia. It was this condition that compromised my immune system resulting in the reaction to the bacteria when I was nipped by my dog. It quickly escalated to septic shock.”

As it would turn out, the sepsis infection had caused irreparable damage. By June 22, Christine began a series of surgeries to amputate her legs, her left arm, and remove dead tissue from her remaining limb and her face — changing her life forever. Little did she know at the time, but this set her on a path of becoming a voice for sepsis survivors. By early July, she was released from the hospital and would learn a new way of life at our Rehabilitation Centre, where she learned to walk again and received support for PTSD. Today, Christine is an active advocate for sepsis survivors, awareness, and for research.

Moving the needle for sepsis treatment

For decades, there has been little progress in advancing specific treatment for sepsis, but world-first research at our hospital shows that a specific type of stem cells may be the key to helping balance out the body’s immune system to improve its response to sepsis. Laboratory studies and early clinical trial results were so promising that Dr. McIntyre’s research was awarded $2.3 million from the Canadian Institutes of Health Research and the Stem Cell Network to begin a larger trial. “Researchers around the world have spent decades trying to find new therapies for septic shock, but so far nothing has improved survival, nor the quality of life for survivors of this devastating illness,” says Dr. McIntyre. “We urgently need new treatments for septic shock and to test them in randomized controlled trials like this one.”

This injection of funds will allow the team to expand the trial to 10 centres across Canada to see whether the stem cells can reduce patients’ needs for organ support in the ICU.

For Dr. McIntyre, this research, which is a huge collaboration among hospital colleagues, including Drs. Duncan Stewart, Dean Fergusson, and Shirley Mei, as well as colleagues throughout Canada and abroad. It provides hope that years of dedication to this mysterious illness may finally move the needle forward for sepsis treatment. “These stem cells hold, in my opinion, immense therapeutic promise for the treatment of sepsis, because these cells act through many mechanisms that relate to sepsis. Not only do they recognize and ultimately kill the bugs causing the infection, but they also calm the immune and blood-clotting responses that our body has to the infection,” explains Dr. McIntyre.

“I see this trial as the very first beginning — it’s a little bud, and we’re just going to grow from it.”

– Dr. Lauralyn McIntyre

And while Dr. McIntyre says her research has shown these cells have other benefits, such as restoring energy to the tissues, and reducing vessel leakiness and the swelling that goes with it, treating sepsis is still an enormously complex problem. “We can’t expect that there’s a silver bullet that’s going to completely cure sepsis, but from what we have learned so far, these cells have the potential to make a real dent in the immense death from sepsis, and we hope will improve the quality of life for survivors of this devastating illness.”

Dr. Lauralyn McIntyre is an intensive care unit physician and senior scientist at The Ottawa Hospital.

The “little bud” that will grow into future sepsis research

This clinical trial is just the starting point to learn more about this deadly infection, and the results will help inform future trials. As the research advances, and more is learned about how the body responds to these cells during sepsis, it will help identify future patients that may have the most to benefit. “So, I see this trial as the very beginning — it’s a little bud and we’re just going to grow from it,” explains Dr. McIntyre.

The growth of this research has been cultivated by what Dr. McIntyre describes as a major collaborative team approach. It includes researchers, both basic and clinical, cell manufacturing experts, trainees, project managers, clinicians, and nurses, as well as patient and family partners, and sepsis survivors, like Christine, who is the lead patient partner. “Working with these patient partners has just been illuminating about post-sepsis survivorship. People like Christine have been so helpful in enabling us to understand the need to study more about the survivorship of these patients and their families, and the quality of that survival,” explains Dr. McIntyre.

“Sepsis took so much from me — it scarred me in so many ways. We need to advocate and educate because sepsis does not discriminate.”

– Christine Caron
Dr. Lauralyn McIntyre with Christine Caron, who is a lead patient partner in sepsis research.

There’s a mutual admiration between the two women, who have each seen sepsis through a very different lens. Christine is thrilled to have her voice heard and to see that needle move forward. “Dr. McIntyre’s research is phenomenal because a lot of patients come out with organ damage, and stem cell research could save so much for so many people. Wouldn’t it be so wonderful if it did?” Christine adds, “Sepsis took so much from me — it scarred me in so many ways. We need to advocate and educate because sepsis does not discriminate.”

“If there's something that we can do to reduce death and help how patients survive this immense illness, we’ve just got to go there.”

– Dr. Lauralyn McIntyre

And so, for Dr. McIntyre, it’s those faces she sees in the ICU and those like Christine, who work alongside her, that continue to motivate her with each step forward in the search for answers in this challenging puzzle of sepsis. “If there’s something that we can do to reduce death and help how patients survive this immense illness, we’ve just got to go there.”

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

Published: January 2023

In late 2019, Camille Leahy was excited about the future. She was ready to embark on a new work adventure after quitting her job of 17 years. However, that all changed in January 2020 when she started feeling unwell and was in a great deal of pain. Camille went to the emergency department closest to her home in Newmarket, knowing something just wasn’t right. The next day, she received a devastating diagnosis — acute lymphoblastic leukemia. It was the start of a rollercoaster journey that eventually led her to a Canadian-first CAR T-cell therapy clinical trial taking place at The Ottawa Hospital.

With barely any time to digest the news of her cancer diagnosis, the 35-year-old learned she needed to begin treatment right away. She was referred to Princess Margaret Hospital in Toronto and admitted as soon as a bed was available. “From there, I started a month of treatment that consisted of intense chemotherapy to get me into remission. The goal was to then continue maintenance therapy for a couple of years, which would include chemotherapy, steroids, and other medications,” explains Camille.

With this sudden diagnosis and the immediate requirement for treatment, it meant the single mom couldn’t start her new job — now she was also without employment. “At that point, we just had to worry about saving my life,” says Camille.

Shocking news after rounds of treatment

After 30 days in hospital and all set to go home, Camille received another blow. The treatment didn’t work, and there were still cancer cells lingering. Her medical team needed to try another option — and right away. This time, Camille was put on an immunotherapy drug known as blinatumomab. After a second consecutive month in hospital, away from her daughter, there was a glimmer of hope — she was in remission.

However, she also learned the cancer would keep returning, so her team recommended a stem cell transplant as her best option. “That was shocking news for me,” says Camille.

“About eight months post stem cell transplant, I woke up with some neck pain. I didn't think anything of it, but unfortunately, blood work showed that the cancer returned, and it was aggressive.”

– Camille Leahy

By July 2020, she had undergone the stem cell transplant and spent another month in hospital, but this time, the world was in the midst of the pandemic — that meant her family, including her daughter, couldn’t visit. Camille was eventually discharged, but another hurdle was around the corner. “About eight months post stem cell transplant, I woke up with some neck pain,” explains Camille. “I didn’t think anything of it, but unfortunately, blood work showed that the cancer returned, and it was aggressive.”

“Have you heard about CAR T-cell therapy?”

It was now March 2021, and Camille was out of options. Her medical team recommended another chemotherapy protocol, but she just couldn’t do it. “When they started naming off the types of chemo involved, I broke down because it just sounded all too familiar to my first month, and that induction didn’t work,” recalls Camille. “Also, this time it was during a pandemic. At least when I was diagnosed in January, I had all my family and all my friends visiting every day. But this time around, I wasn’t going to be able to see my daughter, I wasn’t going to be able to have my friends and family as often as I wanted — maybe once a week. I just couldn’t do it without them, I wasn’t strong enough.”

That’s when she remembered CAR T-cell therapy had been mentioned at one point early on, so she asked her doctor about it. “I asked her, ‘Have you heard about CAR T-cell therapy?’ She confirmed there was a trial going on in Ottawa, and she decided to see if I would meet the criteria for it.”

Soon, Camille got the dose of good news she desperately needed – she was accepted into the trial, and she soon met Dr. Natasha Kekre, the principal investigator.

Dr. Natasha Kekre,hematologist for The Ottawa Hospital's Blood and Marrow Transplant Program.

Read our Q&A with Dr. Natasha Kekre

First made-in-Canada CAR T-cell therapy for cancer shows promise

More than a dozen people with cancer who had exhausted all treatment options are alive and cancer free today thanks to a pioneering, Canadian-first clinical trial. It uses a highly personalized kind of immunotherapy to help the patient’s T-cells recognize and kill their cancer. The results to date could open the door to a new era of made-in-Canada immunotherapies for cancer.

Patients in the trial, like Camille, have their immune cells (T-cells) removed and genetically engineered in a lab with a disarmed virus to produce synthetic molecules called “chimeric antigen receptors” (CAR). These new supercharged CAR T-cells, with their enhanced cancer-killing ability, are then infused back into the same patient.

What is the difference between a T‑cell and a CAR T‑cell?

T‑cells are a type of white blood cell, which play a critical role in the immune system. Originating in the bone marrow and maturing in the thymus — a small gland in the chest that’s part of the lymphatic system — T‑cells focus on attacking specific foreign particles, including bacteria, viruses, and other microbes.

CAR T‑cells are T‑cells that have been modified in a lab to fight cancer cells. First, T‑cells are removed from the patient, then they’re engineered to produce proteins on their surface called “chimeric antigen receptors,” or CARs. These proteins help the cells recognize and bind to proteins on the surface of cancer cells. Once engineered, the CAR T‑cells are reinfused into the patient to do their work.

While Health Canada has approved several commercial CAR T-cell therapies, access is currently restricted to people with just a few kinds of leukemia and lymphoma, and only if they fall into certain age ranges. Commercial CAR T-cell therapy is also very expensive and involves shipping cells to the United States and back.

This new trial is the first to manufacture CAR T-cell therapy in Canada. It uses a different kind of cell manufacturing that opens the door to less expensive and more equitable treatment.

“We’re very excited about the preliminary results of this trial, and we will be moving forward with new and exciting trials across Canada.”

– Dr. Natasha Kekre

“Canadian patients deserve access to the best cancer treatments in the world, and we need Canadian research to make this happen,” says Dr. Kekre, who, in addition to her leadership with this clinical trial is also a scientist and hematologist at The Ottawa Hospital. “We’re very excited about the preliminary results of this trial, and we will be moving forward with new and exciting trials across Canada.”

CAR-T trial provides one last shot

Camille’s cancer journey up until this point experienced many hurdles and that happened once again with the CAR-T clinical trial. During the first attempt, she was sent back home because she had a lung infection. By the second try, Camille was having some neurological symptoms that included her face going numb. “The medical team decided to investigate, and they did a lumbar puncture that showed the cancer had gone into my central nervous system and they hadn’t been able to detect that because there’s a blood-brain barrier. Again, I was sent home,” recalls Camille.

“Obviously when I was told that this was my last shot I was terrified. I knew there were risks, but my options were limited. I took a chance, but I also know how passionate Dr. Kekre is about this trial. I did a lot of research about CAR-T and how effective it was.”

– Camille Leahy
Camille with her daughter, Michela.

She would have to endure lumbar punctures twice weekly with chemotherapy to clear the cancer from the central nervous system — something Camille describes as “awful”, but she didn’t give up.

Finally, Camille got the green light for a third trip to Ottawa, but the day before she spiked a fever. She remembers telling her family, “I know that there’s a chance I might not be able to do it, but I’m going anyway.” Somehow, the fever cleared and finally the team was able to go ahead with the cell collection.

Two weeks later, on September 15, 2021, she had the CAR T-cells reinfused into her body — reprogrammed to now be able to recognize the cancer cells and kill them.

Camille and her daughter waited to see if, finally, they would get good news. “Obviously when I was told that this was my last shot, I was terrified,” explains Camille. “I knew there were risks, but my options were limited. I took a chance, but I also know how passionate Dr. Kekre is about this trial. I did a lot of research about CAR-T and how effective it was.”

Immunotherapy research changes lives

It has been a long and challenging journey for Camille, but she is truly grateful to the entire team at our hospital who were ready to care for her when she had run out of treatment options. It wasn’t until one year after Camille’s CAR T- cell treatment that she really started to believe she could get better. After so many hurdles during this cancer journey, she knew it would take time and wanted to give it a year.

By September 15, 2022, she felt like a new person, and was cancer-free. “I’m back to driving, I’m back to feeling as normal as I can. Obviously, there’s always the fear, but I couldn’t walk last year. I was using a cane and a walker. I struggled a lot. But this trial changed my life.”

“Even if the cancer comes back, this has given me precious time, and I know the research will help many others. It has given me a fighting chance.”

– Camille Leahy

As Camille and her daughter, Michela, are back to doing the mother-daughter things they love, Camille is also advocating for the research that saved her life with the end goal of giving more patients hope. She wants to make sure CAR T-cell therapy is available to others who face an uncertain future like she did. “For it to become more widely available in Canada would be incredible. The research team at The Ottawa Hospital made it possible for me to have this treatment done here in Canada. I didn’t have to raise money to try and leave the country to go get CAR T-cell treatment in the United States. My goal now is to tell my story so that they can continue to do this in Canada and can become more available to everyone here.”

Today, at age 38, Camille is easing back into life and thinking about the future. When her immune system is strong enough, she hopes to return to work. Right now, she enjoys the precious time and memories she’s been given the opportunity to make with her daughter, like driving her to school, taking her to baseball games, and watching her play soccer — moments she doesn’t take for granted. “Even if the cancer comes back, this has given me precious time, and I know the research will help many others. It has given me a fighting chance.”

Download episode #75 of Pulse Podcast to hear Camille talk about why she’s become an advocate for cancer research.

Listen Now:

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