Category: Research

When Owen Snider faced the news that his lymphoma had returned for the third time in ten years, he knew his options were running out. But a transformational new treatment known as CAR-T therapy gave him renewed hope. The Ottawa Hospital was recruiting patients for a clinical trial investigating a made-in-Canada approach to this cutting-edge treatment. He just needed to qualify for the trial.

In 2010, Owen was diagnosed with large B-cell lymphoma. In his early 60s at the time, he went through a chemotherapy treatment known as R-CHOP. For most people, it lasts 18 weeks. “It was a rigorous treatment. I got through it okay and was six years clear, but then it came back — the lymphoma returned in 2016,” says Owen.

When the cancer returned, his care team at The Ottawa Hospital vetted him for a stem cell transplant. By the summer of that year, he went through what he called an intensive program using his own stem cells. A high dose of chemotherapy was used to remove harmful immune cells in preparation for the transplant of his own healthy cells. “It’s pretty brutal, and after two or three months of wishing maybe I wasn’t around, things improved. I was clear for another four years.”

“I was given five or six months to live. My wife and I were downhearted with that news.”

— Owen Snider

Lymphoma returns for a third time

Following his stem cell transplant, Owen remained healthy for four years, enjoying retirement at his home in a beautiful, wooded area near Calabogie, where he lives with his wife, Judith Snider. But then Owen faced his biggest challenge yet when the lymphoma returned — again. This time, the diagnosis came in May 2020, in the midst of the pandemic. “I remember my oncologist saying they’ve done pretty much everything they could. I was given five or six months to live. My wife and I were downhearted with that news. I was basically going to be kept as comfortable as possible for six months,” remembers Owen.

Judith and Owen Snider kayaking.
Judith and Owen Snider kayaking.

However, one week later Owen received a lifeline. His oncologist called to say a CAR-T therapy clinical trial had opened at The Ottawa Hospital — a Canadian first. They wanted to see if he would be a good candidate. Throughout June of 2020, he went through a battery of tests and scans to see if he qualified for the trial.

“This type of immunotherapy research is groundbreaking, and it’s never been done in Canada before.”

– Dr. Natasha Kekre

By mid-June, Owen got the green light. He was a candidate for the clinical trial, and didn’t hesitate to enroll. “I either participate in the trial or I lie around here for four or five months waiting for the end. Which choice would you have made? The positive way to put it is that I was very excited to be a part of the trial. We’re the kind of people where the glass is always half-full,” explains Owen.

What is CAR-T therapy?

CAR T-cell therapy is a type of immune therapy that is an emerging biotherapeutic treatment that harnesses the power of a patient’s own immune cells, known as T-cells, to treat their cancer. T-cells play a critical role by killing abnormal cells, such as cells infected by germs or cancer cells. In some cancers, like lymphoma or leukemia, cancerous cells become invisible to the T-cells that are meant to kill them. In CAR-T therapy, the T-cells are collected and reprogrammed in the lab to recognize and destroy the cancerous cells.

Dr. Natasha Kekre is a hematologist and associate scientist at The Ottawa Hospital.
Dr. Natasha Kekre

Dr. Natasha Kekre is a hematologist and associate scientist at The Ottawa Hospital. She is leading the development of Canada’s first CAR-T research platform in collaboration with the BC Cancer Centre. “This type of immunotherapy research is groundbreaking, and it’s never been done in Canada before. This is a therapy that uses a patient’s own immune system. It’s personalized medicine — it’s very individualized to each patient,” explains Dr. Kekre.

The Ottawa Hospital is one of the first hospitals in Canada to participate in nationally-led CAR-T trials and as one of Canada’s top research and treatment centres, the hospital is ideally positioned to play a lead role in bringing an innovative CAR-T research program to Canada, and to Canadian patients.

Going for the Pac-Man effect

In late June 2020, Owen went through apheresis which is the process of withdrawing the T-cells in his blood. “They put an IV in my right arm, and ran the tubing through the machine, and the machine processes the blood and pumps it back through the tubing into my other arm. I lay there on the bed for three or four hours, without moving I should add.”

“It’s just like Pac-Man, the modified T-cells ran around in my blood stream, chomping away at the lymphoma.”

– Owen Snider

Those T-cells were then sent to a lab in BC, re-programmed, and then returned to our hospital two weeks later. Then the T-cells were re-administered just like a blood transfusion. “It allows for that new immune therapy in these cells to go and find the patient’s cancer cells, attack them, and kill them. And it also stimulates the immune system in that patient to further go attack and fight their cancer,” explains Dr. Kekre.

On July 2, Owen received a PICC line and then went through three days of chemotherapy. Four days later he was re-injected with his T-cells and they got to work. “It’s just like Pac-Man, the modified T-cells ran around in my bloodstream, chomping away at the lymphoma.”

His re-programmed T-cells were specifically looking for cancer cells to kill. Owen would need to wait to find out if it was working.

Owen Snider, seen at home, was treated for lymphoma as part of a CAR-T clinical trial.
Owen Snider

Did the CAR T-cells therapy work?

One month later, Owen and Judith received some exceptional news. “At my check-up 30 days after getting my T-cells back, I was almost clear of cancer. The scan showed that there was almost nothing left. I was gobsmacked,” he says.

By the three-month mark, Owen says he was as “clean as a whistle.” Eighteen months later, there is still no sign of lymphoma.

For Dr. Kekre, giving patients like Owen new hope for the future is what inspires her. “For the first time, I think in a long time, Owen felt that the lymphoma might actually be disappearing. He’s had multiple scans since then that show the same thing. And so now, I think he’s starting to believe it. And I think that’s the reality of why I do this, because patients like him who had no options before, could soon have the option of CAR-T therapy. That’s what happened for Owen and that’s what we hope will happen for many more patients,” says Dr. Kekre.

Dr. Natasha Kekre and Owen Snider. Owen was treated for lymphoma as part of a CAR-T clinical trial at The Ottawa Hospital.
Dr. Natasha Kekre and Owen Snider. Owen was treated for lymphoma as part of a CAR-T clinical trial.

What’s next for the clinical trial?

Dr. Kekre and her team are monitoring all patients enrolled in the trial and expect to publish the results sometime in 2022. The purpose of the clinical trial is to provide proof to Health Canada this therapy is safe. “The reality is that we have a data safety monitoring board, which watches for the safety of the trial, and they’ve had no concerns. So, from a safety point of view, we’re very happy with the trial. And that’s why we are still open and we’re still able to enroll more patients,” explains Dr. Kekre.

Why is The Ottawa Hospital unique in its CAR-T therapy?

CAR-T therapy needs to be individually manufactured for each patient using the patient’s own cells combined with large amounts of highly pure virus to deliver the CAR gene. The Ottawa Hospital’s Biotherapeutics Manufacturing Centre is ideally positioned to manufacture the clinical grade virus needed to create CAR T-cells for clinical trials. In fact, we have the only facility in Canada that has produced this kind of virus for clinical trials.

The hope is that one-day CAR T-cell therapy may also be a treatment for a variety of cancers. “The world is watching us,” explains Dr. Kekre. “We’ve had a lot of attention from Denmark, and a few other European countries are reaching out. They believe in a system similar to ours, where patients all have the right to access healthcare. If CAR-T cells are here to stay, they have to be done in a sustainable approach for our patients. And that’s a big part of what we are building — this is only the beginning. And that’s what people are looking at us to see how we do it.”

“Without philanthropy, we wouldn’t have a Biotherapeutics Manufacturing Centre or a Methods Centre at The Ottawa Hospital, and we wouldn’t be able to do innovative clinical trials like this.”

– Dr. Natasha Kekre

This made-in-Canada CAR T-cell research platform will give Canadian patients more access to innovative clinical trials. “Canadian cancer patients shouldn’t have to wait for the research to be done elsewhere but be able to participate in innovative clinical trials here at home,” says Dr. Kekre.

Grateful for each day and philanthropic support for research

Today, Owen appreciates each day and a good quality of life thanks to the clinical trial. He feels strong and can’t wait for the day when he and Judith can travel again — grateful for the lifesaving research. “It was an honour and a privilege to be chosen for the trial.”

He also credits the extraordinary care team and those special moments when he visited the hospital. “I can tell you that I always felt more than comfortable. I felt encouraged by anyone I met. The team on 5 West as we know it, is wonderful. I had an occasion to go back there this spring, and it was like walking back into Cheers — everybody knows your name.”

As a longtime supporter of The Ottawa Hospital, and to see philanthropy play an important role in making this clinical trial a reality, he’s an even bigger advocate for encouraging support for our hospital. “All I can say is that the core funding of hospitals doesn’t provide for some of the innovative and cutting-edge things that go on, or maybe some really specialized piece of equipment. And that’s where the community donor can help and contribute to that effort.”

Owen and Judith Snider. Owen was accepted into a made-in-Canada CAR-T therapy clinical trial at The Ottawa Hospital to treat his lymphoma.
Owen and Judith Snider.

For Dr. Kekre, philanthropy provides the spark for clinical trials like this, and can help to keep them moving forward. “Without philanthropy, we wouldn’t have a Biotherapeutics Manufacturing Centre or a Methods Centre at The Ottawa Hospital, and we wouldn’t be able to do innovative clinical trials like this. We need this kind of research to get to a place where all Canadians can benefit from these therapies. Without philanthropy, we would never get there.”

And to Dr. Kekre, her team, and their collective efforts to give more patients hope, Owen has a simple message: “Thank you. The whole program is outstanding.”

About the Canadian-Led Immunotherapies in Cancer (CLIC) research program

The CLIC research program, established in 2016, brings researchers, clinicians and patients from across Canada together to build Canadian expertise and capacity for innovation in the promising field of cellular immunotherapy for cancer, including CAR-T therapy. The first CLIC clinical trial launched in 2019 at The Ottawa Hospital and at BC Cancer, with support from BioCanRx, BC Cancer, The Ottawa Hospital Foundation and the Ontario Institute for Cancer Research. Core facilities and resources supporting CLIC include The Ottawa Hospital’s Biotherapeutics Manufacturing Centre, BC Cancer’s Conconi Family Immunotherapy Lab, the Ottawa Methods Centre and the Blueprint Translational Research Group. CLIC team investigators include Drs. Natasha Kekre, Harold Atkins, John Bell, Kevin Hay, Rob Holt, Brad Nelson, John Webb, Manoj Lalu, Kednapa Thavorn, Dean Fergusson, Justin Presseau and Jen Quizi.

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

For decades, Paula Helmer’s lovely voice carried through the alto sections of several Ottawa choirs. But even after her death following a battle with breast cancer, Paula is still managing to be heard — maybe not through song, but through science.

“That’s what Paula was hoping for from all these clinical trials,” says Jeff Christie, Paula’s husband, “that it would move medical science forward.”

“That’s what Paula was hoping for from all these clinical trials, that it would move medical science forward.”

—Jeff Christie

Jeff and Paula met in university, both studying economics at the University of Waterloo, and both moving to Ottawa, Paula’s hometown, to work for the federal government in fulfilling careers that would span decades. All the while, Paula continued her passion for choral singing, with St. Timothy’s Presbyterian Church and the Ottawa Choral Society. But Jeff says it was family life that centred everything — children, grandchildren, travel, and the family cottage.

Paula (back row, fourth from right) in 2005 with members of the Ottawa Choral Society.

“Five years into retired life, it was discovered that Paula had cancer,” Jeff recalls.

It was a deadly form of breast cancer that had metastasized in her spine and was causing her considerable discomfort. Surgery removed the tumour but couldn’t eradicate the cancer, nor control the pain. That’s when Paula was introduced to Dr. Mark Clemons, a medical oncologist with The Ottawa Hospital.

“We came up with a multipronged plan to not only improve (Paula’s) pain,” Dr. Clemons explains, “but to get her disease back under control.”

“It was patently clear from the first meeting,” says Jeff, “that Dr. Clemons was very capable, competent, and wise. He gained our confidence the first time we met and the treatments he was suggesting for her, they were always so successful. How could you not love the guy?”

A passion to participate in clinical trials

Dr. Clemons is also the lead behind The Ottawa Hospital’s REaCT Program or Rethinking Clinical Trials, launched in 2014 with Dr. Dean Fergusson, senior scientist and Director of Clinical Epidemiology Program, and others. The aim of REaCT is to make enrollment in clinical trials easier, by involving cancer patients and their families every step of the way. Typically, only 3% of patients are involved in trials but with REaCT, that number is closer to 90% since the studies don’t involve extra visits or additional tests. Paula began participating in a series of clinical trials aimed at helping her, but also aimed at improving treatment options for future generations. Jeff says that was her driving ambition.

What is the REaCT Program?

The aim of the REaCT (ReThinking Clinical Trials) program is to make enrollment in clinical trials easier, by involving patients and their families every step of the way.

Learn More

“Paula played an important role in advancing the treatment of patients across the world.”

— Dr. Mark Clemons

“It was really important to her, to both of us,” he says. “There are more treatments out there we haven’t found yet and we are going to find them through clinical trials. If you don’t participate, nobody gets the new treatments.”

Empowered and making an impact

More importantly, Jeff says, Paula’s participation in these clinical trials gave her a voice and made her an active participant in her treatment.

“Paula was always left with the impression that she was in the driver’s seat right beside Dr. Clemons. They listened to her, believed her.”

Dr. Clemons explains that one of the many clinical trials Paula participated in involved looking at how often bone agents should be given for patients with metastatic breast cancer. Traditionally, the treatment is delivered as an injection every four weeks, requiring patients to come to the hospital and spend prolonged periods away from home.

“Paula had a driving ambition to not only improve her own prognosis but also help with the knowledge being gained for future patients.”

— Dr. Mark Clemons

“Because of Paula and many other patients involved,” says Dr. Clemons, “we were able to do a trial that showed that an injection every 12 weeks was just as effective and was associated with fewer side effects.” It also added to Paula’s quality of life, allowing the couple to continue to visit the cottage and travel in between those 12-week injections.

“That was a great thing,” says Jeff. “The care we got was supportive of our lifestyle. It allowed us to travel as we had hoped to.”

Paula’s participation in a REaCT trial added to her quality of life, allowing her to continue to visit the cottage and travel with her husband, Jeff, in between 12-week injections.

Paula’s legacy lives on

Sadly, Paula lost her fight against cancer on February 18, 2021. But Jeff is continuing her work, spreading the word about REaCT among friends and colleagues, raising funds to support this critical work that is helping to shape better treatment options for cancer patients around the world.

“I’ve spoken about REaCT in my social circles,” Jeff explains. “I mentioned Paula has participated in at least dozens of clinical trials and benefited from them.”

“It’s fantastic that Jeff is continuing Paula’s legacy,” says Dr. Clemons. “Paula played an important role in advancing the treatment of patients across the world.”

It’s a role that she embraced with the same fervor she approached everything she did in life, whether as an economist, a wife, a mother, and yes, even a singer.

“There are more treatments out there we haven’t found yet and they are going to find them through clinical trials.”

— Jeff Christie

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

Darlene Kulig is an award-winning artist whose paintings are described as bold, joyous, and eye-catching. Born in Ottawa, Darlene now calls Toronto home and brings uniquely Canadian landmarks and landscapes to life through her semi abstracted, spirited art.

When Darlene’s nephew, Craig, passed away in 2016 at the age of 23 from a rare form of cancer, it was a devastating loss for her family. Craig’s father, Bruce Kulig, wanted to do something to keep his son’s memory alive, so he created a fundraising campaign — the Craig Kulig Memorial Fund with The Ottawa Hospital. When Darlene learned about the campaign, she wanted to use her art to have an impact.

Darlene began selling card sets featuring her art, with proceeds donated to our hospital. When the pandemic hit, her campaign took a different twist. She created beautiful masks, and once again a portion of the sales would support the memorial fund.

Darlene in her studio.

Today, Craig’s memory lives on through the countless people who have supported his memorial fund and the impact their philanthropy is having on cancer research. The research will help other patients and their families – just as Craig’s family had hoped.

Q: What inspired you to fundraise for The Ottawa Hospital?

A: In 2016, we lost our dear nephew Craig Kulig, at the age of 23, to an aggressive form of rare cancer. Craig received wonderful and compassionate care from the team of doctors and nurses at The Ottawa Hospital. Since Craig’s passing, it has been my brother Bruce’s goal to raise $100,000 in Craig’s memory.

As an artist and an aunt processing through my grief journey, I felt compelled to create a painting in memory of Craig. I painted Dragonfly Ascending into Twilight which depicts Granite Lake where Craig spent his youth. We donated the large giclee print of this meaningful painting and it now hangs in the oncology department at the hospital.

A memorial for Craig Kulig, funds are raised in his memory for cancer care and research at The Ottawa Hospital.
A memorial for Craig Kulig at Granite Lake with candle houses created by Craig’s sister Katrina.

Q: What is your fundraising all about?

A: Early in the pandemic, I was approached by BYOM, a mask manufacturer, to have my Canadian Landscape paintings printed as fine art face masks. Each artist that was approached was asked to align with a charity, so we created a beautiful line of adult and children’s face masks with all proceeds going to The Craig Kulig Memorial Fund. To date, we have raised over $16,000 through the sale of these masks. We also introduced a beautiful 2022 wall calendar and holiday boxed card sets featuring my art.

Darlene wearing one of her beautiful masks that she sells to raise funds in support of cancer care and research at The Ottawa Hospital.

“As an artist and an aunt processing through my grief journey, I felt compelled to create a painting in memory of Craig.”

— Darlene Kulig

Q: How easy was it to set up a community fundraising event through our Foundation?

A: My brother Bruce set up The Craig Kulig Memorial Fund through The Ottawa Hospital Foundation. It has been a great experience working with their team to promote our masks, continue to raise money for Craig’s fund, and raise awareness for the leading research that is taking place at The Ottawa Hospital.

Q: What might you tell someone who is thinking about donating to The Ottawa Hospital?

A: I believe our fundraising efforts are going to make a difference. It is our hope that other individuals and families can and will have better outcomes. This takes time and much-needed donations. The Ottawa Hospital is a leading research centre that we are proud to be partnered with.

For months, Mina King had been dealing with painful leg ulcers caused by atherosclerosis, a condition that restricts blood flow and can result in amputation if left untreated. As a lifelong musician, this prognosis would mean more than losing her legs, it would jeopardize her ability to play the piano — one of her greatest passions. But, a cutting-edge surgery technique at The Ottawa Hospital, the collaboration of our experts at the Limb Preservation Clinic (LPC), and ongoing virtual care to monitor her healing, kept Mina from missing a beat.

Ulcers: A persistent problem

When Mina first developed sores on both of her legs, she hoped they would eventually go away with time and care. But after almost a year and a half of appointments and regular monitoring at the LPC, things weren’t heading in the right direction.

“Bypass surgeries are very complex and take several hours to complete. Not every hospital is able to perform these surgeries because they’re so technically demanding, and the vessels are so small, but The Ottawa Hospital does more of these intricate procedures than any other hospital in Ontario.”

— Dr. Sudhir Nagpal

“Even though I was getting treated for my leg ulcers, they didn’t improve in size or seem to get any better. And they were painful too,” says Mina, an 89 year old retired music teacher and lifelong musician.

Mina Jean King pictured with her husband, Stan, was treated for atherosclerosis at The Ottawa Hospital.
Mina with her husband, Stan.

Mina’s ulcers were caused by atherosclerosis, a condition where an artery’s blood circulation is slowed because of plaque buildup. While the condition is commonly caused by diabetes, it can also develop with age. Without medical attention, the ulcers can worsen, causing infections or risk of losing a limb.

“If Mina’s leg ulcers worsened, we would have to amputate her legs to save her life,” says Dr. Sudhir Nagpal, division chief of vascular surgery at The Ottawa Hospital and surgeon in Mina’s care. While it would save her life, a double amputation would mean Mina could no longer use the foot pedals of her piano — which she plays every day. “It’s been the strength of my life to be able to play the piano,” says Mina. “I knew something would have to be done.”

After a CT scan in 2020 revealed blood clots had formed in both of Mina’s legs, her care team decided it was time to take action.

Bypassing the blockage

Illustration of a leg bypass
Leg bypass illustration: as arterial blockage worsens, a graft is needed to increase bloodflow to the lower limbs.

Luckily, Mina’s ulcers hadn’t progressed to the point where she needed full amputations and surgery was still a viable option.

In August 2020, surgeons and interventional radiologists at our hospital were able to perform a minimally invasive surgery on her right leg, placing a stent in the artery, to improve blood flow and keep the artery open. However, this approach didn’t work for her other leg.

To get blood flowing in her left leg, surgeons performed a complex leg artery bypass surgery, rerouting her blood supply around the blocked artery with a graft – like a road detour. During Mina’s nearly five hour procedure, a team of highly-skilled experts in vascular surgery used magnifying glasses to carefully connect Mina’s vein around the blocked artery, above and below the obstruction, to create a new route for blood to flow.

Thankfully, Mina had access to this specialized surgical technique at our hospital — a procedure not available everywhere.

“Bypass surgeries are very complex and take several hours to complete. Not every hospital is able to perform these surgeries because they’re so technically demanding, and the vessels are so small, but The Ottawa Hospital does more of these intricate procedures than any other hospital in Ontario,” says Dr. Nagpal.

Identifying a safer anesthesia option – thanks to research

At the time of Mina’s surgery, our researchers had just wrapped up a study on anesthesia and leg artery bypass surgery. The study, which was published in The British Medical Journal in November 2020, showed that patients who had surgery to improve blood flow in their legs fared better and were able to leave the hospital earlier if they had lighter forms of anesthesia, such as epidural anesthesia, that don’t require a breathing tube.

Dr. Sudhir Nagpal The Ottawa Hospital
Dr. Sudhir Nagpal, division chief of vascular surgery at The Ottawa Hospital.

“We’re able to provide excellent, nation-leading clinical care because of the experts we have access to and the research happening right here in the clinic at The Ottawa Hospital.”

— Dr. Sudhir Nagpal

Because Mina’s surgeons had early access to the study’s results at the time of her procedure, they were able to recommend that she opt for the epidural anesthesia. “They asked me what kind of anesthesia I wanted to have and described the different ones but suggested that being 89, it would be safer to get the epidural,” says Mina. “And it all went really smoothly.”

According to Dr. Nagpal, having this research happening under our roof is critical. “Mina was able to benefit from some of the research we’re doing and have a better outcome.”

Access to world-class care

Despite the complexity, Mina’s surgeries were a success. But her path back to the piano wasn’t over yet. One week after her surgery, Mina was discharged to continue her recovery at home with the help of virtual care through the LPC.

The clinic, which began as a pilot project several years ago, brings together care providers from across our hospital with expertise in lower-body wounds. While in the clinic’s care, patients like Mina have access to experts in vascular surgery, wound care, plastic surgery, infection prevention and control, orthopedics, chiropody, and more. The model of care means that patients can access the experts they need without long delays. In fact, it’s a model that hospitals across the country are looking to follow.

“The collaboration between multiple different skill sets and specialties all in one place is what really separates our Limb Preservation Clinic from others like it in Canada,” explains Dr. Nagpal. “We’re able to provide excellent, world-class clinical care because of the experts we have access to and the research happening right here in the clinic at The Ottawa Hospital.”

Mina, with her family, had leg artery bypass surgery at The Ottawa Hospital.
Mina with son David, daughter Jennifer, and husband Stan.

Mina’s care team tracked the progress of her ulcers through a wound care software called how2trak. With the help of an at-home nurse who made weekly visits to Mina’s home following her surgery, photos of Mina’s leg wounds were uploaded into the software and analyzed by her care team to determine if the wound was getting better or worse over time.

“Through this software, we’re able to see that Mina’s ulcers have gone from being fairly large in size to the point where they’re almost healed,” says Dr. Nagpal. “We can do all this while she’s in the comfort of her home.”

Back at the piano

As Mina’s condition improved, her visits with the at-home nurse and experts in the LPC became less frequent. “I feel quite happy about the way things have gone. I don’t have pain now,” says Mina. “Dr. Nagpal was an excellent doctor.”

“It’s been the strength of my life to be able to play the piano.”

— Mina King

Now, with her ulcers nearly healed and access to the expertise of her care team just a virtual call away, Mina is back to her routine of playing the piano every day — without worry.

“I was very glad to get back home and get back to my piano. I think it was one of the things that helped me recover so quickly,” she says. “When I get tired, or anything’s bothering me, I sit down at the piano and it seems to just take it all away.”

Fièrement affilié à l’Université d’Ottawa, L’Hôpital d’Ottawa est un centre de recherche et de santé universitaire de premier plan.

When COVID-19 moved into the Ottawa region in March of 2020, we were in uncharted territory. However, despite the rapidly changing information in the early days, and the unknowns about this virus, something very clear began to emerge – unity. The community would soon show an outpouring of support for The Ottawa Hospital while healthcare teams rallied together to care for patients.

“Thank you to our generous donors – some who reached out for the first time.”
– Tim Kluke

As our front-line workers would go into the hospital each day to face the virus head-on, the community stayed home to help flatten the curve. Nevertheless, it became obvious residents wanted to do more – and they did. Donations both big and small began streaming in and the COVID-19 Emergency Response Fund was created. To date, more than $2 million has been generously donated to support our hospital’s COVID-19 efforts and these donations have already been put to work. Tim Kluke, President and CEO of The Ottawa Hospital Foundation, says this support has made a world of a difference supporting both research and care projects. “This proves once again that we really are stronger when we pull together. Thank you to our generous donors – some of whom have even reached out for the first time. Research currently underway will allow us to better understand and treat the virus, to keep our patients and our community safe.” Donations continue to be accepted today.

Personal Protective Equipment (PPE) was another way our community lent a helping hand. The Ottawa Chinese Community quickly mobilized and raised over $120,000 to purchase necessary equipment like ventilators and PPE for our staff.

In Their Own Words: Good Days, Bad Days, and What Keeps Them Coming Back

Stepping into the unknown

While the community united to show their support for our front-line workers, a COVID-19 floor was created at both the General and Civic Campuses to care for the patients who tested positive for the virus. The team at the General Campus that had originally cared for Thoracic, ENT (Ear, Nose, and Throat), and surgical patients would, almost overnight, become the team caring for COVID-19 patients. Little did they know at the time, they would be caring for these patients for well over a year. “We have a background in lungs and breathing issues on our unit, so we were a natural fit to care for these patients,” says Vanessa Large, a registered nurse at our hospital for the past four years.

Vanessa Large, Kristine Belmore, and Leah Mills worked on the “COVID floor” in 2020. Pictured above wearing personal protective equipment (Image 1) and without (Image 2).

Nevertheless, it was a daunting and draining task. Kristine Belmore is a registered nurse who has been at our hospital for 11 years and never did she imagine her career taking this step. “I was working the day the first positive patients came in. We were constantly getting new updates on protocols for caring for these patients – not just daily but during our shifts,” says Belmore. She adds, “It was the equivalent of how I felt when I was a new nurse preparing for a shift — I didn’t sleep well. I was anxious and there was the fear of the unknown.”

Leah Mills was just three years into her career as a registered nurse when she found herself caring for COVID-19 patients. “There was no easing into the COVID transition; it turned our world upside down,” says Leah.

Resilience as weeks turn into months

Dr. Samantha Halman helps a COVID-19 patient communicate with their loved ones via an iPad.
Dr. Samantha Halman helps a patient communicate with their loved ones via an iPad.

In those early weeks of caring for patients, there was the struggle of watching some patients go from appearing stable to suddenly clinging to life. Those days would take an emotional toll on these nurses. “The increase in demand during the surge of patients was overwhelming. Over time it became easier because we had concrete policies in place and we started recognizing a pattern in patient’s decline,” recalls Leah.

“We became their only sources of human connection, we became their second family. We would be there holding an iPad so they could see the friendly smile of a loved one – sometimes it was to say goodbye.” – Vanessa Large

The playbook had to be reinvented and new ideas had to be considered to help calm patients when they struggled to breathe or feared what might happen next. Then there were the layers of PPE, which created an additional level of safety but also a new challenge. “Caring for patients, especially the elderly who can be confused, was difficult because they can’t see your facial expressions – we had to find new ways to reassure patients when they were scared. We also became the link between the patient and the family, through phone calls and video calls – something we’ve never done before,” says Kristine.

Vanessa agrees adding, “We became their only sources of human connection, we became their second family. We would be there holding an iPad so they could see the friendly smile of a loved one – sometimes it was to say goodbye.”

Mentally and emotionally, the long haul of this pandemic started to wear on these nurses. Leah explains they’re used to helping patients heal and get better. “We’re feeling burned out and exhausted seeing patients decline quickly and sometimes die. It’s not what I’ve been used to in my role.”

Thankfully, over the past year, this dedicated care team has helped ensure the majority of COVID-19 patients have been able to regain their health and return home to their loved ones.

The nurses of the “COVID floor”

“Working on the COVID-19 Unit, with the numbers going up and down, you never know which point is going to be the tipping point.”
— Leah
“The best part about starting on the COVID-19 Unit was the team. Everyone was very supportive, willing to teach the newbies on the unit. And, the patients especially, they were very accommodating, and I will remember them for a long time to come.”
— Margaret
“My worst part of this year was seeing a lot of suffering and not being able to help as much as I would want to.”
— Michael
“COVID-19 has taught me to really value and cherish the time that I had with my family, my friends, and my colleagues.”
— Jeannette

COVID-19 patient grateful for compassionate care

One of the patients, who experienced firsthand compassionate care on the COVID-19 floor, was Fr. Alex Michalopulos. The Greek Orthodox priest spent 10 days in our hospital. He couldn’t be more thankful to be feeling better today. “For the times when the doctors or nurses came in to see me, for the times when I was reassured—I’m thankful I was well taken care of with love and respect for human life.”

“I have a lot more respect for the medical professionals. I always had, but this time it was at a different level. They were there for me.” – Fr. Alex Michalopulos

Fr. Alex Michalopoulos was treated for COVID-19 at The Ottawa Hospital last year.
Father Alex Michalopoulos of the Greek Orthodox Church. Father Alex was treated for COVID-19 at The Ottawa Hospital last year.

As tears well up in his eyes, and he stops briefly to regain his emotions, Fr. Michalopulos says it’s sometimes good to be on the other side, to feel what others are going through. “I have a lot more respect for the medical professionals. I always had, but this time it was at a different level. They were there for me.”

He adds, “They held my hand. They showed compassion. They showed a lot of respect and love. I will be forever grateful for them.” It was that special touch, and care from complete strangers that helped give Fr. Michalopulos the strength to get back home to the family he loves and eventually to his parish family.

“I will always remember how I was treated by strangers. I admire them and will always pray for them.”

In an effort to do his part to help, Fr. Michalopulos is participating in research that is investigating the long-term effects of the virus. Drs. Sara J. Abdallah and Juthaporn Cowan are checking in on participating patients, like Fr. Michalopulos at three, six, and 12 months after they were initially infected.

He explains why it was important to become involved. “I thought it would be useful to help researchers understand the effects and lingering effects of the virus in gathering information to help create a vaccine and or a cure.”

Giving back through research

Researchers at our hospital have been deeply involved in the global race to combat COVID-19. They are exploring more than 60 research projects to support the worldwide effort to find better ways to treat and prevent the virus. A number of those projects have been supported by donors through the COVID-19 Emergency Response Fund, including a world-first clinical trial, led by Dr. Rebecca Auer, which aims to protect cancer patients from COVID-19 – to date, 22 patients, have been recruited.

Dr. John Bell is a senior scientist in the cancer therapeutics program at The Ottawa Hospital.
Dr. Carolina Ilkow is a scientist in the cancer therapeutics program at The Ottawa Hospital.

Drs. John Bell and Carolina Ilkow are harnessing their expertise in making cancer-fighting viruses to develop a vaccine against COVID-19 — a made-in-Canada solution. In addition, our Biotherapeutics Manufacturing Centre is helping to manufacture three other COVID vaccines for clinical trials, as well as an experimental stem cell therapy.

Pushing forward despite a challenging year

As research continues to produce more answers and vaccines continue to roll out across the region, the team caring for patients remains steadfast. “The vaccine brings us hope. I remember how exciting it was when I received mine,” says Kristine.

A nurse at The Ottawa Hospital administers the COVID vaccine to a healthcare worker.
Venus Lucero, a nurse at The Ottawa Hospital, administers the hospital’s first dose of the COVID vaccine.

There is hope someday they can start getting back to the way things used to be, or at least close to it. For Kristine, it would mean not worrying about hugging her children when she comes home from work.

For Leah, it would mean letting her mind shut off for the first time in a year – and truly relax. For Vanessa, it would mean the excitement of spending time with her fiancé, Colin – also a frontline worker – as they’ve been isolated from each other during the pandemic. Despite the challenges, each one takes great pride in the care they’ve been able to provide during these unprecedented times. And how they also helped each other along the way.

Check out Pulse Podcast to hear more about a year of working on the COVID floor.

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

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

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

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

Unusual symptoms continue to develop

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

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

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

— Dr. Carolyn Nessim
Bryde kayaking in Iceland with Natalie.
Bryde and Natalie kayaking in Iceland.

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

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

Pinpointing the cause

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

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

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

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

Most unusual pre-op visit

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

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

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

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

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

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

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

Finding the answers

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

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

— Dr. Neal Rowe

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

Expertise in pheochromocytomas

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

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

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

— Bryde Fresque

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

Moving forward, upwards, and giving back

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

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

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

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

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

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

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

Amidst exciting new updates from research projects supported in earlier rounds of funding from the COVID-19 Emergency Respond Fund, two new projects are now getting underway. Thanks to donor support from our generous community, more than 50 research and innovation projects are in progress and are helping us better understand and address COVID-19.

COVID-19 and rheumatoid arthritis: using big data to
understand risks and improve treatments

Dr. Sibel Aydin, The Ottawa Hospital
Dr. Sibel Aydin

With more than 30 million infections worldwide, researchers now have access to massive amounts of data to try to understand why COVID-19 causes severe illness in some people and mild or no symptoms in others. Factors like age, hypertension and obesity clearly play a role, and it is possible that certain immune disorders may also have an impact. Dr. Sibel Aydin is using a big data approach to determine if people with the immune disorder rheumatoid arthritis are more or less likely to get severely ill with COVID-19. Harnessing data from ICES and the Ontario Best Practice Research Initiative, her team will also look at the impact of immune-suppressing drugs that are commonly used to treat rheumatoid arthritis. This research could improve our global understanding of COVID-19 and lead to better treatments for people with both COVID-19 and rheumatoid arthritis.

Understanding the impact of COVID-19 on women

Dr. Innie Chen, The Ottawa Hospital
Dr. Innie Chen

Dr. Innie Chen is leading research to understand the impact of COVID-19 on women, thanks to seed funding through the COVID-19 Emergency Response Fund.

COVID-19 is affecting women in many ways, from increased caregiving responsibilities to increased risks of domestic violence. Women are also more likely to work in healthcare jobs that have a higher risk of exposure to COVID-19. Finally, women may be negatively affected by delays in access to health care associated with COVID-19.

Dr. Chen has assembled an internationally recognized team that will help understand and address this challenge by developing core outcomes for women’s health equity during Covid-19. The researchers will perform a systematic search of the literature and assemble a multidisciplinary panel of community patient partners and healthcare workers to identify the key issues in women’s health during the pandemic. This information will lead to evidence-based strategies to mitigate gender-based impacts and help improve the lives of women during the pandemic.

Keep checking back to read updates on these and other COVID-19 research and innovation projects supported by donors.

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

The study that is changing breast cancer treatment around the world

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

Gina Mertikas, centre, and her family
Gina and family

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

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

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

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

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

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

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

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

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

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

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

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

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

– Gina Mertikas-Lavictoire

Results change global standard of care

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

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

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

– Dr. Mark Clemons

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

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

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

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

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

— Dr. Dean Fergusson

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

Robert (Bob) Hardy has been in a fight for his life for more than 20 years. From a bone marrow transplant for leukemia, to a blood clot in his intestine and his neck, it seems nothing can slow him down. In fact, thanks to lifesaving care at The Ottawa Hospital, he’s stronger than ever and unwavering in his desire to compete in some of the most renowned marathons around the world — with his walker. Beating his personal best time, year after year, you wouldn’t suspect that this ‘Walker-Runner’ initially had only a 40% chance of survival.

A startling diagnosis

There was a time many years ago when Bob believed he only had six months to live. Feeling slightly fatigued, but healthy overall, he went for a routine physical. When his examination results returned, Bob received startling news. At only 46 years old, and long before experiencing any side effects of the disease, he was diagnosed with leukemia. Bob and his wife, Vittorina, were stunned. All they could think about was how they would tell their two young girls, Shannon and Leah, who at the time were only 13 and nine. “It was a really big shock for all of us. The thought of having to tell our children wasn’t easy, but it wasn’t something I was willing to hide from them either,” said Bob.

But if you’re looking for a woe-is-me attitude, you won’t get it from Bob. Even a diagnosis of this magnitude couldn’t bring him down. “When I told my youngest daughter, Leah, about my diagnosis,” said Bob, “she told me ‘you’re too strong to die, dad.’” That was the encouragement Bob needed to hear. It was her words that motivated him to fight back and beat the disease.

Robert Hardy, in 1997, standing by the water
Robert Hardy in 1997.

A fight for his life

Up until Bob’s leukemia diagnosis he was studying jiu-jitsu – and fit as ever. But while he waited for a match donor for a bone marrow transplant, the medication, interferon, that doctors prescribed to maintain his health was making him weak. Bob was struggling to continue with his training. “I wanted to get my black belt before undergoing my bone marrow transplant,” expressed Bob. He felt a black belt would give him the confidence he needed to begin the long road to healing and recovery. Knowing just how much this milestone would mean to Bob, his doctors allowed him to temporarily discontinue taking interferon for two months prior to Bob’s black belt test, so that he could continue training for the big day. And when that day came, he got his black belt – with honours. It was only then that he felt ready for his bone marrow transplant and the ups and downs that would follow.

A perfect match

After a year of taking interferon, a six-antigen match donor for the bone marrow transplant was found. At the time, performing a bone marrow transplant using an unrelated donor was still relatively new. But researchers discovered that patients can have a match donor outside of their family. “It isn’t common for two people to have the same set of six antigens if they aren’t blood related. I was lucky. They found a perfect match,” explained Bob. More recently, however, advances in research have allowed our experts to perform a transplant using an incompatible donor, significantly reducing the time patients must wait for a match donor. “What this means is that, where once many did not have a donor, now almost everyone has one,” explained Dr. Huebsch. “This research is truly groundbreaking.”

Robert Hardy during his leukemia treatment
Robert Hardy undergoing treatment for leukemia.

With a donor ready to help, the pre-transplant treatment of high doses of chemotherapy and radiation to suppress Bob’s immune system began. Four weeks later, his immune system was primed to receive the bone marrow transplant. He underwent this procedure at The Ottawa Hospital, and remained in our care for three weeks to ensure the transplanted healthy cells were multiplying – and they were.

Bone marrow is the soft, fatty tissue inside your bones, which produces blood cells. A transplant, inserted into the blood stream through a catheter, replaces the unhealthy blood forming cells (stem cells) with healthy ones.

Although doctors wanted Bob to remain in hospital for a few weeks post treatment, he was able to go home for the majority of his recovery. In fact, Bob benefited from our innovative outpatient bone marrow transplant program that has allowed thousands of patients to be treated and recover more conveniently from home. This program was one of the first in Canada and, since its inception, our patients have been surrounded by loved ones throughout recovery.

Thrombosis expertise in Ottawa

Over the course of the next two years, Bob was in and out of the hospital. “The first two years were the hardest. I had a lot of side effects from my treatment,” said Bob. One of the most severe side effects Bob experienced was blood clotting. The first to appear was in his stomach and a second in his neck. Cancer patients are often at greater risk of blood clotting as chemotherapy is hard on the veins. Approximately one in every twenty cancer patients will experience blood clotting – often a life-threatening complication. But Bob was in good hands. He benefited from the development of a tool to help diagnose blood clots quickly, known as the Wells Rule, after Dr. Phil Wells, an expert at The Ottawa Hospital. This tool is now used in emergency rooms and taught in medical schools around the world.

“We have one of the best thrombosis departments in Canada, attracting experts in the field from across the globe.” – Dr. Marc Carrier

Researchers have since implemented a comprehensive program for managing blood-thinning medications for patients at higher risk of developing blood clots, including cancer patients like Bob. This program has ensured that patients at our hospital are more likely to have optimal blood thickness, and less likely to develop blood clots.

More recently, our experts have developed a system to identify the likelihood that a cancer patient will develop blood clots. Although this was not yet available at the time of Bob’s diagnosis, this innovative tool can classify newly diagnosed cancer patients as being at greater risk and they can receive personalized care based on their unique circumstance to prevent blood clotting. “We have one of the best thrombosis departments in Canada, attracting experts in the field from across the globe,” said Dr. Carrier, Chief, Division of Hematology. “Our highly specialized and dedicated researchers are developing groundbreaking procedures that demonstrate our commitment to continuously moving research and treatments forward, so that we can continue to provide exceptional care to each patient that walks through our doors,” said Dr. Carrier.

World-class care in Hematology

Throughout Bob’s treatment, he was cared for through The Ottawa Hospital Hematology and Thrombosis Program, one of the best and largest in Canada. Unlike many other hospitals, where patients must travel to different hospital departments and satellite locations to receive treatment, our unique program provides centralized care for patients with diseases of the lymph glands, blood, and bone marrow for patients across eastern Ontario and beyond.

“We are among the best. Ottawa is at the centre of all sorts of blood transfusion medicine and we’re one of the leading centers in the world for doing, and researching, transplantation for life threatening diseases.” – Dr. Lothar Huebsch

Robert Hardy and Dr. Lothar Huebsch in 2001.
Robert Hardy with Dr. Lothar Huebsch, 2001.

The program, which has attracted leading researchers from around the world, is renowned for the development and advancement of world-first procedures that are changing lives. “We are among the best,” explained Dr. Huebsch, Clinical Hematologist and former head of hematologic oncology. “Ottawa is at the centre of all sorts of blood transfusion medicine and we’re one of the first in the world to successfully perform transplantations for life threatening diseases.” Our Hematology and Thrombosis Program has led the way for decades, researching transplant techniques with other illnesses such as multiple sclerosis, autoimmune diseases, and lymphoma. “This is the kind of research we’ve done for 25 years, and we are one of the leading centers in the world for doing these transplants in the outpatient setting, rather than in a high intensity ward as an impatient,” said Dr. Huebsch.

Road to recovery inspires ‘walker-running’

Bob Hardy, walker running
Robert Hardy walker-running.

With so much time spent in and out of hospital throughout his treatment, Bob needed something to do to keep himself busy while he recovered. So, he got creative. “A few of us used to take our IV polls and race them down the hallways. The nurses couldn’t believe how fast we were moving!” What Bob didn’t realize at the time was racing IV polls would later spark aspirations to participate in some of the most renowned marathons.

Following treatment for the blood clot in his neck, Bob lost his sense of balance. Although he can walk short distances without an aid, he’s unable to run or walk long distance. That’s when Vittorina suggested he get a walker. “At first, I was hesitant about using a walker, but then I realized how fast I could move!” said Bob. And so began his passion for ‘walker-running’.

Bob started his walker-running career participating in the Wobbly Walker-Walk-a-thon, but soon shifted into high gear signing up as a marathoner in Run for a Reason at Tamarack Ottawa Race Weekend. His marathons not only accomplished a personal goal, but also raised funds in support of The Ottawa Hospital.

A new appreciation for life

Bob’s road to recovery hasn’t been an easy one, but there hasn’t been a day he’s felt sorry for himself. Over the years he started to get stronger and complications were fewer and far between. “I am so thankful for the treatment I received. The nurses and my doctors were outstanding – absolutely incredible,” said Bob. “I’m here today, pursuing my passion for walker-runner marathons, because of them. They saved my life.”

Of course, there are still some days that Bob feels more run down than others. On those days he tries to take a walk to reminisce on how far he’s come in his recovery. “I know what it takes to get over things and to get through things. Not only did I have the very best care at The Ottawa Hospital, I had something to live for. I was able to watch my girls grow up. And now, here I am at age 69, almost 70, I’ve overcome countless obstacles and have jumped over hurdles, and I’m really quite happy with my life. I’m really very happy.”

“I am so thankful for the treatment I received. The nurses and my doctors were outstanding – absolutely incredible.” – Bob Hardy

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

Devastated and shocked – that’s how Sindy Hooper and her family reacted to the diagnosis of pancreatic cancer in 2013. Especially considering pancreatic cancer survivor rates are so low. The diagnosis came at a time when Sindy would have described herself as being in the best shape of her life. But suddenly, she was facing the fight of her life, and she looked to the specialized cancer treatment and research at The Ottawa Hospital to help her fight back.

In the months leading up to Sindy’s diagnosis, she had been feeling great. She had completed her first Ironman in August 2012, and that fall she was training to complete another one. Then, in December, she started experiencing discomfort in her upper abdomen and pain in her upper back. However, towards the end of the month her skin started to get very itchy, she became a lot more tired, and she started to lose a little bit of weight. The day before her diagnosis, she woke up and her eyes were yellow. She was jaundiced.

Sindy’s husband, Dr. Jon Hooper, an ICU physician at The Ottawa Hospital initially thought it could be gallstones. The couple headed to hospital unprepared for what they were about to learn. Later that day, an ultrasound would reveal it was pancreatic cancer. “We couldn’t believe the news. I was relatively young. I had just turned 50. I was in the best shape of my life. I had no family history of cancer whatsoever,” says Sindy. Even more alarming were the survival rate statistics.

An aggressive, potent cancer

The pancreas is part of the endocrine system, a group of glands and cells that make and release hormones into the blood, controlling growth, reproduction, sleep, hunger, and metabolism. The cells in the pancreas normally make and release digestive juices to help break down food.

Pancreatic cancer starts in the cells of the pancreas. A malignant tumour of the pancreas is a group of cancer cells that can grow into and destroy nearby tissue. It can also spread to other parts of the body. There has been little progress in the fight against pancreatic cancer in the last 40 years.

The five-year survival rate is only eight percent. The average survival is six months and 75 percent of the people diagnosed with this form of cancer die within the first year.

“We see what people are going through and how we need to do better than we’re doing so far. It gives us a focus and purpose because we know here’s an urgent need for new and better therapies.” – Dr. John Bell

Pancreatic cancers are resistant to most kinds of therapy. The cells have a biology that scientists don’t completely understand, which makes them hard to detect early and hard to treat with conventional kinds of therapies that are currently available. Researchers at The Ottawa Hospital are working to offer hope to pancreatic cancer patients and while she didn’t realize it at the time, this would become very important to Sindy and her journey.

Ready for specialized care

With the alarming news of the diagnosis, Sindy prayed to make it to one year. Her team at The Ottawa Hospital developed a three-pronged care plan. “I am very thankful for having such amazing care close to home – really world-class care,” says Sindy.

The treatment would begin with Whipple surgery. “It’s a seven-hour operation – it’s huge. It can only be done in very specialized centres. I was very fortunate to have that done here in Ottawa.”

In fact, The Ottawa Hospital is one of the few hospitals in Canada to offer this type of surgery. It is used to remove tumours in the head of the pancreas or in the opening of the pancreatic duct. A team that specializes in surgery of the pancreas, liver, gallbladder, and bile duct work together to support the patient through the operation.

Sindy in hospital recovering from Whipple surgery.
Sindy in hospital recovering from Whipple surgery.

In Sindy’s case, the complex surgery removed half of her pancreas, half of her stomach, her gall bladder, bile duct, duodenum, and the tumour. She was in hospital for ten days and then recovered at home for the next five weeks. “Just as I started feeling better in mid-February, I started chemotherapy. I went through 18 rounds of chemo that took me to September. There was also 28 days of radiation in between,” remembers Sindy.

“Whipple surgery is a seven hour operation – it’s huge. It can only be done in very specialized centres. I was very fortunate to have that done here in Ottawa.”
– Sindy Hooper

She was able to withstand the effects of chemo and radiation very well. Her doctors attributed that to the great shape Sindy was in. It helped her power through the treatments. “Through all my treatments, I was still training for Ironman Canada.”

Powering through to Ironman Canada

Sindy Hooper competing in 2013 Ironman Canada during cancer treatment
Sindy crossing the finish line at Ironman Canada in 2013.

Feeling good, Sindy and Jon booked a trip to Whistler, B.C. to take on Ironman Canada in August 2013, even though Sindy was still undergoing chemo treatment. She wasn’t expecting to complete the biking or running portion, but Sindy felt she could tackle the 3.86 km swim. In fact, she not only finished the swim, but also the 180 km bike, and the marathon. “We started the marathon, and it was miraculous. I just felt so good that day. I had lots of energy.”

In the end, together, they finished the Ironman at 11:37 p.m. – 23 minutes before the cut off. But it was bigger than just crossing the finish line. Sindy’s incredible strength to power through an Ironman in the middle of chemotherapy treatment attracted significant media attention. She not only increased awareness for pancreatic cancer, but she also raised $50,000 for cancer research. “Completing the Ironman, raising awareness, and all that money was an absolute gift in the midst of everything I was going through,” says Sindy.

Fundraising for all cancer patients

That $50,000 was just the starting point for this crusader. Sindy has dedicated herself to fundraising for cancer research at The Ottawa Hospital since 2014 through Run for a Reason at Tamarack Ottawa Race Weekend. Her running team is the MEMC crew (Making Every Moment Count). She tries to instill her passion for life in other people and not take things for granted. Along the way, she’s raised over $225,400 for cancer research.

Sindy does it not only for herself but also for other patients. “Cancer research is going to one day save my life again, I’m sure of it.”

“Cancer research saves lives. That’s the bottom line. Whether it’s finding new treatments or early detection methods so cancers can be picked up earlier and treated more effectively – cancer research really does save lives.” – Sindy Hooper

Sindy running in support of cancer research at The Ottawa Hospital
Sindy participating at Tamarack Ottawa Race Weekend in support of The Ottawa Hospital.

For Dr. John Bell, a senior scientist, who’s been investigating this complicated disease for decades at The Ottawa Hospital, it’s patients like Sindy who inspire him and his team of researchers. “I’m really privileged to have a lab at the Cancer Centre. That means every day, I get to see the people we are trying to help, like Sindy, who we want to have a good quality of life and a long life.”

Dr. Bell adds it’s those patients who push him to find answers and that elusive cure.“We see what people are going through and how we need to do better than we’re doing so far. It gives us a focus and purpose because we know there’s an urgent need for new and better therapies.”

One way to find those answers is through clinical trials. And it’s not lost on Dr. Bell that the patients who participate are both courageous and altruistic. “Every patient seems to say the same thing when I speak with them: ‘I don’t know if this is going to work for me, but I hope you learn something from it so that I can help somebody else.’ That’s, really what we get inspired by, that sort of attitude. Sindy has that attitude for sure.”

Finding hope for pancreatic cancer patients

Sindy with Dr. John Bell at The Ottawa Hospital
Sindy meeting Dr. John Bell in his lab.

While treatment options for pancreatic cancer are still limited, there is hope. Researchers at The Ottawa Hospital are leading the world in developing viruses that can attack cancer cells without harming normal cells. These viruses have been tested in clinical trials for other types of cancer, and Dr. Bell’s team is currently working in the laboratory to see if they can be customized for pancreatic cancer. Dr. Bell says that, “absolutely,” the findings from those previous trials could be used in future pancreatic cancer patients.

“It really is I think a burgeoning field, and I like to think we were critical in getting this started.”

As Sindy continues to put her faith in what this research will have to offer in the future, she has a simple message for Dr. Bell and his team. “Thank you for the work that you’re doing.”

“Keep working really hard because there’s a lot of people out there, like me, who are relying on research to find new, better treatments and hopefully one day a cure.”
– Sindy Hooper

2020 brings a new health concern

Even before the emergence of COVID-19, 2020 offered a new challenge to Sindy. On a flight to Hawaii, last winter she, started experiencing intense gastrointestinal pain. As soon as her flight landed, she went straight to the hospital and learned she had a partial obstruction in her GI tract. While she started to feel better, her surgeons back at The Ottawa Hospital encouraged her to return home as they were the best equipped to handle her complicated case should she develop another obstruction and she need surgery.

Back home, Sindy continued to have severe episodes of pain, developed a fever, and then a blood infection. By mid-April, COVID-19 had arrived in Ottawa and doctors were hesitant to operate, but the pain became so severe they had no choice.

Surgeons discovered a significant number of adhesions in the area of her obstructions and removed them. Sindy admits it was a stressful time being in hospital during a global pandemic. “It was so scary by myself – not having my husband there for me.”

Although, she gives credit to the incredible staff who were at her bedside for six days. “I have to say everybody was going above and beyond to make the patients feel comfortable during this time. I was impressed.”

Making plans for the future

Today, Sindy celebrates as a seven-year pancreatic cancer survivor and takes nothing for granted. After she got past that first year of survival, she prayed for two years of survival. “Every year that has passed is just completely incredible to me, Jon, and my sons.”

Every six months Sindy returns to The Ottawa Hospital for a CT scan. While it’s stressful waiting for the results, so far, each scan has resulted in good news, allowing Sindy and Jon to make plans for the next year.

Sindy biking at the International Triathlon Union
Competing at the ITU (International Triathlon Union) Olympic Distance World Championship in Cozumel, Mexico in 2016.

This year, that plan included welcoming a new member of the family – Lexey, a French Bulldog – filling their home with joy. Sindy’s plans also include more running, swimming, and biking. She’s feeling strong again after her surgery, back to training for a 50 km Ultramarines Run in November and a triathlon next summer. She continues to look to the future.

“I’m just so amazed to be defying these odds and to get to continue living, enjoying and loving life.” – Sindy Hooper

You could say that Sindy is making every moment count.

Listen to Sindy Hooper’s story in her own words during a guest appearance on Pulse: The Ottawa Hospital Foundation Podcast.

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

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