A dedication above and beyond for an air force vet nearing 100 years old
Category: Cancer
If there’s one word that comes to mind when you first meet Major James Morrison (Ret’d), it’s “dedication.” He is deeply dedicated to his country, his wife, and our healthcare system. It’s a loyalty that spanned decades — the major will be 100 years old in 2024. He was born the same year The Ottawa Hospital Civic campus first opened in 1924.
Major James Morrison with his wife, Betty.
Every year, for the last 29 years, Major Morrison has generously donated to The Ottawa Hospital.
“I owe it to the hospital for the care they gave me.”
— Major James Morrison
When asked what motivates him to give so loyally, he answers with a charming smile. “Well, mostly because I was a customer there. And I owe it to the hospital for the care they gave me.”
First, it was heart issues. Then, ten years ago, prostate cancer.
“I was treated very well there,” he says, recounting how, at the end of his cancer treatment, he got to ring the bell not once, but eight times.
“Because that’s the Navy tradition. That’s either noon or midnight,” he explains, referring to the tradition of ringing of the ship’s bell eight times to mark the “end of watch,” or in some instances, as a nautical euphemism for finished.
Despite Major Morrison’s nod to this special tradition, it was not the Navy where he spent his long career, but the Royal Canadian Air Force, where he enlisted at just 18 years old.
James Morrison in 1943.James Morrison in 1943.James Morrison (left) and Doug Neil (right) at Down Ampney, England, in February 1946.
“I was only 118 pounds and they said, ‘We can’t take you until you’re 120. Go home and fatten up.’ So, I went home and fattened up,” he recounts.
During the Second World War, he was posted to the Southeast Asia Air Command, and following the war, he transported prisoners to the War Crimes Trials.
Major Morrison married the love of his life, Betty, in 1951, and together they started a family. His career took them to various posts across Canada, and in 1970, he was an Officer Commanding at the Canadian Armed Forces Operation Centre in Ottawa, where he delivered instructions when the War Measures Act was invoked on October 16 of that year.
Later in life, he began patrolling public areas of the airport as the Ottawa Airport Watch, and Betty accompanied him on many of those night shifts. He made his final patrol in January 2014 — on his ninetieth birthday.
These are but a few milestones on a journey that has spanned nearly 10 decades on this earth, from the highs of first enlisting as a young man to the lows of his wife’s diagnosis with Alzheimer’s. “She doesn’t know who I am anymore.”
The two have been married 72 years, and not a day goes by that he doesn’t visit her.
It’s clear Major Morrison is loyal to the core. And while many of his stories are about the past, it’s the future he wants people in Ottawa to focus on; and he encourages others to support The Ottawa Hospital’s Campaign to Create Tomorrow.
“You should invest in this because you may need it in the future at some point.”
— Major James Morrison
The $500-million campaign is the largest in Ottawa’s history and sets in motion a vision to completely reshape healthcare by building the most technologically advanced hospital in Canada and taking groundbreaking research and innovation to unprecedented heights. And it’s something Major Morrison believes is worth supporting.
“You should invest in this because you may need it in the future at some point,” he offers as wise advice to generations that follow. “This new campus is for them.”
The new hospital is expected to open in 2028, and we would love to see Major Morrison there on opening day. “I was sort of looking forward to seeing it,” he says.
Major James Morrison, thank you for your service to our country and our community.
Categories: Creating Tomorrow, Donors, Donors, Patient Care, Patient Care, Patient Care
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.”
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.
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.
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.
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
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.”
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.”
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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Categories: Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Clinical Trials, Creating Tomorrow, Gift In Will, Immunotherapy, World-Leading Research
Published: April 2023
Find out why he credits a “prehab” study for his quick recovery
In May 2021, Christopher Wanczycki’s oncologist gave him some unexpected bad news — there was a two-inch tumour in his rectum. Five weeks after his January 2022 cancer surgery, the 63-year-old was back on the cross-country ski trails. He credits his quick recovery to participating in a national “prehab” clinical trial led by researchers at The Ottawa Hospital.
“Without this program, I can’t imagine what my recovery would have been like,” he says. “I would highly recommend it for anyone in my shoes getting ready for surgery and for post-surgery recovery.”
Christopher underwent aggressive radiation and chemotherapy to shrink the stage 3B tumour in his rectum, and his oncologist recommended surgery to confirm all the cancer was gone.
“I was kind of beaten up at that point, and my oncologist had mentioned that it would take a couple of months for the effects of the chemotherapy to leave my system,” he remembers. “At a final chemotherapy infusion round, I was advised to bulk up, to just eat whatever I could to gain back the weight before my surgery.”
Christopher had lost 37 pounds during chemo and had little appetite. In addition, the swelling and numbness in his legs and feet from chemo made walking uncomfortable.
He took the time between the end of his chemotherapy in October 2021 and before his January 2022 surgery to try to gain some weight back, start some mild exercise, and return to his regular activities.
Christopher Wanczycki skiing.
That’s when prehab kicked in. At the suggestion of his cancer coach, a person assigned through the hospital to help patients navigate their cancer journey, Christopher agreed to join one of the world’s largest prehab clinical trials in November 2021, led by Dr. Daniel McIsaac and his team.
What is prehab?
“Prehab is a bit like training for a race, but instead you’re training for surgery,” said Dr. McIsaac, a scientist and anesthesiologist at The Ottawa Hospital, and Chair in Innovative Perioperative Care at the University of Ottawa. “It’s structured, sustained exercise and nutrition over time that makes the muscles, heart, and lungs stronger. A lot of the exercises focus on strengthening the legs and abdominal muscles, which you need to get out of bed after surgery.”
“Prehab is a bit like training for a race, but instead you’re training for surgery.”
– Dr. Daniel McIsaac
Previous studies have shown that young, healthy people who did prehab before surgery recovered faster and had fewer complications.
“We know that the healthier someone is going into surgery, the sooner they will recover and get back to their daily activities,” said Dr. McIsaac.
However, most Canadians who need major surgery are 65 or older, and many more are weakened by health challenges. While this population has a lot to gain from prehab, it’s usually harder for them to complete the exercises.
Dr. McIsaac’s research program aims to make prehab more feasible for older people with health challenges, so they can reap the rewards of a faster recovery.
What does prehab look like?
When Christopher joined the prehab study in November 2021, research assistant Keely Barnes showed him exercises and stretches to do at home at least three times a week and gave him written and video instructions to follow. Most of the exercises could be done while sitting in a chair.
Christopher Wanczycki skiing.
Keely also asked him to walk, bike, or swim for at least 20 minutes, three times a week and gave him a pedometer to track his distance.
Christopher loved skiing, biking, and other outdoor activities before his cancer diagnosis, so he didn’t mind all the exercise. In fact, he enjoyed the distraction.
“I discovered as a cancer patient, you need something to focus on daily, just to get your mind off things,” he says. “With this study, I decided to give myself a goal, something to focus on each day, and strive to increase the exercise repetitions each week.”
Keely called Christopher every week to see how many repetitions and steps he’d done. Not only was this good motivation to do the exercises, but she also checked to see if any of the exercises were causing him trouble. Together, they figured how to adapt them.
By mid-December 2021, Christopher started cross-country skiing again. All that exercise had also improved his appetite, which helped him gain back the weight he’d lost during chemo.
Research with patient experience at the core
“Patients have told us loud and clear that prehab research needs to be a priority,” said Dr. McIsaac. “They are eager to get back to their daily lives after they’ve had surgery, and prehab can help them do that.”
However, like with any exercise, you need to put in the work to get the benefits. And for older people living with pain and other health issues, putting in that work can be more difficult.
A pilot prehab study run by Dr. McIsaac’s team found that older patients with health issues who had at least 80% adherence to the prehab program could walk farther and had lower self-reported disability scores after surgery compared to those who did not participate. However, the average adherence was only 60%, not enough to see benefits.
“For a prehab program to be successful, we need to support and motivate participants and personalize the exercises to their needs.”
– Dr. Daniel McIsaac
Based on these findings, the team added more personalized and tailored programming to their current national prehab trial at 11 sites across Canada. This trial recruits about 10 new patients a week, and so far, overall adherence has been much closer to 80%. The team aims to recruit 750 people by the end of 2023, with results published in the subsequent years.
“For a prehab program to be successful, we need to support and motivate participants and personalize the exercises to their needs,” said Dr. McIsaac. “Our research assistants call participants week after week, so they get to know them well and can help them through any challenges they’re facing.”
This year, the team plans to launch a smaller trial in Ontario to test a different way of delivering prehab through virtual group sessions. Unlike the national trial where patients are recruited by their surgical team, patients will be able to refer themselves to the trial.
“If we want to bring prehab into everyday clinical practice, we need a process that will work in the real world,” says Dr. McIsaac. “We think that virtual group sessions will probably be more feasible for healthcare providers than individual phone calls. But we won’t know if that model works for participants unless we test it.”
Patient partners share key insights
One of the team’s secret weapons is having patient partners on their side. Team members like Gurlie Kidd, a retired social worker who had surgery at The Ottawa Hospital in 2017, help make sure the research stays relevant to patients.
Gurlie’s input has helped the team better understand how and when to ask surgical patients about taking part in studies, to reduce the burden put on patients. She and other patient partners have also helped the team set priorities and adjust the study’s design, including sending regular updates to patients involved.
“As a member of this research team, I have felt heard,” says Gurlie. “There is a respect for patients and patient input that is kind of amazing. It legitimizes some of the things that we have gone through and acknowledges our expertise.”
“I can’t imagine what my recovery would have been like without it”
After two months of prehab, Christopher felt confident and ready when his surgery date arrived in January 2022. The colorectal surgery went well, and his surgeon removed some additional Stage 1 cancer that was growing near the tumour.
Christopher was amazed by how soon he could leave the hospital after surgery.
“A cancer diagnosis is never easy. The treatment phases are challenging, and I believe participating in this prehab clinical trial was an important part of my treatment plan.”
– Christopher Wanczycki
“My surgery was on a Monday. By Wednesday, I could sit in a chair to eat lunch. On Thursday, I had dressed myself, and was up at the nursing station trying to check myself out. By Friday, I was climbing the stairs at home. That would not have been possible without the prehab program.”
Christopher and his wife at Gros Morne Summit September 2022.
He continued to do prehab exercises for a month after his surgery. A week later — only five weeks after surgery — he was regularly back on his cross-country skis. In April 2022, he was finally declared cancer free.
In September 2022, Christopher hiked to the top of Gros Morne Mountain in Newfoundland with an ileostomy bag, just eight months after his surgery.
He’s grateful to be able to be back to all those activities he loves and credits the prehab study for his quick recovery.
“I’m 100% certain that it does make a difference physically, but also psychologically, to give someone goals, something to work towards. Also, cancer is so hard on your family, on your wife and kids. With this exercise program, my wife could see my progress, and that I was getting better.”
In December 2022, Christopher underwent a successful ileostomy reversal operation. He has since resumed downhill and cross-country skiing.
“A cancer diagnosis is never easy,” he says, “The treatment phases are challenging, and I believe participating in this prehab clinical trial was an important part of my treatment plan.”
Christopher with his family.
Christopher with his daughter and friend.
All research at The Ottawa Hospital depends on infrastructure and support services funded by generous donors to The Ottawa Hospital Foundation. Dr. McIsaac’s research is also funded by the Canadian Institutes of Health Research, the PSI Foundation, the International Anesthesia Research Society, and the Canadian Frailty Network and enabled by the Ottawa Methods Centre and the Office for Patient Engagement in Research Activities.
Categories: Patient Care, Rehab
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.”
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.
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.”
“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 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.”
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.”
Camille and her daughter at a Toronto Blue Jays game.
Camille and her daughter taking part in MudGirl.
Camille and her daughter taking part in MudGirl.
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.
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The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Clinical Trials, World-Leading Research, World-Leading Research
A CANCER JOURNEY
A cancer journey by the numbers
Published: February 2023
Numbers play an important role in our lives. They mark special occasions, important meetings, and sometimes they’re symbolic.
In 1970, Tanya O’Brien lost her aunt Elizabeth to breast cancer — Tanya was just shy of her first birthday. While she was too young to know her aunt, she has a picture of the two of them together. When she looks at that photo, two numbers come to mind — one and seven. “I think of my aunt as number one and myself as number seven. On March 5, 2013, I became the seventh person in my family diagnosed with breast cancer,” explains Tanya.
“Actually hearing you have cancer is like watching yourself in a bad B-movie — nothing feels real. Everything is in slow motion except for your brain which races around, and everything suddenly becomes a question.”
– Tanya O’Brien
Because of this family history, cancer is a disease Tanya has feared much of her adult life. By the time she was in her early 40s, the elementary school teacher had already seen family member after family member face the disease. “My fear would stop me in my tracks. Pink ribbons used to make me cringe. My lumpy breasts were a constant source of drama,” says Tanya.
Then, what she had feared most became reality. In 2013, Tanya was diagnosed with breast cancer. The news came after a radiologist noticed something new during an examination and a biopsy was ordered. “Actually hearing you have cancer is like watching yourself in a bad B-movie — nothing feels real. Everything is in slow motion except for your brain which races around, and everything suddenly becomes a question. Will I die? What will happen to my family?”
Facing cancer head on
Next, Tanya turned to The Ottawa Hospital’s Breast Health Centre (BHC) where over the course of 16 months her care team became household names — a team she says provided her with smiles, explanations, advice, hugs, and assurances along her cancer journey. “They redefined ‘hero’ for me. One step at a time, with an army of people behind me, I found myself being able to fight cancer and confront the fear that had controlled me long before my diagnosis,” says Tanya.
Tanya at The Ottawa Hospital General Campus. Photo by Ashley Fraser.
In 2018, the new Rose Ages BHC opened its doors to patients, thanks to an ambitious $14-million fundraising campaign. The centre houses an impressive suite of technologies that are among the latest and most comprehensive in Canada. The BHC allows patients to be closer to the specialists involved in their care, from before diagnosis to after treatment, and beyond. This means more patients can be treated with therapies that are tailored to their unique circumstances.
“They redefined ‘hero’ for me. One step at a time, with a legion of people behind me, I found myself being able to fight cancer and confront the fear that had controlled me long before my diagnosis.”
– Tanya O’Brien
Access to the most advanced and compassionate cancer care helped ease Tanya’s fears along the way. Her journey included a double mastectomy, reconstruction surgery, chemotherapy, and medication. “Without Dr. Shailendra Verma and Dr. John Lorimer I would not have made it through the first few days of this process. They explained things so clearly and encouraged me that I could do this. They were calm and clear. My oncologist, Dr. Paul Wheatley-Price, along with Drs. Kirsty Boyd and Simon Frank were with me throughout my journey.”
Not unlike other cancer patients, Tanya’s biggest fear was chemotherapy. She remembers that first day of treatment and how the sunshine was beaming through the window — which seemed to reflect the attitude of the staff who were caring for patients just like her. And then came a very special moment, on August 14, 2014 — Tanya rang the bell to mark her last chemo treatment. “I was at the other end of the tunnel. My reconstruction still amazes me. Except for two small lines, I look exactly as I did before. The only difference now is that I can look at myself with confidence knowing that I am well.”
And now back to those numbers, the most recent special number to Tanya is 10. This year marks the 10-year anniversary of being cancer free — a milestone she is deeply grateful for and one that she not only celebrates, but that marks a time of remembering those she’s lost, like her aunt Elizabeth.
Tanya is grateful for each day she’s been given and those who helped her each step of the way. “I’ve been given a chance to live the rest of my life without fear. I have an understanding that healing can happen with an idea, research, medicine, surgery, faith, and more importantly, with the right people. I owe The Ottawa Hospital my life, and there are no words to thank adequately everyone there for what they have done.”
Tanya O’Brien, in her classroom.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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A CANCER JOURNEY
Full circle experience for Denise Picard-Stencer
Update: Sadly, Denise passed away on December 5, 2023, after receiving a new cancer diagnosis last summer. We’re deeply grateful to Denise for sharing her story with us and for her leadership in healthcare, including her years here at The Ottawa Hospital.
After dedicating 27 years of her career to The Ottawa Hospital, Denise Picard-Stencer was shocked when she found herself back at the hospital in 2019 — this time as a patient.
Denise started as an ICU nurse in 1990 at the General. After 13 years, she became an assistant manager in the ICU — a time she remembers vividly because of the SARS virus outbreak. That’s where she discovered her interest in management. She worked in various departments, including the Emergency Department, before making her way into the human resources field. In 2015, Denise took on a new opportunity at Hawkesbury and District Hospital, where she became the Vice-President of Patient Care and Chief Nurse.
Always healthy and active, with a love for cycling and golfing, Denise’s life took a turn in December 2018 when she got very sick. “I went through every test you can imagine trying to pinpoint what might be wrong. We were in the dark for so long, and my condition was deteriorating because the tests kept coming back inconclusive,” explains Denise. “I remember when I was diagnosed in July 2019 with multiple myeloma; it was almost a relief to finally know what was wrong, because now we could treat it.”
Denise Picard-Stencer biking on the beach.
With that diagnosis, Denise found herself back at The Ottawa Hospital, but with a very different perspective — now, she was the patient. “I had 20 weeks of chemotherapy treatment, and then I had a stem cell transplant in February 2020.”
“Although the collection of my own stem cells was a gruelling two-day process where I was hooked up to machines and I had to remain still, in the end, the outcome was awesome,” recalls Denise. The day of her transplant is now known among her family and friends as Denise’s re-birthday. “I put on a shirt with sparkles on my transplant day because I was celebrating.”
Once the stem cell transplant was complete, Denise went home but had to return daily to the hospital for bloodwork and on-going follow-up. This was just as COVID-19 was hitting our community, which was concerning considering her immune system was still fragile.
Ten days after her release, Denise spiked a fever, and she was admitted to hospital for 10 days. But once the fever resolved, her road to recovery got a little smoother, and her stem cell transplant was deemed a success. Slowly, she started to gain weight back. “I was down to 88 pounds when I first left the hospital after the transplant — I had lost 30 pounds when I was sick. It took time to build up my strength again, but I’ve been good ever since. Today, I’m back to cycling and golfing,” explains Denise.
Being on the receiving end of care made Denise reflect on her years as a healthcare professional. “Throughout my career, whether I was interacting with patients as a nurse or in any of my management roles, I always put the patient at the centre, and as a hospital that was our focus — treating a patient like a loved one. So, when I became a patient, I didn’t know what to expect.”
Denise had wondered if all the work the hospital had committed to patient-focused care carried on after she left. “But when I became a patient, I was so impressed. From the technicians in radiology, the doctors, the nurses, and the housekeepers, that approach was there,” says Denise. “They made me feel like a person and not a patient — and these people didn’t know I had worked at TOH for all those years. That made me know I was in good hands.”
Denise Picard-Stencer was treated for multiple myeloma at The Ottawa Hospital.
Witnessing the impact of research
One of her care team members was Dr. Arleigh McCurdy. She remembers an appointment with her hematologist not long after she was on the road to recovery. “I was so happy to have my life back, and I remember telling Dr. McCurdy, ‘It’s a miracle how far I’ve come!’ And she said to me ‘No — it’s research!’ and she’s right!”
“Years before, I participated in a cycling fundraiser to support cancer research at The Ottawa Hospital, and that’s when I made the connection to the impact of research. Little did I know back then, research would benefit me someday.”
— Denise Picard-Stencer
Denise admits the impact of research didn’t hit her right away because she was so focused on getting her strength back. However, it was while reflecting on her care and looking back at some old photos that it hit her. “Years before, I participated in a cycling fundraiser to support cancer research at The Ottawa Hospital, and that’s when I made the connection to research. Little did I know back then, research would benefit me someday.”
In fact, Denise’s cancer story was a learning opportunity for the oncology team. She recalls Dr. McCurdy explaining how her case was so complex it was discussed each week on medical rounds. “The team was studying the latest research to see how they could best diagnose me because I didn’t have a straightforward case, and so there was another link to research.”
Denise Picard-Stencer with one of her grandchildren.
“Clinical trials are the reason why I’m here today”
— Denise Picard-Stencer
Those constant efforts to seek out the best practices and participate in research projects to improve the quality of care for patients is not lost on Denise. “I know if, or when, I have a relapse, and the only option is a clinical trial, I will participate. Clinical trials are the reason why I’m here today — because other patients participated in these studies and the researchers and specialists devoted hours and hours to advancing research. It’s an aspect that the public doesn’t always see, but I knew about it, and I certainly saw that firsthand in my case.”
Today, Denise is enjoying retirement in Sherbrooke, where she now calls home — staying active, and taking every opportunity to spend time with her two grandchildren.
Listen to episode 77 of Pulse Podcast to hear Denise’s cancer journey in her own words.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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A CANCER JOURNEY
Aggressive lymphoma diagnosis that Ram Dubey never saw coming
Published: February 2023
Four years into his retirement, Ram Dubey was enjoying the extra time he had to pursue his interests in painting and photography. Ram had travelled the world throughout his career, thanks to his extensive experience in the stainless-steel industry. Born in India, he spent many years working in different parts of his homeland. His work then took him to Malaysia for several years before he and his family immigrated to Canada in 2003. His expertise in manufacturing stainless steel tubes, used in oil and gas, heat exchangers, and nuclear plants, attracted him to the former Sandvik plant in Arnprior, where he worked for just over a decade prior to retiring.
Onset of challenging symptoms
In October 2019, some red flags started to go up concerning Ram’s health. His hemoglobin levels were low, and he started having stomach cramps from time to time. Six months later, the cramps worsened, and Ram started vomiting every time he ate — as a result, he lost a significant amount of weight. He also discovered a small lump on his neck, and that’s when his family doctor arranged for a CT scan at the Renfrew Victoria Hospital. “Not long after the scan, I got a call from the doctor with the results. She told me there was good news and bad news. The bad news was that I had lymphoma, but she explained the good news was most of the time it’s treatable,” says Ram.
“It was out of the blue. I had just been thinking I had a stomach issue. I never thought I had lymphoma.”
— Ram Dubey
Ram Dubey was treated for lymphoma at The Ottawa Hospital.
The news of a cancer diagnosis was a shock for Ram and his family. “It was out of the blue. I had just been thinking I had a stomach issue. I never thought I had lymphoma,” he explains.
Ram was admitted to The Ottawa Hospital immediately for extensive testing to pinpoint the type of lymphoma and to find out why his stomach was extended. He lost a staggering 95 pounds over three to four months, and as a result, he became quite weak — but his stomach continued expanding. “I learned I had a tumour the size of a football that was pressing against the duodenum — connecting the stomach to the small intestine. Nothing could pass through when I was eating, and that’s the reason why I was sick every time I ate.”
Progressive treatment for an aggressive cancer
Initially, Ram started with a form of chemotherapy treatment known as R-CHOP, and that shrunk the tumour enough to provide some relief. However, when the results from the lymphoma cell testing returned, it revealed Ram had B-cell lymphoma — an aggressive form of the disease. That’s when he met Dr. David Macdonald, who specializes in lymphoma and leukemia. Dr. Macdonald explained to Ram that thanks to research advancements and knowledge, oncologists like him are better equipped to treat patients successfully than they were just 15 years ago. “I would be in hospital for five straight days of treatment that would last a total of 96 hours. It repeated six times, every 21 days,” recalls Ram.
Good news came when scans showed the tumours were shrinking in his neck and stomach, and he was finally able to eat again. By the end of October 2020, Ram received his last chemotherapy treatment and was then referred for six weeks of radiation treatment with Dr. Vimoj Nair at the Irving Greenberg Family Cancer Centre, an Ottawa Hospital facility located in the Queensway Carleton Hospital.
“I went to The Ottawa Hospital because it is the best cancer care. I had Dr. Macdonald, who I believe is one of the top experts in Canada for lymphoma.”
— Ram Dubey
Excellent care and support during a difficult journey
By the summer of 2021, Ram was in remission. “It was a hard journey, but I had good support from my family, including my wife and two daughters.” He adds, “I went to The Ottawa Hospital because it is the best cancer care. I had Dr. Macdonald, who I believe is one of the top experts in Canada for lymphoma. And the support from the doctors and the nurses is so good. I felt like I was being cared for with white gloves.”
Ram explains he was reassured he was getting the best care when he reached out to his niece, who is an oncologist at a Frankfurt hospital in Germany. “I sent her my reports and my treatment plan, and she said Canada is one of the best in terms of treatment and protocols. The cancer treatment is one of the best in the world.”
Today, at age 68 and feeling stronger by the day, Ram certainly won’t ever forget the care he received at our hospital. In fact, he gave Dr. Macdonald a little something to remember him by: a painting of the good doctor as a thank you for saving his life and giving him the opportunity to enjoy retirement with his family. “A special thanks to The Ottawa Hospital with the best nurses and doctors who took care of me. I’m also grateful for my family, friends, well-wishers, and God — without his blessing, the journey would have been more difficult.”
Dr. Macdonald holds a portrait of himself, painted by Ram as a gift of gratitude.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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A CANCER JOURNEY
Anxiety of cancer diagnosis eased by compassionate care team
Published: February 2023
When Jay Abramovitch went to the Emergency Department (ED) in November 2020, he never expected to hear the word cancer — let alone stage 3B colon cancer.
Jay, a firefighter in South Mountain, Ontario, at the time, had been experiencing minor symptoms for a few months. To provide him peace of mind, his family doctor arranged for some tests. Then, in late November 2020, his symptoms, including blood in his stool, got worse, so he went straight to the Winchester ED. “I still wasn’t too worried because the ED doctor initially believed my colon might be inflamed, and he ordered at CT scan,” explains Jay. “I remembered thinking everything would be alright after I got some medications.”
As Jay waited at the hospital for the results, he finally heard his name called. When he saw his doctor’s face, he knew it wasn’t good news. “He took me into a private room and told me I had a mass in my sigmoid colon and some lymph nodes that were possibly malignant. That led to an emergency endoscopy, to biopsy what they found, and several more scans. Waiting for those results was agonizing,” admits Jay.
On Friday, November 24, 2020, Jay learned the news he feared most — he had cancer. “I was shocked, angry, and confused. I was only 36, and I’d always been healthy with no history of colon cancer in my family.”
“I was shocked, angry, and confused. I was only 36, and I’d always been healthy with no history of colon cancer in my family.”
— Jay Abramovitch
Cancer care during the pandemic
Within two weeks, Jay got the call from The Ottawa Hospital’s Cancer Centre and his cancer journey with our hospital began. “From that moment, the support and care were amazing. Elizabeth Birch was my first point of contact. She was my surgeon’s administrative assistant, and I called her my ‘open line of communication’. My wife Leslie and I answered questions for about 30 minutes during that first call, and while I was facing cancer care in the middle of a pandemic, I never felt alone,” says Jay.
By February 2021, Dr. Laura Williams led his major abdominal surgery to remove part of his sigmoid colon. Then, Jay spent eight weeks recovering before undergoing 12 rounds of chemotherapy, administered bi-weekly for six months.
Jay clearly remembers when he walked into the Cancer Centre for the first time — it was a moment that hit him hard. “It was my first appointment with oncologist Dr. Derek Jonker. Before that, it was preparing for surgery, and everything was essentially virtual until the day of my actual operation. I remember looking around the Cancer Centre and thinking ‘I can’t believe I’m one of these patients.’ At age 36, I felt too young to be there,” explains Jay.
The other daunting part was Jay had to go in by himself due to pandemic restrictions. However, Dr. Jonker dialed in Jay’s wife to make sure she was able to hear the care plan firsthand. During that meeting, Jay also learned about some studies linked to the type of cancer and care he would be receiving. When Dr. Jonker presented him with the option of participating in the research, Jay said yes. “I participated in two studies. I almost didn’t, but I ended up actually being really thankful. I like the idea of being able to help other people too — it’s a small way to give back.”
It’s patients, like Jay, who participate in research that help to improve care not only at our hospital but around the world. They help our researchers turn their results into better treatments, shorter wait times, and less pain for our patients.
Newfound joy after ringing the bell
By September 24, 2021, Jay finished chemo treatments and got to ring the bell. His wife was even able to come in and witness the special moment. It was also a time to reflect on the care team that supported him along the way, including the nurses and staff at the Cancer Centre — each playing an important role in his journey.
But an even bigger moment would come for Jay and his wife two weeks later when they received word they were approved to adopt a little girl. Four weeks after Jay’s last chemo treatment, the couple welcomed 12-month-old Kira home. “She was the perfect distraction. It was the best possible thing that could happen after possibly the worst year and a half,” says Jay.
Jay Abramovitch and his wife Leslie, with their daughter, Kira.
Today, Jay has his routine check-ins with Dr. Jonker and he’s doing well. In fact, he’s joined The Ottawa Hospital as a transportation worker, and he helps patients move through the hospital. Jay says after the excellent care he received he can now provide that compassion to other patients with a different perspective of what they’re going through. “It’s a unique opportunity to help those patients. It’s very humbling to be able to provide folks just a little bit of hope and a little bit of positivity in their day.”
Jay is also dedicated to helping others who face their own cancer journey. In his spare time, he’s involved with advocacy and peer support to help men affected by cancer through the Man Up to Cancer group.
“I participated in two studies. I almost didn’t, but I ended up actually being really thankful. I like the idea of being able to help other people too — it’s a small way to give back.”
— Jay Abramovitch
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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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 and Natalie kayaking in Iceland.
Though, at only 32 years old, cancer was the furthest thing from Bryde’s mind. “I was young, healthy, a non-smoker, non-drug user, and active. That active part of my life was actually the only time I initially showed symptoms. That’s when I would overheat on even the coolest days and couldn’t cool down afterwards.”
The spontaneous rupture of Bryde’s adrenal gland six months earlier contributed to the challenge of pinpointing a diagnosis. It was believed he suffered from a large hematoma – a large residual clot after the bleed. “He had such rare conditions – one right after the other. A spontaneous rupture of an adrenal gland happens very rarely. I would say the challenge is that because the blood clot is so significant, it hides the underlying tumour and so it’s difficult to identify on imaging,” says Dr. Nessim.
Pinpointing the cause
Bryde Fresque was treated for a rare cancer 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, 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 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 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.
Categories: Donors
A CANCER JOURNEY
Trusting his instincts led to a rare cancer diagnosis
At the first sign that something might be wrong, Kevin thought he would just wait to see what happens — maybe his one-time symptom would go away. But in the middle of the night, he felt compelled to call to his doctor and leave a message. Tests revealed Kevin had mucosal melanoma — a rare form of skin cancer found inside the body. Today, he encourages others to take action when it comes to their own health.
Kevin got this tattoo, of two Montreal Expos tickets, in memory of his godfather who died of liver failure. They bonded over watching the team when Kevin was young. “He didn’t take his health seriously soon enough,” says Kevin, who hopes he can inspire others — especially men — to avoid the same mistake.
Click here to watch a video Kevin made announcing his diagnosis to his friends and family.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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