A message to other cancer patients: “You are not alone”
In 2019, Jennifer received an unexpected breast cancer diagnosis. It was overwhelming at the time, but she and her family were in it together. Her journey would include chemotherapy treatment, and surgery. While she knows nobody wants to join this club, Jennifer wants others facing a cancer diagnosis to know, they’re not alone.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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A CANCER JOURNEY
A top-notch attitude and big dreams
A young man with a young family and big dreams. But at twenty-nine-years old, Matt received the news no one wants to hear — a diagnosis of medullary thyroid cancer. With his wife and newborn by his side, Matt has kept a “top notch attitude” through the ups and downs of his cancer journey.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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A CANCER JOURNEY
Breast cancer diagnosis shocks pregnant, young mom
At the age of 22, Alyssa Tremblay lost her 53-year-old mom to breast cancer — 13 years after her mother’s initial diagnosis.
For Alyssa, pro-active screening began when she was 26 after she discovered a lump in her breast that was a fibroid. But after that experience and the arrival of her own daughter, Gabrielle, she decided to do the genetic testing to find out if she was at high risk of developing breast cancer.
The young mother would soon learn she had the BRCA2 gene mutation. For the 31-year-old, it brought mixed emotions. “It just felt like a shock but a relief at the same time because I knew I had the gene mutation and that meant I could start taking precautions to hopefully eliminate a cancer diagnosis,” says Alyssa.
Everyone has two copies of each BRCA gene—BRCA1 and BRCA2. You inherit one from each of your parents, and if one parent has a mutation, there is a 50% chance you will inherit it. Thankfully, BRCA mutations are not common — only one in 400 people inherit it — but the impact can be serious. Overall, 13% of those assigned female at birth will develop breast cancer sometime in their life. Those chances jump to 55%–72% for those with the BRCA1 mutation and 45%–69% for those with the BRCA2 mutation. People can take a blood test to check for these mutations if they have a family history of breast or ovarian cancer, or if they have Ashkenazi Jewish heritage, since the prevalence of BRCA mutations is higher in that group.
With the BRCA2 gene mutation confirmed, Alyssa knew she wanted to take the necessary steps to help remove any possibility of her getting breast cancer, but she and her husband wanted another baby too, so she decided to wait.
Then, just one year later, she faced another curveball— a breast cancer diagnosis. First, an ultrasound and mammogram in November 2020 revealed a tumour in her right breast. “I just started getting anxious, and I started thinking ‘What if I’m not here anymore for my daughter and my husband?’ Everything started racing in my head.”
Then, at the end of the month, a biopsy indicated the tumour was cancerous. Incredibly, just three days earlier, Alyssa and her husband, Mathieu, discovered they were going to have another baby. “I was scared every day for my baby,” explains Alyssa.
In January, Alyssa had a mastectomy. That surgery revealed the cancer cells had spread to her lymph nodes, and they were removed. Alyssa then met medical oncologist Dr. Mark Clemons because she would need chemotherapy treatment, something she just couldn’t imagine for her unborn baby. But Dr. Clemons offered her hope. “He was so reassuring telling me ‘We’re saving everybody, you and the baby,’” says Alyssa.
Those words stayed with Alyssa through each treatment and each month as her baby grew inside her. On July 29, 2021, baby Audrée was born via C-section — strong and healthy — and Gabrielle became a big sister.
The next day, Alyssa and her husband held their breath waiting for the results of a CT scan, which had been delayed until after the baby was born. Then some more good news — all clear — the cancer hadn’t metastasized. Once Alyssa recovered from her C-section, she underwent 15 rounds of radiation treatments, and was induced into menopause — all to help ensure she’s able to watch her daughters grow up.
“With the advancements in medicine and the precautions my care team is taking at The Ottawa Hospital, my husband and I are hopeful I’ll watch our daughters graduate from school, get married, and have their own children someday. We’re planning for the future.”
Alyssa Tremblay
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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A CANCER JOURNEY
A cancer diagnosis later in life didn’t stop this athlete from competing
Update: It is with sadness we share that Samuel Lawrence passed away in February 2022 shortly after we published his story. Samuel inspired us with his determination to compete and achieve his goals despite undergoing cancer treatment. We hope that by sharing his story of resilience he will inspire others like he did us, and we offer our sincere condolences to his family.
At age 78, Samuel Lawrence’s athletic ability continued to dominate his life, even after a diagnosis he didn’t see coming.
In October 2018, a regular check-up with his family physician discovered Samuel’s red blood cell count was very low. The news came as a surprise to him and his family. “I didn’t have any physical signs of being sick. I was feeling OK in my day to day life,” says Samuel.
Referred to The Ottawa Hospital for a bone biopsy to try to pinpoint the cause of the low hemoglobin levels, Samuel was shocked by the results. He was diagnosed with a myelodysplastic syndrome, or MDS, and learned this is what happens when a person’s bone marrow does not produce enough functioning blood cells.
What is MDS (myelodysplastic syndromes)?
Myelodysplastic syndromes — or MDS — is a group of conditions in which there aren’t enough healthy blood cells produced by the bone marrow. The immature blood cells build up in the marrow and blood, decreasing the amount of healthy red and white blood cells and platelets. Once referred to as pre-leukemia — because one third of patients with MDS will progress to acute myeloid leukemia (AML) — MDS is now recognized as a form of cancer itself. There is no known cause for MDS, but known risk factors include: exposure to high-dose radiation, some genetic conditions, long-term exposure to certain chemicals, smoking cigarettes, and even treatment for other cancers. MDS usually develops in older people, and more often in men than women. Treatments focus on relieving symptoms and slowing or stopping MDS from developing into AML; treatment can include chemo, drug therapy, blood transfusions, growth factors, or stem cell transplantation.
Treatment began soon after. Samuel continued to visit our hospital’s Medical Day Care Unit (MDCU) every six weeks for treatment that includes two injections. “The regular injections took a toll on me. It took me about a week to recover from each treatment and to get my energy back. The drug was to help maintain my counts, but it’s not a cure.”
In the summer of 2021, his hemoglobin levels dropped again, and his doctors were trying to determine why. Samuel learned his condition is complicated and unpredictable.
Samuel credits the caring team for helping him through each session. “The Ottawa Hospital has been the best. The MDCU is incredible. The nurses who took care of me every six weeks — they were my guardian angels. They were wonderful people and they treated me very well.”
That exceptional care helped Samuel achieve a significant goal in the summer of 2021 when he competed in javelin and high jump at the Ontario Master Championships in Toronto. Samuel recalled sheepishly asking his hematologist, Dr. Grace Christou, if it would be ok to participate. “She bounced out of her chair and became an instant cheerleader, and she told me to go for it!”
He trained through the summer months at the Terry Fox Athletic Facility and competed in mid-August 2021. His doctors altered his treatment in order for him to be able to compete. Samuel medaled in both his javelin and high jump competitions.
Today, the injections have stopped — they became too much for Samuel and he made the decision to end treatment. While his condition continues to decline, he is comfortable and in good spirits. He and his family are grateful for the care he received. “I couldn’t t ask for any better group to treat me and I’m also blessed to be in Canada receiving this care.” He’s also grateful to those hidden heroes — those who generously donate blood on a regular basis to help patients like him.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Look forward. Move ahead. That’s the motto Robert Hurst lives by — no matter what challenges life throws his way.
Forced into early retirement from the Canadian Navy after he suffered significant injuries in a cycling accident, Robert moved to Ottawa in 2007 and started a new career in the technology sector. It wasn’t until 2015 when he would overcome his mental fear of cycling — in fact, cycling played a critical role helping him through a new healthcare hurdle he would soon face.
In late 2017, Robert was diagnosed with a cancerous tumour inside his mouth on his right cheek. Within three months, he had surgery to remove the tumour that had tripled in size. “It went from the size of a marble to a robin’s egg,” explains Robert.
The recovery from the surgery took a greater toll on Robert than anticipated. Once he was ready, he began radiation treatment. It was a difficult and sometimes painful time for Robert, but he credits our Cancer Centre for guiding him through each treatment. “The dietitians, physiotherapists, and the psychologists, I talked to them all. It was like having a small family group in the hospital — they really helped me get through the major parts of radiation. There was a period of time when I couldn’t eat anything solid — it was like swallowing razorblades.”
After 30 rounds of radiation, which took place five days a week for about 90 minutes, Robert had completed treatment, but his journey was far from over. The side effects from radiation resulted in bone death in his right lower and upper jaw. He had surgery in May 2021 to remove three dead teeth, but the bone wouldn’t heal so Robert started regular treatment from the Hyperbaric Unit to help heal the gums. He’s had 116 treatments in total — 30 of which happened at our hospital — to stop a bone infection in his jaw. To this day, he still has exposed bone on his rear molar on his lower jaw that he’s receiving care for by a dental surgeon at our hospital. “But that’s where the cycling comes into play,” Robert quickly adds.
Hyperbaric therapy has been used for decompression sickness since the 1930s, but over the years, its recognized potential in other medical applications has grown, and today, it is used for 14 specific conditions.
Despite everything Robert’s body has been through, he turned to his love of cycling to help build his muscle back up. “Before radiation, I was in really good shape, but within two months of treatment I had no muscle.” That’s when Robert decided to take back control of his body. “I bought an indoor trainer, set a goal, and by August 2019, I completed a 190 km bike ride.”
Since then, he’s logged hundreds of kilometres for different events, including THE RIDE, a past cycling fundraiser for The Ottawa Hospital.
Today, at age 50, Robert is cancer-free. However, there’s a precursor to cancer called lichen planus, which he now has in his mouth and is being monitored closely by his team at the Cancer Centre every three months.
He hopes his motto will catch on with other patients who face this disease. “Look forward. Move forward. What’s done is done. Listen to your doctors at the Cancer Centre. They will help you move forward. You cannot heal if you don’t set positive goals for yourself that is the biggest key to it all.”
He continues to set those goals for himself. “Next summer I have big plans. I’ll be travelling to Kansas for the world-famous 200-mile Unbound Gravel Bike race in June. Then in August, I have been cleared to cycle from Vancouver to Halifax.” For Robert, it’s all about looking forward.
“The dietitians, physiotherapists, and the psychologists, I talked to them all. It was like having a small family group in the hospital — they really helped me get through the major parts of radiation.”
Robert Hurst
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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A CANCER JOURNEY
Diagnosed with two forms of non-Hodgkin’s lymphoma within five years
Janet Pigott’s cancer journey began in Paris, France in late 2010 — the 51-year-old was enjoying a vacation with her husband when she noticed some enlarged lymph nodes. With no previous health problems, Janet didn’t worry much but followed up with her family doctor when she returned home.
By early 2011, Janet faced a diagnosis of non-Hodgkin’s lymphoma — a form known as Follicular lymphoma. This type of lymphoma typically develops slowly, but by late fall of 2011 the cancer got to a point where hematologist Dr. Isabelle Bence-Bruckler put a treatment plan in place.
What is non-Hodgkin’s Lymphoma?
Lymphomas are cancers of the blood and bone marrow that originate in mutated lymphocytes, a type of white blood cell. Lymphocytes are part of the lymphatic system which is in turn a part of the immune system. Usually, the lymphoma cells form in the lymph nodes, but they can spread throughout the body.
There are two main types of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma, or NHL. There are also more than 30 different types of NHL itself. Both Hodgkin and non-Hodgkin lymphoma have similar symptoms —pain and swelling in the lymph nodes, fever, night sweats, and weight loss. The main difference between the two can be seen with a biopsy: Hodgkin lymphoma involves massive lymphocytes called Reed-Sternberg cells. Other differences include that Hodgkin lymphoma patients are often diagnosed younger, it’s rare, and more than 86% of patients survive five years or more. On the other hand, non-Hodgkin lymphoma patients are often diagnosed over 55, it’s the seventh-most diagnosed cancer, and about 70% of patients survive five years or more. Treatment for both can include chemo, drug therapy, radiation therapy, stem cell transplants, or clinical trials with new drugs, drug combinations, or approaches.
Given the chance to participate in a clinical trial, Janet jumped at the opportunity. It included immunotherapy treatment in combination with chemotherapy. “It felt great to be part of something that could lead to cancer treatments that are less toxic, more tolerable, and less painful down the road,” says Janet.
By March 2014, Janet’s treatment was finished, and she celebrated — she was in remission. Not long after, she decided to retire from her role at the Canada Council for The Arts in early 2015 — she was ready to spend more time with her family, including her elderly mother and her three grown children. But, by that summer, she would face a new health challenge when she started noticing lesions on her skin.
Referred to dermatologist Dr. Melanie Pratt, Janet underwent a multitude of tests — all of which came back negative, but the symptoms persisted.
Ultimately, it took three years before biopsies revealed a positive result and confirmed a diagnosis. Janet credits Dr. Pratt for being persistent in diagnosing these mysterious lesions, which turned out to be another form of non-Hodgkins lymphoma known as Cutaneous T-Cell Lymphoma.
A prescribed medication would help eliminate a majority of the lesions on Janet’s body, but one lesion progressed to the point where radiation was required. She had five rounds of radiation, and her treatment was deemed a success by January 2021. “I’m told I’ll always have this type of cancer, but it’s treated like a chronic condition.”
Janet’s first lymphoma recently relapsed. In the coming weeks, her oncology team will determine the best form of treatment and timing. While the news wasn’t entirely a surprise, it was still a bit of shock. “I had practically forgotten about the cancer, but I know I’ll be well taken care of by the hospital,” says Janet.
With over a decade of visits to the hospital, Janet is grateful for the exceptional care and attention she received for both cancers. She witnessed the extra steps staff take to make sure each patient is treated with kindness. In fact, there was one moment on a cold winter day, she won’t soon forget. “I had an early morning appointment in January, and I was tired because I was undergoing chemo. I was on a waiting room bench and I put my head down, when a hospital team member came over with a heated blanket and put it over me. That was pretty special,” says Janet.
“It felt great to be part of something that could lead to cancer treatments that are less toxic, more tolerable, and less painful down the road.”
Janet Pigott
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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The Cancer Journey Series
With each cancer diagnosis, a patient and their family face a difficult and uncertain future.
These are their stories of resilience and hope.
At The Ottawa Hospital, we’re seeing breakthroughs in cancer research that a decade ago seemed impossible. Personalized cancer care allows our medical experts to provide precise treatments, tailored to a patient’s unique cancer. Clinical trials offer patients and their families new hope, and this type of groundbreaking research allows our experts to harness their expertise and develop game-changing treatments.
We believe all cancers can be cured. Our inspiration comes from our patients — our neighbours, colleagues, friends, and family members. Here are just a few of their stories — cancer journeys from around our region. For them, and so many others, we will continue to discover and test novel ways to eradicate cancer and create a better tomorrow.
Diagnosis of Hodgkin’s lymphoma stops Heba Haidar in her tracks
HEBA HAIDAR
When Heba Haidar was diagnosed with Hodgkin’s lymphoma her world came to a grinding halt. On maternity leave, and with three young children at home under the age of five, she worried about what the future might hold.
Randy McElligott’s unusual reaction to his cancer diagnosis
RANDY McELLIGOTT
When Randy McElligott was diagnosed with multiple myeloma, he was happy. Randy’s unusual reaction to this news was because he saw this an opportunity — an opportunity to try something different in his life. He set a goal to run a marathon and he’s never looked back.
Years after losing his dad to cancer, Robert Nsengiyumva faces his own diagnosis
ROBERT NSENGIYUMVA
When diagnosed with stomach cancer at age 53, Robert Nsengiyumva had already lost many family members to cancer, including his dad. Today, Robert’s grateful to be cancer-free thanks to The Ottawa Hospital.
Nurse Sabrina Presta’s very different perspective of life as a patient
SABRINA PRESTA
In 2020, nurse Sabrina Presta found herself as a patient after being diagnosed with thyroid cancer. It gave her a firsthand glimpse about life on the other side of healthcare.
Music leads Caleb Fagen through his journey with Hodgkin’s lymphoma
CALEB FAGEN
Caleb Fagen was close to finishing his undergrad in music at uOttawa when he was diagnosed with Hodgkin’s lymphoma The 21-year-old was completely unprepared for the news, and he shares the toll it took, both physically and mentally.
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 being treated for multiple myeloma.
Anxiety of cancer diagnosis eased by compassionate care team
JAY ABRAMOVITCH
When Jay Abramovitch went to the Emergency Department in November 2020, he never expected to hear the word cancer — let alone stage 3B colon 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.”
Aggressive lymphoma diagnosis that Ram Dubey never saw coming
RAM DUBEY
Four years into his retirement, Ram Dubey was enjoying the extra time he had to pursue his interests in painting and photography. But in October 2019, some red flags started to go up concerning his health, and he was diagnosed with lymphoma.
By the time she was in her early 40s, Tanya O’Brien, had already seen six family members diagnosed with breast cancer — she was terrified she was next. Then in 2013, her worst fears came true, and Tanya turned to The Ottawa Hospital’s Breast Health Centre to face her diagnosis.
Breast cancer diagnosis shocks pregnant, young mom
ALYSSA TREMBLAY
At the age of 22, Alyssa lost her 53-year-old mom to breast cancer. Almost ten years later — now a mother herself — she learned she had the BRCA2 gene. It would be the beginning of a journey Alyssa hoped she would never have to experience.
Trusting his instincts led to a rare cancer diagnosis
KEVIN FREITAS
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 his doctor and leave a message. Tests revealed Kevin had mucosal melanoma — a rare form of skin cancer found inside the body.
A cancer diagnosis later in life didn’t stop this athlete from competing
SAMUEL LAWRENCE
At age 78, Samuel Lawrence’s athletic ability continued to dominate his life, even after a diagnosis of myelodysplastic syndrome that he didn’t see coming. Treatment and guidance from his doctors allowed Samuel to compete at the Ontario Masters Championships in Toronto, one last time, in the summer of 2021.
A young man with a young family and big dreams. But at twenty-nine-years old, Matt received the news no one wants to hear — a diagnosis of medullary thyroid cancer. With his wife and newborn by his side, Matt has kept a “top notch attitude” through the ups and downs of his cancer journey.
“Look forward. Move ahead.” That’s the motto Robert lives by — no matter what challenges life throws his way. In late 2017, Robert was diagnosed with a cancerous tumour inside his mouth. While it’s been a long road of treatment — cycling and giving back have empowered him throughout his cancer journey.
A message to other cancer patients: “You are not alone”
JENNIFER DAVID
In 2019, Jennifer received an unexpected breast cancer diagnosis. It was overwhelming at the time, but she and her family were in it together. Her journey would include chemotherapy treatment, and surgery. While she knows nobody wants to join this club, Jennifer wants others facing a cancer diagnosis to know, they’re not alone.
Diagnosed with two forms of non-Hodgkin’s lymphoma within five years
JANET PIGOTT
Janet’s cancer journey began in Paris, France in late 2010 — the 51-year-old was enjoying a vacation with her husband when she noticed some enlarged lymph nodes. By early 2011, Janet faced a diagnosis of non-Hodgkin’s lymphoma and four years later, yet another cancer diagnosis.
Cancer. It’s a disease that has touched all of us in some way.
That’s why The Ottawa Hospital is challenging the boundaries of conventional cancer care and making critical advancements in cancer research that a decade ago were deemed impossible to achieve.
We treat cancer patients from Deep River to Hawkesbury to Cornwall, and as far away as Nunavut.
Our collaborative team of physicians, nurses, researchers, and other healthcare professionals are harnessing their collective skills, committed to finding the latest treatments options, and enhancing the quality of life for our cancer patients.
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.
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.
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. 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
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.
What’s next for the clinical trial?
Dr. Kekre and her team are monitoring all patients enrolled in the trial and published preliminary results in June 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 chimeric antigen receptors (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 last 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.
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.
Categories: Biotherapeutics, Clinical Trials, Innovation and Technology, Patient Care, World-Leading Research
A resident of Goose Bay, N.L., most of his life, John Bookalam lives for the outdoors. He loves adventures, including international cycling and skiing in the winter. The retired guidance counsellor cherishes that time even more today, after a harrowing medical diagnosis unexpectedly led him to The Ottawa Hospital for neurosurgery.
It all began in late winter of 2017 when John returned from teaching a ski lesson. He was unloading his gear from his SUV when he hit the back of his head hard on the hatch door. Initially concerned he might have a concussion, John quickly eliminated the possibility thanks to his first-aid training. However, a week later, he followed up with his family doctor and an ultrasound revealed what appeared to be a hematoma, a collection of blood outside a blood vessel, which would normally resolve itself. “But the next week, I had to see my doctor again and the hematoma went from four centimetres on the ultrasound to eight centimetres,” says John.
“I was so nervous. I could hardly think.”
— John Bookalam
John on his last solo cycle in the mountainous north west part of the isle of Majorca before his 2017 illness.
The situation turns dire
John’s care team in Goose Bay closely monitored him for many weeks. However, by the end of May, he developed symptoms similar to the flu. “I was burning up. I was on fire and I immediately went to the emergency department of my local hospital. Those symptoms would be a bad omen,” says John.
A CAT scan revealed the hematoma had grown from eight centimetres to 10.6, and the situation was becoming dire. He needed a skilled neurosurgery team to help him — a team that was not available in Newfoundland and Labrador. With roots back in Ontario, he turned to his dear friend, Nadia Marshy, from the Ottawa area for guidance.
Nadia vividly remembers the day she got the call from “Labrador John,” a nickname she gave him through their cycling adventures. She was sitting at her desk when she picked up the phone — John was at his wit’s end. “I knew he’d been hit hard on the head and it had caused a large bump. That was weeks earlier, so I presumed that he was all healed up by now. John proceeded to tell me that not only was the bump much larger, but he was in constant pain,” recalls Nadia.
“She played a vital role in identifying The Ottawa Hospital as an emergency life-line to receive lifesaving surgery.”
— John Bookalam
Calling on our neurosurgery experts for help
Following that call, Nadia was beside herself and she knew her friend was in a medical emergency. “Here I was sitting in my sunny downtown Ottawa office with The Ottawa Hospital and all of its innovation and world-class services next door, and there was my dear friend with this massive, infected lump the size of a grapefruit in desperate need of help and so far away.”
Next, Nadia worked to get John in touch with the neurosurgery department at our hospital — she had witnessed the skill firsthand in 2012 when Dr. John Sinclair performed two lifesaving surgeries on someone close to her. “I gave Labrador John the contact information, and within a few short days, he was on a plane to Ottawa,” explains Nadia.
John, far left, and Nadia, fourth from the right.
John credits Nadia for helping save his life. “She played a vital role in identifying The Ottawa Hospital as an emergency life-line to receive lifesaving surgery.”
Once John landed at the Ottawa airport, he went straight to the Civic Campus with all his documents in hand. He met with neurosurgeon Dr. Howard Lesiuk and plastic surgeon Dr. Daniel Peters and handed them his scans to review. They determined the situation was worse than anticipated, and John would need surgery as soon as possible. “I was so nervous. I could hardly think,” recalls John.
A shocking discovery
The surgery would be long and difficult, and it uncovered something far worse than John had ever imagined when he embarked on the trip to Ottawa. Doctors discovered a non-Hodgkin lymphoma tumour on the back right-hand side of his skull and part of his skull was badly infected. While the news was devastating, John recalls the reassuring words that came from Dr. Peters before surgery. “He said I had a strong heart and tremendous lungs, and both would help me during the complicated surgery.”
“We are blessed to have some of the best minds and the most skillful surgeons on the planet right in our backyard. I am convinced what they did for Labrador John is what no one else could have done, and ultimately saved his life.”
— Nadia Marshy
While the news was devastating, Nadia recalls after the surgery, the pain John had experienced for so many weeks was already subsiding. “He received incredible care. The night before his surgery, he was weak, in agony, and couldn’t hold his head up for any length of time because of the pain and the weight of the mass on his head. The next day, he was able to lie on his head and rest in comfort,” says Nadia.
Next, John was transferred to the Cancer Centre at the General Campus for testing to learn more about the tumour. “I underwent a lengthy procedure by an incredible team to diagnose my lymphoma type.”
Primary central nervous system lymphoma
Diagnosed with primary central nervous system lymphoma (PCNSL), John began chemotherapy treatment here in Ottawa before returning home where he would continue his care at the St. John’s Cancer Centre.
Primary central nervous system lymphoma is an uncommon form of non-Hodgkin lymphoma. It starts in the brain or spinal cord, in the membranes that cover and protect the brain and spinal cord, or in the eyes. This type of cancer is more common in older adults with the average age at diagnosis being 65.
Further testing revealed John had diffuse large B-cell lymphoma – BB Expressor — an aggressive type of lymphoma.
However, after months of treatment, good news came on February 26, 2018, when John learned he was cancer free.
“After almost four years, I’m cancer free and I’ve healed after three head surgeries. I’ve resumed my cross-country skiing and marathon road cycling.”
— John Bookalam
Not yet out of the woods
His journey, though, was far from over. John returned to Ottawa for one more surgery for skull base osteomyelitis — an invasive infection. Other treatments back home didn’t prove helpful and, once again, John required specialized care.
A highly skilled team at The Ottawa Hospital came together again to perform another difficult surgery. They would use a procedure called debridement and they would need to produce a new blood supply to the area. Debridement is when the surgeon removes as much of the diseased bone as possible and takes a small part of the surrounding healthy bone to ensure they have removed all infected areas. “They scraped the bone down until there was no sign of the infection and then did skin grafting on the back of my head,” explains John. The second part of the procedure was even more complex and involved taking an artery from his back, transplanting it to his head — creating a vital blood supply from his ears to the back of his skull. “I thank plastic surgeon, Dr. Sarah Shiga for being there in my time of need. If it were not for team Shiga and Lesiuk, I would never have achieved the quality of life I have today.”
“I owe much gratitude to the surgeons and staff at The Ottawa Hospital. Hopefully, my story will inspire others to donate so others can regain a quality of life as I have in abundance today.”
— John Bookalam
As a result of the debridement, he lost a significant amount of bone at the rear of his skull. Today, he must be very careful — he wears a helmet even when he’s driving to protect his brain, but his adventures continue. John’s grateful for each day and each outing he’s able to plan. “After almost four years, I’m cancer free and I’ve healed after three head surgeries. I’ve resumed my cross-country skiing and marathon road cycling.”
Nadia is also grateful for what she witnessed. “We are blessed to have some of the best minds and the most skillful surgeons on the planet right in our backyard. I am convinced what they did for Labrador John is what no one else could have done, and ultimately saved his life.”
Labrador John continues to say thank you
John’s gratitude goes beyond just words. He started by recognizing his care team through our Gratitude Award Program. While it was an important way for him to say thank you, it’s the special note he got in return from Dr. Shiga, who was a part of the second surgery, that made the donation extra special. “She wrote me a beautiful, personal handwritten letter. That’s one of the best letters ever sent to me,” says John.
The 73-year-old didn’t stop there though. He became a member of the hospital’s President’s Council when he committed to support our hospital with a donation of $1,000 a year. “I owe much gratitude to the surgeons and staff at The Ottawa Hospital. Hopefully, my story will inspire others to donate so others can regain a quality of life as I have in abundance today.”
Nadia is just as happy to see her friend back living his active life. “To see Labrador John fully recovered and cycling up challenging hills and covering incredible distances is fantastic. Those surgeons gave him his life back. He never takes a moment for granted,” says Nadia.
And John says he never will. “I will always donate that $1,000 a year to The Ottawa Hospital until I pass from the earth.”
John, Summit at the summit of San Salvador.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Donors, Gratitude Award, Neuro, Patient Care
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.
“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, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Clinical Trials, World-Leading Research
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