Category: Cancer

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 Fresque, who was treated for a rare pheochromocytoma at The Ottawa Hospital, pictured kayaking in Iceland with his wifte, Natalie.
Bryde and Natalie kayaking in Iceland.

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

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

Pinpointing the cause

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

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

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

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

Most unusual pre-op visit

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

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

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

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

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

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

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

Finding the answers

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

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

— Dr. Neal Rowe

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

Expertise in pheochromocytomas

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

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

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

— Bryde Fresque

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

Moving forward, upwards, and giving back

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

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

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

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

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

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

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

Categories: Donors, Patient Care, World-Leading Research

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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A CANCER JOURNEY

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.

Categories: Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer, Cancer

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.

What is the BRCA2 gene?

While breast cancer genes (BRCAs) might sound like they cause cancer, they’re actually genes that control the production of proteins that help repair damaged DNA and prevent cancer. But when there’s a mutation of a BRCA gene, people have an increased risk of developing several different types of cancer—primarily breast and ovarian—and are more likely to develop it at a younger age.

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.

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A CANCER JOURNEY

Look forward. Move ahead. Cycle through cancer

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.

What is a hyperbaric chamber?

Hyperbaric therapy involves the use of a closed chamber to create a high-pressure environment in which a patient is exposed to high levels of oxygen, the end result being an increase in the amount of oxygen in their blood. The air pressure inside the hyperbaric chamber is more than twice that of the normal atmospheric pressure, and patients are exposed to 100% oxygen instead of the usual 21% we breathe on a daily basis. Oxygen helps specifically with healing wounds, so exposing wounds to 100% oxygen can help speed healing. A session typically lasts 30 minutes to two hours.

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.
Heba's Journey

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.
Randy's Journey

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.
Robert's Journey

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.
Sabrina's Journey

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.
Caleb's Journey

How we'll fight cancer together

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More Journeys

Full circle experience for Denise-Picard Stencer

DENISE PICARD-STENCER

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.
Denise's Journey

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.”
Jay's Journey

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.
Ram's Journey

A cancer journey by the numbers

TANYA O'BRIEN

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.
Tanya's Journey

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.
Alyssa's Journey

Trusting his instincts led to a rare cancer diagnosis

KEVIN FREITAS

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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.

Read More

Originally published: January, 2022

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

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

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

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

— Owen Snider

Lymphoma returns for a third time

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

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

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

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

– Dr. Natasha Kekre

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

What is CAR-T therapy?

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

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

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

Going for the Pac-Man effect

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

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

– Owen Snider

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

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

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

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

Did the CAR T-cells therapy work?

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

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

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

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

What’s next for the clinical trial?

Dr. Kekre and her team are monitoring all patients enrolled in the trial and 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. Owen was accepted into a made-in-Canada CAR-T therapy clinical trial at The Ottawa Hospital to treat his lymphoma.
Owen and Judith Snider.

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

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

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

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

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

Categories: Biotherapeutics, Clinical Trials, Innovation and Technology, Patient Care, World-Leading Research
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