Dr. Barbara Vanderhyden has spent her career looking for the metaphorical missing pieces to some of ovarian cancer’s most complex puzzles. As a senior scientist at The Ottawa Hospital, professor at the University of Ottawa, and Corinne Boyer Chair in Ovarian Cancer Research, Dr. Vanderhyden’s work makes a 3,000-piece puzzle look like child’s play.

From her first award — the Soroptimist Award for her volunteering as a high schooler in 1978 — to the accolades she’s garnered since — including the Dr. J. David Grimes Research Career Achievement Award, the Capital Educator’s Award, and the Governor General’s Caring Canadian Award — Dr. Vanderhyden’s award-winning career has changed the way ovarian cancer is understood and treated today.

Keep reading to learn why physiology is like a puzzle and why sucking eggs is a good thing in Dr. Vanderhyden’s lab.

Q: Can you tell us about your childhood and interests as a youth?

A: I grew up Southwestern Ontario, first in Stratford and then in a small town called St. Thomas. Small towns fit me very nicely; it was a great place to grow up.

For hobbies, I played piano and did a lot of service to the community. There was a teacher at my school who tried to get us out to do outreach in the community as much as possible.

Besides that, my teenage years were made up with academics. I was very good at science and math, which I was drawn to because I’m curiosity-driven. I love the process of trying to figure things out. Give me a puzzle or mystery and I’m a happy camper.

Q: How did you choose to pursue medical research, and specifically ovarian cancer research?

A: I started by doing an undergrad in physiology at Western University, and the first two years were a lot of basic science and math. In third year, I got a medical physiology textbook, and that’s where it first hit me how wonderfully interconnected all our parts are. It’s like a big puzzle, where you can put all the pieces together into one body. I was like, “Wow! Who invented this? Who would make it so complicated?” Now, 40 years later, we’re still learning about how all these pieces function together and what happens when they don’t function well.

There was nothing I wanted to do more than continue to explore the depths of physiology, so I went on to do my postdoc studying reproductive physiology, and then got offered a position here, at The Ottawa Hospital.

I became interested in cancer specifically after my team, as part of the cancer research group, moved into the brand new Cancer Centre in 1995. I was doing reproductive physiology as a scientist, and all of a sudden, there were cancer patients in the waiting areas who I would pass on my way to the third floor for research. It reminded me of where the bigger problems lie and put some onus on me to try to solve some of these puzzles.

I knew the ovary inside and out, and there was very little ovarian cancer research going on in Canada at that time, and so I thought, “OK, there needs to be more. Let’s figure out what happens when a tumour develops in the ovary.”

Q: What’s the most interesting thing you’ve found researching ovarian cancer?

A: What I find the most interesting at any point is whatever I’m working on. But one period that was very exciting was in the 1990s when we discovered the cells in the ovaries have a unique way of talking to each other.

The oocyte — the cell that becomes an egg that can be fertilized — grows within a structure called a follicle. The only other cells in the structure are granulosa cells. At the time, we believed the oocyte was a passive recipient of whatever messages the granulosa cells sent to it: when to grow, when to stop growing, when to mature, when to ovulate. We thought it was all controlled by the granulosa cells. But that didn’t make sense to me, because we know cells communicate with each other, so I thought there had to be a way to prove the oocytes send signals back to the granulosa cells.

The problem was that the follicle structure is a ball, with the oocyte in the middle, so we couldn’t easily study the oocyte without disrupting the granulosa cells. But we found a way to go in and suck the oocyte out of the ball of cells. Unofficially we called it sucking eggs, but when we published, we called it an oocytectomy. It allowed us to study what the granulosa cells did as a three-dimensional structure when the oocyte was inside versus when it was removed. As it turns out, the granulosa cells don’t even know what to do without the oocyte telling them!

A more recent discovery we’ve made is that human ovaries become fibrotic with age. Fibrosis occurs when there’s more collagen, which holds our cells together, than is required, and it forms sheets of stiffer tissue. Fibrotic tissues are a niche for cancer growth, but we don’t know exactly why that is.

That the ovaries develop fibrosis wasn’t unexpected; tissues tend to become fibrotic with age. But we also had an outlier in our collection of data, a postmenopausal woman who should have had a fibrotic ovary but didn’t. We determined she was taking the drug metformin for diabetes, and we’ve since done a number of studies to show metformin actually prevents the aging process in the ovaries. So right now, we’re trying to figure out how fibrotic tissue creates an environment for cancer growth and also how to use metformin to prevent fibrosis of the ovaries.

Q: What is The Ottawa Hospital doing in cancer research that’s exciting?

A: Ottawa was among the first communities to do immunotherapy research. We recognized that surgery, radiation, chemotherapy have their place, but they’re not appealing strategies to deal with cancer for most patients. I’m not an immunologist, but I’m surrounded by people who study immunotherapies and they were among the first to do so. That national sense of biotherapy and immunotherapy work really has its foundation here in Ottawa.

It’s very exciting for me, because ovarian cancers actually don’t respond to immunotherapies. I’m tapping into all this wonderful knowledge and expertise to say, “OK, why not? What makes them resistant?”

Q: What does community support mean for your work?

A: I’ve been very fortunate to have tremendous support from the community — and especially those with ovarian cancer, their friends, and their families — for three reasons. One, the patients have been extremely generous in giving us access to their tumour tissues for our research. Two, when we talk to patients, there’s no hesitation to tell us what works for them and what doesn’t, so we can ensure the research we do is both relevant and important to people affected by this disease. And third, the financial donations they make to research can often mean the difference between being able to do out-of-the-box thinking on a project.

Q: You were instrumental in starting the Ottawa chapter of Let’s Talk Science, can you tell us a bit about that?

A: As a grad student at Western, there was a very fledgling science outreach program in my department, run by another grad student. When I moved to Ottawa, I recognized right away there were no opportunities for students to learn how to teach. So, I set up a science outreach program that was the first branch of Let’s Talk Science outside of London in 1993. The goal is to connect elementary and high school students with science, technology, engineering and mathematics (STEM), help build their skills in the field, and encourage them to pursue STEM careers.

As we went further afield, we noticed more and more discrepancies in science opportunities, and so from 2007 until 2019, I also established and ran a program called Science Travels, which focused entirely on bringing STEM outreach to Indigenous youth in remote northern communities.

I ran Let’s Talk Science Ottawa for 25 years, and I am still involved, but about five years ago we got too big for our britches, and I couldn’t run it anymore and keep all the other things going. It’s now being run full-time by a former volunteer.

Q: Where would we find you when you’re not at work?

A: It depends on the weather and depends on the day. If it’s a cold rainy day, I am curled up in my favourite chair reading a good mystery or whodunnit, or I could be doing a jigsaw. Our dining room table for the last decade always has a 2,000- or 3,000-piece puzzle on it; I get quite a lot of gratification seeing the whole thing when it’s finished.

If it’s nice weather, I’m often taking walks with some of the other women in my neighbourhood. If it’s a Thursday, I’m with the guys in the neighbourhood for a movie night.

I also love eating my husband’s cooking, because he’s an absolutely incredible chef. He was a stroke and osteoporosis researcher, and since he retired, he loves to experiment in the kitchen, and I am the beneficiary of all that experimentation. It’s wonderful.

As the most common cancer, it’s no surprise there’s a lot of awareness around breast cancer. But there might not be as much awareness around the spectacular researchers and physicians who are changing the way we diagnose and treat breast cancer every day. The Ottawa Hospital is proud to say one of the most renowned of them works right here. Dr. Jean Seely is Head of the Breast Imaging Section at the hospital and a Clinical Investigator in our Clinical Epidemiology Program. Dr. Seely’s career is built on bringing research directly into patient care to improve the outcomes and reduce the mortality of breast cancer patients through better screening and diagnosis.

Read on to find out what Sci Fi innovation and personal family moment inspired Dr. Seely to become a breast radiologist.

Q: Did you always know you wanted to be a doctor — and specifically a breast radiologist?

A: I grew up in a family of doctors, so I was interested in being a doctor since I was five. My mother was a family doctor, and my father was a kidney specialist and worked in palliative care. My grandfather was a researcher and a doctor, and he always said medicine was the best field to go into — you could travel the world, teach, research, treat patients.

I knew I wanted to go into medicine, but I didn’t know much about radiology. After I completed med school in Montreal at McGill University, I did a general internship in Vancouver and realized how much I love to diagnose with my own eyes — to make early diagnoses. I remember watching Star Trek where they would use these machines to make diagnoses, and I thought that was something I wanted to do. [Editor’s note: those machines are tricorders.]

My grandmother died of breast cancer when I was four. She was diagnosed at 40, and it metastasized at 60. She would take care of me a lot, so I was very close with her. Looking back, she was instrumental in me going into breast radiology.

Q: How has the field of breast radiology changed since you started?

A: It’s dramatic! When I was in medical school in the ’80s, it’s when the old Canadian National Breast Screening Study was just being done. Nobody was really talking about screening before that; they didn’t pay attention to the quality of the mammogram. You’d get surgery to get a lump removed, and they’d diagnose it as cancer — or not.

“Not only can AI help with risk prediction, but it can improve the accuracy of the read of mammograms by 20%.”

— Dr. Jean Seely

What we do now is a mammogram and an ultrasound. We do a biopsy to see whether you have cancer, and you only get surgery once you have a proven diagnosis of breast cancer.
We have all these tools now that allow us to see cancer before it’s felt. In the ’90s, we started using MRIs for breast cancer, which is basically the most sensitive test for breast cancer. We now use ultrasound to screen — and to guide the needle for the biopsy.

We even have AI, and we can use the imaging components, pixels that are below the threshold of our eye, to predict whether someone will get breast cancer or not. Not only can AI help with risk prediction, but it can improve the accuracy of the read of mammograms by 20%. Some people say AI will take over the radiologist’s job, but I’m not at all worried about that. We do a lot of patient-centred care. We talk to patients, do biopsies, scanning — a lot of hands-on care on with patients.

Q: You’re leading the Tomosynthesis Mammographic Imaging Screening Trial (TMIST) and recently reached 2,000 participants. Can you tell us a little more about this?

A: TMIST is a multi-centre trial, happening at hospitals around the world. We’re looking to recruit 160,000 patients, and we’re at 100,000. At The Ottawa Hospital, we have 2,000 of those patients.

It’s a randomized controlled trial, so patients go into one of two arms: one is the regular screening for breast cancer using a 2D mammogram, and the second is 3D tomosynthesis, which uses a different technology.

Tomosynthesis isn’t a true 3D image, because it doesn’t go all the way around the breast, but it’s a pseudo-3D, where using a very low radiation dose, we get a sweep of images. With 2D imaging, sometimes the compression of the breast creates an overlap of tissue that makes something look like a mass or a density of tissue hiding a cancer. The 3D technique has been shown to reduce the number abnormal recalls — where patients don’t wind up having cancer — and increase the cancer detection rate by 40%. It’s a win-win, where you have fewer abnormals that are truly normal and you have more abnormals that are truly abnormal cancers.

Some people might say, “Why are you studying it if you know it’s so much better?” But we haven’t studied it in a randomized control trial in a very large population. We’re looking to see if it reduces the rate of advanced breast cancers after eight years and if a broad range of people will benefit.

Q: What is The Ottawa Hospital doing in radiology and breast health that is exciting or groundbreaking?

A: What I love about The Ottawa Hospital is that there’s always been this attitude of being the best and trying for excellence — of trying things out and working together to make things happen. And it’s not always necessarily led by physicians — it’s very much a joint relationship between administrators and physicians.

I’ve been here since 2001, and when I’ve gone to meetings or elsewhere, I realize this isn’t the norm. This kind of collaborative approach for innovation and excellence is something we should be very proud of.

Specifically, we’ve implemented things like improving how we locate tumours that were found in screening. It sounds barbaric now, but we used to insert a wire in the patient’s breast on the day of their surgery, and it would be hanging out of the breast, and they’d use the wire to locate the tumour for removal. But now, instead of the wire, we use a tiny little “seed,” almost the size of a grain of rice, with a tiny amount of radiation. The surgeon uses a Geiger counter to find it. It saves money, reduces delays, and improves patient satisfaction — it really revolutionized the approach. We were the third site in Canada to implement this.

We’ve also reduced the amount of time it takes to get an MRI. We used to screen women at higher risk, or those with dense breast tissue, for 45 minutes. We shortened it to 12 minutes. There’s been a huge improvement in patient satisfaction, outcomes, and capacity. Research helped provide this benefit. We were also one of the first in Canada to do this.

Q: If someone has just been diagnosed with breast cancer, what advice would you give them or how would you respond to them?

A: The key when I talk to patients is that there is always hope.

I think the whole reason why it’s important to do this is to undo some of the fear of the diagnosis of breast cancer. One in eight women will get breast cancer. Nobody wants to deal with it, but it’s something we have to be aware of. We have these great tools and wonderful people who are committed to diagnosing and treating it. That’s my hope with this, to provide encouragement.

Unfortunately, there are some people where they present really late, and when they get diagnosed, it’s already spread. That’s harder for us to deal with. That’s one of the reasons I do so much research — because I’m always trying to reduce that advanced cancer rate.

The key in these cases is compassion. My father was a palliative care physician and he always said he learned the most about living through dealing with the dying.

Q: What would we find you doing when you aren’t at the hospital

A: I get a lot of inspiration from my two children and my wonderful husband and friends as well as my three siblings. You might find me in the Gatineaus riding a bike. I also love to ski — cross-country or downhill. I get a lot of benefit from doing exercise in the outdoors. I also love to read — anything with good storytelling — one day I’ll write a book.