Laboratory Medicine Program’s (LMP) Dr. Theodorus Van der Kwast is the lead pathologist in the Canadian Prostate Cancer Genome Network (CPC-GENE) Sequencing Project, which recently discovered a new gene signature in prostate cancer that may help determine disease aggression and specialized treatment.
The study involved the molecular profiling of 74 patients and aims to eventually include surgical samples from 250 patients with prostate cancer. Dr. Van der Kwast, Genitourinary Pathologist, LMP, plays an essential role in acquiring specimens for research, and in this study focuses on patients diagnosed with an intermediate risk prostate cancer. This means the tumours behave quite variably – some with a very slow growth, others that are more aggressive, and a small subset even fatal.
“It’s not easy to collect that number of fresh, frozen specimen samples, especially with such specific criteria,” said Dr. Van der Kwast, who acquired samples from Biospecimen Services, as well as a separate biobank in Quebec. “As a pathologist, we need to ensure we have the highest quality specimen, and that each one meets the same criteria as the last.”
Once all 74 specimen samples were collected, Dr. Van der Kwast and assisting pathologists began studying each specimen individually – making sure there’s a large enough sample of the tumour with the necessary tumour cellularity, and that each specimen is characterized appropriatley, including tumour differentiation grade. After carefully analyzing each of the 74 patient specimens, five individual patients were selected for further investigation.
“I believe that pathology plays such a vital role in this type of cancer research because we are the ones laying the groundwork or the foundation for the rest of the research to come,” says Dr. Van der Kwast. “As lead pathologist, I need to ensure all our samples are very well defined, and the pathology data is able to support the research findings. It’s an essential part of any medical research done at the cellular level, and it requires true collaboration from the pathologists and the rest of the research team to make our work successful.”
“Without any one of us the project would fall apart.”
The research for the CPC-GENE sequencing project will work towards developing a diagnostic test to identify whether a specific cancer gene is present in a patient, and will help determine the aggression of the disease and the likelihood of it spreading outside the prostate during treatment. In addition, the molecular-genetic data of the CPC-GENE project will be made publicly available for the international community.
“It’s incredible research that our team has accomplished, and the pathology data we’ve collected is going to help advance other research projects, and new findings around the world,” says Dr. Van der Kwast. “We plan to publish the genomic data from each specimen so new studies can collaborate with our research, and we can work together to advance our understanding of prostate cancer on an international level.”
CPC-GENE is a member of the International Cancer Genome Consortium (ICGC), which collects the genomic data from cancer research all over the world. The consortium works as a central database for all types of cancers and allows researchers to compare genomic data, develop new findings, and conduct new research with the assurance that each specimen is reviewed by a pathologist.
“In some ways, all research teams work competitively against each other. But we also need each other to advance our findings, and to advance the diagnoses and treatment options available to patients,” says Dr. Van der Kwast. “Compiling the genomic data and making it available to others is exactly how we need to collaborate. It’s a great forum for pathologists and an exciting step forward for pathology.”
Elaine Fagan first found out she had sickle cell disease in 1981 when she was five months pregnant. After being admitted to the hospital, she didn’t get to go back home until 2 months after giving birth.
As blood transfusions are part of the treatment plan for some patients suffering with sickle cell disease, Elaine has had many, many transfusions over the years.
Recently, Elaine told a member of UHN’s Red Blood Cell Disorders Program and Medical Surgical Day Unit that she used to be scared of transfusion but now she is coming to forum meetings and talking to patients about her positive experience at UHN.
While a blood transfusion may feel like it takes up most of the day, Elaine emphasizes that she immediately feels the positive effects of her transfusions.
She would often suffer from shortness of breath, leg pain and swelling – but after the transfusion they diminish over the next couple of days and by the third day are often completely gone.
“I used to walk to the elevator (at home). Now I run to the elevator,” says Elaine. “I do everything like a normal person. I feel like I have nothing to worry about.”
Elaine has expressed her gratitude to her clinicians and support workers for how great she’s been feeling since she had the blood transfusion and is thrilled with the positive change in her health.
“The doctors are trying their best to help me and give me treatment to tackle my disease so I have to try too because they are trying,” she says, emphasizing the role everyone plays, including the patient, clinician, nurses and laboratory medicine team, in delivering quality care to all our patients.
Recently, LMP’s Dr. Suzanne Kamel-Reid was featured in an advertisement in the Globe and Mail for the Princess Margaret Cancer Foundation.
The tagline for the campaign is “Why is in our DNA?” and the ad highlight’s Dr. Kamel-Reid’s work in supporting the foundation’s “noble and necessary quest – to conquer cancer in our lifetime.”
The advertisement highlights how “Dr. Suzanne Kamel-Reid has developed new genetic tools that enable doctors to diagnose and treat cancer more precisely, helping us lead the way in Personalized Cancer Medicine.”
According to the Princess Margaret fundraising site, they’re often asked: Why is The Princess Margaret a world leader?
A lot of that credit lies with the trailblazing science of our world-class researchers who never stop asking “Why?”
Why is the body’s immune system not able to fight off all cancers?
Why does cancer return in some patients?
Why did a particular cancer drug work for one patient but not any of the others?
Why did one patient’s tumour shrink dramatically with radiation, but another’s barely at all?
Part of the foundation’s campaign, as highlighted on their site, includes seven key reasons why the Princess Margaret Cancer Centre will Conquer Cancer In Our Lifetime through Personalized Cancer Medicine. They are:
WE’RE A WORLD LEADER
The Princess Margaret Cancer Centre is one of the top 5 cancer research centres in the world with an outstanding reputation for leading patient care, breakthrough research and high-quality teaching. Located in Toronto, the Princess Margaret Cancer Centre is the only facility in Canada devoted exclusively to cancer research, treatment and education.
OUR WORK HAS GLOBAL REACH
A recent survey of the world’s top cancer centres showed that The Princess Margaret ranked fourth in the number of instances our researchers were cited in high-impact medical and science journals.
WE PUT PATIENTS FIRST
Our ‘patient benefit’ mindset links scientific research with patient care. Our clinicians and researchers collaborate and share knowledge, all in an effort to benefit patients.
OUR RESEARCHERS ARE CUTTING EDGE
We have a rich history of discovery and innovation , including Drs. James Till and Ernest McCulloch’s discovery of stem cells at The Princess Margaret in 1961. We celebrated another major breakthrough in stem cell research when Dr. John Dick identified colon cancer stem cells in 2006. Milestones such as these reflect the remarkable progress being made in conquering cancer at The Princess Margaret.
WE TRAIN THE WORLD’S BEST
We are training the cancer specialists and health care leaders of tomorrow. We provide a rich learning environment for medical residents and young scientists from around the world, who then take what they’ve learned to other top medical centres worldwide.
WE MOVE RESEARCH FORWARD
The many relationships in place with industry partners, other healthcare organizations and academic institutions across Canada and around the world allow us to advance our research more quickly. Massive tasks such as identifying genetic markers of different cancers require intense collaboration.
WE HAVE PASSIONATE DONORS
We have tremendous support from our donor community. We have committed donors who share our conviction that We Will Conquer Cancer In Our Lifetime. Believe it.
This week Blood Transfusion Medicine at UHN underwent joint accreditation assessments by the American Association of Blood Banks (aaBB) and College of American Pathologists (CAP). The accreditation team comprised of Dr. Ramesh Borad and Dr. Elpidio Pena assessed the combined 1572 requirements against the Laboratory Medicine Program’s – Blood Transfusion Laboratories and the patient care areas that transfusion blood products across UHN.
We are thrilled to report that UHN received an amazing 100% on their assessment, with zero deficiencies.
This is a remarkable achievement. UHN has the largest blood transfusion laboratory in Canada that prepares roughly a hundred thousand products a year. This accomplishment demonstrates the daily commitment and focus on excellence, quality and exceptional patient care by both the blood transfusion laboratories and the transfusionists at UHN.
Congratulations and well done to the entire team.
Recently, Dr. Anna Porwit and Amr Rajab, from UHN’s Laboratory Medicine Program (LMP) had their work on flow cytometry protocols presented at a Chicago conference featuring technological innovations in laboratory hematology. Due to high international interest, their protocols for investigating new onset cytopenias have been published in a special issue of the International Journal of Laboratory Hematology.
The protocol has now been practiced at LMP’s Flow Cytometry Laboratory for over two years, and provides benefits to patients with new onset cytopenias, who need to be investigated to exclude acute leukemia, myelodysplastic syndromes (MDS), myeloproliferative neoplasms and lymphomas. Dr. Porwit and Amr’s recommended immunophenotyping strategy uses 10-color FCM panels enabling a comprehensive evaluation of patients with cytopenias.
Read their full publication online: HERE
The ride brought out nearly 30 members of the Laboratory Medicine Program (LMP), all of which pedaled the Big Bike from the front of Toronto General Hospital, all the way around Queens Park and back to our starting line. We were the first team to kick off the annual Big Bike ride, and even though there’s no race or contest involved, I’m pretty sure we were the fastest and loudest team out there.
On top of that, all the donations received from friends and family gave our team VIP status, making us Very Important Philanthropists, and everyone who participated received a commemorative VIP medal.
Having something to remember this year’s race was especially significant because our long-time team captain, Jennifer Hardaker, who has been with the University Health Network for almost 50 years, has announced her retirement for the end of August. Jennifer has participated in the Heart and Stroke Foundation’s Big Bike for 14 years now, and has captained LMP’s team for the last 10. It was an emotional day for many who have participated with Jennifer over the years, but luckily there has been some campaigning to get Jennifer back on the bike next year as a rider.
When addressing the team after the ride, she said, “Thanks to all of you for making this year’s Big Bike such a great success. You made my job easy by being so willing to join the team.” She went on, “I know that you will continue the tradition that we have all enjoyed and encourage new colleagues to take part.”
Well done to everyone who took part in this year’s Big Bike, and a big thank you to Jennifer!