BREAKTHROUGH

WINTER 2019

OPENING THOUGHTS

REFLECTING ON GESTURES OF GRATITUDE

As we inch closer to the end of another tremendous year for the Foundation, now is a time of reflection and appreciation. My personal focus is expressing gratitude to our donors and all the hardworking people at BC Cancer who are changing outcomes. The joy in my job each day is witnessing examples of true generosity and impact.

Recently, I attended a moving presentation by BC Cancer’s new Spiritual Care Practitioner, Alison Cumming. She supports patients and families during their cancer care and assists them in connecting to their own inner spiritual resources and practices, working as part of the inter-professional care team with patient and family counselling. Because this role is not funded by the government, donor support was essential in bringing an expert in this field, like Alison, to BC Cancer.

Earlier this year, I witnessed another moment of true kindness when a local Vancouver philanthropist noticed a need and stepped up to make a change. This individual was inspired by her two friends who had undergone treatment at BC Cancer – Vancouver, and observed that the 5th floor family lounge was in dire need of a renovation. She rallied friends and family to raise and donate $25,000 to the Foundation to create a fresh, comforting space for patients and families in honour of her friends.

In September, cancer care in Prince George received a spontaneous gesture of generosity. Mike Schlater, CEO of Domino’s Pizza Canada wished to honour Tony Wilson, franchise owner of Domino’s Pizza Prince George and his longstanding commitment to the community. Mike visited Tony at BC Cancer – Prince George from Ontario to present the gift: $100,000 to the centre’s Patient Comfort Fund, the largest one-time donation the centre has received in its history.

Today, I urge you to take a moment to pause and reflect about what—and who—you are grateful for, and how you can make a difference in your own way. From the bottom of my heart, I’d like to express my sincere gratitude for your ongoing generosity to help break down cancer and change outcomes for patients and families in our province.

Sarah Roth, 
President & CEO, BC Cancer Foundation

FEATURES

Seventeen-year-old Michelle Reilly with her mother, Carla Thomson

PERSONALIZED MEDICINE GIVES VANCOUVER ISLAND TEEN THE GIFT OF TIME

I want other people to know there is hope—and to just keep smiling.

Michelle Reilly

Last spring, Michelle was enjoying high school and life with her family, boyfriend Dylan and friends in her hometown of Lantzville, British Columbia.

One day, she noticed pins and needles in her feet and thought it was a potential sports-related injury from volleyball. Three weeks later, her foot went numb, and she was sent for a lower-back MRI. It showed nothing.

Later that summer, Michelle began to suffer from such excruciating back pain and numbness in one leg that she was unable to go to school or attend volleyball. She went back to her doctor where she was put on a waitlist to see a neurologist in October.

Before she could see a neurologist, on September 26th, 2018, four days after her 16th birthday, Michelle woke up and had complete paralysis from the waist down. She was unable to walk.

Her mother, Carla Thomson, took her to Nanaimo General Hospital where she was sent home, given she was due to see the neurologist in two weeks, and was told it would be fine to wait until then.

Carla knew something was wrong.

“I put Michelle in the car, got us on the first ferry to Vancouver and took her straight to BC Children’s
Hospital,” she says.

Within three days of being admitted, doctors diagnosed Michelle with what the mother-daughter
duo describes as “the worst of the worst”—midgrade Glioblastoma Multiforme, a type of cancer which caused a tumour on her spinal cord which was later advanced to high-grade.

“When we heard the results, it hit us like a truck,” says Carla. “As her mother, there are so many things that I think of her not taking part in—not graduating high school, not having kids of her own, or not growing old.”

Michelle went in for surgery on October 5th, 2018 to remove the tumour and was able to wiggle her toes again. She then had six weeks of chemo and radiation at BC Cancer – Vancouver.

In December, Michelle went for a follow-up MRI. Her care team thought her case was looking more positive as the tumour had shrunk. Yet in March 2019, she returned for another MRI where she was told that the tumour had grown back.

ENTER PERSONALIZED MEDICINE

When Michelle had her initial surgery, her surgeon was able to take a sample of her tumour so that Michelle could be enrolled in BC Cancer’s flagship personalized medicine program: the Personalized Onco-Genomics (POG) Program.

Just as Michelle and Carla learned that Michelle’s tumour had returned, they also learned that the results from her POG analysis revealed an innovative treatment option—an immunotherapy clinical trial that would be infused once every two weeks.

“I was blown away that was an option. It made me feel really good when they came back with the results,” says Michelle.

While on her new treatment, Michelle showed great progress. Her tumour shrank, she was able to walk with arm support, and was feeling very positive about her situation.

Seven months later, in early October 2019, Michelle’s cancer progressed again.

COURAGE AND HOPE FOR THE FUTURE

On September 22th, Michelle celebrated her seventeenth birthday. Thanks to her immunotherapy clinical trial, she was able to enjoy spring and summer with little symptoms, and hope on the horizon.

“I had a gut feeling things may be going wrong, but I’m still in shock,” says Michelle.

Today, she is facing further cancer progression and requires a wheelchair.

“While we are feeling quite bummed out by my recent cancer progression, the research team behind my case gives me a lot of support,” she says.

Carla and Michelle travel back and forth from Lantzville, Vancouver Island to Vancouver by ferry
almost weekly for appointments and treatments. They like to keep things light with jokes and a positive
mindset.

“Positivity has so much power for healing, and for your mind,” says Michelle. “I want other people to
know there is hope—and to just keep smiling.”

Michelle and Carla are optimistic Michelle’s care team will once again use crucial pieces of information found from her POG analysis to provide her with another treatment option.

“For me, the science and advancements make me really hopeful for the future—even if it doesn’t pan out for Michelle, we feel it’s all worthwhile for future pediatric patients,” says Carla.

 

YOU CAN SUPPORT PERSONALIZED MEDICINE

Help bring more hope to patients like Michelle. Please contact Alyson Killam to learn more at 604.877.6160 or akillam@bccancer.bc.ca

Dr. Bernie Eigle, Medical Oncologist, Provincial Director of Clinical Trials, BC Cancer

BETTER TESTS, BETTER TREATMENT: HOPE FOR BLADDER CANCER PATIENTS IN B.C.

Through clinical trials and innovative research projects, we’re working to change the outcome for all people diagnosed with bladder cancer.

Dr. Bernie Eigl

Bladder cancer is the fifth most common cancer diagnosis in British Columbia and advanced disease is often deadly. “Although most patients initially respond well to chemotherapy, the five-year survival rate is less than 15 per cent,” says Dr. Bernie Eigl, provincial director of clinical trials at BC Cancer. "Through clinical trials and innovative research projects, we’re working to change the outcome for all people diagnosed with bladder cancer.”

Knowledge of the genetic characteristics of bladder cancer is expanding and experts have
identified several unique subtypes of the disease. According to Dr. Eigl, “We now know that bladder cancer
has the third highest mutation rate of all cancers, which explains why treatment often fails but may also
point the way to new therapies.”

Three promising projects are currently underway at BC Cancer:

  1. Platinum-based chemotherapy is the first-line treatment for metastatic bladder cancer. Fifty per cent of patients respond positively, but those who don’t are often too sick to undergo further treatment. For this reason, methods to help predict response are urgently needed. “We’re hoping to establish a practical tool to identify people most likely to benefit from platinum-based chemotherapy, and prioritize those unlikely to benefit for alternative therapies and clinical trials,” explains Dr. Eigl.
     
  2. Immune checkpoint inhibitors (ICIs) are drugs that reveal cancer to the immune system and enable a person’s T cells to more effectively kill cancer cells. The introduction of ICIs for bladder cancer has been a major breakthrough in the treatment of this disease. However, only about 15-20 per cent of people respond to current ICIs and it remains difficult to predict who will respond. “Our goal for this project is to determine whether T cells in a blood sample can predict response to ICIs.”
     
  3. Immunotherapy-based treatments have significantly improved outcomes for people with advanced bladder cancer, but experts are not able to predict who will benefit from immunotherapy-based treatments in advance. “By analyzing the cancer DNA present in the blood, we hope to identify mutations specific to each individual’s cancer,” says Dr. Eigl. “This could eventually allow us to tailor treatments for individuals, improving outcomes and reducing toxicity.”

Stories of Survival

“The main reason I’m passionate about clinical trials is because they’re the best way to move medicine
forward and improve the lives of those touched by cancer,” says Dr. Eigl. “BC Cancer is one of the highest contributors of patients on clinical trials in North America, and often ranks among the top in the world
in accruals to clinical trials, this is something for all British Columbians to be tremendously proud of.”

Recently, two of Dr. Eigl’s bladder cancer patients have shown remarkable responses to innovative therapies offered through a clinical trial:

  • Danny’s Story
    “Danny came to us with Stage IV bladder cancer. Since enrolling in a clinical trial, his cancer has shown a complete response,” Dr. Eigl explains.
    “When my doctor first saw my cancer progress, I was told to get my affairs in order. Then he mentioned clinical trials… I was astounded that, within a month or so, the treatment I was on sent my cancer into remission and has held it off ever since,” says Danny. “I know I am lucky and the clinical trial saved my life. Without it I would still have an advancing cancer, but instead I have humour, hope and a bounce in my step.”
     
  • Ken's Story
    “When they discovered the cancer in between my bladder and kidney, the prognosis wasn’t good, I had about a year left,” says Ken Sheh. 
    “I was told about a new trial underway and I embarked on this journey with little hope. When a year came around, I should have been dead. Instead, I was told I was cancer-free. Then, a routine scan revealed a new spot, this time in my bladder. Thanks to the close eye and support of Dr. Eigl, I was booked into surgery within a few weeks and had it removed. Dr. Eigl and his team saved my life not once, but twice.”
Trish, with her husband John Givins

CELEBRATING FIVE YEARS OF HOPE

The personalized onco-genomics program has bought me wonderful time with people I love and adore, especially my husband and son.

Trish Keating, patient at BC Cancer

This winter, Trish Keating will celebrate five years since her life changed forever. It will mark half a decade since her genome was sequenced through the Personalized Onco-Genomics (POG) Program at BC Cancer.

Trish, a retired costume designer in the Vancouver film industry, faced aggressive colorectal cancer for four years and was considered palliative before beginning the POG program as her last hope.

Through POG, Trish’s care team found her cancer was driven by a specific protein that could be blocked by a re-purposed common blood pressure medication. Trish started on the drug at the end of 2014, and within eight weeks, Trish was tumour-free.

“It’s still so hard to believe,” says Trish. “I was months away from death.”

Trish’s experience is just one example of how genomics—where experts deploy whole genome analysis to inform individual treatment planning for patients – is transforming cancer care for people across B.C.

“Genomics aims to understand the blueprint—what we call the genome—to a cancer, and by understanding that blueprint we can then start to individualize treatments for patients,” says Dr. Howard Lim, Trish’s medical oncologist at BC Cancer. “Genomics will change not only how we treat cancer, but also how we detect and prevent cancer.”

In 2016, Trish’s cancer reappeared twice near her spine. The first time, she had surgery to remove it, and the second time the dosage of the blood pressure medication was doubled, which caused the tumour to shrink.

With the positive news, Trish was able to enjoy two years of travel and quality time with friends and family.

Since last year, she has faced a bumpy ride with a tumour still on her spine and mobility challenges. “The
struggle for me is that my cancer migrated to my spine, and it’s been a rollercoaster,” she says.

Trish also had to have back surgery and now has two supporting rods in her spine.

Today, Trish is hopeful her care team will once again be able to find the root cause of the tumour in her spine through the power of genomics. Trish continues to take her blood pressure medication daily and has CT scans at BC Cancer every three months.

“My heartfelt wish is that the POG Program will free many other people—patients, families and friends—from the suffering of cancer, as it did for me,” says Trish.

“POG has bought me wonderful time with people I love and adore, especially my husband and my son.”

Dr. Scott Tyldesley, radiation oncologist, BC Cancer

A NEW ERA FOR RADIATION THERAPY

More than half of all people diagnosed with cancer need radiation therapy as part of their treatment. Over the last decade, mounting evidence has suggested that precision radiation therapy (PRT) can lead to better outcomes for patients with all types of cancer.

PRT uses specialized, highlyfocused radiation techniques to cure cancer, prolong survival and increase
quality of life. External beam PRT delivers radiation therapy to tumours from various positions around a person’s body, converging accurately on the tumour site.

“By delivering focused high doses of radiation over a shorter period of time, PRT limits the dose that healthy tissues surrounding the tumour receive, while increasing the dose to the tumour itself,” says BC Cancer Radiation Oncologist Dr. Scott Tyldesley.

Improving Radiation Therapy for Children
83 per cent of Canadian children diagnosed with cancer survive and are at risk for long-term effects of radiation treatment. Because radiation therapy requires a high degree of accuracy, patients must remain perfectly still throughout treatment; this can be particularly challenging for children. Those who are especially “wiggly” undergo sedation, which comes with side effects, requires a longer procedure and the expertise of a specialized pediatric anesthesia team. Children traditionally also need more rigid immobilization and permanent tattoos which are used to mark the radiation targets on patients’ skin.

Real-time optical surface monitoring (OSM) is a precision tool that may eliminate the need for patients to be sedated, immobilization devices to keep patients still during treatment and permanent tattoos, while still maintaining accurate positioning.

While children stand to benefit the most from OSM, research suggests that OSM may be used in brain cancer patients as an alternative to more invasive procedures. “Our current goal is to support research projects into OSM that will lead to its adoption as standard of care at BC Cancer,” says Dr. Tyldesley.

Better Results with Fewer Treatments
“Six Degrees of Freedom” Robotic Linac couches are essential for delivering precision radiation therapy and deliver complex techniques as efficiently as possible. Because the couches can move up, down, sideways and tilt in two directions, they allow for better positioning of the patient and targeting of the tumour.

For example, men with prostate cancer currently undergo 20-44 fractions of external beam
radiotherapy (EBRT) over four to nine weeks, requiring patients to make many visits to BC Cancer. With support from BC Cancer Foundation donors, a clinical trial recently launched to compare EBRT with a new PRT technique that reduces the number of treatments to as few as five visits.

The results of this trial could potentially improve outcomes for a significant number of men in B.C., like Doug Sheaff from Parksville, who says, “My best friend needed radiation treatment for prostate cancer. He had to make the trip 37 times—the last five of his treatments were the toughest. On the other hand, I had only five treatments in total with the same amount of radiation, with minimal side effects.”

CENTRE SPOTLIGHT

Warren Clarmont, provincial director of Indigenous Cancer Control at BC Cancer

IMPROVING CANCER CARE FOR INDIGENOUS PEOPLE IN B.C.

As Provincial Director of Indigenous Cancer Control at BC Cancer, Warren Clarmont hopes to
transform cancer care for thousands of Indigenous families in B.C.

The first of its kind in B.C., the Indigenous Cancer Strategy is unique partnership between BC Cancer, First Nations Health Authority, Métis Nation BC and BC Association of Aboriginal Friendship Centres. The strategy was developed with the vision to improve cancer care outcomes and provide better
quality of life for Indigenous people facing cancer.

“Each Indigenous partner has a different demographic in which they serve,” says Warren. “The Indigenous Cancer Strategy improves our collective ability to reach as many Indigenous people as possible.”

The strategy has a number of objectives, including:

  • providing education and awareness on cancer to Indigenous communities and organizations;
  • reducing cancer incidence;
  • detecting cancer at earlier stages;
  • improving the quality of care Indigenous people receive; and
  • improving survivability rates.

It will also focus on partnerships, both at a provincial and regional level. According to Warren, there
is very little information regarding cancer amongst Indigenous people in B.C., so the exchanging of research and knowledge is another important component of the strategy.

“It will provide BC Cancer and our Indigenous partners with more concrete data that we can use to target our efforts, particularly around screening,” he says. “It will also attempt to address barriers along the cancer care continuum for Indigenous people in areas such as prevention, survivorship, palliative care and cultural safety.”

Leading the way in the North
BC Cancer – Prince George serves the highest proportion of Indigenous people out of all of the cancer centres in the province and is leading the way in Indigenous Cancer Control.

The centre has a dedicated Indigenous Cancer Care Counsellor available for patients, a spiritual care
room and a Patient Comfort Fund that covers the cost of groceries, accommodations, taxis and whatever else is deemed as necessary to support a patient through their treatment, says Warren,

“The comfort fund is important as it’s designed to lessen the financial burden that can come with a cancer diagnosis,” he says.


You can help enhance cancer care and improve outcomes for Indigenous communities throughout the province. Contact Lindsay Abbott at 604.675.8015 or lindsay.abbott@bccancer.bc.ca

Replace Me!

Cancer care in Prince George received another boost in celebration of Tony Wilson’s 30 years of owning Domino’s Pizza in Prince George. Mike Schlater, CEO of Domino’s Pizza Canada, announced an incredible $100,000 commitment to support the Patient Comfort Fund at BC Cancer – Prince George in honour of Tony’s longstanding commitment to the community.

YOUR IMPACT

Lorna Shaw

VICTORIA RESIDENT DONATES TO CANCER RESEARCH THROUGH A GIFT OF SECURITIES

Victoria’s Lorna Shaw knows firsthand how cancer can impact a family.

Last year, the 92-year-old Victoria resident donated a $350,000 gift of shares to the BC Cancer Foundation in memory of her husband, son and daughter—all whom she lost to cancer.

“Giving through a gift of shares was easy,” says Lorna. “The process was straightforward, and as a bonus I got more back on my tax return.”

With her gift, Lorna hopes to inspire others and help change the outcome for other families impacted by the disease.

“I’m thankful to be able to honour my husband, son and daughter with this gift,” says Lorna, “and make a difference for others facing cancer.”

Both she and her husband were researchers “back in the day,” and Lorna’s gift will support Dr. Brad Nelson’s immunotherapy research at BC Cancer’s Deeley Research Centre.

One in two British Columbians will face cancer in their lifetime, and generous support from donors like Lorna is helping propel the latest in cancer research and enhancements to patient care.

To learn more about gifts of securities, please contact Kelly Sodtka at 604.877.6165 or kelly.sodtka@bccancer.bc.ca

HEALTHY INSIGHTS

COMFORTING A LOVED ONE FACING CANCER DURING THE HOLIDAYS

While some people thrive in the hustle and bustle of a busy holiday season, for others it can be a time of stress filled with social engagements, out-of-town guests and holiday shopping.

On top of this, many families also find themselves facing cancer during the holidays, making an already stressful time even more challenging. Others may experience grief and sorrow more acutely at this time of year, thinking of a loved one lost to cancer.

“Holidays are a time of tradition and family and are incredibly meaningful,” says Marita Poll,
clinical coordinator, Patient & Family Counselling Services at BC Cancer– Victoria. “It’s often a time where friends and family come together in a way that’s special or different from the everyday, so there’s also a lot of nostalgia tied to our history and experiences during the holidays.”

For someone facing cancer, the strain of keeping up with the busy holiday season may also be accompanied with having to deal with the side effects of treatments.

“When someone is going through cancer treatment, it’s not unusual for them to feel unwell and at times to have diminished energy or stamina physically and psychologically,” says Marita. “So, gearing up for these holiday traditions can take more time and energy.”

If you have a loved one who is facing cancer this holiday season, there are many ways you can be supportive and helpful, according to Marita.

“It’s important to remember that even though on the outside or by appearance someone may look well, looking well doesn’t realistically reflect what they’re feeling physically and psychologically,” she says. “And sometimes we may feel helpless because we don’t know how to help them.”

When it comes to offering help, Marita says it’s best to be direct and give a concrete example of how you can lend a hand.

“Sometimes we don’t know what an individual needs or what they will find helpful, so the statement ‘Call me if you need anything’ is somewhat unhelpful,” she says.

Instead, she suggests offering more specific examples of how you can provide support. “If you can drive them to an appointment on a Friday, tell them that,” she says. “Or if you’re able to show up and take their dog out for a walk, that’s great too.”

For close family members, Marita also suggests offering to send out ‘health update emails’ on their behalf so they don’t feel like they have to repeat their story over and over, which can be tiring.

Patients can also consider creating a “Love Jar” or a “Job Jar” with ideas on how people can provide support.

“Love is a verb, not just a feeling,” says Marita. “Give the people you love jobs to do, because they may not know how to help you during this difficult time.”

When it comes to big family dinners or gatherings, she suggests offering alternative ways of celebrating to take the pressure off of any cooking or hosting duties that may become overwhelming.

“Let them know you’re aware they’re going through treatment and that their energy may be lower and offer to do something different this year,” she says. “Instead of them cooking a turkey and all of the trimmings, suggest doing a potluck instead where each person brings a dish.”

It’s also a good idea to take an overall stock of holiday activities and evaluate together if there are ones you can skip or don’t necessarily have to take part in this year.

“Mental pressure is a time and energy waster, and it’s important to keep this in mind when dealing with increased social engagement during the holidays,” says Marita. “So it’s an important time to ask questions like ‘What are the activities or the people that lift me up and give me energy?’”

Navigating cancer together
Marita says it’s extremely important for family members and caregivers to also remember to take care of themselves by practicing the basics of self-care, including: exercise, rest, nutrition and relaxation and stress management.

“Cancer is an experience that impacts every member of a family,” says Marita. “Even though the cancer may not be in your body, one of the people you love the most in the world is going through this and it affects you too.”

And both patients and their caregivers also need to give themselves permission to ask for help when needed.

“The whole experience is easier to navigate when we rely on each other,” she says. “No one person has to do it on their own.”

If you don’t have friends or family nearby to ask for support, there are programs available. Visit bccancer.bc.ca/healthinfo/coping-with-cancer and familycaregiversbc.ca for more helpful resources and information.