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A Busy Summer: Clinical Work and Research Initiatives at the BC Cancer Agency

July 16, 2014

What a crazy week – summer is a really busy time at work.

Fundamentally, I am a clinician – this is what I do every day of the week. I meet new patients, review their options of treatment and formulate treatment plans based on the available data and science. If radiation therapy is indicated, I plan their treatment based on multiple sources of imaging including CT scans, MRI, ultrasound and PET scan (when required). Once my patients are on treatment, I see them every week and monitor the tumour response or manage the side effects. I also follow a number of my patients at the BC Cancer Agency for several years.

My team at work includes Dr. Doug May, a general practitioner in oncology, as well as dentists, nurses, radiation therapists, nutritionists, counsellors and many others. As mentioned in my previous post, I am a brachytherapist. I treat gynecological tumours (like cancer of the cervix), genito-urinary tumours (like prostate cancer) and gastro-intestinal cancers.

Like other BC Cancer Agency centres, the BC Cancer Agency Sindi Ahluwalia Hawkins Centre for the Southern Interior in Kelowna is an academic centre, which means that we have students from medical school and residents in radiation oncology rotating through our department. Dr. Juanita Crook and I are the mentors for a fellow in brachytherapy. A fellow is a fully trained radiation oncologist who has passed the final examination, acquiring additional training in a specific component of speciality. Dr. Jasbir Jaswal arrived on July 2nd and will be with us for one year. She is an excellent radiation oncologist who will become highly specialized in brachytherapy. Our fellowship is of international caliber and I hope to transmit everything I know about brachytherapy to Dr. Jaswal before she moves on to her new next position.

But my work extends well beyond the clinic. I am currently the chair of the Provincial Genito-Urinary Radiation Oncology group and the chair of the Gynecologic Tumour Site in Kelowna. I am also a researcher. For example, I am the international co-principal brachytherapy investigator for RTOG 1115, a study testing a new hormonal treatment for patients treated for high-risk prostate cancer who receive radiation therapy as part of their treatment.

Locally, I am the principal investigator (with Dr. Juanita Crook) of the QOL study, a randomized study comparing low-dose rate (LDR) and high-dose rate (HDR) brachytherapy as a boost for patients with intermediate and high-risk prostate cancer.  We have 30 patients enrolled in the study so far. The objective is to enrol almost 200 participants in the next two to three years.

We have been the only centre in B.C. offering HDR prostate brachytherapy through research trials. Through our repeated efforts (others would probably call us a little stubborn), the BC Cancer Agency recognized HDR prostate brachytherapy as a standard treatment option two months ago. It is an amazing step forward for the men of B.C. I believe that HDR brachytherapy is associated with less side effects and has many other advantages.

I also work with an international study accumulating data on patients treated for cancer of the cervix utilizing MRI for the planning of brachytherapy. We are one of two Canadian centres participating in the effort led by a group in Vienna, Austria.

Finally, I have two research students working with me this summer on four different projects covering lung cancer, gynaecological brachytherapy and two types of breast brachytherapy.

I think I know why the summer seems so busy!  Doing all these projects makes my work extremely interesting and stimulating.