How CAR T-cell therapy is changing the landscape of cancer care in Alberta

Bachelor of Health Sciences student at the Cumming School of Medicine turns cancer diagnosis into opportunity to help advance research

Cumming School of Medicine student and cancer survivor, Milan Heck.

When Milan Heck first noticed a lump on her hip, she and her family blamed it on the boot cast she wore to heal her broken ankle. But on Aug. 31, 2015, they learned that an abnormal gait wasn’t the culprit. Heck had a tumour. Two-and-a-half weeks later, she found herself at the Alberta Children’s Hospital waiting to meet her oncology team. 

“That meeting is when everything became real,” says Heck, who’s now a second-year Bachelor of Health Sciences student at the Cumming School of Medicine (CSM). “That’s the first time I recall thinking, ‘That’s it. This is cancer.’ I felt numb. I put on a stoic face, surrounded myself with people and tried to make the situation as lighthearted as possible. I think that’s what has helped me cope throughout the years.”

Heck was diagnosed with alveolar soft part sarcoma (ASPS), a malignant soft tissue tumour which starts in the soft connective tissues of the body such as fat, muscles or nerves. ASPS usually starts in the legs or arms and most often metastasizes to the lungs but can involve other organs, such as the brain or bones.

“What felt like a small lump turned out to be a tumour the size of a grapefruit,” says Heck. “Upon initial diagnosis, my doctors also found a lesion on my brain and 13 lesions across my lungs. I was completely in shock.” 

Over the past six years, Heck has undergone nine surgeries, two radiation treatments and has tried numerous medications. Many of which caused unpleasant side effects and complications. While experts do their best to recommend therapies, they face many challenges when diagnosing and treating them.

But thanks to the participation of cancer patients and innovative research methods, new treatment options are on the horizon. 

 

Developing a better understanding

Dr. Jennifer Chan, MD, a pathologist and the scientific director of the CSM’s Arnie Charbonneau Cancer Institute, explains that there’s no standard treatment for most rare cancers because there’s less research on them and, in turn, not enough information to support drug development.

Dr. Jennifer Chan

“The good news is that researchers are no longer studying ‘cancer,’ we’re investigating the various types and subtypes of cancer, and we’re doing it in creative and innovative ways,” says Chan who’s also an associate professor in the Department of Pathology & Laboratory Medicine. “The better we understand a cancer, the better we can treat it.”

One of these ways is by banking leftover clinical samples for research. Another is by using the collected tissue samples to make tumour models from the patients’ cancers. The models allow researchers to study the development and progression of a tumour, and test new treatments to see which ones are effective. 

Thousands of Calgarian patients are making this research possible by contributing pieces of tumour tissue extracted during surgical or biopsy procedures. Heck is one of them, and her samples are currently being used by a team of UCalgary researchers to better understand ASPS.     

 

Giving a gift for research

“When one of my surgeons talked to me about participating, it was an easy decision for me,” says Heck. “Knowing that my donation could help generate knowledge about ASPS, I immediately said ‘yes.’”

To date, Heck has donated three samples, which have been stored within the Charbonneau Institute’s Clark H. Smith Tumour Centre’s tissue bank — a biorepository that specializes in neurological and pediatric diseases and provides samples to local, national and international researchers. The biobank is directed by Dr. Chan who explains that collected samples can sometimes be stored for a while before they’re used. Earlier this year, Heck’s samples were pulled and a team of researchers is now focused on finding new treatments.

“Choosing to participate is like giving a gift for research,” says Chan. “Understanding tumour biology is a critically important step in the process of finding new therapeutic approaches, reducing toxicity of current therapies and improving patient experience. Without participant samples, we wouldn’t be able to model or study these tumours in the same way we are now.”

 

A more tailored approach

Dr. Douglas Mahoney, PhD, a member of the research team and an associate professor in the departments of Microbiology, Immunology & Infectious Diseases and Biochemistry & Molecular Biology, explains that the live samples from the biobank are what allow researchers to test treatments and develop more personalized treatment plans. 

Dr. Douglas Mahoney

“The more we learn from these studies, the more tailored our treatments will become,” says Mahoney. “Up until now, this rare disease didn’t have many preclinical models and we’ve generated them. Now we’re starting to use cell-based therapies to see if they’ll work in vivo.”

Mahoney and his team are using Chimeric Antigen Receptor or CAR T-cell immunotherapy, which uses synthetic biology to modify T-cells — a type of white blood cell that’s essential to the immune system —to recognize and kill the cancer cells. This therapy has successfully treated children and adult patients with forms of leukemia and lymphoma and there’s growing evidence that engineered immune cells also have the potential to be broadly applicable across more types of cancer.

The team has built a new CAR T-cell therapy specifically for ASPS and is testing it against Heck’s cancer. One day, it could become a treatment for ASPS patients like her. 

“My hope is for safer, better therapies for cancer patients,” says Mahoney. “There’s no guarantee that we ever achieve that, but we have the tools, ideas and right people to take a fantastic shot at it.” Heck agrees. 

“New ways of treating cancer are on the horizon,” she says. “Even if I don’t see that happen in my lifetime or receive any of the treatment, I know that there’s potential for someone else down the line to benefit from the knowledge that’s being created, and that’s a silver lining.” 

 

In 2023, the new Calgary Cancer Centre (CCC) will open and will be the largest comprehensive cancer care centre in Canada. The space will create a fully-integrated environment that enables experts like Drs. Chan and Mahoney to efficiently advance their research from discovery, invention, preclinical studies and clinical trials; improving the experience and prognosis of cancer patients. Learn how you can help make a difference by contributing to the CCC or tissue bank

 

Dr. Jennifer Chan, MD, is the scientific director of the Arnie Charbonneau Cancer Institute and an associate professor in the Department of Pathology & Laboratory Medicine at the Cumming School of Medicine. She is also a member of the Alberta Children’s Hospital Research Institute at the University of Calgary.  

Dr. Douglas Mahoney, PhD, is an assistant professor in the departments of Microbiology, Immunology and Infectious Diseases and Biochemistry & Molecular Biology at the Cumming School of Medicine. He is also a member of the Alberta Children’s Hospital Research Institute, Arnie Charbonneau Cancer Institute, and Snyder Institute for Chronic Diseases at the University of Calgary.

 

Written by Melanie Tibbetts for the Cumming School of Medicine. 

Using research to identify what really matters to cancer patients – Dr. Nancy Nixon

Dr. Nixon is a medical oncologist and researcher at the Tom Baker Cancer Centre.

 

When we think of cancer research, we often think of treatment options. But understanding and improving the patient experience and care is just as important for doctors, researchers, and patients. “Research is fundamental in helping us identify new treatment options that allow patients to live better for longer, and increase the number of patients we can treat. It’s also really important in helping to identify what really matters to patients,” shares Dr. Nancy Nixon, a medical oncologist and researcher in Calgary.

Like many Albertans, Dr. Nixon’s family has been impacted by cancer, and it is a large part of why she has focused her time and research improving the lives of metastatic breast cancer patients.

“I lost my mom to breast cancer in 1994, and that’s had a big impact in my life. It’s been behind my motivation to do what I do for a living, pursuing clinical trials and new research. I think it’s exciting to see how the landscape of cancer treatment has changed over time.” 

Dr. Nixon has focused much of her research on understanding and responding to patient priorities. By listening to her patients and understanding what matters most to them, she aims to improve the overall journey of Albertans facing metastatic breast cancer.

“I think it’s important for patients to have some autonomy and control over how they’re treated, and why they are treated in certain ways. It really does make a difference, being able to take power over cancer and not let it control us.”

Through her research, Dr. Nixon is currently focused on supporting patient understanding of treatment options, clinical trials, additional supportive care and networking groups by creating better access to accurate information for metastatic breast cancer patients. 

For Dr. Nixon, the new Calgary Cancer Centre is an opportunity to start from the ground up, to think to the future about what doctors and patients will need and what cancer treatment will look like. It will allow her, along with countless others, to have a more patient-centred approach with its centralized resources, dedication to research and some of the best and brightest minds working to improve cancer treatment and care. “Having resources, along with surgeons and radiation oncologists and medical oncologists all in the same space will really facilitate that patient-centred approach. We won’t be split up in our separate towers. We’ll all be working together in one place as a single group focusing on cancer.” 

Learn more about how the Calgary Cancer Centre will focus on improving the patient experience and helping patients OWN.CANCER in their own terms.

Calgary’s Clinical Research Contributions

Dr. Jose Monzon explains how clinical trial research that begins at Calgary’s Tom Baker Cancer Centre has the potential to impact cancer patients around the globe.

The clinical trials that come to life at the Tom Baker Cancer Centre can change lives beyond Calgary, the province or even Canada. Dr. Jose Monzon knows this from experience.

“When you do clinical trials research, you’re making impacts not only on your community,” explains Monzon, “but also on patients worldwide.”

Monzon is a medical oncologist and medical leader for the Clinical Research Unit at the Tom Baker. He helps manage and oversee the roughly 150 clinical trials happening in the centre at any given time while also leading trials of his own. The role includes meeting with clinical trial unit leaders to discuss trial activities, brainstorm ways to improve the process for patients and find avenues to open other trials. Beyond research, Monzon sees patients and enrolls eligible candidates into existing trials.

While the job can be varied and complex, Monzon’s rationale behind why he does what he does is simple.

“To be able to help patients through that process and that journey seemed important to me,” he says. “I learned very early on that with research, you can make huge impacts on patient outcomes.”

Simply, a clinical trial is the testing of a novel agent — often a drug — or a previously known agent in a unique setting to evaluate its safety, responsiveness, toxicity and, of course, its effect on survival. Eligible patients are enrolled in trials and tracked through regular tests to gauge how the agent is working versus the previously established treatment option.

After three phases with different goals at each, the treatment can potentially become the new standard of care.

According to Monzon, the Tom Baker is unique in its opportunity for investigator-initiated trials, often supported by the Alberta Cancer Foundation. This reputation is attractive for academic researchers across the country and is part of what drew him to Calgary. Monzon has helped lead a handful of trials spawned from findings at the Tom Baker, such as an ongoing look into the positive effects of statins, which are cholesterol medications, on rectal cancer patients undergoing chemotherapy and radiation therapy.

The idea for the trial came from a patient database assembled by fellow oncologist Dr. Michael Vickers during his time working at the Tom Baker. The opportunity to work together and collaborate to create new trials in Calgary not only helps researchers, but also benefits patients.

“These are homegrown ideas. That’s the beauty of it,” says Monzon. “These are trials that can open up options for our patients here.”

Each year, the Tom Baker Cancer Centre enrolls around 400 patients into clinical trials, creating opportunities to pursue alternative treatments that can lead to life-saving results. With the Tom Baker acting either as the starting point or as a contributor to larger trials, the potential for widespread change is immense. And at its core, it all starts with the patients.

“[Clinical trials] provide these options of novel treatments, and it gives the patients hope of responding and prolonging life, but it also helps other cancer patients,” says Monzon. “We have everything to thank for the patients involved in clinical trials. Our goal is to have a clinical trial opportunity for every single patient who comes to the cancer centre and that patient and clinician trial activity should be celebrated and encouraged.”

Brief Glossary Of Clinical Trial Terms

 

Clinical trial: The testing and tracking of a new treatment to evaluate its effects on human health outcomes.

Industry-sponsored trial: When a business or corporation, like a pharmaceutical company, conceives, plans and funds a clinical trial. 

Investigators: The researchers leading and conducting work on a clinical trial. 

Investigator-initiated trial: When an independent researcher has an idea for a trial they want to conduct, conceive, plan and run themselves.

Phases Of Clinical Trials


Bench Research: 
Prior to clinical trials, bench researchers run tests outside of humans. This often means seeing how cells react within cancer cell line models or animal models and how novel agents may show activity in or inhibit pathways.

Phase 1: Often the “first-in-human” trial, phase one starts testing the safety and tolerability of a drug. Researchers start with a very small dose and incrementally increase until signs of toxicity appear. Efficacy and responsiveness data are collected, but it’s not yet the main goal.

Phase 2: Once the dose is established, researchers begin looking at efficacy and responsiveness. An indicator in many clinical trials is how much tumours shrink.

Phase 3: The novel drug or treatment is compared to the previous standard of care. If the new treatment shows improvements in survival, it usually becomes the new standard of care.

Phase 4: Phase four trials happen once the agent is established as a new standard of care. They operate like population-based studies in function, looking into the benefits of the treatment in broader use.

Originally published in Leap Magazine.

Giving Through Generations

 

Philip Libin; Stuart Libin; Harriet Libin;

As children growing up in the mid-1940s, Phil and Harriet Libin learned about the importance of giving back from their respective families. The couple’s parents, Saul and Sonia Libin and Leo and Goldie Sheftel, donated whatever time or money they could afford to people in need. As a result, Phil and Harriet began volunteering in their early teens — before they even met. Regardless of what the Calgary forecast had in store for them, they would each take to the streets with blue collection boxes every Sunday morning, fundraising for the Jewish National Fund of Canada.

“When you go out and get that quarter or that dime or that nickel, it gives you that sense of satisfaction in helping. My parents would never turn away someone in need, and I grew up seeing my parents give,” says Phil. “What’s the old saying: ‘Monkey see, monkey do?’” he chuckles.

Phil and Harriet first met as teenagers while attending Central Memorial High School in Calgary. The couple will celebrate their 65th wedding anniversary this year.

Today, the Libins are well-known as dedicated fundraisers and philanthropists in the city. They started the Phillip and Harriet Libin Family Foundation in 2009 to help support various local organizations and have often focused their fundraising efforts on the medical field. This past year, they donated $3 million to the Alberta Cancer Foundation supporting breast cancer-related research and clinical trials at the new Calgary Cancer Centre.

With this state-of-the-art cancer centre opening its doors in 2023, the Alberta Cancer Foundation, in partnership with the University of Calgary and Alberta Health Services, has launched the OWN.CANCER campaign to raise $250 million in support of enhanced research, treatment and care within the centre.

Raising funds for cancer care and research is a cause close to the Libin family’s hearts. In 2006, Sheryl — Phil and Harriet’s daughter, Stuart’s sister and mother to Michael and Matthew— was diagnosed with breast cancer. Phil and Harriet went to every single appointment with Sheryl at the Tom Baker Cancer Centre. After an 11-year journey with cancer, Sheryl passed away from her illness in 2017 at age 55.

“Sheryl will have been gone for five years in May,” says Harriet. “I always said to Phil, ‘We have to find some way that will be meaningful to keep Sheryl’s memory alive.’ And when the Calgary Cancer Centre came up, we thought it would be a perfect place because it’s meaningful for us and because we went through the process with her.”

Sheryl shared the same generous spirit as the rest of her family, as she and Stuart followed in their parents’ footsteps to volunteer and lend a helping hand to anyone in need.

“We want to do this in memory of Sheryl and in honour of Stuart,” says Phil.

In recognition of the Libins’ contribution, the Calgary Cancer Centre is naming the Knowledge Centre auditorium the Philip and Harriet Libin Auditorium. The space will facilitate meetings, seminars and conferences where medical professionals and patients alike will have a space to communicate and share research.

“This will be a centre of excellence for research,” says Phil. “Educational lectures in this auditorium are going to be key to the patients who are travelling along their cancer journey. For Sheryl, she was sitting on pins and needles wondering, ‘What is this disease doing, how quickly is it moving?’ The unknown is the scariest. So, this auditorium will be a venue to provide a source of information and can help cancer patients start to see how their journey is going to fall into place.”

The Calgary Cancer Centre is still under construction, but requests are already underway to book the auditorium for patient advisory meetings, support groups and lectures.

“We’re quite excited for the centre to open,” says Harriet. “Even though it isn’t going to work for our daughter, this will offer hope for others. Throughout the years and growing up, there was always some member of our family who was not well. It became a part of our lives and always felt important.”

When it opens next year, the 1.3-million square foot Calgary Cancer Centre will have capacity to treat more cancer patients with increased space for clinical trials that is currently available at the Tom Baker Cancer Centre. It will also contain 110,000-square feet of dedicated research space.

“I really hope this centre will give people confidence knowing they have a place to take their loved one to be cared for,” says Harriet. “I hope that in the not-too-distant future, they’ll find cures for some of these cancers or make things easier for people if they can’t be fully cured. I think Sheryl would be honoured to know that we remember her in this way, and she’s in our hearts always.”

Phil and Harriet have raised significant funds for multiple causes over the years. Phil, who led a successful career in development and commercial real estate, has been a member of the Rotary Club of Calgary since 1989 and has served on the boards of various charities. Together, they’ve helped raise millions for local communities and causes.

“You do these things because you want to,” says Phil. “And because there’s a need for them.”

Giving back is a generational habit for the Libins. Growing up, Stuart also learned to contribute back to both the Jewish community and the community at large. As an adult, he joined the Rotary Club of Calgary and the Rockyview Hospital Fund Development Council.

“It was always natural,” Stuart says, “they always had a bug in my ear. I guess you could say I learned a great lesson from [my parents].”

The Libin’s lessons — their generational generosity — will continue to have a lasting impact here in Calgary and will make a tremendous difference for cancer patients at the Calgary Cancer Centre and beyond.

 

Originally written by Jennifer Friesen and published in the Alberta Cancer Foundation’s Blog

Dr. Fiona Schulte is dedicated to helping young patients carry the weight of cancer

Dr. Fiona Schulte

Madison Tutt was going into grade 10 when she got the news: cancer. Not just cancer but an eggplant-sized  neuroblastoma tumour growing in her abdomen, wrapping around her aorta, which explained the pain she’d been feeling all through her body for the past two years. The athletic young Canadian had been setting her sights on making the high-school volleyball team, but now she had much more stressful things on her mind.

She started chemotherapy immediately after her diagnosis; her hair began falling out on Christmas day. After four rounds, and the accompanying nausea and exhaustion, the treatment failed. Her doctors removed the mass in a high-risk surgery, but this brought additional complications – a collapsed lung, a stent that led to a life-threatening blood clot, fear and frustration that this would never end.

Maddison Tutt today

“It took so much longer than what I thought for me to recover. I wasn’t expecting all the hiccups along the way. And that’s where I got really upset and down because I thought this was going to get my tumour removed and everything would be better. I was afraid of a relapse,” she says.

At around this time, Madison was introduced to the psychosocial oncology team at the Alberta Children’s Hospital, including psychologist and researcher Dr. Fiona Schulte, PhD, R. Psych. Over the next few years, Fiona and the team helped to carry the weight of the disease for Madison, supporting her and letting her know that her feelings were normal.

Helping children and adolescents cope with cancer

Fiona Schulte, an AHS clinician and member of UCalgary’s Arnie Charbonneau Cancer Institute and the Alberta Children’s Hospital Research Institute,  always knew she wanted a career in psychology and working with patients. It was when she witnessed a family member’s battle with breast cancer that she shifted her sights to oncology, specifically the psychological impact of cancer in young children.

Pediatric psychosocial oncology is an emerging field, brought about by a new reality that more and more children are surviving cancer. Fiona’s research interest began with understanding how cancer impacts a young child who is diagnosed with cancer, and their family. She is interested in the psychological impact of this for development and mental health – both at the time of diagnosis but also longer term.

“We know that there are certain therapies that impact brain and development in terms of cognition, which has implications for social development and psychological wellbeing,” Fiona says.

Improving the patient experience through integrated care

Fiona is working to understand both the immediate and longer-term psychological impacts of the disease. “The story doesn’t end when treatment does,” says Fiona, who advocates for supports, education,  and knowledge around what the longer term cancer experience looks like. She says cancer needs to be viewed as a chronic health condition; her recent research follows a cohort of children across their lifetime to understand the late effects of diagnosis and treatment. She wants to understand the potential risks and protective factors, including genetic and biological components – something she says is only possible by collaborating and working outside of our silos.

Fiona sees this integration as one of the greatest opportunities of the new Calgary Cancer Centre, which includes a unique new dedicated clinical space for adolescent and young adult care. This space, she says, will allow clinicians and researchers to work together like never before and find new ways to integrate clinical care and research.

Hailing from Eastern Canada, she sees the new cancer centre as a very Calgary enterprise. “I came to Calgary because I knew it to be up and coming, a city of growth and a place of real potential for change.” She believes Calgary can be the leader and hub to take this work further, but “this is not going to be the work of one institution alone. We need to come together as researchers so that we can look at larger samples and populations of survivors to really be able to speak with more certainty about what some of the longer-term impacts may be.”

To Fiona, owning cancer means taking control. “We might not be able to cure cancer, but there are things that we can do. Depression, sleep, anxiety – these are modifiable targets for intervention. I think that is powerful.”

Owning cancer

Madison has been cancer-free since 2014 but still experiences side effects, including pain. She continues to see members of the psychosocial oncology team at Alberta Children’s Hospital on an as-needed basis. She recently graduated from Bow Valley College’s Business Administration Event Management program and is excited for the future.

She says that the support and care she received, at the Alberta Children’s Hospital and through the psychosocial team, made an indelible impact and helped her become who she is today. “While cancer is not something I would wish on anyone, it’s brought me a lot closer to people and has helped me to think, grow and learn.” It’s also helped her to support a young girl she babysat, one who had the same exact cancer as her – an experience she holds near to her heart.

She’s excited for the potential that lies ahead through the Calgary Cancer Centre. “All cancer journeys are scary but having a facility like this will help.” She believes giving to this campaign is important, considering that one in two of us will be impacted by cancer during our lifetime. “Donating may help you down the road, or a friend or family member. Or maybe it’s no one you know personally, but you’re helping someone out. And that’s owning cancer.”

Dr. Darren Brenner and Dr. Winson Cheung are studying big data to improve care for cancer patients across Alberta

Dr. Darren Brenner

Dr. Darren Brenner has done the math. He knows the chances of him walking through the Calgary Cancer Centre doors are high. Not as a doctor, but as a patient one day. He wants to make sure when he—or any other Albertan—is treated for cancer, his health-care team has the best possible data at their fingertips to predict the best outcomes.

Brenner, Dr. Winson Cheung and a team of clinicians and data scientists at the University of Calgary have positioned the city as a major hub for health outcomes research and real-world evidence generation. At its simplest, they are trying to improve patient care by understanding the gaps in screening and treatment as well as in the health-care system. To accomplish this, big data research that intersects with healthcare policy and industry becomes important.

“Data are only useful if they are used to answer the right questions and if they are analyzed in the right way. Because of this, we have developed a team of clinicians interested in outcomes research and big data in the province. This level of clinician engagement is unique yet essential to ensure that our data are leveraged to address the most high priority clinical issues.” says Dr. Winson Cheung.

Dr. Winson Cheung

Using data coupled with artificial intelligence and machine learning is important to improving patient outcomes across many types of cancer. For instance, in Brenner’s ACCORD project, they used a risk prediction model to determine who will continue treatment for early stage cancer, which can be used to identify who to focus on in terms follow-up or who to approach about different treatment options. 

The goal of the future Calgary Cancer Centre is to build a learning cancer care system with the proper tools, teams, and systems so that the data being collected can immediately change the treatment for the next person to ensure it’s the right treatment, for the right person, at the right time.

“If you’re collecting the right data, it can be used to make better predictions and improve care,” says Brenner. “It improves treatment and care for the next patient, because the system learns from every patient who came before them.”

The Calgary Cancer Centre campaign is a once-in-a-generation opportunity. To excel at data-driven cancer care, you need good infrastructure, talented staff to ensure data integrity, and the right data to be collected. “To be successful, you need a learning care system like the one we will set up,” says Brenner, adding it can be done in pieces but this would take longer and won’t achieve the same impact. “If we want to think big, we can only do that because of that building going up right now that will allow us to have the right people in the right place.”

Funding, including philanthropic dollars, is key to setting up Alberta as leader in using high quality data to drive outcomes. “A learning health system is visionary and transformational,” says Brenner. “We need philanthropy to make this successful and that requires an investment. For instance, Alberta is a leader in cancer prevention because we have traditionally invested in that area. Investing in health outcomes research in the proper way will let us do it faster and with greater impact.”

Jim Fiorentini’s Story

Jim Fiorentini shares his story of undergoing immunotherapy in a phase 2 clinical trial led by Dr. Jose Monzon.

Throughout 2019, Calgarian Jim Fiorentini underwent a series of operations and tests after finding a lump on his lower back, which turned out to be malignant. While the initial operations were successful, further lesions found in the late summer and early fall pointed towards the spreading of merkel cell carcinoma — a rare and aggressive type of skin cancer.

When exploring treatment options, Dr. Jose Monzon, Fiorentini’s oncologist at the Tom Baker Cancer Centre, found that Fiorentini was a fit for a phase 2 immunotherapy clinical trial Monzon was leading. Fiorentini decided to move forward with the trial, and is currently on 22 of 24 cycles of immunotherapy, which have shrunk the lesions throughout Fiorentini’s body effectively. He shares his story here:

When Dr. Monzon  — and I remember this just like yesterday — asked me if I was interested to know what my prognosis was if I did not receive any treatment, I told him ‘no’ because I intended to fight this thing. I thought, ‘Alright, now I have a challenge in front of me. I’m not going to let the challenge beat me. I’m going to do what I can to fight, and then we’ll see what happens.’

“It was determined that I was a candidate for the immunotherapy program [clinical trial] as the best course of action. So, it was just days before Christmas 2019 when I received my first injection cycle of immunotherapy.

“The epiphany occurred when there was another lump. I asked Dr. Monzon if I should have it removed, and he said, ‘No, we’re going to use that as a gauge to see if the immunotherapy is working or not.’

“For a number of cycles after, I avoided touching that area or even investigating the lump on my own. And lo and behold, when I went to have a check-up with Dr. Monzon, that lump had disappeared, and I hadn’t even realized it.

“There was a progression. These reductions just didn’t happen overnight — it took a number of cycles. But we could see the slow retraction of these lesions, to the point where most of them, if not all of them, were no longer detectable.

“[This clinical trial] means I have more time with my family. It gives me hope that I can live to be a little older than I am now. I can hopefully share my experience and provide some comfort and hope for those who are going to follow. 

“I can only hope that my small contribution will help people who would have to suffer through this in the future. It makes me feel good that I get to be a part of this — to help and be a contributor in some small way. It’s a wonderful feeling.

“I think my wife said it the best – sometimes God puts us on this Earth for a reason and maybe, it’s possible, that this is the reason why He put me on this Earth — to help.”

Originally published in Leap magazine.

Dr. Joe Dort

Dr. Joe Dort knows head and neck cancer inside and out. A University of Calgary educator and surgeon by trade, he’s dedicated his career to saving patients – not just treating them, but improving the care they receive and restoring quality of life for them and their families.

But it’s his work as a researcher, examining and improving processes in the hospital, where Dr. Dort is making his latest career mark. He is passionate about improving the health care system itself – designing and delivering health care that is more efficient and more effective.

Designing better health care

One of the ways he’s doing this is through a head and neck pathway program he developed in 2010 and continues to be used and refined to this day.

“Back in 2009, if you were a head and neck cancer patient and you were having a surgery, you’d end up in the hospital for an average of 22 days. Over three weeks, you’d have about a one in three chance of having pneumonia and high risk of other complications.”

Deciding that wasn’t good enough, Dr. Dort and the team developed a new care pathway. Today, the current length of stay for head and neck surgery patients is on average is nine to ten days and the pneumonia rate is less than four per cent. Dr. Dort says the difference is standardized care, with a precision medicine focus.

“It’s much less variable because all of the members of the team do the same thing. And if we vary from the protocol, we vary because of something the patient needs.”

Not only is this better for the individual patient; it’s saving the health care system time and money.

“It’s been millions of dollars and thousands of complications avoided because of applying the science of clinical effectiveness to this group of patients, and taking it to broader cohorts of surgical patients.”

This is a powerful example of the way University of Calgary research is informing care and improving outcomes for cancer patients – in Southern Alberta and around the world.

Technologies

Another way Dr. Dort is leading the way in improving treatment and outcomes is by harnessing the power of new technologies.

He and his team are developing a virtual reality (VR) program to practice surgery outside of the human body. Students and doctors will be able to put on VR goggles and go into the operating room to practice operations in a simulated environment. This training and opportunity to practice will benefit countless patients – improving expertise and reducing risk for error.

Alberta-led innovations like these contribute to better patient outcomes, bringing research from the lab to the bedside to advance treatment and care.

Changing the culture of how care is delivered

Dr. Dort sees the Calgary Cancer Centre as an opportunity to get it right for patients and families. He says that the path forward is an improved health care system – something that seems simple but is not easy. But if anyone can do it, he says it’s Alberta, which is set up with the one health care system.

The outcomes of this work are real and life-changing.

“What we’re really trying to do is get closer and closer to a world where more cancers are cured, but also detected earlier and treated better, and treated in a way that allow people to get back to whatever level of function they defined as being meaningful and have a life that they define as a life worth living.”

Through the Calgary Cancer Centre, Dr. Dort says we can change the culture of how care is delivered. “We have a historic opportunity to create something that will really be impactful at the centre level, as well as at the individual level.”

Don and Sherry Wood’s Story

In early 2017, Sherry Wood wasn’t feeling well. Her general practitioner was a good friend of hers — someone she could confide in. After a recommended ultrasound, it was only 30 minutes later Sherry and her husband, Don, received a call, asking them to come back to the doctor’s office.

After more tests, the Woods sat down with a doctor at the Holy Cross, and heard the words, “You have cancer and it is stage 4.” Within a week, Sherry was in treatment. “She was sent to an ovarian surgeon because, at that time, they believed it was ovarian cancer”, says Don.

“They did surgery on what they thought was an ovarian cyst, but it turned out that there were cancerous cells elsewhere in her body. They did what they could, but it started a litany of other tests to determine what it was. It went from a diagnosis of ovarian cancer to colorectal cancer, which meant multiple doses of chemo and surgery.”

The Woods had other hiccups. Sherry’s stage 4 metastatic colorectal cancer spread to her liver and her lungs. “We were lucky she was at the Tom Baker, and we had the best doctors and nursing teams,” says Don. 

Sherry went through more than 30 rounds of chemo and three major surgeries, with Don always at her side. He left his job as the director of an environmental consulting company and started a consulting business of his own so he could care for Sherry through her treatments.

Sadly, she died in April 2020, at home, with Don and their 13-year-old son, Anderson, at her side. 

Don remains a member of the Patient and Family Advisory Council for the new Calgary Cancer Centre, which he joined in 2019. He volunteers his time by offering insight on the healthcare system—and gaps in it–as well as business oversight on several working groups where patient and family advisors (caregivers) participate with AHS staff and other organizations like the Alberta Cancer Foundation and the Cancer SCN. Through continuous feedback and learning, he knows cancer treatments will evolve and improve rapidly.

He believes in the power of research, in the power of data to inform better outcomes and knows that if patients continue to provide much-needed insight to their healthcare teams, it will mean improved treatment and care can only improve. 

We had great oncologists and nurses doing amazing work, but by becoming a family advisor, I learned how to navigate the system as a caregiver. And I figured that we’d learned so much from being on the other side of the table, we could help others.”

Don continues to do that as much and as often as possible, knowing how important it was to Sherry. When the doors open at the Calgary Cancer Centre, he will feel an extra sense of pride, knowing his volunteer work has helped inform some of the small design touches, but also how patient and family reported outcomes could improve treatment and care.