Issue No. 6, July 2013
Community supports Relay For Life
Sunnybrook
hosts first burn
symposium
For the first time, a group of more than 170
burn care specialists from across Canada
and the United States came together at
Sunnybrook on June 11 to learn about the
future of burn care in Ontario.
Presentations were made by a variety of
burn surgeons, researchers and specialists,
including keynote speaker Dr. Richard L.
Gamelli from the Stritch School of Medicine
in Chicago. Speakers covered a wide range
of topics, such as the latest advancements
in burn treatment, surgery, medication and
post-operative care.
The Toronto Raptors’ mascot joined the many participants at Relay For Life in Toronto Central, held overnight
on June 14 at Sunnybrook Park. This year’s event has already raised more than $400,000 for the leadingedge care and research of Sunnybrook’s Odette Cancer Program, and donations continue to be made. “The
Sunnybrook community has stepped up yet again to celebrate life, remember those lost to cancer and fight
back by supporting innovative research. We are humbled by the community’s response every year,” says
Dr. Andy Smith, Sunnybrook’s executive vice-president and chief medical executive.
“The first annual Sunnybrook Burn
Symposium is an important step toward addressing the needs and challenges facing burn
care providers in this province,” says Dr. Marc
Jeschke, director of Sunnybrook’s Ross Tilley
Burn Centre.
Sunnybrook’s heart and stroke
research gets life-saving boost
Sunnybrook’s stroke research is getting a
significant boost as part of an unprecedented
$300-million gift to leading Canadian research centres from the Heart and Stroke
Foundation.
The multi-year commitment will help
Sunnybrook researchers accelerate their work
into discovering better ways to detect, diagnose and treat stroke and cardiac conditions
– and moving them into clinical practice.
“Scientists at Sunnybrook Research Institute
have shared a long and effective partnership
with the Heart and Stroke Foundation.
This pledge will deepen that relationship,
so that – and this is what matters – we can
move results into patient care faster,” says Dr.
Michael Julius, vice-president of research at
Sunnybrook.
As part of the newly formed Heart and Stroke
Foundation Research Leadership Circle,
Sunnybrook is one of 19 centres to benefit
from this gift. Though the foundation has
contributed more than $1.35 billion to research in its 60-year history, this is its largest
commitment.
“Simply put, there’s an urgent need to save
more lives faster and that’s why the foundation
has brought together the Research Leadership
Circle,” says David Sculthorpe, CEO of the
Heart and Stroke Foundation of Canada.
“This $300-million commitment will allow
our partners an unprecedented ability to plan
major research projects, foster greater collaboration and attract even more of the world’s best
researchers within and outside of Canada to
fight these insidious diseases.”
Heart disease and stroke account for almost 30
per cent of all deaths a year in Canada. Every
seven minutes someone dies from heart disease
and stroke – that’s nearly 69,000 people annually. These diseases are also a major drain
on the Canadian economy, resulting in more
than $20 billion spent each year in physician
services, hospital costs, lost wages and decreased productivity.
Dr. Sarvesh Logsetty, director of the Burn Unit
at Health Sciences Centre Winnipeg, speaks
during the Sunnybrook Burn Symposium.
“When we bring together like-minded individuals who are working toward shared goals,
we are making strides toward finding new
ways to deliver effective and compassionate
care.”
The symposium will be an annual event,
and due to the large amount of interest this
year the organizing committee will work to
accommodate over 200 attendees next year.
Laura Bristow
Personal Health Navigator
Individual searching for a second opinion
following life-changing diagnosis
The question: My sister was told at a Toronto
hospital that she has MSA atypical Parkinson’s. We
want to get a second opinion, as she cannot accept
her fate. Can you help us?
The answer: I can understand why you want
a second opinion for a diagnosis that is very
serious and life changing, particularly a diagnosis of multiple system atrophy (MSA).
MSA is a disorder where one or more systems
in the body degenerate. Poor balance, rigidity,
slowness and difficulty with coordination are
typically some of the motor symptoms. Low
blood pressure upon standing, constipation
and swallowing troubles are some of the nonmotor symptoms. There is no laboratory or
brain scan test to confirm the actual diagnosis.
A neurologist would not lightly hand out this
diagnosis unless there was some degree of certainty, says Robert TerSteege, who as an information and referral associate for the Parkinson
Society Central & Northern Ontario deals
with this question from patients often.
“It is not Parkinson’s disease per se. MSA is
one of the most common types of atypical
Parkinsonism. It may look like Parkinson’s
initially,” TerSteege says.
Dr. Mario Masellis, a Sunnybrook neurologist
who specializes in cognitive and movement
disorders, says that “any time we see someone
in our clinic and we find features that resemble
Parkinsonism, we have to do other investigations and medication trials to sort out what we
think is the most likely suspect.”
In the case of someone presenting with
Parkinsonism (symptoms of tremor, rigidity
and slowness), neurologists will typically have
patients take a medication called levodopa/
carbidopa every day for several weeks as a test:
if they respond to the doses, they consider the
patient to have Parkinson’s. However, some
patients may not tolerate this medication
well and people with MSA can fall into this
category.
“If you have a good, sustained response and
you don’t have atypical features, then the
diagnosis is most likely idiopathic Parkinson’s
disease,” Dr. Masellis notes. “If the dosage
is increased to very high levels and they still
don’t have a convincing response, it’s likely
due to other conditions.”
One of those other conditions would be MSA.
An MRI of the brain would be done; certain
features may support a diagnosis of MSA,
but these imaging features are not seen in
Lisa Priest, Sunnybrook’s
Manager of Community
Engagement & Patient
Navigation, provides advice
and answers questions
from patients and their
families, relying heavily on
medical and health experts.
Email your questions to
[email protected]
everyone. It often is a diagnosis of exclusion;
doctors cannot make a definitive diagnosis
because a brain biopsy is required and that is
not the usual standard of care due to the risks
involved.
However, there is one important difference between MSA and actual Parkinson’s, the latter
being that patients experience slight declines
over many years. With MSA, “there is more
rapid progression because of the poor response
to Parkinson’s medications and because of
other features of the condition, including the
swallowing difficulties and low blood pressure,” Dr. Masellis says.
Helping patients to
quit smoking
Sunnybrook’s Smoking
Cessation
Team
hosted a display on
June 5 for World
No Tobacco Day
to build awareness
among patients, staff
and visitors of the critical importance and health
benefits of quitting smoking.
The Smoking Cessation initiative is led by
a core group of interdisciplinary health professionals from the Odette Cancer Program
and the Schulich Heart Centre.
The group collaborates hospital-wide with
health-care professionals including nurses,
clinical educators, pharmacists, social
workers, occupational therapists, radiation
therapists and physicians to offer patients
personalized smoking cessation assistance
through self-help materials, counselling,
education, referrals to community resources
such as Smokers’ Helpline, and follow-up
support.
He notes there are several neurologists who are
movement disorders specialists across Canada.
Many have a one- to two-year wait list for a
consultation.
“We don’t lightly give that particular diagnosis,” he says, noting that a comprehensive
history and physical exam on several occasions
helps make the diagnosis, plus medical imaging may be used to support a diagnosis. “If
the diagnosis is suspected, they watch it over
a period of three to six months to see how the
condition evolves.”
While there is always value in getting a second
opinion, it also depends on where the diagnosis was made. Most neurologists who make the
diagnosis initially would refer to a clinic that
specializes in movement disorders.
“Once you get an opinion from one of these
clinics, the accuracy of the diagnosis is increased,” Dr. Masellis says. However, “if they
are really concerned about the diagnosis or
have doubts about the diagnosis, one second
opinion should be considered.”
To obtain a second opinion, your sister should
go back to her family physician and request
a referral to a neurologist who specializes in
movement disorders.
For more information on Parkinsonism, please
visit www.parkinson.ca
The Smoking Cessation Team’s display for World No
Tobacco Day.
“When individuals experience a health crisis
and are admitted to hospital, they often
approach their care team about wanting to
make personal, positive lifestyle changes,”
says medical oncologist Dr. Andrea Eisen,
who leads cancer prevention for the Odette
Cancer Program and is a member of the
Smoking Cessation Core Committee.
“Our team strives to be as supportive and
empathetic as possible to help those individuals find a way, through resources and
counselling, to quit smoking when and how
it is right for them.”
The Smoking Cessation initiative continues
to expand within clinical programs and departments at Sunnybrook. Its best practice
framework is drawing interest from other
health-care institutions that are looking to
implement similar supports for patients.
For more information, please contact
[email protected]
Natalie Chung-Sayers
Sharing experiences and raising
awareness about ovarian cancer
Sunnybrook’s Odette Cancer Centre Patient
& Family Education Program hosted the first
annual “Ovarian Cancer & You” forum on
May 25 in partnership with Ovarian Cancer
Canada, bringing together individuals living
with ovarian cancer, their families and caregivers, members of the public and specialized
health professionals to talk openly about a
disease for which there is lesser awareness and
understanding.
The event’s main speakers included gynecologic oncologist Dr. Danielle Vicus, psychiatrist Dr. Janet Ellis and registered nurse Susan
Bowles of the Odette Cancer Centre’s Sexual
Health and Rehabilitation Clinic.
Dr. Vicus provided an overview on genetics
in ovarian and breast cancers – specifically on
the BRCA1 and BRCA2 gene mutations and
increased risk for breast and ovarian cancers
– a topic that has become more prominent
following actress Angelina Jolie’s openness
about her preventive mastectomy.
Dr. Vicus also discussed potential targeted
therapies being studied in systemic therapy
that may slow the growth of new blood ves-
sels that feed tumours, including research
being conducted on bevacizumab (Avastin)
and PARP-inhibitor drugs for ovarian cancer.
Bowles provided coping tips related to sexuality after cancer and early menopause resulting
from cancer treatment.
Dr. Ellis, lead psychiatrist with the Odette
Cancer Centre Patient & Family Support
Program, discussed possible stresses at the end
of treatment; how to live with uncertainty
and cope with the fear of recurrence; and how
to use mindful living to affirm meaning in
life, build closer connections with others and
increase spiritual well-being.
Breakout discussion sessions included a
presentation and Q&A by registered nurses
about fatigue and one by a pharmacist on
neuropathy (nerve pain) due to chemotherapy. ‘You are not alone’ was the theme of the
day’s sessions, which also brought together
survivors who were grateful to connect with
one another.
Michelle (Caiying) He, master’s degree in
nursing student and PEARL volunteer
Sunnybrook launches Innovation Hub
Sunnybrook Foundation has launched its
Innovation Hub, a unique initiative to fund
medical advancement.
High-intensity focused
ultrasound at Sunnybrook
changed my outcome
and healed my future.
“We are not simply raising money to build
or develop our health-care system,” says
Dr. Jon Dellandrea, president and CEO of
Sunnybrook Foundation. “We are crowdfunding specific, personally meaningful
initiatives that will pay enormous health
dividends to you and your family.”
Featuring a number of initiatives in need of
community investments, Innovation Hub
is the epicentre of revolutionary thinking
in the areas of heart, brain, cancer, trauma,
education, research and women and babies.
At the Hub, donors choose how their money
will be spent. They can choose an area of
need that is meaningful to them by committing to one or more specific initiatives.­
With regular updates from Sunnybrook doctors
and researchers at the Hub, donors will see the
impact of their investments in real-time, and
later, success stories, including accounts from
patients whose lives have benefitted greatly from
their generosity.
Recognizing and
managing early
dementia
Many people can relate to forgetting an appointment or misplacing their keys. But at
what point do these small hiccups mean there
is a bigger problem with your memory?
During Sunnybrook’s Speaker Series event on
May 28, Dr. Jocelyn Charles, medical director
of the Sunnybrook Veterans Centre, helped
people determine behaviours that may be a red
flag for dementia, which is a decline in mental
functioning that affects daily living.
“It’s hard to recognize because the symptoms
of dementia can be very subtle, especially in
the beginning,” says Dr. Charles, who also
heads Sunnybrook’s Department of Family &
Community Medicine.
Frank Winnacott
“But dementia is increasing in prevalence, so
we’re going to need a good way to recognize it
as people get older.”
Dementia affects at least two of the following
areas: memory, reasoning, judgment, language, recognition or personality. If you notice
that your loved one is asking you to repeat
questions, is interacting less in conversations,
or has noticeable changes in the way they dress
and groom themselves, medical advice should
be sought.
When the tremors in Frank’s hand made it so that he could no longer hold a glass of water, Sunnybrook
tried something new: focused ultrasound on an unreachable area of his brain. Now, Frank can hold
whatever he wants.
Your gift helps fund life-saving innovation. Invest in Sunnybrook.
sunnybrook.ca/HealNow
“The choices allow people to invest not just
in treatment and research, but in their very own
futures,” Dr. Dellandrea says. “They are changing their own outcomes and the outcomes of
patients.”
Dr. Jocelyn Charles, medical director of the
Sunnybrook Veterans Centre, shares insights on
dementia during a Speaker Series talk.
“These stories will leave people with a uniquely
rewarding return on investment,” says Dr. Barry
McLellan, Sunnybrook’s president and CEO.
“By investing in innovative initiatives happening
at Sunnybrook now, they are helping us accelerate the pace at which we build and implement
new infrastructure and discover treatments for
those who count on us, when it matters most.”
For more information about our Innovation
Hub, visit www.sunnybrook.ca/healnow
L.H. Tiffany Hsieh
“The problem of dementia – including our
rapidly growing elderly population, the high
number of people suffering from dementia
and the impact that has on their families and
society – makes it arguably one of the greatest
public health challenges the next generation
will face,” says Dr. Ken Shulman, chief of
Sunnybrook’s Brain Sciences Program and
moderator of the event. Currently, dementia
affects one in every 13 Canadians.
The Speaker Series event – “Recognizing and
Managing Early Dementia” – also featured a
discussion on driving and dementia, and ways
to optimize brain health. You can view the full
webcast at sunnybrook.ca/speakerseries
Monica Matys
How to reach us:
Your Health Matters
Sunnybrook Health Sciences Centre
2075 Bayview Avenue, Suite D1 00
Toronto, ON M4N 3M5
P: 416.480.4040
E: [email protected]
Your Health Matters is published monthly by the Communications & Stakeholder Relations Department and
Sunnybrook Foundation. Submissions to Your Health Matters are welcome, however, they are subject to space availability and
editorial discretion.
Sunnybrook Health Sciences Centre is inventing the future of health care for the 1.2 million patients the hospital cares for
each year through the dedication of its more than 10,000 staff and volunteers. An internationally recognized leader in research
and education and a full affiliation with the University of Toronto distinguishes Sunnybrook as one of Canada’s premier
academic health sciences centres. Sunnybrook specializes in caring for high-risk pregnancies, critically-ill newborns and adults,
offering specialized rehabilitation and treating and preventing cancer, cardiovascular disease, neurological and psychiatric
disorders, orthopaedic and arthritic conditions and traumatic injuries. The Hospital also has a unique and national leading
program for the care of Canada’s war veterans. For more information about how Sunnybrook is inventing the future of health
care please visit us online at www.sunnybrook.ca
Thrill of the Grill – a tasty bar-b-cure for kidney cancer research
A fun and delicious event is set to raise money
for kidney cancer research at Sunnybrook’s
Odette Cancer Centre.
The fourth annual Thrill of the Grill on
Toronto’s Danforth Avenue will take place July
20 and will feature a barbecue rib competition
judged by a celebrity panel that includes Chef
Lynn Crawford, who stars in her own hit cooking show (Pitchin’ In) and is head chef at Ruby
Watchco on Queen Street East.
Sunnybrook’s own Dr. Georg Bjarnason,
a medical oncologist and a leading kidney
cancer researcher, will sit on the panel, as
will Sunnybrook Foundation executive vicepresident Pamela Ross.
“Thrill of the Grill has all the ingredients for
an awesome July afternoon – a fabulous setting on the Danforth, savoury BBQ ribs and
the opportunity for guests to cast their own
in a raffle, with the top prize being a $9,000Lynx grill.
Thrill of the Grill co-chairs Chef Lynn Crawford
and Sunnybrook’s Dr. Georg Bjarnason will join
the event’s celebrity judging panel.
votes for their favourite ribs,” says Susan Puff,
executive director of the Danforth Business
Improvement Area, which produces the event.
Some of the best chefs from the Danforth
will be competing in the rib contest, including those from Allen’s, Factory Girl, Globe
Bistro, The Combine Eatery and The Meat
Department. Event participants can take part
“My husband Ross had kidney cancer and was
a patient at Sunnybrook for four years,” Puff
says. “Through the work of Dr. Bjarnason
and his team, and the ongoing research that
is being done in the area of kidney cancer,
Ross and I were able to have twice the time
together than originally thought. But even
that extra time was too short.
“I hope we can continue to build awareness
and funding for research and new treatments
so other kidney cancer patients get the most
time possible.”
Buy tickets at www.thedanforth.ca and learn
more about kidney cancer care at Sunnybrook
by visiting sunnybrook.ca/kidneycancer.
Dan Birch
Sunnybrook an award-winning leader in pathology reporting
Anatomical Pathology, part of Sunnybrook’s
Division of Laboratory Medicine, was recently awarded the Overall First Place Award
for Canada Health Infoway’s ImagineNation
Outcomes Challenge for adopting a new type
of synoptic pathology reporting.
Pathologists are doctors who study and diagnose disease through examination of organs,
tissues and bodily fluids, and they are key
players in health-care teams at Sunnybrook.
These doctors issue synoptic reports in an
electronic standardized report in a discrete
data field format, meaning that each type of
information has a specific place and format in
the report, and can be searched and analyzed
easily.
“This change from a more narrative style of
reporting means that reports are complete
and concise, providing efficient sharing of
information among the health-care team caring for a patient,” says Dr. Mahmoud Khalifa,
chief of Anatomic Pathology at Sunnybrook.
Dr. Khalifa gives the example of a breast
cancer doctor who requires answers in about
20 different parameters of a pathology report
to decide on a course of treatment for their
patient.
Every piece of information is included in
the one interface, similar to “assembling the
puzzle for the clinician,” Dr. Khalifa notes.
There is added value because information
can be transmitted to Cancer Care Ontario,
a government agency driving quality and
improvement for cancer prevention and
screening. The reports populate a registry that
paints a picture of what is happening across
the province.
Currently, 49 Ontario hospitals submit data
to Cancer Care Ontario, including University
Health Network and Lakeridge Health,
Sunnybrook’s partner hospitals.
Sunnybrook’s Tanya Jorden, laboratory information analyst and team leader, worked with
pathologists to modify the synoptic checklists
to ensure they reflected their current practice,
including terminology, while adhering to the
provincial standard.
As Sunnybrook’s laboratory partnership with
Lakeridge Health and University Health
Network grows, continued investment in
areas such as synoptic reporting ensures that
Sunnybrook’s laboratory continues to deliver
nothing but the best for patients.
Dr. Lorna Mirham, an anatomical pathology
resident, is just one member of Sunnybrook’s
Laboratory Medicine team ensuring that patients
receive timely and accurate diagnoses.
“We continue to apply innovations and
best practices to support our clinicians with
expert analysis that forms the critical basis
for diagnosis,” says Dr. Khalifa. “We are all
collaborating to help the patient.”
James Buttivant, Marie Sanderson