Issue No. 10, December 2013

Through a landmark $10-million invest-ment announced Oct. 29, The Slaight Family Foundation has established The Slaight Centre for Image-Guided Brain Therapy and Repair at Sunnybrook. This centre will be the site of the world’s first clinical trials using focused ultrasound to deliver therapy through the blood-brain bar-rier for dementia, stroke and brain tumours.

At the core of the centre is a PET-MRI scan-ner, a fully integrated molecular imaging system that Sunnybrook Research Institute (SRI) scientists will combine with transcra-nial focused ultrasound – making it the only such system in the world.

This will enable scientists to move promis-ing research from the lab to patients, using focused ultrasound to deliver therapies directly to the brain, not only to treat dis-ease, but also to repair damage and restore function.

“The Slaight Centre for Image-Guided Brain Therapy and Repair will pioneer non-invasive treatments for diseases of the brain and mind. These will be novel solutions for some of the biggest threats to the health of Canadians,” says Dr. Barry McLellan, Sunnybrook’s president and CEO.

“We hope the Slaight Centre’s research will lead to the day when the steady advancement of dementia is halted, when stroke is stopped in its tracks and when damaged brain tissue is regenerated, restoring the brain to a more fully functioning state,” Dr. McLellan adds.

Dr. Jon S. Dellandrea, president and CEO of Sunnybrook Foundation, says The Slaight Family Foundation’s investment will acceler-ate the pace of discovery at Sunnybrook.

“Without this private support, we would not be able to translate our discoveries to

Slaight gift creates innovative brain centre at Sunnybrook

patients nearly as quickly,” Dr. Dellandrea says. “The long-running generosity of The Slaight Family Foundation is an inspiring example of how donor support is allowing us to change outcomes and heal the future, for patients here and around the world.”

The leading-edge PET-MRI scanner com-bines positron emission tomography and magnetic resonance imaging. The system achieves the gold standard of molecular imaging, by fully integrating simultaneous PET and MRI to enable the most complete 3-D picture of the brain possible.

Transcranial focused ultrasound was pio-neered by SRI scientists. Integrating it into the PET-MRI scanner will allow them to take their preclinical results – showing that drugs, gene therapy and stem cell therapy can be delivered directly to the brain in Alzheimer’s disease – to the next level: pa-tients. These clinical trials promise to usher in a new era of therapy for brain disease.

“Sunnybrook has the unique medical exper-tise and technological know-how to bring these treatments to people, but this cannot be done without the acquisition of a state-of-the-art PET-MRI scanner. Our family foundation is thrilled to be making this a reality,” says Gary Slaight.

The Slaight Family Foundation’s investment in Sunnybrook is part of a comprehensive $50-million gift to five health sciences cen-tres in Toronto that will make a life-saving difference for people locally and around the world.

Left: Gary Slaight announces a $10-million investment in Sunnybrook by The Slaight Family Foundation on Oct. 29. The gift is part of a comprehensive $50-million dona-tion to five Toronto health-care institutions. Above: Slaight stands with his wife, Donna, and his daughter, Ali, at the announcement. Top: A recent MRI-guided, high-intensity fo-cused ultrasound procedure at Sunnybrook.

New cancer research investigating why ‘less can be more’ Leading-edge scientists Dr. Robert Kerbel of Sunnybrook and Dr. Yuval Shaked of Technion (Israel Institute of Technology) have launched a collaborative international research program to help bring more effec-tive and less toxic cancer drug therapies into the mainstream.

The unique global partnership aims to get a better understanding of why “less can be more” when it comes to chemotherapy, which is traditionally delivered through high doses of toxic anti-cancer drugs, usually given every few weeks for up to five months.

Dr. Kerbel and Dr. Shaked are at the fore-front of a promising treatment strategy – known as metronomic chemotherapy – that has fewer side-effects and may extend survival of patients with cancers that spread aggressively.

Unlike traditional chemotherapy, metro-nomic chemotherapy uses lower and less toxic doses that are delivered more fre-quently, even daily, over prolonged periods (for instance, more than a year).

“In preclinical research, my laboratory has developed quite effective metronomic chemotherapy treatments for aggressive

metastatic cancers – used either on their own or in combination with drugs called angio-genesis inhibitors, which cut off the blood supply that feeds tumours,” says Dr. Kerbel, a senior scientist at Sunnybrook Research Institute (SRI) and the Canada Research Chair in Tumour Biology, Angiogenesis and Antiangiogenic Therapy.

In recent and ongoing international ran-domized clinical trials of metronomic chemotherapy, the first clinical evidence of the treatment’s promise is now being demonstrated. Large studies are underway among metastatic colorectal and breast can-cer patients around the world.

Sunnybrook’s Dr. Robert Kerbel (pictured) is part-nering with Dr. Yuval Shaked to help bring more effective and less toxic cancer drug therapies into the mainstream.

However, to spur additional and much-needed clinical trials – and to move metro-nomic chemotherapy from a niche concept to a widely-used therapy – the medical on-cology world needs a better understanding of the biological mechanisms the treatment uses to attack cancers.

“This knowledge gap is precisely what our Canadian-Israeli research partnership will target,” says Dr. Shaked, who worked in Dr. Kerbel’s SRI laboratory as a postdoc-toral fellow and is now an associate professor with the Rappaport Faculty of Medicine at Technion in Haifa, Israel.

“Dr. Kerbel’s research laboratory and my lab will work together closely – making use of one another’s expertise – to tackle several aspects of how metronomic chemotherapy acts against cancer cells,” Dr. Shaked says.

Through a generous donation from Michael and Rena Buckstein, Sunnybrook Foundation and Israel Cancer Research Fund (ICRF) are partnering to fund this innovative Canadian-Israeli program.Dan Birch

Parents’ geriatric care at Sunnybrook inspires philanthropyAs they grew elderly, both of Peter Cipriano’s parents were treated at Sunnybrook. He remembers how comforted he felt, on several occasions, when a geriatric medicine specialist guided their care.

“It eased my worries a bit to know that they had a geriatrician looking after them, and I could find answers to my many questions relating to their illnesses and care,” says Cipriano. “I became truly grateful to have had that resource.”

Cipriano has turned his gratitude into philanthropy. He is a great benefactor to Sunnybrook’s Geriatric Medicine Program, personally contributing funds and encouraging his friends and associates to do the same.

Most recently, The Irpinia Club, an Italian social club led by Cipriano, raised $75,000 at its 2013 fall gala event, called Ballo Autunnale. Cipriano personally matched the funds, making the total for the evening $150,000.

The Irpinia Club, which was created in 1977 by Italian-Canadians from the Irpinia region of Italy, had already raised $67,500 towards the Geriatric Medicine Program.

“We are very grateful to Peter and the

Irpinia Club,” says Dr. Rajin Mehta, head of Sunnybrook’s Division of Geriatric Medicine.

“With funds they raised, we have been able to renovate the facilities in our program to make the patient clinic brighter and more comfortable.”

New funds raised at the 2013 Ballo Autunnale will go towards expanding the size of Sunnybrook’s hospitalist fellowship program, to include a rotation through geriatric medicine.

“The needs of these patients are often complex. Pneumonia in a frail elderly person,

The Irpinia Club and its president, Peter Cipriano, recently donated a com-bined $150,000 in support of geriatric medicine at Sunnybrook. Pictured here, presenting Peter’s personal commitment of $75,000, are: (left to right) Peter’s wife Dureen Tseu, son Michael Cipriano and Peter. Accepting the cheque are: Dr. Barry McLellan, Sun-nybrook president and CEO, and Dr. Jon S. Dellandrea, Sunnybrook Foundation president and CEO.

for instance, may be layered on top of existing conditions such as heart attack and stroke. Expanding the fellowship program will help train doctors to see the medical challenges of seniors through the lens of geriatric medicine,” says Dr. Mehta.

Cipriano is thrilled to be a catalyst for much-needed growth in geriatric medicine. “It is important to me that geriatric medicine’s involvement in acute care stays healthy at Sunnybrook. I’d like that model of geriatric care to become the standard at all hospitals and health centres one day.”Celia Milne

Would you share a hospital room with someone of the opposite sex?The question: I recently visited my elderly mother in the hospital and was surprised to find her shar-ing a room with a male patient. Since when have hospitals been putting patients of the opposite sex together?

The answer: Actually, in recent years, quite a number of hospitals across Canada have adopted this practice when space is tight. It’s known as co-gendering and it can speed up access to hospital beds for patients waiting in the emergency department.

In certain respects, some parts of the hospi-tal have always been co-gendered, like the emergency department itself or the intensive care unit where there is a concentration of life-support.

But the practice has grown as hospitals have created specialized wards that group together people with the same medical condition, such as stroke patients, says Debra Carew, director of operations with the Trauma, Emergency & Critical Care Program at Sunnybrook. “There are times when patients may benefit by being in a specific ward or in a specific grouping of patients,” she says.

One of Carew’s responsibilities is patient flow. She notes there are usually a limited number of beds in the specialized wards.

If a patient is to get one of these beds, it may mean sharing a room with a person of the op-posite sex, separated by a privacy curtain. Co-gendering has now spread to more generalized wards, too – especially when the emergency department is extremely busy and there is a backlog of patients who need to be admitted.

For religious or cultural reasons, some patients wouldn’t be able to accept a bed in a room

with an unrelated person of the opposite sex. That will likely mean a longer wait in the emergency department or a hallway where there is little or no privacy. “But maybe, based on their values, that is a better thing to do,” Carew says.

Many patients, however, feel that it is in their best interests to be moved to a ward rather than waiting in the emergency department.Carew says co-gendering is usually just tem-porary. When more beds free up, the patient is transferred to a room with a person of the same sex. “We have some cases where patients don’t mind co-gendering and, because they like the room or their roommate, they end up not moving.”

Some new hospitals currently being planned or under construction will have a very high proportion of private rooms – up to 80 per cent – and will even include extra space so relatives can stay overnight. Not only will these rooms increase privacy, they should also improve infection control.

But it’s hard to do a makeover of an exist-ing hospital. “We looked at putting up better barriers between beds,” Carew says. Unfortunately, there was no easy fix. For now, privacy curtains are the best option.

Personal Health Navigator

Paul Taylor, Sunnybrook’s Patient Navigation Advisor, provides advice and answers questions from patients and their families, relying heavily on medical and health experts. Email your questions to AskPaul@sunnybrook.ca

Second World War veterans (left to right) Don Stewart, Mac Joyner and Daniel Neylan greet children during Sunnybrook’s recent Remembrance Day cenotaph service. Sunnybrook’s Remembrance Day services featured many special guests, including the Lieutenant Governor of Ontario, the Honourable David C. Onley.

Time to go? We can helpIt’s time for you or your loved one to be discharged from the hospital. You have complex health needs, and while you’re relieved that the acute care phase of recovery is complete, you have many questions about how to best prepare for what’s ahead once you’ve returned home.

Sunnybrook’s transitional coordinators are health-care professionals who help facilitate discharge planning for complex patients, with the goal of providing a seamless transition for you or your family member. It is their aim to discharge you home safely, with support if needed. This may be a temporary arrangement while making other plans for the future.

Recently introduced in Sunnybrook’s General Internal Medicine units, transitional coordinators are helping to bridge the more traditional roles of Community Care Access Centre coordinator and hospital social worker by supporting patients and families with complex needs.

Patients with complex needs are typically older with chronic health c o n d i t i o n s , generally use more health services and require more coordination for their care.

“It’s natural to have questions about the next steps and what lies ahead, especially when you have one or more chronic health conditions,” says Inna Panteleeva, a transitional coordinator at Sunnybrook.

Transitional coordinators attend rounds with the entire health-care team, including nurses, social workers, physicians and physiotherapists, to understand patients’ needs and assist with discharge.

“Our role is to demystify and explain the services that are available, and to assist patients and families with the next phase after acute care in the hospital,” adds Elizabeth Dubin, another transitional coordinator at Sunnybrook. “We cannot assume everyone has equal access to information, such as the Internet. There are a wide range of services available in the community and it is difficult to know where to turn.”

What steps can patients and families take proactively at any stage of life? Both Panteleeva and Dubin suggest naming a power of attorney and talking about your wishes with your family and loved ones. For family members, accept that your loved ones may be in different stages of their lives and may require assistance with their recovery at home. Being prepared for this time is enormously helpful.Marie Sanderson

tling cancer,” Dr. Law says. “He and his team have created a host of technological devices that have advanced cancer care here and far beyond our walls.”

One of many examples is the Lucy Phantom, a quality assurance device that confirms the accuracy of all imaging and treatment sys-

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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

Harry Easton, a long-time innovator and supervisor at the Odette Cancer Centre’s machine shop, has been named the inaugural recipient of a new Sunnybrook prize that recognizes and encourages technological advancement in cancer treatment.

The Edmond Odette Prize for Innovation and Technology in Cancer Care was established following Mr. Odette’s passing just over one year ago, on Nov. 17. Friends of the Odette family, and the broader community, honoured his legacy by contributing generously to the Edmond G. Odette Memorial Fund, which gave rise to the Odette Prize.

Easton, who received the award during a Sept. 12 reception, is very deserving, says Dr. Calvin Law, interim chief of the Odette Cancer Program.

“Throughout his more than 20 years at the Odette Cancer Centre, Harry has been known for his technological ingenuity,” Dr. Law notes.

“Harry is a true innovator who works closely with our wide-ranging experts to transform concepts into tangible objects – technologies that improve care for thousands of people bat-

Edmond Odette Prize honours an innovation-filled career tems related to stereotactic radiosurgery, a cutting-edge and extremely precise radiation therapy. The device is so suc-cessful that it is being used by cancer centres around the world.

Easton says he is “very proud” to have been named the inaugural winner of the annual award, especially after 40 years in the field.

He will likely use the prize money to ad-vance the machine shop’s 3-D printing abilities. “There are limitless capabilities in this new technology,” Easton says, noting that it can be used to make treat-ment-related objects that are customized to individual cancer patients.

New signage – located in the Odette Cancer Centre’s east entrance – hon-ouring the tremendous impact of Mr. Odette and his family was also unveiled at the reception, which was attended by the entire family.

“The Odettes’ contributions are visible throughout Sunnybrook, from our state-of-the-art Chemotherapy Unit and Gloria Odette Pharmacy to our leading-edge imag-ing technology,” says Sunnybrook president and CEO Dr. Barry McLellan.Dan Birch

Television show Undercover Boss comes to SunnybrookFor one week in August, Malcolm Moffat – and his true identity as Sunnybrook’s execu-tive vice-president – virtually disappeared. A team of makeup artists with the television show Undercover Boss Canada transformed his suit-and-tie persona into “Ray”, a training recruit with a deep spray tan, wig and goatee.

Under this guise, Moffat worked side-by-side with five different Sunnybrook employees to get a real sense of their daily responsibilities, challenges and personal lives. They included painter Daniel Hand, groundskeeper Rohan Harrison, food services employee Krista Willchuk, Veterans art therapist Lorrie Clarke and environmental services employee Dana Chatzitassis.

As Ray, Moffat got his hands dirty doing everything from scrubbing toilets to repaint-

Sunnybrook painter Daniel Hand shares some tricks of the trade with Malcolm Moffat, a.k.a. “Ray”.

ing walls. He says meeting so many amazing Sunnybrook employees was more than worth the physical challenges that came with the intense week.

“Undercover Boss was a great opportunity to meet some of the unsung heroes at the hospi-tal, and to experience first hand what they do on a daily basis,” says Moffat. “I was truly im-pressed with the commitment of everyone to ensuring the best possible patient experience.”

At the end of the week, all five employees learned of Moffat’s true identity during a special reveal day. Each employee was then offered some meaningful personal and profes-sional rewards.

Sunnybrook would like to thank a number of generous donors for their gifts, including

the Courtyard Marriott Calgary Airport, the Glenbow Museum, the Fairmont Chateau Lake Louise and RBC Royal Bank.Monica Matys

Above: Dr. Calvin Law (right) presents the Odette Prize to Harry Easton. Below: The entire Odette family at the Sept. 12 prize reception.