Celebrate a vital partnership

BASYA LAYE

This is an educational experience for me. As I learn more and more about breast cancer, I realize that that this is an epidemic. Two thousand, eight hundred woman in B.C. will be diagnosed with breast cancer this year, and 600 will die. It is the most common cancer in women. At a meeting we had the other day, out of 11 participants, seven had an immediate family member who had breast cancer,” said Dina Wachtel, speaking to the Independent as director of the Vancouver chapter of Canadian Friends of the Hebrew University in Jerusalem (CFHU), co-hosts of next month’s Gala Celebration in Support of Research for Early Detection of Breast Cancer. Funds raised at the event will support the partnership of Israeli and Canadian cancer scientists, through the collaborative work of the Institute for Medical Research Israel-Canada (IMRIC) and the B.C. Cancer Agency (BCCA).

Hosted by CFHU and the B.C. Cancer Foundation (the BCCA’s fundraising partner), the April 22 gala honors Dr. Karen Gelmon, professor of medicine at the University of British Columbia, senior scientist and medical oncologist at the BCCA and one of the leading researchers in the IMRIC-BCCA partnership. Helping to lead the charge for improved early detection and treatment options, Gelmon heads up the BCCA’s investigational drug program, experimental therapeutics, and, on top of her research and teaching load, she is the author of more than 400 papers in oncology journals, an occasional guest blogger on cancer research, prevention and treatment issues, a regular contributor to a magazine devoted to those living with and fighting breast cancer, and, last but certainly not least, she sees individual cancer patients as a physician.

Gelmon’s fascination with cancer began early in her life, but she didn’t immediately choose to study medicine or oncology until after completing an undergraduate degree in philosophy at the University of Saskatchewan.

“I was interested in medicine and in cancer from an early age – as strange as that sounds,” Gelmon told the Independent. “I remember both reading books about persons with cancer and I also remember hearing and seeing persons when I was a child with cancers and being interested. However, my first degree was in philosophy, which I found fascinating, but realized that I was not going to find a career in that area…. So I then went to medical school in Saskatchewan,” eventually coming to Vancouver, she added, to do an internal medicine residency.

Her career, merging the clinical with the research science, is as multidisciplinary as her interests.

“I grew up in Saskatoon with a small Jewish community and have a large number of close friends from my childhood. After high school, I went to Europe and Israel for a year and returned a couple years later for a summer. Travel has always been an interest and, in my field, doing academic medicine, one gets to travel for both pleasure and work. I have been to a large number of places, including returning to Israel frequently, often for work. This has created some very good links with oncologists in Israel, as well as friends. And now, with the connection to IMRIC, I have more collaborators in Israel.”

After training in medical oncology, Gelmon switched gears briefly, doing AIDS research in the United Kingdom, before returning home to Vancouver and to oncology.

“I think that the science of the field interested me and continues to fascinate me,” she explained of her return. “As well, oncology combines a lot of the medical fields and requires one to remain interested in other aspects of medicine. There is also the psychological side of cancer and the impact of that on both the disease and the care, as well as the quality of the survivorship. And that is impacted by society, which is also interesting.”

Working together, experts from IMRIC and the BCCA are conducting research to develop screening tools, particularly for those deemed most at risk for breast cancer. Teams of researchers are investigating “the fields of genetic sequencing, epigenetics, immunology, stem cell research and cancer imaging” to root out cancer at its earliest stages, in an effort to give women the best chance of becoming cancer-free as quickly as possible.

As to the elements that contribute to positive teamwork, Gelmon said, “Successful collaboration includes doing exciting work, which is academically interesting and which may also have clinical impact for patients. Successful collaboration is creating new links with other scientists and clinicians and exchanging ideas, which makes both sides grow and learn. As well, successful collaboration is when all parties involved feel that they are being valued and that they are moving their field forward.

“With IMRIC, I have begun some collaborations with scientists who have some interesting new genetic findings that we are planning on testing on some of our population banks in B.C. [to] see if they are able to determine the prognosis of various cancers. They also have some other interesting science interests that meld well with the interests of the scientists at the B.C. Cancer Agency.”

Contrary to the visibility of fundraising efforts around cancers, and breast cancer in particular with its pink ribbon campaigns, the need for funding remains great – agencies and research institutions end up spending significant effort on competing for grants and for support from individual donors, said Gelmon.

“The amount of money in Canada is not that great. Nor is it in Israel,” she noted. “The money that supports cancer research, such as our national clinical trials organization in Canada, the NCIC-Clinical Trials Group, is all from donations from events such as daffodil sales. We depend on philanthropy for most of our research. Some of our clinical trials also have pharmaceutical [company] support. Grant support is from philanthropy as well, and is very, very competitive and getting more so. So, we all spend a lot of time applying for money to support our research and, often, the chance of being successful is very low. This does affect the time one has for activities that are supported. There is pressure to get results, as those successes [often] lead to more successful grant funding.”

However, the “greatest pressure to get new and good results,” Gelmon said, “is the human factor: the fact that we see persons with incurable cancers every day, or we see too many persons getting cancer. So, our greatest pressure is our desire to improve outcomes and decrease the mortality from cancer.”

To that end, Gelmon reiterated, the main challenge facing cancer research today “is really funding,” even though “there are lots of good ideas,” she said. “The other challenge is getting new findings into clinical care and diagnosis. It takes a lot of time and money to validate results to the level that will get the new treatment or diagnostic funded for clinical care.”

Another great challenge, she said, is deciphering the “vast amount of genomic data that is being generated … as we are understanding the individuality of cancers. Moving into more personalized medicine is our goal, but also, our challenge, as it is,” remains “stretching how we think about treatments.”

There are several ways by which each of us can reduce our cancer risk and there is a lot of information available on healthy living. However, with competing recommendations, even on specific detection tools, like mammograms, Gelmon offered some advice for wading through cancer prevention and detection information.

“There is no one prevention and, in fact, most of the women I see have lived very healthy lives and have still developed cancer,” Gelmon said. “I recommend persons try to exercise, maintain a normal and healthy weight and eat a healthy diet. There is not one diet, but a balanced diet, high in fruits and vegetables, low in fat, high in fibre and with a limited amount of processed foods, is probably what is recommended. And, although some persons suggest avoidance of alcohol, I usually recommend watching alcohol intake but not avoiding.”

On the detection front, “mammograms have been shown to be effective in a number of studies,” she said. “The main issue is the age to begin [screening but] there is controversy about should it be [at age] 40 or 50. There is also controversy about how often.” That said, “Mammograms are our best population screening method at this time but they are not perfect. I think that, in the near future, there will be ways to determine who is at the greatest risk of getting cancer and screening those women with more extensive [technology] such as MRIs and mammograms,” she continued. “At the same time, we may be able to determine who is not at a high risk and who may be well served by mammograms at a less frequent interval. We have not found that blood marker yet, but I am hopeful we can.”

Gelmon feels fortunate to still find meaning and pleasure in her chosen profession, even though her days are “long and busy.”

“My typical day is made up of a number of activities,” she said. Most days, she sees patients, both new and follow-up cases. “These patients are either being seen on treatment or some of them are on clinical trials,” she explained. “I often have patients in hospital, usually at the B.C. Cancer Agency, and I visit them on the wards. I also have a number of meetings. Many of them are related to research that I do, either planning new projects or applying for grants or reviewing ongoing research. We also have meetings of our groups, the breast group or other groups I work with, such as the groups that do clinical trials of new drugs. Then there is a lot of time spent doing office work, such as answering phone calls from patients, from doctors or from home-care nurses. I also have to follow-up on charts and new reports. Finally, I am on a number of committees, including some international committees, and these often involve conference call meetings.”

Later, she added, “I am very fortunate that I have found the profession that I really love and that I can do. The combination of working with people, the continued interest in new biology and science and the psychological aspects of oncology work for me. But in a fantasy world, I would love to have been talented as a musician or an artist and be in that world. Instead, I just try to appreciate it and be in that world as a … patron.”

Wachtel encourages the local Jewish community to come to the April 22 gala to support the collaborative work of IMRIC and BCCA around early cancer detection, as well as to honor Gelmon for her contributions.

“We need to fight cancer and enable our scientist to have the best tools they need in order to discover new frontiers and push the envelope in finding remedies to cancer,” Wachtel said. “Too many people that we know and are surrounded by are having cancer and, each time that I hear about another friend that was diagnosed with cancer, I realize that my work is even more meaningful and powerful than yesterday. We are running against this imaginary time clock.

“I also realize, in regard to cancer research, that those of us who are lucky to be healthy need to be at the forefront in advocating for improved cancer research capabilities simply because we are so fortunate to be healthy! We are also fortunate to live in a province that has the highest breast cancer survival rate in the world, but, when science fails us and we lose a loved one to cancer, we couldn’t care less about statistics, as [for our loved one, it] becomes 100 percent failure.”

Celebrating the CFHU-BCCF partnership to support the IMRIC-BCCA team of researchers is extremely important, Wachtel added, and funds raised will be shared equally between the institutions. “I am thrilled that we can build this bridge of knowledge that will enable two outstanding institutions to create a long-standing relationship. As I say to our donors, it is with one [gift] that you can support the [B.C.] Cancer Foundation, which is the largest cancer research funder in the province, and, at the same time, support the most important Israeli research institution, ranked 57th worldwide, which is currently the most active Israeli-based organization in Canada. I am a great believer in strengthening the research and business connections between Israel and B.C., and IMRIC, indeed, has led the way in that respect, with scientific collaborations with UBC, [Vancouver General Hospital, the] Rick Hansen Institute and, now, the BCCF.”

The Gala Celebration in Support of Research for Early Detection of Breast Cancer is on April 22, 5:15 p.m., at Rocky Mountaineer Station. To donate or for tickets, contact 604-257-5133 or [email protected] or visit cfhu.org/chapters-Vancouver.

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