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Fight Kids Cancer

SickKids eNewsletter Sept 2015

Welcome to the new SickKids eNewsletter. Distributed quarterly, this publication will focus on a topic and highlight where we’ve been, where we are and where we are going: the THEN, the NOW and the NEXT. Please enjoy our most recent publication, and if you like what you see, subscribe now!

Message from Dr. Michael Apkon | Then - Cancer through the decades | Now - Collaboration KiCS Cancer | Next - Future of Cancer Care


Mike Apkon


September is Childhood Cancer Awareness Month and we are highlighting the amazing ways our staff #FightKidsCancer every day.

Welcome to the redesigned SickKids eNewsletter. Quarterly, we will focus on a topic and highlight where we’ve been, where we are and where we are going: the THEN, the NOW and the NEXT.

September is Childhood Cancer Awareness Month and we are taking the opportunity to highlight the amazing ways our staff, patients and families #FightKidsCancer. At SickKids through the integration of care, research and learning, we work together to fight childhood diseases like cancer and provide better outcomes for our patients. This year we celebrated our 140th birthday and throughout that long history we have seen significant advancements in the paediatric oncology field. Today, thanks to research, education and care, more than 80 per cent of children will survive a cancer diagnosis. There are still many unanswered questions and we are committed to finding the answers and ensuring that all children survive cancer and go on to live healthy, happy and productive lives.  

This September, we invite you to join us – share how you #FightKidsCancer on social media.

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Dr. Mark Greenberg with a cancer patient, in the early years of his career.
Dr. Mark Greenberg with a cancer patient, in the early years of his career.

SickKids Senior Staff Oncologist Dr. Mark Greenberg reflects on the improvements to the diagnosis and treatment of cancer and how our understanding of the disease has advanced during his tenure:

“When I began my career in the early seventies, there were few drugs to manage solid tumours, and the only treatments were surgery and radiotherapy.

A diagnosis of acute myeloblastic leukemia was usually a death sentence – there were no effective drugs and transplantation was far in the future. Acute lymphoblastic leukemia, with a survival rate around the mid 40 per cent range, was viewed as a single disease with one treatment approach. We had just entered the era of prophylactic cranial radiation and did not appreciate its impact on cognitive development.

We did not take an interprofessional approach to treatment like today. Brain tumours were the domain of the neurosurgeon. There was no oncology program and psychologists were rarely involved. There certainly were no services for the few survivors.

Over the years, we came to understand the heterogeneity of what we thought were uniform diseases and have developed more effective treatments, targeted to specific subsets of tumours. Improved and more precise radiation therapy is now widely used. The accuracy of diagnosis has exploded and with greater understanding of individual tumours we are moving into an era of targeted therapy.  We have replaced some aggressive surgical intervention with minimally invasive surgery resulting in rapid recovery times. Our teams are multi-disciplinary – with surgeons, radiation oncologists and oncologists talking to each other before interventions, and pathologists, diagnostic imagers, pharmacists, nurses and behavioural professionals actively engaged. And now we concern ourselves with survivors whose wellbeing is our responsibility well into adult life. There is still much to learn about this disease and I continue to #fightkidscancer every day at SickKids.”

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Drs. David Malkin, Adam Shlien and Gino Somers (pictured left to right).
Drs. David Malkin, Adam Shlien and Gino Somers (pictured left to right).

New KiCS cancer sequencing program: collaboration and innovation leading to more targeted therapies. 

“Collaboration brings people together with different perspectives and areas of expertise. As a group, we can get complex projects off the ground and achieve great things,” says Dr. Gino Somers, Head of the Division of Pathology at The Hospital for Sick Children (SickKids).

Through the collaboration of Somers, Drs. David Malkin and Adam Shlien and their teams, the SickKids Cancer Sequencing Program (KiCS) went from being an idea to an initiative about to be launched. This exciting new program is a three-year clinical research project that will enroll patients from the SickKids Haematology/Oncology and Cancer Genetics programs. KiCS brings together experts in haematology/oncology, pathology, bioinformatics, genetics, genomic research, and genetic counselling. They will use Next Generation Sequencing (NGS) to determine the genetic profiles of tumours, which will help clinicians identify the best individualized treatment options for children with cancer, including patients with the most challenging cancers at diagnosis and those who have experienced a relapse. Precise diagnosis and genetic stratification of these children’s own tumours will inform decisions about their care, identify patients who are genetically predisposed to cancer, and identify potential avenues to innovative experimental therapies.

“Thanks to new sequencing technologies, and clever algorithms, we can begin to get a complete picture of each tumour’s genome. This is a faster and more comprehensive way of understanding what makes each cancer tick,’” says Shlien, Associate Director of Translational Genetics at SickKids. Launching the KiCS program now is the first step in establishing a system that would eventually become a routine part of the care available to all cancer patients at SickKids.

“In paediatric oncology, we are constantly looking to develop better treatment protocols for children with cancer and to do so while also reducing toxicity and morbidity,” says Malkin, Senior Staff Oncologist and Senior Scientist at SickKids. “Tumour and paired normal tissue/blood sequencing has the potential to revolutionize how we care for our patients.”

These same sequencing efforts will also advance cancer research by providing new knowledge about the molecular profile of cancers. With this information, researchers can study how better to manipulate and kill the cancer cells or stop them from growing and spreading. These findings will have the potential to lead to even further improved health outcomes for children and the adults they will become.

“KiCS is a prime example of the strength of collaboration between individuals from various clinical and research teams. We hope this program becomes a tool that helps children lead healthier and happier lives,” says Somers.

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SickKids trains 80 per cent of kids’ cancer doctors in Canada. Four current trainees share their vision of the future of cancer care.


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