The root of the progress made in this province lies in test tubes and trials, questions that lead to ‘what-if’s’ and ‘a-ha’ moments when the imagining of what could be emerges as reality. The future of cancer care lies in the kind of advances that can only be made through research and clinical trials.
CancerCare Manitoba Foundation supports the quest to recruit the best and brightest doctors and researchers in the industry and bring them to Manitoba. We have been successful and are making a tremendous difference. More patients are surviving cancer and many more are living longer with this terrible disease.
We are proud to showcase CancerCare Manitoba’s researchers and share the stories of the grateful patients they serve. Please read below for information about Dr. Shantanu Banerji’s groundbreaking research in the area of personalized genetic testing.
Genetic testing delivers more effective cancer treatments
What characteristics do you share with your family? Do you have the same curly hair as your father or the same blue eyes as grandparents? The experiences and traits we share are part of who we are and help create the story of our lives.
For Joyce and Kelvin Smith, who raised their family outside of Carman, Manitoba, the last few decades have begun to reveal a more insidious genetic commonality.
“In 1985 one of my sisters was diagnosed with brain cancer,” says Joyce. “She had surgery, which succeeded in removing part of the tumour, as well as radiation, but the disease took her life in August of that year.”
Just nine years later, her other sister was diagnosed with breast cancer. She passed away a year later.
In 2013 when Joyce’s thyroid began to increase in size, she had a thyroidectomy, which was diagnosed as cancerous. “After the surgery, I had a cough that wouldn’t go away. I had been told that this was a common side effect of thyroid surgery that typically would disappear, but this one didn’t,” says Joyce.
Ultimately a CT scan and biopsy revealed the truth behind the cough – lung cancer.
“I was absolutely shocked by the diagnosis. I’ve never smoked, so didn’t think this was something I’d have to worry about. However, we have since learned 15 to 20 per cent of lung cancer diagnoses are non-smokers.”
But ‘worry’ and ‘fear’ are close companions to cancer. To learn as much as they could about the disease and all treatment options, Kelvin and Joyce made a trip to the Mayo Clinic in Rochester, U.S. What they heard reassured them.
“The doctors at Mayo Clinic told us that if someone has lung cancer, then CancerCare Manitoba is a good place to be treated. We were so relieved to hear that the doctors at home are at the top of this field,” says Kelvin.
The comfort that this news brought only increased after meeting Dr. Banerji, Joyce’s oncologist at CancerCare Manitoba. “He was amazing to talk to – very professional and answered all of my questions clearly. I felt confident that I was in good hands”, says Joyce.
Genetic Testing for Cancer
Molecular testing is making a huge difference in treating cancer patients. A major problem is that even though CancerCare Manitoba is well positioned in terms of care and treatment, only limited genetic testing is accessible here in Manitoba.
CCMB tests routinely for two genes in patients with Stage IV adenocarcinoma.
“If we can identify a gene mutation then we can select a specific treatment that works, has less toxicity than what we might otherwise pick, and it makes the whole process more cost-effective,” says Dr. Banerji.
Testing on Joyce’s tissue samples came back negative.
But Dr. Banerji suspected that Joyce may have other gene mutations that, if identified, would allow him to provide a more targeted, effective treatment.
“The challenge we face is that we don’t have the equipment in Manitoba to test and certify multiple gene mutations at the same time. That means we need to send tissue away. In the U.S., this procedure can test for hundreds of genes at a time – but it’s expensive for us to use that service.”
Joyce and Kelvin decided to pay a fee and have the test done. That investment paid off. “In Joyce’s case, they found a mutation present in only 1 per cent of patients.
“She was one of the few we found it in. The advantage of these tests is that they look at all those “1 per cent genes”. Now that we know what is driving her cancer, we also know what drug will be most effective. This result opened up a whole new treatment option,” says Dr. Banerji.
As new technologies are evolving, Dr. Banerji recognizes that having access to this type of testing is critical here in Manitoba. He states, “A lot of the progress we’re making in cancer treatment is as a result of molecular testing. This is the future of cancer care.”
Surprising News about Lung Cancer
Joyce’s diagnosis also focused Kelvin’s efforts on research to find out as much as he could about the disease and potential treatments. He was surprised and disturbed by what he found. “I didn’t realize that lung cancer is the leading cause of cancer deaths. It kills more than two times as many Canadians as any other cancer.
Unfortunately, we also found out that the five-year survival rate is just 15 per cent and has hovered around that rate for decades. Many other cancers have seen big increases in survival rates as a result of research. Considering that lung cancer is so prevalent we were surprised to find out how under-funded this area is.”
The Smiths have responded to this news by making a donation to CancerCare Manitoba Foundation specifying the funds be targeted to assist CancerCare Manitoba with their plan to provide molecular testing right here in Manitoba. Their personal experience with Joyce’s treatment program has shown them the importance of having molecular testing available to all Manitobans to enhance cancer treatment programs.
The Road Ahead
More than a year after her diagnosis, Joyce continues with her chemotherapy and has a first-hand appreciation of how important her genetic testing has been. “The first round of chemotherapy I had was totally debilitating – I was nauseous and tired all the time. But with the discovery of my gene, Dr. Banerji has been able to adjust my treatment. When that is no longer effective, we now have a new option to pursue. Most days, I feel pretty good,” she says.
Good enough that Joyce and Kelvin are planning to spend time in Florida this winter.
“Living with cancer means it can be hard to plan too far ahead. I’ll fly home for my treatment and am looking forward to time in the sun.”