0:00

Good afternoon. Thank you for joining us. Tarah Schwartz is off this week. I'm

0:01

Kelly Albert, and this is Health

0:04

Matters on CJAD 800. On today's

0:04

show women from racialized

0:09

communities are at a higher risk

0:09

of dying from heart disease.

0:12

Later in the show, we speak with

0:12

the cardiologist from the MUHC

0:15

about her initiative to reduce

0:15

barriers to accessing health

0:18

care. And the Trottier Family

0:18

Foundation has made a

0:21

significant donation to help

0:21

champion a more

0:24

environmentally-friendly

0:24

hospital. But first, this past

0:27

Monday was World Ovarian Cancer

0:27

Day. The MUHC Foundation is

0:31

proud to support many doctors,

0:31

researchers and clinician

0:34

scientists at the MUHC and

0:34

RI-MUHC who are working to find

0:39

a way to diagnose ovarian cancer

0:39

at an earlier stage when it is

0:43

more treatable and find better

0:43

treatments for patients. On

0:47

World Ovarian Cancer Day, a team

0:47

of dedicated volunteers joined

0:50

us for a thank-a-than; a time

0:50

where we could thank our

0:53

community for their support of

0:53

ovarian cancer research and

0:56

patient care. Valerie Aitken is

0:56

one of those dedicated

0:59

volunteers. She has been an

0:59

incredible supporter of the MUHC

1:02

Foundation, and she joins me

1:02

now. Hello, Valerie.

1:05

Hello, Kelly.

1:05

Speak to us this morning.

1:08

Nice to speak with

1:08

you too. We see each other at

1:11

events every once in a while.

1:11

And I just would love to know

1:14

how long have you been

1:14

volunteering with the MUHC

1:17

Foundation?

1:18

My diagnosis

1:18

with ovarian cancer was in 2015

1:23

and I went through the chemo,

1:23

the surgery. Actually in April

1:31

the next year, I said, how do I

1:31

give back? And I asked to speak

1:35

to somebody at the MUHC

1:35

Foundation to inquire as to how

1:43

that could happen.

1:45

That's incredible.

1:45

And it's been ever since. So

1:47

ever since 2016, you've been

1:47

volunteering with us?

1:51

Yes. And I think

1:51

also I was invited to the

1:55

breakfasts, which explained how

1:55

people can not only give money

2:01

in cash, but give shares, and

2:01

all the all the pros and cons of

2:06

that. So it was besides living

2:06

with ovarian cancer, I always

2:11

call it my journey. I don't call

2:11

it a struggle, whatever; it's a

2:15

journey. I learned more, I

2:15

became more financially

2:20

literate, which I thought was

2:20

for me, I always have to look at

2:25

the positive side. If something

2:25

happens, where are we going to

2:29

go. And for me, it's been able

2:29

to support Dr. Gilbert with the

2:33

award. So that is one of the

2:33

things I have been doing.

2:37

I really do admire

2:37

that because I think oftentimes

2:41

when we're faced with a

2:41

diagnosis, it can be very scary.

2:44

It can be a very overwhelming

2:44

time. But I feel that you have

2:49

really made it your mission to

2:49

look at it in a bright way and

2:54

know that you can change the

2:54

world by making these steps to

2:58

make your life more positive.

3:01

Yes, and also,

3:01

of course the people. The first

3:05

award I gave was given to a

3:05

biomedical engineer, and she is

3:09

still my friend. She is

3:09

responsible for part of the

3:13

little brush that's used in the

3:13

clinical trial. And then my

3:18

second award went to help a

3:18

nurse. She'd always already

3:22

registered nurse, but it helped

3:22

her get her master's degree in

3:25

epidemiology. And this is

3:25

somebody else who I've been in

3:30

touch with. And that also is

3:30

wonderful for me to see how

3:36

these people have contributed

3:36

towards Dr. Gilbert's trial.

3:41

Absolutely. So the

3:41

awards that we're speaking about

3:44

is the Valerie Jasset and Gary

3:44

Aitken Cancer Research Award,

3:47

and this goes towards the DOvEE

3:47

Project. We have spoken about

3:51

the DOvEE Project before on the

3:51

show. But for those who don't

3:53

know, it's a project from Dr.

3:53

Lucy Gilbert, which the goal is

3:57

to be like a Pap test for

3:57

ovarian and endometrial cancer.

4:02

The struggle with these cancers

4:02

is they're diagnosed usually at

4:06

a later stage, when it is very

4:06

difficult to treat. And the

4:10

DOvEEgene test, which was

4:10

created right here in Montreal,

4:13

the goal is to have a test so we

4:13

can detect these cancers earlier

4:17

and treat them at an earlier

4:17

stage. And this research awards

4:20

that you created, the amount

4:20

goes directly to Dr. Gilbert who

4:25

helps select a health care

4:25

worker who wants to make a

4:28

difference and is helping to make a difference. Is that correct?

4:31

That's correct.

4:31

Yes, if she has a need, then she

4:38

can use the money. So it's held

4:38

with the MUHC Foundation. I

4:43

think last year's award has not

4:43

been given yet because she's

4:46

looking for the right person to

4:46

give that money to.

4:50

Incredible. We're

4:50

in conversation with Valerie

4:53

Aitken, who is one of the

4:53

dedicated volunteers at MUHC

4:56

Foundation. She's a really

4:56

important part of our community.

4:59

And so you mentioned you are one

4:59

of Dr. Gilbert's patients. You

5:03

mentioned that you've been

5:03

working with the MUHC Foundation

5:05

quite a bit. Why is it important

5:05

for you to support both Dr.

5:09

Gilbert in the DOvEE Project,

5:09

and also just support excellence

5:13

in health care?

5:19

Obviously, I

5:19

spend quite a lot of time back

5:23

and forth between the hospital,

5:23

the clinics and the various

5:25

things. I think for me

5:25

supporting specifically the

5:33

research into ovarian cancer,

5:33

and to look and see how it can

5:39

be found before it becomes stage

5:39

two, stage three, stage four. As

5:48

you mentioned, are so more

5:48

difficult to treat. And with the

5:52

treatment, I have side effects.

5:52

So I am reminded every day, that

5:57

if it hadn't been for Lucy

5:57

Gilbert and her team, then I may

6:03

not be having this conversation

6:03

with you today. But I think this

6:10

is what I want to do. I want to

6:10

have women, particularly younger

6:18

women, this disease can be

6:18

caught nipped in the bud, and

6:24

then they would have a much

6:24

better quality of life. Quality

6:31

of life is what I see. The

6:31

little things that all these

6:36

treatments leave one with.

6:36

Myself, I want to live my life

6:45

as positively and as actively as

6:45

I can, but there are certain

6:51

things that slow you down,

6:51

because of the treatments. So

6:56

that's why my first donations.

6:56

Mind you, I am followed in two

7:05

other particular clinics, and I

7:05

do give money as well towards

7:10

that particular area of

7:10

medicine.

7:17

It's important to

7:17

give back for sure. In

7:19

conversation with Valerie

7:19

Aitken, who is a donor in our

7:22

community, she's a valued

7:22

volunteer of our community.

7:25

We're running short on time,

7:25

Valerie, but I did want to ask

7:28

you, we talk quite a bit about

7:28

giving back. We talk quite a bit

7:33

about philanthropy. What message

7:33

would you have for our listeners

7:37

about the importance of giving

7:37

back; particularly to a cause as

7:41

important as yours, as important

7:41

as the DOvEE Project, and why

7:46

you feel so connected to it?

7:47

Yeah, I think

7:47

people will say to me, I can't

7:50

give very much and perhaps,

7:50

giving $5 a month. Maybe you're

7:58

going to give up that $5 coffee.

7:58

And that's a way of saying, I

8:03

can do this and it's only a

8:03

little amount. But if everybody

8:07

gives a little amount, then I

8:07

see that as a way. It makes me

8:12

feel good when I'm giving

8:12

whether giving of myself or even

8:16

being able to give the award. So

8:16

at that would be my message.

8:20

That's a lovely

8:20

message. And as you mentioned,

8:23

you know, we have a lot of

8:23

information on our website about

8:26

the financial benefits that come

8:26

from it. There's taxable

8:29

benefits that come from this.

8:29

You can become more financially

8:31

literate when you know about the

8:31

different ways to give. And I

8:35

think you're right, any amount,

8:35

no matter the size of the amount

8:39

is an important demonstration

8:39

that you believe in the cause

8:42

and you believe in our

8:42

community. So thank you so much

8:45

for everything that you do for

8:45

us, Valerie. I really appreciate

8:47

your time today. That is Valerie

8:47

Aitken, one of our dedicated

8:52

volunteers and wonderful

8:52

supporters at the MUHC

8:54

Foundation. Next on Health

8:54

Matters, a donation in support

8:58

of making the many surgeries at

8:58

the MUHC more

9:01

environmentally-friendly. Tarah

9:01

Schwartz is off this week. I'm

9:05

Kelly Albert, welcome back to

9:05

Health Matters on CJAD 800. The

9:09

MUHC Foundation is proud to work

9:09

with a number of other

9:12

foundations who support our

9:12

Dream Big campaign and our goal

9:15

to provide excellent patient

9:15

care and push the boundaries

9:18

forward for innovative research

9:18

to find better treatments. The

9:21

Trottier Family Foundation has

9:21

been an important partner and

9:25

has recently donated $280,000 in

9:25

support of a project to reduce

9:29

the environmental impact of

9:29

anesthetic gases. You might know

9:33

that most surgeries are

9:33

performed with anesthetic gases.

9:36

Eric St-Pierre is the Executive

9:36

Director of the Trottier Family

9:39

Foundation and he joins me now

9:39

to talk about this wonderful

9:42

project. Hello, Eric.

9:43

Hi, Kelly. How are you?

9:44

I'm very well, thank you so much for being here. For those who don't know,

9:46

can you tell me a little bit

9:51

about the Trottier Family Foundation?

9:53

Absolutely. So

9:53

the Trottier Family Foundation

9:55

was established by Lorne

9:55

Trottier and Louise Rousselle

9:57

Trottier back in 2006. It was

9:57

created to create a meaningful

10:02

impact to improve the lives of

10:02

Canadians. And so we've had

10:05

about four main programs. So

10:05

we've been focusing a lot on

10:08

science, a lot on education,

10:08

climate change and health

10:12

sectors. For example, we're

10:12

currently at the Climate Summit,

10:17

which has been hosted in the Old

10:17

Port; in partnership with the

10:21

Montreal Climate Partnership.

10:21

And we're currently trying to

10:23

mobilize diverse stakeholders

10:23

around climate change. So I

10:27

would say Trottier Foundation

10:27

has become one of the largest

10:29

Quebec or Canadian funders, and

10:29

one of the biggest funders on

10:33

climate change.

10:35

Absolutely. And

10:35

so, why was it important for you

10:38

to support this project at the

10:38

MUHC- the hospital is already

10:42

eco-friendly, but to make it

10:42

even more eco-friendly?

10:45

Yeah, that's a

10:45

great question. So we started

10:48

analyzing what we could do with

10:48

our health program that might be

10:52

a little bit more proactive, and

10:52

a little bit more innovative,

10:56

and how can we address systemic

10:56

issues. We started realizing

10:59

that often health care is

10:59

treated separately from climate

11:03

change, or climate change is

11:03

treated separately from health.

11:07

But we realized they're actually

11:07

interconnected. They intersect

11:10

and overlap. For example, about

11:10

5% of emissions come from the

11:15

health and hospital sector. So

11:15

this might include buildings

11:19

that are heated on fossil fuels.

11:19

It might include large fleets of

11:22

vehicles, or think of

11:22

ambulances. But it also might

11:26

include things like food waste,

11:26

material supplies, or even

11:30

different gases. Hospitals and

11:30

the health sector is actually a

11:34

very significant emitter of CO2.

11:34

And last year, at the Climate

11:38

Summit, we had that Dr. Steven

11:38

Williams, who's a doctor at the

11:42

CHUM. And the CHUM announced

11:42

that they would go carbon

11:45

neutral by 2040. And this doctor

11:45

had announced a new method for

11:50

reducing emissions from

11:50

anesthetic gases by over 80%. So

11:55

it was sort of an innovative

11:55

first time that Quebec hospital

11:59

was doing something innovative

11:59

and reducing emissions and

12:03

gases. And so we quickly had a

12:03

conversation with the MUHC and

12:07

we thought, wouldn't this be

12:07

great if the MUHC was to become

12:10

the second hospital in Quebec to

12:10

also reduce emissions, and

12:14

anesthetic gases. We had the

12:14

MUHC very willingly contribute.

12:19

We're in conversation with Eric St-Pierre, who's the Executive

12:21

Director of the Trottier Family

12:23

Foundation, the foundation has

12:23

made a donation to the MUHC

12:27

Foundation for $280,000 to

12:27

support a make the MUHC greener

12:33

initiative. And this project,

12:33

particularly, as Eric mentioned,

12:37

pertains to anesthetic gases. So

12:37

I'll give a bit of background on

12:40

anesthetic gases; about 5% of

12:40

the gases used during surgical

12:44

procedures are the ones that are

12:44

absorbed into the body. So 95%

12:49

of the gases are released

12:49

through ventilation systems into

12:52

the environment. So this project

12:52

will help recuperate these gases

12:58

that are released into the

12:58

environment, and then use them

13:01

again, in a way that... I don't

13:01

know the science behind it, but

13:06

I know that they're able to

13:06

recuperate it to make them

13:08

usable again. So it's really

13:08

special, that it's so

13:13

innovative. And it really shows

13:13

forward thinking. Is that

13:16

important to have this

13:16

forward-thinking, innovative,

13:20

outside the box approach to

13:20

finding solutions?

13:23

Yeah, absolutely. I think the challenge is that the health

13:25

sector is so preoccupied with

13:29

significant health issues. We

13:29

just came out of COVID, or we're

13:32

still coming out of COVID. So

13:32

there's very significant issues.

13:37

And it's hard to make

13:37

connections to the climate

13:41

change, whether how we're

13:41

adapting to climate change, what

13:45

the impact of heat waves or

13:45

flooding on Montreal's

13:48

vulnerable populations. But also

13:48

how do we start reducing

13:51

emissions. So we're actually

13:51

starting to see some leadership

13:54

amongst some health institutions

13:54

that are really starting to

13:58

think about those innovative

13:58

ways to directly reduce

14:01

emissions. We're quite inspired

14:01

by this. And we actually think

14:05

that we should be trying to

14:05

scale this across the province.

14:08

We've got now a second hospital

14:08

that's reducing its gases. But

14:11

we'd love to see this spread

14:11

throughout the rest of the

14:13

province, ideally,

14:15

How does that

14:15

happen? Because I think it's

14:18

really difficult. I mean,

14:18

there's so many hospitals in

14:21

Montreal, of varying ages as

14:21

well. We're fortunate that the

14:25

MUHC is a relatively new

14:25

hospital as is the CHUM. And so

14:29

is it conversations? Is it going

14:29

to government officials? Is it a

14:33

little bit of everything?

14:35

Yeah, it's a little bit of everything. So what we're seeing is leadership.

14:37

We're seeing some hospitals,

14:41

being bold and acting as those

14:41

pilot projects and being the

14:45

early adopters, if you will. And

14:45

but what we really need to do

14:48

now is we need to take that

14:48

leadership and we need to start

14:52

putting it to scale. And that

14:52

will actually involve

14:57

conversations with the Quebec

14:57

government and other

15:00

stakeholders as well,

15:00

potentially City of Montreal,

15:04

health officials. We really need

15:04

to start having some

15:07

higher-level conversations with

15:07

the governments and public

15:11

policymakers to really advance

15:11

the discussion of the

15:14

intersection of health and climate.

15:17

We're in conversation with Eric St-Pierre, who is the Executive

15:19

Director of the Trottier Family

15:21

Foundation. What I really admire

15:21

about foundation supporting

15:26

other foundations is it shows

15:26

that we have one goal in mind.

15:32

It's to improve our community

15:32

improve our province, our city,

15:36

our country. And when we support

15:36

each other, I think it just

15:40

shows how important our impact

15:40

can be. And so I love asking the

15:45

guests that come on the show

15:45

with a philanthropic mind; what

15:49

is your message to listeners

15:49

about the importance of the

15:53

impact of philanthropy and

15:53

giving back? Regardless of the

15:57

size of donation, how important

15:57

is giving back?

16:00

Yeah, getting

16:00

back is crucial. For foundations

16:04

like us, philanthropic dollars

16:04

are still very meaningful. The

16:08

grants we're providing are

16:08

helping benefit hospitals in the

16:13

health sector. But it's actually

16:13

very small compared to what

16:16

governments have. And so our

16:16

support from the Trottier

16:20

Foundation, and I would

16:20

encourage other foundations in

16:23

the Montreal area, to really

16:23

look at their funding as being

16:27

catalytic, being bold and

16:27

innovative. So our hope is

16:31

actually that we may mobilize

16:31

other like-minded foundations to

16:35

start thinking about the links

16:35

between climate and health,

16:38

whether that's reducing

16:38

emissions in the health sector,

16:40

or helping vulnerable

16:40

communities adapt to the impacts

16:43

of climate change. I think it's

16:43

a call to action, if you will;

16:48

for funders to start thinking a

16:48

little bit differently.

16:52

For the average

16:52

person to, I think there might

16:55

be a sort of misconception that

16:55

I don't have a lot of money. We

16:59

all experience financial

16:59

insecurity sometimes, and it can

17:02

be difficult to give back. But

17:02

truly, the impact of every

17:06

dollar is really, really

17:06

significant, isn't it?

17:10

Yeah, absolutely. Every dollar works and has an impact. But everybody

17:12

has also a voice, right? So

17:16

everybody could put pressure on

17:16

their local hospital or if they

17:21

have elected officials, they can

17:21

they can contact their local MP

17:26

or local politicians to really

17:26

ask them- what are you doing for

17:29

climate? And what are you doing

17:29

for decarbonizing the health

17:32

sector, for example? There's a

17:32

lot of tools and toolbox for

17:35

everybody.

17:36

Yeah, I love that

17:36

idea. I think we don't

17:38

necessarily always associate

17:38

giving back with time, like

17:41

volunteering or making calls or

17:41

really using your voice to push

17:46

forward to cause it is important

17:46

to you. So I think that's a

17:48

really excellent point.

17:50

We all have to

17:50

try our best and all hands on

17:52

deck, as they say.

17:54

Well, Eric, thank you so much for coming on the show. We really appreciate it.

17:55

And as I mentioned, this

17:59

donation is really going to help

17:59

push forward a more eco-friendly

18:02

hospital and really continue to

18:02

make the MUHC as green as

18:05

possible.

18:06

Thank you, Kelly. I really appreciate being on.

18:08

That is Eric St. Pierre, the executive director of the Trottier Family

18:10

Foundation, the foundation made

18:12

a $280,000 donation to a project

18:12

that will help recuperate

18:17

anesthetic gases and make a less

18:17

environmental impact. Coming up

18:21

on Health Matters, an historic

18:21

discovery that changed how to

18:24

know who is more at risk for

18:24

breast cancer and the local

18:28

researcher who helped make it

18:28

happen. Tarah Schwartz is off

18:31

this week. I'm Kelly Albert, and

18:31

this is Health Matters. The

18:34

BRCA1 and BRCA2 are two genes

18:34

that impact a person's chances

18:39

of developing breast cancer. You

18:39

might have heard of the BRCA

18:42

gene from celebrity news,

18:42

Angelina Jolie decided to have a

18:46

preventative double mastectomy

18:46

after finding she was a carrier

18:49

of the BRCA1 gene. This

18:49

discovery was first reported in

18:53

1994, and one of the scientists

18:53

at the RI-MUHC was part of the

18:58

team that discovered these genes

18:58

and has helped push forward

19:01

research to whom it impacts. Dr.

19:01

Patricia Tonin is a senior

19:04

scientist in the Cancer Research

19:04

Program at the RI-MUHC, she was

19:08

part of the team who discovered

19:08

the gene and joins me now.

19:11

Hello, Dr. Tonin. Hello, thank

19:11

you so much for being here.

19:15

Thank you for having me.

19:17

In very general

19:17

terms, for those who may not

19:19

know what the BRCA1 and BRCA2

19:19

genes are, can you describe them

19:26

to me?

19:26

Yes. So

19:26

these are genes that code for

19:29

proteins that are involved in

19:29

the normal functioning of our

19:35

cells. All of our cells in our

19:35

body have this, we all inherit

19:39

these genes from our parents. We

19:39

have two copies of them, one

19:44

that we inherit from our mothers

19:44

when we inherit from our

19:47

fathers. And what they produce

19:47

are proteins that are important

19:53

to maintain what we call the

19:53

integrity of DNA in the cells.

19:59

Okay, so sometimes

19:59

the cells change or aren't the

20:07

way that they're supposed to be,

20:07

and that impacts your health?

20:10

Yes. So

20:10

what's interesting about these

20:13

two genes is that if you inherit

20:13

a very variant in these genes,

20:21

which we call pathogenic. In

20:21

other words, if you inherited a

20:24

variant that's not a normal

20:24

variant, that would have no

20:28

consequence. But it's something

20:28

that would change the

20:32

functioning of the protein that

20:32

it makes. This results in one of

20:38

two things, either the protein

20:38

that's made is not functioning

20:41

properly, or it's just simply

20:41

not making a protein at all. So

20:45

what happens is that you can

20:45

inherit this variant from either

20:51

parent. And if you do inherit

20:51

it, it significantly increases a

20:57

woman's chance of developing

20:57

breast cancer and ovarian

21:02

cancer. For men, it increases

21:02

could increase your risk for

21:07

developing breast cancer and

21:07

prostate cancer. Depending on

21:12

what gene is involved.

21:14

Wow. And so this

21:14

is a historic discovery, for

21:19

many reasons, but because it

21:19

really helps pinpoint who's more

21:22

at risk of developing these

21:22

cancers.

21:25

Absolutely.

21:25

So they can be used as what we

21:28

call biomarkers. So we knew that

21:28

carriers of either of these

21:33

variants, they develop breast

21:33

cancer on average at a younger

21:37

age. Before the age of 50,

21:37

sometimes as young as in their

21:42

mid-30s. They can develop

21:42

ovarian cancer; perhaps not as

21:47

young but still ovarian cancer

21:47

is quite a deadly disease. The

21:52

risk for developing ovarian

21:52

cancer is lower than the risk

21:55

for breast cancer, but it's

21:55

still a real risk. And because

21:59

the ways in which to treat

21:59

ovarian cancer are not as

22:02

sophisticated as they are for

22:02

breast cancer, it's possible

22:06

that it can be lethal. We now

22:06

know, through years of research

22:11

that men who carry mutations in

22:11

BRCA1 or BRCA2 are at an

22:18

increased risk for breast cancer

22:18

as well. The risk is not the

22:22

same as for women, but it's

22:22

there. And for BRCA2, the most

22:28

important observation is that if

22:28

they carry mutation and they

22:34

develop prostate cancer, it can

22:34

be quite lethal. So the

22:38

management is quite different

22:38

now for men who have prostate

22:43

cancer, and it's known that they

22:43

carry a mutation in one of these

22:47

genes.

22:48

It's really, really fascinating. We're in conversation with Dr. Patricia

22:50

Tonin, a senior scientist in the

22:53

Cancer Research Program at the

22:53

RI-MUHC. So you are one of the

22:57

scientists who was part of the

22:57

team that made this discovery in

23:00

1994. If you could take us back

23:00

to those years. Did you know

23:06

that what you were working on

23:06

was going to be as

23:10

transformative- I guess is the

23:10

word- as it was?

23:13

Yes, yes,

23:13

definitely. Because the way in

23:17

which we found both BRCA1 and

23:17

reported it in the scientific

23:22

literature into the world in

23:22

1994. And then BRCA2, about a

23:26

year later, it was just after

23:26

the holidays, in December of

23:35

1995. We knew then, that it

23:35

would be impactful. What we

23:42

studied were families that had a

23:42

large number of breast cancer

23:46

cases in them, or ovarian

23:46

cancers and breast cancers. We

23:51

knew that the ages of diagnosis

23:51

of breast cancer were young.

23:54

It's the genetic study of these

23:54

families, which led us to

23:58

pinpoint exactly where in the

23:58

human genome these two genes are

24:02

located. So we had genetic

24:02

markers that we knew we're

24:10

tracking in the families, but we

24:10

couldn't find a gene. Until we

24:14

performed some genetic tests,

24:14

which allowed us to pinpoint

24:17

exactly where these genes were.

24:17

And that's the role that I

24:20

played it for BRCA1 and then for

24:20

BRCA2. By pinpointing where to

24:27

look for the genes, it allowed

24:27

our colleagues elsewhere to

24:31

physically clone the genes. Then

24:31

through DNA sequencing, we're

24:35

able to show the link between

24:35

having a variant in one of these

24:40

genes and the gene itself. Then

24:40

itself becomes a marker which

24:47

then can be used to identify all

24:47

the members of the family. Do

24:51

they contain the same variant or

24:51

not? Because everything is

24:55

hereditary, if it is passed from

24:55

one generation to the next. It's

24:59

not what we called de novo, it's

24:59

not something new. It's

25:02

something that's in your family

25:02

and your family history; it

25:04

could be there for hundreds of

25:04

years. And that reveals itself

25:08

when cancer presents itself.

25:08

Perhaps at an unusually younger

25:13

age, or when you have a lot of

25:13

siblings, or close family

25:18

members that have the disease.

25:18

That's how it reveals itself.

25:22

And it becomes a marker for

25:22

family history of disease and

25:26

for the risk.

25:28

Absolutely. And

25:28

that's how your research is

25:30

continuing. You started

25:30

examining the French Canadian

25:32

population

25:33

yes...

25:34

For these markers

25:34

as well. And we're short on

25:37

time. But can you tell us very

25:37

briefly about what your findings

25:40

were in the French Canadian population?

25:42

Yes, we

25:42

published a paper in 1998,

25:44

showing that women who had

25:44

family histories of breast and

25:54

ovarian cancer had very specific

25:54

mutations in either BRCA1 or

26:00

BRCA2 that were tracked in

26:00

individual families. And the

26:03

significance of this at that

26:03

time, was that it provided a way

26:10

to specifically use these as

26:10

genetic markers for finding

26:17

women and men in the population

26:17

who carry these variants, which

26:21

can then be used for genetic

26:21

counseling purposes. So these

26:25

genes, both genes are very, very

26:25

large. They're very complex

26:29

mutations or variants that can

26:29

occur anywhere in the gene. And

26:32

it made it very difficult to

26:32

find the underlying causal

26:37

variant. In specific

26:37

populations, like the French

26:41

Canadians, which can trace their

26:41

ancestors back to common

26:45

founders. They could have

26:45

inherited the same variant in

26:49

their families for generations,

26:49

tracing back to the 1600s. So we

26:54

were able to find those specific

26:54

variants. And at the time the

26:57

discovery was made was

26:57

important, because it allowed us

27:00

to provide a more precise

27:00

genetic counseling advice to

27:05

individuals who may carry these

27:05

mutations. Because sometimes the

27:09

precision was just not there

27:09

with sequencing. Now we have

27:13

sophisticated sequencing methods

27:13

where we can look at the entire

27:17

gene, but back then it was

27:17

costly, it was not necessarily

27:20

available to everyone. And this

27:20

was one way to be able to reach

27:25

a much larger population, as we

27:25

did with the Ashkenazi Jewish

27:32

population, we offered that as

27:32

well. Now we offer genetic

27:35

testing to everyone who is

27:35

eligible for testing.

27:38

It's incredible

27:38

the advances that have been able

27:41

to be made as a part of this

27:41

discovering, because of

27:44

improvements in technology. We

27:44

just have 45 seconds left, Dr.

27:48

Tonin. But you recently were

27:48

part of the team recognized for

27:52

the BRCA1 and 2 gene discovery.

27:52

You received a plaque in London

27:59

at the Cancer Research Institute

27:59

in London. There's a plaque with

28:04

your name as part of the team

28:04

that made this discovery. How

28:06

special is that honor?

28:08

Just to

28:08

clarify that plaque specifically

28:10

for BRCA2 and not for BRCA1

28:10

because those are two separate

28:15

discoveries, same people. So the

28:15

question is, how does it make me

28:19

feel?

28:20

Yes, how is it to

28:20

be recognized that way?

28:23

Fantastic,

28:23

because the purpose behind this

28:28

plaque is what it contains is

28:28

the order of all the authors

28:31

that published the seminal paper

28:31

on the discovery of BRCA2. The

28:37

purpose behind these plaques,

28:37

that are that are on the

28:40

buildings of these Cancer

28:40

Institute's is to recognize team

28:44

science. In other words, is to

28:44

recognize how many people are

28:50

involved to get to the point

28:50

where we can answer a question.

28:56

Rarely are teams recognized.

28:56

Usually, these are individuals.

29:03

It could be the lead author of

29:03

paper or the leader of the team.

29:06

But in reality, when you pull

29:06

the curtain back and you look at

29:10

what's happening in a lab,

29:10

there's a large number of people

29:13

from graduate student trainees,

29:13

undergraduate students, all the

29:17

way up to the team leaders. And

29:17

then this is replicated across

29:22

many, many labs. To be able to

29:22

achieve the successes that we

29:27

were able to achieve as a group

29:27

with the discoveries of these

29:30

two genes is an example of this.

29:30

It required the study of

29:34

geneticists, molecular

29:34

biologists, biologists, breast

29:39

cancer and ovarian cancer and

29:39

prostate cancer specialists from

29:42

around the world to come

29:42

together to be able to do this.

29:46

I could not have been done with

29:46

one particular group or one

29:50

particular team or one

29:50

particular method, it required

29:54

interdisciplinary effort to be

29:54

able to come to this point. And

30:00

the field that I'm in, also

30:00

continues to operate in that way

30:06

and operates quite successfully.

30:06

I mean, there are other genes

30:09

that have been discovered over

30:09

the past 20 years that are also

30:13

known to increased risk for

30:13

breast and ovarian cancer. So

30:17

it's not just those two genes.

30:17

There's now up to 13 different

30:20

genes that have been identified,

30:20

that will allow us to provide

30:28

advice for carriers and what to

30:28

do.

30:30

It's really

30:30

remarkable, and we're so excited

30:33

to have you at the RI-MUHC

30:33

continuing to push the needle

30:36

forward with your research. Dr.

30:36

Tonin, congratulations on this

30:39

recognition. And thank you so

30:39

much for joining us on the show.

30:42

Thank you. Thank you.

30:43

That's Dr. Patricia Tonin, a senior scientist in the Cancer Research

30:44

Program at the RI-MUHC. Coming

30:48

up next on Health Matters, women

30:48

from racialized communities are

30:51

at a higher risk of dying from

30:51

heart disease. Learn how a team

30:54

of doctors at the MUHC want to

30:54

reduce the barriers to accessing

30:58

care. Tarah Schwartz is off this

30:58

week. I'm Kelly Albert and

31:00

you're listening to Health

31:00

Matters. The leading cause of

31:03

death for women in Canada is

31:03

heart disease and cases are

31:06

rising every year. For women in

31:06

racialized communities, the

31:09

rates are even higher. There are

31:09

many reasons why this is

31:12

happening from limited access to

31:12

cardiovascular specialists to

31:15

risks of being overlooked. But

31:15

Dr. Judy Luu hopes to correct

31:19

this with the creation of POWER

31:19

Hub. It's an initiative at the

31:23

MUHC. Cardiologist Dr. Judy Luu

31:23

joins me now to discuss Good

31:25

afternoon, Dr. Luu.

31:27

Hi, good afternoon, Kelly, thank you for having me.

31:30

Thank you so much

31:30

for being here. So do you think

31:32

the average person; and in

31:32

particular, the average woman

31:35

knows their risks of heart

31:35

disease?

31:39

That's an

31:39

excellent question. So we have

31:42

contemporary research to show

31:42

that the average woman actually

31:46

doesn't recognize that heart

31:46

disease is the number one

31:49

killer. So research from the

31:49

United States, which is our

31:51

close neighbor shows that only

31:51

about half a woman recognize

31:55

this very fact. So it definitely

31:55

suggests that there's a lack of

31:58

awareness among a significant

31:58

proportion of women about the

32:01

risk of heart disease. There's

32:01

lots of reasons why this may be.

32:04

I mean, on top of having

32:04

traditional cardiovascular risk

32:07

factors like high blood

32:07

pressure, high cholesterol,

32:10

diabetes, and obesity, a lot of

32:10

women don't know that these risk

32:14

factors impact them much more

32:14

than they do a man. So for

32:17

instance, a woman with diabetes

32:17

is three times more likely to

32:21

die from heart disease when

32:21

compared to a man. So this

32:25

information is currently not

32:25

that fully obvious in the

32:30

public. And so a lot of women do

32:30

underestimate the risk when it

32:33

comes to heart disease.

32:34

Those are really

32:34

big numbers. And, you know,

32:36

we're speaking more specifically

32:36

about women in racialized

32:38

communities. So how much higher

32:38

is that that risk for women in

32:42

racialized communities?

32:46

For Canadian data,

32:46

we don't have an exact number,

32:49

per se. But we do now recognize

32:49

that, racial and ethnic

32:54

disparities do exist when it

32:54

comes to the occurrence of heart

32:58

disease and the outcomes of

32:58

heart disease. And so what do I

33:00

mean by that? For example, from

33:00

the Heart and Stroke Foundation

33:04

of Canada, we know that

33:04

indigenous women do face a

33:09

higher risk of heart disease and

33:09

stroke. And this is due to a

33:11

number of things that are very

33:11

complex. And I want to caveat

33:15

that there's a lot of factors

33:15

like socio-economic factors,

33:20

employment, education, access to

33:20

health services, nutritious

33:23

foods, adequate housing, so all

33:23

of these can impact racialized

33:28

communities and heart disease.

33:28

Indigenous people are just one

33:32

of them. But there's also other

33:32

examples across the multi ethnic

33:36

spectrum. South Asian

33:36

populations in Canada, also have

33:40

higher proportions of heart

33:40

disease. They've shown again, in

33:44

Heart and Stroke, that South

33:44

Asian people oftentimes have up

33:48

to 10 years earlier, chances of

33:48

having heart disease compared to

33:53

their white counterparts. So all

33:53

in all, I say there, again, I

33:58

want to caveat that there's a

33:58

lot of health disparities. And

34:00

the situation is very complex

34:00

and multifaceted. And what I

34:03

mean by multifaceted is there's

34:03

like systemic reasons, societal,

34:07

and health-related reasons. And

34:07

we're only really beginning to

34:10

understand that we're at the

34:10

very tip of this iceberg in

34:13

trying to help resolve this

34:13

current situation.

34:17

Of course, I mean,

34:17

whether it be socio-economic

34:21

factors, as you mentioned, it

34:21

could there could be a variety

34:24

of reasons why this is happening. But it's important to know that it is happening and

34:25

that it's a problem that we can

34:28

try to help with. We're in

34:28

conversation with Dr. Judy Luu,

34:32

a cardiologist at the MUHC, so

34:32

you want to start an initiative

34:36

called POWER. So it's Pathway to

34:36

Cardiovascular Care for Women in

34:41

Ethnic, Racialized and Remote

34:41

Communities. POWER- I really

34:44

liked that acronym. So tell us

34:44

about the POWER Hub and your

34:47

idea behind it.

34:49

Yes. Thank you so much for this opportunity to talk about the POWER Hub. It

34:51

really came as a call to action

34:55

as a national initiative for

34:55

some research funding. When I

35:02

conceptualize the idea; as a

35:02

team of clinicians, researchers,

35:07

women who have lived experience,

35:07

and other community members, we

35:09

definitely recognize that there

35:09

are several deep layers of

35:13

barriers that exist when we come

35:13

to providing equitable care for

35:18

a woman, especially in our

35:18

province in Quebec. And what I

35:22

mean by these barriers are

35:22

things that are including,

35:25

access to specialists, even just

35:25

cultural awareness and

35:29

sensitivities about heart

35:29

disease. There's also a

35:32

physician-patient language

35:32

discordance, especially someone

35:35

doesn't speak English, or if

35:35

they don't speak French in our

35:38

province. And then importantly,

35:38

really systematically we're

35:43

poorly underestimating the risk

35:43

profile of a woman. And so

35:49

that's how the POWER Hub came to

35:49

be. As a new

35:53

clinician-scientist, physician,

35:53

a woman's heart health

35:55

cardiologist at MUHC, I wanted

35:55

to form this network of

36:03

powerhouse team members to

36:03

really bridge the gap between

36:07

the French and the English

36:07

health care system. And to find

36:11

a way how we can redefine how

36:11

cardiovascular care is delivered

36:15

for women in Quebec. So, very

36:15

briefly to the podcast is

36:21

limited. But briefly, the POWER

36:21

Hub is a virtual network that

36:27

comprises of multiple sites

36:27

throughout Quebec. It includes

36:29

the CHUM that includes like

36:29

physician numbers and

36:32

researchers from the CHUM; as

36:32

well as, Laval. And our other

36:36

international collaborators from

36:36

the US including Cedar Sinai in

36:39

Los Angeles. And this POWER Hub

36:39

is designed to co-develop and

36:46

create with our community

36:46

members. So we have the Jamaica

36:54

Association in Montreal, too.

36:54

And the vision really is to

36:57

create a platform where all key

36:57

stakeholders can really work

37:02

together to understand what the

37:02

disparities and health

37:05

disparities are, and to find

37:05

meaningful and effective ways to

37:10

improve those disparities and

37:10

better deliver access to care

37:14

for a woman in Quebec.

37:16

I find it so

37:16

important and inspiring that

37:19

you're working with the

37:19

community stakeholders. Because

37:21

there's so many different groups

37:21

in Montreal that maybe don't

37:25

feel represented in health care

37:25

and for a variety of reasons.

37:29

But I think it's really, really

37:29

wonderful that you're working

37:31

together with these different groups to make sure that everyone feels supported.

37:36

100%, and one of

37:36

our main tripartite leadership

37:40

members is like I said is the

37:40

Jamaica Association but they

37:42

have access to all the other

37:42

black communities in the City of

37:46

Montreal. I think it's very important for us to reach out to. We're in our infancy and

37:48

trying to really garner those

37:54

relationships with these

37:54

cultural and ethnic community

37:56

associations. So eventually, we

37:56

will reach out to, let's say,

37:59

the Iranian community, the Greek

37:59

communities, and so many other

38:03

the Chinese, Vietnamese etc. And

38:03

so it's important for us to

38:07

really build those relationships

38:07

as they help us in the

38:11

fundamental creation of all

38:11

these deliverables of the POWER

38:15

Hub.

38:16

It's really

38:16

inspiring to hear and I know

38:18

that the foundation is

38:18

supporting you through this

38:21

initiative, and we want to get

38:21

you funding to help expand this

38:24

program and get this program off

38:24

the ground. So I'm really

38:26

grateful to have a cardiologist

38:26

like you who's working so

38:29

diligently to help make sure

38:29

that we have full representation

38:32

and equity in health care. Thank

38:32

you so much, Dr. Luu.

38:35

Thank you.

38:36

That is Dr. Judy

38:36

Luu, a cardiologist and one of

38:39

the team members behind the

38:39

POWER Hub and initiative here at

38:43

the MUHC that hopes to bring

38:43

cardiovascular care to women in

38:46

racialized communities. I'm

38:46

Kelly Albert, thank you for

38:49

tuning in. What would you like

38:49

to hear about on the show? Write

38:52

to me at healthmatters at

38:52

MUHCFoundation.com. You can also

38:56

follow the MUHC Foundation on

38:56

social media or sign up for our

39:00

newsletter at our website,

39:00

MUHCFoundation.com. Tarah will

39:03

be back next Sunday. Thank you

39:03

for listening to Health Matters

39:06

and stay healthy.