0:00

Hello there.

0:00

Thank you for joining us. I'm

0:02

Tarah Schwartz and this is

0:02

Health Matters on CJAD 800.

0:07

Before I dive into today's show,

0:07

I just want to extend a personal

0:12

thank you to Kelly Albert, who

0:12

has been sitting in this chair

0:15

and hosting the show for many,

0:15

many weeks now. It is much

0:18

appreciated. She is a wonderful

0:18

host, and we were thrilled to

0:21

have her in the chair. So thank

0:21

you so much, Kelly. On today's

0:25

show, April is organ transplant

0:25

Awareness Month, it's time to

0:29

bring attention to the lives

0:29

that are saved every day, thanks

0:32

to signing the back of your

0:32

Medicare card. But there are

0:35

still some misconceptions about

0:35

consenting to donation of your

0:39

organs, and some roadblocks that

0:39

can prevent your wishes from

0:42

being fulfilled. Later in the

0:42

show, we speak with a transplant

0:45

surgeon about why deciding to

0:45

donate your organs is more than

0:49

just a signature. To begin

0:49

today, Quebec is so fortunate to

0:53

have the MUHC which is one of

0:53

the top hospitals in the

0:56

country. And the Research

0:56

Institute of the McGill

0:59

University Health Center has

0:59

recently been voted one of the

1:02

top three research hospitals in

1:02

Canada. It is an incredible

1:07

recognition for the researchers

1:07

and staff who work diligently to

1:11

push the boundaries of

1:11

innovative health and medical

1:14

research. Dr. Rhian Touyz is the

1:14

Executive Director and Chief

1:18

Scientific Officer of the

1:18

RI-MUHC and she joins us today.

1:22

Thank you so much for being here. Dr. Touyz.

1:25

Thank you very

1:25

much, Tarah and it's a pleasure.

1:28

Dr. Touyz, I

1:28

remember our very first

1:31

interview when you first

1:31

accepted the position as

1:34

Executive Director and Chief

1:34

Scientific Officer, I'm feeling

1:36

it's about a year and a half ago

1:36

now. So what has the experience

1:40

been like for you so far? What

1:40

is this last year and a half

1:43

been like?

1:45

Yes indeed,

1:45

Tarah. It has been about one and

1:48

a half years, and the time has

1:48

certainly gone by very, very

1:52

quickly. The experience has been

1:52

one of great excitement, of joy,

1:58

and certainly enormous pride. As

1:58

I've gotten to know the

2:03

institution over the past one

2:03

and a half years, it's really

2:07

become incredibly clear to me

2:07

just what an extraordinary

2:11

community of hardworking,

2:11

creative, talented people who

2:16

are so committed and dedicated

2:16

to performing transformative

2:20

biomedical research, really to

2:20

improve the quality of life for

2:24

all. So it's been a fabulous

2:24

experience for me, and one that,

2:29

as I said, allows me to have

2:29

huge honor and feel very

2:34

privileged to do so. Indeed, an

2:34

exciting and busy time, Tarah.

2:40

Now Dr. Touyz,

2:40

how do you explain to people

2:43

when we're talking about

2:43

innovative medical research? How

2:47

do you explain to people what is

2:47

actually being done at the

2:50

Research Institute? How do you

2:50

explain that work in a way that

2:54

people will understand it?

2:57

That's really

2:57

an important question to ask

3:00

because we focus very much on

3:00

trying to understand the causes

3:06

of disease. We are a

3:06

hospital-based research

3:10

institute. So our prime interest

3:10

is to research what is

3:17

underlying disease. And we have

3:17

amazing researchers, both basic

3:23

scientists and clinicians, who

3:23

are working hand-in-hand to

3:28

unravel mechanisms to understand

3:28

better how to prevent disease,

3:34

and also to allow for the

3:34

discovery of new diagnostics,

3:39

and new therapeutics.

3:42

Now, the fact

3:42

that the Research Institute is

3:45

integrated with the hospital

3:45

with the MUHC, I can only

3:49

imagine that that's a huge benefit.

3:53

Not only is it

3:53

a huge benefit, but it's a huge

3:56

privilege. Because in order to

3:56

really understand patients, to

4:02

really understand what

4:02

clinicians have to deal with, in

4:06

terms of trying to manage

4:06

patients with disease. Having

4:10

the scientists close by really

4:10

allows the doctor, the clinician

4:16

and the scientist to ask

4:16

provocative questions that can

4:20

allow for the research that will

4:20

be fundamental in terms of

4:24

having impact and answering the

4:24

unknown questions. So indeed,

4:30

having the patients, having the

4:30

scientists, and having the

4:34

students all working close by

4:34

really does allow for the

4:39

transformative research that at

4:39

the end of the day will have

4:43

impact at the level of the

4:43

patient.

4:46

We're speaking with Dr. Rhian Touyz, who is the Executive Director and Chief

4:48

Scientific Officer of the

4:51

Research Institute of the McGill

4:51

University Health Centre. Dr.

4:55

Touyz, I'm curious about what is

4:55

most exciting, most inspiring to

4:59

you in terms of your position.

4:59

You talk about it with great

5:03

passion, what is the greatest

5:03

point of inspiration?

5:08

When I hear of

5:08

a small discovery or a big

5:11

discovery; no matter what that

5:11

discovery is something new,

5:16

something adding to knowledge,

5:16

something that is going to push

5:20

the boundaries of those unmet

5:20

needs, or those questions that

5:25

they haven't been able to answer

5:25

previously. That's what excites

5:30

me. And to be in an environment

5:30

where we have got young students

5:35

who have been taught by the

5:35

brightest scientists, and the

5:39

clinicians who work at the

5:39

bedside of the patients, working

5:44

in that type of a community is

5:44

honestly, so exciting, Tarah.

5:49

Having that intellectual

5:49

capacity, both within the

5:52

hospital and in the Research

5:52

Institute is really what brings

5:57

a smile to my face every day.

6:01

Dr. Touyz, it

6:01

feels like in every single

6:04

field, everywhere around the

6:04

world, things are moving so much

6:08

faster these days. Is that the

6:08

case in medical research as

6:12

well? Are things advancing

6:12

faster than they have in the

6:15

last 10-15 years?

6:18

This has been

6:18

an extraordinarily exciting time

6:21

in biomedical sciences, in

6:21

health research; you are

6:25

correct. There has been so much

6:25

innovation, whether this is

6:29

related to technologies, to

6:29

nanomedicine, to methodologies.

6:35

We know today, for example, that

6:35

artificial intelligence, machine

6:39

learning is having a huge impact

6:39

in the way we may diagnose

6:43

patients' diseases. Also, in

6:43

terms of therapeutics, the

6:49

technologies that we use today

6:49

are so different to what we used

6:54

10 years ago. But this is at the

6:54

level of both the clinical side,

7:00

but also, of course, within the

7:00

research laboratories. So

7:04

indeed, a very exciting time,

7:04

when there's been huge

7:09

advancements in these areas that

7:09

have really propelled discovery

7:14

to a whole new level.

7:17

Dr. Touyz, I

7:17

know during COVID, and

7:19

post-COVID, we talked a lot

7:19

about how the collaboration

7:22

between doctors, scientists,

7:22

researchers, research institutes

7:27

changed because there needed to

7:27

be that global collaboration in

7:30

order to deal with this pandemic

7:30

that nobody had dealt with

7:33

before. Does that kind of

7:33

collaboration still exist, and

7:37

has it grown in terms of

7:37

collaborating with research

7:39

institutes and researchers

7:39

around the world, outside of

7:42

Quebec, Canada?

7:44

Indeed, I think

7:44

we've realized more than ever,

7:47

and certainly this was

7:47

highlighted with the COVID

7:50

pandemic that we've just gone

7:50

through. We cannot do science

7:54

alone; we need to work

7:54

collaboratively. The more

7:59

brilliance we have around the

7:59

table, the more brainstorming,

8:02

the more expertise, the skills

8:02

that we bring to the table, that

8:07

is what is going to allow for

8:07

the advancement of science, for

8:11

the discovery of new knowledge.

8:11

And importantly, at the end of

8:18

the day, this is what will allow

8:18

us to really help our patients

8:22

both in the prevention of

8:22

disease, and also for better

8:25

quality of life. And more than

8:25

ever, we saw that through COVID,

8:31

where countries were working

8:31

together, researchers working

8:34

together with their clinician

8:34

and counterparts, and

8:37

industries, pharma, governments,

8:37

we were all working together.

8:42

And through those incredible

8:42

collaborations, we were allowed

8:45

to get through the incredibly

8:45

challenging times of the

8:49

pandemic. So yes, that ethos

8:49

continues. And certainly, we

8:55

need to continue to support that

8:55

collaborative effort.

8:59

Dr. Rhian Touyz

8:59

is the Executive Director of the

9:02

Research Institute of the MUHC,

9:02

which was just voted one of the

9:05

top three research hospitals in

9:05

Canada. What was it like to

9:10

receive that recognition, Dr. Touyz?

9:12

Oh, it was

9:12

wonderful. As I said, I'm

9:15

extremely proud to be leading

9:15

this amazing Research Institute

9:21

of over 3000 trainees,

9:21

researchers, clinicians, and

9:25

admin staff. And we will

9:25

continue to work hard so that

9:29

our finest and our contributions

9:29

remain the best with our

9:33

aspirations of really being at

9:33

the top in our field. So indeed,

9:38

enormous pride and much joy.

9:41

And, philanthropy. Dr. Touyz, final question for you. How

9:43

significant is that in terms of

9:47

the research that's conducted at

9:47

the Research Institute?

9:51

Research is

9:51

expensive, and we do need

9:55

funding in order to allow us to

9:55

do the science that we do.

10:00

Without the support that we get

10:00

through our granting agencies,

10:05

and especially without the

10:05

generosity, the commitment, the

10:10

support, and of course, the

10:10

interest that we get through

10:14

philanthropy, we would not be

10:14

able to do what we do. And

10:18

certainly we would not be able

10:18

to go that extra mile to ensure

10:23

that we remain and continue to

10:23

be at the front line in

10:27

research. So indeed,

10:27

philanthropic support is very,

10:31

very important. And this is

10:31

something that we certainly as

10:35

researchers do not take for

10:35

granted. It is with huge

10:39

appreciation that we know that

10:39

there is philanthropy that is

10:45

supporting our science.

10:47

Congratulations

10:47

once again on this award, Dr.

10:49

Touyz, and thank you so much for

10:49

joining us on the show.

10:52

Thank you so much, Tarah.

10:54

Next up on Health Matters, finding new treatments for young adults with

10:56

a rare but life-threatening

10:59

cancer. I'm Tarah Schwartz,

10:59

welcome back to Health Matters

11:02

on CJAD 800. Sarcoma is a rare

11:02

but life-threatening cancer that

11:08

endangers the lives of young

11:08

adults between the ages of 18

11:12

and 40. Many patients are

11:12

diagnosed with sarcoma in

11:16

Quebec, they're treated at the

11:16

MUHC. A team of doctors is

11:20

hoping to create a Centre of

11:20

Excellence in Sarcoma Care at

11:23

the hospital to unite

11:23

specialists and give patients

11:27

access to more treatments. Dr.

11:27

Ramy Saleh is a medical

11:30

oncologist at the MUHC, and the

11:30

Medical Director of oncology

11:34

clinical trials at the Research

11:34

Institute of the McGill

11:37

University Health Centre. Thank

11:37

you so much for joining us, Dr.

11:39

Saleh.

11:40

Thank you for having me.

11:42

So why don't we

11:42

start at the beginning? Can you

11:44

explain to us what exactly is

11:44

sarcoma?

11:49

Of course,

11:49

sarcoma is, as you mentioned, a

11:51

very rare type of cancer. It is

11:51

less than 1% of all cancers in

11:55

adult and around 50% of those in

11:55

children. It mostly involves the

12:01

muscle or the bone or the fat.

12:01

And it is not that common or

12:07

prevalent in Quebec.

12:09

And so when you

12:09

say that it mostly involves the

12:11

muscle, the bone or the fat, is

12:11

it that the cancer starts there?

12:15

Because I think we understand

12:15

cancers. Like we understand

12:17

breast cancer, we understand

12:17

lung cancer, colon cancer,

12:20

sarcoma is a bit harder to

12:20

understand. How can you explain

12:22

it so that we can understand it a little bit?

12:24

It is an

12:24

excellent question. So it can

12:26

arise from any bone in the body

12:26

or any muscle in the body, which

12:30

makes it a more complex cancer

12:30

in nature. So you're right,

12:33

breast cancer always starts in

12:33

the breast. So it's a very known

12:37

area where we can look out and

12:37

watch out for. The hard part,

12:41

for example, in osteosarcoma,

12:41

which is a type of sarcoma, it

12:44

can happen in any bone in the

12:44

person's body, and then from

12:48

there, it can spread around. So

12:48

instead of having one kind of

12:51

sarcoma, there's actually 100

12:51

subtypes of sarcoma, which makes

12:55

it extremely challenging for us.

12:58

Absolutely. I

12:58

know that some cancers are

13:01

genetic, is this one of them?

13:03

You're right,

13:03

some are actually genetic. It's

13:07

not that common. It does arise

13:07

from there. As you mentioned, in

13:12

the most vulnerable population,

13:12

the one between 16 and 40, I

13:18

would say probably 5-10% are

13:18

genetic, the other ones are just

13:23

the buddy predisposed to have cancer.

13:27

And do you know

13:27

at this point, why it targets

13:30

that age group?

13:33

We don't really

13:33

know. But we do know that it

13:36

either comes early on; so

13:36

between the ages of 16 to 40. Or

13:40

it comes very late, around the

13:40

60s or 70s. Usually in that

13:45

population it's patients who

13:45

already had cancer in the past,

13:49

or had some kind of cancer

13:49

treatment, for example, like

13:51

radiation. We expect that they

13:51

can have a sarcoma after

13:55

radiation. So there's two

13:55

populations that are at risk for

13:59

sarcoma. The reason as to why it

13:59

happens, we still don't know,

14:04

given that it is very rare. So

14:04

it's very hard to do research on

14:07

that.

14:08

And is there a

14:08

population you mentioned- one

14:11

population, people have had

14:11

radiation from previous cancer

14:14

treatments. Is there another

14:14

vulnerable population? Like why

14:17

targeting children like it seems

14:17

to it seems to be very broad.

14:21

You're right, it

14:21

is very broad, because what

14:24

we're talking about is 300 cases

14:24

a year. So we don't have that

14:28

much experience. It's not like

14:28

breast cancer with tens of

14:32

thousands of cases a year. We

14:32

only have a very small

14:35

population to study or to try to

14:35

observe and pick up on the

14:39

science of why we're having

14:39

sarcoma. It's not related, for

14:43

example, to food as some people

14:43

think, with other types of

14:46

cancers. We think it could be an

14:46

exposure to radiation in the

14:50

past. Some it's because of

14:50

previous malignancy or the

14:54

previous treatment, but that is

14:54

also rare. Most of the time when

14:57

we see those patients in our

14:57

clinics we don't know the reason

15:00

why it started.

15:02

We were speaking with Dr. Ramy Saleh and we're talking about sarcoma.

15:04

Considering that you've now

15:08

helped us understand how rare

15:08

this cancer is that there are

15:10

less than 300 cases... is that

15:10

less than 300 cases in Quebec or

15:13

Canada?

15:15

In Canada, it's

15:15

about 1000 cases of new

15:18

diagnosis of sarcoma a year. In

15:18

Quebec, our average is between

15:22

250 to 300 cases a year.

15:26

Considering that

15:26

that it is a relatively small

15:29

number, are there signs or

15:29

symptoms? How do you diagnose

15:31

this cancer?

15:33

Most of the

15:33

time, patients come in with

15:36

extreme bone pain or a fracture

15:36

that's unexplained. In others,

15:41

it is just a mass that occurs in

15:41

the belly, where we have a lot

15:45

of fat and this is the typical

15:45

presentation when they come.

15:49

It's not that common to catch

15:49

them super early on. And this is

15:54

why sarcoma tends to be more

15:54

malignant and more aggressive,

15:57

because some of the times when

15:57

we detect those cancers, they

16:00

already started spreading around.

16:03

Yeah, I know

16:03

that we hear that a lot; that

16:05

the earlier you catch a cancer,

16:05

the easier it is to treat. And

16:07

it sounds like are most of these

16:07

cases caught in, in late stage

16:12

because of how tough they are to

16:12

diagnose?

16:15

The challenge in

16:15

sarcoma is what kind of

16:18

treatment that exists. So let's

16:18

focus on that. If you come in

16:22

with an early stage sarcoma, the

16:22

treatment is still very

16:26

aggressive in nature. And what I

16:26

mean by that is, sometimes it

16:30

requires an amputation of a

16:30

limb. As you can imagine, if

16:36

you're between the ages of 16

16:36

and 40, this is extremely

16:38

traumatic at the peak of your

16:38

life. So our treatments in

16:43

sarcoma are not as easy as in

16:43

different kinds of cancers. The

16:48

surgeries can be quite

16:48

extensive, and sometimes can

16:52

limit mobility later on. In

16:52

terms of chemotherapy, most of

16:57

the time, the treatment is

16:57

around 40 weeks, in total. So it

17:02

requires a lot of patience and a

17:02

lot of visits to the hospital.

17:05

And that's the complexity of

17:05

that sarcoma.

17:09

Well, Dr. Saleh,

17:09

you're working on a project with

17:13

Dr. Nathaniel Bouganim to form

17:13

the Sarcoma Research Consortium,

17:17

Quebec, SARCQ. Tell us how you

17:17

hope this consortium will help?

17:22

The purpose is

17:22

we want to help our patients in

17:28

Quebec more. When you have a

17:28

sarcoma that is localized, that

17:34

is treated with chemotherapy and

17:34

surgery, that is great news. But

17:37

what happens to the people with

17:37

advanced sarcoma where the

17:40

cancer started spreading, or

17:40

what we call metastasis? In

17:44

those patients, the treatment

17:44

options are quite limited. We're

17:47

talking about three or four

17:47

options at best. And a lot of

17:51

times, with those treatment

17:51

options we have less than a 50%

17:55

chance that they actually work.

17:55

Recently, over the last couple

17:59

of years, there's been a lot of

17:59

new medications that are

18:03

offering patients much more

18:03

options. And with more options,

18:06

obviously, the longer that you

18:06

can live, and we can give them

18:10

more time and better quality of

18:10

life. Unfortunately, the only

18:13

way to access those drugs is

18:13

through clinical trials. And we

18:17

need to encourage the

18:17

pharmaceutical companies to come

18:20

to Quebec so we can do those

18:20

clinical trials. And we also

18:23

have to get all the patients to

18:23

be seen and to ensure that we

18:26

don't leave anybody behind. It's

18:26

unfair, if we cannot help a

18:31

patient just because they don't

18:31

live on the Island of Montreal.

18:34

So the project came out by

18:34

multiple doctors across the

18:38

province of Quebec, where we

18:38

already know each other, and we

18:41

decided to form this consortium,

18:41

where we will discuss all the

18:47

patients among each other. And

18:47

they will be able to have access

18:52

to any clinical trial that we

18:52

have in Quebec, and at the same

18:55

time to encourage all companies

18:55

who have clinical trials to come

18:59

and invest in our province, so

18:59

we can offer those newer

19:02

medications to our patients.

19:04

I also wonder,

19:04

Dr. Saleh, when you're diagnosed

19:06

with a cancer that is so

19:06

challenging as this one seems to

19:10

be an it's such a rare cancer,

19:10

there must be some kind of

19:15

comfort having an organization

19:15

that is focusing on it because

19:18

patients must feel very alone

19:18

when they're diagnosed with

19:21

this. Is there going to be some

19:21

form of patient support that's

19:24

going to be included in SARCQ as well?

19:26

Yes, that's

19:26

actually an excellent question.

19:29

Sarcoma cannot be treated in any

19:29

hospital. Sarcoma everywhere in

19:33

the world is treated in what we

19:33

call Centres of Excellence. It's

19:37

where you have an oncologist who

19:37

has training in sarcoma and

19:41

orthopedic doctors who know how

19:41

to treat this disease by very

19:45

specific surgeries; as well as

19:45

radiation oncologists. In

19:49

Quebec, the two largest

19:49

hospitals are Hopital

19:53

Maisonneuve Rosemont and the

19:53

MUHC. So we sat all together and

19:56

we decided to merge forces so we

19:56

can merge our experiences

20:00

together so we can offer the

20:00

best quality of care for our

20:03

patients. In SARCQ, the patients

20:03

will have access to not only the

20:07

doctors with the most experience

20:07

in sarcoma in Quebec only, but

20:11

also we'll try to plug them to

20:11

clinical trials as fast as

20:14

possible. We have a coordinator

20:14

that will be helping us match

20:18

those patients to trials. As

20:18

well as to provide- just as we

20:22

do to all our cancer patients at

20:22

MUHC- provide them with a nurse

20:27

as well as psychosocial support,

20:27

and all the services that we can

20:30

offer them in order to alleviate

20:30

the pain that they're going

20:33

through.

20:34

Dr. Saleh, I just want to congratulate you on this incredible project. And to

20:36

say that it feels comforting to

20:39

know that you rally behind it,

20:39

because you're clearly very

20:42

passionate about this cause. So

20:42

congratulations, and thank you

20:45

so much for coming on to talk to us about it.

20:47

Thank you very much. Thank you for having me.

20:50

Coming up on the

20:50

show, deciding to donate your

20:52

organs is so much more than

20:52

signing the back of your health

20:56

card. I'm Tarah Schwartz and

20:56

this is Health Matters. April is

21:00

organ transplant Awareness

21:00

Month. It's heartbreaking for

21:04

those who lose loved ones, but

21:04

donating organs saves lives. But

21:09

there's more to deciding to

21:09

donate your organs than just

21:12

signing the back of your health

21:12

card. Dr. Prosanto Chaudhury is

21:16

a surgeon and the interim

21:16

Director of the multi organ

21:18

transplant program at the MUHC,

21:18

and an associate investigator at

21:22

the Research Institute of the

21:22

McGill University Health Centre.

21:25

Thank you so much for joining us.

21:27

Thank you very much, Tarah for having me on air.

21:30

Dr. Chaudhury,

21:30

organ transplant seems to have

21:33

many facets to it. What drew you

21:33

to this area of medicine I'm

21:37

curious?

21:39

Well,

21:39

that's a tough question. I

21:45

didn't actually start out in

21:45

life wanting to be a transplant

21:47

surgeon. It's something that the

21:47

experiences that I had working

21:51

at the Royal Victoria Hospital,

21:51

before our move on the

21:54

transplant service really opened

21:54

my eyes to. It is really one of

21:59

those remarkable, life changing

21:59

operations. Particularly when

22:05

you're doing liver transplants

22:05

on extremely sick individuals,

22:09

and then get a chance to see

22:09

them returning to normal lives.

22:12

And the same thing for patients

22:12

who receive kidney transplants.

22:14

It's really life changing

22:14

operations. And it's a real

22:18

opportunity to make an impact on

22:18

someone.

22:21

Wow, that sounds

22:21

wonderful. So what is it like to

22:24

be in the operating room for an

22:24

organ transplant operation? Tell

22:28

us a little bit about that setting?

22:31

It's something that I've been doing for 15-20 years almost. And it's

22:32

still as exciting now as it was

22:38

when I first started doing it.

22:38

There's something really

22:40

miraculous about seeing an organ

22:40

that you've taken out of an

22:43

icebox; putting it back into

22:43

someone and seeing it come back

22:47

to life. In the case of the

22:47

kidneys, start making urine. In

22:50

the case of a liver, picking up

22:50

and really taking over all those

22:53

vital functions again. It's a

22:53

really miraculous moment. It has

22:57

its moments of stress. Of course, these are not simple operations, but really, really a

22:59

rewarding experience from the

23:03

surgical side.

23:04

I think a lot of

23:04

us see on television, this sort

23:07

of idea of this box being rushed

23:07

from an ambulance or a

23:12

helicopter into a hospital and

23:12

it goes into the operating room.

23:14

And like is there some truth to

23:14

that that mystique that we see

23:18

in various hospitals shows?

23:21

Well, as

23:21

is often the case, TV tends to

23:23

exaggerate things. But there is

23:23

a certain amount of urgency to

23:26

it. We're fortunate enough in

23:26

Quebec to the benefit from an

23:30

association called ACDO the

23:30

Association canadien des dons

23:35

d'organes. And they actually are

23:35

an organization of volunteers,

23:39

primarily from the police forces

23:39

of the province who drive organs

23:46

around when we're on our way

23:46

from one hospital to another.

23:48

And so there is that urgent

23:48

aspect to it. And we do arrive

23:54

in hospitals with those red

23:54

boxes that you see on TV and

23:56

then bring those red boxes back

23:56

to the hospitals. The time that

24:00

we have to put an organ in

24:00

varies by the type of organ and

24:03

so some are really urgent heart

24:03

and liver we will do immediately

24:09

on arrival. Often the recipients

24:09

are already in the operating

24:12

room when we arrived back at the

24:12

hospital. With kidneys we have a

24:15

little bit more time.

24:17

Interesting. I

24:17

think when most people hear

24:19

about organ transplants, it's

24:19

hard to wrap your head around

24:21

the fact that someone has to

24:21

pass away for someone else to

24:25

live. I'm sure it's very

24:25

different from your perspective

24:28

as a surgeon, how do you see

24:28

that element of it?

24:33

The two

24:33

elements for that. One- the

24:36

members of the transplant team

24:36

are never in direct contact with

24:39

the donors and their families.

24:39

So we don't have that firsthand

24:43

experience of it. We are however

24:43

always cognizant of the fact

24:47

that this is an immense gift

24:47

that someone or some family is

24:52

choosing to give at the end of

24:52

life. And so it is one of those

24:57

unique moments where you have

24:57

that bittersweet mix of a death

25:03

that leads to saving and

25:03

influencing up to eight other

25:07

lives. It's a really remarkable

25:07

moment. And we are always

25:13

thankful and grateful to the

25:13

donors and their families who in

25:16

moments of great crisis, and

25:16

grief are able to make that

25:22

ultimate gift.

25:24

Beautifully

25:24

said, Dr. Prosanto Chaudhury is

25:28

an organ transplant surgeon,

25:28

associate investigator at the

25:32

Research Institute at the MUHC.

25:32

Are they're still misconceptions

25:36

about organ donation, do you

25:36

think?

25:40

Absolutely.

25:40

There are misconceptions about

25:44

people thinking that they are

25:44

not potential donors. Because of

25:49

their age, because of some of

25:49

the medical illnesses they may

25:51

have. And in fact, most of those

25:51

preconceived ideas about who can

25:58

and can't be an organ donor

25:58

aren't always the case. And

26:02

certainly, there's also the

26:02

donation of tissues, which is

26:04

even more broadly applicable,

26:04

has fewer restrictions in some

26:08

senses than then than whole

26:08

organs. So I would say never

26:12

rule yourself out. Someone may

26:12

be able to benefit. The other is

26:19

sometimes the urgency of it. So

26:19

once an organ donor is

26:22

identified, it may take several

26:22

days to completely work them up

26:27

and allocate the organs to the

26:27

best possible recipient. So

26:32

there is urgency, but it is not

26:32

the extreme urgency that we see

26:36

on television.

26:37

Okay, Dr.

26:37

Chaudhury, I wonder how

26:40

important is it to discuss this

26:40

decision to donate your organs

26:44

in advance. Is it as simple as

26:44

okay, we sign the back of our

26:46

health card, if something

26:46

happens to us, our wishes are

26:50

made clear, or is there

26:50

something more that's required?

26:54

It's always best to have the discussion about your wishes to

26:56

be an organ donor, with the

26:59

people who will be making

26:59

decisions and speaking for you.

27:02

When that situation arises,

27:02

unfortunately, when one becomes

27:06

an organ donor, one is usually

27:06

not... one of the dead. So one

27:10

isn't able to express one's

27:10

wishes. And so it's really

27:12

important, in fact, to have the

27:12

discussions with the people

27:16

around you so that they know

27:16

what your wishes are. Signing

27:19

the card is an indication. But

27:19

it's really difficult for the

27:23

people around you to make that

27:23

decision. They're being asked to

27:27

make the decision. If they know

27:27

what your wish is and what your

27:31

decision is beforehand, and

27:31

makes the whole process much

27:34

much easier on them.

27:36

You mentioned in

27:36

a previous answer that up to

27:40

eight lives can be saved. Dig

27:40

into a little deeper with that.

27:45

When you're donating your

27:45

organs, what is it that can be

27:47

given as this beautiful gift you

27:47

mentioned to other people?

27:52

So we're

27:52

looking at the potential to give

27:54

lungs; that may go to one or two

27:54

recipients. A heart, a liver

27:59

which may go to one or two

27:59

recipients, pancreas, two

28:03

kidneys, small intestine, and

28:03

tissues as well.

28:08

Wow, it's

28:08

incredible. As you mentioned, it

28:10

really does sound like the gift

28:10

of life. It really is the gift

28:14

of life, isn't it?

28:14

It really is the gift of life. Absolutely.

28:17

What kind of innovative research in transplants is being done at the

28:19

MUHC and the RI-MUHC now?

28:24

So we're

28:24

involved in a broad range of

28:27

activities in research around

28:27

transplantation right now. Into

28:30

the immunology of transplant and

28:30

how to prevent and treat

28:33

rejection. In terms of

28:33

understanding the changes that

28:37

happen to an organ when it is

28:37

removed from a living body and

28:42

stored and then put back in, and

28:42

how we can lessen the damage

28:47

that occurs during that period

28:47

of time. As well as clinical

28:50

trials of new drugs and

28:50

immunosuppressants that will

28:54

hopefully decrease the side

28:54

effects that patients'

28:57

experience from their

28:57

maintenance immunosuppression.

29:01

So a whole gamut of research

29:01

currently underway here at the

29:04

MUHC

29:06

Dr. Chaudhury, you mentioned that you've been doing this for the past 15

29:07

years. Things move so quickly

29:11

now; it's something we've talked about on the show a couple of times already. But you must have

29:13

seen significant changes in the

29:16

last 15 years.

29:19

One of

29:19

the biggest changes that we see

29:21

is in the donors themselves and

29:21

the kinds of donors and organs

29:26

that we're using. The population

29:26

getting a little bit older and

29:30

still having excellent outcomes

29:30

with those organs. Also, the use

29:34

of preservation technologies;

29:34

machine perfusion is becoming

29:39

increasingly important in the

29:39

way we manage the organs so that

29:43

they go not necessarily right

29:43

from a red box into someone but

29:47

go through a stage where they

29:47

are reconditioned or put through

29:51

processes that allow them to be

29:51

better conserved. I think that's

29:56

something that's going to grow

29:56

enormously in the near future.

30:00

I have another

30:00

question for you. And we only

30:05

have a minute left and I'm

30:05

curious about this Dr.

30:07

Chaudhury, you mentioned that

30:07

the preservation. Is it getting

30:11

easier for bodies to be able to

30:11

accept transplants now? It's

30:15

something I don't know much

30:15

about it but I feel like

30:17

something I've heard is that sometimes people reject their transplants. Is that getting

30:19

better?

30:21

So we've made great strides in the treatment of acute rejection. So

30:23

we rarely have episodes of an

30:27

organ going in and being

30:27

rejected immediately. The more

30:31

problematic issue is one of

30:31

chronic rejection, which

30:34

develops over years and maybe

30:34

quite silent and present only

30:39

when it's too late to treat. And

30:39

so we're really actively

30:43

involved in looking at ways to

30:43

decrease that kind of rejection

30:46

and detect it earlier so we can

30:46

treat it earlier.

30:49

Dr. Prosanto

30:49

Chaudhury, thank you so much for

30:52

joining us on Health Matters. I

30:52

feel I've learned a lot of new

30:55

and wonderful information today

30:55

about your area of expertise. So

30:58

thank you so much.

30:59

Thank you so much, Tarah, for having me on here.

31:02

Next up on the

31:02

show, an early career researcher

31:04

shares how receiving an award

31:04

will help further an exciting

31:08

project. I'm Tarah Schwartz,

31:08

you're listening to Health

31:11

Matters. There are groups that

31:11

are underrepresented in health

31:15

and medical research. Like in

31:15

many fields, researchers from

31:18

diverse backgrounds can have

31:18

difficulties acquiring resources

31:22

to pursue their work. To address

31:22

the lack of diversity, the

31:25

assets management firm Fiera

31:25

Capital and the MUHC Foundation

31:30

founded the Fiera Capital Awards

31:30

for Diversity, Equity and

31:34

Inclusion in Health Care. Fiera

31:34

Capital has committed $120,000

31:39

per year for the next three

31:39

years to support researchers who

31:42

are in their early career

31:42

stages. Annabel Wing-Yan Fan is

31:47

one of this year's recipients.

31:47

She is a PhD student in the

31:49

Baldwin Vision Lab. Annabel,

31:49

thank you for joining us.

31:53

Hello, Tarah. Thanks for inviting me today.

31:55

So Annabel, you

31:55

are a doctoral student in the

31:58

Baldwin Vision Lab at the

31:58

Research Institute at MUHC,

32:02

which we've heard about quite a

32:02

bit today. Tell us a little bit

32:04

about what you're studying. What

32:04

are you doing? What's involved

32:07

in the Baldwin Vision Lab?

32:09

Great,

32:09

thanks for asking. So the

32:12

Baldwin Vision Lab takes a look

32:12

at visual information

32:15

processing. And specifically, I

32:15

look at how that changes in

32:18

aging. And whether it impacts

32:18

older adults in their daily

32:21

lives with a bit of a focus on

32:21

their driving ability.

32:26

So what specifically are you looking at in terms of vision?

32:30

Specifically, in terms of vision, we are really looking at how people are

32:32

able to see faint signals when

32:36

there are noisy backgrounds. So

32:36

when I talk about visual noise,

32:40

you can imagine that like TV

32:40

static, and when participants

32:43

come into the lab, we asked them

32:43

whether or not they could find

32:46

faint patterns in these noisy

32:46

backgrounds. And we're really

32:49

looking at how people are

32:49

processing these visual signals

32:52

in terms of space and also over time.

32:53

And so what are

32:53

you hoping to learn from it?

32:57

What is the goal of this kind of

32:57

study?

33:00

One of the

33:00

interesting things that is more

33:03

talking on the clinical

33:03

application side, is that when

33:07

it comes to age-related changes

33:07

in cognition, we find that there

33:10

are a lot of related things. So

33:10

different areas of cognition

33:13

change, or decline together was

33:13

this isn't the case in vision.

33:17

And that kind of leads to the

33:17

question of why vision changes

33:19

differently, in different

33:19

aspects, and whether or not that

33:22

translates to how aging impacts

33:22

people's daily lives. So one

33:27

aspect of your vision might get

33:27

better as you get older, one

33:30

aspect of revision may get

33:30

worse. So we're really doing

33:32

this research to find if we can

33:32

have a general measure of aging

33:35

that will kind of track how

33:35

declining aging may impact daily

33:38

activities.

33:40

I think most of

33:40

us know that as we get older,

33:43

you reach that point where

33:43

you're like, Okay, I've had

33:46

super vision my whole life and

33:46

now I need reading glasses. So

33:49

that's the one that everyone

33:49

understands in terms of how

33:52

their eyes change as they get

33:52

older. What are some other ways

33:54

that eyes change as we age?

33:57

One of the things that you were talking about there is in terms of

33:59

visual acuity. So as we get

34:02

older, maybe faint things are

34:02

harder to see. But there are

34:05

also other aspects of our vision

34:05

that aren't super obvious. Like

34:08

as we get older, there's parts

34:08

in your visual field that is in

34:11

front of you- how much you can

34:11

see without turning your head.

34:14

And in this visual field, there

34:14

are sometimes places where we

34:17

can't see anymore because as we

34:17

age, the neurons might change.

34:21

And that's not obvious to us,

34:21

because our brain kind of fills

34:24

it in. In the back of your eye,

34:24

you have this blind spot where

34:27

the optical nerves are coming

34:27

out. And we were technically

34:31

blind in that area of our visual

34:31

field, but we can't see that

34:34

because our brain fills in the

34:34

information. So similar things

34:37

may happen as we age in

34:37

different visual degenerations,

34:43

and because we don't notice that

34:43

it can be really dangerous for

34:45

driving. So that's one of the

34:45

things that we should be mindful

34:47

of.

34:48

We're speaking

34:48

with Annabel Wing-Yan Fan; she

34:50

is one of this year's recipients

34:50

of the Fiera Capital Award for

34:53

Diversity, Equity and Inclusion

34:53

in Health Care and we're talking

34:56

about her research now. I know

34:56

Annabel that you're passionate

34:59

about extended reality

34:59

technologies, and we've created

35:03

a web and mobile app for your

35:03

work. Tell us a little bit about

35:05

that.

35:06

For sure.

35:06

For extended reality is in case

35:09

people are not familiar with the

35:09

term; it encompasses virtual

35:12

reality, which is typically a

35:12

screen inside of a headset, and

35:15

augmented reality, which is like

35:15

a digital overlay over the real

35:19

world, such as like Pokemon Go.

35:19

And mixed reality, which really

35:22

is a mix of these two

35:22

technologies. So I've worked

35:25

with many different groups in

35:25

these sorts of technologies. So

35:29

for example, I worked with a

35:29

graduate level software

35:31

engineers to turn lab

35:31

experiments into these fun

35:34

mobile games for children.

35:34

Before starting my PhD at

35:37

McGill, I've worked on a

35:37

research collaboration with the

35:40

pharmaceutical company Novartis,

35:40

Ubisoft, a gaming company, and

35:43

McGill, to develop digital

35:43

treatments for lazy eye. And in

35:47

the past, I've also created

35:47

these prototypes with the

35:50

Microsoft HoloLens, which is a

35:50

mixed reality device to kind of

35:54

assess its use as a research

35:54

tool in vision.

35:57

So these are

35:57

obviously tools and techniques

36:00

that are very new, because this

36:00

is not something that we were

36:03

doing 10-15 years ago. How is it

36:03

changing the landscape of doing

36:08

this kind of research, your

36:08

research and research of your

36:11

colleagues as well?

36:13

Yeah, I'm really excited about where this kind of area is headed in.

36:15

Because like you mentioned,

36:17

these are very new technologies.

36:17

And I think one of the most

36:20

beneficial aspects of them is

36:20

that they're really letting us

36:23

test the scientific paradigms

36:23

inside of a more naturalistic

36:27

setting. People are able to have

36:27

people do locomotion tasks

36:31

inside natural virtual

36:31

environment, we can show people

36:33

more realistic visual stimuli to

36:33

see whether or not our lab tests

36:37

really translate in the real

36:37

world. And even though it's not

36:40

like obviously the same as the

36:40

real world, we are bringing the

36:42

research a bit closer, which

36:42

means hopefully better

36:45

applications and mobilization

36:45

for scientific research.

36:48

So obviously,

36:48

this kind of technology, which I

36:51

also find so fascinating, I see

36:51

the impact being enormous on

36:55

medicine and research in

36:55

general. How does it impact the

36:59

patient in terms of your work?

36:59

Like how does it dribbled down

37:02

to get to having an effect on

37:02

the patient?

37:06

Well, this ties into that work I was talking about with the Microsoft

37:08

HoloLens. So a reason why we

37:10

were looking at this mixed

37:10

reality technology is because

37:13

when people are doing visual

37:13

rehabilitation, for example, if

37:16

you have them come into the lab,

37:16

and they're just looking at a

37:19

screen for hours and hours, it's

37:19

super boring. It's hard to keep

37:22

people engaged It's hard for

37:22

them to make time out of their

37:25

day to do these sorts of really

37:25

important training to help

37:27

improve their vision. But when

37:27

you have mixed reality, perhaps

37:30

now you can have people doing

37:30

their day-to-day life. Obviously

37:33

not doing something like driving

37:33

or something that needs them to

37:36

be paying attention 100%. But

37:36

now you can start maybe doing

37:39

rehabilitation that's more

37:39

integrated into their lifestyle

37:42

without really taking people

37:42

away from their work.

37:45

Annabel Wing-Yan

37:45

Fan is a recipient of this

37:47

year's Fiera Capital Awards for

37:47

Diversity, Equity and Inclusion

37:51

in Health Care. So what does it

37:51

mean to you to be one of this

37:54

year's five winners Annabel?

37:56

I'm very

37:56

grateful to Fiera Capital and

37:59

the MUHC Foundation for this

37:59

award. Personally, it means a

38:02

lot to me, because I feel

38:02

recognized for the first time

38:05

for some of the work I've been

38:05

doing to really help improve

38:08

equity, diversity and inclusion

38:08

in science. And it's also just

38:11

really exciting to see that

38:11

there are these awards happening

38:15

to motivate other BIPOC

38:15

researchers and make up for some

38:18

of the barriers and unique

38:18

challenges that we face in this

38:20

field.

38:21

Yeah, I want to

38:21

talk about that Annabel, in

38:24

terms of the unique challenges

38:24

you face in the field. What are

38:27

your thoughts on this award in

38:27

general, in terms of those

38:29

challenges, what do you see

38:29

those challenges being? Help us

38:32

to understand.

38:34

So I guess

38:34

I'll start by listing three of

38:36

the main challenges that come to

38:36

mind a lot for me, and then kind

38:40

of touch on why the word really,

38:40

I guess, discusses those things.

38:44

So I guess the first is really

38:44

lack of representation. Like

38:47

many other professions, this

38:47

really prevents minorities from

38:50

even considering research and

38:50

academia as a career path. And

38:54

then also in our area of

38:54

research, there are really merit

38:58

based assessments typically. And

38:58

these are based off the idea

39:01

that there's this even playing

39:01

field and really ignores the

39:03

experiences and barriers that

39:03

are faced by BIPOC researchers.

39:07

And then finally, and really

39:07

close to my heart is that there

39:10

is a lot of unrecognized and

39:10

uncompensated work in this area

39:13

as well. Where people of color

39:13

are often put in this position

39:17

of educating and advocating for

39:17

EDI, and it doesn't really

39:21

translate to how their

39:21

performance is assessed by the

39:23

university or funding agencies.

39:23

So even though they're

39:26

passionate, and they want to

39:26

help people; in some ways, it

39:29

even stands in the way of them

39:29

advancing in their careers. And

39:33

I think that's just really

39:33

heartbreaking. So it was really

39:35

exciting to me to see how the

39:35

Fiera Capital Award was really

39:39

implemented. Because I feel it

39:39

addressed this lack of

39:41

representation by giving

39:41

opportunities to speak on our

39:43

research. It also recognizes the

39:43

unique challenges we face

39:48

because in the application, they

39:48

asked us to be able to talk

39:51

about this and show that we are

39:51

mindful and excited about

39:55

promoting EDI practices in our

39:55

workplaces. So overall, I just

39:59

feel like I'm very excited for

39:59

this opportunity and I'm happy

40:01

that it'll be around to help

40:01

future researchers as well.

40:06

That is really,

40:06

really, really well said

40:08

Annabel. Really, really well

40:08

said. Thank you so much.

40:10

Congratulations like I said it

40:10

stem from that whole "if you can

40:13

see it, you can be it", right

40:13

Annabel? Thank you so much for

40:16

joining us on the show.

40:17

Thank you.

40:20

I'm Tarah Schwartz, thank you for tuning in. What would you like to hear

40:21

about on the show? Write to us

40:24

at

40:24

[email protected].

40:28

You can also follow the MUHC

40:28

Foundation on social media or

40:32

sign up for our newsletter at

40:32

MUHCfoundation.com. I hope

40:36

you'll join me again next

40:36

Sunday. Thank you so much for

40:38

listening to Health Matters and

40:38

stay healthy.