rapid response radiotherapy program - sunnybrook.ca · on behalf of the rapid response radiotherapy...

Rapid Response Radiotherapy Program (RRRP) And Bone Metastases Site Group Clinic (BMC)

Annual Report

January–December 2007

Dr. Edward Chow Chair

Rapid Response Radiotherapy Program and Bone Metastases Site Group

1

Executive Summary

On behalf of the Rapid Response Radiotherapy Program and the Bone Metastases Site Group (RRRP/BMC), we are pleased to send you our 2007 annual report. 1. Clinics

a) RRRP clinics: The results indicated that we are meeting the initial goals of the RRPP to provide timely palliative radiotherapy to patients in the terminal phase of their illness. The number of patients seen annually in the five weekly half-day clinics has reached a plateau of 500-600, eighty percent of which are new to OCC.

b) We successfully evaluated the role of an advanced practice radiation therapist with the support of the Ministry of Health (MOH).

c) Dr. Arjun Sahgal joined the palliative team.

2. Education a) Newsletter - Our readers indicated they found our quarterly newsletter HOT SPOT

informative and educational. b) We continue to offer electives to palliative health care professionals to visit our Centre

and learn about our programs.

3. Research a) We were successful in obtaining grant support to continue our research projects. b) Research students from Waterloo’s co-op program have been extremely productive

and have also won numerous awards.

4. Our Quality Assurance rounds resulted in several published case reports.

This report summarizes our very successful year and the academic activities of the RRRP/BMC.

2

Odette Cancer Centre Rapid Response Radiotherapy Program (RRRP)

December 2007

The membership of the RRRP currently includes:

Radiation Oncologists:

Edward Chow (Chair) Toni Barnes Cyril Danjoux Arjun Sahgal May Tsao

Radiation Therapists: Emily Sinclair Lori Holden

Nurses: Grace Chan Michelle Davis Ernest Dixon Macey Farhadian Rosemary Irish Matina Floros Nives Krajnovic Cathy Doyle

Pharmacist: Carlo DeAngelis

Clinical Trials Adam Lam

3

Odette Cancer Centre Bone Metastases Site Group

December 2007

The membership of the BMC currently includes:

Radiation Oncologists: Pharmacist:

Toni Barnes Carlo DeAngelis Edward Chow (Chair) Cyril Danjoux Clinical TrialsAndrew Loblaw (spinal cord compression) Adam Lam Arjun Sahgal May Tsao Bioengineer: Cari Whyne

Orthopedic Surgeons: Joel Finkelstein Medical Physicist:Michael Ford Parminder Basran Albert Yee Laboratory Medicine:

Radiologists: David Cole Richard Aviv Reinhold Vieth Monique Christakis Linda Probyn Basic Science:Robyn Pugash Gurmit Singh – Director of Research, Joel Rubenstein (Hamilton Research Cancer Centre) Sean Symons Shun Wong Medical Oncologists: Urban Emmenegger Yooj Ko Nurses: Macey Farhadian Sharon Lemon

Palliative Care Physicians: Anita Chakraborty Jan Hux Hyon Kim Jeff Myers Giovana Sirianni Debbie Selby Anoo Tamber

Lesia Wynnychuk

4

EDUCATION

The RRRP organizes monthly Palliative Rounds, publishes a quarterly newsletter “HOT SPOT” and provides educational electives for students and health care professionals interested in palliative radiotherapy.

CME Monthly Rounds The rounds are organized by Dr. E. Barnes and held on the last Tuesday of the Month from 12 - 1 p.m. in the R.D.T. Jenkin Auditorium. They are accredited for MOCERT credits.

The subjects discussed during 2007 were: 2007 Title Presenter January 29 “Opiods and Addiction: An Approach to Risk

Management” Dr. Lawrence Librach

February 27 Cannabinoids: Panacea or Problems? Dr. Lawrence Librach March 27 Caring for the Dying in a Multicultural Society: Ethical

Issues in Truth-Telling Dr. J. A. Chandrakanthan

April 24 Psycho-Oncology Update: Focus on Depression and Anxiety Part II

Dr. Eileen LaCroix

May 29 Assessing Quality of Life - From Research to Applying the Findings in Clinical Practice

Dr. Andrea Bezjak

September 25 Managing Symptomatic Bone Metastases: Lessons Learned at a Regional Cancer Centre

Dr. Jackson Wu

October 30 Family Caregiver Perceptions of Quality of Dying and Deathin Metastatic Cancer

Dr. Sarah Hales

November 27 Problems of People Living with Cancer: A Psychologist’s Perspective

Dr. Ross Gray

*Rounds cancelled: June 26, July 31, August 28, December 25

5

Hot Spot Newsletter

In response to a satisfaction survey from our referring physicians who wanted better communication, we initiated a quarterly newsletter in 1999 called “HOT SPOT”. HOT SPOT is the educational newsletter of the RRRP at OCC. It is published quarterly and distributed to oncologists, palliative care specialists, family doctors and professional health care workers in palliative medicine. Our readership has expanded to over 2,000 per issue and we continue to expand our circulation to new readers. Survey results from our readers rated the educational value of HOT SPOT as high and suggested that we add other topics of interest. We increased the content of our newsletter from four to six pages with additional sections and contributors. The newsletter has regular articles on the following topics:

ETHICS RESEARCH PSYCHOSOCIAL TLCPC UPDATE PEDIATRIC EDUCATIONAL ACTIVITIES EDUCATIONAL INSERT

Each issue also has a double-sided educational insert.

The Editorial Board of Hot Spot

Editor Dr. E. Chow Associate Editors Dr. C. Danjoux Consultant Dr. S. Wong Advisers Dr. E. Barnes, Dr. R. Goldman, Dr. A. Husain, Dr. L. Librach,

Dr. C. Newman, Dr. A. Sahgal, Ms. E. Sinclair, Dr. E. Szumacher, Dr. M. Tsao.

Editorial & Financial Managers Ms. S. Lue The publication of the newsletter is made possible by the financial support of pharmaceutical & radiotherapy equipment companies. The newsletter is also available electronically on the OCC web site: http://www.sunnybrook.ca/content/?page=2341.

[Appendix F provides the content of previous issues and inserts of HOT SPOT from 1999-2007.]

6

http://www.sunnybrook.ca/content/?page=2341

Educational Electives As part of our undergraduate teaching, students from the co-op program at the University of Waterloo have their electives working with the RRRP-BMC. This co-operative educational elective has been extremely successful. Several of our students have won numerous awards. Awards Stephanie Hadi (2006-2007), Second year undergraduate student.

ISOQOL New Investigator Scholarship. 14th Annual Conference of the International Society for Quality of Life Research, October 2007, Toronto, Ontario.

Amanda Hird (2006 – 2007), Second year undergraduate student.

2007 Marion J. Todd Memorial Award, Faculty of Applied Health Sciences, University of Waterloo, November 2007, Waterloo, Ontario.

2007 Michael and Karyn Goldstein Best Cancer Research Student Travelling Scholarship Award, Odette Cancer Centre, December 2007, Toronto, Ontario.

2007 RRRP Student of the Year Award, Odette Cancer Centre, December 2007, Toronto, Ontario.

2007 CAFCE University Co-op Student of the Year Honorable Mention Award – Canadian Association for Co-operative Education (CAFCE), 2007, Canada.

2007 EWO Co-op Student of the Year Nominee – Education at Work Ontario (EWO), 2007, Canada.

Julie Napolskikh (2006-2007), Third year undergraduate student.

The Best Poster Presentation Award. 17th Annual Ontario Provincial Conference on Palliative and End-of-Life Care, April 2007, London, Ontario. 2007 Laura Talbot-Allan Award in Applied Health Sciences, University of Waterloo,

Waterloo, Ontario.

[Appendix G – Undergraduate Teaching–Co-op Program]

Dr. Alysa Fairchild, Fellow under the supervision of Dr. Barnes.

The Best Poster Award. International Patterns of Practice of Painful Bone Metastases. 11th Annual International Symposium on Palliative Medicine, Florida, USA, March 2007.

Young Investigator’s Award. Has the pattern of practice in the prescription of palliative

thoracic radiotherapy for lung cancer changed between 1999 and 2006 at the RRRP? MASCC 19th International Symposium Supportive Care in Cancer, St. Gallen, Switzerland, June 2007.

7

Health Care Professionals Electives The RRRP provides an orientation for other health care professionals to experience the activities of the RRRP clinics. Professor O. Bruland from Norway and Dr. D. Rheaume from Nova Scotia spent a couple of days with us as they plan to start a similar project in their Centre. They found the experience valuable and recommend it for others planning to start a similar program.

RESEARCH

The RRRP-BMC team objective is to provide palliative radiotherapy in an academic environment. We participate in local, national and international clinical trials, have regular research rounds and have been successful in securing grants to fund our research projects.

Clinical Trials We participate in several clinical trials. The research students have been an essential resource in helping us to enroll, follow-up, analyze and publish our studies. Without the dedication of our research students, it would have been difficult to successfully complete our research studies.

[Appendix H - A list of ongoing research studies in the RRRP and BMC]

PROG-O (Palliative Radiation Oncology Group Ontario) Our collaboration with Princess Margaret Hospital (PMH) and the Hamilton Regional Cancer Centre Palliation Radiation Oncology Group, led to the formation of the Palliative Radiotherapy Oncology Group Ontario (PROG-O) in 2000. Since then PROG-O has expanded to include Cancer Centres from the Maritimes, Manitoba, Calgary and British Columbia. Currently, this group meets monthly through videoconference. This has improved communication between the staff involved in the palliative radiotherapy program in those Centres and offered the opportunity for collaboration in research. At the last CARO meeting, more Cancer Centres expressed enthusiasm in participating in PROG-O rounds. PROG-O offers a national forum for monthly research discussion in palliative radiotherapy. Over the past years the coordinators for the PROG-O rounds have been Drs. J. Wu, A. Bezjak, R. Wong and T. Barnes. The rounds are scheduled for the first Tuesday of every month held from 12 - 1 p.m.

To represent the change in participation from Ontario to Cancer Centres across Canada we renamed the group as Canadian Palliative Radiation Oncology Group (CPROG)

8

Videoconference Rounds (PROG-O)

The subjects discussed during 2007 were: 2007 Title Presenter(s) January 2 Update on BC Palliative RT studies Dr. G. Duncan, BCCA

Vancouver Cancer

February 6 Rapid access clinic Dr. Rajiv Samant, ORCC

March 6 Technology developments and outcomes Dr. Rebecca Wong, PMH

April 3 New studies Dr. Edward Chow, OCC

May 1 Rapid access clinic, re-treatment Dr. D. Severin, CCI, Edmonton

June 5 Symptom control advisory group initiatives Dr. Jackson Wu, TBCC, Calgary

September 4 Development of a National Curriculum in Symptom Control for Radiation Oncology Residency Training Programs

Dr. Jackson Wu, TBCC Calgary

October 2 Results of a prospective study of Dexamethasone dose and tapering in patients with brain metastasis undergoing WBRT

Dr. Alina Sturdza, PMH

November 6 Early integration of Zoledronic acid with radiotherapy in the treatment of painful bone metastases in prostate cancer

Dr. Urban Emmenegger, OCC

December 4 Quality of Life Instruments in palliative care Amanda Hird, OCC

*Rounds cancelled: July 3, August 7

RRRP and BMC Monthly Meetings Our research rounds are scheduled on the second Tuesday of every month. 2007 Title Chair(s)

January 16 Business Meeting Drs. Edward Chow & Cyril Danjoux

February 20 Quality Assurance Round Dr. Cyril Danjoux

April 17 Research/Education Round Dr. Toni Barnes

June 19 Quality Assurance Round Dr. Danjoux

September 18 Annual General Meeting Dr. Edward Chow

October 16 Quality Assurance Round Dr. May Tsao

November 20 Research/Educational Round Dr. Toni Barnes

December 18 Business Meeting Dr. Edward Chow

*Rounds cancelled: March 20, May 15, July 17, and August 21

9

Grants

A novel delivery system for BMP-2 to enhance ACL graft integration. Physician's Services Incorporated $80,000 (2007 - 2008). Richards RR (PI), Robertson C (MSc Candidate), Yee AJ (collaborator).

A Phase II Study of Early Integration of Zoledronic Acid with Radiotherapy to Bone in the Treatment of Painful Bone Metastases in Prostate Cancer. Novartis Pharmaceuticals Canada Inc. $60,000 (2007 – present). Chow E (PI), Ko Y (PI), Emmenegger U, Danjoux C, Barnes E, Barbera L, Tsao M, Sinclair E, Lemon S, Vieth R. A Phase II Study of Maintenance Therapy with Temsirolimus in Androgen-Independent Prostate Cancer After First-Line Chemotherapy with Docetaxel. Wyeth Pharmaceuticals Canada Inc. $315,000 (2007 – 2009). Ko Y (PI), Emmenegger U, Berry S, Kerbel R.

Biomechanical Implications of metastatic disease in the spine: Evaluation of stability and tumor burden in a pre-clinical model. CIHR (Canadian Institutes of Health Research) $239,460 (2004 - 2007). Whyne C, Yee AJ (Co-PI), Finkelstein J (Co-Applicant).

Biomechanical Implications of metastatic disease in the spine: Evaluation of stability and tumor burden in a pre-clinical model - funding extension. CIHR (Canadian Institutes of Health Research) $40,096 (2007 - 2008). Whyne C, Yee AJ (Co-Principal Investigator), Finkelstein J (Co-Applicant).

Development of a Canadian-led international bone metastases module to accompany European Organization for Research and Treatment of Cancer Quality of Life Group core questionnaire (the EORTC QLQ-C30) for future clinical trials in patients with bone metastases. National Cancer Institute of Canada $271,483 (2005-2008). Chow E (PI), Clemons M, Wu J Bezjak A, Brundage M, Yee A, Bottomley A, Velikova G, and Hoskin P. Imiquimod for patients with positive surgical margins following surgical excision of basal cell carcinoma or squamous cell carcinoma in-situ of the skin. 3M Pharmaceuticals $108,000 (2005 – 2007). Barnes E (PI), Choo R, Assaad D, Antonyshyn O, Fialkov J, Kamra J, Balogh J. Large Aggregating Proteoglycans and Therapeutic Strategies in Intervertebral Disc Cell Metabolism. Zimmer Grant $8,300 (2006 - 2007). Yee AJ, Yang B, Whyne C.

Metastatic breast cancer genome anatomy. Canadian Breast Cancer Research Alliance, Special Competition in New Approaches to Metastatic Disease in Breast Cancer Research $750,000 (2005 - 2010). Seth A, Aubin J (Co-applicant), Kahn H (Co-Applicant), Lyons-Weiler J (Collaborator), Yee AJ (Collaborator), Narod S (Collaborator).

Modeling thin bone structures of the human skeleton. Natural Sciences and Engineering Research Council (NSERC) $165,000 (2006 - 2011). Whyne, C. Photodynamic therapy for the treatment of metastatic breast carcinoma to the spine: development and validation in a preclinical model. Canadian Breast Cancer Foundation - Ontario Chapter $300,000 (2004 - 2007). Yee A, Whyne C, Finkelstein J, Wilson B. Prospective PET study in glioblastoma multiforme patients. OCC Intramural Fund $31,000 (2005 – 2008). Tsao MN (PI), Perry J, Reznik A, Lui B. Recombinant elastin-like polypeptide based materials for use in artificial spinal discs.

10

Emerging Materials Network Collaborative Grant, Ontario Centres of Excellence $211,400 (2006 - 2008). Woodhouse K, Whyne C (Co-Investigator), Yee A (Co-Investigator). Recombinant large aggregating proteoglycans and therapeutic strategies in intervertebral disc metabolism. U of T Zimmer Orthopaedic Research $10,000 (2006 - 2007). Whyne C, Yee A, Yang B, Akens M, Finkelstein JA. The efficacy of risedronate in protecting bone mineral density for men with locally advanced prostate cancer receiving radiotherapy and neoadjuvant/adjuvant hormone therapy for 2 or 3 years. Phase III, Double-Blinded, Placebo-Controlled Study. Aventis-Sanofi Pharma Ltd. $250,000 (2004 - 2007). Danjoux C (PI), Choo R, Malone S, Bowen J, Lukka H, Briones-Urbina R, Ehrlich L, Vieth R.

11

Publications

Ahn H, Mousavi P, Chin L, Roth S, Finkelstein J, Vitken A, Whyne C. The effect of prevertebroplasty tumor ablation using laser induced thermo-therapy on biomechanical stability and cement fill in the metastatic spine. European Spine Journal [Epub ahead of print] 16: 1171-78, 2007. Akens M, Yee AJ, Wilson BC, Burch S, Johnson C, Lilge L, Bisland SK. Photodynamic therapy of vertebral metastasis: Evaluating tumor-to-neural tissue uptake of BPD-MA and ALA-PpIX in a murine model of metastatic human breast carcinoma. Photochemistry and Photobiology 83:1-6, 2007. Barnes E, Fan G, Harris K, Doyle M, Librach L, Chow E, Barbera L, Tsao M, Lam K, Danjoux C. Involvement of family physicians in the care of cancer patients seen in the Palliative Rapid Response Radiotherapy Program. Journal of Clinical Oncology 25 (36): 5758-5762, 2007.

Bethune A, Houlden D, Smith T, Yee A, Midha R, Singrakhia M. Generalized peripheral nerve failure during thoracic spinal surgery; a case report. Journal of Clinical Monitoring and Computing 21(1): 41-47, 2007.

Bradley N, Husted J, Sey M, Husain A, Sinclair E, Harris K, Chow E. Review of patterns of practice and patients’ preferences in the treatment of bone metastases with palliative radiotherapy. Supportive Care in Cancer 15 (4): 373-385, 2007.

Braybrooke J, Ahn H, Gallant A, Bronstein Y, Ford M, Finkelstein JA, Yee AJ. The Impact of Surgical Wait Time on Patient-based Outcomes in Posterior Lumbar Spinal Surgery. European Spine Journal 16(11): 1832, 2007. Burch S, Bisland SK, Wilson BC, Whyne C, Yee AJ. Multimodality imaging for vertebral metastases in a rat osteolytic model. Clinical Orthopaedics and Related Research 454: 230-236, 2007. Chow E, Chiu H, Doyle M, Hruby G, Holden L, Barnes E, Tsao M, Mallia G, Harris K, Danjoux C. Patient expectation of the partial response and response shift in pain score. Supportive Cancer Therapy 4 (2): 110-118, 2007.

Chow E, Fan G, Hadi S, Filipczak L. Symptom clusters in cancer patients with bone metastases. Supportive Care in Cancer 15 (9): 1035-1043, 2007.

Chow E, Harris K, Fan G, Tsao M, Sze WM. Palliative radiotherapy trials for bone metastases: a systematic review. Journal of Clinical Oncology 25(11): 1423-1436, 2007.

Chow E, Loblaw A, Harris K, Doyle M, Goh P, Chiu H, Panzarella T, Tsao M, Barnes E, Sinclair E, Farhadian M, Danjoux C. Dexamethasone for the prophylaxis of radiation-induced pain flare following palliative radiotherapy for bone metastases: A pilot study. Supportive Care in Cancer 15 (6): 643-647, 2007.

Chuang C, Sahgal A, Lee L, Larson D, Huang K, Petti P, Verhey L, Ma L. Effects of residual target motion for image-tracked spine radiosurgery. Medical Physics 34 (11): 4484-4490, 2007. Doyle M, Bradley N, Li K, Sinclair E, Lam K, Chan G, Chow E, Barnes E, Danjoux C, Tsao M. Quality of life in patients with brain metastases treated with a palliative course of whole brain radiotherapy. Journal of Palliative Medicine 10 (2): 367-374, 2007.

12

Fan G, Filipczak L, Chow E. Symptom cluster in cancer patients: a review of the literature. Current Oncology 14 (5): 173-179, 2007.

Fan G, Hadi S, Chow E. Symptom clusters in patients with advanced-stage cancer referred for palliative radiation therapy in an outpatient setting. Supportive Cancer Therapy 4 (3): 157-162, 2007.

Goh P, Harris K, Napolskikh J, Chow E, Sinclair S, Emmenegger U, Lemon S, Yee A, Wynnychuk L, Myers J, Danjoux C, Ko Y. New multidisciplinary prostate bone metastases clinic---first of its kind in Canada. Current Oncology 14 (1): 9-12, 2007.

Hardisty M, Gordon L, Agarwal P, Skrinskas T, Whyne C. Quantitative characterization of metastatic disease in the spine: Part 1 Semi-automated segmentation of the metastatic spine using atlas-based deformable registration and the level set method. Medical Physics 34: 3127-34, 2007. Harris K, Li K, Flynn C, Chow E. Worst, average or current pain in brief pain inventory: which should be used to calculate response to palliative radiotherapy in patients with bone metastases? Clinical Oncology 19: 523-527, 2007.

Harris K, Pugash R, David E, Yee A, Sinclair E, Myers J, Chow E. Percutaneous cementoplasty of the lytic metastasis in left acetabulum. Current Oncology 14(1): 4-8, 2007.

Khoury A, Whyne C, Daly M, Moseley D, Bootsma, G, Skrinskas T, Siewerdsen JH and Jaffray D. Intraoperative cone-beam CT for measurement and correction of periaxial malrotation of the femoral shaft: A surface-matching approach. Medical Physics 34(4): 1380-7, 2007. Khoury A., Siewerdsen J.H., Whyne C.M., Daly M.J., Kreder H.J., Moseley D.J., Jaffray D. Intraoperative cone-beam CT for image-guided tibial plateau fracture reduction. Computer Assisted Surgery 12: 195-207, 2007. Li K, Harris K, Hadi S, Chow E. What should be the optimal cutpoints for mild, moderate and severe pain? Journal of Palliative Medicine 10 (6): 1338-1346, 2007.

Lutz S, Chow E, Hartsell W, Konski A. A review of hypofractionated palliative radiotherapy. Cancer 109 (8): 1462-1470, 2007.

Pugash R, Sinclair E, David E, Myers J, Yee AJ, David E, Chow E. Percutaneous cementoplasty of a lytic metastasis of the left acetabulum. Current Oncology 14(1): 4-8, 2007. Sinclair E, Li K, Pope J, Farhadian M, Harris K, Yee A, Librach L, Wynnchuk L, Danjoux C, Chow E. A Multidisciplinary Bone Metastases Clinic at Toronto Sunnybrook Regional Cancer Centre -- A Review of the Experience from 1999 to 2005. Clinical Oncology 19(3): S45, 2007. Szumacher E, Barbera L, Barnes E A, Keighley-Clarke T, Pressnail B, Matyas Y, Danjoux C, Zhang L, Nyhof-Young J. Improving access to radiotherapy services in the Simcoe-Muskoka region of Ontario – Needs assessment study. CMRTJ 38 (3): 7-16, 2007. Tschirhart CE, Finkelstein JA, Whyne CM. Biomechanics of vertebral level, geometry, and transcortical tumors in the metastatic spine. Journal of Biomechanics 40(1): 46-54, 2007. Wang Y, Chow E, Piliotis E, Tsao M. Initial presentation as sclerotic bone metastases is a patient with acute myelogenous leukemia. Journal of Palliative Medicine 10 (1): 256-259, 2007.

13

14

Whyne CM, Wu F, Skrinskas T, Gordon L, Hardisty M, Basran P. Quantitative characterization of metastatic disease in the spine: Part 2 histogram based analyses. Medical Physics 34: 3279-85, 2007. Yang W, Lam P, Kitching R, Kahn H, Yee A, Aubin JE, Seth A. Breast Cancer Metastasis in a Human Bone NOD/SCID mouse model. Cancer Biol Ther 6(8), 2007. Yee AJ, Akens M, Yang BL, Finkelstein JA, Zheng PS, Deng Z, Hardisty M, Yang BB. The effect of versican G3 domain on local breast cancer invasiveness and bony metastasis. Breast Cancer Research 9(4): R47, 2007.

15

In Press

Bederman SS, Kreder HJ, Weller I, Finkelstein JA, Ford M, Yee AJ. The who, what, and when of surgery for the degenerative lumbar spine. A population-based study of surgeon factors, surgical procedures, recent trends and reoperation rates. Canadian Journal of Surgery. Chow E, Abdolell M, Panzarella T, Harris K, Bezjak A, Warde P, Tannock I. Validation of a predictive model for survival in metastatic cancer patients attending an outpatient palliative radiotherapy clinic. International Journal of Radiation Oncology, Biology and Physics. Chow E, Abdolell M, Panzarella T, Harris K, Bezjak A, Warde P, Tannock I. Recursive partitioning analysis of prognostic factors for survival in patients with advanced cancer. International Journal of Radiation Oncology, Biology and Physics. Culleton S, de Sa E, Christakis M, Ford M, Zbieranowski I, Sinclair E, Cheung P, Campos S, Goh P, Chow E. Rare bone metastases of the olecranon. Journal of Palliative Medicine. de Almeida J, Morris A, Whyne C, James A. Testing Biomechanical Strength of in vitro CSF Leak Repairs. Journal of Otolaryngology. Fairchild A, Harris K, Barnes E, Wong R, Lutz S, Bezjak A, Cheung P, Chow E. Palliative thoracic radiotherapy for lung cancer. A systematic review. Journal of Clinical Oncology. Flynn C, Danjoux C, Wong J, Christakis M, Rubenstein J, Yee A, Yip D, Chow E. Two cases of acrometastases to the hands and review of the literature. Current Oncology. Hadi S, Zhang L, Hird A, de Sa E, Chow E. Validation of symptom clusters in patients with metastatic bone pain. Current Oncology. Hird A, Chow E, Ehrlich L, Probyn L, Sinclair E, Yip D, Ko Y. Rapid improvement in pain and functional level in a patient with metastatic renal cell carcinoma (mRCC): a case report and review of the literature. Journal of Palliative Medicine. Hird A, Chow E, Yip D, Davis M, Hadi S, Flynn C, Sinclair E, Ko Y. Do bone metastases from gastrointestinal cancers produce similar response rates following radiotherapy when compared to bone metastases from other primary cancers? Current Oncology. Kirou-Mauro, Hird A, Wong J, Sinclair E, Barnes E, Tsao M, Danjoux C, Chow E. Is response to radiotherapy in patients related to the severity of pre-treatment pain? International Journal of Radiation Oncology, Biology and Physics. Li K, Sinclair E, Pope J, Farhadian M, Harris K, Napolskikh J, Yee A, Librach S, Wynnychuk L, Danjoux C, Chow E. A multidisciplinary bone metastases clinic at Toronto Sunnybrook Regional Cancer Centre - a review of the experience from 1999 to 2005. Journal of Cancer Pain & Symptom Palliation.

O'Reilly M, Whyne CM. Comparison of CT Based Parametric and Patient Specific Finite Element Models of the Healthy and Metastatic Spine Using a Mesh-Morphing Algorithm. Spine. Razmjou H, Yee AJ, Ford M, Holtby R, Vidmar M, Finkelstein JA. Relationship between preoperative patient characteristics and expectations in candidates for Total Knee Arthroplasty. Physiotherapy Canada.

16

Sahgal A, Chuang C, Huang K, Petti P, Weinstein P, Larson D, Ma L. Split-volume planning of multiple consecutive vertebral body metastases for CyberKnife body radiotherapy. Medical Dosimetry. Sahgal A, Ma L, Chuang C, Hossain S, Petti P, Larson D, Shrieve D. Comparisons of Novalis and Cyberknife spinal stereotactic body radiotherapy treatment planning based on physical and biologic modelling parameters. Radiosurgery. Salvo N, Christakis M, Rubeinstein J, de Sa E, Napolskikh J, Sinclair E, Ford M, Goh P, Chow E. The role of plain radiographs (x-rays) in management of bone metastases. Journal of Palliative Medicine. Tharmalingam S, Chow E, Harris K, Hird A, Sinclair E. Quality of life measurement in bone metastases: a literature review. Journal of Cancer Pain & Symptom Palliation. Wong J, Chow E, De Sa E, Rowsell C, Probyn L, Christakis M, Sinclair E, Law C, Finkelstein J. Immediate pain relief and improved structural stability following percutaneous vertebroplasty for a severely destructive vertebral compression fracture. Journal of Palliative Medicine. Yee AJ, Yoo JU, Marsolais B, Carlson G, Poe-Kochert C, Bohlman HH, Emery SE. A prospective randomized trial on the use of postoperative bracing in lumbar spinal fusion for degenerative conditions of the spine. Journal of Bone and Joint Surgery (American).

17

Books, Book Chapters

Braybrooke J, Yee A, Chow E. Palliative orthopedic surgery. Palliative Medicine. Editor-in-Chief: Declan Walsh. Elsevier (in press). Brown J. Chow E. Bone markers in research and clinical practice. Bone metastases: a translational and clinical approach. Editors: Dimitrios Kardamakis, Vassilios Vassiliou and Edward Chow. Springer (in press). Bruland O, Hird A, Chow E. Radiotherapy of skeletal metastases. ASBMR Primer 7th edition of the primer on the metabolic bone diseases and disorders of mineral metabolism (in press). Chow E. Update on radiation treatment for cancer pain. Current opinion in supportive & palliative care. Pain: cancer section. Section Editors: Sam Ahmedzai and Anthony Dickenson. Lippincott Williams & Wilkins 1: 11-15, 2007. Fairchild A, Chow E. Role of radiation therapy and radiopharmaceuticals in bone metastases. Current opinion in supportive & palliative care. Renal and urological problems. Section Editor: Fred Saad. Lippincott Williams & Wilkins 1: 169-173, 2007. Fairchild A, Chow E. Palliative radiation therapy. Palliative Medicine. Editor-in-Chief: Declan Walsh. Elsevier (in press). Fairchild A, Chow E. Palliative radiotherapy. Cancer pain: assessment and management. 2nd edition. Editors: Eduardo Bruera and Russell Portenoy. Cambridge University Press (in press). Fairchild A, Hird A, Chow E. Pain control with palliative radiotherapy in bone metastases. Recent advances in bone cancer progression and therapeutic approaches. Editor: Dominique Heymann. Research Signpost (in press). Freedman O, Clemons M, Vassiliou V, Kardamakis D, Simmons C, Trinkaus M, Chow E. Assessment of therapeutic response. Bone metastases: a translational and clinical approach. Editors: Dimitrios Kardamakis, Vassilios Vassiliou and Edward Chow. Springer (in press). Janjan N, Krishnan S, Das P, Gould MS, Zampieri J, Crane C, Delclos M, Cleeland C, Lutz ST and Chow E. Palliative radiation therapy techniques. Chapter 20 Pages 271-296. Cancer pain management. Editors: Michael J Fisch and Allen W Burton. McGraw Hill 2007. Nousianen M, Whyne CM, Yee AJ, Ford M. Surgical Management of Bone Metastases. Bone metastases: A translational and clinical approach. Editors: Kardamakis, Ed Chow and Vassiliou, eds. Springer, Berlin Heidelberg New York (in press). Sahgal A, van der Kogel AJ, Wong CS. Spinal cord radiobiology. Spine Radiosurgery (in press). Vassiliou V, Chow E, Kardamakis D. Clinical features and complications of metastatic bone disease. Bone metastases: a translational and clinical approach. Editors: Dimitrios Kardamakis, Vassilios Vassiliou and Edward Chow. Springer (in press). Whyne CM and Hardisty M. Biomechanics of metastatic disease in the spine. The Pathomechanics of Tissue Injury and Disease, and the Mechanophysiology of Healing. Part IV: Cancer and Metastatic Diseases. Editors: Gefen A, ed. Research Signpost (in press). Yee AJ, Chow E. Prognosis in Patients with Bone Secondaries. Prognosis in Advanced Cancer. Editors: Paul Glare and Christakis, ed. Oxford University Press, Oxford (in press).

18

Posters, Presentations and Published Abstracts 4th UK Radiation Oncology Conference. Edinburgh, UK, March 2007.

E. Chow. Meta-analysis of palliative radiotherapy trials for bone metastases. E. Chow. Early phase in the development of a bone metastases quality of life module.

Department of Radiation Oncology, Mount Vernon Hospital. Middlesex, UK, March 2007.

E. Chow. Bone metastases research. Bonus 2 - Breast cancer and bone disease new updates. Toronto, Ontario, March 2007.

E. Chow. Radiotherapy research.

4th Annual Toronto Radiation Medicine Conference. King City, Ontario, April 2007. EA. Barnes. Exploring interprofessional and collaborative roles for patient-centered care.

17th Annual Ontario Provincial Conference on Palliative and End-of-Life Care. London, Ontario, April 2007.

E. Chow. Symptom cluster management. EA. Barnes. Exploring interprofessional and collaborative roles for patient-centered care.

Alon Dembo Professorship RRRP Lecture. Toronto, Ontario, April 2007.

A. Sahgal. Spine radiosurgery. Zenith Meeting. Prague, Czech Republic, April 2007.

E. Chow. Bone metastases module. Grand Rounds, Nova Scotia Cancer Centre. Halifax, Nova Scotia, May 2007.

EA. Barnes. The Rapid Response Radiotherapy Program (RRRP) at Toronto Sunnybrook Regional Cancer Centre.

GU Site Group Presentation at Toronto-Sunnybrook Regional Cancer Centre. Toronto, Ontario, May 2007.

U. Emmenegger. ASCO Prostate 2007. Department of Clinical Oncology, Tuen Mun Hospital. Hong Kong, China, June 2007.

E. Chow. Modern management of bone metastases. Department of Urology, Kitasato University School of Medicine. Kanagawa, Japan, June 2007.

E. Chow. Bone metastases module. Faculty of Medicine, Showa University School of Medicine and Ritsumeikan University. Tokyo and Shiga, Japan, June 2007.

E. Chow. Bone metastases module.

29th Congress of the International Society of Urology. Paris, France, September 2007.

E. Chow. Measuring the impact of bone metastases on quality of life. A second symposium on advanced GU malignancy: Optimizing clinical outcomes in prostate and renal cell carcinomas.

E. Chow. How do we optimize prostate cancer outcomes? Panel discussion and interactive clinical cases. Panel participant. A second symposium on advanced

19

GU malignancy: Optimizing clinical outcomes in prostate and renal cell carcinomas. AOSpine North America Spine Tumor Symposium. Vancouver, British Columbia, September 2007.

A. Sahgal. Adjuvant therapies emerging techniques in radiation oncology: Spine IMRT/radiosurgery.

A. Sahgal. Current updates on non-surgical treatments, specific tumor types, what the surgeon needs to know: Renal cancer.

3rd National Oncology Conference, Nicaraguan Oncology Association. Managua, Nicaragua, October 2007.

EA. Barnes. Palliative radiotherapy. 49th American Society for Therapeutic Radiotherapy and Oncology (ASTRO) Annual Meeting. Los Angeles, California, October 2007.

E. Chow. Are bone metastases from gastrointestinal primaries equally radiosensitive? E. Chow. Quality of life issues and the role for radiation therapy for the palliative care

patient.

Evening Lecture Program on Uro-oncology. Toronto, Ontario, October 2007. U. Emmenegger. Update in hormone refractory prostate cancer: Advances in 2007.

Canadian Palliative Radiation Oncology Group (C-PROG) Videoconference. Toronto, Ontario, November 2007.

U. Emmenegger. Early integration of zoledronic acid with radiotherapy in the treatment of painful bone metastases from prostate cancer.

E. Harry Botterell Lectureship in Neurosurgery, The Toronto Western Hospital. Toronto, Ontario, November 2007.

A. Sahgal. Spine radiosurgery for vertebral metastases: Current technologies and preliminary results from UCSF.

8th Bi-Annual International Stereotactic Radiosurgery Society. San Francisco, California, 2007.

A. Sahgal. Partial volume tolerance of the spinal cord.

Innovative Radiation Oncology Rounds, Odette Cancer Centre. Toronto, Ontario, 2007.

A. Sahgal. Spine stereotactic body radiotherapy for metastatic disease and spinal cord tolerance.

Academic Performance Awards, Department of Radiation Oncology, Odette Cancer Centre. Toronto, Ontario, 2007.

E. Barnes E. Chow C. Danjoux

20

Abstracts, Poster and Peer-reviewed Presentations Akens MK (trainee presentation), Karotki A, Wilson BC, Burch S, Whyne C, Bisland SK, Yee AJ (supervisor): Effect of Photodynamic Therapy (PDT) on Bisphosponate Pre-Treated Breast Cancer Cells In Vitro. (Poster) Orthopaedic Research Society, 53rd Annual Meeting, San Diego, California, Feb 11, 2007 - Feb 14, 2007. Akens MK (trainee presentation), Karotki A, Wilson BC, Burch S, Whyne C, Bisland SK, Yee AJ (supervisor). Effect of Photodynamic Therapy (PDT) on Bisphosphonate Pre-Treated Breast Cancer Cells In Vitro. (Poster) University of Toronto, Faculty of Medicine, Department of Surgery, 33rd Gallie Day, Toronto, Ontario, May 4, 2007. Akens MK (trainee presentation), Yang B, Hardisty M, Yee AJ (supervisor). Versican G3 domain influences breast carcinoma metastases to bone. (Poster) University of Toronto, Faculty of Medicine, Department of Surgery, 33rd Gallie Day, Toronto, Ontario, May 4, 2007. Akens MK (trainee presentation), Yang B, Yee AJ (supervisor). Versican G3 domain influences breast carcinoma metastasis to bone. (Poster) Orthopaedic Research Society, 53rd Annual Meeting, San Diego, California, Feb 11, 2007 - Feb 14, 2007. Akens MK, Karotki A, Wilson BC, Burch S, Whyne C, Bisland SK, Yee AJ. Effect of Photodynamic Therapy on Bisphosphonate Pre-Treated Breast Cancer Cells In Vitro. 53rd annual meeting of the ORS 2007, San Diego, California. Transactions of the Orthopaedic Research Society 2007: pp 0972. Akens MK, Karotki A, Wilson BC, Burch S, Whyne CM, Bisland SK, Yee AJ. Effect of photodynamic therapy (PDT) on bisphosphonate pre-treated breast cancer in vitro. (Poster) Orthopaedic Research Society, San Diego, CA, Feb 2007. Akens MK, Yang B, Yee AJ. Versican G3 domain influences breast carcinoma metastasis to bone. 53rd annual meeting of the ORS 2007, San Diego, California. Transactions of the Orthopaedic Research Society 2007: pp 0981. Berry SR, Ko Y, Emmenegger U, Shaked Y, Choo R, Klotz L, Zhang L, Lee CR, Kerbel RS. Preliminary results of a phase II study of continuous low dose metronomic (LDM) cyclophosphamide (CTX) and celecoxib (CEL) for asymptomatic hormone refractory prostate cancer (HRPC) with assessment of anti-angiogenic biomarkers. 42nd Annual ASCO Meeting, June 1-5, 2007, Chicago, Illinois, USA. Chow E, Harris K, Fan G, Hadi S, Tsao M, Sze W. Palliative radiotherapy for bone metastases: a systemic review. 4th UK Radiation Oncology Conference, Heriot Watt University, Edinburgh, UK, March 19-21, 2007. Chow E, Hird A, Yip D, Davis M, Hadi S, Flynn C, Sinclair E, Ko Y. Are bone metastases from gastrointestinal primaries equally radiosensitive? ASTRO’s 49th Annual Meeting, Los Angeles Convention Center, Los Angeles, California, United States of America, October 28-November 1, 2007. Curtis C, Skrinskas T, Clemons M, Whyne C. Changing disease patterns in breast cancer metastasis to the spine. (Poster) Orthopaedic Research Society, San Diego, CA, Feb 2007. Curtis C, Skrinskas T, Clemons M, Whyne C. Changing disease patterns in breast cancer metastasis to the spine. (Poster) Canadian Orthopaedic Research Society, Halifax, NS, Jun 2007.

21

Curtis C, Skrinskas T, Hardisty M, Clemons M, Whyne C. Quantifying multiplevel tumor progression in the metastatic spine. (Poster) Orthopaedic Research Society, San Diego, CA, Feb 2007. Curtis C, Skrinskas T, Hardisty M, Clemons M, Whyne C. Quantifying multiplevel tumor progression in the metastatic spine. (Poster) Canadian Orthopaedic Research Society, Halifax, NS, Jun 2007. de Sa E, Sinclair E, Danjoux C, Hird A, Barnes E, Barbera L, Tsao M, Chow E. Continued success of the Rapid Response Radiotherapy Program: A review of 2003 – 2006. Canadian Association of Radiation Oncology – Canadian Organization of Medical Physicists Conference, Toronto, Ontario, Canada, October 11-13, 2007. de Sa E, Sinclair E, Danjoux C, Hird A, Barnes E, Barbera L, Tsao M, Chow E. Review of the Rapid Response Radiotherapy Program at an outpatient cancer centre. ISOQOL, Toronto, Ontario, Canada, October 10-13, 2007. Fairchild A, Goh P, Sinclair E, Barnes E, Ghosh S, Danjoux C, Barbera L, Tsao M, Chow E. Has the pattern of practice in the prescription of palliative thoracic radiotherapy changed between 1999 and 2006 at the Rapid Response Radiotherapy Program? The 20th International Symposium of Supportive Care in Cancer, St Gallen, Switzerland, June 27-30, 2007. Fan, G. Speaker for Radiation Therapy Rounds: Toronto Sunnybrook Regional Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, March 2006. Fan, G. Speaker for Symptom Cluster Management Workshop. 17th Annual Ontario Provincial Conference on Palliative and End-of-Life Care, London, Ontario, Canada, April 22-24, 2007. Finkelstein JA, Curtis C, Gordon L, Skrinskas T, Szwedowski C, Yee AJ, Whyne CM (presenter). Finite element analysis of spinal injury mechanisms under vertical loading. (Poster) Canadian Orthopaedic Research Society, 62nd COA and 41st CORS Annual Meeting, Halifax, Nova Scotia, Jun 1, 2007 - Jun 3, 2007. Flynn C, Hadi S, Chow E. Update on the current status of the bone metastases module. 2007 International Society for Quality of Life Research meeting abstracts, 2007. [www.isoqol.org/2007mtgabstracts.pdf]. Quality of Life Research supplement, A-64, Abstract #1678. Flynn C, Hadi S, Hird A, Chow E. Update on the current status of the bone metastases module. The International Society for Quality of Life Research Conference, Toronto, Ontario, Canada, October 10-13, 2007. Flynn C, Hadi S, Hird A, Chow E. Update on the current status of the bone metastases module. The American Society for Therapeutic Radiology and Oncology Conference, Los Angeles, California, United States of America, October 28-November 1, 2007. Flynn, C. Speaker at the Bonus 2: Breast Cancer & Bone Disease New Updates, Toronto, Ontario, Canada, March 30, 2007. Gardiner K, Kirou-Mauro A, Chow E, Selby D, Myers J. An analysis of accrual rates for research studies involving patients whose care is palliative in nature. 14th Annual Conference of the International Society for Quality of Life Research, Toronto, Ontario, Canada, October 10-13, 2007.

22

Gorapalli D (trainee presentation), Whyne CM, Yee AJ (supervisor), Seth A. Studying the use of a poly-N-acetyl glucosamine material in the regeneration of intervertebral discs. (Poster) Institute of Biomaterials Biomedical Engineering (IBBME), University of Toronto, Proceedings of IBBME Scientific Day, Toronto, Ontario, Jun 8, 2007. Hadi S, Fan G, Hird A, Chow E. Disintegration of symptom clusters: indicators of response to palliative radiotherapy. ASTRO’s 49th Annual Meeting, Los Angelo’s Convention Center, Los Angeles, California, United States of America, October 28 - November 1, 2007. Hadi S, Fan G, Hird A, Chow E. Disintegration of symptom clusters: Indicators of response to palliative radiotherapy. ASTRO’s 49th Annual Meeting, Los Angeles Convention Center, Los Angeles, California, United States of America, October 28-November 1, 2007. [http://astro2007.abstractsnet.com/acover.wcs?entryid=500777]. Hadi S, Fan G, Hird A, Kirou-Mauro A, Filipczak L, Chow E. Symptom clusters in patients with metastatic bone pain. 2007 International Society for Quality of Life Research meeting abstracts [www.isoqol.org/2007mtgabstracts.pdf]. Quality of Life Research supplement, A-37, Abstract #1295. Hadi S, Fan G, Hird A, Kirou-Mauro A, Filipczak L, Chow E. Symptom Clusters in patients with bony metastatic pain. CARO-COMP 2007 Annual Scientific Meeting, Sheraton Centre, Toronto, Ontario, Canada, October 10-13, 2007. Hadi S, Fan G, Hird A, Kirou-Mauro A, Filipczak L, Chow E. Symptom Clusters in Patients with Metastatic Bone Pain. 14th Annual Conference of the International Society for Quality of Life Research, Toronto, Ontario, Canada, October 10-13, 2007. Hadi, S. Speaker for Interdisciplinary Radiation Oncology Round (IROR). Odette Cancer Centre, Toronto, Ontario, Canada, September 11, 2007. Hadi, S. Speaker for radiation oncology workshop. CARO-COMP, Annual Scientific Meeting, Sheraton Centre, Toronto, Ontario, Canada, October 10-13, 2007. Hadi, S. Speaker for Session 500: Symptom Cluster Management Workshop.17th Annual Ontario Provincial Conference on Palliative and End-of-Life Care, London Convention Centre, London, Ontario, Canada, April 22-24, 2007. Hardisty MR (presenter), Akens MK, Skrinskas T, Yee AJ, Whyne CM. Direct measurement of strain in tumour-bearing vertebrae by image registration. (Poster) Canadian Orthopaedic Research Society, 62nd COA and 41st CORS Annual Meeting, Halifax, Nova Scotia, Jun 1, 2007 - Jun 3, 2007. Hardisty MR, Akens MK, Skrinskas T, Yee A, Whyne CM. Direct measurement of strain in tumour-bearing vertebrae by image registration. (Poster) Canadian Orthopaedic Research Society, Halifax, NS, Jun 2007. Harris K, Li K, Flynn C, Hadi S, Chow E. Worst, average, or current pain in brief pain inventory: which should be used to calculate response to palliative radiotherapy in patients with bone metastases? 4th UK Radiation Oncology Conference, Heriot Watt University, Edinburgh, Scotland, March 19th-21st, 2007. Harris K, Tharmalingam S, Bezjak A, Flynn C, Wu J, Barton M, Eek R, Safiq J, Velikova G, Bottomley A, Chow E. Early phase in the development of a bone metastases quality of life (QOL) module. United Kingdom Radiation Oncology Conference, Heriot Watt University, Edinburgh, Scotland, March 19-21, 2007.

23

Hird A, Chow E, Yip D, Davis M, Hadi S, Flynn C, Sinclair E, Ko Y. Are bone metastases from gastrointestinal primaries equally radiosensitive? The Canadian Association of Radiation Oncologists and Canadian Organization of Medical Physicists Joint Scientific Meeting, Toronto, Ontario, Canada, October 10-14, 2007. Hird A, Chow E, Yip D, Davis M, Hadi S, Flynn C, Sinclair E, Ko Y. Are bone metastases from gastrointestinal primaries equally radiosensitive? The American Society for Therapeutic Radiology and Oncology Conference, Los Angeles Convention Center, Los Angeles, California, United States of America, October 28-November 1, 2007. Hird A, Chow E. Pain flare following palliative radiotherapy for painful bone metastases. Interdisciplinary Radiation Oncology Rounds (IROR), Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, September 11, 2007. Hird A, Hadi S, Flynn C, Loblaw A, Wong R, Wu J, Chow E. Pain flare following radiotherapy for painful bone metastases: A joint effort of three Canadian cancer centers to determine the incidence. The American Society for Therapeutic Radiology and Oncology Conference, Los Angeles, California, United States of America, October 28-November 1, 2007. Hird A, Hadi S, Flynn C, Loblaw A, Wong R, Wu J, Chow E. Pain flare following radiotherapy for painful bone metastases: A joint effort of three Canadian cancer centers to determine the incidence. The International Society for Quality of Life Research Conference, Toronto, Ontario, Canada, October 10-13, 2007. Hird A, Hadi S, Flynn C, Loblaw A, Wong R, Wu J, Chow E. Pain flare following radiotherapy for painful bone metastases: A joint effort of three Canadian cancer centers to determine the incidence. The Canadian Association of Radiation Oncologists and Canadian Organization of Medical Physicists Joint Scientific Meeting, Toronto, Ontario, Canada, October 10-14, 2007. Hird A, Hadi S, Loblaw A, Wong R, Wu J, Chow E. Pain flare following radiotherapy for painful bone metastases: A joint effort of three cancer centers to determine the incidence. 2007 International Society for Quality of Life Research meeting abstracts [www.isoqol.org/2007mtgabstracts.pdf]. Quality of Life Research supplement, A-101, Abstract #1464. Hird A, Rademacher J. Bone metastases module. European Organization for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) Semi-Annual Meeting. Queen’s University, Belfast Northern Ireland, United Kingdom, November 22-23, 2007. Hird A, Rademacher J. Update of the bone metastases module and proposed shortening of the EORTC QLQ-BM22. European Organization for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) Semi-Annual Meeting. Queen’s University, Belfast Northern Ireland, United Kingdom, November 22-23, 2007. Hird A, Taphoorn M, Rademacher J. Validation of the brain module (EORTC QLQ-BN20) in patients with brain metastases. European Organization for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) Semi-Annual Meeting. Queen’s University, Belfast Northern Ireland, United Kingdom, November 22-23, 2007. Hird A. A rare case of radiation recall dermatitis. Palliative Radiation Oncology Quality Assurance Rounds. Toronto Sunnybrook Regional Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, February 2007. Hird A. Multiple brain lesions from an unknown primary? Palliative Radiation Oncology Quality Assurance Rounds. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, October 16, 2007.

24

Hird A. Pain flare following external beam radiotherapy in the treatment of bone metastases. BONUS 2: Breast Cancer and Bone Disease New Updates; March 30, 2007. Hird A. Quality of life instruments in palliative care. C-PROG Videoconference. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, December 4, 2007. Hird A. Rapid improvement in the bone scan of a patient with metastatic renal cell carcinoma following sunitinib and zoledronic acid. Palliative Radiation Oncology Quality Assurance Rounds. Toronto Sunnybrook Regional Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, February, 2007. Houlden DA, Nolan M, Rowed DW, Schwartz ML, Fazl M, Pirouzmand F, Finkelstein JA, Yee AJ. Transient SSEP change can detect iatrogenic spinal cord injury during spine surgery. 42nd Annual congress of the Canadian Neurological Sciences Federation, Edmonton, AB. Canadian Journal of Neurological Sciences 2007: 33: pp S16. Kirou-Mauro A, Gardiner K, Harris K, Chow E, Selby D, Myers J. Level of concordance between patient and proxy ratings on the Edmonton Symptom Assessment Scale (ESAS) and the European Organization for Research and Treatment of Cancer Quality of Life Palliative Care Questionnaire (EORTC QLQ-C15-PAL). 14th Annual Conference of the International Society for Quality of Life Research, Toronto, Ontario, Canada, October 10-13, 2007. Kirou-Mauro A, Harris K, Sinclair E, Selby D, Chow E (2006). Are family proxies a valid source of information about cancer patients’ quality of life at the end of life? A literature review. 17th Annual Ontario Provincial Conference on Palliative and End-of-Life Care, London, Ontario, Canada, April 22-24, 2007. Kirou-Mauro, A. Speaker at the Sunnybrook Odette Cancer Centre for RRRP/BMC Quality Assurance Rounds. Toronto, Ontario, Canada, June 2007. Larson D, Ma L, Ames C, Chou D, Chuang C, Petti P, Huang K, Weinstein P, Sahgal A. Safe spinal cord and cauda equina partial volume tolerances for spinous/paraspinous radiosurgery. American Society for Therapeutic Radiology and Oncology, Los Angeles, California, USA, 2007. Larson D, Ma L, Ames C, Chou D, Chuang C, Petti P, Huang K, Weinstein P, Sahgal A. Safe spinal cord and cauda equina partial volume tolerances for spinous/paraspinous radiosurgery. International Journal of Radiation Oncology Biology Physics 69 (3): S1, 2007. Ma L, Sahgal A, Larson D, Chuang C, Verhey L. A generalized biologic effective dose model and it's application to radiosurgery and hypofractionated body radiotherapy. Medical Physics 34 (6): 2403, 2007. Mallia G, Wong J, Kirou-Mauro A, de Sa E, Sinclair E, Tsao M, Barnes T, Danjoux C, Chow E. Quality of life and symptoms of patients treated with whole brain Radiotherapy. Canadian Association of Radiation Oncology – Canadian Organization of Medical Physicists Conference, Toronto, Ontario, Canada, October 2007. Moss I (trainee presentation), Woodhouse K, Whyne C, Yee AJ (supervisor). A novel composite Elastin and Hyaluronan scaffold for nucleus pulposus tissue engineering. (Poster) University of Toronto, Faculty of Medicine, Department of Surgery, 33rd Gallie Day, Toronto, Ontario, May 4, 2007. Moss I (trainee presentation), Woodhouse K, Whyne C, Yee AJ (supervisor). A novel composite Elastin and Hyaluronan scaffold for nucleus pulposus tissue engineering. (Poster) TERMIS-NA, TERMIS-NA, Toronto, Ontario, Jun 13, 2007 - Jun 16, 2007.

25

Moss I, Whyne C, Woodhouse K, Yee A. Novel composite hyaluronan/elasting scaffold for tissue engineering of the intervertebral disc. (Poster) Canadian Connective Tissue Conference, 13th annual, Toronto, On, May 2007. Murnaghan O (trainee presentation), Lansang E, Bronstein Y, Weller I, Gallant A, Ford M, Finklestein JA, Yee AJ. Spinal Injury and Polytrauma in Patients Presenting to a Level I Canadian Trauma Institution. (Poster) Sunnybrook Research Institute, Summer Student Poster Competition, Toronto, Ontario, Aug 22, 2007. Murnaghan O, Bronstein Y, Ford M, Gallant A, Adjei N, Finkelstein JA, Yee AJ (presenter). Spinal Injury and polytrauma in patients presenting to a Level 1 Canadian Trauma Institution. (Poster) Canadian Spine Society, 7th Annual Meeting, Mont-Tremblanc, Quebec, Mar 21, 2007 - Mar 24, 2007. Napolskikh J, Bennett M, Chow E, Harris K, Sinclair E, Myers J, Selby D. Demographic profile and utilization statistics of an inpatient palliative care unit within a tertiary care setting. 17th Annual Ontario Provincial Conference on Palliative and End-of-Life Care, London, Ontario, Canada, April 22-24, 2007. Napolskikh J, Chow E, Myers J, Bennett M, Harris K, Sinclair E, Selby D. Defining ‘meaningful palliative care’ in a palliative care unit from the perspective of clinical caregivers. 17th Annual Ontario Provincial Conference on Palliative and End-of-Life Care, London, Ontario, Canada, April 22-24, 2007. Napolskikh J. Aggressive supraclavicular nodal recurrence in treatment of breast adenocarcinoma with no metastatic involvement. Presented for Quality Assurance Rounds, Toronto Sunnybrook Regional Cancer Centre, June 19, 2007.

Razmjou H (presenter), Yee AJ, Ford F, Holtby M, Vidmar M, Finkelstein JA. Relationship Between Pre-Operative Patient characteristics and Expectations in Candidates for Total Knee Arthroplasty. (Poster) Canadian Orthopaedic Association, 62nd Annual Meeting, Halifax, Nova Scotia, Jun 1, 2007 - Jun 3, 2007. Sahgal A, Ames C, Chou D, Ma L, Chuang C, Lamborn K, Chin C, Huang K, Weinstein P, Larson D. Proximity of spinous/paraspinous radiosurgery target to the spinal cord versus risk of local failure. American Society for Therapeutic Radiology and Oncology, Los Angeles, California, USA, 2007. Sahgal A, Ames C, Chou D, Ma L, Chuang C, Lamborn K, Chin C, Huang K, Weinstein P, Larson D. Proximity of spinous/paraspinous radiosurgery target to the spinal cord versus risk of local failure. Canadian Association of Radiation Oncology, Toronto, Ontario, Canada, 2007. Sahgal A, Ames C, Chou D, Ma L, Chuang C, Lamborn K, Chin C, Huang K, Weinstein P, Larson D. Proximity of spinous/paraspinous radiosurgery target to the spinal cord versus risk of local failure. International Journal of Radiation Oncology Biology Physics 69 (3): S1, 2007. Sahgal A, Ames C, Chou D, Ma L, Chuang C, Lamborn K, Chin C, Huang K, Weinstein P, Larson D. Proximity of spinous/paraspinous radiosurgery target to the spinal cord versus risk of local failure. Radiotherapy in Oncology 84 (2): S2, 2007. Sahgal A, Chuang C, Huang K, Petti P, Weinstein P, Larson D, Ma L. Split-volume planning of multiple consecutive vertebral body metastases for CyberKnife body radiotherapy. 6th annual Cyberknife Users Meeting, La Quinta, California, USA, 2007.

26

Sahgal A, Chuang C, Huang K, Petti P, Weinstein P, Larson D, Ma L. Split-volume treatment planning: A novel method in planning multiple adjacent vertebral body metastases for Cyberknife radiosurgery. Accepted: 8th bi-annual International Stereotactic Radiosurgery Society, San Francisco, California, USA, 2007. Sahgal A, Chuang C, Huang K, Petti P, Weinstein P, Larson D, Ma L. Split-volume planning of multiple consecutive vertebral body metastases for CyberKnife body radiotherapy. Canadian Association of Radiation Oncology, Toronto, Ontario, Canada, 2007. Sahgal A, Chuang C, Huang K, Petti P, Weinstein P, Larson D, Ma L. Split-volume planning of multiple consecutive vertebral body metastases for CyberKnife body radiotherapy. Radiotherapy in Oncology 84 (2): S2, 2007. Sahgal A, McDermott M, Ma L, Larson D, Petti P, Berger M, Sneed P. Use of pre-surgical MRI in the treatment planning of tumors with dural attachments for Gamma Knife radiosurgery. Accepted: 8th bi-annual International Stereotactic Radiosurgery Society, San Francisco, California, USA, 2007. Sigal IA, Hardisty M, Whyne C. Mesh-morphing algorithms for generation of specimen-specific FE models of rat tail vertebrae. (Poster) Canadian Orthopaedic Research Society, Halifax, NS, Jun 2007. Sinclair E, Chow E, Loblaw A, Harris K, Danjoux C. Dexamethasone for the prophylaxis of radiation-induced pain flare following palliative radiotherapy for bone metastases: a pilot study. UK Radiation Oncology Conference, Edinburgh, UK, March 19-21, 2007. Sinclair E, Danjoux C, Harris K, Patel M, Barnes A, Barbera L, Tsao M, Chow E. Review of the Rapid Response Radiotherapy Program (RRRP) at the Toronto Sunnybrook Regional Cancer Centre (TSRCC). UK Radiation Oncology Conference, Edinburgh, UK, March 19-21, 2007. Sinclair E, Hird A. Pain flare following external beam radiotherapy in the treatment of bone metastases. Radiation Therapy Rounds: Toronto Sunnybrook Regional Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, April 2007. Sinclair E, Li K, Pope J, Farhadian M, Harris K, Yee A, Librach L, Wynnychuk L, Danjoux C, Chow E on behalf of the Bone Metastases Team. A multidisciplinary bone metastases clinic at Toronto Sunnybrook Regional Cancer Centre - A review of the experience from 1999 to 2005. UK Radiation Oncology Conference, Edinburgh, UK, March 19-21, 2007. Szwedowski T, Fialkov J, Whyne C. Automated segmentation of cortical bone in complex thin bone structures using level set methods. (Poster) Canadian Connective Tissue Conference, 13th annual, Toronto, On, May 2007. Wong J, Tsao M, Mallia G, Kirou-Mauro A, de Sa E, Sinclair E, Barnes T, Danjoux C, Chow E. A prospective study of the quality of life and symptoms in patients with brain metastases treated with whole brain radiotherapy. International Society for Quality of Life Research Conference, Toronto, Ontario, Canada, October 10-13, 2007. Wong, J. Speaker at the RRRP/BMC Quality Assurance Rounds. Case: Soft tissue hand metastasis. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, June 2007. Yee AJ. Bone Morphogenic Proteins and Bone Graft Extenders: What is their role?; Conference Symposia. Canadian Spine Society, Mont-Tremblanc, Quebec, Mar 24, 2007.

27

Yee AJ. Osteobiologics in Orthopaedic Surgery; A Conceptual Update. Grand Surgical Rounds, Department of Surgery, McMaster University, Hamilton, Ontario, Jul 18, 2007.

28

APPENDIX A [Back]

Rapid Response Radiotherapy Palliative Clinics


Staff: Dr. E. Chow (Rad Onc), Dr. C. Danjoux (Rad Onc), Dr. M. Tsao (Rad Onc), Dr. T. Barnes (Rad Onc), Dr. A. Sahgal (Rad Onc), E. Sinclair (RT). Objective: Provide expedited access for symptom relief from incurable cancers in patients with limited life expectancies. Eligible Patients:

Symptomatic cancer (any disease site) where palliative radiotherapy may be indicated.

Patients with life expectancies of <6 months.

A “most responsible physician” available to provide follow-up and ongoing oncological care upon completion of the RRRP consultations.

Ineligible Patients: 1. Candidates for potentially curative treatments. 2. Patients requiring further investigations before radiotherapy opinion can be rendered. 3. Patients who are currently actively being followed by a radiation oncologist at

OCC (unless otherwise specifically arranged). 4. Patients whose disease status is better served by a radiation oncologist who could provide

longitudinal follow-up. 5. Off-service in-patients who require transfer of care to radiation oncology for ongoing oncological

care.

Monday Dr. T. Barnes Sim 4 Tuesday Dr. M. Tsao Sim 4 Wednesday Dr. C. Danjoux Sim 4 Thursday Dr. E. Chow Sim 4 Friday Dr. M. Tsao Sim 4

To make a referral:

1. Contact the new patient booking office and request a referral to the RRRP clinic. 2. Contact the RRRP nurse. 3. Contact one of the RRRP physicians directly.


APPENDIX B [Back]

Decision Tree for Patients Referred to RRRP / BMC (January 2001)

Yes No

29

No

Did patient see a TSRCC Rad Onc?

Is patient new to TSRCC?

Yes No

Yes Refer to his / her Rad Onc

Is patient estimated survival greater than 6 months?

To site group based on diagnosis

- lung - breast - GU etc.

Emergency Urgent Elective < 24 h <1 week Book next available RRRP slot (Cord Compression (Bleeding, Do not book beyond 2 weeks SVCO) SOB)

No Yes YES YES

What is the urgency of appointment?

Is RRRP slot available?

Discuss with RRRP Rad Onc who has a clinic for that day or next few days. Is RRRP Rad Onc able to see patient?

• overbook patient to Rad Onc in RRRP • inform ref MD and patient

No

Refer to Rad Onc on call

** RRRP Policy circulated as addendum to Minutes of Radiation Oncology staff meeting of March 2nd 2000.

30

APPENDIX C [Back]

Jan 1999: Initiated Bone Metastases Clinic (BMC)

A bi-weekly Bone Metastasis Clinic (BMC) was initiated at the OCC on January 8, 1999. The clinic is staffed by Orthopaedic Surgical Oncologists: Drs. T. Axelrod, J. Finkelstein, D. Stephen, M. Ford and A. Yee; Radiation Oncologists: Drs. E. Chow, C. Danjoux, M. Tsao, T. Barnes. The BMC is held on the 2nd and 4th Friday morning of each month in clinic C at the OCC.

The goals of the BMC are to:

Provide an elective orthopaedic consultation service for patients with bone metastasis referred by OCC oncologists; provide elective radiation oncology consultations to patients with bone metastasis referred by SWHSC physicians.

Provide elective orthopaedic and radiation oncology consultations to patients with bone

metastasis referred by community physicians.

Provide follow-up to oncology patients after orthopaedic interventions.

Bone Metastases Clinic – 2nd and 4th Friday (Clinic C)

To make a referral:

1. Contact the new patient booking office and request referral to the Bone Metastases Clinic.

2. Contact the RRRP nurse.

3. Contact one of the RRRP physicians directly.

APPENDIX D [Back]

31

APPENDIX D

32

APPENDIX E [Back]

34

APPENDIX F [Back]

Content of HOT SPOT Newsletter

1999-2007

35

CONTENT AND INSERTS OF HOT SPOT 1999-2007

Editor’s Corner Dr. Gillian Thomas From the Chief Executive Officer Dr. Ken Shumak The first RRRP newsletter Dr. Gillian Thomas Palliative radiotherapy rounds Dr. Ewa Szumacher New combined bone metastases clinic Drs. Joel Finkelstein,

Edward Chow A phase II trial of palliative radiotherapy for metastatic renal cell carcinoma

Drs. Edward Chow, Padraig Warde

Prospective assessment of symptom palliation for patients attending a rapid response radiotherapy program

Drs. Edward Chow, Cyril Danjoux, Rebecca Wong

The challenge of speedy delivery of pain relief met by the rapid response clinic at T-SRCC

Dr. Ewa Szumacher, Ms. Lou Andersson

The cancer pain and palliative care clinic at T-SRCC Dr. Larry Librach Research Corner Dr. Rebecca Wong

Vol 1, Issue 1 February 1999

Message from the Chief Executive Officer Dr. Carol Sawka

A note of thanks Ms. Ruth Connolly, Dr. Edward Chow

Editor’s Corner Differentiating normal grief from clinical depression Dr. Mary Vachon Ontario Drug Benefit (ODB) Formulary Changes Ms. Trudi Schueller Surgical management of metastatic spine disease Dr. Joel Finkelstein Radiosurgery for brain metastases Dr. Phillip Davey Surgical management of metastatic extremity lesions Dr. David Stephen

Vol 1, Issue 2 May 1999

Highlights in the Multinational Association of Supportive Care Cancer Dr. Rebecca Wong Insert May 1999 Cancer Related Pain Management (Sponsored by Janssen-Ortho Inc.) Dr. David Warr

Referring physicians’ satisfaction with the RRRP Ms. Ruth Connolly, Dr. Edward Chow

Preparing the community and health care professionals for new challenges in palliative care – a new endeavour of the rapid response radiotherapy program

Ms. Lou Andersson, Dr. Ewa Szumacher

Editor’s Corner

Management of bone metastases with external beam radiotherapy Drs. Ewa Szumacher and Rebecca Wong

Single dose wide field radiotherapy Dr. Cyril Danjoux Bisphosphonates in palliative care Dr. Sandeep Sehdev Mitoxantrone and prednisone for hormone refractory prostate cancer Dr. Scott Berry

Vol 1, Issue 3 August 1999

Research Corner Dr. Rebecca Wong Insert August 1999 Malignant wound management (Sponsored by Convatec) Dr. Valerie Schultz

Bayview Support Network: Ontario’s first on-site cancer support network Ms. Mridula Sood Dope and cope: it is no longer enough Dr. Michele Chaban Editor’s comment Psychosocial issues with a cancer diagnosis Dr. Margaret Fitch

Vol 1, Issue 4 November 1999

Cancer care at York Central Hospital Ms. Jane Anderson

36

Yee Hong palliative care services: A culturally sensitive approach Dr. Stanley Zheng Hill House – A Richmond Hill hospice Ms. Ann Gold Charles R.R. Hayter, MD, BA, MA, FRCPC joins T-SRCC Interview with Russell Goldman, MD, CCFP, palliative care physician with the Temmy Latner Centre for Palliative Care, Mount Sinai Hospital

Research Corner Dr. Rebecca Wong

Bowel Obstruction Dr. Larry Librach Management of Radiotherapy-Induced Acute Gastrointestinal Toxicities Dr. Rebecca Wong

Insert November 1999 (Sponsored by Novartis Pharmaceuticals Canada, Inc.)

Editor’s comments Dr. Cyril Danjoux Advance care planning for people with cancer Dr. Scott Berry The emotional needs of the person with advanced cancer Dr. Mary Vachon Historical Vignette: The beginnings of palliative radiotherapy in Canada Dr. Charles Hayter When does palliative care begin? Dr. Larry Librach Palliative radiation oncology program at the Princess Margaret Hospital Dr. Andrea Bezjak Ask the Experts Dr. Rebecca Wong



Prevention and treatment of radiation-induced emesis Dr. Rebecca Wong Insert February 2000 Prevention and treatment of chemotherapy-induced nausea and vomiting

(N&V) - (Sponsored by Glaxo-Wellcome) Mr. Carlo De Angelis

From the associate editor’s desk Dr. Edward Chow Enhancing culturally sensitive practice when caring for seriously ill patients and their families Dr. Elizabeth Latimer Quality end-of-life care: What do patients think? Dr. Scott Berry Family dealing with advanced cancer Dr. Mary Vachon Percutaneous vertebroplasty / cementoplasty at bone metastases clinic, TSRCC Dr. Edward Chow Historical Vignette: Dr. Joseph-Ernest Gendreau and the early use of radium Dr. Charles Hayter


Research Corner Dr. Rebecca Wong Insert May 2000 Accessing palliative care in your community

Ms. Joan Pope, Ms. Lou Andersson

From the editorial board Dr. Ewa Szumacher, Ms. Ruth Connolly

When the patient of a young child is seriously ill Dr. Mary Vachon Disclosure Dr. Philip Hebert Utilization of complementary therapies in palliative care Ms. Ruth Connolly Historical Vignette: Private radiotherapy in Canada Dr. Charles Hayter Research Corner - Summer research for the Rapid Response Radiotherapy Program Dr. Rebecca Wong


Andrew Loblaw, MD, FRCPC, joins T-SRCC Insert August 2000

-Nutrition and cancer -The ABCs of vitamins and minerals (Supported by Novartis Pharmaceuticals Canada, Inc.) Ms. Elaine Posluns

Editor’s Corner Dr. Rebecca Wong Report from the “tri-centre” meeting with Dr. William E. Powers Dr. Jackson Wu

Vol 2, Issue 4 November 2000 Adolescents living with a parent with advanced illness Dr. Mary Vachon

37

Resources on the Internet for improving end-of-life care – How to get started Dr. Scott Berry Historical Vignette: Vera Peters: Canadian pioneer in psychosocial oncology Dr. Charles Hayter Research Corner – Informational needs assessment on patients receiving palliative radiotherapy Dr. Rebecca Wong Seventh Annual Conference – The Science and Art of Pain and Symptom Management

Insert November 2000

Cancer-related fatigue -Supported by an educational grant from Janssen-Ortho Inc. Dr. Rebecca Wong

From the associate editor’s desk Dr. Edward Chow Dr. Maureen Trudeau Dr. Kathleen Pritchard Staff stress and suffering Dr. Mary Vachon Historical Vignette: Cancer care before medicare Dr. Charles Hayter Pain and symptom management conference Follow-up for breast cancer Dr. Eva Grunfeld Research Corner – Shared treatment decision-making Dr. Rebecca Wong


Thank you…

-Hormones in Breast Cancer, Metastatic Breast Cancer (Supported by Astra-Zeneca Canada Inc.)

Dr. Maureen Trudeau

-Chemotherapy in Metastatic Breast Cancer Treatment, Treatment of Systemic Recurrence with Chemotherapy (Supported by Aventis)

Dr. Maureen Trudeau

Insert February 2001

-Herceptin (Supported by Hoffman LaRoche) Dr. Maureen Trudeau

From the guest editor's desk Dr. Charles Hayter Addressing spiritual needs Dr. Sharon Grant When the shrink gets cancer and gets spiritually transformed Dr. Mary Vachon Historical Vignette: The history of hospices Dr. Charles Hayter Ethics: Caring for patients with different faiths Dr. Scott Berry Research Corner - Patient expectations Dr. Rebecca Wong


Notice regarding treatment delays... Insert May 2001

A guide to spiritual care of the caregiver, A guide to spiritual assessment of cancer patients. (Supported by AstraZeneca Canada Inc. and Purdue Pharma)

Dr. Michele Chaban

From the editor's desk Dr. Cyril Danjoux Comfort and stress among cancer caregivers Dr. Eva Grunfeld On suffering in terminal illness Dr. Mary Vachon Historical Vignette: The history of morphine Dr. Charles Hayter


Research Corner Dr. Rebecca Wong Insert August 2001 Palliation in lung cancer

(Supported by AstraZeneca Inc. and Purdue Pharma)

Drs. Andrea Bezjak, Dr. Catherine Heath, Ms. Jane Lea

From the guest editor's desk Dr. Andrew Loblaw, Ms. Lori Holden

Survey shows 40% of RRRP patients arrive with missing info: A plea for help

Dr. Charles Hayter, Ms. Ruth Connolly


Finding meaning in life in the face of advancing cancer Dr. Mary Vachon

38

Historical Vignette: The 50th anniversary of cobalt treatment Dr. Charles Hayter Tough decisions about funding for new palliative therapies: How do we decide? Dr. Scott Berry Research Corner Dr. Rebecca Wong


Malignant Spinal Cord Compression (Partially supported by Purdue Pharma)

Dr. Andrew Loblaw, Ms. Lori Holden

From the editor's desk Dr. Ewa Szumacher, Ms. Joan Pope

Advance notice of the ninth annual conference on the science and art of pain and symptom management Denial and minimization in advanced cancer Dr. Mary Vachon Global health ethics and palliative care Dr. Scott Berry Historical Vignette: The story of Essiac Dr. Charles Hayter



Oral health care in the patient with cancer Dr. Trey Petty Mouth care for radiation patients Dr. Alex Hammond


(Supported by Biotene Canada, Division of Bolton Dental Mfg. Inc.)

From the associate editor’s desk Dr. Edward Chow

New chiefs at TSRCC and University of Toronto Dr. Edward Chow, Dr. Cyril Danjoux

Depression in advanced cancer Dr. Mary Vachon Historical Vignette: Blood and medicine Dr. Charles Hayter Hope for a good death Dr. Monica Branigan


Research Corner Dr. Rebecca Wong Insert May 2002

Anemia in hematology and medical/radiation oncology (Supported by Ortho Biotech)

Dr. Gerard Morton, Dr. Rena Buckstein

From the associate editor’s desk Ms. Lou Andersson, Dr. Cyril Danjoux

TSRCC pharmacy services Ms. Kim Stefaniuk The transformation from tragedy into grace in terminal illness – part one Dr. Mary Vachon Historical Vignette: Plants, poisons and potions: Drug treatments for cancer Dr. Charles Hayter TSRCC pharmacy assists Third World countries Ms. Kim Stefaniuk Informed decision-making in palliative care Dr. Scott Berry


Research Corner Dr. May Tsao, Dr. Rebecca Wong

Insert August 2002

Accessing medication (Supported by Amgen Canada and Abbott Laboratories) Ms. Kim Stefaniuk

From the associate editor’s desk Dr. Edward Chow Palliative care is not euthanasia Dr. Monica Branigan The transformation from tragedy into grace in terminal illness – part two Dr. Mary Vachon Palliative care at the University of Texas M.D. Anderson Cancer Center Dr. Toni Barnes Historical Vignette: Charles Huggins: The Canadian who discovered hormone therapy for prostate cancer Dr. Charles Hayter Research Corner Dr. Rebecca Wong


Award of Excellence Dr. Cyril Danjoux

39


Expanded role of hormone therapy as neoadjuvant or adjuvant therapy in prostate cancer patients undergoing definitive treatment. (Supported by Aventis)

Dr. Richard Choo

From the editor’s desk Drs. Cyril Danjoux, Edward Chow

Congratulations on fifth year Dr. Carol Sawka Congratulations on fifth year Dr. Peeter Poldre Suffering, healing and the wounded healer Dr. Mary Vachon More fifth year congratulations Dr. Shun Wong Advance care planning – update and practical tips Dr. Scott Berry Historical Vignette – A century of radiation therapy in Canada Dr. Charles Hayter


Research Corner Dr. Rebecca Wong Insert February 2003 Pain in cancer: The CARE approach Dr. Larry Librach

From the guest editor’s desk Dr. Charles Hayter, Ms. Lou Andersson

The role of the social worker in palliative oncology Ms. Magdalene Winterhoff

Reflections on anxiety in confronting advanced cancer Dr. Mary Vachon Historical Vignette – Spring fever Dr. Charles Hayter


Research Corner Dr. Rebecca Wong Insert May 2003

Advances and challenges in the management of febrile neutropenia. (Supported by Amgen Canada Inc.)

Dr. Elizabeth J. Phillips

From the guest editor’s desk Dr. Toni Barnes Lymphoma in the elderly Dr. Tom Kouroukis Demorarlization in persons with advanced cancer Dr. Mary Vachon Ethical issues in dealing with demands for “futile” treatment Dr. Scott Berry Historical Vignette – The history of oxygen therapy Dr. Charles Hayter


Research Corner Dr. Rebecca Wong Insert August 2003 Advances for end-of-life respiratory care (Supported by Vital Aire) Dr. Chin K. Chung

From the guest editor’s desk Dr. Cyril Danjoux Referral of patients to the rapid response radiotherapy clinic Boredom in terminal illness Dr. Mary Vachon Hot Spot Survey 2003 “No CPR” – Talking it over Dr. Scott Berry Historical Vignette – The Radium Institute of Toronto Dr. Charles Hayter


Research Corner Dr. Andrea Bezjak Insert November 2003 Androgen ablation for metastatic prostate cancer (Supported by Aventis)

Dr. Richard Choo

From the guest editor’s desk Dr. May Tsao Brain metastases: The magnitude of the problem and the struggle to improve outcomes Dr. May Tsao


Dignity-conserving care in palliative care Dr. Mary Vachon

40

When capacity fluctuates, what happens to consent? Ms. Karen Faith Historical Vignette: The Montreal Neurological Institute Dr. Charles Hayter

Research Corner Dr. Alina Sturdza, Dr. Andrea Bezjak


Palliation in patients with metastatic cancer to the brain Management of brain metastases (Supported by Aventis)

Dr. May Tsao

From the guest editor’s desk Dr. Charles Hayter Bisphosphonates in cancer Dr. Rebecca Wong Anger in the person with advanced disease Dr. Mary Vachon Ethics and SARS: Collateral damage and relationships in health care Ms. Karen Faith Historical Vignette: Dr. Herbert Bruce: Ontario cancer visionary Dr. Charles Hayter

Vol 6, Issue2 May 2004

Research Corner Dr. Jackson Wu, Dr. Edward Chow

Insert May 2004

Use of bisphosphonates in men with hormone refractory prostate cancer Use of bisphosphonates in women with breast cancer

Dr. Scott Berry Dr. Mark Clemons

From the guest editor’s desk Dr. Cyril Danjoux Supportive Care in Cancer Symposium Dr. Cyril Danjoux Forgiveness in palliative care Dr. Mary Vachon Making decisions for others Ms. Karen Faith Survey shows 40% of RRRP patients arrive with missing info: A plea for help

Dr. Charles Hayter, Ruth Connolly

Vol 6, Issue3 August 2004

Research Corner Dr. Laura Dawson Insert August 2004

Rapid Response Radiotherapy Program (RRRP) Review 1996-2003 RRRP Referral Form

Dr. C. Danjoux

From the guest editor’s desk Dr. Edward Chow

The effect of SARS on access to palliative radiotherapy in the RRRP

Dr. Justin Lee, L. Holden, K. Fung, C. Danjoux, E. Chow, C. Gillies

Reflections on the life and death of Mary Peacock Dr. Mary Vachon Quality end-of-life care: Role of economics and the moral climate Ms. Karen Faith Historical Vignette: The Canadian Society for the History of Medicine Dr. Charles Hayter

Vol 6, Issue4 November 2004

Research Corner Dr. Jackson Wu, Dr. Edward Chow


Cannabinoids in medical practice Dr. Vincent Maida

From the guest editor’s desk Dr. Toni Barnes Treatment of bone metastases with palliative radiotherapy: Patients’ treatment preferences

Dr. Ewa Szumacher

Parenting teens during a cancer experience Dr. Mary Vachon Hospital CPR policy: Solution, prevention or band-aid? Ms. Karen Faith Historical Vignette: Alfred Hardisty: Ontario’s pioneer in cancer statistics Dr. Charles Hayter

Vol 7, Issue1 February 2005

Research Corner Dr. Rebecca Wong Insert February 2005 Methadone for cancer pain: An analgesic with a difference Dr. Larry Librach

41

From the guest editor’s desk Dr. Edward Chow The do-not-resuscitate (DNR) order – incidence of documentation in patient charts of patients referred for palliative radiotherapy

Ms. Lou Andersson, Ms. Nicole Bradley

Caught in the middle – mid-life adults with cancer Dr. Mary Vachon

Does culture influence patients’ and families’ DNR decision-making? Ms. L. Andersson, S. Mary Williams, N. Bradley

Lessons from my dad Ms. Karen Faith Temmy Latner Centre Update on Palliative Care – Palliative care and children

Mr. Stephen Jenkinson

PROG Rounds Dr. Tanya Berrang

Vol 7, Issue2 May 2005

Farewell to Dr. Charles Hayter Dr. Cyril Danjoux Insert #1 May 2005

Latest advances in antiemetics for radiation therapy and chemotherapy (Supported by an educational grant from Solvay)

Dr. David Warr

Insert #2 May 2005

Novel therapeutics for management for multiple myeloma (Supported by an educational grant from Ortho Biotech)

Dr. Keith Stewart

From the guest editor’s desk Dr. Cyril Danjoux A survey to asses cancer patients’ awareness and interest in hypnosis for pain and distressing procedures – A synopsis

Mrs. Lori Holden, Dr. Charles Hayter

Are we making any progress? Reflections on stressors in the Ontario oncology system over the past 30 years Dr. Mary Vachon Organizational ethics in the eye of the storm: Woodside Hospice and Terri Schiavo Ms. Karen Faith Temmy Latner Centre Update on Palliative Care – End-of-life care distance education: An innovative approach to helping physicians to care for palliative patients

Dr. Anita Singh, Ms. Deborah Adams

Vol 7, Issue3 August 2005

TSRCC investigates advanced practice radiation therapy roles! Ms. S. Robson, R. Barker, L. Holden

Insert August 2005

A more minimally invasive approach to the treatment of metastatic spine lesions. (Supported by an educational grant from Kyphon)

Dr. Michael Ford

From the guest editor’s desk Dr. May Tsao What keeps us going in our work? Dr. Mary Vachon Research ethics and the importance of determining risk Ms. Karen Faith Temmy Latner Centre Update on Palliative Care – Is terminal sedation ethical?

Dr. Victor Cellarius

Vol 7, Issue4 November 2005

Research Corner – Results of three important randomized studies and their clinical implications. Dr. Jackson Wu


Management of hormone refractory prostate cancer / Prostate bone metastases multidisciplinary clinic. (Supported by an educational grant from Novartis)

Dr. Yoo-Joung Ko

From the guest editor’s desk Dr. Edward Chow

Greetings from Cancer Care Ontario Dr. Linda Rabeneck, Dr. Deb Dudgeon

Hope in advanced disease Dr. Mary Vachon Temmy Latner Centre Update on Palliative Care – Palliative care grand rounds Ms. Deborah Adams Private clinics providing palliative IV therapies – What are the ethical issues? Dr. Scott Berry Helping children and caregivers in fighting cancer – Truth telling in paediatric palliative care. Dr. Christine Newman


Research Corner Dr. Toni Barnes

42


Venous thromboembolism in cancer patients (Supported by an educational grant from Pfizer Canada) Dr. Agnes Y.Y. Lee

From the guest editor’s desk Dr. Cyril Danjoux Truth-telling at the end of life Dr. Monica Branigan What students think: Undergraduate students in palliative health care setting Ms. Hannah H. Chiu Temmy Latner Centre Update on Palliative Care – The educating future physicians for palliative and end-of-life care project (EFPPEC): Developing competencies in medical undergraduates and postgraduates Dr. Larry Librach Help no wanted? Dr. Margaret Fitch If symptom clusters exist, how are they relevant to patient care? Dr. Amna Husain


Forgoing nutrition and hydration in children at the end of life: Is it ever justified? Dr. Adam Rapoport

Insert May 2006

Radioimmunotherapies (Supported by an educational grant from GlaxoSmithKline) Dr. Rena Buckstein

From the guest editor’s desk Ms. Emily Sinclair Hope, denial and ethics of care Ms. Karen Faith

The role of a child life specialist at the MBWC-CGPC Ms. Ceilidh Eaton Russell

Quality indicators of end-of-life care in Ontario cancer patients Dr. Lisa Barbera Palliative care consult team: Moving forward Dr. Jeff Myers 16th Annual provincial conference on palliative and end-of-life care Ms. Emily Sinclair Patients’ and health care professionals’ perspectives on the most important quality of life issues in bone metastases

Ms. S.Tharmalingam and Ms. Kristin Harris


Interprofessionalism: A culture of caring Dr. Michele Chaban Insert August 2006

Video/teleconference as a tool to facilitate research and development in palliative radiotherapy – the Canadian model

Kathryn Burrows, Rebecca Wong, Andrea Bezjak, Jackson Wu, Graeme Duncan, Rajiv Samant, Jim Wright, Frances Wong, and Cyril Danjoux

From the guest editor’s desk Dr. Toni Barnes Ethics and preparing for pandemic influenza Ms. Karen Faith Research Column – Symptom control abstracts presented at the annual Canadian Association of Radiation Oncologist (CARO) meeting

Dr. Toni Barnes

Demanding to live Mr. Stephen Jenkinson

Temmy Latner Centre Update on Palliative Care –Tariro (hope) Dr. Sandy Buchman

Communicating with children about dying Ms. Jennifer B. Pond, Ms. Ceilidh E. Russell


Exploring occupational therapy’s role – Working with palliative clients and their families

Ms. Amy Tymchuk


New developments in the treatment of advanced renal cell carcinoma (RCC) (Supported by an educational grant from Pfizer) Dr. Yoo-Joung Ko

Vol 9, Issue 1 From the guest editor’s desk Dr. Lisa Barbera

43

The alchemy of healing: Are we wired for compassion? Dr. Mary Vachon Provincial Palliative Care Integration Project (PPCIP): Enhancing the quality of palliative care services

Dr. Deborah Dudgeon and Raquel Shaw Moxam

Issues in the measurement and management of dyspnea in home palliative care patients: Who might benefit from oxygen therapy and how should they qualify?

Ms. Erica Moran and Dr. Amna Husain

Redirecting hope Dr. Christopher Church

Capacity and consent: Separating fact from fiction Mr. Blair Henry

February 2007

Temmy Latner Centre Update on Palliative Care – Computerization in palliative care

Dr. Albert Kirshen

Insert Nov 2006

Advances in iron chelation for myelodysplastic syndromes (Supported by an educational grant from Novartis)

Dr. Rena Buckstein

From the associate editor’s desk Dr. Cyril Danjoux …on the truth of the matter!?! Mr. Blair Henry Living after cancer: Challenges in being a survivor Dr. Margaret Fitch Improving communication during the palliative care of children with brain tumours – learning from experience

Ms. Ceilidh Eaton Russell

Symptom clusters in cancer patients with bone metastases Ms. Stephanie Hadi, Grace Fan, Linda Filipczak

New imaging studies in locally advance breast cancer Drs. Gregory Czarnota, Rebecca Dent, Jacqueline Spayne, Maureen Trudeau, Kathleen Pitchard, Martin Yaffe, Don Plewes, and Peter Burns


The Rapid Access Palliative Radiotherapy Program: New kid in town Dr. Alysa Fairchild Insert May 2007

Emerging role of chemotherapy in early prostate cancer (Supported by an educational grant from Sanofi-Aventis)

Dr. Rena Buckstein

From the editor’s desk Dr. Edward Chow Error in health care Dr. Philip Hebert Edmond and Gloria Odette make landmark investment at Sunnybrook to help fight cancer

Ms. Natalie Chung-Sayers

Suffering, taboos and interventions Dr. Michele Chaban New initiatives in advance care planning in Canada Dr. Larry Librach


Review of the Rapid Response Radiotherapy Program (RRRP) at the Odette Cancer Centre (OCC)

Dr. Toni Barnes

Insert August 2007

New options for the treatment of moderate pain (Supported by an educational grant from Purdue Pharma)

Dr. Sol Stern

From the guest editor’s desk Dr. May Tsao What hope can mask: Talking to children about life-threatening illness and death

Ms. Lysa Toye

The role of experience and meaning in clinical ethics Ms. Karen Faith The role of the therapeutic clown in the care of children with progressive life-limiting conditions

Ms. Camilla Gryski

Provincial integration project moving forward at Odette Cancer Centre Ms. Martha Wyatt Update: New options for the treatment of moderate pain Dr. Sol Stern


New research in palliative care Ms. Shannon Ellis, Ms.

44

Linda Wood, Dr. Lorraine Wood

Health care professionals’ perception of what defines “meaningful palliative care” in a palliative care unit

Ms. Julie Napolskikh, Drs. Jeff Myers, Debbie Selby

Insert #1 November 2007

Update in the management of colorectal cancer (Supported by an educational grant from Sanofi-Aventis)

Dr. Yoo-Joung Ko

Insert #2 November 2007

The evolving role of cannabinoids in supportive oncology (Supported by and educational grant from Bayer Inc.

Dr. Vincent Maida

45

APPENDIX G [Back]

Undergraduate Teaching – Co-op Program

Programme Student Period

Fourth year student University of Waterloo

Length of stay in hospice care Julie Napolskikh* 2006 - 2007

Second year student McMaster University

Patient/Proxy correlation of ESAS Andrea Kirou-Mauro 2006 - 2007

Fourth year student York University

Patterns of practice at RRRP Eric de Sa 2006 - 2007

Second year student University of Waterloo

Dexamethasone pain flare project Amanda Hird* 2007

Second year student University of Waterloo

Symptom cluster and Brief pain inventory

Stephanie Hadi* 2007

Third year student University of Waterloo

Testicular cancer module development Candi Flynn 2007

First year student Queen’s University

Quality of life in brain metastases Jennifer Wong 2007

* Award Recipients

46

APPENDIX H

47

rapid response radiotherapy program - sunnybrook.ca · on behalf of the rapid response radiotherapy...

Documents