Rankin Run funds help provide ‘extraordinary’ cancer care in Niagara
Preparing the treatment machines required repeated and exhaustive testing to ensure effective performance
ATTACKING A CANCEROUS tumour inside someone’s body with a radiation machine that can pump out 18 million volts of energy is serious business with very high stakes.
Radiation beams must be delivered at ridiculously precise locations, angles and intensity or cancerous cells can continue to live and multiply and healthy tissue can be damaged.
But to do that, the powerful X-ray machines must be calibrated so those beams can be delivered to within tiny fractions of a millimetre because every single cancer radiation treatment plan must be customized.
When medical physicist Joe Szabo of Hamilton’s Juravinski Cancer Centre was asked in 2012 to head the physics centre at the soon-to-open Walker Family Cancer Centre at the new Niagara Health hospital in St. Catharines, the Garden City native put off his pending retirement to jump at the chance to do something important for his hometown.
Getting the three X-ray treatment machines ready for the first patients meant exhaustive testing and measuring again and again to ensure treatments would be exacting.
“It has to be dead on,” said Szabo. “It has to be precise to an amazing detail.”
That all requires high-tech, very expensive equipment targeting tumours with powerful beams that must be planned out with excruciating detail. Each X-ray machine even has its own CT scanner.
“We’ve got all this space-age equipment,” said Szabo, who recently retired and who now lives in Niagara Falls. “It looks like a NASA control centre.”
To test the new radiation machines worth millions of dollars apiece, Szabo and his staff used a special water tank machine with robotically moved probes containing air pockets to measure every aspect of them by
mimicking human bodies that are made up largely of fluid. But the air pockets in the smaller machine are subject to temperature and atmospheric pressure.
There was a problem: The barometer at the hospital used to measure barometric pressure was broken.
It was December, and the first cancer patients were due for treatment in March. There were still weeks upon weeks of testing required including inputting the beam modelling into computers, and the company that manufactured the barometer said it would be weeks before it could be repaired.
Szabo was running out of time. “You can’t mess around with radiation treatment,” he said. “It can’t be even a little wrong.”
The health system’s fundraising foundation came through with funding for the barometer, largely from money donated by the Rankin Cancer Run, said Szabo.
It wasn’t the only case when the run, which has raised an astounding $7.55 million over 12 years and donated $3.5 million to the regional cancer centre, has helped to transform patient care, said Szabo.
At Juravinski, doctors were seeing some women who’d undergone radiation treatment for left-side breast cancer showing up 10 years after the fact with heart problems due to heart tissue suffering collateral radiation damage because of the muscle’s placement in the body near the left breast.
Researchers realized it was important for women to hold their breath in a certain way during radiation treatment for that type of cancer because a moving chest makes exact delivery of the beam difficult.
But even when we hold our breath, our diaphragm can move. At Juravinski, Szabo had been involved in developing technology that allowed women to visualize how they’re holding their breath, so they can minimize movement for optimal treatment. But the St. Catharines X-ray machines were made by a different manufacturer so doctors from that centre were being forced to send some patients with that type of cancer to Hamilton for treatment — which can be 20 to 30 sessions over a period of four to six weeks — to minimize the risk of heart damage.
“That was going against what we wanted: To treat our patients here in Niagara,” said Szabo.
He went to a conference in Vienna where he learned of a new technology that uses lasers similar to bar code readers at supermarket checkouts that scan 50 times a second, allowing a topographic map of patients’ bodies to be created to allow patients to see if they’re holding their breath exactly the way they need to.
But the machine costs hundreds of thousands of dollars and the radiation rooms needed to be renovated to allow the lasers to be installed in the ceilings.
Cancer Care Ontario paid for some of that, but Szabo was able to get the rest from the hospital foundation again thanks to Rankin Run donations raised by the thousands of participants who take part each year.
Rankin Run funds also helped purchase new equipment for new techniques the cancer centre is implementing to treat prostate cancer using what’s known as volumetric modulated arc therapy in which the gantries on the X-ray machines that rotate around patients produce a steady beam rather than sporadic bursts as they move.
That can cut a treatment session lasting 20 to 30 minutes in half — key because the patient or the prostate has less opportunity to move during treatment, said Szabo.
“It’s indispensable,” Szabo said of the equipment the Rankin Run helped fund.
“You can’t get along without it. It means a small centre like St. Catharines can do most of the things that a large centre like Juravinski can do.”
It’s the people who show up each year for the Rankin Run who are making those cancer treatment advances possible in Niagara, said Szabo.
“It’s the generosity of people donating to the Rankin Run that allows us to purchase this equipment and to change your treatment from run-of-the-mill to extraordinary,” he said.
“Because of their generosity they upped the quality of our care in the entire region.”
Dr. Janice Giesbrecht, medical director of oncology for Niagara Health, said Rankin Run funds have allowed numerous other initiatives to enhance patient care and foster research, including funding clinical trials and the hiring of a patient experience co-ordinator to play a key role in quality improvement plans, andhiring a nurse practitioner in the in-patient ward to receive patients who have just received stem cell and bone marrow transplants at Juravinski.
“We’re offering new treatments, offering care closer to home and doing clinical trials,” she said. “It allows us to invest in key areas that we need to grow excellence to deliver that care close to home.”
The Rankin Run funds have led to both short-term and long-term benefits for patients, said Giesbrecht.
“The things that are so brilliant about Rankin is that it’s about all cancer services in Niagara, it’s about all types of cancer, it all stays in Niagara, we’re doing it together and it involves young people and schools, which is our future,” she said.
“That’s huge.”
Some of those advances and research coming out of the Walker centre thanks to equipment the Rankin Run helped to purchase could ultimately help to transform patient care at other cancer centres, said Szabo.
“Somebody running in that run might help somebody across the world,” he said.
Rankin Run director Mary
Ann Edwards said knowing donations are directly helping cancer care in Niagara has energized her all-volunteer run committee to work even harder to raise money.
“The funds we raise are making very significant differences in our cancer care here in Niagara,” she said. “Knowing this ignites even more passion in my soul to pull us together to raise as much as we possibly can.”
The 13th annual Rankin Run is Saturday, May 26, starting 10 a.m. at Grantham Lions Park on Niagara Street in St. Catharines.
For more information visit www.rankincancerrun.com.
“You can’t mess around with radiation treatment. It can’t be even a little wrong.”
JOE SZABO Head, Physics Centre, Walker Family Cancer Centre