Health Professional-Investigator Award

Two out of every five individuals will develop cancer during their lifetime. My research program focuses on cancer prevention and diagnosis, using skin cancer as an initial platform. Skin cancer accounts for two thirds of all cancer cases and is an easily accessible organ to study using optical devices. Biopsies are typically used to detect skin cancers. Disadvantages of skin biopsies include possible disfigurement and complications, lengthy processing time, and occasionally inaccurate or inconclusive results.

Aggressive B-cell lymphomas are the most common form of lymphoma and ~50% of patients are cured with modern treatments. However, the outcomes for patients whose disease is not cured are dismal with ~10% of those patients alive at 5 years. This shows that these lymphomas, although grouped together on the basis of what they look like down the microscope, represent clusters of different lymphoma groups. A better understanding of the 'molecular wiring'of these lymphomas is critical to identify patients at high risk of resistant lymphoma and providing better treatments.

Spontaneous coronary artery dissection (SCAD) occurs when there is a tear in the inner layers of a blood vessel in the heart, causing blockage and reducing blood flow and oxygen to the heart. It is an emergency condition that can result in heart attack and even death. Unfortunately, the causes of SCAD are poorly understood, and it is often misdiagnosed and mistreated.

Interstitial lung disease (ILD) is a progressive lung disorder with no effective treatment. Oxygen is often used to relieve symptoms at the end of life, but the evidence supporting oxygen use in these patients is based on limited data from other diseases. The lack of data on the benefits of oxygen in patients with ILD has resulted in uncertain criteria for its use and limited access to this potentially important medication.

Acute kidney injury (AKI) complicating critical illness is an important problem, contributing to roughly 1.7 million deaths worldwide per year. Treatment is limited to dialysis, which is costly and frequently unavailable. Preventing AKI is a critical step to reduce deaths. Acetaminophen (Tylenol) has the potential to reduce AKI caused by oxidative damage from hemoglobin (released from red blood cells) and myoglobin (released from muscle cells).

Introduction: Colorectal cancer (CRC) is the second most common cancer. Once metastatic, patients are generally incurable and receive treatment to prolong survival. Immunotherapies use a patient's immune system to attack their cancer. These treatments are effective in CRC patients with microsatellite instability (MSI). Unfortunately, 95% of patients lack MSI and are called microsatellite stable (MSS). This group usually doesn't respond to immunotherapy and we need to explore why.

Specific Aims:  

We aim to identify:

Women who inherit a BRCA gene mutation are at high risk for breast cancer and the most lethal type of ovarian cancer, high-grade serous ovarian carcinoma (HGSC).

A woman diagnosed with HGSC has a 20% chance of unknowingly carrying a BRCA mutation, and is eligible for genetic testing. Getting a blood sample to do genetic testing in this woman is critical, because if she is found to have a BRCA mutation: 1) her relatives (daughters, sisters) can be tested, and HGSC can be PREVENTED in them, and 2) she herself can be treated with PARP inhibitors that can improve survival.

The World Health Organization (WHO) aims to eliminate TB by 2050, but Canada is not on target to meet that goal. To reach our national TB elimination targets, we must reduce TB rates by 10% per year but we are only reducing TB rates by 2% per year. My research program is aimed at developing evidence to improve TB screening, prevention and treatment policies in order to accelerate TB elimination in British Columbia (BC) and Canada.  

Deaths due to opioid overdoses have reached epidemic proportions in Canada, with nearly 8,000 Canadians losing their lives in the last two years. Knowledge of how rescuers can best respond to cardiac arrests due to opioid overdose is urgently needed.  

Out-of-hospital-cardiac arrest (OHCA) affects 40,000 Canadians per year. Cardiac arrest is the sudden loss of heart beating, and can occur in people with or without known heart disease. In British Columbia (BC), only 15% of these patients live (50% die before hospital, 35% die in hospital), less than 50% receive bystander cardiopulmonary resuscitation, and only 3% receive bystander automatic external defibrillation. Due to a lack of connected data, little is known about the effect of treatments on long term survival, brain function and quality of life after leaving hospital.

Many patients with depression struggle to return to their full level of functioning in work and other areas of life. These poor functional outcomes in depression may be related to cognitive difficulties, as patients demonstrate problems with memory, attention, and problem solving. We however lack treatments for these difficulties. Cognitive training, consisting of tasks to target cognitive deficits, has been tested but shows inconsistent results in depression.      

Endometriosis is a common condition, affecting 1 in 10 women of reproductive age, or approximately one million women in Canada. Endometriosis occurs when tissue from inside the womb grows outside of the womb, such as in different areas of the pelvis. Half of women with endometriosis experience sexual pain, which is felt as pelvic pain with deep penetration during sexual activity. 

Sexual pain in endometriosis can occur when the endometriosis cells show invasive qualities. We recently identified non-inherited gene mutations in this type of invasive endometriosis. 

Advanced head and neck cancers involving facial bone often require aggressive removal of diseased bone. Reconstruction of the bone is typically done by cutting and reshaping patient donor bone. This process involves is complex, since the accuracy of the reconstruction significantly impacts cosmetic and functional outcomes. Doing this during surgery is challenging, time-consuming and can be improved with better planning before surgery. 

Today the greatest barrier to optimal health among persons living with HIV (PLWH) is antiretroviral (ART) adherence. The WelTel program uses weekly text-messages to improve ART adherence and HIV viral suppression among PLWH, but does not work for everyone. The literature states that personality traits and sense of purpose (dispositional traits) play a role in HIV-related outcomes. Measuring disposition is simple and rapid, and could be used to personalize adherence supports for clients with relative ease. 

Breast cancer is the most common cancer in women. Patients with large breast tumour or palpable lymph nodes often receive chemotherapy first, followed by surgery. During chemotherapy, a doctor performs serial breast exams and occasional imaging to monitor tumour shrinkage, but this is not good enough to capture shrinkage accurately. It is important to develop a better way to measure breast cancer response on chemotherapy before surgery, as it can predict outcomes and change treatment plans.