Physicians of the Zane Cohen Centre

AN INVITATION FROM DR. ZANE COHEN, DIRECTOR

GASTROINTESTINAL CANCERS

Familial Gastrointestinal Cancer Registry (FGICR)

• The FGICR continues to grow with over 2,500 individuals in our Registry. Research continues to look at the hereditary cancer risk and prevention, as well as discovering new genes to explain colorectal polyps and GI cancer in all high-risk families. read more

• Join us in welcoming our newest Genetic Counsellor, Laura Winter. She will work alongside Melyssa Aronson, Kara Semotiuk and Spring Holter. read more

• We would like to thank Terri Berk for her 30 years of service and wish her a happy retirement.

Canadian Colorectal Cancer Consortium (C4)

• We are pleased to announce that the launch of the Canadian Colorectal Cancer Consortium (C4) since October 2013. read more

Ontario Pancreas Cancer Study (OPCS)

• Recruitment is proceeding well. Patients and families are happy to be able to take part in our research. We are involved in several collaborations with international, domestic and local investigators and papers have been published using data from the registry. read more

Ontario Familial Colorectal Cancer Registry (OFCCR)

• Dr. Tae Hart is currently collecting data from participants in the Ontario Familial Colorectal Cancer Registry to examine symptom management problems and quality of life in people who were diagnosed with colorectal cancer more than ten years ago. This study is currently funded by the Canadian Institute of Health Research. read more

Canadian Partnership Against Cancer (CPAC) Rectal Cancer Project

• PI: Erin Kennedy

• Co-PIs: Robin McLeod, Nancy Baxter, Marko Simunovic

• Funding Awarded: $903 000

• We would like to congratulate Dr. Erin Kennedy on the funding awarded to the Canadian Partnership Against Cancer (CPAC) Rectal Cancer Project that she will be spearheading it along with Dr. Robin McLeod. The CPAC Rectal Cancer Project is a multi-year project designed to improve the clinical outcomes for patients by implementing quality initiatives for rectal cancer across Canada.  These quality initiatives include (i) pre-operative staging using magnetic resonance image (MRI), (ii) multidisciplinary cancer conference (MCC), (iii)TME surgery and (iv) pathologic assessment using the Quirke method.    The implementation of these quality initiatives will be evaluated using a set of quality indicators developed for the study and reporting the degree to which each of these quality indicators is achieved at regular intervals on both a national and institutional level.  Additional site specific knowledge translation strategies will be used to further enhance the implementation of these quality initiatives at each individual centre.  This project is highly relevant as successful wide spread implementation of these quality initiatives will lead to improved and more standardized rectal cancer care and set a national standard for these quality initiatives across Canada.

FAP Study at Mount Sinai Hospital

• Cancer Prevention Pharmaceuticals recently opened a clinical trial, at the Zane Cohen Centre, evaluating a new drug combination for patients with Familial Adenomatous Polyposis (FAP). This study will determine if a combination drug treatment can work better than each drug alone in preventing the disease from getting worse. read more

• The purpose of this randomized, double-blind, Phase III trial is to determine if the combination of eflornithine plus sulindac is superior to sulindac or eflornithine as single agents in delaying time to the first occurrence of any FAP-related event. This includes: 1) FAP related disease progression indicating the need for excisional intervention involving the colon, rectum, pouch, duodenum and/or 2) clinically important events which includes progression to more advanced duodenal polyposis, cancer or death.

• More information can be obtained by visiting: ClinicalTrials.gov and search for study NCTO1483144 or visit www.canprevent.com.

INFLAMMATORY BOWEL DISEASE

IBD Research

• Since 2003, Dr. Silverberg’s IBD genetics and biomarkers research studies have included more than 6,000 participants. These studies have contributed to finding over 160 single nucleotide polymorphisms (SNPs), which are genetic markers associated with IBD.

• The role of the microbiome (gut bacteria) is actively being studied by Dr. Silverberg’s research group. Of particular interest is the impact of diet on the microbiome of individuals with IBD. Preliminary findings, in ulcerative colitis patients who’ve undergone an ileal pouch anal anastomosis (pelvic pouch), show that several groups of organisms are associated with pelvic pouch inflammation, with notable decreases in several bacteria with anti-inflammatory potential detected in individuals with inflammation. Of particular interest is the impact of diet on the microbiome in individuals both with and without IBD.

• In addition, Dr. Silverberg’s research group initiated a study investigating recurrence of inflammation in CD patients undergoing their first ileal resection surgery. This study has now been implemented in other North American centres as part of the NIH/NIDDK IBD Genetics Consortium.

• We are currently gearing up for Digestive Disease Week, an annual conference, being held in Chicago in early May. We have a large number of abstracts accepted to this international conference and are looking forward to sharing our research findings with physicians and researchers from around the world.

• For more information on how to get involved in our research studies, please go to our website: http://www.zanecohencentre.com/ibd/research

• Crohn’s and Colitis Canada and the Leona M. and Harry B. Helmsley Charitable Trust today announced the largest-ever funding commitment to Crohn’s disease research in Canada.  The funds will support the Genetics, Environmental, Microbial (GEM) Project, a Canadian-led international research study investigating the causes of Crohn’s disease.

• The $10 million funding commitment is made possible by a lead gift of $6 million from the Helmsley Charitable Trust, one of the largest family trusts in the United States, which includes a focus on Crohn’s disease amongst its funding priorities. The Helmsley Charitable Trust grant will be matched by a further $4 million in active fundraising from Crohn’s and Colitis Canada.

• Canadians have more reasons to be concerned about Crohn’s disease than anyone else in the world.  Canada has one of the highest rates worldwide. An estimated 130,000 Canadians have this lifelong disease. Most alarming, the number of new cases of Crohn’s disease in Canadian children has almost doubled since 1995.

• The GEM Project investigates the ways in which genetic predisposition, environmental influences and microbial interactions combine to determine if a person develops Crohn’s disease. To do this, researchers study healthy relatives – either siblings or children of people living with Crohn’s disease. To-date, the GEM Project has recruited more than 2,800 participants. The aim of the increased funding is to reach 5,000 recruits and the project is actively recruiting eligible participants.

• To participate in or learn more about the GEM Project, please visit www.gemproject.ca

IBD Centre of Excellence

• We are happy to report on continuation and expansion of the well-received IBDWell patient education and self-management program. read more

• Work is being done in the area of pediatric to adult transitioning of IBD patients via the Transition Clinic between SickKids and MSH and the IMPACT-IBD study of transition care being carried out by Geoff Nguyen and one of our new IBD Fellows – Natasha Bollegala.

SURGICAL PROGRAMS

Best Practice in General Surgery (BPIGS)

• The BPIGS group is currently developing guidelines for Diverticulitis, Pancreatitis, Bariatric Surgery-VTE prophylaxis, and Blood Conservation. read more

Implementation of Enhanced Recovery after Surgery (iERAS)

• The BPIGS group received a grant from the Council of Academic Hospitals of Ontario (CAHO) to implement our Enhanced Recovery After Surgery (ERAS) program at 15 centres across the province. read more

• We currently have data on over 1000 patients accruing approx. 50 patients per week, and our patient satisfaction survey has shown excellent results. read more