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Research Initiatives

BC Cancer – Kelowna is the site of many significant research projects.

This page outlines the research projects being done at BC Cancer – Kelowna. If you are interested in being involved in current research at BC Cancer, please visit the Research Involvement page.

Current research
A Phase II Randomized Pilot Study of Low Dose Rate Compared to High Dose Rate Prostate Brachytherapy for Favorable Risk and Low Tier Intermediate Risk Prostate Cancer (Proposed)
Juanita Crook, MD, Francois Bachand, MD
This study compares low dose rate permanent seed brachytherapy for prostate cancer to high dose rate (HDR) brachytherapy, looking primarily at Quality of Life and recovery from treatment. The study also involves multiparametric MRI staging of the cancer, and provides the opportunity for Cell Cycle Progression genetic testing of each cancer to look at how aggressive the cancers are and how this correlates with outcome.

Populating An Epidemiological Model For Breast Cancer With Systemic Treatment Costs In British Columbia
Joyce Epp B.Sc, Breanne Cadham B.Sc, Tony Culos, Rebecca Mlikotic B.Sc (2013), Brent Parker B.Sc (2014)
A comprehensive map of the breast cancer care paths used in British Columbia was developed, involving areas such as screening, diagnosis, treatment, and survivorship. This map forms a framework from which a micro-simulation model of breast cancer in BC will be developed and validated. Chemotherapy costs have been added to the map and, once completed; the model will evaluate the impact of screening on chemotherapy costs. 
Investigators: Rasika Rajapakshe BSc, MSc, PhD, FCCPM

Validation of Volumetric Breast Density as a Risk Factor for Breast Cancer Screening
Zifang Jiang, BSc Student
Mammographic breast density has the potential to be used in risk assessment models as a predictor for breast cancer risk and a predictor for survival outcomes following treatment. This study aims to validate three-dimensional measures of breast density as a risk factor for breast cancer. Furthermore, the study will examine if and how volumetric breast density is associated with tumour characteristics, breast cancer subtypes and survival outcomes following treatment.Screening mammograms and risk assessment questionnaires will be collected from 190,000 women in B.C. over two years. 
Investigators: Rasika Rajapakshe  BSc MSc PhD FCCPM
Development of Ultra-High Resolution CT for Differential Diagnosis of Lung Nodules Found Using Low-Dose CT 
Marc Jutras, BSc Student
The objective of this study is to observe and compare lung tissue samples, both normal and malignant, using micro-computed tomography (micro-CT), in order to identify the key features prevalent within the malignant tissues using the normal tissue as a control. Using micro-CT technology to examine the tissue samples, one may be able to classify tissue as abnormal or malignant by detecting significant features which normally cannot be identified with conventional LDCT scanning. This project will also allow for the determination of the optimal resolution needed during lung nodule imaging in order to bring about a correct malignancy diagnosis.
Investigators: Rasika Rajapakshe, PhD, FCCPM, Thorarin A. Bjarnason, PhD, Michael F. Humer, MD, Derek Hyde, PhD, Diana Ionescu, MD, Qiuyan Y.L.Li, MD, John R. Mayo. MD, Islam Mohamed, MD, Andre Phillion, PhD, William A. Stinson, Marc Jutras

Experimental Validation of VMAT Planning for Prostate Cancer Patients 
Leo Sporn, BSc Student
With the aging population, more prostate cancer patients with hip prostheses receive radiation treatment.  The issue with hip prostheses is that they create substantial artifacts on the CT images which are used by the treatment planning system to generate and evaluate the quality of the radiation treatment plan. In a recent study we investigated using more complex planning techniques such as Volumetric Modulated Arc Therapy (VMAT) for prostate cancer patients with hip prostheses.  This study resulted in a VMAT planning technique which was designed to minimize as much as possible the amount of radiation entering through the hip prostheses. The goal of this project is to validate and quantify the uncertainty (if any) of this VMAT planning technique experimentally.
Investigators: Marie-Pierre Milette, PhD

Quantitative techniques for permanent breast seed implant brachytherapy
Daniel Morton, MSc
Permanent breast seed implant brachytherapy is a novel and appealing treatment option for early-stage breast cancer patients, but the current procedure is technically challenging and difficult to implement. My work aims to improve the accuracy and reproducibility of this procedure through the implementation of 3D ultrasound and precision image guidance in treatment planning and delivery.
Investigators: Michelle Hilts, PhD; Deidre Batchelar, PhD; Juanita Crook, MD
Development of a Prognostic Index to Predict High Risk of Recurrence in Patients with Stage II Colon Cancer
Breanne Cadham, BSc, Brent Parker, BSc
Stage II colon cancers are generally considered to have a favourable prognosis, with 5- year overall survival of at least 80%. However, various disease characteristics, and potentially genetic markers, can be used to identify patients with “high risk” stage II colon cancer; these individuals typically have a poorer prognosis than those without high-risk features. This study aims to identify prognostic features that predict an increased risk of recurrence among patients with stage II colon cancer and subsequently develop a clinically useful scoring system, called a prognostic index, based on these factors.
Investigators: Dr. Janine Davies, Yaling Yin 

Improving Communication and Decision-Making in Cancer Patients (iCANCER)

Breanne Cadham, BSc

Our system is faced with an increasing demand for services at end of life that are contributing to escalating costs and unsustainable utilization patterns. Advance Care Planning discussions may offer some assistance with reducing health care costs while improving quality of care for older Canadians. In this project we are evaluating the feasibility and acceptability of Advance Care Planning informational resources, both web and paper based, in ambulatory oncology setting.

Investigators: Gillian Fyles, MD, Carole Robinson, PhD, RN, Erin McFee, BSN, RN 


Feasibility Of Implementing A Web-Based Patient Follow-up Platform Into BC Cancer For Improving Quality Of Life Care And Research

Bhavan Panghali, Breanne Cadham, BSc

Limited long-term records are available for patients who have completed treatment at the BC Cancer-CSI possibly due to a lack of an efficient follow-up infrastructure. This project will evaluate the success of an online platform for the collection of patient reported outcomes of BC Cancer-CSI patients. To do so, patients’ demographics and preferred method of follow-up will be determined. As well, patients will be educated of the benefits of online follow-up to estimate likelihood of patient use.

Investigators: Rasika Rajapakshe, PhD, FCCPM, HCISPPSM, Sara Taylor, MD



Trends in Mammogram Image Quality, Dose and Screen-Detected Cancer Rates in an Organized Screening Mammography Program
Brent Parker, BSc, Ashley Yip, BSc
A study was conducted to analyze the trends in the Screening Mammography Program of British Columbia’s quality assurance and outcomes data from 1994 onwards to investigate any correlation between improvements in image quality (IQ), changes in radiation dose delivered per screen and detection of breast cancers.  Interestingly, improvements in image quality was related to increased detection of small tumours.
Investigators: Rasika Rajapakshe, PhD, Teresa Wight, RT, Nancy Aldoff, RT, Janette Sam, RT, Dr. Christine Wilson

Modeling Breast Cancer Screening and Care
Chelsea Vandenberg, B. Sc., Stephen Smithbower, B. Sc., Brent Parker, B. Sc., Breanne Cadham, B. Sc., Rebecca Mlikotic, B. Sc.
Breast cancer screening with mammography has been shown to reduce breast cancer mortality. However the frequency and the age range for screening eligibility has been controversial. Therefore a mathematical cancer control model for breast cancer using data from the province of BC is being developed to model different early detection strategies. Once the model is validated, it will be possible to test early detection strategies, and health care costs associated with breast cancer detection, diagnosis, treatment and on-going care.
Investigator: Rasika Rajapakshe, PhD

Enhancement of the Breast Cancer Risk Information Collected at the Time of Screening
Chelsea Vandenberg, BSc
In order to provide more personalized screening regimens, it is important to know which women are at an elevated risk of developing breast cancer. Our results show that the strongest predictive risk factor is having a first degree relative with breast cancer. A questionnaire intended for women who participate in the Screening Mammography Program of BC (SMPBC) was drafted which included family history as well as the other important risk factors investigated in this study. Discussion of results with the SMPBC is leading to a more risk-based screening approach.
Investigator: Rasika Rajapakshe, PhD

Estimating Diagnostic Reference Levels for Mean Glandular Dose within the Screening Mammography Program of British Columbia
Chelsea Vandenberg, BSc
After obtaining radiation data from all of the sites in the Screening Mammography Program (SMP) of BC, the analytic model described by Dance et al. was used to estimate the average and range for mean glandular dose (MGD) and compressed breast thickness at each SMP site. This data was analyzed to compare the difference in MGD and compressed breast thickness for analog (film/screen) units versus digital radiography units. Data was also compared to previously collected data in 2007 to note any changes. The baseline between 2007 and 2011 was the same, but the results showed that the digital units delivered 40% less dose than the analog units. 
Investigator: Rasika Rajapakshe, PhD
Comparison of Rigid Registration Between Prostate MRI and US to Deformable Registration for Localization of the Dominant Intraprostatic Lesion for the Purposes of Intraprostatic Dose Escalation Using High Dose Rate Brachytherapy
Annie Collins, BSc student
Brachytherapy is a form of radiation that places radioactive sources directly into the prostate, permitting delivery of a higher radiation dose. If the cancer within the prostate can be imaged, then the dose of radiation can be selectively escalated using brachytherapy, such as to ablate even larger and more aggressive lesions.  MRI data can be transferred to ultrasound images in order to enable this escalation.  This project compares the dose of radiation received by the dominant intraprostatic lesion when the images are combined using rigid registration (where the images are translated and rotated) versus deformable registration (where the MRI is warped to account for differences in prostate shape). 
Investigators: Dr. Juanita Crook, Deidre Batchelar, PhD

A tool to detect collisions between linear accelerators and patients during external beam radiation therapy
Duncan Szarmes, BSc student
During external beam radiation therapy the linear accelerator rotates around the patient, who is lying on the treatment table, and administers concentrated radiation to the cancer. One problem that may occur during treatment is a collision with the linear accelerator and the patient; this results in the treatment being stopped and re-planned, which is a time consuming process that affects both the radiation therapists and the patient.  This study involves developing a tool that simulates the radiation treatment on a computer, before the patient is brought in for the actual treatment. This will allow radiation therapists to check for collisions and adjust the treatment plan prior to treatment delivery, saving time and avoiding repetition of treatment planning.
Investigators: Rasika Rajapakshe, PhD, Gail Murray, BSc, RTT, ACT, Leigh Bartha, BSc, ACT

Tool for automated computation of dense tissue percentage from screening mammograms
Ethan Owusu, BSc student
To construct a comprehensive model of breast tissue density, the percentage of dense tissue must be collected from a large number of screening mammograms and cataloged. This is a problem, because the estimation of dense tissue currently requires a significant amount of time and human resources. A possible solution lies in the implementation of a fully automated breast density computation and classification algorithm, that would provide consistently accurate and precise measurements in less time, and with little or no human resources or supervision. When complete, the highly portable BDen2 software package will fulfill this role on whatever system or server it is assigned to, leading to faster results in development of a comprehensive breast density model.
Investigator: Rasika Rajapakshe, PhD
Ultrasound-planned high-dose-rate prostate brachytherapy: Dose painting to the dominant intraprostatic lesion
Dr. Ana Ots (fellow), Dr.Miren Gaztanaga (fellow), Brent Parker, BSc
There is evidence from multiple randomized trials that higher radiation doses are required to optimize local control and improve disease-free survival in men with localized prostate cancer and this study investigated the feasibility of using high-dose-rate (HDR) brachytherapy to deliver 125% of the prescription dose to the dominant intraprostatic lesion (DIL) while respecting critical organ dose constraints. The results of this study show that modest dose escalation to the DIL (25–30%) using ultrasound-planned HDR brachytherapy is feasible for selected intermediate- and high-risk patients while respecting critical organ constraints and is achievable within the practice setting of a community cancer center.
Investigators: Dr. Juanita Crook, Matt Schmid, MSc, Cynthia Araujo, PhD, Michelle Hilts, PhD,Deidre Batchelar, PhD, Dr. Francois Bachand, Marie-Pierre Milette, PhD

Prostate Volume Downsizing with Degarelix Prior to Brachytherapy
Dr. Jim Rose (fellow), Dr. Ana Ots (fellow), Dr. Miren Gaztanaga, Brent Parker, BSc
This study assesses the effectiveness of the LHRH antagonist Degarelix in downsizing the prostate prior to brachytherapy (BT) and to evaluate testosterone recovery testosterone recovery. The study is ongoing and preliminary results suggest a consistent and rapid pre-BT prostate volume reduction for the majority of patients after 8 weeks of Degarelix administration with volume stability maintained through the implant period and rapid testosterone recovery commencing as early as within a month following BT. 
Investigators:  Dr. Juanita Crook, Dr. Francois Bachand, Dr. David Petrik

A pilot study of a web-based follow-up platform for collecting quality of life outcomes.
Brent Parker B. Sc., Andrew Moldovan, B. Sc.
As technologies improve and as Canadians become more comfortable using computers and other internet devices, there is an increasing potential to use online platforms as a means of communicating with patients to monitor health.  This stiudy demonstrated that the a pilot healthcare delivery system meets provincial and institutional security, privacy, and ethical regulations. Participation rates from this study indicate that many individuals are interested in engaging in web-based post-treatment follow-up, suggesting that web-based systems are a feasible way to implement treatment related quality of life questionnaires.
Investigators: Rasika Rajapakshe, PhD, Cynthia Araujo, PhD, Juanita Crook, MD

Completeness of Breast Cancer Operative Reports in a Community Care Setting
Jordan Eng, BSc student
Operative reports represent the primary means by which surgical breast cancer data is communicated from the operating surgeon to other care providers. This data is used to inform prognosis and aid management decisions. Despite their importance, these reports have often been shown to be incomplete. We investigated the completeness of breast cancer operative reports in the Interior Health Authority, and examined some factors which may influence the completeness of breast cancer operative reports.
Investigator: Dr. Chris Baliski

Development of a lung cancer surgical outcomes database for the Southern Interior of British Columbia
Christine Haslock, BSc, Ashley Yip, BSc, Brent Parker, BSc, Christina Weisstock, BSc, Stephanie Ruschiensky, BSc
Researchers and physicians in Kelowna are developing a lung cancer surgical outcomes database in order to identify and quantify the challenges related to access to lung cancer care and treatment across the Interior and Northern Health areas of British Columbia. If differences of access to care are apparent, ways to rectify these challenges will be identified.
Investigators:  Rasika Rajapakshe, PhD, Dr. Michael Humer, Cynthia Araujo, PhD
Survey of Engagement with Advance Care Planning; Pilot in Cancer Patient Population
Brent Parker, BSc
Our health care system is facing aging populations and patients are living longer with chronic illness.  Advance Care Planning (ACP) may offer some assistance with reducing health care costs while improving quality of care for older Canadians. This study validates measurement tools that will allow for improved ACP research in the future so that health professionals can better use ACP to improve patient, provider, and health care system outcomes.
Investigators: Dr. Michael McKenzie, Dr. Gillian Fyles, Carole Robinson, PhD


Study descriptions will be moved from the Research Involvement page to this tab shortly.

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