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Research Involvement

The BC Cancer Sindi Ahluwalia Hawkins Centre for the Southern Interior offers many opportunities for our staff, patients, and communities to participate in research.

Research projects support BC Cancer's goals of preventing and treating cancer, supporting patients through and after treatment, and finding better and more effective methods. Staff are involved in planning, delivering, and publishing the results of research. Patients may be involved with research projects which match their eligibility, and contribute to future improvements in cancer care. Communities support research projects through donations to the BC Cancer Foundation, and through raising awareness.

BC Cancer Foundation
The BC Cancer Foundation (BCCF) raises funds to support research and enhancements to care at BC Cancer and maintains offices at each of the BC Cancer centres. Below are some research initiatives at BC Cancer, SAHCSI, funded through BC Cancer Foundation.


Clinical Trials are research studies to examine or compare the effects of treatments on humans. The website has more information about clinical trials at SAHCSI, and about Clinical Trials Research in BC Cancer. If you have participated in clinical trials in BC, you may be invited to take a Clinical Trials Survey about your experiences, to help improve the experience of future research subjects.


The PREDICT project is another study open to many new patients at SAHCSI. Patients can voluntarily provide information now, which will be used in future research projects.

Research Initiatives
In addition to these, other studies every year explore prevention, treatment, and survivorship issues. Learn more below.

 
Your experiences and views are important and during your visits to the BC Cancer, Centre for the Southern Interior you may be asked to take part in one of our research studies. This request can raise many questions, so before you make your decision, feel free to discuss your concerns with any member of your care team. Partaking in a research project is entirely voluntary, and there will be no pressure or expectation put on you to participate.

Our professionals study new or improved cancer treatments, as well as ways to prevent and detect cancer. We are also interested in exploring the perceptions and experiences of our patients. These studies, called clinical trials, are an important part of our activity. Through these studies we hope to continuously learn how to provide better services for all patients in British Columbia.

Find out more about BC Cancer clinical trials, including currently open trials. If you have participated with clinical trials at the Sindi Ahluwalia Hawkins Centre for the Southern Interior, you may be invited to complete a clinical trials survey of your experiences. 

 
 

What Is PREDICT?

 

PREDICT (Personal Response Determinants In Cancer Therapy) is a BC Cancer research initiative that involves the collection of patient information and blood samples to form a bio-bank. A bio-bank is like a library but contains blood samples and other patient data instead of books. Researchers can apply to PREDICT to use patient data to investigate individual factors that contribute to cancer and responses to cancer therapies.

PREDICT began in 2006 at BC Cancer’s Vancouver Island Centre in Victoria, and in 2013 has expanded to the BC Cancer Sindi Ahluwalia Hawkins Centre for the Southern Interior (BCCA-SAHCSI) in Kelowna. Currently, Victoria has over 7,500 bio-specimens in the bio-bank for researchers to access. With PREDICT expanding to the BCCA-SAHCSI and possibly other BC centres in the future, PREDICT is well on its way of reaching the long term goal of collecting 20,000 samples for worldwide research.

PREDICT BCCA-SAHCSI aims to add a tumour tissue repository to the bio-bank in the next year.

Can I Participate?

To be eligible for PREDICT-SAHCSI, a patient must:

  • Be a patient at the BC Cancer Sindi Ahluwalia Hawkins Centre for the Southern Interior,
  • Have a new, confirmed cancer diagnosis,
  • Have had no chemotherapy or radiation treatment in the last 6 months,
  • Be 19 years or older, and
  • Be able to give informed consent

What Would I Be Consenting To?

To participate, you will be asked to:

  • Provide a small (one time) blood sample to be stored in the PREDICT bio-bank.This sample may be taken at the same time as other blood work your doctor has ordered.
  • Give permission to be contacted about future research projects you may be eligible for.
  • Give PREDICT permission to extract a few details from your medical record (i.e. diagnosis, age, gender)

How Do I Get Involved?

Your oncologist or the PREDICT Research Intern may offer you an opportunity to participate in PREDICT at one of your appointments (often the first appointment)
If interested in participating, speak with your oncologist, a nurse, or the PREDICT Research Intern
If you have questions, please call the Research Intern at 250-712-3966 ext 68-6711


Where Do I Donate My Blood For PREDICT?

Currently, blood draws MUST be taken at the Kelowna General Hospital (KGH) Laboratory 
Hours: Monday-Friday between 9:30am-1:30pm
Where is the KGH Laboratory?  See the KGH location map

Frequently Asked Questions

What if I decide that I am not interested in participating in PREDICT?

Participation is PREDICT is strictly voluntary. Regardless of if you decide to participate or not, your care will not be impacted in any way.

How is my confidentiality protected?

  • Blood samples are given a unique identification number so your identity cannot be traced by the researcher unless approval from the donor is given or from a research ethics board.
  • The computer is stored within a secure location. The database is password protected and is only accessible to PREDICT staff.
  • The signed consent form is stored on your BC Cancer chart.
What if I consent and change my mind?
Consent can be withdrawn at any time. To withdraw, simply contact the PREDICT Research Intern who will arrange for your blood sample to be destroyed and your name erased from the database. Your care will not be affected.

I'm not eligible. What can I do to help out PREDICT?

PREDICT is proudly supported and 100% funded by community donations through the BC Cancer Foundation. Without community donors and the support of BC Cancer Foundation, PREDICT-SAHCSI would not have been possible.

If you wish to make a donation to PREDICT-SAHCSI, contact the BC Cancer Foundation at:
(250) 712-3921 or toll free at 1-866-230-9988

Or visit www.bccancerfoundation.com for more details


Handouts for printing

PREDICT Informational Poster
PREDICT Informational Rack Card

Principal investigators

Dr. Peter Watson
BC Cancer, Vancouver Island Centre

Dr. Ivo Olivotto
BC Cancer, Vancouver Island Centre

For more information

Contact the PREDICT Research Intern at 250-712-3966 ext 68-6711 or toll free at 1-888-563-7773 (Victoria centre)


Visit the Victoria PREDICT website, or  www.bccrc.ca/dept/predict

2016 Projects Pending at SAHCSI 

Brachytherapy

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

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.


Proposed study protocol  ;  Consent form


2014 Projects at SAHCSI

Below are summaries of some current research initiatives at the Sindi Ahluwalia Hawkins Centre for the Southern Interior. Research interns and clinical staff work together on these projects, in hopes of furthering the goals of controlling cancer and reducing its impact on British Columbians. 

Projects described in past years are on these pages:


BioBanking and Cancer Control Research

Biology of Lymphoid Cancer (BioLym)

Samantha Gottfred, B.Sc
The BioLym project was initiated by the researchers at the Centre for Lymphoid Cancer at BC Cancer’s Vancouver centre and expanded into the Sindi Ahluwalia Hawkins Centre for the Southern Interior in June 2014. The purpose of BioLym is to support research investigating the biological, genetic and environmental mechanisms that cause lymphoid cancers, the determinants of their clinical behaviour, and how lymphoid cancer treatments work so that more efficient diagnostic tools and therapies can be developed to combat these cancers. An eligible patient provides a blood sample, permission to use leftover biopsy material post-diagnosis, and permission to be contacted to discuss participating in future lymphoma research projects. This resource has enabled the development of novel lymphoma treatments that have been tested and emulated worldwide and study of late complications of successful lymphoma treatment. New lymphoma patients at BCCA-SAHCSI can discuss participation with their oncologist or contact the BioLym-CSI Research Intern at 250-712-3966 ext 68-6887. 
Investigators: Dr. Janine Davies, Dr. Joseph M. Connors
Link for Centre for Lymphoid Cancer homepage, Vancouver site

Personal Response Determinants In Cancer Therapy (PREDICT )

Brittany Boorman, B.Sc. 
PREDICT is designed to support studies by giving investigators access to a permission to contact mechanism and a bank of blood samples from newly diagnosed cancer patients. Since its initiation by the BC Cancer Vancouver Island Center in 2006, over 20 research projects have utilized the blood specimens or the permission to contact basis for research on prostate, breast, colorectal, lung, and skin cancers. Since the establishment of PREDICT at the Sindi Ahluwali Hawkins Center for the Southern Interior in January of 2013, close to 1000 newly diagnosed patients from the interior have consented to participate, helping PREDICT to reach a milestone of  10,000 blood samples this year, half of the target goal.   
Investigator (CSI): Dr. Janine Davies
Predict homepage


Screening and Prevention

Trends in Mammogram Image Quality, Dose and Screen-Detected Cancer Rates in an Organized Screening Mammography Program

Brent Parker, B. Sc., Ashley Yip B. Sc.
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.
Publication link 
Investigators: Rasika Rajapakshe, PhD, Teresa Wight, RT, Nancy Aldoff, RT, Janette Sam, RT, Dr. Christine Wilson
Figure below: Age adjusted Cancer Detection Rates of invasive cancers ≤ 5mm per 10,000 screens between the years 1994-2005

 

Modeling Breast Cancer Screening and Care

Chelsea Vandenberg, B. Sc., Stephen Smithbower, B. Sc., Brent Parker, B. Sc., Chelsea Vandenberg, 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.
Publication link
Investigators: Rasika Rajapakshe, PhD, Cynthia Araujo, PhD, Dr. Chris Baliski, Dr. Susan Ellard, Laurel Kovacic, PharmD, Dr. Melanie Reed, Dr. Scott Tyldesley, Dr. Gillian Fyles, MD

Enhancement of the Breast Cancer Risk Information Collected at the Time of Screening

Chelsea Vandenberg, B.Sc. 
In order to provide more personalized screening regimens, it is important to know which women are at an elevated risk of developing breast cancer. Using data from the Breast Cancer Risk Assessment Project, the most significant and prevalent risk factors in the BC population were determined using the Tyrer-Cuzick risk calculation model which is the most accurate model currently available for predicting risk. The results show that the strongest predictive risk factor is having a first degree relative with breast cancer. Other important factors to collect information about include a more extensive family history of breast cancer, length of hormone exposure (endogenous or hormone therapy), and previous biopsies. Using this information, 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 (CSI): Rasika Rajapakshe, PhD

Estimating Diagnostic Reference Levels for Mean Glandular Dose within the Screening Mammography Program of British Columbia

Chelsea Vandenberg, B.Sc. 
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
Figure below 

  


Radiotherapy and Imaging

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, Bc. S. 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 (CSI): Dr. Juanita Crook, Deidre Batchelar, PhD

A tool to detect collisions between linear accelerators and patients during external beam radiation therapy

Duncan Szarmes, B. Sc. 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. This tool hopes to save time and avoid repetition of treatment planning, and its use will be evaluated over a period of time in order to determine its value and effectiveness.

Investigators (CSI): Rasika Rajapakshe, PhD, Gail Murray, BSc, RTT, ACT, Leigh Bartha, BSc, ACT
Figure below: Sample EBRT treatments reconstructed in a 3D simulation

  

Breast Cancer

A tool for the automated computation of dense tissue percentage from screening mammograms, to assist in the development of a comprehensive breast density model

Ethan Owusu, B. Sc. student
To construct a comprehensive model of breast tissue density, as it relates to the development of breast cancer, 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. Not only is it costly in this regard, but evidence suggests that current methods of estimating percentage of dense tissue in screening mammograms are subject to high levels of inter-observer and intra-observer variation, implying inconsistency in accuracy and precision on the part of the human mammogram analyst.

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 (CSI): Rasika Rajapakshe, PhD
Figures below: Sample BDen2 processed images

   

Completeness of Breast Cancer Operative Reports in a Community Care Setting

Jordan Eng, B. Sc. 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 (CSI): Dr. Chris Baliski

Lung Cancer

Development of a lung cancer surgical outcomes database for the Southern Interior of British Columbia

Christine Haslock, B. Sc., Ashley Yip, B. Sc., Brent Parker, B. Sc., Christina Weisstock, B. Sc., Stephanie Ruschiensky, B. Sc.
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


Prostate Cancer

Ultrasound-planned high-dose-rate prostate brachytherapy: Dose painting to the dominant intraprostatic lesion

Dr. Ana Ots (fellow), Dr.Miren Gaztanaga (fellow), Brent Parker, B. Sc.
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 (CSI): Dr. Juanita Crook, Matt Schmid, MSc, Cynthia Araujo, PhD, Michelle Hilts, PhD,Deidre Batchelar, PhD, Dr. Francois Bachand, Marie-Pierre Milette, PhD
Link to the study manuscript

Prostate Volume Downsizing with Degarelix Prior to Brachytherapy

Dr. Jim Rose (fellow), Dr. Ana Ots (fellow), Dr. Miren Gaztanaga, Brent Parker, B. Sc.
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 (CSI):  Dr. Juanita Crook, Dr. Francois Bachand, Dr. David Petrik


Colorectal Cancer

Use of Clinical and Pathological Factors to Develop a Prognostic Index to Predict High Risk of Recurrence in Patients with Stage II Colon Cancer

Breanne Cadham, B. Sc.
Stage II colon cancers generally have a favorable prognosis. However, various clinical and pathologic factors can be used to identify patients with “high risk” stage II colon cancer. This initiative will work to develop a scoring system for stage II colon cancer patients based on BC Cancer patient data. Once developed, this scoring system could be used by physicians to better estimate the risk of recurrence and the potential for benefit from adjuvant chemotherapy.
Investigators:   Dr. Janine Davies, Brent Parker, B. Sc., Dr. Winson Y Cheung


Advance Care Planning

Survey of Engagement with Advance Care Planning; Pilot in Cancer Patient Population

Brent Parker, B. Sc.
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


Treatment Outcomes

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. These systems can improve healthcare delivery for patients, healthcare providers and healthcare systems. As a proof of principal, this concept was piloted at the Cancer Centre for the Southern Interior to over 1,000 individuals that had been treated for prostate cancer. The pilot demonstrated that the pilot 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.
Web-Based Follow Up Project homepage 
Investigators (CSI): Rasika Rajapakshe, PhD, Cynthia Araujo, PhD, Dr. Juanita Crook
Figure below: Webfollowup pilot study participation rates stratified by age and rural vs. urban status

Data Visualization: A Disease, Treatment and Outcomes Dashboard for a Breast Cancer Registry

Stephen Smithbower, B. Sc., Brent Parker, B. Sc.
Simple to use data visualization tools give clinicians and researchers the ability to examine trends in breast cancer risk factors, disease types, treatment strategies, and cancer outcomes. A computer desktop-based data visualization dashboard was developed to obtain and display this data hosted within a study database. The platform’s user interface continues to be improved upon so that it can accommodate up-to-date and real time data visualization of the breast cancer journey that comparable cohorts of women underwent, from diagnosis to treatment to survivorship and/or palliative care.
Investigators (CSI): Rasika Rajapakshe, PhD

Also see our archive of projects described in past years:

Below are some examples of research which has taken place at the BCCA Sindi Ahluwalia Hawkins Centre for the Southern Interior.


2011 Initiatives

Comparison of Sennosides and PEG for Constipation in Outpatients with Cancer

Constipation is a significant problem for many cancer patients. This study is looking at whether there is a more tolerable and as effective treatment than what is currently recommended. The study is a randomized double blind double dummy crossover design. For further information, please email ldalgleish@bccancer.bc.ca 
Investigator: Dr. Gillian Fyles

Estimation of Breast Cancer Risk Distribution in Three Sample Populations in BC

Early detection is one of the best opportunities to reduce mortality from breast cancer for women who have a high risk of developing breast cancer at a relatively young age. Unfortunately, mammography, the gold standard in breast cancer screening is not very effective in detecting cancer in these young women. However, screening women at high risk with magnetic resonance imaging (MRI) has been shown to detect tumors at an early stage.  However, there is no information available in BC about the number of women who have high risk. This research project answers the clinical question of whether MRI screening will be required for a substantial proportion of BC women based on the current scientific knowledge. 
For further information please go to www.breastcancerrisk.ca
Investigator: Rasika Rajapakshe, PhD.

2010 Initiatives

On the Road Again: Patient Perspectives on Commuting for Palliative Care

The aim of this research was to gain an understanding of the experiences of rural cancer patients who commute to an urban cancer centre for palliative care. Qualitative findings included three major themes: cultures of rural life and care, strategies for commuting, and the effects of commuting. Participants valued their rural lifestyles and gained significant support from their communities.

Strategies included preparing for the trip with particular attention to pain management, making the most of time, and maintaining significant relationships. Establishing a routine helped to offset the anxiety of commuting.

Rural lifestyles are often an important part of overall well-being and commuting for care is both costly and complex. Health care providers should assist individuals to weigh the relative contributions of staying in their rural locale versus commuting for care to their overall quality of life. Further research is needed to understand why patients are reluctant to seek help.

journal article has been published about this research. A booklet for patients and families, It Takes a Team, is also available online.

Investigators: Barbara Pesut, R.N., PH.D, Carole A. Robinson, R.N., PH.D., Joan L. Bottorff, R.N., PH.D, Gillian Fyles, M.D., and Sandra Broughton, B.A., M.SC

2012 Projects at SAHCSI

Some of the projects below have continued into the present. Check our current Research Initiatives page for details on new and updated investigations.

BioBanking and Cancer Control Research

Personal Response Determinants In Cancer Therapy (PREDICT)

Stephanie Ruscheinsky, B.Sc. 
PREDICT began in the BC Cancer Vancouver Island Centre in 2006 and expanded to the Sindi Ahluwalia Hawkins Centre for the Southern Interior in January 2013. The purpose of PREDICT is to support research investigating host factors associated with cancer and responses to cancer therapies, by engaging BCCA staff and newly diagnosed patients. An eligible patient provides a blood sample and permission to be contacted to discuss participation in future research projects. This biobank of samples, and increased number of research participants, will help translate future research into improved treatments and better patient care. New, adult patients at BCCA-SAHCSI can discuss participation with their oncologist or contact the PREDICT-CSI Research Intern at 250-712-3966 ext 68-6711. 

Investigator (CSI): Dr. Janine Davies 
Predict homepage, VIC Victoria


Screening and Prevention



The Breast Cancer Risk Assessment Project

Christina Weisstock, B.Sc. 
Routine mammography can be supplemented with breast MRI to identify malignancies at earlier, less invasive stages. In order to maximize the benefits and reduce harms, only high risk women are recommended to receive MRI screening in adjunct with regular mammograms. To determine the proportion of women in BC at high breast cancer risk, women from the Screening Mammography Program (SMP) were surveyed on personal risk factors and family cancer history. Each woman’s risk of developing breast cancer was computed using the Tyrer-Cuzick risk assessment model. Women were then classified as having low, moderate, or high risk of breast cancer. The resulting risk distribution was extrapolated to the provincial population, and the number of additional MRI machines required to screen these women were estimated. These results may be used to inform decision making regarding resource allocation for breast cancer screening in British Columbia. 
More information on this project. 

Investigators: Rasika Rajapakshe, PhD 


Cloud-Based Automated Mammography Quality Control

Stephen Smithbower, B.Sc. 
Regular quality assurance tests are performed on mammography units in order to ensure that the machines are operating normally. These tests, while simple, can often end up taking a fair bit of time as image acquistion requires careful setup - the results must be manually entered in to a computer, stored in a database, and reviewed later on. We have developed a quality control platform that can automatically perform the required tests, stores them in a database, and provides web-based reports to enable technologists to share and review the data easily. Technologists are only required to take the appropriate diagnostic image, uploaded the image to the BC Transfer Grid, and then log in to the mQC website to review the computer-generated results. 
Investigators: Rasika Rajapakshe, PhD



Enhancement of the Breast Cancer Risk Information Collected at the Time of Screening

Chelsea Vandenberg, B.Sc. 
In order to provide more personalized screening regimens, it is important to know which women are at an elevated risk of developing breast cancer. Using data from the Breast Cancer Risk Assessment Project, the most significant and prevalent risk factors in the BC population were determined using the Tyrer-Cuzick risk calculation model which is the most accurate model currently available for predicting risk. The results show that the strongest predictive risk factor is having a first degree relative with breast cancer. Other important factors to collect information about include a more extensive family history of breast cancer, length of hormone exposure (endogenous or hormone therapy), and previous biopsies. Using this information, a questionnaire intended for women who participate in the Screening Mammography Program of BC was drafted which included family history as well as the other important risk factors investigated in this study. 

Investigators: Rasika Rajapakshe, PhD 


Estimating Diagnostic Reference Levels for Mean Glandular Dose within the Screening Mammography Program of British Columbia

Chelsea Vandenberg, B.Sc. 
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. 

Investigators: Rasika Rajapakshe, PhD


Stratification of the 5-year Cancer Detection Rate using the Gail model as a Breast Cancer Risk Prediction Tool 

Brent Parker, B.Sc. 
Although it has been established that screening mammography programs significantly reduce breast cancer related mortality, screening a population based on limited factors, such as age alone, may not be the most beneficial and effective method of delivering screening programs. Thus, as breast cancer screening continues to evolve, it will likely become increasingly personalized based on a woman’s risk factors. Therefore, risk prediction models have the potential to play a significant role in recommending screening frequency and screening methods for a particular woman. This project will determine if the Gail model (Breast Cancer Risk Assessment Tool) could be used as a tool within the Screening Mammography Program of British Columbia to stratify risk of developing cancer, so that high-risk British Columbian women could be screened more effectively. 
View the Gail Model 

Investigators: Rasika Rajapakshe, PhD


Using Consumer Graphics Hardware to Accelerate Breast Cancer Simulations

Stephen Smithbower, B.Sc. 
Modeling and simulation are powerful tools for estimating the impact of various policy decisions (such as screening women at high risk for breast cancer with MRI). Unfortunately such simulations are also very computationally complex, taking hours or even days for results to become available while we simulate the lives of women who have breast cancer one person at a time. Our work focuses on using consumer graphics hardware, originally designed to power the graphics in modern video games, to speed up our models by simulating the lives of thousands of women in-parallel. We hope to reduce the run-times for our simulations from days to hours, and from hours to minutes. 
Investigators: Rasika Rajapakshe, PhD


Radiotherapy and Imaging 


Development Of A Software Based Automatic Exposure Control For Varian On-Board Imaging

Daniel Morton, B.Sc. 
Modern image guided radiation therapy involves the use of a mounted on-board imager (OBI) to take images of a patient’s position before each treatment. These images are used to determine the treatment couch shifts required for ideal alignment based on digitally reconstructed radiographs created in treatment planning. The lack of an automatic exposure control (AEC) on Varian OBI systems requires x-ray exposure factors to be selected manually from technique factors tables which are based on general population data. This may result in over or under exposed images for certain patients and compromise the accuracy of the image matching. A software based AEC system will be able to predict the optimal, patient specific exposure factors based on patient planning data. This will allow us to accurately choose the techniques that will give the highest quality image to use in image matching, while eliminating the need for multiple unnecessary exposures. 

Investigators: Rasika Rajapakshe, PhD and Cynthia Araujo, PhD


Breast Cancer

Mapping of Breast Cancer Care Paths

Chelsea Vandenberg, B.Sc. 
A comprehensive map of the breast cancer care paths used in British Columbia was developed, including early detection, diagnosis, treatment (surgery, chemotherapy, and radiotherapy), survivorship and end-of-life care. Principles of the model are based on the lung cancer model published by the Canadian Partnership Against Cancer (CPAC). Information for the care paths was collected from published material online as well as from expert opinion in the fields of radiology, radiation oncology, surgical oncology, medical oncology, and palliative care. This map contributes to a model of breast cancer in B.C., which can evaluate the impact of screening and other treatment interventions on downstream factors such as population health and costs to the healthcare system. 

Investigators: Rasika Rajapakshe, PhD and Cynthia Araujo, PhD


Pharmaceutical and Screening Data

Brent Parker, B.Sc. 
It is essential that the Breast Cancer Care Model incorporates screening and pharmaceutical factors. The model will reflect future changes in care, as new chemotherapy regimens (pharmaceuticals) are continually being assessed and implemented, and optimal mammographic screening policies have yet to be determined and will continue to be improved on as research allows. These aspects of the model are designed carefully so researchers and policy makers will be able to predict how such changes will impact breast cancer care, costs, and outcomes. 

Investigators: Rasika Rajapakshe, PhD and Cynthia Araujo, PhD


Quantitative Evaluation of Overall Breast Cancer Burden 

Christina Weisstock, B.Sc. 
A breast cancer diagnosis has wide-ranging effects on a woman and her family, both immediate and long-term. Although previous studies have investigated the discrete physical, psychological and financial impacts of breast cancer, none have comprehensively quantified the overall impact of a breast cancer diagnosis on the patient and family. This project calculates the breast cancer burden in the context of the family system, and will be incorporated into the complete breast cancer micro-simulation model. 

Investigators: Rasika Rajapakshe, PhD and Cynthia Araujo, PhD


Lung Cancer 

Validation Of CPAC Lung Cancer Model Based On Data From Lung Cancer Patients In The Interior Health Catchment Area 

Stephanie Ruschiensky, B.Sc. 
Currently, a database is being assembled to organize and analyze trends in lung cancer patient data from the Interior Thoracic Surgery Group, including a range of patients from the interior and southern regions of BC. Parameters such as patient medical history, lung cancer staging and diagnosis, treatments, and dates of consults and treatments, will go into the database. The patient database will be used to validate the Canadian Partnership Against Cancer (CPAC) Cancer Risk Management Model for lung cancer. If the CPAC model is shown to be valid in BC patients, it can predict the impact of potential lung cancer screening programs, including patient survival rates and costs to the healthcare system. In the future, the lung cancer patient database would improve care by tracking other trends and problems within lung cancer care, such as wait-times. 


Investigators: Dr. Bill Nelems, Dr. Michael Humer, Rasika Rajapakshe, PhD and Cynthia Araujo, PhD


Prostate Cancer 

A Brachytherapy Trial Comparing Anchorseeds® to Traditional Loose Seeds

Brent Parker, B.Sc. 
Permanent seed brachytherapy is a highly effective treatment for localized prostate cancer, however, when loose brachytherapy seeds are used, they can move around within the tissue, leading to decreased dosages to the tumor site and unwanted dosages to the urethra and erectile tissues. In this study we found that a new type of seed, which is a specially engineered coated seed known as AnchorSeeds®, reduces movement of inferiorly placed seeds within the prostate. 
Also called the FAST Trial 


Investigators: Dr. Juanita Crook



Prostate Cancer Web Follow-Up 

Andrew Moldovan 
Many treatment options are available for prostate cancer patients at the BCCA Sindi Ahluwalia Hawkins Centre for the Southern Interior (SAHCSI) including 3DRTP, IMRT, Permanent Seed Brachytherapy implants and High Dose Rate Brachytherapy. In order to effectively compare these treatments, long term patient follow-up is required. However, about 75% of these patients, a significant portion, live in remote areas outside the Central Okanagan region. It is a hardship for patients to repeatedly travel back to SAHCSI for follow-up. Therefore we are developing a web based follow-up system for prostate cancer patients, as a cost effective means of gathering long term follow-up data, which will reduce patient travel requirements. Data entered by patients is automatically evaluated by the software to notice any abnormal results and a physician is immediately notified in that case. Physicians can also view all patient data in real time. The system is now fully functional and undergoing Alpha testing. The website will soon be piloted to evaluate the acceptability of the program and the resources needed to maintain such a system.


Web-Based Follow Up Project homepage


Investigators: Rasika Rajapakshe, PhD, Cynthia Araujo, PhD, Andrea Wolowski and Dr. Juanita Crook

See also our 2010-2011 Research at SAHCSI for descriptions of additional selected projects. 


SOURCE: Research Involvement ( )
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