Up to 84% of Canadians will experience low back pain at some point in their life.
Back pain can be caused by many things, and patients sometimes have to wait a long time before they can see a specialist to have the cause of their back pain diagnosed—years in some cases. This is much too long for some back pain-causing conditions such as axial spondyloarthritis (SpA).
SpA is a form of arthritis that affects the spine and can produce back pain and stiffness. If left untreated, it can lead to severe pain, back deformities and significant disability.
One of the factors that delays diagnosis is the lack of access to rheumatologists, who are doctors specialized in the care of arthritis and other diseases that affect the musculoskeletal system.
A new study led by Krembil Clinician Investigator Laura Passalent examined whether an alternative model of care could help accelerate the detection of SpA for those living with back pain.
The alternative model involved using physiotherapists to supplement the role of rheumatologists. The physiotherapists were provided with additional training to determine whether back pain is likely to be caused by SpA. While physiotherapists typically diagnose and treat different types of injuries, diagnosing SpA is traditionally outside of the scope of their role.
As part of the study, the specially trained physiotherapists assessed 57 patients with back pain for SpA. The records of the same patients were also independently assessed by three rheumatologists.
Ms. Passalent and the other researchers involved in the study found that the diagnoses offered by the physiotherapists agreed with those provided by the rheumatologists up to 80% of the time. The assessment offered by each of the three rheumatologists also matched up to 80% of the time. These findings indicate that the specially trained physiotherapists are comparable to rheumatologists at diagnosing SpA.
“Our study suggests that health care practitioners extending their role, with suitable training, could help reduce bottlenecks in the health care system and improve access to care for SpA patients,” says Ms. Passalent.
This work was supported by the Canadian Initiative for Outcomes in Rheumatology cAre (CIORA).
Passalent L, Hawke C, Lawson D, Omar A, Alnaqbi K, Wallis D, Steinhart H, Silverberg M, Wolman S, Derzko-Dzulynsky L, Haroon N, Inman RD. Advancing early identification of axial spondyloarthritis: An interobserver comparison of extended role practitioners and rheumatologists. J Rheumatol. 2019 May 1. doi: 10.3899/jrheum.180787
Dr. John Dick, Senior Scientist at Princess Margaret Cancer Centre is this year’s recipient of the Dr. Chew Wei Memorial Prize in Cancer Research administered by the University of British Columbia (UBC) Faculty of Medicine.
The award is presented annually to a Canadian physician or scientist who has made outstanding contributions toward the development of anti-cancer therapies. Valued at $50,000, the Dr. Chew Wei Memorial Prize in Cancer Research is among the most esteemed honours granted by a Canadian university.
Dr. Dick is internationally recognized for discovering the origins of leukemia through the identification of leukemia stem cells (LSCs)—the first type of cancer stem cells to be isolated and characterized. Since this landmark discovery, Dr. Dick has continued to advance the field by showing that LSCs are roadblocks to successful therapy and a root cause of relapse. This work has led to many clinical applications including new biomarkers to predict response to therapy as well as new therapeutic strategies for leukemia.
The honour adds to the remarkable list of awards that Dr. Dick has received over his career. His past distinctions include his election as a Fellow of the Royal Society of London, Fellow of the Royal Society of Canada and Fellow of the American Association for Cancer Research Academy. He has also received the William Dameshek Prize and the E. Donnall Thomas Prize from the American Society of Hematology, the KEIO Medical Science Prize from KEIO University in Japan and the Innovation Award from the International Society for Stem Cell Research.
The award will be presented to Dr. Dick at the UBC Faculty of Medicine’s National Research Awards Dinner this fall.
To read more about the prize, click here.
The UHN Office of Research Trainees (ORT) is proud to announce the release of the latest issue of The ORT Times!
The ORT Times is UHN's monthly trainee-focused newsletter. It highlights news and editorials about trainee life, articles to help developing researchers get the most out of their training experience at UHN, tips on career development, and research training opportunities within and outside of UHN.
Feature Stories:
● Krembil Research Day
● Strategic Research Plan and Trainees
● Failure Breeds Success
● UHN CIHR Award Recipients
Conference Reports: Read conference reports from Brian Chan, Geethu Emily Thomas, Mitchell Adamson and Tayler A. Buchan.
Read and download the full issue now!
To see past issues of The ORT Times, please visit ORT’s website here.
It is always useful to have a backup plan, especially when it comes to deciding how to treat cancer.
Having more information about a cancer’s genetic makeup enables clinicians and patients to make faster and more effective treatment decisions using a precision medicine approach. Yet, gathering complete genetic data in a timely manner remains a challenge.
Current clinical practice guidelines recommend that individuals recently diagnosed with lung cancer—the leading cause of cancer-related death—have their cancer tested for at least eight cancer-related genetic changes. However, despite these recommendations, a large number of patient tumours are not tested.
“In lung cancer, there are a number of approved drugs that may benefit individuals with certain changes in their tumour DNA,” explains Dr. Natasha Leighl, lead author of the study and medical oncologist at Princess Margaret Cancer Centre. “Testing for these changes (known as biomarkers) can identify patients who are likely to benefit from treatment with targeted therapy.”
Incomplete genetic testing is common for a number of reasons, including the lack of sufficient tumour tissue, and the fact that testing can take a considerable amount of time. Consequently, treatments are often started before the results become available, as patients are unable to wait.
To address this issue, Dr. Leighl’s team evaluated a quicker and simpler approach to profile cancers using tumour DNA that is present in the blood.
They found that the blood test was faster at returning results, identified biomarker changes at a rate comparable to profiling tumour tissue and increased the number of individuals who received complete biomarker analysis.
“Our findings suggest that biomarker testing of patients using tumour DNA found in blood is a suitable alternative in scenarios where tumour tissue and time are limited,” says Dr. Leighl.
This work was sponsored by Guardant Health. Dr. Leighl is supported through the Princess Margaret Cancer Foundation through the OSI Pharmaceuticals Foundation Chair in Cancer New Drug Development.
Leighl NB, Page RD, Raymond VM, Daniel DB, Divers SG, Reckamp KL, Villalona-Calero MA, Dix D, Odegaard JI, Lanman RB, Papadimitrakopoulou VA. Clinical Utility of Comprehensive Cell-Free DNA Analysis to Identify Genomic Biomarkers in Patients with Newly Diagnosed Metastatic Non-Small Cell Lung Cancer. Clin Cancer Res. 2019 Apr 15. doi: 10.1158/1078-0432.CCR-19-0624.
