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Inventing the Future of Health Care for Ontario and Beyond: Strategic Plan 2018-21
Hospital  >  Welcome  >  Safety, Quality, Strategy, and Management  >  Strategic Plan 2018-21  >  Personalized and Precise Treatments
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Strategic Direction:
Personalized and Precise Treatments

Sunnybrook understands that every patient is unique. This Strategic Direction is about tailoring treatments to meet the specific needs of patients.

Using information such as a person’s anatomy and physiology, genetic make-up, and where and how they live their lives, helps to design treatment that is responsive in real time to ensure the best possible outcome. Personalized and Precise treatments are flexible and adjust according to meet the individual make-up of the patient. This approach to care helps to minimize side effects and contributes to less time in hospital.

This Strategic Direction will see Sunnybrook Research Institute work in partnership with the hospital to discover new treatments and therapies that are custom made for patients. This approach to care will involve creating and using the latest technology in areas such as medical imaging and genetic sequencing to help design and deliver precision treatments that focuses interventions on what matters most to patients.

Goals

Care that is tailored to the patient

Sunnybrook will develop tailored approaches to care to prevent illness, diagnose it earlier, and treat identified issues sooner to give patients the best outcome possible.

Imaging technologies to diagnose,
guide innovative targeted treatments and monitor outcomes

Sunnybrook has globally recognized strength in imaging research which it will use to lead in the development of new models of care enabling patients to recover faster and move on with their lives sooner.

Sharing knowledge with others

As breakthroughs are made with these approaches, Sunnybrook will champion the adoption of these more personalized and precise diagnostics and treatments across the Ontario health system, nationally, and internationally.

Research

Research in this area is having a profound and immediate impact on patients today. For example, trials are underway to explore the use of a technique called focused ultrasound, or what’s being referred to more commonly as ‘scalpel-free surgery’ where there is no incision in the patient. Instead, sound waves are being used to treat hand tremors, brain cancer, depression, uterine fibroids, and many other health issues.

Studies in this area have a common goal to reduce the amount of time patients have to spend in hospital, minimize side effects, and to improve recovery from illness or injury.

Research

Education

As an international centre for work in this area, learners from around the world have already begun to seek out Sunnybrook to learn about new approaches to care being developed in this area. The intention with this plan is to continue to grow in this area and become a leading source of education for this approach to patient care.

Knowledge gained through Personalized and Precise Treatments will be shared through the hospital’s networks and educational partnerships to improve patient care locally and around the world.

Sustainability / Opportunities

Treatments that are designed to fit the individual’s needs may help avoid hospital admission entirely. But if a hospital stay is required, personalizing care will help ensure everything from lab tests to medications and treatment are tailored to the unique demands of the patient’s condition. This helps to focus on providing only the care and tests a patient requires for an optimal outcome. It also results ideally in a shorter hospital stay and fewer complications.

This Strategic Direction is rooted in innovation and discovery. For this area to be successful, it must continue to have the support of granting agencies, government, and the generosity of donors to invest in research to yield results that will tailor care for generations of patients.

Patient Story

When Janice Weintraub heard the words “breast cancer,” she was shocked. “I was told there was a suspicion of DCIS,” Janice says, “but that stage 1 breast cancer couldn’t be ruled out.”

Read more of Janice's story »

DCIS – ductal carcinoma in situ – is early-stage, or stage 0, breast cancer. It’s a lesion in the breast that hasn’t invaded the surrounding tissue. While women with DCIS have a very low risk of dying of breast cancer, some women with DCIS are at a higher risk of developing invasive breast cancer in the future, explains Dr. Eileen Rakovitch, medical director of the Louise Temerty Breast Cancer Centre.

“We can’t accurately identify which women are indeed at high risk and will get breast cancer, and which women will not,” says Dr. Rakovitch. “So right now, we treat everyone.” Treatment includes surgery and radiation.

For Janice, the idea of undergoing extensive radiation and its side effects for a cancer that may never become aggressive did not sit well.

Janice learned about Sunnybrook’s research into the Oncotype DCIS Score. Going beyond what can be viewed under a microscope, the score test looks at 12 genes to see whether they are turned on or off, and calculates a risk of recurrence.

Janice was accepted in the clinical trial at Sunnybrook, and when her Oncotype DCIS Score came back low, she decided not to undergo radiation.

“The risk score helped inform my decision,” Janice says. “It really worked both ways. Had the score come back high, I couldn’t have stood in the face of science and rejected that radiation treatment. I wouldn’t have.”

That’s the wonderful thing about moving DCIS and breast cancer into the genome era, Dr. Rakovitch says.

“It’s individualized, personalized medicine. Instead of using broad estimates, a woman’s own DCIS is sampled and the expression of those genes is measured. We get her individual estimate of recurrence with or without radiation treatment.”

View our Strategy Performance Report on
Strategic Direction 1 - Personalized and Precise Treatments »


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