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Inspiring advances in cancer care

A woman stands smiling behind her is a wooded area
One of many patients taking part in clinical trials at Sunnybrook, Karen Cotnam’s experience inspired her to become a donor.

Karen Cotnam remembers the moment she felt everything was going to be okay during her care journey. It was when a Sunnybrook MRI technologist said, “Hello, I’m Lynn.”

The Montessori specialist and mother of two was at Sunnybrook’s Odette Cancer Program for radiation to treat a brain tumour called a glioma. First diagnosed more than two decades earlier, the slow-growing cancer had transformed into a more aggressive, high-grade form of the disease. Cancers of this type are typically treated with surgery, but in Karen’s case, the tumour was located alarmingly close to the speech centre of her brain.

Rather than undertake a risky operation, Karen’s surgeon referred her to Sunnybrook’s world-renowned Cancer Ablation Therapy Program.

“Everyone I met had the same name as people in my family,” chuckles Karen. “My brother-in-law is Lynn. My nurse was named Ada. That’s my mother-in-law’s name. And on the last day of radiation, my therapist was Thomas, my father’s name.”

“I kept thinking that angels were watching out for me,” says Karen.


Participating in a Sunnybrook clinical trial

Also keeping a close eye on her progress was Dr. Arjun Sahgal, director of the Cancer Ablation Therapy Program and the radiation oncologist who oversaw Karen’s treatment. A participant in a Sunnybrook clinical trial, Karen received magnetic resonance imaging (MRI) before and at key points throughout her radiation series. Dr. Sahgal and his team used the scans to visualize the tumour and adapt Karen’s treatment accordingly.

Dr. Arjun Sahgal and Karen Cotnam having a conversation outside of Sunnybrook’s Odette Cancer Centre.
Dr. Arjun Sahgal and Karen Cotnam having a conversation outside of Sunnybrook’s Odette Cancer Centre.

The trial was an important precursor to the arrival at Sunnybrook of a first-in-Canada technology enabled by generous donors: the Elekta Unity MR-Linac.

Combining the power of high-field magnetic resonance imaging and radiation therapy, the MR-Linac’s groundbreaking technology allows doctors to see the radiation at work in real time. Even more remarkably, they can use what they see to plan the next day’s treatment, so radiation therapy becomes even more personalized.

Although Karen’s daily radiation wasn’t guided by real-time imaging, doctors did conduct MRIs throughout her 33 treatments to ensure the tumour was responding as planned.

“If it wasn’t working, Dr. Sahgal wanted to change the course then instead of waiting a month for the result,” says Karen, who took comfort in this personalized approach.

The results of this and subsequent studies at Sunnybrook are helping to inform the development of standard procedures for adapting a patient’s radiation treatment to changes in the tumour that may occur over time.

“This is a brand-new technology,” Dr. Sahgal says of the MR-Linac. “We’re learning the technical aspects of the machine from scratch and developing frameworks for the rest of the world to use.” Sunnybrook shares these learnings as one of seven founding members of an international consortium that is leading the development of the MR-Linac.

Giving back

Knowing her participation could help future patients inspired Karen to make an impact in another way as well. She recently made a donation to thank Dr. Sahgal and the Cancer Ablation Therapy team for their extraordinary care and support their research going forward.

I used to work for the Oshawa Seniors Centre as an adult day program Montessori specialist. I know the value of clinical research. It takes just a small amount of time for the client but makes a huge difference to the world. That’s why I wanted to help Dr. Sahgal,” says Karen.

Karen also wanted the entire team to know that they made a huge difference in her life.

“If by making a donation I can give them some of the recognition they deserve, then that’s what I wanted to do. They were all my angels.”