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CV: Dr. Arjun Sahgal

Sep 26, 2013

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Researcher aims to make radiotherapy for brain and spine safer, more effective

Bio basics: A scientist in Physical Sciences and the Odette Cancer Research Program at Sunnybrook Research Institute (SRI) and radiation oncologist at Sunnybrook. Born and raised in Ottawa, Ontario. Married with two daughters, aged three and four years.

Why did you go into radiation oncology?

I thought it was the perfect blend of medicine and surgery without having to do surgery. It meant a different way of thinking—treating cancer locally with energy, without using a scalpel or chemotherapy. Growing up, I always wanted to do oncology as I had several family members with cancer, and I worked toward this goal for as long as I can remember.

What is your research focus?

I specialize in focal radiation called radiosurgery to brain, spine and bone tumours. We developed a method called stereotactic body radiotherapy (SBRT) for spinal tumours that precisely hits targets in the spine with high doses to ablate the cancer safely. We've made major contributions by reporting guidelines for safe spinal cord practice and fracture risk to make SBRT safer. We are now reporting outcomes. Our data will help guide the appropriate use of surgery. We're also developing strategies with [SRI's] Dr. Albert Yee to combine new nonradiotherapeutic modalities with SBRT.

I also do radiosurgery to the brain. Here at Sunnybrook, we're about to start frameless radiosurgery so we don't have to screw in the invasive head frame, which is very uncomfortable. We have also adopted an approach to deliver the treatment over several days (hypofractionation) to increase the dose and efficacy of treatment, and still maintain reasonable rates with respect to toxicity. One major aim is to avoid whole brain radiation and offer radiosurgery alone. The toxicities of whole brain radiation are significant; people get neurocognitive damage and a drop in their quality of life. We have data showing a survival advantage for younger patients if we treat with radiosurgery alone.

Do you collaborate with other SRI scientists on your research?

Dr. [Kullervo] Hynynen and I have been looking at magnetic resonance-guided focused ultrasound with Dr. Todd Mainprize for neurosurgery for tumour ablation and opening up the blood-brain barrier. Dr. Greg Stanisz and I started doing specific sequences to measure apoptosis following high-dose radiation in the brain. I've worked with Dr. Richard Aviv in medical imaging on perfusion imaging for brain metastases.

I've also been working with Dr. Cari Whyne. With her expertise we've been able to understand better the relationship between lytic tumours, sclerotic tumours and the risk for vertebral compression fracture. That's becoming more of a major event in these patients following this high-dose focal treatment. We recently wrote a review in Lancet Oncology where we spelled out how we think it happens.

If you weren't in medicine, which profession would you try?

VP, research [laughs]. I collaborate with medical physics people. Sometimes I wonder if I could have done a medical physics or engineering degree.

Dr. Arjun Sahgal