Preparing for the next pandemic

This week on Health Matters, guest host Kelly Albert and Dr. David Labbé discuss his research into prostate cancer and how nutrition could impact treatments. Dr. Tania Janaudis-Ferreira explains her rehabilitation study for patients living with long-COVID symptoms. Dr. Marcel Behr looks ahead to how MI4 will work to combat infectious diseases. And, Casper Lei shares how a devastating cancer diagnosis didn’t stop him from marrying the woman he loves at the MUHC. 

Cette semaine à Questions de santé, l’animatrice invitée Kelly Albert discute avec le Dr David Labbé de ses recherches sur le cancer de la prostate et de l’impact de l’alimentation sur les traitements. La Dre Tania Janaudis-Ferreira présente son étude sur la réadaptation des patients atteints de symptômes de la COVID longue. Le Dr Marcel Behr explique comment MI4 contribuera à combattre les maladies infectieuses à l’avenir. Et Casper Lei raconte comment un diagnostic dévastateur de cancer ne l’a pas empêché d’épouser la femme qu’il aime au CUSM. 

Transcript

Kelly Albert: 0:00

Good afternoon. Thank you for joining us, Tarah Schwartz is off. I'm Kelly Albert. And this is Health Matters on CJAD 800. On today's show, the McGill interdisciplinary Initiative and Infection and Immunity turns five. This special program was created to help researchers discover new ways to treat infectious diseases, which came in handy with the COVID-19 pandemic. So you can discover today how MI4 researchers were in a good position to look into this virus at the onset of the pandemic three years ago. And later in the show, a man whose cancer diagnosis didn't prevent him from marrying his wife in the hospital, more on that later. But to begin for today, prostate cancer is one of the most common cancers in men. While most men are able to manage the disease. It is the third leading cause of cancer related deaths among men and researchers are working to identify why some cases of prostate cancer are more aggressive than others. Dr. David Labbe is an Associate Professor in the Urology Division of the Department of Surgery at the MUHC and he is a researcher in the Cancer Research Program at the RI-MUHC. Thank you for joining us, Dr. Labbe.

Dr. David Labbe: 1:06

That's my pleasure.

Kelly Albert: 1:07

So have you seen any significant advances in treatments for prostate cancer in the last, let's say five to 10 years?

Dr. David Labbe: 1:15

Yes, there were many. I mean, some of the most notorious that happened a couple of years ago. For example, there has been PSMA treatment- PSMA stands for Prostate Specific Membrane Antigen. And there's a new treatment called PSMA radionuclide therapy. What it does is it actually brings radiotherapy, which is typically only used in the case of localized disease, and it makes it available to patients that have metastatic-advanced disease. This is a really significant advance for patients with metastatic late-stage disease. There's also another type of drug called PARP inhibitors that have been recently been approved for the treatment of metastatic disease for patients that have specific tumor genetic alterations.

Kelly Albert: 2:05

That's really promising because the metastatic disease would be the more advanced cancer that has spread, is that correct?

Dr. David Labbe: 2:13

Yes, that's correct. So in fact, you mentioned it correctly, in the introduction that most men will actually successfully manage their disease, but they're still about 4600 men per year in Canada that will die of prostate cancer, and it's mostly in the advanced metastatic stage.

Kelly Albert: 2:34

And so how does it get to the point of that? Is it men maybe aren't aware of the signs and symptoms that are associated with prostate cancer, or they're more dismissive of the symptoms that occur?

Dr. David Labbe: 2:48

It could be it could be that. It is really important that men undergo screening for prostate cancer, as guided by their primary care physician is typically between 55 and 70 years of age. There's a simple blood test and this is combined, usually also with a digital rectal exam. It's possible that men who don't go for that type of screening will be identified with a more advanced disease because we didn't catch it earlier. So it's really important for all men to actually undergo their routine test.

Kelly Albert: 3:24

And would this be every year? Every two years? Every time you see your doctor?

Dr. David Labbe: 3:30

It depends on your age and your family history and so on. It's better to really go in line with the recommendation of your primary care physician regarding your specific conditions.

Kelly Albert: 3:45

That's good advice. Dr. David Labbe is an Associate Professor in the Urology Division of the Department of Surgery and a researcher in the Cancer Research Program at the Research Institute of the MUHC. So we spoke about the need for regular prostate exams. For those listening maybe who don't necessarily know or haven't been for a prostate exam recently, are there some warning signs that they should pay attention to maybe say, this is something that I should consult my doctor about?

Dr. David Labbe: 4:15

I think at a certain point. All men will actually start developing what is called a pre-prostate cancer stage. So if you start to add some pain and so on, this is key to consult as in under any circumstances. The key point of having those routine exam is if there's some signs for example, you have a PSA; so prostate specific antigen level that is higher in your blood than what would be expected at your age. The doctor will actually get a biopsy of your prostate tissue and will look whether or not there's some signs of beginning of a cancer. This might occur without you having any signs of pain. This is why it's better to have it as a routine type of exam rather than just waiting for having some symptoms.

Kelly Albert: 5:17

Waiting to catch something. I think that's really important to note as well. So I do want to get into your research because I do find your research very interesting. Your focus is on nutrition and prostate cancer. So in layman's terms, can you explain what links you found between nutrition and prostate cancer?

Dr. David Labbe: 5:38

I mentioned at the beginning that there are new advances in the treatment of advanced disease. For example, PSMA radionuclide therapy. This is a good treatment for patients that show specific conditions such as having a tumor that will express that molecule that is called PSMA. But even under those circumstances, only about 36% of the men will actually respond to the therapy. Also, the PARP inhibitor treatments are only working or only used in men that are having some specific molecular alteration in the tumor and this is between 13 and 20% of the men. So not all the men will actually be eligible for those type of treatments. And it's not all of them that will actually respond to those treatments. The reasons for that underlying discrepancies is not known. But through our research, we found that nutrition can also alter the efficacy of those type of therapies. So our work is actually to see if we can use precision nutrition, which is defined as a dietary intervention for a short period of time. And whether or not we could use it to potentiate some of these treatments, such as the PSMA, or PARP inhibitor treatments,

Kelly Albert: 7:01

That's really interesting. So what the patient eats while undergoing treatment, could make it more effective. Is that essentially it?

Dr. David Labbe: 7:11

Yes, our lab really studies the biology, what is happening under a specific type of diet and we found some interesting things that maybe diet that are not known as a canonical good diet for the prevention of the disease; they could instead be good for when combined with specific treatments. We're still working on that and we're collaborating with other researcher in the United States and in Australia to really define what are the specific dietary patterns. Or more importantly, if we can identify some nutrients that could explain that increase in efficacy of some of those therapies. But in the precision nutrition space, we're talking about a short dietary intervention, typically a couple of days to couple of weeks.

Kelly Albert: 8:18

Wow, okay. So it would be a sort of aggressive change in that treatment period to see if there's any sort of difference. That's so interesting. In conversation with Dr. David Labbe, who is an Associate Professor in the Urology division of the Department of Surgery and a researcher in the Cancer Research Program at the RI-MUHC. So unfortunately, we're short on time. But I would like to know as you're working on the study, and you mentioned international researchers are collaborating with you in the study. When will we start to see results from the study? Are you in the infancy of the study where you're sort of working on collecting the data and coming together with the investigation to see which nutrients are beneficial?

Dr. David Labbe: 9:05

We started last September. So this is an international study. We're working with people at the University of Washington in Seattle, they actually are the living biobank of prostate cancer tissue that represent the diversity of prostate cancer patients. And so we're using this living biobank, we're testing different dietary intervention to at one point, identify... Because we don't think that all patients will require the same dietary intervention to actually potentiate their treatment. There will be some case-by-case issues and we want to identify if there could be some biomarkers of some profile that we can say, Okay, this patient should get this diet combined with this treatment to optimize the impact of the therapy. So we're working with people at the University of Washington for that. Our timeline is about four years for that study.

Kelly Albert: 10:07

That's incredible and precision nutrition influencing precision oncology is a really great advancement for the future. I'm excited to hear more about your research. Dr. Labbe. We'll have to have you back on the show to discuss it.

Dr. David Labbe: 10:21

All right. I'll be there. Thank you so much for having me.

Kelly Albert: 10:25

Thank you so much. That's Dr. David Labbe, an Associate Professor in the Urology Division of the Department of Surgery and a researcher in the Cancer Research Institute Program at the RI-MUHC. Next up on Health Matters, seeking new ways to help the thousands of Canadians living with the long term effects of COVID-19. Tarah Schwartz is off today. I'm Kelly Albert. Welcome back to Health Matters on CJAD 800. There are thousands of Canadians who are living with the long term sometimes debilitating effects of post COVID-19. Researchers at the RI-MUHC are looking for ways to reduce the severity of these symptoms. Dr. Tania Janaudis-Ferreira is one of those researchers who's hoping to use a rehabilitation program to help these patients. Dr. Janaudis-Ferreira is a scientist in the Translational Research in Respiratory Diseases Program at the RI-MUHC, and a professor in the School of Physical and Occupational Therapy at McGill. Thank you so much for joining us.

Dr. Tania Janaudis-Ferreira: 11:19

No problem. It is my pleasure. Thanks for inviting me.

Kelly Albert: 11:23

This program is really interesting because you must be seeing quite a few lingering symptoms of patients who are suffering from long COVID. What are some of the symptoms that you're seeing?

Dr. Tania Janaudis-Ferreira: 11:35

Some of the symptoms are fatigue, dyspnea or shortness of breath, heart palpitations, difficulty concentrating or brain fog, memory deficiency, anxiety, depression, sleep impairments, generalized pain or pain the muscles, pain the joints. And some other neurological issues such as headaches, dizziness, for example. And also another important thing to note is that individuals with long COVID have is the post-exertional malaise, which is they get an exacerbation of symptoms after some minimal physical or mental and social effort.

Kelly Albert: 12:21

Oh, my goodness, and how long can these lingering side effects happen for a patient? Could it be weeks? Months? More?

Dr. Tania Janaudis-Ferreira: 12:30

It could be could be weeks and months. So the literature tells us different time points. But yes, for example, the post-exertional malaise it could last for days, for hours, or for months. Really what happens in long COVID Is that we have a constellation of symptoms, and sometimes individuals don't have the symptoms at the same time. So it's kind of an episodic nature of the symptoms come and go. But it could take weeks or months, for sure.

Kelly Albert: 13:07

That's really interesting. It must be difficult to kind of pinpoint when these issues could occur for a patient if they're episodic. So you might be fine for a couple of weeks, and then all of a sudden have this post exertion exhaustion?

Dr. Tania Janaudis-Ferreira: 13:25

Exactly yes, that's a challenge, especially for rehabilitation as well.

Kelly Albert: 13:32

Interesting. So we're in conversation with Dr. Tania Janaudis-Ferreira who is a scientist in the Translational Research in Respiratory Diseases Program at the RI-MUHC. There are many conditions that you work with that benefit from rehabilitation programs. How does it seem so far that long-COVID could be one of these conditions that that could benefit from a rehabilitation program?

Dr. Tania Janaudis-Ferreira: 13:54

Yeah, we know that it could benefit based on the symptoms. So we know that individuals who are experiencing long COVID, they have fatigue, shortness of breath, anxiety, depression and cognitive function. These symptoms they have been shown to be improved with exercise based intervention in other populations. And also there are some studies that have shown that these individuals may have mobility issues, balance issues, difficulty walking long distance, or muscle weakness. And so all these issues can be amenable through exercise and rehabilitation.

Kelly Albert: 14:34

And your particular program is a virtual one. Is that correct?

Dr. Tania Janaudis-Ferreira: 14:38

Yes. That's right.

Kelly Albert: 14:39

So tell me how the virtual rehabilitation program works.

Dr. Tania Janaudis-Ferreira: 14:44

Yes. So our program is delivered 100% virtually. So once we recruit the participants. They receive a link to that will take them to some online questionnaires. They will fill out the questionnaires and then the research coordinator books a Zoom meeting to do some physical assessments. They do some sit to stand tests, some walking tests at home. Then once this assessment is done, they notify me. I randomize the patients and then I notify the kinesiologist. If a participant has been randomized to the intervention group, then type of exercise that they are doing with a kinesiologist is, for example, aerobic training, very basic ones, because we're doing the exercise at home. But it's walking on the spot, for example, or functional lower and upper body strengthening, chair stands, or some arm exercise. There's no specific equipment that is needed. But there is there is something at their homes that they can be used the kinesiologist would encourage them to use them.

Kelly Albert: 15:58

That's interesting, because I imagine there's a lot of benefits to the patients to being able to do this program virtually. Especially if you're suffering from mobility issues or fatigue when you travel; doing it from home could be something really effective to make sure that you get the exercises you need.

Dr. Tania Janaudis-Ferreira: 16:17

Exactly. We know that tele-rehabilitation helps. There are many advantages, right so we can improve the patient reach to increase access to rehabilitation; especially for those who are living in difficult areas or rural areas or have limited access to care. There's another advantage that it decreases missed visit rates. Also, people can save money because they don't spend money traveling. And they can perform this exercise this rehabilitation in different locations at home or work, for example. Especially for people experiencing long COVID I think it's a very good way of delivering this intervention, because it avoids exacerbating the symptoms, such as fatigue and shortness of breath, and even the post exertional malaise so they don't have to travel to the hospital to do the intervention. So it really saves their energy in that way.

Kelly Albert: 17:26

Absolutely. It sounds like it. In conversation with Dr. Tania Janaudis-Ferreira, who is a scientist at the RI-MUHC. So what part of this study are you at? Are you actively recruiting patients to participate in this long COVID rehabilitation program?

Dr. Tania Janaudis-Ferreira: 17:44

Yeah, so we are currently recruiting patients. We have already included 94 individuals in the study, which is amazing. And we are recruiting; I have a team helping me recruit these patients, I oversee the whole project. And I check the progress of the study every week. But we are still recruiting, for sure.

Kelly Albert: 18:10

And so if someone is listening right now and would like to be recruited to the study or feel like their long COVID could benefit from this study, how do they get in touch with you?

Dr. Tania Janaudis-Ferreira: 18:20

They can send me an email. I don't know if we're able to they can google my name and McGill There's also an email for this study. But I don't have it here right now.

Kelly Albert: 18:35

Okay, we'll get that we'll get that email at the end of the segment, we will share it for you. Great. Last question for you Dr. Janaudis-Ferreira, what do you hope to learn from this research?

Dr. Tania Janaudis-Ferreira: 18:49

Well, for sure we are interested in learning if this rehabilitation program can improve mobility. This is our primary outcome is mobility in patients living with long COVID. We also want to know if we can improve their muscle weakness, symptoms of fatigue and dyspnea, quality of life. We want to know if there is any effect on anxiety, depression and their general well-being. We're also looking at cognitive function. And we also want to know if this program is safe because our ultimate goal is to make this program available for people across Canada and even other countries. So if we can show that it's effective and safe, that will be great. Also, another advantage of doing this study is that if we prove that is effective, this can be implemented nationally with appropriate cultural adaptation with measures to address inequities in access to internet and electronic devices for example. But it could also be implemented in other centers. And in case we have other future infectious outbreaks that could also be a model that people can use for rehabilitating these patients.

Kelly Albert: 20:18

I'm so glad that we could have you on the show to discuss it. Dr. Tania Janaudis-Ferreira I thank you so much for your time today.

Dr. Tania Janaudis-Ferreira: 20:24

No problem. Thank you. My pleasure.

Kelly Albert: 20:26

Dr. Tania Janaudis-Ferreira is a scientist in the Translational Research in Respiratory Diseases Program at the RI-MUHC. And if you are interested in participating in the study, you can email COVID_rehab at RIMUHC.ca. That is COVID_rehab at RIMUHC.ca. Or you can call 450-700-2741. Next on Health Matters, how an innovative approach to researching infectious diseases put the MUHC in a good place to investigate COVID-19. Tarah Schwartz is off. I'm Kelly Albert and this is Health Matters. Five years ago, Dr. Don Shepherd, Dr. Marcel Behr and Dr. Marie Hudson realized that there needed to be a way for researchers from different disciplines to work together to study and find better treatments for infectious diseases. By working together, researchers could use different approaches to find innovative solutions to treat and hopefully cure some of humanity's deadliest illnesses. They founded the McGill Interdisciplinary Initiative in Infection and Immunity also known as MI4 and MI4 was in a great position to begin working quickly when COVID-19 became a part of our world three years ago. And MI4 is celebrating their fifth anniversary this year. Here to discuss the incredible work that is being done and that there is still to do is Dr. Marcel Behr. He is the Director of MI4 and a clinician scientist. Hello, Dr. Behr.

Dr. Marcel Behr: 21:52

Hello, Kelly, thanks for having me.

Kelly Albert: 21:53

Thank you so much for being here. So MI4 was actually created about two years before the COVID 19 pandemic started. Did you anticipate seeing a pandemic of this size affecting our worlds within the early infancy of MI4?

Dr. Marcel Behr: 22:11

So there's sort of two parts to it. Did we expect a pandemic? Yes, of course, there'd been SARS, there has been MERS, there had been Zika. And we were putting up slides showing the interconnectedness of the world just by airplane routes, and telling people that a pathogen in Hong Kong could be in Montreal one flight away. Did we expect it to happen in 18 months, rather than in three to five years? No, of course, we don't know how to predict when pandemics are going to start. And did we expect something of this magnitude? I don't think anybody did. But the concepts are still there. And I think the risk of another pandemic of this magnitude, arguably hasn't really gone away. But whether it'll be in three years or 13 years, I think we're all are unaware.

Kelly Albert: 22:58

I guess that's a difficult to ask you to predict something like, I imagine. And it's a really interesting time because lockdown occurred in Quebec around three years ago this week. We started to see companies sending their employees home, more lockdown measures. So in your view, how far have we come since that initial lockdown started three years ago?

Dr. Marcel Behr: 23:25

Yeah, I remember reading The Great Influenza around 1918 and how St. Louis shut down and Philadelphia went ahead with a St. Patrick's Day parade. I remember three years ago wondering whether Montreal should close the St. Patrick's Day parade, and whether nursing homes and senior residences close. So we've come a really long way. I went into the cafeteria yesterday to get my soup and I realized there's no plexiglass around the cashiers anymore. We had our division of ID infectious diseases meeting on Monday by zoom, and we talked about whether we can have our next meeting as all of us together in one room. So we really have come a long way. And we are very fortunate because of the vaccines, which have been really fantastic. March of 2023 is a far better place than March of 2020 was.

Kelly Albert: 24:15

Absolutely in conversation with Dr. Marcel Behr, the director of MI4, the McGill Interdisciplinary Initiative in Infection and Immunity. And I mentioned off the top how because you had this infrastructure of MI4, you were in a fairly good place to transition really quickly into researching the virus. Is this something that going forward will help with future viruses that may occur? Where you have this mechanism in place that you can transition really quickly to start looking into what the causes are, better treatments, etc?

Dr. Marcel Behr: 24:49

Yes, that's correct. I think the Canadian scientific reflection is that three years ago, we didn't have drugs. We didn't have vaccines. We didn't really have diagnostics and for a while we didn't even have N-95 masks. I don't know if you remember that there was like rationing of just about everything. And the government of Canada said, you have to do better in the future. We have to be able to come up with things within 100 days of next pandemic. So they've launched some incredible infrastructure support programs through the federal government so that we have clinical trials capacity ready to test drugs in patients, those that we have the containment lab that is fully equipped and ready to handle the next virus. So at a research level, I think the scientists at the McGill University Health Centre and in the McGill community are better prepared. I think industry has also made tremendous strides with new things like the RNA vaccines. Where I am not so convinced we are prepared for future pandemic is organizing our societies. I recently read a book by Michael Lewis, who is known for Moneyball, and The Big Short and other such books. And he talks about pandemic preparedness in the United States, which is arguably the country beside us. But whether things are handled at the federal level, or at the state level. And the same thing in Canada, at the federal level, at the provincial level; there are all these giant kind of logistical issues that are very complicated, and we're really only as good as our weakest link. So if Canadian scientists and Canadian researchers are ready but the processes in our societies aren't ready, or the processes in our neighboring society aren't ready, we can expect to have problems again.

Kelly Albert: 26:46

Yeah, that's really interesting, because I guess a certain portion of the population was anti-vaccine, anti-treatment, anti-lockdown measures, anti-mask. So if we can get those people on board for x future pandemic, we're going to have a problem in containing it, I imagine.

Dr. Marcel Behr: 27:06

Correct. And we also have to remember that every time we have a product, we have to be very clear and deliberate about what it does and what it doesn't do. And so the messaging has to be transparent and fair and open. And we know that vaccines have been fantastic at preventing individuals from getting very, very sick. But they've had a relatively lesser or more modest effect on retransmission in the community. And these kinds of messages have to be very clear. Otherwise, people think you're offering A when you're promising B, and vice versa. So I think all of the science we do has to be done in context. And all of the products we provide and test and vet and clinical trials, they still have to be communicated properly to the to the public.

Kelly Albert: 27:58

Yeah, I think transparency is something that we're all super aware of these days. In conversation with Dr. Marcel Behr, the director of the McGill Interdisciplinary Initiative in Infection and Immunity. So five years, the five year anniversary, how special is this moment for you that it's been five-years since you found MI4 with Dr. Shepherd and Dr. Hudson. And going forward, you have this big bright future ahead of you?

Dr. Marcel Behr: 28:25

I think all anniversaries are a little bit like taking stock. It's like when you turn 40. And you look back and you look forward. Or in this time of year in academic medicine, you have your annual performance review. And you sort of list what it is you set out to do, what it is you did, what you didn't do and why; and what you want to do going forward. So this fifth anniversary has allowed us or almost compelled us to go back to our 2017 papers, and look at what we wrote in 2017. And look at what was prescient and look at what didn't happen. And look at some of the things we expected and some of the surprises, things that surpassed all of our expectations. And that's really the amazing thing is to see how far we've come in five years. And that gives us a kind of a good motivation to task. How much further can we go in the next five years.

Kelly Albert: 29:22

And so now that you've had this opportunity to reflect and go back and look at those initial papers from 2017, what is the focus going forward for MI4?

Dr. Marcel Behr: 29:38

Going forward, we've had stakeholder meetings, external advisory board meetings and discussions with the McGill community. We've decided there's three areas that we can really help advance the scientist and the McGill ecosystem. I consider them a sprint, a long distance race and a marathon. The sprint is pandemic preparedness. We want to be ready the next time there's a March 12, 2020, to be able to deliver things within weeks to month. Rather than waiting for other things, for companies and for trials in the United States, we want to be much faster. So that's the sprint. The long distance race is antimicrobial resistance. We know that the antibiotics we have a limited duration of available utility; we're losing antibiotics faster than they were gaining new antibiotics. And when we lose antibiotics, we lose modern medicine. We lose the ability to do chemotherapy, to do heart surgery, to put prosthetic hips into people. So that's one of the themes is we really want to address antimicrobial resistance. And then the marathon is knowing that there's all of these microbes in our body, interacting with our immune system in all these ways, that are very complicated and poorly understood. And yet recognizing that some of these are going to present as what we now call idiopathic or inflammatory or immune-mediated diseases. We're trying to understand how microbes in our immune system interact, and how this leads to some of the diseases where we just don't know the cause. That's a really interesting challenge because when we know the cause, then that helps us to deliver new solutions.

Kelly Albert: 31:24

Well, I look forward to hearing it. The MUHC Foundation is a big supporter of MI4, and we will continue to do so. Thank you so much for your time, Dr. Behr. I really appreciate it.

Dr. Marcel Behr: 31:33

Well, thank you for your time. And thank you as always for all the support from the MUHC Foundation. It's greatly appreciated.

Kelly Albert: 31:40

Absolutely. That's Dr. Marcel Behr, he is the director of the McGill Interdisciplinary Initiative in Infection and Immunity. Coming up next on Health Matters. He received a devastating cancer diagnosis, but that didn't stop him from marrying the woman he loves at the hospital. Tarah Schwartz is off. I'm Kelly Albert, and you're listening to Health Matters. Casper Lei was a regular active person. He enjoyed cycling around the globe until one day he noticed a shortness of breath and a cough. His doctor didn't initially think anything was amiss and thought it could be asthma. But upon returning from a trip abroad, he got off the plane and went straight to the emergency room in Montreal because something felt wrong. There he was sent to the intensive care unit and a few days later, he was diagnosed with cancer Casper Lei is with me now to share his story. Casper, thank you so much for being here.

Casper Lei: 32:25

Thank you. I'm glad to be here.

Kelly Albert: 32:28

I bet your story is a really intense one I have to say. So you were coming home. You were coming back to Montreal, you got to the emergency room immediately after getting off a flight and so what went through your mind when the doctor said okay, we need to put you in the intensive care unit?

Casper Lei: 32:45

It was actually really funny because actually, I went to a family doctor before my trip. I had like asthma was very young, but it was always very minor. And in the past, there was a few times happened that I just start coughing everything. They say oh, it's because you have this old chronic problem and when you get tired, it just comes back. So when I went to have to go with my girlfriend back then. We thought it was probably nothing major, right? It's like we were actually discussing about after I got out of the hospital what are we going to eat for a late dinner or snack. But we never really expected to stay there for, I think about two months straight.

Kelly Albert: 33:25

Wow.

Casper Lei: 33:25

So yeah, we really weren't expecting like cancer. Actually the funniest is me and my girlfriend, we enjoyed partying. We would go out for drinks and in some way, we have a pretty good alcohol tolerance, just to put it that way. So when the doctor came in and said oh, we have some bad news for you. Both of us just thought, Oh, is it my kidney? Is it my liver?

Kelly Albert: 33:48

Oh my goodness, so you had no idea that it was lymphoma.

Casper Lei: 33:51

Absolutely no idea. Actually because my mother tongue is Chinese when the doctor told me lymphoma; I actually didn't know what lymphoma was. And so we're like, What the heck is a lymphoma? And he said it's a kind of a cancer. And both of us was like, you are a funny one; like no way. Then the doctor said I'm very serious about it. That's when it started to sink in. And I was thinking that oh, wow. You're 100% sure? Like not just a suspicion? And they said yes, we're pretty sure. It's a very late stage as well.

Kelly Albert: 34:27

Because you're quite young, you're very active, you cycle all over the world. Like you have shared pictures of us cycling in different parts of the globe. So it must have been really disorienting to get this diagnosis of cancer and then to have to go into treatment almost immediately.

Casper Lei: 34:47

Yeah, exactly. We pretty much started treatment like a week after they do biopsy and everything that came from that. But the treatments started really quickly.

Kelly Albert: 34:58

My goodness and so you had to do radiation and chemotherapy? Tell me some of the treatments that you had to do.

Casper Lei: 35:05

For me at the beginning it was only chemotherapy, I didn't have to go for radiation. So it was six cycle, and every three weeks, and then there's another chemo on top of that every few weeks. So in the end, I went through nine cycles of chemo.

Kelly Albert: 35:21

Oh my goodness, and then the chemo wasn't as effective as it could be.

Casper Lei: 35:26

At the beginning actually, it was sort of working because at some point, the doctor said, my tumor lit up like a Christmas tree. And once my chemo started, all the minor ones did shrink, but major ones stayed until the very end. So that's when they told me like chemo sort of work, but not how they expect it because a major tumor was resistant to chemo.

Kelly Albert: 35:54

In conversation with Casper Lei, who was a regular active person and was diagnosed with cancer. I love hearing your baby in the background, and we're going get to your baby very soon. Because this has a really happy ending. There's a very good story that comes from this.

Casper Lei: 36:09

Oh my goodness you can hear him!

Kelly Albert: 36:12

But it's lovely. It really is. So the chemotherapy wasn't working as well; you were put into this immunotherapy clinical trial. And I want to talk about this because I think this is so special is that while you were undergoing treatments, you wanted to marry your girlfriend at the time. You said I want to marry you, you asked her to marry you. And you got married at the hospital? Can you tell me a little bit about that?

Casper Lei: 36:35

So originally, when I started my chemotherapy, everything seems to be going well and I seemed to be gaining my strength. So at that point, we were not expecting a second round, we were like, Oh, looks like maybe everything will be under control in like June or July. So that's what I proposed to my girlfriend, and actually a funny thing a lot of my friends asked what made you decide to propose your girlfriend? For me when your girlfriend stays in ICU with you for two months; I think it's easy. It's not a hard decision. And of course, she said yes. At that point, we were planning for a wedding the year after. But then after that my condition went downhill. So when we took on the clinical trial, there was a chance that after they gave me the medication, I would just go into coma. And they would not know when would they wake up. And so my girlfriend said, if that happened, she will really like to make the decision for me, about not knowing for how long and all those. So that's where we decided let's just get married before I have the treatment. So here in Quebec, I heard even the simplest wedding takes about two weeks to plan. For us, it was done in 36 hours.

Kelly Albert: 37:55

Wow!

Casper Lei: 37:57

And we did it in my ICU room. The date before medication was injected into my body.

Kelly Albert: 38:04

Oh my goodness. We're unfortunately we're running really short on time. So I have to wrap up a really long story in a very short amount of time. You got married, how is your health now? You have a baby! Tell me all the good news.

Casper Lei: 38:20

My health is really good now; like actually getting fat which I don't want to. So the baby was born last year. A very healthy baby at the moment. You can hear him. And yeah, life is good. And so I'm still cycling, but with a baby around. It's a bit difficult. But the next on the shopping list is a trailer so I can take my baby out.

Kelly Albert: 38:42

Wonderful! Well Casper, thank you so much for joining me on the show to tell your story. It was so wonderful chatting with you and I'm so glad to hear that your health is doing well. I think it's so wonderful that you went through this very terrible very scary time and you have a wife and a baby and you're doing well now.

Casper Lei: 38:59

Yes, thank you so much.

Kelly Albert: 39:01

Thank you Casper. That is Casper Lei who was diagnosed with cancer, married his girlfriend in the hospital, is doing well now and has a baby at home. I'm Kelly Albert, thank you for tuning in. What would you like to hear about on the show you can write to me at healthmatters at MUHCFoundation.com. You can also follow the MUHC Foundation on social media or sign up for our newsletter at our website. I hope you'll join us again next Sunday. Thank you so much for listening to Health Matters and stay healthy!