Unleashing the power of genetic tests and personalized medicine

This week on Health Matters, Tarah Schwartz speaks with Dr. Andrea Gomez about how personalized medicine is changing health care and how philanthropy helps push the boundaries throughout this process. Claudia Brown introduces what pelvic floor physiotherapy is and how people in Quebec can have access to physiotherapy. Lucie Guillemette shares her remarkable experience as a co-chair for Le Bal Rouge and a member of the MUHC Foundation Board of Directors. And, Dr. Anthoula Lazaris discusses the challenges faced in the battle against metastatic breast cancer and how women can self-examine to stay on top of their own bodies.

Cette semaine à Questions de santé, Tarah Schwartz s'entretient avec le Dr Andrea Gomez sur la façon dont la médecine personnalisée modifie les soins de santé et dont la philanthropie contribue à repousser les limites tout au long de ce processus. Claudia Brown explique ce qu'est la physiothérapie du plancher pelvien et comment les Québécois peuvent y avoir accès. Lucie Guillemette partage son expérience remarquable en tant que coprésidente du Bal Rouge et membre du conseil d'administration de la Fondation du CUSM. Et la Dre Anthoula Lazaris parle des défis à relever dans la lutte contre le cancer du sein métastatique et de la façon dont les femmes peuvent s'auto-examiner pour rester en bonne santé.

Transcript

Tarah Schwartz: 0:00

Hello there. Thank you for joining us. I'm Tarah Schwartz and this is Health Matters on CJAD 800. On today's show, the MUHC foundation is still reeling from the excitement of its fundraising gala, Le Bal Rouge. We will chat with one of the event's co-chairs who helped raise an incredible $1.68 million in support of respiratory research and care at the MUHC. Did you know that physiotherapy can help improve women's health? Later in the show, we speak with a physiotherapist with over 40 years of experience in helping women strengthen their pelvic floors. But first, personalized medicine is an important part of the future of healthcare. New advances are being made every day to identify genetic reasons that an illness may affect one person differently than another. With these tests, doctors and scientists can pinpoint specific treatments for each person to help them get better or live better. Cutting edge equipment is needed to make sure that the MUHC can perform these genetic tests and push the boundaries to more personalized medicine. Dr. Andrea Gomez is Laboratory Director of the Core Molecular Diagnostic Laboratory at the MUHC. She joins us now. Thank you for being here Dr. Gomez.

Dr. Andrea Gomez: 1:19

Hi, thank you.

Tarah Schwartz: 1:20

Now, how do you help people understand what the Core Molecular Diagnostic Laboratory is?

Dr. Andrea Gomez: 1:27

Okay, it does that complex name. But basically, we do genetic tests. And we do two types of genetic tests, genetic tests for any scary diseases, like cystic fibrosis was very common in Quebec, or for example, when you have a family where a cancer is running through the family, then this is a part of the test. And the other part of this we do is we do a test for cancer patients, patients that have cancer that doesn't have material family history of cancer, then we do genetic tests to study those cancers.

Tarah Schwartz: 1:59

Now, when you say genetic tests, help us to understand what you mean, what is different when you're doing a genetic test, versus you're doing any other test that happens to people regularly, what is different about that?

Dr. Andrea Gomez: 2:09

We're gonna see, the people are used to see that validates all the genetic tests, and you can sequence the genome of a cell, then what we are looking at what is in these cancer cells that can be different from one patient to another patient, then we are looking at one of these cancers that has and has been the decision to treat the patients in a better way based on what each cancer has.

Tarah Schwartz: 2:37

So are you quite literally looking at the genome at each person's genome? And what you're finding within that?

Dr. Andrea Gomez: 2:44

Yes, is that we are literally doing checking each cancer or each patient genome depending on if we're looking for a genetic disease or unique disease of cancer. And in case of cancer, we are looking at the genome of the cancer on them those different ways to cut that, then this is a full year of doing.

Tarah Schwartz: 3:06

It sounds like a really fascinating field. Dr. Gomez, can you take our listeners behind the scenes, describe what you do on a day to day basis?

Dr. Andrea Gomez: 3:13

Yes, our work is that every pathologist or gonna call you to send the samples of patients what they want to look at them, we're gonna take that piece of tumor of tissue and we're gonna do the analysis and sequence that gentleman see what we can find on that genome that can guide them call this trip the patients. And our job is we do around 100 cases of cancer a week. We're working look at each one of those cancers and see if there was a possibility or an opportunity to apply the Precision Medicine of the personalized medicine on those patients. Then with the report we generate and colleagues are ready to see okay, what is this cancer, what is special this cancer has and how they can get or treat the patient.

Tarah Schwartz: 4:05

So fascinating. Our guest today is Dr. Andrea Gomez, and we're talking about genetic testing and personalized medicine. We know Dr. Gomez that technological advances are happening at a rapid rate, no doubt in your field genomic testing. It's happening there as well. What have you seen over the last 5, 10, or 15 years in terms of technological advances in the work that you're doing?

Dr. Andrea Gomez: 4:29

I think they change and that bank has been huge. One of the worst examples is the lung cancer in the past 20 years, the change has been the change had been so important before, like the enclosures were treated the page the cancers based on the location that every lung cancer has the same treatment that was basically either surgery radiotherapy or chemotherapy, since the personalized medicine came out with all these cutting edge instruments to do it, then now they can see that two patients with a lung cancer can have different alterations and can be treated with a different drug without the necessity to go to the chemotherapy for a cause that can have side effects, then that has been changing a lot. Almost every month, there are new biomarkers, the laboratories are doing the research are also advanced from doing huge bounce in having every time new biomarkers and the ideas of the laboratory need to cope with that advance and need to be at the same level. We need to be able to offer to patients and to cancer patients at test and we'll be able that like that they're going to be beneficiaries with these new biomarkers, which is why it's super important that our tests would be at the cutting edge of the research.

Tarah Schwartz: 5:53

Absolutely. Since you're the you're the first step in influencing how doctors and specifically cancer doctors are treating their patients, it's so important. I'm wondering how you help define because most personalized medicine, it's a real buzzword now. That's the future of medicine, being able to treat people personally not everybody, as you mentioned, who has lung cancer is going to get the exact same medication, how do you help people understand the importance and what is personalized care?

Dr. Andrea Gomez: 6:22

So I think, as I said before, the personalized care is different things, different approaches in how we help them is to start basically the general multipath cancer and die efficiency. Okay? This cancer has thesis specific alterations of gene that can be treated with this drug that is approved on the market. How we can help the population is to offer the best test the test covers at least everything that is already available. For us, it's important to update every time that tends to be able that I can say go through the same thing that I've seen before, be able to offer a test that is a standard of care and is comparable, for example, with test that has been done in the United States, at hospitals, a module clinic, or the Memorial Sloan Kettering Cancer Center in New York, that our idea is to offer up care that there's going to be a level of that important centers for cancer.

Tarah Schwartz: 7:18

Our guest is Dr. Andrea Gomez, and we're talking about genetic testing, I find your area of research and work, Dr. Gomez, so fascinating genomic testing. What is it that drew you to that field?

Dr. Andrea Gomez: 7:31

I think it's the possibility to help the patients. As I say, we are not a research space, we're a clinical laboratory, we are doing tests that will be at that clinical useful thing for us. I think it's really the end of this translational research between the research and in the side, we are able to apply all that knowledge to actually give a service and a test that is going to be useful for the patient.

Tarah Schwartz: 8:02

We talk a lot about big dreams on the show, what is yours, what is something that you hope to achieve or come close to achieving in your career?

Dr. Andrea Gomez: 8:12

Our major claim is that every cancer patient in Quebec will have a test that is going to be at the level of the standard of care, like a test that is because frankly, only the big centers or academic center can offer this kind of cutting edge testing, when our dream is that every consultation in Quebec has the same procedure list, democratize cancer testing and genetic cancer testing. This is I think, our main objective and will be the dream that every time every patient has a cancer can have this personalized approach and see if that plays they can benefit for a specific charity or a specific prevention for the type of cancer they have.

Tarah Schwartz: 9:01

That is an absolutely brilliant dream I highly supported. Dr. Andrea Gomez is the Director of the Core Molecular Diagnostic Laboratory at the MUHC. Thank you so much for joining us on Health Matters. Thank you very much. Next up on the show a physiotherapist who specializes in women's health shares how physiotherapy can improve your day to day. I'm Tarah Schwartz. Welcome back to health matters on CJAD 800. Last week on the show we introduced you to physiotherapy and help to debunk some of the misconceptions around it. Did you know that physiotherapy can also help specifically in women's health, particularly for the pelvic floor. Claudia Brown is a physiotherapist with almost 40 years of experience in women's health and she joins us now. Hello, Claudia.

Claudia Brown: 9:47

Hi, Tarah, thank you so much for inviting me.

Tarah Schwartz: 9:49

We're happy to have you here. So I'm curious about what inspired you to become a physiotherapist.

Claudia Brown: 9:55

To become a physiotherapist, all my life I always loved health and fitness and I wanted to have a career in which I'd be physically active. When I started 40 years ago, physiotherapy wasn't really well known. But I'd heard about it. I didn't really know what I was getting into. And it did end up being the perfect career choice for me because a few years into my practice, I discovered pelvic floor physiotherapy, and the field of pelvic health has driven me ever since.

Tarah Schwartz: 10:19

Before we get into that, which I really do want to talk about. I'm curious if you said that 40 years ago, physiotherapy wasn't well known. There must have be massive changes that have happened between 40 years ago and now in that field.

Claudia Brown: 10:32

You're so right. Our field of practice has expanded exponentially. It's really amazing when I look back because I teach at McGill University and I talk to students who already know about all different fields of physiotherapy. But just in my physiotherapy career lifetime, there's been huge changes just in the treatment of well, pelvic health, of course, but also in treating cancer, in emergency medicine and treating problems with post surgical conditions, post cancer conditions, dizziness. There's so many things that physiotherapist can do. We're just involved in so many aspects of physical health now.

Tarah Schwartz: 11:07

Alright, so let's jump into your area of specialty or expertise, which is pelvic floor physiotherapy. How do you explain what that is?

Claudia Brown: 11:15

I guess the best way to explain it is to explain first, what the pelvic floor is. The pelvic floor is the floor of the pelvis. So it's really that whole area in your private parts that actually supports all of your abdominal contents, but also supporting the abdominal contents, this muscle of the pelvic floor has to be able to work dynamically, it has to be able to open so that you can go to the washroom, it has to be able to close so that you can prevent yourself from going to the washroom. It's involved also in sexual function. So it's a really functional muscle that works around our private parts. So what we do in physiotherapy is help patients to understand that muscle and help them to use that muscle appropriately.

Tarah Schwartz: 11:58

So you mentioned two issues, using the restroom and when you have sexual activities. Are there other kinds of issues that pelvic physiotherapy pelvic floor other physiotherapy can help with? Are those the two main issues?

Claudia Brown: 12:10

Well, there's bowel and bladder control, of course. And when I talk about sexual functioning, there's sexual functioning in the male and in the female. In women, there's quite a large proportion of women who have pain during sexual intercourse. We can help women with this pain, if the pain is related to something related to physiotherapy. In this case, we can help with sexual function for men and for women. Some men, after they have certain surgeries, they have problems with controlling their sexual function as well. There's not as much research in the male sexual health, so this is another new area of practice that is just coming about. But there's a lot of research now in how physiotherapist can help women with sexual pain, urinary incontinence, so not only incontinence, meaning people who they might laugh or cough, and they'll leak, we can help women with this problem. We can help men who have problems after having prostate surgery who have incontinence, some cases can be helped in that case. But there's also people who have problems with what's called urgency where they have to go to the washroom very often and as soon as they arrive home and they put the key in the door, they really have to run to the washroom, so we can help them with that as well. We also helps with posture and balance.

Tarah Schwartz: 13:24

I have so many questions I want to ask you, Claudia. First of all that's jumping into my mind is, how would women, you mentioned a lot of women, are having pain during intercourse or various other things that you can help treat? How would women know who and what kinds of physiotherapist to reach out to if they're listening right now and thinking, yes, that's me.

Claudia Brown: 13:41

Okay, that's a really good question. What we're seeing is there, since the Internet has become so popular. This was one of the reasons our profession was exploding, because we've had a lot of women who might have had these problems, but are a little bit too shy to discuss them with the doctor or too shy to talk about them even with friends. So we'll go on the Internet, and they'll see on the Internet that wow, there's physiotherapy that can help. So in order to know which physiotherapist to see, in Quebec, we have the OPPQ, which is the Professional Order of Physiotherapist of Quebec, and there's a rostering on that website. So you can you can go onto that website. It's oppq.qc.ca. You can go onto that website and you can plug in your postal code and the area of practice that you need, and list of physiotherapist who are experts or involved in that field will come up.

Tarah Schwartz: 14:32

So interesting. Now, here's another question for you. I'm sure people are wondering about this. So you work at McGill University, you teach at McGill and we're talking about different areas that can help women. Most people think physiotherapy is something that would be covered only if they have insurance. Is that the case? Or if they pay for it?

Claudia Brown: 14:51

This is something that's really interesting to them. That's really changing as well and I'm so excited to see all these changes happen. When I started in this field, it was really only available in private practice. So this means that you have to go to a clinic, you have to pay the money, and you have to either get reimbursed from your insurance or not. Whereas now, because there's so much research in the field, and there's there's government bodies that are really interested in looking into coverage for this, and I've been on a couple of committees in the past couple of years where the research is being looked at, and they're saying, we should make this more available to the general public. And we have seen that happen on its own. So there's several hospitals now in the in the Montreal area, that are treating patients who have problems with urinary incontinence.

Tarah Schwartz: 15:34

Is that something that a doctor can offer up a referral to people? If they go see their doctor, and they want to see a physiotherapist, is that something that their doctor can help them with?

Claudia Brown: 15:43

Yes, and that's really the best case scenario because sometimes, somebody might have a problem with urinary incontinence that's not really related to the pelvic floor, it might be another bladder problem, or it might be a systemic problem that really is out of our area of expertise. So what we really like is if the patient sees their doctor first, and then the doctor will say, Oh yes, okay, you have no other problems. We've done all the investigations. And I think this is a problem for a physiotherapist, and then they'll send you to physio. So our best case scenario is really patients who are come who come referred from doctors, but if they do come on direct access, because they heard that we can help them or their mother was helped, or whatever. Then in that case, if we see what we call red flags, or orange flags, we will send them back to a doctor just to check things out that we think might not be within our scope of practice.

Tarah Schwartz: 16:32

Our guest today is Claudia Brown, and we're talking about physiotherapy. I'm guessing Claudia and just thinking about your last comment that the best case scenario is a referral from a doctor, I guess you have to be dealing with more open minded doctors who are able to see that something outside of traditional medicine can help people or women who are suffering with certain things, is that something that you've come across or notice that it's changing?

Claudia Brown: 16:55

Absolutely, a yes to both questions. Because at the very beginning, it was really only the very innovative doctors or the doctors who were really more interested in research that were interested in sending to physiotherapy. But now because there's so much evidence, there's a lot of research out there and a lot of research actually coming from Canada and coming from Montreal specifically as well is there's a lot of research really proving it. So now that the research is out there, all doctors learn about it. The only problem is what we call knowledge transfer. It is a fact that anything that comes out in research, it takes more than 10 years for it to come into practice. So I'm finally seeing this happen. So we're getting a lot more referrals from doctors for pelvic health. The other thing I'm seeing is when I go to a lot of the international conferences and before of pelvic health or physiotherapy was just considered a "maybe you can try this." Whereas now it's up front and center in all of the conferences and there's always a section on pelvic health and the physiotherapy approach. So it's really really encouraging to see this happen.

Tarah Schwartz: 17:59

I'm so happy to hear that. That is great news to know. Now what information we serve so little time you have Claudia, I feel like I could ask you so many questions, but let's do this one. What information would you want our listeners to know about physiotherapy overall and how it can help?

Claudia Brown: 18:13

You mean physiotherapy in terms of general physiotherapy? Yeah, okay. I guess because the physiotherapy practice has expanded so much. I mean, there is obviously something that we're that we're doing, right. And a big part of it. I think that the beauty of physiotherapy is that we really teach patients how to help themselves. So for one thing, physiotherapist have a lot of time with their patients, or they usually take a lot of time with their patients. And so they'll ask the patients a lot of questions put them to read all of the investigations, all of the radio, radiology reports, or whatever. And then we'll put them through a physical examination. Once we've done that, we can sort of determine what are these physiotherapy problems that we can work on. And then we explain that in great detail to the patient. So the patient when they learn all about this, they're empowered right away, even before we've even started treatment, just the fact that they know what's happening. They know that they will be able to help themselves. So we teach them a lot of strategies, exercises, all kinds of things that we do with them. But our hope is that they will take this on their own and do this on their own.

Tarah Schwartz: 19:17

Wonderful. Claudia Brown, so interesting. Thank you so so much for joining us on the show today.

Claudia Brown: 19:23

Thank you so much for inviting me, Tarah.

Tarah Schwartz: 19:25

Thank you. Next up on Health Matters, the MUHC Foundation's Le Bal Rouge raised an inspiring amount in support of respiratory research and care at the MUHC. We speak with one of the women who made it such a successful evening. I'm Tarah Schwartz, and this is Health Matters. The MUHC Foundation's Le Bal Rouge whose is an annual event and this year, it raised an incredible$1.68 million in support of respiratory care at the MUHC. It was also the first time the event had four women co-chairs who are all titans of industry. One of the co-chairs joins me now. Lucie Guillemette is the recently retired Executive Vice President and Chief Commercial Officer at Air Canada. Thank you for joining us, Lucie.

Lucie Guillemette: 20:08

Thank you very much, Tarah, how are you?

Tarah Schwartz: 20:10

I'm well, thank you. So Chief Executive Vice President, Chief Commercial Officer at Air Canada, you have certainly paved the way for women at that organization. Tell us a little bit about your history, your path?

Lucie Guillemette: 20:22

Well, actually I started with Air Canada 36 years ago. And I have to say that if I had to redo a career, I wouldn't change a thing. I was extremely fortunate at Air Canada. And the truth of the matter is, when I started at Air Canada, the individual that was responsible for all the commercial divisions within the company was a woman. So for us at Air Canada, a lot of work that started many, many years ago to promote diversity and equity.

Tarah Schwartz: 21:03

And it doesn't happen anymore really, like that people stay in one career for 36 years, like younger people tend to jump around a lot. So it really is interesting to talk to someone who's been at a place for that long. You recently retired? How do you feel about the incredible career you've had?

Lucie Guillemette: 21:20

I'm extremely proud of what I was able to accomplish with a lot of colleagues and other candidates that I highly, highly respect. Even through the years, you develop friendships, as well, with colleagues. But the airline industry is a fascinating one. And in a company like Air Canada, it's almost as if, you have many companies within one, there's so many different disciplines, whether it's a commercial branch, whether you're in, loyalty or engineering, maintenance, flight operations in flight service. So for someone who adores that industry, Air Canada, it's certainly a very, very good place to spend to spend 36 years.

Tarah Schwartz: 22:12

You retire from one thing, but that doesn't mean you retire from everything. You are a part of the MUHC Foundation Board of Directors, how long have you been on the board?

Lucie Guillemette: 22:20

I joined in the fall of 2019. It was done just shortly before the start of COVID actually.

Tarah Schwartz: 22:29

And how has that experience been?

Lucie Guillemette: 22:32

I have to say that the work that was accomplished by the team at the MUHC Foundation during that very, very difficult period, was incredibly impressive, and certainly very inspiring. And I certainly appreciated every minute of working on this board.

Tarah Schwartz: 22:51

Our guest is Lucie Guillmette, recently retired Executive Vice President and Chief Commercial Officer of Air Canada. She's also on the MUHC Foundation Board of Directors, and was one of four co-chairs at the Le Bal Rouge gala this year. So how special was it to be the co-chair with three other extraordinary women? What was that like?

Lucie Guillemette: 23:13

I had the pleasure to sit on the board with Lisa, Sacha and Maria. And of course, these are very accomplished women in their respective areas of business. But they're also very compassionate, they're caring individuals, who want to do better for their community. So it was a privilege for me to work with them in support their cause. And it was also extra special to develop the bonds of friendship with these women that of I highly respect. And for us, for sure, it was quite special, because it was the first time I think that four women actually co-chaired the gala.

Tarah Schwartz: 23:54

It absolutely was. Was this your first gala? Did you or have you been to the gala before?

Lucie Guillemette: 23:59

No, I have attended the gala before. As we talked about, I was with Air Canada, and Air Canada has provided support along with other businesses and the community has provided support to the MUHC. So I had attended the gala before. But to attend as a co-chair, I have to say was even more special, the event this year was incredible. But more importantly, it was heartwarming to see the business community come together after the three very difficult use of COVID, to celebrate the achievements of Dr. Schwartzman and his team at the Montreal Chest Institute.

Tarah Schwartz: 24:42

$1.68 million was what was raised, as you mentioned, for Respiratory Care at the Montreal Chest Institute, part of the MUHC, what did that feel like? As the number was climbing up, and then that final announcement of $1.68 million, what did that feel like for you?

Lucie Guillemette: 24:56

Well, the first thing is, I would say is that you actually leave the gala wanting to do more, it was extremely rewarding. And it made me very proud to have been able to contribute to that. But also, proud to support our physicians and the medical community at large, that the Dream Big really is your campaign. It allows physicians like Dr. Schwartzman to make strides and advancements and treatment and care for our communities. It's so critical. And to see how passionate and dedicated they are to their work, it was really a pleasure for me to celebrate. And also, very rewarding to see this $1.68 million. A lot of generous people in our community, and it's certainly much much appreciated.

Tarah Schwartz: 25:50

Is respiratory care a cause that's close to your heart in some way?

Lucie Guillemette: 25:54

I have to say that I am very fortunate to not have had any family or close friends who suffered from serious lung disease. But certainly, the last three years have taught us how scary and serious respiratory diseases can be. So from that perspective, it was a college that I was really excited to support.

Tarah Schwartz: 26:17

Lucie Guillemette is our guest, she is the recently retired executive Vice President, Chief Commercial Officer at Air Canada, also of all members of the MUHC Foundation Board of Directors. Tell us, some people might wonder what is it that a Board of Directors does? How do you explain what it is to be part of a board of directors?

Lucie Guillemette: 26:36

Well, in essence, we're there to provide support, guidance and leadership to the management team. And we're also there to support some, particularly in the case of the foundation, we're there to be able to assist with fundraising through our networks. But really, we are there to support the management team, and to provide strategic direction as well to the team that is in place.

Tarah Schwartz: 27:07

And you mentioned that you've been on the board since 2019, which means that you've seen a lot, you've learned a lot, we often bring doctors in to talk you see all the work that the foundation is doing what has inspired you over the last four years? Or inspired you the most? Or is there something that sticks out for you as a memory over the last four years or something that particularly you walked away thinking, wow, this is incredible.

Lucie Guillemette: 27:28

Well, every time you have the opportunity to listen to a doctor, speak about the research that they're doing or to speak specifically about their cause, it's extremely inspiring. I personally feel privileged to be on one of the committees of the MUHC Board, which does exactly that when it comes to assigning some of the fundraising money to different causes. And I feel every time I have the opportunity to listen to the physicians into their teams talk about the importance of what they're doing and the impact that it has on patient care is extremely inspiring.

Tarah Schwartz: 28:21

It absolutely is. Lucie Guillemette thank you so much for your support through everything all these last years. We appreciate you joining us on Health Matters.

Lucie Guillemette: 28:30

Thank you very much Tarah. And once again congratulations on the gala it was an incredible event.

Tarah Schwartz: 28:36

Thank you so much. Next up a daughter's beautiful and touching tribute for her mother who lost her battle with breast cancer. I'm Tarah Schwartz, you're listening to Health Matters. It was a very special moment. Last week when the Foundation Fondation Yvon Michel came to the MUHC to unveil a special memorial plaque. The plaque was donated in recognition of Louise Drolet, who lost her fight with breast cancer. Louise's daughter Stephanie Drolet is the head of the Fondation Yvon Michel and has worked tirelessly to fundraise in support of metastatic breast cancer research. Her goal is to ensure that more women can be saved from this devastating disease. Dr. Anthoula Lazaris is a Scientist in the Cancer Research Program at the Research Institute of the MUHC. She studies metastatic breast cancer, and she was at that plaque unveiling last week. Thank you for joining us.

Dr. Anthoula Lazaris: 29:27

Thank you for having me Tarah.

Tarah Schwartz: 29:28

Now, as I mentioned, you were at the plaque unveiling which was placed outside the image series breast clinic what was going through your mind as that plaque unveiling was happening?

Dr. Anthoula Lazaris: 29:39

It was a very emotional moment actually. And Stephanie gave a small little speech and you can actually you feel the pain in Stephanie's voice from the loss of her mother. Almost like it happened yesterday. What was very special I found is Stephanie's comment. She really put it very eloquently, that the plaque it's just an object. But what it symbolizes is really more important. And what she stated and I think it resonated with everyone there, that it really symbolizes that we will never forget those who have passed down these corridors and those who have fought and those who are continuing to fight. The other thing is it also symbolizes that, and we want that, and I believe the family wants to symbolize that these women are not alone, and that we are continuing to fight along with them with our own means.

Tarah Schwartz: 30:35

That is so beautifully said. Now, Louise Drolet lost her fight, as we know, because it is a fight. But so much has changed. Dr. Lazaris, in terms of breast cancer care survival rates, can you talk to us a little bit about that?

Dr. Anthoula Lazaris: 30:52

If we're talking about breast cancer that has left the breast and gone to other sites, and specifically I study going to liver, there are treatments. So your oncologist is the best person to determine the right treatment for you, and its standard of care. What is key though, and how to move forward in fighting this disease is, first of all, to monitor the tumors response to the treatment. Now we don't have the perfect treatment today, we're working towards completely destroying the tumor itself, that found its way to the liver. But what's equally important to fight this disease is to be able to see when the treatment stops working. So we can react quickly to change the treatment to a new treatment that will then continue to fight the cancer. So we have control of the tumor before it spreads too far.

Tarah Schwartz: 31:45

We're speaking with Dr. Anthoula Lazaris, and we're talking about breast cancer research. Now your area of expertise, as you mentioned, is specifically when the cancer has moved outside of the breast to another part of the body. In your case, it's liver. What impacts that is that if you catch it early enough, it won't spread like does is the spreading really just about how quickly you catch it?

Dr. Anthoula Lazaris: 32:05

Definitely, we talked about it for breast for colon cancer, early detection. In Quebec, we have an amazing plan for free mammograms for women over a certain age, early detection is your best defense against having it spread metastatically. There are different types of breast cancer, there's different risk factors as well. Unfortunately, for Stephanie, since her mother did have breast cancer, well, she's in a way that advantage because now she can screen herself and screen regularly and early to prevent the disease from happening to her.

Tarah Schwartz: 32:40

Do you also encourage as you mentioned, Quebec has a fantastic plan. Mammograms are free over a certain age. Do you also encourage women to do self exams to be very proactive about being on top of their own body? And if they feel something untoward? They seek help right away?

Dr. Anthoula Lazaris: 32:57

Yes, 100%. Every time I take a shower, I self examine. My daughter, she's 23. Now I've told her the same thing. So it's simple. You're in the shower, you self examine anything, you feel suspicious, any changes anything. Worrying doesn't solve anything, go see your doctor, the doctors are there to help and support you. Go and get yourself examined if you suspect anything, but I agree completely with you, Tarah, we have to also self examine ourselves.

Tarah Schwartz: 33:28

I love that idea. I hope all the women listening or listening to Dr. Lazaris about that because it's a simple thing. You jump in the shower, take the two or three minutes, because as you mentioned, early detection is key. Now, what are the challenges when treating breast cancer once it has metastasized? I guess, a certain treatment if it hasn't moved from the breast to another part of the body? That's one treatment. What are the challenges if it has moved?

Dr. Anthoula Lazaris: 33:52

So the main challenge when it's moved to the liver, which is the only thing I can really speak for, it's finding the right treatment for the patient. So the oncologist will use the standard of care, and will find the right treatment be the first challenge is once unfortunately you have metastatic disease is to control the disease. And that's how we start to win the fight, having it under control. So being able to monitor the tumor, is it responding to treatment, there are tests now that we are developing, and some of them that are close to coming into the clinic when we talk about like blood tests where we can detect the pieces of the tumor in the blood, where we can actually monitor the patient. So the moment they stop responding to treatment, the earlier we can detect a lack of response, the better jump we have on controlling the disease and changing the treatment option for the patient. So we can then attack the tumor from a different angle.

Tarah Schwartz: 34:51

So are you saying that you are able to see in a blood test whether or not that tumor is still responding to them at case you're getting it?

Dr. Anthoula Lazaris: 35:01

Yes, as tumors grow, they shed DNA into our circulation, we can detect that. And what happens is as you treat that level of DNA in the circulation will go down as the tumor dies. But if the tumor starts to grow again, that level starts to go up, just like cancer markers CA, and other cancer markers that doctors currently oncologist look for in the blood. When you see something going up, it indicates that the disease is getting starting to grow and you don't want to lose control. So the same thing with early detection, early diagnosis of response to treatment increases your chance of controlling this disease.

Tarah Schwartz: 35:44

We're speaking with Dr. Anthoula Lazaris, and we're talking about breast cancer, metastatic breast cancer research and care. Now I want to wrap up our interview, Dr. Lazaris, with the book end of the Fondation Yvon Michel, you described it so beautifully that Stephanie Drolet, who is the head of the Fondation Yvon Michel, unveiled a plaque in name of her mom, how do donations like the one from Stephanie Drolet and the Fondation Yvon Michel, how does that help push research forward? How critical is that kind of philanthropy, whether it's from a foundation, whether it's from someone as a monthly $20 donor to the MUHC Foundation?

Dr. Anthoula Lazaris: 36:21

Every donation adds up. What it really helps us research, it's not just research, it also helping us integrate our research into the clinic. So one thing is, especially with the donations from the Fondation Yvon Michel, is we now have the funding available to have access to the latest technologies, finding these molecules in the blood at high sensitivity, for example, retaining talent, having good graduate students that can move the research forward, right? Every penny counts towards this. The other focus of research today, especially in our research institute, because it's associated with the hospital, is integrating our research into the clinic. So it's one thing to find a solution on the bench, but how do you bring it to the patient, you have to have that close connection with the clinic. And the funding actually helps them build that pipeline, get the right nurses involved from the beginning. And the staff on the hospital side, working with us to start integrating this onto the clinical side.

Tarah Schwartz: 37:29

From the bench to the bedside. It's one of the expressions I've come to really appreciate since I've started working at the MUHC Foundation almost three years ago, hard to believe. Dr. Lazaris, it is always such a pleasure to speak with you. Thank you so much for taking the time to come on the show.

Dr. Anthoula Lazaris: 37:43

Thank you so much.

Tarah Schwartz: 37:44

I'm Tarah Schwartz. Thank you so much for tuning in. As mentioned, Health Matters is coming to an end on CJAD. It has been a great three years, but it will live on as a podcast for the MUHC Foundation. So if you like what you're hearing, just head to muhcfoundation.com where you can hear past episodes. And while you're there, sign up to our newsletter and you can be the first to know when we launch Health Matters 2.0 in the fall. I hope you'll join me again next Sunday. That will be our second to last show. Thank you so much for listening to health matters and stay healthy.