HWS Field Trips: London

HWS Field Trips: London

Research hospitals play a leading role in making Ontario healthier, wealthier, and smarter. To demonstrate the world-class hospital-based research happening across our province, we took a field trip to Ontario’s Forest City—London—where researchers at the Lawson Health Research Institute (Lawson) are transforming patient care through discovery and innovation.

Lawson is the joint research institute of London Health Sciences Centre and St. Joseph’s Health Care London. We took a behind-the-scenes tour of the Lawson labs and clinical research space, and were delighted to be joined by patients, researchers, hospital CEOs and local politicians MP Karen Vecchio, MPP Jeff Yurek, and City Councillor Harold Usher along the way.

The Kick-Off

Patients, community members, hospital CEOs, senior staff, researchers, and representatives from all three levels of government were on hand to celebrate and champion the game-changing health research underway at the Lawson Health Research Institute (Lawson). Dr. David Hill, Scientific Director of Lawson, kicked off the tour by sharing a few words about the role of health research in building a healthier, wealthier, smarter province. “It’s research-based hospitals in Ontario that bridge the gap between discovery and the next generation of health service and delivery,” said Dr. Hill.

We were honoured to be joined by City Councillor, Harold Usher, who remarked that health research is a key contributor to London’s economy. We also heard from two members of the London community who have participated in health research at Lawson.

Councillor Harold Usher meets health research participants Michael Allan and Wayne Kristoff.
Hospital staff, community leaders, researchers, MPs, MPPs and more all ready for the tour!
Dr. David Hill, Scientific Director of Lawson
Councillor Harold Usher, London City Councillor

Patients + Research: Wayne Kristoff joined a clinical trial aimed at putting his type 2 diabetes into remission for an extended period of time. “I remember where I was on May 16, 2016,” said Wayne recounting his experience undergoing the treatment regimen, “when I received that call to say the test results were good, and that I could stop taking my diabetes medication.” Wayne has been off of his diabetes medication since then.

Michael Allen, a 2-time cancer survivor, participated in a personalized medicine research study with Dr. Richard Kim, a leader in personalized medicine not only in London, but around the world. “You can’t take a cookie cutter approach,” said Michael. “Medicine is personalized to each patient, and that’s something that Dr. Kim took the time to explain to me.”

Wayne and Michael’s stories drove home the punchline of our tour: health research is a necessity, not a luxury. It saves lives and improves outcomes for patients and families across Ontario. With Wayne and Michael’s stories in mind, a group of over 10 health research champions headed to the personalized medicine labs to begin the tour.

Wayne Kristoff
Michael Allan
And off we go! Dr. Gillian Karnaghan (President & CEO, St. Joseph’s Health Care London), Murry Glendining (President & CEO, London Health Sciences Centre), MPP Yurek, MP Vecchio, Karen Michell (Executive Director, CAHO), Dr. David Hill (Scientific Director, Lawson).

STOP 1: Personalized Medicine Program

Our first tour guide of the day was Dr. Richard Kim, Director of the Centre for Clinical Investigations and Therapeutics (CCIT), and leader in personalized medicine research. The CCIT was the first clinical research centre of its kind in Canada, uniquely built for an academic health sciences centre to serve a dual purpose: enable hospital-based research and attract industry-sponsored clinical trials, supporting the city’s innovation and knowledge-based economy.

Better health at a better price: “Personalized medicine is more than something that sounds cool,” said Dr. Kim. “We’re finding that it’s actually better for patients and cheaper for the system.” For example, at his personalized medicine clinic, Dr. Kim runs genetic testing on patients prescribed the blood thinner drug, Warfarin, to determine the appropriate dosage for each particular patient. This is helping to ensure the safest, most appropriate level of medication while reducing unnecessary care.

Lab space in the CCIT is set up for industry use, drawing investment into London.
Dr. Richard Kim tells the group about Dr. Wendy Teft’s research using personalized medicine to alleviate side effects for patients with colorectal cancer, while leading to better outcomes.
In the genotyping lab, Cameron Ross can processes blood and tissue samples for DNA variants in about 2 hours for personalized medicine.
In the analytical lab, researchers look at drug concentrations in the body through blood and tissue samples to ensure efficacy and safety.

Read more about personalized medicine research at Lawson.

STOP 2: Lawson Imaging

As a key intersection for discovery and innovation, the Imaging team finds itself at the heart of Lawson research activity. Why? The unique technology developed and used here enables researchers in all fields of study (cancer, heart disease, stroke, brain health, and more) to employ new techniques and tactics for solving today’s greatest health challenges. One key piece of technology housed in London is the cyclotron – only one of two in Ontario.

Dr. Frank Prato shares that St. Joseph’s Health Care is home to Canada’s first MRI scan.
Lawson is also home to Canada’s only molecular imaging training program, explains Dr. Savita Dhanvantari.

Cyclotron 101: PET scans (positron emission tomography) measure activity in parts of the body to help detect different diseases. For example, they can show blood flow to the heart to help detect heart disease, or how sugar metabolizes in cells to help detect cancers. The PET scan image is created by positron emission from radioactive pharmaceuticals that are given to patients in advance of the scan. The cyclotron is the technology that makes these radioactive pharmaceuticals, which can be tailor-made to study a variety of disease areas.

The cyclotron is also helping to make Ontario Healthier, Wealthier, Smarter. The Lawson Imaging team is able to sell the radioactive pharmaceuticals that they manufacture to other clinics across Ontario, from Toronto to Windsor. All of the revenue goes back into the research that’s advancing scientific knowledge and improving patient outcomes.

Dr. Mike Kovacs explains how the cyclotron produces radioactive isotopes. Did you know that they have a half life of 110 minutes? They are stored in pressure-controlled chambers with lead walls.

Read more about imaging research at Lawson.

STOP 3:  Parkwood Institute Research

The tour made its way over to Parkwood Institute, where a clinical research program focuses on advancing innovations and discoveries directly related to patient care, in the areas of cognitive health, mobility, and mental health.

Parkwood Institute is home to a collaborative rehabilitation clinic – an open space where patients, caregivers, physiotherapists and occupational therapists are working together, using a variety of high and low tech devices and techniques to achieve daily rehabilitation goals while informing the research studies underway.

Stronger every day:  A research patient who has experienced a spinal cord injury inspired us all as he walked, step by step, around the room wearing an exoskeleton, a machine that sends electronic pulses to his muscles helping him stand upright and move. In the long-term, researchers hope to better integrate this technology with the wearer’s rehabilitation training by enabling the wearer’s brain to control the rhythm of the electronic pulses. Read more about how this technology is having an impact on the daily lives of members of the London community in this London Free Press story.

A research patient makes his way around the rehabilitation clinic in an exoskeleton.

Predicting dementia: We also visited the Gait and Brian Lab, where Dr. Manuel Montero-Odasso is taking an integrated approach to studying mobility and cognition. Right now, the team is working on a gait study, which explores whether changes in the way an individual walks while doing a mental activity might be able to help predict how long it will take people with Mild Cognitive Impairment (MCI) to progress to dementia.

Karen Michell, Executive Director of CAHO, takes the gait test. She walks down the sensor mat first without distraction, and again while thinking through a complex math problem as researchers measure any changes in her gait.

Read more about Parkwood Institute Research.

STOP 4: Kidney and Cancer Research

Did you know that there are over 23,000 Canadians on dialysis? Dr. Chris McIntyre, who came to Lawson from the UK in 2014, explained that the biggest challenge for these patients is often not receiving a transplant, but remaining healthy long enough to get one. Over time, dialysis causes injury to other systems in the body, with the most common cause of death for dialysis patients being sudden cardiac death.

Making dialysis safer: Dr. Chris McIntyre is working with imaging scientists to take a closer look at the causes for sudden cardiac death. By mapping out the problems, Dr. McIntyre and his team will begin to understand where changes are needed to improve dialysis and give patients a better quality of life. In the future, the goal is to conduct personalized imaging so that dialysis improvements are tailored to each patient’s unique needs.

See the small white mass? Dr. Aaron Ward explains that it’s a tumour in the lung.

Smarter care with smart tech: Dr. Aaron Ward is also using imaging to improve prediction of lung cancer recurrence after radiation therapy. Lung cancer is the leading cause of cancer death in Canada, and while radiation therapy is a less invasive treatment than surgery, it doesn’t always work the first time. Complicating matters, this therapy can sometimes result in non-permanent lung injury that can often be confused with cancer regrowth on CT scans after the treatment. The challenge for clinicians is accurately assessing whether the scans show an injury that’s healing, or a tumour that’s growing.

To help solve this problem, Dr. Ward is developing a computer-assisted decision support tool that clinicians can use when assessing the results of treatment. By accurately assessing injury, patients will avoid unnecessary treatment, and by accurately assessing cancer regrowth, patients gain faster access to a second round of radiation.

Learn more about this work from Sarah Mattonen, a trainee in Dr. Ward’s lab, and about nephrology and cancer research at Lawson.

STOP 5: Children’s Health Research Institute

Does past research about fetal health still hold true with today’s population of pregnant moms? This is just one of the questions being answered at Children’s Health Research Institute, a Lawson program.

Measuring fetal health: Dr. Barbra deVrijer, who came to London from the Netherlands, is studying whether our measures for normal fetal metabolism are still appropriate for babies today, given potential differences among pregnant women such as lifestyle, weight, or stress. Her challenge was to find an innovative method of examining the fetus against past evidence-based measures for health – without causing harm to baby or mom.

Like much of the research on our London tour, her solution came through a collaboration with another researcher. Dr. Charles McKenzie developed novel techniques that use an MRI to monitor fat development, track rate of blood flow through the placenta, measure oxygenation and more. In fact, his team is the first in the world to use imaging to measure placenta metabolism.

Dr. Charles McKenzie explains how he is able to measure fat development without causing harm to fetus or mom.
3D image of a fetus demonstrates the types of images the team is able to get using their technology.

Read more about children’s health research at Lawson.

Health research in action: After a full day of inspiring people and incredible research, it’s clear that London is a powerhouse with expertise in a diversity of fields. Regardless of the many research areas, all teams are working together to discover new ways of providing better care.

“Research collaborations happening across the city are providing immense value for our patients and the health care system,” said Murry Glendining, President & CEO of London Health Sciences Centre.

“Over time, new questions capture the minds of our researchers – and so the cycle continues,” added President & CEO of St. Joseph’s Health Care London, Dr. Gillian Kernaghan.

We look forward to seeing how curiosity and health research leadership will continue to drive discovery in London, and we want to extend our sincere thanks to our hosts at the Lawson Health Research Institute, London Health Sciences Centre and St. Joseph’s Health Care. We would also like to thank Councillor Usher, MPP Yurek, MP Vecchio for joining us, as well as the health research champions who came out for the tour kick-off and followed along on Twitter. Finally, we want to thank Wayne Kristoff and Michael Allan for sharing their lived experience with us, and reminding us of the value and need for health research in Ontario.

Why does health research matter to us? We know that it generates new discoveries, better care, and greater efficiency all while contributing to our knowledge-based economy. That’s how it makes Ontario healthier, wealthier, and smarter today. Investing in research hospitals will help us continue to build a healthier, wealthier, smarter Ontario tomorrow.