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UM Today the Magazine | Outsmarting a Brain Tumour – UM Today

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The little girl with the pink glasses and blue sweatshirt smiles back from a photo on the wall. It’s hung in Tamra Werbowetski-Ogilvie’s sixth-floor office, overlooking the treetops of the neighbourhood surrounding UM’s Bannatyne campus.

Alongside the framed photo are images of her own two children, including her daughter. She’s around the same age as this tween who was undergoing cancer treatment and who was connected to a foundation that funded Werbowetski-Ogilvie’s work in pediatric brain tumours—the deadliest of childhood cancers.

The Rady Faculty of Health Sciences researcher recalls chatting with the inquisitive girl on a Zoom call a year ago.

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“Those are emotional meetings, you know? And I can’t get through them without crying. She was so thankful when I met her and just so happy that people were doing work,” says Werbowetski-Ogilvie. “It hits you. See? Already, I’m getting emotional.”

That’s why she opted for life as a stem cell biologist instead of a physician. Pediatric brain cancer became an obvious choice; it’s a discipline starving for discovery. This cancer is surprisingly rare in kids; it’s only been in the last decade that research in this specialized field has gained momentum, with advances in gene sequencing technology. But still, children’s cancers in general are “ridiculously underfunded,” Werbowetski-Ogilvie is quick to point out. “In the States, they account for less than four per cent of all funded research in cancer. And it’s the same everywhere.”

Roughly 1,000 kids are diagnosed with cancer in Canada every year, including about 50 in Manitoba. Around 10 of these children will learn they have a malignant tumour in their still-developing brain. A few of them will be diagnosed with a medulloblastoma tumour—the type Werbowetski-Ogilvie investigates.

“Parents don’t care how rare it is. They want to look for better treatments.”

She’s saying this just weeks before the prestigious journal Nature publishes what is possibly her team’s biggest findings to date. With collaborators in Toronto, Seattle and Tokyo, they pinpointed how and where aggressive types of medulloblastoma first appear—in pre-malignant form—during a child’s brain development, while still in the womb. Kids aren’t usually diagnosed with this type of tumour, known as group 4, until age seven, which suggests there’s a window of several years to prevent the cancer from ever happening.

Until now, group 4 tumours were the least understood, yet they require some of the most intense treatment. Up to 40 per cent of kids don’t survive.


Parents don’t care how rare it is. They want to look for better treatments.

With new clarity of which genes go awry and grow into tumours, clinicians could potentially detect these problematic cells before they turn into cancer—it’s the first time scientists have suggested medulloblastoma is preventable. They can also now develop better human cell models to test potential drugs to slow or stop its spread.

“With better models, we’ll actually be able to make some headway,” says Werbowetski-Ogilvie.

Brain cancer, she reiterates, doesn’t always get its moment in the spotlight. Greater attention tends to go toward unravelling the mysteries of leukemia, which affects the blood and is the most common cancer among children.

“In the leukemias it seems that there’s been better strides made in terms of survival rates. Whereas with brain tumours—especially for these really, really bad cases—current therapies are really not extending life beyond an extra couple of months and are so toxic,” she says. “We need to do better for brain tumours. And I think we are definitely moving in that direction.”

The search for new treatments finds fuel in cancer stem cell biology, where scientists identify a tumour’s “cellular fingerprint.”

“We’re looking for the proteins on the surface of a cell as well as inside the cell that make those tumours unique,” says Werbowetski-Ogilvie. “And then we look for drugs that will target that unique signature.” That way oncologists can go after diseased cells while leaving surrounding healthy cells intact.

This shift in approach will redefine the future of cancer care by offering alternatives to radiation and chemotherapy, which simply goes after all dividing cells, healthy or not, she explains. A more tailored approach is especially overdue for kids since they suffer worse long-term side effects from conventional options.

“Trials and drugs for children cannot be lumped into what is given to adults. They’re not the same. Everything we know about childhood cancer is different: the mutations, the drugs they’ll respond to, how they will respond. We’re dealing with developing bodies, right? And so we have to think about how we treat these diseases in very different ways.”

“This is where I’m meant to be,” says Tamra Werbowetski-Ogilvie, who held a Canada Research Chair in neuro-oncology and human stem cells for a decade.

She and her mostly female team—many of whom are mothers of young children—have spent years investigating another type of medulloblastoma—the sonic hedgehog brain tumour—which originates in the cerebellum. It was a postdoctoral fellow at Harvard Medical School, Robert Riddle, who first identified the protein behind the tumour’s growth. The protein belongs to the hedgehog genes. (Riddle raised eyebrows when he named it “sonic hedgehog” after the 1990s Sega videogame character.)

Werbowetski-Ogilvie set out to uncover a drug that would target this cancer and, in 2018, found that selumetinib slowed the tumour’s growth, as their hypothesis had hoped. But stopping the study there, Werbowetski-Ogilvie notes, would have been like plucking a dandelion from the surface rather than removing its root. So they pursued the possibility of a second drug—and serendipity stepped in.

Had COVID-19 closures in 2020 not shut down her lab, these experiments wouldn’t have been cut short, and her team wouldn’t have gathered data at the precise point that alerted them to just how fast not one, but a combination of drugs—selumetinib, along with pacritinib—was shrinking these tumours. “One model showed an almost 90 per cent reduction in the tumour’s growth. Over time, this translated to a greater than 40 per cent increase in survival,” she says. “You can just feel the excitement in the lab when a story is coming together and it’s all sort of clicking.”

Postdoctoral student Jamie Zagozewski [BSc(Hons)/09, MSc/12] remembers that moment well. “We were just blown away when we saw how much we could shrink the overall size of these tumours,” says Zagozewski, 37. “These parents are going through what I imagine is the worst thing in their entire life, and if I can have something to do with helping to ease that, that’s just incredible.”

Up until then, neither of these drugs had been tried on medulloblastoma—but since they have been used on other childhood cancers, approvals can come quicker, says Werbowetski-Ogilvie.

“I don’t like hearing the term, ‘It’s good enough,’” she says. “You have to stick with it and you have to keep putting in effort. Maximum effort.”

Professor Werbowetski-Ogilvie as a child.

Biochemistry and medical genetics Prof. Tamra Werbowetski-Ogilvie grew up in Thunder Bay, Ont., changing diapers for her mom’s home daycare, and enjoying being around kids and their curiosity. Her dad, a petrographic technician who worked on asphalt and was known as “the rock doc,” would help her with her science projects with a go-to topic of—what else?—erosion. From there, she developed a passion for problem solving.

Finding new ways to treat brain cancer is especially complex since drug candidates must effectively reach tumours in this delicate organ. Many drugs are designed to not affect the brain, to not cross our blood-brain barrier, which protects toxins from getting in. Finding new, tailored treatments is made even more complicated since there are so many different types of tumours: 120 to be exact, according to the Brain Tumour Foundation of Canada.

Thankfully, in recent years, more affordable sequencing technology and an effort by the international research community to catalogue genetic differences among these tumours means scientists have a breakdown of genes involved in all forms of medulloblastoma. While this is extremely helpful, the data doesn’t speak to the behaviour of those genes and how they affect individual cells. It can be overwhelming to try to figure out which to narrow in on, admits Werbowetski-Ogilvie.

“When we get these large data sets, it’s our job to figure out which of these genes or proteins end up being functionally relevant. Not everything is,” she says. “It takes years to prioritize what to work on and figure out what our genes of interest actually do.”

A child's drawing of Wonder Woman, a black and white image of a brain, and a child's art piece made from a milk carton.

In Werbowetski-Ogilvie’s office, on her whiteboard, are old doodles by her son that have been there so long they won’t erase. On her shelf is an anatomical model of a brain, and a ‘science lab’ her daughter made out of a milk cartoon, along with a drawing she did depicting Mom as Wonder Woman—something her team placed prominently during a surprise makeover of the space.

“What I teach in my lab, and what I teach my kids, is perseverance,” she says. “With science, sometimes experiments don’t work, but you have to stick with it.”

That’s not lost on Zagozewski, who says it’s no small thing to be part of a predominantly female team in a STEM field, led by a researcher who’s both tenacious and nurturing. “Not only are we scientists but we’re friends and mothers, all supporting each other,” she says. “It’s not just a job—it’s more than that.”

DID YOU KNOW? Pediatric oncologist Dr. Norma Ramsay [MD/68], a 2021 recipient of a UM Distinguished Alumni Award and mentor to dozens of female researchers, also found her calling in the emotionally charged field of childhood cancer. A leader in stem cell biology, she headed the acclaimed Pediatric and Blood Marrow Transplant Program at the University of Minnesota, improving mortality rates. And if treatments failed, she’d often drive to hospitals, no matter the time of day, to be with children in their last moments.

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Kevin Neil Friesen Obituary 2024 – Crossings Funeral Care

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It is with heavy hearts that we announce the peaceful passing of Kevin Neil Friesen age 53 on Thursday, March 28, 2024 at the Bethesda Regional Health Centre.

A funeral service will be held at 2:00 pm on Thursday, April 4, 2024 at the Bothwell Christian Fellowship Church, with viewing one hour prior to the service.

A longer notice to follow.  

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Spring allergies: Where is it worse in Canada? – CTV News

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The spring allergy season has started early in many parts of Canada, with high levels of pollen in some cities such as Toronto, Ottawa and Montreal.

Daniel Coates, director of Aerobiology Research Laboratories in Ottawa, expects the elevated amounts to continue next week for places, such as most of Ontario, if the temperature continues to rise. Aerobiology creates allergen forecasts based on data it collects from the air on various pollens and mould spores.

Pollens are fertilizing fine powder from certain plants such as trees, grass and weeds. They contain a protein that irritates allergy sufferers.

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Although pollen levels declined after a cold spell in some places, he said they are soaring again across parts of Canada.

“So the worst is definitely British Columbia right now, followed by Ontario and Quebec and then the Prairies and Atlantic Canada for the upcoming weeks,” said Coates in a video interview with CTVNews.ca. “We are seeing pollen pretty much everywhere, including the Maritimes.”

He said pollen has increased over the past 20 years largely due to longer periods of warm weather in Canada.

Meanwhile, the Maritimes is one of the best places to live in Canada if you have seasonal allergies, in part because of its rocky territory, Coates said.

With high levels of cedar and birch pollen, British Columbia is the worst place for allergy sufferers in Canada, he added.

“British Columbia is going strong,” Coates explained, noting the allergy season started “very early” in the province in late January. “It has been going strong since late January, early February and it’s progressing with high levels of pollen, mostly cedar, but birch as well, and birch is highly allergenic.”

Causes of high pollen levels

Coates expects a longer allergy season if the warm weather persists. He notes pollen is increasing in Canada and worldwide, adding that in some cases the allergy season is starting earlier and lasting longer than 15 years ago.

He says tree pollen produced last year is now being released into the air because of warmer weather.

“Mother nature acts like a business,” he said. “So you have cyclical periods where things go up and down. … So when it cooled down a little bit, we saw (pollen) reduce in its levels, but now it’s going to start spiking.”

Along with warmer weather, another factor in higher pollen levels is people planting more male trees in urban areas because they don’t produce flowers and fruits and are less messy as a result, he said. But male trees produce pollen while female ones mostly do not.

Moulds

Coates said moulds aren’t as much of a problem.

“They’ve been mainly at lower levels so far this season,” he explained. “Moulds aren’t as bad in many areas of Canada, but they’re really, really bad in British Columbia.”

In B.C., moulds are worse because of its wet climate and many forested areas, he said.

Coping with allergies

Dr. Blossom Bitting, a naturopathic doctor and herbal medicine expert who works for St. Francis Herb Farm, says a healthy immune system is important to deal with seasonal allergies.

“More from a holistic point of view, we want to keep our immune system strong,” she said in a video interview with CTVNews.ca from Shediac, N.B. “Some would argue allergies are an overactive immune system.”

Bitting said ways to balance and strengthen the immune system include managing stress levels and getting seven to nine hours of restful sleep. “There is some research that shows that higher amounts of emotional stress can also contribute to how much your allergies react to the pollen triggers,” Bitting said.

Eating well by eating more whole foods and less processed foods along with exercising are also important, she added. She recommends foods high in Omega-3 Fatty Acids such as flaxseeds, flaxseed oil, walnuts and fish. Fermented foods with probiotics such as yogurt, kimchi and miso, rather than pasteurized ones, can keep the gut healthy, she added. Plant medicines or herbs such as astragalus, reishi mushrooms, stinging nettle and schisandra can help bodies adapt to stressors, help balance immune systems or stabilize allergic reactions, she said.

To cope with allergies, she recommends doing the following to reduce exposure to pollen:

  • Wear sunglasses to get less pollen into the eyes;
  • Wash outdoor clothes frequently, use outer layers for outside and remove them when you go inside the house;
  • Use air purifiers such as with HEPA (high efficiency particulate air) filters;
  • Wash pets and children after they go outside;
  • Keep the window closed on days with high pollen counts.

Mariam Hanna, a pediatric allergist, clinical immunologist and associate professor with McMaster University in Hamilton, Ont., says immunotherapy can help patients retrain their bodies by working with an allergist so they become more tolerant to pollens and have fewer symptoms.

“Some patients will need medications like over-the-counter antihistamines or speaking with their doctor about the right types of medications to help with symptom control,” she said in a video interview with CTVNews.ca.

Coates recommends people check pollen forecasts and decrease their exposure to pollen since no cure exists for allergies. “The best is knowing what’s in the air so that you can adjust your schedules, or whatever you’re doing, around the pollen levels.”

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Do you need a spring COVID-19 vaccine? Research backs extra round for high-risk groups

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Recent studies suggest staying up-to-date on COVID shots helps protect high-risk groups from severe illness

New guidelines suggest certain high-risk groups could benefit from having another dose of a COVID-19 vaccine this spring — and more frequent shots in general — while the broader population could be entering once-a-year territory, much like an annual flu shot.

Medical experts told CBC News that falling behind on the latest shots can come with health risks, particularly for individuals who are older or immunocompromised.

Even when the risk of infection starts to increase, the vaccines still do a really good job at decreasing risk of severe disease, said McMaster University researcher and immunologist Matthew Miller.

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Who needs another COVID shot?

Back in January, Canada’s national vaccine advisory body set the stage for another round of spring vaccinations. In a statement (new window), the National Advisory Committee on Immunization (NACI) stated that starting in spring 2024, individuals at an increased risk of severe COVID may get an extra dose of the latest XBB.1.5-based vaccines, which better protect against circulating virus variants.

That means:

  • Adults aged 65 and up.
  • Adult residents of long-term care homes and other congregate living settings for seniors.
  • Anyone six months of age or older who is moderately to severely immunocompromised.

The various spring recommendations don’t focus on pregnancy, despite research (new window) showing clear links between a COVID infection while pregnant, and increased health risks. However, federal guidance does note that getting vaccinated during pregnancy can protect against serious outcomes.

Vaccinated people can also pass antibodies to their baby through the placenta and through breastmilk, that guidance states (new window).

What do the provinces now recommend?

Multiple provinces have started rolling out their own regional guidance based on those early recommendations — with a focus on allowing similar high-risk groups to get another round of vaccinations.

B.C. is set to announce guidance on spring COVID vaccines in early April, officials told CBC News, and those recommendations are expected to align with NACI’s guidance.

In Manitoba (new window), high-risk individuals are already eligible for another dose, provided it’s been at least three months since their latest COVID vaccine.

Meanwhile Ontario’s latest guidance (new window), released on March 21, stresses that high-risk individuals may get an extra dose during a vaccine campaign set to run between April and June. Eligibility will involve waiting six months after someone’s last dose or COVID infection.

Having a spring dose is particularly important for individuals at increased risk of severe illness from COVID-19 who did not receive a dose during the Fall 2023 program, the guidance notes.

And in Nova Scotia (new window), the spring campaign will run from March 25 to May 31, also allowing high-risk individuals to get another dose.

Specific eligibility criteria vary slightly from province-to-province, so Canadians should check with their primary care provider, pharmacist or local public health team for exact guidelines in each area.

WATCH: Age still best determines when to get next COVID vaccine dose, research suggests:

 

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Age still best determines when to get COVID vaccines, new research suggests

It’s been four years since COVID-19 was declared a pandemic, and new research suggests your age may determine how often you should get a booster shot.

Why do the guidelines focus so much on age?

The rationale behind the latest spring guidelines, Miller said, is that someone’s age remains one of the greatest risk factors associated with severe COVID outcomes, including hospitalization, intensive care admission and death.

So that risk starts to shoot up at about 50, but really takes off in individuals over the age of 75, he noted.

Canadian data (new window) suggests the overwhelming majority of COVID deaths have been among older adults, with nearly 60 per cent of deaths among those aged 80 or older, and roughly 20 per cent among those aged 70 to 79.

People with compromised immune systems or serious medical conditions are also more vulnerable, Miller added.

Will people always need regular COVID shots?

While the general population may not require shots as frequently as higher-risk groups, Miller said it’s unlikely there will be recommendations any time soon to have a COVID shot less than once a year, given ongoing uncertainty about COVID’s trajectory.

Going forward, I suspect for pragmatic reasons, [COVID vaccinations] will dovetail with seasonal flu vaccine campaigns, just because it makes the implementation much more straightforward, Miller said.

And although we haven’t seen really strong seasonal trends with SARS-CoV-2 now, I suspect we’ll get to a place where it’s more seasonal than it has been.

In the meantime, the guidance around COVID shots remains simple at its core: Whenever you’re eligible to get another dose — whether that’s once or twice a year — you might as well do it.

What does research say?

One analysis, published in early March in the medical journal Lancet Infectious Diseases (new window), studied more than 27,000 U.S. patients who tested positive for SARS-CoV-2, the virus behind COVID, between September and December 2023.

The team found individuals who had an updated vaccine reduced their risk of severe illness by close to a third — and the difference was more noticeable in older and immunocompromised individuals.

Another American research team from Stanford University recently shared the results from a modelling simulation looking at the ideal frequency for COVID vaccines.

The study in Nature Communications (new window) suggests that for individuals aged 75 and up, having an annual COVID shot could reduce severe infections from an estimated 1,400 cases per 100,000 people to around 1,200 cases — while bumping to twice a year could cut those cases even further, down to 1,000.

For younger, healthier populations, however, the benefit of regular shots against severe illness was more modest.

The outcome wasn’t a surprise to Stanford researcher Dr. Nathan Lo, an infectious diseases specialist, since old age has consistently been a risk factor for severe COVID.

It’s almost the same pattern that’s been present the entire pandemic, he said. And I think that’s quite striking.

More frequent vaccination won’t prevent all serious infections, he added, or perhaps even a majority of those infections, which highlights the need for ongoing mitigation efforts.

Lauren Pelley (new window) · CBC News

 

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