TFRI National Dialogues

Dr. Stewart Rorke- Monday, April 12th, 2010




List of Atlantic Dialogue Speakers
(Organized by Core Issues)
    Core Issue #1: Cancer Care & Population Health: Core Issue #2: Cancer Care & the Health System: Core Issue #3: The Science Behind Cancer Care:
    I'd like to start by saying how much I have enjoyed this dialogue. It has truly been a dialogue as physicians, and oncologists, surgeons, you know the day to day clinical experience, one can become focused on treatment A, treatment B, treatment C, and how they apply to each patient, and I think it's healthy to hear these kinds of discussion -to sort of think outside the box. All the other elements that play into a successful holistic treatment approach, and sometimes, as Dr. Whitlock mentioned, in the busy day to day grind, trying to get the essentials done, it is difficult to perform all roles. So this is very healthy, and inspiring to hear this dialogue.

    Mrs. Fox made a statement that caught my attention, about how she sometimes hears comments about cancer research, either not getting to the finish line, or perhaps the finish line is attained and is being hidden. And I've actually heard these comments, not very frequently, but from my patients, and it is interesting to hear, I'm not the only person that has heard this. It's probably... I'm trying to understand that feeling, of when we hear of the tens of billions of dollars that go into the global cancer research initiative. I guess it is kind of outstanding for patients that we can't solve the riddle, and what I usually try to tell some patients is that this is not just some riddle. Cancer is hundreds of diseases that are all very different and complex, but there is hope. We have conquered and solved some of these riddles, and I'd like to finish up by giving you a sample of one of the rare cancers that I had the privilege to deal with, and it is something most of you may have never heard of. It's a cancer called GIST - Gastrointestinal Stromal Tumour, it's a rare type of sarcoma, and I see about a dozen or twenty cases in Newfoundland, per year. And when I was in training in Ontario years ago, I was struck by the fact that this was one of the only cancers that I have ever heard medical oncologists say to a patient, that we have nothing. And we're usually a very optimistic lot that try to find a treatment at all costs, but this disease at that time, was viewed as pretty much as untreatable and chemo-resistant.

    From that time to the time I finished my training in 2001, a new novel oral chemotherapy had come on to the market to treat this disease, and it went from untreatable to almost 360?. A treatment that offered an 80% disease control rate and it turned this death sentence into a chronic disease, almost overnight for many people. And I have some people in my practice now, who have started this new treatment in the first month that I began my practice in 2001, and they still visit me on a monthly or 2 monthly basis. This is a small piece of the global cancer problem, but I think it illustrates hope. It's a case where, as Dr. Porter said, we're looking for the base hits, and putting the pieces together, solving the cancer pieces one at a time. And the knowledge we have gained from treating these GIST cancers, is now spilling into other more common cancers. Not every cancer will have a specific key that will unlock the riddles so precisely, and that's why the basic science, and ongoing research to understand cancer, in its many forms, needs to continue. We have to continue hoping.