November 2008 : Dr Jean-Philippe Pignol [fr]
With a Residency in Oncology degree and a PhD in nuclear physics, Jean-Philippe Pignol wanted to develop new techniques to cure cancer with radiations.
Jean-Philippe began his career as a doctor and a researcher in France, where he collaborated with the Atomic Energy Authority (CEA). His work was about creating, using neutron radiations, nuclear reaction in tumour cells but not in healthy cells. His research and experimentation skills were noticed and he was soon offered an academic job opportunity in Toronto. He came to Canada with his wife and their two children eight years ago. "Here, I had the opportunity to develop researches that I might not have been able to do in France", he said. Jean-Philippe initiated several clinical trials that are changing the practice of breast radiotherapy in North America! Jean-Philippe is a Full Professor at the University of Toronto and a clinican-scientist at the Odette Cancer Centre of the Sunnybrook Health Sciences Centre. As a Radio-oncologist, which means a doctor specialised in treating cancer with radiation, Jean-Philippe is focused on breast cancer. In Canada, 22 000 new cases of breast cancer are detected each year and two millions in the world. "Today 90 % of women with breast cancer will survive. Such that our priority is to improve the treatments", he explained.
Jean-Philippe worked on the elaboration of two new methods of care.
First, breast IRMT that is a more precise way delivering radiation treatment that reduce by 30% the risks of skin burns. The second method consists in implanting permanently radioactive seeds. This technique has been used for twenty years to treat prostate cancer. The challenge of Jean-Philippe Pignol’s team was to adapt this technique to treat breast cancer. After a surgery to remove the tumour, the radioactive seeds are precisely implanted around the surgical cavity. The seed will slowly release radiation over the course of two months. "The advantage of the method is that a breast cancer diagnosis may no longer mean that women have to put their life on hold". Indeed, the treatment is delivered in a single one hour procedure under local freezing, such that patients can live a normal life instead of going to the hospital about 30 times over three to seven weeks with the conventional treatment.
But this innovative treatment is not widely available. The procedure of creating new treatment standards takes time. First, clinical trials test the safety and efficiency of a new modality. Then this new modality is tested randomly against the conventional treatment. This needs time and money. At the present time, 67 patients have been treated with this method at the Odette Cancer Centre of the Sunnybrook Health Sciences Centre. The results of this initial trial show that patients had five times less skin burns compared to the conventional radiotherapy. Moreover, after a follow-up reaching 5 years, no recurrence has been noticed. A new trial is currently under development to test the transfer of technology and detect possible rare complications. This study will be conducted in several centres across Canada and the United States, and will accrue 500 patients. These researches will take about ten years before this treatment could be widely accessible. But the first results are very promising! Doctor Pignol insists that the research wouldn’t have been possible without the generous support of foundations and the support of his patients. He regularly receives letters from women affected by breast cancer coming from all over the world. “I am trying to answer to each one because I think it would not be fair raising hope and then not responding to such requests”. This treatment is safe for early stage breast cancers that represent 20 % of women affected by a breast cancer. This corresponds to small cancer, with no lymph node metastases in and that can be surgically removed by lumpectomy.
Talent, audacity, seriousness and optimism are necessary to cure humanity’s most challenging diseases. Perhaps because he grew up in Africa, Jean-Philippe is dreaming about having developing countries benefit of what he calls "the medicine of the ultra-rich".
Websites you can visit:
Canadian Breast Cancer Foundation: www.cbcf.org
Odette Cancer Centre at the Sunnybrook Health Sciences Centre: www.sunnybrook.ca
The Department of radio-oncology of the University of Toronto includes 57 radio-oncologists and 157 teachers. This team is dealing with between 11 and 12 000 patients a year. There is no equivalent in the world in terms of resource concentration.