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UHN is excited to announce the establishment of the TW-Multidisciplinary Metastatic Spine Clinic as a designated space for consolidating joint care for patients requiring a multimodal treatment approach.
This unique space sees cancer cases with severe pain from complex spinal metastases who benefit from multidisciplinary assessment and care. Patient centred outcomes are a primary focus of this clinic.
Approximately 9,500 Canadians develop spine metastasis each year. About 10% of these cases will result in compression fractures of the spine. As a group, metastatic spine patients are often under-treated due to difficulty in referring and assessing these patients in a timely manner. The result can be severe disability and a reduction in quality of life from pain.
Through a collaborative team involving neurosurgery, neuroradiology and radiation oncology, we're proud to offer a multidisciplinary, patient-focused approach to caring for these complex cases.
Each consultation appointment will be with one or more specialists required in their care. Each consult has input from multiple members of the team, and the care offered is integrated into the oncology plan prior to the appointment.
Learn more about what you can expect when you have a clinic appointment.
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Dr. Massicotte is a surgeon-educator in Toronto, Canada. Since his faculty appointment with the University of Toronto in 2002, Dr. Massicotte has focused his academic neurosurgical career on spinal cord health and minimally invasive surgical techniques. Dr. Massicotte holds a Master of Science degree and in 2017, as an Associate Professor for the University of Toronto, he completed a Master of Business Administration degree to further advance his dual role as medical director for the Back & Neck program and the Concussion (2017 – 2021) program at Altum Health, a division of University Health Network (UHN). The Concussion program was an innovation he started in collaboration with Dr. Charles Tator. Throughout his time as a staff neurosurgeon within UHN, Dr. Massicotte has contributed to furthering research within his special interests: medical education, patient outcomes, and spinal stability. In collaboration with colleagues both nationally and internationally, Dr. Massicotte has been invited to lead numerous international lecture engagements and he has over
70 publications in peered-review articles to his name.
Roger Smith is specialty trained in Neurosurgery with fellowship training in diagnostic neuroradiology and interventional spine radiology. To date, he has performed in excess of 1500 vertebral augmentation procedures, 96% for metastatic cancer. In addition, he performs image-guided needle procedures for pain. He has successfully integrated new techniques in managing complex sacral and vertebral fractures in cancer and osteoporosis. He was instrumental in developing the Kyphoplasty / vertebral augmentation program with Cancer Care Ontario which is now MOH-funded province-wide under the supervision of the CCO Interventional Radiology Steering Committee on which he is a member. He is a technical innovator and has the expertise and experience needed to successfully support an interventional spinal therapy program that bridges a gap between diagnostic evaluation and image-guided procedures. The Multidisciplinary Metastatic Spine Clinic is a collaborative practice with Oncology, Spine Surgery and Interventional Neuroradiology providing integrated rapid care for patients with painful unstable metastatic spine disease and fractures. It is accessible to inpatient and outpatient referrals in a tertiary care environment.
Michael Yan is a radiation oncologist specializing in the treatment of spinal metastases using both conventional and stereotactic body radiotherapy (SBRT) techniques. Holding certifications from the Royal College of Physicians of Canada and the American Board of Radiology, Dr. Yan has gained valuable expertise from a fellowship in spine and CNS oncology at a high-volume institution. He is currently a member of the paraspinal team within the Radiation Medicine Program at the Princess Margaret Cancer Centre. Dr. Yan's clinical and academic pursuits involve the improvement of SBRT parameters for the effective treatment of spinal metastatic diseases, as well as examining its potential in conjunction with other innovative treatments, such as minimally invasive separation surgery and vertebral augmentation. Furthermore, he is dedicated to optimizing patient selection criteria for SBRT compared to conventional radiation therapy. Dr. Yan is enthusiastic about the potential that the MMSC offers for a comprehensive, multimodal approach to addressing the complex needs of this diverse patient population.
The TW-MMSC team is expecting to actively participate in academic, research, and educational activities.
Support the TW-MMSC in providing collaborative, multifaceted care through a financial donation. We need donor support to continue to fund valuable research and pave new ways to care for the patients who need us today. Make a donation to the TW-MSSC today through the UHN Foundation.
You will be contacted with information about your first appointment.
Please bring the following to your appointment. Not all of these items may be needed for your appointment. Our clinic or your referring doctor will let you know what you must bring.
Please arrive 15 minutes before your appointment.
When you arrive, you will sign in with the receptionist. You will need your health card (OHIP card) to sign-in. If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver’s license or passport.
You may be given a Measuring Health Equity Questionnaire to fill out. This form contains questions about your background. We collect this information to find out who we serve and what unique needs you may have. The form is voluntary and you can choose ‘prefer not to answer’ to any or all questions. However, the information you choose to give us will help us improve the quality of care for you and others.
First appointments take longer than follow-up appointments. Your first appointment can take 2 hours or more. Follow-up appointments usually take 15 to 30 minutes. We do everything we can to stay on time but sometimes unforeseen circumstances may delay your appointment.
At the end of your first appointment, the nurse or doctor will give you a contact list for your health care team. If you don’t get a contact list, feel free to ask for it.
After every appointment, a member of your health care team will tell you about your next visit. Be sure you understand what is going to happen next. For example, know the time and place of your next visit or if someone will call you with this information.
If you are unsure about what your next steps are, don’t be afraid to ask a member of your team. We are here to help you.
We understand that reaching us by phone can sometimes be difficult. Often our phone lines are busy or are turned over to the message centre so our staff can prepare for clinic visits or help other patients. We make every effort to return your call within 24 hours. Our staff will try to reach you 2 times. If we are not able to reach you directly you may need to call us again.