What We Do

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.

Tests & Services

  • Vertebral augmentation (vertebroplasty/kyphoplasty/sacroplasty)
  • Radiotherapy (SBRT)
  • Spinal surgery (separation surgery, others)
  • Monitoring, serial imaging
  • Consult services to Medicine and primary oncology services

How to Prepare

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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 Meet Our Team

Multidisciplinary Metastatic Spine Clinic Team


Dr. Eric Massicotte  

Dr. Eric Massicotte | Neurosurgery, Co-Director

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 peer-reviewed articles to his name.

Dr. Roger Smith  

Dr. Roger Smith | Neuroradiology, Co-Director

Roger Smith is specialty trained in Neurosurgery with fellowship training in diagnostic neuroradiology and interventional spine radiology. To date, he has performed over 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.

Dr. Michael Yan  

Dr. Michael Yan | Radiation Oncology

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.

Palliative Medicine Team Members

Administrative Staff

  • Saynab Ali, Administrative Assistant for Dr. Yan
    Phone: 416 946 2436
  • Michelle Macedo, Medical Secretary
    Phone: 416 603 5675
  • Viive Raamat, Administrative Assistant
    Phone: 416 613 4022​


The TW-MMSC team is expecting to actively participate in academic, research, and educational activities.​

 Donations to Our Clinic

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.

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