Colleen Dickie
Colleen Dickie, Director of Operations for the Radiation Medicine Program (RMP) at the Princess Margaret Cancer Centre, has made part of her mission innovating to help improve patient comfort and confidence. (Photo: UHN)

Colleen Dickie says it was Terry Fox who put her on the path to a career in cancer care.

She remembers his stop at the Scarborough Civic Centre in the summer of 1980 on the Marathon of Hope. She watched on a small TV with friends as a large crowd filled the chambers that day, clambering for a glimpse of the young man, who was, by this point, a hero to so many.

It left a profound impression on her, sparking a curiosity about cancer care and a desire to help those impacted by the disease.

"I really admired Terry," Colleen says. "I thought then that cancer meant you lost your leg like Terry lost his. So, as I grew up, I started looking into cancer care, I went to the University of Toronto, and I got into radiation therapy."

Colleen, who currently serves as the Director of Operations for the Radiation Medicine Program (RMP) at the Princess Margaret, has made part of her mission innovating to help improve patient comfort and confidence.

Radiation therapy (radiotherapy) was a major innovation in cancer treatment that was originally presented in a lecture by a German physics professor, Wilhelm Conrad Roentgen, in 1896.

A machine directs a beam of radiation through the skin to a specific part of the body, usually a tumour. Today, about half of all patients with cancer will require radiotherapy as part of their treatment program.

To deliver doses accurately, quality radiotherapy requires accurate positioning of the targeted area and for some cancers that means rigid immobilization of patients.

Twenty-five years ago, many cancer treatment facilities used materials available at the time to successfully position and immobilize patients receiving radiotherapy. Some of these materials were crude, think lead blocks, Perspex – a solid transparent plastic – and even duct tape.

Colleen remembers relying on these historic materials herself early in her career at the Princess Margaret.

Designed, developed, and produced a new device unofficially called 'the Collamy'

Additionally, though, Colleen remembers learning from the Sarcoma Team about a rare and very serious late complication of combined therapy (usually following surgery and radiation) for a high number of patients – radiation-induced bone fractures.

This is because high-dose radiation is injurious to bone and is one of the known risk factors for the development of a late fracture, with late fracture patients developing their fracture four years, on average, after the completion of their treatment.

In some cases, patients treated for soft tissue sarcomas also experience significant wound-healing challenges, with bone not only negatively impacted but skin, fat, and muscle also suffering irreparable damage.

In Colleen's world at the time, patients who experienced bone fractures related to radiation often required multiple, painful surgeries, increasing their risk of deep infection. And if the fracture didn't heal, an amputation might be needed – similar to the procedure Terry Fox endured – a devastating side effect for some patients treated with radiotherapy, on top of having to deal with cancer.

Colleen approached former UHN CEO Dr. Bob Bell and Dr. Brian O'Sullivan about developing a new method of immobilizing patients with soft tissue sarcoma to reduce side effects like radiation-induced bone fractures.

"Bob said, 'Well, do something about it'," Colleen says. "I was still really early in my career and I was so nervous I could barely speak, but I felt challenged.

"So, we started having meetings and we started collaborating."

Working with another radiation therapist, Amy Parent, and the late Dr. Mike Sharpe, a medical physicist, they eventually connected with Bionix Radiation Therapy, an American medical device company. Colleen says this development took years, and couldn't have happened without the support of leaders in the Sarcoma group, Drs. Peter Ferguson and Jay Wunder, who invested in many different kinds of roles that are needed for patient care.

Together, Colleen and Amy designed, developed, and produced a new patient immobilizer. Patented in partnership with the Princess Margaret in 2008, the new device was unofficially called "the Collamy" (short for Colleen and Amy).

Officially, however, the device is called the Radiation Therapy immobilizer T-Form™, and it played a big part in changing the treatment paradigm for soft tissue sarcoma patients, not only at the Princess Margaret, but around the world.

Today, radiation-induced bone fractures and amputations because of these fractures have been dramatically reduced, thanks to the innovation of the Princess Margaret team and Sarcoma Team as well as many other dedicated clinicians in this area.

The next chapter in this story is still being written, but Colleen's early experiences with RMP, PM, The PM Foundation and UHN leaders and their support of many innovations at every aspect of patient care inspired her career change to leadership in hopes of helping others in team UHN.

Funding to develop the "The Collamy" was partially provided by the Princess Margaret Cancer Foundation.
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