In November 2018, Gerene Gaines will undergo a remarkable lifesaving procedure. She will receive a new heart valve, but she will be wide awake and she won’t require any incisions or stitches.
“They’re going to put the valve in through a catheter,” explains Gerene, 71, who lives in Fredericton with her husband of 49 years, Leonard. “I’m a bit nervous but this is so much better than surgery would ever be.”
The procedure is called a transcatheter valve implant, or TAVI, and the New Brunswick Heart Centre in Saint John was the first centre in Atlantic Canada to perform it.
“TAVI is a non-invasive technique that we have been pioneering here in New Brunswick,” says Dr. Jean-François Légaré, a cardiac surgeon and professor at Dalhousie Medicine New Brunswick (DMNB) who conducted the detailed work-up that discovered the deteriorating valve in Gerene’s heart. “Patients who simply could not tolerate heart surgery do so well with the catheter implant, we are usually able to discharge them the day after the procedure!”
Gerene’s doctors believe her aortic valve was damaged by cancer treatment she received over many years. She has had breast cancer twice—in 1989 and again in 2003—both times receiving surgery, radiation and chemotherapy. Even so, in 2004 a routine follow-up CT scan detected cancer in her liver.
“I’ve been doing chemotherapy on a regular basis, as well as hormone treatment, ever since they discovered the metastasis,” says Gerene, who had a third of her liver removed due to cancer in 2006. “I’m so grateful for the treatments, they’ve kept me going all these years.”
Damage to the heart is not an uncommon side effect of breast cancer treatment and cancer treatment in general. That’s why Dr. Thomas Pulinilkunnil, a researcher and associate professor at Dalhousie Medicine New Brunswick, is exploring how cancer treatment affects the heart.
“We’re exploring the molecular mechanisms by which chemotherapeutic agents damage the heart,” says Dr. Pulinilkunnil. “We know that signalling pathways and cellular metabolism can be disrupted, DNA can be damaged, and cells can die, but we want to pinpoint the specific mechanisms to see if there are ways we can rescue the heart.”
Gerene and Leonard are enthusiastic about supporting Dalhousie Medical Research Foundation’s 2018-19 DMRF Molly Appeal, which is raising funds to purchase the ImageStreamX Mark II, sophisticated cell imaging and analysis equipment that will help Dalhousie medical researchers discover treatments and cures for cancer, autoimmune diseases, infections, inherited diseases, and more.
In the case of Dr. Pulinilkunnil and his research team, this equipment will help them understand not only how chemotherapy affects the heart, but also how metabolic disorders such as obesity and diabetes predispose individuals to heart disease and also increase their susceptibility to cancer.