Dr. Muthukumaran Packirisamy, Concordia professor and research team member, is quite optimistic about the future of cancer screening technology.
Concordia researchers have developed a new method of identifying and locating cancers in their early stages by using nanotechnology. Their work was published in the scientific journal Biosensors and Bioelectronics, and Dr. Muthukumaran Packirisamy, a key member of the team, could not be happier with the technology’s progress.
According to the research paper, the team has been able to accomplish great feats. The research focuses largely on capturing extracellular vesicles (EVs) via the technology they developed. Packirisamy defined what these are and why they’re significant. “EVs serve as the liquid, the glue that binds cells to each other — they are the most important method cells communicate, and that’s what makes EVs so crucial in our process.” The researchers created a “magnetic particle based liquid biopsy chip for easy capture of EVs […] and simple isolation using a magnet,” as stated in their paper.
The process, which Packirisamy has been involved with for years, is one that begins with these EVs. As the paper states, “These vesicles contain a myriad of substances like RNA, DNA, proteins, and lipids from their origin cells, offering a good source of biomarkers.” A biomarker is any trait in a given cell or organelle whereby different phenomena can be identified. The paper continues: “The existing methods for the isolation of EVs are time-consuming, lack yield and purity, and expensive. In this work, we present a magnetic particle based liquid biopsy chip for the isolation of EVs by using a synthetic [compound].”
Packirisamy tried his best to break it down. “The best and simplest way I can explain it to you is like this: imagine you want to examine grains of sand. We’ve taken a soccer ball, covered it in oil, and rolled it in sand so it can stick.” The sand in this scenario refers to traces of cancer in cells; the soccer ball refers to the researchers’ nanotechnology and the oil represents the biomarkers.
“One of the reasons we’ve been doing this research is because the traditional ways of detecting cancers can be quite invasive,” said Packirisamy. As stated in a paper published by the National Center for Biotechnology Information, “An invasive procedure is one where purposeful/deliberate access to the body is gained via an incision, percutaneous puncture, where instrumentation is used.”
“Not only is the invasiveness of the entire procedure a significant trauma to the patient, it is also a trauma for the doctor. What we’ve been asking ourselves in this process is how can we study the progress and monitor the process without being invasive? This is where our project comes from,” Packirisamy added.
The significance of this research is that this biopsy chip would make the process of cancer detection much quicker and less intense than the traditional invasive method.
According to the Canadian Cancer Society, approximately two in five Canadians are expected to develop cancer in their lifetimes, and about one in four Canadians is expected to die from cancer. With a toll of 28.2 per cent of all deaths, cancer is the leading cause of death nationwide.
“Through our chip, we can test on a variety of bodily fluids to see if we detect anything. If we find something, we can trace where a potential tumour could be coming from based on the fluid’s trajectory.” When a drop of any kind of bodily fluid is run through the chip, the EVs get attached to these nanoparticles of fluid, like grains of sand onto a soccer ball, allowing them to be separated and analyzed by the researchers.
After combing through the meticulous details involved in this entire process, Dr. Packirisamy took a deep breath and reflected on his work and way of thinking. “You know, I started research 36 years ago in the ‘80s — my formal background is in mechanical engineering. I was designing really big machines: engines, aerospace equipment, you name it. Over time, I got interested in the opposite of what I was working on. I started getting curious about nano-machines. I then began the process of miniaturizing my research. What interested me in the power of nanotechnology was the extreme proximity in the field’s relationship to minute things. That’s what really intrigued me. I see the potential to get smaller and smaller because, essentially, that’s what constitutes the bigger level. That was the philosophy I was into. As you get deeper and deeper, all the boundaries within scientific disciplines get fuzzy, and that’s what fascinates me. The interdisciplinarity of what we do is beautiful. Across various minds, understanding the connection, that is truly wonderful. And that’s what the future needs. I want others in science to break out of their comfort zones. We’re all interested in reducing human pain, and the best work comes from collaboration. Together, we can break through boundaries.”
Best-selling author, public speaker, and social media influencer has made it her mission to spread light and hope on her path to raising breast cancer awareness
“You have cancer.”
These are the words that changed Nalie Agustin’s life when she heard them for the first time in 2013. Eight years later, Agustin is thriving despite living with stage 4 metastatic breast cancer – and she’s doing it in the most inspiring way.
At 24 years old, Agustin found a lump in her left breast. Initially, she didn’t think much of it, given that breast cancer is known to be most common in older women. It wasn’t until the lump continued to grow larger that she decided to take action and seek medical assistance. After several tests, the results came back: On July 17, 2013, Agustin was diagnosed with stage 2 breast cancer.
Driving home from the hospital on that very day, after receiving life-altering news, Agustin recorded a raw, unfiltered and incredibly emotional vlog in her car for her YouTube channel. “The reason why I’m recording this is [be]cause I know I have a crazy journey ahead of me, and this is day one,” she says to the camera.
Eight years later, Agustin has a growing community of over 29,000 YouTube subscribers and 110,000 Instagram followers who are inspired by her ability to shift perspective, find inspiration in the everyday and remain resilient, brave and courageous despite her cancer diagnosis.
These unique abilities have been instilled in Agustin since childhood.
Growing up, Agustin was raised to be thankful for the little things. With family in the Philippines who didn’t have much, her parents always ensured that she and her two brothers understood the importance of gratitude. In the Agustin household, even a simple dinner began with a prayer. “We had to be grateful for everything on the table, no matter if it was big or small, or fancy or not,” she said.
The resilience, courage and bravery that she emanates today also stems from her childhood. As the only girl in her tight-knit family, Agustin was always ready to prove that she could successfully take on any new challenge that stood in front of her with determination and drive. Naturally, from a young age, her ability to face any obstacle head-on was clear.
After completing CEGEP in 2008, Agustin enrolled in communication studies at Concordia University, a program she felt would allow for the exploration of her creativity in several facets of media, including writing and video. As a self-proclaimed “multi-passionate” individual, this program was perfect for her. However, post-graduation in 2012, Agustin landed a job working in eCommerce where she felt incredibly lost and unfulfilled. She knew it wasn’t the right fit for her.
Photograph by Karolina Victoria Jez
“I always knew I was meant to do something special,” recalled Agustin as she reflected back on this time in her life.
While a cancer diagnosis may not have been her idea of “special,” raising awareness about breast cancer in young women and inspiring both the cancer and non-cancer community may have been the “special” she was searching for.
It wasn’t long after Agustin graduated from Concordia University that she received her diagnosis: stage 2 breast cancer.
She spent the following year in and out of the hospital receiving the standard treatment, while simultaneously sharing blog posts to “nalie.ca” and vlogs to her YouTube channel. “As a creative, and being a communications graduate, it just felt therapeutic and right to express myself and write,” she said.
Her blog posts were written in the form of personal diary entries. At the time, Agustin’s goal was to keep her large Filipino family updated with the treatments she was receiving, as well as how she was coping with the challenges she was facing.
What started out as a way to communicate with her close relatives and express herself eventually grew into a large and supportive online community.
“I dedicated my entire journey at that point to advocating and spreading awareness because I didn’t know any other 24-year-old who had breast cancer,” said Agustin.
As Agustin sees it, going through breast cancer at a young age raises unique concerns that may not impact older women in the same way, such as the potential of infertility.
In 2014, after chemotherapy, a mastectomy, and 23 rounds of radiation, Agustin was considered to be in remission. For three years, she was travelling, speaking and sharing her story with many individuals around the world. “I was really living that dream list of things I’ve always wanted to do,” she said.
The sense of freedom that Agustin felt was cut short in 2017, when she had a recurrence. She was diagnosed with stage 4 metastatic breast cancer — which spread to her lungs. “That was really traumatic because I really thought it was over,” Agustin recalled. “I really thought I was in the clear.”
A stage 4 diagnosis is considered incurable and terminal. Evidently, this reality was a scary prognosis that weighed heavily on Agustin and her loved ones.
Although difficult, she continued to share her journey with a growing social media following who were “beyond just followers on Instagram.” Based on the overwhelming support she receives, it’s evident to Agustin that her “followers” genuinely care about her health, happiness, and progress. This is evident in the hundreds of kind, supportive and empowering comments left on every post, and in the meaningful interactions Agustin has with individuals in her direct messages.
For a while, the cancer was quite stable and everything seemed to be going well — until May 2020, when Agustin’s cancer journey took an unexpected and unfortunate turn.
Agustin began experiencing neck pain, headaches, muscle spasms and sudden numbness in her legs. An immediate visit to the hospital and an emergency CT scan confirmed that Agustin’s cancer had spread from her lungs to her brain.
“All I remember hearing in my head was ‘no.’ No, this can’t be true […] No, this can’t be the end,” shared Agustin in an Instagram caption.
What followed were five rounds of whole brain radiation, Taxol (a chemotherapy medication) and stereotactic radiosurgery. “That was probably the toughest time of my entire eight-year journey,” she said.
“My brain is like my artifact, it’s where I get all my ideas, it’s what controls my whole body […] it’s my mind which is key to everything,” she explained.
With such a traumatic diagnosis, Agustin disconnected from social media. She knew that focusing on healing herself had to be the biggest priority. “I had really dedicated my last seven years to helping others, and now I realized I really need to help myself,” she explained.
However, although she temporarily ceased writing for her active online community, she never stopped writing for herself.
Writing by hand in her diary, Agustin wrote out her life lessons learned amidst the trauma.
When Agustin returned to social media four months later, she decided to make separate dated Instagram posts to update her followers. Each post represented an event or an experience that she had undergone during those intense months of treatment. But most importantly, each post had an incredibly powerful caption with an inspiring takeaway. Organizing all these posts within Instagram’s “Guides” feature, she titled them “The Diary of Nalie.”
These posts are the inspiration behind Agustin’s new book, The Diary of Nalie: A collection of life lessons and reflections shared while thriving through stage IV cancer.
“I always wanted to write a book and have something tangible and physical that my community can hold,” expressed Agustin.
Overnight, her book found its place as a #1 Amazon Best Seller in Canada, as well as in two specific categories: #1 Best Seller in Cancer, and #1 Best Seller in Practical and Motivational Self-Help.
“There’s such a big analogy between a stage 4 cancer diagnosis and not knowing what’s to come, and I feel like that’s what people are facing right now – complete unknown and uncertainty,” said Agustin, referencing how the ongoing pandemic has changed life for everyone.
In an Amazon review, one reader shares, “I do not have cancer and I felt like this book spoke to me […] This journal is raw and authentic with so many incredible life lessons that would definitely make you do a double take on how to perceive things in life and how to handle it with grace.”
Another reader wrote that “Nalie will walk you through her journey and inspire you to keep moving forward in the midst of your battles.”
Evidently, The Diary of Nalie is offering a glimmer of hope and inspiration that many are so desperately seeking in such an unpredictable time. That’s why Agustin believes her book has seen so much quick success.
During some of the lowest lows of her cancer journey, her book and its success has ignited a sense of purpose and joy in Agustin and her family’s life. Launching the book was a beautiful way to “flip the script and really celebrate the wins rather than focus on the trauma,” she said.
In true Agustin spirit, she has found a way to give back. On Oct. 20, she will be hosting a book signing at Maison Principal. All ticket sale proceeds will be donated to the Program for Women’s Cancer Research at the McGill University Health Centre Division of Radiation Oncology.
It’s been eight years since the words Agustin never thought she would hear changed her life.
But she will continue to live every day with gratitude and faith.
She will thrive.
She will grow.
She will evolve.
She is determined to do so.
“To me all that matters is focusing not on eradicating the illness, but making sure [I] feel as strong and good as possible, because when you feel strong and good, then that’s living,” she said.
While Agustin is eternally grateful for the medicine she has received and her team of oncologists at the hospital, she believes that’s only half the battle. “Healing happens at home,” she explained.
She believes that effective cancer care is the perfect combination between standard treatments in hospitals and integrative out-of-hospital holistic therapies.
Agustin’s years of undoubtable challenges have also been marked by unforgettable life lessons: taking care of your mind and body is key to truly living. Mindfulness, meditation, healthy eating and light exercise is “the reason I believe I am still here today,” she said.
Agustin is the epitome of what it means to face adversity and uncertainty with resilience and bravery. Throughout it all, she has continued to use her platform as a way of giving back in incredible ways. She remains driven to inspire thousands online, advocate for young women diagnosed with breast cancer, and be a voice of hope within the cancer community.
Agustin calls herself a “Thriver,” and by continuously sharing her genuine and authentic self, she inspires the rest of the world to thrive alongside her.
Thousands of Montrealers bring light to the darkness of cancer
The Light the Night Walk is organized every year in numerous cities across North America to honour those who have been affected by cancer. Families and friends from all regions of Quebec gathered Saturday, Oct. 13 in Parc Jean-Drapeau on Île Notre-Dame, to walk in remembrance of those who have been lost to cancer.
Many musicians were present, such as the People’s Gospel Choir of Montreal, Vikki Gilmore, a Montreal-based singer who performed during the walk, and many more. “It’s such an important cause,” said Gilmore. She felt the best way to get involved was through music, which can sometimes be more soothing than words. Gilmore volunteered at a psychosocial oncology lab for a year and said it was an incredible experience. “I started performing at the march four years ago,” she said. “My aunt passed away from metastatic lung cancer in 2013, and after that, I wanted to get involved in cancer research awareness.”
Light the Night is hosted by the Leukemia and Lymphoma Society of Canada (LLS), a charitable foundation whose main mission is to cure blood cancer. The march helps fundraise for the foundation, as well as other research and support programs for patients.
“What’s great about this event is that it allows people to connect with others,” said Gilmore. “Often, when we deal with loss, grief or the stress and the heartache that comes with the disease, we feel isolated and forget that other individuals are potentially experiencing a similar situation,” she explained.
“What’s great about this event is that it allows people to connect with others,” said Montreal-based singer Vikki Gilmore. Photo by Mackenzie Lad.
A crowd of more than 5,000 people gathered in the park before the march, which took place from 7 p.m. to 9 p.m. There was almost no industrial light throughout the event. The only light cutting through the darkness came from the colourful lanterns waving in the air. From beginning to end, the march was full of cheerful volunteers, and smooth music set the ambiance for the walk.
Volunteers gently shushed the crowd to have a moment of silence for family members and friends who lost someone to cancer. On each side of the trail, there were small transparent bags with artificial candles in each one. Written on the bags were the names of those who have fought against blood cancer.
“It’s hard when you lose a loved one,” said a mother, who wished to remain anonymous, whose daughter passed away from leukemia at the age of four. “To have the family and friends here supporting you and your loss is such a beautiful gesture,” she added.
At the end of the march, volunteers congratulated the participants. “There is so much that can be done,” said Gilmore. “With foundations like the LLS Canada and fundraising events like Light the Night, so much more can be done.” The annual event creates a community of supporters, survivors, researches, and patients who, for one night, bring light to something typically so dark.
Researcher discovers cancer may not be forming in the one way we previously thought
A development in cancer research has been made by researchers from Montreal and London, England. They identified some cancer cells have the ability to co-opt cells—meaning they can obtain nutrients and oxygenation from pre-existing blood vessels—rather than needing to create their own blood vessels for fuel and growth.
Thirty-two researchers from both the Research Institute of the McGill University Health Centre
(RI-MUHC) and the Institute of Cancer Research in London made the discovery, and published their findings in a report titled “Vessel co–option mediates resistance to anti–angiogenic therapy in liver metastases” in the scientific journal Nature Medicine.
“It’s well accepted that when cancer grows, it requires more nutrients and oxygen—which means they require more blood vessels,” said Dr. Peter Metrakos liver surgeon, a member of RI-MUHC, lead author of the study and director of both the Multi-Organ Transplant Program and of Hepatopancreatobiliary Surgery. He said in order for cancer to grow, new blood vessels have to grow into the tumour. Therefore, he said in order for tumours to grow, cancer cells had to produce their own blood cells. He said the new vessel growth in the tumour is called angiogenesis, treatable with antiangiogenic therapies.
Metrakos said for the last 30 to 40 years, antiangiogenic drugs have been under development to target some of these factors. “But the problem has been that the [treatment] results are mixed—it’s not as good as we thought it was going to be.”
He said he believes that if he and his team can stop the new blood vessels from growing into the tumour, the tumour will not continue to gain proper nutrition and lose the ability to sustain itself. Metrakos said while some tumours do produce new blood vessels, it turns out not all of them do. He said he and the team discovered some kinds of tumours obtain nutrients and oxygen by co-opting existing blood vessels in the body.
“So rather than producing new blood vessels, [the cancer cells] kind of sneak their way around a tumour or around a blood vessel and co-opt it and then get their nutrients and oxygenation from blood vessels that’s existing,” said Metrakos. He said this explains why therapies that target new blood vessel development have had mixed results—co-opting cancer cells don’t produce new blood vessels, so there is nothing for the treatment to target.
Concordia’s cancer research lab is located in the SP building on Loyola campus. Photo by Savanna Craig.
In Metrakos’ research on how cancer evolves in the liver, he said he has found that approximately 40 to 45 per cent of tumours acquire their blood supplies through new blood vessels, while an additional 40 to 45 per cent obtain their blood supply by converting existing blood vessels from the liver. He said this clarifies why current treatments that aim for new blood vessels are not as successful as it was thought.
According to Metrakos, this is reflected in the survival rate following tumour-removal surgery, also known as resection. When patients were treated with antiangiogenic therapy and then had a resection, they had a less than 20 per cent survival rate if their cancer had been co-opting, compared to the 50 per cent survival rate of patients with a cancer that produced its own blood vessels.
Metrakos said he can determine whether the tumour is creating new cells or co-opting cells by staining an organ’s blood vessels. He said he has preliminary data that will be able to identify these different types of tumours using imaging with an MRI and a CT scan—but the research is in its beginning stages.
What the researchers have found through the use of an animal model, is by decreasing the motility of an animal via genetically manipulating cancer cells, they find the cancer cannot co-opt blood vessels. This forces the cancer to develop new blood vessels, which can then be targeted with the traditional method of antiangiogenics.
Professor Alisa Piekny’s research team includeshas three PhD students, a masters student, multiple undergraduate students and visiting scientists. Photo by Savanna Craig.
“That’s an experimental model, and it could pan out in human beings, but it could take a little time,” said Metrakos. For now, this theory has only been tested on animals.
“While we assume that any solid tumour over a certain size needs anti-angiogenesis to stimulate these vessels, their group has found there are a lot of tumours that aren’t doing this,” said Alisa Piekny, an associate professor for Concordia’s biology department.
“What would be really important to do is that each patient would have to be treated as a different case and you would have to get that information about their tumour before you start treating them with angiogenic drugs so that you could tailor the treatment more specifically to them,” said Piekny.
Piekny’s cancer research involves understanding the basic mechanism underlying cell division, and testing compounds that may target cell division and could be used in cancer treatment.
Piekny said this new development in cancer treatment reflects an overall change in the way researchers understand cancer. “You can’t treat [all cancer] the exact same way,” she said. She said insights like Metrakos’ helps improve our understanding of these different types of cancers. However, find the cure for cancer will not be an overnight discovery.
“Now we have a way to attack maybe a subset of cancers that do what they found where they can use the healthy vessel instead,” she said. “We’re going to treat those ones a little bit differently and we can improve the success rate, maybe.”
Piekny has a team of Concordia students that conduct research on cancer at the Loyola campus—which includes three PhD students, a masters student, multiple undergraduate students and visiting scientists. The undergrads switch out every couple of terms, the masters student work for usually two years at a time, while PhD’s work for approximately four years.
When asked how long he had been working on this research, Metrakos chuckled. “I’ve been preparing my whole life for this,” he said. He said he’s been working on this for four and a half years. “Obviously it’s going to be another ten years of work to get this to where we want it to go.”
