for spine tumours
Dr. Arjun Sahgal MD, FRCPC Professor of Radiation Oncology
an interview with Dr. Arjun Sahgal
Photo by Meital Yerushalmi
By Sarasa Tohyama
r. Arjun Sahgal is a pioneer in the implementation of stereotactic radiosurgery to treat spine metastases in Canada. He has also played an instrumental role in accelerating the field of spine radiosurgery globally. A staff radiation oncologist at the Sunnybrook Health Sciences Centre and clinician-scientist in the Odette Cancer Research Program at Sunnybrook Research Institute, Dr. Sahgal is also a professor in the Department of Radiation Oncology at the University of Toronto. I had the opportunity to sit down with Dr. Sahgal to discover more about his innovative therapeutic strategy.
David Larson. Traditionally, radiosurgery has been considered a targeted radiation technique used to treat brain metastases. As the technology evolved to deliver highly precise radiation in the body, a few early adopters, including those at UCSF, began to treat spine metastases. The main intent was to maximize local tumour control and prevent malignant spinal cord compression. I had the opportunity to learn the techniqueâ€“which had yet to be implemented in Canadaâ€“and develop it further for mainstream practice, rather than a one-off treatment offered in a few specialized centres.
Can you tell us about your academic trajectory?
In San Francisco, I saw firsthand the patient-reported benefits of spine radiosurgery as they achieved complete pain relief, long-term local tumour control, and no damage to the spinal cord. I wanted to make this therapy available for Canadians. However, I realized that many questions
I was trained in Toronto as a resident and went on to complete a fellowship in radiosurgery at the University of California San Francisco (UCSF) with Professor 14 | IMS MAGAZINE FALL 2017 CANCER THERAPEUTICS
remained unanswered regarding its safe practice, and that this therapeutic strategy for spine metastases was an untouched area globally. My goal was to build a robust program for the University of Toronto, as I worked at the time in both the Sunnybrook Odette Cancer Centre and the Princess Margaret Cancer Centre. How does radiosurgery differ from conventional radiation therapy? The main difference between the two is the radiation dose and exposure to the surrounding healthy tissues. The dose used in radiosurgery is three to four times greater compared to conventional palliative external beam radiotherapy. As early adopters, we challenged the dogma that dose does not matter for spine metastases. We argued in our publications and at scientific meetings that by escalating the dose, we can achieve both better tumour control and
The fall issue of the IMS Magazine for 2017, with a feature on Cancer Therapeutics.