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Nadia Khan – Bourse de stagiaire de recherche 2014

Nadia is a first-year medical student at the Schulich School of Medicine and Dentistry and Western University in London, ON. With her 2014-2015 research studentship she will work with Dr. Michael Cusimano, a neurosurgeon and scientist at St. Michael’s Hospital on a project focused on effect of pituitary tumours on vision.

Nadia’s project has been generously funded by Nexen Marketing, Calgary AB in memory of Joan Horte & Dave Herbert

About the Research

Project title: Vision-Related Quality of Life in Patients with Pituitary Tumours

Difficulty with vision is the most common complaint of individuals with tumours in the pituitary region of the brain. These tumours often encroach on integral components of the visual pathway, and can cause a variety of vision-related symptoms through compression of the optic nerves and chiasm. Deficits from this phenomenon can include decreased visual acuity, diminished colour perception, visual field defects, and optic disc atrophy, among other sequelae. Consequently, it is important to monitor visual function and assess vision-related quality of life in this patient population.

About Nadia, in her own words…

Being awarded a Brain Tumour Research Studentship means that I can dedicate the next two summers of my life to gathering, integrating, and applying clinical knowledge in order to improve the lives of patients with pituitary brain tumours.

In the past year, I have witnessed the numerous challenges that patients face during the recovery process following the diagnosis of a brain tumour, and I realize that despite excellent support from healthcare providers, significant advancements in technology, and increased knowledge regarding neoplasms of the brain, there are still many aspects of patient care that can be improved through clinical research.

For this reason, I am interested in completing a project under the guidance of Dr. Michael Cusimano, a neurosurgeon and scientist at St. Michael’s Hospital with expertise in pituitary tumours, focusing on the vision-related quality of life of patients with this condition.

With the generous support of donors through Brain Tumour Foundation of Canada, I hope to ultimately develop a clinical tool that can be used to measure the effect of pituitary tumours on vision, identify the progression of visual deficits, and track patient responses to therapy. As a future physician with an interest in neuroscience, my dream is to make a positive contribution to patient care, to educate my peers in medical school about issues unique to brain tumour patients, and to pave the way for future research in this area as I continue to work with this important population throughout my medical career.

Final Report

Through the data collected from semi-structured interviews, we have gained a great deal of insight into the world of pituitary tumour patients. We have learned more about the wide range of symptoms patients experience leading up to their diagnosis and the struggles that individuals face in receiving care. For some patients, having their visual symptoms validated and taken seriously is a major factor in vision-related quality of life. Several patients advocated for themselves, in order to have various investigations done for their symptoms. One patient even felt the need to drive to the United States to pay and have a CT scan done. These observations suggest that there may be a need to educate healthcare providers in greater details on the symptoms of pituitary tumours, and ways to recognize the subtle visual changes that can occur.

We also learned that there are not nearly enough mental health initiatives out there to support patients with pituitary tumours. Amongst our group of patients, there were individuals with functioning tumours that were secreting prolactin, growth hormone, and cortisol, in addition to causing visual problems. These patients had the greatest needs for psychological support due to the complex and pervasive syndromes that occur from hormone excess. Nearly every patient that was interviewed acknowledged some form of psychological distress throughout the process of diagnosis and treatment due to their visual problems. For this reason, it is critical to develop strong mental health resources that are widely accessible to this patient population.

As we continue on with this project, and collect data from a larger patient sample, we will undoubtedly learn more about gaps in the healthcare system, and ways to maximize the quality of life in patients with pituitary tumours and visual dysfunction.

Read more from Nadia’s final report…

About my experience

I am immensely grateful to have received this student research award from Brain Tumour Foundation of Canada and Nexen Energy ULC in memory of Joan Horte and David Herbert. Over the past two years, this award has given me the opportunity to work closely with some of the most resilient and inspiring patients that I have ever met. I have immersed myself, with each interview, in the world of patients with brain tumours and have come to understand the challenging physical and psychological journey that individuals go through from diagnosis to recovery. I have had a chance to interview research participants at all stages along this continuum, and have had the privilege of being granted permission by pituitary tumour patients to observe their surgeries as a medical student in the operating room.

During this time, I have frequently found myself admiring the exceptional courage and perseverance that patients demonstrate on a daily basis, and have strengthened my resolve to improve the lives of individuals with brain tumours, as a medical student, and as a future physician. I have yet to decide on the particular field of medicine I would like to pursue, but have strong interests in neurosurgery and neurology, and have consequently requested clinical rotations in both of these areas this upcoming year. Notably, in January 2016, I will be completing a rotation in pediatric neurosurgery at the Children’s Hospital of Western Ontario.

I am honoured that Brain Tumour Foundation of Canada believed in my project and invested in making it a reality. I am also determined to complete the remainder of this project over the next few months, and ultimately produce questionnaire that can make a positive difference in patient care.

The generous gift of this award from Nexen Energy ULC has significantly lightened the burden of my annual tuition, and has brought me closer to fulfilling my dream of becoming a physician and giving back to the community. I hope to continue to honour the memory of Joan Horte and David Herbert through my work on this project, and in all my future endeavours in brain tumour research.