What if tumours could be detected before they became big enough to do any harm? A new program at OICR hopes to change the way that cancer is treated in Ontario and around the world by meeting this challenge.

Since a tumour that is smaller in size is significantly easier to cure and is less likely to spread, OICR has challenged Ontario researchers to develop ways of finding and accurately identifying tumours when they are one millimetre or less in size. The One Millimetre Challenge is a highly coordinated program that will include contributions from scientists and researchers at some of the leading research institutions in the province, including McMaster University, Robarts Research Institute, Sunnybrook Health Sciences Centre, the Toronto Centre for Phenogenomics, University Health Network and the University of Toronto. OICR is funding this research as one of the innovation programs called for in its Strategic Plan.

Dr. Martin Yaffe heads the One Millimetre Challenge. He is a specialist in medical imaging in the Imaging Research Program at Sunnybrook Health Sciences Centre and a professor in the Departments of Medical Imaging and Medical Biophysics at the University of Toronto. He will continue in both capacities while he spearheads the One Millimetre Challenge.

“By improving cancer imaging we can save lives, reduce suffering and deliver health care more efficiently and effectively,” says Dr. Yaffe. “There is a lot of enthusiasm about this program. We hope to capitalize on this enthusiasm to make this program successful and achieve the results we are looking for.”

Until now, limitations in technology have restricted the ability to diagnose tumours smaller than one centimetre in size. At one centimetre, tumours are 10 times larger than the size of the tumour the program would like to identify through better imaging techniques. If imaging technology could accurately detect and fingerprint small tumours, it might be possible to screen patients who have a genetic predisposition to the disease. This could allow development of customized treatments for individual patients so that if a tumour were to develop, it could be found and removed before it had any long-term impact. This method has the potential to save lives and could decrease the cost of cancer care.

The research projects in the One Millimetre Challenge will take advantage of new developments in cancer biology, physics, imaging science and chemistry that will allow more specific targeting of small cancers. It will also try to develop new methods that will indicate which cancers have the potential to be lethal so that researchers can focus on these killer cancers.

The program also hopes to develop a variety of techniques that will work with imaging technology to identify and remove small tumours. Ideas include developing molecular probes to detect tumours, the development of minimally-invasive tools to destroy tumours using the tip of a needle and the development of 3D-guidance devices for needle biopsies.

“We have carefully selected projects that represent a mix between higher risk and potentially high benefit and ones where we are fairly confident of success that can be translated into clinical use fairly quickly,” Yaffe says.

“If we can develop an effective, proactive approach to cancer” says Dr. Tom Hudson, President and Scientific Director of OICR, “we can seriously diminish the impact the disease currently has on people’s lives. Scientists in Ontario have the skills and the capacity to make this challenge a reality and we look forward to helping them to achieve this goal.”

The program is already underway. Twelve projects received seed funding for a year to allow researchers to identify the areas of research that could be the most effective. These short-term projects are looking at specific molecular probes for cancer imaging. Some will be completed within the twelve month period and others will continue when the full research program begins in April 2008.

Yaffe hopes the One Millimetre Challenge can build on the work of many Ontario researchers. “I think that now imaging research in Ontario is unequalled anywhere in the world,” he says. “The fact that we were able to pull together this many centres of excellence for this program is amazing. There has always been an interest among researchers in this field to work together, but this challenge really provides us with the glue to make it happen.”

Dr. Yaffe studied under legendary imaging research Dr. Harold Johns, the Canadian who pioneered the use of radiation therapy in the 1950s, while completing his PhD at the University of Toronto. In the 1980s, Dr. Yaffe was instrumental in the development of computerized images of breast tissue, which first allowed doctors to improve imaging accuracy in young women and those with dense breasts. He has continued to be a key player in the development of imaging technology, particularly related to breast cancer.