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Surgical Oncologist, Clinician Investigator


Dr. Carolyn Nessim is a Surgical Oncologist at The Ottawa Hospital,as well asa Clinician Investigator atthe Ottawa Hospital Research Institute (OHRI).Before arriving at our hospital in 2013, her training took her from Montreal to Toronto and even as far as Melbourne, Australia. While she specializes in soft tissue sarcoma, melanoma, and gastric cancer, her expertise is wide-ranging as she collaborates with other researchers in addition to treating patients.Dr. Nessim also has rhythm. In 2018, she was one of a handful of physicians who competed on the dance floor in front of a sold-out crowd of 800 for Dancing with the Docs, a fundraising event that raises funds for patient care and research at our hospital.Q:When did you realize you wanted to become a doctor? How did you end upin oncology?A: I have wanted to be a doctor since I wassevenyears old—it’s as if it was a calling.Inmy 20s I had a personalhealthscare,andthe nicest doctor took all my fears away with a simple conversation.I remember thinking,“I want to do that for people too.”By my secondyear ofsurgical residency,I knew I wanted to specialize in oncology. I was fascinated by the complextumoursand surgeriesandnew therapies that were changing the face of cancers,but more importantly,I was moved by the relationship that develops with patientsand how rewarding the work is.I’moften askedwhy I chose cancerbecause peopleassumeitmust be so sad. But on the contrary—it is a privilege. To cut is a chance to cure and patients unconditionallytrust us to take care of them.Q:What is the most interesting thing you have learned during your time as a surgical oncologist?A: Forpatientswe cannot cure we still provide support and empathy through a difficult journey,so I believe we still help in those cases as well.No one lives forever,but how we live our journey is what will make the difference,so I believe in hope and positive thinking.Q:What innovations have you seen in the field of oncology since you started?Q:What is The Ottawa Hospital doingin oncologythat isexciting orgroundbreaking?A: I have done some translational clinical research with MicheleArdolino, Jean-Simon Diallo,and Luc Sabourin at theOttawa Hospital Research Institutetobetter understand the genetics and biology of both melanoma and sarcomaand how they respond to oncolytic viruses or why they resist to immunotherapy. It’s very exciting work.Q:You helped uncoverBrydeFresque’s diagnosis of a rarepheochromocytoma,why was this diagnosis a challenge?A: InBryde’scase,he had a spontaneous rupture which led to a large hematoma that hidthe underlyingtumouron imaging.Also, mostpheosrelease adrenalinewhichyou can detect in a 24-hour urinary test, butBryde’swas non-functionalmaking theurine tests negative. These factors madethe diagnosis more difficult to make.Eventually we could see a mass on theimaging,and it was clear the only next best step was to remove it.Q:Thesurgery he needed to save his lifewas incredibly complex, lasting 12 hours.Explain why.A: Thetumourwas quite large—over 20cm—and very inflamed because of the bleeding.Histumourwas also attachedto several organswhichrequiredwhat we call a multi-visceral resectionenbloc (removal of organsthat are touching). This takes time asit involvesvery careful dissection of large vessels that we do not want toinjure.We removedBryde’stumourenbloc with the kidney, adrenal, spleen, distal pancreas, colon and diaphragm and then reconstructedthe diaphragm and colon. Most sarcoma surgeries take anywhere from 5-24hours.Somecan takeeven longer—over 48–hours.Q:What makes rare cancers, like pheochromocytomas such a challenge to diagnose and treat?A: Thereason rare cancers are hard to treat and diagnose is because we need more investment in research. Also, the rarer the cancer the less we are able to run large randomized clinical trials, because there are so few patients.We need more international collaboration for rare cancers to increase the number of patients to better understand these diseases and how to manage them. In the lastfiveyears,we have created aninternationalresearch collaboration for sarcoma called the Trans-Atlantic Australasian RetroperitonealSarcomaWorking group of which I am the Chair of the Research EvaluationCommittee. This has made a huge difference insarcoma research. It includes experts from around the world designing research studies and clinical trials and it will change the face of sarcoma research.Q:What is the most gratifying part of yourrole as a surgical oncologist at The Ottawa Hospital?A: My relationship with my patients. It is the best thing ever. I am inspired by theirstrength, motivation,and humility.Beingeven just a small part oftheir journeyis the mostfulfillingand gratifying part of my jobandpushes me out of bed every morning to come to work.Q:In your opinion, how important is support from the community in advancing cancer research?It is very important. If there weremore awareness and more community support, we could expand our research and study more about diseases like rare cancers.
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