Radiation Medicine Program (RMP)

The Princess Margaret Breast Site Group treats common, rare, and complex forms of breast cancer. Our award-winning QuickStart Program offers one-day radiotherapy for early-stage breast cancer. We offer personalized, state-of-the-art radiation treatment, including:

• Techniques to minimize doses to normal tissues (e.g. heart, lungs): activated breathing control and partial breast irradiation.
• Use of molecular testing/cancer biology to improve radiotherapy management.
• Stereotactic ablative radiotherapy for oligometastatic/oligoprogressive disease.
• Innovative cutting-edge clinical trials.

Learn more about the inter-professional Breast Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret's Central Nervous System Tumour Program treats common and rare tumours of the central nervous system. Our service is divided into four specific clinical programs which encompass all primary and secondary brain and spinal cord tumours. Each program offers a multidisciplinary conference of cases referred for potential treatment.

Learn more about the inter-professional Central Nervous System Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret’s Ocular Oncology Program provides comprehensive care to patients with cancers of the eyes, orbits and adjacent tissues (conjunctiva, lacrimal glands, eyelids). We treat most cases of choroidal melanoma in Canada, and have helped establish programs in Vancouver, Edmonton and Montreal to help patients receive treatment closer to home. We offer state-of-the-art radiotherapy for ocular oncology, including:

• Superficial orthovoltage radiotherapy to treat eyelid cancers while completely protecting the underlying eye from any radiotherapy dose exposure.
• Conventional high energy photon radiotherapy to treat deep tumours in the orbits or intra-ocular tumours with the aim of vision preservation in most cases, while controlling most of the cancers in these regions.
• Iodine-125 brachytherapy for choroidal melanomas with excellent tumour control rates and avoiding enucleation in the large majority of cases (97% eye retention rate).

Learn more about the inter-professional Ocular Oncology Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret Endocrine Site Group treats common, rare and complex cancers of the thyroid, parathyroid, pituitary gland, pancreas, adrenal glands and neuroendocrine tumours, drawing on cutting-edge technology and treatments. We offer state-of-the-art radiotherapy, including:

• External beam radiotherapy (IMRT and Gamma Knife radiation) for tumours of the thyroid and pituitary.
• Redefining the role of radioactive ablation in differentiated thyroid cancer.

We also spearheaded the Ontario clinical trial in the use of Peptide Receptor Radionucleotide Therapy (PRRT) for well differentiated neuroendocrine tumours.

Learn more about the inter-professional Endocrine Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret Gastrointestinal Site Group treats all stages and categories of GI cancers, including rare, difficult-to-treat, and advanced-stage malignancy of the upper GI (esophagus and stomach), hepatobiliary cancer (liver, bile duct and pancreas), as well as lower GI (colorectal and anal cancer). We offer state-of-the-art radiation therapy technology, including:

• Intensity-modulated radiation therapy (IMRT)
• Volumetric modulated arc therapy (VMAT)
• Image-guided radiation therapy (IGRT)
• Stereotactic body radiation therapy (SBRT)
• MR-Linac guided radiation therapy

Our program works within the Comprehensive Cancer Center’s multidisciplinary services. Cancer conferences are attended by GI specialists across many disciplines. We discuss challenging and new GI clinical cases to derive consensus for optimal management, providing comprehensive care tailored to each patient’s needs. We also offer many clinical trials, ranging from early to late phase, aiming to improve patient outcomes with fewer side effects.

Learn more about the inter-professional Gastrointestinal Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret Genitourinary Site Group treats common, rare and complex forms of cancer affecting the bladder, kidney, urethra, ureters, prostate and testes.

Learn more about the inter-professional Genitourinary Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret Gynecologic Site Group treats common, rare and complex forms of cervical, endometrial, ovarian, peritoneal, tubal, vaginal and vulvar cancer. The Magnetic Resonance guided Radiation Therapy (MRgRT) suite at the Princess Margaret Cancer Centre is the first of its kind in Canada. We offer state-of-the-art, high-precision external radiation and brachytherapy treatment, including:

• Image-guided volumetric modulated arc therapy (VMAT)
  
• MRI-based adaptive intracavitary/interstitial brachytherapy
• Cutting-edge clinical treatment studies

Learn more about the inter-professional Gynecologic Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret Head and Neck Centre treats common, rare and complex forms of cancer of the lips and mouth, oropharynx, hypopharynx, larynx, nasal cavity and sinus, nasopharynx, salivary glands and thyroid.

Learn more about the inter-professional Head & Neck Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret Lung Site Group treats common, rare and complex forms of lung cancer.

Learn more about the inter-professional Lung Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret Lymphoma and Myeloma Site Group treats lymphoproliferative disorders, including non-Hodgkin’s and Hodgkin’s lymphoma, acute and chronic leukemias, multiple myeloma and related plasma cell disease. We also perform specialized bone marrow stem cell transplants (autologous and allogeneic). New innovative treatments such as chimeric antigen receptor (CAR) T-cell therapy, and promising drugs in clinical trials research are also offered. We work closely with the Lymphoma, Myeloma, Leukemia and Stem cell transplant services to offer state-of-the-art precision radiotherapy and total body irradiation therapy. Clinical and technical innovations include:

• Respiratory control methods to focus precisely on lymph node targets in the chest and reduce collateral radiation exposure to important structures such as the lungs and heart.
• Intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) to achieve precise conformal targeting.
• Access to clinical trials of new treatment approaches in radiation delivery.
• Bridging radiation therapy with CAR T-cell therapy or stem cell transplants.

Learn more about the inter-professional Lymphoma & Myeloma Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Princess Margaret Melanoma and Skin Site Group treats common, rare and complex forms of melanoma and skin cancer.

Learn more about the inter-professional Melanoma & Skin Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.

The Allan and Ruth Kerbel Palliative Radiotherapy and Oligometastases Program (PROP) now offers both rapid turnaround palliative radiotherapy for patients with a wide array of cancer-related symptoms as well as comprehensive evaluation for indications of ablative radiotherapy intended to eradicate individual metastatic lesions.

For patients needing rapid palliative radiation treatment (tumour-related bleeding, obstruction, pain, cord compression), the program aims to see and initiate treatment for patients within 24-48 hours of referral, more quickly if necessary.

The treatment paradigm for patients with limited sites of metastatic cancer (termed oligometastasis) is shifting in the current era of improved, novel systemic therapy and advancement in radiotherapy technology. As such, PROP will also evaluate patients with oligometastatic and other metastatic cancer amenable to very focused, high-dose radiotherapy intended to eradicate individual metastatic lesions. The technique is termed stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR). It is a highly conformal radiation treatment capable of delivering a higher dose of radiation to the tumor target while sparing the surrounding organs.

Patients can be referred by contacting the referral coordinator or lead physician, Dr. C. Jillian Tsai (Jillian.Tsai@uhn.ca). After-hours referrals can be readily obtained by contacting the radiation oncologist on call through the Princess Margaret switchboard at 416 946 2000.

The Princess Margaret/Mount Sinai/University of Toronto multidisciplinary sarcoma clinic provides clinical care of soft-tissue and bone sarcomas with specific expertise in thoracic, head and neck, gynecologic oncology and neuro and spine surgery to provide the most comprehensive management for every clinical case. We are committed to research, and have a portfolio of clinical trials investigating:

• The optimal way of combining surgery and radiotherapy for extremity tumours.
• Biomarkers for sarcoma.
  
• Early and late phase clinical trials of chemotherapy and targeted drug therapy.
• We maintain one of the largest clinical databases of treated cases and collaborate with international sarcoma research consortia.
• We have a first in Canada Adolescent and Young Adult program to provide social and psychological support to young adults facing life-altering illness.

Learn more about the inter-professional Sarcoma Site Group and its specialized, innovative programs to assess, plan and treat cancer at all stages.