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When a patient is given a form of drug therapy, the goal is to target the organ that is causing, or being affected by, the health issue. However, it’s critical to understand how that drug therapy will affect other organs in the body and how to protect against additional unintended harm.


Siloed approaches to treating patients with multiple health issues represent the current model of care. These approaches can be sporadic and disjointed, increasing the risk that drug therapies and other treatments will complicate, rather than improve, disease prognosis. As a result, patients with multiple health conditions suffer suboptimal outcomes, ranging from repeat hospitalizations, adverse drug reactions, conflicting medical advice, and increased risk of mortality. 


The Hang Tough Initiative was born out of the belief that patients with multiple health issues require seamless and coordinated treatment; one that is easy to access, responsive to their unique needs, and shows the greatest opportunity for success.

Build A New Integrated Model Of Care

A leading team of physicians and researchers from University Health Network are uniquely positioned to improve how we coordinate and deliver care for patients who have, or are at risk of, further health issues. With a new model of care, they will untangle the equally complex interactions and consequences of the disease treatments. Through proactive collaboration and dialogue, this team will improve the prognosis for patients burdened by multiple life-threatening diseases.

Conduct Innovative Research

Through innovative research, a team of seven physicians will equip medical teams with advanced insight on how to care for this growing patient population. This includes devising the most optimal surgical procedures, identifying strategies to prevent consecutive or concurrent complications and developing new therapies to improve patient outcomes. Each of these physicians has a wealth of expertise in cancer, cardiac, and nephrology disorders and are keen to unearth the most advantageous form of treatment for overlapping conditions.

Research Projects

Preventing Heart Valve Complications

There is an increased risk of developing heart disease for patients receiving chemotherapy and radiation as a form of cancer treatment. One such complication is a malfunctioning heart valve, where one or more of the heart’s four valves cannot open wide enough to let blood flow through or cannot close properly to prevent blood from flowing backwards. The goal of this project is to better equip surgeons at the Peter Munk Cardiac Centre to anticipate future heart complications unique to each individual patient, modify pre- and post- heart valve treatment accordingly, and deliver the most optimal patient outcomes.

Preventing Cardiac Amyloidosis

Patients with bone or blood cancer have an increased risk of cardiac amyloidosis, where an abnormal protein (“amyloid”) is deposited in the heart tissue and takes the place of normal heart muscle. It can lead to the stiffening of the heart wall and reduce blood flow in the heart overtime. These protein deposits can also affect the way electrical signals move through the heart, impacting heart rhythm. The goal of this project is to establish the first ATTR amyloidosis (a-amyloid, TTR-transthyretin, the specific protein) research database in Canada that can advise clinicians on what treatment to prescribe a specific patient at a given time in order to increase the chance of success.

Preventing Arrhythmias

 An arrhythmia occurs when the electrical impulses that coordinate heart rhythm aren’t working, causing the heart to beat too fast, too slow, or irregularly. A patient’s quality of life is severely diminished, and they are at a heightened risk of heart failure, cardiac arrest, or sudden death. There are certain chemo-therapeutic drugs that are suspected of increasing the occurrence of arrhythmias among cancer survivors, including Ibrutinib, used to treat patients with lymphoma. The goal of this project is to uncover the mechanism underlying Ibrutinib-induced ventricular arrhythmias to more effectively identify, prevent, and/or reverse the onset of the disease.

Thanks to early funding donated to the Hang Tough initiative, University Health Network Cardiac Electrophysiologist, Dr. Nanthakumar and his team have already uncovered important findings which will significantly contribute to the next stage of this important research.