Untitled Page

Blocking Angiogenesis and Gamma Knife Surgery

Neurosurgeon Gelareh Zadeh’s focus is on neuro-oncology, both in her clinical and research work. Working together as a team with Fred Gentili at Toronto Western Hospital, she continues to build her skull base practice through Fred’s excellent mentorship and collaboration. Endoscopic neurosurgery was historically focused in the region of the sella turcica. However, the transnasal endoscopic approach now includes a much wider range of operations. Anterior and middle skull base pathologies can now be accessed through the expanded endonasal approach.

Gelareh works with Mount Sinai Head & Neck surgeon Allen Vascan in the operating room at Toronto Western Hospital where they are building a skull base program. Gelareh’s second clinical focus in neuro-oncology is the treatment of brain metastases. She runs a brain metastases clinic with Mark Bernstein and the radiation oncologists at Princess Margaret Hospital. “The treatment of this challenging patient population is evolving rapidly as systemic therapy improves overall survival and alters tumor biology. In the past, brain metastases were treated with whole brain radiotherapy, but stereotactic radiosurgery enables us to tailor individual treatments that improve overall quality of life and prolong functional independent status.” There are two gamma knife machines, one at Princess Margaret, used for malignant lesions and one at Toronto Western used for other brain pathologies.

Gelareh was born in Iran, raised in England and came to Canada at age 17. As she and her family arrived in Winnipeg on Boxing Day, her mother, a nuclear chemist was intended to work in the nuclear industry in Manitoba. The family stayed in Winnipeg for 10 years, where Gelareh attended medical school and began her neurosurgery residency. She came to the University of Toronto to pursue a PhD with Ab Guha. Her PhD focused on molecular pathways that regulate tumor angiogenesis. “It was a great 4-5 years of scholarly work at the Hospital for Sick Children. Ab Guha has been an excellent supervisor and mentor for me.” Following her laboratory work, Gelareh continued her neurosurgery residency education at the University of Toronto for the next three years. She was very busy clinically and is grateful to her many mentors, particularly to Chris Wallace for his remarkable mentoring in operating room technique. She performed over 500 operations during her senior year before the current work hour restrictions were in place.

Her PhD work was focused on blocking angiogenesis in a xenograft glioblastoma multiforme model. Vascular endothelial growth factor is the main network builder of angiogenesis. Angiopoietin then matures the basic vascular infrastructure in order to develop the finer vascular radicals. This step requires destabilizing preformed vessels to allow new branching. This process is active in embryogenesis and is recapitulated in tumors. She worked on a competitive inhibitor injected intratumourly to block the Tie-2 receptor. The tyrosine - kinase inhibitor that she developed was a unique contribution. Gelareh worked with Andras Nagy of the Lunenfeld Institute during her angiogenesis research. She finished her laboratory and clinical training in 2006, then went to London, England to the Grey Institute to study radiobiology. It was a stimulating year featuring training in clinical trials of radiotherapy. She also set up a brain metastases clinic there, and got unwanted media attention when she performed the first same day outpatient brain surgery in the UK, a technique that she had learned from its originator Mark Bernstein.

Gelareh Zadeh with her husband Randall Strank and their daughter Ayla

Gelareh Zadeh with her husband Randall Strank and their daughter Ayla

In order to develop stereotactic neurosurgery, Gelareh turned to the Samantha Dickson Brain Tumor Trust for financial support. The Trust provided five million pounds to advance brain tumor research and clinical program development. Matched funds were provided by the National Hospital Foundation to make possible the clinical program in brain tumor care. Professors Fish and Hanna at University College London were instrumental in helping Gelareh secure these funds.

“I missed the academic environment of Toronto Western Hospital and so I returned to work with my clinical and laboratory colleagues. Working in an established environment that supports and fosters research, and collaboration with likeminded clinician scientists is even more important than the funding for research.” Gelareh has a CIHR Surgeon Scientist Award, which is a competitive clinician scientist award offered to approximately ten people throughout the country every year. She learned to value Canadian healthcare while she was in London and saw how two tiers healthcare hurts the public sector, as there is an inevitable drift of practitioners toward private care. She returned in 2008 and has been in her present position for the past three years. The laboratory is going well and her clinical work is very satisfying. Ab Guha and James Rutka have continued their support and mentorship, helping her establish herself as an independent researcher. She has also had an outstanding scientific mentorship and collaboration with Richard Hill, PhD at Princess Margaret Hospital.

Gelareh and Randall Strank have a three year old daughter Ayla. Her mother Fariba has recently retired from nuclear medicine at Health Sciences in Winnipeg to help look after Ayla. The family lives in High Park. Both parents and Ayla are learning the piano together, with Ayla slightly ahead of her mother and father.


Skip Navigation Links