Dr. Jonathan How

Dr. Jonathan How has expertise in managing a wide range of conditions, including:

Hematologic Malignancies (Blood Cancers) Treated

• Multiple Myeloma: A cancer of plasma cells, a type of white blood cell in the bone marrow that produces antibodies, leading to bone damage and other complications.
• Hodgkin Lymphoma: A cancer of the lymphatic system, part of the immune system, characterized by the presence of Reed-Sternberg cells.
• Myeloproliferative Neoplasms (MPN) (Polycythemia Vera, Essential Thrombocythemia, Myelofibrosis): A group of chronic blood cancers where the bone marrow produces too many red blood cells, white blood cells, or platelets.

Benign Hematologic (Non-Cancerous Blood) Disorders Managed

• Sickle Cell Disease & Thalassemia Syndromes: Inherited disorders affecting the structure or production of hemoglobin, leading to various complications.
• Von Willebrand Disease & Other Inherited Bleeding Disorders: Genetic conditions that impair the blood's ability to clot effectively, causing prolonged or excessive bleeding.
• Immune Thrombocytopenia (ITP): An autoimmune disorder characterized by a low number of platelets, leading to an increased risk of bleeding.

This list provides examples of common conditions treated and is not exhaustive. Cancer and blood disorders are complex, and treatment is highly individualized. For personalized advice, please discuss your specific situation with Dr. Jonathan How or your referring physician.

• Interpretation of Special Hematologic Tests (e.g., Flow Cytometry, Cytogenetics, Molecular Studies): Analyzing results from advanced laboratory tests crucial for diagnosing and classifying hematologic conditions.
• Management of Clotting Disorders / Thrombophilia (Inherited & Acquired): Diagnosis, anticoagulation therapy, and long-term management for conditions predisposing to abnormal blood clots (e.g., DVT, PE, Factor V Leiden, Antiphospholipid Syndrome).
• Autologous & Allogeneic Stem Cell Transplant Consultation, Coordination & Post-Transplant Care (as part of a transplant team or referral network): Evaluating eligibility for, coordinating referrals to, and providing follow-up care for patients undergoing stem cell transplantation for hematologic malignancies.
• Bone Marrow Aspiration & Biopsy (Performance or Interpretation): Performing or interpreting samples from bone marrow aspirations and biopsies to diagnose blood disorders and cancers.
• Comprehensive Oncologic & Hematologic Consultation: In-depth evaluation of medical history, review of diagnostic imaging and pathology, cancer staging (if applicable), and development of personalized treatment plans for various cancers and blood disorders.
• Therapeutic Apheresis Consultation (e.g., for TTP, plasma exchange indications): Consultation and coordination for procedures that separate components of blood for therapeutic purposes.
• Neutropenia & Other White Blood Cell Disorders Evaluation: Investigating and managing low or abnormal white blood cell counts, increasing susceptibility to infections.

Note: This list provides a general overview of services offered in Hematology (Blood Disorders). Treatment plans are highly individualized. Dr. How provides a wide array of diagnostic, therapeutic, and supportive care options tailored to each patient's specific condition and needs. Please discuss with Dr. How or your healthcare team for details relevant to your care.

All medical services and treatments are provided in accordance with the standards of practice set by the Collège des médecins du Québec (CMQ) and relevant cancer care guidelines. A referral is required.

Dr. How practices at the CUSM, Dép d'hématologie located in the vibrant Notre-Dame-de-Grâce (NDG) Central neighborhood of Montréal. The facility is conveniently situated near the Mont-Royal Metro Station Area and Plateau Mont-Royal Shopping & Dining districts, making it accessible by public transit, including the Société de transport de Montréal (STM) (Métro, Bus). The center is fully wheelchair accessible, ensuring ease of access for all patients. Metered street parking is available nearby for those arriving by car. The location offers a comfortable and welcoming environment, equipped with advanced diagnostic and treatment facilities to support comprehensive blood disorder care.

Are consultations and treatments with Dr. How, an Hematologist, covered by Régie de l'assurance maladie du Québec (RAMQ) in QC?

Medically necessary consultations, diagnostic tests (like biopsies, imaging reviews), chemotherapy, immunotherapy, targeted therapies, radiation therapy planning and delivery, and management of blood disorders by a licensed Hematologist such as Dr. How are generally covered by Régie de l'assurance maladie du Québec (RAMQ) in QC when a referral from a family doctor or another specialist is in place. Specific drug coverage for newer therapies can vary by provincial formularies and may require special authorization. It's always recommended to discuss coverage specifics with Régie de l'assurance maladie du Québec (RAMQ), Dr. How's office, the hospital's patient financial services, or the cancer care navigation services at the treatment facility.

Do I need a referral to see Dr. How, an Hematologist?

Yes, a referral from your family physician or another specialist is almost always required to see an Hematologist like Dr. How for assessment or treatment of cancer or significant hematological conditions. This ensures that your primary care provider is involved in your care continuum and that you are directed to the most appropriate specialist for your specific situation. Cancer care programs often have centralized intake systems that manage referrals to ensure timely access.

How will treatment decisions be made for my condition by Dr. How?

Treatment decisions in oncology and hematology are highly personalized and made collaboratively. Dr. How will consider many factors, including the type and stage of your cancer or blood disorder, your overall health, genetic markers of the disease (if applicable), current treatment guidelines, and importantly, your personal preferences and values. Often, cases are discussed in multidisciplinary team meetings (tumor boards) with other specialists to ensure a comprehensive approach. You will be an active participant in this decision-making process.

What happens after cancer treatment is completed with Dr. How?

After active cancer treatment finishes, Dr. How will develop a survivorship care plan with you. This plan typically includes a schedule for follow-up appointments and tests to monitor for any signs of recurrence, management of any long-term side effects from treatment, recommendations for healthy lifestyle choices (diet, exercise), and coordination with your family doctor for ongoing general health care. The goal is to support your long-term health and well-being.

What does an Oncologist and/or Hematologist like Dr. How specialize in?

Dr. How specializes in Hematology (Blood Disorders), providing comprehensive care for both benign and malignant blood conditions. He is experienced in diagnosing and treating blood cancers such as leukemia, lymphoma, and myeloma, as well as benign disorders like anemia, clotting abnormalities, and inherited bleeding disorders. His expertise encompasses the full spectrum of hematologic care, ensuring a personalized approach tailored to each patient's specific needs.

What are common side effects of chemotherapy, and how does Dr. How help manage them?

Chemotherapy can cause various side effects, which differ depending on the specific drugs used, the dose, and individual patient factors. Common ones include fatigue, nausea, vomiting, hair loss, mouth sores, changes in appetite, diarrhea or constipation, and increased risk of infection due to low blood counts. Dr. How and the oncology nursing team will discuss potential side effects of your specific treatment plan in detail and will actively work to prevent and manage them with medications (e.g., anti-nausea drugs, growth factors to boost blood counts), supportive care advice (nutrition, hydration, rest), and regular monitoring. Open communication about any side effects you experience is very important for effective management.

What is palliative care, and when might Dr. How discuss it?

Palliative care is specialized medical care focused on providing relief from the symptoms and stress of a serious illness, like cancer or advanced blood disorders. The goal is to improve quality of life for both the patient and the family. It can be provided at any stage of illness, alongside curative treatments, not just at the end of life. Dr. How may discuss palliative care if you are experiencing significant symptoms, to help manage pain, fatigue, nausea, anxiety, or other issues, and to provide an extra layer of support.

What can I expect at my first appointment with an Oncologist/Hematologist?

Your first appointment with Dr. How will be comprehensive and may last an hour or more. It will involve a detailed review of your medical history, family history of cancer, current symptoms, medications, and any previous tests, imaging results (CT, MRI, PET scans), and biopsy reports related to your diagnosis. He will likely perform a thorough physical examination. The main goals are to confirm your diagnosis, discuss the type and stage of your condition (if applicable), and outline potential treatment options. This is a crucial time to ask questions, and you are encouraged to bring a family member or friend for support and to help take notes. Dr. How will explain the proposed treatment plan, including goals, benefits, potential side effects, duration, and what to expect moving forward. Further tests may be ordered.

CUSM, Dép d'hématologie
D02.7040-1001 boul Décarie
Montréal, QC H4A 3J1

Phone: (514) 934-1934 | Fax: (514) 843-1418

The facility is wheelchair accessible.

Dr. How is a licensed Hematologist regulated by the Collège des médecins du Québec (CMQ) under the Medical Act in QC. A referral from a family physician or other specialist is required for most consultations and treatments under the provincial health plan.

Verify registration with the Collège des médecins du Québec (CMQ): https://www.cmq.org/en/directory/physicians?number=12117