In global terms, Canada is falling further and further behind other countries in our ability to access and use effective therapies to treat lung cancer.ISTOCK.COM
Canadian lung cancer patients are surviving longer thanks in part to innovative new drugs but, like many other Canadians living with cancer, face obstacles in receiving the treatment they need to fight the disease, says Stephanie Snow, president of Lung Cancer Canada.
With November being Lung Cancer Awareness month, Dr. Snow says it’s appropriate to focus on how Canada is faring in lung cancer treatment and what needs to be done to improve it.
“In global terms, Canada is falling further and further behind other countries in our ability to access and use effective therapies,” she says. “From the time Health Canada approves a medication until it can be listed by a health care jurisdiction, such as a province, can take several years. This process, known as health care technology assessment, is especially challenging for new targeted therapies.”
The issue, says Dr. Snow, is inconsistent access to public coverage for cancer therapies between provinces and other health care jurisdictions, especially oral take-home drugs. Canada has also been slower rolling out lung cancer screening programs compared to many other countries.
Lung cancer is the most common form of cancer in Canada. There were close to 30,000 new cases in 2021 – and it is also the deadliest.
Twice as many Canadians will die from lung cancer than from any other cancer – more than the combined total deaths due to the other three major cancer types: colorectal, breast and prostate.
And while the Canadian Cancer Society reports that the survival rate at five years for people with lung cancer was at 22 per cent in 2021 – the highest ever recorded in Canada – it is still well below the 64 per cent survival rate of all other cancers combined.
“Much of the benefit seen in survival outcomes is related to improved systemic therapy with two major classes of drugs that have had major impacts on survival: targeted therapies for specific mutations in lung cancer, and immunotherapies that use the patient’s own immune system to attack cancer cells,” says Dr. Snow.
There have also been improvements in the techniques used to treat cancer with radiation and surgery, including minimally invasive surgery to remove tumours using small incisions, and stereotactic radiation techniques that allow a large ablative dose of radiation to be delivered to a small area of the body with high precision.
Dr. Snow says the COVID-19 pandemic badly impacted lung cancer patients who tended to have worse outcomes compared to the general population and were more likely to be hospitalized or die.
Dr. Stephanie Snow“There’s a commonly held perception that ‘they did it to themselves’ or that all lung cancer is caused by tobacco use. In reality, the only risk factor for getting lung cancer is having lungs.
President of Lung Cancer Canada
Many also skipped their treatments rather than travel to hospitals for assessments, tests and therapies out of fear of being infected, she adds.
“Psychologically, lung cancer patients struggled, especially with anxiety,” says Dr. Snow. “Many already live with COVID-19 symptoms, such as a cough and shortness of breath, so they were uncertain as to which symptoms came from their lung cancer and which came from a possible COVID-19 infection.”
People living with lung cancer also continue to endure the stigma associated with the disease even though approximately 20 per cent have never used tobacco products.
“There’s a commonly held perception that ‘they did it to themselves’ or that all lung cancer is caused by tobacco use. In reality, the only risk factor for getting lung cancer is having lungs,” says Dr. Snow. “Patients and their families often internalize these misbeliefs, and that causes self-blame, depression and social isolation.”
This false assumption has also resulted in far fewer research dollars being allocated to lung cancer compared to other cancers even though it is the most prevalent cancer in Canada, she adds.
In spite of the challenges, Dr. Snow says progress is being made towards treatment of lung cancer.
For example, the provinces are in the process of launching, or have launched, lung cancer screening programs that use CT scans proven to improve survival by detecting early-stage cancers, which means they can be managed sooner when the chance for cure is higher.
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