How One Patient’s Lung Cancer Experience Can Help Guide the Newly Diagnosed
One Canadian lung cancer patient is encouraging newly diagnosed patients to better understand their treatment options.
Sonya
Friesen
In 2019, Beverley Moir was given six months to three years to live after being diagnosed with stage 4 lung cancer. Up until that day, Moir had always considered herself healthy. As an active non-smoker, the diagnosis came as a huge shock.
Lung cancer is the most common cancer diagnosed and the leading cause of cancer deaths in Canada. Nearly 70 per cent of cases are diagnosed in a late stage, and fewer than 3 in 10 patients survive 5 years post-diagnosis.
New advancements, including biomarker testing, are helping to change this outlook.
patient tissue to detect genetic mutations, proteins, and patterns that can guide treatment decisions. This form of precision medicine enables healthcare providers to tailor therapies to each patient, often leading to more effective outcomes and more time with loved ones.
For patients, knowledge is power
For Moir, biomarker testing proved pivotal. It identified treatments that offered her a personalized plan, extending her life well beyond her original prognosis. Now, six years after diagnosis, she credits the testing for giving her more time with her
Today, Moir strongly advocates for patients with lung cancer, encouraging anyone diagnosed to feel empowered in their own treatment journey and to ask questions. “Precision medicine is here, it makes a difference, and it’s going to continue to grow and be relevant in treating cancer. It’s the future,” she says.
It’s important that patients understand and advocate for their care and ensure that biomarker testing is conducted. Lung cancer doesn’t discriminate, and despite its common association with smoking, “anyone with lungs can be diagnosed,” says Moir. More importantly, however, she notes,
To learn more about biomarker testing and how the results help with prognosis and tailoring treatments visit RevealYourBiomarker.ca
Sponsored by Boehringer Ingelheim (Canada) Ltd.
PHOTO CREDIT: SCOTT MURDOCH
Life After a Lung Cancer Diagnosis: Targeted Therapies Offer Hopes
Biomarker testing is transforming lung cancer care with targeted treatments, and ALK Positive Canada offers hope and community support for ALKpositive patients.
Janice Tober
When Craig Smith started to feel rundown in 2018, it didn’t surprise him. He was travelling back and forth between Ottawa and London, ON., to help his parents, who were both ill at the time. Then he developed a cough which, at first, he attributed to a possible allergy to a new household addition, dog Bailey.
But the cough got progressively worse, and Smith went to his GP. At only 55 years old, fit and healthy, at first the doctor surmised that Smith had GERD – a gastroesophageal reflux disease which happens when stomach acid flows back into the esophagus, causing heartburn. A chest X-ray was followed by CT scans, and on April 1, 2019, Smith was told he had stage 4 lung cancer.
“The oncology team told me that so much lung tissue was involved that they wouldn’t be able to treat the cancer with radiation or surgery,” says Smith. “In fact, they had rarely seen such a proliferation of cancer in someone’s chest.” A biopsy was taken before Smith suddenly crashed, barely surviving a cardiac tamponade event, this is when fluid builds up and puts pressure on his heart.
The biopsy, however, revealed that Smith’s lung cancer biomarker testing was positive for ALK. While recovering in the hospital, he received a targeted therapy specifically designed to suppress this particular subtype of cancer cells. “It was like a miracle. I started to feel better within days,” says Smith. “About six to eight weeks later, my cancer had reduced by around 30 per cent.”
For those living with lung cancer caused by genetic mutations —such as those with the ALK
mutation—remarkable outcomes like this are not uncommon.
Targeted cancer therapy changes lives
Biomarker testing looks for certain changes (mutations) in the genes of lung cancer cells. While many still believe lung cancer is primarily a smoker’s disease, the reality is that anyone can develop lung cancer — including people who have never smoked a day in their lives.
Katie Hulan is the Vice-President of Advocacy for the non-profit organization ALK Positive Canada, as well as an ALK-positive lung cancer patient, having been diagnosed at 33 years of age. “Biomarker testing can significantly impact the lives of people living with cancer,” she says. “If a specific biomarker is present in lung cells, such as an ALK (anaplastic lymphoma kinase) fusion, the oncology team can provide targeted therapy to the patient. Unlike traditional chemotherapy treatment protocols, where the drugs given attack healthy cells as well as the cancerous ones, targeted therapy means that the patient can take an oral dose of medicine that only works against a specific gene mutation to inhibit cancer cell growth.”
Patients tend to have a much better quality of life with this type of treatment. “Side effects vary from person to person but, for example, I have a full head of hair and a good appetite, I can do weekly runs, and I can travel the world. No one would know I have cancer,” says Hulan.
Biomarker tests are mostly done for nonsmall cell lung cancer (about 85 per cent of cases) because small cell lung cancer has historically shown fewer targetable genetic changes — but new biomarkers and therapies are emerging.
Supporting patients beyond treatment
ALK Positive Canada Inc (APC) is a federally incorporated non-profit organization which started last year and was incorporated at the beginning of this year. The organization started as a private Facebook page in 2018 by some concerned patients. There is a group of four administrators who maintain that page, though it is legally a separate entity to APC.
“We support and advocate for people living with ALK-positive cancer, whether that means campaigning for clinical trials or for better provincial health benefits,” says Hulan. “Ultimately, we want to help find a cure while also improving life expectancy and quality of life.”
Through this, the organization remains an important touchpoint in the lives of many people directly affected by ALK-positive cancer.
Alexandra Chassé is an ALK-positive cancer patient living in Quebec. “For me, the organization made me feel less isolated,” she says. “I was able to connect with people who truly understood what I was going through. I found hope through their stories, and it gave me the strength to be more proactive in my care, to ask the right questions of my medical team, and to maintain confidence in my treatments. ALK Positive Canada provides information and support to those who need it, because no one should face this illness alone.”
If you or someone you know has ALK-positive lung cancer, get involved with ALK Positive Canada by visiting alkpositivecanada.org
How to Help Protect Loved Ones from Invasive Pneumococcal Disease
Invasive pneumococcal disease can cause severe illness and even death, especially in older Canadians. Taking preventative measures is important.
Both pneumococcal pneumonia and invasive pneumococcal disease can cause serious complications in older adults, 1 including cardiac events. 2 Knowing the risks and how to help protect yourself or your loved ones is important.
Invasive pneumococcal disease (IPD) occurs when the streptococcus pneumoniae bacteria — which is responsible for pneumococcal pneumonia and typically causes infections of the ears, sinuses, or lungs 3 — invades the bloodstream and spreads to the brain, joints, heart muscle, or other areas,4 leading to serious conditions like meningitis or sepsis. 5
“IPD is far less common than bacterial pneumonia, but tends to be more severe with worse outcomes,” says Dr. Ronald Grossman, a practising respirologist, Professor of Medicine at the University of Toronto, and former Chief of Medicine at Credit Valley Hospital.
Know the risks
“If someone aged 65-plus is hospitalized with community-acquired pneumonia, the 30-day mortality rate is about 7.6 per cent,”6 says Dr. Grossman. About 25 to 30 per cent of patients with pneumococcal pneu-
monia will develop bacteremia or another form of IPD.7 IPD symptoms include fever, stiff neck, headache, nausea, joint pain, and chills.8
Those most at risk include older adults,9 young children,10 immunocompromised patients, 11 and people with chronic conditions like COPD, heart disease, or diabetes.12
IPD is far less common than bacterial pneumonia, but tends to be more severe with worse outcomes.
Adverse cardiac events are one of the biggest risks.13 “More people admitted to hospital with community-acquired pneumonia will die of cardiac complications than of the pneumonia itself,” 14 says Dr. Grossman.
With IPD, helping to prevent it is preferable to treatment. “Antibiotic therapy may not be enough,” says Dr. Grossman. “We’ve bad outcomes despite therapy.”
Help protect yourself
The pneumococcal vaccine is an
effective way to help prevent IPD.15 However, as with all vaccines, 100 per cent protection may not be guaranteed and adverse reactions may occur. Vaccines do not treat IPD and its complications once it develops.
Dr. Grossman notes that the pneumococcal vaccine is important for older adults to receive, along with other respiratory vaccines like those for COVID, influenza, and RSV.16
Unfortunately, Canada lags behind its vaccination coverage goals: 2023 stats show that only 55 per cent of adults aged 65-plus received one dose of pneumococcal vaccine, versus the goal of 80 per cent.17
A tailored approach to vaccination is wise. Different pneumococcal vaccines exist.18
“The pneumococcus has about 100 serotypes,” 19 explains Dr. Grossman. Different vaccines target different serotypes, or strains, of the bacterium. 20
Dr. Grossman recommends speaking to your health care practitioner about which pneumococcal vaccine might be best for you, and notes that equitable access to vaccination across Canada is essential. Not all of the available pneumococcal vaccines are currently available in all provinces and territories. 21
For more information on pneumococcal vaccinations, speak to your health care provider.
This article was made with support from Merck Canada.
