Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Tuesday, November 01, 2016

Bafflingly Inexplicable

"Anyone with lungs can get lung cancer. I want my story to help spread awareness and end stigma. I want my story to provide hope for others battling the disease."
"I am feeling really, really good."
"But not everyone is that lucky. Not everyone gets treatments [taking part in an experimental clinical drug trial] when they need them. I don't believe it is fair that anyone should have to wait [for federal approval of new cancer-fighting drugs]."
Elizabeth Dessureault, 27, Ottawa
Eighteen months after her lung cancer diagnosis, Elizabeth Dessureault is enjoying every minute with her son, Jack, and feeling positive. - Ottawa Citizen
"It is a very exciting time to be an oncologist in lung cancer. When I see patients benefiting, it is wonderful."
"But it is frustrating not to be able to use them [drugs awaiting clinical trials and Health Canada approval]."
Dr. Paul Wheatley-Price, medical oncologist, The Ottawa Hospital, president Lung Cancer Canada

"Canadian women are losing more years of potential life from lung cancer than women in most other peer countries [such as Australia, France, Germany, the Netherlands, New Zealand, Sweden, the United Kingdom and the United States]."
"If we look back over the last 30 years, Canada's smoking rate among men has been consistently lower than the OECD's, while for women the smoking rate was at times higher than OECD average."
"This may help explain why Canada's results for lung cancer mortality in men ranks better than its results for women."

Lung Cancer Canada report
"We know that non-smoking women are at twice the risk of developing lung cancer as non-smoking men and we really just don't understand why that is."
"We've talked about environmental risks as well as things like air pollution, things like radon, but there may even be some genetic differences."
Dr. Natasha Leighl, medical oncologist, Princess Margaret Cancer Centre, Toronto

Survival of young Canadian women diagnosed with lung cancer is frighteningly poor. Canadians diagnosed with lung cancer must wait lengthy periods of time to be able to access approved costly and new treatments in comparison to peer patients in the United States, even while new advances in drugs and diagnostics are increasingly offering new hope and lengthened life to lung cancer patients across the board.

So far in 2016 over 28,000 Canadians were diagnosed with lung cancer. This form of cancer is responsible for about 25 percent of cancer deaths throughout the country annually. But research into lung cancer attracts a mere seven percent of research funding. In comparison, breast cancer, while causing some seven percent of cancer deaths, remains the recipient of about 25 percent of research funding.Campaigns for breast cancer funding are just more vigorous, and there are greater numbers of survivors to take up the public relations cudgel.

Lung cancer mortality in Canada at 58 deaths per 100,000 population is considerably greater than the OECD average of 43 per 100,000. All peer OECD countries had fewer deaths attributable to lung cancer than Canada, The Netherlands being the sole exception, with the same rate as Canada. In Canada, more people die from lung cancer, than from prostate, breast and colorectal cancers combined. According to Statistics Canada, lung cancer caused 19,110 deaths in 2009, representing eight percent of mortality in Canada.

Gender-wise, among women in 2012, Canada's lung cancer mortality rate was 47.0 per 100,000 compared with the OECD average of 26.5 per 100,000, while for Canadian men the rate was 72.3 per 100,000 versus 66.3 per 100,000. Recent research from the Canadian Institute for Health Information concludes that Canadian women with lung cancer fare worse outcomes than women in 17 other countries. A study done in 2013 concluded that Canada, out of 33 peer countries had the third-highest female lung cancer death rate.

And while men's death rates from lung cancer have been declining since the 1980s, death rates for women have remained stagnant. But even while these statistics refer to high lung cancer numbers leading to significantly higher death rates, Canadians wait longer for drugs -- shown to be effective when used elsewhere in the world -- to be approved for use in Canada and to be paid for through the universal health system by the various provinces.

Guidelines released by the Canadian Task Force on Preventative Health Care recommend annual lung cancer screening for high-risk adults, aged between 55 and 74 with the use of low-dose computed tomography screening. Three pilot projects are expected to be set up in Ontario in the coming year. Screening resulted in a 20 percent mortality drop in the U.S. when it was introduced there. Dr. Wheatley-Price advised that over half the patients he sees have advanced incurable lung cancer by the time they are diagnosed.

He speaks of the frustration of witnessing his patients dying while drugs that could conceivably prolong their lives wait to be made available through approval by Health Canada. Comparing the cutting edge drugs swiftly approved for use in the United States, while approval in Canada can take precious months and years. The young woman mentioned above, Elizabeth Dessureault, has been taking part in a clinical drug trial, and it has extended her life immeasurably.

On diagnosis in April 2015 she was advised there was little hope. She was pregnant at the time and informed by doctors that it was not likely that either she nor her unborn child might survive. She most certainly has, and so has her son, and she has taken to writing a blog, From Lizzie's Lungs, to inform the public that even a young, non-smoker like her is vulnerable to lung cancer onset. She writes her blog so that others can be informed and through becoming informed, being involved and having hope.


Health System Performance for Canada

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