Our resource centre was created to give an initial understanding of your lung cancer diagnosis. For more information, please use the links provided.
Understanding Cancer Survivorship
The reality of a cancer diagnosis is that cancer is a lifelong journey. As a patient or a caregiver, cancer can impact you for the rest of your life.
While the five-year survival rate for lung cancer is only 17%, lung cancer survivorship is improving with new innovative therapies coming to market.
Lung cancer survivorship is complex and the definition of survivorship itself differs from person-to-person. It is important to develop a survivorship and care plan between the patient, the care team, and the primary doctor to promote cooperation between the overall unit.
The Canadian Cancer Survivor Network has some great resources on living with lung cancer after the initial shock of your diagnosis, caregiving resources, and survivorship. Click here for more information.
What does Lung Cancer mean?
Lung cancer is the second most common cancer diagnosis in Canada, but is the number one cancer killer: it kills at least two times more Canadians than any other cancer.
The current outlook for most lung cancer patients is not encouraging; 85 percent of Canadians diagnosed with lung cancer will not live five years. It is our hope that we can help change these statistics.
Right now, treatment options for lung cancer patients are lagging behind in Canada. The Right2Survive campaign aims to bring greater awareness of this disease to Canadians to help fight for lung cancer patients’ right to survive. We hope our advocacy will spread a better understanding of lung cancer; destigmatize the disease; push for greater research to be done in the area; give lung cancer patients better information on their options; push for better and more accessible screening programs; and ultimately bring innovative treatments to market so more patients can beat the odds.
Like all cancers, the earlier lung cancer is diagnosed, the better the opportunity for a cure. Currently, almost half of lung cancer diagnoses are made when a patients’ cancer is already at the most advanced stage.
Research has shown that screening with low-dose computed tomography (CT) using lower doses of radiation (low-dose CT) is effective in detecting lung cancer early in people who have a history of heavy smoking.
For those at risk for lung cancer, a comprehensive program of low-dose CT screening has the potential to save thousands of lives each year.
As of right now, there are no provincial or territorial lung cancer screening programs in place in Canada. The Canadian Task Force on Preventive Health Care (CTFPHC) recommends low-dose CT screening once a year for three years for people who meet the criteria below. The CTFPHC recommends screening for lung cancer in persons who are:
- Aged 55 to 74 –this is the age group where the evidence says lung cancer is the most effective
- Smokers or former smokers who have quit in the last fifteen years
- Smokers who have smoked one pack a day for at least thirty years or two packs a day for fifteen years, equalling ‘thirty pack years’
For more information about screening for lung cancer click here.
Types of Lung Cancer
Lung cancer begins when abnormal cells begin to form in the lung and exponentially grow. As more cancer cells grow, they can form into a tumour and can spread to other areas of the body.
There are two types of lung cancer:
Non-small cell lung cancer (NSCLC)
Makes up approximately 80-85 per cent of lung cancers. It grows more slowly than SCLC. There are three different types of NSCLC:
- Squamous cell (epidermoid) carcinoma
- Large cell (undifferentiated) carcinoma
Small cell lung cancer (SCLC)
Makes up approximately 10-15 per cent of lung cancers. SCLC almost always begins in the bronchi (the airways of the chest).
SCLC grows quickly and often spreads to different parts of the body. It is less likely to be caught at earlier stages. SCLC is composed of much smaller cells and can quickly become fatal if left untreated.
Bio-markers & Molecular Testing
It is important for patients to know and understand their tumour type because it informs their treatment options.
During diagnosis, there are two types of tests which can be done to test for certain changes (mutations) to the genes of the cancer cells; a biopsy which involves removing tissue from the tumour to be tested; and a blood test, known as a liquid biopsy or plasma test. These markers can predict how well a non-small cell cancer may respond to specific treatments and help your doctor to determine what treatment will work best for you.
There are many common tumour types, but the most common mutations for non-small cell lung cancer are:
- The best time to talk to your doctor about tumour testing is before a biopsy is done
- Tell your doctor you want to talk about comprehensive genomic testing
- If your tumour wasn’t tested before you started treatment, it might not be too late—ask your doctor about testing leftover tissue or doing a liquid biopsy (blood draw)
- Has a sample of my tumour been sent for molecular testing?
- What (if any) mutations were found in my biopsy sample?
- What are my treatment options? Am I a candidate for bio-marker testing?
- Should my cancer be tested for other mutations?
- What is the goal of targeted therapy?
Staging is used to determine the spread of cancer, and is based on whether or not the cancer is contained within the lungs or if it has spread elsewhere to lymph nodes and/or other organs. The main stages of lung cancer are stage 1 to stage 4, from least advanced to advanced, respectively. Knowing and understanding the stage of your lung cancer is vital, as your treatment options will be shaped by the stage and progressive of your cancer.
Unfortunately, the majority of patients are already at an advanced stage of lung cancer (stage 3 or 4) when they are diagnosed, making treatment options more difficult.
For more information about the staging of lung cancer click here.
Depending on the stage of your lung cancer, your treatment options- as well as goals- will change. Treatment by stage for non-small cell lung cancer:
While this stage is uncommon, most patients with stage 1 lung cancer will normally have surgery to remove part of the lung or the entire lung. If health issues arise, your doctor may suggest targeted radiotherapy instead. The goal at this stage is to be cured of your lung cancer.
You may be offered surgery at this stage depending on the position of your tumour- this could result in the removal of part, or all, of the lung. After surgery, your doctor may recommend chemotherapy to lower the risk of recurrence. Your doctor may also recommend radiotherapy, or a combination of both chemotherapy and radiotherapy. The goal at this stage is to be cured of your lung cancer, with special attention to ensure it does not return.
At stage three, it is increasingly important to be tested for your bio-marker. Your doctor may suggest a variety of treatment options, from chemotherapy to radiation, or immunotherapy. While many still believe being cured at Stage 3 is not possible, there are new and innovative treatment options that have allowed for a cure at Stage 3. Talk to your doctor about your options.
If you are diagnosed with Stage 4, the goal of your treatment will be to shrink your tumour to reduce symptoms and to control the cancer so that it does not spread further. Your doctor may suggest many different treatment options depending on where your cancer has spread. Again, it is important to know and understand your bio-marker if you are diagnosed with Stage 4 lung cancer.
As lung cancer research progresses, innovative therapies to treat both SCLC and NSCLC are expanding and are showing promising results. It is best to speak with your doctor about your treatment options.
Get more information about treatment options for small cell lung cancer here.
Get more information about treatment options for non-small cell lung cancer here.
While radiation and chemotherapy remain the standard of care for most patients, there has been a shift towards personalized therapy through an increased understanding of the molecular diagnosis and treatment of lung cancer, which is offering patients new opportunities for survival, even at an advanced stage. Your treatment options wholly depend on the type and stage of your lung cancer diagnosis, your tumours mutational status, as well as your overall health and your own wishes.
Treatment options differ based on the type of lung cancer you have:
- Treatment options for Non-Small Cell Lung Cancer are seemingly more extensive. Treatment can range from surgery, chemotherapy, radiation, a combination of these treatments, with some patients at advanced stages opting for biological therapy or immunotherapy. For NSCLC patients, the staging diagnosis is the most important prognostic factor.
- Small Cell Lung Cancer is the most often treated with chemotherapy, and may also be treated with radiotherapy. As SCLC metastasizes rapidly, and is often already metastatic at the time of diagnosis, surgical removal and localized radiation therapy are often less effective.
- As lung cancer research progresses, innovative therapies to treat both SCLC and NSCLC are expanding and are showing promising results.
- It is best to speak with your doctor about your treatment options.
Chemotherapy uses anti-cancer drugs to destroy cancer cells which work by disrupting the growth of cancer cells.
Read more here.
Radiotherapy uses high energy rays to kill cancer cells.
Immunotherapy is a type of cancer treatment that helps your immune system fight cancer. Immunotherapy is used to:
- Stop or slow the growth of cancer
- Help the immune system work better to destroy cancer calls
- Stop cancer from spreading to other parts of the body
There are different types of immunotherapy, all based on your own cancer diagnosis. Ask your doctor if you are a good candidate for immunotherapy.
De-Stigmatizing Lung Cancer
Many people who are diagnosed with lung cancer must also face the negative public perception and stigma of being a lung cancer patient.
Many lung cancer patients, whether they smoke, have quit or have never smoked, feel stigmatized because the disease is so strongly associated with smoking. Stigma often results in negative reactions and blame from others and a perception that those patients ‘brought it upon themselves.’
As a result of this stigma, patients may experience:
- Complex self-blame and intensified guilt and shame.
- Fear of disclosing one’s diagnosis of lung cancer.
- Avoidance of social situations, leading to increased feelings of isolation.
- Increased stress and difficulty coping.
- Threats to economic opportunities and financial problems.
While the connection between smoking and lung cancer cannot be denied, anyone with lungs can get lung cancer. There are other common environmental factors that can lead to a lung cancer diagnosis, including for non-smokers. Exposure to radon, second-hand smoke, air pollution and other factors can all lead to lung cancer.
Whether patients smoked or not, they tend to be blamed for having caused their disease—adding an even greater emotional burden to an already overwhelming situation. When this stigma persists, it hurts patients and their families, who may not get the treatment and supports they need to for their best chance at survival.
For more information about stigma and lung cancer, click here.