Lung cancer treatment in Canada

Lung cancer treatment in Canada is considered to be one of the most effective and affordable in the Western world.

Lung cancer usually develops from cells of the lower respiratory tract (bronchi).

For this reason, it is also called bronchogenic carcinoma.

Canadian doctors distinguish small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).

Small cell tumors grow rapidly and often form metastases (secondary tumors) in distant organs.

However, SCLC occurs in 20% of cases. Approximately 8 out of 10 patients suffer from NSCLC.

Each year, about 29,000 Canadians develop lung cancer, and at least 21,000 patients die from the disease. The incidence of lung cancer remains higher in men (77 per 100,000) than in women (65 per 100,000). This disease is the leading cause of cancer death in both men and women.

This disease kills more people than breast cancer, prostate cancer and colorectal cancer.

However, since the 1980s, the number of men with bronchogenic carcinoma has steadily decreased, while the number of women has increased.

Experts attribute this to the fact that today the number of female smokers has increased dramatically.

Survival rates for lung cancer patients in Canada today are among the best in the Western world. Experts explain the success of Canadian medicine in treating a dangerous disease by actively introducing the best American technologies and targeted drugs, as well as own basic and clinical research.

Lung cancer immunotherapy in Canada is on the rise

An important role in the treatment is played by immuno-oncology, which is intensively developed in Canada.

Lung cancer immunotherapy can significantly prolong the lives of patients with metastatic cancer, who have exhausted all other possibilities.

Treatment of lung cancer is selected individually for each patient, and modern oncology offers many treatment options.

At all times, the main treatment options for patients were systemic chemotherapy with cytostatics, surgical removal of the tumor, and radiation therapy. All of these options are not effective enough in the advanced stages of lung cancer.

In recent years, Canadian doctors, following the example of Americans, have paid attention to the targeted therapy and immuno-onology.

Immunotherapy can really benefit many patients. Technically, it does not kill tumor cells, but rather stimulates the patient’s immune system to fight cancer. Using the body's immune system to search for and destroy tumors, doctors can achieve phenomenal results even with metastatic lung cancer.

There are examples of patients who have lived for three years or more with metastatic cancer (stage IV). Before the advent of immunotherapy, medicine could not help these people, and they were actually sent home to die after another course of chemotherapy.

Continuing research and development of immunotherapy for lung cancer, which is carried out in the largest cancer centers in Canada, provides a new hope for a patient with locally advanced and metastatic non-small cell lung cancer.

Best lung cancer treatment centers in Canada

Where to go for cancer treatment in Canada?

Thousands of medical tourists ask this question. Each province has large hospitals or specialized oncology institutes that can offer diagnostics and treatment for world-class lung cancer.



Here are some of the best lung cancer treatment centers in Canada, where innovative technologies, medicines and clinical trials are available:

• Allan Blair Cancer Centre at Pasqua Hospital, Regina
• Cancer Care Manitoba, Winnipeg
• Cross Cancer Institute, Edmonton
• Hôpital Notre Dame, Montreal
• Juravinski Cancer Centre, Hamilton
• McGill Cancer Centre at McGill University, Montreal
• Mount Sinai Hospital, Toronto
• Ottawa Hospital Research Institute, Ottawa
• Princess Margaret Hospital, Toronto
• Queen Elizabeth II Health Sciences Center, Halifax
• Saskatoon Cancer Centre at the University of Saskatchewan, Saskatoon

In addition to the high technical level of hospitals and patient-oriented service, foreign patients will be pleasantly surprised by the cost of procedures and medicines. Many types of cancer therapy in Canada are 1.5-2 times cheaper than the United States.

Symptoms: How does lung cancer start?

Lung cancer rarely causes symptoms in the early stages.

Symptoms usually occur only when the tumor grows to a large size or gives rise to metastases in other organs.

Therefore, lung cancer in the initial stages is detected only by chance. For example, during X-ray or CT scan of the chest for other reasons.

In addition, typical complaints are usually not associated with lung cancer, but may indicate other “harmless” diseases.

Patients with the following symptoms must immediately consult a doctor to find out the cause:

• A cough that lasts more than three weeks or increases chronic cough
• Permanent sputum production with or without blood
• Unexplained fever
• Dyspnea
• Chest pain
• Weakness, fatigue, impaired performance
• Weight loss
• Hoarseness
• Difficulty swallowing
• Bone pain
• Enlarged lymph nodes above the collarbone

Such symptoms should arouse suspicion of lung cancer, especially in high-risk patients.

These include older smokers, patients with chronic bronchitis, cancer survivors, etc.

Early diagnosis is almost impossible due to diagnostic uncertainty and late onset of symptoms. Doctors have been searching for years for a reliable screening method that can be used in people at high risk. If it was possible to diagnose lung cancer at an early stage, it would be easier to treat.

In Canada, low-dose CT scans are recommended for adults aged 55 to 74 years who are at risk of lung cancer.

However, there is still no procedure that Canadian experts consider appropriate to apply to the entire population.

Diagnosis of lung cancer in Canada

If the patient has symptoms that may indicate lung cancer, the doctor will conduct a series of diagnostic procedures and laboratory tests.

The goal is to confirm or eliminate the most dangerous disease as soon as possible. If the cancer is not confirmed, the doctor will find out the real cause of the complaints. For example, chronic obstructive pulmonary disease often causes persistent cough with sputum and shortness of breath.

Physical examination and medical history

At the first examination, the doctor assesses the general health of the patient. He asks about symptoms and possible risk factors (medical history).

Despite the growing popularity of online consultation, physical examination remains an indispensable diagnostic tool in the hands of an experienced doctor. For example, during an examination, an oncologist may pay attention to enlarged lymph nodes or bulging veins in the neck.

Chest x-ray

A chest x-ray is used to detect tumors and estimate their approximate location and size.

In addition, radiography helps diagnose other lung diseases. Radiography is a simple, cheap and fast method that is available in all hospitals and clinics. An experienced radiologist can tell a lot of useful information before further diagnosis.

Computed tomography

A more detailed x-ray method of computed tomography is performed if the result of a chest X-ray was ambiguous or it indicates cancer.

If a tumor is present, a CT scan can be used to determine the exact location and size of the tumor. Computed tomography also helps to detect metastases in the head, chest and abdomen.

Magnetic resonance imaging

MRI is another valuable method for diagnosing lung cancer. In certain tissues or organs, such as the brain, magnetic resonance imaging is much better than CT scan for excluding or confirming metastases. In addition, MRI does not use potentially harmful radiation.

Bronchoscopy

Bronchoscopy is the most important diagnostic procedure. During the procedure, a flexible or rigid tube (bronchoscope) is inserted into the airway. The bronchoscope is equipped with illumination, optics and special biopsy forceps.

With this tool, the doctor examines the lower airways and, if necessary, takes small samples of suspicious tissue (biopsy).

These samples are examined under a microscope in the laboratory for tumor cells.

If the suspicious tissue is in a lung area that is not directly accessible with a bronchoscope, a sample is taken using a needle (fine needle biopsy).



Fine needle biopsy is performed through the skin or through the esophagus using an endoscope. Under the control of ultrasound techniques or computed tomography, the needle is inserted into the lung tissue, and then the doctor selects a piece of tissue or liquid.

Diagnostic tests to determine the stage of lung cancer

Canadian clinics offer the following methods to determine the spread of cancer:

• Sonography (ultrasound). Sonography is suitable for detecting secondary tumors in the abdominal cavity. For example, in the liver.

• Bone scintigraphy. Bone scintigraphy is designed to detect skeletal metastases. For this purpose, a radioactive substance is injected into the blood, which accumulates in tissues with an increased metabolism. These sites are seen with a special camera. The radioactive substances used for scintigraphy are quickly excreted from the body and do not accumulate for a long time.

• Positron emission tomography (PET): a method based on determining the metabolic activity of tissues using radioactive glucose. In tumors, metabolism is usually much higher compared to the healthy tissues, which can be visualized.

• Mediastinoscopy: This is an endoscopic examination of the mediastinum and lymph nodes, which is performed under general anesthesia. Mediastinoscopy is recommended when CT, MRI or PET give unclear results.

Lung cancer treatment options in Canada

Treatment of lung cancer in Canada is based on surgery, chemotherapy and radiation therapy. In the later stages of the disease, modern targeted therapy and immunotherapy are available. The trust relationship between the physician and the patient is important.

It's not just the choice of the next treatment step. Many patients feel the need to discuss with their doctor not only physical symptoms, but also prognosis, personal fears, social or financial uncertainty. For complex treatment of lung cancer, all these aspects of the disease must be considered.

Interdisciplinary approach

One doctor can not meet all the requirements of the patient. In addition, even the most experienced specialist cannot be an expert in the field of lung diseases (pulmonologist), cancer (oncologist), thoracic surgery, histopathology (pathologist), medical imaging (radiologist), and physiotherapy.

Therefore, the treatment of lung cancer is a team work. The excellent statistics of Canadian clinics is the result of an interdisciplinary approach.

It is important that the doctor has sufficient experience in the treatment of lung cancer and has access to a team of proven specialists.

As a rule, the main contact person for a patient is usually a specialist in oncology or pulmonology.

Getting a second opinion

If you suspect a serious lung disease, there is advisable to get a second opinion.

As a rule, cancer treatment is planned based on the results of diagnostic tests. But these results are interpreted by doctors, who may also make a mistake. This can be an ambiguous situation when there are different treatment options.

In addition, doctor-patient relationships are not always perfect. If you are not sure of your decision, it is better to contact another doctor for a second opinion. In Canadian clinics, you can get a second opinion from experienced oncologists, radiologists and thoracic surgeons.

The choice of treatment depending on the type and stage of the disease

In the treatment of non-small cell lung cancer stage I and II, surgical intervention is a top priority. This gives a chance for long-term results. In the later stages, chemotherapy and radiation therapy are used alone or in combination. In the presence of metastases, the chances of recovery are significantly reduced. The main goal of treatment is to slow the progression of the disease, relieve symptoms and maintain quality of life.

Small cell lung cancer is usually diagnosed at an advanced stage. Often, at the time of diagnosis, metastases are already present in other parts of the body. In these cases, complete surgical removal of tumor tissue is no longer possible.

However, SCLC responds better to chemotherapy compared to non-small cell lung cancer, therefore chemotherapy is the best option.

Surgical removal

Lung surgery is a serious intervention. Surgeons today have access to a wide range of tissue preservation methods.

For example, with lobectomy, only the affected lung lobe is removed, and with segmental resection it is possible to preserve healthy tissue as much as possible at an early stage of the disease. An experienced surgeon seeks to find a compromise between the preservation of functional lung tissue and the removal of potentially dangerous areas.

Lung cancer chemotherapy

Chemotherapy uses drugs that suppress cell division and kill cells (cytostatics). These chemotherapeutic agents are particularly effective on cells that reproduce quickly and have increased metabolism. Therefore, tumor cells suffer more from chemotherapy than healthy cells.

However, chemotherapy has serious side effects. These may vary depending on the drug. Typical side effects of lung cancer chemotherapy include anemia, leukopenia, nausea, vomiting, gastrointestinal disorders, loss of appetite, chronic fatigue and hair loss. In addition, chemotherapy patients are more susceptible to infections.

A combination of radiation therapy and chemotherapy can be useful to achieve better treatment results. Both methods can be performed either sequentially (first chemotherapy, then radiotherapy) or simultaneously. The latter increases the chances of recovery, but also increases side effects.

Radiation therapy (radiotherapy)

Radiotherapy uses high-energy radiation, which is particularly damaging to the genetic material (DNA) of rapidly dividing cells. If the damage exceeds a certain threshold, the cells lose their ability to reproduce and die.

In the simplest case, the radiation source is located outside the body (external beam radiation therapy). The radiation dose, depth of penetration and specific area of the irradiated area are determined by an experienced physician.

Endoluminal brachytherapy. In addition to conventional radiotherapy, there is the possibility of radiotherapy in the respiratory tract (endoluminal brachytherapy). In lung cancer, this technique is used to prevent serious complications.

Innovative treatment methods

In the late stages of lung cancer, as well as in cases of large inoperable tumors, Canadian doctors use innovative treatment methods.

In addition to chemotherapy, targeted agents are used to selectively target tumor cells. This can be achieved if the active ingredients block certain tumor growth mechanisms.

There are several types of targeting agents:

• Drugs that inhibit the transmission of growth signals in tumor cells (tyrosine kinase inhibitors, multikinase inhibitors).
• Drugs that prevent the formation of new blood vessels in growing tumors (angiogenesis inhibitors).
• Substances that block special switches in the immune system (immune checkpoint inhibitors).

However, many of these new innovative methods work only if the tumor has specific features.

Laboratory tests are performed prior to prescribing targeted agents or immunotherapy.

Symptomatic therapy

Unbearable pain is one of the main symptoms of progressive cancer. However, there are many ways to relieve pain, including analgesics, surgery, and high-tech electronic devices. Other symptoms that can be treated are weakness and fatigue, loss of appetite, vomiting and respiratory problems.

In some cases, complete recovery is not possible, so the aim of treatment is to slow down the progression of cancer, relieve discomfort and improve the quality of life of patients (palliative care).

Lung cancer treatment in Canada gives hope to thousands of patients from around the world, especially after the introduction of highly effective immunotherapy. You can get professional help and advice from any of the clinics listed above.

The earlier you start treatment, the better your chances of recovery are.

© Analytical reviews and oncology news by K. Mokanov: clinical pharmacist and professional medical translator