LungHealth
The
Canadian Lung Association Helps Canadians Affected by Lung Disease to Live Their Best Lives
The Canadian Lung Association (CLA) is a national health charity and the leading organization in Canada working to promote lung health and prevent and manage lung disease. The CLA funds vital research, push for improved treatments and innovative policies, and provides support, resources, and information for Canadians living with lung disease and their families.
3. Don’t quit on quitting
Ways to Show Your Lungs Some Love
Winter
1. Learn about chronic cough
It’s estimated that chronic cough — a cough that lasts eight weeks or more — affects about 16 per cent of Canadians between the ages of 45 and 85. It can seriously disrupt your life and affect you physically, emotionally, and socially, but there’s help available to manage your cough. Speak to your health-care provider.
2. Test your home for radon
Radon is a naturally occurring gas that can enter your home through cracks in the foundation and build up to dangerous levels. Long-term exposure is the second leading cause of lung cancer in Canada and the leading cause for non-smokers. The only way to find out if your home has high radon levels is to test for it. High radon levels can be easily fixed at a reasonable price.
There may even be funding available to you for home radon mitigation. Visit our website for more information.
Quitting smoking is hard. People who use supports (including nicotine replacement therapy or counselling) are generally more successful in their attempts. But not all supports work for all people, so take some time to learn which ones might work best for you to give yourself the best chance at quitting.
4. Get vaccinated Making sure you’re up to date on your vaccinations for viruses that affect the lungs — like COVID-19 and the flu — are some of the best ways to keep yourself healthy this winter. Your health-care provider may also recommend getting vaccinated against pneumonia if you’re over 65 or at high risk for infection.
5. Stop idling
Idling — particularly of diesel engines — generates exhaust that’s harmful not only to the environment but also to your health. Exposure to diesel emissions can aggravate existing lung conditions and, in the long term, lead to cancer or other serious issues. Diesel-engine school buses idling outside schools are a significant concern as this can increase the particulate matter in the air to dangerous levels for children whose lungs are not yet fully developed.
“Finally, after two years of trying different medications and receiving referrals, I was diagnosed with COPD.”
Publisher: Evan Sebesta Business Development Manager: Chelsea Siemon Country Manager: Nina Theodorlis
Kylie Armishaw
Addressing the Urgency of Lung Disease in Canada through Policy Change
Delays in diagnosis, rising health-care costs, and stigma underscore the need for a comprehensive approach to lung disease.
Lung disease continues to have a dramatic impact on the health of Canadians. One in five is affected by serious lung disease, and it’s an immediate problem for the country. Contributing to the issue is the stigma around lung cancer attached to the myth that only smokers get lung cancer. In fact, approximately 30 per cent of cases occur in those who have never smoked.
The Lung Health Foundation (LHF) is leading the way in helping Canadians improve their understanding of lung disease. Lung cancer alone has claimed the lives of many — 80 per cent within five years of being diagnosed. In 2022, more than 20,000 people will die from it. Contributing to this poor outcome is the persistent stigma — one that contributes to a lack of screening, delayed diagnosis and treatment, and increased mortality for those with the disease.
Thought leaders gather to create change
To address the devastating consequences of lung disease, involvement from a range of stakeholders is needed. In mid-November, as LHF marked Lung Cancer Awareness Month, it hosted a federal advocacy day on Parliament Hill in Ottawa. It brought together staff, volunteers, and patient advocates from across the country to meet with ministers, members of Parliament, and senators.
The goal was to support the development of more comprehensive policies that will not only save lives but lessen
the financial impact on health care by improving the prevention, diagnosis, and treatment of lung disease. It puts a profound burden on patients, families, and every provincial health-care system. It’s estimated that the direct and indirect cost of treating asthma will be $4 billion by 2030.
The initiative is just one of many from LHF. Its annual Stop Asking the Wrong Question campaign was developed to empower those diagnosed with the lung disease and encourage Canadians to offer their support, not judgment. Each day, 82 people will hear the news that they have lung cancer.
LHF’s focus on advocacy work is expansive. It’s driving policy change in numerous areas, from inequities in lung disease outcomes, to building a national companion diagnostics framework to improve survival and quality of life for patients. The organization’s critical work is aimed at challenging the status quo of lung disease.
A multi-faceted approach to creating change
Each year, Canadian families will continue to needlessly lose a loved one to asthma, tens of thousands with COPD will be hospitalized, and many young people will continue to smoke and vape, putting their health at serious risk. In Canada, lung cancer remains the most commonly diagnosed type of cancer. Moreover, it continues to be the leading cause of cancer death in Canada.
LHF is dedicated to ending health-care gaps around lung disease suffered by more than 7.5 million Canadians. It takes a multi-faceted approach — championing ground-breaking research and offering programs and support needed for patients and their families. Add to the mix efforts focused on policy and practice change, education, and awareness.
Michele Sponagle
Small Gains Make a Big Difference for Small Cell Lung Cancer Patients
With limited options available, there’s an urgent need for new treatments for people living with small cell lung cancer
Anne Papmehl
Lung cancer is the leading cause of cancer death in Canada. There are two main types of lung cancer — non-small cell lung cancer (NSCLC), which accounts for about 80 to 85 per cent of lung cancer cases, and the less common, but much more aggressive, small cell lung cancer (SCLC) which accounts for about 15 per cent of cases.
“SCLC is a relatively rare form of cancer, but because it’s so aggressive, it’s often detected in the later stages after it has metastasized outside of the lungs,” says Dr. Shaqil Kassam, Medical Oncologist at the Stronach Regional Cancer Centre and Medical Director of Research at Southlake Regional Health Centre in Newmarket, Ont.
Significant impacts on patients and family members
“Often, a diagnosis of SCLC can affect a person’s quality of life, from impacting their ability to work to maintaining social relationships,” says Peter Glazier, Executive Vice President at the Lung Health Foundation. “An SCLC diagnosis can lead to increased stress, anxiety, and depression for patients as well as the family members or caregivers of those living with lung cancer who have the added responsibility of providing care.”
Aside from being a devastating diagnosis, advanced SCLC can cause multiple debilitating symptoms, ranging from shortness of breath and cough to more generalized symptoms of fatigue, loss of appetite, and weight loss.
While SCLC tends to grow rapidly, it can also respond rapidly to chemotherapy, which has been the standard treatment for over two decades.
“The major problem, though, is that the positive effects of current treatments generally don’t last, and after a while, the cancer almost inevitably starts to grow and spread again,” says Dr. Paul Wheatley-Price, Immediate Past President of Lung Cancer Canada. “It becomes easy to see why SCLC has such a major impact on the patient who is facing a life-limiting disease, as well as the family members who strive to support them.”
Treatments not advancing as rapidly as for other cancers
In contrast to the treatment of nonsmall cell lung cancer (NSCLC), which has had multiple breakthroughs in the past decade, advances in SCLC have been more modest. “One reason for that is we discovered that nearly 60 to 65 per cent of NSCLC cancers have a driver mutation that tells the cancer to grow, and we have effective drugs to target that mutation which patients respond well to,” says Dr. Kassam. “The problem with SCLC is that there are many driver mutations, so getting a single treatment to target them all is a challenge.”
Urgent need to do more for SCLC community when it comes to researching and accessing novel treatment options There’s an urgent need for new and more effective SCLC treatments to be developed and made accessible to Canadian lung cancer patients, across all provinces and territories. “This requires both development of new treatments through research and then timely approval of effective treatments through our regulatory systems across Canada,” says Dr. Wheatley-Price. Dr. Kassam believes that more research and understanding of the disease will be key to improving quality of life and increasing survivorship (what he refers to as “quantity of quality life”), so patients can have additional time with their loved ones. “We need to figure out what’s driving this cancer to be so aggressive and resistant, and then find ways to target those gaps to develop better treatments .”
example, with NSCLC, skin and breast cancers,” says Dr. Kassam. “It’s going to be along the lines of small incremental gains, which may not seem like a lot, but for patients with SCLC, those small incremental gains can be huge. It means they get to see a grandchild being born, go to a wedding, or experience one more holiday season.”
SCLC is a relatively rare form of cancer, but because it’s so aggressive, it’s often detected in the later stages after it has metastasized outside of the lungs.
To help speed up the regulatory approval and public funding for new treatments, patient family members can play a role in advocating on behalf of their loved ones by reaching out to their government representatives.
“Because these patients are so sick initially and the survival rate is not long, they can’t really advocate for themselves. It really falls on the family members to help governments understand what they and their families are going through,” says Dr. Kassam.
A need to change the conversation
One of the challenges with lung cancer is its association with tobacco exposure, which can lead to stigmatization. “As a society, we must recognize that lung cancer can occur in those currently, formerly, or never exposed to tobacco and that all Canadians are entitled to the best of cancer care, regardless of the type of cancer, their age, gender, or tobacco exposure,” says Dr. Wheatley-Price.
As a small patient group often facing late-stage diagnosis, the SCLC community is frequently sidelined in the development of and access to novel treatments. “Because it’s such a resistant cancer, we aren’t necessarily going to see the same homerun types of improvements that we’ve seen, for
“We challenge Canadians to start asking why it’s the least funded of all cancers,” adds Glazier. “If we change the conversation, we can begin to eliminate some of the barriers that are leading to poor outcomes for SCLC.
If you are a family member of someone living with SCLC, connect with Lung Health Foundation or Lung Cancer Canada to learn more about becoming a lung health advocate and elevating your voice to become an agent
Optimizing Therapies Help People with COPD Breathe Longer and Better
Living well with COPD requires knowledge and understanding to best manage the condition. However, many Canadians have COPD without knowing it. Therefore, testing is essential for proper diagnosis.
Anne Papmehl
Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases where people have difficulty breathing due to narrowed airways. It includes chronic bronchitis and emphysema. It’s estimated that 1.6 million Canadians live with COPD and that almost as many people have the disease without knowing it.1
Understanding major symptoms
A classic symptom of COPD is shortness of breath — also known as dyspnea — which makes it hard to perform everyday activities, such as going up and down stairs, carrying groceries, or making the bed.
About 75 per cent of people living with COPD experience some degree of shortness of breath.
Dyspnea is linked to a downward health spiral, where people living with COPD stop doing everyday activities because it's difficult to breathe — forcing them to reprioritize regular activity. This means less movement and exercise, which in turn may lead to weakening of muscles and joints. As a result, other health issues, like weight gain, heart problems, as well as emotional and mental health problems including anxiety and depression may affect people living with COPD. All these added health challenges are very difficult to manage. This health situation was made worse by the COVID19 pandemic when people were required to stay at home with limited daily physical activity and reduced visits with family and friends.
caregivers who are looking to help. Day-to-day activities, such as household chores, may fall to the primary caregiver when the person with COPD has limitations. This can take a toll on the individual who may struggle with feelings of being overwhelmed and burned out, creating undue stress and tension in the household. There can also be economic burdens if the person living with COPD is unable to work or contribute financially to the running of the household.
While cigarette smoking is a common risk factor causing 80 to 90 per cent of COPD cases, other types of tobacco, such as pipe and cigar, as well as second-hand smoke, shisha, and cannabis, are also included. 2 There are other less common causes of COPD, like severe childhood lung conditions, genetics, and exposure to biomass smoke.
One serious COPD complication is an exacerbation — also known as a COPD flare-up or lung attack. These flare-ups occur when COPD symptoms continue to worsen over a short period of time.
Other COPD symptoms can include:
Prolonged cough lasting more than three months
Cough with mucus
Lung infections from colds and flu that may last longer than usual
Wheezing
Weight loss without trying
Living with COPD can be challenging
While the burden of living with COPD is challenging, it can also be stressful on the families and
One serious COPD complication is an exacerbation — also known as a COPD flare-up or lung attack. These flare-ups occur when COPD symptoms continue to worsen over a short period of time. Since these lung flares can be life-threatening events, and with 1 out of 4 people having weaker lungs as a result, the aim should be prevention overall. Until that’s possible, however, when a lung attack happens, it must be treated immediately.
According to the Canadian Institute for Health Information (CIHI) inpatient information for 2019–2020, COPD or bronchitis was the second most common reason for hospital admissions following childbirth.
Options available to improve care, quality of life, and longevity
COPD management is centred around two goals — symptom management and exacerbation/flare-up management.
Symptom management is based on the patient’s specific needs, depending on the disease severity — mild, moderate, or severe. The standard protocol for people with moderate to severe COPD over the past two decades has incorporated inhaled combinations of therapy including a variety of long-acting options and corticosteroid inhalers. While the
combinations of therapies are still very much part of COPD treatment, there are now other options that are longer-lasting, safer, and more effective — giving people the ability to breathe better for longer. The devices containing these medications have also become easier to use and can dispense multiple medications in a single inhaler, eliminating confusion and ensuring the right inhaler with the right medicines are used at the right time.
The management of a flare-up starts with the patient and their health-care provider recognizing the signs and symptoms and the importance of getting prompt treatment. The three major symptoms include increased breathlessness, amount or thickness of phlegm, and change in phlegm colour. Since flare-ups increase the chance of another episode that could be worse than before it’s important that people understand the need to seek medical attention quickly. If not treated early enough, exacerbations can become severe enough to require a hospital stay, and recovery may be long and difficult. In addition, frequent exacerbations are linked to faster disease progression, worsening quality of life, emotional and mental health issues, and combinations of health challenges that increase risk of death.
Another key aspect of exacerbation management is avoiding triggers, the most common of which are viruses, like a cold or flu, bacteria, and poor air quality. Viruses, in particular, are strongly connected to COPD flare-ups.
With close to 1.6 million Canadians believed to be unaware they may have COPD, patients experiencing shortness of breath, cough, and phlegm should consult with their health-care provider.
Testing to confirm diagnosis and manage disease
With close to 1.6 million Canadians believed to be unaware they may have COPD, Canadians experiencing shortness of breath, persistent cough, and excess phlegm should consult with their healthcare provider, especially if they have certain risk factors, such as a history of smoking, frequent lung infections, heart problems, asthma, or a family history of lung disease. A health-care provider can order a pulmonary function test to confirm the diagnosis. With proper diagnosis and treatment, people living with COPD can better manage their symptoms and prevent flare-ups.
For these people, it’s important to ensure they get the most out of every breath. Taking a quick online symptom test could help identify how COPD symptoms affect the body and how to best seek help. Ultimately, the first step for people living with COPD is talking to their family physician and other health-care providers to learn about the options available to manage symptoms and make every breath count.
REFERENCES 1. Lung Health Foundation, September 19, 2022.http://www.lunghealth.ca/. 2. Ibid. Ibid. 4. Ibid.
With all the COPD therapies available, it’s possible to get more out of each breath.
In today’s environment — now more than ever — it's important that you take care of yourself and your COPD. It all starts with identifying how your symptoms are affecting your daily life. Take the first step by completing this quick test.
It’s important to discuss the results of this test with your health-care provider and ask about other options that may be best for you including those to help better manage your COPD or simplify your care regimen.
Over the past several months, have you noticed a worsening in any of the following:
Your quality of sleep due to your breathing
Your ability to do activities at home
Your breathlessness when walking up an incline or flight of stairs
Your frequency/ severity of coughing
A feeling of tightness in your chest
If you answered yes to any of the questions above, you should speak to your health-care provider about your COPD. Visit notyourcopd.ca to learn more about how COPD affects your life.
Five Reasons You Should Invest in an Air Purifier This Winter
Prioritizing your indoor air quality this winter will have you breathing easier and keeping you healthier.
Sonya Friesen
Canada may be known for its beautiful winters, but the temperatures that accompany the season make spending time outside a less likely occurrence. This means the rise of cozy nights on the couch, but it also means staying on top of indoor air quality. Air purifiers, like the Shark Air Purifier 3-in-1 MAX, offer Canadians the chance to experience cleaner air without leaving the comfort of home. So while winter may bring out the worst in air quality, Canadians can see the benefits of air purification year-round.
Statistics show that the average Canadian spends up to 90 per cent of their time indoors,
WINTER LIVING MADE EASIER
so prioritizing the quality of your air shouldn’t take a backseat this season. Good quality air purifiers are designed to do the work for you. For example, the Shark Air Purifier 3-in-1 constantly monitors the air quality in your home, automatically adjusting its output to suit your needs with Shark’s Clean Sense IQ technology. The purified heat function allows for comfort in your home during the cold winter nights. With HEPA filters that capture 99.98 per cent of airborne particulars, to Pure Air MicroForce technology that purifies spaces as large as 1,000 square feet, easier breathing is within reach.
Winter can be tough during cold and flu season. By making small changes and integrating products that make life easier, you’ll not only feel better, but you’ll also breathe easier during the winter months.
KEEPS YOUR FAMILY
HEALTHY
We all feel the effects of the air we breathe. Poor air quality has been shown to play a role in child development and influence common struggles like allergies.
Pet dander can be one of the toughest air contaminants. Some air purifiers contain antiallergen HEPA filters, which capture pet hair and dander before it gets into your lungs. 2. 3. 4. 5.
IMPROVES SHORT-TERM HEALTH
Poor air can cause a host of health problems. Headaches, throat irritation, and breathing troubles are all issues associated with the quality of the air you’re breathing.
AND YOUR LONG-TERM HEALTH, TOO
The air we breathe can include some scary things — gases, chemical residues, and even mould. Particles in the air can travel into the body and be a precursor to issues like cancer, cardiovascular disease, and asthma.
YOUR FURRY FRIEND KEEPS THEIR FUR TO THEMSELVES
Using a Puffer? You May Need a Spacer
For millions of Canadians living with asthma, using a chamber like the AEROCHAMBER2GO* Chamber can provide better disease management.
Tania Amardeil
If you’re familiar with the experience of wheezing, chest tightness, or shortness of breath, you’re not alone. Over six million Canadians have different forms of lung disease (asthma and chronic obstructive pulmonary disease, or COPD), and there are likely millions more with undiagnosed respiratory diseases. Therefore, proper disease management is critical to staying safe and healthy and enjoying a high quality of life.
Living with asthma
Trish Carter, a 47-year-old mother of two and former Ontario resident who’s now living her dreams on an ocean-side farm in Prince Edward Island, has had asthma since she was around 20 years old. “At first, I didn’t know what it was,” she recalls. “I just chronically had a cough and shortness of breath. Eventually, a doctor said they thought I had asthma and gave me an inhaler.”
Over the years, Trish kept the inhaler close at hand
— next to her on the bench when she played competitive hockey or hooked onto her belt as she rock climbed. She loved being active, but her asthma often got in the way. Many Canadians struggle with their asthma — most people aren’t able to use their inhalers correctly, and most are unaware they even have a problem. This was certainly the case for Trish. She didn’t know that better options were available.
Exploring better options
One of these better options for inhaler users is the addition of a spacer. Use of a spacer is a simple and effective way to help improve the use of your inhaler. Spacers help to ensure that your medicine reaches your lungs where it’s needed and limits the amount that ends up in the back of the throat, which can lead to side effects.
“About 10 years ago, a respiratory therapist introduced me to spacers,” says Trish. “I couldn’t believe the difference it made. It was like day and night.”
The AEROCHAMBER2GO*
Chamber
Trish uses the AEROCHAMBER2GO*
Chamber spacer from Trudell Medical International — based in London, Ont. — which includes a two-in-one chamber
and protective storage case for the inhaler.
It’s designed for on-the-go use.
“It’s a beautiful, magical, compact unit,” says Trish. “Now, anytime I have an asthma attack or symptoms, my recovery is so much faster and easier.”
With the AEROCHAMBER2GO* Chamber, Trish’s asthma is under much better control. Whether she’s riding horses, playing with the goats with her daughters, or moving around hay bales in the barn, she feels a new sense of ease. “Using the AEROCHAMBER2GO* Chamber has definitely improved my quality of life,” she says.
An estimated 1.6 million Canadians are currently living with COPD, and approximately another million have yet to be diagnosed. The AEROCHAMBER2GO* Chamber device is recommended as the on-the-go choice for all individuals experiencing respiratory diseases or infections using a metered-dose inhaler, including those with COPD.
Experiencing Mucus and Chest Congestion? Help Clear your Airways
COPD patients experience excess mucus and blocked airways, which negatively affects their lung health — but fortunately, there’s a specific device designed to help.
Tania Amardeil
Over 1.6 million Canadians currently live with chronic obstructive pulmonary disease (COPD), and the lifetime risk of developing COPD is over 1 in 4 . Moreover, this number is expected to be widely underestimated, w ith as many as 1 million Canadians likely undiagnosed. Over time, hospitalizations for COPD have increased overall, from 83 hospitalizations per 100,000 people in 2006–2010 to 86 in 2011–2015. COPD is the fifth most common cause of disease death in Canada and the number 1 cause of hospital readmission — with a higher readmission rate than heart failure, angina, and other serious chronic diseases.
It leaves some working-age people too sick to work and costs billions of dollars a year nationally in medical bills
and lost productivity. Therefore, ways to manage the disease are desperately needed.
Understanding mucus in COPD
In COPD patients, damaged lung airways become swollen and obstructed. COPD impacts mucus production and clearance, which has severe consequences. Mucus clearance is important because excess mucus can significantly impact airflow, ones ability to breathe, and their lung function and health, which can lead to respiratory infections, poorer quality of life, COPD flare-ups, and hospitalizations.
A build-up of mucus can create an environment for bacterial growth and airway infection that adds to the burden of symptoms. In addition, difficulty clearing excess mucus can lead to increased cough, airway inflammation, and damage, causing a vicious cycle of excess mucus and symptoms.
A solution may be airway clearance therapy, which is a form of drug-free COPD disease management designed to help loosen and clear excess mucus from the airways of the lungs.
Understanding airway clearance therapy
One of the best methods of performing airway clearance therapy is through an apparatus called the AEROBIKA*
Oscillating Positive Expiratory Pressure (OPEP) device. This easy-to-use device can help clear excess mucus in the airways and improve breathing.
The AEROBIKA* device has an award-winning mechanism that creates pulses of pressurein the lungs when breathing into the device. These pulses of pressure can help open weak airways while also producing vibrations that thin and loosen mucus, naturally helping it to be cleared from the airways, which improves breathing.
Using this Candian designed and developed device may empower COPD patients to breathe better and live better by reducing exacerbations.
Trish Carter