Saving lives with early detection and diagnosis

When cancers are caught early, less aggressive therapies can be used, and treatments are more likely to succeed. Research advances over the last several decades are helping us detect many cancers earlier and diagnose them more accurately so that people receive the right treatment at the earliest opportunity.

Here are some of the ways that our funded research has had an impact on improving early detection and diagnosis:

Dr Gelareh Zadeh developed a new test to distinguish between the 2 main types of gliomas and improve patient outcomes. Gliomas are the most common type of brain tumours, and the 2 main types of gliomas have very different prognoses and should be treated differently. Unlike conventional tests to determine the glioma type, which can take weeks, the test developed by Dr Zadeh and her team can provide an accurate response in real time as the surgeon is operating. This information allows the surgeon to make a more informed decision about how much tumour they can safely remove while maximizing a person’s quality of life. It also allows doctors to choose the most appropriate drug to give directly into the brain during the surgery, improving the odds of treatment success.

Getting the right diagnosis is important for any illness, but it is especially important for children and families facing a brain cancer diagnosis. Brain and spinal cord cancers are the 2nd most commonly diagnosed cancer in Canadian children.

Knowing the exact type of brain cancer that a child has ensures that they receive the most appropriate treatment as soon as possible and spares them unnecessary treatments that could damage their growing brains.

That’s why the work of CCS-funded researchers Dr Cynthia Hawkins, Dr Annie Huang and Dr Michael Taylor is so remarkable. They have made practice-changing discoveries about the different subtypes of childhood brain cancers, including common tumours like medulloblastomas and gliomas and rare tumours like rhabdoid tumours, and how each should be treated. Their findings have been incorporated into the World Health Organization’s brain tumour classification manual, a reference guidebook used by doctors around the world. 

Thanks to their collective efforts, children with brain cancer in Canada and around the world can now receive a more precise diagnosis faster and start their treatments earlier, improving their chances of living long and healthy lives.

According to the 2018 Canadian Cancer Statistics special report, more than 80% of breast cancers are diagnosed at an early stage, for which the 5-year survival rate ranges from 93% to nearly 100%. Much of that success is due to organized screening programs that use mammography to detect signs of breast cancer.

But for some people, particularly those at high risk of breast cancer, mammograms may not be the best way to find breast cancer. With support from CCS, Dr Ellen Warner and her team showed that magnetic resonance imaging (MRI) is more effective than mammograms or ultrasounds at detecting breast cancer in high risk people. Since these findings were published, MRI has become part of the standard practice for high risk individuals in breast screening programs across the country.

CCS-funded researcher Dr Martin Yaffe is working to improve breast screening with a new technique called tomosynthesis, or 3D mammography, which could detect more early breast cancers and lead to fewer false positives than conventional 2D mammography. He and his team led a Canadian clinical trial comparing the 2 techniques, laying the foundation for a large, first-of-its-kind, international trial that began in 2017 and is currently recruiting participants at 6 cancer centres in Canada. The results of this trial could offer people a more accurate option for breast screening that will lead to fewer false alarms and cancers caught earlier.

When breast cancers are detected early, people often undergo a test to determine whether the cancer has spread to nearby lymph nodes. CCS-funded researchers Dr May Lynn Quan and Dr Bryan Wells led a practice-changing study that showed the effectiveness of a procedure called sentinel lymph node biopsy in removing and testing lymph nodes for the presence of cancer cells. This method is less invasive and has a lower risk of side effects than the previous standard of care. Thanks to their research, sentinel lymph node biopsy is now the preferred method for lymph node testing, making the process safer and easier for people with early stage breast cancer.

 

Research funded by CCS has paved the way for organized cervical cancer screening programs nationwide that have saved the lives of countless people.

In 1949, Dr David Boyes and Dr Herbert Fidler received a small grant from CCS to start a pilot program to screen women in British Columbia for cervical cancer. At the time, it was the first organized cervical cancer screening program in the world. The success of Dr Boyes’ and Dr Fidler’s program proved that province-wide testing was feasible and served as a model for organized cervical cancer screening programs that are available in every province and throughout the world today. 

Later in the 1970s, CCS-funded researcher Dr Anthony Miller undertook a study which showed that for women aged 30 to 64 years, regular screening was linked to a significant decline in deaths from cervical cancer, highlighting the effectiveness of organized screening programs in saving lives.

CCS-funded research is increasing survival rates for people with Li-Fraumeni syndrome, a genetic condition that puts people at a significantly higher risk of developing cancer in their lifetime. 

With support from CCS, Dr David Malkin developed a new treatment plan to closely monitor people with Li-Fraumeni syndrome and detect tumours earlier. He and his team led a practice-changing study which found that the protocol dramatically increased survival after a cancer diagnosis from 60% to 89%. Today, the so-called “Toronto protocol” (named after the city where Dr Malkin is based) is used around the world to help people with Li-Fraumeni syndrome live longer, fuller lives.

Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death in Canada, accounting for 1 in 4 cancer deaths. 

CCS-funded researchers are improving how lung cancers are diagnosed. Lung cancers called adenocarcinomas can be classified into 5 different subtypes based on how they look under a microscope. Dr Lesley Seymour, Dr Ming-Sound Tsao and collaborators showed that these subtypes could help predict the risk of cancer recurrence and guide treatment decisions. These findings were included in the World Health Organization’s classification system for lung cancers, which guides how lung cancer is diagnosed and treated around the world.