Early detection and accessible screening programs are crucial in the fight against cancer, yet significant gaps in Canada’s healthcare system are delaying diagnoses and treatment.
Dr. Otto Sanchez, a leading cancer researcher, has been at the forefront of exploring how cancer spreads into other organs and how it can be detected and treated more effectively since the 1990s.
He has studied bone metastasis, a common complication for cancers such as prostate and breast cancer. “I particularly studied the bone because the bone is an organ,” he said. His research emphasizes modifying the bone environment to make it less hospitable for cancer rather than solely targeting cancer cells.
“We came up with some experimental evidence that we could alter the cancer. For example, we could add to the bone… with drugs that are used for osteoporosis,” Sanchez said, describing how certain osteoporosis drugs may prevent the spread of cancer to bone.
Despite advances in research, significant challenges remain. Many organizations are stepping up to help survivors and patients.
“Our organization, the Canadian Cancer Survivor Network, is made up of like-minded individuals, survivors, cancer patients and some oncologists. We are here to make life better for not just survivors but patients as well,” said Trevor Miller, communications manager at the Canadian Cancer Survivor Network (CCSN).
He spoke about the gaps in cancer screening and the urgent need for policy changes to improve early detection across the country.
“Treatment goes quickly once a cancer patient gets diagnosed,” Miller said. “The fact of the matter is that getting to that diagnosis, we have screening issues. One of our big focuses is screening because if you catch cancer early, it’s easier to detect and treat, especially if it’s in stage one.”
Miller emphasized that certain cancers have a near 100 per cent survival rate if caught at stage one. However, barriers such as the lack of family doctors and limited screening programs make early detection difficult.
“Cancer can’t wait, and it doesn’t,” he said.
During the COVID-19 pandemic, cancer diagnoses dropped, making screening more difficult. Miller explained that “those cancers could have been caught at stages one or two, but now they’re being diagnosed at stages three and four. This backlog is happening not just in Ontario but across Canada.”
Miller noted that this backlog is significantly impacting cancer patients and making survival more difficult.
To combat these issues, CCSN is advocating for expanded and more accessible screening programs. “We want to make sure that there is no age in and age out of screening because colorectal cancer, for instance, is on the rise in young people,” Miller said.
He proposed making screening more available by allowing any clinician to refer patients, cutting down on healthcare wait times and helping accelerate diagnoses.
Sanchez also noted that the pandemic exacerbated existing issues in cancer care. “COVID-19 was a tremendous challenge for everyone. We were physically isolated and there was no way of screening people,” he said.
As cancer screening programs were delayed or suspended, many cancers that could have been caught at earlier stages are now being diagnosed at more advanced, less treatable stages.
“The pandemic really disrupted cancer care,” Sanchez added. “There were a lot more people that could have been diagnosed at early stages and were diagnosed at late stages.”
Sanchez emphasized the need for equitable healthcare access. “In the last 10 to 15 years, there has been a big emphasis on addressing Canadian cancer health disparities. The principle is that everyone should have equal access to screening, diagnosis and treatment,” he said.
Advancements in personalized medicine and genomic testing are reshaping cancer diagnosis and treatment. “Technology plays a big role. We have a medical laboratory science program here, training technologists who use advanced diagnostic techniques such as genomics and chromatography,” Sanchez said.
“If we want to implement population-based screening, we need to make these technologies affordable.”
CCSN also advocates for the adoption of take-home screening tests to provide quicker results and reduce hospital congestion. “We want to promote easy-to-use take-home tests, such as the FIT test for colorectal cancer, which measures blood in the stool. We also want to see take-home cervical cancer tests and at-home Pap smears,” Miller said.
These tests could free up hospital resources, allowing for faster diagnosis and better patient outcomes.
Additionally, Miller proposed the idea of take-home cancer drug programs, allowing patients to administer certain medications at home instead of in hospitals. This could ease the strain on healthcare professionals and allow them to focus on more intensive cases.
The Canadian Partnership Against Cancer is a federally funded organization that manages Canada’s national cancer strategy. “CPAC works with our partners across the country to improve cancer outcomes for all people in Canada and the way that we do that is by furthering the Canadian strategy for cancer control,” said Shari Dworkin, the organization’s director of screening.
“We work with partners across the country to really further high-quality, accessible, equitable screening programs in the area of cervical cancer, breast cancer, colorectal cancer and lung cancer.”
Dworkin noted Canada has committed to eliminating cervical cancer by 2040, following the World Health Organization’s global goal.
The organization’s action plan focuses on three priorities: expanding access to HPV vaccination, transitioning from the Pap test to HPV primary screening and ensuring follow-up care for individuals who test positive for HPV.
“While screening uptake is pretty good… one of those key barriers is really about addressing some inequities,” she said. “For example, we know that the incidence of cervical cancer is higher among First Nations, Inuit and Métis populations.”
Dworkin also highlighted the potential of self-sampling: “What HPV self-sampling can do is bring testing closer to home. It can bring it closer to the actual individual so they no longer need to visit a primary healthcare provider to receive their test.”
The pandemic impacted screening services, but according to Dworkin “the majority of screening areas have caught up. However, there was a significant delay in people getting screened.”
“I think one of the things that it has done is it’s made our country a little bit more resilient when it comes to screening,” she said. “So really thinking about putting in place different ways of addressing some of the backlog and addressing some of what we saw during COVID.”
She emphasized that HPV vaccination is a key tool in prevention. “With each increase in vaccination and screening, we’ll get closer to the goal of eliminating cervical cancer,” Dworkin said.
As Canada continues to face these pressing issues, researchers like Sanchez and organizations such as CCSN and CPAC are working toward solutions that could improve the lives of cancer patients.
“We don’t have to sit there and wait for the cancer to grow; we can actually advocate, we can talk and we can educate more,” Miller concluded.