Cancer Survival, Research and Support …  We’ve Come a Long Way

Interview with Dr. Stuart Edmonds, Exec V.P. Mission, Research & Advocacy, Canadian Cancer Society

The Canadian Cancer Society is different from other cancer charities in that it takes a comprehensive approach against cancer. The Society is committed to supporting Canadian families impacted by cancer in a myriad of ways. 

They fund high performance research to improve cancer outcomes, while also lobbying government for favourable policy change to positively impact prevention efforts, access to resources, affordability and targeted support.  Their website is an incredible source of information for anyone who wants to learn just about anything related to cancer in this country. 

To get a better understanding how the Canadian Cancer Society’s role has changed over the years, we caught up with Dr. Stuart Edmonds, Executive Vice President in charge of Mission, Research and Advocacy at The Canadian Cancer Society to learn more.

Prior to joining the Canadian Cancer Society, Dr. Edmonds was with Prostate Cancer Canada serving as VP of Research, Health Promotion and Survivorship. Doctor Edmonds holds a doctorate in pharmacology from Oxford University. 

Elan Eisen: Dr. Edmonds, It’s a pleasure to meet you and speak to you today.  Please give us a brief overview of the function of the Canadian Cancer Society.

Stuart Edmonds: The Canadian Cancer Society has been around for 80 or so years now. Our focus is on reducing the burden of cancer for Canadians and supporting Canadians who are affected by cancer. We know that close to one in two Canadians are affected and that it touches many people’s lives across the country.  

People need support as they’re going through their cancer journey, whether it’s for themselves or a loved one. We provide several different services that dovetail nicely with the healthcare system. For example, because we know that smoking is one of the leading causes of cancer, we have a free smokers helpline in both English and French to support people when they want to stop smoking.  

We know that once people are diagnosed, the first thing they do is research the cancer they’re diagnosed with on the internet. Our website is a comprehensive resource of information about all cancers. We’re one of the few organizations that really does cover all cancers in the country. We have a helpline that people can call in to speak with trained professionals who can answer their questions that they perhaps don’t feel comfortable asking their healthcare provider.   

Want another kind of opinion? Our cancer information helpline and online community called Cancer Connection are places where people affected by cancer can talk to one another, share their experiences and find community.   

We’re obviously not a healthcare provider, but we support healthcare providers and patients as they’re getting their treatments. In parts of the country, we provide Wheels of Hope Services where we drive patients to their appointments, as we know that it can be challenging to find parking. We also have lodges in a few areas around the country where people can stay while they’re receiving treatment.   

Lastly, on the research side, we’re funding around about 150 clinical trials in the country right now which gives patients an opportunity to be on new clinical interventions that are not yet offered by the healthcare system. Our goal is to hopefully save or at least extend lives.  

We’re the only national charity that funds basically everything to do with cancer. We fund research across all diseases and parts of the cancer journey from prevention through to diagnosis, treatment, survivorship, and palliation. We’re the only national charity that funds everything to do with cancer. We invest close to $40 million in research each year and this is made possible through the generous donations of Canadians to support our research and all our activities. 

The last area of activity is advocacy. We work to influence federal, provincial, and municipal governments to make policy and practice changes that improve the quality of life of people affected by cancer. Things like access to new medications across the country, improving on tobacco control legislation and most recently we were really excited to get the extension of sickness benefits from 15 weeks to 26 weeks which is a huge issue and not just for people with cancer. This extension applies to anyone who needs to take time off because of sickness.    

E.E.: I can’t think of a family that hasn’t been either directly or indirectly impacted by cancer. I know it sounds like a cliché question, but are we winning the battle?  

S.E.: We’re moving away from that kind of battle terminology, which is an ongoing, interesting discussion that’s going on within the community. But with regards to cancer, we’re making significant headway. In the 1940s, for example, 25% of people would survive cancer and right now we’re at 64% will survive their cancer so we’re making huge strides there. And I really believe that through research we’re doing and that others are supporting around the world, we’re going to continue to make significant steps to increase the survival rates.   

We know that some cancers are now almost 100% survivable if they’re caught early and while that provides a lot of hope for the future, we should still remember that just under 240,000 Canadians will be diagnosed with cancer this year and over 80,000 will die. So there there’s still a lot of work to do to help the people who are facing cancer right now. 

E.E.: Are you able to share any recent research developments or breakthroughs about cancer treatment specifically here in Canada?  

S.E: With over 100 types of cancer, it continues to be very challenging to do research because the same cancer in two individuals could be very different in terms of the characteristics of those cancers. Ten or twenty years ago we would have provided the same treatment to those individuals whereas now have a new way of thinking about cancer called precision oncology or precision medicine where we start to treat individuals cancers rather than the type of cancer.   

For example, one of the best known BRCA breast cancers, when mutated, can cause aggressive forms of the cancer. We now have drugs that can target that mutation which leads to survival for women with that mutation. This is really precision medicine where we understand about the cancer, and we have a drug to treat that particular defect in that cancer cell.   

Over the last 5 to 10 years, we’ve started to see that while one breast cancer may differ from another, a breast cancer may be very similar to a prostate cancer or pancreatic cancer or an ovarian cancer. Which caused us to think that if the treatment works for breast cancer targeting the same mutation, will it work on ovarian cancer, for example.  

This is occurring right now with drugs like Lynparza that target the BRCA mutation and it’s leading to survival for many different types of cancers now, even prostate cancer and pancreatic cancer. So we’re starting to see precision medicine not just for individual cancers but we’re starting to apply it across other cancers which is tremendous as when patients are diagnosed with cancer, they want any treatment that will be effective.

We’re now basically increasing our arsenal of potential treatments that we can offer any patient. We’re able to provide more targeted treatment as opposed to the traditional kind of chemotherapy treatments that are less targeted but can still be very effective.  

E.E.: I’m hearing about this new field of pharmacogenetics where they’re testing individuals to see which types of cancer drugs patients may respond to better given their DNA composition. Can you tell us a bit more about that? 

S.E.: One of the areas where Canada is leading the world is in understanding the genetic makeup of individual cancers. And once we know that we can start to target those individual cancers with specific drugs. One of the key issues with cancer is when it starts to metastasize and moves outside the prostate, the breast etc. and gets into the lymph nodes, the brain and other parts of the body. And that’s really what causes death due to cancer so we’re trying to find what causes that metastases how to stop the metastasis or start the treatment as soon as it metastasizes.  

We know there are a lot of drugs that are very effective therapies for cancer, but the cancer cells become almost immune to certain drugs. Cancer cells are constantly mutating, so when we see a drug is no longer effective, we quickly move someone on to the new drug. This is fantastic because not only is the patient no longer taking a drug that’s not useful, you can imagine what the impact on our healthcare system is as well as we’re no longer paying for a drug that’s no longer going to be helpful. So there’s a win/win all around if we can get this technology to be applied in in the clinic.  

If we start to understand what a what a metastatic cancer cell looks like genetically, we can identify fragments of DNA from these cells that are present in the blood. We have very sophisticated technology now that allows us to look at these fragments of DNA found in the blood from the cancer cell, and we can see when they started to metastasize. This allows us to intervene when the cell becomes metastatic and significantly more lethal in terms of causing death.  

E.E.: I can’t help but notice that the phrase “early detection” keeps coming up here. Obviously, that’s a critical issue here when it comes to cancer. What sort of practical advice can you share with respect to early detection.  

S.E.: We know that for many, cancers, if we detect early, we can treat effectively. If we can treat before it becomes metastatic then survival can be high. Take prostate cancer, for example. If we can treat prostate cancer when it’s still in the prostate, survival can be close to 100% / 10 years. As soon as it metastasizes away from the prostate, survival goes down to below 30% / 5 years. So, early detection is critical for survival for a number of different cancers.  

We have screening programs for breast, colorectal, cervical and lung cancer screening is coming on board now as well. The advice I can give to anyone is if you have any concerns about cancer, you have cancer in the family, for example, or you just have concerns and you’re not feeling quite right, get in touch with your family doctor and get tested.  

It’s better to have information about your body than no information, so at least you can track it and see what’s going on. In terms of testing now and detection, we used to have many very, very invasive tests for detection. Think of colorectal cancer screening, for example, where we used to test using a sigmoidoscopy, which is a just a very uncomfortable, invasive test. Now, we have we moved to the fecal occult blood test, which is testing blood in the stool with an at home FIT test. We’re finally getting to a stage where it’s not just noninvasive it’s also so much easier to do because you do it in the comfort of your home and then send it in.  

E.E.: One of the big issues, as I understand it – especially during the pandemic – is that patients weren’t seeing their doctors, not even virtually. Patients seeing doctors even now has dropped considerably. There’s been a change in attitude, and I would imagine this has had an impact on late detection of certain diseases, illnesses and of course cancers. Any thoughts on that?  

S.E.: Well, this is certainly a concern to us, and I encourage anyone who has concerns about their health to go and talk to their family doctor. I completely appreciate when we’re in the midst of the pandemic people didn’t want to actually go outside and expose themselves to the virus when in a clinic or a hospital. But you know, in many ways these environments are probably the safest environments to go to.   

I just encourage people to go and get checked out checked out whenever they have any concerns and ask questions of their family physician. We are certainly fearing the worst in terms of the effect of the pandemic. We know that screening programs were closed early on the pandemic. They started back up quickly, but people not going to get screening as you say could lead to not just more diagnoses, but more diagnoses at a later stage. I said before, if we don’t diagnose early enough the outcomes are not going to be as good. We’re concerned that in 2, 3 or 4 years’ time we’re going to start to see an increase of later-stage disease and diagnosis.   

E.E.: The Canadian Cancer Society must receive applications for research grants all the time. Can you describe what is the process for deciding you know where and how to allocate funding in Canada Cancer Research? 

S.E.: We have a very rigorous process to select the research that we fund. We’re completely agnostic and we want to fund the best research no matter where it’s located in the country. So, we bring together scientific experts, and people with lived experience to help us choose the proposals that are most likely to have the greatest impact. They help us select what projects we should be investing in to have the impact we want to see. The research has to be based around feasibility and also relevance.   

There are a lot of other researchers around in the world, so we need we need to make sure that we’re contributing to the global knowledge about cancer from a Canadian context. Understanding how we ca\n add to that global knowledge is important. As a team at CCS will have a sense of that but also our expert reviewers will also know. We call on them to ensure that the work that we’re funding is globally significant, but having said that, there are some instances where we need to solve some very Canadian problems.   

There may be best practices we can learn from elsewhere in the in the world, but we also have a very unique healthcare system so conducting research to improve our healthcare system is something that we’re very keen to support. So, while that global knowledge is important, there’s also the Canadian context we need to consider.   

E.E.: Are there any common misconceptions about cancer that the Canadian Cancer Society works to dispel?

S.E.: In this day and age, there are lots of places where people can gather information about cancer although not all are reliable and credible. We do fear that some people are misled and or misinterpret information. We suggest that if anyone has questions, talk to their family physician. We have a page on our website that talks about debunking cancer myths, which is helpful. This can be both negative and positive, as when someone receives a diagnosis, they want to understand what the outcome looks like.

We live in a society that when we hear the C word, it feels like a death sentence and that’s simply not true for all cancers. I encourage people to go to our website and talk to their physician about any questions they have. It’s great that there are opportunities to gather information much more freely than ever before, however distill and validate that information with your physician.  

E.E.: Can you give us a sense of what is available to those of us that want to get more involved in cancer fundraising?  

S.E.: This is Daffodil Month, so this is a big fundraising period for us. We have a really neat 80 kilometre run/walk challenge going on right now on Facebook, which is fantastic. We have events throughout the year as well such as our Relay For Life coming up in early summer and Run For The Cure for Breast Cancer later in the year as well.

So, lots of opportunities to engage with us in terms of supporting the work we’re doing. Also, we always need volunteers, and event volunteers, but volunteers to help us with advocacy work and many of our different programs. For us it’s about building a cancer caring community so people can reach out to us, and we’ll be happy to give them opportunities to engage with us further.  

Visit cancer.ca to donate to the Canadian Cancer Society, create your own fundraising event or to enquire about volunteering.   

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