November is lung month, a time to raise awareness about lung disease. The stats on lung cancer are alarming: it’s the leading cause of cancer-related deaths in Canada, killing more Canadians than colon, breast and prostate cancer combined. Half of all lung cancers are diagnosed at stage four, when there’s little chance of recovery.

But the disease doesn’t get the attention it deserves. “It doesn’t attract the same research dollars or interest of other cancers,” says Dr. Alison Wallace, a thoracic surgeon-scientist at the QEII Health Sciences Centre in Halifax.

Lung cancer affects non-smokers, too
The lingering stereotype that lung cancer only affects smokers affects how people think about the disease, Dr. Wallace says. “The common adage that if you didn’t smoke, you wouldn’t have lung cancer. But we don’t blame people the same way [if they] develop skin cancer because of too much sun exposure.”

People who have never smoked make up one in five new lung cancer cases in Canada. For Canadians under age 55, lung cancer rates are higher among women than men.

Environmental exposure at play
Early-stage disease is often discovered during the search for something else. “The other day, we had a patient who had fallen off a horse and trauma scans showed an early-stage lung cancer,” said Dr. Wallace.

Environmental factors – rather than smoking – are behind many cases among non-smokers. Dr. Wallace is researching environmental exposures that may be linked to lung cancer cases, particularly among young women.

Improving care for Nova Scotians
Nova Scotia has some of the highest rates of the disease in the country. Lung cancer cases in the province are triaged by Dr. Wallace and her colleagues at the QEII. She is one of six thoracic surgeons providing the service, helping about 1,200 to 1,500 patients each year.

Having a central triage system to diagnose, stage and treat lung cancer means better outcomes for Nova Scotians. In 2023, the team will be launching a new lung cancer screening program in the province.

Leading lung cancer research
Dr. Wallace is also helping fill a gap in lung cancer research. Currently, she is studying the link between radon exposure and lung cancer. Radon exposure is the leading cause of the cancer in non-smokers. She is working with the Lung Association of Nova Scotia, Evict Radon and the Canadian Environmental Exposures in Cancer (CE2C) Network to develop a reliable measure of lifetime radon exposure, which is needed to assess long-term lung cancer risk and to make screening programs more inclusive.

Radon is an odourless radioactive gas found in most rock and soil in Nova Scotia. It often accumulates inside buildings to high and cancer-causing levels in indoor air. “Atlantic Canada represents the third most exposed region in the world,” said Dr. Wallace.

Test for radon in your home
The only way to know if you have a radon problem is to test your home. You can borrow test kits from your local library or MLA office, or purchase them online from the Lung Association of Nova Scotia. Private companies also offer the service.

Excellent care is the goal
Looking ahead, Dr. Wallace is excited to see where her research will lead. For her, it’s about providing the best care possible to Nova Scotians with lung cancer. “It’s great to cure people with surgery or even to just help them be more comfortable. We’re here to help them and we want to do our best to better their lives and improve the way lung cancer is diagnosed and treated.”

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