Biomarker testing is transforming lung cancer care with targeted treatments, and ALK Positive Canada offers hope and community support for ALK-positive patients.
When Craig Smith started to feel rundown in 2018, it didn’t surprise him. He was travelling back and forth between Ottawa and London, ON., to help his parents, who were both ill at the time. Then he developed a cough which, at first, he attributed to a possible allergy to a new household addition, dog Bailey.
But the cough got progressively worse, and Smith went to his GP. At only 55 years old, fit and healthy, at first the doctor surmised that Smith had GERD – a gastroesophageal reflux disease which happens when stomach acid flows back into the esophagus, causing heartburn. A chest X-ray was followed by CT scans, and on April 1, 2019, Smith was told he had stage 4 lung cancer.
“The oncology team told me that so much lung tissue was involved that they wouldn’t be able to treat the cancer with radiation or surgery,” says Smith. “In fact, they had rarely seen such a proliferation of cancer in someone’s chest.” A biopsy was taken before Smith suddenly crashed, barely surviving a cardiac tamponade event, this is when fluid builds up and puts pressure on his heart.
The biopsy, however, revealed that Smith’s lung cancer biomarker testing was positive for ALK. While recovering in the hospital, he received a targeted therapy specifically designed to suppress this particular subtype of cancer cells. “It was like a miracle. I started to feel better within days,” says Smith. “About six to eight weeks later, my cancer had reduced by around 30 per cent.”
For those living with lung cancer caused by genetic mutations —such as those with the ALK mutation—remarkable outcomes like this are not uncommon.
Targeted cancer therapy changes lives
Biomarker testing looks for certain changes (mutations) in the genes of lung cancer cells. While many still believe lung cancer is primarily a smoker’s disease, the reality is that anyone can develop lung cancer — including people who have never smoked a day in their lives.
Katie Hulan is the Vice-President of Advocacy for the non-profit organization ALK Positive Canada, as well as an ALK-positive lung cancer patient, having been diagnosed at 33 years of age. “Biomarker testing can significantly impact the lives of people living with cancer,” she says. “If a specific biomarker is present in lung cells, such as an ALK (anaplastic lymphoma kinase) fusion, the oncology team can provide targeted therapy to the patient. Unlike traditional chemotherapy treatment protocols, where the drugs given attack healthy cells as well as the cancerous ones, targeted therapy means that the patient can take an oral dose of medicine that only works against a specific gene mutation to inhibit cancer cell growth.”
Patients tend to have a much better quality of life with this type of treatment. “Side effects vary from person to person but, for example, I have a full head of hair and a good appetite, I can do weekly runs, and I can travel the world. No one would know I have cancer,” says Hulan.
Biomarker tests are mostly done for non-small cell lung cancer (about 85 per cent of cases) because small cell lung cancer has historically shown fewer targetable genetic changes — but new biomarkers and therapies are emerging.
Supporting patients beyond treatment
ALK Positive Canada Inc (APC) is a federally incorporated non-profit organization which started last year and was incorporated at the beginning of this year. The organization started as a private Facebook page in 2018 by some concerned patients. There is a group of four administrators who maintain that page, though it is legally a separate entity to APC.
“We support and advocate for people living with ALK-positive cancer, whether that means campaigning for clinical trials or for better provincial health benefits,” says Hulan. “Ultimately, we want to help find a cure while also improving life expectancy and quality of life.”
Through this, the organization remains an important touchpoint in the lives of many people directly affected by ALK-positive cancer.
Alexandra Chassé is an ALK-positive cancer patient living in Quebec. “For me, the organization made me feel less isolated,” she says. “I was able to connect with people who truly understood what I was going through. I found hope through their stories, and it gave me the strength to be more proactive in my care, to ask the right questions of my medical team, and to maintain confidence in my treatments. ALK Positive Canada provides information and support to those who need it, because no one should face this illness alone.”
If you or someone you know has ALK-positive lung cancer, get involved with ALK Positive Canada by visiting alkpositivecanada.org.
This article was made possible with support from Pfizer Canada.
