1)Doctors are seeing more non-smokers, especially women, with later-stage lung cancer

Courtesy Barrie360.com and Canadian Press

Katie Hulan’s family doctor thought she might have asthma. 

Her cough, which had started about a month and a half earlier, was getting progressively worse. So he gave her some puffers to try, but they didn’t work.  

“I was just getting to the point where I couldn’t speak at work,” said the 37-year-old tech marketing manager. 

“At the end of the day, I would be in pain just from the shaking and coughing.”

Her doctor ordered an X-ray that showed a mass on her lung. 

“(My doctor) said to go to emergency, thinking it was a blood clot,” Hulan remembers.

After about six hours of more tests, they told her she had stage 4 lung cancer. 

“That was one of the most devastating moments of my life,” she said. 

“My immediate reaction was, ‘I know how this story ends.’ And so for me, it just felt completely like a death sentence.”

She had been healthy, active and didn’t smoke. 

“For me to get a cancer diagnosis was a big shock. And then to have a lung cancer diagnosis was very puzzling for me,” said Hulan, who was diagnosed in Toronto in late 2020 and has since moved to Victoria where she continues treatment.  

She’s one of a growing number of non-smokers doctors are seeing with lung cancer. Although smoking remains the leading risk factor, the Canadian Cancer Society estimates about a quarter of lung cancer cases in the country are non-smokers. 

In addition, more of those non-smokers are women than men and it’s not clear why, said Jessica Moffatt, vice-president of programs and advocacy at the Lung Health Foundation.

“One of the theories is that potentially estrogen is doing something to perpetuate tumour growth, but it’s all theories at this point,” she said. 

What scientists do know is that environmental factors contribute to lung cancer risk, especially radon gas.   

According to Health Canada, long-term exposure to radon — an invisible, radioactive gas from the breakdown of uranium in soil and rocks — is the number one cause of lung cancer among non-smokers. The agency says radon is present to some degree in every home and urges everyone to get a radon test kit to check their levels.  

Other risk factors include exposure to second-hand smoke, asbestos and the fine particulate matter in air pollution, Moffatt said.  

As wildfires rage across the country, the effects of that smoke is “a huge concern for us” and is an area being studied to determine lung cancer risk, she said.  

Dr. Rosalyn Juergens, a medical oncologist at McMaster University and Hamilton Health Sciences Centre, said studies have shown that people living in areas with high air pollution rates have a higher risk of developing lung cancer. 

Over about 20 years in practice, she has “absolutely” seen a rise in non-smoking lung cancer patients.  

“It was uncommon for me, not never, but uncommon for me, to see a never-smoker when I first started in practice. And we are definitely seeing more and more,” said Juergens, who is also the president of Lung Cancer Canada.

It’s not clear whether there are more non-smokers getting lung cancer or if they just make up a greater proportion of the patients as fewer people smoke than ever before, she said. 

Many of her non-smoking patients are women, but people simply aren’t aware of lung cancer as a women’s health issue, she said. When non-smokers reach her office, their cancer is often in advanced stages. 

“More women will die of lung cancer than will die of breast cancer, ovarian cancer, and cervical cancer combined,” Juergens said. “One in five of them will be people who have never touched a cigarette a day in their lives.”

Although organized lung cancer screening programs have been running in British Columbia, Ontario and Nova Scotia since 2022, they only target smokers, so non-smokers don’t get the benefit of that early detection. 

In addition, lung cancer is often not top-of-mind for primary-care providers when non-smoking patients come in with a cough, Juergens said. 

“The tricky part about lung cancer is symptoms are generally very subtle, right? Your lungs inside don’t have nerve endings. So it’s not like you’re going to get a pain. You’re never going to feel a lump,” she said. 

But the good news for many patients, Juergens said, is that lung cancer treatment has advanced dramatically since the 1990s, when chemotherapy was often the only option. 

“We do things called next generation sequencing on the vast majority of lung cancers, and that helps us to sort what exact type of lung cancer it is and pick the right treatments,” she said. 

That precision medicine turned Katie Hulan’s initial life expectancy of six months into an average of five to six years. A biopsy showed that her cancer had an ALK genetic mutation — one of about a dozen biomarkers that have specific medications to target the cancerous cells, and is only present in about four per cent of cases.

“When I got that news, it felt like a 180. I had life. I had hope. You know, my oncologist sat down and said, ‘you won the lottery, you have years,'” she said. 

Almost five years after her diagnosis, Hulan continues to take a pill as her treatment, never had to undergo chemotherapy, feels “wonderful” and is determined to live a long, full life. 

She now does advocacy work for the Lung Health Foundation to call for equal access to targeted cancer medication across the country and to urge people to seek medical attention if they have a cough that lasts more than two or three weeks.

“I think the word on the street is that you have to be a person who has smoked and that’s not at all the case,” she said. 

“Anyone with lungs can get lung cancer.”

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

2)Health Canada approves Ozempic to reduce kidney deterioration in people with diabetes

Courtesy Barrie360.com and Canadian Press

By Nicole Ireland, August 19, 2025

Health Canada has approved Ozempic to reduce the risk of further kidney decline among patients with Type 2 diabetes.

Between 30 and 50 per cent of people with Type 2 diabetes develop some form of chronic kidney disease.

An international clinical trial, called FLOW, showed the risk of kidneys significantly deteriorating or failing was 24 per cent lower in patients taking Ozempic compared to those taking a placebo injection.

The patients taking the drug were also less likely to die from cardiovascular disease — another condition that affects many patients with diabetes.

The study, funded by Ozempic manufacturer Novo Nordisk, was peer-reviewed and published in the New England Journal of Medicine last year and contributed to Health Canada’s decision.

Dr. David Cherney, a nephrologist at Toronto General Hospital, helped lead the Canadian part of the trial and says the results show it’s possible to reduce the loss of kidney function before patients need dialysis or a kidney transplant.

“What my patients are scared of is dialysis — dialysis or a transplant,” said Cherney, who is also a senior scientist at the Toronto General Hospital Research Institute, in an interview.

“I can reasonably reduce that risk and thereby reduce their anxiety and fear of serious, serious complications. Not to mention all the cardiovascular disease, which patients are also extremely afraid of.”

Dr. Ehud Ur, an endocrinologist in Vancouver who was not involved in the study, said the results are credible and that Health Canada’s approval of Ozempic to help prevent kidney decline is “great news.”

“The prevention of kidney disease is a very important goal in the management of patients with Type 2 diabetes and this is another tool,” said Ur, who is a professor of endocrinology and metabolism at the University of British Columbia.

Ozempic is the brand name of an injectable dose of semaglutide, a glucagon-like peptide-1 (GLP-1) hormone. Ozempic was first approved in Canada as a diabetes medication because it reduces blood sugar. It can also decrease appetite and has been approved as a weight-loss drug for people with obesity at a higher dose under the brand name Wegovy, which is also manufactured by Novo Nordisk.

In an email, Health Canada confirmed to The Canadian Press that on Aug. 13, it had approved Ozempic “to reduce the risk of sustained estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease and cardiovascular death in adults with Type 2 diabetes and chronic kidney disease.”

Glomerular filtration rate is a measure that shows how well the kidneys are filtering out waste and excess water.

Ozempic is the firstGLP-1 drug approved in Canada to protect both kidneys and the heart in patients with Type 2 diabetes, said Ur, noting that the cardiovascular benefits of semaglutide have been extensively studied.

“The benefit of Ozempic is that you also get weight loss, which is a very important goal for most people (with Type 2 diabetes). That’s a very exciting combination,” he said.

Some people experience gastrointestinal side effects when they take Ozempic, Ur said, including nausea, vomiting, constipation and diarrhea.

More severe complications can include gall bladder inflammation and pancreatitis, but most side effects are minor, he said.

The benefit of slowing or stopping progressive kidney disease in people with diabetes would outweigh the risks of minor side effects, Ur said.

The FLOW trial was conducted in 28 countries, including Canada. The researchers randomized 3,533 people with diabetes and chronic kidney disease to either receive Ozempic or a placebo. The study was conducted between 2019 and early 2024.

Participants were followed for an average of 3.4 years to monitor for “major kidney disease events,” including kidney failure leading to dialysis or transplantation, a 50-per-cent reduction in kidney function measured by glomerular filtration rate, or death from kidney-related or cardiovascular causes.

The Ozempic or placebo doses were given to participants on top of other medications they were taking, including drugs to control blood pressure and blood sugar.

Although reducing blood pressure and blood sugar have beneficial effects for the kidneys, Cherney said Ozempic appeared to have an additional positive impact on kidney function and future research can help pinpoint how that works.

“Another weapon against kidney disease is incredibly powerful. And these medicines will often turn patients around who are doing very poorly because it addresses so many different issues — the kidney, the cardiovascular, the metabolic, and the weight,” said Cherney.

Ur said it’s possible Ozempic could play a role in reducing inflammation in the kidneys and that might be one explanation for its positive effect.

Regardless of the reason for its effectiveness, he said the FLOW trial and Health Canada’s approval reinforces the importance of using the drug “relatively early in the disease process” to minimize kidney damage in people with Type 2 diabetes.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

3) Rising heat a ‘public health crisis’ for workers, including in Canada: WHO

Courtesy Barrie360.com and Canadian Press

By Canadian Press Staff, August 22, 2025

Rising heat a ‘public health crisis’ for workers, including in Canada: WHO

The World Health Organization says climate change-driven heat is a “public health crisis” for workers around the globe and experts say Canada is no exception.

The WHO and the World Meteorological Organization (WMO) released a joint report on Friday saying outdoor workers in construction, farming and other physically demanding jobs are at especially high risk of heat stroke, dehydration, cardiovascular damage and kidney dysfunction.

Although radiation from the sun is an added risk factor on top of air temperature, the report noted that people working indoors in hot, humid conditions are also vulnerable, especially if heat is radiating off of machinery, such as in manufacturing plants.

“The workers keeping our societies running are paying the highest price,” said Rüdiger Krech, the WHO’s director of environment, climate change and health said in a news briefing in Geneva on Thursday.

“These impacts are especially severe in vulnerable communities with limited access to cooling, health care, and productive labour policies.”

Glen Kenny, University of Ottawa research chair in environmental physiology, contributed to the international report and said people may think Canadian workers aren’t as vulnerable as workers in hotter parts of the world, but that’s a mistake.

“In Canada unfortunately, we have these weather extremes. We go from cold to hot. And so our bodies essentially lose that (heat) adaptation during the winter period,” he said in an interview.

The report said the risk of heat exhaustion increases when the core body temperature rises beyond 38 C.

It urged governments and employers to develop heat-health plans, including ways for workers to take breaks and get out of the sun or away from hot machinery and rehydrate regularly.

Employers could also plan shifts and workloads so that the most physically demanding tasks happen during cooler times of the day or evening. They could also lower the intensity of work in periods of high heat, either by reducing the pace of work or incorporating more breaks, the report said.

Whenever possible, workers should wear clothing that allows heat to escape, while still meeting safety requirements for protective gear.

Kenny said it’s critical to tailor heat coping strategies to each individual worker, including those who are older, have chronic health conditions or are less physically fit.

The ability to dissipate heat from the body lessens as people age, he said.

The cumulative effect of working in the heat day after day also needs to be considered, Kenny said.

Staying cool and getting rest outside of working hours is important, he said, but those off-hours during a five-day work week won’t allow full recovery during intense heat, he said.

“The body essentially gets compromised as we go through the work week,” Kenny said.

“If I take a worker on a Monday and look at their body’s capacity to lose heat, they are not the same person by day five,” he said.

“They have a reduced capacity to lose heat and that needs to be accounted for.”

The body gets rid of heat by increasing blood flow to the skin and through sweating, the report said.

When the air is hotter than the skin, the body gains heat and can become dehydrated as more sweating is required to regulate body temperature.

That in turn puts strain on the heart and kidneys because “we only have a certain volume of blood,” Kenny said.

“As you steal (water) away from that volume of blood because you’re sweating … you’re depleting the body,” he said.

Dr. Melissa Lem, a family physician in Vancouver and president of the Canadian Association of Physicians for the Environment, said heat stress affects worker safety in multiple ways.

“Workers’ cognitive functions can be impaired so they can have more trouble concentrating, their performance suffers, they have higher rates of injury,” Lem said.

“And then when you’re breathing faster because you’re overheating, you’re also breathing in more air pollution which can compound the health harms of heat.”

The WHO/WMO report recommends that workers be paired up in a “buddy system” so they can watch out for signs of heat stress.

Signs of heat exhaustion include fatigue, weakness, dizziness, light-headedness, thirst, and mild muscle cramps. If those happen, the worker should be moved to a cool area and drink water or electrolyte beverages.

If the symptoms don’t improve after 15 minutes, the heat exhaustion could be severe. Additional signs of severe heat exhaustion include slow reaction time, severe muscle cramps, blurred vision, headache or nausea.

The most serious form of heat stress is heat stroke, which is a medical emergency and requires “aggressive cooling” with ice and cold water and an ambulance should be called, the report said. Heat stroke symptoms can include vomiting, erratic behaviour, confusion or disorientation, garbled speech, hysteria, delirium, shivering, convulsions and loss of consciousness.

Lem said reading the report took her “right back to the 2021 heat dome (in B.C.) when I saw more patients with heat illness than I ever had in my entire career.”

Most of the more than 600 people who died that summer were elderly and isolated inside their non-air conditioned homes, but she believes many of the additional people who became ill were likely workers.

In addition to adapting to climate change-driven heat to protect workers, it’s also important to address the root causes, she said.

“One of the best ways to keep them safe is capping greenhouse gas emissions and reducing our use and extraction of fossil fuels,” Lem said.

“This will have further effects by reducing the air pollution that workers are exposed to,” she said.

4)’We are in a heat crisis’: Province should track deaths, ensure school AC, group says

Courtesy Barrie360.com and Canadian Press

By Jordan Omstead, Aug. 18, 2025.

Extreme heat is endangering students, workers, renters and some of Ontario’s most vulnerable residents, a network of civil society groups said Monday as they urged the province to better prepare for sweltering temperatures.

The Heat Collaborative issued calls to action Monday including a demand for the province to create an extreme heat awareness program.

Among the network’s other demands, it called on Doug Ford’s Progressive Conservatives to track heat-related deaths and hospital visits, and ensure schools are outfitted with air conditioning.

“Cooling and clean air are not luxuries. They are basic conditions for safety and learning. We need a real plan now,” said parent advocate Farheen Mahmood, who volunteers with the climate action group For Our Kids.

Speaking at Queen’s Park on Monday morning, she said two of her three kids attend schools in Toronto’s east end without air conditioning.

The Toronto District School Board, the country’s largest, has said about one-third of its schools have central air conditioning. It has said it would not be financially possible to expand that, citing billions of dollars in repair backlog.

“Climate change isn’t coming. It’s here. And every hot smoky day we delay, kids pay the price,” said Mahmood.

Parts of Ontario have already endured six heat warnings this year, more than last year’s four. Climate change, driven by the burning of fossil fuels, is already making those heat waves more likely, studies show.

The number of days per year with temperatures exceeding 30 C in Toronto could more than triple by mid-century, from about 20 days to 66 days, according to a staff report prepared for city council.

Speaking at Queen’s Park, members of the network said the province should bring in specific heat stress protections for workers.

“There needs to be better tracking of heat-related illnesses, injuries, and deaths among all workers. Without better data, it’s hard to know how big the problem is,” said Donald Cole, a physician at occupational health clinics and volunteer with the Canadian Association of Physicians for the Environment.

The Ministry of Labour proposed specific heat stress regulations two years ago, but they don’t appear to have taken effect. Critics have since questioned why more hasn’t been done to enforce a higher standard.

Ontario’s labour minister has pointed out that workers are already able to refuse unsafe work. But advocates suggest that fails to account for workers in precarious positions, such as migrant farm workers, who fear repercussions for speaking out or reporting workplace injuries.

The Canadian Press has reached out to the provincial government for comment.

Tenant protections figured prominently into Monday’s calls to action. The network called on the province to pass maximum temperature regulations to ensure landlords keep temperatures below 26 C in rental units.

Toronto is exploring a bylaw to that effect, with staff expected to report back on possible next steps next year.

The proposals have sparked concerns about whether landlords would use air conditioning upgrades as a pretext for evictions or steep rent increases. Monday’s call to action says to ensure tenants are protected, the province should expand retrofit funding and tie it to anti-eviction conditions.

“We don’t have time to wait anymore. We are in a heat crisis,” said Marcia Stone with the tenant rights group ACORN.