David Gray was 12 years old when he lit his first cigarette. Growing up as the middle child in a family of six wasn’t easy. Times were tough and David went to work at a young age to help his mother pay the bills. For David, hard work and responsibility defined adulthood.It was the 1960s and a cigarette was the insignia of the cool; David chose Export A. His habit quickly grew to a pack a day and a lifestyle that revolved around cigarettes. A trip just about anywhere was bookended by a smoke. Like most people of that time, David didn’t associate tobacco with danger. Many years would pass before it was identified as a leading cause of lung cancer, heart disease and numerous chronic health conditions, dubbed the ‘silent killers’. Now at age 54 – after decades of smoking – David decided it was time to take a small but important first step towards finding out just how much his lifelong habit has impacted his health. “I was watching the news and I saw that they were looking for people in Hamilton to participate in a lung cancer screening study. I looked at my wife who has always been concerned about my health and she already had the phone in her hand just waiting for me to dial,” said David. “Although I was reluctant at first, I now know that making that call was the best decision I’ve ever made.” The Pan-Canadian Early Lung Cancer Detection Study, which was first launched in September 2008, is jointly funded through the Terry Fox Research Institute and the Canadian Partnership Against Cancer. The first of its kind, this unique study plans to involve 2,500 current and former smokers across seven Canadian health care centres. Among the centres chosen to participate was Hamilton Health Sciences’ Juravinski Cancer Centre (JCC). “Being selected speaks to the calibre of our team here. This is also good news for Hamilton as our rate of smoking is among the highest in our LHIN,” said Dr. John Goffin, Medical Oncologist and Principal Investigator of the study at the Juravinski Cancer Centre. The goal of the study is to gather vital information required to develop better detection methods, which could ultimately benefit patient outcomes. Current research studies suggest that five-year survival rates for lung cancer can drastically improve from the present 16 per cent to an astounding 77 per cent with the implementation of early detection and intervention techniques such as pre-screening tests. David went through a series of tests for the study including blood work, diagnostic imaging and a bronchoscopy. He was fortunate. A 42-year smoking habit had not turned into lung cancer. But the tests did find something shocking that has forced David to rethink his habit. They discovered Coronary Artery Disease. This form of heart disease is commonly linked to smoking and is caused by the formation of blockages in the major arteries of the heart. If left untreated, it can lead to heart attack, stroke and even death. David’s diagnosis came as a surprise. Although, incidents of clinical trials inadvertently detecting health issues unbeknownst to the trial subject are much more common than what one might expect. To date, the preliminary results of this pan-Canadian lung cancer study have been successful in identifying 29 cases of cancer, five of which were found at Hamilton’s JCC. The study is also creating some optimism among researchers who are now beginning to discover that the early screening tests used to identify lung cancer may also prove to be effective in detecting other smoking and non-smoking related ailments. Dr. John Goffin considers these unexpected results or ‘incidental findings’ to be an added success of the study. “We are beginning to notice that the screening tests conducted on study subjects have not only found early signs of treatable cancer but have also identified signs of cardiovascular disease and respiratory conditions such as Chronic Obstructive Pulmonary Disease (COPD), some cases of which may be very serious.” David was referred to the Hamilton General Hospital’s renowned Heart Investigation Unit for precautionary follow-up testing. It was here that expert cardiologists discovered that David not only had three coronary blockages but he had in fact already suffered from a previous heart attack, which left a significant amount of damaged tissue and impaired heart function. Doctors then delivered the news that he was a candidate for triple bypass surgery, leaving David and his wife shocked. “I’ve always been the kind of guy who thinks: ‘what doesn’t kill you will only make you stronger’,” he said through a slightly nervous laugh. “But learning I had a heart attack without even knowing it, now that was my wake-up call.” David’s story, like most, doesn’t offer a fairy tale ending. Today, 42 years after his first puff, David is just now starting to realize the implications of his lifelong habit. Despite his recent diagnosis of heart disease, David, much like many other long-term smokers, still finds himself grappling with thoughts that the damage has already been done or that it’s too hard, or even worse, too late to quit. However, despite the challenges of quitting smoking and the long road ahead, David is the first to admit that being diagnosed with heart disease was the first step in acknowledging the seriousness of his recently discovered health condition. “It was then that I knew it was time to make a change,” he said. This was a realization that would never have been possible if it weren’t for a simple phone call to participate in the lung cancer screening study. And while he hasn’t quit, he has cut back. That pack a day has been halved. He can now do things without thinking there has to be a smoke before and after. Being part of the clinical trial gave David a new perspective, and chance for change, something for which his wife, children and grandchildren are all thankful. For information on the Pan-Canadian Early Lung Cancer Detection Study, please contact: 1-866-966-LUNG (5864).