Manitoba-developed protocol providing treatment to lung cancer patients with delayed surgeries


A Manitoba-made medical innovation is helping lung cancer patients who have had their surgeries delayed due to the pandemic.

It’s called the Saber Bridge Protocol which repurposes an existing lung cancer treatment to see patients through to surgery if it’s been delayed.

Thoracic surgeon Dr. Biniam Kidane said especially in the first wave of COVID-19 in Manitoba, surgical time was hit hard.

“To the point that early stage lung cancer would have to see delays of up to three to four months to get their lung cancer surgery,” he said.

Dr. Julian Kim, a radiation oncologist at CancerCare Manitoba said from the patient perspective the surgical slowdown created anxiety and fear for the future.

“It’s not just anxiety and fear it’s a real risk of progression of the cancer during the indeterminate wait period that we didn’t know how long we’d have to wait for surgical or time to open up again,” Kim explained.

During the first wave, the two colleagues said they, and the broader oncology community, grappled with the questions: how can treatment be delivered safely? And who can be safely delayed?

“There are groups of patients for whom you can safely delay some treatment,” said Kim, “but for a patient to hear that is devastating.”

They landed on a solution using a highly focused radiation therapy called Saber and wrote a protocol on how to use it in lung cancer patients with delayed surgeries.

Kim described the Saber Bridge Protocol as modern technology meeting a modern problem.

“This is a positive that came out of a very dark situation.”

Before COVID, Kim said Saber was used primarily in early-stage lung cancer patients where the cancer had not yet spread and the patients were not good candidates for surgery.

“This is a homegrown protocol. It was developed predominately in Winnipeg and we are the leading centre for it across the world,” said Kidane.

Kidane said the protocol has been published and other centres are already using it.

In Manitoba it’s been used on and off as surgical availability has been sporadic. Now that there’s a COVID vaccine he adds the protocol can be used to ensure lung cancer patient safety.

“So even when we had surgical availability some patients chose to undergo this protocol until after they could get double vaccinated for example which would maximize their safety for getting a lung surgery,” he said.

Another benefit is Saber is done on outpatients, meaning they do not need to be admitted to hospital to get it.

“Which is why it’s so well suited to treating patients in the pandemic because the patient would walk in, have their treatment, and half an hour later walk home,” said Kim.

Kidane said to the best of their knowledge, the Saber treatment gives the same level of cancer control that surgery does for up to a year.

He describes the protocol as a win-win-win situation because patients’ outcomes will not be affected, while operating room time becomes less competitive as the surgical backlog gets addressed.

“At the end of the day the health-care system wins because they have less people that have to be dealt with complications from operations that make them sicker during the time of COVID.” 

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