March 8, 2025

Connecting the Spots – The Often-Untold Story of Women and Lung Cancer 

Lung cancer kills more women than breast, uterine and colon cancers combined. Yet it’s something that’s rarely talked about and even more rarely studied.  

But here at St. Joseph’s Healthcare Hamilton, we’re using robotic surgery to remove lung cancer tumours with great precision. And we’re researching the demographics of our patient population, too. What we’re finding may surprise you. 

Lately, a number of relatively young, healthy, non-smoking women are being diagnosed with lung cancer. In 2024, the Canadian Cancer Society reported that more than 17,300 women were diagnosed with lung cancer, (compared to 14,800 men) and nearly one quarter of those cancer diagnoses were among non-smokers. 

Because lung tissue has very few nerves or pain receptors, individuals living with lung cancer often experience no symptoms at all until the disease has progressed to a later stage. That was Michelle’s experience. 

Meet Michelle 

Her family doctor ordered a chest x-ray that showed a spot on Michelle’s lung, which was at first thought to be walking pneumonia or a lung infection. But after a course of antibiotics and a repeat x-ray a couple of weeks later, the spot was still there.  

“I was referred for a CT scan and soon after that, my doctor called me with the news that I had an eight-centimetre mass on my right lung that the radiologist said looked like cancer,” recounts Michelle. “I was shocked. Of all the medical conditions we know we might one day face, lung cancer had never been on my radar. I’ve never smoked, I am active, I eat well, my lung capacity was at 98 percent, and I have no family history of lung cancer.” 

Her oncologist prescribed chemotherapy and immunotherapy at the Juravinski Cancer Centre to shrink Michelle’s 8 cm, stage 3 tumor, then she was referred to Dr. Waël Hanna – Division Head, Thoracic Surgery, St. Joseph’s Healthcare Hamilton, Research Lead, Boris Family Centre for Robotic Surgery, and one of the country’s leading robotic thoracic surgeons.  

“Performing lung cancer surgeries has historically been quite difficult and invasive for the patient. Open surgeries required a large incision, manually retracting the ribcage to gain access to the lungs, and it often ended up with patients recovering from their surgery on ventilation in the ICU,” explains Dr. Hanna. “With robotic surgery, we make four small incisions that allow small instruments to travel between the ribs of the patient causing less trauma, reducing blood loss, minimizing scarring, and most importantly – providing better patient outcomes and a speedier road to recovery.” 

Lung cancer surgeries are one of 10 procedures performed robotically at St. Joseph’s Healthcare Hamilton. Seven of those 10 procedures, including surgeries for patients living with cancers of the lung, bladder, esophagus, thyroid and more, aren’t yet funded by OHIP and are only made possible through generous donations made by grateful patients and philanthropists.  

Following the robotic removal of the upper lobe of her right lung and a precise extraction of 18 lymph nodes in October 2024, Michelle is now cancer-free.  

“I was up and walking within a day, had no complications, was off all pain medication a few days after discharge, and was back to hiking by Christmas. It is truly remarkable,” says Michelle. “Being diagnosed with lung cancer and going through treatment is already difficult enough – being the recipient of a robotic surgery definitely made my journey easier.  I am thankful to the donors who make that possible and to Dr. Hanna for his expertise.”  

When asked what message she would impart to other women, Michelle shares three things: “First, Lung cancer is not just a smoker’s disease—it can affect anyone. Second, if you have persistent symptoms, get them checked early, and third, we need to advocate for lung cancer screening to include non-smokers given the rise in diagnoses among women. We’re so proactive when it comes to getting screened for breast cancer and cervical cancer and we need to apply the same principle to lung cancer, too.”  

Robotic surgery isn’t just effective at treating late-stage cancers. It can also remove pre-cancerous tissues before they have the chance to turn into cancer. 

Meet Aida 

Earlier this year, Aida injured her back and went to see her family doctor who requested an x-ray to have a better look. The x-ray happened to include the base of Aida’s lungs where a dark spot was barely visible. More x-rays and a CT scan followed as clinicians investigated what they thought might be a non small cell lung carcinoma. 

Aida, too, underwent a robotic surgery performed by Dr. Hanna at St. Joe’s to remove the mass and shares Michelle’s feedback on how small her incisions were, how well she felt after surgery, and how quickly she returned to her life, her family and her daily activities.  The pathology on the mass from Aida’s lung showed that it was not in fact a carcinoma at all, it was a carcinoid – a rare type of neuroendocrine tumour.  

“I am deeply impressed by the advancements made possible through robotic surgery. And the fact that it was donor funded surprised me, too,” says Aida. “After my care experience, I felt compelled to pay it forward, so I made a donation to St. Joe’s to help fund a robotic surgery. I wanted to ensure someone else would have access to the robotic surgery that I am so grateful to have received.”  

Meet A Woman Helping Women (and Men) Living with Lung Cancer: St. Joe’s Welcomes Dr. Se-In Choe

“Historically, women have been under-represented in lung cancer research and care studies. Similarly, women haven’t tended to permeate the field of thoracic surgery,” says Dr. Choe. “I think that’s part of what attracted me to this field. Knowing that there is great progress being made, but there is still more work to be done, too. I want to be a part of bringing greater equity to women facing a lung cancer diagnosis and greater profile to the remarkable women in thoracic surgery and care, too. Whether they’re surgeons or nurses, respiratory therapists or ICU clinicians.” 

In August 2024, Dr. Choe returned to St. Joe’s as a full-time thoracic surgeon and an Assistant Professor in the Department of Surgery at McMaster University. “I’m happy to be back at St. Joe’s. It’s such a supportive, innovative environment. And there’s something very special about the way the team here cares for their patients. It inspires me every single day.” In February 2025, Dr. Choe performed her first robotic lung cancer surgery at the Hospital.