Image credit: Darryl Dyck/Canadian Press

Breathing Easier

Promise Magazine: Spring/Summer 2017
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By Laura Rodgers

Dr. Don Sin’s research will help predict the progression of COPD and find new ways to manage the disease, allowing millions of Canadians to take another breath

It’s the most common reason people in BC are admitted to hospital; it will end the life of nearly one in 10 of those people before they’re discharged; it affects about three million Canadians, and by 2020 it’s expected to be the third-likeliest cause of death in Canada.

Yet researchers say funding for this disease is scarce. Many patients don’t even know what symptoms to look for until it’s too late.

Dr. Don Sin and his team at St. Paul’s and UBC are working to change all that. He has dedicated his career to the research and treatment of chronic obstructive pulmonary disease (COPD), what he calls the most under-acknowledged disease in Canada. In COPD, swelling or damage reduces lung capacity and prevents the lungs from providing enough oxygen to the blood.

It’s a progressive condition and most patients don’t realize they have it until they’re constantly out of breath. In fact, 40 per cent of new cases are only diagnosed when a patient is sick enough to require immediate hospitalization.

Dr. Sin, whose 13-year career at St. Paul’s has made him a worldleading expert in COPD research and treatment, says the disease is underresearched because it mainly affects a marginalized population: smokers, those exposed to dangerous chemicals in the workplace and people in the developing world who heat their homes with a poorly ventilated hearth or have lived in heavily polluted places.

“There’s social stigma,” says Dr. Sin, explaining that educated and wealthy people are less likely to develop COPD. Though many factors contribute to this stigma, “COPD is often associated with smoking,” says Dr. Sin.

Working at St. Paul’s Hospital and with St. Paul’s Foundation has been pivotal for Dr. Sin. “St. Paul’s is a perfect place,” he says, explaining that the hospital culture includes compassionate care for marginalized people in a way he’s never seen anywhere else.

Targeted Care

Dr. Sin’s current research includes a project funded by Genome Canada, whose goal is to develop a blood test that predicts a breathing crisis before it happens – a test that will reveal how a patient’s disease is progressing. The project began in 2013 and Dr. Sin expects the test will be ready by 2017/18.

In addition, Dr. Sin is developing targeted drugs to be recommended based on those blood tests, so patients can get the right treatment at the right place and at the right time.

Along with local manufacturers, Dr. Sin is also pioneering two promising physical treatments, one using cold (cryotherapy) and another heat (radiofrequency therapy) to precisely remove damaged lung tissue. Cryotherapy – currently in clinical trials – requires a bronchoscopy, in which surgeons put a breathing tube or telescope into a patient’s lungs to apply treatment.

Radio-frequency therapy is completely non-invasive. “Patients will walk into a box or room to receive the therapy for 30 minutes, walk out and go home,”explains Dr. Sin.

The research team is also in a discovery phase with the Centre for Drug Research and Development for targeted drug therapies that could be ingested as a pill, inhaled or injected.

New treatments like these will allow COPD patients to access more personalized, less invasive care. “The whole theme is precision,” says Dr. Sin, adding that the blood tests they’re currently working on will allow doctors to identify what kind of therapy an individual will respond to best. “We may discover 20 or 30 different targets and COPD patients will have a suite of medications to choose from, making it easier to find one that’s effective for them,” explains Dr. Sin.

Projects like these wouldn’t be possible without the help of St. Paul’s Foundation, he says, because the foundation isn’t dedicated to just one disease, but is able to give funding where it’s needed most.

COPD Patient and Advocate Dennis Josey Shares his Story

In 2008, Dennis Josey went to the emergency department when he felt short of breath. His symptoms, like those of millions of other Canadians, presented when they were so bad that a hospital visit was his only option. He later found out that his lung capacity was just 15 per cent – average adult lung capacity is above 80 per cent.

That number eliminated him from a potential COPD study and lung transplant eligibility. Until Josey met Dr. Don Sin.

In 2013, during a St. Paul’s-led COPD and pulmonary outreach session in his community, a hospital representative suggested that Josey make an appointment with Dr. Sin.

“Before, I had no information, no support,” Josey says. “To this day, I give accolades to Dr. Sin, because that’s where it all started for me.”

Josey transferred his care to Dr. Sin, who put him on a transplant list. In 2016, Josey received a new set of lungs. Dr. Sin’s dedication to his patients, proactive treatment methods and sharing of knowledge inspired Josey to become an advocate for COPD treatment.

Now Josey’s lung capacity is greatly improved; he regularly takes long walks around the Vancouver seawall and has energy to spare -– he uses it to run an online COPD support group, work with the BC Lung Association and serve on a Vancouver-wide committee for heart and lung health.

Planting a Seed

How seed funding from St. Paul’s Foundation helped Dr. Sin secure a $7.2-million grant from Genome Canada Funding from St. Paul’s Foundation has been essential to his research, says Dr. Don Sin. In order to apply for the multi-million-dollar Genome Canada grant in 2013, he needed to match a portion of the funding. While Dr. Sin was able to raise $650,000, he still fell well short of what was needed.

To make up the gap, St. Paul’s Foundation provided $750,000 and Dr. Sin became one of 17 grant recipients out of more than 150 applications across Canada.

“We’re at the cusp of making a tremendous impact on patient care and changing the narrative of COPD from a deadly disease to a treatable and perhaps even curable disease,” says Dr. Sin. “And without St. Paul’s Foundation and its donors, this would not have been possible.”

Many researchers like Dr. Sin rely on St. Paul’s Foundation to maintain their lifesaving work. Hospital foundations can provide the necessary kickstart to secure major grants and help fund work on under-acknowledged diseases like COPD. The seed money, from donors like you, can help make projects eligible for large grants; once those grants are received, the funding allows researchers to concentrate on what they do best and produce successful outcomes.

“We’re at the cusp of making a tremendous impact on patient care and changing the narrative of COPD from a deadly disease to a treatable and perhaps even curable disease,” says Dr. Sin. “And without St. Paul’s Foundation and its donors, this would not have been possible.”

What is COPD?

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that occurs when airway passages in the lungs become obstructed because of inflammation and excess phlegm. Two of the most common conditions that contribute to COPD are chronic bronchitis and emphysema. The former is the inflammation and eventual scarring of the airway tubes, while the latter is the enlargement and destruction of the air sacs within the lungs.

Dr. Sin’s projects rely on the support of donors like you. To learn more visit donate.helpstpauls.com/COPD

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