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Blame, shame overshadow real plight of lung cancer sufferers

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There's still no clear way to catch it early

http://www.ajc.com/news/content/health/ ... ancer.html


The Atlanta Journal-Constitution

Published on: 08/16/05

As a war correspondent, Peter Jennings dodged bullets and bombings to bring people the nightly news.

As a lung cancer patient, Jennings didn't stand a chance.

"He didn't die from a bomb or a bullet," said Dr. Fadlo Khuri, a lung cancer specialist and professor at Emory University's Winship Cancer Institute. "He died from a cigarette."

The Aug. 7 death of one of America's most urbane, sophisticated news anchors at age 67 from lung cancer came with a sad lesson: People who appear to be on top of the world get lung cancer from smoking, and most of them die from it.

More sad news came the day after Jennings' death. Dana Reeve, wife of the late Christopher Reeve, revealed she has lung cancer.

Reeve became one of about 11,000 nonsmoking women who are diagnosed with lung cancer each year.

Researchers think second-hand smoke could be to blame. They say more studies are needed, but sufficient funds are not available because this devastating disease, often associated with smoking, has become stigmatized.

It also was reported late last week that Barbara Bel Geddes, Miss Ellie on the '80s drama "Dallas," died from lung cancer. Her Aug. 8 death illustrates another point about the deadly disease: Lung cancer claims the lives of more women than any other form of the disease, including breast cancer.

News of Reeve and the deaths of Jennings and Bel Geddes point to the common challenges facing lung cancer patients, their families and physicians.

Chief among them, experts said, is blame.

"When people with lung cancer are diagnosed, the very first thing people ask is, 'Is she a smoker?' '' said Dr. Jennifer Garst, a professor at Duke University Medical Center and a lung cancer specialist. "You don't hear that with other cancers. People just ask, 'What can I do? When can I bring some food?' I don't care what your personal habits are; no one deserves to get lung cancer."

While cigarette smoking is implicated in about 85 percent of all lung cancers, Garst and others said they do not think that patients with lung cancer should be blamed for having an addiction, especially one that many acquired before they knew of the dangers of cigarettes.

Instead, they suggest that people need to understand that lung cancer is a particularly horrible disease. With a five-year survival rate of about 15 percent, it is among the deadliest of the major cancers. Only liver and pancreatic cancers have poorer survival rates.

It is also hard to detect. Its symptoms — fatigue, shortness of breath, weight loss — are vague and can fit a host of illnesses.

Because the lungs are internal organs that cannot be felt by a doctor during a routine exam, doctors cannot feel a small tumor.

Also, because the lungs are large — each is about the size of a football — a tumor can lodge in the walls of the lung and grow for months, even years, before it is detected.

There is no reliable screening method to detect lung cancer. Even chest X-rays are of little help. In the vast majority of cases, the disease has spread to other parts of the body before X-rays pick up malignant growths in the lungs.

And while a major national study is under way to determine whether a three-dimensional CT scan might be a good diagnostic tool, the American Cancer Society and many lung cancer specialists do not recommend the scan for routine screening yet.

Lung cancer is actually a group of diseases in which the genes of the cells in the lung are damaged, explained Dr. Michael Thun, an epidemiologist and vice president of the American Cancer Society.

Genetic damage occurs before a cancer forms, Thun said. The damage usually happens over years.

Cigarette smoking is the chief culprit, but asbestos, radon and other toxins also have been identified as causes of the disease.

"Smokers are continually bombarding their cells and the genes in their cells with carcinogens," Thun said.

Doctors group lung cancer into two broad types — one that has very small but very fast-growing cells and others that are not as fast growing. Small-cell lung cancer responds well to chemotherapy but can double in size within a month and spread fast to other parts of the body. Nonsmall-cell cancers do not respond as well to chemotherapy but do respond to surgery.

Doctors are particularly alarmed about the new cases among nonsmoking women. "That's a frightening amount," Khuri said. "We're talking about a disease in nonsmoking women that's on a par with leukemia. This is a very disturbing pattern."

Duke's Garst has started a Web site, womenagainstlung

cancer.org, to share research and information about lung cancer in women and what may account for the rise of the disease in nonsmoking women.

She and other researchers have some theories. Second-hand smoke inhaled from households in which a parent or spouse smokes may be one factor. Other toxins, such as those in household cleaning products, could be another.

Doctors know that females who smoke are more vulnerable than men to the toxins in cigarette smoke. Researchers need more money and time to answer more definitively, however, and they worry that they won't have either unless public perceptions about the disease soften.

"We've got to get above that guilt and blame," said Garst, a native of Athens.

"I'm not sure that we can continue to go down this path [of blaming patients]," Emory's Khuri said. "We need to enforce smoking cessation laws and to increase prevention efforts. And we need to put the blame for this squarely where it belongs — on the tobacco companies and not the victims."

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I just found this one too... I liked it except it talks about how we need to get over the blame game but leads the story on how it's all because of smoking.

If they could have highlighted what was covered in the last few paragraphs and dehighlighted the first few, I think it would have been better... but those who get past the first couple of paragraphs might learn something.

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I must say as a person who is in watch and wait and see mode for "suspicious" lung nodules on both lungs I sometimes feel like we are just waiting for this to not be early stage. Waiting for the nodules to grow to do anything. My family history is awful my own smoking history is awful and I have had previous gyn cancers. YET we are watching and waiting for this crap in my lungs to grow instead of doing something NOW. I am trying to trust the Docs but can't get rid of the feeling that I already have lung cancer and we are just waiting for it to grow to do something. I feel like if something was done now maybe I could be one of the "lucky" ones. I don't know just venting on the whole catching it early thing. Thanks for listening... :roll:

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Consider, if you will, a little bit of irony.

The late Peter Jennings smoked as a young man -- admittedly. Much of the filmed footage of him throughout his early career showed him with a cigarette in his hand, or lighting up, or whatever. Those of us who grew up in that era remember televisions shows, including news broadcasts, where people smoked right there on the shows.

Finally, he quit. He reported on and produced many stories about the tobacco industry after that, and was not a friend to them at all.

And then on one sad day, he faced his audience and told us that he had cancer. He told us he was "weak," and that he had started smoking again about the time of the 9/11 attacks. In short, he was telling us that he was just like the rest of us - human.

The irony? Mr. Jennings knew, perhaps more than most people, about what he perceived to be wrongs carried out by the tobacco industry. Yet, when it came down to it, he started smoking again, meaning that he began sending money from his pocket into their hands just like he'd done for years. Knowingly. Willingly. After all the reports he'd produced and reported on about those same companies.

IMO, it's time to stop pointing fingers everywhere and seeking whatever we can to "blame." We know that smoking is a factor, and a big one, but that it is not the only one. We also know that tobacco companies, just like gun manufacturers, can make all the products they want, and until and unless we actually pick up one of them and use it, it isn't going to harm us.

I think it's the people -- the personal stories -- the lack of funding for research that goes along with the stigma -- all those things that gets the attention, just as it did with Mr. Jennings, Dana Reeve, and others.

This is the theme I've used when writing to local news media, and it's had a reaction from one of them already. I'm hopeful they will have some special reports for Lung Cancer Awareness Month as a result.


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I myself wear a button that says no one deserves lung cancer and they don't regardless of how one gets it, we are all human. Funny thing is not one single (family/friends/strangers) person to date has asked me what does it mean and why do I wear it. I agree, Lung Cancer needs to be brought out of the closet like anything else and given a fair shake. I have even had people ask me if I tell people I have Lung Cancer as if it is something I should hide, be ashamed of or feel guilty about. I don't get it...

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Good for you. My button says "Cancer Sucks" and one says "Don't worry." I wear them every day of my life. With my radiation induced pixie haircut, I rarely fail to get at least a few comments about the button. All up and down the streets where I work (downtown) I have friends -- all of which follow my progress. It's a great feeling, and I know they know more today about this than they did a year ago, because I've told them. I also carry copies of that ad with the woman in it that says, "She can't stop smoking because she never started."


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