Despite being the deadliest, lung cancer is often ignored

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By Garret Condon

Quick, can you identify the color of the wristband for advocates of lung cancer research and survivorship? Pink? No, that’s breast cancer. Blue? Sorry, that’s prostate cancer. Don’t know? Join the club.

“Nobody wears one,” said Dr. Lynn Tanoue, medical director of the Yale-New Haven Thoracic Oncology Program and associate professor of pulmonary medicine at the Yale School of Medicine. “It’s clear.”

It’s also clear that the stigma of cigarette smoking is the reason why there are fewer research funds, advocacy groups and well-recognized wristbands for lung cancer than for other forms cancer. If you’ve got lung cancer, chances are you smoked. And if you smoked, well, it’s your fault, isn’t it?

In the past few weeks, both ABC News anchor Peter Jennings and former “Dallas” star Barbara Bel Geddes died of lung cancer. Their being longtime smokers figured prominently in their obituaries.

The American Cancer Society’s projections suggest that many non-celebrity Americans also died of lung cancer in the last 10 days. Lung cancer is cutting them down at the rate of about 4,500 every 10 days. By the end of the year, lung and bronchial cancer will have claimed 163,510 U.S. — more than the combined death toll of the four next most deadly cancers: colon, breast, pancreas and prostate.

Besides dealing with grimmer survival odds than many other cancer patients, lung cancer patients also must contend with the lung-cancer culture of blame.

When actor Christopher Reeve’s widow, Dana Reeve, announced she has been diagnosed with lung cancer, the Christopher Reeve Paralysis Foundation, which she heads, was quick to point out that she is a non-smoker.

Non-smoking patients sometimes react to their diagnoses by asking: Why me? Dr. Frank Detterbeck, chief of thoracic surgery at Yale and associate director of the Yale Cancer Center, said that he’s seen such patients say, “People think I must have smoked, but I haven’t.”

Among people diagnosed with lung cancer, about 15 percent of females and 5 percent of males never smoked, according to Tanoue. And ex-smokers account for about half the patients now being treated. These are people who, as Tanoue observes, “tried to be good citizens regarding their health.” Quitting greatly reduces one’s risk of lung cancer, but the risk still remains higher than for people who never smoked.

Obviously, it’s not helpful to point the finger at patients who are facing a difficult course of treatment. It’s also not fair, according to the Yale doctors.

“Smoking is such a difficult thing to give up; it’s not right of us to have an attitude of: ‘Oh, well, it’s your fault,’ ” said Detterbeck. Tanoue said smokers are victims, too. “I think smokers are victims of the fact that cigarettes are incredibly addictive,” said Tanoue. Certainly that’s been the position of the lawyers and attorneys general who have taken on Big Tobacco in recent years.

The five-year survival rate for those diagnosed with lung cancer between 1995 and 2000 was 15 percent. By comparison, during that same period the five-year survival rate for women diagnosed with breast cancer was 88 percent, and the rate was 63 percent for people with colon cancer. The dismal outlook for lung cancer patients stems in part from the fact that people whose symptoms are bad enough to send them to the doctor usually have advanced lung cancer.

Detterbeck notes that while the five-year survival rate for lung cancer survival lags far behind other forms of cancer, the treatments improve every year. One-year survival was only 10 percent two decades ago, and it is now about 50 percent. Peter Jennings’ rapid demise, he said, “is not the norm anymore.”