Women Lift Smokescreen on Lung Cancer

[Leslie221]

Bay Area BusinessWoman

www.babwnews.com

November, 2005

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Women Lift Smokescreen on Lung Cancer

—By Janet Rhodes

Say the words, “lung cancer”, and many people picture an older man with a cigarette in his mouth. At only 47 years old and with rosy cheeks and clear eyes, Sandy Britt does not fit that image. Like 10 to 15 percent of those diagnosed with lung cancer each year, she has never smoked.

Lung cancer has become a woman’s issue. Eighty percent of the lifelong nonsmokers diagnosed with lung cancer are women, and the disease will kill twice as many women as breast cancer this year.

“I was stage IV [the most advanced stage] when I was diagnosed; the doctor said she wasn’t going to treat me at all,” recalled Britt, an Alameda resident and a member of the Lung Cancer Alliance’s California Committee, which since July has been seeking a gubernatorial proclamation declaring November California Lung Cancer Awareness Month.

“Stage I is the only curable lung cancer,” explained Britt, whose father and 42-year-old brother died of lung cancer, 10 and 20 years after each had quit smoking. “If a parent or sibling dies of lung cancer, you are three times more likely to get the disease. But when I asked my brother’s oncologist about getting checked out every year, he said to get a mammogram instead.”

More than 60 percent of all new lung cancers are diagnosed in those who never smoked or who quit, sometimes decades ago. But many physicians seem unaware of that.

Three years before her diagnosis, Britt had had an abnormal chest x-ray that was not taken seriously. As a 43-year-old nonsmoker, she didn’t fit the profile of a lung cancer patient. “The doctor said there was no need to follow up, even when he had a patient sitting in front of him with an abnormal chest x-ray and a family history of the disease.”

“Shame on that doctor,” said Laurie Fenton, president of the Lung Cancer Alliance (LCA), a national advocacy group for lung cancer patients. “And shame on those who are perpetuating mistruths about lung cancer. The nature of this disease is so lethal and so silent, you don’t realize you have it until it’s metastasized.”

Fenton noted that the decision to screen for lung cancer — to get tested when no symptoms are present — should be based on several factors. These include: the patient’s family history; exposure to radon and secondhand smoke; and whether, how much, and for how many years a woman has smoked. Fenton added that former smokers are always at elevated risk, but that the risk decreases with time.

Depending upon the patient’s history, a low-dose spiral CT scan, which can detect tumors the size of a pea, should be ordered, not a chest x-ray, which shows only larger masses. Referring to chest x-rays as “obsolete,” Fenton added, “Many in the medical community are not as informed as they could be. The majority of calls to our 800 number are people who were misdiagnosed with bronchitis, put on antibiotics for four months, and then told, ‘You have lung cancer. Go home and put your affairs in order.’

“Peter Jennings and Dana Reeve [a former smoker and nonsmoker] represent the true face of lung cancer,” continued Fenton. “We want this disease looked at in its entirety. Until then, mortality rates will remain high.”

Tobacco Industry Blamed

On September 7, 2005 the LCA filed a brief in the U.S. District Court, asking that the tobacco industry be required not only to fund smoking cessation programs, but also independent research on the etiology, diagnosis, treatment, and cure of lung cancer. In its brief, the LCA argues that by concealing the addictive effects of smoking, the tobacco industry has stigmatized lung cancer victims, resulting in inadequate research funding. To date, none of the Philip Morris Tobacco Master Settlement Fund — which exceeds $200 billion — has gone to lung cancer research.

A reluctance to fund research into the treatment and cure of lung cancer is not confined to the tobacco industry, according to Kim Norris, a lung cancer widow and a member of Women Against Lung Cancer.

“My viewpoint,” said Norris, “ is that there are three parts to knocking out lung cancer: tobacco cessation, early detection, and lung cancer treatment. The American Cancer Society and the American Lung Association have put all this time and energy into the first part and completely ignored the second and third.”

She noted that the ACS and ALA have joined forces with the American Heart Association to form the Coalition for a Healthy California. The Coalition has proposed an initiative, the Tobacco Tax and Disease Prevention Act of 2006, which would tax each pack of cigarettes at $1.50. One third of the funds would be earmarked for smoking cessation, which Norris heartily endorses. But when she researched the two-thirds earmarked for disease prevention and research, Norris discovered, “not one penny of this proposed tax is earmarked for lung cancer research.” Instead, the funds would go toward prevention of obesity, heart disease, stroke, and asthma; and research into other cancers.

“Please make a plea for research,” said Susan Mantel, executive director of Joan’s Legacy: The Joan Scarangello Foundation to Conquer Lung Cancer, which funds innovative research. Scarangello, a lifelong nonsmoker, had been diagnosed with recurring pneumonia for two years. Her doctor, like the one initially seen by Sandy Britt, had been reluctant to look for lung cancer in a nonsmoker.

“When a doctor thinks, this is what a lung cancer patient looks like to me, a man in his 60s who smokes,” Mantel said, “it takes them a long time to change their patterns of medical practice.”

Jill Siegfried, PhD, co-director of the Lung and Thoracic Malignancies Program at the University of Pittsburgh Cancer Institute, noted, “The fact that smoking has increased the amount of lung cancer has made everyone, including doctors, forget that the lung is an organ susceptible to cancer, in and of itself.

“The lung has a huge surface area — as big as a football field — and interacts with the environment. So it is subject to insult by pollutants and irritants. Recent reports note that increased particulates in urban air are increasing the background lung cancer rate, aside from smoking.”

Women More Susceptible

When queried as to why the majority of nonsmoking lung cancer patients are women, Siegfried cited two reasons: Women have a lower ability than men to repair DNA damage, and “we know that lung cancer tumors have estrogen receptors. In the lab, we’ve made lung cancer tumors grow by giving them estrogen.” She added that although they had established an association between estrogen and lung cancer, association is different from causation. “The smoking factor needs to be separated out,” she said. “We need scientific studies in women who never smoked to look at estrogen levels over time. That’s never been done.”

Nancy Michener, a never-smoker and 5.5-year lung cancer survivor, wrote in a letter to California’s Health and Human Services Department, “I dream of the day when lung cancer is as ‘popular’ in the public eye as breast cancer. I would love to be asked to donate $1 or more toward lung cancer research at my local grocery store.”

Michener’s letter is one of many requests for Governor Schwarzenegger to sign a state proclamation declaring November Lung Cancer Awareness Month. At the time of press, the proclamation had not been signed and the committee had not yet received a firm commitment that it would be.

“People do not survive this disease, because there is no research,” said Britt, who serves with Michener on the LCAM committee. “I know my life could change in a day,” Britt said. “I feel glad to be alive and well. I want to put a face on this.”

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LUNG CANCER ALLIANCE

The Lung Cancer Alliance is arranging meetings with California state legislators during November. If you would like to attend, please call (202) 463-2080.

For more information about lung cancer, please visit: www.lungcanceralliance.org, www.americanlegacy.org, www.4walc.org, and www.joanslegacy.org.

If you have questions about lung cancer or have been recently diagnosed and would like to talk to someone, please call (800) 298-2436. The LCA has established a peer-to-peer support program, pairing patients with others who have had lung cancer.

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SHOULD YOU SCREEN FOR LUNG CANCER?

Many women who used to smoke wonder whether they should get a CT scan or x-ray even if they have no symptoms of lung cancer. Many medical professionals advise women who smoked at least one pack a day for 10 years to do so. Here are a few things to consider:

1. CT scans often detect masses that are not cancerous, and the only way to determine whether they are malignant is to biopsy them, have them surgically removed, or have follow-up scans to see whether the mass grows.

2. Insurance usually will not cover the cost of CT scans unless symptoms are present.

3. CT technology and radiologists’ expertise varies. Make sure the place you receive your CT is reputable and that the scans are read by experienced professionals.

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DID YOU KNOW?

• When diagnosed at stage one, lung cancer survival rates top 70 percent.

• Lung cancer is the leading cause of cancer deaths in the United States.

• In 1987, lung cancer surpassed breast cancer as the leading cause of cancer deaths in women.

• Lung cancer will kill nearly twice as many women as breast cancer this year.

• Lung cancer will kill more people this year than melanoma and cancers of the breast, prostate, colon, liver, and kidney — combined.

• Sixty percent of new lung cancer cases are diagnosed in people who never smoked or quit smoking, including some who quit decades ago.

• The Centers for Disease Control 2005 budget includes $204 million for breast and cervical cancer research, $14 million for prostate cancer research, and $0 for lung cancer research.

For more information on the above statistics, please visit: http://www.lungcanceralliance.org, http://www.joanslegacy.org, and http://www.cdc.gov/cancer/lung/statistics.htm

Janet Rhodes is a freelance writer and editor whose husband quit smoking on July 11. Reach her at janet@bratcat.com.

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