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Make lung cancer screening routine


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Make lung cancer screening routine

By David R. Work


The American Lung Association has designated November as Lung Cancer Awareness month to focus attention on this deadly disease. My family has been acutely aware of this affliction since my wife was diagnosed with lung cancer at the Mayo Clinic in Jacksonville, Fla., six years ago. She died in August, comfortable and pain free, at the Meadowlands Inpatient Hospice facility in Hillsborough.

There is no cure for lung cancer.

The progress of the cancer may be interrupted occasionally, but the five-year survival rate is between 10 percent and 15 percent.

Readers can get a better perspective by looking at the numbers. The most recent annual statistics available show that 160,000 deaths were due to lung cancer, while breast cancer caused 41,000 deaths. The American Lung Association reports that, from 1992 to 2004, $1.6 billion was spent on breast cancer research while lung cancer research totaled $33 million during the same time period.

This reveals the bizarre situation where the disease which is the leading cause of cancer deaths annually has only 2 percent of the funding level for breast cancer research! Our priorities are obviously out of order on this subject.

Some people assume that lung cancer victims must have smoked tobacco and their disease is a consequence of their own actions. This stigma is not warranted as my wife never used tobacco. She is counted as part of a growing group, including many women, who never used tobacco yet still contracted lung cancer.

One major reason for the lethal nature of lung cancer is that it is often not discovered until the condition is well advanced and perhaps less responsive to treatment. Traditional and orthodox medical practice has not included regular testing or screening of patients for lung cancer without any signs or symptoms of the disease. Good news has surfaced lately on this topic with a report in the New England Journal of Medicine on research involving 31,000 patients in seven countries who received CT scans that detected 484 lung cancers, 412 of which were at an early stage.

Researchers at the University of North Carolina have also published an article in The Journal of Clinical Oncology that proposes genetic testing for propensities to develop lung tumors and potential treatment for the disease. While these procedures are still in the developmental stage, it is a good sign of important progress.

Both Duke and UNC would solidify their reputations as leaders in health care by starting routine screening for lung cancer. We use regular PAP tests to detect cervical cancer and sigmoidoscopy for early detection of colon polyps. Routine lung cancer screening would be a step forward in setting a new standard of practice as well as a public benefit.

Several years ago the tobacco companies entered into a settlement with state attorneys general that provided payments to states involving billions of dollars in return for a waiver of the right to further litigation by states against the companies. Many public health professionals assumed that part or all of this money would be used for health care, but that is not the case. There are some specific provisions in the agreement involving promotion and other activities, but much of the money can be used at the discretion of individual states.

We need to recenter our priorities on funding cancer research without delay. All of us who have be affected by this disease know that each day is a gift and know that some gifts are better than others and some days are better than others. This can be a good day by recognizing that lung cancer research funding belongs at the top of the list.

David R. Work retired in May after 30 years as the executive director of the North Carolina Pharmacy Board. He can be reached at dwork@nc.rr.com.

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