Lung Cancer: It’s not just for smokers

By Meryl L. Bralower and Pasi A. Jänne

JUST BECAUSE you never smoked, don’t think you won’t get lung cancer.

Lung cancer is the leading cancer killer of both men and women in the United States, accounting for 30 percent of all cancer deaths. It takes more lives than breast, prostate, colon, liver, melanoma and kidney cancer combined.

Its link to smoking has made lung cancer an underdiagnosed and underfunded disease. With 15 percent of these 173,000 annual deaths attributed to nonsmokers, it is time for that to change.

The untimely death of Dana Reeve has brought attention to the fact that there is an increase of lung cancer in nonsmokers, especially in women. Eighty percent of all nonsmoking lung cancer patients are women.

Up until then there was an inextricable link between lung cancer and smoking in the minds of the public and for many doctors as well. There was an assumption that if you never smoked or smoked a minimal amount, you would be immune from lung cancer. This connection linking smoking and lung cancer created a stigma around the disease. The perception that patients with lung cancer brought it on themselves affects the degree of empathy they receive compared to other cancers. And most important, it affects both its early detection and its funding for research.

Today lung cancer needs to be on the radar screen for everyone, not just people who smoke. Doctors, especially primary care physicians, need to be more suspicious when nonsmokers exhibit symptoms that can include a persistent cough, shortness of breath, repeated attacks of pneumonia or bronchitis, wheezing or hoarseness, and an increased amount of sputum or sputum streaked with blood.

Often the disease goes undetected because of the lack of symptoms until the disease is in its later stages. Other types of cancer that have diagnostic testing have greatly improved survival rates. Compare lung cancer with its survival rate of 15 percent for five years, to breast cancer at 89 percent, prostate cancer at 99 percent, and colon cancer at 64 percent.

The research dollars don’t reflect the prevalence of lung cancer, which kills twice as many women as breast cancer. In 2004, the American Cancer Society spent an estimated $130 million on research, with $29 million tabbed for breast cancer and only $12 million for lung cancer. In 2003, the federal government spent $14,045 per breast cancer death and $10,761 per prostate cancer death on research. In contrast, for each lung cancer death, only $1,632 went toward research.

There needs to be more funding devoted to lung cancer, its epidemiology, its prevention, and hopefully its cure. We need to know what factors in addition to smoking cause lung cancer so we can do more in terms of prevention.

Reprinted with permission from Meryl L. Bralower