Winnipeg Free Press - PRINT EDITION

Non-smokers get lung cancer, too, but that's not an excuse

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My patients always give me the wrong answer when I ask them, "What cancer kills women more than any other malignancy?" Most say breast cancer, but lung cancer kills more women than breast and colon/rectal cancer combined. However, there's hope for both sexes.

Unfortunately, there's an interesting, recurrent, yet depressing reaction, particularly for non-smokers, who develop lung cancer.

When told someone has breast cancer, there's always a sympathetic ear, but when informed a person has lung cancer, sure as night follows day, the first quick response is: "Was he or she a smoker?" It's a remark that puts an unfair stigma on non-smokers.

It happened to the widow of Christopher Reeves (Superman). She developed lung cancer but never smoked. It was a tragic label for a wife who had dedicated so many years to helping her stricken husband.

This year, another 110,000 men and 90,000 women in North America will die of this disease. Of this number, 10 per cent of men and 20 per cent of women have never smoked.

One would think that if smokers looked at the carnage, they would do everything in their power to stop smoking. Breast cancer patients have an 85 per cent chance of being alive in five years. Those treated for lung cancer have an 85 per cent chance of being dead. Ten years after breast cancer treatment, patients are four times more likely to have survived.

Why non-smokers develop this malignancy is not known. A Swedish study found an increase in lung cancer in people exposed to residential radon gas, a breakdown product of uranium, but other studies have not been able to duplicate this result.

Other researchers link lung cancer to scarring that occurs with recurrent bouts of pneumonia, tuberculosis and other illnesses. Still more associate this malignancy with atmospheric exposure to a variety of products.

What about genetics? Iceland's remote location has resulted in a national genealogy database unique to that country. This has allowed researchers to trace connections between families since the settlement of the country, particularly in a study of 2,756 patients diagnosed with lung cancer between 1955 and 2002.

The study concluded lung cancer appears to run in certain families. The report from the Landspitali-University Hospital in Reykjavik says the risk also extends to relatives beyond the immediate family. So aunts, uncles, cousins, nieces and nephews still run a risk, but at lower levels than the immediate family.

The Icelandic study stressed that although genetics appears to play a role in developing lung cancer, tobacco smoke plays the dominant role.

There's precious little to say at the moment about improving the diagnosis and treatment of lung cancer. The mortality figures tell the story. In spite of high-tech CT scans and MRIs, smokers will continue to die unless they toss away tobacco. If the smoker accomplishes this, the news is all good. Within minutes of a final cigarette, the body begins a series of recuperative changes that go on and on. For instance, 20 minutes after the final puff, blood pressure falls, heart rate decreases and body temperature of hands and feet increases to normal.

After another eight hours, the blood level of carbon monoxide drops to normal and the oxygen level becomes normal. After 24 hours, the risk of coronary attack decreases, and after 48 hours, nerve endings start working again to improve smell and taste.

During the next three months, circulation improves, and as lung function increases up to 30 per cent, walking becomes easier. Former smokers notice within one to nine months there's less coughing, sinus congestion, fatigue, shortness of breath and more energy.

Just one year later, the risk of coronary attack has decreased an amazing 50 per cent. In 10 years, the chance of developing lung cancer is similar to that of a non-smoker.

These numbers are better odds than at Las Vegas. Surely, any sane person would toss cigarettes away.


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Republished from the Winnipeg Free Press print edition August 17, 2012 A21

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