Dana Reeve's announcement and Peter Jennings' death are casting
a spotlight on a dirty secret about lung cancer: You don't have
to be a smoker to get it.
This year, deaths from lung cancer will exceed the number of deaths
from almost every other cancer combined, and even people who gave
up smoking decades ago, and people who have never smoked at all,
will be among its victims.
Most people think of lung cancer as a male disease. Unfortunately,
American women are catching up. I was surprised when I learned
that I was one of them.
In November 2003, I broke my arm at my health club and was diagnosed
with incurable (Stage IV) lung cancer that had metastasized to
my shoulder and arm - a big shock for someone who stopped smoking
38 years ago, exercises an hour a day, and has worked in public
health for the last 25 years.
At the time of my diagnosis, I was under the care of four highly
regarded physicians. My symptoms were hoarseness, complete exhaustion
and severe pain in my arm - the result, I thought, of a sports
injury. Two of my physicians had experienced recent sports injuries
and were sympathetic.
Since my diagnosis, I have read extensively about lung cancer
and am fully aware of the challenges in diagnosing this disease.
One reason for this is that lung cancer is often difficult to
detect in its early stages, since there is no simple test, such
as the PSA test for prostate cancer or mammograms for breast cancer.
However, among the warning signs of lung cancer are the very symptoms
I presented to my doctors. (Other symptoms include chronic cough,
shortness of breath, unexplained weight loss, and pain in the
chest, shoulder or arm). None of my physicians suggested a chest
X-ray, even though I reported on all medical forms that my father
had died of lung cancer. I had smoked, as had many Americans in
the early 1960s, before the surgeon general's landmark report
on Smoking and Health in 1964. Since I had quit smoking decades
ago, lung cancer wasn't even on my radar screen in 2003.
Lung cancer is not on most women's radar screens, but it should
be. Among U.S. women, lung cancer surpassed breast cancer as the
leading cause of cancer death in 1987 and now accounts for 25
percent of cancer deaths among women (just 50 years ago, it accounted
for only 3 percent).
Although public-health advocates have focused most lung-cancer
prevention efforts on smoking cessation, the risk of lung cancer
is still higher for former smokers for at least 20 years after
they stop smoking. Several studies suggest that women who are
former smokers or exposed to secondhand smoke may be more likely
to get lung cancer due to their diminished ability to repair damage
in their lungs caused by carcinogens, and the role of estrogen
in their lives.
Cancer now surpasses heart disease as the nation's leading killer.
And lung cancer is the leading cancer killer. The time from apparent
health to diagnosis to death can be devastatingly short, as we
learned this week. And, as we also learned, it's not just smokers,
and not just men, who are at risk.
What can we do with these hard-learned lessons? Smokers, former
smokers, and others at risk of lung cancer should ask their physicians
about screening options, so that they can be diagnosed earlier
than Peter Jennings - and me.
But to make a real difference, our country's health agencies need
to devote more resources to improve the early detection of lung
cancer. There are millions of lives at stake - including the 1
out of 7 Americans who have quit smoking but are still at risk.
Rosalind Brannigan recently resigned as vice president of Drug
Strategies, a nonprofit research institute. She wrote this piece
for the National Research Center for Women & Families (www.center4research.org).
Ms. Brannigan passed away on August 19, 2005. 