Just because you never smoked, don't think you won't get lung cancer.

<http://www.boston.com/news/globe/editorial_opinion/oped/articles/2006/05/07/lung_cancer_its_not_just_for_smokers/>

MERYL L. BRALOWER AND PASI A. JÄNNE
Lung cancer: It's not just for smokers

By Meryl L. Bralower and Pasi A. Jänne | May 7, 2006

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, ovarian, prostate, and colon cancer combined. Its
link to smoking has made lung cancer an underdiagnosed and underfunded
disease. With 15 percent of these 160,000 annual deaths attributed to
nonsmokers, it is time for that to change.

The recent 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 now there has been 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.

Unlike other common cancers, there is no diagnostic screening for lung
cancer. 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 87 percent, prostate cancer at 98 percent, and colon cancer at
62 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.

There is promising new research into targeted therapies for lung cancer.
By identifying each cancer's unique gene pattern, the most effective
therapies can be chosen for patients. Compelling examples include
gefitinib and erlotinib, drugs targeted at specific growth-factor proteins
found in many lung cancers. In a subset of lung cancer patients, more
commonly in non-smokers, these drugs are particularly effective due to
unique genetic alterations present in these tumors. By continuing to study
genetic alterations in lung cancers, more effective therapies may be on
the horizon for the vast majority of patients.

It is time to shine a spotlight on lung cancer. We have done that
successfully with other prevalent cancers, and that has resulted in
greater public awareness, earlier detection, increased research, and, most
important, saved lives. First we have to educate the general population as
well as the medical community so that there will be earlier detection. We
need better diagnostic tools that will help with this process, and we need
to find more effective treatments that increase survival rates.

Every three minutes someone is diagnosed with lung cancer. Men have a
lifetime risk of 1 in 13, and women 1 in 17. We have to treat lung cancer
as a disease that could happen to any of us, because it can, even if we
never smoked.

Meryl L. Bralower, a consultant to new ventures with a social orientation,
is a nonsmoker and a survivor of lung cancer. Dr. Pasi A. Jänne is a
physician-scientist at the Lowe Center for Thoracic Oncology at
Dana-Farber Cancer Institute and an assistant professor of medicine at
Harvard Medical School.
© Copyright 2006 Globe Newspaper Company.


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