Alarm bells rang loud and piercing in my head this past week, as I listened to someone comment about lung cancer being a smoker’s disease. “Lung cancer in never smokers is rare.” What really sent that proverbial fingernail on the chalkboard sensation traveling south from my head was that these words were spoken not by a neighbor, or even the next person in line at the grocery store checkout. They were spoken by an oncologist from a major cancer center. Though I regularly check my status to avoid false alarms, studies published this week in Clinical Cancer Research assured me that my wiring was intact.
If lung cancer in never smokers is separated out – it is still one of the most common causes of cancer mortality in the United States. Lung cancer in never smokers is the 6th leading cause of cancer-related deaths in our country.
It is important to take a careful look at lung cancer in never smokers, because the causes, and response to treatment is different. Exposure to radon is the most significant risk, followed by exposure to secondhand smoke, asbestos, and other environmental factors, possibly even HPV. The nature of cancer cells in never smokers is also different. Never smokers are more likely to have certain genetic mutations present in cancer cells, and subsequently respond better to some therapies that target these mutations.
Back to the alarm bells. The reasoning behind my concern is fairly simple. Lung cancer survival is better the earlier it is diagnosed. The early symptoms of lung cancer, even in smokers, are often mistaken for other conditions such as asthma or allergies. Unless we have our radar on red alert, and educate the public that lung cancer can happen to anyone, we are not going to find it when it is most curable.
We are currently entertaining the EARLY bill introduced by Debbie Wasserman Smith, a bill that recommends educating young women about breast cancer at a cost of $45 million. Let’s look at the stats. Many more women die from lung cancer than breast cancer each year, and 20% of these women have never even touched a cigarette. As we question the risk overdiagnosing and alarming women about breast cancer, shouldn’t we question the greater risk of underdiagnosing and minimizing the risk of lung cancer in never smokers?
Sources:
Rudin, C et al. Lung Cancer in Never Smokers: A Call to Action. Clinical Cancer Research. 2009. 15(18):5622-5.
Rudin, C. et al. Lung Cancer in Never Smokers: Molecular Profiles and Therapeutic Implications. Clinical Cancer Research. 2009. 15(18):5646-61.
Samet, J. et al. Lung Cancer in Never Smokers: Clinical Epidemiology and Environmental Risk Factors. Clinical Cancer Research. 2009. 15(18):5626-45.
