Lung cancer stories give us a glimpse into the life of lung cancer survivors. Anthony's lung cancer story raises the question. What caused my lung cancer?
My friend Anthony used to smoke. That was long before I met him during his wild college days. A decade and a half later, with support from his patient but persistent wife, he kicked the habit. A marathoner and health food nut for the next two decades, he thought his persistent cough must be some form of allergy. After six months of “doctoring,” he was diagnosed with lung cancer, stage 2b non-small cell adenocarcinoma. He was 48.
Anthony called me in distress. Unlike people he knew with other forms of cancer, it seemed everyone he spoke with assumed he had brought the cancer on himself by smoking. He wanted to know - did smoking cause his cancer?
My answer was – “I don’t know” – but Anthony’s story is typical of many diagnosed with cancer. There is not one clear cause. Cancer is often a “multifactorial disease,” meaning that many factors work together to create the changes that result in cancer.
In Anthony’s case, smoking certainly may have contributed, but his smoking history of 15 pack-years (number of years smoking multiplied by packs per day) is less than most diagnosed with lung cancer this young. He had also been a non-smoker for over 10 years. 10 years after quitting smoking the risk of dying from lung cancer is 30-50% less than someone who continues to smoke. And, for those who quit smoking before the age of 50, by age 54 their risk of dying overall is the same as if they had never smoked. Anthony had never tested his homes for radon, and radon is the leading cause of lung cancer in non-smokers. He did have the home that he had lived in for 3 years at the time of his diagnosis tested and it was normal, but he does live in a state where 1 in 3 homes have elevated levels. He had done wood restoration work using products containing carcinogens without a proper mask. On the other hand, he was an avid exerciser, something that appears to lower risk.
We will never know what combination of exposures in his life was the culprit. What we can learn from Anthony is to be aware of risk factors, and minimize those we can control. Anthony quit smoking and will have any home he buys in the future tested for radon. His experience also emphasizes that we need to be sensitive to those with lung cancer and not dwell on smoking as we talk with them. People with lung cancer, no matter how much they smoked, need our support, not our judgment.
Epilogue: Anthony is doing well 5 years out from his diagnosis of lung cancer. He is now pushing to have every home in the United States tested for radon.
Story written with permission from “Anthony,” whose name I changed though he wishes his story be shared widely.References:
National Cancer Institute. Cancer Risk: Understanding the Puzzle.