lung cancer and women - from Zuckerman

[Guest guest]

Note: forwarded message attached.

A few months ago, I met Ros Brannigan, a lung cancer patient who inspired us to examine what can be done to improve screening and treatment for lung cancer. Ros spent her career working to improve policies on HIV/AIDS and drug abuse, but since being diagnosed, she was doing everything she can to warn other women (and men) about the importance of being tested for lung cancer. This message is especially important for women who had breast implants, since implants seems to increase the risk of lung cancer. I was able to help Ros get her op-ed disseminated by the Knight Ridder newswire, and was thrilled to see that her op-ed was published in the Philadelphia Inquirer on Aug 12, and the Miami Herald, Houston Chronicle, and numerous other newspapers in Hawaii, NJ, Florida, and elsewhere in the following days. She died a few days later, making her message even more powerful.

Best wishes,

Zuckerman

Philadelphia Inquirer, Fri, Aug. 12, 2005

Up in smoke

By Ros Brannigan

Dana Reeve's announcement and 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 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.

lind 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).