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Home News and Update Year 2010 Blame's Net Catches Non-smoking Lung Cancer Patients

Blame's Net Catches Non-smoking Lung Cancer Patients

Indian Express
17 July 2010
By Jane E Brody

Blame's Net Catches Non-smoking Lung Cancer Patients
WHEN it comes to advocacy and research funds, the leading killer cancer – lung cancer – gets short shrift.

People with the disease are assumed to have brought it upon themselves by smoking. And the 10 to 15 per cent of patients who never smoked are typically tarred with the same brush. One–tenth of men and one–fifth of women with lung cancer have never been smokers, and in some parts of the US, Northern California, for example, as many as 35 per cent of women with lung cancer never smoked or lived with smokers.

There are two things wrong here, according to clinicians who treat this killer of nearly 160,000 people a year – more than deaths from cancers of the breast, prostate and colon combined. One is the element of blame.

"Lung cancer is underfunded and a major reason is the idea that it is all related to smoking and it’s the smoker’s fault," said Dr Michael Thun, an epidemiologist at the American Cancer Society. Most smokers who develop lung cancer were hooked on nicotine long before smoking was linked to cancer.

For non–smokers who get lung cancer – about two–thirds of them women – Dr Joan Schiller, an oncologist at the University of Texas Southwestern Medical Center in Dallas said they are "a disenfranchised group that did nothing wrong, yet women with breast cancer get all the support and empathy."

"A sizable number of non–smokers get lung cancer, more than those who get leukemia or AIDS," she said.
"If lung cancer unrelated to smoking was listed as a separate disease, it would be the sixth most common cause of cancer deaths." Smoking–related lung cancer typically strikes older people (the average age at diagnosis is 71), but it often afflicts non–smokers much earlier, in the 30s and 40s or even younger.

And because doctors rarely suspect lung cancer when people who never smoked develop respiratory symptoms, the disease is typically diag nosed too late for any hope of a cure.

Many non–smokers are treated for months for conditions like pneumonia, bronchitis or asthma before the real problem is uncovered.

Among factors that account for the lung cancer in non–smokers, the best known is passive smoking. Nonsmokers married to smokers increase their risk of lung cancer by 20 per cent, Thun said.

An estimated 21,000 cases each year result from exposure to radon, a radioactive gas in dirt and rocks that can seep into the air inside homes, offices and schools. Radon is second to smoking as a known cause.

Asbestos exposure is another potential risk. Non–smoking asbestos workers face a fivefold risk of developing lung cancer compared with other non–smokers.

Air pollution is a relatively minor threat, resulting in perhaps 2,000 lung cancer deaths a year in nonsmokers. The hormone estrogen is believed to account, at least in part, for the number of women who develop lung cancer unrelated to smoking, and for the fact that women nonsmokers get the disease at a younger age than men.

Then there is the possibility of an inherent genetic susceptibility. Dr Ping Yang of the Mayo Clinic in Rochester, Minnesota, has found that significantly reduced activity of a gene called GPC5 is associated with lung cancer in people who never smoked. This gene, which regulate growth factors, is the first to be specifically linked to lung cancer in non–smokers. The New York Times

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