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Two different life stories, one common disease 

Lung cancer has forced Neal and Zisook into a kind of club that no one wants to be a member of. They have become unlikely friends, engaged in a campaign of awareness and compassion in their roles as representatives for the American Lung Association in greater Chicago for November, which is Lung Cancer Awareness Month.

Their messages have a common purpose, if originating from opposite circumstances. Neal wants people to realize that lung cancer is not just a smoker's disease. Zisook suggests parents hammer home the dangers of smoking by asking children to take five family members and five best friends and then decide which five will die.

"You have to put that right in people's faces, and that is horrible, but it is the truth," he said. "Sure, I always knew smoking is bad, but no one ever told me that 50 percent of people who smoke will die from it." . . .

"What we are finding is that because of that stigma, lung cancer is not financially supported in the same way as other cancers," said Harold Wimmer, chief executive officer for the American Lung Association of Illinois of Greater Chicago. "The fact is that lung cancer is the No. 1 cause of cancer-related deaths, but 40 percent of individuals who have lung cancer are nonsmokers."

The disparity in per-patient spending on research each year is striking: For lung cancer it's $1,826 per death, compared with $27,038 for breast cancer, according to 2009 statistics from the National Institutes of Health.

Another disparity: 160,000 people this year will die of lung cancer compared with 25,000 of breast cancer, Wimmer said. . . .

Neal and Zisook are doing their part to raise awareness. And although Neal said "smoking is disgusting" she does not think people should die for taking up a bad habit.

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• Smoking: why women are at great risk 

Recently, further scientific evidence has emerged to suggest that women may be at particular risk from smoking.

This year, a Norwegian study of almost 2000 women showed that women were at a higher risk of chronic obstructive pulmonary disease (COPD) at a younger age, and after smoking less heavily, than men.

COPD is an umbrella term that incorporates emphysema and chronic bronchitis. There are four stages of the condition, which are ranked in terms of their severity.

"We estimate that 2.1 million people in Australia have some form of COPD, and half of them don't know it," says Heather Allan, director of the COPD National Program at the Australian Lung Foundation. . . .

This isn't the first study that suggests that women may be more at risk from smoking than men. A 2005 Monash University found that women were more susceptible to exposure to smoke than men. Allan says researchers believe this could be because women have narrower and more sensitive airways than men.

A report by the British Lung Foundation in 2005 suggested it may be because women's lung capacity is smaller, and population studies have also suggested that there may be a genetic element involved.

This is why health campaigners are so concerned that more young women in their teens and 20s are starting and continuing to smoke than men. . . .

The reasons for women's increased risk of lung disease have not yet been fully researched. According to NHS Direct in the UK, a gene that speeds up the growth of lung tumours is known to be more active in women.

The female hormone oestrogen is also known to affect the development of such tumours. . . .

For the cost of a local call from anywhere in Australia, the Quitline provides advice and assistance to smokers who want to quit.

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• Cancer hits Tennesseans hard  

Tennesseans die of cancer at the fifth-worst rate in the nation.

What kills them most frequently is cigarettes, but a powerful mix of misinformation and denial also drives up the death count.

A Tennessean examination that included dozens of interviews with doctors, cancer experts and patients across the state found health professionals frequently encounter people who have ignored symptoms for months or even years before going to a doctor. A lack of urgency or confusion about routine cancer screenings, coupled with misconceptions about treatment and even a fatalistic acceptance of the disease, leads to cancers being diagnosed too late to be treated successfully.

"There's a personal value system, a thought process that says, 'It can't be me,' and an incredibly complicated health system," said Mary Jane Dewey, director of the state Health Department's sole free cancer screening program. "Even people with insurance can't understand their policies."

Lung, breast, prostate and colorectal cancers are the most commonly diagnosed in the state. In the 2001-05 reporting period, more Tennesseans died from lung cancer — 20,629 victims — than from the other three combined. . . .

But money can be an issue. The Tennessee legislature put $10 million into smoking prevention and cessation programs for the first time for the 2007-08 fiscal year, but then halved that the following year. This year, the state's tobacco control program is running on a $1.5 million budget, all but $300,000 of that from a Centers for Disease Control grant.

The money pays for the state's 1-800-QUIT-NOW line, which matches smokers with counselors to help them quit, and literature.

But anti-smoking advocates look most longingly at the state's $4.8 billion settlement with tobacco companies, which it began receiving in annual payments in 1999. The legislature voted to put the money into the general fund; none into anti-smoking programs. Tennessee has collected $1.9 billion to date.

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Lung cancer leading cause of cancer death in women 

Blount Memorial Cancer Center Director Carmen McCloud says the Cancer Center had 86 female patients who suffered from lung cancer in the last two years. She said smoking caused 90 percent of those lung cancer cases. Thursday is Great American Smokeout Day, which is a good time to think about giving up tobacco products, she says.

"The Great American Smokeout is a day to stop smoking and change your life. On Thursday, free information on how to quit smoking will be available in the hospital's outpatient lobby between 7 a.m. and 3 p.m.," McCloud adds.

According to the American Cancer Society (ACS), within 20 minutes of quitting smoking, blood pressure drops to normal, pulse slows to normal and the temperature of your hands and feet increases to normal.

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• New lung cancer wonder drug offers cure hope for deadliest form of disease  

A new lung cancer drug that can cure the deadliest form of the disease is being developed by scientists.

The treatment, which appears to have no side affects, killed all traces of the 'small cell' version of the cancer in more than 50 per cent of the British trials on laboratory mice. It also blocked the cells' ability to resist standard chemotherapy treatment.

A fifth of lung cancer patients have the 'small cell' form, in which the tumours spread so quickly they can rarely be removed. Only 3 per cent of sufferers can expect to survive five years after diagnosis.

Professor Michael Seckl, head of Molecular Oncology and Lung Cancer Research at Imperial College, which led the research, said he hoped to start clinical trials with human patients as early as next year.

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Puff ban hole in cancer fight 

The ban on public smoking is likely to have only a limited impact in the country on tobacco-related cancers which are primarily driven by tobacco chewing, a senior oncologist has said.

Although smoking can cause cancers of the lung, larynx and oesophagus, cancer registry figures suggest oral cancer, which is associated with tobacco chewing, accounts for the majority of tobacco-related cancers in the country, said Pankaj Chaturvedi, a surgeon at Mumbai's Tata Memorial Hospital.

"About 60 to 70 per cent of India's estimated 250-million tobacco users chew tobacco," Chaturvedi said at a conference organised by the health ministry to devise strategies to address the problem of smokeless tobacco. "The ban on smoking deals with only about one-third of tobacco users."

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Lung Cancer Alliance Staff and Advocates to Ring Closing Bell of New York Stock Exchange(TM)  

Lung Cancer Alliance (LCA) announced that LCA staff, advocates and friends will ring The Closing Bell for the New York Stock Exchange(TM) (NYSE) tomorrow afternoon at 4 pm ET.

Five and a half year lung cancer survivor and LCA-NY advocate, Richard Heimler will mark the end of the day's trading by ringing The Closing Bell.

He will be joined by LCA Staffers Sheila Ross and Miguel Velez and lung cancer survivors, advocates and LCA supporters in the televised ceremony.

"As a lung cancer survivor and on behalf of Lung Cancer Alliance and all those impacted by the disease, we are grateful to the New York Stock Exchange(TM) for this opportunity to get our message out during November, Lung Cancer Awareness Month," said Heimler.

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• Debate continues over diagnostic scans for lung cancer  

For the 42 percent of Americans who smoke cigarettes or once did, a ruling from the state's highest court last month seemed to offer hope that a simple screening tool could help them ward off advanced lung cancer.

The judges decided that Philip Morris USA may have to pay for lung scans for smokers so they can get early warning if they've developed cancer - and get treatment before it spreads into a deadly mass. (A federal court would have to affirm the state's decision before the company would have to pay.)

Even before the court weighed in, advocates had been pressing politicians for money to pay for CT scans for high-risk but asymptomatic people - insurers generally don't cover the test for screening - particularly since a group of New York researchers published results in 2006 suggesting that screening is saving the lives of smokers, former smokers, and people exposed to secondhand smoke and other hazards, such as asbestos. Some smokers are so convinced of the benefits of CTs they pay the $400 screening fee themselves.

"Our movement is really taking hold,'' said Joanne O'Connor, cochair of the Lung Cancer Alliance in Massachusetts, which is lobbying legislators for funding. "I wouldn't want to find out [I had lung cancer] like my sister did when she was already stage four. She died six months later.''

But even as pressure for CT scanning builds, many of the country's top cancer specialists are saying not so fast. . . .

The Massachusetts Supreme Court relied in part on Miller's expert testimony during the lawsuit brought against Philip Morris by two Massachusetts smokers. Since the 2006 study was published, however, the New England Journal has published three corrections, including one from Henschke revealing that some of the funding for the study came from cigarette-maker Liggett Tobacco.

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Gauging the Risks From a Smoker’s DNA and History 

To take Synergenz's Respiragene test, consumers swab the inside of a cheek to get DNA and send the sample to a laboratory in Kentucky. The Synergenz Web site says a physician is required to sign a form requesting the test. The Respiragene test looks at 20 spots in a person's genome where DNA varies among people. It uses that data, as well as nongenetic information like the person's smoking history, to compute a risk score.

About 50 percent of smokers will end up in the group that is deemed to have the average risk of lung cancer for smokers, said Dr. Robert Young, Synergenz's chief scientific officer.

Thirty percent will be in the high-risk group, with about four times the average risk for smokers. And 20 percent would be in the very-high-risk group -- those with about 10 times the risk of an average smoker.

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Chinese University of Hong Kong details research in lung cancer 

According to recent research from Hong Kong, People's Republic of China, "Chinese women in Hong Kong have among the highest incidence and mortality of lung cancer in the world, in spite of a low prevalence of smoking. We carried out this population-based case-control study to evaluate the associations of previous lung disease and family cancer history with the occurrence of lung cancer among them."

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• A review of human carcinogens—Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish 

New evidence continues to add to the extensive list of tobacco-related cancers (table); there is now sufficient evidence that tobacco smoking causes cancer of the colon3 and of the ovary.4 More than 150 epidemiological studies of tobacco smoking and breast cancer were reviewed. Large cohort studies5, 6 published since 20022 consistently show a small positive association (relative risks 1·1—1·3). Many chemicals in tobacco smoke cause mammary-gland tumours in animals, and these carcinogens are stored in breast adipose tissue in women; therefore, the Working Group concluded that there is limited evidence that tobacco smoking causes breast cancer. A causal link between parental smoking and childhood cancers has been established. Four recent studies showed that children born of parents who smoke (father, mother, or both, including the preconception period and pregnancy) are at significantly higher risk of hepatoblastoma, a rare embryonic cancer. The UK Childhood Cancer Study7 reported a relative risk of 1·86 for paternal smoking only and 2·02 for maternal smoking only, increasing to 4·74 (95% CI 1·68—13·35) when both parents smoke. For childhood leukaemia, a meta-analysis reported an association with paternal smoking before pregnancy (summary relative risk 1·12, 1·04—1·21).8 Second-hand smoke causes lung cancer.2 There is now limited evidence for an association with cancers of the larynx and the pharynx,9 whereas evidence for female breast cancer remains inconclusive. Since second-hand smoke contains most of the constituents of mainstream smoke, it might also be associated with other cancer sites. Many types of smokeless tobacco are marketed and all contain nicotine and nitrosamines. Hundreds of millions of people use smokeless tobacco, mainly in India and southeast Asia, but also in Sweden and the USA. Earlier findings showed a causal association between use of smokeless tobacco and cancers of the oral cavity and pancreas, and there is now sufficient evidence for cancer of the oesophagus.10 All of the forms of tobacco discussed above induce malignant tumours in laboratory animals.

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VIDEO: DR. LUNG LOVE // Starring in PUBLIC SERVICE ANNOUNCEMENT 

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Lung Cancer Awareness Month is November each year 

Lung Cancer Awareness Month (LCAM) is a national campaign dedicated to increasing attention to lung cancer issues. By organizing rallies, distributing educational material, holding fund-raising events, contacting Congress, and speaking to the media, those involved in LCAM bring much-needed support and attention to a disease that each year kills more people than breast, prostate, colon and pancreas cancers combined.

Here's how you can participate!

Raise Awareness You can raise awareness about lung cancer where you live in many ways during November:

* Sponsor an event to bring your community together around lung cancer.

* Gain official attention for lung cancer with petitions, proclamations, and more!

* Distribute LCA's Public Service Announcement to local media

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• November Is Lung Cancer Awareness Month 

More people die from lung cancer than any other type of cancer. In 2004,* lung cancer accounted for more deaths than breast, prostate, and colon cancer combined. The most important thing you can do to prevent lung cancer is to not start smoking or to quit if you currently smoke.

In 2004,*

* 108,355 men and 87,897 women were diagnosed with lung cancer.†

* 89,575 men and 68,431 women died from lung cancer.†

Smoking and Secondhand Smoke

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Delays in Lung Cancer Care More Common in Public Hospitals  

The length of time a patient has to wait between lung cancer diagnosis and treatment is influenced by a number of health-care system factors, a new U.S. study finds.

Researchers at the University of Texas Southwestern Medical Center analyzed data on 482 patients diagnosed with non-small cell lung cancer.

They found that factors such as type of hospital (private or public), insurance coverage, age and race have a major impact on the time it takes for a patient diagnosed with lung cancer to receive treatment.

For example, 59 percent of patients treated at a public hospital had advanced (stage 3) lung cancer, compared with 37 percent of patients treated at a private hospital. The researchers also found significant differences in patient populations at public and private hospitals in terms of age, race and socioeconomic status. . . .

The study appears in the November issue of the Journal of Thoracic Oncology.

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