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Lung cancer patients fight stigma
By Maggie Fox, Health and Science Editor Fri May 30, 12:08 PM ET


WASHINGTON (Reuters) - "I'm sorry. You don't have breast cancer," the oncologist told Charmaine Atkenson.


The 48-year-old mother of two had something far worse -- stage 4 lung cancer. It had spread to her spine, bursting the bone open. It was not only a sentence of death; it was a judgment.

Even though Atkenson never smoked, she felt almost ashamed. "I found that I never would even say what kind of cancer I had. Or I would always start by saying I never smoked and I never lived with a smoker," she said in a telephone interview.

Lung cancer patients, advocates and specialists are meeting this week in Chicago, alongside the annual American Society of Clinical Oncology meeting, to try to dispel some of that shame.

Atkenson is there, taking part in an "advocacy summit" -- the group's first attempt to organize a movement akin to the powerful groups that have lobbied successfully to get more funding for breast and prostate cancer research.

Dr. Joan Schiller of the University of Texas Southwestern Medical Center and the National Lung Cancer Partnership said lung cancer carries a stigma that no other cancer does.

"They feel ashamed of their cancer. They feel guilty about their cancer," said Schiller, who published a study last year in the Journal of Thoracic Oncology showing primary care doctors were less likely to send lung cancer patients to a cancer specialist than patients with other types of cancer.

This means doctors, researchers and even patients are not pressing as hard for better therapies as they do for other cancers.

DEADLIEST CANCER

Lung cancer kills 1.3 million globally a year, according to the World Health Organization, and the American Cancer Society says lung cancer was diagnosed in 213,380 people in the United States in 2007, killing 160,390, making it by far the deadliest U.S. cancer.

Yet Schiller says less money is spent on lung cancer research than on other cancers. In 2006, the National Cancer Institute estimated it spent $1,638 per lung cancer death, compared to $13,519 per breast cancer death and $11,298 per prostate cancer death.

Atkenson's oncologist assumed the large tumor in her spine was caused by undiagnosed breast cancer that had spread.

"He said, 'But don't worry. We know so much about breast cancer -- we can really promise you a full life expectancy'," Atkenson said. After the test results came back, the message was far different.

"He said, 'You have lung cancer, metastatic lung cancer and you have four to six months to live."

He was wrong. Atkenson, of Hinsdale, Illinois, is still alive and well nearly two years later. Newer treatments offer better hope to lung cancer patients -- including several in studies to be presented to the ASCO meeting.

But she finds herself explaining almost guiltily that her cancer is a mystery because she never smoked. "I even had an oncology nurse say to me, 'How did you get lung cancer' and I said probably because I had lungs. She never would have asked that if I had any other kind of cancer," Atkenson said.

DESERVING IT

Not only does the stigma affect funding and perhaps even doctor's attitudes -- it may prevent patients from pursuing lifesaving treatments, Atkenson and Schiller both believe.

"I think a lot of them, when they get handed the diagnosis, they feel as if they did cause it to themselves," Atkenson said.

"Smokers feel they somehow deserve it."

Two-thirds of all cancer cases can be traced to lifestyle, including obesity and poor diet.

But no one blames breast cancer patients for their disease. "If I had had cervical cancer, nobody would have asked me 'how many sexual partners did you have?"' Atkenson added. Cervical cancer is caused by a wart virus that is transmitted sexually.

Even if she had been a smoker, Atkenson said, "Nobody deserves lung cancer. Nobody deserves any kind of cancer."

(Editing by Michael Kahn, editing by Jackie Frank)

The Lung Cancer Alliance,another patient advocacy group, used to have a web site that said that 50% of lung cancers were in x-smokers, 20% in never smokers, and only 30% in current smokers.

This seems to have not gone too well with the big boys,ACS and ALA,who say that about 90% are in smokers. That web site is no longer in operation.

The big guys never say if x-smokers are included in their smoker group.

Probably because, by their own guidelines, any x-smoker that quit more than 15 years ago would have about the same risk for LC as a never smoker.
http://www.cancer.org/docroot/PED/content/PED_10_2X_Cigarette_Smoking.asp

The risk of lung cancer is less in people who quit smoking than in people who continue to smoke the same number of cigarettes every day, and the risk decreases as the number of years since quitting increases.
http://www.cancer.org/docroot/PED/content/PED_10_13X_Gu...Quitting_Smoking.asp

Why Quit?

Quitting smoking decreases the risk of lung cancer, other cancers, heart attack, stroke, and chronic lung disease.

10 years after quitting: The lung cancer death rate is about half that of a continuing smoker's

http://stopsmoking.uchicago.edu/benefits.html

Chicago STOP Smoking Research Project

Benefits of Quitting Smoking
Health benefits from quitting smoking:

lung cancer death rate decreases by half in 5 years, and is similar to that of nonsmokers after 10 years
http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=33568

Long-term Benefits of Quitting
At 5 years:
from 5 to 15 years after quitting, stroke risk is reduced to that of people who have never smoked.

At 10 years:
risk of lung cancer drops to as little as one-half that of continuing smokers
At 15 years:
risk of coronary heart disease is now similar to that of people who have never smoked

risk of death returns to nearly the level of people who have never smoked(note: this statement would include LC death!-Gary K.)

According to the CDC the smoking rate in 1965 was about 50%.

By 1990 the smoking rate had dropped to 23%.

http://apps.nccd.cdc.gov/brfss/Trends/trendchart.asp?qkey=10000&state=US

By 2006 the smoking rate was 20.1%.

[URL=ttp://www.statehealthfacts.org/comparemaptable.jsp?ind=80&cat=2[/URL]

We see that the great majority of x-smokers had quit more than 15 years ago and would have the same LC risk as never smokers.

The ACS's and ALA's 90% figures MIGHT be SOMEWHAT misleading,if not a complete lie.

The difference in research money is criminal.

quote:

the American Cancer Society says lung cancer was diagnosed in 213,380 people in the United States in 2007, killing 160,390,

Holy Hell, when did lung cancer top 200,000 a year? Scratch that. I just looked in my computer and see that I have that figure from the NCI (not ACS) back in December.

Btw, what doctor would tell a patient that breast cancer that had spread to the spine was an easy fix? It's no longer just breast cancer if it spreads.

Have a link for the LCA tbat works,so here is a revision of my original post.
Gary K.

http://www.lungcanceralliance.org/washingtonbriefs_2007_fact_sheet.htm

In fact, non-smokers now account for nearly 20 percent of all new lung cancer cases and over 50% of new lung cancer patients are former smokers, many of whom quit decades ago, says the Alliance for Lung Cancer (Alcase), a Vancouver, Wash.-based non-profit group.

http://stopsmoking.uchicago.edu/benefits.html
Chicago STOP Smoking Research Project

Benefits of Quitting Smoking
Health benefits from quitting smoking:

lung cancer death rate decreases by half in 5 years, and is similar to that of nonsmokers after 10 years


The American Lung Association
http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=33568

Long-term Benefits of Quitting
At 10 years:
risk of lung cancer drops to as little as one-half that of continuing smokers
At 15 years:
risk of death returns to nearly the level of people who have never smoked(note: this statement would include Lung Cancer death!-Gary K.)

http://apps.nccd.cdc.gov/brfss/Trends/trendchart_c.asp?...key=10000&SUBMIT1=Go

http://www.statehealthfacts.org/comparemaptable.jsp?ind=80&cat=2

According to the CDC,there has actually been very little decrease in the percentage of the population that smokes since about 1990.
1965 = 46% smoked
1990 = 23% smoked
2006 = 20.1% smoked

About 90% of ex-smokers had quit by 1990.

Thus, almost all ex-smokers would have the same risk for lung cancer as never smokers.

Since smokers make up 27% of the adult population, this means that 27% of the population account for 30% of the lung cancers.

This is about the same ratio as never/ex-smokers and lung cancer(73% of population account for 70%of the lung cancers).

Smokers have very little added risk of lung cancer!!

http://www.statehealthfacts.org/comparemaptable.jsp?ind=80&cat=2
Adult Smoking Rate(cigarettes)
United States 20.1%


ACS Cancer Report 2008:
In 2005, 6% of adults aged 18 and older had smoked cigars in the past month.

I understand that pipe smokers are only 1% of the adult population.

20% + 6% + 1% =27% of the adult population are smokers.


The medical establishment has helped turn smokers into second class citizens and it has pushed quit-smoking drugs that harm and kill.

The medical establishment,with the motto "First of all,DO NO HARM", should be deeply ashamed.

Anti smokers should be...well, you decide for yourself what should be done with THEM!!

About 90% of ex-smokers had quit by 1990.

Thus, almost all ex-smokers would have the same risk for lung cancer as never smokers.

Since smokers make up 27% of the adult population, this means that
27% of the population account for 30% of the lung cancers
....................................

There are about as many x-smokers as smokers.

There are about 50 million smokers and thus about 50 million x-smokers. 10% of the x-smokers have a risk of lung cancer somewhat approaching smokers = 5 million.

There are about 225 million adults in the USA, 5 million is 2.2% of them.

Thus, you would have 27% of the adult population as smokers and 2.2% of the population as somewhat recent x-smokers, total 29.2% of the adult population getting 30% of the lung cancers.

This is rather close to the same ratio as the rest of the adult population.

Conclusion: I respectfully submit that smokers have no greater risk of getting lung cancer than non-smokers.

Gary K.

quote:

Originally posted by gkayser30:
Conclusion: I respectfully submit that smokers have no greater risk of getting lung cancer than non-smokers.

Gary K.

Are you only talking about current smokers? Current and former smokers together = 45% of the adult population yet have 80% of the lung cancers.

One thing is former smokers are more likely older than current smokers. I think only 10% of older people (60+) smoke while something like 30% of 25 year olds smoke. Naturally, the older you are the more likely you are to get (lung) cancer.

So I'm not sure you can really say smokers are at no greater risk because eventually they'll be old.

quote:

Current and former smokers together = 45% of the adult population yet have 80% of the lung cancers.

.............
True;but,about 90% of ex-smokers had quit by 1990.
http://apps.nccd.cdc.gov/brfss/Trends/trendchart_c.asp?...key=10000&SUBMIT1=Go

adult smoking rate 1965 = 46%
adult smoking rate 1990 = 23%
adult smoking rate 2002 = 23%
adult smoking rate 2006 = 20.1%

Total decline in rate is 26%,with 23%(90%) by 1990, only about 3%(10%)decline since 2002.

Thus,according to the ALA, almost all ex-smokers(90%),would have the same risk for lung cancer death as never smokers.
The American Lung Association
http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=33568

Long-term Benefits of Quitting
At 10 years:
risk of lung cancer drops to as little as one-half that of continuing smokers
At 15 years:
risk of death returns to nearly the level of people who have never smoked(note: this statement would include Lung Cancer death!-Gary K.)

While it is true that only 10% of the population over 65 are smokers and this is where about half of lung cancer deaths occur,
-
http://apps.nccd.cdc.gov/brfss/age.asp?yr=2006&state=US&qkey=4394&grp=0

-about 43% of this age group are x-smokers that had quit decades ago and their deaths would have to be included with the never smokers, not with the smokers.

Plus, to say that any smoker's/x-smoker's lung cancer was CAUSED by smoking is simplistic.

There are 30 different THINGS that can cause lung cancer, this means that there are 2.147 billion combinations of THINGS that could be the cause of any one lung cancer.

This would be especially true for seniors that had been exposed to those THINGS for a long time.

Plus, one can not be certain that a death was caused by lung cancer!!

http://www.forces.org/writers/hatton/files/lies.htm

A joint report by the Royal Colleges of Pathologists Surgeons and Physicians ("The Autopsy and Audit", 1991), says: "In autopsies (post-mortems) performed on patients thought to have died of malignant disease (cancer) there was only 75% agreement that malignancy was the cause of the death and in only 56% was the primary site identified correctly." (So if you are told you have cancer there is a one in four chance that you haven't, and even if you have there is almost a fifty-fifty chance that you're being treated for one in the wrong place).

The report ended: "Such high levels of discordance mean that mortality statistics which are not supported by autopsy examinations must be viewed with caution."

The risk of misdiagnosis is heightened by the fact that it has been found that there are 38% of un-detected lung cancers in non-smokers, 20% in moderate smokers, and only 10% in heavy smokers.

The autopsy rate in the USA is about 5% or less and then mostly for violent deaths.

I feel comfortable with:
29.2% of the adult population getting 30% of the lung cancers.

This is rather close to the same ratio as the rest of the adult population.

Conclusion: I respectfully submit that smokers have no greater risk of getting lung cancer than non-smokers.

Check out this story from Oregon:

http://www.lifesitenews.com/ldn/2008/jun/08060402.html

The Oregon Healthcare System has decided it won't pay for drugs to slow the growth of this woman's lung cancer, but WILL pay for assisted suicide, should she decide to kill herself.

You think they'd try that stunt with a breast cancer victim? I don't.

Regards,

quote:

Originally posted by gkayser30:

quote:

Current and former smokers together = 45% of the adult population yet have 80% of the lung cancers.

.............
True;but,about 90% of ex-smokers had quit by 1990..........

Yeah, I figured that's what you were going by (risk diminishing). I was lazy and didn't say that though.

I think they've been lowering the risk as an incentive to get more people to quit. They used to say the risk eventually gets down to 1/2 that of an active smoker, which would still be 5x higher than a never smoker.

quote:

Originally posted by Jennifer Wiegand:
Check out this story from Oregon:

The Oregon Healthcare System has decided it won't pay for drugs to slow the growth of this woman's lung cancer, but WILL pay for assisted suicide, should she decide to kill herself.

You think they'd try that stunt with a breast cancer victim? I don't.

Regards,

State-assisted suicide just sounds disgusting.