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Associated Press
(MSNBC.com), August 10, 2005.
For people like Dana Reeve,
genetic factors likely fuel the disease
Most lung cancers occur in smokers, but
nonsmoker Dana Reeve’s situation isn’t as
uncommon as it appears.
Like Reeve, widow of “Superman”
star Christopher Reeve, 1 in 5 women diagnosed with
the disease never lit a cigarette, doctors say. Yet
they share an unfortunate stigma with cancer patients
who smoked.
“The underlying
assumption is, you were a smoker and you caused this,
therefore you’re not going to get my sympathy,”
said Tom Labrecque Jr., who started a foundation to
raise awareness after his nonsmoker father died several
years ago of the disease.
No one “deserves” lung cancer,
doctors say. But nonsmokers do have one silver lining:
They respond better to the newest targeted cancer drugs
like Iressa and Tarceva.
That’s because people who get lung
cancer early in life, like the 44-year-old Reeve, are
more likely to have genetic factors fueling their disease,
doctors say. Only 3 percent of lung cancers occur in
people under 45, regardless of smoking status.
Reeve, an actress who leads a paralysis
research foundation named for her husband who died last
year, disclosed Tuesday that she was being treated for
lung cancer but gave no details on how or where.
Her announcement came two days after ABC
News anchor Peter Jennings, a smoker, died of lung cancer
at age 67.
No one 'deserves' cancer
Despite their different smoking histories,
they share the most common cancer in the world, and
the deadliest. This year in the United States, an estimated
93,010 men and 79,560 women will be diagnosed with lung
cancer and almost an equal number — 90,490 men
and 73,020 women — will die of it.
About 10 percent of men and 20 percent
of women with lung cancer never smoked, and the number
of nonsmokers with the disease doesn’t seem to
be rising significantly, said Dr. Michael Thun, chief
epidemiologist for the American Cancer Society.
But awareness may be on the rise because
of the aggressive anti-smoking campaigns in recent years.
And stigma may be rising, too.
“When people get breast cancer,
people say, 'What can I do to help you?' When people
get lung cancer, people say, 'Did you smoke?”’
said Susan Mantel, executive director of Joan’s
Legacy, a fund-raising group named for Joan Scarangello,
a nonsmoker and former head writer for newsman Tom Brokaw.
Scarangello died in 2001 of lung cancer, as did her
nonsmoking mother before her.
“There is a definite stigma,”
said Labrecque, recalling comments after the funeral
for his father, a former chairman of Chase Manhattan
Corp.
“People would say, 'I didn’t
know he smoked,”’ he said.
His foundation’s Web site even acknowledges
this trend, by stating that more than half of people
newly diagnosed with lung cancer each year have either
never smoked or quit smoking.
Doctors who treat the disease, like Dr.
Bruce Johnson of Dana-Farber Cancer Center in Boston,
bristle at the notion of “innocent” and
“not so innocent” victims.
“People who smoke don’t deserve
to get lung cancer, and people have worked very hard
to quit,” he said.
Nonsmokers who have surgery for their
cancer have a lower risk of developing a second tumor
than smokers. Also, smokers who quit after cancer surgery
have better survival odds, he noted.
Turning the corner?
Nonsmokers also respond better to Iressa
and Tarceva, said Dr. Alan Sandler, director of thoracic
oncology at Vanderbilt-Ingram Cancer Center in Nashville,
who has been involved in testing these new generation
drugs that more precisely attack the molecular factors
making these cancers grow.
“The malignant cell in a smoker
is much more complex” and has more mutations than
nonsmokers tend to have, Sandler said.
Researchers now are studying whether nonsmokers
do better in general on chemotherapy than smokers, he
said.
Meanwhile, the cancer society is hoping
for an eventual decline in lung cancer cases to mirror
the decline in smoking rates.
“Cigarette consumption is down where
it was at the start of World War II. About 1 in 5 people
are current smokers,” Thun said.
“Lung cancer death rates have fallen
17 percent in men from 1990 to 2002. Both incidence
and death rates have leveled off in women, so we are
turning the corner.”
As for stigma, he would rather see it
on those who sell cigarettes than those who use them.
“If there’s blame to go around,
most of the blame falls on the tobacco companies,”
Thun said.
View article online at www.msnbc.com
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