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Women’s Risks For Lung Cancer
I thought I was doing all the right things. Daily exercise, a balanced diet, hadn’t smoked for 38 years, was being seen on a regular basis by highly regarded doctors in Washington, DC. As a public health professional, I kept abreast of the latest medical news. You might then imagine my surprise, when, 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. At that time, there was a lot that I didn’t know about lung cancer and the special risks that women face. I didn’t know that research shows that women who are former smokers may still have significant risk for lung cancer even 20 years or more after they quit smoking. I didn’t know that there is a genetic component that can put individuals at risk. I didn’t know that African-Americans experience the highest incidence of lung cancer and the highest death rate. I didn’t know that female smokers are more likely than male smokers to develop lung cancer, according to a 2005 article in the Journal of Clinical Oncology, and that women who have never smoked are more likely to develop lung cancer than men who have never smoked. These differences, the article states, are due to hormonal, genetic and metabolic differences between the sexes. I didn’t know the extent and severity of lung cancer, that it is the leading cancer killer in the U.S., claiming more lives than breast, ovarian, prostate and colon cancer combined. I didn’t know that the five-year survival rate for lung cancer is only 15%, compared to 87% for breast cancer, 98% for prostate cancer and 62% for colon cancer. How is it possible, I wondered, that this grim information about lung cancer could be so little known among the general public? Had I known, before my diagnosis, what I know now, I would have aggressively sought screening (low-dose, single-breath CAT scan) years ago. At the time of my diagnosis, I was under the care of four prominent physicians (an allergist, two ear, nose and throat specialists and an internist). My symptoms were hoarseness and complete exhaustion -- two of the warning signs of possible lung cancer, according to the National Cancer Institute (some others are chronic cough, shortness of breath, unexplained weight loss and chest pain). Despite these symptoms, none of these physicians suggested even a chest x-ray, though I reported on all medical forms that my father had died of lung cancer. I also had smoked, as had almost all my peers, in the early 1960s, but 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, nor, it appears, on those of many physicians. Over the past 20 months, I have had three rounds of chemotherapy and two rounds of radiation to treat bone cancer. One of the chemotherapies involved a new, targeted therapy called Iressa, which worked well for me but only for seven months. The “good news-bad news” syndrome of cancer treatment, along with the side effects of treatment, is enormously draining, physically, mentally and emotionally. My experience has taught me that individuals have to learn to recognize the warning signs and to push their doctors to test for lung cancer if any symptoms appear. Early detection can prolong life. Women, especially, even if they have never smoked, should be aware of their higher risks.
Rosalind Brannigan, M.P.H., resigned in December 2004 as Vice President of Drug Strategies, a non-profit research institute and was a fulltime advocate for lung cancer patients until she passed away in August, 2005. She held a Masters in Public Health from Johns Hopkins University.
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