But I never smoked
Lung cancer is very much a threat to women-even among those who've never smoked. Learn the truth about this disease and how to protect yourself.
By Kathleen Phalen Tomaselli
In her 73 years, Norma Lenox of Fredericksburg has lived a full, healthy life. And if it wasn't for her irritable bowel and her problem knee, she'd feel about perfect. Sure, she admits to an occasional foray into forbidden tasty treats and an uncomfortable puff of a cigarette when she was 16, but mostly her record is clean. No smoking. No drinking. And lots of fruits and vegetables.
So when her doctor told her she had a mass in her lung, Lenox didn't think much of it; probably old scar tissue from pneumonia. Anyway, the CT (computed tomography) scan was for belly pain, not lungs. "When they said, ‘you have lung cancer,' I was floored. I could not believe it," she shares.
The true story of Norma Lenox reveals the many misconceptions associated with lung cancer. Lenox shares her story to help shed light on these common myths.
Myth #1: Women who have never smoked or who quit smoking will not get lung cancer.
One in five women with lung cancer has never smoked, says Heidi Gillenwater, M.D., a member of the University of Virginia Health System's lung cancer team. She is also a board member of the National Lung Cancer Partnership that is dedicated to raising awareness, particularly among women, about lung cancer. Eighty percent of never-smokers with lung cancer are women. "We're now seeing lifelong non-smokers with lung cancer," adds David R. Jones, M.D., Lenox' doctor and chief of Thoracic Surgery at UVa. "There's a changing biology of the disease for women and we don't know why. It may be related to hormones, there may be an under appreciation for second-hand smoke, but we can no longer say everyone who gets lung cancer is a smoker."
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And so the search began. Ticking through life events, Lenox listed the possibilities. Was it the smoke she inhaled while working as a county account clerk? "There were a few years they smoked at their desks," she says. Maybe it was her repeated bouts with pneumonia. Or could it be the year-and-a-half her husband smoked in the 1960s? The refrain was always the same: I just don't know. "My husband was a construction worker and he worked with asbestos," she says. "Maybe it was from washing his clothes; I have no clue where it came from."
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Myth #2: Lung cancer patients cause their illness because of lifestyle choices.
Lung cancer patients - smokers and non-smokers - often feel ostracized because of the associated stigma. Fifty percent of new lung cancers, however, are found in former smokers. Those married to smokers are also at greater risk. Radon - a naturally occurring radioactive gas released in rock, soil, and water and often found seeping into basements - is the second leading cause of lung cancer, says Gillenwater. The Environmental Protection Agency (EPA) estimates that radon is responsible for more than 20,000 lung cancer deaths per year.
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In the first few days, it was worry on top of worry. Norma Lenox worried about losing her hair. She worried about her husband. "He's not in the best health." And the what-ifs mounted. What if it's been there a long time? What if it is too late? What if my gastroenterologist had not discovered it?
"Norma had a shadow on her chest X-ray and she's a lifelong non-smoker," says Jones. "In situations like this, it's common for a doctor to think it is scar tissue from a previous illness. Unfortunately, many in the medical community still think you should not get lung cancer unless you are a heavy smoker ... And yet we are losing 81,000 wonderful women in the U.S. every year to lung cancer."
All Lenox wanted was to get on with it. "I had to have it out," she says. "It was all contained in my right lower lobe. I didn't need chemo or radiation. I didn't lose my hair. I did fine."
Jones was able to remove Lenox' tumor through a small incision. "And we were able to get all the affected lymph nodes," Jones says. "She was in the hospital for about three days. Fortunately, she was in the early stage."
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Myth #3: A lung cancer diagnosis is hopeless.
Most lung cancer patients do not seek help until they have symptoms, but that usually means that the cancer is found when treatment options are fewer.
A CT scan can catch the disease before it has spread to other parts of the body. However, this screening tool remains controversial because insurance won't usually pay for the $300 scan, and it may find a spot that a surgical biopsy reveals to be harmless. Nonetheless, in a study published in the New England Journal of Medicine, researchers found that patients diagnosed with stage I lung cancer had a high rate of survival. "It was almost 90 percent as compared to 15 percent for more advanced cancers," notes Benjamin Kozower, M.D., a UVa thoracic surgeon. "Especially with early detection, lung cancer is not hopeless," he says. The best news? There are things you can do to reduce your risk. (See "Beating Lung Cancer.")
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These days, Lenox vows to get back to her Weight WatchersTM meetings and continues to teach Sunday school. She visits Jones every three or so months and things look good. "When lung cancer is caught early," Jones says, "that's when the opportunities for a cure are best."
At UVa's Health Resource Center, find tips and resources to help you give up smoking for good. (Click on Smoking Cessation.)
Already quit or never smoked but still concerned about your risk for lung cancer? Talk to your doctor. A chest X-ray or CT scan can detect it in a more treatable stage.
If you've been diagnosed with lung cancer, you'll want to put UVa's lung cancer team on your side. Learn why.
An Epidemic Among Women?
Take a short quiz to find more startling facts about lung cancer.
This article appeared in the winter 2007 issue of Vim & Vigor, a family health magazine sponsored by UVA Health System. If you don't already receive it at home, sign up today. It's free.