Women of every age know the threat that breast cancer poses. Girls grow up watching their mothers march against it, and that activism has brought much needed resources and attention to the disease. Yet the cancer that kills more women each year than breast, ovarian and cervical cancers combined is lung cancer. Because it was once mostly a male disease, and because it is associated with smoking, women assume if they never smoked, or if they stopped years ago, they don't need to be on the lookout for this deadly cancer.
But they do. Two-thirds of lung cancer's female victims quit at least a decade earlier or never smoked at all.
Yet the stigma of smoking and the shame people feel for bringing on their illness has caused women to delay seeking medical attention in the early stages of lung cancer. As a result, lung cancer rates have continued to rise, and 23 years ago the disease overtook breast cancer as the leading cause of death in women. Yet who knew?
At a Capitol Hill briefing last week, the Lung Cancer Alliance released a report about women and cancer titled, "Out of the Shadows,"
which documents the gaps in research funding and the need for equality in disease treatment. Lung cancer is now the cancer that women are most likely to die from. Among the report's findings: Women who have never smoked appear to be at two to three times greater risk for developing lung cancer than men who have never smoked. Women tend to develop lung cancer at younger ages than men, and the disease is striking more younger women who have never smoked. The report was prepared by Brigham and Women's Hospital's Women's Health Policy and Advocacy Program at the Connors Center for Women's Health and Gender Biology.
Among the speakers was Deborah Morosini, an M.D. and a pathologist and the sister of Dana Reeve, who died of lung cancer four years ago at age 44. Morosini recalled how her family giggled when Dana, an aspiring actress, started dating Superman, aka Christopher Reeve, after they met at summer theater at Williamstown. They went on to marry, and to live happily ever after, when a horseback riding accident turned Superman into a quadriplegic at age 41.
"It was one of the worst things that could happen," said Morosini, "but they didn't become victims." They took their tragedy out of the shadows and in the 11 years Reeve lived with his disability, the couple became an inspiration to others with spinal cord injuries. After her husband died at age 52, Dana returned to sing "Cabaret," putting her life and her career back on track. When she developed what Morosini says was a very mild cough, no one was particularly worried, not even when a lesion was found on her lung and her liver. Morosini figured it was a parasite that could be easily treated. "I'm a pathologist . . . . Why was this not on my radar?" she exclaimed before an audience of physicians, activists and survivors. Dana Reeve, who had never smoked, died seven months later. "This new report gives us an enormous platform from which to educate people about lung cancer," Morosini concluded.
Lung cancer has historically struck more men than women, but the gap is narrowing, and it will take more research dollars to understand the genetic and hormonal differences in how the disease affects women. Despite the incidence of lung cancer in non-smokers, smoking remains the most obvious risk factor. The report identifies "gendered health behaviors" such as the age of men and women when they start smoking, and even how they smoke, the number of puffs taken and how deeply they inhale. There are 45 million former smokers and 40 million current smokers in the U.S., and statistics tell us that half of them will die prematurely.
If that's not enough of a wake-up call, check out Donna Trussell's report on the President's Cancer Panel
, which says the "true burden of environmentally induced cancer has been grossly underestimated."
Developing a non-invasive early test is a research goal. Currently, 80 percent of lung cancers are found too late to respond to treatment. "Where are the dollars from the cigarette settlements?" asked one woman, who said she is in treatment for Stage 4 lung cancer. "I heard it's going for roads, not research." She heard right, explained one of the experts in the audience. The basis of the 1988 settlement with the four largest U.S. tobacco companies was to compensate states for expenses incurred treating people with tobacco-related illnesses. The states got the money with no strings attached, and funding research on a disease where patients are routinely blamed as responsible for their condition has not been a high priority.