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The death of Dana Reeve on Monday serves as a reminder of one of lung cancer's tragic truths.
"If there was no smoking, there would still be lung cancer," says University of Pittsburgh lung cancer researcher Jill Siegfried. In fact, she says, even if no American ever smoked, lung cancer would still be the fourth-most-commonly diagnosed malignancy in the USA.
And 85% of non-smokers diagnosed with lung cancer -- including, by all accounts, Reeve -- are women, Siegfried says. One out of five women with lung cancer never smoked, compared with one out of 10 men with lung cancer.
In general, fewer women than men smoke, but that doesn't fully explain why lung cancer patients who never smoked are overwhelmingly female, Siegfried says.
Although lung cancer kills about 15,000 female non-smokers in the USA each year, "when many people, both doctors and non-doctors, think about lung cancer, the face they see is an older, smoking man," says Joan Schiller, a lung cancer doctor at the University of Wisconsin-Madison. Frustrated with the lack of attention to women with lung cancer, Schiller founded Women Against Lung Cancer four years ago; she is the organization's president.
Schiller notes that women represent about 40% of lung cancer patients, "and nobody talks about it or wants to talk about it."
Researchers have only recently begun investigating why women who have never smoked are more likely to develop lung cancer than their male counterparts. Studies of mice suggest that estrogen may play a role, Schiller says.
About 95% of lung cancers in both sexes have estrogen receptors, Siegfried says. She and Schiller are involved in research looking at whether Faslodex, an anti-estrogen drug used to treat metastatic breast cancers that contain estrogen receptors, might be effective against metastatic lung cancers in women.
Genetics also might play a role in lung cancer risk. Just months before Reeve was diagnosed, her mother died of ovarian cancer. Siegfried says her research has found a disproportionate number of breast and ovarian cancers among the relatives of women with lung cancer.
Lung cancer itself appears to run in the Scarangello family. Joan Scarangello McNeive never smoked, but she died in 2001 at age 47, just nine months after she was diagnosed with lung cancer. McNeive died 20 years after her mother, who also never smoked, died at age 50, also just nine months after being diagnosed with lung cancer.
When McNeive was diagnosed, her family realized that "nothing had changed in 20 years," says her brother's wife, Roxanne Donovan, a founding board member of Joan's Legacy, a New York-based non-profit group that has awarded $1.3 million for lung cancer research.
"There was nothing they could do for Joan," Donovan says. "There was nothing they could do for her mother."
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