Don't smoke? Lung cancer still a threat, studies show

Estimated read time: 3-4 minutes

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WHEN 44-year-old Dana Reeve died this week, just seven months after her lung cancer diagnosis, the world took notice and nonsmoking women pricked up their ears. How could a nonsmoker die of a disease usually associated with pack-a-day types? Regina Santella is a professor of environmental health sciences at the Mailman School of Public Health at Columbia University. She also is a lead investigator in a study looking at how lung cancer differs between men and women, and between nonsmokers and people with a history of smoking. We asked her to help us better understand the reality of the risks of lung cancer, the biggest cancer killer in the United States, according to the National Cancer Institute.

It turns out that while most lung cancer results from smoking, there is also some data suggesting that women may be more susceptible to the carcinogens in cigarette smoke than men. In fact, new studies are under way right now that test this hormonal hypothesis - the idea that hormones have some impact on the metabolism of certain environmental carcinogens, like tobacco.

Case in point: Women with a history of reproductive cancers - like breast cancer - that are known to be related to hormones have a higher risk of getting secondary lung cancer, and critical research is now looking into that connection.

While we don't yet have conclusive evidence about why lung cancer affects nonsmokers, lung cancer is sometimes caught early. With surgery, people with these Stage 1 cancers have reasonable survival statistics.

At the same time, there's not much that women - or men, for that matter - can do to prevent lung cancer. By the time you have clinical symptoms, like difficulty breathing or coughing, the cancer may have spread or be too far along to successfully treat it. And CT scans aren't done as a matter of routine, especially in an otherwise healthy nonsmoker.

There are many more diagnostic tools in the works. For example, new blood tests are being developed that analyze blood samples and test for certain proteins in the blood that could indicate a tumor or for tumor DNA floating around in your plasma.

So, with statistics pointing to 10 percent of lung cancer in patients who never once lit up one cigarette, what's to account for this number?

Some of these lung cancer cases are caused by environmental/secondhand tobacco smoke, making spouses or family members of tobacco smokers at a higher risk of getting lung cancer. In addition, if your parents or grandparents had lung cancer, you're at higher risk, and you're definitely at higher risk if you've had significant exposure to asbestos or radon.

There is one positive in Dana Reeve's message of strength and hope - even in the face of her diagnosis. She maintained her healthy lifestyle to the end, and that's a take-home message for all of us. What does this mean? Follow a diet filled with fruits and vegetables, exercise regularly, lose weight and cut out the alcohol. It's the best we can do until we know more about this insidious disease.