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LUNG CANCER's MYSTERIES: Death Puts Baffling Disease in Spotlight

Posted on: Wednesday, 8 March 2006, 06:00 CST

By Patricia Anstett, Detroit Free Press

Mar. 8--Her husband of nearly 60 years, a longtime smoker who still smokes, has never had lung cancer. But Irene Frankhouse, his nonsmoking wife, was diagnosed with it.

All her clean living, to no avail. "Isn't that a kick?" said Frankhouse, 79, who lives in Southfield and was diagnosed in 2002.

Lung cancer, which late Monday claimed the life of activist and nonsmoker Dana Reeve, 44, is filled with mysteries like these.

The leading cause of cancer death in U.S. men and women, it accounted for an estimated 163,510 deaths last year.

Some lifelong smokers never get lung cancer, though they may die of some related lung or heart problems. Yet others who never smoked or lived with a smoker, develop lung cancer.

About 15% of the estimated 172,570 cases of lung cancer diagnosed last year in America occurred in nonsmokers like Reeve, the wife of late actor Christopher Reeve.

Most lung cancer cases are caught too late. Medicine needs better detection tools, said Dr. Robert Chapman, a lung cancer expert in Detroit's Henry Ford Health System.

Chest X-rays miss many tumors and, as a result, many lung cancers are diagnosed late, when patients report symptoms, such as excessive coughing, to their doctors, Chapman said. Only 15% of patients are alive five years after a diagnosis.

A disease that has been on the rise in women for decades, lung cancer is filled with gender differences.

* Men are more successful at stopping smoking, and have been quitting at higher rates than women.

"Men are better at stopping smoking and they are not initiating smoking as much," said Dr. Antoinette Wozniak, a medical oncologist at the Barbara Ann Karmanos Cancer Institute.

As a result, death rates from lung cancer have been dropping in men for 15 years. But in women, death rates only began to stabilize in the last five years.

* For every 100 nonsmokers diagnosed with lung cancer, 60 are women and 40 are men, said Dr. Gregory Kalemkerian, codirector of thoracic oncology at the University of Michigan Medical Center. The numbers likely reflect the greater number of male smokers, historically.

The numbers are exactly the opposite in smokers. For every 100 lung cancer patients who smoke or once did, 60 are men and 40 are women, Kalemkerian said. The differences likely reflect how much and how long a person smoked.

* Young girls are more likely to start the habit than boys, wrongly perceiving smoking as a diet aid or because of media influences that include more female smokers, compared with decades ago, when their mothers were growing up.

Other lung cancer cases are likely due to household, workplace and environmental exposure to carcinogens such as asbestos and air pollution, as well as radon, a radioactive material in the ground that comes from uranium.

Sometimes, there are no good answers at all.

In October 2004, Gladys Earby, 68, of Inkster was diagnosed with lung cancer even though she never smoked, lived with a smoker or worked in an office where smoking was allowed.

"My folks didn't smoke or drink," she said Tuesday. "It was something in the family we didn't do."

After going from one specialist to another, an astute allergy doctor noticed a spot on a chest X-ray, she said. It turned out to be cancer. Cancer, though not lung cancer, runs in her family.

She's now involved in a study at Detroit's Karmanos institute to test her blood for genetic mutations.

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Copyright (c) 2006, Detroit Free Press

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Source: Detroit Free Press

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