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A Woman's Concern: Lung Cancer Has Long Worried Smokers, but Many Don't Know It Claims As Many Casualties As Breast, Ovarian and Uterine Cancers Combined, and It Can Affect Female Nonsmokers.

Posted on: Monday, 13 March 2006, 09:00 CST

By Barbara Anderson, The Fresno Bee, Calif.

Mar. 13--The recent death of Dana Reeve, widow of actor Christopher Reeve, put a spotlight on concerns about a growing number of lung cancer deaths in young women who never smoke.

There is no question more women are being diagnosed with lung cancer at ages younger than 50, say cancer doctors in the central San Joaquin Valley.

Reeve, a nonsmoker, was 44 when she died March 6.

No one knows why lung cancer strikes female nonsmokers in higher numbers than men. Both men and women are exposed to risks, including secondhand smoke and radon, but women who don't smoke are about twice as likely as nonsmoking men to get lung cancer.

"There's obviously something peculiar going on here," says Dr. Marshall Flam, a Fresno oncologist.

But doctors say that while lung cancer rates for women who have never smoked are disturbing, they remain a fraction of the total cases.

About 90% of men and 80% of women treated for lung cancer have a history of smoking.

A decades-long smoking habit is why Deirdre Beasley, 45, of Fresno, is preparing for a third round of chemotherapy to reduce tumors in her left lung. And the same addiction is why Joyce Morris, 68, of Fresno, goes for chemotherapy treatments every three weeks.

For the 40 years she smoked, Morris says she didn't worry about lung cancer. "That wasn't going to happen to me," she says. "And I enjoyed every [cigarette] I smoked ... "

Dr. Rendoll Concepcion, a Fresno surgical oncologist, says: "You never can stop emphasizing how serious smoking is."

"This is serious business -- you can die from smoking," he says. "You can definitely suffer serious illness. Cancer is just one of many catastrophic events that can happen from smoking at a very early age."

Cigarette smoking kills about 178,000 women in the United States each year, according to the federal Centers for Disease Control and Prevention. The three leading smoking-related causes of death for women are lung cancer, heart disease and chronic lung disease.

Says Dr. John Reinsch, an oncologist at Kaiser Permanente Medical Center in Fresno: "Lung cancer kills as many women as breast, ovarian and uterine cancers together. It's a huge public health issue."

According to the Cancer Registry of Central California, 1,689 women from Merced to Tulare were diagnosed with lung cancer between 2000 and 2004. Between 1998 and 2003, 1,269 Valley women died of the disease.

The risk of getting lung cancer from smoking is the same for men and women, Reinsch says. A smoker has a 10% to 20% risk of developing lung cancer over a lifetime.

Beasley took her first puff on a cigarette when she was 17. By the time she was in her 40s, she was smoking about a pack a day.

"I don't know how I smoked for that long," she says.

She hasn't had a cigarette since November 2004, when doctors diagnosed cancer in her left lung.

She received chemotherapy for the tumors and the cancer remained in remission until last November. She finished another series of treatments in February. A recent test showed the cancer has returned, she says. She expects to begin another series of chemotherapy treatments later this month.

Beasley says doctors at first thought the sharp pains in her left side were caused by bronchitis. Chest X-rays didn't reveal anything. When her breathing worsened she was admitted to a hospital in November 2004 and doctors discovered three cancerous tumors in her left lung.

Lung cancer often goes undetected in the earliest stages. Says Concepcion: "The lung is an area where you can have a tumor sitting there for some time and it causes little, if no, symptoms at all. By the time you have symptoms, it's because you're injuring major airway passages or causing obstruction of those passages."

Morris assumed pneumonia was causing the shortness of breath she had for a few weeks. She learned she had lung cancer from an emergency room doctor. Says Morris: "The doctor said it very bluntly -- not any warning or anything -- 'You've got cancer.'"

Reinsch says researchers continue to study the differences in lung cancer between men and women.

A few things they know: Women tend to develop adenocarcinomas, a type of non-small cell lung cancer, where men usually get another non-small cell type called squamous cell carcinoma.

Researchers don't understand all the molecular aspects of lung cancer, he says, but hormones could have something to do with the disease in female nonsmokers. "There's a relationship between receptors that stimulate cancer cell growth and estrogen receptors," he says.

A lot remains to be solved about lung cancer in female nonsmokers, but smoking's role in lung cancer is no mystery.

Says Reinsch: "It's so damaging that other factors don't even have a chance to come into play."

The reporter can be reached at banderson@fresnobee.com or (559) 441-6310.

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Copyright (c) 2006, The Fresno Bee, Calif.

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Source: The Fresno Bee

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