"The risks attributed to the act of smoking, and especially passive smoking have been greatly exaggerated."
Dr. Ken Denson,Thame Thrombosis and Hemostasis Research Foundation, UK (Boston Herald 11/22/99)
If the Lung Cancer Alliance truly desired to achieve its stated goals, it would have proposed legislation or a referendum instead of a feel good self promotional proclamation for a lung cancer awareness month.
Besides, Schwarzenegger has been actively promoting lung cancer by smoking cigars and building a smoking tent.
Perhaps you should read this:
http://www.scotcourts.gov.uk/
opi...2005CSOH69.html
My sister died of non-smoking related lung cancer on October 22, 2005. She was diagnosed in June 2005, two days after her baby was born. She was only 25 years old.
On November 4, 2005, I gave a speech in honor of my sister for the Lung Cancer Alliance. I read the original proclamation proposed, as well as the revised proclamation. The original proclamation asked that lung cancer be treated as lung cancer, not as a smokers disease. I understand that smoking can increase the risk of lung cancer, but smoking can also increase the risk of breast cancer, prostate cancer, colorectal cancer, etc. However, only lung cancer has the stigma associated with it.
There are many non-smokers who are originally misdiagnosed because doctors have the misconception that only smokers get lung cancer. My dad is a health care professional and even he did not realize that non-smokers could get lung cancer. My sister never worked with smokers, never lived with smokers. How did she get lung cancer? We may never know. I do know that if she had any other type of cancer, when I told people she died of that cancer they would probably say, “Oh, I am so sorry” or something along that line. Since she died of lung cancer, the first question to come out of their mouths is “Did she smoke?” It is almost like they want to hear she smoked, and that her punishment for smoking is lung cancer. Well, I think that smokers and non-smokers alike do not deserve lung cancer.
The Lung Cancer Alliance is trying to remove the stigma that lung cancer is a smokers only disease. This is not to say that smokers should be taken out of the loop, or that people can suddenly start smoking. The first rule I have seen on every web page for lung cancer prevention is to stop smoking. However, there are several cases where doctors will immediately eliminate lung cancer if a non-smoker comes to the doctor's office with a respiratory aliment. Two days after my sister died, a man by the name of Steve Neifert also died. He was misdiagnosed originally because he never smoked.
I agree with you that smoking cessation is key to preventing lung cancer, but I also think that just because someone never smoked, doctors should not assume that the person does not have lung cancer.
It is nice that November is made lungcancer awareness month and it is a
step forward to make people aware of lungcancer. It is in my opinion wrong
that all the emphasis is put on smoking
The Governor could have write a proclamation more geared to the disease and not to smoking. there is a stigma to the disease that it only affecting smokers but actualy there is a significant amount of people who never smoked or are ex smokers. Now there are popping up a large amount of young woman who are coming down with this awfull disease and never smoked I think there isvery little understanding about lung cancer and the causes of lungcancer and the public should be informed about this disease.I think the proclamation should not have the issue of smoking in there but it should be geared just to the disease itself. I can tell you from experience that my opinion about lung cancer has totally changed.Unfortunately it took the death of a person very close to me to come to that point of understanding
If there is one thing the whole world seems to know, it is the link between smoking and lung cancer. Anyone dealing with lung cancer can tell you that it is invariably the first response from every person. I highly doubt that Lung Cancer Alliance's attempts to fully educate people on the ENTIRE story of lung cancer will do much to weaken that bond.
What people do NOT know are the links between smoking and a multitude of other illnesses, and most have no idea that lung cancer can strike even decades after quitting, or the unthinkable, a person who never smoked. Anti-smoking advocates (and I include myself here) do disservice to their cause by focusing so completely on lung cancer. Other diseases get a "free ride" while lung cancer patients pay the full price of the association with tobacco - but those other diseases are certainly happy to be first in line when the tobacco monies are handed out, while lung cancer languishes miserably in the funding cellar.
The definition of "former smoker" used by the CDC in its study "Cigarette Attributable Morbidity -US, 2000" was "persons who reported having smoked less than or equal to 100 cigarettes DURING THEIR LIFETIME" (emphasis mine). Gives a vastly different perception of "former smoker," doesn't it. This is not to in any way deny the disastrous consequences of smoking, but only to highlight the absurdity of blaming someone for their lung cancer. Most people do not realize that only two out of ten smokers get lung cancer - they are far more likely to have a heart attack. The same report listed lung cancer at the bottom with 1% compared with heart attack third on the list with 13%. If we had followed the same philosophy with heart attacks (focus totally on cause) we would not have the lifesaving surgeries, stents and medications available today.
I was a part of the committee involved in trying to get the governor to sign the proclamation which focused on the DISEASE of lung cancer not the ADDICTION of tobacco (as a colleague so beautifully pointed out). We have 46 million former smokers and 45 million current smokers in this country. We also have 25,000 neversmokers getting lung cancer every year. While our anti-smoking efforts have produced some wonderful results (not only for lung cancer, but for many, many other illnesses), the fact is that even the Campaign for Tobacco-free Kids has to admit that 23% of high school seniors are still smoking. We are far from winning this war on tobacco and even once it is won, we will still have to minister to the wounds it has inflicted for decades. Are you willing to simply write off those millions of lives? Continuing to dedicate the vast majority of lung cancer funding solely to tobacco control measures is to perpetuate the inexcusable situation which has persisted over the last thirty years.
Yes, we certainly did protest the governor's proclamation in which three of the four points focused on tobacco. I invite you and others similarly inclined to read the issued proclamation and then contact myself, or other members of Lung Cancer Alliance's CA Steering Committee so we can contrast it with the one which we had requested. Lung cancer is not synonymous with smoking and deserves to be handled with the same compassion and urgency with which we approach other life-threatening diseases. I can testify firsthand to the devastation it causes - just two months ago my neversmoking husband paid the ultimate price for the neglect of lung cancer research. Unless we educate the general public and those who have been so admirably involved in tobacco control efforts for so long, millions more will face a similar fate.
A typo correction to my previous comment. The CDC study's definition of former smoker is "persons who reported having smoked GREATER than or equal to 100 cigarettes during their lifetime." My point remains the same. Many people would be shocked to suddenly find themselves classified as a "former smoker" and to learn that even as little as five packs of cigarettes smoked during adolescence (a time particulary vulnerable to risk-taking behaviors)could be damaging much later. It would undoubtedly alter their perception of the disease.
I would only note that Joyce's comment seems to confirm and amplify my basic point. Only it seems that the attempt to obscure the strong connection between tobacco use and lung cancer is even more deliberate than I had imagined. I find this irresponsible and frankly, reprehensible.
Sorry, but as a physician who has pronounced the deaths of hundreds of lung cancer patients, I know the proper way to prevent this epidemic. And the #1, #2, and #3 approaches are to address the damage caused by tobacco products, both from active and passive smoking.
To suggest otherwise is simply denying the overwhelming scientific evidence on this issue, and is inconsistent with public health, while being supportive of the tobacco industry's decades-long effort to undermine the links between tobacco products and lung cancer.
Just to set the record straight, many people, including my brother die from lung cancer each year, and have never smoked. The idea of the that Lung Cancer is the result of smoking only is absurd.Also I think you would be shocked to find out how much money goes to reasearch for a cure for Lung Cancer, because of people than think it is a end result of smoking only. There is plenty being done to help people stop smoking, what needs to be done now is money for reaserch to find a cure for smokers, and non smokers.
Rich-
I agree with you completely on the need to find a cure for lung cancer. I'm not questioning that at all. What I'm questioning is the distortion of the truth that the Lung Cancer Alliance is apparently now intentionally trying to convey to the public in order to secure funding. I simply don't agree with this kind of deception as a tactic. I don't see why the Alliance cannot be forthright and honest at the same time as it tries to advocate for increased lung cancer funding. And I think if the concern is to take the stigma off of smoking, then that should be done directly. Advocate for smokers and ex-smokers by educating the public about the addictive nature of nicotine, the practices of the tobacco industry, which tries to addict kids when they are young, and therefore is responsible for the lung cancer epidemic. What the Alliance is doing is, I think, greatly increasing the stigma attached to lung cancer and smoking by not even being able to acknowledge with a straight face that smoking is the predominant reason for the lung cancer epidemic.
I'm afraid, Dr. Siegel, that you have missed the point. To suggest that in making people more fully aware of all aspects of lung cancer, we obscure the link and are ultimately supporting the tobacco industry's agenda, is extremely misleading and betrays a serious disrespect for the intelligence of the general public. In actuality, your insistence on blaming the victim for the consequences of their addiction aligns much more closely with the longheld position which the tobacco industry has used so effectively for decades.
The point was that tobacco control does nothing to help all those who ALREADY have lung cancer (regardless of its etiology) and the millions for whom the die is largely set. This proclamation was about THOSE people. If you desire a proclamation designating a different month "Anti-Smoking Month" and details the huge number of illnesses linked to smoking (including lung cancer), I will be the first to sign on.
We are strong supporters of anti-smoking efforts and applaud any progress made in reducing tobacco usage. However, the time to allot sufficient research funding for early detection and improved treatment options is long overdue.
How many of those hundreds of lung cancer patients you prounounced dead had kicked their habits or never smoked at all? It seems morally reprehensible to urge smokers to quit and then do nothing to help them deal with the residual effects of their usage other than to wag a finger, and say "I told you so." Surely you have pronounced dead many more smokers from heart disease. Do you respond similarly to them? Do you advocate pulling funding for other cigarette-attributable morbidites, such as heart disease, and redirecting it to tobacco control? Would those other diseases not benefit greatly from the extinction of the tobacco scourge?
It is time that all of us working toward a goal of helping people live healthier lives recognize the contributions of the other, be open to new perspectives and work cooperatively to see that resources are directed to help all those who suffer.
I really do not see the deception that you seem to see. If I try to find resources about lung cancer, there is a wealth of information that will tell me the first thing I need to do is stop smoking. Even if you explore the Lung Cancer Alliance website, there is information on tobacco and smoking cessation.
However, for people like my sister, who never smoked, how is this going to help them? When I tell people my sister died of lung cancer, they immediately ask me if she smoked.
Breast cancer risk also increases if you smoke. However, you don't see people saying, "Oh, you have breast cancer. Well, you shouldn't have smoked." It is almost like lung cancer is the punishment for smoking.
How many people in your practice do you treat with lung cancer who never smoked? Or do those people get the door slammed in their face because it isn't possible for a non-smoker to get lung cancer? And what about the people like my nephew, who has to grow up not knowing his mom, because lung cancer took her from him even though she never smoked.
I recognize that your perceptions won't change, and I find that really unfortunate. If more doctors recognized that non-smokers can also be affected by lung cancer, maybe there wouldn't be so many misdiagnosed patients. And maybe we could actually help these people before the cancer has taken over their body so much there is no hope for them.
Joyce-
I think you're still missing my point. I am not in any way suggesting that we should pull funding from lung cancer research directed at preventing non-smoking-related causes of lung cancer or finding a cure. In fact, I think we should be spending drastically more money on these causes, and I have devoted most of my career to helping prevent lung cancer not among smokers, but, in fact, among nonsmokers.
The simple fact is that the Lung Cancer Alliance criticized a document for linking smoking and lung cancer and for emphasizing smoking prevention. That's it - plain and simple. A public health group acting responsibly just doesn't do that.
Unfortunately, Dr. Siegel, just like Governor Schwarzenegger, persists in completely missing the point about Lung Cancer Awareness Month. I am the never-smoking Stage 4 lung cancer patient who requested the proclamation from the Governor on behalf of the Lung Cancer Alliance. I asked the Governor for a compassionate proclamation akin to ones he has issued for other cancers such as breast or prostrate. I am living proof that ANYONE can get lung cancer. As a very healthy, active, even athletic, individual who had never smoked or lived in a smoking household, I was absolutely stunned by a diagnosis of lung cancer at age 44. I have been fighting this battle for nearly six years and have far from won the war. My cancer and I are currently at a standoff, and unfortunately, no one, not even my highly skilled doctors know how long it will last. But, one thing we all sadly know is that there is no cure for this illness. As in the case of most non-smokers, neither my doctors nor I will ever know the cause of my lung cancer, and do you know what? It simply does not matter, and I am so very tired of answering the eternal question “Did you smoke?” The answer is that by the time a person has lung cancer it is far too late to worry about whether or not they smoked. What does matter is that they now have cancer and deserve as much understanding, compassion and help from the public and the medical community as those with any other cancer. Lung Cancer Awareness Month is the time to focus on early diagnosis, appropriate treatment, sympathy, support and funding as is customary for ALL other cancers. Very sadly, the state proclamation does nothing at all but to perpetuate the stigma of this illness. Lung cancer is deserving of compassion, attention, increased funding and is far more than the sum of its multiple, and many times, unknown causes. I thank the many great cities and counties throughout the state of California (including Los Angeles, Sacramento, San Francisco and San Diego) who issued wonderful Lung Cancer Awareness Month proclamations with eloquent and sensitive language and for understanding that the month of November is the time to educate the public about ALL the facts concerning this devastating and complex disease, not the least of which, very sadly is its politics.
Nancy Michener, Chairperson, CA Steering Committee for the Lung Cancer Alliance, Six Year Lung Cancer Survivor(Still Battling), Neversmoker
I agree completely with you Nancy - this is the time to educate the public about ALL the facts concerning lung cancer, and the most important one is that it is predominantly caused by smoking. That doesn't mean that many people, like you and two close members of my family who died recently of lung cancer, get lung cancer without having smoked. However, what is wrong with stating that most lung cancer is caused by smoking, but that a large number of cases are not caused by smoking? I don't see why we need to hide the fact that smoking is the predominant cause of lung cancer.
LUNG CANCER ALLIANCE AND NANCY ARE RIGHT ON TARGET. WHAT IS THE MATTER WITH PEOPLE. THE PEOPLE WHO SAY THE MOST NEVER HAVE ANYTHING CONSTRUCTIVE TO SAY.
I HAVE STAGE 4 LUNG CANCER. I DO NOT SMOKE, NEVER HAD A DRINK, NO CANCER IN MY FAMILY, MOTHER DIED AT 100, FATHER AT 90. NO RED MEAT FOR 26 YRS, EXERCISED 3 HRS DAY 7 DAYS WEEK FOR 26 YRS. 4 SICK DAYS IN 30 YRS WORK.
ALL I CAN SAY IS PEOPLE WHO DO NOT HAVE LUNG CANCER DO NOT KNOW WHAT THE HELL THEY ARE TALKING ABOUT. IT SHOWS THEY DO HAVE A LOT TO SAY ABOUT WHAT THEY DON'T KNOW, THAT INCLUDES DOCTORS (GOD).
IT WAS ONCE SAID, "TAKE AN EDUCATED MAN OFF OF THE TOPIC HE WAS EDUCATED IN AND I WILL SHOW YOU A FOOL"
I WOULD LIKE TO HEAR YOUR PEARLS OF WISDOM IF AND WHEN YOU GET LUNG CANCER AND THERE IS NO CURE.
Dr. Siegel, OK, here goes another 47 year old female with stage 4 lung cancer who never smoked. I'm the third one in my family to get it, my dad died at 63 and my brother at 42, both former smokers.
The Lung Cancer Alliance is not trying to hide the fact that smoking causes lung cancer. They advocate for everyone with lung cancer smoker, former smoker and never smokers. They are simply trying to separate the disease from the assumed "cause" and have it be treated as a disease worth sympathy and support. My brother was considered a "barely smoker" so he and I obviously had a genetic predisposition for it. (my dad did not smoke around us)
If 60% of new cases are former or non smokers, how does ALWAYS tying it to smoking help? My dad and brother are dead because of the stigma which translated into no effective treatment options and no early screening methods. I am a ticking time bomb.
I understand what you are trying to convey and I agree that we need to keep getting people to quit, but we need to provide treatment for them if they get it ( not to mention all of us never smokers).
As a physician in the field, I would very much like to know how you think this issue should be addressed in terms of a public awareness campaign resulting in increased funding for lung cancer research, treatment and early detection programs?
Sandy Phillips Britt
I agree Ms. Britt, and understand her frustration. I do understand that Dr. Siegel is not advocating abandonment of any research/treatments being devised, nor is he making the argument that lung cancer would be non-existent if all smoking were to go away tomorrow.
To make lung cancer purely a smoker's disease is one of the greatest injustices of modern day "science", as well as modern day advocacy. I know of an entire family -- all non-smokers in non-smoking households -- who were killed by this disease; a father, 2 sons, and 1 daughter. All were diagnosed when they hit their 60s, although one was substantially younger when he succumbed.
I know that at least one of them had their diagnosis delayed because of a healthy and non-smoking lifestyle. It was, certainly, a genuine surprise to his health care team. It shouldn't have been the test of last resort.
Their offspring, now approaching their 50s and 60s -- again, all non-smokers in non-smoking households --are understandably nervous and wondering if they should just retire now and enjoy what might be left of their lives.
With recent research suggesting a genetic link to this disease (research that has previously been neglected due to a mentality that it's a just punishment for smoking), it is becoming increasingly difficult to justify the perpetuation of that wayward school of though.
While smoking is strongly, overwhelming correlated to lung cancer, we must dismiss the prejudice that it is the only cause. It should not become an orphaned disease simply because we non-smoking advocates, sometimes gleefully, give ourselves and others a false sense of security in this regard. We should never, ever be caught saying or implying that the elimination of tobacco use will free mankind of this disease.
This is probably one of the biggest disservices we have committed.
I'd also like to thank Dr. Siegel for his site, his disciplined logic, his integrity in dealing with facts, and for not pandering to hysteria.
I've done my fair share of amateur research and statistics and I detest the perversion of science that's taking place in many arenas.
We can see what hysteria has done in the world of breast cancer, prompting some women to see their breasts as 2 precancerous lesions that need to be preventively lopped off.
I am ashamed at the lengths to which some public health advocates will go for crusade or profit.
When I found out that, in some places, cancer charities are spending more on lobbyists than on research and helping the afflicted, I've stopped donating to them. Money is being channeled away from research and into politics. Now, before I commit money, I find out how they commit their own money. I hope you will do the same.
Best wishes to you. Keep up the good work.
LeanderJ - Please clarify this comment as I am unsure of your reference - "I am ashamed at the lengths to which some public health advocates will go for crusade or profit."
One final comment and then I must move on. The Lung Cancer Alliance represents the ENTIRE lung cancer community – which includes advocating for all those with the disease and those still at risk. The single biggest obstacle to obtaining sufficient funding for lung cancer research is the stigmatization perpetuated by the widely held belief that smoking and lung cancer are inextricably linked. The relentless insistence of most tobacco control advocates that smoking be at the forefront of any mention of lung cancer becomes an insurmountable barrier to extinguishing the stigma. Lung Cancer Alliance has never disavowed the link between smoking and lung cancer and supports tobacco control efforts. I believe that the public is capable of understanding all the factors of lung cancer (including that only two out of ten smokers get lung cancer, but are far more likely to have a huge number of other diseases), and intelligent enough to not subsequently assume that smoking does not put their health at great risk.
There has been an overwhelming resistance to fund research for the disease itself because (and I quote from a discussion with an American Cancer Society spokesperson) "we have to put the money where we get the most bang for our bucks - and that is in tobacco prevention and cessation." Money spent on tobacco control is often counted as money "spent for lung cancer." This “proper way” of dealing with the lung cancer epidemic has been the strategy for 30 years, and yet the survival rate remains relatively unchanged with more than 170,000 people diagnosed and over 163,000 dead in 2005 alone. While other cancers (and related illnesses) have seen dramatic improvements in survival rates, a diagnosis of lung cancer still portends a horrific experience.
Draw a parallel with the HIV/AIDS epidemic. The heartbreaking diagnosis of Ryan White was pivotal to that movement and provided opportunities for advocates to get their messages across. We know that hemophiliacs were by far not the major population affected, but suddenly people were willing to listen because they were able to get beyond the stigma and blame. While it is true that there now seems to be an issue of persons returning to risky behaviors, it is not because they believe they cannot get HIV/AIDS. Quite the contrary, it is because they feel the medicines are sufficient to handle the illness (ill-advised as that is).
Dr. Spiegel, I respect and appreciate that you support increased funding for lung cancer research and trying to eliminate the stigma, but that is very unlikely to happen as long as you continue to insist that smoking be emphasized in all discussions of lung cancer. You see, you should feel proud as you have done your job too well – the link between smoking and lung cancer has been cemented in the public’s mind for eternity. I answered that question daily for the entire two years of my husband’s struggle. It is time to focus on the disease itself.
Sorry, Joyce, I meant that some advocates become so single minded in their presentation, that it misleads (hopefully unintentionally) people into thinking that no futher research can or should be done into a particular disease. In this case, lung cancer. So many people equate it with smoking only, so the disease itself gets neglected.
Keep up the good work!
This seems to be an extension of a trend in the last few years to widen the pool of potential lung cancer victims, beyond those of current and former heavy
smokers.
Could I ask a question? To what degree is excess fear being used with regard to the threat of lung cancer by these groups to ensure their own continued
survival? I have no doubt that primary smoking is bad for you, and is a definite factor in lung cancer, and it was for that very reason that I gave up the habit
last year. But to read from some of the Cancer and Lung Society websites, then I wasted my time, because I am going to get cancer anyway regardless of
whether or not I stopped smoking. The very fact that I once smoked has guarenteed that. So I need to get CT scans every year, perhap every week to be
absolutely sure. And if I had never smoked, well the fact that I was in Vermont in 1991 when someone was smoking, well I'm at high risk, and I still need the
CT scans, maybe once every fortnight though.
When I gave up smoking, I worried about the risk that I would get cancer, especially after reading some of these websites. To put it in context I'm 44 and
smoked about 15 cigarettes a day for 20 years. I went to my doctor and asked her what my risk was for lung cancer. Her reply - it would be quite unusual for
someone who gave up at my age to get lung cancer, but there's no guarantee it would not happen. She suggested that I left it in God's hands and concentrated
on enjoying my life. It's a slightly different perspective. My understanding is that if you have never smoked you have a 1 in 30000 chance per year of being diagnosed
lung cancer, I imagine that there are other illnesses with much higher risk.
There's more than likely some risk associted with past smoking, but are we being brainwashed about the extent of the risk so that all these non-profit organisations
continue to prosper?
I'm just asking questions here, that's all.
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