Celebrities' deaths heighten awareness of lung cancer

August 11, 2005|By Frank D. Roylance | Frank D. Roylance,SUN STAFF

The death of ABC news anchor and longtime smoker Peter Jennings this week has drawn new media attention to an old and brutal killer - lung cancer.

"It's a very tough disease, really a collection of diseases ... and you don't want any of them," said Dr. Michael J. Thun, head of epidemiological research at the American Cancer Society.

Today it kills more people in the United States than any other form of cancer. On Monday, the day after Jennings' death, actress Barbara Bel Geddes, former star of the soap opera Dallas, died of lung cancer at 82.

The disease has been one of the hardest forms of cancer to cure, among the most difficult to survive and least likely to win public sympathy.

"There's a sense that patients gave it to themselves - they smoked," said Dr. David S. Ettinger, a professor of oncology at the Johns Hopkins University School of Medicine.

But that's not necessarily the case. On the day after Bel Geddes died, actress Dana Reeve, 44, widow of Superman star Christopher Reeve and a nonsmoker, announced that she, too, has the disease.

The American Cancer Society estimates that doctors will find lung cancer in more than 93,000 men and 79,560 women this year. Almost the same numbers - 90,490 men and 73,020 women- will die from it.

That's more deaths among men than the next four deadly cancers combined - prostate, colo-rectal and pancreatic cancers and leukemia. Among women, lung cancer kills more people than breast and colo-rectal cancers put together.

Cigarette smoking is by far the biggest risk factor in lung cancer, blamed for an estimated 80 percent of lung cancers in women and 90 percent in men, according to the American Cancer Society.

But it's not the only cause. Others include exposure to secondhand smoke, radon and asbestos. Genetic factors also contribute to the death toll, scientists say.

Lung cancer is notoriously difficult to beat, Ettinger said. With all stages and forms of the disease counted together, doctors are able to keep only 15 percent of lung cancer patients alive for five years.

"That's improving," Ettinger said. "If you diagnose it earlier, if you shift the curve to an earlier disease stage, you increase the cure rate, and I think we are heading in that direction."

With early detection, doctors can keep 60 percent to 70 percent of patients alive for five years. But that success rate falls to 2 percent in patients whose cancers are found at advanced stages - when they have spread to other parts of the body.

Improved screening technology and promising new drug therapies have given physicians and patients some reason for hope, but there have been no real breakthroughs.

Thun said scientists are studying a new tumor detection technology called "helical CT scanning" that can detect potential lung cancer nodules earlier and improve survival rates.

The problem is that it can't differentiate between nodules that are cancerous and those that aren't. So patients must undergo needle biopsies and surgery to find out for sure - procedures that carry their own dangers.

"The question is do the benefits outweigh the risks," Thun said.

Doctors have also been enthusiastic about new drugs that target lung cancers. One of them, Iressa, seemed to produce major improvements in some patients, Thun said. But later trials found no overall benefit.

"Lung cancer has been one of the most difficult cancers to find major advances in treatment," he said. "But the potential has improved with the identification of genetic mutations that allow lung cancers to survive and grow and spread."

The really good news on the lung cancer front has been a sharp reduction in U.S. smoking rates since the first surgeon general's report to officially link lung cancer to smoking was issued in 1964.

That year marked the apex of per capita cigarette consumption here, Thun said, a habit that had been growing since the 1920s and 1930s - accelerated by the romantic image of smoking in advertising and movies, and the free cigarettes servicemen received during World War II.

After the war, many women who had not already begun smoking picked up the habit from returning servicemen. By 1965, just over half of all adult American men smoked and about a third of women did. But women's smoking rates were rising, too.

The surgeon general's report marked a turning point. Since then, public education, increasing restrictions on where people can light up and rising cigarette taxes have all pushed people to quit - or never start.

By 1974 less than 43 percent of U.S. men were smoking, and today it's 24 percent, only slightly higher than women. Per capita consumption of cigarettes is now at its lowest level since World War II.

Researchers say the delayed payoff from that drop in male smoking is a 17 percent reduction in lung cancer mortality rates since 1990.

The falloff in lung cancer rates has been so steep, Thun said, that it has offset the increases in population. The number of lung cancer deaths among men fell a bit between 1990 and 2002.

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