The Ins and Outs of Lung Cancer - pt. 1

March… (Lung cancer awareness month)

I want to start with a story of a beautiful women named Janie Proia who lived with us for almost 6 years. She came to our home and rented a room from us, after a series of broken promises from her ex husband. She had left him 15 years prior, and he never honored the conditions of the divorce court. He changed his name, moved every 6 months and avoided the law. She left him due to his drug use because she wanted to become clean and sober and he didn't. Because of her drug use 15 years prior, she was put on a list, you know, that list where hospitals and doctors use as a warning of drug abuser’s(even though she had been clean and sober for 15 years).She had no family to speak of, so we became her family.

Around the second year she was with us, she started to get full body pain all of a sudden so she went to the local Hospital where they did a series of tests on her. Their diagnosis? Arthritis. They referred her to a Doctor in Suncook NH who refused to put her on any pain med’s knowing that her disease would get worse into her 60’s. No anti inflammatory, nothing to help her. She begged and pleaded for them to do more test’s, because she felt something else was wrong. This went on for another 4 years until one morning, Bob and I found her on the back deck rolling in pain and crying, begging us to help her end her life.

We all had enough. We took her to Dartmouth Hitchcock to my Doctors PA(physicians assistant). After hearing her story, he immediately ordered a pet scan (something he felt should have been done years prior). He also put her on anti inflammatory and pain meds. Ahhh, for the first time in 2.5 years, she was pain free and feeling so much better. He called us 4 days later and the next day, we sat there laughing and positive that they would help her. Sean came into the room, sat down, looked at both of us, and said, “I don't have great news for you” Your adrenal glands are dead and you show signs of Bone cancer. Before we could ask any questions, he stated that the Primary was LUNG CANCER, but that was not his concern, as they could not only control it, but get rid of it based on where it was. He explained that cells leaks from the lungs and destroyed the glans which then leaked into the bone. Now, we all know, that once cancer permeates the bone, it can travel anywhere.. Janie and I sat there with our mouths open not knowing what to say. I finally asked” whats the prognosis”?(although one thing became very clear, that her two year increased pain was due to bone cancer) not Arthritis. 5 Weeks later, she was in hospice and 4 weeks later, she was gone. Our precious, light of bob’s and my life, was gone forever due to two things:

1) Misdiagnosed by a major hospital

2) Refusal from another doctor to do the appropriate tests and accused her directly of making up pain just to get drugs.

Symptoms of Lung cancer

There are defined symptoms of lung cancer but here is the problem, they can be signs of other problems as well. Actually, they can be symptoms of anything from colds, upper respiratory infections, but we at AJ’s Wigs always say and stress, that if you have two or more signs of anything, please go to the doctors. Here are the beginning signs:

Now, these can be also slightly different then advanced Lung cancer, which are:

Now, notice the first one is bone pain? Remember what I stated above with Janie's story? For 4 years, she had extreme body pain and her doctors never cared to look further. BUT YOU MUST BECOME YOUR OWN ADVOCATE.

How can you tell if you have lung cancer or if its the flu or pneumonia?

Whether its cancer or something else, so many normal colds, aches and pains have so many of the symptoms of something more serious, and something more serious has the same symptoms of something common. Now, read this again….you can think it is serious, but its not, and you can think it’s a simple cold , and its not!!!!… So, how do you tell. A cold or flu will typically last up until 2ish weeks and pneumonia untreated is in fact deadly, however, treated with antibiotics, will last up until sometimes 3ish weeks depending on the severity of the infection. But the problem with the common cold, flu and something like pneumonia is that the symptoms are much the same. Lets take pneumonia:

The common cold and flu are both contagious viral infections of the respiratory tract. Although the symptoms can be similar, flu is much worse. A cold may drag you down a bit, but the flu can make you shudder at the very thought of getting out of bed. Congestion, coughing, sneezing are common with Bot h colds cold and flu bring  coughing and headache and chest discomfort. With the flu, however , you are likely to run a high fever for several days and have body aches, fatigue and weakness . Symptoms of the flu also tend to come on abruptly. Usually, complications from colds are relatively minor, but a severe case o r flu can lead to a life-threatening illness such as pneumonia.

S o, the cold, flu and pneumonia have several things in common like symptoms and other factors that lung cancer has. However, the key word is..PERSISTAN T … persistent cough, aches, fatigue etc.

Risk factors  

The risk factors with Lung cancer aren’t always clear, nor is it what you always correlate lung cancer to be about. No one disagrees that smoking isn't great    for your lungs, but three out of four surveys state that roughly 42-47% of Lung cancer cases, the patient has never smoked nor been around second hand smoke. I t is true that up until 15 years ago, most restaurants, bars, salons, and public places allowed smoking, or had smoking / non smoking sections, so when we start with risk factors, it makes sense when more people above 65 (2 out of 3) are at risk for Lung cancer. The average age at diagnosis is about 71.  

Second with risk factors, is Genetics. Patients who have a family member who has had lung cancer are more prone to be predisposed to Lung cancer. Whether they smoked or not, or were around second hand smoke, it doesn’t matter. Genetics plays a huge part in quite a few cancers.

Third, is a bit more complicated and that is Life style.(these are not listed in order of severity)

• Smoking and secondhand smoke: Smoking is widely considered the leading cause of lung cancer. For those who don't smoke but are exposed to smoke at home or work, secondhand smoke may significantly increase their risk of lung cancer. However, even though this is first in the life style risk factor, please remember the above, because a lot of people who are diagnosed are shocked because they have never smoked.

• Exposure to asbestos or other pollutants:  Carcinogenic chemicals in the workplace increase lung cancer risk, and don’t forget, that professions such as coal mining, hair stylist, housekeeping and cleaning, healthcare workers, Manufacturing, Construction, farming, auto body(spray painting), fire fighting.

• Exposure to radon: Radon is a colorless, scentless radioactive gas that is found in some houses and is a leading cause of lung cancer. Now, I’m going to spend a bit of time on Radon.

How does radon cause cancer?

Radon decays quickly, giving off tiny radioactive particles. When inhaled, these radioactive particles can damage the cells that lining the lung. Long-term exposure to radon can lead to lung cancer, the only cancer proven to be associated with inhaling radon. There has been a suggestion of increased risk of

leukemia associated with radon exposure in adults and children; however, the evidence is not conclusive.

How many people develop lung cancer because of exposure to radon?

Now, according to the NATIONAL CANCER INSTITUTE.(even though they differ from other national institutions)Cigarette smoking is the most common cause of lung cancer. Radon is the second leading cause of lung cancer in the United States. Scientists estimate that 15,000 to 22,000 lung cancer deaths in the United States each year are related to radon.

Exposure to the combination of radon gas and cigarette smoke creates a greater risk of lung cancer than exposure to either factor alone. The majority of radon-related cancer deaths occur among smokers. However, it is estimated that more than 10 percent of radon-related cancer deaths occur among nonsmokers.

How can you tell if your building or home is, or has been exposed to radon? Some think it is a simple air test that you can purchase from home depot , but its not. The best test is a ground soil test . Short-term detectors measure radon levels for 2 days to 90 days, depending on the device. Long-term tests determine the average concentration for more than 90 days. Because radon levels can vary from day to day and month to month, a long-term test is a better indicator of the average radon level. Both tests are relatively easy to use and inexpensive. A state or local radon official can explain the differences between testing devices and recommend the most appropriate test for a person’s needs and conditions.

Cancer death rate  

More people die per year from Lung cancer then Breast cancer, Prostrate cancer or Colon cancer. It continues to be the leading cause of death among cancer patients even today. And sadly, the survival rate is only 17%. But, here is the CATCH . You don't always die of actual lung cancer. Lung cancer can be the primary (as in Janies case) and through modern treatment, can be contained, however, because of where the lungs are located and the functions of the lungs, one single cell can escape and not only grow, but attack other organs again such as in Janies case. She didn’t die of lung cancer, she died of brain cancer. Her lungs, which were the primary, could have been controlled if caught in time

, but cells had leaked through into her adrenal glands, then into her bones and we all know, once it goes into the bone, the cells have free reign to go up the spine and into the brain. With our experience at AJ’S Wigs, yes, the survival rate is only 17%, if it is the primary, but often times, as stated above, that’s not what the patient dies of.

One might ask why is the death rate so high as compared to other cancers? S adly, until about 4-5 years ago, lung cancer was on the lower rung of funding primarily d u e to the old stigma of “hey, they decided to smoke, they should suffer the consequences”. When researching this blog, I was shocked and dismayed to read this, because no one deserves to die or have their life cut short, and who ever decides on how much money goes into funding different cancers, should be ashamed of themselves for not allocating the proper funds to the number 1 killer cancer.

N EW HOPE… As of 2012, more and more funding has been allocated to the study of Lung cancer. This is mainly due to the change in attitude and the increased knowledge of the fact that so many people who have never smoked develop lung cancer nor been around smoke . There was also a breakthrough in the knowledge that women are more likely to develop lung cancer during or after menopause because of estrogen receptors.

Since lung cancer is, in many ways, a different disease in women, it is important to look at the possible role of estrogen. But as noted above, what we understand about estrogen and lung cancer is still in the early stages.

With any procedure or medication, it is extremely important to weigh the benefits of treatment against the possible risks. For example, if your doctor recommends that you have your ovaries removed for some reason, the benefit of the procedure may far outweigh a possible increase in lung cancer risk, once your over your child baring years.

For now, these studies are a good reminder to talk with your doctor if you are on hormone replacement therapy, particularly if you smoke, and to ask questions. Do you need to take the medications? Are there any alternatives? Are there benefits that go beyond the potential risk of a higher mortality from lung cancer (or breast cancer)?

Part two… Can you live with one lung? What about lung transplants? More about Estrogen.