Non-Smokers Suffer Lung Cancer Stigma

Smoking is such a well-known cause of lung cancer that many don't realize thousands who never smoked get the diagnosis. The great majority are women. Recent research shows it's really a different disease than smoking-related lung cancer. But those with the diagnosis say they suffer the same stigma.

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RENEE MONTAGNE, host:

And here's something else to consider: sometimes breathing problems signal some very serious and unexpected health problems. That's certainly the case with lung cancer in people who have never smoked.

NPR's Richard Knox has this story.

RICHARD KNOX: Jo Costello(ph) is 21. She's a senior at UC Berkeley. She's a member of the crew team. She never touched a cigarette, but she just got diagnosed with lung cancer.

Ms. JILL COSTELLO (Senior, UC Berkeley): I got back from national championships on June 1st, and then went to the trainer later that week with, like, abdominal bloating and just discomfort.

KNOX: At first doctors thought she might have ovarian cysts, then they did more tests.

Ms. COSTELLO: They found some masses in my lung and liver and breasts. So, after some biopsies and tests, the next day they told me that I had cancer. It's lung cancer that just metastasized to different areas in my body now and bone actually.

KNOX: Metastatic lung cancer is scary. But she hopes the fact that she's in good shape will help. She says, I'm planning on knocking it out. Jill Costello is especially young, but it's not rare to find a diagnosis of lung cancer in people who've never smoked. Heather Wakelee of Stanford University is Costello's doctor.

Dr. HEATHER WAKELEE (Division of Medical Oncology, Stanford University School of Medicine): In fact, about 10 percent of men in this country who developed lung cancer have never smoked. And it's actually about 20 percent of women who develop lung cancer have never smoked.

KNOX: That translates to about 10,000 men and 17,000 women who get lung cancer every year even though they never smoked. Lung cancer in never smokers ranks with brain, liver or ovarian cancer. In the number of cases more women get it than uterine cancer. But still, this diagnosis often comes as a total surprise.

Dr. WAKELEE: It's complete shock, a lot of why-did-this-happen-to-me. And for some of them it's - there's anger about the fact that the finger is pointed at them for getting an illness that they had nothing to do with.

KNOX: Kathy Reid(ph) knows that feeling. She was diagnosed two years ago.

Ms. KATHY REID (Retired Marine Gunnery Sergeant): I had had a cough for a whole year prior to that and the doctors had just kept saying bronchitis.

KNOX: Reid is a retired Marine Gunnery Sergeant and a marathon runner who lives in Virginia. She says people always assume that she must have smoked.

Ms. REID: They look at you with that look. I say, I never smoked. I always feel like I have to defend myself, not that it's right that everybody gets cancer, but it's like people are looking at me and thinking that I did it to myself.

KNOX: With somebody who never smoked, the obvious question is whether secondhand smoke is the culprit. Dr. Jyoti Patel of Northwestern University says probably not.

Dr. JYOTI PATEL (Oncologist, Northwestern University): Usually what we quote is that 15 to 20 percent of lung cancer in never smokers is due to environmental tobacco smoke.

KNOX: The biology backs that up. Dr. Adi Gazdar studies lung cancer at the University of Texas, Southwestern Medical School in Dallas. He says the DNA of tumors from smokers shows telltale damage from chemicals in tobacco smoke.

Dr. ADI GAZDAR (Pathology, University of Texas Southwestern Medical School): In never smokers, lung cancers lack this characteristic pattern that to me is powerful evidence that tobacco carcinogens are not the major driving force.

KNOX: Also, most never smokers who get lung cancer get a different type than smokers do. Lucky for them this type often responds to two new cancer drugs. They target and turn off a particular mutation found in patients who didn't smoke and in Asians, particularly Asian women. These drugs aren't cures, but they give researchers reason to think there will be other ways to defeat this unexpected kind of lung cancer.

Richard Knox, NPR News.

RENEE MONTAGNE, host:

You're listening to MORNING EDITION from NPR News.

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