Political Action Needed to Counter Growing Lung Cancer Threat to Women

Women must make lung cancer as hot and as female a public issue as they have made breast cancer, urged a cancer expert speaking at the 1997 Biennial Symposium on Minorities, the Medically Underserved, and Cancer in Washington, DC. Five years from now, twice as many women will die of lung cancer than of breast cancer, warned Paul Bunn, Jr., md, Grohne/Stapp Chair in Cancer Research and director of the University of Colorado Cancer Center.

Despite this looming threat, Americans today do not generally receive optimal care for this extremely deadly malignancy. Recommending immediate action, Bunn stated that Americans must demand that recent advances in lung cancer treatment become much more widely available. The control of tobacco must also become a top national priority, he added.

A rocketing rate of female lung cancer follows inevitably from trends in female smoking over recent decades, Dr. Bunn noted. Lung cancer, he warned, will soon be the number-one health issue facing American women. The time has come for women to make lung cancer as important a political issue as they have made breast cancer.

More Women and Young People Smoking
One prong of the campaign must target cigarettes, he stated. Smoking accounts for 85% of all lung cancers, and 30% to 40% of such cancers occur in current smokers. Tobacco companies in recent years have consciously—and successfully—targeted young women, especially whites, who are now one of the fastest-growing groups of smokers. For the first time, more of them now light up than their male counterparts, Bunn noted.

Smoking rates have dropped since the US surgeon general’s report in 1964, when half of the adult population smoked. After a number of years of decline, the rate is once again rising among the young, with a third of this year’s high school graduates smoking regularly.

Better Availability of New Therapies
A second prong of the campaign, Bunn said, must be to make the best possible therapies available to all lung cancer patients—something that now happens in only a minority of cases, he reported. New chemotherapeutic agents can quadruple survival rates compared to traditional ones, with as many as 50% of cases alive after 1 year, Bunn stated.

The widespread perception that a diagnosis of lung cancer equals a death warrant keeps the great majority of American lung cancer patients from even hearing of these new treatments, let alone getting to take advantage of them. This must change, Dr. Bunn insists. And, he believes, the political dynamism that transformed breast cancer from an unmentionable disorder to a national cause in little more than a decade can and will, if unleashed, extend or save the lives of many stricken by a disease that is simplicity itself to prevent but costly and difficult to cure.

Chemoprevention and Screening
The nation’s millions of ex-smokers also need chemoprevention regimens, he added. The risk of lung cancer drops as soon as smoking ceases, but takes about 15 years to drop to about twice that of a person who never smoked. About half of all lung cancers occur in former smokers. Although many studies have shown that a diet high in fruits and vegetables can afford even smokers some protection against lung cancer, high doses of micronutrients, such as beta-carotene, do not. Therefore, a diet containing five daily portions of fruits and vegetables is highly recommended for smokers.

Finding better screening methods is also an urgent priority. It is not clear whether chest x-rays work as a screening technique, Bunn said, although it is known that sputum tests and white light bronchoscopy are not effective. Bronchoscopy using biofluorescence appears to be more promising in detecting lung cancer at earlier stages.