'The World'

By Ruth Bird

When Dana Reeve, widow of actor Christopher Reeve, died of lung cancer, the stories of her death pointed out that she didn't smoke. She was young, only 44; she had nursed her paralyzed husband for eight years; she left a

13-year-old son an orphan. And how could she have gotten lung cancer? She had never smoked.Lung cancer is often preventable, and it is usually fatal.

Unfortunately I will also become a victim of this disease. Not for myself, but a victim because I am a friend of a lung cancer person. One of my very dearest friends will undergo a lung operation this coming Tuesday.


Be cautious of any information or claims obtained from unmonitored sources, in particular the Internet. The Internet can be an empowering source of information, but a healthcare professional should be consulted before making medical decisions.

What is cancer?

Cancer is a disease that starts in our cells. Our bodies are made up of millions of cells, grouped together to form tissues or organs. Genes inside each cell order it to grow, work, reproduce and die.

Normally, our cells remain healthy. Sometimes a cell's instructions get mixed up and it behaves abnormally. After a while, groups of abnormal cells can circulate in the blood or immune system, or they can form lumps or tumours.

Tumours can be either benign (non-cancerous) or malignant (cancerous). Benign tumour cells stay in one place in the body and are not usually life-threatening.

Malignant tumour cells are able to invade the tissues around them and spread to other parts of the body. Cancerous cells that spread to other parts of the body are called metastases. The first sign that a malignant tumour has spread is often swelling of nearby lymph nodes, but cancer can metastasize to almost any part of the body. It is important to find malignant tumours early and treat them.

Cancers are named after the part of the body where they start. For example, cancer that starts in the colon but spreads to the liver is called colon cancer with liver metastases.

There are four main types of lung cancer: small cell lung cancer, squamous cell carcinoma, large cell carcinoma and adenocarcinoma. Tobacco smoking is strongly linked to the first three but only weakly linked to adenocarcinoma. However, this type of lung cancer has been linked to the use of low-tar cigarettes.

The best means of prevention is to never start smoking or using chewing tobacco, or to stop using tobacco products. A healthy diet is an important part of prevention.

The outlook varies by cell type and stage of the disease. In general, the prognosis is better for squamous cell cancers than for adenocarcinomas. Early detection is key to better chances of survival.


According to the American Lung Association, 87 percent of lung cancer cases are caused by smoking. Another 12 percent are linked to radon exposure.

Only 15 percent of people diagnosed with the disease will still be alive five years after the diagnosis; 60 percent die within the first year. What is Chemoprevention? For individuals who demonstrate the greatest risk, researchers are currently conducting several new trials to test the use of natural and synthetic substances to prevent development of the disease. This new research has been coined, chemoprevention.

The National Cancer Institute's (NCI) chemoprevention research effort started in the early 1980s and has grown considerably since that time. Currently, approximately 400
compounds are being studied as
potential chemopreventive agents, mainly in laboratory research. Over 40 of these compounds are being studied in clinical trials (research studies with people). Some of these agents are being investigated as single agents; others are being tested in combinations of two drugs. Chemoprevention trials look at possible ways to prevent cancer with interventions that include drugs, vitamins, diet, hormone therapy, or other agents.

The American Cancer Society (ACS) has set aggressive challenge goals for the nation to decrease cancer incidence and mortality--and to improve the quality of life of cancer survivors--by the year 2015. To address these critical goals, the ACS publishes the Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and ultimately, to affect dietary and physical activity patterns among Americans.

These guidelines, published every five years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and as such, they represent the most current scientific evidence related to dietary and activity patterns and cancer risk.

The ACS guidelines are consistent with guidelines from the American Heart Association for the prevention of coronary heart disease as well as for general health promotion, as defined by the Department of Health and Human Services' 2000 Dietary Guidelines for Americans.

In 2006 there will be an estimated 174,470 new cases of lung cancer and an estimated 162,460 Americans will die from the disease.

The American Cancer Society offers support and hope for people diagnosed with lung cancer and their families as well as resources to help smokers quit 24 hours a day, 7 days a week, including its own Quitline, which since its launch in May 2000 has provided services to more than 150,000 callers. For more information, call 800-ACS-2345 or visit www.cancer.org.

Lung cancer chemoprevention - Why does it not work?From the National Cancer Center.

Common wisdom is that vitamin in fruits and vegetables prevent cancer. However, trials of supplementing vitamins like vitamin A analogues (retinoids: beta-carotene, retinol, retinyl palmitate, or isotretinoin) or vitamin E (alpha-tocopherol), did not prevent lung cancer in smokers. Randomised trials in all the three settings: primary (healthy high-risk e.g. smokers), secondary (pre-malignant lesions), and tertiary (prevention of second primary tumours in previously treated patients), have produced negative results (either neutral or harmful).

Chemoprevention trials were prompted by relationship between diet and lung cancer. Diet rich in foliage vitamins was protective against lung cancer - as demonstrated in a recent Dutch study of 939 patients. Similarly, higher blood level of ß-carotene is linked to a lower risk of lung cancer. Nonetheless, intervention trials failed to show a reduced risk in lung cancer by consuming ß-carotene. A phase III trial, the Alpha-Tocopherol, Beta-Carotene (ATBC) [beta-carotene (20 mg/d), alpha-tocopherol (50mg/d)] indicated significant increases in lung cancer incidence (18%) and no effect on lung cancer mortality (risk ratio, 0.99).

Another study, CARET, had a 28% increase in lung cancer with vitamin treatment. Similarly, in both Euro-scan and the US-Lung Intergroup Trial (both testing retinoids in tertiary prevention), results were neutral.

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