Losing to Lung Cancer

While fewer people are dying, it’s still the number-one killer

I remember walking into the Madison Magazine offices in October 2003. A man I didn’t recognize—he was bald, his complexion was yellow and his eyes were circled in red—greeted me enthusiastically. I was taken aback for a moment. I couldn’t figure out why he was so excited to see me and why he called me by name. Then it hit me. This wasn’t a stranger. This was someone I knew, someone who knew me.

It was Brian Howell, then the editor of Madison Magazine. He was deep in the throes of lung cancer. In the weeks between my visits to the magazine offices, he had lost his hair. He had gone from vibrant—there was no one more alive than Brian Howell—to very ill, although his voice was still bright. I remember that despite how sick he looked, he never seemed to stop smiling that day.

A month later he was gone.

The next year I wrote a story about lung cancer. At the time it was one of the most devastating cancers, killing more than a host of other cancers—breast, colon and prostate—combined. A diagnosis was essentially a death sentence. Most instances were caught in late stages when treatment options were limited and survival rates bleak. Fewer than fifty percent of lung cancer victims lived five years or more. Brian died nine months after diagnosis. Not a lot has changed. According to the U.S. Centers for Disease Control and Prevention, lung cancer still kills more individuals than any other type of cancer. While the CDC reports that death rates have slowed significantly, lung cancer is still a devastating blow.

Brian Howell

Dr. Anne Traynor, an associate professor of medicine at the UW Carbone Cancer Center, focuses much of her work on lung cancer and agrees that lung cancer cures and treatments have not advanced the way they have for other cancers.

Traynor says studies have shown that better CT screening would help, since one of the reasons lung cancer is so deadly is that it is caught so late. Unfortunately the current method has an astoundingly high false-positive rate—upward of ninety percent—so Medicare won’t pay for it. And if Medicare won’t cover it, few private insurance companies will pick up the tab. Traynor says there is a lot of  research going on to lower that false positive rate so that covering screening will be more attractive, but securing funding to study lung cancer is not that easy.

The vast majority of lung cancers (estimates connect between eighty and ninety percent of instances) are caused by smoking. As a result, there is a pervasive sentiment—borne out by scientific studies—that the patient is to blame for the disease despite the fact, Traynor points out, that most heavy smokers never get lung cancer and 35,000 nonsmokers get the disease every year.

Further, this hostility and lack of sympathy explain the funding disparities between lung and other common cancers. For example, Traynor points out that breast cancer is funded at a rate fourteen times higher than lung cancer is.

“The majority of people have no ill will toward a breast cancer patient,” she says.

Traynor notes that there have been some promising developments with drug treatments for nonsmokers, who tend to get a molecularly simpler form of lung cancer than smokers. Also, there has been some progress toward a vaccine of sorts that bolsters the immune system to enable it to fight off lung cancer growth. But the progress has been slow.

“I’m ecstatic that it’s getting better in lung cancer,” Traynor says. “It’s just not getting better quickly enough.”

I can’t help thinking that if the ever-optimistic Brian Howell were still alive, even he would agree.

Jennifer Garrett is a Madison-based freelance writer. Read her Health Kick blog.

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