Lung Cancer Is Not A Laughing Matter
You may or may not be a fan of Kathy Griffin’s acting or comedy, but she recently became a member of a growing group of never-smoking Americans who face a lung cancer diagnosis.
She recently tweeted “Yes, I have lung cancer, even though I’ve never smoked! The doctors are very optimistic as it is stage one and contained to my left lung. Hopefully no chemo or radiation after this and I should have normal function with my breathing.”
According to data from the CDC, non-smokers account for approximately 10% to 20% of lung cancers diagnosed in the United States, or roughly 20,000 to 40,000 lung cancers annually. *
Lung cancer in early stages, such a Kathy Griffin’s, is often found by accident. In early stages, lung cancer patients don’t often experience symptoms, or if they do experience symptoms such as shortness of breath, a cough, or chest pain which commonly occur, they are often misdiagnosed and confused with other illnesses. A cough, fatigue, or shortness of breath does not usually inspire a non-smoking person to rush to their physician to specifically discuss lung cancer. As a result, by the time lung cancer is considered diagnostically, it is often at a later stage. However, if you are aware of a family history of lung cancer, long term environmental exposure to radon, asbestos, open fires, frying foods, or have a history of other inflammatory lung disease, and some of the above symptoms are present, it could signal lung cancer and it’s important to feel empowered to have a straight forward conversation with your provider.
Currently the only method available for early-stage lung cancer detection is a low dose Computed Tomography (CT) scan. Medicare part B guidelines are often used by physicians to assess whether to order a screening for patients. Unfortunately, current guidelines are restrictive and do not consider non-smoking risk factors. They are:
- The patient is ages 55-77.
- The patient does not have signs or symptoms of lung cancer (asymptomatic).
- The patient is either a current smoker or quit smoking within the last 15 years.
- The patient has a tobacco smoking history of at least 30 “pack years” (an average of one pack [20 cigarettes] per day for 30 years).
As a person whose mother and biological grandmother both had lung cancer, I am aware that I am at increased risk of developing the disease even though I am a mother with teen age children and a non-smoker. When I recently noticed a constellation of whisper-like symptoms, I had a conversation with my physician and brought up the idea of having a low dose CT scan. Given my family history, at minimum, a baseline lung scan would be a good thing to have, I suggested. My provider said he agreed; however, he could not order the scan because I did not meet the criteria above. The HMO computer program was strictly set to those guidelines (or perhaps he was?). I believe a revision of current low dose CT scan screening guidelines to include non-smoking risk factors such as family history or environmental exposures is necessary and would save lives.
Fortunately, I was able to transfer to a more seasoned physician who understood what to by-pass in the computer system so he could order a baseline low dose CT scan for me. As a smoker or non-smoker it is important to know your risk factors for developing lung cancer, minimize exposure to known risks and not to give up if you are initially denied access to what may be a critical component of your care. Hopefully, in the near future we will have better early detection technologies as well as more inclusive policies around their use.