Category Archives: Lung cancer

Immunotherapy, Keytruda, Lung cancer, Nobel Prize

Immune therapy breakthrough for cancer wins Nobel

Two medical researchers, James Allison of the U.S. and Tasuku Honjo of Japan, were awarded the Nobel Prize for medicine this week for their breakthrough research in harnessing the body’s own immune system to fight cancer.

Allison and Honjo’s breakthroughs came way back in the 1990s. Their research eventually led to the production of immunotherapy drugs such as Yervoy in 2011 and later the well-known drug Keytruda.

Immunotherapy unleashes the body’s own immune system to attack cancer cells rather than chemotherapy. It tends to not have as many side-effects as chemotherapy and for certain kinds of cancers, such as melonoma, it has provided astounding results. Keytruda is most famous for being known as “The Jimmy Carter” drug because Carter was given the drug on an experimental basis several years ago when he had advanced melanoma and brain cancer. And Jimmy is still around today to talk about it.

Keytruda has shown success in treating certain kinds of small cell lung cancer (if patients have certain gene markers). While there are some reports that people with melanoma have been literally cured by Keytruda, it’s not a cure for lung cancer. However, for some patients, they live much longer on the average than with traditional chemo and have much better quality of life.

From a Scientific American article:

Allison, a professor at The University of Texas M. D. Anderson Cancer Center in Houston, discovered that a molecule called CTLA-4 (cytotoxic T-lymphocyte antigen 4) acts as a “brake” on the immune system; remove the brake and—in many cases—immune cells are unleashed to fight the cancer. Allison spent 17 years convincing others that this approach could work, leading to approval in 2011 of the drug Yervoy, which showed near-miraculous results for a fraction of patients with a lethal form of skin cancer.

The pharmaceutical industry is vigorously pursuing immunotherapy, and hundreds of trials are currently underway based on CTLA-4, PD-1 and other immune approaches.

For decades researchers had been trying to figure out effective ways to use the body’s own immune system against cancer. They tried vaccines and other approaches for ramping up immune activity. Allison’s insight, Perlmann said, was to trigger the brakes instead. “It represents a completely new principle because, unlike the previous strategies, it is not based on targeting the cancer cells but rather the brakes, the checkpoints of the host immune system,” he said. “It represents a paradigmatic shift and a landmark in the fight against cancer.”

Honjo’s research was completely separate from Allison’s, but used a similar approach.

From the article:

Meanwhile Honjo, of Kyoto University in Japan, was studying a different immune brake called PD-1 (programmed cell death 1), according to Thomas Perlmann, secretary general of the Nobel Committee, who spoke about the findings amid the prize announcement early Monday. Allison’s success with CTLA-4 in cancer persuaded Honjo to consider his molecule in cancer as well—and he found PD-1 therapy was even safer and more effective against a number of cancers, including lung cancer, which kills about 150,000 Americans a year. Drugs based on his findings also work in combination with Yervoy against a number of types of cancer.

Keytruda is not quite a miracle drug, unfortunately. Not everyone has the gene markers for it, but it has gained a massive reputation thanks to Jaimmy Carter. From a Times Now article:

While in theory it should work for most forms of cancer, it’s most effective on those with the highest numbers of mutations such as melanomas, lung cancer and smoking, he added.

And it has sometimes been met with too much enthusiasm by patients. In the US, some have reportedly asked their doctors to immediately use immunotherapy instead of traditional treatments like chemotherapy, even when they are more effective.

After his big win on Monday, Allison warned that immunotherapy will not replace all other cancer treatments. Instead, it is “going to be part of therapy that potentially all cancer patients will receive in five years,” he told a press conference in New York. Honjo, meanwhile, said he wanted to continue his research “so that this immune therapy will save more cancer patients than ever”.

 

 

Cancer, Lung cancer

Cancer rate keeps dropping

According to information from the American Cancer Society, the  cancer rate 2015 dropped 1.7 percent.

While that may not sound like a big number, first, it’s part of a long-term trend in which the mortality rate for cancer has dropped 26 percent  over the past 25 years (which translates into 2.4 million fewer deaths).

And the biggest reasonf for the drop? According to this Washington Post article:

Cancer Statistics 2018, the organization’s annual look at incidence, mortality and survival, tracks the decades-long decline in mortality as driven largely by falling death rates among four malignancies — lung, breast, prostate and colorectal cancer.  Ahmedin Jemal, the group’s vice president for surveillance and health services research, said the decreases largely reflect reduced smoking and advances in prevention, early detection and treatment.

Overall, the cancer death rate has dropped from 215.1 per 100,000 population in 1991 to 158.6 per 100,000 in 2015.

Otis W. Brawley, chief medical officer of the American Cancer Society, said in a statement that the report underscores the importance of continued efforts to discourage tobacco use. While the reduction in cigarette smoking has pushed down mortality rates, “tobacco remains by far the leading cause of cancer deaths today, responsible for nearly 3 in 10 cancer deaths.”

That number is a huge drop — 215.1 per 100,000 to 158.6 per 100,000. Roughly a 36 percent drop. Why? SMOKING has dropped.

The smoking rate in 1991 … about 25 percent. The smoking rate in 2015 … about 17 percent.

The news isn’t all good. Lung cancer remains by far the No. 1 cancer killer.  For men in 2015, 83,000 of all cancer deaths were from lung cancer, out of 323,000 cancer deaths (about 26 percent).

Among women, 70,500 of all cancer deaths were from lung caner, out of 286,000 cancer deaths (about 24.5 percent).

The next highest cancers? For men, it’s prostate cancer at 29,000 and for women it’s breast cancer at 41,000. So lung cancer for men and women combined kill considerably more than twice as many people as prostate cancer and breast cancer combined.

 

 

 

Lung cancer

My long-overdue eulogy for Ted

This is a post I started a half-dozen times over the past three years and I could never get through it. I would set it aside and then revisit it a few weeks or months later and then I still wouldn’t be able to finish.

Because it was just too hard for me to finish.

It’s a post about Ted, a longtime editor and  publisher I worked for for eight years in the 1990s.

It was eight memorable years working for one of the most interesting and eccentric people you’ll ever meet in this business. I never got a chance to say goodbye to Ted. I found out from a former coworker three years ago that he had died of lung cancer at 72.

I was reminded of that this week. It has been almost exactly three years since he died.

I don’t know if Ted ever smoked. He was from the generation in which virtually everyone smoked, but I never saw him once light up a cigarette. Perhaps he smoked long ago. But, ultimately, I don’t believe it matters. No one deserves lung cancer. I watched my dad die of it 38 years ago and despite his four pack-a-day habit, he didn’t deserve that. And 15 percent of the people who die from it never smoked a single cigarette, anyway, so … so what. So, I’m not here to lecture about smoking.

Anyway, it was under Ted that I first became a sports editor. Ted had a vast amount of knowledge and interest in sports. He played basketball at Lafayette University (and my publisher at the time played basketball for the University of Texas. Wow, did I ever feel like a schmoe around those two.). He local sports for 20 years. He was a huge Mariners and Seahawks fan. I had a lot of fun taunting him with how bad the Mariners’ bullpen was in the late 1990s:

“Hey, did you see that eighth inning last night?”

(Ted’s voice) “Oh, my God, I want to kill Bobby Ayala. I swear I hate him, I want him to just die …”

Ted once made the funniest joke I’ve ever heard. We were talking about the NFL or something and he blurted out, “I swear if Hitler played the Dallas Cowboys, I’d cheer for Hitler …” (Making this very funny was the fact that Ted was Jewish.). I literally fell out of my chair laughing.

I was hired there partly to build up the sports coverage on San Juan Island. Ted was one of the few people in this business that I could actually talk hockey with.

Back in those days, if you didn’t have cable, the only TV you would get was CBC in Vancouver, so lots of people there watched the Canadian hockey they’d show from 4 p.m. to 10 p.m. every Saturday night (and seven nights a week during the Stanley Cup Playoffs).

In order to write this column, I need to be honest. Ted and I used to really butt heads a lot. I mean, a lot. Because Ted often had a way of doing things that went against everything I was taught in Journalism 101 that would leave me pulling my hair out. He tended to dedicate too much space in his stories talking about the officiating, he had a real blind spot for his own biases sometimes, etc.

One of the biggest fights I remember us getting into was when I covered a state semifinal baseball game, I wrote that an outfielder made a “Ron Swoboda-ish” diving catch to get the final out in the bottom of the seventh. We had an argument that went around in circles for hours because he wanted to change it to Ken Griffey-ish because he had never heard of Ron Swoboda (I did have the edge on him on baseball). I know this must sound petty, but we went around in circles over this for literally six to eight hours. I won that battle. “Ron Swoboda-ish” stayed, but our feathers were ruffled for days afterward.

So, his pet name for me was “the Claude Lemieux of reporters.”

For those who aren’t hockey fans, Claude Lemieux (no relation to Mario) was a pesky, dirty, cheap shot player from the 1990s, the kind of guy the NHL has mostly run out of the league today. That was about the worst insult he could think to throw at me. He thought it was funny to call me Claude Lemieux because he knew it got under my skin. I would just respond, “that doesn’t even make sense.”

But through all that fighting and hair-pulling, I couldn’t help but like the man. He was wickedly funny. He had some weaknesses, sure, we all do, but he also had strengths. Things I genuinely learned from. Ted had a unique ability to sniff out quirky, off-the-wall human-interest stories like no one else I’ve ever seen. For years, I had been nothing but a pure meat and potatoes reporter, in fact, at one paper I worked at, the paper was literally nothing but board meetings and all I did was sit in commission meetings for 40 hours a week. It was pretty damn boring.

So, this is something I’ve tried to take to heart — that these are the kinds of stories that make small-town newspapers valuable to their communities. Trust me, I’m nowhere near as good at it as he was. He simply found stories that no one else could. He did it by wandering through the streets of Eastsound on his way to lunch and listening. And that was the biggest thing I learned from Ted.

At the end, despite all of our battles, when I left, we embraced and all was forgiven. We kept in touch for a few years until Ted retired and moved to Hungary for a while to research his family background (much of his family was wiped out in the Holocaust). After he moved to Budapest, I completely lost track of him. He apparently moved back to the Pacific Northwest a few years ago, but I didn’t realize that and I certainly was shocked to hear that he had become ill and quickly passed away.

That was a rough summer. A coworker of mine died of breast cancer and a good friend of mine died of complications from AIDS and then Ted, all in a period of about four weeks. He was a big part of my career and my life for eight years.

And the danger of drifting away … you don’t get to say goodbye.

Immunotherapy, Keytruda, Lung cancer

New drugs making progress against lung cancer

Lung cancer is one of the deadliest forms of cancer. At one time 90 percent of the people who developed lung cancer died from the disease. The number is better now, but the death rate for lung cancer is still one of the highest for any form of cancer.

The five-year survival rate today for lung cancer is still only about 17.7 percent and more than half the people who are diagnosed die within a year. However, early detection is key. Lung cancer is a bitch about metastasing to other parts of the body. If it can be caught early while still localized in the lung, the five-year survival rate jumps to 55 percent.

They haven’t found a cure, of course, but no drugs are making big progress on lung cancer, as well as prostate and breast cancers.

One of the main drugs used against a certain kind of lung cancer (that younger people and nonsmokers tend to get) is Xalkori, makde by Pfizer. This new drug is called Alecensa, made by Roche.

The AP did a big story on this last week. From the story:

“Roche’s Alecensa stopped cancer growth for 15 months longer than Pfizer’s Xalkori did in a study of 303 people with advanced lung cancer and a mutation in a gene called ALK. About 5 percent of lung cancer patients — 12,500 in the U.S. each year — have an ALK mutation, especially younger people and nonsmokers who get the disease.

Alecensa kept cancer from worsening for 26 months versus 11 months for Xalkori. It also penetrates the brain better: Only 9 percent of those on it had their lung cancer spread to the brain during the first year of treatment versus 41 percent of those on Xalkori. Serious side effects and deaths were less common with Alecensa.

The federal Food and Drug Administration approved it in December 2015 for ALK-related lung cancers that worsened despite trying Xalkori. The new study tested it as initial treatment and is aimed at getting full approval for that.

Xalkori is around $10,000 a month and Alecensa about $12,500.”

So, this drug extends the life of lung cancer patients by two years on the average.

Look at the price tag, though. Imagine trying to pay for that without medical coverage.

Obviously not a cure, but maybe making a dent in that terrible survival rate. Incredible with the advances in treating cancer, especially childhood leukemia, that they have made so little progress in treating lung cancer. I think that is partly because of the stigma that continues to surround lung cancer compared to other kinds of cancer.

Another promising front is immunotherapy with drugs such as Keytruda (this is an esperimental drug taken by Jimmy Carter when he was diagnosed with terminal brain cancer a few years ago and he’s still kicking). I’ve written about this before.

From a Medscape article:

The overall response rate (ORR) of 45% reported for pembrolizumab (Keytruda) first-line is unprecedented, Dr Soria said. Together with the superior progression-free survival (PFS) and overall survival (OS), as well as the better tolerability, when compared with chemotherapy, these findings indicate that pembrolizumab is now “the new gorilla” in the treatment of (non-small cell lung cancer), and probably a new standard of care, he said.

There was also good news on the breast cancer and prostate cancer fronts. A new drug called Zytiga delayed cancer growth for 18 months for men with advanced prostate cancer, while a drug called Lynparza helped delay breast cancer growth for seven months.

Cancer, Lung cancer

Not surprising — Southerners most likely to die from smoking-related cancers

Auto Racing: NASCAR Heinz Southern 500: Dick Trickle (84) smoking cigarette on track before race at Darlington Raceway. Darlington, SC 9/3/1989 CREDIT: George Tiedemann (Photo by George Tiedemann /Sports Illustrated/Getty Images) (Set Number: X38788 TK3 R6 F13 )
Getty Images, obviously. A totally non-stereotypical depiction of Southern cigarette smoking.

This is a bit from the “Well … duh” department. A new study from the American Cancer Society shows that Southern states have the highest death rates from cancers caused by smoking.

Forty percent of the cancer deaths for men in Arkansas are smoking -related cancers, while 29 percent of the cancer deaths for women in Kentucky are for smoking-related cancers, according to the ACS.

Nationally, roughly about 29 percent of all cancer deaths are blamed on smoking-related cancers, primarily lung cancer.

The study also looked at other cancers thought to be linked to smoking, such as liver, throat, pancreas, colon and kidney, as well as leukemia.

lung cancer rates
Lung cancer rates. Darker is deadlier.

Most of the 10 highest states for cancer death rates are in the South, while most of the 10 lowest are in the West, where smoking rates are low. The lowest state was Utah, with 22 percent of cancer deaths among men  attributable to smoking and 11 percent for women. Utah, mostly because smoking is a sin among Mormons, has the lowest smoking rate in the nation. California and Hawaii are the next two lowest, I believe.

What do almost all Southern states have in common? Low cigarettes taxes and virtually no statewide smoking bans (Only two or three Southern states even bother to ban smoking in restaurants, much less bars.). They also spend the least on tobacco education. And gee, what a coincidence, they tend to have the highest smoking rates (Kentucky and West Virginia keep trading back and forth over which state has the highest smoking rate).

The average cigarette tax in the South is 49 cents a pack, compared to about $1.80 a pack in the rest of the nation.

The South by far has a much higher lung cancer rate than the rest of the country. Add to that a high rate of diabetes (which probably has to do with the Southern diet, but smoking is a contributor to diabetes) and it’s simply not a very healthy part of the country.

I want to make clear I’m not making fun of the South here. Lung cancer is no laughing matter, no matter what part of the country it’s happening in.

 

 

Keytruda, Lung cancer

Jimmy Carter on the forefront of possible breakthrough in lung cancer drug

160616-jimmy-carter-cancer-1215p_e510b4c7e214f042414c426212d131b0.nbcnews-ux-2880-1000

Jimmy Carter was diagnosed about a year ago with advanced liver cancer that had metastasized into his brain and other organs. Usually, for a 90-year-old man, the prognosis is not good.

However, a year later, Carter is at the moment cancer-free and apparently has no plans of dying any time soon. Carter was given an experimental immunotherapy drug called Pembrolizumab (trade name Keytruda, which I’m going to use because it’s easier to spell), which worked wonders on his cancer.

Keytruda has also been shown to be effective in treating small-cell lung cancer, still one of the most difficult types of cancer to treat. Despite the dramatic drop in smoking rates the past 25 years, lung cancer remains the No. 1 cancer killer in the West.

Because Keytruda is working so well in treating lung cancer among 300 trial patients, the drug company Merck announced that it will no longer hold trials and will make Keytruda available to these lung cancer patients. According to Merck, Keytruda worked as well if not better than conventional chemotherapy and helped stopped the growth of lung cancer tumours.

From an NBC story:

The details are not available yet. “We look forward to sharing these data with the medical community and with regulatory authorities around the world,” said Dr. Roger Perlmutter, president, of Merck Research Laboratories.

Independent committees look at the details of the patients and how well they are doing in drug trials like these. It was one of these independent committees that recommended stopping the trial based on what they saw but that doesn’t necessarily mean they shared the details with the company or anyone else.

“I suspect the findings were significant enough that this will be a practice-changing finding,” Dr. Pasi Janne, lung cancer specialist at Harvard Medical School and the Dana-Farber Cancer Institute, told NBC News.

Keytruda has not been approved yet for wide use by the Food and Drug Administration, but the process of getting its approval has begun. Keytruda has been OK’d for patience for whom standard chemotherapy has failed. Merck is seeking its approval as a first-line drug for lung cancer. The FDA has been known to give quick approval to these kind of immunotherapy cancer drugs.

From NBC News:

They treat cancer by stopping tumor cells from cloaking themselves against the normal, healthy immune system response.

They work on the principle that it’s not where cancer starts that matters, but the genetic mutation that causes the cancer. So a lung tumor in one patient may look like the melanoma in another.

— targets the activity of genes called PD-1 (anti-programmed-death-receptor-1) and PD-L1. The interaction between the two genes lets some tumors escape detection and destruction by immune system cells.

PD-1 stops immune cells from attacking normal healthy cells by mistake. Tumor cells make PD-L1 turn on PD-1 when immune cells approach.

This trial only included patients whose tumors cells made a lot of PD-L1. That is only a portion of people with lung cancer – 25 percent in one recent trial.

Immunotherapy is a whole new way of treating cancer, including lung cancer,” said Janne, who was not involved in the study. “Having seen patients benefit who failed existing therapies, now doing well on these new therapies, is fantastic.”

John Stossel, Lung cancer

John Stossel reveals he has lung cancer; diagnosis doesn’t stop him from remaining a hopeless douche

fox_ff_stossell_order_150208a

This is a touchy subject for me, because I would never celebrate anyone getting lung cancer. Nobody deserves lung cancer, not for any reason.

So, I have to tiptoe carefully around what I want to say, which is John Stossel doesn’t exactly deserve lung cancer, but I will say that, man, his diagnosis is absolutely dripping with irony.

Stossel is a Libertarian wingnut who now works for Fox Business News. He’s too much of a dick to work at a legitimate news network anymore. The reason I find his diagnosis ironic is he has railed in the past against smoking bans as a violation of private property rights, and he claims there is no hard evidence that secondhand smoke is deadly. Never mind the fact that this has been decided by the U.S. Surgeon General, the Environmental Protection Agency, the National Institutes of Health and about a million scientists that there is exceedingly overwhelming evidence that secondhand smoke absolutely is deadly and that people absolutely have gotten lung cancer from constant exposure to secondhand smoke; no, John Stossel is a Libertarian and like all Libertarians, they know more than everyone else. They are the smartest people in every room they walk into. Trying to “prove” the deadliness of secondhand smoke to a diehard Libertarian opposed to smoking bans would be like trying to prove evolution to a fundamentalist Christian. Save yourself the migraine.

18k1xyrtnjtxfjpg

Like I said, I’m not going to point at Stossel and go, “ha, ha!” because he now has lung cancer, the same disease that likely thousands if not hundreds of thousands of people have died from over the past 50 years from breathing other peoples’ cigarette smoke. I will say I’m enough of a jerk that I am actually having to fight the urge, however.

Stossel also doubled down on his doucheness by complaining about the medical system and whining that he got lousy customer service in the hospital because of “socialism.” Here’s his idiotic comments:

But as a consumer reporter, I have to say, the hospital’s customer service stinks. Doctors keep me waiting for hours, and no one bothers to call or email to say, “I’m running late.” Few doctors give out their email address. Patients can’t communicate using modern technology.

I get X-rays, EKG tests, echocardiograms, blood tests. Are all needed? I doubt it. But no one discusses that with me or mentions the cost. Why would they? The patient rarely pays directly. Government or insurance companies pay.

Customer service is sclerotic because hospitals are largely socialist bureaucracies. Instead of answering to consumers, which forces businesses to be nimble, hospitals report to government, lawyers and insurance companies.

This Crooks & Liars article makes a pretty good point that anyone who has ever dealt with a bank or an airline (Or WordPress or an Internet provider for that matter), knows damn well about how difficult it is to talk to a live person to get customer service. Yeah, that’s about socialism, all right.

He also claims he’s going to be OK and they caught the lung cancer early and that he’s at one of the top hospitals in the nation, paid for by what I’m sure is an excellent health plan from News Corp.  So, he’s got excellent coverage, they’re curing him, but he’s pissing about lousy customer service. This is beyond being an ingrate. This is typical Libertarian “what about me?” ingrate. Like every Libertarian, Stossel can’t seem to think past his own creepy mustache. Yes, I’m sure there is lousy customer service at times in the health care system, but a) does he actually think he’s the only person out there dealing with a cancer diagnosis? Guess what, pal, over half a million Americans a year get that diagnosis and most of them aren’t whining about customer service … that’s just you being you; and b), most of them are glad to get treatment, especially those people who would never receive treatment in a purely market-driven Libertarian health care system because they wouldn’t have coverage, and there’s lots of people whose coverage is crappier than yours and don’t get the luxury of treatment at one of the top hospitals in the country. I don’t see them going on TV to piss about it.

Honestly, I hope Stossel beats it. Sometimes illness and brushes with death actually changes people — but I seriously doubt that’s even possible with this nitwit.

Lung cancer, Uncategorized

Going beyond cigarettes — starchy, sugary diet may raise risk of lung cancer

1 Comment

donuts

A very interesting story that really surprises me.

According to a study from the MD Anderson Cancer Center in Houston, researchers interviewed 1,900 people who had just been diagnosed with lung cancer and compared that with 2,400 other people without cancer who were interviewed. They asked questions about lifestyle choices, including smoking, and diet.

What they found is that people with “high glycemic index ” diets (lots of sugar and starch) were more likely to be in the lung cancer group than people with low glycemic diets. The link was stronger among people who didn’t smoke, they found.

From an NBC News article:

How can this happen? Doctors aren’t sure, but there’s a theory that high-glycemic foods stimulate the body to make insulin, which in turn affects the growth of cells via compounds called insulin-like growth factors or IGF. Cancer is the uncontrolled proliferation of cells, so it might be that the high-glycemic foods are fueling the growth of tiny tumors.

“IGFs have been shown to play a critical role in regulating cell proliferation and differentiation in cancer and there is evidence to suggest that IGFs are elevated in lung cancer patients,” Wu’s team wrote.

It’s a suspect in several types of cancer.

“Previous studies have investigated the association between glycemic index, and the related measure glycemic load, and a variety of cancers including colorectal, stomach, pancreas, endometrial, ovarian, prostate, and thyroid but these studies are limited and results have been largely inconclusive,” the researchers wrote.

This study is not conclusive, either. For one thing, the researchers asked their volunteers to remember what they ate. For another, it’s an association. People who eat high-glycemic foods may also do something else that also raises their risk of cancer. And this particular study focused only on non-Hispanic white people.

It’s important to keep in mind that about 15 percent of the people who get lung cancer are people who never smoked, and about 20 percent of women who get lung cancer never smoked. Secondhand smoke might be a factor, but so is genetics likely and possibly diet, according to this survey.

I don’t really know what low glycemic versus high glycemic entails, so here is a list included in the article:

According to the American Diabetes Association, low-glycemic foods include:

  • 100 percent stone-ground whole wheat or pumpernickel bread
  • Oatmeal (rolled or steel-cut), oat bran, muesli
  • Pasta, converted rice, barley, bulgar
  • Sweet potato, corn, yam, lima/butter beans, peas, legumes and lentils
  • Most fruits, non-starchy vegetables and carrots

Medium glycemic index foods include:

  • Whole wheat, rye and pita bread
  • Quick oats
  • Brown, wild or basmati rice, couscous

High glycemic index foods include:

  • White bread, including bagels

  • Corn flakes, puffed rice, bran flakes, instant oatmeal

  • Shortgrain white rice, rice pasta, macaroni and cheese from mix

  • Russet potato, pumpkin

  • Pretzels, rice cakes, popcorn, saltine crackers

  • melons and pineapple

Oh, good, I do like baked potatoes, so that’s the only high glycemic food I each much of on this list.

 

Cancer, Kentucky, Lung cancer, Uncategorized

Tobacco-growing, tobacco-smoking Kentucky leads the nation in cancer rate

691add6432bea01946eb234ae350fdf2
Kentucky tobacco farm

Not the least bit surprising, but something to think about when it comes to tobacco control.

This is why people in tobacco control care about the issue; ultimately it comes down to people dying from tobacco.

When most people think of Kentucky, they think of horse country, the Kentucky Derby, and idyllic bluegrass hills. But, there’s a terrible dark side to that bucolic landscape. According to this USA Today story, Kentucky has the dubious distinction of being No. 1 in the nation for having the worst cancer rate. The biggest reason why? Lung cancer. Lung cancer is the third-most common form of cancer in the U.S. (behind breast cancer for women and prostate cancer for men). However, while lung cancer represents about 13 percent of all cancers, it also represents 27 percent of all cancer deaths. That’s the most … by a LOT. Lung cancer kills more people than colon, breast, pancreatic and prostate cancer combined. It continues to be one of the most, if not the most, difficult form of cancer to treat.

According to USA Today, the rate for lung cancer deaths in Kentucky is 50 percent higher than the national average. From the article:

Lung cancer incidence per 100,000 people: 92.4, compared with 60.4 nationally. Mortality per 100,000: 68.8 — around 120 in the hardest-hit Appalachian counties — compared with 45 nationally.

KySmokingRates2011-13
Kentucky smoking rates, by county

Kentucky has a notoriously high smoking rate. It was the highest in the nation until recently, but now it is second highest in the U.S. at 26.5 percent, (only West Virginia is higher) considerably higher than the national average. Kentucky’s smoking rate was over 30 percent as recently as 10 years ago. The national average, according to this article, has dropped all the down to 15.2 percent (I haven’t seen that figure widely reported; I saw 16.8 percent a few weeks ago.). Kentucky also has a higher than normal death rate from breast, colon and cervical cancers. That might be partly attributable to smoking. Kentucky also has a ridiculously low cigarette tax at 60 cents a pack, one of the lowest in the nation.  The national average is over $1.50 a pack. There is also no statewide indoor smoking ban, though several large cities in Kentucky do ban smoking indoors. These factors help to encourage smoking. They really do. Every state that imposes a smoking ban and/or raises its cigarette tax sees its smoking rate go down. Of course, Kentucky just elected a conservative Republican as its governor, so don’t expect a cigarette tax increase any time soon.

From the article

For many years, Kentucky has had a quarter of adults smoking,” said oncologist Dr. Goetz Kloecker, a lung cancer specialist with University of Louisville Physicians. “I have patients who started puffing at 8, 9 and 10 years old…It’s part of the culture.”

Because of that culture, “cigarettes are still cheaper than in other places,” Kloecker added. “If you go to Chicago or New York, there are fewer teenagers starting to smoke. The higher the costs, the lower the smoking rate.”

TOBACCO-farmsGrowing (2)

One of the reasons smoking is so ingrained in the culture is Kentucky is one of the leading tobacco-growing states. Kentucky has a lot fewer tobacco farmers than it once did (wow, there were 56,000 tobacco farms in Kentucky in 1992), but it is still second in the U.S. behind North Carolina in the level of tobacco produced. And in fact, North Carolina and Kentucky absolutely dominate the market with over 70 percent of the tobacco grown in the U.S. coming from those two states. (Interestingly, North Carolina actually has a statewide smoking ban and a relatively low smoking rate for a Southern state at 20.2 percent in 2013 — likely lower than that today.)

Other environmental factors are playing a role. Kentucky has a high level of radon in homes and especially in the Appalachian region, residents have high levels of chromium and arsenic in their systems. (Probably from mining operations and groundwater contamination.).

Other factors are mentioned by USA Today, such as poor health screenings in the state and obesity, but the high smoking rate is the biggest factor, no doubt.

Betty Draper, Lung cancer, Mad Men

“Mad Men” and the smoking culture of the ’60s — killing off one of its characters through lung cancer

betty draper
Betty Draper is being killed off with lung cancer

One of the things that the show “Mad Men” has gained notoriety for is its depiction of the hedonistic culture of the establishment of the 1960s — from three martini lunches to infidelity and most obviously, smoking.

Main character Don Draper smokes heavily and has been in charge of advertising campaigns for cigarette brands. In fact, most of the characters on the show are seen every episode smoking. I’m old enough to remember that that’s what it was like back in those days. Virtually everyone smoked … and in my experience, virtually all of those smokers eventually died or was seriously sickened by their smoking. Smoking was glamorous in the 1960s, it was a horror in the 1970s and 1980s when all that “glamour” started killing everyone off through heart and lung disease.

enhanced-buzz-4929-1360198456-3

One of the main characters, Don Draper’s ex-wife Betty Draper has been diagnosed with lung cancer and is dying. The show takes place in 1970 and it’s very true that a lung cancer diagnosis in 1970 was pretty much a death sentence. So “Mad Men” is not only showing the Devil-may-care culture of the 1960s, but one of the consequences of that culture — which is a hell of a lot of people back then died of lung cancer (In fact, I’ve called it the “slow-motion tobacco holocaust of the 20th century.”).

HuffPost wrote about how cancer diagnoses worked in the early 1970s and suggested “Mad Men” was spot-in about the stigma around a cancer diagnosis in those days.

Smoking seemed cool and glamorous well through the 1960s. It was cool and glamorous not only in billboards and magazine ads, but in countless movies of the time. James Bond smoked cigarettes. Matt Helm smoked cigarettes (and Dean Martin died of lung cancer and emphysema), etc.

don_draper-620x350
Don Draper

From a Daily Beast column on Betty Draper’s lung cancer. This column by Lizzie Crocker about smoking on the show is absolute awesome. I’m quoting several paragraphs here because she is explaining this much better than I can (Since I’ve never really watched the much of the show):

As with many of the series’ final episodes, the decision to kill off Betty with lung cancer was rather on-the-nose. For a show in which so little actually happens, it’s clear Matthew Weiner, the show’s creator, is rushing to tie up loose ends, like Betty and Sally’s fraught relationship, which has led to some soap-operatic plot twists.

We knew someone was going to die in these final episodes, and the fraught, discontented, ill-fated Betty, still in her 30s, had to suffer the health consequences of chain-smoking that everyone else on Mad Men has managed to avoid. Roger had a heart attack earlier in the series and he still puffs away with impunity.

But not Betty, whose diagnosis is confirmed not by the doctor but by her husband Henry, having just received ‘the news.’ When she reaches for a pack of cigarettes in the car, he angrily snatches them and tosses them in the back.

We see her disease-clogged lungs on an X-ray; a desperate Henry breaking down when he visits Sally at school; Sally devastated and covering her ears when Henry tells her about the diagnosis.

—–

The link between smoking and cancer has always lurked in the background of the show. In the pilot, “Smoke Gets in Their Eyes,” Don has to think of a clever way to sell Lucky Strikes after the 1960 Reader’s Digest report linking cigarettes and cancer. The client isn’t pleased when Pete suggests they work society’s “death wish” into a new campaign slogan.

But Don saves the day with a pitch emphasizing how Lucky Strikes are made: “Everyone else’s tobacco is poisonous. Lucky Strikes are toasted.” All cigarettes are toasted, of course, but consumers don’t know that. “Advertising is based on one thing: happiness,” Don tells the client.

Happiness is “the smell of a new car. It’s freedom from fear.” And all Lucky Strike smokers need is “a billboard on the side of the road that screams with reassurance that whatever you’re doing, it’s ok.”

—–

And as we close in on the series finale, Betty’s diagnosis seems to be the apogee of the show’s relationship with smoking.

That slow-motion shot of the sauntering Peggy from two Sundays ago, one of the most memorable moments this season, will likely be the last time that we see a cigarette as emblematic of anything other than anxiety and death.

Cigarettes, and their celebration, were one of the vital accessories of Mad Men, the show’s perverse fuel. Now, stripped of their allure like those stripped of their status in the move from SCDP to McCann, they’ve come to signify the very literal death of the show.