Category Archives: Lung cancer

The lung cancer and nicotine genes


Yesterday I mentioned the “lung cancer gene.” This is interesting stuff to me, and exciting for a potential cure to lung cancer, the No. 1 cancer killer.

Several years ago, researchers isolated a gene mutation that appears to mark whether you are at risk for lung cancer.

One of the most exasperating arguments I’ve ever had with smokers, both in real life and online, is “if smoking causes lung cancer than why don’t all smokers get lung cancer?”

It’s a weak excuse to keep smoking. I remember having that very argument with my mom 30 years ago when my dad died of lung cancer. But, they’re right in that only about 10 percent of smokers ever develop lung cancer. This lung cancer gene mutation could explain why and many other things.

Here’s how it works, keep in mind that 15 percent of the people who get lung cancer (and 20 percent of women who get lung cancer), never smoked a cigarette in their lives. Why do some nonsmokers get lung cancer and most smokers don’t?

It’s been long known that cigarette smoking causes lung cancer by literally screwing up the DNA of the cells in the smoker’s lungs. Why do 10 percent of smokers have their DNA messed up and not all smokers?

In 2008, it was announced that there appeared to be a genetic mutation behind lung cancer. If you have this genetic mutation, you are at increased risk to lung cancer even if you are a non-smoker. I’ve read that your risk is something like 30 to 80 percent higher than a nonsmoker without the gene.

If you have this genetic mutation and you smoke, you are at extreme risk for lung cancer. One article I read long ago (can’t find it now), suggested that your odds of getting lung cancer are 50-50.

If you do not have this mutation, smoke ’em if you got ’em, because you will likely NEVER develop lung cancer … however, this gene mutation has no effect on your chances of getting COPD or heart disease or other kinds of cancer from smoking. So, really, you’re just dodging one out of a potentially large number of bullets.

If you do not have this mutation and do not smoke, your chances of ever getting lung cancer are astronomically low. Unless you’re breathing radioactive isotopes, you don’t even need to worry about it. You’re probably more at risk for being hit by lightning.

This gene might also have something to do with why marijuana smokers do not appear to be at increased risk for lung cancer while cigarette smokers are.

This is where the genetic issue gets even trippier. Not only does there appear to be a gene that makes certain people more susceptible to lung cancer, there also appears to be a gene that also makes some people more susceptible to addiction to nicotine. That could explain why some people can quit smoking while others cannot. It really has nothing to do with willpower. Some extremely strong-willed people simply cannot kick the nicotine, while others can do it and never look back. It might be genetic.  What’s really weird are studies suggesting that the same gene mutation might be responsible for both increasing the risk of lung cancer and the susceptibility to nicotine addiction. Trippy stuff.

How people evolved with these genetic markers triggered by tobacco is beyond me. Tobacco in its current form didn’t even exist until perhaps 150 to 200 years ago. What the North American Indians smoked thousands of years ago is nothing like the tobacco grown today. It’s a mystery.

Anyway, the other exciting part of this is perhaps one day lung cancer will be treated via gene therapy. Already, in this day and age, if you want to pay the money, you can have a gene test done to see if you have this gene mutation. The down side to such a test is maybe some people will say, “hooray, I can smoke all I want now…” which would be a dumb response to such a test. Like I said earlier, you could still lose years off your life through COPD and heart disease by smoking.

Another exciting development of this discovery is scientists are working on a drug to block the gene mutation before it ever develops into cancer.

Pot smoking doesn’t cause lung disease: The lung cancer gene, part 1


A study that came out last month determined that occasional post smoking doesn’t cause near the damage to lungs as cigarette smoking.

The study followed 5,115 regular pot smokers over the course of 20 years.

This reminds me very much of a study done about 5 years ago showing that even chronic pot use doesn’t appear to lead to an increased risk of lung cancer.

“We hypothesized that there would be a positive association between marijuana use and lung cancer, and that the association would be more positive with heavier use,” the study’s lead researcher, Dr.Donald Tashkin of the University of California at Los Angeles stated. “What we found instead was no association at all, and even a suggestion of some protective effect” among marijuana smokers who had lower incidences of cancer compared to non-users.

So what’s going on here? Why is tobacco smoke so unhealthy and pot smoke apparently does minimal damage (though the article does point out that some studies have shown an increase in bronchitis and chronic coughs in pot smokers).

In any case, every major study on the issue has consistently shown that pot is considerably less dangerous to the lungs and heart than tobacco (not getting into whatever cognative damage chronic pot use might cause. When it comes to lung and heart, tobacco is far, far, far worse). Not to mention the difference of physical addiction between nicotine and THC. I quit smoking dope 20 years ago and it was the easiest thing I’ve ever done. No night sweats, no cravings, nothing. Why one continues to be illegal and the other legal continues to mystify me. And there doesn’t appear to be a lot of political will out there for legalizing dope.

Pot smoke actually has some of the same toxins as cigarette smoke, but in different doses. One theory is that additives in cigarette smoke are making cigarettes so deadly, but I’m dubious of that one. People were dying of smoking in the 1930s long before the tobacco companies were pumping additives into their tobacco. Another theory is that tobacco smoke is ingested more deeply, but I’m dubious of that one, too, because pot smoke is ingested pretty deeply into the lungs.

I have a theory that lung cancer (forgetting for a bit the heart damage and COPD that smoking causes) is both a genetic and environmental disease, which could be one big reason tobacco smoking causes so much lung cancer while pot smoking doesn’t. There’s been a lot of really interesting and exciting information that has come out about the genetic component of lung cancer the last few years. I’ll write about that in part two tomorrow.

New study: Cancer death rates in America dropping dramatically!

Great, great news.


According to a new study released by the American Cancer Society, cancer death rates have dropped drastically over the past 20 years — 23 percent for men, and 15 percent for women.

Two big reasons — better screening and treatment, and a third reason obviously — a LOT fewer people smoking (Down from 50 to 60 percent in the 1960s to 20 percent today).

Get this, 40 percent of the overall decline in cancer deaths among men (and 34 percent among women) is caused specifically by the decline just in lung cancer deaths (Lung cancer is by far the biggest cancer killer — the next four cancer killers — colon, prostate, pancreas and breast cancer, kill fewer people per year than lung cancer alone.)

Still, even in 2012, about one-third of the cancer deaths in America will be caused due to smoking (and 160,000 of the 577,000 estimated cancer deaths in 2012 will be lung cancer, about 28 percent), according to the ACS. Another third will be caused by obesity and poor nutrition.

From the report. Estimated cancer deaths in 2012. I put this here just to illustrate the damage done by tobacco.

Total cancer deaths 2012 estimated: 577,000

1) Lung cancer 160,000 — 28 percent of all cancer deaths (85 percent smokers or former smokers)

2) Colon 51,000

3) Breast 39,000 (suggestions tobacco increases risk)

4) Pancreas 37,000 (Definite links to tobacco, 50 percent smokers or former smokers)

5) Prostate 28,000

6) Leukemia 23,500 (suggestions of tobacco increasing risk of certain kinds of leukemia)

7) Liver 20,500

8) Non-Hodgkin lymphoma 19,000

9) Bladder 15,000 (Definite links to tobacco, 50 percent smokers or former smokers)

10) Esophagus 15,000 (strong links to tobacco)

November is National Lung Cancer Awareness Month and National COPD Awareness Month

November is both National Lung Cancer Awareness Month and National COPD Awareness Month:

Here’s my contribution to raising awareness

Death toll in 2009
All causes 2.4 million
1) Heart disease 600,000
2) Cancer (other than lung cancer) 400,000
3) Lung cancer (28 percent of all cancer deaths) 160,000
4) Respiratory disease (primarily COPD) 130,000
5) Stroke 128,000
6) Accidents 117,000
7) Alzheimer’s 79,000
8 Diabetes 68,000
9) Flu, pneumonia 53,000
11) Suicide 36,000
13) Chronic liver disease and cirrhosis 30,000
15) Parkinson’s disease 20,000
16) Homicide 16,600

√ So, basically 12 percent of the people who died in 2009, died of lung cancer or COPD. 12 percent. Roughly one death out of eight.
√ Lung cancer is 28 percent of all cancer deaths.
√ Lung cancer and COPD in 2009 killed more people than Alzheimer’s, diabetes, the flu, suicide, cirrhosis of the liver and homicide … combined.
√ 85 to 90 percent of the people who died of lung cancer or COPD were smokers or former smokers, which means they are preventable deaths
√ That means about 250,000 deaths could have been avoided
√ 250,000 is about the population of Lincoln, Neb. or Madison, Wis.
√ Did I mention these were preventable deaths?

Lung cancer rates dropping for men … and finally for women, too


Great news from the Centers for Disease Control.

Compiling data from 2008 (it takes a few years to put this together), in a trend that began in the 1990s, the lung cancer rate for men in the United States continued to drop.

Better news, however, is the lung cancer rate for women dropped for the second straight year. Lung cancer rates for women have been highly stubborn in refusing to drop, even though the smoking rate among women has dropped over the past 30 years. The fact that more non-smoking women get lung cancer than non-smoking men might also have some effect on the lung cancer rate for women being so stubborn.

In 1999, the lung cancer rate for men was about 93 cases per 100,000 population. In 2008, that dropped all the way down to about 79 cases per 100,000.

Lung cancer rate dropping
Lung cancer rate dropping

In 1999, the lung cancer rate for women was about 54 cases per 100,000. That increased to about 57 cases per 100,000 by 2006, but then has dropped back down to about 53 cases per 100,000 in 2008. Finally, that lower smoking rate for women is starting to pay dividends (Remember, there is an infamous “30-year lag” between smoking rate and lung cancer diagnoses. Lung cancer really didn’t become an epidemic in America until the 1930s, after cigarettes became popular in the early 1900s.)

Again, this is outstanding news. Lung cancer is the No. 1 cancer killer in America (about 160,000 people a year), and more than any other cancer, it is almost directly the result of lifestyle choices. About 85 percent of the people who get lung cancer are either smokers or former smokers (about 90 percent of men and 80 percent of women).

The CDC study broke down the lung cancer rates by region:

In the South, among men, the lung cancer rate dropped from about 106 cases per 100,000 population in 1999 to about 88 cases per 100,000 in 2008 (Another way of looking at this is one male out of 940 in the South had lung cancer in 1999; back in the late 90s, the smoking rate among men in the South was still above 40 percent.).

In the South, among women, the lung cancer rate dropped from about 61 cases per 100,000 in 2005 to about 60 cases per 100,000 in 2008. Not much of a drop, but it might be the beginning of a long-term trend.

Lung Cancer men
Lung Cancer men

In the Northeast, among men, the lung cancer rate dropped from about 91 cases per 100,000 in 1999 to about 81 cases per 100,000 in 2008. Among women, the lung cancer rate unfortunately rose from about 55 cases per 100,000 in 1999 to about 59 cases per 100,000 per 2008. This is the one bit of bad news in the study.

In the Midwest, among men, the lung cancer rate dropped from  about 97 cases per 100,000 in 1999 to 86 cases per 100,000 in 2008. In the Midwest, among women, the lung cancer rate has dropped from about 59 cases per 100,000 in 2006 to 57 cases per 100,000 in 2008.

In the West, there has been the most dramatic drop in lung cancer rates. The West also has the lowest smoking rates of any region in the country. Hawaii, California, Utah and Idaho are among the four lowest smoking rate states in the country.

Lung cancer women
Lung cancer women

In the West, the lung cancer rate for men dropped from about 77 cases per 100,000 in 1999 to about 60 cases per 100,000 in 2008, a decrease of 22 percent. In fact, the lung cancer rate for men in the West was roughly the same as women in the South in 2008.

In the West, among women, the lung cancer rate dropped from 50 cases per 100,000 in 2006 to about 45 cases per 100,000 in 2008. It appears the West is a driving force for that lung cancer rate finally beginning to drop among women nationwide.

Lung cancer death rate drops for women … for first time in 40 years

Great news! Smiley

Get this, for the first time in FOUR DECADES, the lung cancer death rate for women has FINALLY dropped.


The lung cancer death rate for women has been STUBBORNLY persistent, even though a much smaller percentage of women smoke today. This is partly because a relatively large percentage (roughly 20 percent) of lung cancer cases among women occur in women who have never smoked.

According to this this report from the National Cancer Institute, between 2003 and 2007, the lung cancer death rate for men in the U.S. dropped 2.5 percent a year. That’s good news, but not necessarily new news. The death rate from lung cancer among men has been dropping since the 1990s. However, the lung cancer death rate during that period for women dropped 0.9 percent. That’s not a dramatic drop, but it’s the first time since the 1970s that rate has finally dropped.

Why? Fewer smokers, obviously, but I also think it’s because those who do smoke, smoke less than they do 40 years ago, and there’s less exposure to secondhand smoke.

Overall, there was a decrease in the death rate for all cancers during that time. Fewer smokers, better detection and more successful treatment, especially for childhood leukemia were all reasons why. The one bit of bad news is there was a slight increase in incidence of childhood leukemia during that time (I’m guessing to more toxins in the environment and food, maybe).

Children and cigarettes

This is a Dinosaur Jr. album cover

Two articles today about smoking and cigarettes.

One comes from a jury award in Boston. I’ve read about this case before. In the 1950s, Lollilard employees used to hang out at playgrounds handing out cigarettes to kids to get them started smoking. A jury awarded the family of a woman who died from lung cancer a $152 million judgement (including $81 million in punitive damages) because she got hooked on cigarettes from Lollilard enticing her and others with free cigs. The woman said that Lollilard employees first gave her free cigarettes when she was 9 years old. She got free cigarettes for years and didn’t actually start smoking them until she was 13. Here is her son’s story, in the Boston Globe.

At the trial, Lollilard denied giving away free cigarettes to children. Of course, they wouldn’t lie. Right? I mean, cigarette company never lied about their product causing lung cancer … or nicotine being physically addictive …. right? Smiley

There is also a racial component to the case. The plaintiffs claimed Lollilard intentionally targeted black children in black neighbourhoods with a brand — Newport — that has long been marketed to blacks.

Pretty disgusting stuff.

Cigarette smoke in apartment buildings bad for kids

A recent study showed that children living in apartment buildings had 45 percent higher amount of tobacco byproducts in the their bloodstream than children living in houses … even if adults in their units weren’t smokers.

Time Magazine’s story:

In a study of tobacco exposure from secondhand smoke in more than 5,000 children, researchers led by Dr. Karen Wilson at University of Rochester found that youngsters aged 6 to 18 years who lived in multi-unit housing had a 45% increase in a chemical byproduct of tobacco in their blood compared with children who lived in detached family homes. And these were youngsters who lived in units where nobody smoked inside the apartment itself, meaning that the exposure was occurring primarily via secondhand smoke drifting in from other units.

This study surprised even the scientists involved. 99 percent of white children living in apartment complexes had cotinine, a byproduct of cigarette smoke, in their systems. It’s a pretty shocking story. You should read it.

Frankly, I can believe it. When I still lived in a condo (It was a non-smoking building), I still had neighbours downstairs who smoked. One guy moved in who literally went out on his deck every 20 minutes to smoke. That smoke blew right into my place. It was really nasty when you would get two or three people downstairs outside smoking. One day I came home. I had left my bedroom window open because it was hot, and there was literally a fog of cigarette smoke in the apartment from the guys downstairs. I had to have the carpet cleaned and the upholstery cleaned to get rid of the reek. I had tobacco grit in my throat and nose from breathing it. It reminded me of how awful my parents’ smoke had been. It really pissed me off. Fortunately, he wasn’t a bad guy at all — just utterly clueless about his cigarette smoke — and we were able to work things out amicably (they were breaking the rules. The rules said no smoking on the property, period), and they agreed to stop smoking underneath my deck.

I think it’s a case in which some smokers to this day (granted, a lot of smokers “get it.”) continue to be clueless about just how far their smoke can drift, and just how much it irritates non-smokers.

Surgeon General new report on smoking … cigarettes are bad, M’kay

OK, what has gotten a lot of press from a truly extensive Surgeon General’s report on cigarettes released yesterday is a conclusion that “there is no safe level of cigarette smoke.”

The media has turned this into “just one cigarette can kill you.” Unfortunately, the report does contain a passage that just a few minutes of cigarette smoke can give a person with heart disease a heart attack. Well, having someone sneak up on you from behind and say, “Boo!” can give you a heart attack if you have serious heart disease. It’s a really stupid point.

The real crux of the report, which the media has missed somewhat, is that it examines how cigarettes cause various forms of cancer and lung disease.
In summary:
• The chemicals and toxicants in tobacco smoke damage DNA, which can lead to cancer. Nearly one-third of all cancer deaths every year are directly linked to smoking. Smoking causes about 85% of lung cancers in the U.S.
•Exposure to tobacco smoke quickly damages blood vessels throughout the body and makes blood more likely to clot. This damage can cause heart attacks, strokes, and even sudden death.
• The chemicals in tobacco smoke inflame the delicate lining of the lungs and can cause permanent damage that reduces the ability of the lungs to exchange air efficiently and leads to chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.

I found the lung cancer chapter the most interesting. Sure enough, here is the conclusion I was looking for:

“There is consistent evidence that a combination of polymorphisms in the CYP1A1 and GSTM1 genes leads to higher DNA adduct levels in smokers and higher relative risks for lung cancer than in those smokers without this genetic profile.
“Exposure to cigarette smoke carcinogens leads to DNA damage and subsequent mutations in TP53 and KRAS in lung cancer.”

So, here’s the thing to wrap your heads around. Smoking fucks with your DNA. It isn’t just irritating the cells of your lungs, it’s actually changing the DNA of those cells.

The various cancers mentioned by the report were lung, mouth, throat, stomach, pancreas, bladder, kidney and leukemia. Surprisingly, lymphoma was not mentioned. I had always thought there was an increased risk of lymphoma if you smoked, but this report doesn’t mention that, so I suppose not.

One of the things that has long baffled scientists is why most smokers don’t get lung cancer. Somewhere between 10 to 20 percent do, depending on what study you read. Why don’t the 80 or other 90 percent get lung cancer is smoking is carcinogenic?

The answer apparently is in genetics, which the report refers to above, and I was hoping it would talk about that. People with a certain gene are more prone to lung cancer. If they smoke and have this gene, they are at extreme risk of lung cancer. If they don’t smoke, they are still at elevated risk of lung cancer. That’s why 10 percent of men who get lung cancer aren’t smokers, and 20 percent of women. Perhaps there are other environmental factors, such as radon or air pollution. But, the fact remains, that roughly 85 percent of the people who get lung cancer are smokers.

So, if you don’t have this gene and smoke, you will probably never get lung cancer. You may die in your 50s of heart disease or die from COPD or some other form of cancer, but you probably won’t get lung cancer. So, you’re not somehow magically out of the woods if you don’t have this gene. It isn’t that simple.
Anyway, here is the press release on this report. You can download the whole 700-page document if you wish. Or you can just download the executive summary.

Lung cancer doesn’t just kill smokers — The story of Jill Costello

Chris Ballard had an excellent article in this week’s Sports Illustrated. (Normally, I’m not a big fan of Chris Ballard’s stuff, some of it I find kind of trite, but this was his best article yet.).

Ballard wrote about a young coxswain for the University of California, Jill Costello, who led her rowing team to a Pac-10 championship, and to the national championship meet, while battling lung cancer.

I knew as soon as I started reading the article how it was going to end. Lung cancer has one of the lowest survival rates. Why? Part of the reason is because not a lot of research dollars go into lung cancer as compared to other kinds of cancer. Why? Because lung cancer has a stigma. Because many people still assume anyone who gets lung cancer deserves it.

Jill Costello was one of the 20 percent of women who get lung cancer who are non-smokers. About 15 percent of the people, male and female, who get lung cancer are non-smokers. Some studies have suggested that lung cancer is genetic. If you have a certain gene, and you smoke, there is a very high likelihood you are going to get lung cancer. If you don’t have the gene and smoke, you will probably never get lung cancer — but you will still get all the heart disease and COPD and other kinds of cancer smoking causes. If you have the gene and don’t smoke, you are at increased risk for lung cancer — not as much as if you smoked — but still an increased risk. Jill probably had the gene.

Jill battled her illness, and, more dramatically, the myriad side-effects of the chemotherapy, while continuing to compete for the Cal rowing team. It was a heart-wrenching article for me, having watched a parent go through this 30 years ago.

Like I said, I knew the story would end a certain way. Cal did not win the national championship. They came in fourth, and a month after the national championships, Jill died at the age of 23.

One of the things I’ve come to appreciate when I started getting involved in tobacco issues is how much stigma there is attached to lung cancer; how many times people with lung cancer have to answer the question, “are you a smoker?” I’ve since gone to great lengths to avoid attaching blame to smokers who get lung cancer. It isn’t there fault they took up a bad habit in their teens that turned out to be physically addicting. We all did dumb things in our teen years, but most of us can laugh about it. A smoker trying to quit, or a smoker with cancer, it’s not a laughing matter when they look back and say, “Why did I start smoking when I was 15?”

So, all I ask is if you know someone with lung cancer, just don’t ask them, “are you a smoker?”