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October 1998
PEP Pioneers
Second Wind
Torrance, California
Dear Friends:
At last, there is a growing
grassroots effort to increase the public and medical profession’s
interest in lung cancer. Lung
cancer is by far, the most common fatal malignancy in both men and
women in the United States today.
As a matter of fact, lung cancer kills more women than
breast, ovarian, and uterine cancer combined.
We know exactly what causes lung cancer, but we are not
making much progress in dealing with it. Smoking, which is responsible for at least 90% of lung
cancer, continues in about 25% of our population with 47 millions
smokers at risk. Even
former smokers remain at risk for at least twenty years or more
after stopping smoking. Since there are approximately 45 million former smokers, over
a hundred million people in this country are at risk of developing
lung cancer sometime in their lifetime.
Unfortunately, no physicians’
organization, or even the American Cancer Society recommend
screening for early diagnosis.
The reason is that studies sponsored by the National
Institutes of Health more than twenty years ago, did not show a
great improvement in lung cancer mortality in a large, screened
population. When
screening was done, more early cases were found, and survival was
actually improved. These
studies are now believed to be inadequate, because they did not
screen the patients at highest risk.
In a study conducted recently in Colorado where we did sputum
pap tests, which look for malignant cells in sputum that is coughed
from deep portions of the lung, we have found a large number of
hidden cancers in early stages of disease.
The population screened smoked a pack a day or more for more
than thirty, or in most cases, forty years.
These individuals were also selected because they had some
degree of airflow obstruction, as measured by spirometry.
In this group of people, we found 2% lung cancer.
Subsequent studies are revealing additional hidden tumors.
We estimate that 4% to 5% of those screened will be found to
have lung cancer in early and curable stages. Mammo-graphy only
yields .4% to .5% positive results in women in the highest risk age
group. Why do we
continue to ignore lung cancer in the light of this new information?
Unfortunately, lung cancer is not a man’s or a woman’s
issue. Prostrate and
breast cancer, though far less of a problem, receive most of the
attention.
A new Association, the Alliance
for Lung Cancer Advocacy, Support, and Education, (ALCASE), is
developing a tour of regional workshops entitled, “Lung Cancer: A
Revolution in Care”. The
purpose is to increase the public’s and profession’s awareness
of the fact that lung cancer can be identified early, and cured. People
should be identified and diagnosed early, and treated by
pulmonologists, oncologists, and surgeons when the chance of cure is
high. In response to
the pleading of experts in lung cancer identification, including
myself, the American Cancer Society has agreed to rethink their
position on screening. But
even before we get their blessing, patients who are heavy smokers
and have airflow obstructions, and particularly those with a family
history of lung cancer, should ask their doctor for a sputum pap
test, chest x-ray, or CT scan to be able to diagnose lung cancer
early and treat it effectively.
I will be
in touch next month.
Your friend,
Thomas Petty, MD
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