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Lung Cancer, the Deadliest of all Cancers, Receives Far Less Funding, Empathy in Asheville Area

ASHEVILLE — Lung cancer doesn't have an iconic ribbon or well-known signature color. In fact, it doesn't even have its own support group in Western North Carolina.

Yet lung cancer will take more lives this year than breast, prostate, colon and pancreatic cancers combined.

November marks Lung Cancer Awareness Month, but as many area physicians, health workers and patients have noticed, awareness is in relatively short supply. But in even shorter supply for lung cancer patients is public empathy.

In the wake of ‘Pink October's' flood of breast cancer awareness efforts, the elephant in the room is one thing that hasn't been painted pink, but remains a distinct shade of lung cancer's signature gray.

“Lung cancer certainly kills more people, but it doesn't have the sexy marketing campaign that breast cancer has had,” said Becky Pitts, a lung cancer nurse navigator at Mission Hospital, and a breast cancer survivor herself.

“Part of the reason is that there's no way to blame women for having breast cancer, but people fault lung cancer patients for their disease,” Pitts said. “It just hasn't received that sympathy.”

Out of the shadows

According to the American Cancer Society, smoking accounts for about nine out of 10 lung cancer deaths. That includes nonsmokers who are exposed to second-hand smoke and are about 20-30 percent more likely to develop lung cancer than nonsmokers who have not been exposed, he said.
Radon is the second leading cause of lung cancer.

Radon is a colorless, odorless, radioactive gas made by the natural breakdown of uranium in soil and rocks. According to the American Cancer Society, radon accounts for about 10-15 percent of lung cancer cases. Asbestos and arsenic exposure are also identified causes.

Family history alters a person's likelihood of developing lung cancer only slightly.
So enters the not-so-pink elephant: Some ask, do lung cancer patients deserve the financial support and community empathy that other cancers have, since lung cancer is so strongly tied to smoking?

If the perception is that lung cancer is their fault, do lung cancer patients deserve funding as much as “faultless” cancer patients?

While more women than men are diagnosed with breast cancer every year — about 207,000 — lung cancer is the leading cause of cancer death in both women and men in the United States. Although lung cancer has long been considered a man's disease, lung cancer in women has jumped six-fold over the past 30 years.

And according to a recent report, “Out of the Shadows” by Brigham and Women's Hospital, a teaching affiliate of Harvard Medical School, the lung cancer blame game is proving more and more unfair.

According to the study, more than 60 percent of people diagnosed with lung cancer are nonsmokers at the time of diagnosis, including former smokers. Out of that 60 percent, 20,000-25,000 people who have never smoked at all are diagnosed with the disease every year in the United States.

More people who have never smoked die from lung cancer than from AIDS, liver cancer or ovarian cancer.

Lung cancer in WNC

While Buncombe County has incidence and mortality rates similar to state and national numbers, Buncombe is among the 10 counties with the highest radon rates in the state.

Despite the sobering statistics on lung cancer's deadly impact, the disease has a unique stigma of blame that seems to have crippled awareness and fundraising efforts.

While WNC is host to at least four breast cancer-specific support groups, the American Cancer Society database of support groups knew of none for lung cancer patients or caregivers.
But as Theresa Stoker, clinical manager of Cancer Care of WNC points out, it may be lung cancer patients who need disease-specific support the most.

“I think when lung cancer patients go into a mixed group they often feel uncomfortable,” Stoker said. “They can feel tainted, like they've brought it on themselves and they deserve to be sick. That makes it incredibly difficult to get the support they need to fight the cancer.”

The lack of empathy for lung cancer is not limited to public perception.

Federal spending for lung cancer research is 21 times lower than that of breast cancer per cancer death, and 13 times lower than that of prostate cancer.

“They say that colon cancer is 10 years behind breast cancer when it comes to awareness, screening and survivorship resources. If that is the case, I believe lung cancer is at least 50 years behind breast cancer,” said Molly Black, regional community coordinator with the American Cancer Society.

“The reality is that the army of survivors that we see filling up Pack Square Park does not yet exist for lung cancer. We simply do not have enough people surviving.”

Nothing is impossible

The Brigham and Women's report also addressed the difference in development of lung cancer among women and men, indicating that women who have never smoked are at greater risk for developing lung cancer than men who have never smoked. In fact, about one in five women who develop the disease has never smoked.

Diane Sharp is one such woman, a lung cancer survivor who has never smoked or even lived with a smoker. Sharp, 58, is also an internationally competitive triathlete.

“I was just astounded,” said Sharp of her initial diagnosis. “There was a moment in the beginning of thinking, ‘I'm in amazing shape, why the hell do I have this disease?' but in the end you just realize it could be anything — anyone can get sick. You tap into all the best available resources you have to eliminate this disease. Mix of prayer and medicine worked for me.”

In December 2006, she caught a nagging cough and cold that only bothered her at night. In anticipation of a visit from her brother-in-law, who is especially sensitive to upper respiratory illness,
Sharp reluctantly went to her doctor, only to find out she had lung cancer.

Based on initial biopsy results, she was told she had six months to live.

Doctors were able to remove the lower left lobe of her lung, however, and spare her from chemotherapy and radiation.

Again, doctors handed her devastating news — that without complete lung capacity, she would no longer be a competitive athlete.

“My lung specialist told me that yes, I could continue to compete, but that I would be last or in the back of any race,” Sharp said. “That's all I really needed to hear.”

Less than six months later — right around the time of her projected death sentence — Sharp came in fifth in her age group at the National Championship Triathlon in Portland, Ore.

Even after suffering two stress fractures — one in each foot — Sharp has found a way to prove that apparently, it isn't all in the lungs. Since she couldn't run, she did the next best thing — she swam.

After losing her husband, Bob, to pancreatic cancer in June, Sharp honored him in Baltimore's Swim Across America, a 3-mile swim that raises money for cancer research.

“Getting in the pool the first time after surgery was certainly shocking,” Sharp said of her training, “because it's all about controlled breathing. But I just kept plugging away and built up my capacity. Nothing is impossible — really, nothing.”

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