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" &amp;quot;You have lung cancer.&amp;quot; Oncologist Harvey Pass, M.D., always dreads saying these four words. But when he broke the news to one particular patient last year, it was especially difficult. &amp;quot;This was a young 30-something woman who had never smoked a cigarette in her life: Her parents had been smokers and she had vowed to steer clear of the habit,&amp;quot; recalls Pass, chief of Thoracic Oncology at the New York University Cancer Institute. &amp;quot;She looked stunned and said, &amp;#039;I don&amp;#039;t understand. What could I have done wrong?&amp;#039;&amp;quot;  Fact is, lung cancer kills more women than breast, ovarian and uterine cancers combined -- some 68,000 women will die of it this year alone. So why does this young woman&amp;#039;s diagnosis come as such as a shock -- to her and to you? Because lung cancer has long been brushed aside as the &amp;quot;guilty&amp;quot; cancer, a self-inflicted disease reserved for rasping old men with nasty smoking habits. But the recent death of Dana Reeve, 44, revealed the reality of this horrific disease: Its incidence in women has jumped fourfold in the past 30 years, and it&amp;#039;s striking us at a younger age -- 41 percent of all lung cancer cases occur in women who haven&amp;#039;t yet reached their 50th birthday. Even scarier, 20 percent of women sufferers are nonsmokers. The bottom line: Lung cancer is a killer no woman can afford to ignore.   Yet despite lung cancer&amp;#039;s deadly track record, it remains underfunded and under-researched. Last year, the Centers for Disease Control and Prevention (CDC) spent $204 million on breast and cervical cancer research, but not a cent on lung cancer. Unfortunately, shame often keeps sufferers with a history of smoking from petitioning for help, which keeps lung cancer out of the publicity limelight, which in turn drives fund-raising efforts and research dollars. &amp;quot;I&amp;#039;ll never forget a conversation I had with one young female patient who had never smoked in her life,&amp;quot; says Gregory Otterson, M.D., associate professor of internal medicine at Ohio State University. &amp;quot;She said, &amp;#039;I know I&amp;#039;m probably going to die, but I want to participate in raising money for lung cancer. Is there a run or walk that you know of?&amp;#039; I shook my head no. She was outraged -- and she had every right to be.&amp;quot;   Why women are more at risk than ever Deaths from lung cancer among women skyrocketed more than 600 percent between 1950 and 1997. And no, it&amp;#039;s not just because we are smoking more: &amp;quot;Research suggests women are more susceptible than men to the carcinogens in cigarette smoke,&amp;quot; says Mark Kris, M.D., a lung cancer specialist at Memorial Sloan-Kettering Cancer Center in New York City. One Canadian study of heavy smokers found that women were almost three times as likely to develop lung cancer as men, even when they smoked the same amounts.   Even secondhand smoke packs a bigger wallop on women: There are twice as many female nonsmokers with cancer as there are males. &amp;quot;Women&amp;#039;s bodies just seem less capable of repairing the DNA damage that occurs after any kind of exposure to cigarette carcinogens,&amp;quot; explains Kris.   Women are also most likely to develop adenocarcinoma, a type of cancer that develops along the lung&amp;#039;s outer edges. On the plus side, it&amp;#039;s one of the more curable forms of the disease. But the challenge is detecting it, since symptoms are vague and nondescript. &amp;quot;The most common complaint I hear from these women is that they just don&amp;#039;t feel right,&amp;quot; says Kris. &amp;quot;They might get breathless walking up a flight of stairs or feel weak and achy. But nothing that would make them go, &amp;#039;Aha! I think I have lung cancer.&amp;#039;&amp;quot; As a result, adenocarcinoma often isn&amp;#039;t caught until late in the game, when the five-year survival rate drops to around 15 percent.   One more women-centric risk factor: estrogen. Researchers suspect the female hormone may actually spur the development of cancerous cells. &amp;quot;We&amp;#039;re not sure exactly why, but it seems that if a woman has some potentially precancerous cells in her lungs, estrogen stimulates them to grow and become malignant,&amp;quot; says Kris.  How to protect yourself  Smokers still make up the majority of lung cancer victims, but many are in denial: Their habit isn&amp;#039;t worth worrying about, they figure, unless they&amp;#039;re going through a pack a day. And the lack of public outcry and media attention (give yourself a gold star if you even know that November is Lung Cancer Awareness month) makes it easy to hide from the brutal facts. In fact, just one cigarette a day increases a woman&amp;#039;s risk tenfold. The best defense: Quit. It won&amp;#039;t be easy, it&amp;#039;s true, but there are currently an estimated 45.7 million former smokers in the U.S. And you can be one of them. Within just two to three weeks of stubbing out your cigarettes, your lungs start to repair themselves. &amp;quot;Your risk will never get back down to zero, but a woman who started smoking at 15 and stops when she is 30 can cut her risk in half by the time she&amp;#039;s 45,&amp;quot; says Norman Edelman, M.D., Chief Medical Officer of the American Lung Association.   Here, five additional ways to fend off lung cancer if you&amp;#039;ve already kicked the butts -- or even if you&amp;#039;ve never lit up:   Smoke-proof your environment:  &amp;quot;If your spouse smokes, ban him from lighting up inside your home, period,&amp;quot; says Edelman. This is vital if you have a family history of lung cancer, since there&amp;#039;s a strong genetic propensity for the disease, and secondhand smoke amplifies the risk. To lobby for clean air outside your home, sign the American Lung Association&amp;#039;s petition supporting smoke-free communities at lungaction.org/campain/cia.   Test for radon:  This odorless radioactive gas occurs naturally in rocks and soil, and it&amp;#039;s the second leading cause of lung cancer in the U.S. &amp;quot;Outdoor levels are so low they pose virtually no risk, but the gas can seep up into your basement and become dangerously concentrated,&amp;quot; explains Michael Thun, M.D., head of Epidemiologic Research at the American Cancer Society. If your house wasn&amp;#039;t checked for radon during its inspection, get it tested now. Log on to the Environmental Protection Agency&amp;#039;s Website at epa.gov to locate a radon service professional.  Eat your broccoli: Former women smokers who consume plenty of soy, beans, broccoli, carrots, spinach, tea and rye are about half as likely to develop lung cancer as those who get hardly any of the above, according to a recent study at the University of Texas MD Anderson Center. The reason: All these foods are rich in phytoestrogens, estrogen-like compounds that may affect estrogen receptors and block the hormone&amp;#039;s ability to stimulate cancer cell growth.   Check for asbestos: Houses built before 1970 may have insulation containing asbestos, a fiber linked to less than 1 percent of lung cancer cases. &amp;quot;Asbestos is still present in many homes, but it&amp;#039;s not considered harmful unless it&amp;#039;s released by deterioration or renovation,&amp;quot; says Edelman. If you&amp;#039;re concerned, contact a local environmental company for an inspection (go to epa.gov for a referral); removal requires a professional contractor.   Get screened: Ex-smokers age 50 and older should ask their doctors about computed tomography (CT) scanning. The technique detects early signs of cancer by sending X-ray pulses through the chest, and research shows it finds four times as many malignancies as a traditional chest X-ray. &amp;quot;CT scanning does have a high rate of false positives, so we&amp;#039;re currently limiting it to patients age 50 and over with a 20-year history of smoking,&amp;quot; says study author Claudia Henschke, M.D., chief of Chest Imaging at New York Presbyterian Weill Cornell Medical Center.   Treatment breakthroughs There is some good news for women who are worried about lung cancer: As a group, we tend to respond better to treatment -- and to survive longer -- than men. &amp;quot;There&amp;#039;s a whole new class of chemotherapy drugs that&amp;#039;s particularly effective in women with adenocarcinoma and/or those who have never smoked,&amp;quot; says internist Otterson. Called targeted therapies, they attack epidermal growth factor receptor, a protein that causes cancer cells to divide rapidly.   Meanwhile, much-needed funding for research may also be on its way. This past March, in the wake of Reeve&amp;#039;s death and that of ABC news anchor Peter Jennings, Congress sponsored two resolutions requesting the president declare lung cancer a national public health priority and calling for a 50 percent reduction in the disease&amp;#039;s death rate by 2015. &amp;quot;We&amp;#039;re making progress, even if it&amp;#039;s baby steps,&amp;quot; says oncologist Pass. Still, with nearly 20 Americans dying every hour of lung cancer, it&amp;#039;s clear that more dramatic strides are required. For your part, you can join the fight for more research on the disease and its cure by supporting organizations such as the Lung Cancer Alliance (lungcanceralliance.org) or the American Cancer Society (cancer.org). If you smoke, quit today. And even if you don&amp;#039;t light up, steer clear of any secondhand smoke. We&amp;#039;ve all avoided facing the harsh realities of lung cancer for some time, but at last, the smoke is clearing. "^^<http://www.w3.org/2001/XMLSchema#string>
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