Within the last month, Oni no Husband’s aunt has been diagnosed with lung cancer which has spread up into her brain. Chemo was ineffective, so they stopped, and they didn’t give her radiation because they didn’t feel she could tolerate it. (She is in her late 60’s, but was skinny and frail even before she got sick.) She is now at home on pallative care.
We’ve been trying to figure out what could have caused it. Auntie was born and raised in the Philippines, on the border between Ilocos Norte and Ilocos Sur. She never smoked, and very few of her family and friends in the U.S. are heavy smokers (though lots of Filipinos back home are). She moved to the U.S. about 15 years ago, give or take.
The most likely culprit to me would be second hand smoke/industrial pollution from her time in the Phillipines - but don’t the lungs repair themselves when taken away from the carcinogens? I thought that after 15 years even a smoker’s lungs were almost as clear as a nonsmoker’s…
I’m not looking for a diagnosis or anything, just curious as to what other factors might have been.
Radon gas has been fingered as a culprit too. From what wiki says the average rate of US homes with radon problems in 1 in 15, and Iowa has the highest rate radon gas in homes…since NH is 1 in 3, I can’t imagine how bad the problem is in Iowa.
Asbestos causes pretty much all cases of mesothelioma, the disease that killed (among others) Warren Zevon. Mesothelioma isn’t really lung cancer, though, since the pleura is outside the lungs.
The causes of cancer are not well understood. Ordinary air pollution expered by anyone living in an urban setting may have a role, and we now know that some cancers are caused by viruses. Particulate matter, say from diesel emissions are certainly suspect.
I am sorry to hear about your Aunt, but some things we may never know the causes of, and in any case, nothing can change the now, so the best course of action is to make the most of the time she has left and keep her as comfortable as possible.
Causes of cancer are not well understood at he cellular level. In general any damaging insult increases the risk of lung cancer. Radon gas, radiation, scar tissues, diesel/pollutant/chemical exposures…the list goes on for putative insults. I believe immunosuppressed states are also on the list of things which increase a lung cancer risk; the role of the immune system in keeping rogue cells under control is not well understood, but probably has a role to play in the natural prevention of cancers.
Damaged cells do not necessarily “repair” themselves. The reason you see lung cancer risk in former smokers diminish after 15 years is that you’ve outlasted the cell doubling time–cancers which formed back when the patient smoked should have shown up by 15 or 20 years later. Consider a tumor with a doubling time of 100-200 days; it takes a long time to go from a rogue cell to a clinically significant cancer. It’s very common–and tragic–to stop smoking and show up with lung cancer 5 or 10 years later. The cancer was there all the time; it just had not become clinically significant because the tumor mass was too small.
There are several main cell types of lung cancer (squamous, adenocarcinoma, large cell ((the non-small cell types)) and small cell), and so it’s hard to be more specific about your relative.
I remember reading that firefighters are one group of non-smokers who have a higher prevalence of lung cancer compared to general non-smoking population.
*“To summarise, the published reviews of the literature indicate that:
• there is good evidence that the following cancers are associated with fire fighting: testicular cancer, prostate cancer, non-Hodgkin lymphoma.
• there is reasonable evidence that the following cancers may be associated with fire fighting: melanoma, multiple myeloma, bladder cancer and brain cancer.
• there is some evidence that the following cancers may be associated with fire fighting: leukemia, kidney cancer, skin cancer, buccal cavity/pharynx, oesophageal, stomach, colon and rectal cancers and lung cancers for non-smokers.” * http://www.fire.qld.gov.au/communitysafety/freesafetydownloads/pdf/Firefighter%20final%20report.pdf (Specific references listed at the end)
An association of firefighting with asbestos-related exposure is also surmised; this can lead to both asbestosis and mesothelioma. Mesothelioma is not typically grouped into the category of “lung cancer” although one its sites of occurrence is the lining of the lung.
There is a substantial workers-compensation and liability overlay for associating various professions with various diseases, so it’s common to see efforts made at validating those putative associations.
And, sometimes, it “just happens”. Someone I knew very incidentally through work - a woman of about my own age (late 20s at the time), who had never smoked, been raised in the US etc.- developed lung cancer and died a year or so later. I believe it tended to run in her family.
She was of Chinese descent, if that means anything (perhaps hereditary-type lung cancers might be more common among Chinese).
Did they biopsy the cancer tissue to identify it as originating in the lungs? If not, it may have started somewhere else (say, as melanoma) and spread to the lungs and brain.
Sadly true. A well-known example was comedian Andy Kaufman, a non-smoker, who died of lung cancer at 35.
We lost a dear family friend two years ago to lung cancer. She had never smoked, but she spent many years as a secretary, working for a heavy smoker (this was in the 1980s, before they began to ban smoking in office buildings), and she also lived her entire life in the Chicago area, which has fairly significant air pollution.