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Lung Cancer Claims Peter Jennings

Breaking News - August 2005 - Week 2

(Aug 10, 2005)

Healthcare in  the News

-- Newsman Peter Jennings' death Sunday from lung cancer, four months after he revealed he had been diagnosed with the disease, hammers home the overwhelming health threats posed by smoking -- even to ex-smokers, experts say.

Picture of a female radiologist reading an x-ray

Jennings, the face of ABC News for more than two decades, quit smoking 20 years ago. But he admitted starting again after the Sept. 11, 2001, terrorist attacks.

According to the American Lung Association, about 87 percent of lung cancer cases are caused by smoking, and 40 percent to 50 percent of new cases may occur in former smokers.

Lung cancer is cancer that usually starts in the lining of the bronchi (the main airways of the lungs), but can also begin in other areas of the respiratory system, including the trachea, bronchioles, or alveoli. It is the leading cause of cancer death in both men and women. In 2005, 172,570 new cases of lung cancer are expected, according to the American Cancer Society.

Because most lung cancers are diagnosed at a late stage, the five-year survival rate is only 15.2 percent, compared with 63 percent for colon cancer, 88 percent for breast cancer and 99 percent for prostate cancer, according to the American Lung Association.

Number One Cancer Killer

In 2005, lung cancer will take about 163,500 American lives and will maintain its place as the number one cancer killer, outpacing deaths from the second, third, fourth, and fifth most common causes of cancer deaths combined, states Dr. Bill Solomon, associate professor of medicine at SUNY Downstate Medical Center in New York City.

Ninety percent of people who are diagnosed with lung cancer will eventually die of the disease, adds Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation in New Orleans.

Not everyone who smokes will get lung cancer and not everyone who quits will be protected. Why? No one knows for sure.

People who smoke have a 10- to 15-fold greater risk of developing lung cancer than those who never light up, experts say. And, for the most part, the more you smoke -- or smoked in the past -- the greater your accumulated risk.

"The risk does decline with time after you stop but those numbers aren't clear," Dr. Norman Edelman, chief medical officer of the American Lung Association, states.

A landmark study published last year in the British Medical Journal found that cigarette smokers die an average of 10 years sooner than nonsmokers. At least half, and possibly up to two-thirds, of people who smoke from youth on are eventually killed by their habit, a quarter of them in middle age, the study reported.

But the study also found that quitting can offer big advantages. Stopping at age 50 cuts the risk of dying in half, while quitting at age 30 almost eliminates the risk.

Dr. Derek Raghavan, director of the Cleveland Clinic's Taussig Cancer Center, says that the instant a person stops smoking, he starts getting better. Three to five years after quitting, the risk of getting lung cancer is reduced by half. However, ex-smokers may feel worse before getting better.

"You destroy so many of the little hairs that … they take awhile to grow back," Dr. Raghavan says. "Before they can [feel any improvement], smokers sometimes report feeling a bit worse, so they say, 'I don't feel any better, why not smoke?' The fact is, nothing will make you healthier than not smoking."

But individuals are still, well, individuals. Jennings, who was 67 when he died, quit smoking 20 years ago but admitted starting again after 9/11. That might have further damaged lungs that were not yet healed, Brooks said.

There were likely other factors at play as well.

"We're gambling with other things in the environment or genes or both," Dr. Edelman says. "The fact that Jennings smoked for a long period of time increased his risk of getting lung cancer. How much that risk was dissipated by stopping for 20 years I don't know, but it was obviously not entirely."

The ABC News anchor joins a long list of celebrities who smoked and developed lung cancer, including Yul Brynner, Nat King Cole, Gary Cooper, Walt Disney, Duke Ellington, Betty Grable, and George Harrison.

Lung Cancer Not The Only Concern

Lung cancer is not the only pitfall of smoking. "Smoking is also responsible for many cases of bladder cancer in males, head and neck cancer, esophageal cancer, and pancreatic cancer," Dr. Solomon says.

Actor Michael Landon's four-pack-a-day habit likely contributed to his fatal pancreatic cancer. Humphrey Bogart and Sammy Davis, Jr. both were smokers and both developed throat cancer.

Experts advise that if you are an ex-smoker with a cough, get to a physician and get screened.

If you are a smoker, stop.

"Quitting is good. It's always good to quit, no matter how long you've smoked," Dr. Edelman says. "You'll reduce your risk of lung cancer, reduce the degree to which you have chronic obstructive pulmonary disease, reduce your risk of other types of cancer and of heart disease. The data is very clear. Even if you're 75, you can benefit from stopping."

Always consult your physician for more information.

For more information on health and wellness, please visit health information modules on this Web site.

Secondhand Smoke, Obesity Harmful to Teens

Obesity and tobacco smoke are a dangerous cardiac combination for America's teens, a new study finds, and the danger is nearly as great if the smoke arrives secondhand rather than puffed directly.

"A lot of public attention has turned from tobacco to obesity," said lead researcher Dr. Michael Weitzman, a professor of medicine at the University of Rochester School of Medicine and Dentistry. "There has never been substantial enough attention paid to the dangers of secondhand smoke to children."

Reporting in the journal Circulation, Weitzman's team looked at data on nearly 2,300 adolescents, aged 12 to 17.

They found those who were overweight and had been exposed to tobacco smoke were most likely to have the metabolic syndrome, a constellation of factors such as high blood pressure, high blood cholesterol, and high blood sugar that increases the risk of heart attack, stroke, and other cardiovascular problems.

The new report "is the first study in any age group to show an association between secondhand smoke exposure and the metabolic syndrome," Weitzman said. "It uses a biological measure of exposure to secondhand smoke."

That marker is the blood level of cotinine, a molecule produced when the liver breaks down nicotine.

Only 1.2 percent of those in the study whose cotinine levels indicated no exposure to smoke had the metabolic syndrome, while 8.7 percent of those who smoked had the syndrome and 5.4 percent of those with levels indicating exposure to secondhand smoke met the criteria for the syndrome.

An even greater risk was found for teenagers who were overweight or at risk of being overweight and were also exposed to smoke.

Only 5.6 percent of the overweight teens who had no smoke exposure had the metabolic syndrome, compared to 23.6 percent of those who smoked and 19.6 percent of those exposed to smoke.

"So being around smokers can increase the risk by fivefold, while active smoking increases the risk sixfold," Dr. Weitzman says. "And the effects occur at low levels of exposure."

Because metabolic syndrome often leads to serious medical problems later in life, "the 30 percent or more of children growing up in households with a smoker are at vastly increased risk for morbidity and mortality," he states. "This is likely to be the first generation in our nation's history that will have a shorter life span than the generation that preceded it."

Some legislative action is needed to prevent children from being exposed to secondhand smoke, Weitzman says. For example, only half the states have regulations restricting smoking in child-care centers, says Dr. Weitzman.

"But what this says is that if we care about our children's health, especially in the face of the epidemic of obesity, we need to be far more stringent in getting the message out to parents and do all we can to reduce exposure to smoke in all settings," Dr. Weitzman says.

The study "adds to the body of evidence demonstrating that secondhand smoke exposure is one of the most serious causes of disease in the United States," says Matthew L. Meyers, president of the Campaign for Tobacco-Free Kids. "It is particularly disturbing because it demonstrates that exposure to smoke as a child could well have long-term heart disease consequences."

The message to parents is clear, Meyers said. "They should just not smoke in front of their kids," he stressed. "They should not smoke in the house at all."

Always consult your physician for more information.

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