Lung Cancer and Our Sense of Justice

Published: 2009-08-09, Last Modified:

One aspect of our shared human behaviour that frequently seems to show itself is our common belief in the concept of justice. This belief system is heavily ingrained within us, existing across cultural lines and even within the thought processes of our primate cousins. However, as a thought process that has likely evolved within us, it is primitive in many aspects and often times, does not reflect true fairness, balance or overall effectiveness. In particular, our reduced attention to lung cancer as a condition worth researching is one of those situations when blindly submitting to our sense of justice does us all more harm than good.

As the number one cancer killer in the UK, USA, Australia and Canada, lung cancer takes the lives of roughly 220,000 people in these countries annually. However, when it comes to “sexy” cancer causes, lung cancer simply isn’t and sadly ends up being treated as badly as the poorly-dressed fat girl with pimples and a lisp in the funding popularity contest. In the US, lung cancer ranks fourth in terms of overall funding, receiving less than breast cancer, prostate cancer and colorectal cancer.

All this inattention to the disease stems from its association as a condition brought on by the lifestyle of smokers. However, while 85 to 90% of cases fit this category, the other 15% or roughly 33,000 deaths in the countries mentioned means that almost as many nonsmokers are dying of lung cancer as there are people dying of either prostate cancer or colorectal cancer. In other words, our collective dismissal of the disease as “something people have inflicted upon themselves” means many truly innocent victims are being caught up in our sense of justice. Conversely, however, the “innocence” of the nonsmokers assumes that smokers have somehow committed a crime so heinous that they deserve the sort of sort of death that cancer brings.

Though lung cancer has long been comparatively under funded, there have been advances made in understanding and treating the disease. In part, some of the advances seen for lung cancer come from the fact that “a rising tide floats all boats” and as a result, cancer research in other areas sometimes improves the knowledge of lung cancer. One recent research finding that started with studies into colorectal cancer has found a reason for the ease with which lung cancer spreads or metastasizes. This is important because lung cancer has a strong tendency to spread to other organs and the brain.

The researchers found that a particular form of cell communication affecting colorectal cancer is also important in lung cancer and that when this communication is hyperactive, the result is that certain genes that promote movement of cancer cells become active. More important than this knowledge however, is that the researcher’s work suggests that drugs that help to regulate this cell communication may help to stop the spread of lung cancer. This is good news because this cellular communication path is already being studied heavily for aiding Multiple Sclerosis patients as well as slowing breast and skin cancer. Any knowledge gained here has a good probability of aiding in fighting lung cancer.

Besides the more research focused understanding of the disease itself, patient treatment of lung cancer using radiation is also advancing. Research at the University of Michigan has found that treating cancer that has spread from the lungs to the lymph nodes or organs with both chemotherapy and high dose radiation can slightly increase the lifespan of patients. Those with later stage lung cancer still have a very low chance of survival so at this point in time, extending life is the second best option.

For earlier-stage lung cancer patients, the news is definitely more positive. A study by the Wisconsin Cancer Center has found that earlier-stage lung cancer patients could reduce the chances of the cancer spreading to their brains by a factor of 2.5 times if they had brain radiation therapy following chemotherapy. What will be interesting is to see whether these same levels of success can be seen when radiation is applied to other areas of the body.

In related research an important study at the University of Kentucky Markey Cancer Center for those with early stage inoperable lung cancer found that targeted high dose radiation treatments were able to eliminate lung cancer in 90% of patients without the cancer having returned after 4 years. This non-surgical approach could be very valuable to elderly patient for whom major surgery is risky. In general, any approach that reduces the risks of surgical complications will help save patient lives.

Though many nonsmokers may feel a sense of justice deep inside because smokers who develop lung cancer get “what’s to coming to them”, there are considerable downsides to this way of thinking. With lung cancer soon to be the number one cancer killer worldwide, many people will die from the disease because of our underdeveloped understanding of how to treat it. This lack of understanding is in large part because of the inattention paid to researching this unpopular disease.

Unfortunately with costs for treating lung cancer patients ranging between $20,000 and $60,000 US per person, the resulting annual costs of $1.5 to $4.4 billion dollars to treat those 220,000 people is very expensive especially when we consider that these people will die. Would it not be better to spend more research dollars to understand and develop treatments for this disease while continuing to educate the public on the dangers of smoking? Despite many nonsmokers having spent years choking on other people’s smoke in many public places, the reality is that any feeling of justice regarding smokers developing lung cancer is simply misplaced.

Have you or someone close experienced lung cancer and experienced the limited treatment options available? Have you seen others with the “I told you so” mentality regarding lung cancer in smokers?

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