Women & Lung Cancer

Nov 18, 2012|

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Automatically Generated Transcript (may not be 100% accurate)

This is Roswell. Rookie by Roswell Park Cancer Institute. European opinion or your total options. You're hosed him when you connect to Roswell -- it's a comprehensive look at all aspects of cancer care treatment diagnosis and research. From a comprehensive source Roswell park. Cancer institute here in Buffalo, New York. I'm Jim lingered -- they were going to talk about lung cancer ending its relationship with women something we have not discussed here on the program before. In studio with me today here at Roswell park is doctor Mary Read. Associate professor of oncology in the department of medicine here Russell park also director of collaborative research. Very welcome to the it is so one of the the top cancers that do you know we've we've discussed over the years here. In the studio but we've never talked to instance you know specificity. In its relationship with women. And that's that's I think highly interesting too the women in the audience and anyone out there listening right now what is the relationship between. Lung cancer in women as we know it. Right now. Well I'm actually the rates when you look at age adjusted rates are actually higher in women than they are in men and still you know men. Constitute two thirds of lung cancer cases that there -- the actual rates some women are higher and that's something that we don't really come understands. On. We do know that lung cancer kills more women. Then breast cancer colon cancer combined. It's the biggest. Leading cause of cancer death among both men and women. But you know I think because it's not as common as breast cancer we sort of get thrown off track. Lung cancer actually kills more women than breast cancer. You don't when we think of lung cancer the first. You know that notion and our mind is tobacco smoking. Cigarettes. Not male female you know and we don't think -- -- relationship. Gender we think that you know probably. You know if you hear someone has lung cancer had lung cancer. Did they smoke do you smoke. Not are you -- you female. But that obviously comes comes to play. Well you know smoking still causes the majority of colon cancers 90%. But in women we we do know that it's slightly lower it's about 80% are really smoking related. And some of has to do we you know the actual causes of lung cancer in. Non smokers -- never smokers. You know we don't completely understand but we do know that it's slightly more common in women. On that these cancers tend to be. In the periphery of the outer areas of -- long they're more likely to be -- carcinoma. And if a woman who was never smokers. Gets lung cancer they tend to respond better than a woman who got lung cancer from smoking. Now these trends that started to change. About a decade ago. On that we saw an increase of lung cancer among never smokers. Now we know that that's true. And that that tends to be more common among women although they're still. You know men who are never smokers who get lung cancer. The good part is that there are more responsive. The bad part is is that when you have symptoms like a persisting cough for an infection that doesn't go away and you never smoked. Lung cancers the last thing that you're thinking of and so frequently these cancers picked up. In women never smokers. Because they go for artistic straighter they have an unresolved. Infection. Where they're getting evaluated for life insurance and that's how the majority of these lung cancers and never smokers gets picked. But I do wanna say that still the majority and it's unfortunate. On the majority of lung cancers in women is related to smoking and not necessarily you know active smoking. You know we know that between men and women. Half a lung cancer cases that are picked up are among people who authority -- it. And again that's. You know a tough thing to do the right thing he quit smoking in May be ten years since you quit smoking. And you can't have symptoms that you don't think of as lung cancer because you don't smoke anymore. But you know we're really seeing this upsurge in people who did damage to their lungs that is really never got repaired. I never go back to normal and we see both men and women. You know they can have quit for ten years. And we still see. Likelihood of lung cancer. -- We you know we're gonna spend a lot of time today talking about women in lung cancer women who are smokers and nonsmokers who have lung cancer. But I guess from I want to emphasize here because they know it plays an enormous role in lung cancer is that a majority of those. Diagnosed. With lung cancer. Tobacco probably played a role correct not gender correct. Could it mean it is that the big exposure the difference in rates between men and women is still perplexing. We we think some of that may be hormonal influences obviously. You know we're really there's a lot of research going on actively to look at the effects of estrogen. And estrogen withdrawal during menopause and the effects on bone cancer and tumor growth. Now we also know that sometimes. Women may be exposed to different environmental. Causes than man. On May be slightly different occupational. May be different ways that they are exposed to passive smoking. For never smokers you know you intensely. Interviewed them for whether. Their style smokes for the the group with parents that smoke because there was something that created. And an environment in Milan to grow the tumor. If you are a woman who gets tumor younger. On the influences of genetics that you inherited. Is is stronger than if you're a woman who's never smokers. At the age of fifty or sixty who gets one cancer those are more environmental exposures. That's not really different among. With men but we do see younger. -- cases of lung cancer in never smokers more common among women -- With what you said so far. Why is lung cancer known as a man's disease I mean we really do think. As I think society thinks that way when we think lung cancer rethink. You know a middle aged guy. Or an older guy who's been smoking for three years it's a man's disease here we just came off of Breast Cancer Awareness Month in October. We're so much focus was on on women and breast cancer as you know you know appropriately so. However this is a huge problem with women in its not a man's disease. Well it doesn't but you know men started smoking first. You know it was more socially. Acceptable you know from the turn of the century for -- to really use cigarettes her. Tobacco products as a habit. -- and women Mercer if latecomers to the picture. Fine and by the time and the surgeon general's report came on the sixties say that smoking was related to lung cancer. When when women were really starting to come into their own -- smokers. And the tobacco industry started its target products for women these. Longer thinner you know attractive. On cigarettes. Had filters that they are still really a lot of advertising was aimed at sort of the female image we started to see more women smoking in the movies in the seventies and eighties. And then at that time man we're really starting to quit. It pretty big numbers because we understood that relationship of smoking to lung cancer. Time and you know we've seen women smoking rates they've gone down not as dramatically as they have among men. Now we're seeing the decrease in lung cancer mortality go down as well but still with women you know if they -- there persistent smokers. They came annaly and maybe they smoke less and they definitely -- different products and I think that also influences -- overseeing kind of different. Rates we're seeing. These. Tumors growing in the outer parts of the -- in women more often and then. On men smoked non filtered cigarettes where they get a lot more center of disease so that if you. Had symptoms may be those who are more obvious symptoms and so that's really contributed to it. I think it's more -- quit smoking. And maybe more young women start taking up the habit. That perception of who really smokes me may change. But you know men. You know we -- -- cigarettes -- -- when they find wars we still do you make tobacco very accessible. We know that there's an interaction with smoking and some of the occupational. On areas that we're predominantly male like heavy industry. Steel mills. Chemical factories and served. And that leads us to seeing how this disease where presents differently between the genders. I'm curious do we. Overlook. Lung cancer in women you know for example is if if if you know two people -- defeat female present. You know symptoms. You know symptomatic to lung cancer you know could you mentioned the chronic cough from. You know do we do we look at the man and say you know do you smoke and it could be lung cancer and we need to. Can work up do we do we look at males and females you think in today's society differently. From that standpoint it's. I think it's probably. Changed the -- analysts in fifteen years that we really understand that women. Will die from lung cancer is frequently Asman. You know if you smoke for twenty years as a woman you don't get a pass. From lung cancer and I think we understand that there's been some research out recently. From the universe from the United Kingdom and a million Mormon. Study that showed that women. Will die from smoking. If they smoked into their sixties that a woman who quits early can actually give herself back ten years of life. That you know women who -- chronic long term smokers lose. At least a decade of their lives from smoking and so you know now the evidence is really end. You know that the difference in product that difference in aware of the tumors may grow. The difference in the actual crude numbers of women who smoke you know it's still lower. But that we now know that women. Will succumb to this disease. Actually more frequently by age. Than men and so that has changed. Com you know I think that same answers throws a wrench into it. Is that four lung cancer women don't require quite the robust smoking habits that men do so -- a woman sing I smoke. A pack a day and you know you may not immediately think of lung cancer whereas. You know especially in the older. On male cohorts of demand in the sixties and seventies they smoked two packs a day for forty years they started when they. You know one off in the service her. You know when they were working. And kind of it heavy industrial jobs and some of our perceptions of change because now we now. Women are actually more susceptible from lung cancer gunman. It's it will -- disease presents slightly differently. It's more common among never smokers. Females than -- and so that perceptions changed I think. You know we can easily do this spiral CT. Now to look for lung cancer. Rather than just chest X ray. Where you know we've we're doing a lot to educate the community on symptoms and a lot to educate patients on symptoms. But you know that that has changed. You mentioned that that research in the United Kingdom where you get into some more detail on that little bit later. In the program a piece of little data point that really stuck out in my mind as I was through you know getting ready to you know to speak -- you today 20%. Of of women diagnosed with lung cancer. Have never touched a cigarette that's that needs to be or I'm sure is a pretty perplexing. Piece of data for you in in everybody that works with this. This disease. It is it's perplexing because what really is pushing those tumors salon. You know is it an environmental exposure like passive smoking is it a genetic burden and you know we're gaining a lot of understanding. Of through looking at some studies of and family registries to see if there are some. Parts of the genome that increase your susceptibility. Com and these cases tend to be younger. And which is really devastating because they they don't necessarily have. Great outcomes and so it is is problematic it's worrisome. On especially as we go forward. On 20% is a lot. You know when you're you're talking about you know tens of thousands of women getting lung cancer who never smoked. And they tend to come in as kind of leader cases because their tomb where there tumors grow they have symptoms at a late stage. The good part is is that they respond to treat. And better but you're still talking about women who -- very active. You know. Time in -- the prime of their lives and in their careers and their families having to deal with. They're very aggressive and kind of long term treatment for more for cancer. When they actually don't have the major risk factor. That is something we need to figure out but to put it in context. -- You know one intense smokers get lung cancer. And those are common. And we still don't know how to tell the smoker that's gonna get lung cancer. And until we really understand the early Genesis of this cancer given a huge. Carcinogenic exposure like smoking with multiple chemicals. We're really going to struggle to figure out in a woman. Who never smoked where there when I cancers can start how -- we -- those women and a you know we started lung cancer screening -- for high risk people. We're not gonna get close to screening the general population of women. Who didn't smoke for lung cancer for a long time until we really understand. Those early changes or. Bio markers that are indicative of -- long that's kind of progress to cancer and then never smoker. Mean there's a lot of their -- women never smokers out there so it it's really important scientific community. You know get the money to do research so that we can really begin to understand this cancer and if we can't do it among smokers. Where it's so common. We're not can make it to be able to do that among never smokers and that's why at this point. You know it's getting better research -- lung cancers so important we really need to reverse these trends and you know we don't wanna see the number of never smokers get lung cancer going up and not understanding why. What's you know what they've been exposed to learn how to identify them early. Some of that research we'll talk about in in just a moment this is -- list that is doctor Mary Read. Associate professor of oncology in the department of medicine here at Roswell park you're listening to Roswell she's also the director of collaborative research here at Roswell Park Cancer Institute before we get to the research. You know we've talked a lot about tobacco and it it comes up you know obviously quite a bit when we talk about lung cancer. -- don't smoking in any time is not a good thing for anyone. Quitting anytime. And quitting at different times I guess you know makes a difference in someone's. Potential. 44. You know getting -- cancer. If if you're a long time smoker and you quit today if you. Start smoking today. If you continue to smoke those are all different factors with. Relation to two lung cancer how to they come into play is you know we talked today about. Specificity with with females. Well. -- -- here I can't say I can't talk about this without saying that if you smoke any time you quit. Is your image that earlier the better the less exposed you are the better it decreases your chance of getting lung cancer and it decrease your chance of getting the other. Myriad of cancers and other diseases that our congress. And or. Or enhanced by having a smoking exposure so at any time it's -- to quit and it's certainly better. Not to start and it's really important naturally kids start because we know that. That earlier age of initiation is really critical time for it for the people who are gonna be addicted for the rest of their lives so the longer. That you printed off the better. But to never start is really the critical thing and there's no amount smoking. Which is good for your body. So natural cigarettes not being -- them. Tobacco is filled with carcinogens. Things are added during the processing but tobacco is cancer causing cars and home goods cigarette. There's no cigarettes how to avoid risk if you smoke. Com. Dose and duration are two really critical things in measuring the likely that are measuring your risk of cancer. The more you smoked per day. Increase your risk and the -- the number of years you smoked and we know other some other things you know. That the the part that affects one in the most I think is. No we have these. Very intricate and advanced. Delivery systems analyst cigarettes to women prefer in terms of filters. And in terms of flavors that make in a much easier product to consent. He can take a nice deep inhale when you have a strong. Filter on there. Time there's a lot -- the industry has really. Fine tuned how to make smoking easy you know it's not like the old and filtered cigarettes that burn your throat. And then you get to inhaled deeply and people who are in the car with smokers. Who are actually inhaling cigarette the smoke diseases and him. On into the deep parts of you on which now we've seen that the majority of cancer lung cancers. -- -- two thirds and growing actually form in the outer reaches of the -- because the smoke is much easier to pass and take a deep breath. We know that women who. -- We know that women who smoke the cigarette to the end of the cigarette. And all these sort of nuances about the habit in addition to how many cigarettes they smoke and Hong smoked all contribute to risk of lung cancer. At no time is there -- no benefit to quitting smoking and we know that up to the point. People who quit. Even at the time of diagnosis do better. Because say the least they get more of the drugs are given they do better with radiation treatment they. They recover better from surgery if -- nonsmokers. I was gonna save you right up to the point of someone diagnosed with lung cancer he admitted to a place like Roswell park being treated for lung cancer. And stopping smoking at that time there's a benefit right there's always just ahead absolutely. And the other some research going on here and I think. You know come on some of the future reports that the benefit. To being a nonsmoker. When you have surgery in your under anesthesia. When you -- came home. The European radiation therapy. You get better response from those treatments if you're not actively smoking and you know it's a very complicated process but. You know it's it's obvious that just from the fact that your lungs are functioning better to some of the metabolic enzymes. Change when you quit smoking to effective food taste better response to the fact that you feel. More like you can be more active. You know. It is hard and you know I've talked to a lot of people who have been diagnosed. That is their most stressful time and to give up a habit like smoking. At a time like that. You know is really difficult. Come but a lot of things are difficult and if you gonna go under treatment for lung cancer you wanna. Give yourself the best advantage and the best thing you can do -- to quit smoking. It always has an improvement it's not necessarily gonna mean that you're never gonna get lung cancer. We're that you -- have a recurrence but you are in better shape from the minute you quit smoking. Always -- if you know great analogy is that a lot of people smoking casinos race and you can smoke and in a lot of casinos. It's a gamble and you know -- I mean it is it really is I mean you said one intent and I think earlier in the in our discussion you know one intend. Manila halted that they you know you've been talking specifically about you know some sort of a gender or or demographic but. -- you know if one and -- are gonna get cancer because they smoke. You know it's Campbell it's a gamble and a that's -- that the researcher wanna get into this a little bit a million women. Participated in a research study that you've already referenced. In the United Kingdom what did we find out what do we know today that we didn't know prior to that research. Well. I think they're a couple very clear messages that women die from smoking. Related diseases -- -- -- -- we're not immune in fact we may be more susceptible amendment. That in. Two thirds of deaths of smokers. Who are in their 50s60s. And seventies. Are related to smoking if they're -- two thirds. It means not only are you risking -- you're gambling about lung cancer -- gambling about a lot of other diseases like cardiovascular disease and kidney disease and you know stroke those are all smoking related. On diseases not exclusively but when you smoke you really contribute to your risk of death. From a myriad of of diseases including cancer. We also learned that the younger you quit smoking. The longer you survive. So that if women her quitting in their thirties and forties. You know when there at the peak of their careers and when their -- raising their kids can actually. I'd give themselves another decade of life by quitting smoking and you know when you face. Diagnosis of cancer or any thing any other serious condition a decade of life is really an important time it's precious. And you know we are very seldom -- -- -- present and with. On some behavior. That we can change that will really extend our lives and now that we know. For women who can quit smoking. You really can extend your life. Not just from lung cancer but from a lot of other fun. Diseases. Who were. The other aspects of of lung cancer that we've talked about on this program before and with you before I guess is. That lung cancer tends to be detected Italy stage and all you know through all the conversations I've had with all of the experts and and everybody here arousal part I know early detection is key you know to to good outcome. And that's really problematic because lung cancer. Can be and in is in most cases detected early stage right correct and that is. You know is certain movie is is that changing his or something we need to know about that is her away for people to. Tips to change that -- and you know among themselves as a way to identify. Lung cancers earlier in the day in in the staging. Well up until about three years ago there was no. Recommended screening for colon cancer and -- and I think we've talked about this before on one of your programs. That there was a very large study of men and women in the US 53000 participants who were. -- between the ages of 55 and 74. Who'd smoked at least for thirty years one -- there two packs a day fifteen years and -- what we call -- thirty. -- here exposure which is. Which is substantial but it's certainly not. As much as we can usually see when we have ask people hear us well. But thirty pack years of exposure who had no symptoms of lung cancer who had no prior cancer. They may have had some lung disease. But there -- no other features that brought him and the study and then these two requirements age and how much they smoked. What we learned from that study is that if you do an annual low dose spiral CT which isn't very quick test it's. You know it's available here Roswell on others a few other places in our community. That you can actually decrease the mortality from lung cancer by 20%. Now we've never had a drug. Or a surgical technique. Or any kind of treatment for lung cancer that actually sees that kind of change immortality. And what it tells us is two things. If you can detect colon cancer earlier -- stage three and four when you don't have the option for surgery and your. Your chance of living five years this is unacceptably low. So you can pick this disease that pearly when you can have surgery and maybe have some chemotherapy or radiation. And then if you do pick it up for early you actually change the course this disease. So my opening information indeed lung cancer leading cause of cancer deaths in women and pretty important conversation today you know Mary thank you so much for your time appreciate it. Thank you very much and that's doctor Mary Read associate professor of oncology in the department of medicine here at Roswell park she's also director of collaborative research. Here at Roswell if you'd like to ask any questions of Roswell. Or find out more information you can call them told free anytime at 877 ask our PCI. That is 8772757724. The website. Always useful and hopefully get these shows for example in their entirety at Roswell park. -- Listen to Roswell this Sunday mornings at 630 young WB yeah. Rocky by Roswell Park Cancer Institute European opinion for your total options on line at Roswell this god of war. Hanging. And hanging do you know. New.