Face of lung cancer — once older men with a history of smoking — has changed significantly

Many lung cancers are now found in non-smokers, and scientists want to know why.

According to the headline of a story by Nina Agrawal and Allison Jiang in The New York Times early this week, "the face of lung cancer — once older men with a history of smoking — has changed." Significantly.

Lung cancer is the deadliest cancer in the United States, notes the article that then goes on to say that "the disease's incidence and death rates have dropped over the last few decades, thanks largely to a decline in cigarette use, but lung cancers unrelated to smoking have persisted."

Worldwide, "roughly 10 to 25 percent of lung cancers now occur in people who have never smoked," the piece continues, "Among certain groups of Asian and Asian American women, that share is estimated to be 50 per cent or more."

Dr. Maria Teresa Landi

The thinking used to be that smoking was "almost the only cause of lung cancer," the story quotes Dr. Maria Teresa Landi, a senior investigator at the National Cancer Institute, which is part of the National Institutes of Health. 

Landi is studying "the role that environmental exposure, genetic mutations, or other risk factors might play. She and other researchers "have already found some early hints, including a clear link to air pollution," Agrawal and Jiang's article states.

The piece also quotes Dr. Heather Wakelee, chief of oncology  at the Stanford University School of Medicine, to the effect that "we all still think about the Marlboro man as whaat lung cancer looks like." 

In many cases, however, that's no longer the case. "We're just baffled as to why," Wakelee adds.

One large study led by Landi and colleagues at the University of California, San Diego, the Times story reports, "is looking at the mutational signatures, or patterns of mutations across the cancer genomes, of 871 non-smokers with lung cancer from around the world."

Their latest findings from the study, dubbed Sherlock Lung and published in Nature this month, "showed that certain mutations, or changes to DNA, were much more common in people who lived in areas with high amounts of air pollution —  for example, Hong Kong, Taiwan, and Uzbekistan," the article says.

More information on the multiple kinds of cancer can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at caregivers. I am, in fact, hard at work on a second edition. 

My other books are Mystery Dates — How to keep the sizzle in our relationship; The Roving I, a compilation of 70 of my newspaper columns; and Grampy and His Fairyzona Playmates, a whimsical fantasy intended for 6- to 10-year-olds that I co-authored with my then 8-year-old granddaughter. Check out my blog at https://woodyweingarten.com for more info on them.

Columnist suggests three strategies that could possibly reduce your risk of contracting cancer

By employing three strategies, you may reduce your cancer risk. 

That, at least, is the opinion of Dr. Jerry Saliman, whose Senior Life column in an earlier-this-month edition of j. the Jewish News of Northern California, focused on those strategies — being on the lookout, catching symptoms early, and paying attention to risky behavioral factors.

Dr. Jerry Saliman

Regarding the first strategy, Saliman writes that unfortunately only four types of cancer screening have received a high-level record recommendation from a U.S. task force: colon, lung, breast, and cervix.

As to the second line of reasoning, the columnist, a Bay Area physician who retired from Kaiser South San Francisco after a 30-year career and now is a volunteer internist at Samaritan House Medical Clinic in San Mateo, suggests that "by catching cancer early, the survival rates may be four times higher compared with later-stage detection."

Saliman adds, about the last strategy, that the American Cancer Society's prevention studies have been crucial in detailing risk factors — including, in the 1950s, being the first to identify smoking as a major reason for cancer. The ACS has since, via its ongoing research, "found that older age and smoking have the highest relative risk for developing any cancer for both men and women."

Additional risks for men, his column says, "are family history of cancer, red meat consumption, alcohol intake, and physical inactivity."

More information on risks can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Neither bras nor caffeine cause breast cancer

Article details risk factors for breast cancer while outlining preventive measures and dispelling myths

Are the causes of breast cancer known?

No, according to a feature story by Dr. Lizellen La Follette in the Marin Independent Journal that I've kept around quite a while because it's a good summary.

Both the article and its headline note, however, that although the roots of breast cancer aren't clear, the risk factors are.

Dr. Lizellen La Follette

La Follette details those factors: gender (being a woman); age ("two out of three with invasive cancer are diagnosed after age 55"); family, personal health, menstrual and reproductive histories; dense breast tissue; radiation to the chest; genetic changes; poor diet and alcohol consumption; obesity; lack of physical activity; smoking; and exposure to DES, a medication to prevent miscarriage that was heavily prescribed from the '40s through the '60s. 

Also, looking for dimpling or puckering of the breast, inversion of the nipple, redness or scaliness of the breast skin or nipple/areola area, or discharge of secretions from the nipple.

La Follette also dispels some myths about the disease — including the biggie, that it's contagious. It's not.

Other myths include that the disease can be caused "by wearing underwire bras, implants, deodorants, antiperspirants, mammograms, caffeine, plastic food serving items, microwaves or cellphones."

The article also suggests what women can do as prevention: having monthly breast cancer exams, checking for changes in breast tissue (such as in size), and feeling a palpable lump.

As for the risks, La Follette writes that a woman's "risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed" with it — "and her risk increases if a relative was diagnosed before the age of 50."

Furthermore, she notes, "studies show about 5 to 10 percent of breast cancers can be linked to one mutations inherited from one's mother or father."

Regarding smoking, the columnist contends that smoking is a danger "particularly when it's long-term, heavy and among those who started before their first pregnancy." Meanwhile, the risk "is about 1.5 times higher in overweight women, and two times higher in obese women than in lean women." 

In addition, La Follette maintains that "numerous studies confirm on average alcohol consumption increases the risk of breast cancer in women by about 7 to 10 percent for each drink consumed," and she writes that "women who have two to three alcoholic drinks a day have a 20 percent higher risk…compared with non-drinkers."

Finally, she postures that "early menstruation (before age 12), mate menopause (after 55), having first child at older age or never having given birth can be risk factors."

La Follette also takes a moment to mention males, citing statistics that while the average man's lifetime risk is about 1 in 1,000, African-American men "are hit harder by breast cancer than their white counterparts and after diagnosis are three times more likely to die" from it than white men.

To learn more about other causes of the disease, get a copy of  "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Less smoking may have aided drop in disease

Higher percentage of women now getting lung cancer, Time says, despite dip in mortality rates

Women now account for "disproportionately high number" of lung cancer diagnoses.

That's true despite overall mortality rates having "fallen significantly in recent decades" — and in spite of women traditionally having "smoked less than men and thus developed and died from lung cancer less often."

At least that's the conclusion of an article in Time magazine by Jamie Ducharme, a piece from the end of last year just sent to me by a friend for this blog.

Ducharme's story indicates that part of the reason for the overall dip in the disease, the most deadly form of cancer in the United States, is because medical advances have been occurring for decades, and because there have been major decreases in smoking.

But the "why" of the shift from "what was historically a men's disease" apparently is not apparent. 

Alice Berger, PhD.

"It's completely unknown right now," Time quotes Alice Berger, a Ph.D. who researches genetics and cancer at Seattle's Fred Hutchinson Cancer Research Center.

And Dr. Ahmedin Jemal, co-author of a study in the New England Journal of Medicine, is also quoted as saying "smoking habits cannot totally explain the demographic shifts" even though his 2018 report "showed that "rates of long-cancer incidence actually rose over the past 20 years among women born around either 1950 or 1960."

Researchers have determined, in fact, that "the type of lung cancer most common among nonsmokers disproportionately affect women, and young women are more likely to have a gene mutation often found in the tumors of nonsmokers."

The mutation, not incidentally, does respond well to newer targeted therapies, Berger notes in the piece. 

She also repeats a theory that "quirks of female sex hormones or women's immune systems could be responsible" for the disproportion.

A lot more information on scientific research can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.