Myth #1: Smoking Causes Lung Cancer–Period.

Now, lest anyone declare me irresponsible for making such a statement let me be clear.

It is quite evident that a history of smoking causes a person to be dramatically more at risk for developing Lung Cancer than a non-smoking counterpart.  I will give you that. 

However, the way this phrase is tossed around–has been used by organizations like the ACS, has been used by medical professionals, even–is irresponsible, and I will go ahead and say it, incorrect.

First lets look at the numbers:  According to Lung Cancer.org, over 50% of those newly diagnosed with lung cancer will be former smokers or never smokers.  The breakdown looks like this:

• Current Smokers make up 35-40% of new Lung Cancer cases
• Former Smokers make up 50% of new Lung Cancer cases
• Never Smokers make up 10-15 percent of new Lung Cancer cases (courtesy of Lung Cancer Alliance)

On top of that, this quote may surprise some: 

“A smoker’s risk of getting lung cancer is in the range 1 in 10 to 1 in 20.”  (from  http://www.health.nsw.gov.au/topics/lungcancer.html)

Now I’m not denying that a 10% risk is still too great a risk to take, but….  If only 1 in 10 smokers actually gets Lung Cancer…..  can we really say that Lung Cancer is caused by cigarettes?  Always?  If smoking is the only cause of Lung Cancer, why don’t the other 90% of smokers get a similar diagnosis?  There have to be some other factors involved.  What is the missing link causing these 10% to be the ones stricken with Lung Cancer?

If 10-15% of those who are being diagnosed with Lung Cancer are never-smokers, then there has to be something else at work here, yes?  And….  if there is something else at work for that 10-15% isn’t it possible, even probable, that there is similarly something else at work for at least some of the smokers who are diagnosed?

So what could that ’something else’ be?  What are the other known risk factors?

• Age:  Most diagnoses occur after the age of 45.   (Note–as will be visited in another “Myth” this does not mean that people under the age of 45 cannot get Lung Cancer)
• Radon:  This is the second-leading cause of Lung Cancer in the United States.  It is a colorless and odorless gas that occurs naturally in soil and rocks.
• Environmental Carcinogens:  arsenic, asbestos, uranium, diesel fuel, etc.  For that matter, I recently read an article that found deep-fat frying to be a common link for some Asian non-smoking women who were diagnosed. 
• Radiation Therapy to the chest area
• Family History of Lung Cancer–Note:  If you go into a doctors office and say, “I have a family member who had Lung Cancer, am I at risk?” they may say, “No!”  My doctor did.  But studies are increasingly finding that genetics may play a role here too.  Anecdotally, I can tell you that there are several families on my Lung Cancer board who have lost several family members to the disease.  In my family, I know that two of my Maternal Grandmother’s brother’s died of Lung Cancer long before my Mom was diagnosed.  If a doctor ever does tell you this, refer them to this study. 
• Lung Diseases:  Some lung diseases including TB have been associated with an increased risk for Lung Cancer.

So…  Clearly, there’s more to the story than, “Smoking Causes Lung Cancer.”  This is why it’s so frustrating to me and so many others who are dealing with Lung Cancer in their lives, (whether through their own diagnosis or the illness of a loved one) to be asked, “Did you/he/she smoke?” immediately after hearing the words, “Lung Cancer.”  There are so many more factors that should be considered….  Not the least of which being the humanity of the person with the diagnosis.

If you were to ask me what I believe caused my mother’s lung cancer, I would have to answer honestly, “I don’t know.”  I could hazard a guess that her smoking played a part.  I could wonder if the chemicals that she was exposed to regularly at the factory in which she worked played a part.  I might logically guess that her family history predisposed her to the disease and her other risk factors twisted the wrench to make it happen.  But I would not tell you, “She smoked.”  I will not now or ever blame my mother for this horrible disease happening to her.  Suggesting that a person who has Lung Cancer has it simply because they smoked sounds a great deal to me like placing blame.

YES, EMPHATICALLY, YES smoking dramatically increases one’s risk for developing the disease….  And those who want to decrease their risk significantly–maybe even by the greatest degree–should never smoke or at the very least quit, but note–”Risk factor” and “Direct Cause” are not synonyms as we have historically been lead to believe.

Now, I can’t tackle the other myths without referring back to this one, so expect it to come up again (and again and again).  But from now on think twice when hearing, “Smoking causes Lung Cancer.”  Lung Cancer, like most things is about more than meets the eye.

Resources:  http://lchelp.org/, http://www.lungcanceralliance.org/facing/risks.html, http://www.lungcancer.org/patients/fs_pc_lc_101.htm, http://www.journaloftheoretics.com/Editorials/Editorial%201-4.html

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