One of the lousiest cancers to have is lung cancer, because of the low cure rate.
And today the blogosphere is mourning the death of Cathy Seipp, who just died at age 49.
Ironically, Ms. Seipp had the type of lung cancer not associated with smoking, but 85percent is caused by smoking cigarettes.
Most of the lung cancers are found after they spread, because the common types spread early. Then there are the “secondary” lung cancers, which start elsewhere but spread into the bloodstream, and you find them on the chest x ray.
But the sad part of the ones that start in the lung is that often they spread early, so by the time you find them on an X ray, it’s too late. An X ray can see something as small as a quarter inch, but a lot of these cancers start in the bronchial tubes, and on an X ray are hidden behind the shadows of the hearts and blood vessels, so are hard to pick up.
Illustration here.
Back 35 years ago when I was in medical school, we did a study of Chest X rays every three months, and didn’t find it caught them early enough to do much good. More recently, there was a study suggesting that a CT scan, which can see in three dimensions, might catch them earlier…and indeed, it did. But, as Medpundit points out, it didn’t make much difference in the survival rate ether: the same percentage of people died but because the cancer was “found” earlier, it made it look like they lived longer. LINK2

Medline has a lot of information on the cancer, and how you treat it depends on the type. The common types are small cell and non small cell cancers.
Usually we Family Docs pick them up on someone who is coughing and looks a bit grey. Then we send them to a specialist to do a biopsy, which is usually by a bronchoscope, or tube down the bronchial tubes. Then they see the cancer doctor. If the tumor hasn’t spread, and is near the outside of the lung, a surgeon can take it out. But alas often it has spread, so you just arrange palliation.
But once in awhile you get a fast growing small cell cancer that responds to chemotherapy, and you even get a cure.
I’ve had several smoking relatives die of the disease, and always tried to get my patients to quit. Calling it “addiction” is somewhat misleading, since as I would remind my patients, tobacco addiction only kills the body, not the soul, so if I had an alcoholic or crank addict going into rehab, I would tell them to stop the hard drug first and later we could worry about the cigarettes.
Ironically, as Susan Estrich points out, although Lung cancer kills more than other cancers or HIV, funding for research is much less than other more “glamorous” diseases like breast cancer and HIV. Part of this is because it is mainly caused by a behavior…but then so is HIV. And ironically, lung cancer kills more women than Breast cancer, but it is not touted by feminists or in women’s magazines as a “cause”.
If any good can come from the death of this dear lady, it may be that the “blog burst” from Cathy’s death will seep into the media and we will have more research into finding a cure for this terrible disease.
Nancy Reyes is a retired physician living in the Philippines. Her webpage is Finest Kind Clinic and Fishmarket and she writes medical essays on Hey Doc Xanga blog.

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