Tumor initiation and early tumorigenesis: molecular mechanisms and interventional targets
Lung Cancer Without Smoking?
Lung cancer is not just a smoker's disease anymore. Air pollution is emerging as a major risk factor, especially in cities. Protect your lungs, and breathe clean! Highlights:
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What is Lung Cancer? Lung cancer is a condition where abnormal cells in the lungs grow uncontrollably and have the potential to spread to other parts of the body. While smoking is a major cause, lung cancer can also occur in people who have never smoked. In these cases, environmental factors like air pollution are believed to play a big role.Advertisement
How Air Pollution Affects the Lungs Air pollution contains harmful substances such as:Advertisement
Who is at Risk for Lung Cancer? People who live in areas with high air pollution are at greater risk. Some groups are more vulnerable than others. People living in big cities where pollution from vehicles and industries is high.Women are affected more often by lung cancer unrelated to smoking. People with lung conditions like asthma or chronic bronchitis may be more susceptible. Indoor pollution such as smoke from cooking fuels has a higher risk.
Air Pollution and Lung Cancer Polluted air contains fine particles that can enter the lungs and trigger long-term damage. Over time, these particles can change the way lung cells function, sometimes leading to uncontrolled cell growth, which is what happens in cancer. Unlike smoking-related lung cancer, which often affects larger airways, pollution-related lung cancer tends to develop deeper in the lungs.Although we cannot completely avoid air pollution, there are ways to reduce exposure:
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A Billboard Saved Me From Dying From Lung Cancer — Before I Even Had Symptoms (Exclusive)
Denise Lee, now 63, smoked for 40 years, starting when she was 14. A year after her last cigarette, she saw a public service announcement created by Hill Holliday for the American Lung Association's Ad Council campaign, saying that former smokers were eligible for a special lung cancer screening. Lee got the scan, which led to a lung cancer diagnosis before she even had symptoms. Below, she shares her story with PEOPLE.
I started smoking when I was 14. My first cigarette was one of my mom's cigarettes. She never smoked in front of us — she always smoked in the bathroom, in our basement.
One day, I just went in and got one of her cigarettes and smoked it. It was terrible. It was awful. But I viewed cigarette smoking as a weight-loss aid. I was heavy, and I figured that if I smoked, I wouldn't eat — and if I didn't eat, then I wouldn't gain weight. I had huge body image issues.
Smoking was more acceptable back then. I went to an all-girls Catholic high school, and we actually had our own smoking area that the school provided for us, believe it or not. The only person I didn't smoke in front of was my mom. While I was still at home before I went off to college at Howard University, I developed a really bad cough, and my mother did mention, 'You need to stop smoking,' so she knew at that point.
Denise Lee on vacation — just weeks before her cancer diagnosis.Courtesy of Denise Lee
In college, I used it as a stress reliever. I was away from home, and it just became a way of life at that point.
After that, it would depend on what was going on. I don't think I ever got under a pack. As a public defender, life never was really mellow. If things got really crazy, I could go up to two packs a day easy. As soon as I would wake up, I would have a cigarette. Before I quit, I could smoke a half a pack of cigarettes before I even got out of the house.
I did try to quit multiple times, but, you know, nicotine is pretty addictive. I got the brilliant idea that, because I hated non-menthol cigarettes, I would smoke non-menthol cigarettes — and because I didn't like them, I wouldn't smoke them. Well, we know what happened… I became addicted to non-menthol cigarettes.
I was 54, I knew I needed to quit. Did I want to quit? No, but I knew health-wise, I needed to quit.
Denise Lee shares a selfie in Washington, DC.Courtesy of Denise Lee
I was able to quit with the help of the prescription drug Chantix. I was smoking, and the best cigarette was the first cigarette of the day with coffee. On April 20, 2017, I woke up and I didn't want a cigarette.
A while later, I was driving and stuck in traffic on highway 880. I lived in Fremont, Calif., but worked in San Jose. I see this billboard that says that if you currently smoke or quit within the past 15 years, this test could save your life. I passed it probably about six times more, and I said, you know, I gotta talk to my doctor about that.
I went up on the website savedbythescan.Org and took the quick quiz. It told me that I qualify. I made the appointment for the day after I got back from a six-week vacation. It was a CT scan, real easy, and took maybe less than two minutes.
The billboard Denise Lee saw that "saved my life.".Courtesy of Ad Council
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Less than 24 hours later, I got a call from a pulmonologist saying that they needed to see me ASAP. They told me that they found a mass in my upper left lobe. They suspected that it was lung cancer. I will never forget that conversation. I was walking with a friend, and my primary care physician physician called me. I just kept saying, 'I'm going to die.' My friend just took the phone and she talked to my primary care physician, because I just couldn't. She got all of the information.
After several tests, they took a biopsy. It came back cancerous. I had no symptoms.
I had my surgery on March 7, 2018, almost a year after I quit smoking. It was an aggressive surgery because the tumor was pretty big. They took the whole upper left lobe and 18 lymph nodes to make sure it hadn't spread. Fortunately, it hadn't. Afterward, I did four rounds of chemotherapy and qualified for a clinical trial of an immunotherapy drug, which was taken monthly for a year.
Denise Lee's last day of chemotherapy.Courtesy of Denise Lee
I haven't had a recurrence and it's been eight years.
The advantage of them finding it so early is that I had a lot more treatment options. I was able to have surgery, chemotherapy, qualify for a clinical trial. One of the advantages of early detection is that the goal of treatment becomes a cure as opposed to palliative. And I had so many treatment options.
I'm now 63. I'm great, still traveling, exercising, I'm working with other people diagnosed with lung cancer. I like being able to tell my story because if even if it helps one person then that's worth it to me.
If you qualify, get it, please get it. It saved my life. If I had a page in Wikipedia, "Early Detection Saves Lives," my picture would be right there.
To assess your risk, visit savedbythescan.Org.
Lung Cancer In Never-smokers, Right-sizing China's Economy: SCMP Daily Highlights
Catch up on some of SCMP's biggest China and economy stories of the day. If you would like to see more of our reporting, please consider subscribing. 1. Air pollution threat as lung cancer cases in never-smokers on the rise: studyDespite drops in tobacco use worldwide, the incidence of lung cancer among people who have never smoked is increasing, with higher risks for younger generations and women – particularly in China – a global analysis led by the World Health Organization has found.
2. China has met most of its 5-year goals. It hasn't done so well on emissionsChina met most of its targets under the current 14th Five-Year Plan to 2025 but has fallen short on energy efficiency and emission goals, according to Tsinghua University researchers.
3. Scholar Jing Qian on right-sizing China's economy in the age of Trump
Illustration: Lau Ka-kuen The researcher surveys the dividends of "Made in China 2025" and shares why he thinks Trump's contradictions could benefit bilateral relations.
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