Lives up in smoke
02/08/04
Lung cancer still a leading cause of death
Elkhart County is beating national and state mortality rates, but 30 out of every 100,000 area residents aren't beating lung cancer.
And deaths probably won't stop soon.
"The smokers of today will be the lung cancer patients of tomorrow," said Dr. Daniel Bruetman, oncologist in the Goshen Health System.
In the latest report, 27 percent of Hoosier adults and 32 percent of Indiana's High school students continue to smoke. Yet, lung cancer is the leading cause of cancer deaths in the United States, killing more than 151,000 Americans a year, and in Indiana, taking 4,000 Hoosiers each year.
"The discouraging news is that we know what causes lung cancer, yet people continue to smoke," said Dr. Robin Zon, oncologist in the Elkhart General Healthcare System.
And even nonsmokers aren't clear and free from cancer concerns. Many of the chemicals in tobacco smoke are inhaled by innocent individuals, making secondhand exposure responsible for approximately 3,000 lung cancer deaths and as many as 50,000 deaths from heart disease each year in America.
"Secondhand smoke has been underestimated as far as potential damage," said Mark Potuck, a health educator in tobacco control with the Elkhart County Health Department.
"I tell kids don't go home and tell your parents their secondhand smoke is killing you," Potuck continued. "Ask mom and dad nicely to go outside to smoke."
Potuck tells the story of a teacher who came up to him after a presentation to say that she lost her husband to lung cancer at age 47, although he never smoked. The man played in a band for 20 some years and constantly breathed the other three members' smoke.
Potuck spends a lot of time in elementary schools, trying to educate students.
"The more kids hear the message of the harmful addictiveness of cigarettes and nicotine, the more likely they are to take it to heart and not start," Potuck said.
Bruetman doesn't believe education is enough. Americans have been hearing for years that smoking is bad for their health, he explained.
"This is a product that is legal and widely available, and as long as that's the case, the numbers aren't going to change dramatically," Bruetman said. "Education is part of the process, but we still have to have other organizations that play a role -- from industry, tobacco growers, Congress, etc."
The National Institutes of Health estimated overall costs for cancer in 2002 at $171.6 billion. The figure included direct medical costs, lost productivity due to illness and lost productivity due to premature death.
In 2003, United Cancer Services of Elkhart County gave $70,000 in financial assistance to 529 cancer patients.
"We see all kinds of cancer, but surgery isn't an option for most people with lung cancer," said Pete Norton, UCS executive director. "It's a high mortality cancer, and it's an expensive cancer to treat.
"Probably 75 percent of the people who come here have a job, have insurance, have a house and have a car or two," Norton added. "But you can't work when you're in treatment, and insurance and disability usually start three to six months after you're diagnosed."
There is no test for early detection of lung cancer. Symptoms often appear after the disease has spread, although advancements in medicines over the last 10 years have prolonged some lives.
"The average life expectancy for someone with the most advanced stage of cancer was four to six months," Zon said. "We're seeing individuals trying various treatments who are living longer.
"They may average 15 to 18 months in the fourth stage, but usually not beyond two years," Zon continued. "Lung cancer tends to be more aggressive and not as easily controlled."
Surgery is used in limited stages to remove cancerous tumors. Radiation therapy kills cancer cells through X-rays, and chemotherapy can be effective against cancer cells through injected or oral drugs.
"The most frustrating part is that lung cancer is the No. 1 most preventable cause of death," said Shelby Peck, patient services coordinator of the American Cancer Society in Elkhart and seven other counties. "You can cure this disease if you don't smoke.
"As an adult you can make that decision to smoke," Peck continued. "But young people get addicted and don't know the health hazards. If you make it through high school without smoking, your chances are good not to start."
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