Listen to Your Cough!! It Could Save Your Life.

Alice had a cough that just would not go away. She came to see me and we treated it with conservative measures for a couple of weeks, but when it persisted in spite of that initial treatment, I gave her an order for a chest xray. I also referred her to an allergist, at her request because she was certain this cough was a reaction to something in her workplace. She went to the allergist; she skipped the chest xray.  She continued to cough.

A few months later, Alice showed up in my office with two strange lumps under the skin of her thigh. They looked like cysts, so we attempted to drain fluid out and I found they were solid. A week later a surgeon removed these lumps and diagnosed metastatic squamous cell carcinoma – from a primary lung cancer.   Alice had never smoked.

Her mother had died of lung cancer years before, and Alice had been exposed to passive cigarette smoke during most of her childhood. Alice died a long year after her diagnosis. Her death was heart wrenching and painful, not only because I was close to her but because it may have been unnecessary. We will never know.

Lung cancer continues to kill more people in the United States than any other kind of cancer. More than breast cancer, more than prostate cancer, more than colon cancer or leukemia. The death of Peter Jennings and the announcement by Dana Reeve (Christopher Reeve’s widow) have brought lung cancer back to the headlines. But this time there is a new twist:  Fifteen percent of patients diagnosed with lung cancer are never-smokers.

This is one of the hardest forms of cancer to cure, primarily because, as in Alice ’s case, it is too often diagnosed after it has metastasized throughout the body.  The symptoms of lung cancer are so common that they are easy to ignore. Until they become serious, and then it may be too late. The most common are:

When lung cancer spreads to distant organs, if may cause:

Many of these symptoms are also noticed with less serious diseases. A cold can cause a cough that persists for several weeks. Sinusitis can cause sputum to be bloody. Asthma or severe allergies can cause wheezing and shortness of breath.  So how do you tell if you should be checked for lung cancer? 

Consider your risk factors.  The most common and well known risk factor for lung cancer is cigarette smoking. Exposure to passive smoke is a proven risk, and the increase in lung cancer diagnosis in the baby boomer generation is evidence of this. Passive smoke exposure may be the key to the significant percentage of never-smokers who are diagnosed each year.

The second most common cause of lung cancer is radon which is a naturally occurring colorless odorless gas that is released from the earth in areas with uranium deposits. Radon is not limited to desert country. Homes and businesses across the United States have been found to be contaminated with this gas, much to the surprise of the inhabitants. The only way to know if your space has radon buildup is to get it tested.  For more information about radon, see http://cis.nci.nih.gov/fact/3_52.htm

Asbestos exposure causes many health problems, one of which is lung cancer. For information about this long known risk factor, see http://cis.nci.nih.gov/fact/3_21.htm 

Genetics plays a role in lung cancer also and recently scientists have located the gene that may be responsible on Chromosome 6. So if a family member has had lung cancer, consider yourself slightly more at risk. Add this increased risk to your own smoking history, or your own exposure to passive smoke, and you should be vigilant.

If you have any of these risk factors, and if you have any of the symptoms listed above, PLEASE do not ignore the warning signs. Do not be afraid to go to you doctor and request a chest xray. If that chest xray is read as normal, but you still have doubt, ask for further tests – CT scans can be helpful, sputum can be looked at for abnormal cells, and a pulmonologist (lung specialist) can be helpful in making a diagnosis. Listen to your cough. It may save your life.