No One Is Safe

Like so many people, I was saddened by the death last night of Dana Reeve. I admired the way she stood by her husband through his paralysis ordeal.

Dana Reeve died of lung cancer at 44 years old and had never smoked. Today, people are asking about how that could happen — believing that lung cancer only happens to older people who were long time smokers.

To clear up some of the confusion, I asked Dr. Robert Ashton, Chief of Thoracic Surgery at Hackensack University Medical Center, a few questions about lung cancer.

Dr. Manny: Can patients get lung cancer if they do not smoke?

Dr. Robert Ashton: Yes. Ten to 15 percent of patients who develop lung cancer have never smoked. The cause of lung cancer in these individuals may be a combination of genetic and environmental factors. Research continues to find the basis for lung cancer in non-smokers, as well as smokers. It is important to understand that smoking is the leading cause of lung cancer and quitting is essential for this disease as well as your overall health.

Dr. Manny: Does lung cancer affect men and women the same way?

Dr. Robert Ashton: Overall, yes. However, some studies do show that women who smoke have a higher incidence of lung cancer when compared to men. Women also die at a greater rate than men. There are many reasons for this, and more work needs to be done to understand these differences.

Dr. Manny: Should people be routinely screened for lung cancer?

Dr. Robert Ashton: Currently there are no screening recommendations by the American Cancer Society or American College of Chest Physicians. The question is currently being studied in national trials. Recent smaller trials have shown that CAT scans can find lung cancer at earlier stages, and therefore may be better treated and cured in these early stages. Individuals who smoke should see their primary physicians and discuss the option, realizing that insurance may not cover the cost of the screening scan.

Dr. Manny: What are current treatment options available?

Dr. Robert Ashton: There are a combination of treatment options available, including surgery, chemotherapy, and radiation. Depending upon the stage of the patient, each one independently, or in combination may be used. It is important for patients to be properly staged and treated by individuals who specialize in lung cancer. Lung cancer kills more people per year than breast, colon and prostate cancers combined. Therefore, it is essential to receive the best treatment from the beginning.

Many of you have written in to share your cancer stories. Here are just a few of them. As always, thank you for your e-mails. Please keep writing!

“I was very sad to hear about the passing of Dana Reeve. It is a horrible loss for all of us, especially her family and beautiful son. My dad passed away from lung cancer in May 2003 at the age of 58, so unfortunately, I am well-informed on this subject. I spent a lot of time researching, and my original thoughts were the same as most Americans — that lung cancer is a smokers’ disease. My dad quit smoking 15 years prior to his diagnosis. He had regular check ups and chest x-rays, but no matter what precautions he took, it was shocking to hear the stage IV diagnosis in January 2003. The thing that was most shocking was to find out that a good majority of these lung cancer patients had not smoked a day in their life (in non-smoking households!). A lot of the regular smokers had quit years before anything being wrong. I remember hearing that if you quit, it is actually possible to reverse a lot of damage. As you stated, lung cancer is very prevalent in America, and ironically, the most under-funded cancer in the U.S. The discussion in the media on this cancer has been so one-sided. It’s not right that the first question someone asks is, ‘Did you smoke?’ As if they brought it on themselves. We need to erase that stigma.” — Janine (Winthrop, MA)

“I recently read your blog article regarding lung cancer and the awareness that the passing of Dana Reeve brought to it. I was disturbed to read that there are no screening recommendations by the American Cancer Society. That might explain why lung cancer kills more people than breast, colon, and prostate cancers. Why are there no screening recommendations in place for many kinds of cancer? Wouldn’t it make sense to have insurance companies cover any kind of screening to avoid late detection? After all, a lot of insurance companies are pushing people to quit smoking. I can only hope that the majority of insurance companies and various cancer societies can work together in helping people get early detection instead of choosing to ignore this. It can save so many lives and potentially avoid major costs in treatment.” — Chavis (Kalamazoo, MI)

“I am a lung cancer survivor. I was diagnosed in 1999 with carcinoid of the lung, had a lobectomy in April of that year, and I am cancer-free almost seven years later. I am perhaps one of the ‘lucky’ ones. My tumor was relatively small and I had excellent physicians. Many carcinoid cancer patients have never smoked.” — MaryWills (Birmingham, AL)

“I am not a doctor, but everyone in the world could quit smoking and there would still be lung cancer. Blaming it on smoking makes lawyers rich and takes the heat off of the other reasons.” — Edward (Springfield, MO)

P.S. Don't forget to watch FOX News Channel. And please feel free to write to me at DRMANNY@FOXNEWS.COM and tell me what you think. Ask a question, share a thought, share a remedy — We'll try to answer all of your mail online or on the air.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit