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 From: graemeedge@canada.com 
  
 No smoke without fire 
 By Denise Winterman 
 BBC News Magazine   
  
  
 Not everyone with lung cancer is - or has been - a smoker. But some 
 sufferers 
 say people assume they have been - and warn that the stigma could be costing 
 lives. 
  
 Wednesday is No Smoking Day, which puts lung cancer back on the national 
 agenda - briefly. 
  
 Viewed by most as the "smokers' disease" it is rarely in the headlines and 
 definitely not a cause celebre like breast cancer, despite being the biggest 
 cancer killer in the UK. To put it bluntly, it has a serious image problem. 
  
 One in 10 people who get it have never actually been smokers themselves or 
 lived with smokers, according to Cancer Research UK. Dana Reeve, the wife of 
 Superman actor Christopher Reeve, died of the illness on Tuesday despite 
 being a non-smoker her whole life. 
  
 Prejudice 
  
 But people's assumptions that sufferers have been smokers has far reaching 
 consequences, from the way sufferers are treated to funding for research. 
  
 On a personal level lung cancer patients are viewed as "only having 
 themselves to blame" for getting the disease. And despite claiming the lives 
 of more than 38,000 people every year - more than leukaemia, breast and 
 prostate cancer combined - it receives just 4% of the national cancer 
 research budget. 
  
 "You are judged in a way that you never would be if you had breast cancer," 
 says 47-year-old Theresa Fletcher, a life-long non-smoker and lung cancer 
 patient. 
  
 "The first thing I am ever asked when I tell people about my illness is if I 
 smoke or ever have done. The inference is that they think people with the 
 disease must have brought it on themselves. Fighting lung cancer is tough 
 enough without having to deal with other people's prejudice about it." 
  
 And the assumptions don't just start outside the hospital, they are also 
 made 
 by other cancer patients. 
  
 "I have spent a lot of time in hospital waiting rooms over the last few 
 years 
 and other people always ask me if I have breast cancer," says Theresa. 
  
 "They just assume if you are a woman you won't have lung cancer, as it is 
 seen as an old man's disease. But it's not, anyone can get it and not 
 necessarily through smoking. People need to be educated so they don't make 
 assumptions and realise they are at risk too." 
  
 The married mother of five was diagnosed in 2003. She had found a small lump 
 on her neck but had none of the symptom commonly associated with the 
 illness, 
 such as coughing and breathlessness. 
  
 Assumptions 
  
 A biopsy confirmed it was lung cancer, leaving her devastated. Things got 
 worse when in July 2004, a scan revealed the tumour had spread to her brain, 
 but after treatment she is now in remission. 
  
 The reaction to Theresa's lung cancer is not unusual and the stigma that it 
 is always caused by smoking is costing lives, says the Roy Castle Lung 
 Cancer 
 Foundation (RCLCF). 
  
 Even if everyone gave up cigarettes today lung cancer would still exist as 
 it 
 is not exclusively caused by tobacco and its incubation period can be 
 decades, says the charity's chief executive Mike Unger. 
  
 "The stigma surrounding lung cancer and smoking is doing huge damage and has 
 serious consequence when it come to funding, research and saving people's 
 lives," he says. 
  
 I really believe it helps to maintain a positive attitude throughout your 
 treatment but that is hard when you know people think your illness is your 
 own fault 
 Theresa Fletcher   
 "It receives just 4% of the total funding for cancer research in spite of 
 killing 22% of cancer patients. When it comes to campaigning, we are the 
 only 
 lung cancer charity in the UK and we are always struggling to raise money. 
 This is all costing lives. " 
  
 According to RCLCF, for every mortality from leukaemia €9,008 has been spent 
 on the patient, for breast cancer it is €3,000, but for lung cancer it is 
 just €117. 
  
 It has one of the lowest survival rates for any cancer because it is often 
 not detected and treated early enough, but no national screening programme 
 is 
 planned while €72m is being spent on one for breast cancer. The government 
 says it is following a trial of lung cancer screening in the US to see if it 
 would actually save lives. 
  
 Theresa says while the media reports the debate about breast cancer patients 
 wanting the drug Herceptin, there is no similar awareness of the access 
 problems of the lung cancer drug she has been using, Tarceva. Some primary 
 care trusts are refusing to approve the €1,500-a-month drug, though that is 
 not widely reported. 
  
 The high profile of other cancers should not be changed, she says, but lung 
 cancer should stand alongside them, both in terms of campaigning and 
 funding. 
 Only then will the stigma be tackled. 
  
 "No cancer is easy to deal with, whatever type you are unlucky enough to 
 get, 
 and surviving it is an achievement," she says. 
  
 "I really believe it helps to maintain a positive attitude throughout your 
 treatment, but that is hard when you know people think your illness is your 
 own fault. I used to get angry, but now I don't waste the energy." 
  
 My mum had secondary cancer of the lungs and liver. The initial diagnosis 
 was 
 bowel cancer. It is very true that these less talked about cancers are not 
 as 
 'trendy' as say breast cancer. There is certainly more of a stigma attached 
 to lung and bowel cancer, and as such funding into research is much much 
 lower as discussed in the article. People do automatically lump all lung 
 cancer suffers together as 'smokers who brought it on themselves' which is 
 hugely unfair to people like my mum who are not and have not been smokers. 
 Nic Allen-Smith, Honiton, Devon 
  
 my mother-in-law died last year of lung cancer and like Dana Reeve had been 
 a 
 non-smoker the whole of her life. She had a persistent cough for a month 
 which turned out to be a symptom of lung cancer. People need to be aware of 
 the possible symptoms of the disease and be more sympathetic and open-minded 
 about the possible reasons why people might get the disease. 
 Katy Weiss, London, UK 
  
 The article seems to suggest that sympathy is due to those who have never 
 smoked and get lung cancer, but in the case of those people who have smoked 
 and possibly as a result have lung cancer they do not deserve any sympathy 
 and money should not be spent trying to save their lives. I find this line 
 of 
 argument very unjust. It is not fair that people are treated differently 
 depending on what kind of life threatening disease they have. We live in a 
 society where many of the things we do may cause us harm, smoking ,drinking, 
 eating fatty food, not taking enough exercise, and not eating enough 
 vegetables. Some of us get away with this unhealthy life and others are less 
 lucky. There are many studies which show that people who do certain things 
 are more or less likely to get certain illness. Would it be acceptable to 
 ask 
 a breast cancer sufferer if they had breast fed their children? A lot of 
  
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