I posted a blog here last November in memory of my late sister, Lilian Williams, née Pion. Although a nonsmoker, she died of lung cancer shortly before her 58th birthday, and I’ve remained convinced ever since that it was due to her involuntary (and sometimes voluntary) exposure to secondhand smoke. This blog further reflects on that view.
I’ve received quite a few comments from Virgil Kleinhelter who, despite the name, is evidently writing from the U.K.
[Update: A MoGASP supporter subsequently sleuthed this and located a Mr. Virgil Kleinhelter in Fairdale, Ky, so delete my supposition above.]
I generally allowed them, but when a recent e-mail from him focused more on epithets and offensive remarks, I wrote back to Mr. Kleinhelter that his comments would no longer be allowed on this blog. Several e-mails later I received the following from him which, while rather dismissive of smoke-sensitive individuals because they merely “don’t like the smell” of SHS, nonetheless provided an interesting link to a recently published study in PubMed, which I believe is a reliable on-line source for peer-reviewed articles.
I was sufficiently intrigued to go on-line and check out the summary of the study, originally conducted by a researcher in Oslo, Norway. The conclusion I came to is entirely contrary to Mr. Kleinhelter’s. Please read the following, which kicks off with Mr. Kleinhelter’s comment, and let me have your considered opinions (sans epithets!):
2010/02/15 at 9:32am
When will it sink in that SHS is not the threat it is made out to be. It always goes back to, I don’t like the smell or some other feeble reason to control others.
The latest research into passive smoking. It has been discovered that mechanism that triggers lung cancer in non-smokers is quite different to that in smokers.
Therefore breathing in other peoples smoke will not ever give you lung cancer. “INTERPRETATION: Lung cancer in never-smokers should probably be regarded as a different disease-entity than smoking-induced lung cancer. This could impact prognosis as well as treatment.” http://www.ncbi.nlm.nih.gov/pubmed/19844277
Mr. Kleinhelter’s conclusion that “breathing in other peoples smoke will not ever give you lung cancer” is completely contrary to what has become accepted on the subject since at least the first U.S. Surgeon General’s Report, “The Health Consequences of Involuntary Smoking,” released in 1986. [Click on the title for the full report or here for the summary and conclusions in Chapter 1.] A major conclusion of that report was that there was a causal link between lung cancer and secondhand smoke exposure in healthy nonsmokers. The best estimate, which is currently 3,000 lung cancer deaths (LCDs) a year in the U.S., is about 20% of all nonsmoker LCDs each year.
Following is the entire abstract I found on-line of the paper referenced by Mr. Kleinhelter:
Lung cancer in smokers and never-smokers
[Article in Norwegian]
Tidsskr Nor Laegeforen. 2009 Sep 24;129(18):1859-62.
Helland A, Brustugun OT.
Onkologisk avdeling, Radiumhospitalet, Oslo universitetssykehus, Rikshospitalet, 0310 Oslo, Norway. firstname.lastname@example.org
BACKGROUND: Lung cancer is the most frequent cancer-related cause of death for both sexes. Smoking is the cause of most cases, but estimates show that 15-20 % of cases in the western world are not associated with tobacco. Recent evidence – based on molecular and clinical studies – indicate that lung cancer in patients who have never smoked has certain characteristics that are different from those in patients who smoke. In this article we describe some of these characteristics.
MATERIAL AND METHODS: The present paper is based on literature identified through non-systematic searches in PubMed.
RESULTS: Lung cancer in never-smokers is estimated to be the seventh most frequent cancer type on a global basis. A number of molecular and clinical characteristics differ between lung cancer related to tobacco use and those not related to tobacco use. 62 % of lung cancers among never-smokers are adenocarcinomas and 18 % are squamous cell carcinomas, while corresponding numbers among patients who smoke are 19 % and 53 %. The K-Ras-gene is often mutated in tumours from smokers, but seldom in tumours from non-smokers; whereas the EGFR-gene is mutated in tumours from non-smokers, and not in smokers. Also, age and sex distribution, therapy response and prognosis are shown to differ between the groups.
INTERPRETATION: Lung cancer in never-smokers should probably be regarded as a different disease-entity than smoking-induced lung cancer. This could impact prognosis as well as treatment.
I just checked on my sister’s British death certificate – she died from inoperable, incurable lung cancer on November 11, 1988, shortly before her 58th birthday – and it notes the cause of death as follows:
1b. Squamous cell carcinoma of lung
Certified by D.Elsdon Myers M.B.
According to the research in this Norwegian paper, my sister died from the type of lung cancer that is more common among smokers, even though she never was a serious smoker herself. (When my sister was a young teacher I recall visiting her in her apartment and she would smoke after a meal without actively inhaling and never became addicted. But she was clearly not smoke-sensitive, because at least one of her good friends later in life, Harry Diamond, was a heavy smoker. I found that out when I met him at her funeral and he was puffing away at every opportunity.)
To me, rather than diminishing my belief that secondhand smoke was causally related to my sister’s premature death this study actually reinforces it.
Reminder: If you wish to submit a comment for publication please include your full name at the end of it. If you don’t wish it to be made public let me know and I’m willing to respect that but I won’t consider anything signed only using a first name or a pseudonym.