High-profile lung cancer cases prompt doctors to speak against smoking ..."radon was the No. 2 highest risk for lung cancer."


High-profile lung cancer cases prompt doctors to speak against smoking
By Angie Santello , Herald-Standard


Dr. Elmer Cano, medical director of radiation oncology at the Robert E. Eberly Pavilion on McClellandtown Road in South Union Township, explains an image showing a cancerous lung as Dawn Peskorski, medical dosimetrist, looks on Tuesday. (Ed Cope)
Two national celebrities stricken with lung cancer prompted local doctors who treat the disease to reach out to the community in an effort to stop the No. 1 cause of the disease: smoking.
Peter Jennings died from lung cancer at the age of 67 on Sunday, while Dana Reeve, the 44-year-old widow of Christopher Reeve, who died last year, made the announcement that she, too, is facing a battle with lung cancer. The news came just two days after the ABC News anchor's death.

Jennings was a smoker, but Reeve was reported not to smoke.

Dr. Sajid Mumtaz Peracha said smoking is easier to talk about now, as people are more receptive to listening to medical advice from doctors, although they may not always heed that advice or be honest in reporting how often they actually smoke.

"They know it's just not the doctor talking. There is a proven advantage of not smoking," he said.

Peracha oversees chemotherapy treatments at the UPMC Cancer Center in Uniontown. Fifty cancer patients are treated in the Woodlawn Avenue office each working day, while eight to 10 of those 50 are lung cancer patients.

Lung cancer killed 160,440 people nationwide in 2004, resulting in more Americans dying each year from lung cancer than from breast, prostate and colorectal cancers combined, according to statistics from the American Cancer Society.

A higher incidence rate of cancer than expected was recorded in Fayette County from 1998-2002, said Richard McGarvey, spokesman for the state Department of Health. According to latest statistics from the state Cancer Registry Dataset, 139 cases of bronchus and lung cancer were expected in the county in 2002, while 150 cases were observed.

A notable number of World War II veterans have been diagnosed with lung cancer because smoking was popular for that generation, he said.

"We knew this would take generations of undoing," he said.

To get people to kick the habit is a "long journey or an uphill task," said Peracha. But if doctors keep kindly asking their patients "are you trying to stop smoking?" at each visit, they'll understand that it's something they need to do.

"It's like parents asking their kids again and again not to do something," he said. "For the most part, they're pretty honest. Some may fib to hide embarrassment."

The sexy, attractive image of smoking needs to be reversed in order to see the number of smokers lowered, although the United States has made some recent advances by banning smoking from a number of public facilities.

This had created an inconvenience for the smoker, something that may be showing more and more smokers that they can quit the habit.

"They go without it for an eight-hour working day," said Kathleen A. Thomas, certified registered nurse practitioner with the Uniontown office shared by doctors Peracha and Gauri J. Kiefer.

"They may not see anybody smoking," added Peracha. "It's taking away the stimulus."

McGarvey said smoking cessation outreach efforts have helped lower the number of minors who smoke and the number of retailers who sell cigarettes to minors.

"As people become more educated, they tend not to start or if they are smoking, they quit," McGarvey said.

The state Department of Health promotes the message that it is never too late to quit.

"Because if you stop smoking, your lungs can help repair themselves and work with the body to repair and restore parts of the lung," McGarvey said.

In Pennsylvania, he said, about 25 percent of people smoke. In 2003, 124 people living in Fayette County died from lung cancer.

But, according to local doctors, smokers aren't the only ones at risk of lung cancer. As in Reeve's case, nonsmokers can be afflicted with the disease.

Smoking is the leading cause of lung cancer, but exposure to radon, asbestos and second-hand smoke can lead to the disease as well, said Peracha.

He noted that your risk for lung cancer increases with exposure to carcinogens such as radon and asbestos, especially when combined with cigarette or cigar smoking.

Inexpensive tests for radon, which is a radioactive gas produced in the minerals of soil, can be purchased at the local hardware store. The results of the tests can be sent to a local laboratory to determine the level of radon in the home. Older homes are proven to have higher levels of radon than newer constructions because tests for the gas are being done more often, said Peracha.

"Nine to 10 years ago," said Peracha, "radon was the No. 2 highest risk for lung cancer."

Peracha described cancer as an "unprogramming," a deviation from the body's programmed cell generation and destruction.

"You have to have a program to generate the creation of cells. If they keep going, but forget to die, they keep multiplying," Peracha said. "Cancer is a group of tissues that forget to die and keep growing. The idea of chemotherapy is to bring them back to their programmed cell death."

Chemotherapy is among three modalities or treatments used to treat cancer patients. Surgery, what Peracha said is the only true cure for cancer if caught in its early stages, radiation or a combination of two can treat the cancer patient, depending on the stage of the disease.

Perach's office in the Uniontown Medical Pavilion concentrates on chemotherapy, while the Uniontown office of Elmer R. Cano housed at the Robert E. Eberly Pavilion along McClellandtown Road concentrates on radiation treatments.

A branch of the UPMC Cancer Centers, the radiation treatment center, 60-70 percent of the patients are treated in-house by state-of-the-art radiation therapy. The patients arrive at the center already diagnosed, but a CT Scanner determines how to access the tumor more effectively to minimize complications, said Cano.

Cano and his team of medical dosimetrists determine the amount of cancer in the lung through a series of computer images. A grayish blur indicates abnormal conditions on the image. A healthy lung would be black, indicating air in the lung, by comparison.

"It's just not normal anatomy," said Cano, noting smoking causes 80 percent of lung cancer afflictions.

Cano said 175,000 United States citizens are diagnosed with lung cancer every year, while 160,000 will die annually.

To prevent death and a life full of battling the debilitating disease, the ultimate goal is to stop smoking, both local doctors emphasized.

Peracha said he understands the difficulty in quitting - as he had family members in the same boat. At least cutting back on the number of cigarettes you smoke will be beneficial for not only one's body, but will also help in the effectiveness of cancer treatments.

As much oxygen and blood supply as possible is needed for the maximum positive results for cancer treatments - whether radiation or chemotherapy - and smoking lessens both necessities.

"They need enough social, emotional and educational awareness to stop," said Peracha. "The biggest thing we can do is to let them know that help support groups are out there and encourage them as far as prevention is concerned."

People can acquire a list of classes, counseling services and more by calling the Fayette County Tobacco Control Coalition Tobacco Cessation line at 724-430-5615 or 1-877-NO-Z(9)ONE-1.

For lung cancer support, call the Lung Cancer toll-free information line at 1-877-646-LUNG or 1-877-646-5864.