Monday, March 1, 2010

Interesting Observation

I take a class on clinical controversies, which examines clinical trials and looks at what went wrong, what could be done better, etc. Last week we had a hematology-oncology attending come talk about 2 cancer studies. He made a comment in passing that really hit me.

We were talking about lung cancer, which is his specialty. It's the #1 cancer killer of both women and men. He said that most people, even doctors, are shocked when they hear that. He said breast, prostate, even colon cancer get a lot more publicity and research money despite causing so many fewer deaths per year.

He then said, "I think the numbers shock peope because whenever you read an obituary and someone dies of lung cancer it just says 'So-and-so died of cancer.' But, if they die of breast cancer, for example, it says, 'breast cancer.' Read the obituaries some time - if it doesn't specify the cancer, it's probably lung cancer. And if it does say lung cancer, they will go out of their way to say that the person was a non-smoker."

I never thought of that, but it really rings true. I think there's a stigma attached to lung cancer - like you did it to yourself (hence the quickness to point out if someone was a non-smoker). I also think people don't want to organize marathons or raise money around lung cancer because it's so preventable. There's a lot of blame attached to lung cancer, inherently. I never thought about it, but I know that when I hear of a smoker with lung cancer, I think, "Well, what did they expect." This doesn't mean that I give them worse care or that I treat them badly. It just means I have a little less sympathy for them. Same with alcoholic patients with cirrhosis. Maybe it's because we see these patients in such volume that you get jaded to the individual patient. You see them as another smoker with another lung cancer. It's just sad.

I think people probably do this with HIV as well. It's super easy to rally around kids with HIV - they are innocent in their disease. But people with multiple sexual partners, people who use IV drugs...those people are gambling and losing. I don't know why I have so much more sympathy with HIV patients. Maybe because people diagnosed with HIV in the beginning were "innocent" - no one knew how it was being passed around, no one knew who was going to get it. And these people were shunned, attacked, and left for dead. Literally. When I see a person recently diagnosed with HIV, like any other preventable condition, it makes me sad. I can't understand why they don't protect themselves.

I guess it's time for my pitch: Stop smoking, no excessive alcohol, no intravenous drugs, practice safe sex, wear seat belts and use sunscreen. Life ain't half bad if you can surround yourself with lovely people and act lovely in return. Might as well make it last.


Ask Angie said...

In the past 6 months, I know of 3 cases of advanced lung cancer where the women were not smokers.It does make you wonder if people were more aware that the lung cancer was the biggest killer than they may take more precaution with their respiratory health or at least demand some type of screening. (Not sure what is the appropriate screening for early detection of lung cancer.)

On a lighter note, I think it's funny you only prohibited IV drugs - the pill or snorting kind is just fine? :)

Just a Doc said...

Ha, you're right Ang. I guess the ones that cause the most PHYSICAL harm are IV drugs. The others mostly cause you to lose your marbles. I'm not a shrink so I don't deal with those much. However, to clear the record, I am against all forms of illicit drug use, even pills. :)