Lung cancer is catching up with more and more women. The disease, which is fatal for 86 percent of its victims within five years of a diagnosis, is now the leading cause of cancer death among women. Yet the disease is as preventable as it is deadly: Nearly 90 percent of lung cancer cases are smoking-related.
For the country's 23 million female smokers, the news keeps getting worse. Researchers are finding that the effects of tobacco seem to be far more damaging to women than to men. Scientists at the University of Pittsburgh discovered that a gene that accelerates lung cancer growth is more active in females. The findings might explain why women are one and a half times more likely than men to develop lung cancer, even when they smoke fewer cigarettes over a shorter period of time.
Women smoke because girls smoke -- 90 percent of smokers start using cigarettes before the age of 18. Each day, about 4,000 youngsters try their first cigarette and 1,000 become new regular, daily smokers. About one-third of youth smokers eventually die prematurely of smoking-related causes. And high school seniors are continuing to use cigarettes in record numbers: One in four is now a smoker. Although teen boys traditionally smoke more than girls do, that gap has disappeared. In fact, between 1.5 and 2 million teen girls are smokers, a number that's "outrageously high," according to Susan Moses, the deputy director of the Center for Health Communication at the Harvard School of Public Health.
Many women who smoke sporadically don't consider themselves smokers at all -- despite the ever-present pack of cigarettes in their handbags. These social smokers take a few quick drags between fetching the dry cleaning and the kids' prescriptions or smoke three or four cigarettes when they go out with friends. But "there's really no safe level of smoking," says Virginia Ernster, Ph.D., scientific editor for the U.S. Surgeon General. And "social smoking can lead to regular smoking, because women don't even realize that they're addicted until it's too late."
Nicotine-replacement therapies -- patches, gums, nasal inhalers -- that work for men "aren't that effective for women," Kenneth Perkins, Ph.D., a psychologist at the University of Pittsburgh. Instead, antidepressants such as Zyban, which also inhibits postcessation weight gain, "are far better for women," he says.
Women at risk for lung cancer often undergo yearly chest X-rays as a precaution. But X-rays are notoriously ineffective in detecting small tumors, and X-ray results can easily be misread or misinterpreted.
A new lung-cancer screening method that uses a CT scanner, however, holds the promise of catching the disease far sooner--and possibly increasing a woman's odds of survival. The scanners can provide doctors with a three-dimensional cross section of the lungs, revealing the exact shape and location of internal organs and soft tissue. They can also detect tumors that are the size of a pea. The scans are so accurate that preliminary research conducted at Cornell University found CT screenings could detect early-stage malignancies that conventional chest X-rays missed some 85 percent of the time.
Based on those results and other promising studies, hospitals nationwide have been inundated by patients requesting the procedure. However, many health insurance plans won't pay for the scan, which usually costs less than $200, because it's considered too experimental.
Stopping smoking has almost instantaneous health benefits. Here, a rough timetable of how long it takes a woman's body to rebound after she quits smoking, according to a 1990 U.S. surgeon general's report. Keep in mind that these are estimates, and they vary depending on how long and much a woman has smoked, her age, when she started and stopped, and her overall health.
- Immediately following her last puff, a woman's pulse rate and blood pressure -- which are abnormally elevated during smoking -- start returning to normal. Blood levels of carbon monoxide, a potent carcinogen inhaled during smoking, begin to decrease.
- A few days after she quits, a woman's senses of smell and taste become sharper as nerve endings regrow. Breathing is less difficult as greater amounts of oxygen reach the lungs, and some women begin to feel more energetic.
- Within a year, coughing, fatigue, and shortness of breath diminish.
- After five smoke-free years, a woman's risk of developing mouth, esophageal, or bladder cancer drops by 50 percent. Lung infections, such as bronchitis and pneumonia, are far less frequent.
- After 10 to 15 years, her likelihood of dying prematurely, especially from a stroke or a heart attack, is about the same as for a woman who has never smoked. Her chances of developing pancreatic cancer have declined significantly. Compared with a woman who continues smoking, her risk of getting lung cancer has dropped by 50 percent to 70 percent -- and will continue to fall the longer she remains tobacco-free.