President's Report

As healthcare professionals responsible for the cardiopulmonary health of our patients, we are well aware of the toll lung cancer takes on our patients and their families.

Although we may eventually diagnose some of our patients with lung cancer, many are under our care for other smoking-related diseases, such as chronic bronchitis, emphysema, and coronary artery disease. We establish close relationships with these patients and their families, experiencing their ups and downs alongside them. It is these patients’ stories that should motivate us to continue our fight against smoking and its consequences.

Take Annie, my favorite patient. Annie had emphysema and was part of our practice for many years. Although her FEV₁ barely hovered around 25%, and she knew that the damage to her lungs was irreparable, she did not lose her zest for life.

Annie started smoking while in college as a challenge from her “cool” friends. She tried to quit smoking so many times, she lost count. She was so proud when she did not smoke for a year or so.

Unfortunately, I was a mute witness to the constant struggle between her body and her mind. Even after her body was ravaged by the effects of emphysema— her legs swollen from corpulmonale and she became wheelchair-bound— Annie continued to speak her mind and maintained a great sense of humor.

It lifted my spirits to see Annie and hear her voice on a busy day. I wondered how someone could be so full of life when faced with meager resources and deteriorating health. Annie was the first to volunteer for any of our clinical research studies and was a crowd favorite as a patient volunteer for teaching programs conducted at our facility. She loved being interviewed and would tell it like it is, especially when it came to the curses of smoking!

Once, Annie was scheduled to meet a group of visitors learning about COPD but was in the hospital with a COPD exacerbation. She still came—in her wheelchair, wearing a hospital wristband, and with her oxygen and IV pole in tow.

It was a devastating loss to me and my colleagues when she died in her sleep. Annie, I miss you! Now, there will be no Annie to say, “Dr. Kay, I will go to Washington with you and talk to those Congressmen!”

Smoking-related diseases do not spare those with higher education or success. My father-in-law, an ophthalmologist, also suffered from emphysema. I stood witness as he struggled to breathe, and his once active and athletic body was replaced with skin and bones. Eventually, the effects of smoking took their toll on the simple necessities of daily living. Emphysema took away my father-in-law’s life 20 years after he had given up tobacco.

There are many celebrities and public figures who have smoked and, subsequently, succumbed to lung cancer: Peter Jennings, Sammy Davis Jr, Yul Brynner, Ed Sullivan, Groucho Marx, Walt Disney, Gary Cooper, Jesse Owens, John Wayne, George Harrison, Rosemary Clooney, Edward Morrow, and Vincent Price, to name a few. There are so many celebrity spokespersons for many diseases, and we should admire their devotion to these causes.

However, in the United States, nearly 20,000 more women die of lung cancer than of breast cancer each year. Nonetheless, only 2% of cancer research dollars is allocated to lung cancer research. This obvious disparity in funding is in part due to lack of public awareness. How is it that the public is so aware of breast cancer when more women die of lung cancer than breast cancer? Despite so many high profile celebrities dying of lung cancer, why is there no spokesperson to draw attention to this preventable cancer?

The answers, I suspect, are many.

First, celebrities do not want to publicly admit that they are ex-smokers. Second, there is no good screening tool for lung cancer. Katie Couric raised awareness of colon cancer prevention by nationally televising her own screening colonoscopy, but what test would a smoker promote?

The staggering financial, emotional, and health costs of tobacco use need to reach the forefront of the health-care debate. This is one area of preventive care that has the potential to save billions of health-care dollars.

A leader in lung cancer education, the American College of Chest Physicians has published a number of provider and patient resources related to lung cancer, including evidence-based lung cancer guidelines and tobacco prevention education materials.

Throughout the 2010: The Year of the Lung campaign, the ACCP will build on the strong foundation of its lung cancer guidelines to increase awareness regarding lung cancer prevention, diagnosis, and management.

The ACCP also will provide educational material for clinicians, patients, and patient families regarding critical care units and end-of-life and critical care family assistance programs.

The Grim Statistics
Lung cancer is the leading cause of cancer deaths in men and women in the United States and throughout the world, yet it is the least funded.

Lung cancer causes more deaths than the next four most common cancers combined, including breast, colon, pancreas, and prostate. Furthermore, of the five leading cancer killers, lung cancer has one of the lowest 5-year survival rates, second only to pancreatic cancer.

We all should be aware that in the United States, lung cancer receives just $1,200 of federal funding per death, while breast cancer receives more than $27,000 per death, followed by $14,000 for prostate cancer and $6,500 for colon cancer.

I would like to take this opportunity to invite the membership to suggest ways to start a concerted effort to at least reduce the prevalence of this evil. I very strongly believe that, together, we can make some inroads in combating this scourge to our national health.