Two women, a mother and a daughter, are both diagnosed with cancer. The daughter, a young mother of four children, is found to have an aggressive form of breast cancer. Throughout her ordeal with surgery, chemo, and radiation—the fatigue and nausea, the infections and wracking pain, the agony of radiation burns—she finds tremendous support. Not only from family, friends, and neighbors, but from strangers—a host of groups run by breast cancer survivors, women who will clean your house, do your laundry, drive you to treatment, drop off food, and more. Better than that, these women will welcome you into their network and provide emotional support, the kind one can only receive from someone who has walked the same steps.
The daughter’s spirits can be described as incredibly positive throughout her experience. She had her down days to be sure, but overall her attitude was inspiring. Along with her own inner grit, she credits much of her optimism to the support she received from those who know and love her, as well as the outreach efforts of breast cancer survivors and the sense of belonging to this incredible collective of women. When the daughter was too sick to take part in a breast cancer walk for which she organized a team, others took her place and walked on through the night. The outpouring of love and friendship overwhelmed her. Today the daughter is doing well and has a promising prognosis. She finished the last of her radiation treatments in September. She’s gone back school, continues working, and is intent on living her life to its full potential.
The mother’s experience was quite different. There was no organized outreach to turn to, no network of women, no groups offering to help around the house, provide transportation, or extend emotional support. There were no walks, no teams to form, no fundraisers to take part in. The mother’s journey can best be characterized as lonely and isolating. She kept much of her experience to herself, hesitant to share what she was going through because of the kind of cancer she had. She was afraid of judgment, afraid that others would cast blame, as she herself did, believing she’d brought on her own health crisis. Her self-loathing was palpable. Worse, it was and continues to be a detriment to her emotional and physical well-being. Today she is cancer free, though she remains convinced that she will not live long. This fear is a result of the less than promising mortality statistics for her kind of cancer. The fear is further magnified, I suspect, as a by-product of guilt, the dark, lingering shadow of shame.
Why was the mother’s experience so different? Because she had lung cancer. Because she had been a smoker. Because if you have lung cancer, you’re on your own.
What if you never smoked and still get lung cancer? You have a lot of explaining to do if you want to garner empathy and support. You have to try to interrupt those judgments before they harden, those preconceived notions that you have no one to blame but yourself.
And what if you were a smoker? Why do we despise them so much, deny them any measure of compassion? Nicotine is far more addictive than alcohol, is equal to cocaine and methamphetamine in addictive properties. About 15% of people who drink regularly will develop an addiction, compared to 45% of those who smoke. And yet, alcoholism is termed a disease but smoking is not. Attitudes have softened toward the alcoholic because of this distinction; more sympathy is offered, more understanding. Not for the smoker. Especially the smoker who develops lung cancer as a result of an addiction more powerful than the simple willpower society thinks they need only to exercise.
Lung cancer is the number one cancer killer of women and is deadlier than breast, ovarian, and uterine cancer combined. Lung cancer also affects women differently than men; one in five women with lung cancer never smoked, which is twice the percentage as seen among men with the disease. Yet, despite these indisputable statistics, lung cancer has never received public attention or research dollars in proportion to its prevalence or deadliness. Only 15% of women diagnosed with lung cancer survive more than 5 years, while the odds for breast cancer survival for the same period is an astounding 88%. This is no accident; far more awareness is given to breast cancer, which results in more research, more breakthrough drug and medical therapies. This is the direct result of activism on the part of women, an act to be applauded; we can accomplish great things when we band together.
Combined with the lack of private dollars to support lung cancer awareness and funding efforts, few federal or state dollars are allocated toward prevention or research. Even the monies set aside to prevent smoking and encourage cessation with the 1998 class action settlement against the four largest U.S. tobacco companies have been misused. Forty-six states receive millions of dollars from this settlement each year, in part to compensate for Medicaid costs to treat lung cancer patients, but in large part to promote anti-smoking measures. The money, however, is being spent elsewhere, such as repairing roads or funding other state projects and budget shortfalls. According to tobaccofreekids.org, as of November 30, 2011, “…states have cut funding for tobacco prevention and cessation programs to the lowest level since 1999, when they first received tobacco settlement funds…the states this year (Fiscal Year 2012) will collect $25.6 billion in revenue from the tobacco settlement…but will spend only 1.8 percent of it on programs to prevent kids from smoking and help smokers quit.” And states are getting away with it. Which shows that even allocating money to prevent a disease where patients are routinely blamed for their condition cannot find a priority.
Lung cancer—whether its victims are smokers or not—is more lethal than it needs to be. Part of the problem is simply lack of awareness and funding, but the larger part is the quiet prejudice, the unfortunate notion that people with lung cancer deserve their fate. When I learned last week that yet another friend was diagnosed with breast cancer, there was comfort to find in the high survival rates, the ever-improving treatments and drugs that will work to her advantage. If she’d told me that she’d been diagnosed with lung cancer, however, what comfort could I have offered? What statistics could I cite to ease her mind? How could I convince her not to fill her thoughts with self-blame, to ignore the apathy she will encounter, that doing so would be counter-productive to her recovery and healing?
When it comes to lung cancer, we as women should not judge each other; we should embrace one another, acknowledge the shrewd power of addiction, bring awareness to fund cessation efforts and research as aggressively as we pursue a cure for breast cancer. Because that mother and daughter you just read about? They are my niece and my sister-in-law. They could be yours, too, or just as easily your mother, your daughter, your sister, or your best friend.
Wouldn't you want them all to have an equal chance at the best possible recovery?
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