When Emmy and Grammy award-winning comedian and actress Kathy Griffin, known for her sometimes controversial, pull-no-punches brand of comedy, revealed this summer that she has lung cancer and would need surgery to remove half of her left lung, the news took many by surprise – including, especially, Ms. Griffin, who says she’s never smoked, which experts say is the number one risk factor for the disease.
Ms. Griffin’s diagnosis raises questions about how a professed non-smoker can develop lung cancer. Mark Dylewski, M.D., chief of general thoracic surgery at Miami Cancer Institute, says that non-smokers account for roughly 17 percent of the lung cancer cases diagnosed each year in the U.S., and that lung cancer in particular is a complex disease process.
“We know that smoking is the the likely cause of lung cancer in the majority of people,” says Dr. Dylewski, who also serves as medical director for robotic thoracic surgery at Baptist Health South Florida. “But the truth is, we don’t really know what triggers lung cancer in non-smokers.” Environmental factors can certainly play a role, he says, noting that exposure to diesel fuel, printing inks, radon gas, asbestos and many other chemicals is a major risk factor for the disease, as is secondhand smoke exposure.
“It could also be genetic, as some non-smokers with lung cancer report having family members who also were diagnosed with the disease even though they, too, didn’t smoke,” Dr. Dylewski says. “And, it could also have something to do with hormones, as more women non-smokers seem to be developing adenocarcinoma, a type of non-small cell lung cancer, as they reach menopause in their 50s, 60s and 70s.”
More likely, though, says Dr. Dylewski, it’s not any one particular factor at work but a confluence of factors which together can trigger the abnormal cell growth that leads to tumors — whether it’s lung cancer or any other type of cancer.
Lung cancer is the country’s third most common cancer, according to the U.S. Centers for Disease Control & Prevention (CDC), and roughly 235,760 new cases will be diagnosed this year. More men and women in the U.S. die from lung cancer than any other type of cancer, the CDC says.
From published news reports, Dr. Dylewski says it appears Ms. Griffin may have been diagnosed with an adenocarcinoma, “a small nodule inside the parenchyma of the lung,” and that she likely has stage 1 or stage 2 cancer, meaning it hasn’t spread beyond the lung itself and the tumor can be surgically removed. “If you remove that, you remove the cancer,” he says.
Dr. Dylewski says that close to two-thirds of the people diagnosed with lung cancer are diagnosed at stage 3 or 4, at which point the cancer has already metastasized to other regions, surgery is no longer an option and long-term survival rates are much lower. For these patients, he says, chemotherapy then becomes the standard course of treatment, possibly in tandem with radiation therapy.
The number of late-stage lung cancer diagnoses is actually decreasing with the implementation of lung cancer screenings with CT scans, says Dr. Dylewski. “We’re catching more and more patients in the earlier stages of their disease where surgery can still be an option.” The difference between an early diagnosis and a late diagnosis, he says, is a survival rate that’s about five times higher.
Common symptoms of lung cancer
A number of people diagnosed with lung cancer never experience any symptoms, which is one reason why it can be so difficult to diagnose in early stages, says Dr. Dylewski. But for those who do, some of the symptoms they commonly present with include:
- Chronic cough
- Constant chest pain
- Shortness of breath
- Recurring lung infections, such as pneumonia or bronchitis
- Bloody or rust-colored sputum
- Swelling of the neck and face
- Pain and weakness in the shoulder, arm or hand
- Loss of appetite and weight loss
Early detection is key to survival
As for Ms. Griffin, she says that because her cancer was caught early, her doctors “are very optimistic” that she won’t have to undergo chemotherapy or radiation and that she should “be up and running around as usual in a month or less.”
Dr. Dylewski says that Ms. Griffin’s diagnosis should give everyone – smokers and non-smokers alike – added motivation to get screened for lung cancer. The recommended screening test for lung cancer is low-dose computer tomography (also called a low-dose CT scan, or LDCT), which he says involves an X-ray machine that scans the body and uses low doses of radiation to make detailed pictures of the lungs.
The U.S. Preventive Services Task Force recommends yearly lung cancer screening for current or former smokers with a smoking history of 30 or more pack years – meaning they smoked one pack a day for 30 years or two packs a day for 15 years. Those recommendations are for adults, ages 55 to 80, who either currently smoke or quit within the past 15 years.
But even non-smokers should get screened if they have other risk factors, says Dr. Dylewski. “Anybody who feels that they have a significant risk for the development of lung cancer – smokers especially – should really pay attention to their health and seek out an opportunity to get screened,” he advises. “Early intervention is key to the hope of curing lung cancer before it becomes advanced.”
According to Dr. Dylewski, Baptist Health offers affordable CT scan lung cancer screenings for patients who believe they may be at risk. “We screen 3,000 patients a year who are smokers, and screenings are available with a prescription at most Baptist Health locations in South Florida.”
Dr. Dylewski also emphasizes the importance on getting a second opinion, especially with lung cancer. “When you’re faced with such a complex cancer, it’s important not to settle with one opinion, but to seek out the opinions of multiple experts,” he says. “Not everyone is a specialist in every particular disease process, and when you’re in the fight of your life you want to be sure that all that can be done is being done.”