when it was discovered
that there was an
increased lung cancer
risk among never-smok-
ing women who were
married to smokers, and
at present accounts for
a total of approximately
3,000 lung cancer
deaths per year in the
United States. In fact,
Harvey Pass, M.D.
nonsmoking spouses
who are married to cig-
arette smokers are about 30% more
likely to develop lung cancer than
nonsmoking spouses who are mar-
ried to nonsmokers.
It turns out that these are molec-
ular markers of the damage done
by the carcinogens in tobacco
smoke, and these markers may give
insight into susceptibility for cancer
development. Studies have verified
that these markers as well as other
gene mutations are higher in
women than in men for the same
level of smoking. Moreover,
researchers have also described
genes which help get rid of these
carcinogens and thus will influence
our inherent susceptibility to
smoke carcinogens, and are search-
ing for gender differences among
these genes.
What about hormones? Elegant
work performed and reported by
Dr. Jill Siegfried from Pittsburgh
and Dr. Ann Schwartz from Detroit
have shown that the lungs as well
as lung cancers have estrogen
receptors like breast tissue does,
and that differences in the capacity
to control estrogens may impact on
lung cancer risk, especially in
women. Even more intriguing is
that the previously mentioned sus-
ceptibility genes may interact with
estrogens differently in females
compared to males, possibly
explaining some of the gender dif-
ferences for lung cancer rates.
So how should women take a
pro-active role in battling the lung
cancer epidemic? First of all take
that most important step to recog-
nize that one of the best
ways to decrease lung
cancer risk is to stop
smoking! Seek profes-
sional help from experts
who can support you
through the difficult
times during withdraw-
al, and who can monitor
your progress if you
need pharmacologic
help to stop smoking. If
you are concerned as a
present or former smoker about
your risk for lung cancer, you can
enroll in either of two national pro-
grams which are investigating
whether computerized tomography
(CT) scans can detect lung cancer
early and possibly increase the
number of patients surviving the
disease after treatment. Ask your
doctor about the National Lung
Cancer Screening Trial sponsored
by the NIH or the International
Early Lung Cancer Action Project
at selected sites across the U.S.
— Harvey Pass, M.D.
Barbara Ann Karmanos
Cancer Institute
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Recently, the news has been filled
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therapy (supplementing the body's
own estrogen) for postmenopausal
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Hormone therapy fell out of
favor almost overnight. What
happened?: Since its develop-
ment nearly 20 years ago, estrogen
therapy (ET, also called hormone
replacement therapy, or HRT) has
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