Lung cancer etiquette: Thanks for not asking if I smoked
The death of Dana Reeve, Christopher Reeve's widow, from lung cancer has focused attention on the disease she was diagnosed with less than a year ago. Reeve, like 15 percent of people diagnosed with lung cancer, was a nonsmoker. But the usual assumption that victims somehow "asked for it" by smoking has created an unfair stigma, says Lori Hope, a lung cancer survivor and author of Help Me Live: 20 Things People With Cancer Want You to Know. She spoke with Katherine Hobson about her experiences.
Do people really ask people diagnosed with lung cancer whether they smoke?
Everyone I've ever spoken to—and I've interviewed a lot of survivors—said one of the first questions people ask is, "Did you smoke?" or "Were you a smoker?" What's so awful about that question is that if you are a smoker, you probably feel horrible about it. Almost everyone who smokes wants to quit—the majority of people, like me, started when they were young and got addicted. Anyone who is diagnosed with cancer will ask themselves, "Why me?" and try to figure it out. The thought that you may have brought it on yourself is devastating—it's not only affecting you but your loved ones. Do you ask someone who had a heart attack what his cholesterol level is?
Besides leading to nosy questions, what does that stigma mean?
Research into the disease is underfunded, and I think the stigma does contribute to that. We tend to believe lung cancer is self-inflicted, and there's a moral judgment about people who smoke. We haven't had a powerful enough lobby [to change that perception], but a groundswell is growing. People like Dana Reeve help. We need people to speak up. It's difficult to admit you're a lung cancer survivor—people continue to judge you. But as more people who never smoked or quit decades ago are diagnosed, the myth [of lung cancer as self-inflicted] will disappear.
How were you diagnosed with lung cancer in 2002?
The tumor was discovered by mistake when my doctor ordered a CT scan of my abdomen for another problem. The radiologist happened to look at the scan more carefully after I left and discovered something in my lung. While I was lying on the table, he held my hand and said my abdomen was all clear, and then he called a couple of hours later and told me [about the suspicious spot]. I had quit smoking almost 20 years before and had no idea I was still at such a high risk. It was early stage, Stage I, and treated only with surgery—no chemotherapy or radiation. The chance of a cure is much, much higher [at an early stage], but I still go in for a CT scan every six months to a year. Lung cancer tends to recur, and one just hopes that if it does recur, it's in an operable place.
What should you say to someone who has been diagnosed with cancer?
One of the most important things that people with cancer would like you to know is that they like to hear success stories, not horror stories. Without thinking, you can share a story that can be devastating. Consider your words.
And what about the smoking question—we're all curious, after all.
I think it's impossible to erase that curiosity, but it's not appropriate to ask. If they didn't smoke and they trust you, they'll tell you [they didn't smoke]. If they did smoke and feel close enough to you, they'll say, "I can't believe I smoked."
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