Anita Creamer: Lung cancer is striking nonsmokers as well, especially women

It's a gain for women that no one likes: Statistically speaking, lung cancer is becoming a women's issue – and a deadly one. But Grace White is trying hard to beat the odds against her. A lifelong nonsmoker, she was diagnosed in November with lung cancer that had metastasized to her spine.

"Doctors told me I had three months to a year," says White.

It's a sunny spring morning in Colfax, where White, who's 58 and a former stand-up comedian, lives. Her daughter, Alyssa Cook, is visiting today from just down the road. And here, too, is Olivia, White's granddaughter, a 3-year-old sprite who runs in and out of the living room while we talk.

Now Cook looks at her mother with surprise. She hadn't heard the prognosis before.

"You are such a secret keeper," she says.

The statistics, while not a secret, aren't widely understood. Breast cancer kills fewer women each year, but it gets a lot of publicity and research funding. Lung cancer gets shrouded in blame – and denial and, yes, secrecy.

Lung cancer leads all cancers in killing both men and women, according to the American Lung Association, causing more deaths each year than breast, colon and prostate cancer together.

"When I learned that, I was like, 'Wait, are you kidding?' " says Dr. Deborah Morosini in a phone interview from Boston. She became a nationally known advocate for lung cancer awareness and research after her sister, actress Dana Reeve, the widow of Christopher Reeve, died of the disease in early 2006.

"I'm a doctor. I'm a pathologist. If I don't know this, it's alarming."

More alarming still, while the death rate from lung cancer in men has leveled off, it's still rising among women.

Like Grace White, one in five women diagnosed with lung cancer never smoked, says the lung association. More than half of women with lung cancer will die within a year of diagnosis.

But White is undeterred.

"We don't look at statistics," says her daughter. "I won't accept that prognosis."

"It's true," says White. "I taught her not to accept 'no' as an answer.

"You don't have to roll over and succumb to someone else's opinion on your health," says Cook.

It's clear from the look in their eyes that they mean it. They're determined. The problem is, cancer doesn't care.

Why the alarming uptick?

Scientists simply don't have all the answers. We know that smoking leads to a greater risk of lung cancer. But what's causing the disease in so many women who've never smoked?

Environmental factors like radon exposure, perhaps, or secondhand smoke. As Grace White says: "My dad smoked. My grandfather smoked. My husband smoked."

Lots of us can look back to a childhood of long rides in the family car, windows rolled up, with the fumes from the grown-ups' cigarettes wafting into the back seat. Memories also linger of long-ago cross-country plane trips with smoke hanging thick in the air from the smoking section in the back.

"Women tend to be more prone to the carcinogenic effects of tobacco smoke," says Dr. Sarita Dubey, a lung cancer specialist at the University of California, San Francisco. "But in treatment, most clinical trials show that women do better. Women have better response rates and better survival rates."

This good news-bad news equation is complicated by the fact that early lung cancer detection remains rare. Research on one promising detection method, lung CT scans, hasn't yet led doctors to consider it the standard of care.

And so, Dubey says: "Breast and colon cancers have good screening. If a woman has a lump in her breast, she can feel it and go to the doctor.

"But with lung cancer, you don't feel anything until the lungs themselves are causing you to cough."

By the time people have symptoms, lung cancer is generally at stage four, having already spread to another major organ.

Grace White remembers feeling tired, with a little back pain.

"But I'm a tough old bird," she says. "The pain I had with cancer was nothing compared with cramps as a teenager."

Deborah Morosini remembers that the only complaint her sister, Dana, had was a mild cough and slight shoulder pain.

About the writer:

• Anita Creamer's column appears Wednesdays, Fridays and Sundays in Scene. Reach her at (916) 321-1136 or acreamer@sacbee.com. Back columns: www.sacbee.com/creamer.