How and Why Did I Get Lung Cancer?

We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.

Go ahead, guess the first question virtually every person asks when I tell them I have lung cancer. If you guessed the one about whether I was a smoker, you'd be spot on the money. Happened to me again just yesterday when a new acquaintance asked me where he could read my writing and I mentioned this site, LungCancer.net. It turned out that his curiosity about my smoking habits was less out of prejudice and more rooted in a recent legal case he had been involved with -- a patient who had cancer caused by second-hand smoke in the workplace was a client of his and they had apparently just secured a hefty settlement. We then chatted a bit about the various ways that one might end up with lung cancer. None of them seemed to apply to me.

Lung Cancer Risk Factors

Smoking

There are a few common causes of lung cancer that most people already know about or would discover quickly with a quick Internet search. The most obvious one, of course, is smoking. Cigarettes in particular but also cigar and pipe smoking have been linked to lung cancer (as well as throat, tongue, and bladder cancers) for decades. The anti-smoking campaigns in print and television have been so prevalent for the last 40 or so years that few people would be surprised by the fine print on the side of a pack of cigarettes. When I grew up in the 1970s and 80s, cigarettes were commonly referred to as "cancer sticks." It is not surprising, therefore, that many people automatically assume that if you have lung cancer, you must have been a smoker.

Asbestos

Unless you worked with asbestos and have mesothelioma. Even though asbestos exposure is not the only cause of mesothelioma, that relatively rare form of lung cancer is so heavily linked to asbestos that it is easily thought of as "the other" lung cancer, for those people who did not get the disease from tobacco use.

Radon Gas

More common than asbestos, however, is lung cancer caused by exposure to radon gas. While radon is a very common element and it leaches into the air in many populated areas around the globe, it is dangerous when a high concentration of it is captured in the air we breathe. This is especially problematic with enclosed basements that are built over granite deposits, but it is also extremely easy to test for and to take care of through properly sealing the foundation of a building and ensuring proper venting to the outside.

Genetic Predisposition

Other less understood causes of lung cancer can include a genetic predisposition. People with a family history are far more likely to be genetically predisposed to lung cancer, but sometimes a person is simply born with a chromosomal mutation or the body may simply have an inability to either repair damaged DNA or effectively cleanse away dangerous chemicals. There is also the possibility of diet playing a role in the development of lung cancer. Although there is little solid evidence of causation, some studies have shown a potential link to how a person processes sugar and the types and quantities of sugars consumed. Of course, "healthier" diets have many benefits besides lowering cancer risk.

Air Pollution

There is one more relatively common cause of lung cancer, and it is something that millions of people are exposed to every day: air pollution. While less than 3% of lung cancers are directly attributable to pollution, it is a clear health risk that everyone should be aware of and work to mitigate. Living relatively close to freeways for the better part of the last 30 years, the only thing that I can possibly point my finger to as a potential cause of my lung cancer is air pollution. But the areas I have lived in never seemed particularly polluted -- some were even prone to constant breezes, so the pollution always seemed to be blown away. It was not like my neighbors were all getting diagnosed with lung cancer, either (I don't know of any who were). So, pollution alone seems unlikely to have caused my cancer, though maybe I was just susceptible to it for reasons unknown. Or perhaps it was pollution in concert with another, yet unknown element that caused this cancer to grow. I doubt that I will ever know.

Even if I did have the answer to what caused my lung cancer, I would still be fielding questions about my smoking habits. I did not earn this cancer. There is no obvious reason that I would have developed it. And that is okay because the question itself opens up a new dialogue that can help others to both understand the challenges of lung cancer research and the stigma with which patients often live.¹