Earlier this year, the Centers for Disease Control (CDC) rolled out a series of graphic TV commercials aimed at exposing the horrors of smoking. They made it seem like lung cancer victims have no one to blame but themselves. These TV spots weren’t just ethically wrong. They were scientifically wrong too.
You see, lung cancer is not just a disease acquired by bad behavior. Japanese researchers recently uncovered two more genetic components to lung cancer. I’ll tell you more them in a moment. But first, let’s consider why no one in the U.S. knows about these genetic risk factors…
Thirty years ago, the National Cancer Institute’s “behavioral scientists” took the reins for the government’s lung cancer program. (Away from the actual research scientists, I might add.) And they promptly made the purely political decision to drop all scientific research about the biology of lung cancer. They decided to focus exclusively on smoking cessation and smoking prevention. And they decided lung cancer is a “behavioral” problem. And a “bad behavior” problem at that, to be ostracized and punished.
I know because I was there.
Then, for the ensuing three decades, the NCI ignored the science about lung cancer. And they certainly ignored the genetics of lung cancer. They never gave a thought to risk factors other than smoking. They simply told us lung cancer comes from smoking. And if you don’t want lung cancer, don’t smoke. Plain and simple.
And you see how well that advice turned out…
Lung cancer remains the leading cause of cancer deaths in the U.S. And lung cancer victims feel ashamed and guilty about their disease. Health care professionals even admit some bias against them. You certainly won’t see any ribbons proudly flying for lung cancer victims. All this because the government decided 30 years ago to focus exclusively on tobacco as the one and only cause.
The problem is, one-third of today’s lung cancer victims were never smokers.
And another one-third were former smokers. Clearly, something else besides smoking is at play when it comes to lung cancer.
We know the vast majority of smokers never get lung cancer. In fact, 90 percent of smokers don’t get lung cancer! And we’ve known that fact for a long time. We also know that different genes code enzyme variants in the lung. And this determines your lung tissue’s sensitivity to smoke exposure. In other words, some men and women have lung tissue that responds badly to smoke exposure. But others have more resilient tissue.
Plus, we know that different genes make you more or less susceptible to other kinds of cancer. For example, if you carry the BRCA1 or BRCA2 gene, you’re more likely to develop breast cancer. Doesn’t the same kind of effect hold true for lung cancer?
Of course it does!
But we never followed those leads in the U.S. because the NCI dropped the real science by the roadside 30 years ago.
Fortunately, not all countries have raised the white flag of surrender. Especially not Japan.
In fact, a lot of good lung cancer research comes out of Japan. Last October, I told you about a Japanese study that found men and women who carry a specific genetic mutation run a higher risk of developing lung cancer. Even if they do NOT smoke. That’s important…because in Japan, non-smokers account for 15 percent of lung cancer victims. So they have good reason to look beyond smoking as the one and only cause of lung cancer. [insert hyper link to: https://www.drmicozzi.com/gene-mutation-increases-lung-cancer-risk]
The latest Japanese study looks at the genetics of surviving lung cancer.
For this study, the research team analyzed the DNA of 387 lung cancer patients. They found that non-smokers with a double dose of a gene called NFR2 had higher survival rates. The NFR2 gene “turns on” other genes that detoxify cells and act as antioxidants. The researchers said this is the very first clinical evidence that lung cancer patients with certain gene variants have a better prognosis.
It makes perfect sense that certain genes make you more vulnerable to lung cancer. Indeed, we already knew certain genes make you more vulnerable to emphysema (now called COPD), another “smoking-related” lung disease. And we’ve known this fact for decades. I learned it as a college student. Over one summer break, I had a student research scholarship at City of Hope National Medical Center outside Los Angeles. I worked in the lab of Dr. Jack Lieberman. He was working out the different genetic variants that determined who would get emphysema.
He found that some genetic variants were so sensitive, men and women who carried them could develop emphysema from just breathing the air. Now, remember, we worked in “greater” LA in the 1970s. So the air quality was terrible. But other patients who didn’t carry the variant seemed almost immune to the effects of air pollution and smoking.
Without a doubt, this is a very exciting area of lung cancer research. And the Japanese researchers are certainly onto something big. I can only hope some of the growing interest in the genetics of lung cancer catches on in the U.S. Until then, I’ll keep bringing you what I learn about from our pioneering friends oversees in my Daily Dispatch.
1. “SNP (–617C>A) in ARE-Like Loci of the NRF2 Gene: A New Biomarker for Prognosis of Lung Adenocarcinoma in Japanese Non-Smoking Women,” PLoS ONE 2013; 8 (9): e73794 DOI