How Not to Die of Lung Cancer

Quitting smoking is only part of the solution.

The day we found out my father had lung cancer, a neighbor had come by my childhood home upstate, but no one answered the door. The neighbor went on inside and looked around – none of us locked our doors out there in the country at the time – and found my father alone, lying on the floor upstairs unable to get up. My father was a tall man, about six foot two, and lean, and seemed mostly all muscle as long as I had known him, so this was really a shock.

I had been working down in New York City for many years when my father got sick. On our weekly calls, he had talked about his aching bones. It never occurred to me that could be from having lung cancer. He quit smoking about 6 years earlier. (Quitting smoking isn’t always enough.) He had no symptoms of lung disease. (Lung cancer doesn’t have symptoms at first.) No mention of lung trouble after his regular physicals at the local V.A. hospital in Albany. (Not everyone checks to see if you might have lung cancer.)

How lung cancer starts, and finishes

Cancer starts from a change in a single cell. No one realizes it is happening. There are trillions of cells in our body and any one of them can change. One tiny living lung cell is insulted by something like smoke that changes the DNA – it’s smoke in about 80% of lung cancer cases. Or it is some other irritant, or the DNA just mutates all on its own for no known reason – in the other 20% of lung cancers. Then that one cell multiplies, and more cancer cells grow, and make clusters or tumors. It goes in stages. In late stages, cancer cells continue to grow and spread throughout the body.

The later the stage of cancer, the less treatments we have available to us. In my father’s case of lung cancer, that meant no treatments at all.

From lung cancer, to the bones, to the heart

I took a train up from New York City to the hospital, where a doctor told me my father’s bones were like Swiss cheese. They were full of holes from the cancer that had spread from his lungs.

The next week I rented a car and drove my young daughters up to visit with him. They were about 7 and 10 years old. His cheeks were flushed pink, which looked healthy, but wasn’t. It was from radiation that wasn’t helping. He couldn’t move much in the hospital bed, but he seemed cheerful. One after the other, he asked each of his granddaughters to hand him a cup of water with a straw in it, and slowly took a sip.

“There,” he said. “Try to remember this. You can always say you gave your grandpa a drink when he was in the hospital.”

A few short weeks later, he passed away alone at midnight. Calcium leached out of his disolving bones into his blood, collected around his heart, stiffened it and shut it down.

Every day, lung cancer takes the lives more than 356 of our friends, neighbors and loved ones. 

In the US. – American Lung Association, 2022

For too many people who die from lung cancer, the disease is noticed only at a late stage. But for people whose cancer is identified in early stages, treatment can work. In some cases cures are possible.

How screening for lung cancer saves lives

Times have changed. These days, a low-dose CT scan of the lungs can identify lung cancer in early stages. Unfortunately, the American Lung Association says only 6% of the people in New York who could get one, do. It takes about 30 seconds. It is not an invasive test, but a scan – an imaging test you can get once a year. Something like a mammogram, but much quicker and without the pain, because it doesn’t involve being touched or squeezed at all.

You can get a low-dose CT scan for free every year if you are at a high risk of lung cancer – and have health insurance. “High risk” has a strict definition. You have to be at least 50 years old. You have to have smoked a lot (the equivalent of a pack a day for 20 years). And you have to smoke now or have quit smoking up to 15 years ago. A lot of us are at high risk, but only 6 out of a 100 here get a scan. I really don’t know why.

The scan wasn’t around at the time my father was getting his check-ups at the V.A., but now it is universally accepted as the only test that reduces deaths from lung cancer. I always think that if we had the lung cancer screening scan back then, maybe my father, his granddaughters, and I would have had more time together. And more time to say goodbye. It all happened too fast.

If someone you love smokes a lot, or did before, please share with them about how not to die of lung cancer. Screening saves lives.