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Lung cancer patients deserve greater support, whether they smoke or not

Professor Ian Olver -
22 August 2012


Each year 40,000 Australians die from cancer-related illness – the number one cause being lung cancer.

Surprised? You’re not alone.

According to a recent Galaxy poll which asked asked Australians which cancers they thought caused the highest number of deaths, breast cancer topped the list.

This is hardly surprising, given the high level of breast cancer awareness compared with other cancers – and full credit must be given to the energetic, well-supported community groups that have worked so effectively to achieve this.

But breast cancer is fourth on the list of cancers which cause death in Australia. Lung cancer tops that unfortunate list by a substantial margin. In 2007, 7626 Australians died from lung cancer – well over double the 2,706 who died from breast cancer.

Bowel cancer, at 4,047, and prostate cancer, 2,938, are second and third respectively.

But this isn’t a contest: all cancer death is a tragedy and all patients deserve equal support.

The problem is that despite lung cancer’s high rate of death, it doesn’t capture the community’s interest and support in the same way breast cancer does.

Why? Of course, no-one can say for sure. But as someone who has worked in cancer care for more than 30 years, I would suggest it’s due to an assumption that patients are smokers who’ve brought the condition on themselves. This is terribly wrong for two reasons.

First, and most importantly, not all lung cancer patients are smokers. Around a third of lung cancer cases in women and 10% in men are not related to tobacco use at all. When you consider that 9,700 lung cancers are diagnosed each year in Australia, these aren’t small numbers.

Second, blaming a lung cancer patient who was a long-term smoker is blaming the victim. Long-term smoking creates a powerful chemical addiction, usually formed at a young age. And most smokers wish they could quit.

The frustration of those living with lung cancer is understandable – they’re not only dealing with a terrible, untreatable disease but they also face unwarranted stigma.

The reason the Cancer Council invests so heavily in reducing tobacco consumption in Australia is that 20% of all cancer deaths are the direct result of smoking. So cutting the smoking rate is an effective way of reducing overall cancer deaths, which is our main priority.

We also fund research into lung cancer detection, treatment and patient support. But we need to do more – and improved outcomes in these areas will only be achieved through increased community support for the disease.

Cancer research is a highly competitive business and there’s never enough funding to go around. Grants tend to be allocated to projects that are most likely to be successful, such as those based on encouraging preliminary findings. This is understandable – funding bodies and their supporters want to see results.

Progress on improved lung cancer treatment has been slow because it’s such a complex and aggressive type of cancer. As a result, researchers find it much more challenging to develop a proposal for lung cancer research that’s likely to yield a result with the limited funds available. It’s a catch 22.

The solution may be to shift towards “priority-driven” research, where funding is prioritised according to unmet need rather than the likelihood of success. We’re currently trying to make this shift in the projects we fund at the Cancer Council.

We’ll only be able to offer cancer patients more effective treatment with further research. This may mean running up blind alleys and funding studies that aren’t always successful but it’s necessary to get long-term results.

The importance of improved lung cancer treatment deserves greater recognition in the community, whether or not people with the disease ever smoked.

So if you meet someone living with lung cancer, please don’t blame them for their condition or make assumptions about its cause.



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