I used to smoke.
The story, the dumb story, was that I picked it up trying to impress a girl. She was a waitress named Angie. I was a dishwasher. We were in high school and used to go to these weekend parties hosted by the manager of the restaurant where we both worked.
This was an entirely bad idea on his part. Half of us were underage. None of us had any sense, but they were great parties Ƶ loud, silly and probably some of my best memories from my senior year.
The parties were a chance for me to cut loose, hang out with college kids, drink sour beer Ƶ and talk to Angie.
But there was a problem. WeƵd be talking and laughing and then sheƵd ask me for a cigarette. I didnƵt smoke and Angie wasnƵt supposed to smoke. She was a long-distance runner and didnƵt buy her own cigarettes. She only smoked when she drank beer.
So, with drink in hand, Angie would wander off to find one, which would derail whatever budding romance I had forming in my head.
I wanted to keep her around.
After one of these parties, I bought a pack of Marlboro Lights and a lighter. Then I talked my little sister into showing me how to smoke.
Smoking at parties led to smoking on my lunch breaks at the restaurant and eventually to smoking back and forth to work.
The joke was on me, of course. At the end of the summer, Angie and I went off to our freshman years at college. She went to Virginia Tech to study accounting. I went to East Tennessee State University, listened to Pink Floyd records, ate a lot of Chinese food and spent many late nights discussing the works of Hunter S. Thompson.
I probably should have gone to class.
Angie and I lost touch, but I got to keep smoking as a souvenir.
For the next 20 years, I smoked on and off. Sometimes, IƵd go a year or two without smoking, but then IƵd pick it up again for six months or longer.
I had no illusions. IƵd been around smokers all my life. Even they told me smoking was bad and that IƵd regret it. Smoking caused cancer and we all knew that, but I donƵt remember any of us knowing anyone who had lung cancer.
Even after I began driving for the American Cancer Society years back, I donƵt think any of the people I took to treatment had lung cancer, but most of my passengers didnƵt bring up what they were specifically being treated for.
The American Lung Ƶsociation offered to give me some perspective and matched me up with Dr. Bobby Mahajan for a call to talk about cancer Ƶ particularly lung cancer.
He was astounded when I said that I didnƵt think IƵd met anyone who had lung cancer. More than 2,000 West Virginians are diagnosed with lung and bronchus cancer each year.
Percentage-wise, this is another bad thing for which West Virginia tops the list. Nationally, about 53 in every 100,000 are diagnosed with lung cancer. In West Virginia, our rate is 76.1, and the five-year survival rate here is about one in four.
Dr. Bobby told me screening is a problem. The numbers of people getting screened, particularly in rural parts of the state, is very low.
ƵAnd thatƵs a challenge because the majority of patients, about 85% of them, are diagnosed at stage three or four.Ƶ He explained, ƵStage three or four is not operative or treatable by radiation. ItƵs not curable at that point.Ƶ
You want to catch lung cancer early, during stage one or two.
At stage one, the cancer is nodules in the lungs, which can usually be removed. Dr. Bobby said he uses something like an X-box controller to guide a robot to do the work.
ƵThe outcomes for these people are great,Ƶ he said. ƵAbout 88% survival after five years.Ƶ
Stage two is more serious, probably involves more surgery and possibly radiation, but also the outcomes are good. People can live with it.
But at stage three and four, cancer has probably spread beyond the lungs. It is a much larger problem and treatment is more complicated.
Screening for lung cancer, he said, is important because the symptoms might be negligible until it is kind of late.
But still, knowing that, people put off screenings. People get weird about it. Lung cancer has a stigma, because it is typically associated with smoking and smoking is seen as a lifestyle choice Ƶ a vice Ƶ and the illness is considered self-inflicted.
And smokers who get lung cancer sometimes feel like they deserve it. Guilt and embarrassment will keep people from seeking treatment.
Dr. Bobby said the problem with smoking isnƵt all that simple.
ƵPeople forget that smoking was part of the fabric of American life,Ƶ he said.
And it still kind of is.
Still, smoking is bad. Cigarettes are chockful of chemicals and just inhaling smoke irritates and damages your lungs.
ƵAnd so, thereƵs a repair of that injury over and over again,Ƶ he explained.
This creates the opportunity for cancer cells to develop, which then can grow out of control.
ThatƵs significant in West Virginia, which leads the nation in percentage of smokers Ƶ roughly 26%, compared to the national average of 13.5%.
But lung cancer isnƵt as simple as just cigarettes.
ƵThereƵs a huge genetic component,Ƶ he said.
About 20% of those diagnosed with lung cancer have never smoked, and the rates are a little higher among Ƶians because of a specific mutation.
So, Dr. Bobby said lung cancer can be caused by a number of things, but yes, cigarette smoke is still the largest-single cause.
Getting well from cancer has always been a challenge, but treatment has improved over the past decade and itƵs not automatically chemotherapy.
ƵChemotherapy is essentially poisoning the body to kill cells that grow quickly,Ƶ he said. ƵItƵs very effective in killing cancers, but it also kills normal cells that grow quickly, like your stomach lining, your hair.Ƶ
The side effects are brutal, and survival can be poor.
ƵItƵs not necessarily that the chemo isnƵt working, itƵs just that you canƵt tolerate the side effects that come with the toxicity,Ƶ he said.
More recent treatments do a better job of just targeting the cancer. There are fewer side effects, and, even if the disease canƵt be cured, it can be managed.
ƵCancer becomes a chronic illness, but not a death sentence,Ƶ he said.
Ƶ far as avoiding cancer, Dr. BobbyƵs advice sounded familiar: DonƵt smoke.
ƵThatƵs suggestion one, two and three,Ƶ he said.
Easier said than done.
ƵMost smokers want to quit,Ƶ he said, but he acknowledges that cigarettes are addictive.
Still, resources to quit exist. Help quitting is available.
Beyond that, living a healthy life, eating right and getting regular exercise help more than youƵd think.
And go see your doctor. Really.
Dr. Bobby said itƵs natural and normal to want to skip those yearly exams, to tell yourself you feel fine, so you must be fine.
ƵSeeing your doctor on a regular basis allows you to make sure those preventative care methods are used on a regular basis without having to navigate the health system, which is already challenging in general,Ƶ he said.
