Growing up in the American Midwest, my Christmas memories are of frigid winter air, white snow-covered hills, an abundance of food, and lots of aunts, uncles and cousins crammed inside. If we were at Uncle Buck’s house it would be filled with cigarette smoke as well.
Christmas 1988 was quite memorable. I opened one of my gifts – my first leather jacket – at Uncle Buck’s. We celebrated Christmas with Uncle Buck several times since. Things had changed the last Christmas I spent with Uncle Buck,
As we approached the house I could see Uncle Buck outside in the cold smoking. Aunt Janette’s advanced emphysema meant smoking wasn’t allowed inside any longer.
Christmas 2009 wasn’t very merry. Uncle Buck had to tell 5 children, 10 grandchildren, 14 great-grandchildren, 7 sisters, 1 brother and more than 30 nieces and nephews – I have lung cancer.
When diagnosed Uncle Buck’s cancer had already spread beyond his lungs. He went through chemotherapy and radiation, but it was too late for surgery. Just weeks after his 70th birthday Uncle Buck died, two years and four months after he was diagnosed.
Most of the 12,000 Australians diagnosed with lung cancer in 2015 have a similar story to Uncle Buck’s. The chances of surviving lung cancer are poor. More Australians die of lung cancer than any other cancer. How different would Uncle Buck’s story have been if his cancer was detected earlier, if he had surgery, if he had quit smoking?
Less than a quarter of the lung cancers diagnosed in NSW are detected before it spreads. Screening smokers for lung cancer doesn’t look beneficial in Australia. However, campaigns and guidelines can increase awareness of the signs and symptoms. In NSW less than two in five people diagnosed with early non-small cell lung cancer get surgery. Finding and treating lung cancer according to clinical guidelines could improve the chances of survival for some but prognosis is still poor. Detecting Uncle Buck’s lung cancer earlier might have made other treatment options, like surgery , possible but it is unlikely he would be still be alive to celebrate Christmas this year.
Before the widespread use of cigarettes and smoking, lung cancer was rare. Cigarettes cause 80% of lung cancers, 84% among men and 74% among women. Secondhand smoke causes an additional six percent of lung cancers in non-smoking Australians. The evidence is indisputable. Lung cancer is preventable by reducing smoking rates. If Uncle Buck had quit smoking in his 30s he may have avoided lung cancer altogether. A recent Australian study suggests that if Uncle Buck quit before 45, his risk of dying would have been similar to someone who had never smoked. Smoking rates in Australia are highest in people aged 25 to 59 suggesting many smoking related deaths, including those from lung cancer, could be prevented if people quit earlier.
Over the past three decades we halved Australian smoking rates. We achieved this through expanding smoke-free areas, informing people about the harms, making cigarettes less affordable and supporting people to quit smoking. Cancer Council’s goal is reduce deaths from cancer by 50% over the next 20 years. In order to achieve our goal we need to urgently reduce smoking rates and reduce exposure to secondhand smoke in order the prevent lung cancer. We can do that by: