Truth on Television: You Don’t Have to Smoke to Get Lung Cancer

By Cynthia Floyd Manley

If you are a fan of Desperate Housewives, you may be familiar with the recent lung cancer storyline for Karen McCluskey, the nosy and outspoken neighbor played by actress Kathryn Joosten.

Actress Kathryn Joosten as Karen McCluskey on ABC's Desperate Housewives.

Mrs. McCluskey had what we in the cancer community have jokingly called “TV version” lung cancer — the kind that is quickly and easily treated off camera in a short story arc with apparently no side effects or time off for surgery.

Her experience was not very realistic and the storyline way too brief, but one piece of the story was very real. At her “I Beat Cancer” party in Sunday night’s episode, Mrs. McCluskey told her guests, “You don’t have to smoke to get lung cancer.” She noted that at the clinic, she’d met another lung cancer patient, a young woman, a nonsmoker, close to the age of character Gabriella Solis. “You could be that woman,” she told Gabby.

Make no mistake, smoking is by far the greatest culprit when it comes to lung cancer. Joosten, who has faced lung cancer twice in real life, smoked for decades and has been a public spokeswoman for smoking cessation and prevention. The message — to quit smoking or never start —remains the same.

Still, one in 10 people with lung cancer have no smoking history. The proportion is even higher — as many as one in five — among women. Scientists at Vanderbilt-Ingram Cancer Center are focused on understanding why. One possibility is that, although lung cancers in smokers and nonsmokers develop in the same place in the body, these may be entirely different diseases at the molecular level. Different genetic abnormalities may be driving them, and they may require different treatments targeting those abnormalities.

Dr. William Pao, who joined Vanderbilt-Ingram from Memorial Sloan-Kettering last year to lead its personalized cancer medicine initiative, is leading a Web-based clinical trial to search for those genetic differences. “Our goal is to look at the DNA in blood or saliva samples as part of a future genome-wide association study,” Pao told the VUMC Reporter last year. “You can look at more than half a million areas in the DNA where people may differ. When we start to see patterns in the DNA of patients like never-smokers, we can try to identify genetic mutations that may be important in the lung cancer disease process.”

In addition to encouraging smoking cessation and prevention, Joosten has been an outspoken advocate for increasing research funding for lung cancer and against the stigma that those with lung cancer face. Because so much of lung cancer is associated with smoking, Joosten says, the public often perceives that patients who have the disease brought it on themselves.

But no one deserves lung cancer. As Mrs. McCluskey so aptly pointed out to her guests: “You could be that woman.”

This piece initially appeared in The Tennessean, March 29, 2010. Manley is the Vanderbilt-Ingram Cancer Center’s Associate Director for Communications. Follow her on Twitter.