Tuesday, 20 July 2010

Do you smoke?

That's the question you hear every time you visit the doctor. Harmless enough, you think? A simple yes or no, and the 'no' can be delivered with an air of irresistible superiority, can't it?

Did you know that nonsmokers can get lung cancer? Oh yes, we don't have a monopoly on that. In the interests of equality, you nonsmokers can get lung cancer with almost exactly the same frequency as smokers. The figures are massaged by including 'have you ever smoked', so someone who tried one cigarette 20 years ago and didn't like it counts as a smoking-related cancer. Isn't statistical absurdity wonderful?

Did you realise that if you answer 'no' to the 'Do you smoke' tick-box and you're at the doctor's because you have breathing problems, the one thing he will not be looking for is lung cancer? You can't possibly have that. You're a non-smoker. Must be something else.

Meanwhile cells divide, lumps grow, and your GP is looking for something that isn't what you have. Alien is growing in your chest and he refuses to see it because Righteous logic has dictated it cannot be there.

I quote from a new addition to the list, someone who thinks along the lines of Frank Davis and an increasing number of us:

Lung cancer is not always diagnosed in non-smokers, because doctors aren't necessarily looking for it.

Lung cancer has always been, and remains, a fairly rare disease. Many GPs will go their entire careers without seeing one single case. If you say 'yes, I smoke', they will test for it as a matter of urgency because they have heard ASH insist that all smokers get it. Good news for smokers. We all get checked.

If you say 'no' they will discount it as a possibility because ASH insist that only smokers get it. Bad news for non-smokers. Your cancer will go undiagnosed until the lump is as big as your head. In the case of the rabid antismoker, about one millionth the size of your ego and five hundred times bigger than your IQ.

Smokers didn't do this. ASH did this. With twisted science and hysteria, ASH have ensured that if you say you don't smoke, your spontaneous cancer will be ignored as an impossibility even up to the point where it pops out of your chest and says 'Hi there'.

If you visit your GP with chest problems, always, always answer 'yes' to 'do you smoke?' He will then at least order the full range of appropriate tests.

If you say you don't smoke, you'll die.

It's hard not to laugh.


Anonymous said...

You could always answer "only passively"

Anonymous said...

Lucy Page Gaston the original anti smoking harpie died from throat cancer aged 64 .
A teetotal non smoker .
She probably thought it was thrush.

Dioclese said...

Nice one LI. I just love the irony of it!

Peperbarmi said...

The last time I went to the doc`s I was half pissed and no doubt stinking of fags,I forgot why I was there in the first place,I sat their trying to remember but it had gone,doc was furious and I was given a 15 min lecture on the dangers of drinking and smoking and kicked out with a handful of fucking leaflets.

Went back to the boozer and my mate said "was it ear wax",I said "what",he said "WAS IT FUCKING EAR ..oh never mind" ,I said "EH"

Anonymous said...

In Canada and the USA, particularly California, lung cancer among non smokers is on the increase and ranks about seventh of all cancer types. There is concern that because of its association with smoking, less money is spent on research and its victims are dismissed as secret smokers. That seems to be the same in the UK. Lung cancer among non smokers is fairly common - not in the premier league of breast, colon and smokers lc, but in the Championship. I've read any CRUK etc mentions of it. You've got to feel a little sorry for non smokers who get lung cancer. Some of them may kept well out the way of tobacco smoke, but inadvertently lived in a house full of radon. So, you non smokers out there: if you die of lung cancer and start wondering why nothing can be done, and there is no ribbon for you, blame ASH UK, which is funded from your taxes.

Chalcedon said...

But non-smokers very rarely demonstrate COPD (unless their work or environment exposes them to breathable particulates) but most if not all smokers will demonstrate some degree of COPD. At the more extreme end 90% loss of lung capacity. Not a pretty sight. Much higher incidence and prevalence then lung cancer of any kind. COPD kills more women per year than does breast cancer.

Pat Nurse said...

I'm afraid I tell medics when asked that question :"That I refuse to give any details of my lifestyle habits on the grounds that I may be discriminated against so that means I will not say if I smoke, drink alcohol, like cream cakes, mountain climbing or horse riding."

The doctor just ends up looking at me as if I'm a nut and says - "so you do smoke." I reply by saying they can assume what they like but the issue of lifestyle choice is my politics and the movement includes smokers and non-smokers alike

The docs know they can't just look at me with prejudice so I have to be treated as fairly as a non-smoker which means they can't take for granted anything about whatever symptoms I might have based on whatever untruths the criminals at ASH have spread!

DaveA said...

Good piece Leg Iron and let me tell you what I know about lung cancer and smoking. 86% of lung cancer patients are smokers and it is contracted causually by smoking. The burning of the tobacco produces benzo(a)pyrene a 5 ring benzene molecule and is a class A carcinogen. We all have on chromosome 11 the transprotein gene (p53) which protects our bodies from all cancer cell multiplication. The ingestion into the lungs of benzo(a)pyrene causes a mutation of the p53 gene called a guanine to thymine transversion, the helix strands of the DNA become corrupted. The p21 gene which deals with DNA mutation and repair is unable to cope with the continued assault on the lungs.

This means lung cancer cells can then multiply and replicate. The good news however is that this G to T transversion is never seen in non smokers. It is a medical impossibility for a non smoker to contract lung cancer from passive smoking. Roy Castle did not die from playing the trumpet in smoky clubs. Instead in non smokers it is thought that the epidermal growth factor receptor protein (EGFR) gene or the GPC5 gene. What causes that to mutate is unknown because of the obsession with passive smoking, although it has been suggested that Human Papillomavirus types 16 and 18, genital warts to you and me, maybe the cause as it is with cervical cancer. They found the RR for smoking and cervical cancer was 2.5. The correlation with smoking was not causation. HPV is more likely to be contracted by promiscuous people and the correlation is that promiscuous people are more likely to smoke.

Yes the anti smoking zealots are killing people with the insistence that it is SHS.

My provenance for this is the World Health Organization and its cancer arm the IARC. Tobacco companies always tried to deny the link between smoking and lung cancer and the WHO set out to prove it was. Alas they also proved SHS was harmless and they have lied to us for at least 12 years.

"In 1998, Pierre Hainaut and his collaborators at IARC analyzed the mutations in lung cancers that were at the time in the IARC p53 database. They found that the positions of damage by benzo(a)pyrene spotted by Pfeifer and his team were frequently the sites of mutations in lung cancers of smokers but rarely in lung cancers of non-smokers."

"However, the whole argument has been blown up by the identification of distinct mutations in the lung cancers of smokers and of non-smokers."

Also what kills many non smokers from lung cancer is that it becomes a secondary infection which finally kills you. Sir Bobby Robson initially had a melonoma, then a brain tumour and finally died of lung cancer. A film was made of Canadian Terry Fox who tried to run the length of Canada despite having a leg amputated for knee cap (patella) cancer. He succumbed to lung cancer at 21.

So your theory that lung cancer maybe under reported in non smokers maybe entirely correct.


Amusing Bunni said...

Just cause a dr., or anyone asks you a nosey, intrusive question doesn't mean you have to answer it. If you don't want to get into a big discussion with him, just say "no". If you say yes, you get put on a watch list and are lectured to stop smoking.

I'm tired of everyone getting all up in my biz, and I don't have time to argue w/ idiots, so I just tell 'em what they want to hear, and move on. This is in real life, of course. I'm not as PC online ;-)

Leg-iron said...

Chalcedon - do the particulates emitted by car exhausts not form part of the non-smoker's environment?

Yes, there are risks in smoking. I've never denied that. There are risks in any activity that is enjoyable. The risk is part of the enjoyment.

The risks in smoking apply only to the smoker. The antismoker claims that one cigarette produces more harmful smoke than driving a car are ridiculous.

Yet it is on the basis of imaginary harm to others, not the smoker's own risk, that all this banning has come about.

The ban is not, and never was, about health.

Leg-iron said...

DaveA - so if a nonsmoker shows up with lung cancer, the assumption will be that he's lying about smoking?

In which case, how many of the 86% of smoking lung cancer patients are smokers and how many were just assumed to be smokers by doctors who 'just know these things'?

Okay, you have the mechanism but remember that smokers are also open to the non-smoking-related lung cancer. I appreciate that you can tell the difference but is this done routinely? Or is it a case of 'smoker - check box and assume the cancer is smoking related'.

How many of those told that their smoking caused their cancer were in fact doomed by genetics to get it whether they smoked or not?

It's far from being clear-cut.

The worst part is, as you say, there is little to no research on non-smoking-related lung cancers because that would spoil ASH's passive-smoking fun.

Some of them might be entirely preventable. As long as ASH are around, we'll never know.

(Yes, yes, smoking-related lung cancer is preventable by giving up smoking. Except it isn't. Many ex-smokers develop the cancer after quitting. Besides, I know the risks, I accept the risks, I harm nobody apart from producing a smell they don't like.)

Leg-iron said...

Amusing Bunni - I also let idiots believe what they want to believe most of the time.

If I have the time though, I do enjoy a good argument.

Fredrik Eich said...

"Cigarette smoking and indoor activities do not substantially increase human exposure to BaP[Benzo-A-Pyrene], relative to exposures to background levels of BaP present in the environment." - here

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