As reported by the Danbury News-Times, August 8, 2005.

Doctors Warn Ex-smokers Still Prone to Cancer

By Robert Miller

Peter Jennings died only four months after he was diagnosed with lung cancer. That makes him the exception rather than the rule — a new generation of drugs is keeping many lung cancer victims alive longer, sometimes considerably so.

"If you were to ask me, I couldn't remember when my last lung cancer patients lived only four months after diagnosis," said Dr. Orion Howard, director of medical oncology at the New Milford Hospital-Columbia Presbyterian Regional Cancer Center. "Today, they're living one year, two years, sometimes three."

Jennings was a heavy smoker, albeit one who gave up cigarettes for 20 years. Those years of smoking make Jennings part of the tragic rule and not exceptional at all. Smoking kills.

"Ninety percent of lung cancers are smoking-related — maybe more," said Dr. Carolyn Runowicz, director of the Neag Comprehensive Cancer Center at the University of Connecticut Medical Center in Farmington. "One-third of all cancers are related to smoking. Think about it. Nothing makes me more impassioned than to see young kids smoking."

Jennings, the debonair Canadian who anchored ABC's "World News Tonight" for 22 years, made a raspy-voiced announcement in April that he had been diagnosed with lung cancer. While he spoke of returning to the anchor's chair, he never appeared on air again. He died Sunday at the age of 67.

Jennings was a heavy smoker until his 40s. He kicked the habit for more than 20 years, then resumed smoking after the events of Sept. 11, 2001.

Dr. John Pezzimenti, chairman of oncology at the Praxair Cancer Center at Danbury Hospital, said Jennings' death underlines the hard truth about smoking — it damages the body's tissues, and that damage doesn't go away. It wasn't the resumption of smoking that hurt Jennings, Pezzimenti said; it was all the other years.

"There are literally hundreds of carcinogens in cigarette smoke and they cause many different types of injuries," he said.

Dr. Frank Detterbeck, professor of thoracic surgery and associate director of clinical affairs at the Yale Cancer Center in New Haven, said there is a common misconception that once you quit smoking, your lungs can return to their healthy, pre-cigarette state.

"In fact, about half the people we treat for lung cancer are ex-smokers," Detterbeck said. "When you quit smoking, the damage doesn't keep getting worse. But it doesn't disappear, either. It sort of reaches a plateau."

What quitting does do is considerably reduce the risk of getting lung cancer. Detterbeck said compared to a non-smoker, a regular, pack-a-day smoker is 2,000 times more likely to get lung cancer. Twenty years after quitting, that's down to being 400 times more likely to get the disease.

There are also people who get lung cancer without ever smoking. Detterbeck said if you have a parent or a sibling who develops lung cancer, your chance of getting it is also 400 times greater than someone without the family history.

About 173,000 people develop lung cancer in the United States each year, causing about 160,000 deaths annually, according to the American Cancer Society. In men, the incidence of lung cancer is slowly declining. In women, it's leveling off after climbing precipitously from the 1970s through the 1990s. Today, about 68,500 American women die annually of lung cancer — more than the deaths caused by breast cancer and ovarian cancer combined.

"It's a very insidious disease," said Dr. John DeFrance, a cardiothoracic surgeon at Danbury Hospital. "It doesn't come with a lot of symptoms. People think 'I'm getting a little old and out of breath. I'm feeling a little more tired than I used to be.' "

If there is good news, it is that oncologists and surgeons now know how to better manage the disease. DeFrance said Danbury Hospital, like many hospitals, uses a multi-disciplinary approach to lung cancer cases, with each case reviewed by its Lung Tumor Board.

Doctors have learned combining surgery and chemotherapy is more successful than surgery alone. Several new drugs — with more on the way — are allowing oncologists to manage lung cancer, if not cure it.

UConn's Runowicz, president-elect of the American Cancer Society, said Jennings' case is a cautionary tale.

"The message is this," she said. "Never start smoking. It's not just lung cancer, it's cervical cancer, it's pancreatic cancer, it's bladder cancer, it's all the head and neck cancers. If you are smoking, get into a smoking cessation program, and quit. Otherwise, you just continue to add insult to injury."