Courtesy: Medical Miracles, from Readers Digest 1981.
November.
From the frontiers of science and the far horizons of
personal courage, these stories of medical triumphs and miracles will reaffirm
your faith in the awesome powers of the human spirit. Dramatic victories and
human triumphs.
Selected and edited by the editors of Readers Digest
Depending on how much they smoke, cigarette smokers are 5 to
17 times more likely to die from lung cancer that are non-smokers—a fact most
of the will readily acknowledge. But
while admitting that cigarettes cause cancer, these same smokers nevertheless
refuse to give them up, reasoning that the harm, if any, has already been
done. “If I’m marked for lung cancer,”
runs their argument, “It’s too late to do anything about it. Why stop now?”
Why, indeed? For
years there was a certain irrefutable logic to this argument. Cancer of the lung is a silent invader, one
that usually grows to lethal dimensions before signaling its presence. Thus, despite the most skilled treatment, the
rescue rate is still dismally low; of the total number diagnosed, only 5
percent are cured. So why stop? Why give up a habit you’ve grown to love?
It seems a comforting, warm, smug kind of
justification. But it no longer holds
water. Indeed, today there is good
reason to believe that a period occurs early in the life history of lung cancer
when the ore-cancerous cells actually require a continuous supply of the cancer
producing irritant—tobacco smoke, in this instance—to survive and grow. If this supply is turned off and kept off for
five years or more, the potentially lethal cells will shrivel up and disappear.
This fundamental and rather startling discovery came during
a 13-year study conducted in my laboratory at the Veterans Administration
Hospital in East Orange, New Jersey. My
colleagues in the study were Dr. E. Cuyler Hammond and Lawrence Garfinkel, then
have the American Cancer Society’s statistical department. What we were looking for when we launched the
project were very early changes that might signal the beginning of cancer in
the bronchial epithelium, the lining of the branching air passages within the
lungs, where cancer is often known to arise.
We could not, of course, witness these changes in a living person, for
they occur deep within the lung. Our
information has come, therefore, from studies of more than 100,000 paper-thin
silvers of lung tissue, taken at autopsy from over 1200 men and women, ranging
in age from 22 to 84, who had died from heart disease, brain tumor, phumonia,
accidents and other causes including, of course, lung cancer. Among them were light, moderate, heavy and
non-smokers, and ex-smokers.
During one of these studies, as we examined sections from
smoker’s lungs, we noted that many changes in the cell pattern of the bronchial
lining had taken place, in a gradual evolution.
In effect, we were observing the step-by-step transformation of normal
cells into cancer cells. And the
frequency of abnormal cells closely paralleled the number of cigarettes the
person had smoked during his life. But
in many of the slides we noticed that the membrane that separates these cells
from the underlying supporting tissue was still intact, holding the mest of
potential troublemakers in place—and thus preventing their escape into the
blood vessels which would spread them to other areas. We classified this stage of development as
“cancer in situ,” which simply designates a cluster of tumor cells still lying
within the bronchial lining where they originated.
As long as cells remain quietly in situ they do no
harm. But they still carry the malignant
potential. And the next step in their
life history is penetration of the basement membrane. When this happens the tumor has reached the
point of no return, invasive cancer has begun.
At this point, to see what actually does happen inside a habitual
smoker’s lung after he stops saturating it with tobacco smoke, we set up
comparative study of three 72-man groups.
Those in one group had smoked most of their lives, to the time of death. The second group was lifelong
abstainers. The third consisted of men
who had smoked ten years or more and had given up it at least five years. All had died of causes other than lung
cancer.
To assure that we would not be influenced in our search for
cancer cells by foreknowledge of a person’s smoking habits, the lung sections
in each group came to our laboratory identified only by serial number. But after we had finished our examination of
some 10,000 slides, and our reports were linked up with individual case
histories, we saw at once how finitely the cessatio of smoking was reflected in
the condition of the bronchial lining.
Cancer in situ, that last stage before invasive cancer, appeared 40
times as often in the smokers as in those who had quit. (No cancer in situ was seen in any of the
non-smokers.) In many instances, the
bronchial linings of the ex-smokers were healthy-looking as a child’s. Yet the odds are overwhelming that these same
lung linings at one time harbored numerous pre-cancerous lesions—lesions that had
disappeared without a trace after the individuals stopped smoking.
Well, not quiet without a trace. As I was porting over the thousands of slides
I was struck by the appearance here and there of odd-looking cells of a type I
had never seen before. The cell nuclei
were contracted, crescent-shaped or just shriveled, and sometimes had left a
clear halo around them as they shrank.
At first, I simply made the notation, “Unusual finding in epithelium,”
and told associates what I had seen.
They checked the origin of each strange slide; then, while keeping that
information from me, they asked me to re-examine the first thousand slides.
Eventually, I found the disintegrating nuclei in 518
sections—and it turned out that every single one had come from the lung of an
ex-smoker. We never saw a disintegrating
nucleus in the tissues of either a heavy, continuing smoker, of in a person who
had never smoked.
The implication was clear.
What we were viewing was the death and disintegration of pre-cancerous
cells. And it seemed statistically
beyond doubt that the process was the direct result of the removal of the
irritant, which had induced the abnormal development in the first place—the
tobacco smoke.
Although we have no way of knowing just how much time
elapses after the flow of tobacco smoke is turned off before this self-repair
process begins, our studies indicate it will take place in a high percentage of
smokers who stop smoking for five years of more.
Today, fortunately, many smokers are giving the
disintegration process a chance. The
U.S. Public Health Service reports that since 1957 there has been a significant
decline in the number of people who smoke.
The American Cancer Society’s statustucsm based on a massive survey of
the smoking or non smoking habits of the million American men and women, suggest
that the longer you stay off cigarettes the more closely your life expectancy
and general health will approach the levels of those who have never
smoked. In fact, after ten years of no
smoking, the death rates of ex-smokers and lifelong abstainers are virtually
the same.
Why stop now? The
answer is crystal clear.
