As I wrote this title I can already hear my kids. "Mom - is there anything that doesn't raise the risk of cancer?" So I'll jump to my defense first. Lung cancer is most treatable in the earlier stages of the disease. If people know they are at risk, perhaps they will be more likely to watch for the early symptoms of lung cancer and catch it in those stages.

We know from previous studies that COPD is associated with an increased risk of developing lung cancer, and that risk seems to be independent of smoking.

But a new study looked at 2 other common conditions: chronic bronchitis and asthma.

Among people living with chronic bronchitis, there was an increased risk of developing squamous cell carcinoma of the lungs.

Among those with asthma, the risk of small cell lung cancer was elevated.

It's important to note that this study was done looking at tin miners in China and may not apply to people in other occupations in the United States.

So what does this mean for you or your loved ones?

Lung cancer remains the leading cause of cancer deaths in both men and women in the United States, and as of yet, we don't have a widely available screening tool for early detection. If you have a history of lung disease talk to your doctor. And check out these tips on lowering your risk:

• 10 Tips to Lower Your Risk of Lung Cancer

Photo: istockphoto.com

_Sources:

_{Fan, Y. et al. Prior lung disease and lung cancer risk in an occupational-based cohort in Yunnan, China. Lung Cancer. 2011 Feb 28 (Epub ahead of print)}

_{Rooney, C. and T. Sethi. The Epithelial Cell and Lung Cancer: The Link between Chronic Obstructive Pulmonary Disease and Lung Cancer. Respiration. 2011. 81(2):89-104.}

Just last week I wrote about a study in which fish oil combined with chemotherapy for lung cancer improved the response and possibly survival. Now another study suggests fish oil may help with maintaining weight and muscle mass as well.

Researchers separated 40 people with non-small cell lung cancer into two groups for their first course of chemotherapy (a 10 week course). One group was given a supplement of 2.2 grams of eicosapentanenoic acid (EPA) daily, an omega-3 fatty acid derived from fish oil. The other group was given "standard care" without the supplement.

On average, the fish oil group maintained their weight, whereas the group that didn't receive fish oil lost about 5 pounds. Muscle mass was better preserved in the fish oil group as well, with 69% (vs 29% in the non-supplement group) either maintaining or gaining muscle mass. There was no difference between the two groups in adipose tissue (fat tissue) gained or lost.

This was a small study, but another study last year in people living with stage 3 lung cancer found that fish oil supplementation improved nutritional status as well.

Why is this important?

Unlike many of us who don't mind losing a pound or two, weight loss and loss of muscle mass in people living with cancer can be a big problem. Malnutrition may worsen the side effects of chemotherapy, it is associated with a poor quality of life, and may have a significant impact on survival. In one study it was estimated that malnutrition is a hidden cause of lung cancer deaths, responsible for perhaps 20 to 40% of deaths.

Again it's important to stress that any supplements you take during cancer treatment should be discussed carefully with your doctor, as some supplements could actually interfere with your treatment.

Photo: istockphoto.com

_Source:

_{Murphy, R. et al. Nutritional intervention with fish oil provides a benefit over standard of care for weight and skeletal muscle mass in patients with nonsmall cell lung cancer receiving chemotherapy. Cancer. Published online 28 Feb 2011. DOI: 10.1002/cncr.25709.}

_{van der Meij, M. et al. Oral nutritional supplements containing (n-3) polyunsaturated fatty acids affect the nutritional status of patients with stage III non-small cell lung cancer during multimodality treatment. Journal of Nutrition. 2010. 140(10):1774-80.}

I'm often surprised by the response I get when I mention that the majority of people who develop lung cancer now are non-smokers. "What? You've gotta be kidding! Where did you hear that?"

Yet it's true. Lung cancer occurs more often in people who've already kicked the habit -- and that act of courage may have occurred well in the past.

A new study gives us numbers to talk about. Researchers looked at over 600 people who were referred for lung cancer surgery and who were asked the question; "Did you smoke, and if so, when did you quit?"

Of these patients 77% had a history of smoking in the past, but only 11% were current smokers. The "average" patient had quit smoking 18 years before the diagnosis of lung cancer. The former smokers were broken down further by how long they had been "smoking abstinent":

• 14% had been smoke free for less than a year
• 27% were smoke free for 1 to 10 years
• 21% were smoke free for 10 to 20 years
• 16% were smoke free for 20 to 30 years
• 11% were smoke free for 30 to 40 years
• 10% were smoke free for 40 to 50 years

The conclusion was that the majority of patients in this group had been smoke free for more than a decade prior to their diagnosis of lung cancer. It is important to note that this was a group that was referred for surgical treatment of lung cancer, and as such, were likely in the earlier stages of the disease.

Why is this important?

Lung cancer is most treatable in the early stages of the disease. Since we don't have a widely available safe and effective screening test at this time, it's important for individuals at risk to be aware of the symptoms of lung cancer.

It's also important as we work to dispel the stigma of lung cancer. How many of us have tactlessly made a comment about smoking to someone newly diagnosed with lung cancer?

Part of me hesitated to write about this study. I don't want to throw a black cloud over current smokers who are trying to quit. Because even if people who smoked in the past are at greater risk than never smokers for developing lung cancer, quitting makes a difference. What do the statistics say about quitting or cutting down upon subsequent lung cancer risk?

• What Percentage of Smokers Develop Lung Cancer?

If you smoked at some time in the past (or even if not because never smokers get lung cancer too...), take a minute to become familiar with the symptoms of lung cancer.

• What are Early Symptoms of Lung Cancer?
• Symptoms of Lung Cancer in Women
• Symptoms of Lung Cancer in Men

Photo: National Cancer Institute, Bill Branson (photographer)

_Source:

_{Mong, C. et al. High Prevalence of Lung Cancer in a Surgical Cohort of Lung Cancer Patients a Decade After Smoking Cessation. Journal of Cardiothoracic Surgery. 2011. 6(1):10.}

If you've been diagnosed with lung cancer, I'm sure you've wondered what else could possibly be done to improve your survival. What about all those supplements displayed in the health food store? Is there anything that is "missing" that could be combined with conventional medicine that might make a difference?

A new study looked at fish oil (did your grandma ever try to spoon feed you cod liver oil?) combined with chemotherapy to see if it would make a difference. This was a pretty small study - only 46 people - but the results said yes. In those people with advanced non-small cell lung cancer who were given fish oil supplements along with chemotherapy, both the response rate to treatment and 1-year survival rate were higher.

Clearly something worth looking at. But when I see studies like this I like to look at it from different angles. After all, it is hard to prove cause and effect. I like to add seaweed to the soups I make and don't have lung cancer, but that doesn't mean that seaweed prevents lung cancer. So what do studies say that have looked at fish oil and lung cancer from another angle?

On a population basis, fish oil has received a positive vote for people with lung cancer. An earlier study in Norway found that women who consumed cod liver oil daily for a year before their diagnosis of lung cancer had a 44% lower chance of dying from the disease.

In mice, the use of fish oil supplements has been evaluated, and the mice given fish oil supplements had a lower risk of developing lung cancer in the first place. Fish oil may have a preventative role in lung cancer. That is at least - in mice.

Sometimes the benefits of a nutritional supplement are limited to only symptoms and quality of life, and may not make a difference in survival. One study looking at a nutritional approach using fish oil supplements in people with stage 3 lung cancer found that they did indeed improve nutritional status.

Of course it is important to note that the use of any supplements for people with lung cancer should be considered only in the setting of a careful discussion with your oncologist. What works for one person could be detrimental to another. And just because many of these supplements are called "natural" doesn't mean they are safe. Poison ivy is natural but...you get my drift. Yet it can't hurt to ask your oncologist her opinion of this recent study.

Further Reading:

• Alternative Treatments for Lung Cancer - What Works?

_Source:

Photo: istockphoto.com

_{Mernitz, H. et al. Fish oil supplementation inhibit NNK-induced lung carcinogenesis in the A/J mouse. Nutrition and Cancer. 2009. 61(5):663-9.}

_{Murphy, R. et al. Supplementation with fish oil increases first-line chemotherapy efficacy in patients with advanced nonsmall cell lung cancer. Cancer. 2011 Feb 15. (Epub ahead of print)>}

_{Skeie, G. et al. Cod liver oil, other dietary supplements and survival among cancer patients with solid tumours. International Journal of Cancer. 2009. 125(5):1155-60.}

_{van der Meij, M. et al. Oral nutritional supplements containing (n-3) polyunsaturated fatty acids affect the nutritional status of patients with stage III non-small cell lung cancer during multimodality treatment. Journal of Nutrition. 2010. 140(10):1774-80.}