Expert Interview

Ask the Expert – James L. Mulshine, M.D.

What causes lung cancer?

“In close to 90 percent of cases, lung cancer is caused by the chronic irritation of tobacco smoking landing on the airway cells associated with smoking tobacco,” says James Mulshine, professor of internal medicine and associate provost for research at Rush University Medical Center. “A much smaller number of cases are due to asbestos fibers trapping in the lung or exposure of airway cells to radiation or other cancer inducing substances,” he adds.

I don’t smoke. I don’t really need to worry about lung cancer, right?

“This is pretty true as long as you do not have chronic exposure to second hand smoke, radon, asbestos or a few other exotic things,” Dr. Mulshine explains. “However, lung cancer risk is significantly lower even in smokers and people who eat a diet rich in fruits and vegetables.”

I’ve tried to quit smoking but it’s a hard habit to break. What resources are available for people like me?

“The most important resource is yourself and friends to help you quit cold turkey,” says Dr. Mulshine. Thankfully, there are a range of new tools including drugs that mirror nicotine effect, hypnosis, and support groups which help smokers kick habit. “The American Legacy Foundation, American Cancer Society, many state public health departments, your doctor and many other institutions have tools to help you quit,” Dr. Mulshine explains. “Search the web. Talk to your doctor. Talk to former smokers. Do everything you can to stop smoking as it is the most dangerous factor in leading to premature death in our society,” he adds. “One out of every two deaths before age 65 in our society is due to smoking.”

What can I do to help a friend or loved one quit smoking?

“Be a great coach and supporter,” suggests Dr. Mulshine. “According to the Surgeon General’s Report, smoking is one of the strongest addictions that exist. Heavy smokers may have to try a number of times before being successful,” he says. “No smoker is successful in quitting however, if they are not determined to do so. This is a challenging situation that requires profound respect for your smoking friend or loved one.”

“Keep in mind that now close to 50 million smokers have quit,” adds Dr. Mulshine. “While the cravings do continue in many, the overwhelming majority feel much better for the effort.” Dr. Mulshine also suggests asking a former smoker to help you with your friend or loved one’s smoking cessation plan. “Former smokers are the most credible and passionate advocates for smoking cessation,” he explains.

Isn’t lung cancer detectable only when it’s too late?

“The great news is that smoking cessation immediately starts paying health dividends,” says Dr. Mulshine. “The heart attack risk goes down immediately. The destruction of lung cells stops. However, the risk of lung cancer does not significantly diminish for an individual,” Dr. Mulshine explains. “Such a person should talk to their doctor about early detection options. The world of early detection with spiral CT for lung cancer is moving quickly.”