Hi,
Losing your mother and many of her siblings to cancer, and also having seen your father battle cancer, must
have definitely taken an emotional toll on you.
However, you must realize that being fatalistic about this issue is not the best response.
You have been smoking for a long time despite a strong family history. One of my patients in a similar
situation argued that "My mother never smoked, yet died of lung cancer. My uncle smoked heavily, yet
lived a healthy life till age 90. So why should I quit smoking?". It is difficult to convince such
patients. Cancer textbooks make statements like "Most lung cancers occur in smokers; Most smokers do not
develop lung cancer". So what does this mean in plain English? I will try to explain.
There are, broadly speaking, two ways human cancer develops. One is genetic, the other is environmental.
An example of genetic predisposition to cancer is FAP or Familial Adenomatous Polyposis. Most people with this
gene defect (in chromosome 5) develop colon cancer.
An example of environmental insult causing cancer is the atomic bombing of the Japanese cities in World War 2,
which were followed by a huge increase in leukemias and other cancers in survivors who were exposed to the
radiation.
A person blessed with very "good" genes may tolerate greater degree of environmental insult (like
prolonged heavy smoking), yet not develop cancer. Another person not so lucky, may inherit some "cancer
predisposing genes", and may develop cancer without ever smoking.
I suggest that you quit smoking. Take help for this if needed. And seek an internists appointment to evaluate
your current symptoms. Please go for regular checks.
