(Reuters Health) – Lung cancer patients at public hospitals, which serve a greater proportion of poor and disadvantaged people, are less likely to receive adequate treatment for pain and other symptoms than patients treated at a cancer center, according to a new study.

Patients at public hospitals were nine times more likely than the cancer center patients to come in with more-severe symptoms to begin with.

“I think it’s been noted…for the last couple of decades” that cancer “is less well managed in what we consider underserved patients,” said Dr. Charles Cleeland from MD Anderson Cancer Center in Houston, who led the study.

Underserved patients tend to be poor, single, unemployed, non-white, and receiving public assistance health insurance. They also tend to have low levels of formal education.

I’ve written a lot about the stigma of lung cancer. Yet, sometimes our perspectives change. Today I’m writing about the stigma of lung cancer in a new light. From the stance of a recently diagnosed breast cancer patient — me.
On one side, I have had the opportunity to experience a wee trace of the “stigma” of cancer. I’ve also been asked questions. “Do you have a family history of breast cancer?” “How long did you breastfeed your children?” “Were you exposed to pesticides as a child?” Of course nobody has asked if I smoked, or directly implied that I “caused” my cancer. But questions nonetheless.

Dianne Caridi, Sandy Uhl-Solomon and Caren Gorenberg all have something in common: none smoked and all developed lung cancer.

They are the personification of an alarming statistic — nearly 18 percent of female lung cancer patients have never smoked. Another 60 percent stopped smoking years or decades ago.

“I want people to be aware — it can hit anybody,” said Uhl-Solomon, 54. She was diagnosed with stage 4 cancer on March 24, 2010. She has had three surgeries, spent 28 days in the hospital and endured six months of chemotherapy. She is now back to running/walking five miles a day.

Fish oil may counter weight loss in cancer patients undergoing chemotherapy, according to a new study published in the online edition of the journal Cancer.

In the study, researchers at the University of Alberta in Edmonton, Canada, enrolled 40 patients with non-small-cell lung cancer. They were all in the early stages of treatment. Sixteen of those patients took 2.2 grams of fish oil per day, while the remaining 24 received standard care. The study, which lasted about 10 weeks, ran until the patients completed their initial chemotherapy treatments.

Smoking is such a well-known cause of lung cancer that many don’t realize thousands who never smoked get the diagnosis. The great majority are women. Recent research shows it’s really a different disease than smoking-related lung cancer. But those with the diagnosis say they suffer the same stigma.

RENEE MONTAGNE, host:

And here’s something else to consider: sometimes breathing problems signal some very serious and unexpected health problems. That’s certainly the case with lung cancer in people who have never smoked.

NPR’s Richard Knox has this story.

RICHARD KNOX: Jo Costello(ph) is 21. She’s a senior at UC Berkeley. She’s a member of the crew team. She never touched a cigarette, but she just got diagnosed with lung cancer.

Ms. JILL COSTELLO (Senior, UC Berkeley): I got back from national championships on June 1st, and then went to the trainer later that week with, like, abdominal bloating and just discomfort.

Ed Grace’s journey as a caregiver began in December of 2004 when his wife, Diana, a nonsmoker, was diagnosed with stage IV lung cancer.

Over the next 2 1/2 years, the semi-retired aerospace engineer experienced many of the same emotional highs and lows as his wife as she underwent endless rounds of chemotherapy.

Grace, who had worked on the Apollo moon program, says he initially approached his wife’s illness as a problem to be solved, just as he would tackle an engineering problem.

He quickly learned that her cancer had its own agenda. In a diary he later published online, Grace writes about trying to stay upbeat while fighting anxiety, depression, and stress during the toughest days of his wife’s illness.

Preliminary findings from the first clinical trial in lung cancer to use molecular analysis of tumor biopsy samples and an “adaptive” design to direct patients to a specific targeted therapy were presented at the AACR annual meeting in Washington, DC. In the study, dubbed BATTLE, patients had their tumor samples tested for specific biomarkers and were enrolled into one of four treatment arms, each one testing a different targeted therapy, based on that analysis. (See the box below.)

The first 97 patients to enroll in BATTLE were randomly assigned to one of the four treatment arms as would traditionally be done. After that point, new patients were assigned to one of the arms based on a statistical model called an adaptive Bayesian model. In addition to using the result of the biomarker analysis, the model made the assignment based on findings from patients who had already undergone treatment, which, as the trial proceeds, are fed back into the model.

Twelve years ago in this space I wrote about my mom undergoing surgery for lung cancer.

I talked about her enduring nine weeks of chemotherapy before the surgery to remove a lobe of one lung. I also discussed the emotional turmoil the dreaded C-word diagnosis puts a family through and how I desperately hoped she could go home from Luther Hospital cancer-free.

Lange Productions announces “Be a Survivor – Lung Cancer Treatment Guide.” The book’s uniqueness is the positive, upbeat, encouraging tone that motivates and empowers lung cancer patients and their loved ones. Until now, lung cancer patients were under-informed about their options, and under-motivated to seek out cures. Many struggle under the negative stigma that their disease was self-inflicted. Physicians may approach them with less optimism, citing poor survival rates, leaving patients uninformed, and under-encouraged.

Hearing the word cancer strikes fear in nearly everyone. Most women dread breast cancer, but lung cancer is the deadliest enemy for women and men. The stunning reality is it’s no longer a smoker’s disease as many families are learning the hard way.

NewsCenter 5 anchor Heather Unruh’s mother Dee was diagnosed with lung cancer two years ago.

“I felt I needed to prop you two up. And your dad,” Dee said about the day she had to tell her daughters and husband what the doctors had found.

The news was especially stunning because Dee Unruh does not smoke.

“There is a stigma. No matter what. And the first question people always ask is, ‘Do you smoke?’ or they’d say, ‘But you don’t smoke,’” she said.

Neither do 60 percent of new patients, experts said.