Lung Cancer

People's ideas about the causes of lung cancer

Research has shown that the major cause of lung cancer is smoking and the use of tobacco. Smokers and ex-smokers are at greatest risk of developing the disease. For those that give up smoking for 15 years  or more the chance of developing the lung cancer is similar to that of a non-smoker. Some of the people interviewed here were sure that their lung cancer had been caused by smoking.

He believes that smoking and later passive smoking caused his lung cancer.

He believes that smoking and later passive smoking caused his lung cancer.

Age at interview: 75
Sex: Male
Age at diagnosis: 69
SHOW TEXT VERSION
PRINT TRANSCRIPT
Well I don't think there's any doubt that my lung cancer was caused through smoking. I was like many other people, I didn't smoke as a young lad and I was called up into the services and we were given by the government then one hundred and fifty, we had fifty free issue cigarettes every week and we were given one hundred and fifty at a very cheap price when we were serving abroad. And of course boredom sets in with nothing much to do in the evenings and you just sit and smoke one after the other. That continued of course after I left the service, you get the habit, you carry on smoking.  

It was the in thing in those days all through the fifties and sixties for people to smoke, and of course I was one of the people caught up in it. In 1967 I took a public house and of course the atmosphere in a public house didn't help matters. I did in fact give up smoking in the, in the late seventies, completely myself, and although I gave up smoking because I had read so much about problems, it was obviously too late. And another thing was that my occupation at the time meant that I was taking, although I wasn't smoking I was taking in other people's smoke anyway.

There are other risk factors for the causes of lung cancer such as age, genetic risk, past cancer treatment and previous lung disease like TB (tuberculosis). It is also known that mesothelioma (a form of lung cancer) is caused by contact with asbestos. It can develop many years after exposure to asbestos.

Explains that mesothelioma was caused by contact with asbestos.

Explains that mesothelioma was caused by contact with asbestos.

Age at interview: 55
Sex: Male
Age at diagnosis: 54
SHOW TEXT VERSION
PRINT TRANSCRIPT
But my particular cancer, mesothelioma, is not caused through smoking, it is caused through working with asbestos when I was a young man. I did an apprenticeship in engineering and also welding when I was 16 and I worked for the same company till I was 26 but for the first five years I was there, I was an apprentice, but the factory actually run on steam; everything, we used to make tyres so everything was run on steam.  

And in those days, back in 63/64, everything was lagged in asbestos. The boilers that we had was lagged in asbestos, all the pipe-work was lagged in asbestos, even the roof was lagged in asbestos so you just couldn't avoid it. Any pipe-work leaks we had we had to knock the asbestos off with a hammer, sawed a bit of bad pipe-work out and re-weld a new piece in. The worst, the worst exposure really was every two years, I worked there ten years so if you like five times I was exposed to, when we did insurance testing for the boilers. Because on the outside of the boiler it was, the lagging was six inches thick and it was, because we were young kids, apprentices and that, it was our job to strip all that off. And they're very large steam boilers and we'd spend a week nearly just hacking and pulling all this asbestos off, lagging off the boilers. And then once you get down to the boiler itself you'd be wire brushing the rivets and the seams, and all that, ready for pressuring it for insurance testing.  

And I mean as kids we just, we played in it, we'd be knee deep in it some days and we'd be throwing it at each other and just messing about in general with it. Nobody realised at the time that it was, that it was going to be a problem later on in life. And of course with asbestos the incubation period is between thirty and forty years so you can be quite happy as I was for forty years nearly and then it just changes your life without any warning at all really.

People may develop lung cancer without ever having smoked themselves. The impact of environmental tobacco smoke on health has been disputed, but one man was told that his cancer had developed because of passive smoking. He felt annoyed and stigmatised when a doctor assumed he had been a smoker, (also see 'Feelings of stigma, shame and guilt about having lung cancer').

He is sure that lung cancer patients are stigmatised because of smoking.

He is sure that lung cancer patients are stigmatised because of smoking.

Age at interview: 56
Sex: Male
Age at diagnosis: 42
SHOW TEXT VERSION
PRINT TRANSCRIPT
Yeah me feelings on it, I said, talking about, I think cancer does have a stigma attached to it. I know in my own instance, with lung cancer, I think all lung cancer patients are stigmatised because of smoking. Attitudes from other people who are non-smokers as I was, mine was, I was told mine was through passive smoking.

When I went to the, to see an oncologist for further treatments because I'd had an operation and I'd had half of my left lung removed, I asked them what he thought what caused it and he just laughed and said 'That's obvious, through smoking.' And me wife who was with me at the time, and we've been together since we were 14 and she just said 'Well he's never smoked'.

So right away what I was, annoyed me as well as that, on my, my medical records I'm classed as a smoker and every time I ever went for review after that they would ask me 'Are you still smoking?' because that's down there. And no matter how I told them, I'd say 'Look I don't want that on there, I never smoked.' but its only my word that can go against that, that says that.

Radon gas is the second biggest cause of lung cancer after smoking (although this number is still very small compared with smoking). Radon is a naturally occurring gas that is released from areas where there is a lot of granite such as the West Country and the Peak District. Exposure to high concentrations of radon can increase the risk of developing lung cancer. If you are worried about the level of gas in your home you can get a radon detector from the radiation protection division of the Health Protection Agency. They can also advise you on what you can do to reduce the risk.

 
Exposure to substances such as asbestos, uranium, chromium, nickel, diesel exhaust fumes, silica and synthetic fibres has been linked to the disease. These are rare causes of lung cancer because you would normally only come across these chemicals in large amounts if you worked with them, and not many people do. Pollution, both inside and outside the home, can probably increase the risk of lung cancer. Some people said that although health professionals had told them that their cancer was due to smoking, they believed that other factors, such as diesel fumes could have 'triggered' the disease. Many had given up smoking before their mid 40's and some did not believe that smoking could have caused their cancer.

Thinks his lung cancer was caused by smoking and other factors such as diesel fumes.

Thinks his lung cancer was caused by smoking and other factors such as diesel fumes.

Age at interview: 57
Sex: Male
Age at diagnosis: 56
SHOW TEXT VERSION
PRINT TRANSCRIPT

I started smoking when I was 12 years old, back in the 60s, in fact back in the 50s, God am I that old, back in the 50s. It was just one of those things in those days, everybody did it. Like nowadays everybody doesn't do it, which is a darn good thing. And I walk along here seeing the kids around here who are all smoking and I thought you bloody fools, if only you knew. But trying to talk to them is like talking to a brick wall, they just don't want to know.

Did you smoke till quite recently?

I smoked up until let's see now, I think smoked up until three years ago when I actually went, I actually stopped, I went on Nicotinell patches and actually stopped smoking for a year and a half. And then I started smoking, but I was only, I was smoking roll-ups, I wasn't smoking normal cigarettes I was smoking roll-ups. But I must admit, and I shouldn't do it, I still have the occasional one now, it's only the occasional one though. I shouldn't do it but after 40 odd years it's a hard habit to break even though you've got all the tablets and all the wonderful things in the world to stop you from doing it.   

But that's what they reckoned caused it was smoking. But it could've been anything basically. I used to work you know with asbestos but I know it's not that because they would've picked that up on the bronchoscopy, they would've picked it up on that. I was in the Army so you know fumes, diesel, gasoline, the whole business, the whole schmuck all the way through, it could've been anything there that done that, something just triggered it. But they reckoned I'd had it for about nine years, but this was, this was just the, this was the top end of it, this was it saying enough is enough do something about it or the body do something about it.  

And as I said it was a shortage of breath that May trip. I'd come up those stairs and I thought what is wrong with me? I said "I've never been like this before." Of course I thought I had this viral infection in the throat. Well I put it down to, I put it down a certain amount to smoking, it must be. Smoking, the environment as well, diesel fumes, it's got to be something there.
 

Some of those interviewed here were heavy smokers, but adamant that environmental factors and chemicals, such as spray paint, carbon dust, or asbestos, had contributed to their condition. A few people were angry that on occasion doctors appeared to be judgmental and unsympathetic, blaming them for their disease. However, one person's doctor had said that smoking and tobacco were not necessarily to blame.

Says that other factors such as environmental pollution, chemicals in food may be to blame as well as tobacco companies.

Says that other factors such as environmental pollution, chemicals in food may be to blame as well as tobacco companies.

Age at interview: 55
Sex: Female
Age at diagnosis: 50
SHOW TEXT VERSION
PRINT TRANSCRIPT

Well it were upsetting. I've been in hospital quite a few times for different things, nothing as serious as that, and I have never been addressed in a way that I felt uncomfortable about something I'd done and he [the doctor] made me feel that I'd brought it all on myself. Since then being involved with, can I say Roy Castle Lung Foundation, and also my own support group and the Macmillan campaigners that basically lung cancer patients find themselves in the position where they feel that they've caused it all themselves. And where you know some cancers, people are very sympathetic towards, like ladies having breast cancer and it's very highly backed by the normal public you know, when it comes to charities and donations and what have you, lung cancer is like the bridesmaid, never a bride, you know it's like the poor relations of cancers. They don't get funding like other cancers get and probably that's because we feel that it's our fault. But at the end of the day it's not our fault it's the tobacco manufacturers' fault for putting the carcinogen in, sorry carcinogens in, in the first place.  

We [in our support group] all agree that there's other things other than smoking that can cause lung cancer you know like environment, like where I live there's a motorway over the road. Just over the bridge there used to be a chemical factory, all my life you know when I were a child growing up round here, and it were pumping thick yellow smoke out 24 hours a day. And unfortunately in this area there is quite a lot of people do get lung cancer you know, it's quite common. But you don't find that out until you've actually got it yourself, because nobody wants to talk about it so you know.

So you think the environment is also [to blame]?

Oh certainly yeah and along with everything you put in your mouth like stuff they they're putting on food to give it a longer shelf life, things that they're doing to make them all the same size and the same shape, all the chemicals that you get from that you know from that source. So yeah I think there's a lot of other things, why it's more rampant now than it's ever been before you know.
 

Diet may play a part in the incidence of lung cancer. Some evidence suggests that high consumption of saturated fats, and a low intake of fruit and vegetables increases the risk of the disease. One man thought that his diet may have played a part in causing his lung cancer.

Thinks his lung cancer was caused by smoking and another factor such as a poor diet.

Thinks his lung cancer was caused by smoking and another factor such as a poor diet.

Age at interview: 48
Sex: Male
Age at diagnosis: 48
SHOW TEXT VERSION
PRINT TRANSCRIPT
Apart from cigarettes have you ever thought about other sort of causes of lung cancer, can you just talk about your thoughts around that?

Yes the surgeon did say to me that cigarette smoking certainly hadn't helped but he was pretty sure it was cigarette smoking and AN other and he was equally sure that he wouldn't be able to identify what that AN other was.

AN other?

Another, another area, another causal agent for the cancer. I suspect poor diet will have had some you know part to play. I'm not a great eater of fruit and vegetables and that is, they definitely minimise the likelihood of the development of lung cancer.  And I was, and I'm a terrible dairy products man but that's changing now.

Other suggestions by the people we interviewed about the causes of lung cancer included stress, bereavement, physical trauma and faulty genes. One woman was convinced that her cancer had been caused by a clot on the lung.

She thought it was not just due to smoking, but was hereditary.

Text only
Read below

She thought it was not just due to smoking, but was hereditary.

Age at interview: 68
Sex: Female
Age at diagnosis: 66
HIDE TEXT
PRINT TRANSCRIPT

Do you ever think what might have caused the lung cancer?

Well I don't really know. I mean even the specialist said that, I said to him "What have I done?" I mean I know smoking doesn't help but I mean he said it's not only smoking, he said it could be other things like food or you know like in the air or like from exhaust from cars and, nobody can put their finger on it I don't think.

What did you say to him?

I said, "Well I always thought it was hereditary but there's no cancer in our family at all." Chest we've all, I mean my son has got emphysema but no there's no cancer in our family. My mother died of her chest but there you are.

A few people had no idea why they had developed lung cancer. They suggested that cancer was 'one of those things', 'a cell gone awry', or 'just something that happens'. One person suggested that her lung cancer might have been caused by an attack of Asian flu. Some pointed out that people can smoke all their lives yet not develop lung cancer.

For more information sources see our Resources page.
 

Last reviewed May 2016.

Last updated May 2016.

Copyright © 2024 University of Oxford. All rights reserved.