[HN Gopher] Lung cancer in never-smokers: a hidden disease (2019)
       ___________________________________________________________________
        
       Lung cancer in never-smokers: a hidden disease (2019)
        
       Author : YeGoblynQueenne
       Score  : 122 points
       Date   : 2021-05-03 10:28 UTC (12 hours ago)
        
 (HTM) web link (journals.sagepub.com)
 (TXT) w3m dump (journals.sagepub.com)
        
       | calibas wrote:
       | Various scientists and organizations have been yelling for years
       | that air pollution is one of the leading causes heart disease and
       | cancer. It's not "hidden", it's being ignored...
       | 
       | https://www.iarc.who.int/wp-content/uploads/2018/07/AirPollu...
        
         | throwawaysea wrote:
         | Does the possibility of other causes (like air pollution) also
         | mean that some portion of lung cancer incidents are
         | misattributed to smoking, overstating its dangers by some
         | amount?
        
           | hammock wrote:
           | Smoking increases your risk of cancer from air pollution, so
           | it's not so simple
        
         | hammock wrote:
         | Radon is the second leading cause of lung cancer
        
         | hammock wrote:
         | Air pollution was a huge issue when I was growing up as a kid,
         | the #1 environmental cause. At some point people stopped
         | talking about it and focused mostly on global warming.
        
         | agumonkey wrote:
         | Do you, or anyone around here, use air cleaning devices in your
         | homes ?
        
           | gher-shyu3i wrote:
           | It's not hard to build a DIY air filter with a box fan. Lots
           | of videos on youtube.
        
           | calibas wrote:
           | I have an air quality monitoring device and I live in a place
           | with clean air, so I just open a window. A PM2.5 of 2.318
           | (ug/m3) inside my room at the moment.
        
       | [deleted]
        
       | bokchoi wrote:
       | My father also died last year from lung cancer and never smoked
       | in his life.
        
         | gadf wrote:
         | Sorry for you to hear that :(
        
       | knolan wrote:
       | Here in Ireland we have a lot of limestone and new houses must
       | have radon barriers in their foundation. People living in older
       | houses without them are susceptible to lung cancer. Growing up my
       | parents always kept our windows open when possible. My
       | grandmother, a non-smoker, died of lung cancer.
        
         | coldcode wrote:
         | My mom died of lung cancer (actually brain cancer which often
         | is the end result) but never smoked; however her father smoked
         | all his life, and my dad smoked for decades before quitting. We
         | never did figure out where the original cancer came from. End
         | stage lung/brain cancer is a terrible way to go, which is why I
         | have zero idea why anyone smokes at all.
        
           | TaupeRanger wrote:
           | If you don't die from lung cancer you'll die from some other
           | terrible thing. I don't smoke but I can see why, if it gives
           | someone satisfaction and/or relaxation, they would be willing
           | to risk that kind of death in exchange for a lifetime of
           | mental hacks (though there are arguably safer methods of
           | similar efficacy).
        
             | usgroup wrote:
             | Unfortunately smoking doesn't really do that either. I'd
             | say it has close to no benefits from a day to day cognitive
             | perspective anecdotally. I think it's the same for coffee.
             | 
             | Great for socialising though . Smokers have more fun at
             | parties since you end up chatting to other smokers whilst
             | outside in sub zero weather sucking on your death stick.
             | 
             | And damn do I miss a cig after dinner
        
               | anders_p wrote:
               | I was a smoker for 20 of the 45 I've been alive. Around 1
               | pack a day.
               | 
               | It was exactly the social aspect of smoking that I liked
               | the most, now that I look back at it.
               | 
               | Smokers have an easier time establishing a bond, when
               | placed in new groups like work or school. They meet up at
               | the designated smoking spot and chat while smoking. It's
               | a great ice breaker.
               | 
               | I found that I had an easier time, when having to do
               | group work, than non-smokers since there was already a
               | loose connection with the other smokers. It was always
               | the non-smokers, who were having difficulty finding group
               | mates.
               | 
               | I now vape on an e-cigarette instead. Still go with the
               | smokers, so I have not lost the social benefits :)
               | 
               | I highly recommend giving e-cigarettes a try, for any of
               | you smokers out there, who are having a difficult time,
               | quitting the habit.
               | 
               | I'm aware that it's in no way healthier, but am convinced
               | that it's less damaging. Anecdotal, yes, but it sure
               | feels like a better alternative. Tried nicotine gum,
               | band-aids etc., but I guess there was more to my
               | addiction than just the nicotine. The rituals of inhaling
               | and fondling with something. It's the only thing that's
               | worked for me.
        
               | anders_p wrote:
               | Correction. Can't edit, but the last paragraph should've
               | been:
               | 
               | "I know that it's in no way HEALTHY*, but..."
        
               | pvarangot wrote:
               | I got one of those vape things people use for dry weed
               | that gets up to 405F and vape dry rolling tobacco. You
               | can do it inside as it doesn't smell or the smell is
               | pleasant or you can use as an excuse to go hang out with
               | the other smokers too.
               | 
               | You also are only burning tobacco and inhale almost no
               | plant matter. I would give it a try. I feel better with
               | that than with e-cigs.
        
               | TaupeRanger wrote:
               | What? Who are you responding to? I said it helps one
               | relax and/or gives satisfaction, and then you said "it
               | doesn't do that" (using a personal anecdote as evidence?)
               | but then your last sentence suggests you did actually
               | experience those things you said you didn't? I can't
               | understand what your point was here.
        
               | m00dy wrote:
               | Your comment made me smile :)
        
               | halikular wrote:
               | You have more fun in the actual party inside.
        
             | Robotbeat wrote:
             | Man, lung cancer and stomach cancer are two of the worst
             | ways to go...
        
               | TaupeRanger wrote:
               | Not much different than other ways of slowly dying TBH.
               | They're all mostly horrible.
        
               | da_big_ghey wrote:
               | i have knew persons who were dying in peace while sleep.
               | i only am hoping i shall be this fortuneate.
        
               | refurb wrote:
               | That happened to my grandfather as well. 3 pack a day
               | smoker and died in his sleep at 70.
               | 
               | But I agree otherwise. My wife's parents both lived into
               | their late 90's but had lost most of their cognitive
               | ability for the last 5 years - so much they couldn't live
               | independently. Not sure that's a great alternative death.
        
             | halikular wrote:
             | The nicotine is what CAUSES the stress in the first place,
             | and you have to relive it by smoking or ingesting the
             | nicotine in another way. So essentially what you have done
             | is raised the baseline stress level and you temporarily
             | lower it when you get your nicotine. Then the stress levels
             | will be ascending proportionally to the nicotine
             | concentration in your blood which is constantly metabolized
             | and descending. Nicotine has a half life of about 1-2
             | hours, so it doesn't last very long.
        
               | TaupeRanger wrote:
               | Hard to follow this. Do you mean the _lack_ of nicotine
               | causes stress during withdrawal? Of course it does, but
               | that doesn 't mean a person can't get a net overall
               | decrease in stress by smoking regularly. I'm not
               | suggesting it of course, but I can understand the
               | personal motivation of someone who does.
        
               | halikular wrote:
               | The nicotine levels rapidly decrease just minutes after
               | smoking and stress levels are beginning to climb in
               | response until you smoke another cigarette. The cycle
               | repeats and the average stress levels over time than for
               | a non-smoker. If you're addicted you always stress about
               | when you are getting your next dose of nicotine.
        
         | vharuck wrote:
         | It's a good idea to test basement radon levels when buying a
         | new house. In my state, it's a check box on the required
         | paperwork, so every buyer can see it's an option. The tests are
         | cheap and quick. Check with your state for any help with
         | finding testers or paying for the tests and mitigation systems.
         | 
         | Radon levels vary a lot. In Pennsylvania, the worst areas lie
         | along the Appalachians, but even then neighboring houses can
         | have huge differences in radon. So even if your soon-to-be
         | neighbors didn't have a problem, do the test.
        
         | verelo wrote:
         | Glad someone brought up radon. No one knows about it. Get a HRV
         | or ERV and ideally slab depressurization, Google the terms if
         | unfamiliar folks! Enjoy the diy projects haha
        
           | dboreham wrote:
           | Slab depressurization (essentially creating a partial vacuum
           | under a building's concrete slab floor) can work very well.
           | These days usable radon concentration meters are quite
           | affordable. I used one in a building I own to verify the
           | effectiveness of a slab depressurization system. It reduced
           | measured radiation levels to a small fraction of the
           | baseline. Of course you need a building with a slab
           | foundation to use this technique.
        
             | verelo wrote:
             | Yeah it's an amazingly simple approach. I did it in a house
             | i renovated, the building inspected tried to stop me as he
             | wasn't familiar with the system and thought it would
             | actually allow radon in. Turns out he had a family member
             | die from lung cancer and they believed they was a possible
             | link. I expect at some point it'll be part of most modern
             | building codes where there is a basement connecting to a
             | living space.
        
         | secondcoming wrote:
         | My parents house was part of a national radon survey in Ireland
         | back in the 90's I think. I had a small little black
         | monitor/'counter' in my bedroom for maybe a year (I'm a bit
         | fuzzy on the details). Anyway, they sent us the results when
         | the experiment ended and we sent the device back.
         | 
         | The results were quite bad I seem to recall (I may be mis-
         | remembering according to [0]) Our house was in rural Cork and
         | was build by my parents in the 80's.
         | 
         | My father died from lung cancer but he was a heavy smoker; my
         | mother smokes very occasionally and she's fine.
         | 
         | However, my aunt, who lived next door, maintained a very
         | healthy lifestyle and also died of lung cancer; her husband is
         | also fine.
         | 
         | [0] https://www.epa.ie/radiation/radonmap/
        
       | dccoolgai wrote:
       | Don't forget asbestos, which despite all the hubbub never got
       | banned. It's used in all kinds of stuff and just one or two
       | microfibers of it in your lungs and your fate of a slow painful
       | death is sealed.
        
         | the-dude wrote:
         | > just one or two microfibers of it in your lungs and your fate
         | of a slow painful death is sealed.
         | 
         | Hell of a claim. Sources?
        
           | Someone wrote:
           | https://www.britsafe.org/publications/safety-management-
           | maga...:
           | 
           | * In July 1984 the Health and Safety Executive (HSE)
           | published an update to guidance note EH10, Asbestos - Control
           | Limits, measurement of airborne dust concentrations and the
           | assessment of control measures, which introduced a limit
           | value of 0.01 fibre/ml.*
           | 
           | That's 100 fibers/liter, so at least that with every breath
           | you take.
           | 
           | Because of that, I think that, if that claim is true, it only
           | is if you wouldn't die of something else first.
        
             | stordoff wrote:
             | The stance of the HSE in 2010 is worth mentioning:
             | 
             | > There is a lack of scientific consensus as to whether
             | there exists a threshold of exposure to asbestos below
             | which a person is at zero risk of developing mesothelioma.
             | However, there is evidence from epidemiological studies of
             | asbestos exposed groups that any threshold for mesothelioma
             | must be at a very low level - and it is fairly widely
             | agreed that if a threshold does exists then it cannot
             | currently be quantified. For practical purposes HSE does
             | not assume that such a threshold exists.
             | 
             | https://web.archive.org/web/20111030182149/http://www.hse.g
             | o...
        
           | dccoolgai wrote:
           | >The one asbestos disease that is different is mesothelioma.
           | Very small amounts of asbestos can give you mesothelioma.
           | Asbestos workers' families have gotten mesothelioma from the
           | dust the workers brought home on their clothes.
           | 
           | https://www.health.state.mn.us/communities/environment/asbes.
           | ..
        
             | the-dude wrote:
             | The magic word there is of course _can_. Although both
             | asbestos and mesothelioma are very nasty, I fail to see
             | evidence for your claim that _your faith is sealed_.
        
             | shawnz wrote:
             | https://thorax.bmj.com/content/58/9/809#xref-ref-7-1
             | 
             | > Necroscopic studies have led to the determination of
             | asbestos fibre load and the demonstration of a dose related
             | effect, thus making improbable the argument that
             | mesothelioma only requires one fibre of asbestos for
             | initiation of the malignancy.
             | 
             | Furthermore, asbestos exposure in urban settings is very
             | common:
             | https://www.atsjournals.org/doi/10.1164/arrd.1980.122.5.669
             | 
             | > We isolated uncoated asbestos fibers from the lungs of 21
             | urban dwellers who had fewer than 100 asbestos bodies/gram
             | of lung, a level shown previously to be associated with
             | environmental rather than occupational exposure to asbestos
        
               | dccoolgai wrote:
               | Considering that Mesothelioma can take 30+ years to
               | manifest, that info about exposure being common does
               | _not_ improve my day.
               | 
               | The truth is, it's hard to unravel: especially with 100s
               | of billions of dollars on the line in liability, there is
               | probably some "sugar science" going on - maybe on both
               | sides even.
               | 
               | What I _do_ know is that: 1. It's harmful af (regardless
               | of "how much" the research says, the fact is: harmful
               | af). 2. Everyone thinks it's banned, but it's not. 3.
               | Some people make billions of dollars continuing to use it
               | (enabled by #2) 4. I'm not in the set of people described
               | in #3
               | 
               | I'd like it to be banned.
        
               | shawnz wrote:
               | I certainly agree with all that. It should be banned.
        
         | Phurist wrote:
         | AFAIK inhaling in some fibers usually shows an effect after
         | around 20 years. If you breathed in a lot of them (working with
         | asbestos without protection for a long period), then you will
         | most probably start experiencing some breathing problems first
         | of all. Absestosis I think is the correct term ?
         | 
         | Actual cancer would depend on a lot of different additional
         | factors.
        
           | dccoolgai wrote:
           | Mesothelioma is a particularly nasty form of lung cancer.
           | Asbestosis is dose-related, but mesothelioma is not. Details:
           | https://www.health.state.mn.us/communities/environment/asbes.
           | ..
        
         | ornornor wrote:
         | The town of asbestos in Quebec (which they renamed last year
         | because it was too shameful) had one of the largest (the
         | largest?) asbestos mine in the world. It closed in 2011 with
         | plans from the government to inject close to 60 million $ to
         | reopen it... it didn't go through because the party that
         | promised it lost the elections to the party that promised NOT
         | to do it, but note that the question of whether anyone would
         | still buy asbestos never entered into consideration. So yeah
         | all this asbestos must be going somewhere if it's still
         | profitable to mine.
        
         | mschuster91 wrote:
         | > Don't forget asbestos, which despite all the hubbub never got
         | banned.
         | 
         | I was a bit astonished by that claim since I had thought that
         | the entire developed world has banned asbestos usage for
         | _decades_... turns out that while the US does have bans on
         | certain products, there is no federal ban on the stuff (https:/
         | /en.wikipedia.org/wiki/Asbestos_and_the_law_(United_S...).
         | 
         | Jesus. WTF?
        
           | colechristensen wrote:
           | Asbestos is an almost magical material and if handled
           | carefully (say similar levels that medical workers have to
           | take for covid, surgeries, microbiology, etc) there isn't
           | much risk. It shouldn't be in common construction or
           | household materials but i'm not too worried about specialized
           | industrial applications.
        
             | nate_meurer wrote:
             | No, there is nothing magical about asbestos. There is no
             | application for it that can't be performed just as well by
             | safer synthetic mineral fibers.
             | 
             | The only thing special about asbestos is its extremely low
             | cost.
        
           | nicolas_t wrote:
           | In a similar vein, Japan only stopped using Asbestos in
           | construction materials in 2005. So anyone buying an old house
           | in Japan is pretty much guaranteed to have Asbestos...
        
             | ComputerGuru wrote:
             | Good luck finding an old house in Japan!
        
               | nicolas_t wrote:
               | I mean old by the definition of Japan. As in > 30 years
               | old :)
        
         | agumonkey wrote:
         | stupid warning for the vintage crowd, lots of device had
         | asbestos in the materials (among other toxic substances now
         | banned), be careful
        
       | gadf wrote:
       | Could microplastics, aerosolized in seawater be playing a role in
       | this? I saw something that most of the non-smoking related lung
       | cancers are in coastal regions
        
       | tr14 wrote:
       | My great grand mother died from lung cancer and never smoked one
       | cigarette in her life. She was a humble and very sober woman. (no
       | alcohol, no tobacco or drugs, just her medication). The reason,
       | why she died of lung cancer is, that the area, where she grow up,
       | was near coal mine & chemistry plant. LVL 89 tho, nice age
       | anyways. RIP Grandma. On the other hand, my neighbor from the
       | rural area, where my mother was born & raised, lived all the way
       | up to LVL 93. He had one shot of hard liquor every day and smoked
       | exactly 3 cigarettes a day. His calm live and routines granted
       | him a superior lifespan. He died from age, calmly in the bed,
       | with relative good health for his level.
        
         | secondcoming wrote:
         | LVL?
        
           | meepmorp wrote:
           | Level. Like in a video game. Don't you think of the lifespans
           | of your friends in family and terms of video game levels?
        
             | theandrewbailey wrote:
             | No. Leveling up implies some sort of growth or improvement.
             | We all know people where one year older doesn't mean they
             | leveled up.
        
               | username90 wrote:
               | Level in games doesn't necessarily correlate with skill.
               | People can build their character badly and end up with
               | subpar skills for their level.
        
               | lloeki wrote:
               | People are still figuring the rules for the game as it
               | came without any manual:
               | 
               | https://www.reddit.com/r/outside
        
           | dmichulke wrote:
           | In a way life is about maxing skills and avoiding perma-
           | death.
        
             | tr14 wrote:
             | thanks, you feel me.
        
               | dmichulke wrote:
               | No offense intended, I just felt your motor memory wrote
               | LVL but you meant age. I apologize.
        
               | tr14 wrote:
               | None taken.
        
             | wiz21c wrote:
             | Well, I tried to ascend one or two times, but never did it
             | :-)
        
           | [deleted]
        
           | eplanit wrote:
           | Me too... some mysterious synonym for "years"?
        
             | aflag wrote:
             | I think it means level. I assume the reason to say that is
             | that having a higher level in a video game is considered
             | good, whereas it is common for people to discriminate
             | against people of more age.
        
         | techrat wrote:
         | > His calm live and routines granted him a superior lifespan.
         | 
         | My mean, spiteful and horrendous grandmother in law was nothing
         | but pure bile and hatred. Every day she lived her life in
         | perpetual outrage and never had a moment's peace.
         | 
         | She lived to 96.
        
           | PedroBatista wrote:
           | She probably outsourced the hate and outrage to those around
           | her, inwards she was 100% peace.
        
             | alejohausner wrote:
             | This is known as _projective identification_.
        
           | monopoledance wrote:
           | Those people may actually be able to offload stress, anxiety
           | and worries...
           | 
           | I fear most evil folks sleep well at night.
        
             | reddit_clone wrote:
             | That's my theory too. Mean people cause stress to others
             | and send them to early graves. They themselves live free of
             | illness causing stresses.
             | 
             | Karma is something people invented for some temporary
             | solace.
        
           | cm2012 wrote:
           | Yep. My wife's grandma is probably the most evil human being
           | I've ever met in person, and she's very healthy now at 88.
        
         | vcxy wrote:
         | I grew up in WV. I have many friends from near the DuPont
         | plant. We like to joke about how we grew up drinking dupont
         | water...kind of morbid though since it's pretty true.
        
         | xroche wrote:
         | > was near coal mine
         | 
         | In Europe, coal typically kills more than 20,000 people _every
         | year_:
         | https://www.theguardian.com/environment/2013/jun/12/european...
         | 
         | [ And yet Germany and Belgium decided to end nuclear energy
         | because people are afraid of the "risks", but keep coal plants.
         | ]
        
           | hkt wrote:
           | Germany and Belgium have cultural hangups about nuclear that
           | relate to the fact most Germans (and probably also Belgians)
           | felt they'd be the first to die if there was a nuclear war.
           | Not that this excuses them from being reasonable, of course,
           | but it is worth keeping in mind just how occupied by the
           | threat of nuclear annihilation many people in those countries
           | were, and for how long.
        
             | Robotbeat wrote:
             | I'm a fan of nuclear, and I suspect you're right. The
             | reasons people say they oppose even existing nuclear (cost,
             | waste, safety) don't usually pass scrutiny. I suspect it is
             | primarily due to their association with nuclear weapons. It
             | instills a pretty deep fear, which I don't entirely blame
             | them for. ...however it has pretty terrible health,
             | environmental, and economic consequences to prioritize
             | nuclear phase out over fossil fuels (especially coal).
        
               | hanniabu wrote:
               | The reason I'm against nuclear power is the human greed
               | factor. See my past comment for more details and sources:
               | 
               | https://news.ycombinator.com/item?id=26348520
        
               | da_big_ghey wrote:
               | we are having way to ensure beter compliance. may be we
               | need for to make nuclear executive responsible with jail
               | time if requirements broken. certainly nuclear safety has
               | more importance than sox compliance.
        
               | Robotbeat wrote:
               | I find none of this convincing. Industrial accidents
               | happen with all thermal power plant types. And coal ash
               | disposal has a _worse_ track record than nuclear waste.
               | (Coal ash being naturally radioactive!) And the aerosols
               | produced from coal transport and burning are a continual
               | problem of lung cancer.
               | 
               | Nuclear is remarkably well-regulated by comparison. I
               | understand why people may want to get rid of it
               | eventually, but compared to coal, it's sunshine and
               | rainbows.
        
           | bildung wrote:
           | At least for Germany this isn't true, both nuclear and coal
           | are phased out with about the same end date.
        
             | Robotbeat wrote:
             | Why would you not prioritize ending coal first??
        
               | bildung wrote:
               | Because Fukushima provided a once-in-a-lifetime
               | opportunity for politicians to go against the local
               | energy giants without them being able to gain the upper
               | hand in the inevitable fight about the narrative in the
               | local media. This is all power politics.
        
             | 00jimbo wrote:
             | it doesn't work quite like that, though; while nuclear is
             | down to ~13%, a quarter of the german energy sector is
             | still burning coal. in fact, the plan to shut down fossil
             | fuels was hindered by (imo) the short-sighted view to
             | curtail nuclear before it was necessary.
        
               | bildung wrote:
               | Coal is down from 45% in 2013 to 23% in 2020.
               | https://en.wikipedia.org/wiki/Energy_in_Germany
               | 
               | During the same time, nuclear is down from 17% to 13%.
               | https://energy-
               | charts.info/charts/energy_pie/chart.htm?l=en&...
               | 
               | Still too little too late in my opinion, but one has a
               | hard time arguing that nuclear plays a role here at all.
        
               | 00jimbo wrote:
               | the point i was making was less that this speedup of
               | nuclear draw down was problematic so much as the whole
               | viewpoint that ending advancement of nuclear power as a
               | whole. germany limiting the lifespan and new construction
               | of nuclear power dates back to the early 2000s, fukushima
               | just reset the timelines back to the original 2022
               | closing dates.
        
             | collyw wrote:
             | I find it quite amusing that Germany seems to be very anti-
             | nuclear as a culture, yet they are right next door to
             | France which has plenty of Nuclear power plants.
        
               | fileeditview wrote:
               | And many Germans absolutely loathe the French reactors.
               | Especially because France loved to place many of them
               | directly at the border to Germany. There were several
               | news pieces over the past century where the condition of
               | some of those reactors was questioned.
        
               | est31 wrote:
               | FTR Fessenheim has been shut down in 2020. As for
               | Cattenom, it's still operating.
        
               | xroche wrote:
               | > condition of some of those reactors was questioned
               | 
               | The nuclear security agency in France is one of the
               | toughest in the world, and is independent. They notably
               | demand "current" state-of-the art security for all
               | nuclear plants (vs. state-of-the-art at the time of
               | building in the US, typically)
               | 
               | French nuclear plants typically never killed anyone (and
               | will never), unlike German coal plants (which are at
               | least partially responsible for the 22,000 coal-related
               | premature deaths every year)
               | 
               | Nuclear energy is a very emotionally polluted debate (no
               | pun intended), but facts tend to shows that this is the
               | cleanest and safest energy.
        
           | CorrectHorseBat wrote:
           | We're not keeping coal in Belgium. The last coal mine in
           | Belgium closed in 1992, the last coal power plant closed in
           | 2016.
        
             | wazoox wrote:
             | Yup, actually the Belgian government plans to close all
             | nuclear plants real soon now, and replace them all with
             | imported gas. This is beyond stupid on so many levels.
        
               | foobarian wrote:
               | Would that be Russian gas they can then use as a
               | bargaining chip?
        
               | wazoox wrote:
               | Who knows. They plan to shut them off so quickly it may
               | not even be possible to build the necessary gas plants
               | (of course they promised to replace them "mostly" with
               | solar and wind, which is a complete joke and would
               | require at least a decade of building at full speed, not
               | a mere couple of years).
        
           | CaptArmchair wrote:
           | > Belgium
           | 
           | Belgium doesn't have coal plants.
           | 
           | Belgium's nuclear plants are/were scheduled to close because
           | they've surpassed their initial lifespan. An extension was
           | added but that has almost been surpassed as well. These are
           | plants which have been in operation for 40-50 years.
           | 
           | Replacements aren't being build because they are "unsafe".
           | They aren't being build because it's economically not viable
           | to do so in a country like Belgium. Not at this moment in
           | time, not in the past 20 to 30 years.
           | 
           | Belgium's major energy operators are also largely controlled
           | by French energy conglomerates such as ENGIE.
        
         | SketchySeaBeast wrote:
         | > His calm live and routines granted him a superior lifespan.
         | 
         | That's just conjecture on your part. Some people are lucky,
         | others are not, it's not always due to behavior. 3 cigarettes a
         | day is also extremely low - the average is apparently 14[1]
         | right now.
         | 
         | [1] https://www.cdc.gov/media/releases/2018/p0118-smoking-
         | rates-...
        
           | zadler wrote:
           | It's low but the risk of smoking one a day isn't 1/10 of
           | smoking 10 a day, it's probably much higher.
           | 
           | https://www.bmj.com/content/360/bmj.j5855
        
             | mmcgaha wrote:
             | When I was young, I figgured what would be the big deal
             | smoking a few cigarettes per day. By the time I was 25 I
             | realized that two packs per day was getting out of control.
             | 
             | I don't believe there is any harmful information but the
             | whole picture is that most folks cannot smoke a few per
             | day. Eventually cigarettes will own most smokers.
        
             | monopoledance wrote:
             | You probably have to differentiate risk. I assume for some
             | risks associated with smoking there is a linear correlation
             | with exposure, where it's on/off for others, or e.g.
             | following a logarithmic function.
             | 
             | Nicotine, CO and radioactive toxicity have a long half-
             | life, where primary radical damage or reactive carcinogen
             | burden is dose dependent stochastics.
             | 
             | Also people forget, you are much, much more likely to die
             | from cardio-vascular damage or COPD as a consequence of
             | smoking, than lung cancer.
        
           | gwbas1c wrote:
           | > 3 cigarettes a day is also extremely low
           | 
           | The addictive nature of cigarettes makes it very hard to
           | stick to 3 a day.
        
       | mrtnmcc wrote:
       | I good reminder to test your home for Radon. Check your local
       | Radon maps, there are hot spots throughout the world that vary
       | locally. Even if maps show low values it is worth testing.
        
       | subpixel wrote:
       | Old wood burning stoves are also quite unhealthy, and perhaps
       | even dangerous. My wife won't let me use ours, which is only 20
       | years old.
       | 
       | The EPA issued new regulations such that all new stoves
       | manufactured after 2020 emit far less smoke and particulate both
       | indoors and out.
       | 
       | The American Lung Association actually runs programs that will
       | pay you to replace your old wood stove, which probably says
       | something about their potential impact on health.
        
         | Izikiel43 wrote:
         | What about barbecues?
        
           | subpixel wrote:
           | All sorts of fires contribute to air pollution and barbecues
           | are not an exception.
           | 
           | The compounding factor with woodstoves is that they are
           | indoors and they are often the primary source of heat for
           | months on end, meaning they they emit smoke and particulates
           | into the air you breathe all day and all night.
        
       | ghjnut wrote:
       | This is me. I'm 34 years old and was diagnosed with stage 3B non-
       | small cell lunge cancer in February- a 3cm adenocarcinoma in my
       | right lung as well as metastases in some lymph nodes. When they
       | tested me they found my cancer to have an ALK+ biomarker which is
       | frequently found in young, non-smokers. Luck of the draw I guess.
        
         | pazimzadeh wrote:
         | I'm sorry to hear that. You might want to look into high dose
         | IV Vitamin C injections for solid tumors (which have the
         | oppposite effect of oral Vitamin C).
         | 
         | High-dose vitamin C enhances cancer immunotherapy
         | https://stm.sciencemag.org/content/12/532/eaay8707
         | 
         | Scroll down to cancer treatment:
         | https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessiona...
        
           | voldacar wrote:
           | I was about to downvote but that first study actually looks
           | legit. Still a mouse model, but maybe worth looking into
           | further.
        
             | pazimzadeh wrote:
             | My understanding is that Linus Pauling and others had
             | incredibly promising human trials, but attempts to
             | replicate always seem to alter one 'minor' detail or
             | another like adding glutathione (an anti-oxidant) or giving
             | high dose vitamin C orally instead of intravenously. This
             | is before they knew that Vitamin C is pro-oxidant when
             | deliver at high dose in the blood. You want anti-oxidants
             | to prevent cancer but once you have cancer you want
             | oxidants. Like you want bullets.
             | 
             | What the mouse model suggests is that you need an immune
             | system in the first place to get the benefits of high dose
             | IV vitamin C (HDIVC), since the mice lacking an adaptive
             | immune system didn't get the effect. It's unclear how
             | exposure to different amounts of chemo, which messes with
             | the immune system, disrupts the effectiveness of HDIVC. i.e
             | should it be tried first, or in what combination?
        
           | ghjnut wrote:
           | Definitely not the craziest think I've heard (vitamin B17
           | is). I'll check it out.
        
         | azalemeth wrote:
         | I'm very sorry to hear that. It is my understanding that there
         | are several ALK tyrosine kinase inhibitors that have specific
         | approval for use in your condition (crizotinib, ceritinib,
         | alectinib, and brigatinib) and I do hope you get the best care
         | you can possibly get and fight the good fight.
        
           | ghjnut wrote:
           | That is correct. Unfortunately the TKIs are more for
           | slowing/stopping spread temporarily until the cancer no
           | longer responds - then on to the next one. My doctors were
           | going for curative so I've been going the more traditional
           | route and those will likely be tagged on post-surgery in an
           | effort to keep anything missed in check. Also ALK+ is non-
           | responsive to immunotherapy which would have been nice weapon
           | to have in the arsenal as a cleanup crew.
           | 
           | It may be a pipe dream, but I'm hoping to hold on long enough
           | that some of these new mRNA approaches start offering
           | clinical trials I might be able jump in on.
        
             | azalemeth wrote:
             | I am very glad to hear that you are getting neoadjuvant
             | chemotherapy. I really do hope the resection is complete,
             | and the chemotherapy works.
             | 
             | Regarding "holding on long enough" -- something that there
             | has been shoddy but interesting evidence for over a number
             | of years in dragging yourself further to the right of a
             | Kaplan-Meier plot is dietary modification. As you probably
             | know, one of the hallmarks of cancer is metabolic
             | dysregulation [1] -- specifically a shift towards
             | "anaerobic" glycolysis, that is, the increased uptake of
             | glucose and an increase in the proportion of which ends up
             | as its ultimate metabolic fate as lactate rather than
             | entering the TCA cycle as pyruvate and being oxidised. Some
             | thing that has been explored in the past is providing the
             | organism with ketones as a primary fuel source (which enter
             | the TCA cycle directly as either beta-hydroxybutyrate or
             | acetoacetate) and do not get transported through the glut
             | glucose transporters: in non-cancerous cells with some
             | degree metabolic flexibility there is significant scope for
             | generating other needed metabolites from the TCA cycle and
             | a series of beautiful pathways to let that process happen.
             | As a result, there are a series of papers that indicate
             | that a purely ketone-based diet (exogeneous or endogenous)
             | _may_ be associated with an increase in life expectancy [2,
             | 3, 4; or google scholar GS1] as -- the narrative goes --
             | cancer cells can 't utilise the alternative fuel source as
             | effectively. In mice, with a well controlled tumour
             | xenograft, this has shown to extend survival, fairly
             | significantly.
             | 
             | However, take this with a large grain of salt: there is
             | some evidence that ketone utilisation might be associated
             | with "stemmness" and baddness in general [5, 6] which (and
             | herein starts a "I am hypothesising" warning) may be due to
             | a selection pressure for metabolic flexibility and the
             | return to a more fetal phenotype. The diets are also very
             | difficult to adhere to in patients. These diets are just
             | starting to be assessed properly, in people, in RCTs (e.g.
             | [7]), but I can't find any evidence of a trial in lung
             | cancer patients without a background of smoking
             | specifically.
             | 
             | The most recent major review on the topic I can easily find
             | [8] does seem to hint quite strongly that it might be worth
             | considering, and there is some evidence that it potentiates
             | tumours to other chemotherapies. If I were in your
             | unfortunate position, I would personally discuss the
             | concept with the oncologist in charge of my care - the
             | basic idea "makes sense" to me, at least.
             | 
             | ---- [1] https://www.sciencedirect.com/science/article/pii/
             | S009286741... or https://sci-
             | hub.st/https://www.sciencedirect.com/science/art...
             | 
             | [2]
             | https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.28809
             | or https://sci-
             | hub.st/https://onlinelibrary.wiley.com/doi/pdfdi...
             | 
             | [3] https://nutritionandmetabolism.biomedcentral.com/articl
             | es/10... or https://sci-hub.st/10.1186/1743-7075-4-5
             | 
             | [GS1] https://scholar.google.co.uk/scholar?hl=da&as_sdt=0%2
             | C5&q=ke...
             | 
             | [4]
             | https://link.springer.com/article/10.1007/s12032-017-0930-5
             | or https://sci-
             | hub.st/https://link.springer.com/article/10.1007...
             | 
             | [5]
             | https://www.tandfonline.com/doi/abs/10.4161/cc.10.8.15330
             | or https://sci-hub.st/10.4161/cc.10.8.15330
             | 
             | [6]
             | https://www.tandfonline.com/doi/abs/10.4161/cc.9.17.12731
             | or https://sci-hub.st/10.4161/cc.9.17.12731
             | 
             | [7] https://www.mdpi.com/2072-6643/10/9/1187
             | 
             | [8] https://www.sciencedirect.com/science/article/pii/S2212
             | 87781...
        
               | ghjnut wrote:
               | I have been turned off by how the approach is to treat me
               | and I'm primarily a passenger for this ride. In response,
               | I did the same research you did and came across the same
               | stuff. During the chemo/radiation I was on a strict
               | ketogenic diet with a less strict intermittent fasting
               | schedule. Post-surgery I'm going to go the full 9 yards
               | and extend to 7-day fasting once a month after hearing
               | this anecdotal story:
               | 
               | https://www.saronarameka.com/ https://www.frontiersin.org
               | /articles/10.3389/fonc.2020.00578...
        
               | imoverclocked wrote:
               | If you are looking for recipes or a second opinion
               | relating to food, my girlfriend (who used to work as an
               | neuro-immunologist doing cancer research) now does keto
               | coaching and also has a ton of recipes online.
               | 
               | https://primalwellness.coach
        
               | ghjnut wrote:
               | Thank you. This is exactly the stuff I'm looking for as a
               | newbie to keto.
        
             | magicalhippo wrote:
             | If you haven't, ask your doctors where it might to spread
             | to, and carefully monitor changes in those areas.
             | 
             | I have experienced three cases in my close relationships
             | where spreading was not picked up for a long time due to
             | being in different body parts.
             | 
             | In one of the cases asthma medication and physiotherapy was
             | prescribed for a year before an unrelated shoulder x-ray
             | caught the attention of the radiologist, and further images
             | showed the cancer had spread to lungs and spine...
        
               | ghjnut wrote:
               | I hadn't considered that. Thank you, I'll bounce that off
               | them.
        
             | agumonkey wrote:
             | > It may be a pipe dream, but I'm hoping to hold on long
             | enough that some of these new mRNA approaches start
             | offering clinical trials I might be able jump in on.
             | 
             | According to Vince DeVita (ex head of NCI) it was the way
             | they did things in the early days. Make people survive
             | until something new came up.
             | 
             | Hopefully with the advances in medical research things will
             | accelerate.
             | 
             | Best wishes
        
         | ArkanExplorer wrote:
         | What level of air pollution exposure do you have? Have you
         | monitored your indoor air quality with a PM2.5 device, or used
         | an air purifier? Do you live near a busy road, or a coal plant?
         | 
         | Good luck for your treatment and recovery.
        
           | ghjnut wrote:
           | I live in Denver. I have not done any testing but moved into
           | this house June 2019. Our inspection found the radon levels
           | to be 3.9 pCi/L (4.0 is the recommended actionable cut-off).
           | I recently installed a radon abatement system as we're
           | refinishing the basement. Wish I knew for sure.
        
         | rootbear wrote:
         | My sister (age 67) was diagnosed with exactly this a year ago,
         | except she's stage 4. She's on Alecensa (alectinib) and is
         | doing well, all things considered. Her left lung doesn't work
         | very well, but she's dealing with it. Her cancer isn't
         | localized, so surgery isn't an option. She did have radiation
         | therapy on one tumor.
         | 
         | Alecensa is freaking expensive. Even with Medicare, it's
         | costing her about $10,000 a year in deductibles and copays.
         | 
         | I wish you all the best for your treatments.
        
           | ghjnut wrote:
           | That's actually better than I heard. Since ALK is more
           | generally rare biomarker (as opposed to EGFR) more of the
           | drugs are still in trial. I asked an oncologist friend about
           | costs and she said $11,000/month.
        
             | rootbear wrote:
             | The raw cost of Alecensa is around $18,000/month, if I
             | recall correctly. Medicare covers all but $800 of that,
             | once the copays are spent.
        
         | cschneid wrote:
         | That's the cancer my dad has - non-smoker, just a surprise
         | stage 4. He's had great success with a few different inhibitors
         | over the years.
         | 
         | His doctor's approach has been using them to reduce the cancer
         | to near-zero, and then radiation (and in future, chemo) to
         | knock down any stray masses that get a foothold.
        
         | tomcam wrote:
         | Holy shit, my best to you.
        
         | EForEndeavour wrote:
         | Sorry to hear. I don't know much about cancer, but that sounds
         | scary to say the least.
         | 
         | What was your pathway to diagnosis? Was it picked up in a
         | routine checkup, or did you feel symptoms that convinced you to
         | see a doctor?
        
           | ghjnut wrote:
           | I had a dry cough for about 3 months that only seemed to crop
           | up in the evenings. I didn't think much about it as I have
           | quite a few allergies and chalked it up to that. I decided to
           | visit the doctor when I started getting some chest tightness
           | when I was going to sleep and I was also getting what I can
           | only describe as hot flashes just as I was falling asleep. It
           | felt like just as I was about to fall asleep I'd get an
           | adrenaline shot and I'd spring back up wide awake.
           | 
           | My PCP did a clean EKG which showed nothing, then it showed
           | up on X-Rays. I immediately got PET scans which showed 2
           | masses. I then had a bronchoscopy to ensure it was malignant
           | where they noticed additional lymph nodes. I then had a
           | mediastinoscopy showing spread in 3 clusters of chest lymph
           | nodes. I went through 6 weeks of chemo and radiation that
           | resulted in a 25% reduction in the primary tumor and no
           | change in the metastases in a hilar lymph node. I'm now
           | scheduled for a bi-lobectomty to remove my superior and
           | middle lobe on the right side, as well as however many lymph
           | nodes they can get a hold of (check out "da vinci thoracic
           | surgery" to see the robot beast the surgeon will be using).
           | 
           | I have almost no symptoms outside of a slight cough and still
           | run 1-2 miles per day.
           | 
           | I've generally been a grin-and-bear-it guy when it comes to
           | my health. Please suck up your pride and stay on top of your
           | health.
        
             | quenix wrote:
             | The "adrenaline shot" you describe -may- be normal. It's
             | called a [hypnic
             | jerk](https://en.wikipedia.org/wiki/Hypnic_jerk).
        
               | ghjnut wrote:
               | That sounds a lot like it. Maybe the cancer triggered it
               | or maybe I just lucked out with an unrelated symptom
               | prompting me to visit a doctor.
        
             | rockyj wrote:
             | I was diagnosed with "Thymus Carcinoma", pretty similar
             | story as yours. Had chemo, surgery and radiation. Doctors
             | also did "hot chemo" during the surgery. With the grace of
             | Jesus I am alive today.
             | 
             | It was a tough few months, but because of my trying times I
             | think I got stronger in my faith and I would say it was
             | worth it. It's a good feeling to live life knowing that God
             | is by you, makes one more empathetic and puts value back on
             | the important things like family.
             | 
             | Everyone has their own journey, I just want to encourage
             | you :)
        
             | EForEndeavour wrote:
             | Thank you for sharing this extremely detailed experience. I
             | could definitely see your comment helping to save some
             | stranger's life when they google something like "adrenaline
             | shot before sleep chest tightness."
             | 
             | Best of luck with your impending encounter with the da
             | Vinci bot and life after cancer.
        
             | usgroup wrote:
             | You're an awesome human. I'm in awe of your composure and
             | wish I could do the same if it ever happened to me.
        
             | moooo99 wrote:
             | Thank you for sharing your story, that pathway sounds scary
             | to say the least. I am absolutely impressed how well you
             | seem to take it.
             | 
             | I which you the best of luck and a long life after your
             | encounter with that incredibly scary yet fascinating robot!
        
       | agumonkey wrote:
       | before I can find a nicer source, here are some geographical maps
       | of lung cancer
       | 
       | https://duckduckgo.com/?t=lm&q=map+of+lung+cancer&iax=images...
       | 
       | helps getting an idea of environmental impact
        
       | kozikow wrote:
       | My mother was recently diagnosed with stage 4 lung cancer. Never
       | smoked, no alcohol. For 3 months doctors were diagnosing her
       | coughing as probably covid related, even when tests came
       | negative. Probably a lot more people got late cancer diagnosis
       | due to Covid. And lung cancer deaths are at 150K vs 577K for
       | Covid.
       | 
       | As article says, genetic mutations are much more common among
       | non-smokers. Exon 19 deletion egfr mutation was detected, so she
       | started on Osimertinib that works very well. Sadly Osimertinib
       | will work for a year or two, and then cancer mutates and gains
       | resistance.
        
         | izend wrote:
         | What about Radon exposure? Big problem in Canada in certain
         | cities:
         | 
         | "Over 16% of lung cancer deaths are attributed to radon
         | exposure in Canada. It is estimated that more than 21,000
         | Canadians will die from lung cancer this year, and more than
         | 3,000 of those deaths are because of exposure to radon
         | indoors."
        
         | ufo wrote:
         | Just to add a clarification for the rest of HN, since this is a
         | common source of confusion... Every cancer has gene mutations.
         | Typically these mutations are only present in the cancer cells
         | and are not there from birth. They don't indicate a hereditary
         | predisposition to getting cancer.
         | 
         | Really sorry to hear what your family is going through. This
         | kind of stuff is never easy to deal with.
        
       | diob wrote:
       | I grew up in a household where they chain smoked inside. Pretty
       | much just waiting to get cancer at some point.
        
       | bengale wrote:
       | My friends grandfather died from a lung cancer he got from years
       | of soldering before they introduced the lead free stuff.
        
         | bijant wrote:
         | lead is terribly toxic stuff, but the lung cancer would most
         | likely be caused by the flux, which you will still find in lead
         | free solder. Which is why You should always ensure good
         | ventilation when soldering.
        
       | fortran77 wrote:
       | And I suspect these unfortunate individuals are treated with
       | suspicion / lack of respect from the medical and insurance
       | industries.
        
       | AtlasBarfed wrote:
       | I fervently hope mass adoption of EVs will lead to a marked
       | decrease in cancer, and not just lung. Who knows what oil,
       | antifreeze, additives, and all the chemicals used in processing
       | no longer being emitted on tailpipes, dumped as part of refining
       | byproducts, and the like are no longer placed into the
       | environment.
        
       | decafninja wrote:
       | My uncle died of lung cancer in Korea; neither him nor anyone in
       | his family smoked. If culprits were to blame, it's probably his
       | coworkers - Korean men are notorious smokers even today and it
       | was worse when he was of prime working age. (quick Google stats
       | indicate 40% of men smoking vs. 16% in the US as of 2016, and
       | it's obvious many, many men smoke if you just live their and
       | peoplewatch.)
       | 
       | His death is one reason I really hate smoking. In Manhattan it's
       | especially annoying when you have to go past an honor guard of
       | smokers wreathed in a carcinogenic miasma cloud of smoke when you
       | enter or leave office buildings, or if you're walking in a
       | tightly packed crowd and someone ahead of you decides to light
       | one up and cropdust everyone behind with a blessing of cancerous
       | smoke.
        
         | collyw wrote:
         | You don't think that diesel fumes are a more likely culprit?
         | 
         | I saw this study mentioned which showed negligible risk for
         | passive smoking unless you are actually living with a smoker.
         | https://www.forbes.com/sites/danielfisher/2013/12/12/study-f...
        
           | decafninja wrote:
           | Korean corporate culture is extremely workaholic - even today
           | but especially during his working years (1970s to early
           | 2000s) - he probably spent more time with his coworkers than
           | his family.
           | 
           | Also people likely smoked indoors in the office when he was
           | working. Indoor no smoking bans didn't come until later in
           | his career, and even today I think enforcement is much more
           | lax compared to the US.
        
             | ornornor wrote:
             | > he probably spent more time with his coworkers than his
             | family.
             | 
             | This is so sad. Unless he didn't like his family.
        
             | Clubber wrote:
             | From the article he linked.
             | 
             |  _The study found no statistically significant relationship
             | between lung cancer and exposure to passive smoke, however.
             | Only among women who had lived with a smoker for 30 years
             | or more was there a relationship that the researchers
             | described as "borderline statistical significance." Over at
             | the Velvet Glove, Iron Fist blog, however, journalist
             | Christopher Snowden notes "there's no such thing as
             | borderline statistical significance. It's either
             | significant or it's not," and the reported hazard ratio was
             | not._
        
       | refurb wrote:
       | The article is interesting for what it doesn't call out. There
       | are people that get lung cancer without a cause - just an unlucky
       | lottery of errors introduced through natural processes.
       | 
       | If I recall correctly, 1/3 to 1/2 of all cancers don't have a
       | cause. Just bad luck.
        
         | ComputerGuru wrote:
         | Don't have a cause or don't have a known cause? There's a big
         | difference between random mutation and unknown precipitator.
        
           | pessimizer wrote:
           | It's not the cancer caused by moral failure, it's the good
           | kind which is caused by God's plan.
           | 
           | https://www.dailymotion.com/video/xc3x84
        
         | hh3k0 wrote:
         | > There are people that get lung cancer without a cause
         | 
         | I'd be quite surprised if breathing in microplastics does not
         | contribute to the risk of lung cancer -- and essentially every
         | human being is exposed.
        
       | freddealmeida wrote:
       | my dad died from lung cancer. He smoked his whole life. His MRI's
       | looked pretty good. So this is interesting. Makes sense. Poison,
       | radiation.
        
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