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Angela Deneris and Cordelia Schaffer: We thought we were safe from lung cancer. Utah’s pollution proved us wrong

Don’t think that just because you live a healthy lifestyle you are immune to lung cancer.

(Trent Nelson | The Salt Lake Tribune) Poor air quality obscures the Oquirrh Mountains and downtown Salt Lake City, as seen from the University of Utah on Friday, Dec. 3, 2021.

We are two women with one too many things in common. We both lived our adult lives in Salt Lake City, are nurses, college professors, were never exposed to radon or occupational hazards and are non-smokers. We shared the mistaken belief that our healthy lifestyles would protect us from serious diseases.

The one-too-many things we have in common is that we were both discovered to have advanced non-small cell lung cancer caused by a common genetic mutation activated by Salt Lake valley air pollution.

Even though we were/are college of nursing professors and read medical literature, neither one of us realized breathing polluted air put us at higher risk for lung cancer, according to the CDC. We blithely assumed non-smokers didn’t get lung cancer. Too late we learned many studies have shown long-term air pollution exposure is toxic enough to cause lung cancer in people like us.

We learned the hard way that, in most cases, lung cancer can remain early stage and asymptomatic for many years and solid tumors usually take decades to develop. But in 2013 lung cancer in an 8-year-old girl in China, attributable to air pollution, set off alarm bells throughout the world.

In 2019, 300,000 lung cancer deaths globally were linked to exposure to outdoor air pollution. According to the CDC, up to 20% of lung cancers occur in non-smokers.

We learned our ignorance isn’t uncommon. We were both initially worked up by our family physicians for other possible reasons for our fatigue, persistent cough and shortness of breath with exercise, delaying our diagnoses and treatment. This is typical of lung cancer, the number one cancer killer in the U.S.

Because non-smokers aren’t screened for lung cancer, and the early-stage symptoms are subtle and self-reported, it isn’t usually diagnosed until Stage III or IV, when it is much more difficult to treat, and survival is low -- exactly our situation. Too late we also learned that air pollution also increases the size and grade of lung cancers, and even impacts our ability to survive by decreasing the effectiveness of our treatment and by making us more susceptible to recurrence.

Fortunately for us, there is an oral chemotherapy medication we take that can extend our lives by a few years, but this isn’t the way we expected to live them, with debilitating symptoms, extensive medicine-generated side effects and very expensive medical costs.

The World Health Organization has declared air pollution a leading cause of cancer, and there is no safe level of air pollution, just like there is no safe number of cigarettes a person can smoke. But air pollution also causes a list of other diseases nearly as long as those from smoking — virtually every type of lung disease, heart and blood vessel diseases, impaired fetal development, chromosomal damage, pregnancy complications, brain and neurologic disorders like strokes and Alzheimer’s, type II diabetes, accelerated aging and premature death.

We share our stories in the hope you and your health care providers won’t wait until it is too late to learn more about the negative consequences of chronic exposure to air pollution. Lung cancer is a real possibility, and it shouldn’t be considered only after everything else has been ruled out. It is only one of many poor health outcomes that needs to be considered when symptoms first appear in non-smoking patients.

We also issue a call to arms for all who live in this beautiful state to work with our elected officials to change public policy and to fight against proposals that will increase air pollution, such as the inland port and water rights causing Great Salt Lake to become a dry, toxic dust generating wasteland. We must advocate for healthier air to protect ourselves and those who come after us, and an end to public policy that benefits the few at the expense of the many.

Behind every abstract statistic on the health hazards of air pollution is a human face — someone’s spouse, mother, father, grandparent, brother, sister or newborn baby — someone who was denied a long, healthy life simply because of the air they breathed. We hope hearing our stories and seeing our faces can lead to fewer stories like ours.

Angela Deneris

Angela Deneris, Ph.D., CNM, FACNM, is a professor, clinical emeritus, at the University of Utah College of Nursing, was a practicing nurse-midwife for 40 years and faculty in the Nurse-Midwifery and Women’s Health Nurse Practitioner Program for 30 years, retired and resides in Sugar House.

Cordelia Schaffer

Cordelia Schaffer, RN, MSN, CHPN, has been a nurse educator at Westminster College since 2008. She has worked in health care since 1985, specializing in hospice, and resides near Rose Park.