January 28th, 2009
06:05 PM ET

John Updike: Lung Cancer’s Long Reach

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Cate Vojdik
AC360° Writer

Pulitzer Prize-winning novelist John Updike died yesterday of lung cancer. He was 76, the same age as my father when he died of lung cancer. I’m sure the Updike family is cloaked in grief, just as mine was nearly eight years ago.

It’s unclear when Updike was diagnosed; he passed away in a Massachusetts hospice. As recently as November, the legendary author was out and about, promoting his new novel “The Widows of Eastwick.” He certainly doesn’t look seriously ill in this October video interview with the New York Times.

That’s the thing about lung cancer. It does its damage out of sight, surreptitiously, over decades, deep within the body's tissues. It’s typically quite advanced by the time it’s diagnosed, and there are few effective treatments for late-stage lung cancer. The illusion is that it kills quickly, but in fact, stealth, not speed is its defining feature; in the pantheon of malignancies it is a long-distance runner.

My father, like Updike, started smoking when the health risks of tobacco were still largely unknown. Luther Terry's watershed Surgeon General report documenting that smoking causes lung cancer was issued on Jan. 11, 1964, when Updike was 31 years old. Several photos that accompanied his obituaries The GuardianThe New York TimesNew York Magazine show Updike holding a cigarette. In at least two, his elbow rests on his knee, his palm facing the camera, fingers curled casually around the thin white cylinder. The ashy butt and faint haze of smoke indicate the cigarette is not a mere prop.

When those pictures were taken (one in 1955, the others circa early 60s) Updike couldn't have known that cigarettes could - or would - eventually kill him. I have no idea if he later tried to quit or continued to smoke throughout his life. From my father’s experience, I know how difficult it is for smokers to give up their habit, especially if they started in their youth. Even though my father failed in this respect, his message to me and my sister from the time we were little was clear. “Don’t ever smoke,” he would tell us with urgency. “I wish I had never started.”

The truth is, most smokers don't die from lung cancer; Updike and my father were on the wrong side of the odds. According to the Fred Hutchinson Cancer Research Center (and many other sources), only 10 percent of lifetime smokers develop lung cancer.

But here’s the other half of the equation: Nearly 90 percent of people who get lung cancer are smokers. Translation: If you smoke, you’re basically playing Russian roulette with your health. You’re betting that you’re not in the minority of smokers predisposed, for whatever genetic reason, to developing lung cancer – and there’s currently no definite way to know if you’re in that unlucky subset.

Those numbers may help explain why, although lung cancer is the leading cause of cancer-related deaths for both men and women, it doesn’t attract the biggest research dollars or the most attention, let alone universal sympathy. Many advocacy groups attribute this second-class status to the stigma that surrounds lung cancer. Since smoking is a choice, many people blame lung cancer patients for their fate; patients themselves often feel guilty. I know my father did.

I haven’t observed the same kind of guilt – or blame – heaped on people with diseases linked to, say, obesity (high blood pressure, heart disease, some forms of cancer). Many who have lost loved ones to lung cancer, myself included, find this curious, and frankly inconsistent.

A couple of weeks ago, another death reported in the New York Times caught my eye. A 42-year-old physician - loving wife and mother of three young children - had died after an 18-month battle with lung cancer. Her death notice specified that she was a nonsmoker. I can understand why her family chose to point out that she didn’t contribute to her fatal illness by an unwise lifestyle choice. But I’d also like to think they may have wanted to signal that lung cancer can strike anyone, even nonsmokers. Advocacy groups believe that spreading such awareness could help boost research funding for the disease.

If you’ve lost a loved one to lung cancer, it doesn’t matter, in the end, whether or not they smoked. Your heart breaks just the same. You grieve.

And that's why this afternoon I struggled to stifle the urge I had when I spotted a young woman in her 20s having a smoke outside our office building. I want to shake her and shout: “Don’t you realize there might actually be a bullet in that chamber??”

soundoff (8 Responses)
  1. Dan Taylor

    Updike, fortunately, did not die at young age. It appears that lung cancer is a wraith that can kill former smokers even after they quit (though at a greatly reduced rate). Apparently, tobacco carcinogens stay in the lung tissue for some time after the smoker quits causing pre-cancerous changes in the lung, which can advantage of declining immunity in old age. Recently, I read a report that women are dying in their 30's (one lung cancer victim was only 22 when she died, also reported on CNN). These reports are truly tragic, and a warning–especially for girls–who are tempted start.

    January 29, 2009 at 8:52 am |
  2. Ilhana, Bosnia

    I lost my grandfather, whom I never met, due to throat and lung cancer in the early 80's. I used to hide my uncle's cigarettes before he luckily quit smoking. Even though people don't get this disease exclusively because of smoking, I still urge everyone who does it to quit as soon as possible. R.I.P. John Updike.

    January 29, 2009 at 4:52 am |
  3. peter crapsody

    he lived to be 76. that's pretty old. he would have died of something or other. sooner, rather than later.

    January 28, 2009 at 9:36 pm |
  4. Jana Baldwin

    If there were words for the outrage I feel towards the Tobacco Companies I would state them on this blog. . . there is not a four letter word that describes my pure hatred, despise and disgust for the Tobacco Companies. Yes. . . I am "one of those" that first blames the Tobacco companies and then the person. Nicotine is more addictive than heroine and crack (according to research done by the CDC). What can I say? I am $100,000 in debt working on my masters in public health to try and prevent people from smoking and help smokers to quit. Too many lives are taken and the US spends somewhere in the ballpark of $250 BILLION dollars a year in Tobacco related healthcare costs.
    Aside from all these statistics when I think about the people the LIVES, the lungs, the pocket books, the mothers, the babies, the fathers, the grandma's, grandpa's that smoking affects, I can't help but GET ANGRY and make a scene when I see someone smoking. I have "Quit" materials on hand. . one would say I am "ruthless" because I care. EVERYONE needs to be RUTHLESS in the fight against tobacco. . . God Bless the Updike family and ALL OF THOSE lost to TOBACCO.

    January 28, 2009 at 8:17 pm |
  5. Megan Dresslar - Shoreline, WA

    I remember that time my grandmother and my dad had lung cancer, it was so bad disease to beat...... my dad died in 1996 before my grandmother pass away by lung cancer one year. my grandmother never smoke at all, but my dad smoke addict too much. his doctor found that tumor his lung during surgery before he died. I think that smoking is not good health..... that is so dangerous thing, and not safe for smoking people have cancer. my hearts goes out to John Updike's family and friends.

    January 28, 2009 at 7:25 pm |
  6. pat griffith

    perhaps Alpha 1 antitrypsin deficiency was a factor it's more common than you think people just don't get tested for it until late. it's an inherited disorder and there is treatment for it although no cure often misdiagnosed as allergy asthma in adults. it makes one susceptible to lung or liver cancer.

    January 28, 2009 at 7:19 pm |
  7. Noelle Francis

    My father too passed away from lung cancer. He started smoking when he was 16 which would have been 1937 – when it was cool to smoke. He struggled to quit and probably never appreciated me decorating his not so secret smoking place (the downstairs bathroom) in anti smoking paraphernalia that I got from the Doctors office I worked at. He had stopped smoking 8 years before he was diagnosed. He showed no symptoms of lung cancer and it wasn't until it had spread to his bones that we found out he had the dreaded curse. Who knows how long it crept through his system.

    January 28, 2009 at 6:31 pm |
  8. Tammy, Berwick, LA

    I understand. My godfather died of lung cancer in 2007. He was a heavy smoker at one point in his life, but quit over twenty years ago with my dad (his younger brother) when their dad developed heart problems and emphysema from years of smoking. I remember watching my grandfather cough up pink and black pieces of lung in the hospital (enough to make me never want to smoke). I mostly remember my godfather's last week when the cancer had spread to his brain and he had no clue who I even was. I was his only niece and godchild. People don't think lung cancer or other diseases can happen to them until it's too late. There were so many times within these last years I'd have given anything to have my godfather and grandpa back. Smoking took them both. Knowing that, the nicotine fix just isn't worth my life or the grief of those left behind. I feel sad for the Updike family and all the fans he left behind.

    January 28, 2009 at 6:19 pm |