Lung cancer: the physician's responsibility

Our plain-English summary of Lung cancer: the physician's responsibility, by A. Ochsner (1968).

The study

• Author: A. Ochsner
• Published: Hospital Practice, July 1968
• Type of article: Editorial
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This editorial is a short opinion piece on lung cancer and cigarette smoking. It does not mention asbestos. The author recalled seeing nine men with lung cancer in six months in 1936, after seeing only one patient in the previous 20 years. All nine had smoked heavily since the First World War, and the author suggested at that time a possible causal link between cigarette smoking and bronchogenic cancer. The author reported a five-year survival rate of 6% in the author's own experience, close to the 5% to 8% reported by Dr. Roswit. The author also described blood tests run by colleagues on patients having lung function studies. Cancer cells were found in the arterial blood of 40% of patients with proved bronchogenic carcinoma and in none of the patients with non-cancerous disease. The author cautioned that finding these cells does not necessarily mean the cancer will spread. The author concluded that, apart from rare adenocarcinoma, practically all lung cancers are preventable, and that physicians had failed to warn patients about smoking.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Editorial (opinion piece drawing on the author's clinical experience and colleagues' observations); not a formal study
• Who was studied: The author's own lung cancer patients at Ochsner Clinic, New Orleans. These include nine men seen over six months in 1936 and, according to the second, garbled section, more than 1000 cases seen over time. Colleagues also performed blood cytology on all patients having pulmonary function studies at the author's hospital.
• Exposure: Cigarette smoking (the second section also discusses snuff, cigar and pipe tobacco for other cancers). No asbestos or other fiber exposure is discussed.
• Main results:
  • In 1936 the author saw nine patients with lung cancer in six months, after seeing only one patient in the previous 20 years
  • Five-year survival was 6% in the author's experience, compared with 5% to 8% reported by Dr. Roswit
  • Neoplastic cells were found in the peripheral arterial blood of 40% of proved cases of bronchogenic carcinoma
  • No neoplastic cells were found in the blood of patients with non-malignant disease, and there were no false positive results
• The authors' conclusion: The author concluded that the rising incidence of bronchogenic carcinoma is due to cigarettes rather than longer life spans, and that practically all lung cancers except rare adenocarcinoma are preventable. The author also concluded that physicians have been derelict in not warning patients about smoking and should advise all patients not to start or to stop.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Bronchogenic Carcinoma, Adenocarcinoma.

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