We cannot think of a better way to kick of Lung Cancer Awareness Month 2016 than with this excellent Q&A with a leader in the movement - and our friend - Bonnie Addario.  Please read this inspirational and informative interview from Genentech:  https://www.gene.com/stories/qa-bonnie-j-addario

Many of us have been upset recently as well-meaning organizations have made smoking cessation the focus of lung cancer awareness month.  Certainly, encouraging the public to never begin, and to quit if they smoke, is admirable. And for people with lung cancer, quitting may improve survival.  Yet lung cancer awareness month should have a different focus.

Spreading information on smoking cessation does little overall for those living with lung cancer today. Five months after receiving a diagnosis of lung cancer, only 14% of people with the disease are smokers.  To focus on smoking is analogous to making breast cancer awareness month all about informing women that they should have their first child before the age of 30 (to decrease the risk of breast cancer.) Awareness month should be about supporting people with the disease, not about discussing the causes.

Awareness month should also be about funding to research better treatments. Those who smoked in the past won't benefit from a lecture about what they may have done differently 20 years ago.  Instead, they need treatment today. And for never smokers with the disease--not uncommon considering lung cancer in never smokers is the 6th leading cause of cancer deaths in the U.S.--this focus makes a month designed to celebrate their lives irrelevant. 

Some people may remain skeptical, but read on for further reasons why lung cancer awareness month should not have smoking cessation as the central focus.

The majority of people with lung cancer are non-smokers.

This heading is not a typo.  The majority—roughly 60% of people—diagnosed  with lung cancer are non-smokers.  This includes people who smoked at some time in the past, as well as never smokers.  In the United States 20% of women with lung cancer are never smokers, with that number rising to 50% of women with lung cancer worldwide.

Numbers such as 20% may seem small, until you take a look at the statistics.

Lung cancer is the leading cause of cancer deaths in both men and women in the United States.  Lung cancer kills twice as many women as breast cancer, and 3 times as many men as prostate cancer.  

And while around 30 to 40% of people smoke at the time of diagnosis, only 14% of people with lung cancer are smoking 5 months after diagnosis.

In other words, the vast majority of people with lung cancer today will not benefit from hearing about the hazards of smoking.  Not only is this focus not helpful, but it serves to propagate the stigma of lung cancer as a smoker's disease.  Unfortunately this vast majority, including most never smokers, have already been subjected to the blame game.  Have breast cancer?  Nice.  People act loving and ask how they can help you.  Have lung cancer?  Raised eyebrows accompanied by some variation of the question,"How long did you smoke?"  
There are many reasons that living with lung cancer can be harder than living with breast cancer.  Let's not add cancer awareness month to the list.

There are Other Causes of Lung Cancer

There are many causes of lung cancer. Even if tobacco had never been introduced on the planet, we would still have lung cancer.  Yes, smoking is the leading cause of lung cancer, but causes other than smoking are very important.  Though the number seems small—20%  of women who develop lung cancer being never smokers—this translates to a fifth of the 71,660 lung cancer deaths in women expected for 2015.

Radon exposure in the home is the second leading cause of lung cancer, and the number one cause of lung cancer in non-smokers.

Roughly 21,000 people die from radon-induced lung cancer each year, and this cause is entirely preventable.  Picking up a radon test kit from the hardware store for around 10 bucks, and having radon mitigation done if the test is abnormal, is all that's needed.

Putting these numbers in perspective may help.  Around 39,000 women are expected to die from breast cancer in 2015.  If we had a $10 test to check for a risk factor, and a procedure costing less than a grand that could completely prevent half of breast cancer deaths, do you think we would have heard?  Why doesn't the public know about this?  It goes back to the focus of this article; we are placing the emphasis of lung cancer awareness on smoking, and in doing so, are leaving the public with a false sense of assurance that all's well if you don't smoke.

There are other causes worth mentioning, from air pollution, to indoor air pollution, to secondhand smoke, to occupational hazards.  Don't assume you are safe if you never smoked.

Learn about the other causes of lung cancer in non-smokers and what you can do to reduce your risk.

People Who Have Quit Smoking Are Still at Risk

Quitting smoking certainly reduces the risk of lung cancer, but for most, some risk always remains.  The numbers in the last slide attest to this.  There are more former smokers who develop lung cancer each year than current smokers.

If you smoked in the past, don't fret yet.  After 10 years of quitting, the risk of lung cancer decreases by 30 to 50%. There are also some ways of reducing your risk of dying from lung cancer.

One method is low dose CT lung cancer screening.  While screening doesn't lower the chance that you will get lung cancer, it does increase the chance that if you develop lung cancer, it will be found in the earlier, more curable stages of the disease.  It's thought that screening people at risk could reduce the mortality rate from lung cancer by 20% in the United States.  Screening is currently recommended for people between the ages of 55 and 80, who have a 30 pack-year history of smoking, and continue to smoke or quit within the past 15 years.  In some cases screening may be recommended for other people based on personal risk factors for lung cancer.

In addition, studies looking at exercise and lung cancer as well as diet and lung cancer suggest there are some things that both people without and people with lung cancer can do to lessen risks. 

The Stigma Interferes With Early Diagnosis

My favorite part of lung cancer events I attend, is when lung cancer survivors share their story.  A special time, but oh so painful.  Time and time again people share what eventually led to their diagnosis -- often a series of visits, with several doctors, over a period of months, during which time they have been diagnosed with everything from asthma to Lyme disease.

Lung cancer flies below the radar screen for many health care professionals, especially lung cancer in never smokers and lung cancer in young adults.

For this reason, many are diagnosed when lung cancer has already spread, and the chance of a cure with surgery has passed.  In fact, young adults and never smokers are more likely to be diagnosed at an advanced stage of the disease.
Until we have a widespread screening tool for lung cancer, it's important for health professionals and patients alike, to realize that all you need to get lung cancer is lungs.  The symptoms of lung cancer can be different in non-smokers than smokers, and those of lung cancer in women are often different than symptoms in men.  Be your own advocate.  If you have any symptoms that aren't adequately explained, ask for a better explanation or a second opinion.  If we are to find lung cancer early, we need to dispel the myth that lung cancer is a smoker's disease.  That's part of what lung cancer awareness month is all about.

The Stigma Interferes With Research for New Treatments

Private funding for breast cancer surpasses that of lung cancer by a great distance, as evidenced by Susan G. Komen being a household word and pink ribbons having a widely recognized significance.  How many people can name the largest non-profits for lung cancer, and how many people even know the color of the lung cancer ribbon?

Public funding also lags far behind for lung cancer, and this is important because funding means dollars which in turn means research.

In 2012, federal research spending added up to $26,398 per life lost to breast cancer, vs only $1,442 per life lost from lung cancer.  I have often wondered what the survival rate for lung cancer would be if the same amount of money and research had been invested as has been with breast cancer.

Why is the funding so low, and why are researchers less likely to devote themselves to lung cancer?  The stigma.  There is an unseen, unheard statement that says, "These people smoked so they deserve to have cancer."  Nobody deserves to have lung cancer, whether a never smoker or a lifelong smoker. Making smoking cessation the focus of lung cancer awareness only increases this stigma and gap. 

The Stigma Interferes With Research About Causes

I made a comparison earlier about deaths from breast cancer, vs that from radon-induced lung cancer. That can be taken a step further.  I read studies galore looking at possible causes of breast cancer, as well as dietary and other measures which may reduce the risk. It's rare when I find similar studies looking at lung cancer.  

What is causing lung cancer in non-smokers?  Why is lung cancer increasing in young, never smoking women?

We need to change the face of lung cancer, so that we can begin to look at possible answers to these questions.

Lung Cancer is Increasing in Young, Never-Smoking Women

Most of us have read the headlines in recent years.  Lung cancer in men is now decreasing in the United States, while that in women has leveled off.  Yet there is one group for whom lung cancer is steadily increasing.  Young, never-smoking women.

These women have to put up with constant questions about their smoking status, or another variant, "Did your parents smoke when you were growing up?" 
Why can't we treat these women as we treat women with breast cancer in October?

Lung cancer isn't a "smoker's disease."  Someone with lung cancer could be your mother or your daughter or your sister or your aunt. These young women deserve to know that they aren't being dismissed for having a smoker's disease, while at the same time coping with the stigma.

Focus of Lung Cancer Awareness Month

Okay.  So smoking cessation shouldn't be the focus of lung cancer awareness month.  What should be at the center of awareness?

Number one should be support.  Every single person with lung cancer -- regardless of smoking history -- deserves our love, compassion, and the best care possible. Think of how women are treated during breast cancer awareness month, how they are celebrated, how they are reminded that research is being done to make a difference.

If you just don't know what to say, check out these tips on things not to say to someone with lung cancer.  How would you treat your friend or loved one with lung cancer differently, if she had breast cancer instead?

Number two should be about awareness.  Not smoking cessation as this is done everywhere year round.  Instead awareness that lung cancer occurs in non-smokers and having knowledge of the early symptoms could make a difference. Those who are former smokers should have the opportunity to learn about screening options.

And just as breast cancer awareness month raises funds for research, lung cancer awareness month should also be a time to educate and encourage those with lung cancer about new advances, while providing funding for further advances.

A Word About Smoking and Lung Cancer

For smokers with lung cancer, quitting is critical. To speak of separating lung cancer awareness month from smoking is not to dismiss smoking as a cause of lung cancer.  It is.  

For the minority of people living with lung cancer who smoke, quitting is incredibly important, and likely the most important thing anyone can do to improve survival.  Check out these 10 reasons to quit smoking after a diagnosis of cancer. Quitting smoking after a diagnosis of lung cancer improves the response to cancer treatments, improves quality of life, and improves survival.

For those without lung cancer, quitting not only reduces lung cancer risk, but improves survival in other ways. In addition to lung cancer, there are many cancers that are associated with smoking, and many other medical conditions associated with smoking.

The Quit Smoking Toolbox is a free resource to help you gather the tools you need to be successful in giving up the habit.

But remember that these tips on smoking and cancer were placed at the end for a reason.  They apply to only a minority of people living with lung cancer today.

Click here for ways to help.

by Dr. Lecia V. Sequist
Originally published by CNN.com on 10.30.13

Dr. Lecia V. Sequist is a medical oncologist at the Massachusetts General Hospital Cancer Center, an associate professor of medicine at Harvard Medical School. and a member of the LUNGevity Foundation's Scientific Advisory Board. The opinions expressed in this commentary are solely those of Dr. Lecia V. Sequist.

My patient, "Judy," is one of more than 228,000 Americans this year who will be diagnosed with lung cancer.

And like most of her fellow lung cancer patients, she is struggling not only to learn all she can about her diagnosis and treatment options, but also to adjust to the overwhelming burden of shame and stigma that plagues this disease.

When asked who is providing her with support, Judy said she is ashamed to admit her metastatic, incurable cancer diagnosis to loved ones, and that she is bearing the burden alone. Because one of the strongest risk factors for lung cancer is smoking, our society has come to the conclusion that people diagnosed with lung cancer somehow deserve it, that it was brought on by their own "bad" behavior.

Tell a friend or colleague that your aunt just found out she has lung cancer. Almost always the response will be, "Did she smoke?"

Then tell someone else that your aunt just found out she has breast cancer, or colon cancer, or any other type of cancer you can think of. This time the response will be pure sympathy, without any blame attached.

Donna Summer died of lung cancer not related to smoking

The feeling that lung cancer patients should somehow be held liable for their cancer diagnosis is often the only notion people have about lung cancer.

Lung cancer is the deadliest cancer, responsible for more than 25% of all cancer deaths. It kills roughly twice as many women as breast cancer, and almost three times as many men as prostate cancer.

What many people don't realize is that about 60% of all new lung cancer diagnoses are among people who have never smoked or are former smokers, many of whom quit several decades ago.

For the first time, the World Health Organization recently declared air pollution as a leading cause of lung cancer. In short, anyone with lungs -- anyone who breathes -- can get lung cancer.

Researchers are on the verge of a seismic shift in our ability to diagnose and treat lung cancer, and more funding is desperately needed to bring these promising new therapies to fruition.

In the last five years, researchers have learned that some lung cancers are remarkably sensitive to a new type of treatment, one that comes in a pill and is targeted specifically toward the genetic defects that make that particular cancer "tick."

In clinics across the country, oncologists are testing their lung cancer patients to find out which type of gene the cancer carries so they can know which type of targeted therapy will work best. As a result, some patients are living longer, with fewer side effects and improved quality of life compared to traditional therapies.

In addition, in the last two years researchers have started to learn how to harness the immune system to attack lung cancer, and have seen some patients with advanced disease go into prolonged remission, sometimes lasting long after the immune therapy is stopped. These types of successes in lung cancer treatments would have been unimaginable 10 years ago.

Scientists are deeply committed to broadening and improving therapy options until there is an effective treatment for all lung cancer patients.

Unfortunately, the stigma associated with lung cancer has translated to a massive inequality in research funding. When analyzing the combined 2012 cancer research dollars granted by federal organizations, for every woman who dies of breast cancer, more than $26,000 in federal research funding is devoted to breast cancer research. But for every woman who dies of lung cancer, just over 1,000 federal dollars are invested. The difference is staggering.

November is national lung cancer awareness month. Scientists don't have millions of dollars to spend on marketing to call attention to the need for research dollars. If they did, they would spend that money on research.

You can help by spreading the word about the need for lung cancer research to family and friends. By rejecting the tendency to blame lung cancer patients for their disease, you can help lift the crushing weight of stigma and guilt that for some can be as bad as the cancer itself.

With increased research, more lives will be saved. Please join me this November and talk about lung cancer, for Judy, and patients everywhere who are too ashamed to mention it.

Lung cancer programs receive a fraction of the grants devoted to types that take fewer lives, data show. The stigma of smoking looms large.

by Bridget Huber
This article was originally published in The Orange Country Register on November 15th, 2012.

Lung cancer takes more lives than any other cancer. This year it will kill an estimated 160,340 Americans – more than breast, colon and prostate cancers combined.

While lung cancer remains largely a death sentence – just 15.9 percent of those diagnosed are alive five years later – the federal government funds far less research on the disease than on other common cancers. The discrepancy is starkest when death rates are taken into account. In 2011, the two federal agencies providing most of the research money funded breast cancer research at a rate of $21,641 per death while spending $1,489 per lung cancer death.

It has been 41 years since President Richard Nixon signed the National Cancer Act, effectively declaring war on cancer. But there will be no victory without winning the battle against lung cancer, which causes more than one in four U.S. cancer deaths. Advocates say efforts to improve lung cancer patients' chances have been stalled by unexamined biases among health officials and the public as well as by scant research funds. They also cite the paradoxical invisibility of a disease that claims so many lives but has few champions of the sort who have brought breast cancer to national prominence.

The stigma of smoking is largely to blame. Anti-tobacco campaigns have done their job too well, leading many to see lung cancer as self-inflicted. That stigma keeps some families and patients from speaking out, while corporate donors stay away from the disease, and some scientists and policymakers question whether scarce research dollars should be devoted to a smokers' illness.

But an estimated 15 percent of lung cancers are diagnosed in people who never smoked. If lung cancer in these people was considered a separate disease, it would still be the sixth-leading cancer killer in the U.S., ahead of liver, ovarian and esophageal cancers. Researchers estimate that an additional roughly 50 percent of lung cancer cases involve former smokers who quit the habit years ago.

"This is a public health problem that needs to be addressed regardless of how it came about," said Dr. David Carbone, a leading lung cancer researcher at Ohio State University. "We need to take care of those who are sick and need to do everything we can from a public policy perspective to reduce the number of people at risk in the future."

Funding questions

Recent breakthroughs in cancer genetics and lung cancer screening have added urgency to advocates' calls for more money for lung cancer research, which will get $231.2 million this year from the two main federal agencies funding such work. "We are at a precipice where we could really break through," said Kim Norris, president of the Lung Cancer Foundation of America.

But these advances have come at a time when funding for all research is scarce. And many influential scientists balk at letting pressure from advocates influence research priorities. In their view, it could set the entire cancer research field back by creating a quota system for research on specific cancers that could divert funds from the most cutting-edge science.

Carbone, however, says unless a portion of federal funds is specifically directed to lung cancer, advances in the field will remain baby steps. "We didn't send people to the moon because we happened to have a rocket ship sitting around. We sent people to the moon by saying, 'That's what we want to do.' And then we figured out how to do it."

Making that moonshot will mean convincing the public and policymakers that lung cancer victims are worthy of support. Part of the challenge is that the disease is so deadly that there is no critical mass of survivors to raise its profile. Most people are diagnosed at an advanced stage and die within six months, said Jeffrey Borgia, a cancer researcher at Rush University Medical Center in Chicago. "There's not much time to fit a walkathon in," he said.

In contrast, breast cancer advocates have raised millions through everything from road races to galas. The White House is lit pink each October for Breast Cancer Awareness Month. Pink ribbons have been attached to items including pistols and fried chicken buckets, becoming so ubiquitous that some question whether the cause has become too commercialized. Lung cancer groups, however, have struggled to attract attention. The original color for lung cancer ribbons was clear – as in, invisible.

Perhaps the best example of how strong advocates can spur scientific research is the Defense Department's medical research program. In 1992, the National Breast Cancer Coalition, led by a breast cancer survivor and lawyer Fran Visco, persuaded the Defense Department to create a breast cancer research program funded by Congress. The resulting Congressionally Directed Medical Research Program has been allocated $2.8 billion for breast cancer research in the past two decades.

But even though the armed forces skew heavily male and military members smoke at high rates (cigarettes once were included in soldiers' rations and have been sold at cut-rate prices on military bases), it was 17 years before the program began researching lung cancer in 2009.

"It's really challenging now. There just isn't a champion," said Regina Vidaver, executive director of the National Lung Cancer Partnership.

The stigma problem

Before it can find its champion, lung cancer will have to shed its stigma. Last summer, advocates released an ad campaign aimed at shocking the public into examining its biases against people with lung cancer.

Posters featuring a young man with geeky glasses and a plaid scarf began popping up across the country. "Hipsters deserve to die," they read. "Cat lovers deserve to die," read another.

The point was provocation, said Kay Cofrancesco, a spokeswoman for the Lung Cancer Alliance, which sponsored the ads. When a person hears that an acquaintance has lung cancer, she said, a question immediately springs to mind: Did he or she smoke?

The answer often is no. Yet the stigma persists, even though lung cancer among nonsmokers is rising, with women accounting for two-thirds of these diagnoses. One famous example is Dana Reeve, the singer-actress and widow of Christopher Reeve. A nonsmoker, Reeve was just beginning to emerge from the grief of losing her husband when she was diagnosed with stage 4 lung cancer at age 44.

Yet blaming smokers who fell prey to cigarette marketing seems inconsistent – after all, society condemns tobacco companies for deceiving customers and even maximizing the addictiveness of cigarettes. We should "vilify the tobacco industry instead of vilifying patients," said Dr. Carolyn Dresler, an official with the Arkansas Public Health Department.

Lung cancer can be caused by such factors as exposure to radon, asbestos and other toxins. About 10 percent of lung cancer deaths are linked to heredity, said Ann Schwartz, a researcher at Wayne State University in Detroit. Yet lung cancer's image as solely a smoker's disease can undercut support for research that looks at other causes, such as heredity.

Changing the money

Many lung cancer advocates and researchers have called for a reassessment of the way money is distributed at the country's largest funder of cancer research, the National Cancer Institute.

Research grants from the NCI are the most important financing a cancer researcher can get. But the NCI's funding, allocated by Congress, has remained nearly flat since 2003, though it did get an additional $1.26 billion as part of the stimulus package of 2009.

Congress does not dictate how much NCI can spend on each type of cancer. Instead, NCI funds the cutting-edge science most likely to move the entire field of cancer research forward.

Lung cancer receives less funding than other cancers under this approach, too. In fiscal year 2012, the NCI will devote $221 million in research grants to lung cancer and $712 million to breast cancer, according to National Institutes of Health estimates.

NCI officials caution against reading too much into these numbers. Most of the research it funds is basic research applicable to multiple types of cancer. The institute also funds tobacco control and financed the National Lung Screening Trial, a large, multiyear study that showed that screening smokers via low-dose CT scans reduces the number of lung cancer deaths.

But some researchers, like Carbone, say the problem with the NCI's prerogative of funding the most advanced cancer research, regardless of what organ it involves, is that research on some types of cancer is further along than others. Breast cancer, for example, has been better funded for longer and had earlier breakthroughs that attracted more top researchers and more funding, from the federal government and other sources. "The infrastructure in the one disease is better than the other. It's a self-perpetuating problem," Carbone said.

Cancer research is increasingly focused at the molecular level instead of at the organ level. Researchers now know that cancers at different sites in the body can be caused by some of the same genetic mutations. But a single mutation can behave differently in different organs, so it is still necessary to look at particular cancers such as lung cancer, Carbone said.

The other side of the argument is represented by Dr. Harold Varmus, the NCI's director. He declined to be interviewed, but in a speech at the National Press Club in September, he said he would "object dramatically" to efforts such as legislation that would force the NCI to set aside specific pots of money for certain cancers. This approach, advocated by some groups over the years, would "take the decision-making about grant making out of the hands of the NCI and [put] it in the hands of advocacy groups," he said.

by By Lynne Eldridge MD
This article was originally published at About.com on
November 29th, 2012.


As Lung Cancer Awareness Month draws to a close I'm glowing from hearing about all of the events - and how each year there are more and more advocates investing their precious time and energy to spread awareness and provide funding for lung cancer research. But amidst that glow is a sadness. It seems just when I get excited about a new organization or another medical institution promoting awareness, I read the second line. "The key to reducing lung cancer deaths is to launch more anti-smoking campaigns."

Yes, those campaigns are important. But if we want to reduce lung cancer deaths, anti-smoking campaigns just aren't going to do it. Or even come close.

I'm sure many of you are saying, what in the world is she talking about?

A statistic may help:

• Nearly 80% of people diagnosed with lung cancer now, in 2012, are non-smokers. All of the anti-smoking campaigns imaginable are not going to make a difference for this 80%.
  

Maybe a few numbers will make it even clearer. In 2008, the last year from which we have numbers available, there were 158,592 deaths from lung cancer in the United States, including 70,051 deaths in women. (Note that in the same year, there were 40,589 breast cancer deaths in women.) Using the 80% statistic, 126,874 of these deaths could not have been prevented by anti-smoking campaigns.

So why are we focusing on anti-smoking campaigns? Why are we focusing our attention on only 20% of people who develop lung cancer? Don't get me wrong. This group of 20% who are current smokers deserve our love and attention just as much. But what about the other 80%?

Since one of my pet peeves is listening to people rant who don't have a solution in mind, I'll offer a few.

Perhaps we should be focusing more attention on other known causes of lung cancer. Radon is the second leading cause and is totally preventable. Checking for radon in your home doesn't even take willpower. Occupational exposures need more attention as well.

And we need to focus more energy on treatment research. Even if we focus our efforts on the 20% with smoking cessation programs, many of those people will still develop lung cancer due to their history of smoking in the past.

To do this we need funding. To get funding, lung cancer needs to recognized. 

Thanks to everyone who worked so hard to make this year's Lung Cancer Awareness Month more visible. Blessings to all of you.

Sources:

• Centers for Disease Control and Prevention. Breast Cancer Statistics. Updated 04/30/12. http://www.cdc.gov/cancer/breast/statistics/
  
• Centers for Disease Control and Prevention. Lung Cancer Statistics. Updated 04/30/12. http://www.cdc.gov/cancer/lung/statistics/index.htm
  

Part I:  Jill's Legacy
Part II:  The Great Lung Run

A young woman is nearly finished running from New York City to San Francisco to raise awareness and funds for lung cancer.  

Over the last few months,  this story should have been all over the internet, newspapers, magazines, and on TV.  It is not.  Why?

by Lynne Eldridge MD
This post was originally published at About.com on November 12th, 2012.
---
Thanks to one solitary person with tsunami-like vision, Lung Cancer Awareness Month 2012 will again be celebrated by a lighting of the falls.

On November 16, 2012, Niagara Falls will be lit up in white for lung cancer. Not once, but twice.

Last year I shared the story of how this came to be. A story that transcends the event, transcends the waterfall, and transcends even lungLy cancer awareness month. The story about how a single person who wants to make a difference, and doesn't say "I can't," can help each of us who hears it begin to say "I can." I know I felt that way after hearing Christine Dwyers story. You can read it here.

This year, on November 16, 2012 from 8:00 to 8:15 and again from 9:00 to 9:15 Eastern Standard Time the falls will be illuminated in honor of Lung Cancer Awareness Month.

If you get a chance to attend the event, dress warmly. You can watch the display from Niagara Falls State Park, NY, or from Niagara State Park, Ontario, Canada.

But the really cool thing is that anyone, anywhere in the world can take part in this event via live webcam.

Links for the live feed:

• American Falls Live Webcam
  
• Niagara Falls Webcam
  
• Falls View Cam
  

Last year, despite the cold chill of November, Christine described the event as almost spiritual. As I remember her excitement, the thought keeps coming to my mind; what would happen if each of us lived the quote that Christine shared last year? "If you don't like something, do something to change it."

Christine has lived up to that quote. The event last year was driven by her realization about lung cancer - that it affects far too many people; people from every walk of life. Having lost her step grandfather, step dad, and best friend from the disease, she founded "Make Some Noise for Lung Cancer Awareness." Most recently, and after arranging for Niagara Falls to be lit again for lung cancer this year, her dear mother has also been diagnosed with stage 4 cancer. As she stands in the cold -- but with a warm heart - watching the falls lit up this Friday, please hold her in your virtual arms.

Photo: © Christine Dwyer