There is no denying the tragedy of Dana Reeve's death from lung cancer at the age of 44 earlier this month.

		The Thinkers This monthly series will highlight people from Western Pennsylvania who are on the forefront of new ideas in their fields. Jill Siegfried Age: 51 Position: Co-director, Lung and Thoracic Malignancies Program, University of Pittsburgh Cancer Institute. Education: Bachelor's degree in molecular biology and German, Wellesley College, 1976; master's and doctorate in pharmacology, Yale University, 1978 and 1981. Previous positions: Acting chairperson, Pitt department of pharmacology, 2002; pharmacology professor, Pitt, 1988-present; program leader, Research and Testing Inc., Research Triangle Park, N.C., 1983-88. Professional honors: Nine active research grants from the National Cancer Institute; member, National Cancer Institute's Women, Tobacco and Cancer Working Group; board member, Women Against Lung Cancer Alliance for Education and Research; Pitt Cancer Institute Scientific Leadership Award, 2002; Alton Oschner Award Relating Smoking and Health, 2000. The Series Click here to view other installments in this continuing series.

But there may be a small silver lining from the passing of Christopher Reeve's widow, says Jill Siegfried, a nationally known lung cancer expert at the University of Pittsburgh.

It could open up one more window to illuminate a disease that has been shadowed by a stigma of shame and blame.

Even though it is the leading cause of cancer deaths in the United States, lung cancer attracts much less research money than other major cancers, Dr. Siegfried said, largely because it is so strongly linked to smoking that people often blame the victims for giving the disease to themselves.

But Mrs. Reeve, known worldwide for her advocacy for paralysis patients, never smoked. In fact, 13 percent of the people who get lung cancer each year have never smoked, and 80 percent are women.

The recent death of another celebrity -- ABC News anchor Peter Jennings last August -- highlighted the risk of lung cancer for ex-smokers.

Mr. Jennings had quit smoking 20 years before he got the disease. Of the more than 180,000 people who get lung cancer each year in the U.S. nearly half are ex-smokers.

Both Mrs. Reeve's and Mr. Jennings' deaths "will make a huge difference" in public perceptions, Dr. Siegfried believes, "because up until recently, people didn't talk about lung cancer."

"When you have someone like Peter Jennings who quit smoking and got lung cancer anyway -- I mean, we have 50 million ex-smokers out there, and most of them are over the age of 50, and so I think it drives home to them that they are also at risk," she said.

"And then when we have a non-smoker like Dana Reeve, it drives home that not everybody with lung cancer gives themselves this disease, and that we really ought to be thinking more about getting over that and thinking about this as a severe medical problem we should be doing something about."

Lung cancer rates have declined in recent years as the percentage of men and women who smoke continues to drop.

"But what I always try to emphasize," Dr. Siegfried said, "is that our population continues to grow, and we actually have the exact same number of smokers today as we had in 1960" -- nearly 45 million.

Among non-smokers, women are particularly vulnerable to lung cancer. In fact, she said, nearly 18,000 American women who never smoked get lung cancer every year -- almost as many as get ovarian cancer.

Dr. Siegfried said estrogen may help explain those numbers.

	Graphic: Lung cancer's research gap

Researchers have found estrogen receptors in women's lungs and in lung cancer tumors, and Japanese studies have shown that the longer a woman's reproductive span, from puberty to menopause, the more likely she is to get lung cancer.

As the primary female sex hormone, estrogen is responsible for the growth of breasts, the development of the uterus and ovaries, and other reproductive functions.

So it's quite possible, Dr. Siegfried said, that if there are already precancerous cells in the lung, "then when you stimulate them even more with estrogen you're just accelerating the process by which that tumor is becoming malignant."

A family history of lung cancer is associated with getting the disease at a younger age, and like Mrs. Reeve, most lung cancer patients younger than 50 are women.

Researchers also know that women have less natural ability to repair genetic damage in their lungs than men do.

Dr. Siegfried, 51, a Milwaukee native, said she was drawn to her specialty in the early 1980s "because I realized at the time that there were very few basic scientists working on lung cancer."

That is still a problem today.

Researchers gravitate toward other types of cancer for two reasons, she said.

First, treatments for many other cancers have much better success rates than for lung cancer, she said. Five-year survival rates for breast cancer, for instance, are almost 90 percent, and for prostate cancer are nearly 100 percent.

Lung cancer has a five-year survival rate of 15 percent.

And even though perceptions are changing, many doctors still look on lung cancer patients with a mixture of fatalism and disdain, Dr. Siegfried said.

The attitude of too many doctors, she said, is "you've got it, and you're going to die, and there's nothing we can do for you, and you smoke, so you shouldn't complain."

The poor survival rates for lung cancer are strongly linked to how advanced it usually is by the time it's discovered. The five-year survival statistic for Stage 4 lung cancer, the most advanced form, is less than 1 percent, and 45 percent of lung cancer patients aren't diagnosed until they reach Stage 4.

There are no blood screening tests that can detect lung cancer, and X-rays and CT scans are not good at picking up the smallest lung tumors, Dr. Siegfried said.

That's especially distressing, she said, because if lung cancer can be diagnosed at the earliest stage, the five-year survival rate is 60 to 70 percent.

The best future hope for an early screening test, she said, might be a technology called proteomics, which can assemble profiles of people's proteins by analyzing their blood serum. Pitt researchers are now investigating whether lung cancer patients have a distinct profile that could allow early detection of the disease.

The outlook for treatment is slowly getting better, she said. If patients' lung cancers can be caught early, chemotherapy can significantly increase their survival odds.

New treatments also are being developed that target lung cancer cells more precisely, she said. At Pitt's labs, she is involved with studies of Faslodex, an anti-estrogen drug, and antibodies to a natural substance called hepatocyte growth factor.

Her professional goal: to bring to fruition at least one new cancer therapy, from the lab through animal studies to people.

"I realize that even when things look good in animal studies and there is a strong scientific rationale, they may not work in patients with cancer," she said, "but even if what I develop doesn't pan out in patients, I hope it will lead to new approaches that others can successfully develop."