Should cancer of the lung be added to the list of health risks women face just because they are women?

A study presented recently at the annual meeting of the Radiological Society of North America in Chicago showed that women who smoke are twice as likely to develop lung cancer as their male counterparts. As a risk factor for smokers, female gender appears to outweigh age and amount smoked. Some researchers point fingers at the female hormone estrogen, but there is strong evidence implicating a more likely culprit: the bottling up of emotions, particularly anger.

David Kissen, a British thoracic surgeon, noted in the 1960s that his patients with lung cancer were frequently characterized by a tendency to stifle their feelings. In a number of studies, he showed that people with lung cancer “have poor and restricted outlets for the expression of emotion,” as compared with non-malignancy lung patients. The risk of lung cancer was five times higher in men who lacked the ability to express their emotions effectively. The more a person repressed emotions, Dr. Kissen learned, the less cigarette consumption it took to trigger the onset of cancer.

Dr. Kissen’s observations were spectacularly confirmed by a 10-year prospective study in Cvrenka, an industrial city in the former Yugoslavia. In this study, 1,400 subjects were interviewed before any of them had disease. A decade later, the researchers found that people who smoked and whose psychological profiles were characterized by the bottling-up of emotions were at far great risk of developing lung cancer than those whose emotional expression was not impaired.

If the link isn’t immediately obvious, that is only because we have been conditioned to think about disease in narrow and simplistic ways.

One of the common myths about illnesses is that they have single causes. “The large majority of lung cancers are caused by carcinogens and tumour promoters ingested via cigarette smoking,” says one of the most respected medical texts currently in use. The statement is scientifically incorrect, despite the truth it contains.

If cigarettes by themselves could cause lung cancer, every smoker would develop malignancy. Many do, but the majority do not — hence, other factors must be involved.

In reality, the growth of cancer represents not only malignant change induced by a carcinogen but also an immune system whose capacity to keep the abnormality in check or to destroy it has been diminished. In many people, the immune system is powerful enough to withstand the malignant damage to the lung cell’s DNA from the byproducts of cigarette smoke. In some, it is not. Here is where emotions and stress play a major role.

We now know that the separation of mind/body as practised by orthodox Western medicine has no scientific basis. The emotional centres of the brain are physiologically connected with the nervous system, the immune apparatus and the hormonal organs. Rather than separate systems, the emotional, hormonal, immune and nervous mechanisms of brain and body form a vast supersystem, intricately joined physiologically and functioning in unison. Stress in any part of this supersystem will necessarily affect the other parts. The blurring of emotional boundaries can suppress the human organism’s immune defences and the body’s capacity to repair DNA damage.

How does all this relate to women and lung cancer, or, for that matter, to the generally known fact that women are at greater risk than men for the onset of non-smoking-related malignancies?

In our culture, both men and women may find themselves under severe pressure to suppress and betray their true selves in order to fit in, to be “acceptable.” But women are the ones usually appointed to take care of others while neglecting their own emotional needs.

In relationships with their male partners, for example, women are more likely to be charged with doing the emotional work for both. They are more likely to be absorbing their partners’ stresses while silently containing their own, more prone to take on the task of preserving harmony at all costs.

Women in our society may be considered the stronger sex, in that they are trained to put up with more stress uncomplainingly, but they are often less powerful: less in control and less able to reject the world’s demands.

Women are thus conditioned to be “strong” — compliant and agreeable, the ones who do not express anger. These are the traits research has consistently associated with higher risks for malignancies of all kinds and which the British and European studies have also related to lung cancer.

In a person who is an emotional absorber — a stress sponge, if you will — the toxins of cigarette smoke act on a body with reduced physiological defences. It is social and cultural expectations, not biological gender per se, that make women more vulnerable.