Knee arthritis may be sign of lung cancer in smokers

Rome: Arthritis of the knee may be the first sign of a type of lung cancer that is hard to treat in heavy smokers, suggests research published ahead of print in the Annals of the Rheumatic Diseases.

The Italian researchers reviewed the case notes of all patients with rheumatic disorders, diagnosed at one tertiary referral centre over six years.

Between 2000 and 2005, more than 6500 new patients attended the clinic. Of these, 296 (4.4%) were cases of monoarthritis—inflammation in just one joint—of the knee.

Among this group of patients, the knee arthritis, which was very mild, was the first sign of as yet undiagnosed non-small cell lung cancer in just under 2%.

All the patients were middle aged men, who had been heavy smokers for most of their lives.

But in every case, the lung cancer was operable, and once the cancerous tissue had been removed, the knee symptoms subsided.

Non-small cell lung cancer is linked to other conditions, which feature abnormal growths, in up to 20 per cent of cases, say the authors. And spread to the bones occurs in around one in five cases.

But the authors note that it has not so far been linked to arthritis.

Non-small cell lung cancer is particularly difficult to treat unless caught early, and in over half the cases diagnosed, the disease is already advanced.

Features that could act as early warning signs are therefore especially important, say the authors.

Smokers twice as likely to loose sight in old age


London: 13 million smokers in the UK are doubling their chances of sight loss later life according to definitive new research published on RNIB Eye Test Action Day – September 7.

The link between smoking and age-related macular degeneration (AMD) is now as strong as the link between smoking and lung cancer, yet few people are aware of the link or even of AMD.

AMD is the UKÂ’s leading cause of sight loss. Around 500,000 people in the UK have AMD and an estimated 54,000 people have the condition as a result of smoking.

A new report published by AMD Alliance UK, reveals that only seven per cent of people know that AMD affects the eyes but that seven out of ten smokers would either stop smoking permanently or cut down if they thought it could harm their eyesight.

The benefits of quitting smoking are very real. Studies have shown that people who stopped smoking 20 years ago have a similar risk of developing AMD as non-smokers, and that the risk starts to decrease after ten years of not smoking.

A call for action
Steve Winyard, RNIBÂ’s Head of Campaigns and Chairman of AMD Alliance UK, said: “Smoking is the only proven cause of AMD that people can do anything about, yet people are not aware of the link and most people have not even heard of the condition. The message is simple: do not take up smoking and if you do – stop!”

“RNIB is calling on the Government to introduce specific warnings on cigarette packets and to fund a major public awareness campaign on the dangers of smoking to your eyesight. RNIB is also joining the British Medical Association (BMA) and the Royal College of Ophthalmologists in calling for a ban on smoking in all enclosed public places and workplaces across the UK.”

Simon Kelly, Consultant Ophthalmic Surgeon at the Bolton Eye Unit and co-author of the research published today, would also like to see warnings on cigarette packets. He said: “Knowledge of the link between smoking and AMD is very low but evidence from Australia and New Zealand shows that raising awareness of this link creates a powerful message for the general public. A survey amongst patients in Bolton also published today suggests that fear of blindness is as compelling as fear of lung cancer and heart disease as a motivator to quit. In my clinical experience when people are diagnosed with AMD and learn of the link with smoking they are often sufficiently shocked and motivated to want to stop smoking straight away.”

Pauline Edwards was diagnosed with AMD and told about the link with smoking. As she had smoked most of her adult life, she was very shocked. “If I had been told that I could lose my sight because of smoking I am sure I would have given up. I stopped the day I found out.” Pauline’s full story

Stop smoking today
Smokers wanting friendly help and advice on how to quit can ring Quitline on 0800 00 22 00 and speak to a trained QUIT counsellor. Alternatively email for a same day personal reply. A free QUIT pack is also available to all smokers wanting to stop.

Download our smoking and sight loss factsheet for further information about the links between AMD and smoking:

PDF version of smoking and sight loss factsheet
Word version of smoking and sight loss factsheet.
Get an eye test
Getting a regular eye test will check your eyes are healthy – a simple eye test can save your sight. NHS sight tests are available free to people under 16 or under 19 in full time education and to people over 60. People who are on benefits and low incomes are also eligible. Glaucoma sufferers and their close relatives over 40, diabetics and people who are registered blind or partially sighted also qualify. Vouchers are available to assist with the cost of glasses.

RNIB recommends full eye tests for children under the age of 16 and adults over 60 every year, other adults should have a test once every two years unless advised otherwise by their optician.

Get involved
Help us spread the word. Download and print copies of our campaign poster:

PDF version of “Double your chances of sight loss” poster
Word version describing the “Double your chances of sight loss” poster
Research and further information
The full report containing the research findings is written by the AMD Alliance. It raises awareness of AMD and associated risk factors.

Dr Kelly’s research about smoking and sight loss is published in ‘The Eye’, the journal of the Royal College of Ophthalmologists.