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ANDERSON COOPER 360 DEGREES

Lung Cancer: The Quiet Killer; Dana Reeve Remembered; Interview With Lance Armstrong

Aired March 7, 2006 - 22:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


HEIDI COLLINS, CNN ANCHOR: And, again, everyone, welcome to the show tonight.
We're calling tonight's special coverage "Lung Cancer: The Quiet Killer," quiet for the way it strikes and for how even the mention of it can terrify people into silence, but not tonight.

We can't imagine Dana Reeve would stand for it. Nor would Lance Armstrong. He joins us shortly. And you will also be hearing from men and women with lung cancer, some doing better than others, but none giving up.

And we will be taking your phone calls as well. Dr. Sanjay Gupta is here, Susan Mantel of Joan's Legacy, and Dr. Pasi Janne of the Dana-Farber Cancer Institute in Boston.

That toll-free number, we want to put it on the screen for you now, 877-648-3639. Again, it's 877-648-3639. We hope to hear from you all soon -- John.

JOHN ROBERTS, CNN SENIOR NATIONAL CORRESPONDENT: Heidi, we begin tonight with the death and, more importantly, the life of a remarkable woman, sadly, a remarkably young woman, who fought the good fight, not once, but twice, each time in the public eye, while raising a son and living her life.

Dana Reeve died last night at a hospital in Manhattan of lung cancer. She was just 44 years old and a non-smoker. That's one thread running through the entire program tonight. And so is this.

(BEGIN VIDEOTAPE)

ROBERTS (on camera): (AUDIO GAP) ... hi lung cancer last year, she faced a familiar question: How do you cope with it all?

(BEGIN VIDEO CLIP, NOVEMBER 2005)

DANA REEVE, WIDOW OF CHRISTOPHER REEVE: We're going to get through this, like we got through everything else.

(END VIDEO CLIP)

ROBERTS: Her smile masked a tremendous will, one that got her through all but impossible times, so difficult, few people could imagine.

(BEGIN VIDEO CLIP, "LARRY KING LIVE")

D. REEVE: Life keeps me going. I'm -- I'm basically a happy person. I don't -- I don't need a lot of prompting to keep going.

(END VIDEO CLIP)

ROBERTS: Dana Reeve's first passion was the theater, studying in London and finding a home at the Williamstown Theatre Festival in Massachusetts, where she met the man who would become her second passion.

The Reeves were married in 1992. He made movies. She acted and sang cabaret. They had a son, Will. In 1995, their world fell apart. Christopher Reeve was paralyzed in a riding accident. Dana, he said, gave him the strength to go on, telling him he was still the same person she married just three years before.

(BEGIN VIDEO CLIP, "PAULA ZAHN NOW," NOVEMBER 21, 2003)

CHRISTOPHER REEVE, ACTOR: Then you realize how lucky you are to have people who are there for you no matter what. Yes, it may be an achievement to fly solo, but there's a great deal more true satisfaction in flying together.

(END VIDEO CLIP)

ROBERTS: For a decade, Dana Reeve was her husband's rock, nursing him through a painful rehabilitation, together raising public awareness of and money for signal cord research, and speaking out for the rights of the disabled.

(BEGIN VIDEO CLIP)

D. REEVE: He now faces what hundreds of thousands of disabled men and women face daily in this country and around the world, limitations, frustration, sorrow, anger, humiliation, injustice, but, also, on a daily basis, he experiences great joy.

(END VIDEO CLIP)

ROBERTS: She made sure the public saw the man, and not just the wheelchair. But she didn't abandon her own acting career, appearing on stage and on the small screen in the TV dramas "Law & Order" and "Oz."

(BEGIN VIDEO CLIP, "OZ")

D. REEVE: I would like to add your name to the list.

(END VIDEO CLIP)

ROBERTS: When Christopher Reeve died in October of 2004, Dana Reeve was soon back in the public eye.

(BEGIN VIDEO CLIP, OCTOBER 2004)

D. REEVE: As I proudly introduce our friend and declare my vote for the next president of the United States, John Kerry.

(CHEERING AND APPLAUSE)

(END VIDEO CLIP)

ROBERTS: Turning her private pain into public clout, championing stem cell research to honor her husband's struggle.

(BEGIN VIDEO CLIP)

D. REEVE: He worked so hard, and his work was so important that we really need to go forward.

(END VIDEO CLIP)

ROBERTS: She went forward herself, returning to the stage and the cabaret. But fate dealt her another blow, lung cancer.

(BEGIN VIDEO CLIP, NOVEMBER 2005)

D. REEVE: Just when you think you're coming out, you know, and you think, OK, it's all right, I see the light at the end of the tunnel, then I got this diagnosis in the summer.

I think I learned a long time ago that life just isn't fair, so you better stop expecting it to be.

(END VIDEO CLIP)

ROBERTS: Dana Reeve lived her final months as she had lived her whole life, with a smile and a song, one of her last public appearances, a January tribute to hockey legend Mark Messier.

(BEGIN VIDEO CLIP, JANUARY 2006)

D. REEVE (singing): I will always be with you.

(CHEERING AND APPLAUSE)

(END VIDEO CLIP)

ROBERTS: Peter Kiernan joins us now. He is the chairman of the Christopher Reeve Foundation and a longtime friend of the family.

Peter, thanks for being with us.

You know, the one thing that I kept on hearing from people today was -- and Dana Reeve said it as well in that piece -- it's just so unfair. I mean, this is a woman who, by any measure, suffered the trials of Job, only to succumb herself to a -- to a disease. Where did she ever get the strength to deal with what she has been -- what she dealt with over the last 10 years?

PETER KIERNAN, CHAIRMAN, CHRISTOPHER REEVE FOUNDATION: It's a pleasure to be with you tonight, John. I have to say that I think the whole world was pulling for Dana. If there's anybody on the planet who deserved a break, it was Dana Reeve. I think that she found strength in many things that were close to home, her son, the love of her family, through her years with Chris. They were an unbelievably complementary couple.

ROBERTS: People I talked to today said that they had spoken with her fairly recently, maybe a month ago, over the holidays, perhaps, and, by all accounts, she seemed to be getting better. And -- and, then, suddenly, she took a turn for the worse.

At -- at what point, Peter, did it become apparent that her health was failing?

KIERNAN: Dana is somebody who -- who wore her illness well, if you will.

And she was fighting the good fight every step of the way. Now, I was with her just a couple of days ago. And I can tell you, even then, she had her eyes on the fight and was determined to find a way to get home to be with her son. This is somebody who may have lost her battle to cancer, but death has no pride in this case. She fought it bravely right to the end.

ROBERTS: You know, a lot of people are wondering as well about their son, Will, 13 years old. He lost his father. He has now lost his mother. How -- how is he doing?

KIERNAN: Will is doing fine. And, happily, he is in the warm embrace of family and friends. The Reeves were like a magnet for people who cared and loved them all, and Will is in the center of that affection right now.

ROBERTS: As -- as you know, as -- as the chairperson of the foundation, Dana and Christopher helped that foundation raise millions, if not tens of millions, of dollars. And now there's a problem with the budget for the Paralysis Resource Center, in that the White House has zeroed out some $6 million that was destined for that center.

What happens next with the foundation? What happens with the center, now that federal funding looks like it's going to be cut in budget year 2007?

KIERNAN: I'm glad you asked the question because the Christopher Reeve Foundation is very much in business.

Even this afternoon, we met to go over some of the budget issues that you described tonight. And we're going to fight this one, just like Chris fought his challenges and Dana fought hers. We owe them no less. That funding is either going to come from the federal government, or we're going to go out and raise it from private individuals. But they worked too hard for too long to create the Paralysis Resource Center to let it stop now.

ROBERTS: Well, Peter Kiernan, we certainly wish you a lot of success in that. And thanks for being with us on this difficult day.

KIERNAN: Thank you, John. I appreciate it very much.

ROBERTS: I very much appreciate it -- now back to New York and Heidi.

COLLINS: John, thank you.

My next guest is one of the greatest athletes of all time, an inspiration to millions battling cancer, and a friend of Dana Reeve.

Seven-time Tour de France champion Lance Armstrong survived advanced testicular cancer that spread to his brain and lungs. Now, thanks to his foundation, Armstrong is helping give people with cancer the tools and information they need to live strong.

We welcome Lance Armstrong to 360.

LANCE ARMSTRONG, CANCER SURVIVOR: Thanks for having me.

COLLINS: Thank you so much for being with us.

Also with us tonight is our good friend, 360 M.D. Dr. Sanjay Gupta.

Lance, let me first ask you, how did you and Dana become friends? Let's talk about her for just a moment.

ARMSTRONG: You know, unfortunately, I -- I met Dana through the illness. I mean, when she was diagnosed, their closest friends, Chris and Dana, were Robin and Marsha Williams.

And Chris and -- and Robin went to school together at Juilliard and -- and were fast friends and were best friends since then. And Marsha called me one day, and she said: I -- I have a friend who has just been diagnosed with lung cancer.

And she didn't want to say the name. It wasn't public yet. And I -- I understand that. And I did what I could. And -- and, then, when the news came, and I immediately called Marsha back and I said, OK, I have figured out who your friend is, and that, during this process, got to know Dana, talked to her a little bit, obviously, the initial call just to say, hey, I'm -- I'm here if -- if you ever need anything.

COLLINS: Yes. What do you say?

ARMSTRONG: Well, that's tough.

I mean, it's -- sometimes, you -- you don't have to say very much. Sometimes, people rely on you to say a lot. But, most of the time, I think they just want to know that -- that you're there to listen, and they -- and they -- and if they want to share their story, or if they want to ask you some questions, you're there to really listen to them intently, and -- and give them honest feedback. And, you know, I told her that I would do whatever I could as a -- as an individual, or as a cancer survivor, or the foundation would do whatever they could, and if she just needed somebody to talk to. And, actually, the one thing that I kept telling her was that -- because I knew that Will was young kid. I knew he was a sports fan.

I said: Listen, I'm in the city all the time. If -- if he wants to go just run around in the park, or if he wants to go play video games, or whatever he wants to do, I will do that.

(CROSSTALK)

ARMSTRONG: I will do anything.

COLLINS: I will bet that was probably priceless for her.

ARMSTRONG: Yes, and so...

COLLINS: And that -- that really is, I think, the thing here that has caught a lot of people's attention...

ARMSTRONG: Right.

COLLINS: ... is that boy. He's 13. Now both of his parents are gone.

You have children. How -- how do you help these kids?

ARMSTRONG: Well, fortunately, he's an amazing kid. I mean, as I -- as I -- I said a little while ago, we went to the U.S. Open together. And he was so full of life. This kid, this is not a normal 13-year-old. I mean, I don't think...

COLLINS: Well, look at his parents.

ARMSTRONG: Yes, but he -- he's -- he's -- he's bright. And -- and his -- his step-sisters, or step- brothers and sisters are really bright. He's going to be well taken care of. He has got a great head on his shoulders.

And it's -- listen, no family needs this, if you consider Christopher's death, if you consider that Dana's mom died just after Christopher died, if you consider that her father had a stroke at Thanksgiving, if you consider what happened to her last night.

You start to wonder what -- what can one family tolerate. And in the middle of this is a 13-year-old boy. And, as -- as I told Marsha today, because I called Marsha this morning as soon as I -- I got the news, and I just said, listen, whatever Will needs, I'm there. I mean, if I need to come back up, if -- if -- whatever he needs to do, wants to do, I'm here.

And, as a parent, boy, you don't ever want to leave your kids, you know and...

(CROSSTALK) COLLINS: That's for sure.

ARMSTRONG: Yes.

COLLINS: And, also, I can't imagine. You have to have every ounce of fight to be fighting a disease like this. And then to add in this very, very complicated extra layer of being a celebrity, and there are obligations there, I would imagine, too.

How -- how do you handle all of that at the same time?

ARMSTRONG: Well, I don't know.

I -- you know, fortunately, when I was diagnosed, I was -- it made news, but it didn't make huge news, so I was able to sort of live my life and fight my disease in a -- in a fairly private way. For Dana, I mean, through the process, on the heels of Christopher's death, you know, it was stuff. They had to be very private.

And -- and -- and they wanted to be private. But now that -- that she, unfortunately, passed away, it brings a whole new level of awareness to the disease. I mean, I think Peter Jennings' passing was -- was huge for cancer. I mean, it's -- it's -- we don't ever want to lose anybody. But, when Peter Jennings dies of lung cancer, people say, oh, my God, what? Peter Jennings died?

When Sheryl Crow is diagnosed with breast cancer, people say, oh, my God; Sheryl Crow has breast cancer? I mean, it brings a spotlight to the illness that we desperately need. And, so, you have to take these opportunities and ask hard questions of the people who make the big decisions, and say, hey, enough is enough. You know, it has been a long time since we decided to fight this war, and we're not doing enough.

DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: And -- and there has been a war on cancer for almost 40 years now, Lance.

You know, something else striking to me is that, you know, lung cancer is the biggest killer of all. And you get about $30 million, $30 million, $40 million in funding towards that.

Breast cancer, you just mentioned, about $1.4 billion -- there's huge disparities in this, and, yet, we're still not making a dent.

ARMSTRONG: Right.

GUPTA: As -- as an advocate, and a very powerful one, what -- what do you say about that?

ARMSTRONG: Well, the perception around lung cancer is that, if somebody gets lung cancer, they smoked for 20 or 30 years...

COLLINS: Right.

ARMSTRONG: ... and they deserve it. Well, nobody deserves cancer. I mean, listen, we always say that you should not smoke. And if you're 15 or 16 years old, you know, OK, do I take that puff and get started on this habit? The answer is no, absolutely not.

But if you make it to 45 or 50 and you get lung cancer, you don't deserve to die. But the illness is really -- it really is the red- headed stepchild of cancers. And it kills more than any of them combined. But people almost look at it and say, well, touche. You know, you -- you chose your lifestyle.

And -- and, well, that's true. They may have chosen their lifestyle. That doesn't mean that we don't deserve to -- to research them a lot.

And, in -- and, in Dana's case, I mean, 44 years old, was never a smoker, you -- you look at that situation...

(CROSSTALK)

ARMSTRONG: ... and, I mean, obviously diagnosed late, because why would she expect anything? When I first talked to her, I said, well, did you have any symptoms? I mean, what was -- you know, only at the very end.

(CROSSTALK)

COLLINS: And the symptoms come so late, right?

GUPTA: They -- they -- they can. And even a cough can be a very late symptom.

You know, Lance, you asked me to help you with LIVESTRONG. And, you know, you say something I -- that I remembered. Knowledge is power. Unity is strength.

ARMSTRONG: Yes.

GUPTA: And attitude is everything.

ARMSTRONG: Right.

GUPTA: You weren't given very good odds yourself.

ARMSTRONG: Well...

GUPTA: How important was attitude for you?

ARMSTRONG: Well, you know, I looked at -- it's -- it's ironic, because I looked at my disease. And I was -- let's say it was a coin toss when I was diagnosed. And that doesn't sound very good.

I mean, I don't want to flip a coin for my life right now. But I -- I actually looked at lung cancers that had a 3 or 4 percent survival rate. And I said, boy, I'm glad I'm not that guy.

GUPTA: Yes.

ARMSTRONG: And, so, you know, other people might be a 95 percent cure rate or whatever.

And -- and, as we said just on -- on "LARRY KING," I mean, we should not -- I mean, the patient walks in and said, what are my chances? Give me my number, Doc. Is it -- is it 50 percent? Is it 2 percent? Is it 98 percent?

We are not numbers. And, so, you have to go in. You have to ask the hard questions, get second, third, fourth, fifth opinions, whatever it takes to find the place that you feel like you will be best served. And, after that, you know, you -- you sit down and you say, I'm here. This is my place. And I'm going to believe in these doctors. I'm going to believe in the medicine. I'm going to believe in the procedures. And I'm going to believe that I'm going to make it.

And, if I don't make it, I want to die in peace, knowing I tried everything. And -- and I got to a place when I ended at Indiana University, where I said, look, you know, if this doesn't work out, boy, I -- I can't question anything.

GUPTA: Yes.

COLLINS: Lance Armstrong, it is a pleasure meeting you.

And, Sanjay, you're going to stick around to..

(CROSSTALK)

GUPTA: Sure.

COLLINS: ... take some call in a few minutes.

GUPTA: Absolutely.

COLLINS: But, for now, we want to toss things back to Washington and John.

ROBERTS: All right, Heidi, Dr. Gupta, stay right there, because there's a lot more to get to tonight, including the science and the art of spotting lung cancer while you can still treat it, especially in non-smokers, like Dana Reeve.

We will have that story tonight, and these stories.

(BEGIN VIDEOTAPE)

ANNOUNCER: What you don't know about Dana Reeve and the quiet killer that took her.

UNIDENTIFIED FEMALE: One hundred and seventy-three thousand people will be diagnosed this year with lung cancer. How do you keep ignoring those people?

ANNOUNCER: Tonight, the fight we must not ignore and why experts say they're not getting what they need to win the war on lung cancer.

Like Dana Reeve, also in her 40s, Joan never smoked, but the story of she lived until she died of lung cancer will stay with you.

UNIDENTIFIED MALE: It was such a shock to find out that this healthy woman would be diagnosed with a fatal disease.

ANNOUNCER: Joan's enduring legacy will challenge you and save other women.

Call us. 360's panel of medical experts take your calls on the detection, the treatment, and the race to find a cure -- that and more all ahead on this special edition of ANDERSON COOPER 360, "Lung Cancer: The Quiet Killer."

(COMMERCIAL BREAK)

ROBERTS: Lung cancer is the quiet killer, because it's rarely detected early enough to cure it. For Dana Reeve, a cough was the first sign that something was wrong. And her case isn't unusual.

With lung cancer, there's no agreement on the best way to find the disease before it causes symptoms, before it spreads, before it kills.

Again, here's 360 M.D. Dr. Sanjay Gupta.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): It started as a nagging cough for Micki McCabe. Doctors prescribed antibiotics for what they thought was pneumonia. No improvement. Then she was X-rayed, but, still, doctors needed to see more.

MICKI MCCABE, LUNG CANCER SURVIVOR: I had the CAT scan, which did seem to indicate that there were some tumors. I remember asking him then, did it seem very likely that I had lung cancer? He answered me very forthrightly that, more than likely, I did have lung cancer.

GUPTA: She was lucky. The C.T., or CAT scan, caught the cancer early enough that an operation could remove all of it. She was cured.

Now, Micki's case demonstrates a universal truth of medicine: Catch it early and you're more likely to beat it. But, you see, Micki's case is rare. When it comes to lung cancer, most patients don't catch it early enough. Many doctors might recommend a CAT scan for a smoker over age 50, but that's where the rules end.

DR. ROBERT KORST, ASSOCIATE PROFESSOR OF CARDIOTHORACIC SURGERY, NEW YORK-PRESBYTERIAN HOSPITAL/WEILL CORNELL MEDICAL CENTER: It is really hard to make any recommendations about screening in a patient who is not a smoker.

GUPTA: Unlike mammograms for breast cancer, scans for colon cancer, and PSA tests for prostate cancer, in lung cancer, we aren't even sure who to screen. C.T. scans have been proven to detect lung cancer better and earlier than X-rays and ANY other diagnostic test.

So, now a 50,000-patient study is trying to determine if CAT scans are the way to go. Results from that study are expected in the next few years. But, for now, they're expensive and not covered by insurance.

DR. SANJAY SAINI, PROFESSOR AND CHAIRMAN OF RADIOLOGY, EMORY UNIVERSITY SCHOOL OF MEDICINE: Whether or not C.T. -- lung cancer screening with C.T. does, in fact, save lives, we -- we don't know the answer to that yet.

Unfortunately, as you look inside the human body, there are things that we find that can be potentially bad, but we also find things that are of no consequence.

GUPTA: They're called false positives. And they occur 25 to 70 percent of the time, irregular results that can lead people to unnecessary procedures, from biopsies to invasive surgery.

Dr. Len Horovitz says that may be true, but it's still worth the risk.

DR. LEN HOROVITZ, PULMONARY SPECIALIST, LENOX HILL HOSPITAL: If there's a 25 percent false negative rate, that means that there's a 75 percent positive rate.

GUPTA: And he points out another virtue of a false positive: Simply having any kind of abnormality, even if it turns out to be nothing bad, can still scare people enough to make them stop smoking.

Micki McCabe, though, didn't wait for any recommendations. She's convinced that she's alive today because of that one scan years ago.

MCCABE: The early detection probably is why I'm talking to you now.

(END VIDEOTAPE)

ROBERTS: OK, tonight, Dr. Gupta is going to help us sort through fact and fiction when it comes to cancer.

Even though lung cancer is the leading cancer killer, there are clearly huge gaps in our understanding of it. So, let's do a little true and false with Dr. Gupta.

And let's start with this one: If you smoke now, you might as well continue, because you're destined to get lung cancer.

Dr. Gupta, true or false?

GUPTA: That is absolutely false, John, a really important point that it's always a good time to quit smoking.

Let me give you a couple of quick facts. If you're -- if you're 50 years old and you have been smoking your entire life, quitting today will cut your risk in half in a few years. If you're 30 years old, and you quit smoking today, you can reduce your risk back down to zero within a few years. So, it's always a good day to quit.

ROBERTS: All right. Question number two: Smoking is by far the number-one cause of lung cancer, but radon gas is the leading cause among non-smokers; true or false?

GUPTA: That is true. And this is actually surprising to a lot of people.

Smoking is far and away the number-one cause. You know, eight -- eight or nine times out of 10, it's going to be smoking. But radon, which is this naturally occurring uranium byproduct found in the soil, can actually infiltrate into your basement, and has been associated with lung cancer as well. So, it's actually the second most common cause of lung cancer.

ROBERTS: And I think I know the answer to this question, number three: Asbestos causes lung cancer; true or false?

GUPTA: That is true as well -- a lot made of asbestos over the years. You won't find much asbestos anymore, because of all the regulations with regards to building, John.

But asbestos specifically causes a type of cancer known as mesothelioma. And that is a type of lung cancer that is -- is -- is somewhat treatable, but can also be very deadly, if not caught early.

ROBERTS: All right. We will get to some more true-and-false in our next hour of 360.

Dr. Gupta, thanks very much.

GUPTA: Thank you.

ROBERTS: Now here's Heidi.

COLLINS: And more of our special, "Lung Cancer: The Quiet Killer," is just ahead.

But, first, Erica Hill from Headline News joining us now with some of the other stories we are following tonight.

Hi, Erica.

ERICA HILL, HEADLINE NEWS CORRESPONDENT: Hi, Heidi. Good to see you tonight.

We start off with news on the Patriot Act. It turns out, it is not going to expire after all. On Capitol Hill today -- actually, earlier this evening -- the House voted to renew controversial provisions of the sweeping bill. Supporters say the Patriot Act makes the country more secure. Some critics, though, believe it gives too much power to the White House. President Bush is expected to sign the legislation by Friday.

In New Orleans today, officials recovered the body of another Katrina victim -- the body found behind a house in the city's Lower Ninth Ward. Authorities are hoping DNA testing will help identify the remains. Now, that discovery comes just two hours after another body was found also in the Lower Ninth Ward.

In Florida today, a thick fog leading to a massive highway pileup -- it happened this morning near -- near Belle Glade. Thirteen tractor trailers and cars were involved in the chain-reaction crash. Six people were injured. Two are in critical condition.

And, in Pennsylvania, a 75-year-old woman is now under arrest for armed robbery. Police say Marilyn Divine held up a bank inside a supermarket yesterday morning. She allegedly showed two tellers a gun and told them to hand over the money. After a short chase, she was taken into custody.

Kind of a shocking story there, Heidi.

COLLINS: Boy, that's for sure.

Erica Hill, thanks so much. We will talk with you again soon.

Still to come tonight on 360, the story of Joan's Legacy, an organization founded in memory of a non-smoker who died of lung cancer.

And we're taking your calls, 877-648-3639.

From Washington and New York, this is a special edition of 360.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

SEN. TOM HARKIN (D), IOWA: Whoever coined the phrase that life is unfair must have had the Reeve family in mind, but these two people faced adversity with unflinching courage.

(END VIDEO CLIP)

COLLINS: Senator Tom Harkin there on the Senate floor today.

The death of Dana Reeve brings home a frightening truth, while lung cancer is often associated with smoking, it also strikes those who have never had so much as a single puff of tobacco in any form. That is what happened some years ago to a sharp, young journalist, no more a smoker than Dana Reeve, whose friends and colleagues decided that in her memory this was a cause they had to take up: the fate of those attacked by a disease unfairly thought of as always self- inflicted.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: She could fill the room with her laughter. She loved a party.

UNIDENTIFIED FEMALE: She was a person of great loves and great hates. And if she loved you, you were just lavished in that. UNIDENTIFIED MALE: Joan was a personality. She was a -- she was a toughie (ph). She was a newswoman.

COLLINS (voice over): Joan Scarangello was a brilliant news producer and writer who had worked with some of the top news people in the business. She was also a loving sister and wife, athletic, smart, and young.

Joan was 47 when she died of lung cancer. She had never smoked a day in her life.

UNIDENTIFIED MALE: She would tell somebody that she had lung cancer. The first question would be, "Oh, are you a smoker?" The year that Joan died, 20,000 to 25,000 nonsmokers died of lung cancer.

COLLINS: From the moment Patrick McNeve (ph) first met Joan, he knew that he had met his mate, if not his match.

UNIDENTIFIED MALE: I had a premonition that I would see her at the Christmas party and that we would hit it off. And that's what happened. The next premonition I had was myself in a tuxedo, and she was wearing a white satin dress.

COLLINS (on camera): Really?

UNIDENTIFIED MALE: We were going to get married, and that's what happened.

COLLINS (voice over): But what the premonition left out was the one wedding detail that would change everything. Joan had been going to the doctor for a cough that she simply could not shake.

UNIDENTIFIED MALE: And we went to the doctor's office and he told us, you know, "You have lung cancer." And there was this moment of just being totally stunned.

COLLINS: What this meant for Joan was the same disease that took her mother from her 20 years ago, at only age 52, was now the same disease spreading through her own body.

UNIDENTIFIED MALE: Now, mother died in '81. We just figured, you know, that we were just unlucky. Twenty years later, our sister was diagnosed with lung cancer and we found out that virtually no progress in that intervening time has been made in finding a cure.

You know, my mother was diagnosed and has had seven months from diagnosis until the day she died, and Joan had nine months.

COLLINS: Amazingly, those nine months, according to Patrick, were the happiest days for Joan.

UNIDENTIFIED MALE: The moments after her diagnosis were some of the happiest months of her life because she didn't know she was going to die so soon. So she was able to quit her job. She was able to spend more time with friends, spend time out in Southampton, which she loved so much, and write her book. Know that made her happy. I don't think she had any idea how close to death that she was.

COLLINS: But neither did Patrick, really. They planned a lavish wedding in Manhattan, a day she wouldn't let anything ruin.

UNIDENTIFIED MALE: There had been a doctor we had seen in Boston who wanted to do lung surgery on her, remove an entire lung. And she said, "I will not do that. I will not go down the aisle in a wheelchair. I'm going to be healthy. I'm going to look good for my wedding."

And she looked stunning. She was just absolutely gorgeous. So we had a beautiful wedding.

COLLINS (on camera): What are your memories from the wedding?

UNIDENTIFIED MALE: It was a perfect day. I mean, it's -- just give me a second.

UNIDENTIFIED FEMALE: She was coming in, and it was a sunny day, and the sunlight just came and just hit her as she was coming down the aisle. And we all -- we all thought of it as a blessing.

Sorry.

UNIDENTIFIED MALE: We had no honeymoon to speak of because we said, you know, some other day we'll decide to take our honeymoon, when you're better. Little did we know that that honeymoon would never happen.

COLLINS (voice over): Just a few months later, Joan Scarangello McNeve (ph) died of lung cancer, exactly 20 years to the month of her mother's death.

UNIDENTIFIED MALE: We got married the following February, had a lovely wedding. And she died that July. I mean, that's how quickly things happened. She was diagnosed in October and she died the following July.

COLLINS: But her legacy lives on. Patrick and Joan's families joined to form a unique and powerful nonprofit in her name. With private donations, Joan's Legacy funds innovative research into lung cancer.

UNIDENTIFIED MALE: She was always looking for the story that she felt like wasn't getting the attention. And, you know, at the end of the day she became the story.

COLLINS: And of all the stories she helped tell, her own became the one that left a permanent mark.

UNIDENTIFIED MALE: She may have died, but the fight will go on. As the minister said at her funeral, he says, "People die. Love does not."

(END VIDEOTAPE)

COLLINS: And if you would like to learn more about Joan's Legacy, you can always go to our Web site, cnn.com/360/blog.

Also, if you have any questions about lung cancer, we have the answer. Our team of cancer experts will be taking your phone calls when 360 continues. That number there on your screen now, 877-648- 3639.

Also tonight, a portrait of three women who never smoked but who died of what many call the smoker's disease.

360 will continue.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

DANA REEVE, ACTRESS: Just when you think you're coming out, you know, and you think, OK, it's all right, I see the light at the end of the tunnel, then I got this diagnosis in the summer. And it's been -- you start to wonder.

It's a rocky road. And -- but I do feel that with the support that I've received and just our family unit is so tight, that we're going to get through this like we got through everything else.

(END VIDEO CLIP)

COLLINS: Courage words from Dana Reeve, who last night lost her battle with lung cancer.

Many of you watching tonight certainly have questions about the disease. Well, now is your turn to ask them.

So here to take your phone calls in New York, 360 M.D., Dr. Sanjay Gupta and Susan Mantel, executive director of Joan's Legacy, the cancer research fund-raising organization that we reported on just a little bit earlier. And with us, too, in Boston is Dr. Pasi Janne of the Dana-Farber Cancer Institute.

Thank you all so much for being with us tonight.

And again, we want to put that number on your screen one more time so that you may call and ask your questions -- 877-648-3639.

John Roberts, now to you.

ROBERTS: Yes. And Heidi, just as we're getting our first caller set up, let me throw a question out there to Dr. Janne if I could.

Dr. Janne, I can just imagine what's going through the minds of the people across America tonight. And that is, the next time they get a cough, they're going to say, oh my goodness, is it cancer because that's the way that it started in Dana Reeve?

How do you know when a cough is a cold and when it's cancer? Or can you tell?

DR. PASI JANNE, DANA-FARBER CANCER INST.: Well, the symptoms and signs of lung cancer are not -- not specific. That is, that coughs are obviously associated with other respiratory illnesses and more -- and most commonly things that are seen during the winter months.

I think the times to bring these to the attention of your physicians is when they don't go away, or when they're treated, or when they get worse. That's the time that you need to do additional evaluations to make sure that these are not signs and symptoms of something more serious than just a respiratory infection.

ROBERTS: So how long would you have a cough before you became very concerned about it?

JANNE: Well, certainly something that was going on from weeks to months would be something a little bit atypical from a typical respiratory infection. Certainly if it was getting worse in intensity, it was associated with pain, with coughing up blood. Those would be all signs that there was no ordinary cough and that it may be a sign of something more serious.

ROBERTS: All right -- Heidi.

COLLINS: We know that people have questions out there, John. So we want to go ahead and get our first caller.

Now, this is Frank in New Jersey.

Frank, I believe you have a question to Dr. Sanjay Gupta?

CALLER: Yes. Thank you very much for taking my call.

I'm a 55-year-old person who has never smoked a day in his life, yet my paternal grandfather and father both died of lung cancer. Now, both were heavy smokers. And I'd like to know whether or not I run a risk, a genetic risk for developing this disease and whether or not there are any preemptive tests that I can undergo to determine an earlier diagnosis.

GUPTA: Yes. You know, Frank, thanks for your question.

A couple of things to think about. One is that I don't know how long you lived in the same household as your father when he was a heavy smoker, how much secondhand smoke you were exposed to, because that's something to consider as well.

The genetic risk is there, although somewhat small, I think. You might be someone who qualifies for some -- some earlier screening or someone who just pays more attention to the things Dr. Janne was just talking about, if you had a persisting cough, for example, or if you had some swollen lymph nodes, or something that seemed unusual to you, hoarseness of the voice that wouldn't go away. You might want to get that checked out earlier, rather than later.

The tests that we're talking about here, the most definitive test for you, would be probably a CAT scan of your lungs to actually see if there was anything unusual or abnormal there.

ROBERTS: Bonnie from Pennsylvania is on the line with us now.

Bonnie, what's on your mind?

CALLER: Hi. I'm a 63-year-old nonsmoker with advanced lung cancer. And now that more emphasis will be placed on the fact that Dana Reeve was a nonsmoker and that you can get cancer, possibly get cancer from second-hand smoke, I would like to know what we can do to make smokers more aware of the seriousness of second-hand smoke.

ROBERTS: Susan Mantel, that sounds like that's one that's right up your alley. Do you want to take that?

SUSAN MANTEL, JOAN'S LEGACY LUNG CANCER FOUNDATION: Sure. Well, Bonnie, I think that there are two parts to your question, from our point of view.

One is making smokers more aware. A lot of states have put initiatives into place trying to establish clean air acts. And New York is one that I'm lucky enough to live in where that's been taken very seriously. Illinois has just put that into place in some places. Chicago in a thorough way.

So there's more and more of a push. Actually, the Lung Cancer Alliance has a great map where you can see the states that are moving on that and also how you can get involved with doing that.

And that said, you know, I think it's -- it's up to all of us to make sure that our own environments are as clean as possible, and then know at some point, you know, it's about taking care of ourselves as patients whether we smoked or not.

COLLINS: Susan, thank you so much for that.

And we want to let you know we will be taking more of your phone calls when 360 continues. This is your chance to ask the questions you've always wanted to ask at that phone number -- 877-648-3639, 877- 648-3639.

We'd also like to hear from you on our blog. Once again, that address is www.cnn.com/360.

Back in a moment.

(COMMERCIAL BREAK)

COLLINS: We are answering your questions tonight about lung cancer. The phone number once again is 877-648-3639.

And with me here in New York are Susan Mantel, executive director of Joan's Legacy. That's a group that funds research into lung cancer and particularly nonsmoking-related lung cancer.

And 360 M.D. Dr. Sanjay Gupta, you've seen this guy before.

And in Boston, Dr. Pasi Janne of the Dana-Farber Cancer Institute.

One more time for the phone number, folks, 877-648-3639.

We want to go ahead now and get to Jan in Michigan. She is calling in. And I believe this phone call will be for Dr. Janne.

Jan, go ahead.

CALLER: Yes, growing up I was exposed to second-hand smoke and now have asthma. I was wondering if there's been any studies connecting people with asthma and lung constrictions. Are they more likely to get lung cancer than anyone else?

JANNE: Well, certainly second-hand smoke is associated with the development of lung cancer and individuals who don't themselves smoke. And it can obviously cause other lung illnesses, such as the asthma and respiratory illnesses that you're describing.

The association between the asthma and lung cancer, however, is less clear in my mind. But certainly the exposure to second-hand smoke is much clearer.

ROBERTS: We're also answering your e-mails tonight.

Allison from Missouri sent in an e-mail, and she asked, "Do lungs ever fully recover after quitting smoking?"

And Sanjay Gupta, why don't you handle that one. Is it dependent on how long a person has smoked or is it not dependent?

GUPTA: Yes, it is dependent, to some degree, on how long the person's been smoking. Let me say a couple of things.

One is that it's always a good time to quit smoking. So regardless of whether your lungs can fully recover or not, it's always good to quit smoking.

A couple of quick stats, though.

If you're 50 years old and you quit smoking today, you can cut your risk in half. That's really important.

If you're 30 years old and you quit smoking today, you can actually bring your risk back down to zero. And if you consider that your lungs are fully recovering, taking your cancer risk back down to zero, then it certainly does.

COLLINS: Never too late to quit.

GUPTA: That's right.

COLLINS: Montie in Alabama is on the phone for us now.

Hi, Montie.

CALLER: Hi there. COLLINS: Go ahead with your question.

CALLER: My family has been decimated by cancer, particularly lung cancer. My father died about three years ago after his lung cancer migrated to his brain.

He buried two sisters from lung cancer just a couple years before him passing away. My brother is at very end stage Non-Hodgkins Lymphoma. Our son had multiple myeloma and he's in remission, and my husband is battling the after-effects of prostate cancer, but his cancer -- he's cancer-free.

But my question is this: my mother was diagnosed with small cell lung cancer in 1985. And she took massive radiation. It aged her 30 years. She's 70 now. She had COPD, advanced emphysema.

COLLINS: Montie, that's -- it's unbelievable. Your question, I believe, we should probably direct to Dr. Janne from the cancer institute. What is your question for us tonight?

CALLER: My question is, with her having 35 percent lung function and still smoking like a train and having smoked all her adult life, even since her cancer treatment, what -- how is it that she staves off the return of lung cancer?

JANNE: Well, certainly if she continues to smoke that is the biggest risk for her to develop lung cancer. Having one lung cancer, which she had in the past, also puts her at risk of developing a second lung cancer.

So certainly the best way for her to prevent the development of recurrence or a second lung cancer would be to stop smoking altogether if possible.

ROBERTS: All right. That's all the time that we have for now, but we're going to come back next hour and answer some more questions that you might have. So keep those calls coming in.

You know, before tonight, you may never have heard that lung cancer kills more women than breast and ovarian cancer combined. So why isn't that publicized?

We'll have the answer coming up.

This is a special edition of 360, "Lung Cancer: The Quiet Killer."

(COMMERCIAL BREAK)

ROBERTS: More of our special, "Lung Cancer: The Quiet Killer," is just ahead. But first, Erica Hill from HEADLINE NEWS has some of the business stories that we're following tonight.

(BUSINESS REPORT)

ROBERTS: We want to thank our international viewers for watching.

And ahead on 360, the life and death of Dana Reeve, gone at just 44, the victim of lung cancer. Tonight, we look at her legacy and the quiet killer that claimed her.

Also, he is an inspiration to millions. Tonight, cancer survivor and seven-time Tour de France champion Lance Armstrong talks to us about losing his friend, Dana Reeve.

And later, three women, they never smoked but all have been diagnosed with lung cancer. We'll hear their stories of courage when our special report continues.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com

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