When Dannie Woodrum developed a nasty, tiring wheeze at the age of 32, the possibility of lung cancer never crossed her mind. After all, her exposure to tobacco, while extensive, had not been extreme: both of her parents smoked cigarettes while Dannie was growing up, and her husband, Ron, was a smoker for the first several years of their marriage. Living in a tiny South Carolina town where smoking was, as she recalls, "the thing to do," Dannie herself had taken up the habit as a teenager. She managed to quit after eight years, however, and now hadn’t smoked for nearly as long. She decided her symptoms must be allergies -- and the local doctor she visited agreed.

But lung cancer was, in fact, exactly what Dannie had. When her condition was finally identified, she was confronted with a challenge unlike any she had ever imagined having to face. The devastating diagnosis also placed her squarely in the middle of an ominous trend in women's health. "Lung cancer kills about 70,000 women each year, and that number is on the rise," says Duke thoracic surgeon Thomas D'Amico, MD. Lung cancer is the leading cause of cancer death in this country.

Tucked invisibly among the reams of data that yield statistics like these are human stories like Dannie's. The busy mother of three young daughters, she ignored her mysterious, stubborn respiratory condition for as long as she could. Then, one morning she woke up to a terrible, crushing pain in her chest. X-rays, followed by a bronchoscopy, revealed that lung cancer had invaded a primary airway in her left lung, and the entire lung had collapsed as a result. When the couple got the shocking news, Ron's response was immediate: Dannie had to be treated at Duke.

There, things moved quickly. D'Amico removed Dannie's ruined lung, using a minimally invasive surgical technique that left her with only a 3 ½ -inch scar along her left side. Because she was still a young woman, her chances of coping well with aggressive treatment -- and of reaping decades of life in the bargain -- were strong. So, after recovering from surgery, Dannie was given a course of chemotherapy, followed by radiation therapy.

Dannie recently celebrated five years with no recurrence of her cancer -- the milestone typically used to pronounce a bout of cancer “cured.” But she must live with the knowledge that she is now at higher risk for developing a new lung cancer. She must also live with painful memories. Dannie still cringes when she remembers the seemingly endless series of daily injections that she had to give herself, with her husband's help, to keep her white blood cell count up during months of treatment.

Recalling the emotional stresses that the illness imposed on her family is even more harrowing. "I wasn't there when my youngest went off to her first day of kindergarten," Dannie says. "It still hurts to think of everything I missed -- and everything I put my girls through. I nearly killed myself and deprived them of their mother."

A lingering sense of uncertainty about the future now exaggerates Dannie's natural parental anxieties. "Sometimes I think I'm too hard on my daughters," she says. "I want so much to get them on the right track, because I don't know what will happen.” (Dannie will be coming to Duke for regular checkups for the rest of her life.)

Yet there's no doubt that Dannie is one of the lucky ones. "Most lung cancers are asymptomatic until they have metastasized to other areas of the body and become much harder to treat successfully," says D'Amico. "Dannie's tumor was still fairly small, but it was located in an area where it caused disproportionate damage to the lung -- and that's why it was discovered."

Of course, when it comes to the notion of "luck," everything is relative. Medical science has yet to determine why some young people like Dannie get lung cancer, while other people smoke well into old age and never become ill. "Everybody has his or her own genetic factors that affect how their lungs respond to toxins," says D'Amico. "We've seen enough young people with lung cancer that a case like Dannie's doesn't really surprise us anymore. Anyone who has ever used cigarettes is at a higher risk to develop lung cancer. That's why it's so important to avoid the habit or, if you do smoke, quit as soon as you possibly can."

Garst, too, is a passionate advocate for awareness of the dangers of smoking, especially for women. "For reasons we don't understand, women's lungs seem to be more vulnerable to the carcinogenic properties of tobacco," she says. "Yet women have not stopped smoking in recent years at the rate that men have. Some of the reasons they started in the first place -- for example, the idea that it makes them seem hip or glamorous -- make it harder for them to stop. It takes a lot of determination and willpower to break a dependency on cigarettes. But the harmful effects of long-term tobacco use make quitting well worth the effort."

As for Dannie, she's determined to do what she can to prevent young people from smoking in the first place. Working part time as a substitute teacher, she talks with students about what she's been through at every appropriate opportunity. "If I had any idea what lay in store for me," she says, "I would never have lit that first cigarette."