Published Nov 23, 2020

Princess Margaret Had Lung Biopsy in 1985 to Check For Cancer After Smoking Heavily For Years; It’s Important to Be Proactive

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Decades of Smoking

Princess Margaret, portrayed by Helena Bonham Carter in Netflix’s show The Crown, had a lung biopsy to see if she had cancer; she started smoking cigarettes when she was just 15-years-old.
A lung biopsy is a procedure where doctors will take a part of the lung and examine it for any signs of cancer or other diseases.
Tobacco in cigarettes is a carcinogen that causes mutations in lung cells and enables the growth of cancer; 80% of lung cancer deaths are caused by smoking.

The late Princess Margaret, a member of the Royal Family, is getting renewed attention through actress Helena Bonham Carter’s portrayal on Netflix show The Crown; as is the fact the royal took serious steps to figure out whether she had lung cancer. As a long-time smoker, and having lost her father to the disease, Princess Margaret needed to take control of her health.

Princess Margaret was never diagnosed with lung cancer, but was at serious risk of the disease due to her smoking habits. She started when she was just 15-years-old, and continued until she quit cold turkey in 1991. However, in 1985 before she stopped smoking, she had a lung biopsy to determine whether she had lung cancer. This is the same procedure her father, King George VI, went through which diagnosed him with the disease. He passed away from lung cancer at 56-years-old in 1952.

A lung biopsy is a procedure where doctors will take a part of the lung and examine it for any signs of cancer or other diseases. By examining the sample under a microscope, this is a critical step in determining whether the organ is showing signs of disease. Once locating cancerous cells, the next step is determining the stage.

Developments in Diagnosing Lung Cancer

Lung biopsies are a critical step in diagnosing lung cancer, but since Princess Margaret’s procedure 35-years-ago, researchers have found ways to diagnose the disease in a less invasive way. Traditional bronchoscopy (a type of lung biopsy) can't always access the outer regions of the lungs, and in the past, this meant that surgery was required to diagnose out-of-reach lung cancers. However, with the discovery of electromagnetic navigation bronchoscopy, intensive surgery is sometimes not necessary.

This new biopsy creates a 3D road map of the lungs from a CT scan to guide your surgeon to the lesion. Tiny catheters are then placed through the bronchoscope to reach and biopsy the tumor. It can take up to five days to get the results, but the procedure itself is very quick.

“This is not a painful procedure for the patient,” Dr. Ashutosh Sachdeva, Director of Interventional Pulmonology at University of Maryland, told SurvivorNet in a previous interview. “The entire process may take an hour, or at times, hour and a half. We do get some feedback from the pathologist immediately, if there is an abnormality. But in general, it takes about three to five days for the patient to get final results.”

Doctors will also need samples of the lymph nodes, which sit around the windpipe. This is so they can examine whether the lung cancer has spread. To do this, doctors will pass an endoscope with a tiny camera down into the windpipe to reach the lungs, where it creates images of lymph nodes using sound waves. A hollow needle can then be passed through the scope to retrieve biopsy samples of any enlarged lymph nodes.

Dr. Ashutosh Sachdeva breaks down a minimally invasive procedure to diagnose lung cancer

Smoking’s Link to Lung Cancer & Treatment

Lung cancer is the second most common cancer and the leading cause of cancer death in the United States. Even though people who don't smoke can also be diagnosed with the disease, those who smoke are at significantly higher risk. The tobacco in cigarettes is a carcinogen that causes mutations in lung cells and enables the growth of cancer. In fact, according to the American Cancer Society, about 80% of lung cancer deaths are caused by smoking.

"If you're smoking, don't smoke," Dr. Joseph Friedberg, the head of the Division of Thoracic Surgery at the University of Maryland School of Medicine, previously told SurvivorNet in an interview. "You never return down all the way to the person who never smoked as far as your risk of lung cancer. But it goes down. It goes down with time. So if you're smoking, stop. That decreases your chance of getting a lung cancer."

For those diagnosed with lung cancer who haven’t stopped smoking, the habit can also influence lung cancer surgery. Smoking can paralyze tiny, hair-like cells called cilia which line our windpipes and sweep mucus out of the lungs. If these cells are paralyzed, the mucus has a harder time being flushed out of the lungs. This can heavily influence the after-math of lung cancer surgery since these secretions can get caught in your lungs and increase the risk of developing pneumonia, a potentially fatal complication for those recovering.

Dr. Joseph Friedberg explains how quitting smoking can help outcomes of lung cancer surgery

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