Invisible toxin

In July 2016, Patti Busch leaned over her grandson's Pack 'n Play and felt a sharp pain in her side.

The next day, a scan revealed a tumor so large that it had cracked Busch's rib when she bent over.

A biopsy and further examinations confirmed the worst. Busch had stage 4 lung cancer.

The retired Newark florist had been careful about her diet. She exercised and never smoked.

She had no idea what could have caused the cancer, until her doctor mentioned a word she only vaguely recognized: radon.

She and her husband, Buddy, immediately tested their home for signs of the invisible and odorless gas that can seep into homes from the ground.

They discovered their home contained 25 pico-Curies of radon for each liter of air-six times the level deemed safe.

The couple installed a system to pull radon out of their home. Busch knows it may not help her now, but she hopes her experience helps others.

She has joined forces with Annie Cacciato, another woman with stage 4 lung cancer that she believes was caused by radon. The two met last year while being treated at the Arthur G.

James Cancer Hospital at Ohio State University.

Busch and Cacciato are helping spread the word about radon, which the Environmental Protection Agency has labeled the nation's second leading cause of lung cancer, after smoking.

"I think we can do something valuable with this terrible situation," Cacciato said. "People may have toxic gas in their home and not know about it." Cacciato was diagnosed with lung cancer in 2013. Like Busch, she was not a smoker.

But she knew enough about radon to have installed a system in a previous home and to test the air in her current home.

When her lung cancer was diagnosed, she was confident the radon didn't come from her home. Then another place occurred to her: the building where she had housed her art education nonprofit group for five years. Her concerns led to the building being tested. The test revealed a reading of 25, the same reading Busch discovered.

"There's no doubt in my mind" the radon caused the cancer, Cacciato said.

The EPA estimates that radon is responsible for about 20,000 lung-cancer deaths each year, and scientists have demonstrated a link between radon and cancer. But determining the source of lung cancer in nonsmokers is notoriously difficult.

"There's absolutely no way of being 100 percent sure what causes a person's cancer," said Dr. David Carbone, director of the thoracic oncology program at the James.

"But radon gas is a radioactive substance that you breathe into your lungs, and it deposits a particle that is highly radioactive.

When it decays, it gives a big punch to the cells," said Carbone, who is treating Cacciato.

"It's pretty clear that it's something that should be avoided." Radon has been shown to be especially dangerous when combined with smoking, said Carbone, who installed a radon removal system in his own home after discovering elevated levels of the gas.

Radon can seep into homes through a crawlspace, slab or basement floors and walls. It can be at least partially removed by installing a mitigation system, basically a tube that sucks air (and radon) from the ground below the home to outside the building.

Such systems typically cost $1,000 to $1,500.

Cacciato, Busch and health advocates such as the American Lung Association recommend radon tests for new homes or homes that are sold.

"I believe all homes and buildings where people spend large amounts of time, such as home, school and work, should be tested and mitigated," said Cacciato, who in December completed coursework to become a licensed radon tester in Ohio.

Some municipalities require new homes to include radon removal systems. Cacciato would like to see a similar statewide requirement, along with a requirement that homeowners disclose any radon tests or mediation on homes when they sell.

While there is no requirement to test homes when they are sold, such tests have become common in recent years.

"We'd like to see all homes tested," said Chris Alexander, supervisor of the Ohio Healthy Homes and Lead Poisoning Program.

"Radon testing is not expensive. You can easily test your own home as a homeowner." Homeowners can hire a radon company to test a home, or, for less money, can buy a kit to test the home themselves.

Short-term test kits, which can take only a few days, can be purchased for under $15, but Consumer Reports magazine and most experts recommend a long-term test, which measures radon levels over several weeks.

Those test kits range from about $20 to $200.

Alexander said homeowners should be sure to hire a licensed radon company to install a removal system, if needed.

"Unless you've tested, you don't know what the radon situation is in your house," Evans said.