Learning you have lung cancer as a non-smoker

Lung cancer can be a shocking diagnosis when you've never smoked - how can it be?

Categories: For Potential Participants, [Cancer, Lung Cancer]

It wasn’t that long ago that cigarette companies advertised in magazines and their packaging lacked visible health warnings. In the 1990s however, public health agencies started to educate on the risks of smoking relative to developing lung cancer and other serious medical problems. As a result of this messaging, many people came to associate smoking behavior with lung cancer. Though smoking is implicated in the cast majority of lung cancer cases, there are patients with lung cancer that never picked up the habit.

Finding yourself diagnosed with a cancer that you didn’t think you were at risk for can be shocking. Some non-smoking patients may have been exposed to second hand smoke or environmental pollutants (i.e., radon) correlated with tumor development in the lungs. Other patients will learn that their cancer likely stemmed from increased genetic risk that they were unaware of previously. Patients coming to terms with a diagnosis of lung cancer may feel compelled to share their ‘non-smoker’ status to try and remove any feelings of personal stigma around the diagnosis.

Roughly 10-20 percent of lung cancers in the US (so about 20,000 to 40,000 cases annually) develop in persons who report never smoking (or smoking less than 100 cigarettes). Under a microscope, cancer may look differently in lungs affected by cigarettes. However, symptoms may present the same (cough, chest pain, shortness of breath). The most common lung cancer in non-smoking individuals is called an adenocarcinoma. This form of non-small cell lung cancer typically starts in the cells lining the air sacs of the lung. People who have smoked tend to be diagnosed with a different non-small cell cancer called squamous cell; this form of cancer is rarely found in non-smokers.

Adenocarcinomas tend to grow more slowly than other forms of lung cancer. The survival rate of patients diagnosed with a lung adenocarcinoma has improved significantly in recent years. Data from the National Cancer Institute indicates that the survival rate rose from 20.8 percent in the year 2000 to 26.7 percent in 2013. This is due to the availability of new targeted therapies and better, more precise surgical techniques (to remove the tumor) and radiation (beams of high energy that can destroy any remaining cancer cells).

For patients that wish to understand if and how their genes may have played a role in the development of lung cancer, an altered gene may have been inherited at birth or else acquired later in life. Alterations can make it difficult for a person’s body to ward off cancer growth or have attributes that are linked with faster growth. An oncologist may test the patient as well as the tumor for specific biomarkers in order to determine best course of treatment and any findings that might be relevant to other blood relatives.

Patients that are open with family and friends about their lung cancer diagnosis can help educate on the disease. For those who have a smoking history, letting others in on the journey can be helpful in convincing smokers in one’s life to either take steps towards quitting, or else spur interest in a lung scan. Non-smokers who share their story can help raise awareness around the reality of lung cancer in those who never used tobacco. This may encourage others to learn about their genetic risk or evaluate how to reduce exposure to external sources of potential carcinogens.

Interested in learning more about clinical research for lung cancer, both adenocarcinomas and squamous cell varieties? Use our trial search to look for trials in need of participants.



Lung Cancer Among People Who Never Smoked | CDC

Lung Cancer in Nonsmokers > Fact Sheets > Yale Medicine

Adenocarcinoma of the lung - Harvard Health

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