Non-Smokers And Lung Cancer
- Kathy Griffin is part of the 20% of lung cancer patients who have never smoked. Lung cancer causes other than smoking include exposure to radon, second-hand smoke, or environmental pollutants.
- Women are also at higher risk of lung cancer, and women in Griffin’s age group (50-60) have actually seen an increase in cases in recent years.
- Non-smokers have a far greater survival rate than smokers who are diagnosed with lung cancer, and can often be treated with targeted therapy.
That diagnosis was even more of a shock given the fact that Griffin, 60, has never smoked in her life.Read More
Causes of Lung Cancer in Non-Smokers
Despite some promising drops in mortality rates, lung cancer still kills more Americans every year than any other form of cancer. And while most of those who are diagnosed are or were smokers, one in five individuals will have never touched a cigarette or vape in their lifetime.
“Some lung cancers are from unknown exposure to air pollution, radon, or asbestos,” Dr. Raja Flores, system chair of thoracic surgery at Mount Sinai previously told SurvivorNet. “We also see more never-smokers with lung cancer who have a family history of it.”
There is a good deal of research on the causes of lung cancer in those who have never smoked, and in most cases it is environmental factors that are suspected of causing the disease.
Radon is the second-leading cause of lung cancer, responsible for anywhere from 3 to 16% of cancer cases depending on the levels present in a given area, according to the World Health Organization.
Smokers, meanwhile, are 25 times more at risk from radon than non-smokers.
Breathing secondhand smoke is another lung cancer risk for non-smokers. About 7,000 adults die of lung cancer from breathing secondhand smoke each year, according to the American Cancer Society.
Air pollution is also known to cause some lung cancers, while other factors seen in non-smoking patients diagnosed with the disease include a family history and having previously been diagnosed with HIV or AIDs.
Women and Lung Cancer
Cancer death rates have been largely decreasing in recent years, with lung cancer seeing some of the biggest declines.
The Annual Report to the Nation on the Status of Cancer examined cases from 2014 through 2018 and found that the mortality rate among lung cancer patients decreased 4.3% in women.
That was not as much, however, as the 5.2% decrease that men saw in that same time period.
The New England Journal of Medicine published a similar study in 2018 that found while there had been declines in incidences of lung cancer in both young men and young women, those declines had been far steeper among men. The study noted that differences in smoking patterns were not believed to be the cause. In that study there was also one group of women who were seeing increases in lung cancer while the rest saw decreases – women who were in their 50s.
A February 2020 study in the International Journal of Cancer found that women between the ages of 30 to 49 were being diagnosed with lung cancer at higher rates than men. This study also notes that differences in smoking patterns do not fully explain the increase for women. Study authors hypothesized that smoking filtered cigarettes could potentially be noteworthy, or that women have different genetic risk factors for lung cancer than men.
Symptoms of Lung Cancer
Kathy Griffin’s doctors were monitoring a previously known mass on her lung. This is not the case for most people, who should look out for these symptoms of lung cancer:
Symptoms of lung cancer typically include:
- Sudden and unexplained weight loss
- Constant coughing that becomes painful over time
- Shortness of breath
- Changes in voice or difficulty speaking without getting winded
- Pain in the torso, mid- and upper-back, and shoulders
- Discoloration or a sudden change in color of mucus and saliva
Treating Lung Cancer in Non-Smokers
There are two major types of lung cancer: non-small cell and small cell. Non-small cell breaks down into three subtypes: adenocarcinoma, squamous cell carcinoma and large cell carcinoma.
“Adenocarcinoma is the most common type in both smokers and never smokers,” says Flores, “but we see more adenocarcinoma in never smokers than squamous and small cell. We see all three types in those who smoke.”
The lung tumors of those who have never smoked are genetically different from those of smokers. This matters because these genetic traits are often what makes the tumors grow. Different drugs target different genetic traits in order to stop or slow the progress of the disease.
Lung tumors in non-smokers are more likely to have mutations in a gene called EGFR and another called ALK. Doctors have treatments that can stop or slow the growth of cancers with these genetic traits.
People who have EGFR-positive lung cancer often respond to drugs that target that gene, known as “targeted therapy,” such as erlotinib (Tarceva) and gefitnib (Iressa). People who have the less common ALK gene mutation may take a targeted medication that blocks that gene’s activity, such as alectinib (Alecensa), brigatinib (Alunbrig), ceritinib (Zykadia), crizotinib (Xalkori), or lorlatinib (Lorbrena).
Non-smokers respond better to targeted drugs, Flores says.
No matter what the genetic makeup of the tumor, when doctors find your cancer early enough, the ideal treatment is first to remove as much of the cancer as possible with surgery. Kathy Griffin revealed that she is having half of her lung removed to beat the disease. Non-smokers tend to do better with lung surgery than smokers do because their lungs work better to begin with. Overall, non-smokers have higher lung cancer survival rates than smokers.
A Survivor’s Tale
Donna Hunting, like Griffin, was in her 50s when she learned that she had stage IV non-small cell lung cancer.
A non-smoker, Hunting previously told Survivor Net: “That day was shattering to my family and to me.”
The good news is that after testing showed her tumors had a mutation in a specific gene, doctors were able to put her on a pill that blocked those mutations. In less than two months there was no longer any evidence of the disease in her body.
“Cancer is a part of my life now, but it isn’t my whole life. I’m not letting cancer define me,” said Hunting.
Non-smokers should not think they are immune to the disease. As Hunting pointed out: “It’s not a smokers’ disease. If you have lungs, you can get lung cancer.”