Lung Cancer in Women and Nonsmokers: What To Know About Symptoms, Diagnosis, and Treatment – On Cancer – Memorial Sloan Kettering

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Dr. Helena Yu specializes in developing new treatments for lung cancer.
study in October 2023 about the rates of lung cancer in younger women made some alarming headlines. That research found that lung cancer in women between the ages of 35 and 54 is more common than it is among men in the same age group.
Overall, though, the news about lung cancer is largely hopeful. In fact, another 2023 study from the American Lung Association found that survival rates for lung cancer are improving, especially among historically marginalized communities of color. This is due to advances in the detection, diagnosis, and treatment of lung cancer, which have resulted in a greater number of people with lung cancer being cured or living a much longer time with the disease. Many of these advances have been made by doctors and scientists at Memorial Sloan Kettering Cancer Center (MSK).
We spoke with MSK thoracic oncologist and early drug development specialist Helena Yu, MD, about why lung cancer is more common in women than men in the 35-to-54 age group and why people get lung cancer even if they’ve never smoked.
On the whole, the statistics on new cases of lung cancer are promising. The number of people being diagnosed with lung cancer every year is falling, thanks in large part to a reduction in the number of people who smoke.
Research has found that although lung cancer rates are going down in both men and women of all ages, they are decreasing more slowly in younger women. This is why more women than men are being diagnosed in this age group.
We don’t know why this is the case, but we have some theories. It may be that women metabolize the carcinogens found in cigarette smoke in a different way than men do. It may also be that women are more susceptible to certain environmental exposures, like air pollution and radon, a radioactive gas found naturally in some environments. But no direct links have been confirmed, and there is still a lot that we need to study.
Much of my research focuses on lung cancer caused by a mutation (or change) in a gene called EGFR. This mutation is more likely to be found in people with lung cancer who have never smoked. It’s also more commonly found in women than men, and in Asian women in particular. The people who get these EGFR-related cancers don’t have the demographics of “typical” lung cancer patients.
As the number of smoking-related cancers continues to go down, the overall proportion of lung cancers in nonsmokers, including those caused by EGFR and other specific gene mutations, will increase.
The most common symptoms of lung cancer are the same in men and women. They also are not different based on your age, ethnicity, or smoking history. They include:
The problem is that when someone who is young, female, or a never-smoker goes to the doctor with lung cancer symptoms, the suspicion that they may have cancer is much lower than it would be for others. That’s because of the stereotype that people with lung cancer are most likely to be older men, especially current or former smokers.
I’ve treated patients who were mistakenly diagnosed with asthma, bronchitis, or walking pneumonia before finally learning they had cancer.
We know that the earlier lung cancer is detected, the more likely it is to be successfully treated. This illustrates the value of getting a lung cancer diagnosis as soon as symptoms appear. It’s also why people who are at increased risk should participate in a lung cancer screening program.
Many of the symptoms of lung cancer are common, and I don’t want to worry people unnecessarily about having lung cancer. But it’s important to know your body. If you feel like something is not right and your doctor is not taking your concerns seriously, it’s OK to be persistent about getting scans or other tests.
Due to new treatments like targeted therapies and immunotherapy, lung cancer deaths are decreasing. MSK has been instrumental in bringing new therapies to approval through lung cancer clinical trials (research studies). There are many different clinical trials available at MSK for people with lung cancer.
Some of these new treatments are targeted therapies based on molecular changes in tumors. At MSK, we use MSK-IMPACT®, a tumor genetic test, to match our patients with the best treatment based on the individual characteristics of their cancer. We also offer MSK-ACCESS®, a liquid biopsy test that can monitor a patient’s response to treatment and determine when we may need to change course and offer them something different.
There is a stigma around lung cancer because of its connection to smoking. But anybody with lungs can get lung cancer. I don’t want patients to ever feel guilty or responsible for their cancer diagnosis.
I hope that by educating people about lung cancer and its causes, we can decrease the stigma while increasing awareness about early detection and new treatment options.
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