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Lung Cancer in Nonsmokers: Yes, It’s Possible

If you’ve never taken a puff of a cigarette, you might assume you’re safe from getting lung cancer. It’s true avoiding these cancer-causing products and other forms of tobacco significantly reduces your risk for lung cancer, but nonsmokers may still be at risk.

“Lung cancer has historically carried a negative stigma where people feel like they caused it, ” said Elbert Kuo, MD, a thoracic surgeon at Banner MD Anderson Cancer Center and co-director of the Lung Cancer Program. “However, as many as 20% of people who die from lung cancer each year have never smoked or used any form of tobacco.”

The rate of lung cancer in nonsmokers is increasing

The overall rate of lung cancer diagnoses and related deaths is decreasing thanks to screening and early detection, but the percentage of cases in what experts call “never smokers” is rising. For never smokers, early symptoms are often overlooked because lung cancer may not be considered a risk. This means that lung cancer is usually diagnosed at later stages when it’s more difficult to treat. “We need to find lung cancer earlier when it’s treatable and survivable,” Dr. Kuo said.

Lung cancer risk factors in nonsmokers

There are several factors, aside from smoking, that increase your risk for lung cancer. Whether you smoke, quit smoking or are a never smoker, read on to learn more about potential risk factors and how to lower your risk.

Genetic Mutations

One predictor of lung cancer could be in your DNA. “We now know that genetics can play a role in lung cancer,” Dr. Kuo said. “Many lung cancer patients who are nonsmokers show a particular gene that has mutated or is abnormal. The good news is that we can treat these mutations with targeted therapies.”

Family History

If you have a family history of lung cancer, you could be at greater risk for developing the cancer as well. This is particularly true if you have a first-degree relative, that means a parent or sibling, who developed the disease before age 50.

Environmental Factors

In addition to genetics and family history, there are a number of environmental factors that can increase your risk for lung cancer. These include exposure to:

In addition to these environmental risk factors, having the human immunodeficiency virus (HIV) also puts you at higher risk of developing lung cancer.

Types of lung cancer in nonsmokers

The two main types of lung cancer are small cell lung cancer and non-small cell lung cancer. The most common type in nonsmokers is a non-small cell lung cancer called adenocarcinoma.

“Adenocarcinoma often starts in the outer part of the lungs and can be present for a long time before someone even starts experiencing symptoms,” Dr. Kuo noted. “In some instances, it may have already started to spread to other areas of the body before a diagnosis is made.”

Symptoms of lung cancer in nonsmokers

The early stages of lung cancer rarely cause symptoms – for smokers or nonsmokers.  However, some people may experience some of the following symptoms:

  • Persistent cough
  • Shortness of breath, wheezing or hoarseness
  • Coughing up blood or rust-colored phlegm
  • Swelling of the neck and face
  • Repeated episodes of pneumonia or bronchitis
  • Constant chest pain
  • Arm or shoulder pain
  • Unexplained weight loss or loss of appetite
  • Feeling weak or tired
  • Widening of the fingertips and nailbed also known as “clubbing”

"If you have any of these symptoms, talk to your health care provider,” Dr. Kuo said.

Reduce your risk for lung cancer

The most important thing you can do to reduce your risk for lung cancer is to not use tobacco products of any kind.

And while there isn’t much you can do to change your genes or family history, you can still help lower your risk for lung cancer by avoiding secondhand smoke and other environmental risk factors. You can also have your home tested for radon.

Worried you might be at risk for lung cancer?

Lung cancer screening is only recommended for people with a smoking history according to the following guidelines:

  • Ages 50-80 years of age
  • Are current smokers, or former smokers who have quit within the past 15 years
  • Have a 20 pack-year smoking history (for example, one pack a day for 20 years or two packs a day for 10 years)

However, if you have a family history for lung cancer, have been exposed to environmental risk factors, such as radon, or are experiencing symptoms, talk to your health care provider to be screened.

“Nationwide only 4% of the people eligible for lung cancer screenings have gotten them,” Dr. Kuo said. “There is a huge opportunity here to find lung cancer early and beat it.”

Looking to the future

Lung cancer is still most often diagnosed at a late stage, but “the future outlook is very bright and promising,” Dr. Kuo said. “We have increased awareness, early detection through lung cancer screenings and amazing advances in our treatment of the disease. Over the next decade, we hopefully will change the face of lung cancer and increase the number of survivors.”

If you believe you may be at risk for lung cancer, talk to your health care provider or find a Banner MD Anderson Cancer Center specialist near you. Visit bannerhealth.com.

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Cancer Lung Cancer Pulmonology and Asthma

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