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occurs naturally outdoors. It has been found in concentrated amounts inside some homes that were built on soil that contains natural uranium deposits. The Environmental Protection Agency publishes a guide on how to test for radon gas in your home.
Secondhand smoke: This is the smoke you breathe in from another person’s burning tobacco product, which is linked to an estimated 7,000 lung cancer deaths each year in the U.S. Researchers are also studying “third-hand smoke,” or the film (usually invisible) of nicotine and chemicals that may be left on furniture, walls, clothing, and other surfaces.
Cancer-causing agents at work: This is a special concern for those with prolonged and repeated exposure to such carcinogens as asbestos, heavy metals, and diesel exhaust.
Air pollution: While scientists link indoor and outdoor air pollution to lung cancer, the risk of lung cancer from air pollution is believed to be low in the United States, where air quality is regulated, compared to many other countries in which it is not.
What are the symptoms of lung cancer in nonsmokers?
Most nonsmokers have no early signs of lung cancer, which means it is often not diagnosed until it has spread—but some do have symptoms in the early stages. These are similar to the symptoms in smokers and may include the following:
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worse over time
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pneumonia
What is the treatment for nonsmoker lung cancer?
When nonsmoker lung cancer is diagnosed early, surgeons can usually treat it by removing the affected tissue or tumor. People who don’t smoke typically tolerate surgery better because they have better lung function.
It’s best to treat cancer when it’s caught early and confined to a local area, which makes it easier to remove entirely, Dr. Boffa says. The surgeon will remove not only the abnormal nodule, but also some of the normal tissue around it, along with the lymph nodes, which can carry cancer to other parts of the body. (Cancer that is found in the lymph nodes helps the pathologist determine the stage of the cancer, or how advanced it is.)
“This guides us as far as helping to make decisions about additional therapy, such as targeted therapy or chemotherapy after surgery,” Dr. Boffa says.
How is knowledge of genetics improving treatment of lung cancer in nonsmokers?
In many cases, this is driving treatment choices. At Yale, all lung cancer patients—smokers, nonsmokers, and never-smokers—undergo genetic testing. If tumor profiling shows a particular gene has mutated or become abnormal, an oncologist may treat it with targeted therapies. These are anti-cancer drugs that can kill specific cancer cells without harming normal cells.
“This is a vast improvement over chemotherapy, which also affects healthy cells, resulting in difficult side effects,” says Dr. Chiang.