Martha’s cough started changing. It wasn’t just a tickle anymore, it was deeper, more persistent. The mucus in her airways felt thick and sticky. Her doctors chalked it up to a rare lung condition, but something didn’t feel right. Then came the X-ray, revealing a shadowy spot on her lung. That “shadow” turned out to be a Stage IIIA lung cancer, a diagnosis that hit Martha, a non-smoker, like a punch in the gut.
It’s a scenario becoming increasingly common. Lung cancer, once firmly linked to smoking, is now silently targeting those who’ve never touched a cigarette. In fact, between 10 and 20% of lung cancer diagnoses are now made in people who’ve never lit up.
Why is this happening?
Turns out, lung cancer in non-smokers is a different beast. It’s often adenocarcinoma, a type that starts in mucus-producing cells, and while it shares some similarities with smoking-related cancers, it has its own distinct set of genetic mutations.
One of the key differences is a mutation called EGFR. This gene codes for a protein on the surface of cells, and mutations in EGFR are more common in non-smokers, especially women, particularly those of Asian descent.
While the exact reasons for this are still being investigated, scientists are exploring the role of hormones and certain genetic variants that affect oestrogen metabolism, particularly in East Asians.
The good news is that the discovery of these driver mutations has led to the development of targeted therapies. EGFR inhibitors, for instance, have been around for about 20 years, and many patients have seen impressive results. But as with any cancer, resistance can develop, leading to relapse.
The fight against lung cancer in non-smokers is ongoing. Scientists are constantly working to understand the disease, develop new drugs, and improve treatment outcomes. The future is looking brighter, with newer medications and improved diagnostic tools offering hope for a better prognosis.
This is a story about a silent killer and the tireless efforts to fight it. It’s a story about understanding a disease that’s evolving and finding ways to combat it, even when it hits those who never expected it.
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