Lung Cancer in Never-Smokers: Treatment Options When It’s Caught Early.
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A doctor meets with a patient and shows the results of a lung scan in an office setting.

Lung cancer is on the rise among people who have never smoked—including celebrities such as comedian Kathy Griffin, who went public with her stage 1 lung cancer diagnosis in August 2021. 

While lung cancer is highly treatable when detected early, only 16 percent of lung cancers are diagnosed at an early stage. That is because early-stage lung cancer rarely causes symptoms.

In the U.S., about 10-20% of lung cancers occur in people who have never smoked or who smoked fewer than 100 cigarettes in their life. Lung cancer can be caused by cell mutations with or without a known cause or exposure to environmental toxins such as secondhand smoke. More women than men (15.7% vs. 9.6%) who never smoked are diagnosed with lung cancer. 

The lungs don’t have pain sensors, so most people don’t know a tumor is forming until it is big enough to cause functional problems. Additionally, lung cancer screening is not recommended for never-smokers because the risks of screening (cost of time and radiation exposure) outweigh the benefits (finding cancer) which makes diagnosis at early stage difficult in this population. 

When lung cancers are found early in never-smokers, it’s often because something unusual shows up during imaging of the chest for another reason, such as an X-ray, CT scan, or mammogram. 

Early detection can decrease mortality by as much as 20%, even among high-risk populations. If you have a history of risk factors—or if you notice any unusual symptoms—talk with a doctor to see if you might need further evaluation. 

Early lung cancer has few symptoms.

Symptoms of early lung cancer, if they occur, can be similar to those of other conditions. When they are noticeable, signs of early lung cancer can include:

  • Dry cough
  • Coughing up blood
  • Fatigue
  • Pain in the chest, if the cancer is growing against the lining of the lung
  • Shortness of breath
  • Unexplained weight loss

If you experience any of these symptoms, don’t ignore them. Talk with your doctor, especially if you have risk factors such as a family history of lung cancer or known or suspected exposure to environmental toxins, such as radon or secondhand smoke. 

Thanks to advances in cancer care over the last decade, early-stage lung cancer is highly treatable, and often cured, with surgery, radiation therapy, and/or chemotherapy with immunotherapy.

Early-stage lung cancer treatment.

The lungs are made up of five lobes: the right lung has three, while the left lung has two. When cancer cells are isolated to just one lobe, removal of that lobe can be the best chance for a cure, especially if patients have good lung function before surgery. 

Minimally invasive surgical techniques allow access to and removal of the affected lobe with smaller incisions, smaller surgical scars, and less pain than with traditional surgery:

  • Patients are placed under anesthesia, and a breathing tube is placed in the throat to support breathing during surgery (intubation). 
  • Using a small camera and precise robotic-guided instruments, the surgeon makes two or three small incisions to access the affected lung between the ribs.
  • The surgeon dissects and removes the affected lobe without opening the patient’s chest or moving the ribs. 
  • The small incisions are closed, and the patient is awakened from anesthesia.

Most patients can go home after staying just a day or two in the hospital. While some reduced lung function is to be expected, most patients start to feel “normal” again 6-12 months after lobectomy. 

Some patients may experience soreness or numbness at the surgical site or symptoms such as shortness of breath, fatigue, or a sore throat as the body heals. People reported that Kathy Griffin says her voice sounds different after surgery; while uncommon, this could be a side effect from lobectomy or even the intubation and may be temporary. 

While any surgery carries a risk of complications, most patients decide these risks are acceptable to be able to remove the lung cancer. Dedicated multidisciplinary thoracic oncology teams, like the one at MedStar Washington Hospital Center, specialize in chest and lung cancer. Our close-working team of radiologists, pulmonologists, radiation oncologists, thoracic surgeons, and oncologists has access to the latest imaging, surgical technologies, and leading-edge personalized therapies that reduce the risk of complications and speed recovery.

Patients who have lung cancer surgery may need radiation therapy, chemotherapy, or both to shrink the tumor before surgery or destroy cancer cells that remain after surgery. 

Some patients with small or contained tumors can choose targeted radiation therapy instead of surgery. A radiation oncologist can direct strong beams of radiation to the tumor while sparing healthy tissue around it. Radiation can shrink the tumor or in some cases eliminate it. 

How to reduce lung cancer risk as a never-smoker.

Sometimes, it is unclear why someone who never smoked develops lung cancer. While you cannot control all of your cellular process or the world around you, there are proven ways to reduce your risk of lung cancer:

  • Get plenty of cardiovascular exercise—aim for 30 minutes of moderate-intensity activity a day, such as walking, running, swimming, or playing pickleball. If your lungs are otherwise strong and healthy, your recovery from lung surgery will be smoother.
  • Don’t believe the common misperception that vaping or smoking substances other than cigarettes is safe. We generally recommend that everyone avoid inhaling anything other than the air that’s around you. If you question whether it’s safe to inhale something, it’s safest not to do so.
  • If a loved one needs help to quit smoking or vaping, talk with a doctor about effective treatment options. Lean on the MedStar Health experts in our Smoking Treatment and Recovery (STAR) Program to help them kick the habit. 
Lung cancer detection and treatment has improved significantly in the last 10-15 years. Finding cancer early and getting connected with an expert team can result in positive outcomes for lung cancer.

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