ALL YOU NEED IS LUNGS
It’s well known that smoking is a significant risk factor for lung cancer. It causes almost three-quarters (72%) of cases. But, it’s not just a smokers’ disease. Anyone can get lung cancer.
20% of people diagnosed with lung cancer have never smoked and this figure is rising. By ‘never-smoker’ we mean someone who has smoked fewer than 100 cigarettes in their lifetime.
ANYONE CAN GET LUNG CANCER
People who don’t smoke usually don't consider lung cancer as a possibility, even when they have persistent unexplained symptoms.
Around 90% of people with non-smoking lung cancer are diagnosed when the disease is at an advanced stage when treatment that could cure them is no longer an option.
As a result, too many people die needlessly from non-smoking lung cancer. It’s now the eighth most common cause of cancer-related deaths in the UK, and the seventh most prevalent cancer in the world .
It’s Time To Take Action
We want to change this. That’s why ALK Positive UK, EGFR Positive UK and the Ruth Strauss Foundation have teamed up to encourage people with symptoms to see their GP and request a chest X-ray.
If you have symptoms, the chances are they are not caused by cancer and having a chest X-ray will put your mind at ease. But if it is cancer, the earlier it’s diagnosed the better the chances of treating it successfully.
The symptoms of lung cancer are often similar in both smokers and non-smokers. They include :
A persistent cough
Fatigue – feeling tired all the time
Shortness of breath
Hoarseness – a croaky voice
Ongoing pain in the chest, neck, upper back or shoulder
Unintentional weight loss and loss of appetite
A chest infection that won’t go away/keeps coming back
Coughing up blood
Persistent enlarged lymph nodes around the collarbone in the neck
If you’ve been experiencing persistent symptoms and there is no obvious cause, visit your GP and request a chest X-ray.
What are the symptoms?
Types of non-smoking lung cancer
Around 80-85% of all lung cancers are non-small cell lung cancer (NSCLC) , and most cases of lung cancer in non-smokers and never-smokers are NSCLC.
There are many sub-types of NSCLC, but the three main ones are adenocarcinoma, squamous cell carcinoma and large cell carcinoma.
Large cell carcinoma is characterised by large, abnormal-looking cells and usually starts in the centre of the lungs. It is very rare.
Squamous cell carcinoma often develops in the bronchi cells that line the airways in the middle of the lungs.
Adenocarcinoma is the most common type of NSCLC. It usually develops in the mucus-making gland cells in the outer parts of the lungs. Adenocarcinoma is the most common type of lung cancer in people who have never smoked.
About 50-60% of the types of lung cancers in people who never smoked are adenocarcinomas. About 10-20% are squamous cell carcinomas. The rest are small cell lung cancers (6-8%) and other types of lung cancer.
What causes lung cancer in people who have never smoked?
Scientists and doctors are still learning about non-smoking lung cancer. So far, research has identified some possible causes, including :
second-hand tobacco smoke, or passive smoking
exposure to cancer-causing substances in the workplace (this is more common in men than in women)
outdoor pollution
You may be more at risk of non-smoking lung cancer if you’ve previously had lung disease or certain infections, such as tuberculosis (TB), human papillomavirus (HPV) or pneumonia .
Genetic mutations and lung cancer
Non-smokers are more likely to have developed lung cancer as a result of a genetic mutation or abnormality.
Two genetic mutations that can cause lung cancer are found in the ALK and EGFR genes, which are explained below. In both cases, the mutations are not hereditary (passed on from parent to child) but develop later in life.
ALK+ lung cancer
ALK is short for anaplastic lymphoma kinase. ALK is a gene that provides instructions for making proteins in the body. When the ALK gene fuses or sticks to another gene, the cells mutate causing them to divide and multiply more quickly than normal. This proliferation of cells is what causes cancer, and as the cells continue to divide and multiply, so the cancer grows and spreads. When the ALK gene behaves this way, it’s called ALK fusion or ALK rearrangement. When that happens and causes lung cancer, it’s called ALK-positive lung cancer.
Around 5% of cases of NSCLC are ALK-positive . ALK-positive lung cancers are most commonly found in people with adenocarcinoma and in people who have never smoked.
EGFR+ lung cancer
EGFR is short for epidermal growth factor receptor. EGFR is a protein found in cells that helps them to grow and multiply. When the gene responsible for the EGFR protein is damaged or mutated, the cells continue to grow and proliferate, which causes cancer.
When this gene mutation causes lung cancer, it’s called EGFR-positive lung cancer.
Around 10-15% of lung cancers in the UK are EGFR-positive . Like ALK-positive lung cancer, EGFR-positive lung cancer tends to be found in people with adenocarcinoma, and in non-smokers and never-smokers.
