Most people think of lung cancer as a disease of the elderly, but it also affects younger people, albeit less commonly. When lung cancer does occur, it tends to be unique, both in the type of cancer involved and in the risk factors. Often, lung cancer in young adults progresses and requires aggressive treatment, but the results are usually good.
age and gender
Lung cancer is associated with older age, with 70 being the average age at diagnosis. About 53% of cases occurred in adults 55 to 74 years old, while 37% of cases occurred in people over 75 years old. In contrast, only 10 percent of lung cancers occur in people under the age of 55, and the incidence declines sharply every decade before that age.
According to a 2019 study, Cancer Journal, Only about 1.4% of lung cancers occur in people under the age of 35.
One of the things that makes lung cancer different in younger people is that younger women are more susceptible to the disease than younger men. This compares to 57.8% of men and 45.9% of women in the larger cancer patient population.
How is lung cancer different in women?
Cancer type and stage
The main type of lung cancer affecting adults under the age of 35 is adenocarcinoma.Given that lung adenocarcinoma is the most common type of lung cancer overall, this is not an entirely unusual finding.
A notable difference is the severity of youth. Young people tend to have more advanced lung cancer at diagnosis, and most have stage 4 disease (also called metastatic lung cancer).
Metastasis is the process by which cancer spreads from a primary tumor to diseased organs and is a sign of advanced, incurable disease. In young adults, metastases usually affect a single organ, most commonly the pleura (lining of the lungs), bone, liver, and brain.
Where does lung cancer spread?
Delayed diagnosis is considered to be the main reason for the high incidence of advanced lung cancer in young adults. Lung cancer is often not considered by doctors when young adults have respiratory symptoms.
Even if cancer is suspected, chest X-rays often miss lung cancer at an early stage, in part because adenocarcinomas occur in the outer parts of the lung rather than in the airways or in the center of the lung (like squamous cell carcinoma).
How to Diagnose Lung Cancer
Another difference in lung cancer among young adults is that it is associated with smoking.According to a 2018 review Translational Lung Cancer Research, Young people with lung cancer are more likely than smokers to become non-smokers.
This is in stark contrast to statistics seen in more lung cancer patients, where approximately 85% of cases and 90% of deaths can be directly attributed to cigarette smoke.
According to published in Cancer Journal Involved 8,734 lung cancer patients under the age of 35, of whom 71.6% were non-smokers, and about half of them had no smoking history.
Why does lung cancer increase in people who never smoke?
Genetics is thought to play a central role in this abnormality. Just as BRCA gene mutations are known to increase the risk of breast cancer, researchers have begun to identify gene mutations that also increase the risk of lung cancer.
Three gene mutations commonly associated with lung adenocarcinoma are:
- EGFR mutation, the most common genetic alteration in lung adenocarcinoma patients
- ROS1 rearrangement, found in 1% to 2% of patients with non-small cell lung cancer (eg, adenocarcinoma)
- ALK rearrangements, one of the more common mutations found in never-smokers, are found in 3% to 13% of lung cancer patients
Of the three, EGFR mutations are the least common in young adults with lung cancer and are associated with less aggressive disease.
ROS1 mutations and ALK rearrangements are not only more common in young adults with lung cancer, but are almost always associated with aggressive disease.
These and other gene mutations develop in up to 59 percent of lung cancer patients. Other less common mutations include HER2 and BRAF2, which are also associated with breast cancer.
Family history is considered a major risk factor for lung cancer in young adults. 2017 Journal Review Oncology Letters It was concluded that having a parent or sibling with lung cancer increases your risk of developing lung cancer by 50% compared to someone with no family history.
Still, the findings are far from conclusive. In fact, some studies have found no evidence of familial associations for lung cancer in young adults, suggesting that delayed diagnosis and other risk factors, such as secondhand smoke, radon exposure in the home, or air pollution, contribute to the development of lung cancer. risk. Further research is required.
Will I get lung cancer if my parents have lung cancer?
Diagnosis and Treatment
The diagnosis of lung cancer in young adults is no different than in older adults. It may involve imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI) scans, as well as investigative procedures such as bronchoscopy and sputum cytology. Lung cancer can be definitively diagnosed by biopsy.
Depending on the stage and grade of the disease, treatment will involve many of the same options as older adults. These may include:
- Surgery, usually for stage 1, 2, and some stage 3 cancers
- Chemotherapy, the backbone of lung cancer treatment
- radiation therapy, often used to control advanced cancer
- Immunotherapy, using drugs such as Opdivo (nivolumab) or Keytruda (pembrolizumab) to stimulate a defensive immune response in patients with stage 3 and 4 lung cancer
Targeted therapy is a newer class of drugs that work by attaching to unique receptors on mutated cancer cells. Because the drug only attaches to these receptors, they do not touch other normal cells and cause fewer side effects.
There are several targeted drugs approved in the United States for the treatment of lung cancer. Some of the more commonly used drugs are:
- Tagrisso (osimertinib), first-line targeted therapy for EGFR-positive tumors
- Tarceva (erlotinib), for tumors with certain EGFR mutations
- Vizimpro (dacomitinib), also used in people with certain EGFR mutations
- Xalkori (crizotinib) for people whose tumors have ROS1 or ALK4-EML rearrangements
More targeted drugs include:
- Alecensaro (alectinib) for metastatic ALK-positive tumors
- Alunbrig (brigatinib) for metastatic ALK-positive tumors
- Zykadia (ceritinib) for metastatic ALK-positive tumors
- Lorbrena (lorlatinib) for metastatic ALK-positive tumors
- Rozlytrek (entrectinib) for metastatic ROS-1-positive tumors and metastatic NTRK-positive tumors
- Trabecta (capmatinib) for metastatic tumors with mesenchymal-epithelial transition [MET] Exon 14 skipping mutation
- Retevmo (selpercatinib) for metastatic RET-positive tumors
- Tafinlar (dabrafenib)/Mekinist (trabetinib) for metastatic tumors with BRAF V600E mutation
- Gilotrif (afatinib) for metastatic tumors with certain EGFR mutations
- Iressa (gefitinib), for metastatic tumors with certain EGFR mutations
Compared with older adults, young adults are more likely to develop treatable genetic mutations, such as ALK4-EML, and are more likely to be candidates for drugs such as Xalkori.
Because many dangerous genetic mutations can be treated with targeted therapy, genetic testing (also called genetic or molecular analysis) is highly recommended to see if young adults have a treatable mutation. Genetic analysis is recommended for all advanced cancer patients.
How to treat lung cancer
Although lung cancer in young adults tends to be advanced when it is first diagnosed, they tend to have better outcomes (prognosis) than older adults with the same stage and cancer type.
Younger adults are generally better able to tolerate cancer treatment and are therefore often treated more aggressively than their older counterparts.The use of targeted drugs also helps increase the likelihood of sustained progression-free survival in young adults.
According to research in Journal of Oncology, The 5-year survival rate of lung cancer patients aged 18-35 was 53.3%. This is significantly better than the 16 percent five-year survival rate seen in more people with the disease.
Lung cancer survival rates by type
Resources are available for young people with lung cancer, including local and online support groups and nonprofits that specialize in serving young people with lung cancer.
- The Bonnie J. Addario Lung Cancer Foundation supports people age 50 or younger by helping them understand the health care system and the various financial assistance programs available to them.
- Stupid Cancer: Youth Cancer Voices is a supportive community to meet online and in person to empower young people with cancer. There’s also a “Stupid Cancer” radio show, as well as regional gatherings and an annual summit.
- The Ulman Cancer Fund for Young Adults provides information, resources and advice for young adults with cancer. This includes help with treatment decisions, housing, college scholarships, jobs, financial aid, fertility issues, and general health and wellness counseling.
Social media has also proven to be a powerful resource for young lung cancer patients. Every other Tuesday night, there’s a Twitter chat involving lung cancer patients, cancer advocates, family members and therapists. Use the hashtag #LCSM (which stands for Lung Cancer Social Media) to identify posts and engage in conversations.
Coping and Living with Lung Cancer
Lung cancer is uncommon in young people, but it does happen. Because it’s easy to miss it in the early stages, speak up if you have signs or symptoms of lung cancer and a family history of the disease. This is true whether you are a smoker, ex-smoker or never. By catching lung cancer early, you have a better chance of getting long-term remission and living a normal, healthy life.
Frequently Asked Questions
What is the average age of lung cancer patients?
The average age of people diagnosed with lung cancer is 70.People under the age of 55 account for only 10% of lung cancer cases, while people between the ages of 55 and 74 account for 53% of lung cancer cases.
What are the symptoms of small cell lung cancer?
Symptoms of small cell lung cancer (SLCL) include chest pain, cough, and difficulty breathing. These symptoms are often not informative enough to diagnose SLCL, so your doctor may ask about your family’s cancer history.
What are the most common types of cancer in young adults?
The most common types of cancer in young adults aged 20 to 39 include breast cancer, brain and spinal cord tumors, cervical cancer, colorectal cancer, lymphoma (Hodgkin and non-Hodgkin), melanoma, ovarian cancer, testicular cancer, Thyroid cancer, and sarcoma (connective tissue cancer).
Signs and symptoms of lung cancer in non-smokers