While celebrating with friends after her high school graduation, 16-year-old Amy Clark suddenly fell from a fence and injured her back. Initially, she felt fine, but over the next two years, persistent back pain led her to seek medical attention. A CT scan revealed that her back was completely normal, but it uncovered a suspicious spot on her right lung.

Amy was referred to a respiratory specialist. The doctor explained that this type of lung lesion is typically seen in long-term smokers and is very rare in young women. After eight months of monitoring and tests, Amy was diagnosed with stage 4 lung cancer, which had metastasized to her lymph nodes and posterior ribs. She was just a month shy of her 21st birthday.

Amy shared that she never thought she would get lung cancer because she had no obvious symptoms and had never smoked. She was left wondering, "How could this happen?"

As shocking as Amy's story is, it's not unique. An increasing number of young women who have never smoked are being diagnosed with lung cancer. Approximately 20% of cases now occur in non-smokers, and this number is on the rise. If categorized separately, lung cancer in non-smokers is the 8th leading cause of cancer death in the UK and the 7th globally. In Vietnam, according to the Ministry of Health, 15-35% of lung cancer cases are due to exposure to secondhand smoke, and the number is increasing.

Notably, women account for nearly 70% of these cases. Doctors and researchers are exploring several hypotheses, with air pollution emerging as a key factor.

"We have found a clear link between air pollution and lung cancer in never-smokers. Fine dust particles in the air can cause chronic lung inflammation and promote tumor growth," said Doctor William Hill from the Francis Crick Institute, London.

Amy Clark, diagnosed with lung cancer at 21. Photo: Amy Clark

Amy Clark, diagnosed with lung cancer at 21. Photo: Amy Clark

A major obstacle is the difficulty of early detection. Professor Matt Evison, deputy medical director of Cancer Alliance, explained that symptoms like coughing, chest pain, or back pain are easily mistaken for other common problems. As a result, over 90% of non-smokers are diagnosed only when the cancer has reached an advanced stage.

Another example is Jules Fielder, who was diagnosed with incurable lung cancer at just 37. She had never smoked and initially noticed a lump in her neck. Before that, she had sought medical attention several times for back and elbow pain but was misdiagnosed. By the time it was discovered, the cancer had spread to her spine and pelvis.

A major risk factor is the EGFR gene mutation, which accounts for nearly 20% of adenocarcinoma cases in non-smoking women. Cells carrying this mutation are often dormant but can be activated by air pollution. However, tumor development takes decades, leading to late detection.

Although air pollution levels have decreased significantly in the UK over the past 20 years, the lasting impact of these mutations will likely cause the number of cases to continue rising. Scientists believe that with better pollution control, the incidence rate could decrease.

In addition, female hormones are also suspected of contributing to the increased cancer rate. Doctor Robert Hynds, University College London, suggests that estrogen or autoimmune diseases, which are more common in women, may be linked to chronic inflammation and increase cancer risk.

Jules Fielder, diagnosed with incurable lung cancer at 37. Photo: Jules Fielder

Jules Fielder, diagnosed with incurable lung cancer at 37. Photo: Jules Fielder

Currently, targeted therapies for gene mutations like EGFR have helped extend the lives of patients. Tyrosine kinase inhibitors like Osimertinib can control the disease for years without the need for chemotherapy.

For Amy, this therapy has allowed her to maintain a near-normal quality of life. At 26, she continues to work, hike, and attend music festivals like Glastonbury.

Mel Erwin, another patient, has had a similar journey. When she began experiencing fatigue and shortness of breath in 2020, she attributed it to long Covid. However, an X-ray revealed a tumor in her left lung. After surgery to remove half of her lung, two years later, she was diagnosed with terminal lung cancer.

Mel is currently taking Osimertinib, which helps inhibit tumor growth. "It's allowing me to live well, and I plan to live for many more decades," she said.

Mel also emphasized that people should not ignore any unusual signs in their bodies. She advises seeking medical attention if there are any concerns and not being afraid to be "a nuisance" to protect one's health.

Stories like Amy's, Jules', and Mel's pose a significant question for the medical community: "How can we detect and protect non-smokers from a disease still perceived as solely linked to smoking?". While there are no definitive answers yet, recognizing the risk factors, from pollution to hormones, is the first step toward changing perceptions and health policies.

Thuc Linh (Adapted from Daily Mail)