On Jan. 25, the GO2 Foundation for Lung Cancer held a special live discussion called “Why Can Lung Cancer Happen to Young People?” The stream featured Dr. Jorge Nieva, associate professor of clinical medicine at University of Southern California, and Dr. Narjust Duma, associate director of the Cancer Care Equity Program and a thoracic oncologist at the Dana-Farber Cancer Institute.
In this installment of GO2’s “Lung Cancer Living Room” series, Dr. Duma and Dr. Nieva discussed an upcoming epidemiologic trial for people who were diagnosed with lung cancer when they were under 40. Unlike drug trials, which test the efficacy of newly developed treatments on volunteers, epidemiologic trials help researchers uncover the causes of different diseases.
As Dr. Nieva noted, many people think about lung cancer as a disease that affects elderly people, but that’s not necessarily the case. “About 8 percent of the cases are in people who are under 55,” Dr. Nieva stated. “Another 2 percent are people who are under 45.”
Dr. Nieva cited an earlier epidemiologic trial conducted with the hopes of understanding how lung cancer appears in young people and in older people. “There were a lot of differences,” Dr. Nieva said.
Younger individuals with lung cancer, the study found, often did not have a history of smoking. Women were also found to have higher rates of lung cancer at young ages than men. What’s more, almost 84 percent of participants were found to have specific biomarkers — mutations in genes like the EGFR, ALK, and ROS1 genes. These changes are not seen as frequently in older individuals with lung cancer.
“Lung cancer is still considered a disease of older, white men,” Dr. Duma commented. “But we see that is, unfortunately, changing over time. Over the last 10 years, we have seen an increasing number of patients that are younger than 50, younger than 40 years old, diagnosed with lung cancer.”
According to Dr. Duma, the rates of lung cancer in younger populations is on the rise in the U.S., as well as in Europe, Asia, and Brazil. She confirmed the disease is different for young people than it is for older ones. “A good percentage of the patients that are younger than 50 that get diagnosed with lung cancer are women. There is also a good percentage that are of Asian descent, and the majority of the type of lung cancer that happens in younger patients is a type called adenocarcinoma.”
The stereotype of how the typical person with lung cancer is supposed to look poses unique challenges to the health care community. Dr. Duma said, “These younger patients suffer a lot of delays in diagnosis. They're often told they have asthma; in the case of women, it can be called anxiety. And that delays the diagnosis, making these patients at high risk for being diagnosed as stage 4 or metastatic disease.”
“More and more younger patients are dying of the disease,” Dr. Duma said. “And due to the stigma associated with lung cancer, we don’t see a big sign in the news.”
To help uncover the causes of the growing incidence of lung cancer in young people, the Addario Lung Cancer Medical Institute is now enrolling participants in an epidemiologic study titled Epidemiology of Young Lung Cancer.
As Dr. Duma and Dr. Nieva explained, the study is recruiting young individuals with non-small cell lung cancer. Participants must have been diagnosed before 40 and undergone comprehensive biomarker testing.
Dr. Nieva urged those who are eligible to enroll. “Progress doesn’t happen in a vacuum,” he insisted. “That progress happened because we participated, and we had clinical trials. And it was the patients who enrolled in those clinical trials … that make the treatment of the next generation of lung cancer patients better.”
You can learn more about the study and sign up online.