Getting lung cancer as a non-smoker is “a lot more common than people realize,” says Dr. Nathan Pennell, a lung cancer specialist, affecting 20,000 to 40,000 people a year

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Kathy griffin
Kathy Griffin
| Credit: FilmMagic

Kathy Griffin shared difficult news last week: despite never being a smoker, she was diagnosed with stage 1 lung cancer, and would undergo surgery to remove part of her left lung.

While the majority of lung cancer diagnoses occur in people who smoke, a small but growing portion of patients are non-smokers.

"It's a lot more common than people realize," Dr. Nathan Pennell, a lung cancer specialist at the Cleveland Clinic, tells PEOPLE. Of the 200,000 Americans a year who are diagnosed with lung cancer, around 10% of the men and 15% of the women have never smoked, though those percentages are likely higher, as the data is a few years behind, he explains.

Pennell says researchers are unsure if the rise in lung cancer cases among non-smokers is because "it's truly more common and more people are getting it, or whether it's just a higher percentage of people with lung cancer are non-smokers because fewer people are smoking. Less than 15% of adults in the U.S. are smoking now, which is fantastic, so a higher percentage of the cases of lung cancer in the last five or six years are in non-smokers."

But generally, "the only thing you need in order to get lung cancer is lungs," he says.

Here's what to know about lung cancer in non-smokers.

How do non-smokers get lung cancer?

It's not fully known how non-smokers develop lung cancer, Pennell says, but "there are a number of risk factors other than tobacco for lung cancer."

"There's definitely some component of family history," he says. "Radon, which is a colorless odorless gas that is in most people's basements in the United States, is probably the second biggest risk factor for lung cancer behind tobacco. That's something that everyone tests for now when they sell a house, but for older people, it wasn't routinely tested for when they were growing up and they could have been exposed to that. And industrial pollution and other things like heavy metals certainly can play a role as well."

What are the symptoms of lung cancer?

Unfortunately, lung cancer is difficult to diagnose early in non-smokers.

"We have screening CT scans, but that's only for people who have smoked at least 30 packs a year and are over age 50," Pennell says. "For people who have smoked less than that, or have never smoked, there's no screening."

Part of diagnosing lung cancer in non-smokers comes down to "luck," he says.

"If they go into the emergency room because they had a bike accident or a car accident and get scans, doctors could spot a nodule in their lungs," he says. Otherwise, people may develop a bad cough or be coughing up blood, which would hint at lung problems, but "unfortunately, most of the time when you develop symptoms from your lung cancer, it's more advanced at that point and harder to cure."

Griffin had that luck on her side, and said that her doctors noticed her lung cancer during a regular checkup.

What does treatment typically involve?

For those like Griffin with stage 1 lung cancer that has not spread outside the lungs, "the typical surgery is a lobectomy," Pennell says.

"Doctors will usually remove the complete lobe of the lung where the tumor is, leaving you with the other half still to breathe. And in non-smokers, especially, typically you can survive just fine on three quarters of your lungs," he says.

The whole portion of the lung, and not just the tumor itself, must come out because of how fast the cancer moves.

"Lung cancer is very nasty and it spreads very early through the lymphatic channels to lymph nodes," Pennell says. "The lungs are essentially sort of the filter system for everything that you breathe, and have very extensive lymphatics and lymph nodes throughout them. And so it has been very conclusively shown that just removing the portion of the lung with the tumor in it has a much higher rate of recurrence than removing the entire lobe of the lung, which also removes all of the lymph nodes and fabrics."

RELATED VIDEO: Kathy Griffin Reveals Lung Cancer Diagnosis, Will Undergo Surgery: 'Doctors Are Very Optimistic'

But if the cancer truly hasn't spread — which is something doctors will get a better sense of once they remove the tumor — surgery is usually enough. If it has moved out of the lungs, though, patients could need additional treatments like chemotherapy or radiation.

What is recovery from lung removal surgery like?

In 2021, a lobectomy is minimally invasive surgery, Pennell says, and has "very short recovery times."

"Oftentimes people are only in the hospital for 48 hours and within a month they feel seventy-five percent better. And within three months they feel, more or less, a hundred percent again."

While you "do lose some of your excess capacity for exercise or breathing," he adds, it won't have much of a noticeable effect unless the patient is a pro athlete.

"People can even live with one lung, honestly. Especially if they're healthy."

How can we improve outcomes for non-smokers with cancer?

Pennell wants people to be aware that "non-smokers absolutely get lung cancer."

"It's a lot more common than people realize," he says. "And we do need to do a lot more research in order to try to help screen for that, because right now there really is no way of identifying lung cancer in non-smokers other than again, by luck."