Lung Cancer in Young Adults

Many people think of lung cancer as a disease of older people, but lung cancer does occur in young people.

There aren’t any clear criteria defining “young” when it comes to lung cancer. Many studies and articles discuss lung cancer occurring under the age of 40, 45, or 50 as young. Other people would define “young” as being diagnosed with lung cancer before the age of 60. Currently, the average age at diagnosis is 70.

Statistically, there are some ways in which lung cancer in young people is quite different from lung cancer in older people.

How Common Is It?

At first glance, lung cancer in young people may seem uncommon. But considering that lung cancer is the leading cause of cancer deaths in men and women in the United States, even a small percentage can translate to many people with the disease. Every year, about 200,000 people are diagnosed and 150,000 people die. The deaths are not limited to older people. Approximately 13% are younger than age 50 years.

Stage at Diagnosis

Younger people tend to have more advanced lung cancer at the time of diagnosis than older patients; a greater number of young patients are diagnosed with stage 4 disease. This makes sense in some ways. Lung cancer—especially in young, healthy, never-smokers—isn’t usually high on a doctor's radar screen, and this can result in a delay in diagnosis. Those who are young are often first diagnosed with asthma, bronchitis, or even allergies before the diagnosis is finally made. Many young people have had chest X-rays which have failed to show cancer, and it's important for anyone of any age to know that chest X-rays can miss a diagnosis of lung cancer.

Genetic Predisposition

People who are diagnosed with lung cancer at a young age are more likely to have other family members who have suffered from the disease. It's likely that heredity plays a much larger role in lung cancer that develops in young patients than in older patients, and researchers are just beginning to identify some of the genes that may predispose young people to the development of lung cancer.

Type of Lung Cancer

The most common type of lung cancer in young people is lung adenocarcinoma, a type of non-small cell lung cancer, accounting for roughly 57% of lung cancers in young adults. Among older adults, lung adenocarcinoma is found is slightly less than 45% of the time.

Molecular Profile

All young adults with lung cancer should have gene testing (molecular profiling) done. Young adults with lung cancer are more likely to have an EGFR mutation, a mutation in a gene that develops after birth and codes for a protein that "drives" the growth and spread of cancer.

A 2015 study of adults age 30 or less with lung cancer found that EGFR mutations, as well as some other common targetable gene mutations, were more prevalent than in older adults with the disease. Other mutations, such as ALK rearrangements and ROS1 rearrangements are much more common in young adults with the disease.

Thankfully a few targeted therapies are now available that address this mutation and can result in prolonged progression-free survival for many people with these mutations. There are also other gene mutations that appear to be more common in young people.

Resources

Resources are available for young adults with lung cancer, and young adults with any form of cancer. Some people with lung cancer prefer local and online support groups which include only people with lung cancer. The reason is fairly simple. If you are coping with stage 4 lung cancer and the frightening survival statistics, it may be hard to identify with a woman with early-stage breast cancer with a 5-year survival rate of over 90 percent, and who is most concerned about preserving her fertility.

  • The Bonnie J. Addario lung cancer foundation is specifically addressing both the differences in molecular profiles for lung cancer in young adults and the unique needs of lung survivors. If you are 50 years old or younger with lung cancer, make sure to contact the Foundation.
  • LUNGevity has played an amazing role in connecting young people with lung cancer. Each year the organization hosts the annual HOPE Summit in Washington DC, as well as several regional summits around the country.
  • Social media has proven to be a helpful resource for young people with lung cancer. Every other Tuesday evening there is a tweet chat which includes people with lung cancer, advocates, family members, oncologists, radiation oncologists, thoracic surgeons, researchers, and more. To find the community, use the hashtag #LCSM which stands for lung cancer social media.
  • Stupid Cancer: The Voice of Young Adult Cancer is a community that meets online as well as in person in order to empower young adults with cancer. There is also a Stupid Cancer radio show as well as a chance to meet face to face with other young adults with cancer from around the country at the annual summit and regional meet-ups.
  • The Ulman Cancer Fund for Young Adults provides a free one-on-one navigation system to help address the many issues that young cancer patients may face. Some topics may include fertility concerns, how to return to work or school after treatment, college scholarships, financial assistance, and health and wellness concerns.
  • CancerCare provides support services such as free counseling, support groups (both in-person and online,) financial assistance, and educational workshops accessible from your phone or computer for people living with cancer and their families.
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