Metastatic lung cancer life expectancy: Survival rates and more
I Thought I Pulled A Muscle But I Actually Had Stage 4 Lung Cancer Aged 37 Despite Never Smoking - Here Are The Signs You MUSN'T Ignore
A Texas woman was diagnosed with stage 4 lung cancer at just 37 years old, despite never smoking.
Tiffany Job, a nurse and mother of eight-year-old twin boys, assumed that the pain in her right rib that began in March 2020 was a pulled muscle resulting from a workout.
However, scans would later reveal tumors in her lungs that had spread to her neck, and bones.
'I think I was just in denial, like "This is not happening."' said Tiffany. 'It was shock. A lot of shock.'
Her case comes amid a mysterious rise of cancer cases in people under 40, including colon and appendix cancer.
Lung cancer - the deadliest form of the disease - is also rising, particularly in women, thought to be linked to the fact women are slower to give up cigarettes.
Tiffany Job, 40, was diagnosed with stage four lung cancer after mistaking her symptoms for a pulled muscle
Ms Job's cancer had spread to her pelvis, right femur, and cervical spine
Tiffany's 'pulled muscle' quickly became the least of her problems when a collection of other symptoms cropped up.
On a hiking trip in July 2020, she could barely walk a few feet without her heart rate shooting up and becoming short of breath.
Then, a month later, Tiffany developed a cough that wouldn't subside. Doctors performed blood tests and prescribed a course of antibiotics and steroids.
However, nothing helped.
In September, Tiffany went to her primary care doctor, who ordered a pulmonary function test (PFT). This test measures lung volume and capacity, as well as how air moves through them. 'I failed that miserably,' she told The Patient Story.
Her husband, Nick, said: 'I think they said she had the lung capacity of an 80-year-old.'
'That raised some pretty significant concerns. That was, I think, the first real alarm bell for the primary care doctor.'
'Nobody ever speculated that lung cancer could have even been an option.'
Over the next few weeks, doctors speculated that it could be anything from sarcoidosis - an inflammatory condition caused by an immune overreaction - to Covid to tuberculosis.
Finally, after spending days in isolation, scans revealed that Tiffany had stage four non-small cell lung cancer, which had spread to her pelvis, right femur, and neck.
Ms Job said she was 'in denial' after hearing about the lung cancer diagnosis, especially because she had never smoked
Ms Job posted on Instagram in November that her primary tumor is growing, and her current treatment is ineffective (pictured here with her husband, Nick, and their twin sons)
Lung cancer is the deadliest form of cancer in the US, according to the National Cancer Institute (NCI). It accounts for one in five cancer deaths, followed by colorectal cancer, which causes one in 10 cancer deaths.
About 53 percent of cases are diagnosed when the disease has traveled to multiple other organs.
'The vast majority of lung cancers are diagnosed in the advanced stage because their symptoms don't present until it's moved pretty fast,' Nick said.
The survival rate also drops significantly in these cases, with fewer than 10 percent living for five years.
Only one in four lung cancer patients survive after five years.
There are two main types of lung cancer: small cell and non-small cell.
Non-small cell lung cancer is the most common type, accounting for nine out of 10 lung cancer diagnoses, and typically grows more slowly. It usually doesn't cause any symptoms until it has progressed.
Lung cancer is the deadliest form of cancer in the US, according to the National Cancer Institute (NCI). The survival rate drops sharply as cancer spreads. Advanced lung cancer has just an 8.2 percent five-year survival rate
The above shows lung cancer cases among men and women split by age groups. It reveals the disease is now more common in younger women, compared with other groups
Signs of non-small cell lung cancer, according to the NCI, include chest pain or discomfort, a lingering cough, trouble breathing, wheezing, coughing up blood, loss of appetite, unintentional weight loss, fatigue or lethargy, trouble swallowing, and swelling in the face or veins in the neck.
Cigarette smoking is the leading cause of lung cancer, though Tiffany noted that she never smoked. Exposure to secondhand smoke has also been shown to increase this risk.
Men were nearly twice as likely as women to develop the disease in the 1980s, driven by higher smoking rates and workplace exposure to substances like asbestos.
But with declining cigarette use and increased safety regulations, the pattern has flipped, with young and middle-aged women now being diagnosed with the disease at higher rates than men.
Some evidence suggests this is because women are slower to quit smoking.
Tiffany's tumor had a genetic mutation known as EGFR (epidermal growth factor receptor). This means the cancer causes an excess of the EGFR protein, which can accelerate the growth of lung cancer cells.
This qualified her for a clinical trial of a drug that would specifically target the mutation.
'The prognosis for lung cancer is pretty bad, and chemo doesn't have a good track record, especially for her subtype of cancer,' Nick said.
Tiffany added: 'When we heard "clinical trial," I was very open to it. I think being a nurse, I've always been pretty open to things like that.'
'I feel like that's how we learn. We don't get information if people don't do it.'
However, Tiffany posted on Instagram in November that, despite the novel therapy, the primary tumor in her lung is growing, and her current treatments are no longer effective.
Still, she remains optimistic.
'We don't know what's going to happen to us by the end of the day, so we may as well just live for each and every moment,' she said.
Studies Find Nonsmoking Women Getting Lung Cancer But Going Unscreened
Over 50% of women with lung cancer are non-smokers - and that rate is only increasing.
getty"This year, nearly 250,000 Americans will be diagnosed with lung cancer," President Biden wrote to mark the beginning of National Lung Cancer Awareness Month, which takes place every November. Lung cancer is one of the most common cancers in and the leading cause of cancer death for both men and women - but the president's proclamation didn't include the fact that lung cancer is now affecting women, even non-smoking women, at a higher rate than men.
Historically, lung cancer was known as a men's disease, due to their higher occupational exposure and higher smoking rates than women's. Occupational hazards, such as exposure to asbestos, arsenic, benzene, cadmium, coal tar, disease fuel emissions, formaldehyde, and medical radiation, can all increase the risk of lung cancer. 5.3% of total cancer cases in men are linked to occupational exposure, compared to 2.3% of female cancer cases, since fields with high exposure, such as construction, freight handling, painting, pipefitting, and plumbing, are usually male dominated.
Lung cancer was known as a men's disease; occupational hazards - a common causes of lung cancer - ... [+] were and are present in professions that are male-dominated.
Eva EpkerSimilarly, men historically and currently smoke more than women. Cigarette smoking remains the most common cause of lung cancer across sexes, causing 90% of cases in men and 70-80% cases in women. As of 2021, about 13.1% of men smoke while 10.1% of women smoke.
However, over 50% of women with lung cancer worldwide are non-smokers (compared to only 15-20% of men). Non-smoking women also have a higher incidence of lung cancer (19%) than non-smoking men do (9%). And, even when adjusted for smoking status, the female sex is associated with a higher risk of lung cancer. Lung cancer diagnoses have risen 84% among women – but have dropped 36% for men – over the past 40-plus years, and women between the ages of 30 and 49 not only are being diagnosed with lung cancer (when the average age at diagnosis is about 70 years old) but also are being diagnosed at a higher rate than men of the same age.
Although smoking is the most common cause of lung cancer, the percentage of the population that ... [+] smoke or have smoked has been steadily decreasing.
Eva EpkerAnd yet there isn't any conclusive data explaining these sex-based trends. Possible and partial explanations include the makeup of cigarettes as well as women's hormones, environmental exposure (to air pollution, cooking oil fumes, secondhand smoke, wood combustion, or other carcinogens) and genetics. For genetic specifically, a protein called CYP1A1, which activates carcinogens, is overexpressed in women. Women also have more frequent p53 mutations, which are responsible for 60% of lung cancers, than men do, and have an increased gastrin-releasing peptide receptor - GRPR - that stimulates cancer cell proliferation. These genetic differences may cause women to have a higher susceptibility to carcinogens – substances that increase an individual's risk of cancer – and, subsequently, have higher rates of lung cancer than men have.
But this potentially higher susceptibility isn't reflected in the current lung cancer screening guidelines or the studies that led to the development of those guidelines. The National Lung Screening Study, which started in 2002, recruited 55,000 participants but only 39% were women. Similarly, the NELSON study, which started in 2003, had over 15,000 participants but only 16% were women. Women were, thus, underrepresented in the former and current smokers recruited for these trials – and non-smoking women weren't represented at all. As a result, lung cancer screening eligibility applies to individuals who smoke at least 20 packs a year and are at least 50 years old; there are no sex-based differences in these guidelines, despite the rising cases of lung cancer in both smoking and non-smoking women. As a 2022 review concludes, "The lack of guidelines and risk assessments for light or never smokers predisposes women with lung cancer in particular to be missed with current screening recommendations."
Lung cancer is disproportionately affecting women - but the reasons behind this sex-based ... [+] difference, including the rising rates of cancer in non-smoking women, are largely unknown
Eva EpkerIn addition to being ineligible for screening, women, both smokers and non-smokers, may not even notice that they have lung cancer until it has progressed to a late stage. Women are more likely than men to develop lung adenocarcinoma (cancer that develops in the cells that line the outside of the lungs) while men are more likely than women to develop squamous cell carcinoma (cancer that develops in the cells that line the inside of the lungs' airways). Both cancers' symptoms can include a bloody cough, a recurrent or worsening cough, difficulty breathing or swallowing, hoarseness, and swelling in the face and neck veins. However, lung adenocarcinoma can also manifest in abdominal pain, bone pain, headaches, and/or mucus secretion: symptoms that aren't necessarily specific to lung cancer and that may cause the cancer to be misdiagnosed.
In short, non-smoking women are doubly disadvantaged: they usually aren't eligible for lung cancer screenings under the current guidelines because they don't smoke, and their cancer may be missed or dismissed until a stage where it is near-fatal.
Lung cancer is the leading cause of death - and the survival rate only decreases with each ... [+] subsequent stage at diagnosis.
Eva EpkerWhen their lung cancer is correctly diagnosed and treated, however, both smoking and non-smoking women have shown to respond better to lung cancer treatments than their male peers. Women see more positive results than men across various treatment options – including EGFR inhibitors, platinum-based chemotherapies, surgery, and radiotherapy. Women with lung cancer also survive significantly longer than men, in part due to their treatment and lifestyle choices and the characteristics of their tumor.
But, much like the rising rates of lung cancer in women, the main reason behind their improved survival rates is still unknown, serving only to highlight the sparse research in sex-related differences in lung cancer. Two articles, both published in 2021 echo this fact. One states, "The double-edged sword of female sex and lung cancer necessitates that future studies aim to better understand factors (environmental, genetic, hormonal) in addition to smoking intensity and duration that may affect risk". The other argues for "targeted therapies" and "screening recommendations" that reflect the role of sex, noting that "the data regarding optimal care and outcomes is still lagging behind" for women.
These calls for sex-specific research, the rising rates of lung cancer in women, especially non-smoking women, and federal programs – including the reignited Cancer Moonshot program and recent White House Initiative on Women's Health Research – all may help catalyze change and improve the lives of both smoking and nonsmoking women. As President Biden wrote in his proclamation on National Lung Cancer Awareness Month, "During National Lung Cancer Awareness Month, the First Lady and I have one message to the Nation: There is hope."
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