What Can We Learn From Kathy Griffin About Lung Cancer?

• Lung cancer can affect non-smokers too; it is not just a “smoker’s disease” anymore
• Don’t ignore a persistent cough; early detection will save your life

"Yes, I have lung cancer even though I've never smoked!" is a powerful statement that highlights the persistent stigma associated with lung cancer.

It may surprise some, but between 10 to 20 percent of lung cancer patients in the US are non-smokers or had quit smoking a long time ago. This can be attributed to various non-smoking risk factors, including genetic predispositions and mutations in genes like TP53, HER2, EGFR, KRAS, PIK3CA, and ALK. Although the chances of inheriting lung cancer are low, some of these gene mutations can be passed down through families.

What causes somatic (non-hereditary) mutations that lead to lung cancer in non-smokers?

The recommended test for detecting lung cancer is a low-dose CT scan. The US Preventive Service Task Force (USPSTF) suggests annual low-dose CT screening for adults aged 50 to 80 who:

• Are current smokers or
• Have a smoking history of 20 packs per year or
• Have quit smoking within the past 15 years.

Associate Professor Robert Meguid from the University of Colorado School of Medicine (Cardiothoracic Surgery) mentions, "Lung cancer is typically identified in never smokers incidentally on a chest X-ray or CT scan in the ER because of a car accident or for some other reason."

However, routine lung cancer screening is primarily recommended for people who smoke. The incidence rate among never-smokers is too low to be included in screening guidelines.

According to researcher Robert Volk from The University of Texas MD Anderson Cancer Center, "We don’t screen non-smokers because, in a very low-risk population, there is a greater chance of doing more harm than good."

Lung cancer screening poses risks, including radiation exposure from the CT scan and the potential for overdiagnosis. Any screening test may yield false-positive or false-negative results. A healthy person receiving a false-positive result (indicating no cancer) may undergo unnecessary follow-up tests and incur additional costs.

Whether you have smoked in the past or not, it's essential to discuss your family history of cancer, especially lung cancer, with your doctor. Additionally, seek a diagnosis if you experience:

• A persistent cough over an extended period
• Pneumonia that does not clear up after antibiotics
• Coughing up blood
• Rapid and unexplained weight loss

When addressing early detection for non-smokers, Dr. Ravi Salgia recommends using a multi-cancer early detection test (MCED). "Multi-cancer early detection tests are on the horizon," he stated. "With blood tests, we'll soon be able to pick up cancers that way and get them earlier." Dr. Salgia chairs the medical oncology department at the City of Hope National Medical Center in California.

The multi-cancer early detection (MCED) test, often referred to as a liquid biopsy, can identify cancer markers and sites through a simple blood test. The Galleri™ test by GRAIL is a type of MCED approved by the US Food and Drug Administration (FDA) for use in clinical laboratories. It is capable of detecting up to 50 cancer types. While the sensitivity for different cancers may vary, MCED tests like Galleri™ aim to detect cancer at an early, treatable stage.

Griffin was diagnosed with Stage 1 lung cancer. The 5-year survival rate for localized non-small cell lung cancer (NSCLC), like Griffin's, is 65%, according to the American Cancer Society. It's crucial to recognize that lung cancer is not exclusively a "smoker's disease." Non-smokers can also develop this cancer. Whether you are a smoker or a non-smoker, paying attention to your respiratory health and seeking medical advice when needed is a critical step in preventing lung cancer.