Debunking the Most Common Lung Cancer Myths

Even though lung cancer is the leading cause of cancer deaths in the U.S., many people don’t know much about it. Unfortunately, lack of symptoms often means that lung cancer can go undiagnosed or misdiagnosed for a long time, which can make it harder to treat. People commonly believe it is a disease that affects only those who smoke, but Dr. Amit “Bobby” Mahajan warns that this stigma is extremely misleading. “While smoking is the most common cause of lung cancer, there is a surprisingly high incidence of lung cancer diagnosed in people who don’t smoke. In fact, 20% of people diagnosed with lung cancer have never smoked,” he explained.

This is just one of the myths that Dr. Bobby, the medical director of interventional pulmonology and complex airways disease program for the Inova Health System, has agreed to help us demystify.

Myth: Only smokers get lung cancer.

As Dr. Bobby said, smoking is still the number one cause of lung cancer. Increasingly, lung cancer is discovered “on accident”, or incidentally, in individuals with no symptoms and no smoking history. This happens when someone is evaluated for an unrelated medical issue and the imaging reveals signs of lung cancer. The misconception that smoking is the only cause of lung cancer can create added distress around receiving a lung cancer diagnosis and results in a stigma that can negatively affect the quality of care and outcomes. 

“The most common causes of lung cancer in never-smokers are radon exposure and genetic mutations,” Dr. Bobby said. Radon is a naturally occurring radioactive gas that can seep into homes and buildings through cracks and other openings in floors, foundations, walls and other areas. Because it is colorless, tasteless and odorless, radon can be hard to detect, yet long-term exposure can significantly increase a person’s likelihood of developing lung cancer. 

Another common cause of lung cancer is genetic mutations. “For instance, mutations like the EGFR mutation, more commonly noted in Asian males and females diagnosed with non-smoking lung cancer, can lead to uncontrolled cell growth and cancer,” he continued. 

Myth: Lung cancer is always fatal.

According to Dr. Bobby, one of the biggest misconceptions about lung cancer is “that all is lost when someone is diagnosed with it.” This is far from the truth. In fact, the five-year survival for lung cancer has increased to 29.7% over the last few years. The key is early detection, which is why low-dose CT (LDCT) lung cancer screening is so important. When lung cancer is found early, treatment can occur when it is most effective. Annual screening is recommended for people who are high-risk. Unfortunately, lung cancer screening is underutilized, with only 18.2% of all those eligible getting screened.

Even though 85% of lung cancers are diagnosed at later stages when it is harder to treat, research breakthroughs and advancements in treatments have given all lung cancer patients hope. “Knowledge is power when it comes to lung cancer. Advances in genetic therapies and immunotherapies have shown remarkable progress in treating lung cancer more effectively and with fewer side effects,” Dr. Bobby said. 

Myth: Lung cancer symptoms are obvious. So, if you don’t have symptoms, you don’t need to be screened.

Part of the reason lung cancer is often diagnosed at later stages is that it typically causes no symptoms in its early stages. Or as Dr. Bobby says, “The most common symptoms for lung cancer are not symptoms. This is why it is so challenging to detect cancer early.” 

By the time symptoms appear, lung cancer has most likely progressed to an advanced stage. "This underscores the importance of lung cancer screening for high-risk patients,” explained Dr. Bobby. “If you meet criteria for lung cancer screening, you should still be screened even if you have no symptoms.” 

Myth: Young people don’t get lung cancer.

Lung cancer is most commonly associated with people 50 years of age or older, but people can get lung cancer at any age. About 10% of lung cancers are found in people under 55, with 1.4% of cases occurring in those under 35, according to the Journal of Cancer. Adenocarcinoma, the most common type of lung cancer overall, is also the most common type of lung cancer affecting adults under 46. “Though it's rare, genetic factors can even result in the development of lung cancer in people in their 20s,” Dr. Bobby said.   

Myth: If you quit smoking, you are no longer at risk for lung cancer.

Myth: Besides not smoking, there is nothing I can do to prevent lung cancer.

Quitting smoking is essential, but it’s not the only step. Since they are newer to the market, smoking alternatives such as e-cigarettes and nicotine pouches are still being studied for their effects on the lungs. But Dr. Bobby warns that their addictive nature means they, “can often lead to smoking, which is the most common cause of lung cancer with chronic use.”

Other ways to reduce your risk include: 

• Reduce your exposure to radon. Test your home for radon and get a mitigation system installed if the radon level is equal to or above the Environmental Protection Agency’s action level of 4.0 picocuries per liter (pCi/L).  
• Stay away from secondhand smoke. There is no safe level of exposure to tobacco products, so keeping your home smokefree and staying away from smoke is one of the best ways to reduce your risk.
• Wear protective gear. If you work with hazardous materials, it is important to follow safety guidelines to protect yourself from exposure. 
• Get regular checkups. Staying informed about your health and discussing any concerns with your healthcare provider can ensure that if you do develop cancer, it is caught early when it is most treatable. 

  Learn more about lung cancer at lung.org/lung-cancer.