The 12 lung cancer symptoms commonly found in patients who have never smoked

WE’RE all well aware of the perils of smoking, with cigarettes responsible for seven out of 10 cases of lung cancer.

If you’ve never puffed on a cigarette, your odds of sidestepping the disease are altogether much stronger.

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But it’s still possible to develop lung cancer even if you’ve sworn off tobacco.

In fact, up to 14 per cent of people with lung cancer in the UK have never smoked, according to Cancer Research UK.

“To put this into perspective, if lung cancer in people who have never smoked was a separate disease, it would be the eighth most prevalent cause of cancer-related death.”

In some ways, nonsmoker lung cancer might be considered a separate disease to smoking-related lung cancer, as it has unique molecular and biological characteristics and responds differently to treatment.

Sufferers might also be struck down by a different set of symptoms, according to oncologists at Yale Medicine.

Anne Chiang, a thoracic medical oncologist and chief network officer at Smilow Cancer Hospital, explained: “We used to think all lung cancers were the same, but now we understand that there are different kinds.

“The good news is that the types of lung cancer that nonsmokers tend to get are usually driven by a molecular change or mutation that can be detected in the tumour, and there are drugs and therapeutics available for them,” she went on.

Most nonsmokers are in fact diagnosed with a non-small cell type known as adenocarcinoma, which often starts in the outer areas of the lungs, in mucus-producing cells that line the small airways called bronchioles.

By contrast, smokers tend to develop a type of non-small cell lung cancer squamous cell carcinoma, Yale oncologists said.

Thoracic surgeon says Daniel Boffa said adenocarcinoma has a different shape to other types of lung cancer.

“If you are a smoker, you can think of your lung as a bag of white marbles, and cancer is like putting a black marble in there,” he explained.

“The type of cancer a nonsmoker gets is more like putting in black sand. Instead of a spot or a lump, it’s more like a hazy area. It’s more diffuse.”

If you haven’t smoked, your lung cancer is also more likely to grow more slowly.

What are the symptoms of nonsmoker lung cancer?

Most nonsmokers have no early signs of lung cancer, which means they’re often not diagnosed until it has spread.

But some people do notice symptoms in the cancer’s early stages, Yale oncologists said.

These are similar to the symptoms in smokers and may include the following:

• A cough that doesn’t go away or gets worse over time
• Coughing up blood
• Chest pain or discomfort
• Trouble breathing
• Wheezing
• Hoarseness
• Loss of appetite
• Weight loss for no reason
• Fatigue
• Trouble swallowing
• Swelling in the face and/or the neck
• Recurrent lung infections, including pneumonia

What are the risk factors for lung cancer?

Even if you’ve never picked up a cigarette in your life, a combination of other factors can still put you at risk of developing the disease.

For starters, passive smoking – breathing in other people’s cigarette smoke – can slightly increase your risk, according to Macmillan Cancer Support.

Your age is another driver, as the cancer is more common in older people, with more than four in 10 people diagnosed with lung cancer being 75 and over.

Materials and substances you inhale while working can also increase your chances of developing lung cancer.

One such material is asbestos, a material that was previously used in the building industry.

People who have been in prolonged or close contact with asbestos have a higher risk of getting lung cancer, Macmillan said.

Heavy metals and diesel exhaust are two more cancer-causing agents that people could be exposed to at work, Yale oncologists added.

Then there’s radon gas.

In certain parts of the UK, a natural gas called radon can pass from the soil into the foundations of buildings.

While exposure to high levels of radon isn’t common, it can increase the risk of developing lung cancer, particularly in people who also smoke.

Finally, where you live can also up your risk, as research has shown that air pollution can be a driving factor behind lung cancer cases.

The risk is linked to air quality and how much pollution a person is exposed to, but for most people, the risk is very small, Macmillan noted.

It was announced last year that more than a million smokers and ex-smokers will be invited for NHS lung checks under an ambitious targeted lung cancer screening programme.

Those who will be called forward for checks include people who:

• Live in an area where lung health checks are currently offered
• Are aged between 55 and 74
• Are registered with a GP surgery
• Are current or former smokers

Nonsmokers risk of cancer might not be eligible for the screening programme, but you should speak to your GP if you have a family history of lung cancer.

It’s also important to bring up concerns about exposure to secondhand smoke, radon, pollution or other known contributors.

You should see a GP if you experience any lung cancer symptoms.