These days lung cancer has become so inextricably linked with smoking that you’d be forgiven for thinking it is exclusively a smokers’ disease.
However, 10-15 per cent of all lung cancers are diagnosed in people who have never smoked. Less than 14 months ago, Mary McElligott found herself in this situation.
McElligott began 2012 with a party to celebrate her 50th birthday. At the end of the year she found herself undergoing surgery for lung cancer.
Tumour in lung
Having worked as a nurse for most of her life, she had always been health conscious and had never smoked. In October 2012 she was stunned when her GP called to say the results of a chest X-ray had shown a tumour in her right lung.
“I’d had a head cold and after about two days I got a fierce pain in the left side of my chest which the GP said was pleurisy,” McElligott recalls. “As the week went on the pain was getting worse, so I went back to the GP and she reiterated that it was pleurisy and kept treating me for that. “After two or three more days the pain wasn’t getting any better and, being a nurse myself, I got afraid.
“I picked up the phone and rang the GP and insisted on a chest X-ray. They did the X-ray and discovered that I had a tumour in the right lung.”
For McElligott, the following days and weeks were traumatic. “I was terrified. I couldn’t believe it because, in reality, I was actually very healthy. I was in complete disbelief. It was a very frightening experience for me and my family.”
While her GP and consultant talked about Pet scans and surgery, McElligott found it hard to take any of it in. At just 52 years of age and with four children she couldn’t help worrying about what the future held for her and her family.
Six weeks later, McElligott underwent surgery to remove the tumour and, because the disease was identified at such an early stage, she did not require chemotherapy or radiotherapy. She returned to work six months later.
Although she will have to undergo annual check-ups for the next four years she is now, thankfully, cancer-free.
“To be honest it was luck that it was found so early. Obviously somebody was looking out for me that I actually pushed for the X-ray,” she says.
McElligott is one of about 2,000 Irish people diagnosed with lung cancer each year. About 200 of these cases occur in people who have never smoked. Two-thirds of non-smokers who get lung cancer are women.
While smoking remains the number one cause of lung cancer, other risk factors have been identified, including radon gas and asbestos.
Much research is also now ongoing into the genetics of lung cancer in non-smokers but the exact cause is as yet unknown.
Aoife McNamara is a cancer information services nurse with the Irish Cancer Society and she stressed that lung cancer in non-smokers is very rare.
"About nine out of every 10 lung cancers occur in smokers or ex-smokers, but it is possible to get lung cancer and never have smoked," she says.
"It is an area in which research is ongoing worldwide. We are seeing these non-smoking patients and we are not sure why they are developing lung cancer. We don't have a conclusive answer to it yet."
There is some research to suggest that the underlying characteristics of lung cancer in non-smokers is very different to that in smokers.
A number of studies have found that individuals who have never smoked respond better to chemotherapy. Research has also found that certain genetic mutations are more common in non-smoking lung cancer and this makes the disease more responsive to the new sophisticated chemotherapy-like medicines known as biologic therapies.
Lung cancer kills more Irish people than any other type of cancer, largely because it tends to be diagnosed so late.
The early signs are often overlooked and symptoms, such as persistent coughing, difficulty breathing, tiredness and chest pain are frequently attributed to chest infections or flu.
When it comes to lung cancer, early diagnosis and treatment are vital, McNamara says.
“Lung cancer is the biggest cancer killer in both men and women,” she says. “In 2011 it killed more Irish women than breast cancer. A lot of Irish women know about BreastCheck and mammograms and checking their breasts, but people don’t do the same when it comes to their lung health.
“It’s all about early detection. If people are diagnosed at an early stage, there are much more treatment options available to them. There is a very real chance of cure if the cancer is found early enough.”
At this time of year, many of us fall victim to coughs and colds. The advice from the Irish Cancer Society is that if you have a cough or other chest symptoms that are not getting better, even with antibiotics, your GP can refer you for a chest X-ray. Even if you are a non-smoker, be aware of the early signs of lung cancer and don’t delay in seeking advice if you are concerned.
McElligott’s advice is to listen to your own intuition: “Follow your gut instincts. Even in nursing, I always say that the patient is generally right. People don’t come lightly with their complaints. If you develop a cough or you’re not happy, follow your gut instinct and get a check-up and go for a chest X-ray if you have to.
“Cancer is such a scary diagnosis, particularly lung cancer. It can be very final. In a lot of cases it doesn’t have a good outcome.
“But there are people who are living with a diagnosis of cancer and there are people living on treatment. Recovery from cancer is possible.”