More women under 65 are being diagnosed with lung cancer, Maryland doctor says

A growing number of people, particularly women under 65, are being diagnosed with lung cancer despite never smoking, a Maryland doctor is cautioning.

"Over the last 10 years or so, we've noticed an increasing trend of patients with no or minimal smoking history being diagnosed," Dr. Samuel Rosner, a thoracic oncologist at the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, said.

A recent American Cancer Society study found that lung cancer incidence is now higher in women than in men under age 65. Women who have never smoked are more than twice as likely as men who have never smoked to develop the disease.

Doctors are still trying to understand why. 

Environmental exposures like radon, air pollution, and even fine particulate matter are under investigation. Genetics also plays a role.

Jessica Kahler's story

In 2024, 42-year-old mother of three Jessica Kahler was diagnosed with Stage IV lung cancer that had already spread to her spine.

Ironically, Kahler spends her days analyzing tissue samples for signs of cancer; now she was a patient herself.

Kahler has never smoked. She has never lived in a home filled with secondhand smoke. She lives a healthy lifestyle. 

But in the fall of 2023, she was blindsided by a diagnosis that didn't seem to fit the mold.

"I was sick with what we thought was pneumonia, so I went to urgent care, and we did a chest X-ray," she recalled. "And we found a mass."

What followed was a whirlwind: testing, scans, and a deeper search for answers. 

Kahler thought back pain might have been from caring for her father, who had also been diagnosed with brain cancer. But a scan revealed lesions in her spine, lung, and lymph nodes.

"It was very emotional. Of course, you wonder, what did I do wrong? Or what could I have done differently?" Kahler said. "I never smoked. My parents never smoked. We lived in a relatively healthy environment."

Lung cancer remains the deadliest cancer in the United States, claiming more lives than breast, prostate, and colorectal cancers combined. And despite the stigma linking it almost exclusively to smoking, a growing number of patients like Kahler are proving that the disease can strike anyone.

Genetic component to lung cancer

Kahler's tumor carried a mutation in the EGFR gene, a relatively common cause of non-small cell lung cancer in nonsmokers.

The discovery gave her hope. 

"When we found out I had the EGFR mutation, it was a big sign of hope," Kahler said. "Because I knew that medicine would help me."

Kahler began taking osimertinib, a targeted therapy that goes after the specific mutation driving her cancer. She's also undergone radiation treatment to her spine and lungs, with more scheduled for her lymph nodes. Recent scans have shown no evidence of disease.

Jessica's prognosis

Still, the diagnosis is Stage IV. 

"It's typically not curable," Kahler said. 

But she is holding onto hope, her faith, and the love of her family. 

"My husband and my children are my reason," Kahler said. "They are amazing, and I couldn't do this without them."

Dr. Rosner, who treats Kahler, said that being able to offer targeted therapy to patients like her is a major advancement. 

"This medicine allows people to continue to work, to be a parent. It's been a game changer," he said.

"She's part of our family here. I wanted to do the best I possibly could for her."

As she continues her treatment, Kahler hopes her story helps others.

"I had to realize that everything happens for a reason," she said. "And I was put on this path for something bigger."

As she continues her treatment, Kahler hopes her story helps others, especially those who never imagined they could face a diagnosis like this.

"I had to realize that everything happens for a reason," she said. "And I was put on this path for something bigger."