At 36, what can cause cancer in my non smoker cousin?

Question

Hello, Doctor,

My cousin is 36 years old and a non-smoker with no major health issues before, but recently he was diagnosed with stage 4 lung cancer after sudden symptoms. This has been very shocking for all of us. Please tell me,

Can a 36-year-old non-smoker get stage 4 lung cancer suddenly?
Does this mean the cancer was present for a long time without symptoms?
Are there specific genetic or environmental causes in such cases?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Yes, it is possible, though uncommon, for your cousin, who is 36 year old non smoker, to be diagnosed with stage 4 lung cancer. In such individuals, the disease often behaves differently from the typical smoking-related cancers and can be driven by specific genetic changes within the tumor.

In most cases like this, the cancer does not develop suddenly. It is usually present for some time but remains silent because early-stage lung cancer often does not produce noticeable symptoms. By the time symptoms such as cough, breathlessness, or chest discomfort appear, the disease may already be advanced.

In non-smokers like your cousin, the following factors are responsible for cancer,

Certain genetic mutations in the tumor, such as EGFR (epidermal growth factor receptor) or ALK (anaplastic lymphoma kinase) -related changes, are commonly seen and can lead to cancer development even without traditional risk factors.
Environmental exposures like indoor air pollution.
Passive smoke.
Occupational exposures.

I have seen similar cases where otherwise healthy young individuals present at an advanced stage simply because the disease remained asymptomatic for a long period. It is understandably very distressing, but such cases are recognized in medical practice.

I hope this information helps you.

Feel free to ask further queries.

Thank you.