Can an active 50-year-old male develop stage 4 lung cancer?

Question

Hello doctor,

I am writing because my elder brother, at the age of 50 and very physically active, was just found to have stage 4 lung cancer. My elder brother has always been an avid hiker and treks once a month. He has never smoked a day in his life. Our whole family is quite perplexed at how this is possible.

Can a 50-year-old active hiker still develop stage 4 lung cancer?
Is it possible that air pollution or second-hand smoke could have led to this cancer?
What treatment alternatives are there in this case?
Can this cancer be managed, and can he live a better life?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Though this is a worrying condition, your brother's diagnosis of stage 4 lung cancer, there have been a lot of medical breakthroughs in the treatment of lung cancer over the past few years.

Some patients suffering from stage 4 lung cancer can be put through tailored treatments that will help in halting the development of the disease, reduce the symptoms, and enhance their quality of life. In some instances, this treatment may lead to a significant improvement in the disease even when it is at an advanced stage.

There are many treatment methods available, depending on the kind of cancer, the type of genetic mutation present in the tumor, programmed death-ligand 1 (PD-L1) expressed by the tumor, the size of the tumor, and the general health of the patient.

These factors determine whether the treatment should involve anticancer drug chemotherapy, targeted therapy, immunotherapy, radiation therapy, or a combination of all these. Most of the new-generation targeted therapies and immunotherapies cause less harm compared to chemotherapy.

With regard to the cause of lung cancer, the answer is yes, lung cancer can occur in an individual who has never smoked. Smoking is the leading risk factor, but there are other possible causes of lung cancer for those who have never smoked. For instance, lung cancer in a non-smoker could result from genetic mutations in the cancer cells, air pollution, passive smoke, radon gas, exposure at work to substances like asbestos, silica, diesel fumes, and other chemicals. Some non-smokers with lung cancer do not have a specific cause.

For your brother who has never smoked, his oncologist will likely recommend molecular (genomic) analysis of the cancerous tumor. Such tests can help discover genetic mutations that may be targeted for treatment, improving the chances of success in such cases.

Besides treatments for the disease, he should ensure proper nutrition, physical activity as much as possible, quick relief of any symptoms, and, importantly, get emotional support from his family.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.