I’m a doctor — female nonsmokers get lung cancer more than men, look out for these troubling signs

November is Lung Cancer Awareness Month — an estimated 235,000 new cases of lung cancer and 125,000 deaths are expected to occur this year in the US.

Dr. Daniel Sterman, the division director for pulmonary, critical care and sleep medicine at NYU Langone Health and NYU Grossman School of Medicine, talked with us about the risk factors and symptoms of lung cancer and the future of lung cancer treatments.

He also warned that it’s not just smokers who can develop the disease — and switching to vaping may not actually reduce your risk.

Who is most at risk for developing lung cancer?

Patients at greatest risk for lung cancer are those with a history of considerable cigarette smoking — the equivalent of a pack of cigarettes a day for 20 years — and are either actively smoking or have quit within the last 15 years.

Are there symptoms to look out for? When should I talk to my doctor?

Most cases of early lung cancer do not have symptoms, but if you have a cough that hasn’t gone away, unexplained chest pain that persists or a cough that produces mucus with blood in it, you should be evaluated.

How does lung cancer screening work?

Screening for lung cancer can save lives. It’s done through what’s called a low-dose chest CT scan, which takes about two minutes. It’s a low-radiation dose — about the same as four chest X-rays — and it should happen on a yearly basis. According to research done by the National Cancer Institute, annual lung cancer screenings have been found to reduce mortality among smokers by 20%.

It’s important to note that CT scans are very sensitive and, in some instances, can pick up “false positives” — abnormalities in the lungs, including small scars or tiny lymph nodes, that are not cancer and are unlikely to ever cause a problem.

If one of these abnormalities is detected, you may need a follow-up CT scan, a biopsy or another procedure. Any findings from your scan are communicated to your doctor, who will work with you to determine the appropriate next steps. In most cases, no cancer is found. To avoid unnecessary tests or procedures, it’s important to only screen people who have an increased risk for lung cancer.

Our program, which is part of Perlmutter Cancer Center, offers lung cancer screening for people at risk. NYU Langone’s Lung Cancer Screening Program is a collaboration of our pulmonary medicine, thoracic oncology, thoracic radiology and thoracic surgery experts.

How common is it for nonsmokers to develop lung cancer?

It is not all that common for people with no history of cigarette smoking to develop lung cancer, but unfortunately, it is much more common for women nonsmokers to develop lung cancer than it is for men.

It’s not entirely clear why this is the case, but approximately 20% of all new lung cancer cases in the US are women who have no history of cigarette smoking or minimal cigarette smoking in the past. We need to find out more about why this is the case.

Does switching from cigarettes to vaping or e-cigarettes reduce a person’s risk of lung cancer?

We don’t know whether switching from tobacco cigarettes to electronic cigarettes or vaping has any significant impact on lung cancer risk.

There was one study from South Korea that was presented at the American Thoracic Society this past May in which switching from tobacco cigarettes to electronic cigarettes in South Korea actually appeared to increase the risk of developing lung cancer.

So much more needs to be learned and studied, and honestly, we do not know the long-term effects of vaping or electronic cigarettes.

What is the risk of lung cancer with marijuana use?

We do not know whether marijuana increases lung cancer risk, and among the things that need to be studied is a combination of marijuana and tobacco smoking, which is fairly common, especially among young adults.

So what are the odds of beating lung cancer?

The odds of beating lung cancer are increasingly good as time goes on. We have had incredible revolutions in the development of treatments for lung cancer, including robotic surgery for resection of early-stage lung cancer, which is now becoming almost an outpatient procedure.

Novel immunotherapies, in combination with chemotherapy and occasionally with surgical interventions, can treat locally advanced lung cancer.

New therapies can specifically target, like a key and lock, specific mutations that cause lung cancer, dramatically extending the lives of patients even with metastatic lung cancer. We are turning lung cancer from a death sentence into a disease that one can live with.

We look forward to many more interventions that will benefit patients in the future.

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Dr. Daniel Sterman is the division director of Pulmonary, Critical Care & Sleep Medicine at NYU Langone Health. He is also the Thomas and Suzanne Murphy Professor of Pulmonary and Critical Care Medicine at NYU Grossman School of Medicine and the director of the Pulmonary Oncology Program. He specializes in interventional pulmonology and treats people who have cancer and benign disorders of the lungs and lung membranes.

NYU Langone Health’s pulmonology and lung surgery services recently tied for the No. 1 rank in the country in US News & World Report’s “Best Hospitals” rankings.