Lung cancer in non-smokers: what to know

Lung cancer can occur in people who have never smoked, and diagnosis depends on tests rather than smoking history alone. Other exposures, inherited factors and tumour changes may be relevant, but sometimes no single cause is identified.

Lung cancer is a group of diseases with different cell types and biological features. A non-smoker may still develop a tumour, and the absence of smoking does not rule it out when symptoms or an imaging finding needs investigation. Cough, breathlessness, chest discomfort, fatigue, recurrent infections or persistent hoarseness can have many causes.

A tissue sample helps identify the cancer type. Genomic tumour profiling may find changes that guide discussion of targeted medicines. Stage, lung function and general health also shape the treatment plan.

Arrange assessment for symptoms that persist, worsen or interfere with daily life. Tell the clinician about second-hand smoke, indoor or workplace exposures, previous radiotherapy, family history and medicines, while remembering that these details do not prove a cause.

If cancer is confirmed, ask how the tumour was classified and whether testing is complete before deciding what the treatment names mean. Options may include surgery, radiotherapy, chemotherapy or another systemic treatment. Supportive and palliative care can help with symptoms at any stage.

Seek emergency help for severe breathing difficulty, collapse, coughing a large amount of blood, a seizure or sudden weakness on one side. Contact a clinician promptly for a persistent or worsening cough, unexplained weight loss, chest pain, fever or hoarse voice.

What tests are needed to explain my symptoms or scan? What type of tumour is present? Should genomic tumour profiling be considered? What exposures or family details are useful? Which treatments fit the stage and biology? Who should I call if symptoms change?