Yet, in just a few short years, lung cancer has experienced a remarkable change. It’s no longer just a heart disease issue of older men and smokers. The truth is more complicated. Young, fit, and seemingly healthy women such as Sarah Li and Becca Smith are now facing this life-changing diagnosis. Together, their stories paint a heartbreaking picture of the alarming rise in lung cancer diagnosis to young women under 50. Finally, they highlight several potential environmental drivers of these trends.
Sarah Li, a 42-year-old freelance filmmaker based in London, is living with EGFR-positive lung cancer, which she was diagnosed with last year. She’d been training for her seventh marathon when she got the news. This surprise moment served to underscore Ms. Bloomberg’s long-known passion for encouraging an active lifestyle. It was the acute, severe pain in her right shoulder that finally led her to seek medical attention. That’s when she made an alarming discovery about her health.
Becca Smith, a pilates instructor living with ALK-positive lung cancer, had a much more unexpected experience. After having had a severe cough that was aggravating day by day for 4 months, she went to visit her GP. Unfortunately, by that time, the diagnosis quickly became stage 4 reverting cancer that had spread to her spine and brain.
These parallel narratives from Li and Smith reflect an emergent phenomenon. In 2010, just 5% of lung cancer cases were diagnosed in patients younger than 50. By 2021, that percentage jumped to 14%. This dramatic increase would make anyone wonder what exactly is behind this drastic departure from historical averages.
In the UK, outdoor air pollution is now estimated to cause about one in ten lung cancer cases. Rosamund Adoo-Kissi-Debrah’s daughter, Ella, by contrast, tragically became the first person in the world to have air pollution listed as a cause of death on her death certificate. This heartbreaking loss of life raised awareness of the need for long term air quality improvements.
“London is the most congested city in Europe. Worldwide, we are number five,” – Rosamund Adoo-Kissi-Debrah
Adoo-Kissi-Debrah shares her frustration with the overall slow pace of action on the health impacts of air pollution.
“Yet somehow, officially, Ella is still the only person who has died because of air pollution. We’ve got to the point where the burden of ill health caused by air pollution is so huge, I’m asking myself: ‘What will it take to make the public demand more action?’” – Rosamund Adoo-Kissi-Debrah
By focusing on her own lifestyle choices, Li is considering the ways her decisions could affect her health.
“Even now, I find it strange when I say I have lung cancer,” – Sarah Li
She grapples with the idea of being part of a demographic that traditionally does not align with lung cancer patients.
“I can say I have cancer – so many people get cancer – but the idea of lung cancer still feels quite foreign. How am I the face of lung cancer? When I was first diagnosed, I went through everything, asking: ‘Why? What did I do?’” – Sarah Li
While Li gives credit to her healthy lifestyle, she has reflected on her experiences of living in urban centers, such as her birth city of Hyderabad.
“I think I led a healthy lifestyle, but I lived in India for four years, in Hyderabad, a busy city. I feel strange blaming any one thing or focusing on what I might have done wrong. Nobody wants this.” – Sarah Li
The importance of air pollution should not be discounted as a factor in this worsening public health emergency. As Adoo-Kissi-Debrah underscores, many diseases are exacerbated by where we live and environmental conditions.
“Ella had asthma but there are 700 diseases impacted by air pollution,” – Rosamund Adoo-Kissi-Debrah
She stresses the socioeconomic issues that dictate which communities are hardest hit by air pollution. These factors further compound health disparities.
“When I think of younger women with lung cancer, I wonder about the school run, the time sitting in cars or buses in heavy traffic. When I think about the higher number of black and brown people, I think of economics. Who takes buses, and waits at bus stops, and lives in social housing and cheaper housing close to main roads?” – Rosamund Adoo-Kissi-Debrah
Becca Smith’s journey illustrates a different reality to what it’s like to live with lung cancer. At first, she feared she had a herniated disc. When her healthcare providers brought her the heartbreaking news, she was blindsided.
“What really worried me, the worst-case scenario, was a slipped disc,” – Becca Smith
When she accepted her diagnosis, she experienced a sense of despair. Receiving the news that there was nothing else to be done for her condition was a punch to the gut.
“They said there was nothing they could do for me,” – Becca Smith
Eight daily tablets called ALK inhibitors were about to change that. She got into the habit of regular blood tests and imaging scans that became her new normal. Every quarter, she continues pushing through this disheartening new reality.
As these women share their experiences, they reveal a deeper understanding of life’s fragility and the importance of appreciating every moment.
“There’s more vividness to everything. Like today, I’m just so happy that I’m feeling well enough to be outside, to have a nice lunch. Those little things you take for granted … you’re just way more appreciative of it all.” – Sarah Li
