Susan Wojcicki, the former CEO of YouTube, left a powerful message for the world just weeks before her death.
“Although lung cancer overall is decreasing due to lower tobacco use, lung cancer among non-smokers has been rising significantly,” Wojcicki wrote in a YouTube blog post published in August.
Wojcicki, who had been a trailblazer in the tech industry as one of Google’s first employees, passed away after a two-year battle with lung cancer at the age of 56. In the blog, she urged for more resources and attention towards lung cancer research, particularly for women and non-smokers. The blog was shared by YouTube with her family’s consent shortly after her passing.
“At the end of 2022, I was diagnosed with lung cancer,” she revealed. “I had almost no symptoms and was running several miles each day at the time. I had never smoked, so I was completely shocked by this diagnosis.”
She shared her personal reflections on the disease: “Having cancer hasn’t been easy. As a person, I have changed a lot. One of the most important lessons I have learned is to focus on and appreciate the present. Life is unpredictable, but there is beauty in the everyday. Moving forward, my goal is to live fully in the moment and advocate for better understanding and treatment of this disease.”
Wojcicki’s story is not unique. There has been a concerning trend in the U.S. of young and middle-aged women being diagnosed with lung cancer at increasingly higher rates than men, and many of these women have never smoked. Around two-thirds of lung cancer cases in non-smokers are found in women.
One such case is 36-year-old Jhalene Mundin, a nurse from New Jersey. Mundin had no risk factors and had never smoked, but last year, she was diagnosed with stage IV lung cancer, an advanced form of the disease that had already spread beyond her lungs.
The news hit her hard. “I remember I was crying. I thought it might be stage II or III, but when she said it was stage IV, I felt like the room was closing in. I kept thinking about my kids – they still need me,” Mundin said.
Initially, Mundin had chalked up her persistent cough to a lingering symptom of COVID-19. It wasn’t until she visited the doctor for a hip X-ray that an additional chest X-ray revealed a mass in her lungs. The cough, it turned out, was due to the cancer.
Like most lung cancer patients, Mundin didn’t show symptoms until the disease had already advanced. Common signs of lung cancer include a persistent cough, chest pain, shortness of breath, fatigue, weight loss, and sometimes coughing up blood.
Research has shown that lung cancer diagnoses in women have risen by 84% over the past 42 years, while the rate has decreased by 36% in men. Among non-smokers, women are more than twice as likely as men to develop lung cancer.
Dr. Helena Yu, a thoracic medical oncologist at Memorial Sloan Kettering Cancer Center, explained the trend: “Lung cancer is clearly on the rise in non-smokers, with around 20% of all lung cancer diagnoses now involving non-smokers – that’s about 40,000 cases annually. Unfortunately, this increase in diagnosis is matched by an increase in lung cancer-related deaths.”
She added that some of these cases are tied to genetic mutations, such as EGFR mutations, which are more prevalent in women. For some patients like Mundin, genetic factors appear to play a significant role in the development of lung cancer.
“I was mad that no one had talked to me about this mutation,” Mundin said. “Had I known, I could have taken action sooner. Why isn’t there more screening for this like there is for breast cancer or colon cancer?”
EGFR mutations, linked to lung cancer, can cause cells to grow uncontrollably. These mutations are particularly common in women, especially those who have never smoked. Studies have shown that EGFR mutations are present in about 59% of tumors from women, compared to 26% of tumors from men.
Kara, a 38-year-old patient of Dr. Yu, also had EGFR-related lung cancer. “My hope for the future is that there will be more research into EGFR and that we can find a cure,” Kara said. She had no history of smoking or other risk factors but was diagnosed with stage IV lung cancer after doctors discovered a large tumor in her arm. Although it was unexpected, Kara continues to live life normally, running marathons and enjoying time with her family.
Despite the uncertainties surrounding the causes of rising lung cancer rates in young women, experts like Dr. Yu are investigating potential environmental factors, genetic mutations, and other causes.
Dr. Yu noted that certain mutations like EGFR are more common in women, particularly those of Asian descent. Mundin, who is Asian, believes that genetic factors may have contributed to her diagnosis, as she later learned of other women in her social circle who had similar mutations.
The rise in lung cancer diagnoses among young, healthy women who have never smoked calls for greater awareness and research into the causes and treatments of the disease. Dr. Yu and other oncologists emphasize the need for more research into genetic mutations and targeted therapies, which are proving to be effective for some patients.
As new treatments emerge, the outlook for patients with lung cancer, particularly those with genetic mutations, is improving. Targeted therapies that focus on the genetic underpinnings of cancer are giving patients a better chance at survival.
However, experts agree that more research, awareness, and funding are needed to address the growing number of lung cancer cases among young women and non-smokers.
Wojcicki’s call for greater resources and understanding of lung cancer is one step toward finding answers, as more individuals, like Mundin and Kara, continue to navigate their journeys with the disease.