Lung cancer is not just a smoker’s disease – teacher fights to end stigma

The misconception that lung cancer is only a smoker’s disease is causing diagnosis delays for thousands of sufferers, a terminally ill patient has warned.

Natasha Loveridge received a shock diagnosis last December after her breathing became squeaky.

Just a month later, the 49-year-old primary school teacher was told her disease had progressed to an incurable stage.

She is now fighting to raise awareness that “if you’ve got lungs, you can get lung cancer”. Natasha said: “I find myself having to justify it. I always say, ‘I’ve got lung cancer but it’s non-smoking, it’s caused by a gene mutation’.

“I constantly have to qualify it and that’s wrong. There is this stigma that you must have brought it on yourself.”

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Around 48,000 people are diagnosed with lung cancer each year in the UK. While the majority are smokers, around 15 percent are people whose disease is not linked to use of cigarettes and has unique molecular and biological characteristics.

Almost six in ten cases of lung cancer are diagnosed at stage three or four, too late for curative treatment.

Natasha lives with her husband Matthew and daughters Gracie, 17, and Emily, 15, in Guiseley, Leeds.

Her cancer is thought to have been caused by a mutation in the gene that codes for a protein called EGFR, which is more common in women.

She was previously fit and healthy, completing a 10km run at least once a week and enjoying cycling, yoga and a balanced diet. This meant both Natasha and her doctors were slow to suspect cancer.

She recalled: “My first symptom was that it sounded like I had swallowed a squeaky dog toy – my breathing sounded like a creaking door. I also had this irritable dry cough.

“I didn’t think much of it. I thought it was long Covid. Why would I have lung cancer? When you’re a non-smoker it doesn’t even come onto your radar that you could have lung cancer.”

A chest x-ray revealed abnormalities in her lung but medics initially thought Natasha had tuberculosis. “They looked at my profile, I was 48 and very fit and healthy. Not what you would expect for a lung cancer patient,” she added.

By the time her cancer was diagnosed, it was already stage three. Within a month it progressed to stage four and tests showed it had spread to her brain.

Natasha immediately started taking the wonder drug osimertinib, which blocks proteins on cancer cells that encourage growth.

Recent scans showed her primary lung tumour had shrunk by a quarter and her brain metastases were too small to be seen.

Studies suggest osimertinib can keep cancer at bay for around two years for patients like Natasha.

When her disease was first detected, she feared she would not see this spring. But Natasha is now making plans for her dream holiday to Italy next year and tries “not to look over the cliff” of her prognosis.

She said: “There are people who have been on osimertinib for five plus years. I hope to goodness that I am one of those people, and then I’m hoping that in that time there will be new targeted treatments.

“Science and medicine is advancing at such a quick rate at the moment. I just keep hoping, because if you can’t have that then what have you got?”

Natasha is working with charities to raise awareness of non-smoking lung cancer so that more patients can be diagnosed early when treatment is more likely to be successful.

“We need to really start to crush these stigmas and misconceptions,” she added. “It’s part of the reason why the majority of people with EGFR+ and non-smoking lung cancer get diagnosed at such a late stage.

“I’d like to get to a point where I can say to people ‘I’ve got lung cancer’, rather than ‘I’ve got lung cancer but I don’t smoke’. Increasing awareness of non-smoking lung cancer will hopefully save lives.”

A 2019 study found that if lung cancer in non-smokers was considered a separate disease, it would be the eighth most common cause of cancer-related death – higher than ovarian cancer, leukaemia and lymphoma.

As rates of smoking decline, the relative proportion of lung cancers in non-smokers is rising.

Ruth Strauss, wife of former England cricket captain Sir Andrew Strauss, died of non-smoking lung cancer in 2018 aged 46. Sir Andrew launched the Ruth Strauss Foundation in her memory to raise awareness of the need for more research and to support other affected families.

Deepa Doshi, the foundation’s head of mission services, said: “Like Ruth, too many people are dying from non-smoking lung cancer each year.

“Due to the perception of lung cancers being a smoker’s illness, patient’s symptoms are not always picked up early enough. Diagnosing lung cancer early gives patients more options for treatment and more years to their lives.”