Lung Cancer in Young Adults (Under 50)

Contact the Young Lung Cancer Program 

Referring physicians: 617-632-6875
All other inquiries: 617-632-5301
Fax: 617-632-4413

For general inquiries, email younglungcancerprogram
@dfci.harvard.edu.

For urgent or clinical concerns, contact your care team.

For many people, early adulthood is a time for school, work, relationships, and raising a family. A lung cancer diagnosis can disrupt those plans. At Dana-Farber, we provide expert care for adults diagnosed with lung cancer before age 50, with support at every step.

How Lung Cancer Can Look Different in Younger Adults

Lung cancer is more common in older adults (the median age at diagnosis is about 67). When it happens under 50, it can be harder to recognize. Symptoms may look like other conditions, and diagnosis may be delayed. 

Many younger adults with lung cancer:

  • Have never smoked
  • Are more likely to be women
  • Are more likely to be Hispanic or Asian/Pacific Islander
  • Are more often diagnosed with adenocarcinoma, a common type of non-small cell lung cancer (NSCLC)

Adenocarcinoma is more likely to have certain genetic changes that may be treated with targeted therapy. Targeted therapies treat cancer based on its biology and may have different side effects than standard chemotherapy.

Younger adults are also more likely to be diagnosed after cancer has spread (metastasized), including to the brain. That’s why early, accurate testing and planning are so important.

Trends in Young Lung Cancer

Overall lung cancer rates have gone down in the U.S., mainly because fewer people smoke. But the number of younger adults diagnosed with lung cancer has stayed about the same.

Many younger adults with lung cancer have never (or rarely) smoked. Researchers are studying other possible factors, such as radon exposure and other environmental risks.

Common Symptoms of Lung Cancer in Young Adults

Common signs may include:

  • A cough that doesn’t go away
  • Shortness of breath
  • Chest pain
  • Coughing up blood
  • Unexplained weight loss
  • Ongoing fatigue

If cancer has spread, symptoms may include headaches, bone pain, or new neurologic symptoms (such as weakness or dizziness). These symptoms can look like other common non-cancer conditions, which can delay a lung cancer diagnosis.

How Lung Cancer Is Diagnosed

Testing is similar for younger and older adults. Your team may use:

  • Imaging tests: This may include a chest radiograph and chest computerized tomography (CT). 
  • Tissue diagnosis: This may include a bronchoscopy, a thin, flexible tube used to look inside the airways and collect tissue when needed
  • Molecular testing: This may include comprehensive DNA and RNA sequencing, especially for young patients with non-small cell lung cancer (NSCLC). 

Staging also helps guide treatment. These tests may include PET/CT or brain MRI (especially when there is concern that cancer has spread to the brain). Watch the American Cancer Society’s lung cancer staging video playlist to learn more.

Genetics-Informed Care from the Start

Because gene changes in the tumor are more common in younger patients, early molecular (tumor genetic) testing can help guide treatment choices. For many people with NSCLC, the care team may recommend broad tumor testing (often DNA and RNA-based) to look for changes, such as:

  • EGFR
  • ALK
  • ROS1

Your results can help your team decide if options like targeted therapy or a clinical trial may be a good fit.

Treatment Options 

Treatment options are similar for younger and older adults, but your plan is personalized based on the stage, tumor type, tumor genetics, and your overall health. 

Options may include:

  • Surgery (often for early-stage disease)
  • Radiation therapy (for certain localized or locally advanced cancers)
  • Systemic therapy, such as:
  • Clinical trials, which may offer access to new therapies
  • Supportive care and survivorship care, including symptom support and long-term planning