For years, lung cancer was considered a disease of smoking, of aging, and of men. Now, greater understanding lung cancer differences in women helps guide effective treatment.
As more women took up smoking in the middle of the last century, more of them began to be diagnosed with lung cancer. Now, as the number of women diagnosed each year with lung cancer continues to grow — even as the rate of lung cancer diagnosis among men has leveled off or even decreased — researchers are learning much about the lung cancer differences in women and men. And that knowledge means lung cancer treatment has become more sophisticated, and targeted to each patient.
Researchers and physicians have long recognized that lung cancer is not a single disease, but many different ones. And we now know, too, that lung cancer can be a very different disease for women than for men.
What are the lung cancer differences in women?
One reason is that women are more likely to develop a different variety of lung cancer than the one that most often affects men.
Generally, there are two types of lung cancer:
- Non-small cell lung cancer, which accounts for about 80 percent of lung cancers
- Small-cell lung cancer, which comprises 15 to 20 percent of diagnosed lung cancers
However, non-small cell lung cancer has three subtypes:
- Adenocarcinoma, which accounts for about 50 percent of non-small cell cancers
- squamous cell carcinoma, the second most common type of non-small cell lung cancer
- Large-cell lung cancer
Different disease, different symptoms
For several years, the fact that heart attack symptoms are different in women than in men has been getting well-deserved attention.
Now we know that just as heart attack symptoms can be different for women, so can lung cancer symptoms.
In small-cell or squamous non-small cell lung cancers, tumors often grow near or within large airways, where they are likely to cause coughing, bleeding, or airway infections. So, in men, those symptoms often are the first indication of lung cancer.
Women, on the other hand, are more likely to develop adenocarcinoma. In that cancer, tumors often grow on the outer edges of the lungs, and so are less likely to cause coughing or bleeding.
Women’s symptoms, which tend to be vague, can include:
- Shortness of breath
- Chest and back pain
In the past, those symptoms have not been widely associated with lung cancer, which may be one reason adenocarcinomas — the lung cancers most likely to affect women —often are detected later.
While cigarette smoking still accounts for 80 to 90 percent of lung cancers, some 20 percent of women diagnosed with the disease have never smoked. In fact, a higher percentage of women who have never smoked are diagnosed with lung cancer than men who have never smoked.
Reasons for Hope
Still, women facing lung cancer have many reasons to be encouraged.
- Researchers aren’t sure why — it may be the type of lung cancer women tend to get or hormones may play a role — but the prognosis for women often is more favorable.
- Women historically have responded better to some chemotherapies used in treating lung cancers.
- Some of the most successful new lung cancer therapies target tumors with specific genetic mutations, including one known as epidermal growth factor receptor (EGFR). For reasons still being researched, EGFT is more common among women with the disease than it is among men.
- Between 2011 and 2017, more new treatments for lung cancer were approved than in the 40 years leading up to 2011.
Greater understanding of the disease, and lung cancer differences in women, is leading to unprecedented treatment advances. Which means that for both women and men with lung cancer, the outlook has never been better.