“It bothers me when people ask me if I smoke.”

This is reflected in the first National Lung Cancer Observatory, which the Spanish Lung Cancer Group (GECP) presented this week. Women already account for one in four diagnoses, and people aged 40 to 50 account for about 13.3% of the total. “It didn’t surprise me because This is what we usually see in a consultation.“Enric Carcereni, second vice-president of the GECP, assured EL ESPAÑOL of this latest information.

Because this is the first registry of 34,000 patients from 90 hospital centers, it is impossible to make comparisons. But Carcereni believes that while they are not the majority, “you see more and more” He doesn’t know what might be driving the increase. He suspects that the risk factors are different from those in the general population. That is, they don’t usually smoke, there are more women, and molecular changes play a bigger role.

The vice president of the Spanish Society of Medical Oncology (SEOM), Javier de Castro, agrees with this assessment: “This is still the main cause, but there are other causes.” Risk factors beyond tobacco“Overall, this practice is behind this tumor in 87% of cases (40.5% among heavy smokers and 46.5% among ex-smokers).

This percentage drops to 60% if we are talking only about women. Compared to men, molecular changes pose a higher risk for them. “The EGFR gene mutation, one of the most common,” explains Carserene, “is more likely to occur in women and non-smokers,” as is the case with Stephanie Oyonarte da Rocha.

Cancer at 35

This French-born woman who has lived in Seville for over three decades was diagnosed with lung cancer on June 6, 2016; or what is the same, four days before my 35th birthday“You know something is going on because you feel unwell. But then at that age you are told you have a tumor…”, he recalls in a conversation with this newspaper.

You only need to talk to her to see this, but if it’s not clear, she presents herself as an energetic person. Although before the diagnosis it was impossible to prove it to him:”My capabilities remained at 10%“I was teaching and had to go to the infirmary to sleep.”

Lack of energy wasn’t the only symptom that alarmed him. Also I had pain in my stomach and chest.. Although the “most striking thing” was that his fingers were altered because he suffered from clubbing, the most common cause of which is lung cancer.

Despite all these signs, he was sent from one specialist to another without a clear answer. He had to insist on a CT scan, which confirmed the diagnosis: “It’s terrible. But This is not the worst thing that has ever happened to me in my life.“.

His mother also had a mutation in the EGFR gene. The tumor He was diagnosed three years after his daughter.“That was the worst. I remember him saying to me, ‘Well, I can accompany you now because you showed me how to do it,'” Stephanie recalls of her mother, who died last year from the same cause.

Possible genetic predisposition

Studies conducted to date have failed to genetically link the two cases. But it is possible that the opposite will be proven in the future: “Both my oncologist and those who know our history do so. they think it’s hereditary. Because there are few examples, but they exist.”

Dr. Javier de Castro admits that in the case of women there may be a hormonal component and hereditary. “Classically, lung cancer was thought to be a non-genetic cancer. But in recent years, we’ve seen that it can be.”

It’s for this reason that Stephanie admits she’s troubled by the question of whether she smoked. “My mother never smoked a cigarette in her life,” he adds. “And even if you smoke, the only thing you need to get lung cancer is to have lungs. Everyone has them, so no one is free“, which is confirmed by the Spanish Association of Lung Cancer Patients (AEACaP), of which he is a part.

She also does not support treating the disease with euphemisms.”I do not share the concept of “struggle”.“When I die, let them say it was from lung cancer, diagnosed at 35.” He has since undergone two operations.

The first of these occurred a month after he was diagnosed with a stage III tumor. After “very tough” chemotherapy, he went into remission for almost a year, ending in June 2018: “I was stage IV and they couldn’t operate on me” The team at the Virgen del Rocio University Hospital decided to give him a targeted therapy known as afatinib. He abandoned it in March 2020 when he underwent a second surgery and started a new treatment called osimertinib.

The drug, approved by the European Medicines Agency in 2018, has become a first-line treatment for patients diagnosed with EGFR-mutated lung cancer. “I’ve been taking it for just over four years now and the disease seems stable based on follow-up data,” Stephanie says of the pill she’s taking reduces the risk of death by halfas demonstrated by a study presented at the American Society of Medical Oncology (ASCO) meeting just a year ago.

More research, less taboo

This Sevillian, an adopted child, knows that if she had been diagnosed 15 years ago, she would not be telling her story now. But as the saying goes, there is little help. And in this case, although research has advanced in recent years, there is room for improvement. “I always I offer my blood to anyone who wants it so they can conduct an investigation. “Whatever they want,” jokes Stephanie, who knows that treatment for stage IV lung cancer is currently very limited.

This does not stop him from talking (without euphemisms) about the disease he has been living with for eight years. In fact, he believes that the problem is that people do not talk about it, but construct an imaginary one that does not always correspond to reality: “When I first entered the oncology office, I realized that the vast majority do not wear a scarf.”

Stephanie adapts her daily routine to her fatigue, even though she can’t be outside all day. And when asked how she is, she prefers to say, “I’m fine.” “If you want to know a little more, I’ll tell you. But I don’t dwell on the pain. People don’t know what it means to live“.