February 17, 2026

@michaelokun

What can we learn from lung cancers in never smokers? What are the silent clues hiding beyond cigarettes? Are there lessons for Parkinson's and Alzheimer's? Never smokers means individuals who have smoked fewer than 100 cigarettes in their lifetime and yet still developed lung cancer. Caswell and colleagues describe in a new paper in Trends in Cancer, how lung cancer in never smokers is emerging as a biologically distinct disease and why it may hold clues for prevention, early detection and precision therapies. Key Points: – Lung cancer in 'never smokers' is rising globally and frequently presents later because symptoms are nonspecific and screening programs rarely include this group. – These cancers may harbor actionable driver mutations such as EGFR and ALK, making them biologically distinct and more amenable to targeted therapies. – Environmental exposures including air pollution, radon and secondhand smoke, along w/ inherited genetic risk and inflammatory processes, all contribute to disease risk even in the absence of smoking. My take: This paper forces us to not only rethink lung cancer but to re-think potential causes of disease in general. The discussion in the paper highlights how environmental exposures, inherited biology and inflammation can all quietly shape cancer risk. These ideas should be 'noodled' in other diseases like Parkinson's and Alzheimer's. Understanding the principles that may underpin 'never smokers' may unlock new pathways for prevention and interception, hopefully long before symptoms appear. Here are 5 points that resonated w/ me: 1- Lung cancer can occur in folks who never smoked, reminding us that both environmental and genetic risks matter. 2- These cancers may carry targetable mutations, offering opportunities for personalized therapies. 3- Air pollution, radon and secondhand smoke seem to quietly increase risk over decades. 4- Screening strategies must evolve to identify high risk individuals beyond smoking history alone. 5- Studying 'never smokers' may reveal prevention strategies that benefit everyone. Does this make you think more deeply about neurodegenerative diseases? #michaelokun #fixelinstitute #parkinson #lungcancer