Lung cancer in young people like Freek Rikkerink (32) is very rare. On average, eight Dutch men between the ages of 30 and 34 are diagnosed each year. Because there are initially few symptoms, the disease is often discovered late.
Freek, from the musical duo Suzan & Freek, shared on Instagram on Tuesday that he has lung cancer and that there is no chance of recovery due to metastases.
Usually older people get lung cancer. In 85 percent of cases, the disease is also caused by smoking. But occasionally the disease affects young people, such as blogger Eva Hermans-Kroot, skater Paulien van Deutekom and now Freek.
According to figures from the Netherlands Cancer Registry (NKR), between 1989 and 2023 an average of just under eight men between the ages of 30 and 34 were diagnosed with lung cancer each year. By way of comparison: in 2023, 189 men were told they had testicular cancer.
In a slightly larger group of young men and women (between 18 and 39 years old), lung cancer was diagnosed an average of 76 times a year between 1989 and 2023. But that remains extremely rare. “Of all cancer diagnoses within that age group, only 2 percent involved lung cancer,” says researcher Henrike Karim-Kos.
There are no nerve endings in the lungs
That does not alter the fact that lung cancer is a very serious diagnosis at a young age. “Especially because half of the patients already have metastases at the time of diagnosis,” says Marjon Kranenbarg of the Comprehensive Cancer Center Netherlands (IKNL). This is because there are relatively few symptoms or complaints in an early stage. As a result, lung cancer is often discovered late.
Lidia Barberio, director of Lung Cancer Netherlands, agrees. “There are no nerve endings in the lungs,” she says. “That means you only notice something when the lung cancer is in a late stage. And then they are still fairly general complaints.”
Possible complaints include persistent fatigue or a cough that just won’t go away. If lung cancer is discovered early, it is often by chance. For example, during a CT scan after an accident or a heart examination.
It is not known which form of lung cancer Freek suffers from. In young people, it is usually a type where the cause is a mutation, a ‘spontaneous’ change in a gene.
Targeted therapy is often used against this type of cancer: instead of chemo- or immunotherapy, you take a pill at home. “With a mutation, you generally have a better chance of living a number of years longer than with a form caused by tobacco addiction,” says Barberio.
Lung cancer patient who climbs the Alpe d’Huez by bicycle
A small bright spot after a lung cancer diagnosis is that patients can sometimes lead an active and even sporty life for years. “You think of people sitting on an oxygen bottle, but the treacherous thing is that you can’t see anything on the outside,” says Barberio. She knows lung cancer patients who climb the Alpe d’Huez by bicycle or do spinning weekly.
But the patients live with the uncertainty that things can suddenly get worse. At some point, the cancer becomes more resistant to the medication and therefore no longer works properly. Then it can deteriorate rapidly.
According to Lung Cancer Netherlands, a population screening is currently only useful for people over fifty who have smoked for a long time and heavily. According to Barberio, screening all young people is currently not a realistic option due to limited availability of scans and exposure to radiation. Although that could change in the future if research becomes less invasive and cheaper.