She was 32, living in the Netherlands, and building a life she assumed unquestionably had decades left in it. Then a cough that would not go away turned everything upside down. "I was eventually diagnosed with stage 4 lung cancer," Ramirez, now 36, told Newsweek.
"I have no family history of lung cancer, haven't really smoked a cigarette, and yeah it was quite shocking to get that kind of diagnosis." Ramirez's case is a stark illustration of a pattern oncologists have increasingly flagged in recent years: lung cancer diagnosed in younger, nonsmoking patients, often driven by genetic mutations rather than tobacco exposure, and often caught late because doctors do not expect to find it in someone so young and otherwise healthy. Ramirez, who is Cuban- and Salvadoran-American and was raised in Florida, first noticed a cough in September 2022, not long after moving to the Netherlands. She assumed it was seasonal.
"It kept going on for months, until December actually," she said. "I was getting ready to go home for the holidays and my partner at the time suggested that I go to the doctor here in the Netherlands to get it checked out." She said she "really had to exaggerate some of the symptoms" just to secure an appointment. Her Dutch general practitioner suspected bronchitis and prescribed standard medication.
Sadly, the cough did not relent. While visiting family in the U.S. that winter, Ramirez went to an emergency room, where a chest scan showed inflammation but prompted no further investigation. She flew back to the Netherlands for work and returned to her physician, who this time suspected a respiratory infection.
A subsequent work trip to the U.S. came and went, and by the time she got back, she said, her doctor "felt like he had run out of options" and referred her to a pulmonologist, who initially suspected tuberculosis. Then came a PET scan—and a moment familiar to patients in the Dutch healthcare system, where test results are often posted to an online portal before a doctor calls. "I got a notification one weekend, opened it, and it said I have a tumor," Ramirez said.
A biopsy followed and in February 2023, at 32, she learned she had stage 4 EGFR-mutated non-small cell lung adenocarcinoma. The cancer had already metastasized to her brain, including her left frontal lobe, which is what pushed her diagnosis to stage 4. "One of the hardest parts of the diagnosis was grieving more than my health," Ramirez said.
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