Florez Highlights Overlooked Needs of Young Patients, Women With Lung Cancer

Narjust Florez, MD, a thoracic medical oncologist at Dana-Farber Cancer Institute, discusses the clinical and structural gaps facing young patients and women with lung cancer, a population she says remains understudied and underrepresented in clinical trials.

Florez, who is also associate director of the Cancer Care Equity Program and an assistant professor of medicine at Harvard Medical School, said her focus shifted away from a planned career as a phase 1 trialist after a clinical encounter revealed how stigma surrounding lung cancer affects outcomes and survivorship in younger patients.

She noted that since 2018, younger women have developed lung cancer at higher rates than younger men regardless of tobacco use, yet the disease remains widely associated with older men. This mismatch contributes to diagnostic delays, she said, citing her team's LEAD study, which found that lung cancer symptoms in young women are often misattributed to anxiety rather than malignancy. These delays can allow a potentially curable cancer to progress to metastatic disease, shortening survival.

Florez also pointed to gaps in fertility counseling and sexual health discussions for young patients, noting that longer survival on targeted therapies has not been matched by attention to these quality-of-life concerns. She said clinicians should present options rather than make assumptions about patients' reproductive or family goals.

In counseling newly diagnosed patients, Florez emphasized addressing feelings of guilt, including guilt related to smoking history, and reframing the clinical relationship around problem-solving rather than blame.

She encouraged colleagues to consider that treatment decisions for young patients carry long-term consequences, since these patients often tolerate more sequential lines of therapy over many years. She also urged providers to ask about caregiving responsibilities, noting that many young patients—particularly women—simultaneously care for children, aging parents, and spouses, and may need additional social work support to manage these competing demands.

Read the full interview with Dr Florez.