A Young Nonsmoker’s Battle with Stage 4 Lung Cancer

Yvette Ramirez, at the age of 32, faced a future she never anticipated. She lived in the Netherlands, never smoked, and had no family history of lung cancer. A persistent cough changed her life dramatically.

She was diagnosed with stage 4 lung cancer, a situation becoming increasingly common among younger nonsmokers. Genetic mutations are often responsible, catching patients and doctors off-guard, resulting in late-stage diagnoses.

Ramirez’s journey began in September 2022 when she noticed an ongoing cough shortly after moving to the Netherlands. Initially seen as seasonal, the cough persisted into December.

I was getting ready to go home for the holidays, and my partner suggested I see a doctor here in the Netherlands to get it checked out.

Her initial appointment resulted in a bronchitis diagnosis, with standard medication prescribed. However, the cough stayed relentless.

During a U.S. visit, an emergency room scan showed inflammation but no further investigation was conducted. Back in the Netherlands, her physician suspected a respiratory infection. Eventually, she was referred to a pulmonologist who initially suspected tuberculosis.

A PET scan soon revealed a tumor. The Dutch healthcare system often posts test results online before doctor consultations. Ramirez learned of her tumor through such a notification.

By February 2023, a biopsy confirmed stage 4 EGFR-mutated non-small cell lung adenocarcinoma. The cancer had spread to her brain, advancing the stage to 4.

Facing an Uncertain Future

Dealing with her diagnosis required grieving not only her health but also the future she assumed awaited her, including having a family.

This prompted her to revisit her roots and a project dear to her, founding Kuro Libros, an independent bilingual children’s publishing brand. The debut book, Mi Familia Cubana con Kuro / My Cuban Family with Kuro, tells the story of Kuro, her black cat, visiting family in Miami.

This venture was born from her desire to leave a mark rather than solely as a response to cancer. Sharing her diagnosis has highlighted that stage 4 lung cancer can impact diverse individuals, not just smokers.

Living Beyond Cancer

Ramirez began targeted therapy with osimertinib (Tagrisso) in 2023 but switched to erlotinib after drug-related issues. By July, she resumed a reduced dose of osimertinib along with tepotinib (Tepmetko) following MET amplification detection.

Her treatment continues as she views her condition as a chronic disease. She values making plans and creating fulfilling experiences, refusing to let cancer define her identity.