Lung cancer in never-smokers: What physicians should know

In this episode of Physician Huddle by UCI Health, thoracic surgeon Hari B. Keshava, MD, joins the show to discuss the rising incidence of lung cancer in never-smokers, persistent gaps in lung cancer screening, and the growing importance of coordinated follow-up for incidental lung nodules.

Keshava also explains how advances in minimally invasive and robotic thoracic surgery, along with targeted therapies and immunotherapy, are reshaping treatment pathways for patients with lung cancer. He also shares his unusual path to medicine, from electrical engineering to thoracic surgery, and reflects on how a personal, family experience with serious lung disease continues to shape the way he cares for patients and their loved ones.

Topics discussed: 

• Why lung cancer screening rates have improved, but remain far below where they should be
• Common physician and patient barriers to low-dose CT screening
• How to talk with patients about smoking history without judgment
• What to do when a lung nodule is found incidentally
• How the UCI Health lung nodule clinic helps streamline follow-up and next steps
• The rising incidence of lung cancer in never-smokers, particularly in certain patient populations
• Questions surrounding genetics, driver mutations, and environmental exposure
• How robotic and minimally invasive thoracic surgery is improving recovery
• Why targeted therapies and immunotherapy are changing surgical decision-making
• Keshava’s path from electrical engineering to thoracic surgery
• How personal experience shapes empathy, expectation-setting, and patient communication
• What makes thoracic surgery and multidisciplinary cancer care at UCI Health distinctive

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