Yvette Ramirez never smoked. She had no family history of lung cancer. At 32, living in the Netherlands, she believed she had many years ahead. Then a persistent cough changed everything. “I was eventually diagnosed with stage 4 lung cancer,” Ramirez shared with Newsweek at age 36. “I have no family history of lung cancer and hadn’t smoked, so it was shocking to get that diagnosis.”
Ramirez’s case highlights a pattern oncologists are noticing: lung cancer in younger, nonsmoking patients. Genetic mutations, not tobacco, often cause it. Due to the patient’s age and health, doctors frequently diagnose it late.
Raised in Florida, Ramirez was Cuban- and Salvadoran-American. A cough developed after moving to the Netherlands in September 2022. She thought it was seasonal. By December, preparing for the holidays, her partner insisted she see a doctor. Despite her symptoms, her Dutch doctor suspected bronchitis and prescribed common medication.
The cough persisted. Visiting the U.S. that winter, an emergency room chest scan showed inflammation, causing no alarm. Returning to the Netherlands, her doctor suspected a respiratory infection. Subsequent U.S. travel passed, and her doctor, out of options, referred her to a pulmonologist who initially suspected tuberculosis.
A PET scan soon changed everything. Receiving results online, she learned about a tumor. “I got a notification one weekend,” she recalled. A biopsy confirmed stage 4 EGFR-mutated non-small cell lung adenocarcinoma in February 2023. The cancer had spread to her brain’s left frontal lobe, classifying as stage 4.
“One of the hardest parts of the diagnosis was grieving more than my health,” Ramirez shared. “I had to grieve the future I assumed would always be available to me, including the possibility of having a family.”
The diagnosis pushed her to consider her legacy. Returning to a shelved project, Ramirez focused on Kuro Libros, a bilingual children’s publishing company. Her debut book, Mi Familia Cubana con Kuro / My Cuban Family with Kuro, features her cat visiting family in Miami.
“The book wasn’t a cancer project,” she said. The diagnosis altered her relationship with time. Initially hesitant to share her diagnosis publicly, she now sees value in sharing. “I wanted people to understand that stage 4 lung cancer does not have one face,” Ramirez emphasized. “It affects younger people and nonsmokers.”
Starting targeted therapy with osimertinib (Tagrisso) in 2023, she stopped due to drug-related pneumonitis. She switched to erlotinib until mid-2025, then resumed a reduced dose of osimertinib in July. Testing revealed MET amplification, so doctors added tepotinib (Tepmetko) to her regimen.
Ramirez continues treatment with regular imaging and monitoring. She describes living with a chronic disease, not being defined by it. “Continuing to make plans, build something, and pursue meaningful work is not denial,” Ramirez stated. “For me, it’s a way to refuse letting cancer become my entire identity.”