IN THE SUMMER of 2021, Aurora Lucas had a lot on her plate. The then-28-year-old worked at a high school as a learning specialist during the day and took online courses to earn a doctorate in education in the evening. Additionally, she and her husband, Joel, had just purchased their first home in the Chicago area.
So when Lucas started feeling fatigued, she chalked it up to her busy schedule. “Everything was going on at once, and I thought I was just exhausted,” Lucas says. She soon developed a cough and experienced back pain so intense it woke her up in the middle of the night. She felt so tired that she feared she would fall asleep at the wheel on her drive home from work.
In August 2021, Lucas saw her primary care doctor, who downplayed her symptoms and suggested she drink some hot water with honey. “He was the authority figure in the room; he was the licensed doctor, so I didn’t say much more,” she says. Then one day in September, she started experiencing chest pain and went to the emergency room. Doctors there diagnosed her with Wolff-Parkinson-White syndrome, a birth defect that causes the heart to beat faster but is typically not life-threatening. The condition, however, did not explain her intense back pain and persistent cough. The emergency room doctors called her primary care doctor to get him to order a PET scan, a requirement for the test to be covered by her health maintenance organization (HMO) insurance plan. But the primary care office didn’t return the hospital’s phone calls, so after two days, Lucas headed home with more questions than answers.
After not returning Lucas’ calls for months, her doctor finally ordered the PET scan in November. Days later, she logged into her patient portal to find the results. Without a call from her doctor to explain the language in the report, Lucas immediately forwarded the results to her cousin, who is an ultrasound technician, and her sister, who is a nurse. Through tears, they told her the scan showed a mass in her right lung.
Cases of lung cancer in people who don’t smoke cigarettes are rising in some populations.
Up to 20% of lung cancer cases occur in people who do not smoke, and among nonsmokers, women are twice as likely as men to develop lung cancer. Researchers are trying to understand exactly what causes the disease in nonsmokers. Possible causes include air pollution, secondhand smoke and exposure to harmful chemicals or materials, such as asbestos and radon. Lung cancer in nonsmokers is more likely to have a mutation in the epidermal growth factor receptor (EGFR) gene, which can drive tumor growth.
While lung cancer incidence has dropped by 1.1% annually in women overall in the U.S., cases have gone up by 2% per year among Asian American women, despite Asian American women having lower smoking rates than other ethnic groups. EGFR mutations occur in up to 15% of all lung cancers, but researchers have found up to 74% of Asian American women who develop the disease have an EGFR mutation. One study, called the FANS (Female Asian Never Smokers) study, is recruiting Asian American women who have never smoked to identify what causes lung cancer in this population, with the hope that information will lead to preventive measures.
Current U.S. guidelines limit screening mainly to older people who have a smoking history. Some researchers have suggested expanding screening to include nonsmoking Asian American women at high risk for the disease. This could help find cases of lung cancer in this population earlier when they are easier to treat.
On Dec. 1, 2021, Lucas switched her insurance to a preferred provider organization (PPO) plan, which allowed her to choose from a wider selection of providers. She immediately found a new primary care doctor, who ordered a biopsy and imaging tests. By Dec. 6, she had a diagnosis: stage III non-small cell lung cancer (NSCLC) that had spread throughout her right lung and to surrounding lymph nodes.
Exploring Options
While Lucas describes the time she spent trying to figure out what was wrong as “hell,” she says those four months did teach her to be assertive in medical appointments. Lucas, who was born in the Philippines and moved to the U.S. at age 9, says speaking up for herself didn’t come naturally. “I had to learn to talk back, which was everything against my culture. We don’t talk back. We don’t question what the doctor is saying,” she says.
After seeing a general oncologist at her community hospital, Lucas decided to get a second opinion from a lung cancer specialist accustomed to treating young people at Rush MD Anderson Cancer Center in Chicago. Both oncologists recommended starting with radiation and chemotherapy to shrink the tumors, but the oncologist at Rush recommended a shorter course of chemotherapy, which could limit the risk for side effects. Lucas felt reassured knowing the doctors at Rush had worked with other young lung cancer patients.
Aurora Lucas, left, is pictured with her sister, Vanessa Barba. When Lucas was diagnosed with stage III non-small cell lung cancer, she and her husband moved in with Barba, who served as an additional caregiver during Lucas’ treatment. Photo by Matthew J. Odom
Lucas started treatment at Rush in January 2022. The radiation and chemotherapy reduced the size of her tumor, which meant she could have surgery to remove the cancer. However, tumor testing revealed the cancer had a mutation in the epidermal growth factor receptor (EGFR) gene, which can lead to excessive cell growth. This meant targeted therapy alone might be enough to control her disease, according to Irene Haapoja, an oncology clinical nurse specialist on Lucas’ care team at Rush. Lucas feared that removing part of her lung would diminish her quality of life, so she opted to try targeted therapy. In March 2022, she began taking Tagrisso (osimertinib), which targets the EGFR protein to slow down or stop tumor growth. The drug has kept her cancer in check, although she gets scans every three months and annual brain MRIs to monitor for signs of progression. Lucas will keep taking the oral pill as long as the cancer continues to respond, Haapoja says.
The 32-year-old regularly experiences side effects of Tagrisso, including dry skin, fatigue and stomach issues. The drug’s most heartbreaking impact, however, has been preventing her and her husband from starting a family. Lucas has always dreamed of being a mother, so before starting treatment, she had some of her eggs retrieved in case treatment prevented her from conceiving naturally in the future. But Tagrisso can harm a fetus, so she is not supposed to become pregnant while taking the drug. With the possibility that she may never stop taking Tagrisso, Lucas and her husband are still open to having children via surrogacy, but she is also trying to embrace a future that might not include children.
Acting early can preserve fertility options that may not be available after treatment.
Both cancer and its treatment can negatively affect a person’s chances of naturally conceiving a child. However, pursuing fertility preservation before starting treatment can help protect the ability to have children. Before treatment starts, women can opt to freeze embryos, eggs or part of an ovary. In other cases, they can have surgery to reposition the ovaries away from the area that will be impacted by radiation. Men seeking fertility preservation can provide a semen sample to be frozen and stored. Sperm from the sample can be used for in vitro fertilization in the future. (Read more about male infertility.)
Women diagnosed with cancer who are interested in having children in the future should discuss fertility with their oncologist as early as possible, according to Elizabeth Fino, a reproductive endocrinologist and the director of oncofertility at the NYU Langone Fertility Center in New York City. While oncologists should bring up fertility preservation options, patients may need to start the conversation themselves, she says. Fino suggests women ask their oncologist the following questions:
- Could my cancer or treatment impact my fertility?
- Do I have time to consider fertility preservation?
- What fertility preservation options are available to me?
- How much would fertility preservation cost?
- Can you refer me to an oncofertility expert whom I can talk to about this in more depth?
Cancer’s Financial Toll
Lucas also has had to defer other dreams. With medical bills piling up after her diagnosis, she and her husband decided to rent out the house they had just bought. To help save money, the pair moved in with Lucas’ sister, Vanessa Barba, and continues to live in her basement apartment. Lucas was thankful to have her sister as another caretaker during her treatment, but she hated having to rely on others for support. “I felt so ashamed moving back in with family because I was always about independence and having my own space,” she says.
With her appointments and treatment during the day, Lucas had to choose between having her husband by her side or going without him so he could earn a paycheck as a house painter. “There’s the emotional comfort that he’s there, but then [there’s] the financial aspect as well,” Lucas says.
A cancer diagnosis is devastating at any age, but younger adults often have less savings to buffer the financial impact. One study suggests half of people with cancer ages 18 to 39 report experiencing financial toxicity, which describes when a person’s medical bills cause financial burden and related stress, compared with 41% of adults ages 40 to 64 and 10% of adults older than 65.
Aurora Lucas paddles her kayak over rapids during a First Descents white water kayaking program for young adult cancer survivors in July 2024. Photo by Matthew J. Odom
Adults treated for cancer earlier in life also face other unique challenges once treatment is complete, including treatment-related health issues that can extend for the rest of their lives. They may feel strangely like outsiders looking in as they watch their peers establish careers, pursue romantic relationships and start families. “It’s the time we’re supposed to be on top of our careers and our dreams, and then cancer just kind of has to put a pause on that,” Lucas says.
Finding Connection
A few years after her diagnosis, Lucas felt increasingly isolated and lost. As she grieved the life she thought she’d have, she didn’t have anyone who could relate to her experiences as a cancer survivor. Despite strong family support, she felt obligated to put on a brave face.
But that sense of isolation ebbed in July 2024 when Lucas joined other survivors for an escape offered through First Descents, a group that hosts free outdoor adventures for young adults diagnosed with cancer or other conditions. The week of white water kayaking in Oregon jolted her out of her depression. For the first time, she was surrounded by people her age who had been through similar experiences. The more they talked, the more she discovered her peers had the same frustrations, fears and hopes, and hearing about how they thrived after treatment encouraged her. “She came back really absolutely happier, more smiles, and you can see just a different light in her,” Barba says.
Young adult cancer survivors find connection in outdoor activities.
Lung cancer survivor Aurora Lucas participated in several outdoor programs exclusively for young adults diagnosed with cancer. These retreats gave Lucas the chance to speak openly with fellow survivors. “Just having those connections made me feel less alone,” she says.
The following programs offer free outdoor activities and adventures for young adults with cancer:
- The Dear Jack Foundation hosts yoga and meditation retreats at various locations across the U.S. Cancer survivors ages 18 to 39 can attend by themselves or with a caregiver.
- First Descents offers outdoor adventures, such as kayaking, rock climbing and surfing. Programs across the U.S. are open to people ages 18 to 45 who were diagnosed with cancer or multiple sclerosis.
- Project Koru allows cancer survivors ages 19 to 39 to participate in a weeklong surf camp in Costa Rica and other locations.
- True North Treks leads wilderness excursions in various U.S. locations for people ages 18 to 39 who were diagnosed with cancer and their caregivers.
Through similar programs, Lucas has embraced adventure and physical activity. She attended a surfing camp in Costa Rica, trekked through the mountains of Michigan with her husband and surfed the waves along the coast of El Salvador. Lucas says the retreats helped her find joy in physical activity, despite how treatment has impacted her body.
Speaking Out
Lucas began documenting her cancer journey on TikTok and Instagram shortly after her diagnosis. In 2023, the focus of her content shifted to community building and educating other young people diagnosed with cancer. She often shares short videos where she looks directly at the camera to offer information, advice and encouragement, whether discussing the common side effects of Tagrisso or sharing questions that patients should ask their doctor during medical appointments. “It was a way for me to connect and actually help people know how to advocate in those rooms,” she says. Her perspective has resonated with viewers on both platforms, as she now has a combined 10,000 followers.
Aurora Lucas, right, and her husband, Joel, shoot a video for her social media channels. Lucas’ content about her cancer journey has resonated with other young survivors, garnering a combined 10,000 followers on Instagram and TikTok. Photo by Matthew J. Odom
One of those followers, Bianca Bye, discovered Lucas’ social media accounts after searching for information on Tagrisso following her father’s NSCLC diagnosis in July 2023. “I felt comforted just by watching her videos,” Bye says. “She just has this demeanor that is so peaceful and powerful at the same time.” Bye, who launched her own organization to increase awareness called the Young Lung Cancer Initiative, began reposting Lucas’ videos, and the two continue to work together.
Lucas also shares her story at patient advocacy events and on podcasts and news broadcasts. “She’s kind of come into her own as someone who wants to stand up and have the world recognize what’s happened to her and what should be done to help other people in similar situations,” Haapoja says.
Aurora Lucas posts about her cancer journey and offers advice to fellow survivors on the following social media accounts:
Instagram: @drauroralucas
TikTok: @aurorainnalucas
Lucas’ advocacy is, in many ways, a natural progression of her love of teaching, according to Barba. “She’s always been that person that has a big heart. She always wanted to help people,” her sister says. During the 2024-2025 school year, Lucas worked remotely teaching high school students in Alaska. But as her advocacy work takes a greater share of her time, she feels increasingly drawn to using her voice to ensure others with the disease have information and do not feel alone.
Even though cancer has reshaped her life, Lucas has a lot to celebrate. In May 2025, she completed her dissertation and received her doctorate in leadership and special education. The same month, her husband, who was born in Mexico and has lived in the U.S. without legal status, became a legal U.S. resident. With his immigration status settled and her coursework complete, the pair can finally settle into married life. They’re free to do things typical for 30-something couples, like planning an upcoming trip to the Philippines—her husband’s first visit to where Lucas grew up. “There’s been a lot of good brain space not having to fear what’s going to happen next,” she says.
Cancer Today magazine is free to cancer patients, survivors and caregivers who live in the U.S. Subscribe here to receive four issues per year.
