Stage 4 lung cancer survivor says, 'I never smoked,' pay attention to symptoms
November 14, 2025Categories: Cancer Patient Stories
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Julie Paup considered herself a healthy person, except for a cough that wouldn’t go away. After six months of coughing, Julie, who was 44 years old at the time and had never smoked, was diagnosed with Stage 4 lung cancer in 2015.
According to the CDC, about 10% to 20% of lung cancer cases occur in people who have never smoked or smoked less than 100 cigarettes in their lifetime.
Julie of Cedar Falls, Iowa, went to the doctor about her cough several times before her diagnosis. After coughing up blood when her lung collapsed, she was given a chest x-ray that led to a CT scan and a lung biopsy that led to a final diagnosis of Stage 4 lung cancer four days later. The cancer had metastasized to her lymph nodes, pelvic bone and her spine.
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Julie never thought she could be experiencing the symptoms of lung cancer. She wants people to know you don't have to smoke to get lung cancer. “It’s frustrating to hear people say, ‘Oh you must have smoked.’ If you have lungs, you can get lung cancer,” Julie said.
Lung cancer symptoms are the same for smokers and non-smokers. Some people have general symptoms of not feeling well or feeling tired all the time. Others, like Julie, experience a persistent cough, cough up blood, or have chest pain, wheezing or shortness of breath. If you have any of these symptoms, talk to your doctor.
Julie doesn’t want lung cancer's association with smoking to get in the way of somebody’s diagnosis.
“Don’t ignore your symptoms,” she said. "If you know something is not right, be your own advocate and push for answers. Don’t let someone talk you out of it. If you think you need a second opinion just to make sure, don't hesitate to do that.”
According to the American Lung Association, lung cancer has a five-year survival rate of 18.6%. It's now been 10 years since the diagnosis and Julie is cancer free thanks to MercyOne Waterloo Cancer Care.
“I was very lucky to have received new medications that were just being introduced, like immunotherapy and targeted therapy drugs,” she said. “Those new drugs saved my life. I can never say thank you enough to my oncologist at MercyOne who never gave up on me.”
