Lung Cancer – The Silent Killer

Lung cancer is the most common cancer as well as the most common cause of deaths due to cancer in the world. According to estimates, more than 22 lakh people have been diagnosed with lung cancer in 2020 worldwide. And this number is projected to exponentially increase to over 36 lakhs by 2040. Equally alarming, more than 18.5 lakh people are feared to have died worldwide due to lung cancer this year alone. In an attempt to create awareness amongst people regarding lung cancer, August 1st is globally observed, as the “World Lung Cancer Day”.

Surprisingly enough, in India however, lung cancer comes in as the fourth most common cancer, after breast cancer, mouth cancer, and neck of womb (cervix) cancers, which seems to be out of sync with the global trends. Is it due to some inherent immunity that we have to lung cancer? Unlikely. It may rather be attributable to, either the widespread prevalence of respiratory disease like Tuberculosis, which may be inadvertently deemed to be the diagnosis in cases due to overlapping symptoms or due to the lack of a robust network of cancer registries across the country, which may lead to under-reporting of cases.

Smoking in the form of cigarettes, or even bidis may contain as many as 5000 chemicals; more than 70 of which are known to be associated with risk of promoting cancer development. Even e-cigarettes or “vaping” are known to be injurious to health. Though, smoking tobacco, either current or former, is clearly the strongest risk factor for lung cancer, even non-smokers are vulnerable to develop lung cancer. In fact, non-smokers tend to be younger, and often present at more advanced stages of cancer in comparison to smokers. Reasons for lung cancer in non-smokers could be second-hand (passive) smoking, workplace exposure to asbestos, diesel exhausts, or certain other chemicals, indoor air pollution, or exposure to radon, or rarely due to genetic susceptibility.

Anyone (especially smokers) should not ignore, the following, as these may be the warning symptoms of lung cancer

• a cough that doesn’t go away;
• shortness of breath with activity;
• repeated chest infections;
• blood with cough or mixed with phlegm;
• increasing shoulder, arm, chest or back pain; or
• unexplained fatigue or weight loss

It is not uncommon to see patients affected with lung cancer, in advanced stages, where they are no longer curable, because of these subtle signs, which can be easily attributed to something else like a change in weather, or being out-of-shape or allergies. And because late presentation, when the disease has spread to lymph nodes or another part of the body, has been the norm, it has generally been fatal for people who are diagnosed with it. But this is now gradually changing due to advances in medical science.

Rapidly evolving medicines in the field of lung cancer treatment has literally given patients, a new lease of life. Genetic changes are now being routinely studied in lung cancers, to better understand the disease and guide therapy to improve and prolong life. Not just that, the place of treatment has shifted from hospitals to clinics and out-patient departments. Improvements in technology, have given the opportunity to remove lung cancer through robotic and key-hole surgery, reducing hospital stay to just a few days even after complex procedures.

Scientists in the western world, have now proven, that it is possible to detect to lung cancer in the early stages, effectively in heavy smokers, with the use of regular Low Dose CT (LDCT) scans, thereby reducing deaths from lung cancer. Also, disease identified in the initial stages, is easier to treat and has more chances of being cured, giving patients upto 13 times higher likelihood of living for more than 5 years. This technology, though available, has unfortunately not been promoted widely in our country, due to constraint of resources.

By raising awareness with correct information, I hope to encourage people to seek timely medical advice and ensure best possible chance of treatment. I urge you, to contribute to the momentum by sharing the article along with your picture with a white/pearl ribbon – the universal colour depicting lung cancer awareness