Lung cancer ranks as one of the most commonly diagnosed cancers in India - Dr Jitender Rohila

Overall it is the 6th most common cancer in India with an age-standardized incidence rates incidence rate of 5.4 per 1Lakh population, more common in males (7.8), Females (3.1) and a leading cause of cancer related mortality with rates of 4.9 per 1 lakh population. (ref -GLOBOCAN 2020)

It is often termed as silent killer because of its asymptomatic nature in early stages of disease and patients usually present in advanced stages where treatment options are less curative.

Common symptoms include persistent coughing that worsens over time, chest pain, difficulty breathing, wheezing, coughing up blood, feeling constantly fatigued, and unexplained weight loss. These symptoms can be confused with a lot of non-cancerous conditions like tuberculosis which hampers the early diagnosis of lung cancer.

Risk factors:

• Tobacco smoking: India has a significant burden of tobacco consumption, both in terms of smoking and smokeless tobacco. Cigarettes, bidis (a local form of hand-rolled cigarettes), and hookah are prevalent. Bidi smoking, in particular, has been strongly associated with lung cancer in Indian men.
• Air pollution: Both indoor and outdoor air pollution contribute to the risk of lung cancer. Indoor air pollution, often due to burning of biomass fuels for cooking and heating, is especially relevant in rural India.
• Occupational risks: Exposure to asbestos, radon, and other occupational carcinogens has been linked to lung cancer, though their contribution to the overall lung cancer burden in India might be less compared to tobacco.
• Diagnosis: of lung cancer often included physical examination by expert doctor, imaging tests like chest X-rays and CT scans/PETCT for staging. A biopsy is then taken to confirm malignancy, and molecular testing can pinpoint specific genetic mutations. Non-small cell lung cancer (NSCLC) is the most common type, followed by small cell lung cancer (SCLC). Within NSCLC, adenocarcinoma has been increasingly recognized, even among non-smokers, possibly due to other factors like air pollution.

Treatment: Multiple treatment options are available including surgery, radiation therapy, chemotherapy, immunotherapy and targeted therapies depending on the stage of presentation with early-stage cancers having a much better prognosis than advanced-stage diseases.

Prevention: Most important is abstaining from tobacco or quitting if already a smoker. Avoiding second-hand smoke, limiting exposure to carcinogens like asbestos, and reducing air pollution intake are other preventive measures. For high-risk individuals (current or previous smokers), screening with low-dose CT scan of the chest annually can aid in early detection. Raising public awareness about the hazards of smoking and promoting healthy lifestyles are pivotal in preventing lung cancer.