Incidence India is the second largest consumer and third largest producer of tobacco in the world. 28.6% of the Indian population uses tobacco products (42.4% men and 14.2% women), accounting for an estimated 267 million tobacco users in the country. Tobacco-related cancers constitute 27% of all cancers for both sexes combined. In India, lung cancer accounts for 5.9% of all cancers and 8.1% of all cancer-related deaths. The prevalence of smoking in patients with lung cancer is nearly 80%. There are 2.26 million active cases of lung cancer in India over the last 5 years.Also Read - Gynaecological Cancers And Fertility: Early Detection to Treatment, Know it All

Etiology /Cause / Risk factors for lung cancer include:

  • Smoking. Risk of lung cancer increases with the number of cigarettes smoked per day and the number of years you have smoked. Quitting at any age can significantly lower the risk of developing lung cancer.
  • Exposure to secondhand smoke. Is also a significant risk factor
  • Previous radiation therapy. If you’ve undergone radiation therapy to the chest for another type of cancer, (treated in the past with radiotherapy) then there is an increased risk of developing lung cancer.
  • Exposure to radon gas. Radon is produced by the natural breakdown of uranium in soil, rock and water that eventually becomes part of the air you breathe. Unsafe levels of radon can accumulate in any building, including homes.
  • Exposure to asbestos and other carcinogens. Workplace exposure to asbestos and other substances are known to cause cancer — such as arsenic, chromium and nickel.
  • Family history of lung cancer. People with a parent, sibling or child with lung cancer have an increased risk of the disease.

Signs and symptoms of lung cancer may include:

  • A new cough that doesn’t go away even with antibiotics and other symptomatic treatments.
  • Coughing up blood in sputum, even a small amount. This is seen in 20 to 60 per cent of patients with lung cancer.
  • Shortness of breath due to fluid build-up in the lungs
  • Chest pain due to involvement of ribs or lining of the lung cavity
  • Hoarseness of voice due to the involvement of the nerves.
  • Losing weight without trying (a sign of advanced disease with spread to distant organs)
  • Bone pain due to the spread of cancer to the bones
  • Headache due to metastases to the brain

Types of lung cancer :

There are 2 main types of lung cancer when studied under a microscope: Also Read - Heart Attack: 8 Early Signs To Catch

  1. Small cell lung cancer ( related to smoking) and
  2. Non-small cell lung cancer

A diagnosis chest x-ray should be advised for all suspected patients, but in India, the prevalence of benign and inflammatory diseases like tuberculosis and sarcoidosis is still high and they can present with much of the same symptoms and nodules in the lung on the chest X-ray. Also Read - Desi Ghee Side Effects: Stop Eating Ghee Right Away if You Have These Health Conditions

Low-dose computed tomography (LDCT) of the chest is an established strategy for the screening of lung cancer.

Flexible bronchoscopy and transthoracic sampling are the most often used techniques for the diagnosis of centrally located lung cancers while the peripheral one-third of lesions are accessed transthoracically.

Endobronchial ultrasound (EBUS) guided biopsy

Transthoracic biopsies are generally performed under CT image guidance. However, at present, less than 1% of hospitals in India have a dedicated setup for interventional radiology.

  • Treatment: Once the diagnosis is established it is mandatory to stage the disease so as to decide the course of treatment with PETCT, whether to go straight ahead for surgery or give neoadjuvant chemotherapy with or without radiotherapy followed by surgery. Surgery is a major undertaking This can be done via an open or conventional approach or a minimally invasive approach.
  • Prevention: The National Tobacco Control Program was launched by the Government of India from 2007 to 2008 with the aim to raise awareness of the deleterious effects of tobacco, regulate tobacco production and consumption, and enact and enforce the Cigarette and other Tobacco Products Act. This includes printing of pictorial warnings on tobacco products and the release of promotional videos for the same.

But what can you do to the prevention of lung cancer?

There’s no sure way to prevent lung cancer, but you can reduce your risk if you:

  • Don’t smoke. Don’t give in to the temptation. Don’t give in to peer pressure. Follow healthier ways of dealing with stress like meditation and yoga. Have a frank discussion with your children about not smoking, and confide in them about the dangers of smoking so that they know how to react to peer pressure.
  • Stop smoking. Stop smoking completely and permanently. Quitting reduces your risk of lung cancer, even if you’ve smoked for years. Many aids for stopping smoking are available that can help you quit. Options include nicotine replacement products, medications and support groups.
  • Avoid secondhand smoke. Counsel people, u live or work with to stop smoking. At the very least, ask them to smoke outside. Avoid areas where people smoke, such as bars and restaurants.
  • Avoid carcinogens at work. Take precautions to protect yourself from exposure to toxic chemicals at work. Wear the face mask, gloves and all protective equipment provided by your employer. Your risk of lung damage from workplace carcinogens increases if you smoke.
  • Eat a diet full of fruits and vegetables. Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Vitamins in the form of supplements have actually been proven to increase the risk of cancer
  • Exercise most days of the week. If you don’t exercise regularly, start out slowly. Try to exercise most days of the week.

(Inputs by Dr Mehul Bansali, Director,  Surgical Oncology, Jaslok Hospital) 

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