According to the International Agency for Research on Cancer (IARC), lung cancer is the most common cancer affecting people globally, accounting for 11.6% of new cancer cases. It is also the most common cause of cancer related deaths, accounting for 18.4% of all deaths globally. In India, about 70,000 new cases of lung cancer are diagnosed every year with almost 70% of them detected at an advanced stage.
Risk factors
Tobacco smoking is the single most important risk factor for lung cancer. This includes cigarette, bidi, cigar and hookah smoking. Passive smoking also increases risk of the disease
Asbestos is another human carcinogen for lung cancer. It is widely used in construction, automobile parts and textile industry
Workplace exposure to arsenic, chromium, diesel exhaust, silica and nickel also alleviates risk
People who spend much of their time in the basement at home or at work have a greater risk of being exposed to radon gas which is another risk factor
Air pollution, especially indoor air pollution due to coal burning is a strong carcinogen
Genetic factors also plays an important role in increasing risk
Warning signs
The initial warning signs include chronic cough, blood in sputum, increasing breathing difficulty, chest pain, and change in voice. Warning signs at an advanced stage comprise bone pain, headache and unexplained weight loss. The symptoms of lung cancer overlap of its symptomatology with that of TB (tuberculosis) of lungs and this can cause a delay in detection in most cases.
Detection
One should opt for a biopsy which is essential not only for the confirmation of the disease but also for subtyping it further. Lung cancer is of various types (small and non-small cell cancer). There are further subtypes of non-small cell lung cancer, namely squamous, adenocarcinoma and large cell carcinoma. With advances in diagnostics, it is possible to classify lung cancer based on molecular markers to plan personalised treatment in a given case. Whole body PET CT scan helps in staging lung cancer.
Treatment
Treatment of lung cancer has undergone a paradigm shift in recent years. Treatment is based on the stage of the disease. Surgery and radiotherapy can aid in early cure. For the advanced stage, one can opt for chemotherapy, targeted therapies (in form of tablet, capsule) or immunotherapy for treatment of patients with stage II and IV disease. These advanced and more refined treatments have led to an increase in the life expectancy of lung cancer patients.
Prevention
Prevention of the disease is possible to a large extent by avoiding smoking in all forms (including second hand smoke). One must also protect themselves from exposure to toxic chemicals at work and adopt all possible means to ensure protection against air pollution through the use of masks, air purifiers and restricting outdoor activities. In addition, consuming a healthy diet with plenty of fresh fruits and vegetables and regular physical activity is recommended. Heavy smokers can undergo screening through a low dose CT scan of the chest if advised by the doctor.
(Author Dr Jyoti Wadhwa is Director of Thoracic and Head & Neck Oncology department at Medanta, Gurugram)
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