Written By: Debjani Arora | Published : March 27, 2018 8:13 PM IST
There was a time when it was thought that only smokers suffer from the deleterious lung cancer. But with changing times and sedentary lifestyle choices and given the environmental pollution levels, lung cancer is becoming relatively common in India. Not only smokers, even non-smokers are falling prey to it. We chatted with Dr Arvind Kumar, Chairman, Center for Chest Surgery and Director, Institute of Robotic Surgery at Sir Ganga Ram Hospital (SGRH) New Delhi to know more about the changing scenario of lung cancer and how this endemic can be brought to a halt. Here is what he had to say:
Why is lung cancer on a rise in India?
Lung cancer is on a rise because of multiple factors and one of them is smoking, which is showing a rising trend. The second reason is air pollution. Air in most of the cities in our country is heavily polluted. On top of that, a smoker in that city is smoking about 8 to10 cigarettes per day, so thousands of smokers are just adding more toxins to the atmosphere. This is exactly the reason, why we are seeing more lung cancers in non-smokers and women. This is also a reason why the cancer is seen in younger people too. Since people are being exposed to toxins from the very early age of their lives, so by the time they are in their 30s, they have been exposed to the smoke for 25-30 years whereas, earlier people used to get cancers in their 50s or 60s. Here are ways in which you can get lung cancer even if you don't smoke.
Can we share data on the y-o-y trend observed?
Thirty years back in the late 80s and early 90s, most of the lung cancer patients were smokers, they would be smoking 20-25 cigarettes a day and hardly 5 percent or even less were non-smokers. In the last few years, there have been reports from Tata Memorial Hospital, Mumbai and there have been reports from Cancer Hospital at All India Institute of Medical Sciences, Delhi and our own data (though not yet reported but analyzed) shows that nearly 50 percent of our patients today are so-called non-smokers.
What are the factors responsible for the rise in lung cancer cases?
The factors responsible for the rise in lung Cancer are:
Smoking and now pollution plays a major role in rising trends in lung cancer.
Is there a changing trend observed in the age category being affected by lung cancer?
Yes, two to three decades back, the lung cancer was somewhere 4th or 5th in terms of incidence in overall cancer incidence today in terms of incidence. But today lung cancer is one of the largely affected cancers in males in India and is rising rapidly in females also. Here are few trends were seen these days
The symptoms of lung cancer are quite common to TB, thus leading to advance stage lung cancer and rise in a member of deaths, can we support this with data?
Lung cancer also presents with a cough, blood in the sputum, TB also presents with a cough and blood in the Sputum, so about 10-20% of the patients that we see ultimately diagnosed with lung cancer, the earliest part of their symptoms presented to doctors have been treated for tuberculosis, this is the data we have from our practice that about 10-20% of our lung cancer patients have already been treated for Tuberculosis because the symptoms are common. Here is how it can affect if lung cancer is diagnosed as TB.
What is the best option for early diagnosis of lung cancer?
The Best option for diagnosing lung cancer is to do what is called screening low dose CT Scan in high-risk population which means people above the age of 55 who have been smoking for more than 25 years of their life, this is the targeted group, studies have been done in the USA and it shows an increase in the incidence of early or asymptomatic lung cancer picked up by the routine CT. By definition, screening means doing a test in an otherwise normal individual but the one who is at the high risk of developing lung cancer. Screening for lung cancer by low dose CT scan in chronic smokers above the age of 55 has been shown to detect the early lung cancer and if treated early, they have a better survival.
How does low dose CT scan function and how can it help in decreasing lung cancer deaths?
Low dose CT scan will be able to diagnose many of the cancers and what is called preclinical stage which means they have occurred there but not caused any symptoms due to very small size and you pick it up at a very small size and you treated and that is a curative resection, so you have actually resected the cancer part before it gets a chance to spread to any other area.
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