Breathe easy with regular check-ups

India is witnessing a steep rise in patients afflicted with lung cancer. Lung cancer is the second most common cancer found amongst men and women. According to health experts, lung cancer accounts for 8-9% of all cancers and is second to head and neck malignancies (16%) in males. If we consider both the sexes, lung cancer becomes the fourth most common malignancy, accounting for approximately 7% of all cancers.

GLOBOCAN 2018, a worldwide cancer statistics agency, reports that lung cancer is the leading site of cancer in men. Data suggests that males are more likely to be diagnosed with lung cancer than women with a male to female ratio of 4.5:1 and this ratio varies with age and smoking status.

The mean age for developing lung cancer is 55 and it is predominantly found among people who smoke and consume tobacco frequently. However, smoking can also cause cancer in other parts of the body such as the head and neck region, stomach, liver, pancreas, colon, rectum, bladder, kidney, cervix, blood and in the bone marrow.

In India, 87% of male and 85% of female patients with lung cancer have a history of active tobacco smoking, while history of passive tobacco exposure was seen in 3% of patients. It has been found that beedi is more carcinogenic than cigarettes and, therefore, the relative risk of developing lung cancer is higher for beedi smokers when compared to cigarette smokers.

In addition, hookah smoking has also been associated with lung cancer. The risk may be even higher if there is a positive family history, since they share the same living space.

While smoking tobacco, toxic chemical particles from smoke cling to household items like curtains, clothes, rugs, food, furniture and other materials used commonly by other family members which results in second hand smoking. Younger the age of exposure, more is the chance of developing cancer.

Evidence suggests that some dietary factors may work as a protective agent against lung cancer while some may increase the risk of lung cancer. People who have low intake of foods rich in beta-carotene, such as carrots, have a higher risk for lung cancer. Also, arsenic in drinking water (primarily from wells) can increase the risk of lung cancer

Today, doctors typically diagnose for two types of lung cancer, small cell and non-small cell, depending on how they appear under a microscope. Statistically, 80–85 % of the cases are non-small cell lung cancer (NSCLC). NSCLC, which includes large-cell carcinoma and large-cell neuroendocrine tumours, are less aggressive and are more likely to be cured with supportive treatment. In these cases, doctors primarily treat patients using surgical resection and chemotherapy, which is used both pre-operatively and post-operatively.

In stage 1 and 2 of lung cancer, the tumour is likely to have developed in the lung and would be less than 5 cm. In these early stages, the tumour might not have spread to other parts of the body. The recommended course of treatment in stage 1 and 2 will include surgery followed by chemotherapy, if required.

In stage 3, the cancer spreads to the lymph nodes and other parts of the lung for which combined chemotherapy and radiation therapy is the suggested treatment. In stage 4, cancer spreads to other parts of the body for which doctors treat primarily with chemotherapy or targeted agents.

Early detection critical

Identifying lung cancer in its early stage can be difficult, but easier and more effective to treat. If the disease is identified at a potentially curable stage, there is a higher probability for a longer survival rate for the patient. It is difficult to identify symptoms in the early stages of cancer, so it is essential to carry out regular health check-ups.

Patients can be initially diagnosed with a simple chest x-ray, if the tumour is big enough while a CT scan and MRI is required to get more accurate results. The tumour is then biopsied to identify the severity of the disease.

Today, five-year survival rate for lung cancer is 56% for cases detected when the disease is still localised (Stage 1, 2 and 3). However, only 16% of lung cancer cases are detected at an early stage. If the tumours have spread to other organs, the five-year survival rate is only 5%.

It is essential to adopt an active lifestyle by quitting tobacco, avoiding passive smoking and engaging in regular exercise. These preventive measures may prove sufficient to stay cancer-free.

(The writer is Medical Oncologist, Cancer Physician, BGS Gleneagles Global Hospitals, Bengaluru)