risk factors and symptoms lung cancer

Risk factors and symptoms of Lung Cancer in India

Hi I am Dr. Vikas Goswami, Senior consultant department of Medical Oncology at Max hospital.

Lung Cancer in India

I am basically into the field of cancer treatment and cancer prevention so today, I’m going to talk about something which is very common is lung cancer so first and foremost we need to know what is the incidence of lung cancer by incidence I mean how common is it or is it uncommon so, lung cancer in India is the second most common cancer occurring in males and in females.


90% patients who have had a history of lung cancer have history of smoking
(Credit: Nopphon_1987/Shutterstock)

Are you at risk of developing lung cancer? So, we need to know the most common risk factor is smoking 90% patients who have had a history of lung cancer have history of smoking now smoking can be in the form of cigarettes, beedi, e-cigarettes or it can be in the form of smokeless tobacco, Gutkha or other forms of chewable tobacco which we consume all of them can cause lung cancer. There is a myth that e-cigarettes are safe that myth is wrong it’s not the case even e-cigarettes cause lung cancer some people think that smoking Shisha, there are shisha bars even that is not safe. even that is the cause of lung cancer. Every day 3,500 documented cases of cancer are attributed to tobacco alone so, tobacco is the number one reason for lung cancer.

Now if you don’t smoke doesn’t mean that you are completely out of risk because a smoker can also cause lung cancer to the people who are around him that’s called a secondhand smoke. Secondhand smoke is let’s say my family member or my friend smokes and I am sitting around I am exposed to the fumes so I am also at risk so people who are exposed to secondhand smoke are also at risk of developing lung cancer.

There is something called as a third hand smoke tertiary smoking what is that? That you are sitting in enclosed room where people are actively smoking then the fumes kind of cling on to the carpets, on the curtains, the furniture exposing yourself into such environment also increases your risk of lung cancer so first hand smoke, secondhand smoke, third hand smoke all of them cause lung cancer but the good news is that if you stop smoking your risk of developing lung cancer starts decreasing so the first thing is stop your smoking rather advise your friends and your family members to stop smoking not only does it decrease the incidence of lung cancer in them but also in you.


pollution is a mixture of PM 2.5 particles, construction material etc
(Credit: https://www.forbes.com/sites/sap/2019/06/07/world-environment-day-to-beat-air-pollution-make-the-invisible-visible/#509cc22a8129)

Now there are also other causes of lung cancer smoking we see 90% cases yes they do have a history of smoking but 10% don’t out of those 10% some are exposed to second or third hand smoking but there are other causes which can cause lung cancer now the another most common cause which is pertinent to us is Pollution. WHO has labelled pollution as a carcinogen pollution is a mixture of various things it’s a mixture of PM 2.5 particles it’s a mixture of construction material. Now construction material like silica asbestos is a risk factor for lung cancer in our part of the country like Delhi lot of construction activity is happening and that’s a cause of pollution if you remember whenever the pollution is very high the government first of all stops construction activities so, such material is also a cause of risk factor.

Getting exposed to chemicals

Exposing yourself to certain chemicals like workers who are in iron founding industries people who are exposed to let’s say paint industry people who are exposed to polycyclic aromatic compounds for example people working in petrol pumps these are the people who are also at risk of developing lung cancer.

Radon Gas & Sick building Syndrome

(Credit: http://affordableradoncolorado.com/health-risks-radon-gas-poses-can-breathe-easy)

Another interesting thing is something called as radon gas exposure to radon gas is a very big risk factor in non-smokers now radon gas is a colorless odorless gas usually secreted by the environment by the soil. In countries like us they usually do a mapping where the radon gets excreted. In our country we don’t have such data radon gets accumulated. In closed buildings radon gets accumulated specifically in the basements so if you are working in closed buildings and in basements where there is no ventilation there is a possibility that you might be getting exposed to radon there is a term called a sick building syndrome, if you search this term on Google you will find the correlation between sick building syndrome, radon gas and lung cancer.


Another is factor for lung cancer is alcohol. If you consume alcohol your chances of developing lung cancer increase. So, all the causes are tobacco a major cause but there are other causes like pollution, getting exposed to chemicals, sick building syndrome.

Common Symptoms

Now coming to the symptoms how does one think that a person might be having lung cancer so first of all there has to be a risk factor usually there is a shortness of breath because it’s a lung cancer so, of course shortness of breath might be a symptom. The other symptoms can be chest pain, blood in sportin, somebody has a persistent cough with blood, change of voice, hoarseness of voice these are some common symptoms.

Uncommon Symptoms

Then there can be uncommon symptoms of metastasis for example born pains of swelling of face weakness of muscles of the hand. These are some of the symptoms which might be attributed to the metastasis or lung cancer.

So, the problem is that people who spoke usually have COPD it’s a disease of the lung they also have shortness of breath now they often attribute their shortness of breath to smoking that is number one reason for missing lung cancer early, number two is in India usually people are not aware, even doctors working in the periphery are not aware that lung cancer can manifest. So, sometimes it might so happen that a patient is mistreated for tuberculosis for a very long time & if you have the symptoms you should certainly consult your doctors regarding the suspicion of lung cancer. You should often ask your doctors by any chance do I have lung cancer or not if we are suspecting lung cancer what do we do? the first investigation which we do is imaging various forms of chest x-ray. CT scan of the chest if on imaging we find something suspicious the next investigation is biopsy and FNAC. Now by what do I mean by biopsy is that we take a small tissue from the suspected tumor and subject it to the laboratory for testing. If it turns out to be lung cancer the next question which we want to know is what is the subtype of lung cancer. Now the subtype of lung cancer can be non squamous lung cancer or ask adenocarcinoma so it’s progeny divided in two non small cell and small cells are usually chemo sensitive and non smell cells we have a plethora of targets to attack, before we start the treatment. There is something which is called as staging, by staging I mean whether we want to know the tumour is localized to the lung or it has spread out to the body the usual sites of metastasis for lung cancer are the lung cancer goes to labor, the lung cancer goes to bones, the lung cancer goes to brain, these are the usual sites of metastasis. So this is usually cleared by doing a PET CT and sometimes doing an MRI of the brain.

After doing staging we broadly divide the lung cancer into whether it is localized that is limited to the lung or it has spread out a cancer which is localized usually if it is early, we try to do a surgery. In stage one we usually do a surgery, Stage two we usually do a surgery followed by something that might be radiation or chemo, in stage three we usually do either surgery or radiation. As the primary modality of treatment a stage four which is like an extensive disease is usually treated with medicines. The moment we see a stage four cancer the first thing which we want to know in a non small cell lung cancer are there, any driver mutations are there, specific type of mutations for which we can give personalised treatment. Now the mutations means changes in the DNA which propelled this cancer so the mutations are usually studied in the lab based upon certain reports. Now let’s say the tumour has a specific mutation, we have specific medicines for that mutation something called as EGFR mutation if it is prevalent then we have a medicine called that is the tyrosine kinase inhibitor if we have let’s say alt mutation we have a medicine for that another very potent class of drugs which are active in lung cancer right from the start is called as immunotherapy. So we can give oral tablets we can give immunotherapy and the backbone of the disease in the last we can give chemotherapy usually the average survival has crossed one and a half to two years now that’s a very promising news.

So to sum it up one should be aware what are the risk factors for lung cancer what are the symptoms for lung cancer whether the lung cancer if somebody has it is localized or advanced that is one question which you should ask and the treatment like I told you if it is advanced we usually give targeted medicines in the form of immunotherapy oral tablets or chemo therapies. If it is localized we try to restrict it by doing a radiotherapy or a surgery lung cancer is a lethal disease but we are progressing on the path to make it a chronic disease on your part you should try to reduce the risk factors which is try to reduce your smoking if you’re a nonsmoker try to reduce the smoking in your immediate environment if that is also clean restrict yourself by exposing less to the pollution.

Thank you.

Disclaimer: Above text is transcripted from video, uploaded on WithU Oncology Youtube Channel.

Issued in Public Interest by WithU.in
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