CHENNAI : Lung cancer is often associated with smoking, but a significant number of non-smokers also develop the disease. In India, the prevalence of lung cancer among non-smokers is a growing concern, highlighting the need to understand the factors, early detection, and treatment options.
Understanding the causes
While smoking remains the leading cause of lung cancer, several other factors contribute to the disease in non-smokers. These include:
Air Pollution: India faces severe air pollution, particularly in urban areas. Pollutants such as particulate matter (PM2.5) and nitrogen dioxide (NO2) can damage lung tissue and increase the risk of lung cancer. Long-term exposure to polluted air is a significant risk factor for non-smokers.
Indoor Air Pollution: Many households in India use biomass fuels like wood, and crop residues for cooking and heating. The smoke from these fuels contains carcinogens that can lead to lung cancer. Women, who are often responsible for cooking, are at risk.
Radon Gas: Radon, a naturally occurring radioactive gas, can accumulate in homes and buildings. Long-term exposure to radon is the second leading cause of lung cancer globally, and affects non-smokers.
Genetic Factors: Some people inherit genetic mutations that increase their susceptibility to lung cancer. Family history plays a role, and non-smokers with a family history of lung cancer are at higher risk.
Occupational Hazards: Exposure to carcinogens such as asbestos, arsenic, and diesel exhaust in the workplace can lead to lung cancer. Non-smokers working in certain industries may be at increased risk.
Symptoms and diagnosis
Persistent cough
Shortness of breath
Chest pain
Unexplained weight loss
Fatigue
These symptoms are often mistaken for other respiratory conditions, leading to delays in diagnosis. Non-smokers may not consider themselves at risk, which can further delay seeking medical attention.
Early detection is crucial for improving survival rates. Low-dose CT scans are effective in detecting lung cancer at an early stage, especially for high-risk individuals like chronic smokers. However, awareness and accessibility to such screening methods are limited in our country.
(The writer is a senior director, medical oncology & hemato-oncology, Fortis Hospitals)
PREVENTION & AWARENESS
Reducing Air Pollution: Implementing and enforcing stricter air quality regulations can help reduce the overall exposure to harmful pollutants
Improving Indoor Air Quality: Promoting the use of cleaner cooking fuels and proper ventilation in homes can decrease indoor air pollution
Radon Testing: Encouraging radon testing in homes and buildings can help identify and mitigate radon exposure.
Occupational Safety: Ensuring strict adherence to safety regulations in workplaces where there is exposure to carcinogens, can protect workers, especially in mining industry where asbestos exposure is high.
Treatment Options
Surgery: Removal of the tumour and surrounding lung tissue is an option for early-stage lung cancer.
Radiation Therapy: High-energy radiation is used to kill cancer cells or shrink tumours.
Chemotherapy: Drugs are used to destroy cancer cells or prevent their growth. Often required in most stages of lung cancer.
Targeted Therapy: This treatment targets specific genetic mutations that drive cancer growth. It is ‘particularly effective in non-smokers who may have distinct genetic profiles compared to smokers’.
Immunotherapy: This therapy helps the body’s immune system recognise and attack cancer cells.