Lung Cancer

Lung cancer is one of the leading causes of cancer death worldwide and in India. Tobacco is the biggest single cause — cigarettes, bidis, hookah. Second-hand smoke, indoor biomass smoke (cooking on wood/crop residue), air pollution, and occupational exposures (asbestos, silica, radon, diesel fumes) also contribute. Lung cancer is increasingly seen in never-smokers, particularly Indian women.

Symptoms

• Persistent cough — new, or a changed "smoker's cough."
• Coughing up blood or blood-streaked sputum.
• Chest pain worse with breathing/coughing.
• Breathlessness.
• Recurrent chest infections.
• Hoarseness.
• Unexplained weight loss, fatigue, loss of appetite.
• Bone pain, headaches, neurological symptoms — advanced disease.

When to see a Health Expert

• Any cough lasting more than 2-3 weeks — especially with blood.
• Anyone over 40 with these symptoms and any tobacco history.
• Unexplained breathlessness or chest pain.
• Don't assume "just TB" — TB and lung cancer can look similar on X-ray and must be properly distinguished, especially if symptoms don't improve with anti-TB treatment.

Diagnosis

• Chest X-ray and contrast CT scan are the main imaging.
• Biopsy — by bronchoscopy, CT-guided, or EBUS — confirms cancer and type.
• Molecular testing (EGFR, ALK, ROS1, KRAS, PD-L1) — guides targeted and immune-based treatment.
• Staging scans — PET-CT, brain MRI.

Treatment — matched to type and stage

• Early-stage non-small-cell lung cancer — surgery (lobectomy) often curative.
• Locally advanced — radiation + chemotherapy, sometimes surgery.
• Metastatic — targeted therapies for patients whose tumours have matching mutations; immunotherapy; chemotherapy. Oral targeted tablets have transformed some lung cancers into manageable long-term conditions.
• Small-cell lung cancer — chemotherapy + radiation; rapid but often responsive.

Prevention

• Don't use tobacco — any form. Stopping, at any age, reduces risk over time.
• Reduce indoor smoke — use LPG or clean fuels; improve kitchen ventilation.
• Reduce outdoor air pollution exposure on high-AQI days — N95 masks, avoid outdoor activity.
• Occupational protection — mask, ventilation, compliance with safety rules in dusty or chemical industries.
• Screening with low-dose CT is reasonable for heavy long-term smokers in some guidelines; not yet a national programme in India.