Increasing number of women are falling victim to lung cancer: Doctors

India is seeing an increase in the incidence of lung cancer, especially among women and younger age groups, note medical experts. "Most of the lung cancer cases being diagnosed - are in Stages III and IV - an already advanced state. Amongst them, only 20-30% are getting diagnosed in Stages 1 and II while the rest are going undetected," informs Dr Vinod K Ramani, a preventive oncologist from Sammprada Hospital, Bengaluru.

Medicine has yet to find a definitive cure, but what makes it tougher is that lung cancer traditionally attacks during the 4th and 5th decades of life. Dr Shivacharan P.V. highlights that the highest proportion of cases being recorded - are in the age group of 55 to 64 years, with a survivability limit of 5 years or more for about 20-25% of them and 10 years for 10-15%.

Speaking of treatments, the toxicity associated with therapy can be substantial and many patients are unable to tolerate it. Additionally, the cost of therapy ( Rs 5 to Rs 10 lakh on average), especially for newer treatments like immune therapy, targeted therapy and anti-angiogenic treatment, can also be a roadblock for many patients. With alarming numbers and whopping treatment costs, how can we effectively address and manage the hidden menace?

To uncover the risk factors, symptoms and available screening tests for lung cancer in young women, Midday sought answers from lung experts who highlight the primary obstacles in managing these cases. Their findings are detailed here.

Factors contributing to the rising incidence of lung cancer among women

Over 80% of lung cancers are related to tobacco smoking in its various forms, shares Dr Radheshyam Naik, consultant medical oncologist, at Sammprada Hospital. "The risk increases with the duration of smoking and the number of cigarettes one smokes per day. Early-age smoking raises the risk substantially. Also, exposure to carcinogens like asbestos, in addition to smoking, increases the risk of lung cancer several-fold."

Other important risk factors include passive smoking which accounts for 5% of lung cancers as exposure to secondhand smoking increases the risk of lung cancer, he adds.

This spurt can also be attributed to the following factors:

1. Increased exposure to radon gas: a naturally occurring radioactive gas that can accumulate in homes and buildings and is a known cause of lung cancer.
2. Asbestos exposure can cause lung cancer by releasing fibers that, when inhaled, irritate and damage lung tissue, leading to cellular changes and cancer development. Asbestos is naturally present in pipes, walls, vehicles, roofing sheets and vinyl flooring.
3. Not following necessary precautions while handling chemical machinery exposes one to ingesting carcinogenic elements.
4. Traffic and industrial pollution is one of the leading factors as air gets polluted with particulate matter and carcinogens from vehicle emissions and industrial activities.
5. Reduced vegetable and fruit intake, hormonal factors, and genetic factors are some of the minor risk factors.

However early diagnosis continues to remain a challenge. "A proportion of smokers may have chronic bronchitis which is difficult to differentiate from cancer, and hence they present themselves late to a doctor. Also, many cases of lung cancer get mistaken for tuberculosis initially. There is also reluctance among Indians to get screened for cancer regularly," informs Dr Vishwajeeth Pai, consultant medical oncologist.

Smoking kills, now more than ever

Early-age smoking and secondary smoking are the single most important factor in the rise of lung cancer in young women, stresses Naik. Early-age smoking results in a longer duration of exposure to carcinogens, thus increasing the cumulative risk of lung cancer.

Dr Amol Pawar, radiation oncologist, Onco Life Cancer Centre, Chiplun outlines that excessive smoking can cause permanent damage to one's lungs as it contains toxins like nicotine, tar, acetone, and carbon monoxide that can interfere with one's airway passage. It also increases your risk of developing lung diseases like COPD (Chronic obstructive pulmonary disease), asthma, emphysema, and chronic bronchitis.

Symptoms and screenings for lung cancer

To begin with, there are no early signs to detect lung cancer. Only frequent and consistent screening can help. Naik suggests taking up screening tests like a low radiation CT scan of the chest to rule out early lung cancer. If symptoms like cough, breathlessness, haemoptysis (coughing blood), loss of appetite and fatigue are prevalent, then the cancer is well advanced in its growth. One must also consider their exposure to risk factors and a family history of lung cancers by consulting a pulmonologist, he adds.

Early warning signs shouldn't be neglected as they can help save lives and improve the quality of life. Pawar adds more symptoms to watch out for chest pain, shortness of breath, wheezing, unexplained weight loss, arm or shoulder pain, hoarseness, feeling extremely tired, jaundice, and severe headache.

Low-dose radiation CT scans of the lung are the primary method for early detection, typically recommended for smokers, as only 15% of lung cancers occur in non-smokers, informs Nail. Individuals with high-risk factors, such as smoking, exposure to pollution, or a family history of lung cancer, are advised to undergo an LDCT annually.

Emerging methods, such as blood-based biomarkers and breath analysis, are being explored for detecting compounds in exhaled breath, but LDCT remains the standard for early detection in high-risk individuals.

Can breathing exercises help?

Breathing exercises do not reduce the risk of lung cancer but they can improve the quality of life in lung cancer patients, informs Dr Atul Narayankar, Wockhardt Hospitals, Mira Road.

"Certain breathing techniques can help ensure that your lungs are functioning well. This includes exercises like belly breathing, pursed lip breathing, relaxed deep breathing, and tummy breathing. Practicing these breathing exercises for more than 5 minutes a day can be beneficial in reducing lung damage or even lung cancer," explains Narayankar.

Naik adds that deep breathing in the form of pranayama done in a good atmosphere under the right guidance may help though - there is no evidence for the same. If deep breathing is done in a polluted atmosphere, it may increase the chances of lung cancer. Breathing exercises like diaphragmatic breathing and rib stretch breathing can improve lung health.

Lifestyle modifications to reduce their risk of lung cancer

First and foremost: quit tobacco. Lifestyle modifications can play a crucial role in improving the quality of life by lowering the risk of developing lung cancer. This includes certain adjustments like eating plenty of vegetables and fruits, avoiding smoking or even secondhand smoking, and being physically active for more than 45 minutes a day.

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Pawar recommends limiting alcohol consumption and lowering exposure to cancer-causing chemicals and polluted air

What does new research say?

There are better treatment options available. "Better surgical techniques, focused radiotherapy, immunotherapy, targeted treatments, genomic profiling, anti-angiogenic therapy, and better supportive care are available to treat lung cancers," shares Naik.

Technological advancements in the field of lung cancer ignite hope for people suffering from cancer. For instance, the ongoing research in biomarkers and using Artificial Intelligence may help in analysing more accurately and quickly. This can help increase the chances of successful treatment outcomes and improve the quality of life, concludes Pawar.