Fear of Lung Cancer Current Status In India.

In 2020 out of 13.25 lakhs with 8.51 lakh deaths in India, Lung cancer, formed 8% [75000 new patients] of this incidence in men and an alarming rise in women in India.

85% of the lung cancers are Non Small Cell Lung Cancer (Adenocarcinoma 40%, Squamous Cell Carcinoma 30%, large cell carcinoma 10% and mixture 5%] and 15% are small cell lung carcinoma. Generally the cancer starts at one location of the lung, grows slowly to involve the surrounding organs like the chest wall, blood vessels, or spread through the lymphatic into the hilar, mediastinal, neck or abdominal lymph nodes, spread through blood streams to farther areas like the opposite lung, liver, adrenals or bones and even the brain..

Cancer Lung is diagnosed incidentally [10% of lung cancers in 2020 at Asian Cancer Institute, Mumbai were diagnosed incidentally during C.T. Scan done for suspect COVID. Or it could present with cough, blood in sputum, loss of appetite / weight, chest pain, backaches or headaches. Hormone producing lung cancer can present due to effects of hormones.

Doctors after physical examination for enlarged lymph nodes, painful bone spots or enlarged liver ask tests like routine blood investigations, Chest X-ray [ shows a lesion in lung fields] , C.T. Scan [ shows exact extent and size of the tumor] MRI [ shows if a bone is involved or if there is brain spread] or body PET/CT. Scan [ shows disease activity intensity, location and spread thus staging the disease] Early stage diagnosis benefits as survival durations and cures are linked to stage- 70% - 95% in stage I: 50% - 70% in stage II: 30% - 50% in stage III and less than 10% in Stage IV.

Atmospheric pollution, exposure to tobacco [smoking or eating], past tuberculosis, past radiation, professions like mining, construction industry [exposure to Radon] are causative reasons while Obesity, diabetes, passive smoking, vapor from cooking with high carbon contribute.

Treatment is surgery (Lobectomy, Segmental Resection, Pneumonectomy or specialized sleeve resection) by either open or by endoscopic or robotic surgery.. Chemotherapy and radiation helps in improving survivals in selected patients... Special tumor tests like genetic mutations help in administering targeted therapy & PDL-1 shows usefulness of immunotherapy to prolong survivals.. Radiotherapy treats painful bones spread or brain spread with associated weakness / paralysis. In elderly / unfit patients, stereotactic brachytherapy can give survivals equivalent to surgery. Preventive check-ups with low dose spiral C.T. Scan help reduce lung cancer mortality by 20% in high risk individuals.

Regular check-ups after the age of 40 can diagnose lung cancer in a reasonable stage with a potential to cure. Avoidance of tobacco, Regular exercises, control of diabetes will help reduce lung cancer in a great population. Governments around the world have started encouraging non smoke emitting fuels for public and private vehicles to reduce obnoxious emissions and lower the incidence of cancers.