A World Lung Cancer Day Special
August 1 is observed as World Lung Cancer Day and we enlighten ourselves by speaking to DR AMIT DIAS, Asst Professor at the Department of Preventive & Social Medicine, Goa Medical College, on this occasion. He told us that there is only one way to love your lungs — Quit smoking! He also warns about the hazards of vaping which is catching on with youth and compromising their health.
QUESTION: DOCTOR, WHY DO WE NEED TO HAVE A SPECIAL AWARENESS DRIVE FOR LUNG CANCER?
DR AMIT DIAS: Lung Cancer is one of the most common cancers in the world, leading to around 18 lakh deaths annually, which accounts for 20% of cancer mortality. It is one of the most common cancers among men. Most lung cancers are caused due to smoking and this is preventable.
Q: How can we be sure that Cigarette smoking causes lung cancer? I know a few people who had lung cancer but never smoked in their life.
A: Your observation is right. Recently we lost one of our doctor colleague to lung cancer and it was a wake-up call to all of us as he was not a smoker. This was the same argument used to challenge the findings of Sir Richard Doll, who in the 1950s did studies that for the first time proved that lung cancer was caused by cigarette smoking. Remember, in those days, after the world wars, smoking was catching up as a craze and at the same time there was a rise in the incidence of lung cancer.
Richard Doll was an epidemiologist who proved that there was a very strong association between smoking and lung cancer and the association was causal. However, there are multiple causes of lung cancer and smoking is just one of them. Therefore, you can have a person who is not exposed to smoking, yet suffers lung cancer. Today as we celebrate Lung Cancer Awareness Day we must give credit to Sir Richard Doll whose contribution literally “kicked the butts” and alerted us about the harmful effects of smoking.
Incidentally, Sir Richard Doll was a smoker himself, who gave up smoking after his study. We all need to give up our habits which damage our health and cause suffering to both patient and his family and friends.
Q: GREAT, HE LED BY EXAMPLE. CAN YOU TELL US WHAT ARE THE RISKS OF LUNG CANCER?
A: As I mentioned, those who smoke are at the highest risk. This also includes those exposed to secondhand smoke. Exposure to asbestos and other carcinogens, air pollution, radiation therapy, and radon gas are also at risk. Besides those with HPV infections, alcohol users, and those with a family history, the elderly are also at risk of developing lung cancer.
Q: WHAT ABOUT VAPING/ CAN IT CAUSE LUNG CANCER?
A: Yes, vaping is yet another risk factor for lung cancer. It is being promoted as an alternative to cigarette smoking but vaping is also bad for the delicate tissues of the lungs. A study revealed that there are around 6.25 lakh Indian children who smoke and many of them use e-cigarettes or do vaping pens. It’s a dangerous new fad among the youth, especially while going for tuition and coaching classes. Unlike cigarettes, there is very little smell and telltale signs that would alert their teachers and parents.
Vaping coats the lungs with toxic substances like volatile organic compounds (VOC), ultrafine particles, etc. It has Diacetyl which is a safe and approved food additive but when this is inhaled, it causes scarring of the lung alveoli and leads to thickening and narrowing. The long-term effects of vaping are still to be researched.
Q. IS THERE ANY GOOD NEWS ON LUNG CANCER DAY THIS YEAR? IS THERE SOMETHING NEW IN THE MANAGEMENT OF THIS CANCER?
A: Yes, there is a lot of development in the area of cancer management. Unlike a few years ago when cancer was almost like a death sentence, it can now be cured, especially if detected early. What is very encouraging is that with the introduction of biomarkers, we can now be better equipped to treat lung cancer. With the earlier chemotherapy, the five-year survival rate was 4-6%. However now, with targeted therapy and biomarkers, the survival rate is 60%.
Q: THAT’S INTERESTING, CAN YOU TELL US MORE ABOUT BIOMARKERS?
A: Though you may look at lung cancer as one type of disease, it is not so. There are various types of lung cancers and each has specific characteristics. Biomarkers help us get a more detailed picture of the type of cancer, its genetic characteristics, its potential for aggressive growth, and its relationship to the patient’s immune system. Based on this information the doctor can suggest specific treatment modalities to target the specific cancer that is most effective and least toxic.
In the last two decades, there have been significant advances in the management of lung cancer. There are around 20 biomarkers specific for lung cancer and several have specific therapies. Molecular testing is now a mandatory part of the protocol for the management of lung cancer and is available in India as well. There is a lot of research going on. The management is moving towards personalized precision medicine which is a game-changer.
Q. WHAT ARE THE DANGER SIGNALS OF LUNG CANCER?
A The main symptoms of lung cancer are:
- Persistent cough that does not go away even after 2-3 weeks
- Persistent chest infections
- Breathlessness
- Coughing up blood
- Pain while breathing or coughing
- Weakness and loss of energy
- Unexplained weight loss
- Loss of appetite
Often one may not detect lung cancer in the early stages as the symptoms may appear after there is considerable damage to the lung. The early signs are often brushed aside and ignored.
Q. THANKS DOCTOR FOR ALL THIS USEFUL INFORMATION. WHAT IS YOUR FINAL MESSAGE FOR OUR READERS?
A: Take care of your lungs. The COVID pandemic showed us how much we depend on our lungs — 80% of lung cancer cases are associated with smoking. The government of Goa has been taking steps to improve cancer services in Goa and people must avail of these services.
Be aware of the danger signs. Educate children. Avoid vaping. Get screened if you have a history of lung cancer in the family We need to monitor the cancer situation and maintain a proper cancer registry to know the trends and take corrective action. Join the awareness drive and help raise awareness about lung cancer. To start with let us take a pledge to love our lungs and the best way of doing this is – stop smoking from today!
