Health Spot­light

This World Can­cer Aware­ness Month, let’s take a close look at the link be­tween…

Health & Nutrition - - CONTENTS - DR ViVek NANgiA Head & Director, Pul­monology, Med­i­cal Crit­i­cal Care & Sleep Dis­or­ders For­tis Hos­pi­tal, Delhi

De­cod­ing the link be­tween lung can­cer and non-smok­ers, this World Can­cer Aware­ness Month

Lung can­cer is one of the com­mon­est can­cers in the world. It ac­counts for more can­cer deaths than any other can­cer. It is in­creas­ingly be­ing rec­og­nized in In­dia and in re­cent years has sur­passed the ear­lier com­mon­est form of can­cer, that of orophar­ynx, to be­come the com­mon­est ma­lig­nancy in males. The ma­jor risk fac­tor for de­vel­op­ing lung can­cer is tobacco use and this dis­ease is of­ten viewed solely as a smoker’s dis­ease. How­ever, a sig­nif­i­cant num­ber of pa­tients with lung can­cer have no his­tory of smok­ing. Ac­cord­ing to the data avail­able, as many as 20 % of the lung can­cer pa­tients in the Western coun­tries and al­most 50 % of the lung can­cer pa­tients in In­dia are non-smok­ers. In fact, it is so com­mon in non-smok­ers also that if lung can­cer in non-smok­ers had its own sep­a­rate cat­e­gory, it would rank among the top 10 fa­tal can­cers.

Lung can­cer in non-smok­ers is a dif­fer­ent dis­ease in many ways. It usu­ally presents as a more ad­vanced dis­ease, at an ear­lier age, say around 50 years. It has a gen­der predilec­tion, that two-thirds of the non­smok­ers who get lung can­cer are women. It is es­pe­cially seen in pa­tients with higher waist cir­cum­fer­ence and those suf­fer­ing with metabolic syn­drome. A lot of re­search in the past decade or so has elu­ci­dated var­i­ous other fac­tors that cause lung can­cer.

Air pol­lu­tion - WHO (World Health Or­ga­ni­za­tion) has la­beled air pol­lu­tion as the sin­gle most im­por­tant en­vi­ron­men­tal health haz­ard. Both in­door pol­lu­tants like the fumes from cook­ing oil fol­low­ing stir-fry­ing, deep-fry­ing, and pan-fry­ing, which in­volve heat­ing oil to high tem­per­a­tures and the smoke from a coal stove as well as out­door pol­lu­tants like in­dus­trial and ve­hic­u­lar smoke can trig­ger off lung can­cer.

Radon gas - The lead­ing cause of lung can­cer in non- smok­ers is ex­po­sure to radon gas. Radon oc­curs nat­u­rally out­doors in harm­less amounts, but some­times be­comes con­cen­trated in homes built on soil with nat­u­ral ura­nium de­posits. Stud­ies have found that the risk of lung can­cer is higher in those who have lived for many years in a radon-con­tam­i­nated house.

Oc­cu­pa­tional ex­po­sure - It is known to oc­cur in in­di­vid­u­als who are chron­i­cally ex­posed to chem­i­cals like as­bestos, ar­senic, sil­ica and some other chem­i­cals.

Sec­ond hand smoke - Also called pas­sive smok­ing, it can be equally dan­ger­ous. It refers to the smoke in­haled by peo­ple stand­ing in close prox­im­ity of the peo­ple who are smok­ing. Al­most two thirds of the smoke is lib­er­ated by a smoker in the air around him. These of­ten grow in the outer re­gions of the lungs and can be present for a long time be­fore symp­toms oc­cur. Symp­toms such as short­ness of breath, fa­tigue, or symp­toms due to spread of the can­cer to other re­gions of the body (such as bone pain) may be more com­mon. These can­cers are mostly of the ade­no­car­ci­noma va­ri­ety and are known to have cer­tain spe­cific ge­netic mu­ta­tions, which ac­tu­ally turn out to be ben­e­fi­cial for the pa­tient, as then cer­tain ther­a­pies tar­get­ing these mu­tated genes can be used for its treat­ment. There­fore any­one be­ing di­ag­nosed with lung can­cer must un­dergo ge­netic test­ing for these genes. Lung can­cer in non-smok­ers is of­ten di­ag­nosed at a late stage, be­ing first at­trib­uted to a res­pi­ra­tory in­fec­tion or even al­ler­gies. Still, some stud­ies sug­gest that the over­all sur­vival is bet­ter in non-smok­ers. This dif­fer­ence is most apparent for those who are di­ag­nosed at an early stage of the dis­ease. Fe­male non-smok­ers have a bet­ter prog­no­sis in gen­eral than male non-smok­ers with lung can­cer. A healthy diet com­pris­ing lots of fruits and veg­eta­bles may help re­duce the risk of and pro­tect against lung can­cer. But any pos­i­tive ef­fects of fruits and veg­eta­bles on lung can­cer risk would be much less than the in­creased risk from smok­ing.

smoke Sec­ond hand refers to the smoke in­haled by peo­ple stand­ing in close prox­im­ity of the peo­ple who are smok­ing.

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