Dr Rajesh Mistry, Director, Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, who has been tracking lung cancer cases over decades, says that while 65 per cent of his patients have a history of tobacco and smoking, 35 per cent do not.
When Big Bang Theory actor Kate Micucci, 43, announced on TikTok that she had been diagnosed with lung cancer despite never smoking cigarettes, it had more than shock value. It hinted at a growing public health concern where younger adults, both men and women, are being increasingly diagnosed with the disease. It has also stoked concerns about how early should one get tested for lung cancer.
“It’s really weird because I’ve never smoked a cigarette in my life so, uh, you know, it was a surprise. But I guess it happens, and so the greatest news is they caught it early, they got it out — I’m all good,” Micucci said in the clip she posted on December 8.
Dr Rajesh Mistry, Director, Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, who has been tracking lung cancer cases over decades, says that while 65 per cent of his patients have a history of tobacco and smoking, 35 per cent do not. “The risk is not zero,” he adds. Even the US Centers for Disease Control and Prevention (CDC) has said that as many as one in five cases happen in people who had never smoked or who smoked fewer than 100 cigarettes over their entire lifetime.
Except for smoking, what are the biggest risk factors? As Dr Mistry says, “There are a lot of carcinogens floating around on particles in the atmosphere. There was a time when people talked about second-hand smoke but with smoking being banned in common shared spaces for quite sometime now, clearly there is a threat from environmental pollutants, be it diesel exhausts, or other carcinogens like benzene, arsenic, silica, asbestos and radon, the last an odourless, invisible, radioactive gas that’s naturally released from rocks, soil and water and which builds up in the air.” Studies have shown how air pollution causes lung cancer not by mutating DNA but by creating an inflamed environment that encourages growth of cells with existing cancer-driving mutations.
However, Dr Mistry explains, the amount, range and duration of exposure to air pollutants and the individual’s genetic background are equally crucial to developing lung cancer. “You cannot pinpoint and say these many people are likely to develop cancer,” he adds. Besides, he feels the spurt in early detection is largely because everybody was getting a CT scan of the chest post-COVID. So the early stages of the cancer got picked up. “Lung cancer is silent and asymptomatic in the early stages and unfortunately the symptoms like persistent coughing, chest pain, acute breathlessness or blood in the sputum show up in the later stages. So unless you have undergone a scan that was recommended for some other body condition, it’s not possible to spot the early signs and symptoms,” says Dr Mistry. Even in Micucci’s case, doctors found a spot on her lung when they did a scan of her heart to find out the reasons behind her abnormal blood test results.
How then does one diagnose lung cancer in non-smokers? Screening applies to only high-risk groups and smokers, according to Dr Mistry. “That’s why do not ignore any prolonged chest discomfort, persistent coughing or blood in the sputum. I am not saying that these symptoms could not be caused by other conditions but get investigated to rule out chances,” he advises. Lung cancer surgery is recommended only in cases of early diagnosis.
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