Even If You're Not A Smoker Your Lung Cancer Chances Are Still High

Ankita never smoked a cigarette in her life. So she assumed her nagging chronic cough must’ve something to do with congestion or pollution. She was first diagnosed with bronchitis in March 2015 but no amount of medication helped. The chest irritation became unbearable, she could barely utter a line without coughing.
5 months later, extensive X-rays revealed a possible patch of pneumonia. After days of antibiotics and weight loss, she finally thought that it would be the end of all the coughing jokes. But that was not to be. The cough got worse.

Days after her 32nd birthday, she collapsed with breathlessness and heartburn. An extensive investigation revealed a tumour, the size of a lemon, buried at the back of her lung which escaped all scans over the past year.

Ankita was diagnosed with lung cancer, stage 4. The worst kind. Incurable and untreatable. Ankita, not her real name, never smoked a cigarette in her life.

 Ankita belongs to my extended family. She was into biking, hiking; the healthiest, most outdoorsy person I knew. Clearly, not even clean living guarantees a free pass.

Till the last decade, the average age of lung cancer was 70-years. It only happened after years of smoking or living in a cloud of second hand smoke. Today, according to CDC Atlanta, 10 to 15% of all lung cancer patients are young, healthy, non-smokers under the age of 40.

And the unsettling part - in Delhi, 20% of lung cancer patients have never touched a cigarette in their lives; the incidence is 5% more than the global average.

The percentage of non-smoking lung cancer patients has gone up to 20%. Increasing air pollution levels may have a role to play. 

Dr Julka, Oncologist, AIIMS 

 

In the US, lung cancer in non-smokers has become the sixth largest cause of death. There are no such pan- India statistics but according to the Delhi Cancer Registry, lung cancer cases have shown the highest spurt among all cancers in the Capital, shooting up from 14 cases per one lakh population in 2008 to 16 cases per one lakh population in 2010.

While smoking and tobacco consumption remain the number 1 cause of lung cancer, the rate at which non-smokers are getting this disease is worrying. We still don’t know a lot about this cancer in non-smokers.

Dr Sanjeev Mehta, Pulmonologist

What we know is this:

• In the last decade, more women non-smokers have been diagnosed with lung cancer than men.
• The symptoms, if any, in the young and the non-smoking lot often get mistaken for something else. By the time the disease is diagnosed, they are already pretty sick.
• Asians and African-Americans have a higher rates of illness and death from lung cancer than the Americans or people of European descent.
• Living with a smoker increases chances of lung cancer in the non-smoker by 31 percent : Centers for Disease and Prevention.
• Adenocarcinoma or non-small cell lung cancer, is what non-smokers mostly get. Ankita has this one. Scientists feel this type of lung cancer needs more potent treatment to make it a livable disease.

So is it just a stroke of bad luck or an errant gene allowed to run amok?

Genetic Alteration Makes Some Carcinogen Sponges: The genetic changes in non-smokers are pretty different from smokers. And then some people are what the medical community describes as ‘carcinogen sponges’ - their bodies are not designed to wipe out toxins. They are made to hoard cancerous elements.

Air Pollution: What could be the reason behind the staggering statistic of 20% non-smoking lung cancer patients in Delhi? Better diagnostic facilities for one but countless studies worldwide have proved a correlation between air pollution and lung cancer.

Exposure To Asbestos: The World Health Organisation says that exposed workers are seven times as likely to die of lung cancer and those who smoke, in this group, run a 90 times higher risk of getting lung cancer than their counterparts.

Cooking fumes: Scientists say this could be the reason why Asians run a higher risk than Europeans. Could all the kitchen-slogging and toxic cooking oil fumes be doing more harm than good?
A lot of research is needed to understand these causes.

Investment in lung cancer research has doubled over the last decade but it still receives only one-third the funds breast cancer receives and less than half of those given for leukemia - the bias stems from the fact that lung cancer is primarily self-inflicted. But that’s not true anymore. Anyone with lungs is at risk of lung cancer.

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