Persistent cough over 3 months could signal lung cancer

August 1 is World Lung Cancer Day

Dr Tamojit Chaudhuri

Every year on August 1st, the World unites to raise awareness about lung cancer, the most common and deadliest cancer globally. Lung cancer also poses a significant threat in India, accounting for 5.9% of all cancers and a troubling 8.1% of cancer deaths.

Lung Cancer burden as reported in GLOBOCAN 2020 is as follows: globally, it is the 2^nd most common cause of cancer (including both genders), incidence being 11.4%; it is the number one cause of cancer related deaths (18%). In India, it is the 4^th most common cause of cancer (72,510 new cases/year) and the 4^th leading cause of cancer-related deaths (66,280 lung cancer-deaths/year) with a case fatality rate of >90%. In 2023-24, 156 new cases of lung cancer were diagnosed at MTMH (91 males, 65 females).

Common symptoms of Lung Cancer: These are dry, persistent cough lasting for more than 3 months, hemoptysis (coughing up blood), hoarseness of voice, chest pain/heaviness, shortness of breath, back pain or unexplained weight loss.

The risk factors are tobacco use, smoking, genetic predisposition, environmental or occupational exposure (radon gas, radiation, air pollution etc.).

Types of Lung Cancer: About 15% of lung cancers are of Small cell lung cancer (SCLC); the non-small cell lung cancer (NSCLC) are about 85%.

Screening for Lung Cancer: As per American cancer society guidelines, all heavy smokers (20 or more cigarettes daily for 30 years or more) between the age 55 to 74 years should undergo an annual low-dose CT Thorax. Screening protocols are not well established for lung cancer in India.

Staging and diagnosis of lung cancer: At MTMH, about 70-80% of patients present with stage 4 disease. Diagnosis is usually by imaging and CT-guided biopsy.

Treatment: Stage 4 disease is not curable and is usually managed with chemotherapy, targeted therapy or immunotherapy.

In Stage 1 and 2, surgery is treatment of choice; a combination of chemotherapy and radiotherapy is given in stage 3 disease.

Treatment options for lung cancer have significantly improved in recent years, and survival rates are steadily increasing. We believe continued efforts in the right direction will play a vital role in promoting early detection and eventually saving lives.

(Author is Sr Consultant and HOD, Medical Oncology, MTMH.)